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-Patrick
Dr. Myers on PCa & Vitamin D - Advanced Prostate...
Dr. Myers on PCa & Vitamin D
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pjoshea13
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Thanks for showing us how wrong he was in 2015. I'm sure many who looked at the data available back then agreed with him.
It is difficult to measure the space between emotional distance and mental clarity. Data may have spurious correlations, but I see the logic of what you have shared. There are no silver-cupped holy grails in overcoming prostate cancer, just wooden ones are too weak for present science to fill with a cure. I believe people take supplements because doing something is better than feeling helpless. A shaken faith can lead to a deeper belief that answers do exist.
You make logical sense. Thanks for the insight.
in reply to Jvaughan0
"I believe people take supplements because doing something is better than feeling helpless."
I think when it comes to cancer patients, you are right about that.
But there are better ways to deal with the feeling of helplessness than taking things that could be potentially harmful. The best way is finding and taking effective, proven treatments. Knowing that I am choosing the wisest course of action makes me feel less helpless.
Flydoggy in reply to
oh yes...but who, what to believe with the info coming at us all so hard and fast. I don't know about anyone else but I am often overwhelmed with all the info...it can be exhausting trying to determine the right path.
That is why we have SOCs and levels of evidence? otherwise, not much more than deciding on something based on old wives' tale
Understand this is my viewpoint only, SOC can be a cookbook for an idiot. While at Duke my tumor load exploded, I had mentioned Lu-177 to my OC. She agreed it was a viable choice if I displayed an avid PSMA result. I flew to UCLA and the scan was positive. All scans previous showed no metastatic disease however I had a high tumor load on PSMA. This was the beginning of Covid....She said if I could not get to tx out of he country we could try to slow it down with chemo until I could get it here. She took part in the Vision trial.. I made it to India and that is another story...My main residence is in Macon , Ga. I do go to a local hospital for a Lupron injection so not to travel to Duke for a 30 sec. shot. The OC is sort of amazed at my persistence to travel for care ie, MD Anderson, Duke , UCLA, now UT Southwestern Dallas and Delhi , India..Guess what , He had no clue of what Lu-177 was. He was straight SOC and wanted to keep the patients in his hospital because it is good for business. We must understand this is a business and many try to sell us on care. Anyway, got the idea ( lu-177)from this site years ago and moved. I think there is enough brain power here to toss different paradigms around and explore..Becoming toxic on supplements is not one of them...anyway you can attribute my post to coffee and a keyboard...Blue Skies to all.
in reply to maley2711
SOC is not something to be worshipped. I'd refer you to Dr Scholz book "Invasion of the Prostate Snatchers". Urologists are in the business of performing surgeries, accepted as SOC at least until recently. Maybe there are kinder, gentler approaches to prostate cancer treatments that don't have such adverse effects on quality of life.
pjoshea13 in reply to
Let's not get into the urologist versus oncologist debate ***. SOC for advanced PCa has a 70% five-year mortality rate.
I was too young at diagnosis to accept SOC odds after primary treatment failed.
I spoke to my doctor last week. He opened with "O'Shea, aren't you dead yet?" Our little joke. He knows the stats with bone mets.
*** Incidentally, you should check into the oncology practices that own radiation facilities.
I bet that there are more urologists that have patients that selected radiation, than oncology patients that selected surgery.
Myers surprised me in a vlog post when he described radiaton as "the treatment that gives on giving" - & I believe that most of his patients had radiation. Often where he himsel was treated.
-Patrick
On other hand, know men who were brachyed MANY years ago......and AOK today. Apparently today's RO is vastly improved..at least studies seem to indicate so. THere is no treatment without possibility of life-changing SEs. Buffett chose radiation...he seems like an intelligent man?
Dr. Myers is an intelligent man too. He sent a lot of patients down to Florida to receive radiation. He doesn't view radiation as the benign therapy that some do.
Eventually, he became deeply disturbed that some patients were returning with T cell counts at the level that distinguishes AIDS from HIV.
Incidentally, Myers told me that "They removed almost every lymph node in my body. I don't suppose they would do that these days." (2004. Apologies to Dr. Myers if I misquote.) He has been cured, but he had some surgery too.
I think the issue that everyone is missing is that there can be no benefit to not supplementing vitamin D if it is out of range.
It would seem any credible study would need to deal with that issue.
There can be no virtue or benefit to maintaining vitamin D levels intentionally below range.
