Ok, I am putting a line in the sand… I predict the Institute of Medicine and the authors of the recent paper on Vitamin D could indirectly be responsible for excess deaths and increased disease as a result of people following their recommendations. The report basically said that 600 IU of vitamin D is enough for everybody and every concern and that more than 4000 iU a day is dangerous.
Balderdash on both counts.
See the full commentary from Dr. Cannell below for more of the facts… now I will continue my rant….
This is a great example of how reactive the thinking in “medicine” is and how we are having a hard time seeing the bigger picture of HEALTH rather than DISEASE. You see, Creating Health is very different than Treating Disease. The IOM is working from a flawed paradigm that has largely caused our current health crisis. They examine the data (likely not consciously) like we should wait for a dysfunction to get so severe that we cannot ignore it any longer, name that dysfunction a “Disease” and now treat it with potent medications that often throw off-kilter the body’s own self-adaptive strategies.
These Treat-’em-and-street-’em approaches can be studied using a Randomized Trial (DBRPCT) which assumes all people are “average and identical” so a single powerful (and often highly profitable patented) drug can be applied to all people (big market share). This is even if that drug only makes a whiff of a difference that is impressively called statistically significant but is really nearly clinically meaningless. All this is reinforced by our medical reimbursement system that pays us doctors to treat “Disease” and not to restore function… Too much positive reinforcement on the $$$ side of things to make many want to see change. ….. Yea, that is a whole another series of posts to unpack those statements…. but the bottom line is the IOM is being REACTIVE instead of PROACTIVE in approaching this question and that approach is nested within a greater framework of the philosophy of the medical-industry in these times.
Finally just look at their darn name… the Institute of MEDICINE. As long as we keep things “diseases” and don’t work earlier upstream in prevention and improvement of function the medical establishment will be forced to continue using last-ditch powerful medications, and thereby maintain control over the prescription pad and control over the money stream. It is time to break the broken “Medical-Treatment System” and replace it with true Health Care which focuses upon individual health-responsibility, and function and quality of life centered outcomes. AND Don’t you DARE call what we currently have a “Health Care System” because the payment structure for services and therefore most services themselves are not focused either on either health or care at present.
One clinical note. I have been impressed with how much better Allergy Elimination Treatments proceed when an individual has enough vitamin D. This makes good biochemical and physiological sense – as does taking fish oil – to improve the immune response to sublingual immunotherapy. More on our approach to allergies at MaxWell Clinic.
Since Dr. Cannel has the right to speak on this topic at length given that he has dedicated the decade to fleshing out the story of Vitamin D in full I am reproducing his response to the IOM Vitamin D paper in full below. Here is the link to the Vitamin D research council.
Today, the FNB has failed millions…
3:00 PM PST November 30, 2010
Children with vitamin D deficiency rickets After 13 year of silence, the quasi governmental agency, the Institute of Medicine’s (IOM) Food and Nutrition Board (FNB), today recommended that a three-pound premature infant take virtually the same amount of vitamin D as a 300 pound pregnant woman. While that 400 IU/day dose is close to adequate for infants, 600 IU/day in pregnant women will do nothing to help the three childhood epidemics most closely associated with gestational and early childhood vitamin D deficiencies: asthma, auto-immune disorders, and, as recently reported in the largest pediatric journal in the world, autism. Professor Bruce Hollis of the Medical University of South Carolina has shown pregnant and lactating women need at least 5,000 IU/day, not 600.
The FNB also reported that vitamin D toxicity might occur at an intake of 10,000 IU/day (250 micrograms/day), although they could produce no reproducible evidence that 10,000 IU/day has ever caused toxicity in humans and only one poorly conducted study indicating 20,000 IU/day may cause mild elevations in serum calcium, but not clinical toxicity.
Viewed with different measure, this FNB report recommends that an infant should take 10 micrograms/day (400 IU) and a pregnant woman 15 micrograms/day (600 IU). As a single, 30 minute dose of summer sunshine gives adults more than 10,000 IU (250 micrograms), the FNB is apparently also warning that natural vitamin D input — as occurred from the sun before the widespread use of sunscreen — is dangerous. That is, the FNB is implying that God does not know what she is doing.
