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Medical Forum / General / Nutrition / October 2006Low vitamin D levels: a greater risk of nursing home admission and mortality
Persons with circulating vitamin D values under 25 nmol/L had nearly 4 times the risk of being admitted to a nursing home as did persons with values over 75 nmol/L. ------------------------------------------------------------------------------------------- Am J Clin Nutr. 2006 Sep;84(3):616-22; quiz 671-2. Low serum concentrations of 25-hydroxyvitamin D in older persons and the risk of nursing home admission. Visser M, Deeg DJ, Puts MT, Seidell JC, Lips P. Institute of Health Sciences, Faculty of Earth and Life Sciences, Vrije University, Amsterdam, Netherlands. BACKGROUND: The prevalence of vitamin D deficiency in nursing home patients is high. OBJECTIVE: We aimed to ascertain whether lower serum 25-hydroxyvitamin D [25(OH)D] concentrations increase the risk of future nursing home admission and early death. DESIGN: We included 1260 independent, community-dwelling persons aged > or =65 y who were participating in the Longitudinal Aging Study Amsterdam (1995-1996). Study outcomes were time to nursing home admission during 6 y of follow-up and time to death until 1 April 2003. RESULTS: Vitamin D deficiency [25(OH)D < 25 nmol/L] and insufficiency [25(OH)D = 25-49.9 nmol/L] were present in 127 (10.1%) and 462 (36.7%) subjects, respectively. During follow-up, 138 subjects (11.0%) were admitted to nursing homes, and 380 subjects (30.2%) died. The risk of nursing home admission for participants with 25(OH)D deficiency was 53 cases per 1000 person-years higher than that for those with high 25(OH)D (> or =75 nmol/L) concentrations (58 compared with 5 cases). After adjustment for potential confounders, the hazard ratio (95% CI) of nursing home admission was 3.48 (1.39, 8.75) for vitamin D-deficient, 2.77 (1.17, 6.55) for vitamin D-insufficient, and 1.92 (0.79, 4.66) for vitamin D-borderline persons as compared with persons with high 25(OH)D (P for trend = 0.002). The results remained after additional adjustment for frailty indicators. Lower 25(OH)D was associated with higher mortality risk, but this association was not significant after adjustment for frailty indicators. CONCLUSION: Lower serum 25(OH)D concentrations in older persons are associated with a greater risk of future nursing home admission and may be associated with mortality. PMID: 16960177 http://tinyurl.com/jnuep Editorial comment by vitamin D scholar Robert P. Heaney: http://www.ajcn.org/cgi/content/full/84/3/471  SignatureJuhana Readers of this should note that this comes from a nutrition journal that is NOT a medical journal. Larry E. > Persons with circulating vitamin D values under 25 nmol/L had nearly 4 times > the risk of being admitted to a nursing home as did persons with values over [quoted text clipped - 39 lines] > > http://www.ajcn.org/cgi/content/full/84/3/471 : Readers of this should note that this comes from a nutrition journal : that is NOT a medical journal. : : Larry E. Go and educate yourself, Larry. Clinical nutrition is a part of nutritional medicine. American Journal of Clinical Nutrition is the top rated specialized nutrition journal in the world. In this fresh article Professor Aliya Khan states that "ninety seven percent [97%] of people admitted to hospital for fractures have inadaquate vitamin D." http://www.therecord.com/pdfs/2006Sep29/F01.PDF -- Juhana :: Persons with circulating vitamin D values under 25 nmol/L had nearly :: 4 times the risk of being admitted to a nursing home as did persons [quoted text clipped - 42 lines] :: :: http://www.ajcn.org/cgi/content/full/84/3/471 : In this fresh article Professor Aliya Khan states that "ninety seven : percent [97%] of people admitted to hospital for fractures have : inadaquate vitamin D." : : http://www.therecord.com/pdfs/2006Sep29/F01.PDF The above statement made by professor Khan is further confirmed by this study where virtually all (99 %) of hip fractrure patients admitted to hospital in London had suboptimal vitamin D status. ----------------------------------------------------------------------------------------- Curr Med Res Opin. 2005 Dec;21(12):1891-4. Prevalence of vitamin D inadequacy in osteoporotic hip fracture patients in London. Moniz C, Dew T, Dixon T. Department of Clinical Biochemistry, King's College Hospital, London, UK. BACKGROUND: It is well established that vitamin D levels are suboptimal in the elderly and that adults with fragility fracture are more likely to have serum vitamin D levels either lower than those of control patients of similar age, or below the normal range. OBJECTIVES: To investigate the prevalence of vitamin D inadequacy in an elderly population with hip fractures from London (UK) and compare levels with data previously presented from Glasgow (UK). RESEARCH DESIGN AND METHODS: A retrospective patient audit was carried out over a 17-month period (September 2003-January 2005). Patient records were searched for hip fracture admissions and cross matched with vitamin D analysis carried out within 3 days of the hip fracture admission. The resulting records were hand searched to exclude patients with a hip fracture resulting from high impact/trauma. RESULTS: There