And it would be dubious advice to rely on a trial with anomalous unexplained results, to decide to do so.
All these conflicting opinions can be resolved with a simple rules: keep your vitamin D in range.
Why would you not want to do that? And if you are going to intentionally keep it below range, you better have better data to justify it than currently exists.
Don't you think?
SEE ALSO this issue in another context.
goodhousekeeping.com/health...
A new study has reignited a debate over the role of vitamin D in mitigating severe COVID-19 symptoms as researchers suggest those with a deficiency may be more likely to develop serious illness.
Leading infectious disease experts say that more in-depth research is needed to confirm whether vitamin D is directly associated with COVID-19 severity.
Vitamin D cannot prevent COVID-19 transmission all on its own, and experts say its crucial to speak to a doctor before seeking out supplements, as large doses can be harmful to your health.
I don't think anyone argues against supplementing if Vitamin D is below minimum recommended levels.
That was my recollection of Myers position.
He just wanted vitamin D to be in range.
Was my recollection wrong and was he promoting maintaining it above range?
What is the darned range anyways. Lol
I will have to look it up.
"Many experts recommend a level between 20 and 40 ng/mL. Others recommend a level between 30 and 50 ng/mL. "
My recollection is that when Myers was talking to me he wanted to maintain vitamin D at 50.
20 is what is now recommended as minimum.
The Vitamin D Council recommends 50 ng/mL.
That makes me comfortable to continue targeting 50.
By most measures it seems reasonable.
The "Vitamin D Council" is a self-serving made up organization to promote Vitamin D. It's like saying the "Vitamin B17 Council" recommends laetrile.
TA, didn’t the vitamin D study you cited in your previous post deal with higher levels of vitamin D supplementation as opposed to studying the impact of vitamin D deficiencies? Correct me if I’m wrong but I don’t think It addressed Dr. Meyers main point that substantial vitamin D deficiencies could in fact be detrimental to PC.
Schwah
It depends what one means by "deficiency" - The American Society of Family Physicians sets the recommended dietary allowance at 600 iu/day - easily obtainable with sunlight and the myriad Vitamin D fortified foods.
aafp.org/afp/2018/0215/p226...
JoAnn Mason, probably the foremost expert on this, points out: "A common misconception is that the RDA functions as a “cutpoint” and that nearly the entire
population must have a serum 25(OH)D level above 20 ng per milliliter to achieve good bone health. The reality is that the majority (about 97.5%) of the population has a requirement of 20 ng per milliliter or less. Moreover, by definition of an average requirement, approximately half the population has a requirement of 16 ng per milliliter (the EAR) or less. "
luigigreco.info/public/60/v...
The link includes this: "The National Academy of Medicine has noted that vitamin D intakes above the tolerable upper limit of 4,000 IU per day may cause toxic effects such as renal impairment, hypercalcemia, or vascular calcification."
Of course... they "may." But how is that useful without any indication of what intake levels actually DO help cause those, and HOW OFTEN they are caused, and in what people (with what other comorbidities, medications, or supplement regimes)? Are the incidents common, or extremely rare? We all know the answer.
I suspect the reported cases of death and severe illness due to misuse of aspirin, ibuprofen and tylenol are GREATER than reported cases of death and severe illness due to misuse of D3 by, about... well, by about roughly the total number of reported cases of death and severe illness due to misuse of aspirin, ibuprofen and tylenol .
I can tell you something else that "may" cause renal impairment, hypercalcemia, or vascular calcification: genetics, combined with a thousand variations of the standard American diet and lifestyle.
Are you sure that poor, black men from northern cities, who cannot afford to be tested for deficiency, would be better told that a D3 supplement of 4k (costing a few cents a day)is more likely to do them harm than good, rather than being told the opposite?
Actually, those toxicities are quite common. High Vitamin D pulls calcium out of bones and causes osteoporosis. We just saw, in the D-Health trial, there was a 24% increase in cancer among those taking high amounts of Vitamin D for years.
You would be hard pressed to find a dairy food that is NOT fortified with Vitamin D. That plus a small amount of sunlight is more than enough to prevent rickets.
Are you suggesting that we eat dairy products to get vitamin D? Anything but a capsule, I suppose.
Why is vitamin D added to dairy if supplementation isn't necessary. Surely, deficiency must have been very common for the US government to want to fortify milk?
Are you saying that the optimum vitamin D level is the amount that will prevent rickets?
You say "a small amount of sunlight". In Buffalo & anywhere in Scandinavia today, you could sit naked all day in the sun & not make any vitamin D.
