Food is not medicine: Vitamin D

I dont understand people who view food as medicine.

Well, I mean, I guess I do. Theyre terrified of disease X/Y/Z (even if X/Y/Z is treatable/preventable with modern medicine), and they think a component of food helps treat/prevent disease X/Y/Z, so they religiously eat said food.

So I guess I mean to say “People who view food as medicine are being silly.”

Obviously, consuming food and getting proper nutrition is important. If you dont get enough Vitamin C, you get scurvy. Dont get enough iron, you get anemia. Dont get enough folic acid, your child is at risk for birth defects. Dont get enough Vitamin D, you get rickets.

But people seem to think that “If not enough is bad… and having enough is good… getting SUPER MEGA ULTRA DOSES of _____ will turn me into SUPERMAN!!!!”

Why the hell do I care?

Because of crap like this:

Vitamin D proven far better than vaccines at preventing influenza infections

(Mike Adams, for those of you who dont know him)

Here is what I want to make 100% clear, right up front. This is the one thing you need to take away from this post:

The role of Vitamin D in infections (viral or bacterial), is still up in the air. There is no reason why you should currently favor Vitamin D supplements over your annual flu shot, especially if you are in an at-risk population. Maybe in 10 years we will know ‘yea’ or ‘nay’, but we do NOT right now. Get your flu shot. –ERV

Vitamin D and host resistance to infection? Putting the cart in front of the horse. (free full text!)

The kind of Vitamin D your body uses is not the kind of Vitamin D you eat. Your body takes the Vitamin D you eat and turns it into the kind of Vitamin D you can use, usually via an enzyme in your kidneys.

What does this have to do with your immune system?

We can also make some immune cells produce usable Vitamin D in the lab. We do not know much about how/when/if this happens during in infections, and whether that is a side-effect of infection, or part of the pathogens strategery, or part of our immune systems strategery to get rid of the pathogen.

We also know that the amount of usable Vitamin D you have floating around has an effect on your immune system… and its not the effect you might be thinking if you read that Adams article. Vitamin D has historically had a calming effect on the immune system. Its not something that tells your immune cells to rev up and get ready for a fight.

(paragraph edited 9/29/10 for clarity) In both cell culture and small animal models, numerous laboratories have found that Vitamin D has a calming effect on the immune system. Active Vitamin D helps tell your immune system to stfu by (I believe indirectly) interfering with Th1, Th2, and Th17 immune responses, and encouraging Treg development (Tregs are the ultimate immune system buzz-kill). Furthermore, small animal models of genetic immune diseases (inflammatory bowel disease, multiple sclerosis, etc) support the ‘Vitamin D is calming’ hypothesis, both biochemically and physiologically. While deficiencies in Vitamin D are associated with human immune disorders, it has yet to translate into useful therapeutic or preventative treatments.

What does this mean in the pathology of infectious diseases?

If you totally knock out the gene that makes the enzyme that turns Vitamin D into usable Vitamin D in mice, OR you supplement mice with lots of Vitamin D, and then infect them with bacteria and viruses and such… pretty much nothing happens. Mice get sick and then they get better, apparently irrespective of Vitamin D. Sometimes no Vitamin D metabolism makes things better. Sometimes Vitamin D supplementation makes things worse. Its all kinda up in the air. Certainly nothing cut and dry like ‘VITAMIN D CURES FLOO!!!’

So what about the study claiming Vitamin D supplementation was better than a flu shot?

Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren.

Well, its a paper. Definitely neat and novel. But one paper isnt the be-all-end-all. Other labs need to replicate it, but make their studies better– larger, more controls, dose/response, there are a ton of further avenues of research. But a Very Important Person in influenza hasnt been able to replicate those findings in a controlled, small-animal, laboratory setting.

We just dont know for sure yet.

We do know, however, that vaccinations work.

We also know that some people genuinely do have Vitamin D deficiencies. If you think you are one of these people, you can go to your physician/PA/nurse, get a simple blood test done, and know in about a week. You can then get prescription grade Vitamin D to take until your blood tests come back normal. This is not a big deal at all– Mom just had this done. She didnt ‘guess’ she had a Vitamin D deficiency because she got two colds last winter, and treat herself with holistic natural organic Vitamin D she bought on the internet. She went to the goddamn doctor like a grown up.

Furthermore, we also know what happens if you overdose on Vitamin D, because you dont believe in that hoity-toity ‘medicine’ crap. Want to know what happens when you over supplement with vitamins? Go ask Gary Null.

Dont treat food like medicine.


  1. #1 Norman Yarvin
    September 27, 2010

    The main argument that more vitamin D is likely to be helpful for most people is the evolutionary one: human biochemistry evolved running around naked in the hot African sun, with a lot more vitamin D than most people have today. So whatever the immune system is doing with the vitamin (and yes, it’s complicated, and as yet not completely elucidated), it probably operates best with more than most people have today.

