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Supplementing Vitamin D has no effect on fracture risk

Tall_Allen profile image
95 Replies

I know a number of you supplement Vitamin D in the hope of reducing fracture risk due to ADT-induced osteoporosis. It doesn't work.

An update of the VITAL randomized clinical trial reported no difference in fractures among people supplementing Vitamin D vs. people not supplementing it. There were no differences by age, sex, race, BMI, baseline use of calcium or Vitamin D supplements, or serum Vitamin D levels.

nejm.org/doi/full/10.1056/N...

If your doctor told you to take it, and you do not have a deficiency (below 20 ng/dl), you may want to send him that link and discuss with him.

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MrG68 profile image
MrG68

Do you have any RCT resources where they used around 10KIUs.2KIUs is quite low. Your body can make the equivalent of 20K with about an hour of sunlight.

Tall_Allen profile image
Tall_Allen in reply toMrG68

Yes, 10Kiu has been found to reduce BMD by 3.5%:

jamanetwork.com/journals/ja...

garyjp9 profile image
garyjp9

Thank you, TA. What if you DO have osteoporosis and/or low bone mass? I see they excluded such patients from their conclusions.

Schwah profile image
Schwah in reply togaryjp9

Weight lifting. My nine density improved substantially from weight training 3 days a week all Muscle groups.

Schwah

Tall_Allen profile image
Tall_Allen in reply togaryjp9

They did not exclude them. They just did not exclusively include them. It was a random population sample. It made no difference to BMD among people who were already taking supplements (Vitamin D and calcium) presumably for that purpose. Rickets is caused by a Vitamin D deficiency, but a surplus of Vitamin D does not strengthen bones - it weakens bones at very high levels.

tango65 profile image
tango65 in reply togaryjp9

The treatment for osteoporosis is mainly done with biphophosnates or with Denosumab, weight training, exercise, and adequate intake of calcium in the diet or supplementation if serum calcium is low. Vit D could be used if blood levels are low.

mayoclinic.org/diseases-con...

Wings-of-Eagles profile image
Wings-of-Eagles

Thanks Allen. Do you have any studies that show how well Xgeva works to reduce the risk of bone fracture? Or should I take it continuously. I had regular Xgeva shots for about 3 1/2 years 2014 -2018. Then after a bone density or osteoporosis test showed my bone strength is in the normal range , the former Onc doc took me off it for a while. Then back on it for a while 2019-2021, 2 years. Currently I missed a shot in May 2022 because of an insurance lapse and now Dr. Tanya Dorff -City of Hope says I dont need it right now, my PSA is undetectable. I might have missed something in my consult with her last Friday .

Tall_Allen profile image
Tall_Allen in reply toWings-of-Eagles

It's probably inadvisable to take it for more than 2 years at a time, certainly not if your BMD is already in the normal range.

Wings-of-Eagles profile image
Wings-of-Eagles in reply toTall_Allen

Thank You Thank you. Yes that's what my Onc's at CTCA and COH said , plus no long term use studies of possible side effects yet. I'll save some money too, because it is so expensive on my Insurance. I am at the age 66 when nothing about my body seems "normal" anymore, lol

dans_journey profile image
dans_journey

I don't have access to the full study, so I can only rely on the abstract.

You're correct, Allen, that there is no difference between those who took vitamin D and those who took the placebo based on the study results. However, when I look at the participant list, it appears that the participants selected were just run of the mill people off the street.

There is NO mention of any participants who were actively participating in androgen deprivation therapy as part of the study. Does the study specifically address the impact of vitamin D on those undergoing ADT and, if so, what was the outcome? If not, it seems to be a stretch to apply this study to ADT patients and further study is required specifically for ADT patients.

Tall_Allen profile image
Tall_Allen in reply todans_journey

The full paper is linked. It made no difference to BMD among people who were already taking supplements (Vitamin D and calcium) presumably for that purpose. The stretch would be to suppose that men who have low BMD due to ADT would be different from anyone else who has low BMD.

MrG68 profile image
MrG68 in reply toTall_Allen

Yeah, I found it crazy that the supplier of the D3 messed up the source but didn't notify them. Just shows you really - even with controls of an RCT it can still go wrong, and at a large expense. Yikes!As for the bone density, I believe this is why you're supposed to take K2 with D3 supplementation. The K2, which most people are generally deficient, gets depleted the more D3 you take. K2is supposed to be essential for increasing bone density. It's not really a shock to me that by taking higher doses of D3 without it would lead to lower BMD. I don't suppose you have an RCT with 10K D3 and K2, do you?

I see what you're saying with low BMD and ADT, but I also think that dans_journey has a good point. I mean that's the purpose of having these trials in the first place, isn't it? - so we can try to achieve results where they're scientifically proven as opposed to having a view of it being a stretch - in any way. Do you have any papers where they specifically target ADT? I'm only saying that because you said the post was for reducing fracture risk due to ADT-induced osteoporosis. It would be nice to have a paper specifically targeted towards ADT.

Tall_Allen profile image
Tall_Allen in reply toMrG68

So you take one more useless chemical to make up for the deficiencies of the other useless chemical you are taking?

