Why does the government ignore evidence for the benefits of Vitamin D?

Just how much do we need?

It’s probably worth clarifying how vitamin D is measured at this point. It gets a bit tricky because it can be measured in two different ways: – nanomols per litre (nmol/L) – used in the UK – and nanograms per millilitre (ng/mL) used in the USA. To convert one to the other 25 nmol/L = 10ng/mL. There are also two ways of measuring the amount contained in food or supplements – micrograms (μg or even mcg=millicentigrams) and in international units – IU. Traditional UK advice has been that an adult needed 200IU or 5 micrograms a day.

The amount which people need to get in their food or from a supplement to raise the amount in their blood by a certain amount varies enormously. But a rough guide is the basic intake of 200 IU (5 μg) per day can raise the vitamin D in your blood by 2 ng/mL (5 nmol/L) in about 3 months. So to push your blood level up from 25 nmol/L to 125 nmol/L you would need at least 100 μg or 4,000 IU a day for 3 months.

My experience made it clear that the reason doctors weren’t being told, or at least encouraged, to check patient’s levels and supplement if they were too low was that the SACN was only advising about the minimum required to avoid problems and not the optimum need to provide better health.  Also, the SACN did not seem to accept some of the latest research, especially Observational studies. What happened next confirmed this.

I did a bit more sleuthing and discovered that the body that SACN reported to was the now defunct Food Standards Agency (FSA). So in December 2009 I went to the next meeting of the Food Standards Agency and asked whether they were aware of the Call-To-Action group and all the evidence for widespread deficiency they had been collecting and the benefits of supplementing to correct it.  The answer I received was alarmingly inadequate.

We can all get enough from food and sun: not true

The FSA – the body set up to monitor our food and eating habits – told me two things:  that everyone could receive sufficient Vitamin D from their food and secondly that anyway people could get what they needed from the sun. Neither is true in the UK.

You would have to eat at least four oily fish a week (which almost no one in the UK does) to be getting even close to the amount Call-to-Action were recommending and in the UK it is impossible to make any vitamin D from the sun for about six months of the year.  I was so incensed by this level of ignorance and the harm it was doing to people that I went home and wrote a 9-page letter to the Chairman of the SACN and hand- delivered it the next day.  I also wrote covering letters to all 5 of the Health Ministers and a few other significant people like the Chief Medical Officer.

I learnt 2 things from this exercise:

  1. That ministers don’t want to know about widespread vitamin D deficiency because they all referred me back to the SACN, saying they were “waiting for advice from our experts, the SACN”. This committee was as good as government expertise on vitamin D could be.
  2. That the naive idea that I and others had that SACN and related government bodies were interested in discovering how nutrition and supplements could improve people’s health was simply wrong.

This became all too clear when I went to the next SACN meeting following the delivery of my letter. The committee did discuss it and the chairman and the minutes of the meeting gave me the response:  “What you are asking for is “Risk Management” but this committee only does “Risk Assessment””.

Rufus Greenbaum

Rufus Greenbaum

Rufus Greenbaum describes himself as a “private individual” but he has an extensive knowledge of Vitamin D and has also been experimenting with various approaches to preventative health and recording the results. His page with Vitamin D UK data.
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12 Comments

  • Good to know that people are picking up on this and trying to get the health professionals to pay more attention to it in the UK!

    You have a small but important error on this page:
    ” Traditional advice has been that an adult needed 200IUs or 5mg a day.” 5mg should be 5mcg.

    Personally I found that, despite eating oily fish twice a week, eating butter (fortified with vit D to “summer butter” levels) AND taking a fish oil supplement daily, I was STILL mildly deficient in vit D (by Australian standards, where I now live). Vit D testing is quite common here, as so many people use so much sunscreen and stay out of the fierce sun – and they are quite keen to promote supplementing it to prevent certain possible health outcomes, including bowel cancer, MS, Alzheimer’s. In my case, supplementing vit D3 separately MAY have contributed to a successful pregnancy after 3 miscarriages (low vit D status being associated, as I’m sure you know, with both miscarriage and subfertility).

    I still take 3000IU per day and on my last blood test, my levels hadn’t fallen out of range again so that’s good news.

    Keep up the good work with trying to get more people to understand the value and importance of good vit D levels.

    • Editorial

      thanks for pointing out the error – will correct. Resistance to vit D still strong here – about 18 months ago I suggested a story on vit D to the BMJ – British medical Journal) to be told “we don’t believe in vitamin D”!

      • The BMJ “don’t believe in vitamin D”?? Good grief.

        Mind you, I’m not sure they believe in coenzyme Q 10 either, although they have allowed articles on that component’s depletion due to statin use, so maybe it is “more important” than vitamin D in their eyes.

        Vitamin D must be more of a threat to certain extremely large commercial enterprises than I thought!

  • When I was in hospital recently with a kidney stone I was asked if I took vitamin D. They told me it that it can cause kidney stones (LOL). Any comments on this?
    Eve

    • Editorial

      Hi I am not a clinician and I’ll try to get a response for someone better qualified but this is a copy of the first two paragraphs of a report on the news site Science Daily in October this year. It seems reassuring.

      Vitamin D Does Not Contribute to Kidney Stones
      Oct. 17, 2013 — Increased vitamin D levels may prevent a wide range of diseases, according to recent studies. However, some previous studies led to a concern that vitamin D supplementation could increase an individual’s risk of developing kidney stones.
      However, a study of 2,012 participants — published in the American Journal of Public Health -found no statistically relevant association between 25-hydroxyvitamin D (25 (OH)D) serum level in the range of 20 to 100 ng/mL and the incidence of kidney stones.