    Of course if you don’t believe in evolution, you’re welcome to neglect that argument.

  2. #2 Jess
    September 27, 2010

    LOLZ I just wrote a pretty similar blog post about antioxidants (particularly in relation to dark chocolate) since it’s just wall-to-wall “PACKED WITH ANTIOXIDANTS!” labels in supermarkets these days. GET FECKING GOJI BERRIES INTO YOU NOW NOW NOW SO YOU CAN LIVE FOREVERRRRR. I felt the need to hand-draw an inverted-U curve to illustrate my point. Desperate times call for desperate measures…

  3. #3 ERV
    September 27, 2010

    Norman– More is not better. Go look at the U-curve at Jesss blog (DRAT! possessive nouns that end in ‘s’, my arch enemy!). And careful about using evolution to justify nutritional woo.

    Jess– Dried goji berries are one of the grossest ‘foods’ I have ever consumed. *shudder*

  4. #4 John La Puma MD
    September 27, 2010

    Today, I got a flu shot. I also took 2000IU of vitamin D3.

    These things can (and here, do) co-exist, happily. Not Gary Null doses, and not 500000 daily…but sensible doses.

    A very good study from Utah recently showed the national prevalence of vitamin D deficiency at 64%: Nothing to sneeze at, even if the influenza finding is never repeated, given the data about adequate vitamin D levels and cancer, heart disease, bone health.

    IMO the more people learn about the relationship between what they eat and their personal health, the fewer supplements they are likely to need, and the less disease they are likely to have. Lots of vectors are moving in this direction, from Let’s Move to Michael Pollan to the price of health care.

    More is not better, and goji berries are not my cup of dried fruit, despite their antioxidant level. But we need to get closer to an understanding of healthy food, healthy you: too many people do not make this connection, even a little.

    John La Puma
    author, ChefMD’s Big Book of Culinary Medicine

  5. #5 Minnesota
    September 28, 2010

    How many medicines are derived from foods / extracts from plants?

    Give up the blog you are destroying the reputation of the site by complete lack of intelligence.

    Please get a clue.

  6. #6 Norman Yarvin
    September 28, 2010

    ERV, obviously you’re attacking the woo crowd, but where I got my appreciation for vitamin D (as well as the evolutionary argument) was from researchers specializing in the vitamin, such as Reinhold Vieth, who were arguing for its benefits long before the woo crowd picked up on it. See, for instance, this article:

  7. #7 Charl
    September 28, 2010

    Ben Goldacre talks about this a bit in Bad Science. I seem to remember him talking about a meta-analysis of lots of trials and experiments that showed that, while vit D doesn’t make you any less likely to get a cold/flu, it does reduce the duration of the symptoms.

  8. #8 Stephen Wells
    September 28, 2010

    @1,5: would our immune systems also operate better if we chipped stone tools and got eaten by leopards a lot? Those are also features of our evolutionary history. Be careful of Panglossian assumptions.

  9. #9 MikeMa
    September 28, 2010

    I was recently told (via blood test) that I needed vitamin D, given a script for a cute green pill and I take it once a week. I see 2 different docs and when the 2nd heard about the dosage, got a little nervous. She ordered a test to see if the my vit. D levels were okay now or maybe too high. They were okay.

    All this was started and confirmed with blood work. No guesses, no mega-doses based on mega-hope and Null/Adams crap. I also will get a flu shot – cheap and effective.

    The evolutionary theory is novel but don’t forget we are still evolving. We may b able to get by (eventually) with less D or different sources.

  10. #10 Norman Yarvin
    September 28, 2010

    Stone tools and leopards don’t have much to do with the immune system. Vitamin D does: it’s the raw material for a messenger molecule (1,25-dihydroxy-vitamin D) which performs immune system signaling.

    By the way, this is the respectable version of the Vitamin-D-protects-against-flu hypothesis:

    Of course there it’s presented as a hypothesis which certain evidence suggests but which might be wrong, not as a ha-ha-ha-our-numbers-are-better-than-yours anti-vaccination screed.

  11. #11 Facts
    September 28, 2010

    Just because you found only one paper does not mean there are not others.

    The data stretches back to 1918;

    Surgeon-General, Massachusetts State Guard.

    Use Google Scholar to search for the thousands of recent studies on vitamin D. Make sure when you read an article the serum level being tested is between 40-60 ng/ml, which is the theraputic standard. The bulk of the population is <25 ng/ml.

    Or watch the many lectures online, from major medical schools now being given by researchers and professors.

    Ignorance is bliss. Vitamin D deficiency is a hormone deficiency, not a nutritional one. Treat vitamin D deficiency like any hormonal deficiency. It was mistakely labeled a vitamin many decades ago. It is a hormone intricately invovled with the immune system.