-Patrick
Yes, rickets once was common. Food is now fortified with Vitamin D and other vitamins, so deficiencies are no longer common. There was a flurry to measure Vitamin D in the early days of the pandemic. What they found will surprise you. In the UK and nordic countries, the serum Vitamin D was higher than in Mediterranean countries. The reason? In the northern countries, people ate packaged/fortified foods and supplemented Vitamin D. Along the Mediterranean, people stayed indoors and ate fresh foods.
Let's be specific: if "quite common" then I expect there must be studies estimating exactly how often a daily dose of 4-10k (which is the only really "common" dosing range above 4K) leads DIRECTLY, as the causal factor, to the know outcome of renal impairment, hypercalcemia, or vascular calcification without some complicating factor.
If you told me it was a common outcome for those dosing daily at 40k to 100k, I would believe you... but then the text should read "intakes FAR above the tolerable upper limit may cause toxic effects." [If forty shots of booze can bring death, would it make sense for me to say "intakes above our four shot limit may lead to death"?]
And what we just saw, in the D-Health trial, was there was a 24% increase in cancer among those taking EXTREMELY high amounts of Vitamin D on one day a month, and zero Vitamin D for 29 days, for years. I would strongly advise against THAT practice, as would most established "experts" who study and advocate for any kind of D supplementation.
Why are you afraid to be specific? Have you decided that since those details don't matter to you, as an expert capable of dismissing any potential benefit in having good circulating levels of ALL vitamin D metabolites as well as the parent vitamin, that then these minor details shouldn't matter even to those who would appreciate knowing them?
You are knocking the PhD-proponents of D supplementation by use of a study with a dosing regime that is of the very kind that these PhD-proponents warn us AGAINST! Some might find your omission of that fact disingenuous, if not dishonest.
And why exactly would the very low level of D that is needed to prevent rickets necessarily equate to the OPTIMAL levels that might best benefit a growing boy, a healthy adult man, or aging geezers like us who are in diseased states of varying degree? I expect most people want more out of life than "no rickets."
You make the common error of assuming that if some is good, more is better. That's not how biochemistry works.
I'm not afraid to quote studies, I just have done it so often that if you have not seen it by now, you seem to suffer from confirmation bias that is impairing your ability to learn and accept new info. I cannot fix your dysfunction - you will have to work on it by yourself.
Nonsense, I am not assuming that "more is better" any more than you. Like you, I assume states of "not enough" and "just enough" and "too much" all exist. For either of us to believe in transitions among those states, we have to believe that "more IS better" if you don't have enough, and that "more is worse" when you are about to transition into having too much.
How could I possibly think more is always better when my main criticism of the study in question is that the dosing was too high?
Rather, I am asking: if minimal levels of any needed compound prevent one specific disease state, why would ANYONE ASSUME that there are NO higher levels that could be of possible benefit beyond mere prevention of that one disease state? States between those of "just enough" and "too much" might be more satisfactory, more optimal, than being right on the edge of either of those states, deficiency or excess.
If I am assuming anything, it is that "bare minimum" is unlikely to be the same as "optimal," just as both of those are unlikely to be "excessive," based on definitions of words.
I do also assume, however, that there is no single-point serum demarcation that could be accurately applied as the exact numerical level of "sufficiency" to ALL adult members of a population with any certainty. It seems far likelier that there would be something like a borderline RANGE of values that might vary between individuals, as well as vary within an individual depending on his diet, microbiome, medications, disease states, etc. The single-point serum value we want to apply to all individuals equally, in all disease states, probably amounts to an educated guess that may be a bit too high or a bit too low. Is there a reason in expanding that guess to a range of values that we wouldn't want to tend towards what most expert researchers consider "optimal" rather than barely sufficient?
I did not say you were "afraid to quote studies" in general, but only that you were failing to do so here, in a way that would let those who are reading your words know that the particular manner of supplementation in the study was done entirely different from the manner they most likely use,.. not to mention, done in a manner that proponents of D3 supplementation commonly recommend AGAINST. Do you think NONE of the men reading here would want to know this detail, even if you personally found it superfluous?
Your words speak for themselves. I'm glad you are walking them back now.
Myers mentioned Calcium supplements. I've been taking 1200 mg per day. My vitamin D level is good. I'm on Firmagon. PSA 0.06. Testosterone 30. Scans don't show any mets. Thanks in advance for responding.