were data for 103 hip fracture patients, 79.6% of the patients were women (n = 82). The mean age at the time of fracture was 73.4 years, 100% were aged 60 years or over and 41% were aged 75 years or over. Around 20% of the patients were receiving supplementation with calcium and/or vitamin D and were not excluded from the analysis. The mean vitamin D level was 32.1 nmol/L (12.9 ng/mL), SD = 19.4 (7.8), however, it is likely that the true mean is lower since in approximately 15% of cases vitamin D levels were reported as < 12.5 nmol/L, but were transcribed at 12.5 nmol/L in order to allow a numerical value to be calculated. Ninety-nine per cent of patients had a vitamin D level < 80 nmol/L, 94.2% < 70 nmol/L and 81.6% < 50 nmol/L. There were no significant differences by patient age or sex, however, there were significant seasonal differences in vitamin D. In the year from September 2003 to August 2004, 82.8% of summer admissions had vitamin D levels < 70 nmol/L compared with 98.0% in winter (p = 0.04). Mean vitamin D levels in the 30 patients with parathyroid hormone (PTH) levels above the reference range were significantly lower than levels in the 71 patients within the range: mean 19.9 nmol/L, SD = 16.2 versus mean 37.5 nmol/L, SD = 18.5 (p < 0.0001). Furthermore, 50% of the patients with PTH levels above the reference range had vitamin D levels < 12.5 nmol/L, reflecting extremely low levels of vitamin D. CONCLUSIONS: This study confirms almost universal vitamin D inadequacy among 103 patients admitted to hospital with hip fracture in London, although the prevalence of inadequacy is slightly lower than that seen in a similar study carried out in Glasgow. PMID: 16368037 http://tinyurl.com/k832e SignatureJuhana No need. The mere fact that there is absolutely no medical insight at all in your posts demonstrates that nutrition is a field unto itself (certainly a profession) and the fact that you are willing to push vitamins and supplements without medical advice or testing reinforces that. Larry E. > : Readers of this should note that this comes from a nutrition journal > : that is NOT a medical journal. [quoted text clipped - 60 lines] > :: > :: http://www.ajcn.org/cgi/content/full/84/3/471 : No need. The mere fact that there is absolutely no medical insight at : all in your posts demonstrates that nutrition is a field unto itself [quoted text clipped - 3 lines] : : Larry E. Larry, as you are so clever and you clearly have medical insight that I don't have, I would pleased to hear what is your solution to the well documented and wide spread vitamin D deficiency? It seems that the problem does not solve by itself. -- Juhana My solution is NOT to assume that you have a vitamin D deficiency if you don't know. Go to endo and have your serum vitamin D levels checked. If they are insufficient, your endo will make recommendation for supplementation ... and at the proper dosages. Simple as that. Larry E. > : No need. The mere fact that there is absolutely no medical insight at > : all in your posts demonstrates that nutrition is a field unto itself [quoted text clipped - 11 lines] > -- > Juhana : My solution is NOT to assume that you have a vitamin D deficiency if : you don't know. Go to endo and have your serum vitamin D levels : checked. If they are insufficient, your endo will make recommendation : for supplementation ... and at the proper dosages. Simple as that. : : Larry E. My vitamin D levels are at adequate level, that is not the problem. I asked you about the wide spread problem of vitamin D deficiency as I thought that you are clever and have medical insight you spoke about. ::: No need. The mere fact that there is absolutely no medical insight ::: at all in your posts demonstrates that nutrition is a field unto [quoted text clipped - 11 lines] :: -- :: Juhana > : My solution is NOT to assume that you have a vitamin D deficiency if > : you don't know. Go to endo and have your serum vitamin D levels [quoted text clipped - 6 lines] > you about the wide spread problem of vitamin D deficiency as I thought that > you are clever and have medical insight you spoke about. OK. If someone has a vitamin D deficiency borne out by low serum vitamin D levels, then I suggest vitamin D supplementation with ongoing monitoring via serum vitamin D testing. Larry E. > ::: No need. The mere fact that there is absolutely no medical insight > ::: at all in your posts demonstrates that nutrition is a field unto [quoted text clipped - 11 lines] > :: -- > :: Juhana ::: My solution is NOT to assume that you have a vitamin D deficiency if ::: you don't know. Go to endo and have your serum vitamin D levels [quoted text clipped - 14 lines] : : Larry E. This is exactly what I have done myself and what I am suggesting. SignatureJuhana Then we are in agreement, terrific! Larry E. > ::: My solution is NOT to assume that you have a vitamin D deficiency if > ::: you don't know. Go to endo and have your serum vitamin D levels [quoted text clipped - 16 lines] > > This is exactly what I have done myself and what I am suggesting. >My solution is NOT to assume that you have a vitamin D deficiency if you >don't know. Go to endo and have your serum vitamin D levels checked. If >they are insufficient, your endo will make recommendation for >supplementation ... and at the proper dosages. Simple as that. How much will this cost? RArmant <rarmant@sbcglobal.net> wrote in part: >>My solution is NOT to assume that you have a vitamin D deficiency if you >>don't know. Go to endo and have your serum vitamin D levels checked. If >>they are insufficient, your endo will make recommendation for >>supplementation ... and at the proper dosages. Simple as that. > >How much will this cost? For the world's population?! -- Jim Chinnis Warrenton, Virginia, USA jchinnis@alum.mit.edu Don't know off the top of my head. But how much will it cost for you to ingest an overdosed amount of a biochemical substance into your body? Larry E. >>My solution is NOT to assume that you have a vitamin D deficiency if you >>don't know. Go to endo and have your serum vitamin D levels checked. If >>they are insufficient, your endo will make recommendation for >>supplementation ... and at the proper dosages. Simple as that. > > How much will this cost? >Don't know off the top of my head. But how much will it cost for you to >ingest an overdosed amount of a biochemical substance into your body? If you only supplement in the winter and don't exceed 4000 IU/d (or actually 10000 IU/d), the chances for overdosing are practically nonexistent. But there could be enormous costs for not supplementing due to increased risks of osteoporosis, cancer, multiple sclerosis, type 1 and 2 diabetes, arthritis, congestive heart failure, etc. If in doubt limit your daily dose to 2000 IU/d, which is regarded absolutely safe by both American and European authorities. SignatureMatti Narkia Still ... to have your serum vitamin D measured and to titer up your dosage to the point where you are certain that you are in the normal range is the lowest risk and safest way to proceed. Larry E. >>Don't know off the top of my head. But how much will it cost for you to >>ingest an overdosed amount of a biochemical substance into your body? [quoted text clipped - 6 lines] > If in doubt limit your daily dose to 2000 IU/d, which is regarded > absolutely safe by both American and European authorities. >Still ... to have your serum vitamin D measured and to titer up your >dosage to the point where you are certain that you are in the normal >range is the lowest risk and safest way to proceed. Vitamin D is not some new drug that has had a lot of hype and advertising and billions spent on marketing. Its safety profile is well-known. It is also a nutrient the body can use and is thus designed for the body, unlike a drug. (Not to say too much of a good thing isn't necessarily dangerous.) Nutrition does require a degree of caution--one which I wish were applied more rigorously to prescription drugs. Maybe we'd have 100,000 fewer deaths from screw-ups annually. Let alone the outright murder committed by companies that oversell COX-2 inhibitors, hormone replacement therapy and other toxic medications that have little or no superior benefit to older, cheaper medications and may in some cases be much more dangerous. George M. Carter Not saying it's unsafe. Saying that ANY substance ingested into the body that affects metabolic processes must be measured, must be monitored, and must be adjusted to an individual's needs. To dispute this or to blindly recommend something like this is simply irresponsible. Larry E. >>Still ... to have your serum vitamin D measured and to titer up your >>dosage to the point where you are certain that you are in the normal [quoted text clipped - 17 lines] > > George M. Carter >Not saying it's unsafe. Saying that ANY substance ingested into the body >that affects metabolic processes must be measured, must be monitored, >and must be adjusted to an individual's needs. To dispute this or to >blindly recommend something like this is simply irresponsible. Oh, nonsense, Larry. Monitoring can make sense, I don't dispute that. But do you monitor your blood sugar, short of having diabetes, every time you eat? Or your antioxidant level? In the ideal world, monitoring blood levels of micronutrients would be lovely. Most people can't afford that--and 47 million of us don't have insurance as the US government is too busy being bought by pharma to shovel FAR more drugs into people than are needed or advisable. As well as being bought by the insurance industry. It's not about health--it's about profit. Period. So we waste 16% of the GDP on these outrageous, wasteful costs and things like bloodwork for VItamin D3 level will be utterly eclipsed. Most physicians won't even know what you're talking about. I don't dispute it may be a good idea to do if one thinks taking 1,000 to 4,000 IU of vitamin D3 is something they want to do. Most people won't. But it is a hell of a lot safer than taking a COX-2 inhibitor, say, for minor pain associated with osteoarthritis of the knee or a statin for primary coronary heart disease prevention. George M. Carter >>Not saying it's unsafe. Saying that ANY substance ingested into the body >>that affects metabolic processes must be measured, must be monitored, [quoted text clipped - 7 lines] > But do you monitor your blood sugar, short of having diabetes, every > time you eat? Or your antioxidant level? Speaking of nonsense, even a person with lower than average intelligence reading this