  12. #12 becca
    September 28, 2010

    Pedantically, shouldn’t this be “sunlight is not medicine”- since vitamin D isn’t necessarily in food anyway?

    Also, you say “small animal model”… small animal like rodent? Like nocturnal rodent?

    I’m coming to this from the perspective of someone who studies the innate immune system. The stuff on TLR signaling and the vitamin D receptor and tuberculosis is AWESOME. The molecular basis is there through a couple of pathways. Vitamin D WILL modulate the immune system, and it will be in a beneficial direction in some cases (though certainly not in all).
    So anyway:
    1) taking vitamin D *instead of* getting a flu shot, for most individuals, if the aim is to prevent flu? FAIL
    2) if you’re allergic to eggs or something, is it better than nothing? Could be, and it probably won’t hurt
    3) Taking mega-doses… well, there are doses and doses. I don’t think we’ve got a great idea of a reasonable RDA for vitamin D for optimal health. We’ve got a great idea of *adequate intake* for preventing rickets. But for reducing depression in people in Finland? Maybe not. For reducing severity of tuberculosis or flu? Maybe not. There seem to be a variety of benefits from ‘more than the minimum’ supplementation. Obviously, it’s fat soluble, so there always needs to be some caution because of that. But somewhat large doses should definitely be studied.
    4) the evolutionary argument I see as compellingly in favor of the importance of vitamin D is skin color. Lighter skin color, certainly with respect to skin cancer and perhaps in other senses, is not biologically advantageous… except for getting more vitamin D as you move into climates with less sunlight. Why would we evolve from a good protective covering to more vulnerable covering if not to get more of a critical nutrient?

  13. #13 ERV
    September 28, 2010

    Hi John! This isnt meant to be snarky, but its probably going to come across that way 😛 I really am interested in your responses.

    Today, I got a flu shot. I also took 2000IU of vitamin D3.

    These things can (and here, do) co-exist, happily. Not Gary Null doses, and not 500000 daily…but sensible doses.

    No offense, but this reminds me of the science/religion debate. Yes, you can be an Evangelical Christian and a professional scientist like Francis Collins (hes not one of those CRAZY Evangelicals! hes one of the sensible ones). Yes, you can accept the benefits of vaccinations and be a fan of supplements. But the fact you can do those things doesnt mean it is logically and scientifically sound.

    It doesnt really matter if 100% of the hospital patients in that study were Vitamin D deficient. If you personally are not Vitamin D deficient, what is the point of supplementation? What other substance would you, as an MD, prescribe in the absence of a deficiency? Iron? Human growth hormone? Thyroid hormone? Just because ‘sensible’ doses are pushing the top of the bell-curve, not into the crazy Null/Adams range, doesnt mean they are useful in the absence of deficiency.

    Furthermore, Im assuming as an MD, you actually have tested yourself for deficiency, and you were actually deficient. Thats why youre taking the supplement. You literally ‘wrote the book’ on ‘food as medicine’, but even with your top-tier education, high income, and access to healthy food, cant get enough Vitamin D from your diet. Its disingenuous to say ‘Oh one day when people care about their diets, no one will need supplements!’ when you yourself are on them.

    As I said in the OP, my mom was on Vitamin D this year. She is highly active (cardio and weights), eats healthier than I do, walks outdoors, etc, yet she still needed medical intervention. I do not like implication that people who need medical intervention ‘did something wrong’, when sometimes, despite our best efforts, we do need medical help for things. They dont need crap products or crap information from snake-oil salesmen on the internet. They need physicians who support evidence based medicine.

  14. #14 ERV
    September 28, 2010

    becca– Not mice, ferrets! And I believe they altered Vitamin D via diet, not by putting cages out by the pool 😛

    I agree that in vitro TB-macrophage stuff is cool, and mice supplemented then infected didnt get as sick… but human data has been ‘meh‘.


  15. #15 Orakio
    September 28, 2010

    Ugh, food as medicine. The worst part about the whole thing, and I think the thing that trips up a lot of laypeople, is the sheer complexity of the issue.

    A large number of health problems are really are intricately linked to our diets, and they’re the kind of things that affect us every single day. When our doctors tell us we have to modulate our diets as concurrent therapy for our diabetes, our heart disease risk, our etc, the natural question that we’re going to ask is Okay, what other little problems will eating right cure?

    Pile that on top of wanting things to be simpler, and we pop supplements – which are pills, and as every six year old knows, pills are Medicine! Pile that on top of the fact that doctors do make mistakes, the fact that there’s still a lot of stuff we don’t know, a healthy dose of paranoia against ‘modern’ and ‘unnatural’ stuff, and now you have a foothold for anyone who can make themselves sound sensible.

