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Vitamin D: a pseudo-vitamin for a pseudo-disease No association between vitamin D levels over a lifetime and the risk of fracture

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MEle
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By Tim Spector, King's College London

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I understand from my family doctor there is no way of preventing fractures apart from being careful and that the alendronic acid or prolia are hopeless against this. However in this part of the world, our summers are hopeless so we do need extra vitamin D. Vitamin D has many proven advantages especially to our immune system so I would not be dismissing this valuable vitamin for no good reason

Nanaedake profile image
Nanaedake

The article states that we should all focus on a healthy diet and sunshine. Unfortunately, a lot of people in this country do not get out into the sunshine even in the summer as they work indoors in shops or offices without windows. It states that evolution should have made us able to cope with low winter vitamin levels. However, it's only in recent years that people have spent so much time indoors and, when outside, covered in sun screen so perhaps evolution hasn't had to adapt?

The article dosen't state whether vitamin D levels were checked in healthy people or those with health conditions. Doesn't a meta analysis mean looking back at previous information to extrapolate data? What might be true for a healthy person might not be true for someone with a health condition and fracture prevention might not be the main benefit of good vitamin D levels.

It might be true that no one can totally prevent a fracture from a fall but osteoporotic fractures often don't involve a fall. Apparently, there is evidence that bisphosphonates increase bone density in some people, however, we might all find out the science is flawed.

The article talks about a healthy diet but there doesn't seem to be a consensus in the UK about what a healthy diet is. In fact, it's probably pretty difficult to maintain a healthy diet as we mostly don't know what our foods have been sprayed with, what fertilisers have been used and what genetic modifications have been made.

Probably the right kind of exercise is the best thing we can do to help ourselves and of course, I'd love a few months holiday in the sun every year - wishful thinking though.

Bev53-SB profile image
Bev53-SB in reply toNanaedake

Well said

HeronNS profile image
HeronNS

And what about Vitamin K2, which used to be adequately supplied by a healthy diet, but because of changes in the way we feed our animals (grain instead of grass) most North Americans at any rate are deficient in this vitamin which has been shown to directly benefit the bones? We take supplements because the base is now so low in many ways owing to a decline in the nutrition of our food. Maybe someone living in sunny Spain near sources of grassfed animals and their products, fresh caught oily fish and loads of fresh vegetables and fruits can be healthy as healthy without supplements. But we don't all have the benefit of such an environment.

LynneH-19 profile image
LynneH-19

Unfortunately as we get older our bodies are less efficient at making D3 from sunshine.

I usually take D3 at least 5 times a week. Dosage varies summer (2000 IU) and winter (5000 IU) depending on blood level. I don’t sun bathe, but this summer in the U.K., we have actually had several months of continuous sunshine, so when I wasn’t working indoors, I’ve been gardening or walking and exposing more skin.

I stupidly assumed that I would be making D3, so haven’t been taking my 2000 IU of D3 as frequently over the last couple of months. I was therefore disappointed to find my D level had fallen from 145 nmol/L in Feb, to 105 nmol/L. this month. Still reasonable, but showing that D3 supplements are a more reliable option, as you get older.

Eating a so called ‘healthy’ diet is also harder than it should be, especially getting D3 from diet. Foods that contain D3 are somewhat limited. I buy tinned Wild Alaskan Red Salmon which is a good source of D3, omega 3 and essential protein. But like all sea food, I question how safe is it nowadays, to eat it more than once or twice a week, without risking ingesting toxic pollutants like lead, mercury and God knows what other toxic pollutants.

We can only do our best, but I feel the farming/food industry is getting out of control. The fact they are now allowed to spray crops in the U.K. with glyphosate just prior to harvesting, beggars belief!

Met00 profile image
Met00 in reply toLynneH-19

I had the same experience as you, Lynne, Vit D levels dropped significantly during the summer despite spending loads of time in the sun, so I won't be reducing my supplement over the summer months in future!

HeronNS profile image
HeronNS in reply toLynneH-19

There was big push back regarding genetically modified wheat. I think the farmers simply said they would never plant it. As far as I know it's never been approved. So if any GM wheat is on the market it's actually illegal. But the same farmers (I'm talking Canada here) blithely spray glyphosate on wheat as a dessicant. So we really aren't any further ahead. 😡

Met00 profile image
Met00

I have several questions about this study! First, when it talks about "higher" vitamin D levels, what levels were actually being compared? The NHS says anything over 50nmol is sufficient, so if they were, for example, comparing levels of say, between 30nmol (mentioned in the article as adequate) and 70nmol and this showed no difference in fracture risk, it could be that nobody in the study had sufficiently high Vit D levels over their lifetime to make a difference! Second, it looks as though they looked at Vit D on its own, but there's a lot of evidence that our diets are deficient in other vitamins and minerals, which all impact on how Vit D works to send calcium into the bones to keep them strong and healthy. For example, what about Vit K2 and magnesium? Third, it mentions a meta-analysis of 50,000 older people, where Vit D and calcium supplementation made no difference to fracture rate. How does this relate to lifetime Vit D levels? It's known that once we get past age 30 or so, we stop "depositing" good bone, and from age about 40 our bones start to thin. In which case those first 30 years are the time that Vit D levels would be expected to make a difference (along with plenty of weight-bearing exercise and a healthy diet, rich in calcium, magnesium and K2). And finally (sorry to go on!), the article dismisses Vit D as having no benefit in preventing fracture risk, yet completely overlooks the many other health benefits of high vit D levels, such as reducing cancer risk.

LynneH-19 profile image
LynneH-19

I agree. Since keeping my D at around 150nmol/L. For a few years, I haven’t had a cold or other infection, even though I work with younger staff who always get seasonal infections. Vit D3 certainly seems to help my immune system.

HeronNS profile image
HeronNS

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

It's an interesting and up to date publication. But I note with concern that the overactivation of Vitamin D caused by sarcoidosis is not mentioned. As sarcoidosis can be non-symptomatic people may have it and never know. I insisted on a Vitamin D test early in the polymyalgia/prednisone journey because I have biopsy-proven sarcoidosis. It was found that my D was nearly to the toxic level. It took a winter of no extra D supplements to get it down to a low normal, then just taking half what my doctor had recommended when I started prednisone to bring it to an optimum level. Because I can only have the test once a year, despite being a patient at risk, it will be interesting to find out what my level will be the next time I can arrange a test.

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