knowns that the situations are nowhere near comparable. Gimme a break. Do you take us for fools? > In the ideal world, monitoring blood levels of micronutrients would be > lovely. Most people can't afford that--and 47 million of us don't have [quoted text clipped - 3 lines] > > It's not about health--it's about profit. Period. Again, not even comparable. > So we waste 16% of the GDP on these outrageous, wasteful costs and > things like bloodwork for VItamin D3 level will be utterly eclipsed. > Most physicians won't even know what you're talking about. Again, that's why if you're going to fool around with this stuff, you need an endocrinologist ... and most people with osteoporosis use one. > I don't dispute it may be a good idea to do if one thinks taking 1,000 > to 4,000 IU of vitamin D3 is something they want to do. Most people [quoted text clipped - 3 lines] > > George M. Carter That is your opinion. And you are not a physician. Neither am I ... only saying that one needs to be consulted in this situation. I find it interesting that this whole post started as a singular post on the sci.med.diseases.osteoporosis ng, and that Juhanna seemed to be so insecure and uncertain about his/her position that he/she felt the need to cross-post ... which is considered to be poor internet etiquette. If you guys want to continue to discuss this hokus pokus kinda stuff, why don't you keep it on your nutrition ng. Enough already. Larry E. : I find it interesting that this whole post started as a singular post : on the sci.med.diseases.osteoporosis ng, and that Juhanna seemed to : be so insecure and uncertain about his/her position that he/she felt : the need to cross-post ... which is considered to be poor internet : etiquette. His would be correct. I did not post to two groups out of insecurity but because the topic genuinely belongs to the items discussed in both groups. I don't consider it a bad netiquette to post this kind of topic to two groups; actually it is quite common. E.g. many topics discussed in sci.med.nutrition are posted cross-posted to sci.med.cardiology and vice versa. Two groups is not that much after all. I recall some flexibility. : If you guys want to continue to discuss this hokus pokus kinda stuff, : why don't you keep it on your nutrition ng. Enough already. If you don't find these postings and discussions interesting, why don't you just ignore them? Relax! SignatureJuhana > : I find it interesting that this whole post started as a singular post > : on the sci.med.diseases.osteoporosis ng, and that Juhanna seemed to [quoted text clipped - 8 lines] > are posted cross-posted to sci.med.cardiology and vice versa. Two groups is > not that much after all. I recall some flexibility. Not really. To cross-post midway through an exchange just to bring in another group is discourteous and demonstrates that you needed support cause you couldn't defend yourself. If you really felt the topic was appropriate for both groups, why didn't you post it originally to both groups? Why did you wait until you were challenged before cross-posting? > : If you guys want to continue to discuss this hokus pokus kinda stuff, > : why don't you keep it on your nutrition ng. Enough already. > > If you don't find these postings and discussions interesting, why don't you > just ignore them? Relax! Interesting? Yes. As long as you don't mislead people, which is what you are trying to do. Let's face it, you and your buddies can flame me if you want, but we all know that the supplement industry (at least in the US) is a largely unregulated industry ... which lends itself to much in the way of scandal. No one knows when someone is just trying to reel them in and take their money vs. when something is legit. There is nothing wrong with basic vitamin supplementation that has been approved and recommended by the FDA. But I will stand by my statement that if you ingest a substance or a larger dosage that has effect on the human body's metabolic subsystems, it needs to be discussed with a doctor and monitored. Especially something like this that entirely needs to be customized depending upon the individual's own metabolic processes which can differ greatly. You also never know what else is going on inside that person's body in terms of a unique condition that could be affected either positively or negatively by what you are recommending. Are you so full of yourselves that you can't admit to this and yield to common sense? Larry E. ::: I find it interesting that this whole post started as a singular ::: post on the sci.med.diseases.osteoporosis ng, and that Juhanna [quoted text clipped - 16 lines] : groups? Why did you wait until you were challenged before : cross-posting? That is not correct. I did post this originally to both groups as you can see. Check my first posting. ::: If you guys want to continue to discuss this hokus pokus kinda ::: stuff, why don't you keep it on your nutrition ng. Enough already. [quoted text clipped - 4 lines] : Interesting? Yes. As long as you don't mislead people, which is what : you are trying to do. I am not misleading people. That is just your uneducated opinion. : There is nothing wrong with basic vitamin supplementation that has : been approved and recommended by the FDA. My task is not to be a