    And when you wake up one morning sick, or in pain, you just want it to go away; it’s not the condition that makes people stop and go whoa, is that really gonna help?

    Then, you have the whole journal system making it difficult for people to read the source material on this stuff, and having to rely on journalists publishing stuff to the interblags or the papers, and, well, it’s a mess to educate yourself.

  16. #16 Mu
    September 28, 2010

    Carrot cake diet to fight flu, I knew I can get my manuscript published some day!

  17. #17 John La Puma MD
    September 28, 2010

    Orakio/15 is right: food as medicine is complex and crucial: maybe worthy of its own NIH department. And supplements are medicine, though that doesn’t make them bad or good. No healthy pattern of eating and living can rival the immediacy of narcotics for pain, or the effectiveness of the CCU for serious cardiac illness.

    What people seem to like most about my most recent book are the tidbits–the “little bites” that show better absorption of curcumin with piperine than without it; the hike in lycopene and beta carotene in a watermelon stored at room temp instead of the fridge; the bioavailability of lutein from a spinach salad with full fat dressing instead of low fat.

    They’re a way to participate and engage…all of which is great. Those tidbits that can motivate people to want to learn more and do their own investigation. Which can be laborious. But also fascinating. And often, very tasty.

    For 13, I am sorry to hear about your Mom, and I hope she’s made a full recovery. My Mom too takes vitamin D (actually had a normal level pre-op) but still needed her knee replaced…and is doing everything she can, including yoga and prescription medication, to get better.

  18. #18 Jason
    September 28, 2010

    Oh – I haven’t seen anything like this in the original post or comments! I can make a contribution!!

    Fat soluble vitamins (A,D,E and K) — if you take too many — can result in toxicity. Best to make sure you’re getting enough, but there’s such a thing as too much!!

    It’s also why I laugh when people take those vitamin C boosters — i hope they enjoy the taste cuz those things are gonna come right on out in urine.

  19. #19 Orakio
    September 28, 2010

    Do not mistake me.

    Recognizing that there is a complex interplay between the input to our bodies we call food and the output that we convienently call health does not, in any fashion, excuse jumping the gun and saying Vitamin D capsules will cure the flu.

    What I was attempting to point out is that sorting the wheat from the chaff is exceedingly difficult for the average consumer, especially one who is actively suffering. Many effects are subtle at best, often conflicting, and sometimes negative, while what the consumer wants is a panacea. It really doesn’t matter how much beta carotine you can extract from a watermelon, if beta carotine won’t help!

    (Disclaimer: I am unable to access anything other than the abstracts of those papers at this time. The conclusions may be significantly different… but I doubt it.)

  20. #20 Bronze Dog
    September 28, 2010

    I can understand some of the ‘food as medicine’ concept, but certainly not a lot of the way out there woo about food. Disclosure of my biases:

    I tend to view diet as a useful (but, of course, nowhere near perfect, like many woos argue) preventative measure: If you don’t want a heart attack at 40, consider eating salad more often and cutting down on the triple bacon cheeseburgers.

    I also see diet as having a role as a small aid to some recovery: It seems sensible to me that someone with a broken bone might want to drink a bit more milk for the calcium, but that can wait until after he’s in a cast. I tend to suspect there might be wisdom in ‘chicken soup for a cold’ sort of thing for some illnesses, but I’m withholding judgment until I learn more about that sort of thing.

    The ‘small aid’ thing I mention kind of touches on something I read a while back, by Orac, I think: Woo ‘nutritionists’ like to whine that doctors don’t know anything about nutrition, citing that there aren’t overarching ‘nutrition’ classes. What actually happens is that all the various classes tend to have small parts about nutrition as it relates to their specific context.

  21. #21 cynical1
    September 28, 2010

    “Give people with asthma or MS or arthritis or lupus or some kind of disease where their immune system is running around screaming ‘AAAAAAAAAAAAHHHHHHH!!!!!! AAAAAAAAAAAAAAAAHAHAHAHAHAAAAAAHHH!!!!’ like a kid hopped up on cocaine, and things calm down. Thing get better.”

    Give them what? Vitamin D? Sorry, I don’t think so. If it were just that easy………..

  22. #22 Jonathan Fenton, DO
    September 28, 2010

    As a physician practicing orthopedic medicine a full 40% of my athletic patients ages 35-75 have laboratory documented hormonal and nutritional deficiencies impacting their pain and rehabilitation. I’m amazed at how many doctors pontificate without testing, when blood levels of vitamin D, B6, B12, ferritin, iron, testosterone, thyroid, DHEA, etc are all easily obtained. So many of my patients improve with appropriate, lab based hormonal and nutritional support that it greatly lessens the need for interventional treatments, and therefore costs. As individual genetic variance in nutritional needs and optimal levels evolves so should medical care, and this has certainly not been the case.
    Vitmin D supplementation has been part of chronic pain treatment since I finished my training in the early 90’s!