I just posted the RCT you are asking about. That defines "confirmation bias" when you are so confirmed in your belief that you won't even look at the evidence you previously asked for.

This was the largest trial of Vitamin D ever done. It showed no benefit in supplementing even among those who were already supplementing it and calcium for BMD loss. The proof is now in the other camp - any who believe that in their particular case there is a benefit must prove it with an equally high level of evidence.

MrG68 profile image
MrG68 in reply toTall_Allen

Yeah, but respectfully that’s not really my view though.K2 is not a useless chemical, as you put it, it’s an important vitamin wrt bone density - which is what this paper is referring to and doesn’t address. It maybe the largest study ever created or to ever to be created, and I also have no reason to suspect with the parameters they did they study the results are accurate. But the point still stands. It doesn’t take into consideration K2 which affects bone density and D3 effectively depletes it. Maybe you could give an alternative study with about 10K that takes that into account to validate your point.

FWIW, I don’t have any bias toward it. But why do you suggest it’s useless? You normally have K2 in your diet. This is in balance with your D3. By increasing your D3 this causes an imbalance.

Also the bit where you say ‘people who were already supplementing it’. That’s actually a potential problem. When you do a drug RCT people don’t have drug this in their system. The results are more dependable. When you investigate D3 in this way, some are/have been supplementing, others are not, peoples D3 will change with sun exposure and dietary intakes. People will have different sun exposures and different diets. Some will put on sun block. Also the fact that they are doing the trial based on IU intake is also another potential problem. Peoples blood level concentrations should really be measured not IU intake because 10K will give all different kinds of concentrations. There’s a LOT of factors there.

Hope that helps.

Edit: sorry I missed off the point that was raised previously by dans_journey. Do you have a study that related directly to ADT? I think it was a very valid point.

GreenStreet profile image
GreenStreet in reply toMrG68

Completely agree need D3 and K2 pity the study did not seem to realise this

Tall_Allen profile image
Tall_Allen in reply toGreenStreet

Maybe it would have worked, maybe it would not have. How would you possibly know?

in reply toTall_Allen

USELESS???…please Alan!

Tall_Allen profile image
Tall_Allen in reply to

When you hold onto convictions about what works even in the face of the highest level of evidence, you are no longer practicing medical science.

in reply toTall_Allen

Alan, are you saying Follow the science… many of us did that without question, regarding Covid. Science is not always right, TA.

Tall_Allen profile image
Tall_Allen in reply to

It worked for Covid, and it works for PCa. Otherwise, you are just practicing voodoo.

in reply toTall_Allen

lol ok Alan..hold up , just getting my last pin....feel anything yet???

Tall_Allen profile image
Tall_Allen in reply to

pin? Do not know what you are talking about?

MrG68 profile image
MrG68 in reply toTall_Allen

I think he’s referring to your reference of voodoo - you know, a voodoo doll, sticking in pins, maybe?

MrG68 profile image
MrG68 in reply toTall_Allen

It’s not that people are not following the science, as you say. The science is only as good as the procedures and constraints they are tested with. Here, for example, they didn’t take into consideration the effects of D3 for bone density wrt K2. Like I said previously, I’m quite sure the science was done correctly - under the constraints of their procedures. If anyone references a paper, it doesn’t give them the right of not being challenged. In fact it should actually be encouraged. Then they can address the actual issues - with science.

This paper doesn’t include an important aspect of bone density - K2. D3 and K2 are used synergistically. By altering one, you create an imbalance. You are of course free to ignore the raised issues. It doesn’t mean that people are ignoring the science though. It doesn’t allow you to justify dismissing the raised issue by saying it’s just a ‘useless chemical’. It’s not very scientific, is it?

Like I said previously, maybe you could supply a better paper wrt the discussion with K2 included but with a decent level of D3.

I’m not being argumentative, I’m just pointing out what I see as shortcomings in the trials - which are very relevant to bone density.

Tall_Allen profile image
Tall_Allen in reply toMrG68

You can always make up some "but if..." as an excuse to not follow the science.

A chemical is useless, until it is proved useful. It is unscientific to take a substance just based on an imagined benefit. That is how hypotheses come about, and K2 is as good a hypothesis as any. But until a hypothesis is tested and proved, it is not scientific to take it. You are just imagining a benefit, which is a useless exercise.

Tall_Allen profile image
Tall_Allen in reply toMrG68

It is absolutely that you are not following science. What science does not mean is "Oh, they would have seen an effect if they had only done XYZ in addition to ABC. I know that combination works because of a mouse study." That is called "confirmation bias," not science. The burden of proof is on those who put forth the hypothesis that ABC+XYZ works. Until you can prove it, it is a useless chemical. Maybe you can produce such a randomized clinical trial?

Here's an explanation of how science does work.

healthunlocked.com/advanced...

MrG68 profile image
MrG68 in reply toTall_Allen

Well that may be your opinion, but I don’t agree with it. You just can’t provide a reference to a paper and think it’s applicable in every situation. I have no problem with the science they did for your reference. The issue, as I see it, is more you’re shoehorning every situation to those papers.

