Maximizing alarm and minimizing information

Extra Calcium and Vitamin D Aren’t Necessary, Report Says

On health issues the following has got to be a close contender for first place in infuriating:

The very high levels of vitamin D that are often recommended by doctors and testing laboratories — and can be achieved only by taking supplements — are unnecessary and could be harmful, an expert committee says. It also concludes that calcium supplements are not needed…The group said most people have adequate amounts of vitamin D in their blood supplied by their diets and natural sources like sunshine, the committee says in a report that is to be released on Tuesday.

And that’s it, except for details about sources and lists of dire things that can happen if you take too much.

So, most people?  Who are these most?  And is there any age group – ahem! – that might not be included in the most?  For example, like presumably millions of women across American, I’ve been told recently to take calcium-D supplements by two different doctors.  No one said anything about amounts.  So maybe that’s not good advice, but what would good advice look like if you are at the age where women start  to lose bone mass?

So I went to the report itself.  That was not fun.  It is not written for people who do not know the relevant medical terminology.  What I did find out  is that bone health for post-menopausal women and elderly men is about the same.  After that, I couldn’t understand it, but I did conclude that I should get my level of vitamin D checked.  If you do try to search the report, “elderly men” will uncover information for post-menopausal women.  And I’m sure that in the approximate 2,000 hits for you to look at, there’s something there.  And it does all look believable.

There was also a revised guideline for amounts to take:

And that looks useful, except if like me you live in the southern USA you may have a lot of D already from the sun.  So these can’t be good guidelines for avoiding taking too much, I surmise.

I would consider phoning one of the doctors who recommended I take the supplements, but in my experience the chances are very high that that would end up in an insulting conversation that started with their observation that I shouldn’t believe everything I read.  And as it ended I would see that yet again here are people who are not going to accept any suggestion from a patient that they may not know it all.  Arrrrggghh!!

Not that this is irritating or anything.


We should note that much of the emphasis of the report is that the use of vitamin D for something other than bone health is unjustified.  Also, people of color probably do know that they will get less vitamin D from the sun.

8 thoughts on “Maximizing alarm and minimizing information

  1. Thanks, Rob. I didn’t hear it really do anything for the questions I – and surely many, many others – have. What do you do when you’ve got evidence that you do not have good bone health? And if only a few of us need supplements, what’s going on with the millions and millions of older people who are losing bone mass?

  2. I’m also puzzled. I’m glad to know that 20-30 is a good range for vitamin D levels in your blood (not 30+), but the two times I’ve had mine checked in the past year it’s been 15 and 13. The first time, a year ago, my bones and teeth had begun hurting; I was put on VERY high-dose prescription supplements for a month and got better. And the second time, a few months ago, was in late summer and I was startled not to have gotten enough vitamin D from the sun. So I do believe that I should be on vitamin D supplements, as does my doctor.

    Still, I’ve had several experiences recently (on issues where the stakes were much higher, actually) of being prescribed, or having my partner be prescribed, medicine that turned out to be harmful. So I read the Times story with much interest, and… still don’t know whether overdoing it with my (expensive!) vitamin D supplements is something I should be worried about.

  3. The FDA’s RDAs are meant to be more than adequate for the nutritional needs of 98% of the population. So that’s what the story means by `most’ — literally, almost everyone. Some individuals may need more, of course, but those tables suggest there isn’t much of an age difference after infancy, and no sex difference. (Assuming, of course, that the studies the FDA is consulting included women as well as men. Maybe that’s what you’re asking about?) I take that to imply that, unless your serum vitamin D levels are especially low or you’re showing signs of vitamin D deficiency (ie, rickets), you almost certainly shouldn’t be taking supplements. The question to ask your doctor, then, is what evidence suggests you’re suffering a vitamin D deficiency.

    The Wikipedia page for vitamin D cites this article (a highly-cited piece published in a very prestigious nutrition journal, if your doctor wants to know) to support a claim that your skin won’t produce too much vitamin D no matter how much time you spend outside. If right, that’s not surprising to me; our bodies are generally rather good at that sort of self-regulation.

  4. Dan, I wish that were the answer, but I’m afraid it isn’t. The percentage of people liable to have poor bone health (as the report puts it) is well over 2%. People over 65 formed 12+% of the population in 2008, and it’s probably higher now. Also, post menopausal women typically start to lose bone mass and that’s probably at least most women over 55.

    So taken literally, the report seems to imply that these people don’t need extra calcium or D. Well, maybe, but the common lore among doctors seems to be that supplement help them. And I could not find anything in the report that addresses this. It is written as though only around 2% of the population has bone health problems, and that seems just false.

    Of course, it might be saying that the supplements don’t help those with poor bone health, but that didn’t seem a conclusion they were drawing..

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