  23. #23 ERV
    September 28, 2010

    cynical1– While Vitamin D doesnt totally ameliorate those diseases, it apparently is inversely correlated with disease severity, and supplementation (people with those diseases are Vitamin D deficient) has some therapeutic value.

    Review referenced favorably in the Bruce paper.

    Jason– I make my own cereal (Alton Browns granola recipe!), I make my own bread, I dont eat red meat very often, and I gave myself a nice case of anemia. To help with that, I now eat fortified store-bought cereal and take a multivitamin every morning. I laugh 2 hours later because my pee is green. YAY VITAMINS!!!

    John La Puma MD– *blink* *backs away slowly*

  24. #24 Medicien Man
    September 28, 2010

    I don’t understand peple who view manmade deathtrap vaccines as the answer to everything. Vitamin D is a great way to biuld up the immune system as well as build bone strength. There is no way in all of hell that I will be taking one of your killer vaccines. Forget it. Vitamin D is safer, more effective, and vastly cheaper.

  25. #25 R2
    September 29, 2010

    Vitamin D can be used to treat psoariasis. It’s caused by overactive CD8 cells (which is why HIV positive people can get a flare-up, CD4 cells go down, CD8 goes up to compensate). CD8 cells (maybe other immune cells as well) have Vit D receptors. So, a nice Vitamin D gel calms them down (as was said).

    So, I find it weird that it helps prevent disease that requires a bigger immune response. But, hey, if it works, great, let’s see if the results can be replicated. It would also be important to see how safe it is at the doses required, not just the typical ‘it’s natural so it MUST be safe!’ assumption.

  26. #26 GS
    September 29, 2010

    I’m one of the nuts that sees food as medicine. Dr. Dean Ornish has published studies that show proper diet can reverse/prevent heart disease. The diet he prescribes works better than any medicine or therapy currently available. That’s food as medicine and it’s proven/effective.

    I’m not sure how Vitamin D as a miracle cure would qualify as ‘food as medicine’ since Vitamin D is a hormone and isn’t naturally found in food.

  27. #27 Tristan
    September 29, 2010

    Fat soluble vitamins (A,D,E and K) — if you take too many — can result in toxicity.

    And how – the 50mg of vitamin D I have sitting in a bottle in the lab has to be labelled as a poison, and the MSDS is covered in dire warnings about how carefully it should be handled.

  28. #28 drk
    September 29, 2010

    Your examples disprove your thesis. If vitamin D can be used to treat immune system disorders, then it seems that food (as you use the term) can be used as medicine (as you use that term).

  29. #29 Triangle_Man
    September 29, 2010

    As alluded to above, if you want to make a “food is not medicine” argument, vitamin D is not the nutrient you want to pick. The vast majority of circulating vitamin D comes from exposure of skin to solar UV. The vast majority of variability in vitamin D is related to variability in solar UV exposure first and use of supplements second. You mention rickets as a consequence of vitamin D deficiency, but it is clear that there are other physiological consequences to insufficient vitamin D. If it is logical to supplement with vitamin D to prevent rickets, why is it not logical to supplement to prevent other problems?

  30. #30 ERV
    September 29, 2010

    Thank you all so much for ‘reading’ my post.

    There is a difference between diseases caused by deficiencies (which obviously can be treated by alterations in diet and supplementation), and the assumption that supplementing in the absence of deficiency provides an even greater health benefit. Vitamin D supplementation does not turn you into a super human that cannot get influenza, TB, arthritis, lupus, etc, yet that is precisely how it is marketed by woo-stream media.

    I thought I made that point abundantly clear in this post, but apparently, I write in Greek. Apparently I also eat exotic foods like ‘fish’, ‘eggs’, and ‘milk’, stuff other humans dont touch too, so, *shrug*

  31. #31 R2
    September 29, 2010

    I sorta agree with you. I mean, I agree with the general idea (how the woo uses vitamins, etc) and the next is just a bit of nit-picking, really.

    When used to treat, say, psoriasis, you are not treating a Vit D deficiency. You are adding extra to make CD8 cells calm down. (But, of course, there is a big difference between eating the gel and placing it on the lesions).

    Tristan: Are you being sarcastic? It’s hard to get tone in text.

  32. #32 Patricia
    September 29, 2010

    Speaking for myself, I am learning that, whether you want it to or not, food can indeed act as a medicine.

    I have suffered from autoimmune hepatitis for the last ten years and I have discovered that plant estrogen in my food triggers this illness and vitamin D supplementation helps keep it under control.