Disturbingly, this FNB committee focused on bone health, just like they did 14 years ago. They ignored the thousands of studies from the last ten years that showed higher doses of vitamin D helps: heart health, brain health, breast health, prostate health, pancreatic health, muscle health, nerve health, eye health, immune health, colon health, liver health, mood health, skin health, and especially fetal health.
Tens of millions of pregnant women and their breast-feeding infants are severely vitamin D deficient, resulting in a great increase in the medieval disease, rickets. The FNB report seems to reason that if so many pregnant women have low vitamin D blood levels then it must be OK because such low levels are so common. However, such circular logic simply represents the cave man existence (never exposed to the light of the sun) of most modern-day pregnant women.
Hence, if you want to optimize your vitamin D levels — not just optimize the bone effect — supplementing is crucial. But it is almost impossible to significantly raise your vitamin D levels when supplementing at only 600 IU/day (15 micrograms).
Pregnant women taking 400 IU/day have the same blood levels as pregnant women not taking vitamin D; that is, 400 IU is a meaninglessly small dose for pregnant women. Even taking 2,000 IU/day of vitamin D will only increase the vitamin D levels of most pregnant women by about 10 points, depending mainly on their weight. Professor Bruce Hollis has shown that 2,000 IU/day does not raise vitamin D to healthy or natural levels in either pregnant or lactating women. Therefore supplementing with higher amounts — like 5000 IU/day — is crucial for those women who want their fetus to enjoy optimal vitamin D levels, and the future health benefits that go along with it.
For example, taking only two of the hundreds of recently published studies:
Professor Urashima and colleagues in Japan, gave 1,200 IU/day of vitamin D3 for six months to Japanese 10-year-olds in a randomized controlled trial. They found vitamin D dramatically reduced the incidence of influenza A as well as the episodes of asthma attacks in the treated kids while the placebo group was not so fortunate. If Dr. Urashima had followed the newest FNB recommendations, it is unlikely that 400 IU/day treatment arm would have done much of anything and some of the treated young teenagers may have come to serious harm without the vitamin D.
Likewise, a randomized controlled prevention trial of adults by Professor Joan Lappe and colleagues at Creighton University, which showed dramatic improvements in the health of internal organs, used more than twice the FNB‘s new adult recommendations.
Finally, the FNB committee consulted with 14 vitamin D experts and — after reading these 14 different reports — the FNB decided to suppress their reports. Many of these 14 consultants are either famous vitamin D researchers, like Professor Robert Heaney at Creighton or, as in the case of Professor Walter Willett at Harvard, the single best-known nutritionist in the world. So, the FNB will not tell us what Professors Heaney and Willett thought of their new report? Why not?
Today, the Vitamin D Council directed our attorney to file a federal Freedom of Information (FOI) request to the IOM‘s FNB for the release of these 14 reports.
Most of my friends, hundreds of patients, and thousands of readers of the Vitamin D Council newsletter (not to mention myself), have been taking 5,000 IU/day for up to eight years. Not only have they reported no significant side-effects, indeed, they have reported greatly improved health in multiple organ systems.
My advice, especially for pregnant women: continue taking 5,000 IU/day until your 25(OH)D is between 50–80 ng/mL (the vitamin D blood levels obtained by humans who live and work in the sun and the mid-point of the current reference ranges at all American laboratories).
Gestational vitamin D deficiency is not only associated with rickets, but a significantly increased risk of neonatal pneumonia, a doubled risk for preeclampsia, a tripled risk for gestational diabetes, and a quadrupled risk for primary cesarean section.
Today, the FNB has failed millions of pregnant women whose as yet unborn babies will pay the price. Let us hope the FNB will comply with the spirit of “transparency” by quickly responding to our Freedom of Information requests.
John Jacob Cannell MD Executive Director