Vitamin D. To drink or not to drink, that is the question. (Or a story about how I took an analysis that I was not prescribed)

Prehistory

In November 18, I accidentally passed an analysis on vitamin D. (I was not prescribed to check it, the fact is that the laboratory had a discount on the analysis package, which included the ones I needed, plus a couple more.) The result surprised me somewhat. The necessary tests were normal, but vitamin D was in short supply.




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“It’s sucks,” I thought, and decided to study this question a little bit. As it turned out, now the vast majority of people lack this vitamin, since over the past hundred years we have left the sunny fields and moved to offices with artificial light. But it does not matter, the standards are known, and with low rates of this vitamin, it makes no sense even for a doctor to go. Reassured by this, I visited iHerb and, after three months, brought my result to “decent” 79 ng / ml.



I also decided that I would take an analysis on this vitamin D once a year, just in case, for control.

That would be the end of the story, but more recently I was asked to translate an article by a German doctor under the heading “Dangers of vitamin D treatment . ” The article argued that the modern norms of vitamin D are too high, and taking this vitamin in excess of the norm even in insignificant amounts does more harm than good. On the one hand, the article was written by a practicing doctor with more than 30 years of experience, and on the other hand it was a bit strange and the author was a doctor of anthroposophical (that is, non-standard) medicine.

Usually, when the official science shows the results of double-blind, placebo-controlled studies, and a strange loner comes out against it, who says that this is not at all the case, we believe the majority. And usually it is justified. However, since the case with this vitamin touched me personally, it became interesting to me and I decided, as far as possible, to sort out the detected contradiction.

As you probably already guess, everything turned out to be quite so unequivocal as we would like.

Can you believe the official science only on the basis that it is official? (lyrical digression)

Several centuries ago, official science claimed that the Earth was flat and held on three pillars, and the guy who dared to deny this and explain something there was burned at the stake so as not to muddy the water. And the fact that this happened a long time ago does not at all mean that the situation has somehow changed. Just look at the history of a lobotomy or thalidomide. This is me to the fact that humanity at all times has been subject to mass delusions on certain issues and there is no guarantee that now "all errors are in the past." Someone might argue, they say, in those days there was no known blind placebo-controlled study. On the one hand, this is so, but on the other hand, financial interest at all times allowed to get the necessary figures on paper, and now this financial side is stronger than ever before. Even today, every year, certain medicines are withdrawn from circulation, because despite all the research and tests that have been carried out, “suddenly” it turns out that the harm from using them is more than good.

Do you still trust double-blind, placebo-controlled studies? Me not!

Okay, just kidding. I believe such research is a great methodology. But I do not really trust the people who conduct these studies and the conclusions they draw from them. The fact is that such studies cost a lot of money, which the state (it’s not about ours) can spend more profitably and therefore most of such research is carried out with money from commercial organizations. And commercial organizations, of course, do not give money just like that, and it is quite clear that they want some “return” from their investments. This is where data manipulations begin.

For example, here is one very interesting study , the authors of which came to the conclusion that beef lowers cholesterol. How? Elementary! It is only necessary to properly load the control group with cholesterol from other sources (pork, poultry, fish, eggs and fatty milk) and reduce the amount of fiber, and in the right groups, on the contrary, remove all these products and add fiber.



All this allows us to write in the conclusion that "These results ... provide support for the inclusion of lean beef in the diet that is good for the heart." At the same time, in conclusion, for some reason they do not write that beef is useful only as a substitute for pork. After a careful study of the study, there is every reason to conclude that the same diet (BOLD +), but without beef, would generally be much more beneficial for the heart. However, having read only the conclusion it is logical to assume that it will be more useful to simply ADD beef to your diet.

Unfortunately, there are a lot of similar studies. Let's return to vitamin D.

A course of vitamins or hormone therapy?

The first and most important thing to know about vitamin D is that it is not a vitamin, but prohormone . Initially, he was mistakenly referred to as vitamins, and when his true nature was discovered, which happened much later, he was already known to the whole world as a vitamin and (for some reason I did not know) did not rename it.

Which is characteristic, this is not some scientific super discovery. There is no disagreement among scientists on this issue - everyone who is interested in this question has long been aware of this. (Although doctors, unfortunately, are not always interested).

Nevertheless, it was a super discovery for me personally. If the D-hormone were honestly written on my vial, my attitude would be completely different. It's one thing to write yourself a course of vitamins in the dose recommended by the manufacturer and a completely different thing - hormone therapy. Yes, I understand perfectly well that it is foolish to think that my health is interesting to the state or some pharmaceutical companies, and it is quite clear that if the package had written “hormone” the sales would have dropped several times, but it was still unpleasant. I admit, in my naivety I expected more honesty in this matter.