    If I eat soy or flax or peanuts or almonds, or use cosmetic products that contain plant estrogens like lavender or oat kernel extract, my immune system begins to attack my liver, my liver swells up, my urine turns dark, my feces turn yellow, and I feel extreme fatigue.

    So food in my case is definitely acting like a medicine, only one that can you sicker instead of better.

    My liver specialist and I have discovered that eating other certain foods seems to make my immune system calm down and be less sensitive to estrogen. Brussels sprouts, broccoli, cabbage, dark leaf lettuce and lamb are foods that seem to be able to keep my immune system on an even keel.

    Vitamin D supplements are an important part of that package.

    This program of avoiding certain foods and eating others is working so well now that I’ve been able to go off of prednisone completely, and now we’re stepping down my dose of Cellcept with the goal of seeing whether I can go off of immune suppressant medications entirely and treat my illness with diet alone.

    So far it’s working. I’m very excited, because it’s not fun taking medicines that advertise osteoporosis and fatal brain infections as possible side effects.

  33. #33 Orakio
    September 29, 2010

    @32, 29, 28, 26:

    There is a major difference between using dietary intervention in an illness which is significanly based on the inputs and outputs of the body to begin with, or as a component of allergy avoidance, and the use of dietary intervention in the expected defeat of a quasi-species which has as its major operational parameter the infection of and replication in otherwise healthy human beings.

    The presence of sufficient specific nutrients and hormones may, or may not lessen the excess to which the immune system goes in order to defeat an invader – But the fast track of immunization, the training to the immune system provided by a vaccine, is still superior for the prevention of illness.

  34. #34 cynical1
    September 29, 2010

    I know that this is likely to send you into one of your tirades, but I am undaunted.

    The reference you provide gives no evidence for efficacy of vitamin D supplementation in any of the autoimmune diseases that you list. The one reference suggesting efficacy in MS was done in 16 MS patients of which only 10 completed the study and there was no control and it was published in the journal Medical Hypotheses. What a joke. The other study using a synthetic vitamin D analog, alphacalcidiol in 16 RA patients was open label divided into two separate disease activity groups and conducted for that whopping clinically relevant period of 3 months and came from that stalwart of great science, Yugoslavia. It also caused hypercalciuria in 30% of the group. And I won’t even bother acknowledging the fish oil studies in your reference.

    Well Abbie, that’s just shit and you know it. You’re all over the shoddy study above with vaccinations and vitamin D (and I agree with you 100%) but you want to support your statement with this shit? WTF?

    As for the data linking disease activity/severity to vitamin D levels, you really can’t delineate cause and effect there, for instance diet and sunlight exposure. UV-B radiation causes release of the peptide hormone alpha-MSH which is a much more potent immunosuppresive than Vitamin D. In fact, ACTH – the physiological precursor to alpha-MSH was used for decades to treat MS relapse. UV-B also causes rise of serum vitamin D levels. So what? All of this anecdotal data is interesting but should NEVER be used to suggest clinical efficacy through supplementation or even disease association. (Incidence of rape and ice cream sales go up in the summer but they’re not connected.)

    So I will repeat, I really don’t think there is any evidence to suggest that Vitamin D supplementation does jack shit to reduce disease severity in autoimmune diseases (in humans). And I don’t think that some poor uneducated patient should read your post and believe otherwise. And if you want to continue to argue, I will taunt you a second time.

  35. #35 becca
    September 29, 2010

    Oooo, ferrets! Did not know about that.

    The paper you linked to looks like a good study. It’s a good population to use (given who gets TB, and who could benefit from cheap supplements), but not the one I’d most expect to see an effect of modest vitamin D doses in (the latitude is wrong). Still, I think people have been trying this for a long time, with some studies showing an effect and some not.
    Since there are polymorphisms in the vitamin D receptor, maybe it’s host genetic variation. Unless it’s like malaria, and there actually a lot of ways to get the disease (in some models, and probably some patients, more inflammation is needed to clear the parasites. In other models, and probably some patients, less inflammation is needed to avoid dying of cerebral malaria… if TB has a similar stratification- with immune ‘boosts’ only sometimes helping, you could get a very equivocal pattern of clinical data even as the drug was helping some patients).

    So now I wonder if vitamin D has variable effects, or one consistent effect that simply has different clinical effects depending on the disease context. Probably both. Why must science be so complicated?

  36. #36 ERV
    September 29, 2010

    cynical1– Nope. You only get ERV tirades if youre wrong. I agree with you, and I will try to alter the wording of the OP tonight so its more accurate.