"Among both Blacks and Whites, we observed a threshold for calcium intake (604 mg/day) below which prostate cancer risk declined sharply."ncbi.nlm.nih.gov/labs/pmc/a...
That may be higher if you are taking Xgeva or Zometa.
Sorry for being stupid but I read the study and didn't understand any of it. I just want to know if I should take calcium or not.
Cancer risk declined when intake was below 604 mg/day. You are taking double that, not even counting food sources. Isn't that clear?
Yes. I'm stopping calcium supplements.
My MO is the one who told me to take 1200 mg of calcium per day. I emailed him and told him I was discontinuing it because TA on Heathunlocked told me to.
LOL.You may get him to take you seriously if you showed him the peer-reviewed journal article instead.
Too late for that. He told me to find another doctor. Now I don't know what to do. I wish I never brought it up. I had a good schedule of getting lab work and seeing him every month. It was very convenient for me and was working. I don't know where to go now.
I assume you're joking. I would drop you too.
I'm not joking. I told him how knowledgeable TA on HealthUnlocked was and he told me to get treatment from him. No one else around here is taking new patients. So I've decided to let the cancer run it's course. Thanks for your help and encouragement.
Dr. Myers made quite a number of assertions in this short video. If the video now shows us "how wrong" he really was when he made it, can you tell us point by point which assertions he made then that now have been proven wrong (with new data seen since 2015)?
See reply to Schwah above.
I guess I missed the link where Dr. Myer's is proven wrong. Could you provide that for me
Thank you
How about vitamine D related to a stronger Immunity? If it will not help us with PCa then it will help in other ways....
That turns out to be false too.
How about depression?
I've never seen any link to depression in people with normal levels. Have you?
All this talk about Vitamin D is quite D-emoralizing......
Good Luck, Good Health and Good Humor.
j-o-h-n Sunday 02/20/2022 7:21 PM EST
in reply to j-o-h-n
It thought it was D-lightful.
When I started ADT I started taking D3. I have taken 5000iu for about 15 years. In that time my blood D3 and Ca remained in the lower quartile of normal. (but took Ca sups). What might it have been without the D3? We cannot know but there is evidence that ADT lowers D3 and it (and Ca) sups keep them in a normal range. We have every incentive to look after our bones.
PCa itself takes two actions to protect itself against D3:
it suppresses production or the enzyme that converts calcidiol (25-D3) to calcitriol (1,25-D3) within the cell ... and ...
it upregulates the enzyme that clears calcitriol.
An impressive two-pronged strategy.
Isn't that suggestive of D3 being an important part of our defense against progression and death?
But the anti-supplement wing of this group is not interested in any research that takes place in the lab, it seems.
-Patrick
Agree. I cannot say there is a direct causal relationship with progression or not but an indirect relationship is a no-brainer. I have been puzzled by the irrational aversion of the anti-sup brigade to research. We know bugger-all about this disease. After 80 years we are still finding out new stuff about testosterone! We cannot have RCTs for everything but research can point us in useful directions.
Many say that taking supplements interferes with conventional treatment. How long after starting Vit. D and calcium did you first realize it was making your ADT less effective?
I have not noticed any effect on the influence of D on ADT or any other treatments, SOC or other. I took it as part of a strategy to maintain bone health which becomes very important in the later stages of our bastard bug. My bone density is not far from that of a young adult. The rest of me is pretty old and ragged. Of course I need to keep Ca dosage moderate (too much is bad) and take vit K2 (M4 & M7) to direct it to bones, not arteries. The other thing we need to keep within healthy range is sugar and insulin - hence metformin. PCa and treatments have adverse effects on many important parameters and we need to watch those and take compensating action otherwise they can shorten our life and make it more miserable than necessary.
Thank you for this video Patrick. So good that Dr Myres would test the vitamin D levels before prescribing.
If supplementing, the optimal form is D3. There is no reason to do this if in normal range.Better than a pill is sun exposure rather than sun avoidance.
The dermatologists object, rightly citing increased skin cancer.
However sun avoidance studies show avoidance results in shorter life span similar to smoking 20-40 cigarettes a day. With increase in other cancer like colon cancer.
Skin cancer is highly treatable with a 1% mortality.
Sun blockers are absorbed by the skin and are bad for coral.
If you are concerned about sunburn avoid vegetable oils which are inflammatory.
Very hard to burn is veg oil avoider.
