More vit D news:

[PMRpro]

theguardian.com/lifeandstyl...

There are the usual discrepancies in the statements as the Professor said “This is a particular problem within the UK population where almost everyone is going to have vitamin D deficiency, but it’s a particular concern for people with inflammatory diseases,”

while

"The Department of Health has said the vast majority of people in the UK get the vitamin D they need through a healthy diet and sun exposure. Foods naturally high in vitamin D include, eggs, salmon and sardines.

"

which we know is not true.

However,

"DoH expert advisers want the recommended daily intake to increase from three micrograms to 10 micrograms to protect against bone and muscle conditions. They also say supplements may be necessary for certain groups of people and everyone should consider taking them in the winter months.

Hewison said the levels of vitamin D needed to prevent inflammatory diseases may need to be higher; and the paper, published in the Journal of Autoimmunity on Tuesday, suggests it will certainly need to be so for people who have rheumatoid arthritis.""

It will be interesting if they find that the inflamed cells in PMR/GCA and other autoimmune disorders also do not respond to vit D normally.

[babssara]

Hi PMRpro, great thought provoker as usual. I have had Vit D capsules prescribed since PMR/GCA, RA diagnosed.

Hope you are keeping well. Granddaughter imminent!!!! So excited,

Babs

[SheffieldJane in reply to babssara]

Hi Babs, I have just packed a rose pink tutu, a little white top with Ruby's name picked out in faux diamonds, and a tiara to send to my 4 year old granddaughter in Australia. You are going to have such fun!

[SheffieldJane]

Hello PMRPro, Is there a way I can take these supplements and avoid bladder inflammation? At present I take Adcal in chewable form. I don't remember the massive dose, once a month pill, I took for deficiency in vit D, giving me any trouble. I think the irritation comes from the chalky deposit that you once explained could be a factor.

[PMRpro Ambassador in reply to SheffieldJane]

I think it is the calcium in the Adcal that is the pest - I have the same problem though, interestingly enough, it is better with a different brand. But you can buy plain vit D from H&B and even Boots for a very reasonable price. You should never up the dose of Adcal or the like to increase the amount of vit D you take - then you get calcium problems and too much calcium is not a good thing.

There are all sorts of versions of vit D - OH gets a spray bottle here in Italy! He like it - he's hopeless at taking tablets!

[SheffieldJane in reply to PMRpro]

Thanks. A spray version sounds good. I'll have a scout around.

[DorsetLady PMRGCAuk volunteer]

Hi,

Even though I stopped Pred over a year ago, my GP recommended I stay on Adcal tablet. Wise man?

[CT-5012]

Thank you PMRpro for the link to a very interesting article, perhaps it's not the pred that causes osteoporosis????

[PMRpro Ambassador in reply to CT-5012]

I don't think it is necessarily pred - I think there is a lot of hype. It may speed things up in patients who are already prone to bone density loss but other than that probably not so much. After all, 50% of the US population are said to develop osteoporosis. But somewhere else there is the figure that 40% of pred patients do. Sounds like a good deal to me!!!!

They don't make a fuss about omeprazole - which can do it all on its own. So they hand it to patients on pred - now THEY may be at risk?????

[CT-5012 in reply to PMRpro]

I was suddenly, more than a year into pred, had this added to my request for repeat prescription of pred. No discussion just a note saying if I was taking pred I should take this too. Not having any problems it went back with a note saying no thanks no problems. Not had it added again. Never decided if it was AA or this that caused IBS first time round with pred.

[Hidden]

Thanks for the info!

Just curious though how much D people are taking and what your docs say is an acceptable D level?

[PMRpro Ambassador in reply to Hidden]

It is generally felt now that up to 10,000 IU per day is OK for most people. But there are conditions where lots of supplemental vit D is NOT a good idea and you may develop a very high blood level. So it needs to be checked annually.

The opinion on what is acceptable is changing - although there are still dinosaurs in the UK who believe about 50 is terribly high when it probably isn't. Over 100 seems more advisable. But of course that depends on the units they are using - 100 – 150 nmol/L (the traditional unit in the UK) is equivalent to 40 - 60 ng/ml.

But the real crux of this study is that people with autoimmune disorders may, for some not entirely clear reason, need a lot more vit D. Low vit D is commonly found in people with a/i disorders - is it cause or effect? Is low vit D so bad for a healthy person? Possibly not.

A study done in Finland some years ago found that supplementing newborns with vit D reduced the incidence of Type 1 diabetes when they got to teenage - which suggests there is a causative element there.

[SusanEleven in reply to Hidden]

I take 4000 IU per day to stay in the normal range. My Vit D blood level was 17 when I insisted on being tested many years ago. My endocrinologist said it was a severe deficiency. She tests my blood annually now.

[SusanEleven in reply to SusanEleven]

Forgot to say my doc and I did a little experiment one year. I increased my daily sun exposure one summer to see if my Vit D level rose. It did not.

[Hidden]

Thanks. My report lists a reference range of 30-100 ng/ml. I thought that seemed pretty broad. My result was 38 which falls in the normal range but I thought was low. It has dropped a bit because I got lazy and wasn’t taking D regularly.

Needed this reminder!

[PMRpro Ambassador in reply to Hidden]

I suspect that is from the low level that is a minimum to the top level they feel you shouldn't exceed in case it is "dangerous". But to some extent that is a bit like the concept that a man with a flag had to walk in front of a car because it was too dangerous to exceed walking pace...

[Insight329]

Interesting read on RDA for Vitamin D

blogs.creighton.edu/heaney/...

[PMRpro Ambassador in reply to Insight329]

How very interesting indeed. No wonder 10,000 IU/day longterm has been found to not be dangerous!

There ARE articles in various places that say the daily REQUIREMENT is IRO 7,000 IU - but of course they then add that a short time in the sun can create 20,000 IU. But it doesn't always - and the advice for the last umpteen years to "avoid the midday sun" and "slip, slap, slop" add to the problem, especially in northern climes. The stocks you achieve by September have to last until the next May - and many are already scraping the bottom of the barrel.

And it is an error that I suspect applies in parallel to an awful lot of research. You can prove almost anything if you choose the right statistics for your paper - and a lot of medics know nothing about statistics and a lot of statisticians brought in to cover that know nothing about biology and medicine.

[Insight329]

blogs.creighton.edu/heaney/...

This article by the late Dr. Heaney is also interesting regarding the importance of protein in conjunction with calcium and Vitamin D in bone health.

(If the link doesn’t work, I got to it from the above mentioned link. It was his previous blog with an arrow to it found in the upper left hand side of the page).

[PMRpro Ambassador in reply to Insight329]

Worked for me - and the theory works for me too. I shall continue with a decent dollop of animal protein - not the meat-free option my GP tells me I need for PMR...

[BonnyQuine in reply to Insight329]

Many thanks - extremely interesting.

[Insight329]

A bit about Dr. Heaney. asbmr.org/publications/news...