Let me give you an example. You sent out your opinion piece previously with multiple references to studies with D3. I had no issues with the papers on how they were done or their results - scientifically.

The issue for me was that every paper you referenced was using a low dosage of 2000IUs. Your body can easily make 20kIUs equivalent. This was probably done because the RDA is around 600IUs and may have been considered high relatively speaking.

So, my disagreement is not with the way the science was done - scientifically. Moreover, it’s more to do with the application of that papers results. Personally I would not have referenced those papers as definitive proof.

Just because you reference a well done study as an appeal to authority, doesn’t mean that it’s definitive proof for that particular issue.

Also, I think that dans_journey’ comment about the patients not actually being on ADT but used to ‘prove’ the effect for ADT patients was very relevant.

Hope that helps clarify why I’m pointing out things I believe to be taken into consideration. It’s not some attack on you or the work you do on the site.

Tall_Allen profile image
Tall_Allen in reply toMrG68

If you look at the highest quality evidence available (below), there is no benefit. It is not just my opinion. It is the opinion of the scientific community.

prostatecancer.news/2018/07...

When someone holds onto beliefs in spite of the best evidence, they are no longer in the realm of science. Here are the characteristics of pseudoscience:

prostatecancer.news/2021/07...

MrG68 profile image
MrG68 in reply toTall_Allen

So let me ask you this. If you do an RCT on D3 and you give them 2kIUs, like in these studies, how good are the application of those studies in real life? Your body can make 20k in about an hour with sunlight. Some have sun exposure, sun blocks and all kinds of different things what has effectively change the 2K dosage which is dwarfed by what your body can make. So basically youre testing something to a level of 2K - but it will fluctuate and is extremely low. Dosage relatively speaking. The blood concentration of D3 isn’t a linear response. It’s won’t have much impact.

With a drug, your body cannot make that drug so the results are much more dependable. Here it’s not the case.

All my opinion of course.

Tall_Allen profile image
Tall_Allen in reply toMrG68

Your premises are all wrong.

Sunlight gets an average person to about 400 iu Vitamin D3, not 5000iu:

jaad.org/article/S0190-9622...

The Recommended Daily Allowance is 600iu.

ods.od.nih.gov/factsheets/V...

2000iu/day increase in intake is a huge amount.

MrG68 profile image
MrG68 in reply toTall_Allen

Oh I must have missed that but in all those trials that said something like ‘we realized that based on the ‘average’ persons IU being about 600IUs we can now make the assumption that we have a great signal to noise ratio and totally ignore that issue.’You can’t validate that by saying ‘on average’ some people… I mean that’s not very scientific, is it? This will also vary daily. We can’t even predict the when the sun comes out weather wise. It’s all variability. I assume these participants didn’t get their blood drawn every day to work out their average figure. Maybe they got one day of excellent sunlight a day before their blood work.

You also don’t know how different people have different responses to sun exposure. Like I said it isn’t a linear response curve. Lets also ignore any dietary factors that include both D2 and D3.

You see they are extremely limited on this control and it’s measurement.

You’re body has the capability of making 20K irrespective of the average.

The daily allowance of 600IUs isn’t a hill I’d be willing to die on. It’s not something I’d be using as a reference.

Tall_Allen profile image
Tall_Allen in reply toMrG68

Vitamin D is stored. In many trials, they simply gave a large monthly dose (e.g., 100,000 iu/month in the VIDA trial).

prostatecancer.news/2018/07...

These are population-based trials, so basing it on the average is indeed exactly the point. Variations are equal in the treatment and the control groups - that is exactly what randomization does and why it is so useful.

MrG68 profile image
MrG68 in reply toTall_Allen

Yeah, there’s another potential issue there wrt to trials. You should really supplement daily and not in a bulk dosage. When you take VD3, most of your cells have a VD3 receptor. This uses the parent D3. Some get metabolized by your liver to make the 25 hydroxy and then by your kidneys to create the 1,25 hydroxy. This is the one used for bone metabolism in general. There’ll be other things but I believes that’s the main usage. The one you measure in your blood is the 25 hydroxy.

So basically, your blood measurement doesn’t reflect the amount of the parent D3.

Once cells pull in the parent D3 it gets used up internally. So you should prefer daily as opposed to weekly/monthly. It get used up quickly even if your blood has a high concentration of the 25 type.

Your body is designed to make D3 from sun exposure daily, not in one great bit dosage at the end of the month.

When you store the D3 it’s the 25 hydroxy not the parent - which is the one that’s used by all your cells outside the bone metabolism system.

Like you said, that’s what they do for many trials.

Think I got that right. It’s been a while since I looked at all of that. Apologies if it’s not correct, but that’s my understanding.

Edit: so if you’re taking D3 related to prostate cancer, I suggest you take it daily!

Edit-2: that should still be ok for bone metabolism … I think 🧐

Edit-3: I think it’s possible that the cells introduce the parent D3 internally by some method like osmosis or something and not by the receptor. I know there’s a 1.25 hydroxyl receptor for cells. Like I said it’s a while since I looked at that. 😱Apologies if it’s confusing.