Thanks Patrick, always good to hear Snuffy’s voice again. Since Myers is the highly respected doctor here with a wealth of research and experience, I’ll stick with his advice. He started me on vitamin D back when I was a patient of his. His approach and treatment regimen has kept me around long past my expiration date, and I still follow it today. Dr. Sartor reviews my supplements during each visit and has never told me to stop vitamin D. I’ll stick with what my doctors tell me.
Ed
Im hating on all this negative vitamin D talk, all it’s doing is scaring people, stuff like “I’m going to make sure my husband stops taking it” is making me crazy. I’ve had a Gleason 9 cancer for almost 18 years and have been taking high dose vitamin D (10000iu) along with other supplementation for over 15 years and to be honest I don’t even remember what information I used to start taking it and guess what “I’m still here”……move on
I believe Dr Myers targeted the 60-80 range, although it might be 50-80. He tested regularly and understood the synergies better than anyone I think. Plus D was one of the multi-modal pathways that cumulatively resulted in better outcomes. That was a major key to his success. I didn’t read through the studies, but unless they were designed in a way to test Myers’ approach, then they don’t help to evaluate efficacy.If he determined that minimal thresholds had to be attained and these various studies had thresholds below his, then are they relevant?
Also, he was very careful to recommend several high D products- not just any D.
Any many would add that they be taken in the evening.
Every makes their own decision and stay strong with your decision.
What I heard over and over on this site and it seems like it get lost in the dialog is the real issue is Vitamin D "DEFICIENCY". What I heard Dr Myers say on that video is that men with Vitamin D "deficiency" are prescribed supplements tailored for them until they are in range. What I've heard Tall Alan say many times including here is IF a man has a Vitamin D "deficiency" it makes sense to take a supplement. Sounds like they are saying the same thing. The most recent studies indicate 20 ng/mL is the MINIMUM vitamin D level and below that it makes sense to take a supplement. For us with aPc on ADT (and/or with bone mets) I would not settle for the minimum vitamin D level I'm rather be safe and be a bit higher than that (maybe 30 - 40). So what is important, get your Vitamin D tested every 3 months when you get your PSA and testosterone tested and make sure you are in range. If you have osteoporosis and on a medication for it (I do, and on Zometa) it is extra important that your Calcium and vitamin D are in range because the drug reduces your calcium levels. Get tested so you know your levels. IMO don't go crazy and over supplement yourself. If your vitamin D is already a little above 20 ng/mL and it makes you feel better to take a supplement go for it but get tested regularly to make sure and your vitamin D is in range 20 - 40 ng/mL.
Consider what Dr. Myers said about sun exposure and geography. He was probably also referring to studies where "significant inverse risk associations were found for men born in a region of high solar radiation versus low solar radiation, with a slightly greater reduction for fatal than for nonfatal prostate cancer."
Of course no one is going to conclude that vitamin D status is the ONLY factor at play in prostate cancer risk. The point is only that there are logical reasons to think it MIGHT be one, and only one, of MANY factors.
In the populous cites of more northern latitudes, it happens to be poorer populations of people of color who end up at higher risk for deficient levels of vitamin D (as dark skin, just as less sun exposure, lessens the body's ability to generate adequate levels). Do members of these populations routinely get tested for D levels? Of course not.
So until it is actually demonstrated that modest daily supplementation of D3 has a likelihood of being dangerous, the risk/reward analysis for untested men MIGHT favor supplementation at lower doses of around 1k-5k IU. (Please everyone, be aware of what the word "might" actually means!) Just sayin' that men can consider the evidence that a D3 pill MIGHT hurt them, and the evidence that a D3 pill MIGHT help them, and proceed from there.
I just posted the following on the other D3 thread:
From 2016: uahs.arizona.edu/blog/2016-...
University of Arizona Professor Rick Kittles, PhD, is director of the Division of Population Genetics (Center for Applied Genetics and Genomic Medicine) and professor of surgery in the Division of Urology at the UA College of Medicine.
Instead of focusing completely on the DNA, Kittles and his team have been looking at how the environment could be influencing prostate cancer risk. Notes Dr. Kittles, “Supplementation may allow us to decrease the disparities that we see in prostate cancer between African Americans and other ethnic groups.”
"Research has shown that the local environment surrounding the tumor in African American men with prostate cancer is different than what is seen in men with European ancestry. Both the immune and inflammatory response surrounding the tumor is altered in men with low vitamin D levels. Dr. Kittles and his team are looking at how genes respond to chronic vitamin D deficiency, and how that influences prostate cancer.
