From MedPageToday
Questioning Medicine: The Vitamin D Craze
Published: Nov 25, 2014 | Updated: Nov 26, 2014
By Joe Weatherly DO
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner
Joe Weatherly, DO, and Andrew Buelt, DO, are family medicine residents in St. Petersburg, Fla. Together, they co-produce the podcast Questioning Medicine, where they deconstruct issues confronting today's clinicians. In this guest blog, Weatherly gives his take on vitamin D research.
Now that the vitamin D research fires have begun to die down, I wanted to look into this apparent health fad to see what, if any, evidence came from the intense focus on this particular supplement. In 2012 alone, there were more than 3,600 publications in PubMed on vitamin D: opinion articles, small studies, large studies, evidence reviews, and meta-analyses. Then a review of the meta-analyses with a little "expert opinion" to top things off.
In the end, I think an overwhelming lack of definitive evidence was, in and of itself, the conclusion. We did, however, learn a few things about screening for hypovitaminosis D, potential outcomes associated with it, and potential benefits from treatment.
Screening
Just this week, the U.S. Preventive Services Task Force (USPSTF) said there was not enough evidence to support screening asymptomatic individuals for low vitamin D.
The main harm associated with testing for hypovitaminosis D is cost. Even though testing may hover around the $100 range, repeat non-evidence-based testing among several groups on an already strained healthcare system could redirect valuable healthcare dollars away from patients with other illnesses.
Causes of Hypovitaminosis D
Some of the most common causes of vitamin D deficiency are believed to be:
Questioning Medicine: The Vitamin D Craze
Published: Nov 25, 2014 | Updated: Nov 26, 2014
By Joe Weatherly DO
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner
Joe Weatherly, DO, and Andrew Buelt, DO, are family medicine residents in St. Petersburg, Fla. Together, they co-produce the podcast Questioning Medicine, where they deconstruct issues confronting today's clinicians. In this guest blog, Weatherly gives his take on vitamin D research.
Now that the vitamin D research fires have begun to die down, I wanted to look into this apparent health fad to see what, if any, evidence came from the intense focus on this particular supplement. In 2012 alone, there were more than 3,600 publications in PubMed on vitamin D: opinion articles, small studies, large studies, evidence reviews, and meta-analyses. Then a review of the meta-analyses with a little "expert opinion" to top things off.
In the end, I think an overwhelming lack of definitive evidence was, in and of itself, the conclusion. We did, however, learn a few things about screening for hypovitaminosis D, potential outcomes associated with it, and potential benefits from treatment.
Screening
Just this week, the U.S. Preventive Services Task Force (USPSTF) said there was not enough evidence to support screening asymptomatic individuals for low vitamin D.
The main harm associated with testing for hypovitaminosis D is cost. Even though testing may hover around the $100 range, repeat non-evidence-based testing among several groups on an already strained healthcare system could redirect valuable healthcare dollars away from patients with other illnesses.
Causes of Hypovitaminosis D
Some of the most common causes of vitamin D deficiency are believed to be:
- Inadequate exposure to sunlight (sunscreen or dark skin)
- Obesity
- Fat malabsorption syndrome (e.g., celiac disease)
- Bariatric surgery
- Nephrotic syndrome (vitamin D bound to albumin)
- Drug catabolism (HIV medications and anticonvulsants)
- Granuloma-forming disorders, lymphomas, and primary hyperparathyroidism
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