Tall_Allen profile image
Tall_Allen in reply toMrG68

It's only confusing because you are creating byzantine reasons why 3 excellent large RCTs should not be used to guide patients. You are making up science as you go along. To you, science=what I agree with. This is called "confirmation bias" and is bad for your health.

MrG68 profile image
MrG68 in reply toTall_Allen

Yeah, sorry you see it like that. I will continue to post what I believe to be correct. You are free to ignore it, no worries. FWIW, I have never refuted any of the science. I have said multiple times that I believe that the science is good. Maybe you can point out where you believe I’ve said that. It doesn’t matter though. I don’t believe that it’s me that has a bias. Just because you reference one of your opinion pieces doesn’t mean that people can not challenge what you are saying. After all, that’s what healthy debate is about, don’t you agree?

Edit: on a positive note, I learnt a new word today - Byzantine!

MrG68 profile image
MrG68 in reply toTall_Allen

Yeah, I've got a question about that actually. Had me thinking a bit.If you do an RCT with a drug. It's randomized but the dosage of the drug is constant. It's constant because your body can't make the drug so you can control an exact dosage.

But if you consider something like D3, you're also getting dosages from various places - the sun, diet and the dosage administered. These will create different levels of blood concentrations. So effectively the dosage isn't constant. It would be different if you were looking at blood concentrations and adjusting the intake wrt that measurement.

So how does randomization actually fix that? Because that is like saying that we are giving a random amount of the thing we are testing for because its changing. You could look at it like actually its a ranged dosage as opposed to something like 2KIUs equivalent. With the drug, it's constant and you don't have that issue.

Tall_Allen profile image
Tall_Allen in reply toMrG68

Let me explain the process. A Phase I study is dose-finding -- they use it to find the right dose. Phase II is usually toxicity and efficacy. If it survives that, it moves to Phase III, which determines whether it meets its purpose.

I guess you didn't bother to read how they arrived at the doses and the restrictions from other sources for the Vitamin D RCTs. If you had, your questions were answered. Researchers spent a lot more time than you have thinking about it. It's always a better idea to assume that some very smart people worked it out than to assume you know better. You might learn something from them.

MrG68 profile image
MrG68 in reply toTall_Allen

Hang on a minute. Regardless how they arrived at the dosage, this dosage changes.With a drug, it’s constant.

So if I had 2 people, given a 1000 iu dosage , their dosage could be the following;

Day 1: 1000 ius , 1500ius

Day 2: 2000ius, 2000ius

It literally a moving target during the trial regardless of what they used to establish the daily dose.

I’m sure these people are smart as you say. But how does randomization solve that?

You say they used restrictions for other sources of D3. How can you restrict it? You have to eat and you have to venture out in the sun.

Edit: Maybe this will help to explain what I'm trying to say wrt confounders wrt RCTs.

ncbi.nlm.nih.gov/pmc/articl...

Tall_Allen profile image
Tall_Allen in reply toMrG68

For every out of whack person in the treatment group, there is an out of whack person in the control group. That's what randomization does. I suggest you read about "randomized clinical trials."

Maybe you should actually, you know, read about the trial.

MrG68 profile image
MrG68 in reply toTall_Allen

That is so bizarre. The reference I included said it was a confounding issue that was just basically allowed. They didn’t mention it being corrected by randomization. Maybe they’re just unaware that randomization is the pancreas for every argument that’s put to you. Maybe you should read the article I posted.

I did speed read it though. Maybe it’s something I missed.

Tall_Allen profile image
Tall_Allen in reply toMrG68

The reference you cited did not include the large, well-designed RCT (D-HEALTH, n=21,315 ) that addressed all of her concerns and still reached the same conclusions:

prostatecancer.news/2018/07...

Once again, the burden is on you to prove a benefit, after 3 huge RCTs show no benefit.

MrG68 profile image
MrG68 in reply toTall_Allen

That’s fair enough TA. You’re free to take that path. I respect your opinion. But my question is, if you look back, how does randomization solve these issues? This is what you posted and that’s what I’m questioning. You said randomization fix this.I know how randomization works. I don’t know how it would work here as you’ve specified.

Tall_Allen profile image
Tall_Allen in reply toMrG68

Randomization assures that whatever confounders are in the treatment group are also in the control group. It is only the comparison that's important. D-HEALTH addressed the confounders she mentioned and still found no difference. If you believe that because of confounding, it can't be studied, then it is not a scientific question.

MrG68 profile image
MrG68 in reply toTall_Allen

No, not at all. I believe exactly what was said in the paper. RCT's for D3 have cofounding issues, which are recognized but allowed. Randomization can't possibly correct these because they are recognized as confounding issues. If that wasn't the case there would be no paper. I'm not saying that it can't be studied - sounds more like a straw man argument to be honest. I have never once suggested that they shouldn't be studied.

As it happens, I actually agree that RCTs are the best level of evidence that we've got. I weigh these HEAVILY wrt all the other papers. I believe that the science is correct - within its constraints. That doesn't mean they are applicable for every possible situation. But it doesn't mean you should disregard the results.