One avenue to alleviating this disparity could be through vitamin D supplements. Dr. Kittles is hoping to start clinical trials soon to see whether supplementation with vitamin D in African American men helps slow progression and ease the severity of prostate cancer. It is [possible] that a combination of genetics and vitamin D deficiency can largely explain why prostate cancer tends to be more severe in African American men. Alleviating vitamin D deficiency in this population is a simple option."
Until such trials occur and yield definitive results, does it make sense to scare men away from ANY supplementation of D3 because of results from a SINGLE trial that used an ill-advised dosing schedule of a single mega-dose per month?
I believe that it is fairly well-established that multiple sclerosis is a disease of lattitute. Maybe there are others? In 1990, Gary Schwartz may have started the massive research effort into PCa risk & vitamin D3 deficiency with his hypothesis:
"Prostate cancer is a major cause of cancer death among males, yet little is known about its etiology. We hypothesize that Vitamin (Hormone) D deficiency may underlie the major risks for prostate cancer, including age, Black race, and northern latitudes. These factors all are associated with decreased synthesis of Vitamin D. Mortality rates from prostate cancer in the U.S. are inversely correlated with ultraviolet radiation, the principal source of Vitamin D. This hypothesis is consistent with known antitumor properties of Vitamin D, and may suggest new avenues for research in prostate cancer."
pubmed.ncbi.nlm.nih.gov/224...
A while back, I compared the PCa rates of the Nordic countries with that of the Mediterranean countries. There are actually quite a lot of Med countries & what they have in common - more than the mythical Med diet - is location, location, location & very low PCa rates. If your shadow is longer than your height, your skin cannot make vitamin D. And for much of the year in the Nordics, you will have the long shadow at noon & will not be showing much skin anyway. And, surprise, the Nordics have high PCa rates.
Yet we are supposed to ignore all of this because our local guru has found a study that he likes?
With almost 1,500 studies on PubMed, it's like being told that Euclid was wrong and we need to rethink geometry.
And for those who think that it's only a matter of getting 25-D above 20 ng/mL, it's much more complicated than that.
-Patrick
FYI, Nikolai Ivanovits Lobachevski has been the founder of a known non-Eucledian geometry. There are a number of them. Euclidian geometry is based on the assumption that there is only one straight line parallel to some other and passing through a specific point. Lobachevski said infinite number lines. If someone says 32 lines, a new geometry is born.
One of my favorite Tom Lehrer songs: Nikolai Ivanovits Lobachevski was his name.
Unfortunately I am one of us that has both MS and advanced PCa. All my docs, neuro, MO, GP,even my dermatologist, have recommended keeping my D level between 40-80. That's what I'm doing.
Good for them.
All the best, -Patrick
P.S. With PCa, having 25-D3 at 40-80 or 50-75, or something similar is just part of it. We need 1,25-D3 to fight PCa.
Without getting into detail, here's what I do:
- avoid exessive calcium intake (don't neglect magnessium)
- stay away from phosphates - deli meats, soft drinks
- don't have large portions of meat (high in phosphorus). The "old 96 oz-er" is definitely out.
- fructose in my coffee - it keeps 1,25-D3 levels elevated, (You could use fruit that is OK for diabetics - berries - low-bush blueberries, say. LOL)
Something that might be considered, and cannot be evaluated in large general-population studies, is whether certain disease states might effectively nullify what are considered "optimal" nutrient ranges (covering sufficiency, insufficiency, deficiency, etc) in normal, healthy adults of varying ages.
That could mean in certain stages of certain cancers or other diseases, it might be more beneficial to the individual to reach levels (of any of various serum markers) that would be considered either "inadequate" or "more than adequate" in the general population.
Those depending ONLY on the highest levels of evidence are of course not going to be convinced that such an idea is even possible with respect to any clinical application, because of the philosophy that without large randomized clinical trails, the result of any intervention (based only in mechanistic or observational evidence) must by default be considered "harmful."
It seems to amount to an idea that if we can't definitively and statistically prove that something is truly helpful, that lack of proof can then be used to help "prove" that the intervention is harmful. To suggest something MIGHT help more than it might hurt is considered dangerous, even though it is implicit in the language of that suggestion that, well, it might hurt more than it helps. Isn't the risk of the unknown implicit in just about everything we do, everyday, lol?
