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The Great D-bate

2010 December 21

Do you really need that Vitamin D supplement? A recent government-funded report says no, but Cleveland Clinic MD Tanya Edwards says, “Not so fast . . . ”

Over the last year, FOF interviewed numerous women’s health doctors, and again and again we’ve heard the same song: Vitamin D is crucial for good health, and most of us aren’t getting enough of it. But a report released this December by the Institute of Medicine contradicted what we’ve been hearing and left us more confused than ever.

The study, conducted by a 14-person expert panel, examined thousands of findings on Vitamin D and was funded by the United States and Canadian governments. They found that “The majority of Americans and Canadians are getting enough vitamin D and calcium,” and that 600 international units of vitamin D daily is all we need for healthy bones. It also reported that the high doses of vitamin D favored by many doctors are not necessary, and may, in fact, be harmful. “For most people, taking extra vitamin D supplements is not indicated,” said Dr. Clifford J. Rosen, a member of the panel and an osteoporosis expert at the Maine Medical Center Research Institute.

What’s an FOF to do? The only thing she can do: Read the report for herself and then talk to a doctor she trusts. We spoke to Dr. Tanya Edwards, a physician at the Cleveland Clinic who specializes in nutrition.

  • FOF: What is your top-line reaction to this report?
    • Dr. Edwards: The National Institute of Medicine has to be very conservative, especially about changing the recommended daily dosage of a vitamin. They need to have hard data that says, ‘we gave these thousands of people vitamin D at this dose, and we gave these thousands of people a placebo at this dose, and we waited for 20 years to see what would happen.’ Of course, we don’t have that sort of data now, because we haven’t been looking at this issue long enough.
      But for them to just come out and say “there’s no evidence that higher doses of vitamin D does anything”–that’s just so not helpful. There is so much promising new research on Vitamin D that I think their response is irresponsible and inadequate.
  • FOF: The report says that a vitamin D level of ‘20 or above nanograms per milliliter’ of blood is sufficient. Do you agree?
    • ImageDr. Edwards: That number is based purely on vitamin D and bone health. If your vitamin D level is between 20 and 30 it will maintain bone health. But new studies are showing that when you get that number above 50, vitamin D may have additional benefits. It may actually turn on and off genes that are associated with cancer, stroke, depression and cardiovascular disease.
      When I started getting my own patients’ D levels up between 50 and 80, their depression started going away; their fatigue started going away; their skin started clearing up; their diabetes was easier to control and so on.
  • FOF: Where do you get the number ‘50’?
    • Dr. Edwards: That is what our levels would be if we were working outside near the equator with very little clothes on–which is what we were physically designed to do. We were not designed to sit inside all day long and wear sunscreen.
  • FOF: What would you recommend to the average person?
    • Dr. Edwards: The current recommended daily dose of vitamin D is 400 IU, but that is woefully inadequate for most people. This report recommends 600 IU, but in my opinion, that’s still not enough. Have your vitamin D level checked, and take enough vitamin D to get your vitamin D level between 50 and 80 and to keep it there for the rest of your life.
  • FOF: Are there dangers of getting too much?
    • Dr. Edwards: If you get your level checked and stay below 80, there are no dangers. If you take more Vitamin D and your level gets to 100 or 200, then there is a danger that your calcium level will go too high resulting in kidney stones, abdominal pain and lethargy. However, vitamin D experts will say there have been no reported cases of toxicity with vitamin D3–the natural vitamin D. Toxicity can occur with vitamin D2.
Author
Tanya Edwards, MD
Cleveland Clinic Center for Integrative MedicineTanya Edwards, MD, is a Family Physician who consults at the Cleveland Clinic Center for Integrative Medicine. Dr. Edwards teaches complementary and alternative medicine at Case Western Reserve University School of Medicine where she established the Area of Concentration for Alternative Medicine. Her expertise includes inflammation, nutrition for the prevention and treatment of chronic illness, the clinical use of nutraceuticals, as well as mind-body therapies.
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  • Janice M says:

    Zinc, garlic, vitamin E, St. John’s wort – miracle supplements rise and fall, and I am always suspicious of multiple claims such as “…their depression started going away; their fatigue started going away; their skin started clearing up; their diabetes was easier to control and so on.” The best advice from FOF is to talk to a doctor you trust.

  • crm says:

    Since my doctor just told me to “take more calcium and Vitamin D” to offset the effects of a medication I have been put on…thanks for your timely report. Having heard of NIofA report I was confused as to how much was safe.

  • Andy says:

    My doctors are both fans of Vit D with calcium. I’m dlighted that at 69 my bons are strong and I don’t suffer from anything, much less bone density loss. I’m sticking with it!

  • mizliz96 says:

    I recently had my vitamin D level tested & I was at a level of 13. My dr precribed 50,000 units in a pill once a week for 6 weeks & then to have my level tested again. At that time I will ask her what dose I should take per day to maintain a adequate level. All these studies are very confusing. The blood test I had recommended a level of 30. I hope that increasing my vit D level helps with depression. I also might mention that I am extremely fair skinned & almost never go in the sun.

  • sonsethues says:

    My D levels were low. It took several years to get them within a normal range. The doctor put me on a D2 which made me quite sick and a visit it to the emergency room. After to switching to 5,000 units a day of D3 my level were normal and I feel much better. My doctor explained that D2 has to be converted to D3. From my experience I would never recommend D2.

  • cobrateacher says:

    I’ve had very low D levels for years, although I take supplements, and get sun every day. Is there anything else that works? Levels remain low, no matter what I do!

  • kathleenklatt@yahoo.com says:

    I’m in a study for vitamin D, to see how much you need and to see if it prevents cancer, builds bones and many other things. I send my blood to be analyzed every 6 months.
    So stay tuned. There are 1,600 of us in the study. The study goes on for 5 years. But I’ve already seen one good thing about taking more D. My bones are stronger.

  • Leanernow says:

    anyone living above the Mason Dixon line needs to supplement with D3. If you can keep it under the tongue for a minute, it will absorb better, and drink it down with a glass of water. I take 2000 iu a day.

  • Bashinka says:

    I wanted to add ACUPUNCTURE and HEALTH as passions of mime on the earlier page, but couldn’t find a way to do it!

  • Congrats to Chelsea!