    If you REALLY want a tirade, you could try to tell me I dont know what a quasispecies is, or tell me XMRV and endogenous MPMVs are the same thing 😉

  37. #37 Veronica
    September 29, 2010

    Different strokes for different folks. One size does not fit all. Is it silly to consider that everyone has a different immune system and for a certain population Vitamin D may be better than the flu shot at preventing the flu? Just because a study says something does not mean that it applies to the individual. People know their own bodies and we should all be able to make the decision after considering what we feel we want to consider is the right answer for us.
    If people rather use Vitamin D, let them. They are fully informed adults in that people who seek out this type of information tend to be highly educated and have read many studies. the masses will continue to fall lockstep behind Western medicine and get the shot. So what is the problems with those of us who have decided we have a way that might work better for us doing it? I take full responsibility if I catch the flu. That is because I live a lifestyle to do everything to keep my immune system strong.
    The condescending tone of many scientist and physicians does not convince me that there is only one answer or one way. Consider that there may be several ways and help individuals find the way that works for them.

  38. #38 ERV
    September 29, 2010


    … See, that is going to get a tirade, cynical1.

    Unless you all eat her alive before I get back from boxing.

  39. #39 Elisa
    September 29, 2010

    My understanding is that vit D insufficiency and deficiency is quite common. Dermatologists want people to supplement vit D rather than sit in the sun – which is the historical way to get vit D. I have friends living in Hawaii – they are a white couple with light skin. They never wear sun screen and usually wear minimal clothing. When all the news about vit D came out they both had their levels checked. They were both deficient. I’ve been taking 5000iu’s a day for three years and my levels are at a good point. It’s true, I get regular blood tests but I recommend them broadly.

    That said, I don’t suggest people should skip necessary vaccines nor do I think antibiotics are bad when used in a targeted fashion. Allopathic medicine is great at dealing with major illness but it sucks at optimizing health. A nutritious diet and exercise goes much farther to keep people healthy than any pharmaceuticals. Drugs are great at fixing things when they are broken but lousy at prevention.

  40. #40 Prometheus
    September 29, 2010


    “The condescending tone of many scientist and physicians….” etc.

    So you make decisions about your physiology, immunity and your general medical condition based on the sounds your butt makes after you eat?


    Let us know how that goes.

  41. #41 ERV
    September 29, 2010

    cynical1– Okay, paragraph fixed! Do you agree, or do I need another spanking 😉

  42. #42 ERV
    September 29, 2010

    “Dr” Veronica– You know what I think is condescending?

    You wasting a degree that 99.999999999% of the population on this planet cant even dream of. Throwing it away, like a bloated queen tossing out a feast after shes had her fill, while others starve. Hey, Dr. Veronica, why dont you tell everyone here why it DOES matter to them whether you get an influenza vaccine or not? I have fucking ERV readers who can explain that. ERV readers without ‘MD’s. What a fucking waste your education was, to yourself and humanity.

    You turn your nose up at ‘Western medicine’– Do you have any fucking idea how many lives those evil ‘vaccinations’ and ‘antibiotics’ have saved in the ‘Eastern’ world? Do you have any idea what more vaccines, better vaccines (green vaccines) would mean to people in ‘the East’? No, its just us ‘condescending’ scientists that worry about such things. Great minds like yours worry about dating a fat guy and how to make your ‘body more alkaline, whatever the fuck you think that stupid shit means.

    How ‘condescending’ of me and every other scientist out there who tries to share their education with anyone who is interested, because we believe people are smarter, are more clever than they might think they are. Us ‘condescending’ scientists who think people are inherently smart enough not to fall for the stupid crap leeches like you throw up, if only they had a bit more good information.

    Get the fuck out, bitch. And take your ‘tone’ with you.

    P.S. 80% of children over the age of 12 have a black-belt in taekwondo. Who the fuck advertises that like it means anything? Might as well put ‘can ride a bike without training wheels’ on your CV. Christ.

  43. #43 daedalus2u
    September 29, 2010

    Let me say I completely agree with ERV. If you think about how organisms evolved, they didn’t evolve with supplements and stuff, they evolved eating what ever dead stuff they could find, what ever living stuff they could catch, and what ever plants didn’t have so many toxins in them that they killed them.

    Nothing that organisms evolved to eat had other organisms evolving so that they would provide the right amount of nutrients (except maybe seed dispersal fruits). Organisms are rich in nutrients as food because organisms need those nutrients for their own metabolism.

    If organisms required a specific amount of anything to regulate their physiology, they would have either quickly evolved other regulatory pathways, or died.

    Your immune system is too important to depend on getting exactly the right amount of vitamin D for it to work. The same is true of every single other system. Yes, people can get insufficient vitamin D. They get rickets and other well recognized vitamin D deficiency disorders.

  44. #44 R2
    September 29, 2010

    Elisa: Allopathic medicine is a homeopathic concept. That’s not how it really works, using ‘opposites’ is not the point.