I went to Dr. Myers because my MO gave me 1 to 2 years to live as a Gleason 9 (5+4). I have survived almost 20 years because of his treatment. He tested me for Vitamin D and found that I was deficient. At that time I was in Florida and outside most of the time. I asked how that was possible given my exposure to the sun. He said that as we get older that the body does not readily absorb vitamin d from the sun. He also said that studies had been done in nursing homes and found that those with vitamin d deficiencies were much more likely to fall. I went on vitamin d and stay on it.My current MO, a research Doc who only sees patients two days a week told me that vitamin D had been shown to help in resistance to Covid.
May Dr. Myers is not the best for some, but he was wonderful for me. Do not understand why some in this group take pot shots at him.
I met Myers but was never a patient. I developed a high regard for him when he was releasing his weekly vlog posts. Someone new to PCa & even not so new, could learn an awful lot from those posts. Google "askdrmyers" - add a topic or wade through them all. There is a lot of free info in them.
I hope he is enjoying retirement.
-Patrick
Patrick, so hard with all this data. Calcium is good for our bones….No stop it feeds PCa stop all Calcium supplements.
Vitamin D is necessary, and good to be in the Sun w your shirt off….No stop all Vit D supplements it feeds PCa.
Coffee is bad for you, its acidic….No coffee is good for you.
What is going on?
Mike
I feel the same way, I'll just keep reading and hope it clicks for me one of these days.
i agree it is so confusing it makes me doubt so many things. The main takeaway for me that is not confusing is to ask for my vitamin D level to be tested when I get my PSA tested so I at least know if my level is on the low side or high side with what I'm doing already. The calcium level is part of the metabolic panel blood test I get at least once or twice a year so I can see level. I can take supplement's based on those results. Good luck, sometimes it feels like a crap shoot.
Mike,
What is going on?
There are some who are against vitamin / mineral supplementation.
Did you notice the recommendation that we drink milk to get D3? Why is supplementation ok if it is in food, unnaturally.
Vitamin D is not a vitamin. The body can make it, but doesn't, at many lattitudes, during the winter months. There are no foods that (naturally) contain enough vitamin D.
(Defintion of vitamin:
"A vitamin is an organic molecule ... that is an essential micronutrient which an organism needs in small quantities for the proper functioning of its metabolism. Essential nutrients cannot be synthesized in the organism, either at all or not in sufficient quantities, and therefore must be obtained through the diet." (Wiki)
From the UK NHS:
"In the UK, sunlight doesn't contain enough UVB radiation in winter (October to early March) for our skin to be able to make vitamin D.
"During these months, we rely on getting our vitamin D from food sources (including fortified foods) and supplements."
nhs.uk/live-well/healthy-bo...
& coffee is good for you. Don't let them take that away from you. LOL
-Patrick
Dr Thomas Friedman has proved in his lab that he can STOP Metastisis by lowering Glucose and Glycogen levels. He has been unable to obtain funding for a human trial! He adds, metastisis is what eventually kills us. Mike
I can hardly believe the prattle this subject inspires. A clean diet, some sun and plenty of weight bearing exercise is vastly superior to vitamin D supplementation.
in reply to London441
The time spent on the replies certainly could have been put to better use.Some of our more ALT treatment leaning members have an affinity for writing lengthy rambling responses that do not make for easy understanding.
Well, since you have the word "London" in your handle, I will make you aware that the NHS advises that sunlight at that northern latitude doesn't contain enough UVB radiation from October to March for our skin to be able to make vitamin D. So "getting some sun" will do nothing in the other half of the year.
NHS says rather than risk becoming deficient, everyone over the age of 5 years (including [and especially] pregnant and breastfeeding women) is advised to consider taking a low-dose daily supplement of vitamin D in those winter months.
And while mostly only association studies, there is much research relating vitamin D deficiency and living at higher latitudes with increased risk for many chronic diseases including autoimmune diseases, some cancers, cardiovascular disease, infectious disease, schizophrenia and type 2 diabetes.
But I would agree if you CAN get your vitamin D from the sun, that is the ideal way to get it. Who knows what other benefits a short exposure might bring, in addition to generation of the D3 pre-vitamin and vitamin?
My comment 2 years later: I have always been a weight lifter myself, but it's repeated impact load you are looking for when trying to avoid osteoporosis: jumping (even jumping the rope) and running are superior to any weight lifting. While running, every time your foot touches the ground, the load, due to acceleration, can easily be 3-4 time your bodyweight. And it's repeated, compression and extension.