I stand by what I've said and also what the paper recognizes. RCT's have limitations and specifically with D3 one should recognize what these are. These are the things I've been pointing out. As the title of the paper says, this is why RCT's fail for D3.

It's not some personal attack on anyone. I'm just posting what I believe to be correct.

Just my opinion, but I'm not the only one who believes this.

Tall_Allen profile image
Tall_Allen in reply toMrG68

Suggest you read the D-Health protocol.

Tall_Allen profile image
Tall_Allen in reply toMrG68

I really don't understand her point. Maybe you can explain. In the US and in most western countries, chronic Vitamin D deficiency is rare. Many foods are fortified with it, and many in the US and Australia get all we need from the sun. If she is saying that adding more Vitamin D to people who already have an ample supply is on the flat part of the dose-response curve, I agree with that, and that is exactly what is proved by these RCTs.

MrG68 profile image
MrG68 in reply toTall_Allen

This is my understanding:

When you take D3, it has an s shaped response curve. It's not linear. This has one of two effects.

1. People will get different blood concentrations wrt IU intake.

2. People will get different effects from the different blood concentrations.

Peoples response on how their body reacts to the D3 will place them on different parts of that curve.

So if you're at either the top end or bottom end of the curve you can increase/decrease your D3 with supplementation and/or food sources, but not see any effects.

You will however see a better response if you're on the middle bit with a high gradient.

You can be deficient and start supplementing and not see a great response depending where you are on the bottom plateau. So different people can be deficient and supplement, one person might easily get out of deficiency if he's close to the bend. The other person could take the same amount but see very little effect if say he's to the left of the curve. It's all to do with how your body responds.

Interestingly if you're on the upper plateau a large increase in D3 wont necessarily put you into toxicity - depending on the definition of toxicity. You generally have to go extremely high to do that. That being said, there will be people who are up there also who have a more sensitive response and could achieve that much easier.

This is why, IMO, you should really be cautious about simplifying the process of D3 allocation in terms of IU's. Not only in trials, but in daily supplementation. People look at the IUs and not ng/ml in the blood. You should measure blood concentrations.

If you measured the blood, as in say a RTC, you can adjust accordingly due to changes in diet and sun exposure. Obviously I can see why that's not done. But it certainly is a consideration you should take note of.

As for D3 deficiency, it depends on what you agree is deficient. It's considered that 20ng/ml is deficient. Others say its less than 30ng/ml. But taking 600IUs of D3 won't necessarily take you far enough along that bottom plateau.

I personally do not consider 600IUs to be anywhere near enough. I want to be up on the high gradient part - past the 50ng/ml. I know a lot of people who have taken much higher than 600IUs and are still very low. There are people who take 5KIUs and are still relatively low. This comes as a surprise because they are expecting to be higher up because they assume its linear. This is why blood measurement is so important. Obviously you'll get people who are more sensitive and have a better response.

Yes, there is a lot of great sun exposure in places like Australia and such. When people who are deficient there, it's usually due to them overprotecting themselves from the sun.

They stay out of the sun, wear sunblock and cover up because they are afraid of skin cancer. You should make sure you get your required sun exposure everyday before applying these measures of protection.

Everybody's body types are different, but ideally you are supposed to expose all your body with the exception of your face until you turn a little pink. Usually somewhere around the 30 mins mark. But it obviously depends on how strong the sun is where you live and how used your body is to the exposure.

As you tan, you potentially need to expose yourself a little longer. People with dark skins need a LOT more exposure.

Hope that helps.

Tall_Allen profile image
Tall_Allen in reply toMrG68

All drugs have an s -shaped response curve, and Vitamin D is just another drug (steroidal, btw). As I explained in an earlier post, the bottom flat part is the deficiency concentration. Then it rises steeply as Vitamin D has a natural effectiveness. After that, adding more has no effect, which is what all these RCTs proved.

What you consider personally has no bearing. I agree that occasional measurement is prudent, but as long as one has over 20 ng/dl, that is all that is required to avoid a deficiency.

MrG68 profile image
MrG68 in reply toTall_Allen

So, unless I’m mistaken, and apologies if I am, the resource explains why RANDOMIZED Controlled Trials fail with D3.It’s says one of the confounding issues wrt the results is dosage and all the rest. This is recognized and just allowed anyway.

Yet, your solution is to say that randomization will remove that. The trial is randomized and they say it’s a confounding issue. If randomization removed that, it wouldn’t be a confounding issue wrt the results.

And yes I understand randomization and it’s knock out effects. The issue, however, is you’re trial has a variable dosage. This is also recognized as a confounding issue.

Hope that makes sense.

in reply toTall_Allen

I take vit K2 for bone health. Plenty of science behind it for those not irrationally hostile toward supplements. I also take vit D3 even though I live in a sunny climate area. Patrick had at least one post extolling the benefit of K2 + nattokinase in preventing calcification of arteries. It is all there in this article if you dare to examine it.

healthline.com/nutrition/vi...

MrG68 profile image
MrG68 in reply to

If you eat natto you get a lot of K2 and nattokinase. It's a really great superfood, if you can stand it. Not everyone can tolerate it.

in reply toMrG68

I take a supplement with both K2 and natto so I don't consume natto as part of my diet.