Norms

The second thing I wanted to check is the norms. Who measured the level of D-hormone in people who get enough sun and what were the results?

There were 100,500 scientific publications on this topic of varying degrees of credibility, but oddly enough, they did not echo each other at all, confirming the current norms. For example, one of the most authoritative sources - the Institute of Medicine of the USA (since 2015 - the National Academy of Medicine of the USA) published in 2011 the “Handbook on the norms of consumption of calcium and vitamin D”. Let me give you an excerpt from the chapter “Conclusions about vitamin D deficiency in the United States and Canada”:

“... Limit levels of vitamin D intended to determine deficiency in the interpretation of laboratory tests and for use in clinical practice are not within the competence of this committee. However, the committee noted with some concern that serum vitamin D thresholds, defined as signs of vitamin D deficiency, were not systematically scientifically developed.

From the point of view of the committee, there is currently a significant reappraisal of the level of vitamin D deficiency among the population of North America due to the use of threshold values ​​substantially higher than the levels defined in this report , based on available data. Earlier reports reported that serum vitamin D concentrations above 11 ng / ml are an indicator of adequate vitamin D levels for children from birth to 18 years old, and concentrations above 12 ng / ml correspond to an adequate indicator of vitamin D for adults aged 19 to 50 years. In recent years, other thresholds have been proposed for determining the deficit and what has been called “deficiency”. In modern literature, they include values ​​in the range from above 20 ng / ml to values ​​above 50 ng / ml. It can be expected that the use of higher limit values ​​will artificially increase the estimates of the prevalence of vitamin D deficiency.

... Data analysis carried out by this committee suggests that people are at risk of vitamin D deficiency for bone health at levels below 12 ng / ml. Some, but not all, people are potentially at risk at levels ranging from 12 to 20 ng / ml. For almost all people, a vitamin D level above 20 ng / ml is sufficient. The concentration of vitamin D in serum above 30 ng / ml is not always associated with an increase in benefit. Indicators above 50 ng / ml may be cause for concern. Given concerns about high levels of vitamin D in serum, as well as the desire to avoid incorrect classification of vitamin D deficiency, there is a serious need for health care and clinical practice to reach consensus on determining levels of both vitamin D deficiency and its excess. The current lack of evidence-based guidelines is a concern and concern, since serum vitamin D levels above 20 ng / ml can sometimes be classified as deficient and treated with high doses of vitamin D many times higher than the consumption levels recommended by this report. ”

Then where did the current norms come from?

Later that year, a certain “Endocrine Community” published a report in which, without a trace of embarrassment, literally wrote the following:
“Vitamin D deficiency has been historically determined and recently recommended by the Institute of Medicine as less than 20 ng / ml. ... "

In response, several leading epidemiologists and endocrinologists who were on the initial committee of the Institute of Medicine published an article in the New England Journal of Medicine “Vitamin D deficiency: is there really a pandemic?” This article argues in favor of reducing the currently accepted threshold. level of 20 ng / ml, and states that the level that they rated as acceptable was never intended to determine vitamin D deficiency. Moreover, they believe that excessive screening for vitamin deficiency is currently underway Mine D and unnecessary treatment of people with whom, and so everything is in order.

After getting acquainted with these materials, I considered it inappropriate to further study the issue, for the following reasons:

• Despite the complexity of the issue for me, as an average person, it seems to me that for scientists it is not a rocket science at all. In other words, I strongly doubt that modern scientists are really unable to determine the rate of any hormone. Speaking more simply, both sides know the answer to the question, but some of them are cunning.
• The history of the last decades suggests that if scientists cannot come to an agreement on a relatively simple question, then we need to look for who will benefit from certain results. There are only two options:
  
  1. Perhaps we all really need to catch up with artificially synthesized D-hormone, and a group of scientists from the Institute of Medicine decided to publish deliberately incorrect data. But why? For the sensation? Their work is not at all sensational. Who can benefit from everything to stay as it is and the people not spend money to buy the medicine they need? I could not think of an answer to this question.
  2. Perhaps the opposite is true, and we do not need to take a hormonal drug, and in this case, the guys from the endocrine community, and perhaps some other "experts" artificially inflate the norm. Who can it be profitable? Considering that the global D-hormone market was estimated at $ 130 million in 2018, and also that “vitamin” is still written on the cans with this drug, I can quite clearly imagine who benefits from this alignment.

This concludes my story, and as a result I would like to say that I do not agitate anyone to drink vitamin D , D-hormone, or not to drink. Of course, there are conditions of the body in which it is necessary to artificially add this hormone to the diet, but at the same time, everything is not so simple, as it is written in deciphering the results we receive from medical laboratories.