gramophone of outdated government opinions. I am not going to waste further time in discussing with you. SignatureJuhana "Juhana Harju" <spamshantigiriorama.removespam@gmail.com> wrote in part: >: There is nothing wrong with basic vitamin supplementation that has >: been approved and recommended by the FDA. > >My task is not to be a gramophone of outdated government opinions. Certainly not restricted to an incompetent agency in one country! If we all want to just follow the recommendations of our government overseers, we should shut down these newsgroups! The recent findings re vitamin D are important and address concerns of those in multiple newsgroups. -- Jim Chinnis Warrenton, Virginia, USA jchinnis@alum.mit.edu : "Juhana Harju" <spamshantigiriorama.removespam@gmail.com> wrote in : part: [quoted text clipped - 3 lines] :: :: My task is not to be a gramophone of outdated government opinions. : Certainly not restricted to an incompetent agency in one country! Indeed. It is unfortunate that other contries are following blindly the decisions made by FDA. If some drug is approved by FDA it will be soon approved in EU and other countries, no matter if there are concerns about safety and other issues. : If we all want to just follow the recommendations of our government : overseers, we should shut down these newsgroups! You couldn't be more correct! : The recent findings re vitamin D are important and address concerns : of those in multiple newsgroups. SignatureJuhana > ::: I find it interesting that this whole post started as a singular > ::: post on the sci.med.diseases.osteoporosis ng, and that Juhanna [quoted text clipped - 19 lines] > That is not correct. I did post this originally to both groups as you can > see. Check my first posting. I did. That's not the case. Recheck it. > ::: If you guys want to continue to discuss this hokus pokus kinda > ::: stuff, why don't you keep it on your nutrition ng. Enough already. [quoted text clipped - 13 lines] > > I am not going to waste further time in discussing with you. >There is nothing wrong with basic vitamin supplementation that has been >approved and recommended by the FDA. But I will stand by my statement >that if you ingest a substance or a larger dosage that has effect on the >human body's metabolic subsystems, it needs to be discussed with a >doctor and monitored. Larry have you ever sunbathed in the swimming suit for 20 minutes? If you have, did you discuss it with your doctor and had your vitamin D level monitored? If not, why not, because you got 10 000 - 25 000 IU of vitamin D every time you did it? A bit more than mere 2000 - 4000 IU some people here are suggesting to be taken in the winter in the areas, where there is no cutaneous production of vitamin D in the winter. What about those lifeguards who get this 10 000 to 25 000 IU of vitamin D from the sun every day, perhaps throughout the year in some areas. Do you think that they should discusss it with their doctor and have their vitamin D level monitored? If not, why not, because they are getting many times more vitamin D every day from the sun than the mere 2000 - 4000 IU, which you think should not be taken in the winter without monitoring vitamin D level? SignatureMatti Narkia >>There is nothing wrong with basic vitamin supplementation that has been >>approved and recommended by the FDA. But I will stand by my statement [quoted text clipped - 17 lines] > mere 2000 - 4000 IU, which you think should not be taken in the winter > without monitoring vitamin D level? Ingesting it as a supplement is way differnet from getting it the natural way. All I am suggesting is a consult with a physician who knows, rather than taking the word of someone who recommends it over the internet ... who doesn't even know the patient, their history, and their background. Why is that something that is so hard for you all to accept? If you are so sure that what you preach is correct, what are you afraid of? Are you afraid, pray tell, that a qualified physician may not agree with you? I don't understand why doing something so sensible is so objectionable to an educated group of people ... unless you are afraid of something. Larry E. >>>There is nothing wrong with basic vitamin supplementation that has been >>>approved and recommended by the FDA. But I will stand by my statement [quoted text clipped - 20 lines] >Ingesting it as a supplement is way differnet from getting it the >natural way. No it isn't. Whether vitamin D3 is produced in the skin, when the skin is stimulated by the sun's UVB rays, or ingested as a supplement, it is exactly the same molecule, which after that goes to the liver to be converted to 25(OH)D a.k.a calcidiol, the circulating form of vitamin D. Our body has no idea where it originates from. >All I am suggesting is a consult with a physician who >knows, rather than taking the word of someone who recommends it over the [quoted text clipped - 5 lines] >objectionable to an educated group of people ... unless you are afraid >of something. I'm not against the tests, I just don't see them necessary for suppplemental doses of 2000 - 4000 IU/d. But if in doubt, go to the test by all means. But one has to be a bit careful with the tests, because the current tests can be inaccurate: Although the scientific