Tall_Allen profile image
Tall_Allen in reply to

There is only hypothesis generation behind it, It is not practice-changing.

tango65 profile image
tango65 in reply todans_journey

All patients with cancer were excluded.

"The trial protocol has been described previously23,24 and is available with the full text of this article at NEJM.org.

Among the exclusion criteria was a history of cancer, cardiovascular disease, or hypercalcemia (Fig. 1). Participants were

not recruited on the basis of vitamin D deficiency, low bone mineral density, or fracture

history.

After a 3-month placebo run-in phase,

participants who took at least two thirds of the

trial pills underwent randomization. Participants agreed to limit any nontrial supplements

of vitamin D to 800 IU per day and of calcium

to 1200 mg per day"

This is link to the study #23 mentioned above which has the trial protocol:

ncbi.nlm.nih.gov/pmc/articl...

KocoPr profile image
KocoPr in reply totango65

It seems a lot of these studies with supplements are designed to fail. Why with all the lab studies on vit D and K2 wouldn’t they include K2 and the dose of vit D is way to low, plus it looks like these are healthy people in the study. Also did the study take into account time of year latitudes, sun exposure.

This study is useless. Im still listening to my MGH OC and taking Vit D . I would never take it without K2.

Oh and anytime i get up feeling stiff and sore like an old man i take my 10k vit D with K2 and i wake up next day like a new person.

Tall_Allen profile image
Tall_Allen in reply toKocoPr

You can do whatever you like, but there is no science behind it. There is much to be said, however, for the placebo effect.

Lab studies are only used to develop hypotheses. Higher doses of Vitamin D deplete BMD.

MrG68 profile image
MrG68 in reply toTall_Allen

That’s what amazes me actually. Placebos are used in trials and it’s accepted that there is a placebo effect - the ability to react to something due to belief.But a vitamin? Nope totally useless.

Tall_Allen profile image
Tall_Allen in reply toMrG68

So you hold the unfounded belief that placebos exist for every other pill except this one?

Schwah profile image
Schwah

Any other impacts (good or bad) studied besides fractures? Schwah

Tall_Allen profile image
Tall_Allen

No benefit for diabetes, and here's what I have:

prostatecancer.news/2018/07...

nejm.org/doi/full/10.1056/N...

Fiddler2004 profile image
Fiddler2004

Thanks for the heads up...

Jalbom49 profile image
Jalbom49

The official daily dose of 400u Vit D was set to prevent rickets.It has nothing to do with optimal dose for metabolic and immune health.

Recent papers suggest optimal serum levels to 50ng/ml requiring a dose of 5000u/day or more.

The fat soluble Vitamins A,D,K2, all work synergisticly. Not K1 which is a coagulation factor.

For those who wish to get D from the sun, there is a free app, D Minder, which allows you to monitor your exposure.

New research shows further benefit from the sun, but not from uv, but from near infrared, which stimulates intramitochondrial Melatonin, the most powerful antioxidant.

MrG68 profile image
MrG68 in reply toJalbom49

Yes, I had that on my list of things of interest - the infrared affects on mitochondria.It got lost somehow. Doh!

6357axbz profile image
6357axbz

Thanks TA

Manilo profile image
Manilo

I started Calcium and vitamin D two years ago to reduce osteoporosis I had 5 vertebrae smashed in 3 events

I then had kidney stones and had to do litotricy

I stopped vit D and calcium

I started walking around 2 miles per day and within 6 months my femur went from 2.5 to 0.8 in densitometry. No more osteoporosis there.

Now I walk even more, and I do moderate weight lifting and gym to workout all muscles around the spine and ribs, arms, etc, to calcificate the bones

I refused taking denosumab. Oncologist said osteoporosis would never go back. Only increase. Except if taking denosumab, that it would stop increasing.

MO was wrong. Exercise giving Some pressure and stress to the bones, induces them to calcification to counteract impact and stress

Pte82 profile image
Pte82 in reply toManilo

Manilo, vitamin D and calcium need magnesium for bone health. My mother's doctor told her to take calcium and vitamin D for bone health. She developed osteoporosis and when she stood one day her femur broke. I asked the doctor why this happened and was told she is 85 and nothing can be done. I learned about magnesium and when included with the calcium and D she increased her bone density. Even today calcium with D alone is still being used as the gold standard. Now K2 is being included with calcium and D but without magnesium poor results will continue along with kidney stones and calcification of soft tissue.

Tall_Allen profile image
Tall_Allen in reply toPte82

Instead of multiplying the pills popped (magnesium and K2), of which there is NO good evidence of effectiveness, she may be better off with an estrogen patch and whatever exercise her doctor recommends.

Pte82 profile image
Pte82 in reply toTall_Allen

Just adding magnesium to what she was using restored bone, no K2

Manilo profile image
Manilo in reply toPte82

I eat magnesium in my diet. As well as calcium. And now I use the sun for vitamni D instead of pills.Exercise a lot and good diet. My osteoporosis is going back to normal levels.

Your mother doesn't have prostate cancer. With ADT it is another situation.

