Low Vitamin D Causes Problems For Acutely Ill Patients:
Dr Paul Lee, Professor John Eisman and Associate Professor Jackie Center, researchers at Sydney's Garvan Institute of Medical Research, examined a cohort of 42 Intensive Care Unit (ICU) patients. Forty-five percent turned out to be Vitamin D deficient.
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When the team correlated the Vitamin D levels with a disease severity score, there was a direct correspondence between sickness and Vitamin D deficiency. In other words, the sicker someone was, the lower the levels of Vitamin D. Out of the 42 patients studied, there were 3 deaths. The 3 patients who died all had the lowest level of Vitamin D in the cohort.
The big glaring issue here is causality. Is the level of Vitamin D just an indicator of someone who is ill, or a reason they are prone to being ill? More research needs to be done:
The next step will be a randomised control study to investigate whether Vitamin D has benefits in critically ill patients. In simple terms, two groups of patients (who are evenly matched) will be treated, with Vitamin D added to the treatment of one group, but not the other. The outcomes will then be compared.So should doctors be trying to raise the Vitamin D levels of their patients in the meantime?
Dr Lee hopes the randomised study may provide a more definitive answer to the question. "However, Vitamin D is very safe. It's inexpensive and has a very large safety window, making toxicity unlikely, unless there are underlying diseases causing high calcium. Giving vitamin D to severely deficient patients is very unlikely to cause harm. In addition, ICU patients are lying in bed for a long time, and are at risk of bone loss and osteoporosis. So if nothing else, Vitamin D will help protect their bones."
Supplementation may not be a cure all, and we may find that all these correlations are popping out of the fact that Vitamin D levels are a proxy for suppressed immune systems in some manner. But the downsides of supplements are probably minimal. Here's the letter in The New England Journal of Medicine.
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Vitamin D is a hot topic of research in cancer, but the answer is not nearly as clear cut as the "alt-med" types think. They tout vitamin D as virtually a cure-all, but thus far, although there is retrospective and some spotty prospective evidence that low vitamin D levels are associated with increased cancer risk, but at the moment there just isn't good evidence that vitamin D supplementation after cancer has developed improves survival, as Dr. Len points out:
http://www.cancer.org/aspx/blog/Comments.aspx?id=174
Personally, my view is that low vitamin D levels are probably not good and probably do predispose to some cancers but that we don't have enough data on long term vitamin D supplementation to determine whether there are downsides that outweigh or equal the plus sides. You can't assume that the "downsides of supplements are probably minimal," at least not over the long term, although it's probably correct that there are few, if any, downsides to supplementation over the short term, as in an ICU stay.
Of course, ICU patients are uniformly messed up metabolically; so it's not surprising that if one looks for vitamin D deficiency in ICU patients one will find it. Also remember that this is a small study and that correlation does not necessarily equal causation. It will be interesting to see if a randomized study finds anything.
Oh, forgot this one as well:
http://www.cancer.org/aspx/blog/Comments.aspx?id=266
There is so much data showing vitamin D prevents cancer and has a probable role in cancer treatment. The Canadian cancer society now recommends everyone take vitamin D to prevent cancer. There is no known downside to having optimal vitamin D levels. Take a look at www.vitaminD3world.com for some good summaries of the data. The site also has a good newsletter
Orac - anything on Vitamin D deficiency and recurrence, or conversely 5 year survival rate after surgery, say?
And anything on whether there are differences depending on whether the Vitamin D is taken in food form or as a supplement?
Also, I'd really like to know what the best form of supplement is.
Mike, 2000 i.u. per day sounds like a lot.
Vitamin d is not a cure all. What has been identified is a vitamin d famine. Like all famines it is bad for you. If we optimise the cancer suffers vitamin d levels they will have less bone loss, less infections, lower blood pressure and possibly less cancer. The D3 supplements are identical to that produced by the sun and many animals (those with fur) take d orally.
How do I know I tried it 5000IU a day for 2 years. Best thing I ever did.
Got high blood pressure try 5000IU of D3 a day for 6 weeks,then get your blood pressure checked.
2000IU is not a lot. By now (Sept 2009) this recommendation would be 5000IU.