vitamin D studies use accurate vitamin D tests, tests used by commercial laboratories often use cheaper methodology, and frequently their tests are not properly standardized and calibrated. There is documented evidence that there can be upto 30% differences in the results from different laboratories. Also, it has been shown that the bodies of healthy men uses 3000 - 5000 IU of vitamin D/d, if it is available. Therefore to retain the summer levels of vitamin D in the winter in high latitude areas, one has to consume in average about 4000 IU/d in the winter. This is only possible with the supplements. SignatureMatti Narkia Larry schrieb: >>> There is nothing wrong with basic vitamin supplementation that has >>> been approved and recommended by the FDA. But I will stand by my [quoted text clipped - 22 lines] > knows, rather than taking the word of someone who recommends it over the > internet ... You don't have to take our word for it. There is a lot of peer reviewed literature available on this topic on the internet. For example this article: http://www.ajcn.org/cgi/content/full/79/3/362#F4 There are a lot of references and links to articles which referenced this article at the end, so you can delve into this topic as deep as you like. > who doesn't even know the patient, their history, and their > background. To take a vitamin D supplement is general advice for people living in areas where there is not much sun during the winter and not about any patient in particular. > Why is that something that is so hard for you all to accept? > If you are so sure that what you preach is correct, what are you afraid > of? Are you afraid, pray tell, that a qualified physician may not agree > with you? Even a qualified physician may not be on top of things when it comes to current research. > I don't understand why doing something so sensible is so > objectionable to an educated group of people ... unless you are afraid > of something. I'm not afraid of people asking their physician about vitamin D. And in fact I do think that people should determine their vitamin D level if their insurance covers this or they can afford to pay for it on their own. But not because it might be dangerous to take a vitamin D supplement without testing, but because for many people vitamin D deficiency may be one of their biggest health risks and of course it would be a good thing to know about this as much as possible. Thorsten >>>Not saying it's unsafe. Saying that ANY substance ingested into the body >>>that affects metabolic processes must be measured, must be monitored, [quoted text clipped - 11 lines] >reading this knowns that the situations are nowhere near comparable. >Gimme a break. Do you take us for fools? I'm beginning to. >> In the ideal world, monitoring blood levels of micronutrients would be >> lovely. Most people can't afford that--and 47 million of us don't have [quoted text clipped - 5 lines] > >Again, not even comparable. Yes. It is more than comparable. When we have an entire system bent on selling more drugs of minimal or no utility rather than making changes in lifestyle that can improve outcomes, we have a profit-pushed system, not a health--pushed system. >> So we waste 16% of the GDP on these outrageous, wasteful costs and >> things like bloodwork for VItamin D3 level will be utterly eclipsed. >> Most physicians won't even know what you're talking about. > >Again, that's why if you're going to fool around with this stuff, you >need an endocrinologist ... and most people with osteoporosis use one. LOL...NOW you're talking about osteoporosis. Well, gosh, maybe we should look at the nasty drugs they use to treat that? >> I don't dispute it may be a good idea to do if one thinks taking 1,000 >> to 4,000 IU of vitamin D3 is something they want to do. Most people [quoted text clipped - 4 lines] >That is your opinion. And you are not a physician. Neither am I ... only >saying that one needs to be consulted in this situation. That's different from insisting on blood tests. I am certainly not against blood tests and in the best of situations, people SHOULD be able to work with their physician about what they are doing for their health. Based on good information. >I find it interesting that this whole post started as a singular post on >the sci.med.diseases.osteoporosis ng, and that Juhanna seemed to be so >insecure and uncertain about his/her position that he/she felt the need >to cross-post ... which is considered to be poor internet etiquette. People do that all the time. Good? Bad? I don't know. >If you guys want to continue to discuss this hokus pokus kinda stuff, >why don't you keep it on your nutrition ng. Enough already. Vitamin D3 is "hocus pocus" kind of stuff? You want to convince me you're a fool? George M. Carter Larry schrieb: > Still ... to have your serum vitamin D measured and to titer up your > dosage to the point where you are certain that you are in the normal > range is the lowest risk and safest way to proceed. Yes, I suppose it is. However, taking a moderately dosed supplement (2000-4000 IU/d) without prior testing is still a lot safer than doing nothing at all, which is what most people do. Of course, if you live in Florida and get a lot of sun througout the year, taking a supplement may not be