I am glad she is calcified with those magnesium pills.

Try guacamole, which also has lots of magnesium. And green leafy greens for calcium.

Vitakine D from the moderate sun exposure

Pte82 profile image
Pte82 in reply toManilo

Look into annatto tocotrienol for your bones and prostate cancer.

MrG68 profile image
MrG68 in reply toTall_Allen

Doesn’t have to take any pills. Just eat foods with magnesium and K2.

in reply toPte82

Magnesium is also important for heart health. With a history of atrial fibrillation I take magnesium. I stopped taking it along with my a-fib meds, prior to a-fib ablation surgery. They tested me before the surgery, said I was magnesium deficient and gave me magnesium. Imagine that -- a heart surgeon (electrophysiologist to be precise) validating a magnesium supplement !

Pte82 profile image
Pte82 in reply to

WSOPeddie, BINGO! My mother's heart issues were resolved when she began using magnesium for her bones. This krispin link may be of interest to you, it has a list of causes for loss of magnesium plus other stuff.

krispin.com/magnes.html

MrG68 profile image
MrG68 in reply to

Yes. I had somewhat of a similar experience. What the doctor was suggesting was crazy. I wasn’t on meds, but they were trying to get me to consider all kinds of things.

in reply toMrG68

All kinds of things ... meaning supplements? I'm a proud and grateful supplement taker.

MrG68 profile image
MrG68 in reply to

Nope, he considered supplements are a waste of time. Yet, potassium and magnesium sorted out my issue.

in reply toMrG68

A lot of doctors despise supplements and chiropractors.

Tall_Allen profile image
Tall_Allen in reply to

Someone has to stick up for science

in reply toTall_Allen

They are protective of their turf -- which doesn't include supplements. Can't prescribe them so no money in it for them and supplements encroach on their medical 'science' (i.e. stuff they learned in medical school, not science in the broader sense).

leebeth profile image
leebeth in reply to

They are not paid to write prescriptions so that logic does not make sense. Physicians also prescribe exercise. The benefits are proven. That’s the difference.

in reply toleebeth

Generally you have to make an appointment to see them to write a new prescription and sometimes even to get one refilled. They bill that visit. When was the last time your doctor suggested that you see them before taking a supplement? Exercise? We shouldn't need a doctor to 'prescribe' that. BTW, I've had a doctor refuse to write a prescription for metformin that I requested and he refused to renew a prescription for lorazepam for occasional insomnia. When he left and a new doctor replaced him, she readily wrote those prescriptions. Apparently her ego wasn't threatened by a patient making such requests.

Tall_Allen profile image
Tall_Allen in reply to

When I need a drug, I talk to my doctor on the phone or through the patient portal. In your case, the first doctor had more interest in having his patients not take unnecessary drugs. It sounds like the second one would have given anything you asked for.

leebeth profile image
leebeth in reply to

I do not need to see my provider if I need a new prescription or a refill. The phone or the portal work just fine. I am glad my doctor does not just prescribe any prescriptions I might demand, but instead we have a dialogue about any proposed med. If my request is not based on science, and evidence, I hope that the request is not granted but an explanation given as to their thought process.

As a nurse, I have seen first hand some of the complications that can occur when a patient takes supplements and does not report this to their provider.

Boywonder56 profile image
Boywonder56

Thanks ta my onc had d tested came back somewhat low....but i attributed it to lack of sun since i was limiting exposure to the relentless houston heat.....he wants me on xgeva for bone loss in hips and spine , from now stable mets...but i have nixed it as the oral side effects will probably add to the dental problems already incurring from adt...ill start dunking my oreos in whole milk stead of skim.....

Tall_Allen profile image
Tall_Allen in reply toBoywonder56

Maybe try an estrogen patch (with tamoxifen) and increase weight-bearing exercise? A weaker bisphosphonate, alendronate, is used in the UK.

Boywonder56 profile image
Boywonder56 in reply toTall_Allen

Thanks ta....

swwags profile image
swwags

I'm always skeptical of small trials, but to Tall_Allen's point, here are the results of a much larger study that confirms the same:pubmed.ncbi.nlm.nih.gov/304...

and in plain English:

statnews.com/2022/07/27/dai...

in reply toswwags

As already discussed here one needs weight bearing exercise. I also recommend magnesium and vit K2 for bone health. It isn't rocket science. Supplements aren't superstition either.

MrG68 profile image
MrG68 in reply toswwags

Yes and some would argue that 2K is too low to really have an effect. Unless of course if you believe that the the RDA is adequate at an equivalent of 600IUs.

Tall_Allen profile image
Tall_Allen

Often, patients read studies like that and jump to erroneous conclusions. All it says is that magnesium as well as all micronutrients is important for our health. It says, get it tested once in a while to see if your serum levels are low. If not, do nothing! If low, the first step should be to get what you need from the foods you eat. There is likely to be better balancing of nutrients, sustained health of your microbiome, and better bioavailability is you get it through food.

OTOH, supplements tend to throw everything out of whack. As you see in some comments above, to deal with the imbalance, you will have to take even more chemicals. There are toxicities that occur when you take too much of anything. Your body wasn't designed for supplements - it was designed for food.