Sure plyometrics, running, rope etc are all very good. Not ‘superior’ to lifting though. Old people need to lift too, both are important. Avoiding osteoporosis, like the rest of aging, becomes almost a full time job.
I was referring to osteoporosis. In that case they are proven superior by research for the reasons I specified. But yes lifting is fundamental!
Love it. Franco Columbu vs Jack Lalanne.
🤣🤣🤣🤣
you waited and waited till you could use jack lalanne against me... 😀
No...you're Franco...London is Jack.I've been on and off this site since I've been dx'd. And I find it amusing the debates on exercise and what benefits bmd and muscle.
I'll throw an exercise that proven to build bmd..rowing. low impact but the muscle contractions require put enough stress on the bone that increase bmd results.
It does not have the weight load or frequence of load/unload of running but to me it's surely less boring than a treadmill! 
in general any exercise is better than no exercise for osteoporosis, the problem is that not everyone can sustain the join/bone stress of running or jumping. But if one can, then there is nothing as time/effort effective as that.
ncbi.nlm.nih.gov/pmc/articl... there you go for rowing!
Plenty of studies on rowing and bmd. You're still young...wait until those knees start to grind...the rowing machine will be your friend.😀
well, if I had the space to add a new gy machine to my arsenal...it would surely be a rowing machine 😀
Understand that... that's why I belong to a gym in addition to having my home gym....Anyway..I was just busting balz...now go workout...
Despite the moniker, I don’t live in the UK. if I did I admittedly would not be citing sunlight as one of my vitamin D sources lol.
However, if I did live there my approach wouldn’t be any different. Sun May be easy to obtain for some and hard for others, but all the vitamin D supplements and sunshine in the world can’t do what weight bearing exercise can do for your bone health and overall health.
Clearly there’s no certainty on either the benefits or possible harm of vitamin D supplements. I watch my numbers (including a yearly Dexa scan) and let them be my guide.
I don’t fault anyone for taking supplements, we’re all just trying what we believe will help, trusting the information we choose.
I believe a good diet and the right types and intensity of exercise Is far more beneficial than has yet been ‘documented’ and precludes the need for most supplementation.
Sadly, most older people don’t lift. This is crazy. Its value is incredibly comprehensive and guaranteed safe. The absence of it hastens our decline at a ever accelerating rate as we age, with or without supplements.
I did a deep dive into Vit D recently in putting together my overall diet/supplement plan. Never saw the Snuffy video but ran across some well designed studies in the context of PCa and arrived at a target of 45-70 ng. Never had my Vit D checked which was dumb considering I live at 47.6 degrees latitude in the Seattle area and doesn't get a lot of sunshine and suspect I've suffered from moderate Seasonal Affective Disorder in the winter. Was taking supplements, about 25,000 IU a week but not super consistent. Just got tested and am at 25 ng. Wasn't surprised. Did more reading on what dosages are required for what boost. Mega doses are safe for initial boost. I went 300,000 IU over 3 days (100,000 a day) and am now, during the summer I'm going with 30,000 IU a week (5,000 6 days a week) and will retest in 3 months and am logging my diet to make sure I'm not overdoing it on calcium.
One thing I found in my deep dive is that studies have shown the bump in Vitamin D levels from sunlight is not as significant as people think. So you may need to maintain a more consistent supplement intake year-round and don't want to significantly reduce it in the Summer assuming the sun exposure is giving you the rest of what you need. As pointed out, as long as your calcium intake is in check, it's really hard to "overdo it" on Vitamin D intake.
ncbi.nlm.nih.gov/pmc/articl....
"The sunlight exposure group showed a slight increase in serum 25(OH)D level, but the absolute increase was less than one-third that of the vitamin D supplementation group (+0.9 ng/mL, P = 0.043). Only two participants in the sunlight exposure reached serum concentrations of 25(OH)D ≥ 20 ng/mL at follow-up. "
"Sunlight exposure was not sufficient to overcome vitamin D insufficiency or deficiency in the current study subjects. Effectiveness of current sunlight exposure guidelines among various populations should be reassessed in larger clinical studies."
Also another tip for the penny pinchers. Most medical facilities, the lab fee is in excess of $100 for a Vit D check, not covered by insurance. I used Ulta Lab Tests to have my B12 and Vit D checked, was around $25 for each test (look for discount codes.) They mainly use Quest Diagnostics for the blood draw which is in grocery stores all over the place. Saved me probably about $150 than having both tests done at my normal clinic.
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