    Also, medicine can be good at prevention. If it’s not the focus, then yes, it is something we have to put more resources in. But it is not a flaw in the “theory”, but a flaw in the execution. I’ve never heard of ANY doctor say ‘No, don’t eat a balanced meal… just take PILLS!!!” or “Don’t worry about smoking, we have chemotherapy now! Cigarettes for everyone!”

    In fact, medicine is trying to move towards a greater and greater emphasis on prevention all the time. See vaccines. Screening. Nutrition.

    Woo trying to coopt PROVEN prevention strategies like excercise and good, healthy eating pisses me off.

  45. #45 Adi
    September 30, 2010

    Muie la iehovisti, mormoni si atei!

  46. #46 cynical1
    September 30, 2010

    Looks great, Abbie! Oh, and I loved the tirade to Dr. V. It was certainly justified.

  47. #47 eridani
    October 1, 2010

    So many people are posting anecdotes about themselves or their loved ones having actual vitamin D deficiencies as if that somehow proves the article wrong, but that’s not what this article was about.

    Those anecdotes are no more valid as arguments than if ERV had said, “insulin injections don’t cure cancer,” and everyone chimed in with, “Oh, yeah? Well my mother’s a diabetic and needs insulin.” Uh huh. And if she had cancer, it wouldn’t make a lick of difference to the cancer.

    This article was about using vitD in a specific context, to wit, instead of taking the flu vaccine, and THAT usage is “off label” and unproven.

    So this means you have a few options here: As a scientist, you can create the peer reviewed and properly controlled study to prove conclusively once and for all that it works or doesn’t and maybe get yourself a Nobel Prize. As a layperson, unless you want to play Dr. Jekyll with your body and muck around with magical thinking and unproven potions, your only sane option is to wait until some scientist does just that. But as a doctor or other health care professional, to recommend it AS SUCH A PREVENTIVE FOR FLU, especially for those patients who could die without protection, would be irresponsible bordering on malpractice because it is NOT consistent with current medical standards.

    If you have been tested and shown to have a vitD deficiency, mazel tov, eat your fish, drink your milk, take your pills, whatever your doctor tells you, but don’t assume based on confirmation bias and a deep seated desire not to face the needle that you’ll be protected from the flu.

    Big Placebo is NOT a valid replacement for Big Pharma, no matter how much people might wish it so, no matter how convinced you are that Big Pharma is part of a conspiracy to kill every man, woman and child on the planet or some such. That’s not to say every claim made by every nutritional supplement is bogus, but without peer review of the testing process, proper testing with control groups and reproducibility, those claims have no objective basis. I would LOVE it if soybeans to cure breast cancer. I would LOVE for vitD to prevent the flu better than a nasty needle jab full of “poison,” as the anti-vax people are so fond of saying. That doesn’t make it so.

    As for homeopathy, a high school background in chemistry should make it clear why THAT is hogwash, but in case it doesn’t, here’s James Randi discussing it.

  48. #49 me
    October 1, 2010

    if there’s any question about vitD’s efficacy, then you AREN’T using enough!!!

  49. #50 K7AAY
    November 2, 2010

    Kind sire, why do you disagree with many, many MDs and MPHs who declare the utility of Vitamin D3 (not all Vitamin D, but the specific D3 variant) in suppressing multiple diseases? Would you please be so kind as to review and report on your findings thereafter?

  50. #51 Nat
    November 12, 2010

    Meh.. typical “science-based” post. Granted, Mike Adams is a crazy fundamentalist when it comes to these things, but that does not make vitamin D worthless. And for some bizarre reason, you feel compelled to push the prescription form of vitamin D (ergocalciferol) when it’s *scientifically* known to be inferior to D3 (cholecalciferol). It smacks of a faith-based belief that anything that comes from a doctor is automatically better.

    You put up bogeymen like Mike Adams to induce guilt by association, so that people will conclude vitamin D supplementation is nonsense and “go the the goddamn doctor.” I guess there’s nothing faith-based about insisting that “the goddamned doctor” has the best solution to every health problem even when it’s been scientifically shown that their product (ergocalciferol) is inferior to the one you can buy at Rite-Aid (cholecalciferol).

    But yeah, I’m just one of the ignorant masses slavering after everything nutball Mike Adams says in a desire to prop up my nonsense beliefs, I guess. After all, isn’t that the narrative that has been playing in your head(s) since the first sentence of this post?

  51. #52 W. Kevin Vicklund
    November 13, 2010

    D3 is “superior” to D2 because it has fewer metabolites, which results in a higher percentage of usable molecules. In other words, it takes somewhat more D2 to have the same effect as D3, and there’s some additional stuff floating around. But it’s cheaper to make D2, and more importantly, control the dosage.

    In any case, Abbie isn’t pushing D2 over D3. She is pushing getting the doctor-recommended dose for a specific condition from a reputable manufacturer over a “more is better” guess from a fly-by-night operation.

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