necessary. But if you live further north, chances are high that you don't get enough vitamin D during the winter. Thorsten Exactly. So you are contradicting yourself. You are saying that taking a dose such as 2000-4000 may not even be necessary. Doesn't make sense. Know for sure! Have it monitored by a physician. LArry E. > Larry schrieb: > [quoted text clipped - 12 lines] > > Thorsten >Exactly. So you are contradicting yourself. You are saying that taking a >dose such as 2000-4000 may not even be necessary. Doesn't make sense. It does makes sense. If you live in the area, where the sun's UVB-radiation is abundant throughout the year (tropical and subtropical areas), and you go out daily to get your 10-20 minutes of UVB-radiation on a large enough skin area, you don't need vitamin D supplements, but if you live above 40th latitude, there is not enough UVB-radiation in the winter to stimulate cutaneous vitamin D production. So in these areas you need to take say 2000 - 4000 IU/d in winter to retain vitamin D-levels not too far below the summer levels, and to avoid inceased risks of many chronis diseass. That's not so hard to understand, is it? SignatureMatti Narkia >>Exactly. So you are contradicting yourself. You are saying that taking a >>dose such as 2000-4000 may not even be necessary. Doesn't make sense. [quoted text clipped - 9 lines] >and to avoid inceased risks of many chronis diseass. That's not so >hard to understand, is it? Perhaps the first study, which showed the influence of season and latitude on the cutaneous synthesis of vitamin D3 was Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab. 1988 Aug;67(2):373-8. PMID: 2839537 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=R etrieve&dopt=abstractplus&list_uids=2839537> Abstract: "Sunlight has long been recognized as a major provider of vitamin D for humans; radiation in the UVB (290-315 nm) portion of the solar spectrum photolyzes 7-dehydrocholesterol in the skin to previtamin D3, which, in turn, is converted by a thermal process to vitamin D3. Latitude and season affect both the quantity and quality of solar radiation reaching the earth's surface, especially in the UVB region of the spectrum, but little is known about how these influence the ability of sunlight to synthesize vitamin D3 in skin. A model has been developed to evaluate the effect of seasonal and latitudinal changes on the potential of sunlight to initiate cutaneous production of vitamin D3. Human skin or [3 alpha-3H]7- dehydrocholesterol exposed to sunlight on cloudless days in Boston (42.2 degrees N) from November through February produced no previtamin D3. In Edmonton (52 degrees N) this ineffective winter period extended from October through March. Further south (34 degrees N and 18 degrees N), sunlight effectively photoconverted 7-dehydrocholesterol to previtamin D3 in the middle of winter. These results quantify the dramatic influence of changes in solar UVB radiation on cutaneous vitamin D3 synthesis and indicate the latitudinal increase in the length of the "vitamin D winter" during which dietary supplementation of the vitamin may be advisable." Another useful article about the influence of season and latitude on the cutaneous synthesis of vitamin D3 is Engelsen O, Brustad M, Aksnes L, Lund E. Daily duration of vitamin D synthesis in human skin with relation to latitude, total ozone, altitude, ground cover, aerosols and cloud thickness. Photochem Photobiol. 2005 Nov-Dec;81(6):1287-90. PMID: 16354110 [PubMed - indexed for MEDLINE] <http://phot.allenpress.com/photonline/?request=get-abstract&issn=0031-8655&volum e=81&page=1287> <http://www.bioone.org/perlserv/?request=get-abstract&issn=0031-8655&volume=81&pa ge=1287> Checl out also the pages VitD Duration of Vitamin D Synthesis in Human Skin <http://zardoz.nilu.no/~olaeng/fastrt/VitD.html> VitD-ez Easy Duration of Vitamin D Synthesis in Human Skin <http://zardoz.nilu.no/~olaeng/fastrt/VitD-ez.html> mentioned in the above abstract. SignatureMatti Narkia >>>Exactly. So you are contradicting yourself. You are saying that taking a >>>dose such as 2000-4000 may not even be necessary. Doesn't make sense. [quoted text clipped - 58 lines] ><http://phot.allenpress.com/photonline/?request=get-abstract&issn=0031-8655&volum e=81&page=1287> ><http://www.bioone.org/perlserv/?request=get-abstract&issn=0031-8655&volume=81&pa ge=1287> The full text of this article seems also be freely available, at the url <http://phot.allenpress.com/photonline/?request=get-document&doi=10.1562%2F2004-1 1-19-RN-375> SignatureMatti Narkia Larry schrieb: > Exactly. So you are contradicting yourself. No, not really. > You are saying that taking a > dose such as 2000-4000 may not even be necessary. Even if such a dose may not be necessary for some people, it is unlikely to do any harm. Vitamin D deficiency, on the other hand, has been linked to highly increased risk of a number of diseases. For the prevention of cancer, ensuring an optimal level of vitamin D is the most important thing you can do (perhaps except quit smoking). So even if there is only a remote chance of being deficient taking a supplement is still safer than doing nothing. For most people living further north than florida there is more than remote chance of being deficient. > Doesn't