Diagnosis and treatment of Vitamin D deficiency

[Bill]

http://www.vitamindcouncil.org/PDFs/diagnosis-vitdd.pdf

[Bill]

Three treatment modalities exist: sunlight, artificial ultraviolet B radiation or supplementation. All treatment modalities have their potential risks and benefits. Benefits of all treatment modalities outweigh potential risks and greatly outweigh the risk of no treatment.

[Bill]

Recently, 50,000-IU capsules of colecalciferol (vitamin D3) became available at some health-food stores in the US and over the internet. Grey et al. recently treated 21 vitamin D-deficient patients with 50,000 IU of colecalciferol weekly for 4 weeks, then 50,000 IU monthly for 1 year [75]. Blood levels rose from a mean of 11 ng/ml at baseline to 30 ng/ml at 6 months and to 31 ng/ml at 1 year, indicating such doses do not achieve natural 25(OH)D levels and that 25(OH)D levels do not continue to rise after 6 months of such treatment.

[Bill]

Cod liver oil contains a variable amount of vitamin D, but usually contains high amounts of vitamin A. Consumption of preformed retinols, even in amounts consumed by many Americans, may be causing low-grade, but widespread, bone toxicity [76]. Vitamin A antagonises the action of vitamin D [77] and high retinol intake thwarts the protective effect of vitamin D on distal colorectal adenoma [78]. Different brands of cod liver oil contain variable amounts of vitamin D, but usually high amounts of vitamin A; the authors do not recommend cod liver oil.

[Bill]

It is important to understand that neither the regular consumption of recommended amounts of vitamin D (e.g., 400 IU of vitamin D in a multivitamin) nor the regular consumption of vitamin D fortified foods (e.g., 100 IU/8-oz glass of milk) effectively prevents vitamin D deficiency [79,80]. Furthermore, 2000 IU/day for 1 year failed to achieve a 32 ng/ml target 25(OH)D concentration in 40% of 104 African-American women studied

[Bill]

Previous skin cancers, especially cutaneous melanoma, are contraindications to excessive UV exposure, although a recent study found reduced mortality in melanoma patients who had continued exposure to sunlight [93]. However, for a number of reasons – including medical-legal reasons – the authors recommend oral treatment for patients who have had any type of skin cancer.

So, even though the evidence is that people with melanoma will actually do better if they receive continued UVB exposure, the author doesn't recommend it because he is afraid of being sued. A perfect example of CYA.

[mcguffy]

hmmm, interesting

[Bill]

Yes, I found it interesting too.