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Does Vitamin Therapy Work?

Summary:
According to modern medicine, vitamin therapy is hocus pocus.  It relies on a mixture of voodoo plus the placebo effect.  A report published in the Annals of Internal Medicine says unequivocally, vitamin and mineral supplements are a “waste of money.”  A noted professor of medicine says multivitamins just create “expensive urine” as they are rapidly excreted in urine (pssst… water soluble drugs suffer the same fate).  But is modern medicine just protecting its income stream derived from its own lack of preventive medicine and reliance upon prescription drugs to keep office appointment books full? Vitamin D in dietary supplement form has been singled out as offering nothing more than the placebo effect for healthy adults.  One researcher

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According to modern medicine, vitamin therapy is hocus pocus.  It relies on a mixture of voodoo plus the placebo effect.  A report published in the Annals of Internal Medicine says unequivocally, vitamin and mineral supplements are a “waste of money.”  A noted professor of medicine says multivitamins just create “expensive urine” as they are rapidly excreted in urine (pssst… water soluble drugs suffer the same fate).  But is modern medicine just protecting its income stream derived from its own lack of preventive medicine and reliance upon prescription drugs to keep office appointment books full?

Vitamin D in dietary supplement form has been singled out as offering nothing more than the placebo effect for healthy adults.  One researcher says the widespread faith in vitamin D’s benefits is like a religion.  The criticism is that vitamin D pills are unproven.  (But not disproven!)

At least one study pointedly estimates ~$184 billion in healthcare costs could be saved annually in the U.S. by application of a dietary supplement regimen that includes vitamin D — to the growing millions of pre-diabetic Americans.  Here’s the story.

Time to buy old US gold coins

Groundbreaking study

Researchers in Canada embarked upon a 2-year study of adults to intervene in the progressive onset of diabetes.  The goal was to achieve a circulating vitamin D blood level of 100 nanograms concentration (250-nanomoles) per blood sample.  Such a high blood level is considered to be a vitamin D overdose by most physicians.

These researchers pointed out that vitamin D supplementation would be expected to produce the same blood concentrations of vitamin D as regular sun exposure and should not be considered dangerous.

The Vitamin D Council indicates the primary side effect of high-dose vitamin D, hyper-calcification, only occurs when blood levels reach or exceed 250-nanomole or 150-nanogram concentration per blood sample.

In the study the dosage of oral vitamin D administered was tailored for each individual participant and ranged from 1000 to 20,000 IU/day.

A multivitamin was given in combination with liquid oral vitamin D.  The multivitamin initially contained 200 milligrams of niacin taken twice daily (400 mg total/day).  Because of the niacin flush experienced by many subjects, compliance with the vitamin regimen was poor.

In the second year of the study the multivitamin was then reformulated and niacin was reduced to 15 milligrams/day.  Omega-3 fish oil was also added to the regimen.  Some participants received additional dietary supplements on a discretionary basis such as vitamin C, magnesium and probiotics.  There was far greater compliance in taking the multivitamin in the second group taking the reformulated version with less niacin.

This resulted in a reduced risk of progression from normal blood sugar levels to a pre-diabetic state and an increased likelihood of a pre-diabetic improving to normal blood sugar levels (as measured by hemoglobin A1c test).

The results

The percentage of subjects returning to normal blood sugar levels from a pre-diabetic state was 44% for the group taking vitamin D + reformulated multivitamin and only 8% for the group taking vitamin D but non-compliant with multivitamin.

This may help explain why other studies that employed vitamin D alone (up to 12,700 IU) did not produce a reduction in a long-term measure of (Hemoglobin A1c) of blood sugar.  Other nutrients may be critical, at least among pre-diabetics and diabetics.

After the first year 14% fewer subjects (projected to be 140 out of 1000) with normal blood sugar taking vitamin D, but non-compliant in taking the multivitamin, would progress to a pre-diabetic state.  Whereas in the second year of taking vitamin D + multivitamin + fish oil compliantly the percentage not progressing to pre-diabetes was 51% (or 510 out of 1000).  This suggests that only well nourished subjects would fully benefit from a tailored vitamin D regimen.  Researchers estimated vitamin D alone produced about one-quarter to one-third of the overall improvement.

The annual costs for the vitamin regimen were $350.  The tailored vitamin D + reformulated multivitamin regimen + fish oil regimen would be projected to save $4 million of dollars in healthcare costs per 1000 individuals so treated.

The results

The National Diabetes Statistics Report for 2017 estimates 23.0 million Americans of all ages have diagnosed diabetes and another 7.2 million are undiagnosed, or 9.4% of the population.   The prevalence of diabetes rises to 25% in the age 65-plus- population.

The number of new cases of diabetes was estimated to be 1.5 million in 2015, with more than half of these cases comprised of Americans age 45-64 years of age.  An estimated 33.9% or another 84 million US adults were judged to be pre-diabetic (by HbA1c test) in 2015.

Applying a vitamin D + multivitamin + fish oil regimen, which resulted in 44% fewer subjects reverting back to normal blood sugar levels from a pre-diabetic state, for 84 million pre-diabetics, would result in ~37 million Americans reverting back to normal blood sugar levels at a savings of ~$148 billion a year.  Astounding!

Preventive medicine is a disincentive

Does modern medicine really want to see $148 billion taken out of its pocket and health insurance rates lowered?  Do doctors want to be reduced to prescribing vitamin supplements rather than drugs and face losing income once patients figure out they can comply with such a regimen without a doctor’s prescription?  Preventive medicine is a disincentive for doctors.

For do-it-yourselfers who want to take charge of their own health, American adults can purchase an in-home blood test (~$58) from The Vitamin D Council.  Only when blood levels exceed 150 nanograms per milliliter blood sample or greater than 250 nanomole should there be concern of overdose.

A list of symptoms of vitamin D-overdose is provided by The Vitamin D Council.  The Vitamin D Council also provides instruction about how much supplemental vitamin D to take to achieve optimal blood levels depending upon your initial vitamin D test.

Almost $30 billion more dietary supplements would be sold should such a public health regimen be fully implemented among the pre-diabetic population.  That would almost double annual sales of dietary supplements in the U.S.

Another failed study looms

Health authorities are looking towards the VITAL trial to provide conclusive evidence of any health benefits derived from vitamin D supplementation.  The VITAL trial involves 2000 IU of vitamin D + omega-3 fish oil and was due to be completed by the end of October 2017.

But 2000 IU of supplemental vitamin D doesn’t even raise blood levels and represents only the amount of natural vitamin D produced by ~ 5 minutes of sunshine.  The VITAL trial is intended to test for cancer and cardiovascular disease, not diabetes or pre-diabetes.  But we can easily see it is likely to be a negative or null study by design.  Criticism of the VITAL study design has already been issued. Since when did the equivalent of ten minutes of sunshine cure or prevent any disease?

The big vitamin D mistake

Of acute interest in the ongoing debate over dietary supplement efficacy is a recent report entitled The Big Vitamin D Mistake that notes correction of a statistical mistake by the Institute of Medicine found that 9122 IU/day of vitamin D is needed to achieve a 100-nanomole/ 40-nanogram blood concentration level and that 8895 IU is needed for 97.5% of individuals to achieve greater than 50-nanomole/ 20-nanogram concentration per blood sample.  This needs to be compared to a Recommended Dietary Allowance (RDA) for vitamin D of 600 IU.  The report calls for a revised RDA of 8000 IU for young adults to achieve and maintain a 75-100 nanomole blood level with practically zero risk of toxicity!

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