make sense. > Know for sure! Have it monitored by a physician. If you can afford this, this is surely a wise course of action. Not least because the results more likely than not will be a strong incentive to increase your vitamin D level. Either by getting more sun or by taking a supplement or both. Thorsten >Larry schrieb: >> Still ... to have your serum vitamin D measured and to titer up your [quoted text clipped - 9 lines] >north, chances are high that you don't get enough vitamin D during the >winter. Thorsten, from your email address I figure that you seem to be from Germany. Do you have 1000 IU (or larger) vitamin D products in Germany? Here in Finland we have only 200-300 IU products, and I've sometimes ordered LEF's 1000 IU capsules from Life Care in Denmark. If you have those 1000 IU capsules/tablets, do you know any online shops or pharmacies, which sell these products. I've previously orderd some medicines by FAX from Frankfurt Airport pharmacy, and I could order vitamin D from there or other sources in Germany, if I knew that 1000 IU capsules/tablets are available. SignatureMatti Narkia >>Larry schrieb: >>> Still ... to have your serum vitamin D measured and to titer up your [quoted text clipped - 19 lines] >order vitamin D from there or other sources in Germany, if I knew that >1000 IU capsules/tablets are available. Here in the US Healthy Origins has a 2,400 IU vitamin D3 softgel -- http://www.iherb.com/store/ProductDetails.aspx?c=Herbs&pid=HOG-15305 The oil the D3 is suspended in is olive oil. Iherb is located in the state of California. >>>Larry schrieb: >>>> Still ... to have your serum vitamin D measured and to titer up your [quoted text clipped - 25 lines] >The oil the D3 is suspended in is olive oil. >Iherb is located in the state of California. I cannot order from outside EU. I'm looking for EU sources. SignatureMatti Narkia Matti Narkia schrieb: [...] > Thorsten, from your email address I figure that you seem to be from > Germany. Yes, I am. > Do you have 1000 IU (or larger) vitamin D products in > Germany? Here in Finland we have only 200-300 IU products, and I've [quoted text clipped - 4 lines] > order vitamin D from there or other sources in Germany, if I knew that > 1000 IU capsules/tablets are available. You could perhaps order products with 1000 IU per tablet from DocMorris, a Dutch company selling medicines over the internet to Germany. They offer two such products on their website (http://www.docmorris.de). The website seems to be in German only, but if you call them, I am sure there will be people who can talk English. I'm not sure whether they deliver to Finland, though. Thorsten >Matti Narkia schrieb: >[...] [quoted text clipped - 19 lines] >there will be people who can talk English. I'm not sure whether they >deliver to Finland, though. Thanks! SignatureMatti Narkia : Persons with circulating vitamin D values under 25 nmol/L had nearly : 4 times the risk of being admitted to a nursing home as did persons [quoted text clipped - 41 lines] : : http://www.ajcn.org/cgi/content/full/84/3/471 According to this study more than half (52 %) of North American women receiving osteoporosis therapy have vitamin D inadequacy. ---------------------------------------------------------------------------------------- J Clin Endocrinol Metab. 2005 Jun;90(6):3215-24. Prevalence of Vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. Holick MF, Siris ES, Binkley N, Beard MK, Khan A, Katzer JT, Petruschke RA, Chen E, de Papp AE. Boston University School of Medicine, 715 Albany Street, M1013, Boston, Massachusetts 02118, USA. PURPOSE: To evaluate serum 25-hydroxyvitamin D [25(OH)D] concentrations and factors related to vitamin D inadequacy in postmenopausal North American women receiving therapy to treat or prevent osteoporosis. METHODS: Serum 25(OH)D and PTH were obtained in 1536 community-dwelling women between November 2003 and March 2004. Multivariate logistic regression was used to assess risk factors for suboptimal (<30 ng/ml) 25(OH)D. RESULTS: Ninety-two percent of study subjects were Caucasian, with a mean age of 71 yr. Thirty-five percent resided at or above latitude 42 degrees north, and 24% resided less than 35 degrees north. Mean (sd) serum 25(OH)D was 30.4 (13.2) ng/ml: serum 25(OH)D was less than 20 ng/ml in 18%; less than 25 ng/ml in 36%; and less than 30 ng/ml in 52%. Prevalence of suboptimal 25(OH)D was significantly higher in subjects who took less than 400 vs. 400 IU/d or more vitamin D. There was a significant negative correlation between serum PTH concentrations and 25(OH)D. Risk factors related to vitamin D inadequacy included age, race, body mass index, medications known to affect vitamin D metabolism, vitamin D supplementation, exercise, education, and physician counseling regarding vitamin D. CONCLUSIONS: More than half of North American women receiving therapy to treat or prevent osteoporosis have vitamin D inadequacy, underscoring the need for improved physician and public education regarding optimization of vitamin D status in this population. PMID: 15797954 http://tinyurl.com/zt9tq SignatureJuhana get $500 now http://black-jack-card-game.prevet.biz Posted via medical forums at http://medical.gr77.com |
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