KocoPr profile image
KocoPr in reply toTall_Allen

No doubt if you are deficient in a certain nutrient the closer to the source the better, but most people are now deficient in magnesium because the soils have been depleted.

I would say prescription drugs are far and above the number one reason things are thrown out of whack, and Doctors prescribe many more drugs to counter the damage the previous prescription.

Many more health issues from prescriptions than supplements.

Magnesium depletion in soils

ncbi.nlm.nih.gov/pmc/articl...

higher soil concentration of K+, Ca2+ and ammonium results in lower Mg availability to plant roots because of competition during the uptake process.

Tall_Allen profile image
Tall_Allen in reply toKocoPr

It's impossible to have photosynthesis without Mg. So green leafy vegetables are the best source. No reason to supplement if serum levels are OK. Check first before popping a pill.

We have no idea how many health issues are caused by unwarranted supplements. It is not reported. We do know that people with cancer who take supplements are twice as likely to die.

prostatecancer.news/2018/07...

Pte82 profile image
Pte82

smurtaw, good article, thanks. Use as little as 3mg of boron adds magic to the mix. If you have time Dr Jorge Fleschas MD has a youtube video called Boron and Health is worth a watch.

ncbi.nlm.nih.gov/pmc/articl...

KocoPr profile image
KocoPr

Thanks TA,

From reading that article it wasn't the herbs,supplements etc that killed the patients earlier than conventional treatment it was the ,,,,

Per the article:

Although these observational studies did not follow prostate cancer patients long enough to detect differences in survival, we see the damage that use of both complementary and alternative medicines had on patients with more virulent cancers. Patients who get complementary medicine are more likely to refuse conventional treatments (even though they received at least one conventional treatment) and are about twice as likely to die because of that decision.

Now that I can totally agree with.

I recently had a family friend call me for advice and she told me she got diagnosed with BCa a year ago with small lump on breast and now she has a lump on neck and armpit. She saw the OC right away but refused the chemo and radiation and decided to go to hippocrates institute for a week.

She asked me what herbs to take while she was coughing and i asked are you smoking she said yes. I told her that im not going to pull any punches and she said thats what she wanted. I said your gonna die if you don’t do what the OC says and stop smoking, get on a very healthy diet.

So she definitely fits in the statistics for that study.

I myself may fit in that category as I followed the OC, and RO, except i got the radiation but not ADT. Then a few years later i had bio recurrence and delaued till my PSA climbed to 15.

I am presently on darolutamide and lupron but am supplementing.

Still it is important to have your macros measured. Although how does one measure curcuminoids, flavanoids, flavones, etc that are the main constituents of studies in the plants.

From the article:

Complementary medicine was defined as use of “other-unproven: cancer treatments administered by nonmedical personnel” in addition to at least one conventional cancer treatment modality, defined as surgery, radiotherapy, chemotherapy, and/or hormone therapy. 258 patients who chose a complementary therapy were matched to 1032 patients who did not use any complementary medicine on age, clinical group stage, Charlson-Deyo comorbidity score (CDCS), insurance type, race/ethnicity, year of diagnosis, and cancer type using the propensity score matching technique.

After 5 years of follow-up, comparing users of complementary medicine to matched non-users:There was no difference in delay of treatment, but there was a greater probability of refusal of surgery (7% vs 0.1%), chemo (34% vs 3%), radiotherapy (53% vs 2%), and hormone therapy (34% vs 3%).

82% survived for 5 years vs 87% among non-users, and were 2.1 times more likely to die after adjustment.

The differences in survival were attributable to refusal of conventional treatment.

Differences in 5-year survival were significant for breast cancer (85% vs 90%), and colorectal cancer (82% vs 84%), but not for lung cancer or prostate cancer.

Alternative medicine was defined as “other-unproven: cancer treatments administered by nonmedical personnel” and who also did not receive conventional cancer therapy, defined as chemotherapy, radiotherapy, surgery, and/or hormone therapy. 281 patients who used alternative medicine were matched to 560 patients with similar characteristics (cancer type, age, clinical group stage, CDCS, insurance type, race, and year of diagnosis) who did not use alternative therapies using propensity score matching.

After 66 months median follow-up, comparing users of alternative medicine to matched non-users:

55% survived for 5 years vs 78% among non-users, and were 2.5 times more likely to die after adjustment.

Differences in 5-year survival were significant for breast cancer (58% vs 87%), lung cancer (20% vs 41%), colorectal cancer (33% vs 88%), but not prostate cancer (86% vs 95%)

The survival curves for prostate cancer had just begun to diverge at 5 years (75% were low or intermediate risk).

Bigmaristuff profile image
Bigmaristuff

Many prostate cancer victims cling to the belief that there is more to life than ADT, chemotherapy, radiation therapy and surgery. I tried to link the YouTube video and it failed to load on this forum. So, do a YouTube search for Dr John Campbell : vitamine D and Prostate cancer. Today is June 1, 2023 and the video was published 1 month ago. Check it out and by all means, discuss it with your doctor.

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