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NEJM: Vitamin D deficiency may be exaggerated

Vitamin D is essential for strong bones and may play a role in other health conditions, but it is not certain. Misconceptions about vitamin D   recommendations can lead to misinterpretation of blood tests. Many people   think they need more vitamin D, but in fact they do not need that much. In a   study published Thursday in NEJM, some experts Help sets the limit level.


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Recently, the doctor once again made a warning about vitamin D, you may think, this is "we need more vitamin D" message. Instead, they say, we do not have too much of a need for a vitamin D blood test, too many people taking an excessive amount of vitamin D.

Vitamin D is essential for strong bones and may play a role in other health conditions, but it is not certain. Misconceptions about vitamin D recommendations can lead to misinterpretation of blood tests, and many people think they need more vitamin D, but in fact they do not need that much, published in Thursday's New England Journal of Medicine. In the study, some experts helped set the level of qualification. The correct explanation is that less than 6 percent of Americans (ages 1 to 70) are deficient in vitamin D, and only 13 percent are at risk for vitamin D deficiency. "But these levels do not constitute a disease," the authors write.

However, one might argue that there is still risk.

Doctors do not recommend blood levels of vitamin D testing, unless the body has a problem, such as osteoporosis suspects, but this test is more and more. In health insurance, from 2000 to 2010, this test increased by 83 times last year, 8.7 million test, each test costs 40 US dollars. This is the fifth most common test in health insurance, second only to cholesterol levels, more than blood sugar, urinary tract infections and prostate cancer screening.

"I do not know when the epidemic begins to detect each person 's vitamin D deficiency, but patients are often asked to do it, especially baby boomers," said Kenny Lin, a family physician and preventive medicine expert at Georgetown University.

The use of vitamin D pills has also increased in the United States, from 5 per cent in 1999 to 19 per cent in 2012. This may be due to the fact that many studies have shown that "sunshine vitamins" are too little to cause harm and that our skin can produce vitamin D from sunlight. In the winter or from food sources (such as milk and oily fish) is difficult to get enough vitamin D, but many foods and drinks are added to vitamin D, the tag will soon have to carry this information.

Too much vitamin D may cause high calcium in the blood, which can cause nausea, constipation, kidney stones, abnormal heart rhythms and other problems.

"We are not saying that moderate doses of supplements are risky, but more are not necessarily better," said JoAnn Manson, Ph.D., of Brigham and Women's Hospital. "In this paper, she and several other medical research consultants, Set RDA, or recommend a meal allowance.

People are physically different, so they need any different vitamins. The institute evaluated this by comparing the various measures of intake and blood levels with bone health. They estimate that, on average, about 400 international units of vitamin D are needed every day, while those over 70 need 600 international units.

For safety, and to ensure that everyone has enough vitamin D, they set the RDA at the high end of the population's demand spectrum - 600 to 800 IU according to age. Therefore, by definition, almost everyone really needs vitamin D are below this level.

The authors write that many people and their doctors believe that RDA and its corresponding blood levels as a cut-off value for each person need to be above this value. As a result, people are often told that they are deficient in vitamin D or lack vitamin D, in fact, they are not.

"If you are pursuing a laboratory quantity, this will result in a lot of people taking more than the demand for vitamin D," Manson said. "The quality of testing in the lab is very different."

The bottom line, says Manson, is to get 600 to 800 units of vitamin D a day from food or supplements, and skip blood tests unless you have a specific risk factor.

She is helping to guide an important study that is testing whether higher levels of vitamin D can lower the risk of cancer, heart disease, stroke, memory loss, depression, diabetes, bone loss or other illnesses. Nearly 26,000 people ingest 2000 units of D-3 (the most active form of vitamins, also known as vitamin D3) or placebo every day for five years. The results are expected to be released in early 2018.

Reference: Vitamin D Deficiency — Is There Really a Pandemic?

DOI: 10.1056/NEJMp1608005

The claim that large proportions of North American and other populations are deficient in vitamin D is based on misinterpretation and misapplication of the Institute of Medicine reference values for nutrients — misunderstandings that can adversely affect patient care.

 


Souce: NovoPro    2016-11-16