      See the full version at:
      http://www.sciencedaily.com/releases/2013/10/131017173352.htm

  • Rufus this needs to go on Facebook.

    Eve

  • Rufus, excellent article, thank you.A conference, titled “Vitamin D, Sun and Human Health,” will be held on April 28th and 29th 2014, at the Holmenkollen Park Hotel in Oslo, Norway.
    The conference will provide the latest scientific news and research on all things related to vitamin D. This includes deficiency, supplementation, sun exposure, and health benefits of adequate vitamin D levels. The conference is mainly aimed for health professionals, medical doctors and researchers.
    Organizers are currently accepting proposals for presentations at the conference. In addition, they invite all attendees to submit an abstract to publish in a special edition of Dermato-Endocrinology, on vitamin D, sun and health. Abstracts must be original, unpublished work.
    For more information on the conference and how to register, and more, visit the conference website: http://oslo2014.d-vit.eu/

  • I have shared this on my FB page…. it is an excellent article about a deplorable situation. And without attempting any racism at all… how do Muslim Women who must cover themselves completely manage to keep their levels in the ‘normal’ range? GP’s in the UK obviously don’t care….. It sounds as if they wait for signs of Rickets to offer healing?

    by the way EDITOR I am not receiving regular notifications of new items posted…. I did register and you did say all was OK

    • Editorial

      Not sure it is fair to say UK GPs don’t care about vitamin d status of Muslim women, some are certainly well aware of it and try to help but but getting official recognition of the need for testing and supplementation is difficult.
      Sorry to hear you are having problems getting notification of new postings, will check out what’s happening.

  • I figured out more new stuff on this weight loss issue. One particular issue is that good nutrition is tremendously vital whenever dieting. An enormous reduction in bad foods, sugary ingredients, fried foods, sweet foods, beef, and whitened flour products may be necessary. Keeping wastes parasitic organisms, and toxic compounds may prevent aims for shedding fat. While specific drugs briefly solve the problem, the nasty side effects will not be worth it, they usually never present more than a non permanent solution. This can be a known idea that 95% of fad diets fail. Many thanks sharing your thinking on this blog site.

  • Excellent, Rufus.

    It is readily apparent to reasoned analysis that the way we live out our lives involves less frequent exposure to sun compared with times of the past, and even the best of dietary sources represent inadequate supply, hence the reason pale skin (deficient in the natural dark pigment and sub-block melanin) makes for a good evolutionary adaptation to more temperate latitudes – we need the necessary exposure to the sun to photosynthesise cholecalciferol (vitamin D) from its biochemical pre-cursor, cholesterol, and yet another reason to perceive we need all the cholesterol nature granted us with. That we can synthesise vitamin D is an indication we need to, because it would be rare for diet to match demand. We work longer than we ought, because many of us feel compelled to, then many of us work indoors and rarely see real daylight.

    Vitamin D is said to be genetically restorative. Are you in a position to write a feature upon this for HIUK?

    I’m no biochemist, but I note how genetic theory has advanced of late. The more dynamic and responsive component of the genome actually resides in the epigenome. While the epigenome sounds sophisticated and complicated it must be one of the simplest bits of chemistry in the body. Methyl (-( -CH3 ) tags that may be attached to individual genes render them mute, – so they have no say (cannot express themselves). Ergosterol, D2, 7-dehydrocholesterol, and D3, each look to me that they could be generous methyl group (-CH3) donors given need and appropriate requirement. Does this speculative observation on my part connect with D3s reputed capacity to repair damaged DNA, do you know? Aberrant methylation within the epigenome is increasingly considered the roots of cause where cancers are concerned.

    Additionally, would you know if homocysteine induced cholesterol derived oxy-sterols could be rendered (detoxified) by any antioxidants, and might vitamin E feature? Homocysteine theory has it that usual detoxification of homocysteine involves the process of methylation and the donation of methyl groups from B6, B12, or folic acid which opens the pathway for homocysteine to be converted to methionine. At the same time, if capacity for methylation is compromised homocysteine levels can rise and persist and promote peroxidation of otherwise healthful cholesterol.

    I’m afraid I could not attend debates and meetings of the SACN or NICE. The temptation to stamp up and down shouting indignantly, “It’s the environment you silly (so-and-sos)!! The departure from wellness witnessed in modernity is largely man-made, and the causes reside in aspects of the ‘environment’ we modern humans have fashioned for ourselves.!,” would be too great.

    NICE, the National Institute for Care and Clinical Excellence is not interested in demystifying effect, cause, and prevention. Instead NICE confine the application of their expertise to diagnosis and treatment. This pathway is second rate.

    Moreover the second rate pathway is compounded because the fat/cholesterol hypothesis of heart disease is falsehood from beginning to end, and championing it does much harm and no good. The policy upon lipid modification, prescribing statins, does not uphold standards of best practice and instead rank as guidelines that, in my eyes, trends to clinical malpractice.

    GPs could learn from a Naturally Oriented Institute for Care and Clinical Excellence (NO-NICE) promoting and permitting higher standards of care and prevention. Such a body could defeat the patients present lowly status of cash-cow for the big-pharma, and shave £millions from the national drugs bill.

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