Can I take too much Vitamin D ?

What happens if I take too much Vitamin D ?

The European Food Safety Authority has stated that it is safe for anyone aged 11 or older to take 4,000IU (100micrograms) each day
They also state that a No Observed Adverse Effect Level (NOAEL) is 10,000IU (250micrograms) a day
( http://www.efsa.europa.eu/en/search/doc/2813.pdf )
They specifically include pregnant women, which implies that Vitamin D is very safe

Vitamin D is stored in your fat, rather than being water soluble, so your blood levels may depend on your size and weight

So a small person might choose to take 1-2,000IU (25-50micrograms) each day, while a large person might choose to take 5-10,000IU (250micrograms) each day

In 1999 the American Journal of Clinical Nutrition published a paper by Reinhold Veith with the title:
Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety
He reviews the whole subject of sunlight and vitamin D and cites many studies of the effects of vitamin D supplementation. He states:
“If there is published evidence of toxicity in adults from an intake of 250micrograms (10,000 IU) per day, and that is verified by the 25(OH)D concentration, then I have yet to find it.”

Dr John Cannell of the Vitamin D Council recently wrote to me about a personal experiment that he ran:

In 2012 I decided to do a toxicity study on myself to help answer a few questions.
I started taking 100,000 IU/day (2,500 micrograms) in June of 2012.
I measured my 25(OH)D and Urine CA/Cr ratio every week. The 25(OH)D was run by two different methods. Towards the end I also had a 1,25 and 24,25 run.
My 25(OH)D slowly increased to 300 ng/ml (750nmol/L) by LCMS at about 4 months. My serum and urine calcium and urine CA/CR ratio remained normal.
I wanted to see if sun exposure would affect 25(OH)D so I started sunbathing an hour every day for 2 weeks.
My 25(OH)D levels decreased to 250 ng/ml (625nmol/L) despite the fact I was still taking 100,000 IU/day.
It seemed to indicate that sun exposure will help reduce elevated 25(OH)D levels.
By six months my 25(OH)D level was 350 ng/ml (875nmol/L) but my serum CA, 24 hour urine calcium and CA/CR ratios remained normal.
However, I started having anorexia and nausea (some symptoms of D intoxication) when I got to 350 ng/ml (875nmol/L) so I stopped the vitamin D.
It took about 6 months for my 25(OH)D to get under 100 ng/ml (250nmol/L). The anorexia and nausea went away in about a month.
The different methods of measuring 25(OH)D showed about a 25% variance on some measurements. My 1,25 never went above normal but my 24,25 level was elevated the last 3 months.
It is assumed that toxicity is a side effect of hypercalcemia.
I guess the anorexia and nausea may have been psychosomatic as I got very nervous when my 25(OH)D got above 200 ng/ml (500nmol/L).

What I learn from this personal experiment is that it is very difficult to cause harm by taking too much Vitamin D

Comments ?

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Back Pain

If you have back pain have you tried boosting your Vitamin D ?

A woman who had had back pain for over 20 years found that the pain went away after 2 weeks of high dose Vitamin D. Similarly, there are many people with Fibromyalgia who find that boosting their Vitamin D helps

Some people find that their back pain is seasonal. Since the Vitamin D in our bodies from the sun is at its lowest in January, February and March the New Year is the time of year in which back pain is often the worst
What is your experience ?

Boosting your Vitamin D has 2 advantages. It increases the strength of your muscles as well as helping your bones to grow stronger. This will help you take a little more exercise, which will also speed up the improvement.

You may wish to take a large Loading Dose for a few days to see if it works and provide faster relief.
How much should you take ?
See: https://vitaminduk.com/2012/02/21/how-much-vitamin-d/

How can you test if your Vitamin D is low ? There is a simple test which you can do for yourself at home. Press your sternum ( the lowest bone in your ribcage ) and both your shin bones as hard as you can to check if it hurts. Mayo Clinic in USA says that there is a 93% chance that a blood test by your doctor will then show that you are medically deficient
Read more about this at: http://www.vitamindwiki.com/Quick,+free,+self+test+of+vitamin+D+deficiency

Other things that you might try:
* Magnesium – relieves muscle tension
* Vitamin C – 500 mg each hour
* Vibration & massage – 2 minutes to improve circulation
* Back movement exercises while lying on the floor (Feldenkrais)
Read more here: http://www.vitamindwiki.com/Back+Pain

Which type of Vitamin D should I take and where can I buy it ?
https://vitaminduk.com/buy-vitamin-d/

Where can I buy Magnesium & Vitamin C ?
http://www.greenvits.co.uk

What works for you ?
Do post your comments and experiences

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Depressed and SAD ?

January, February and March are the worst months in the UK for Depression

The stores of Vitamin D that we had built up from the previous summer are at their lowest
The “half-life” of Vitamin D in the body is 30-60 days, so our Vitamin D from the sun is now less than 10% of what is was at the end of last summer
You may have a little Vitamin D from your food, but it is very little

Seasonal Affective Disorder shows up progressively in a number of ways, finally leading to full Depression:

* Difficulty waking
* Decreased Energy
* Craving for Carbohydrates
* Increased Appetite
* Sleeping longer
* Weight gain
* Difficulty concentrating
* Decreased libido
* Withdrawal from family & friends
* Depression + Anxiety + Irritability

Do you recognise any of these and do they change throughout the year ?

The best solution is to find some sunshine or equivalent
Alternatives that seem to help are to take supplements to boost your Vitamin D and your Omega-3.

If you can take a short break in the sunshine, that is probably the best
Sunbathing on a long weekend in North Africa, or Tenerife or Cape Verde or the Middle East would be wonderful.
Try exposing most of your body for 15-30 minutes a day in the mid-day sun without sunscreen.
If you have fair skin you might sunbathe for a shorter time and if you have dark skin for longer
But – be very careful not to burn or let your skin start becoming pink

See a separate page which discusses how you may be able to improve your tolerance for the sun by taking Vitamin D capsules in advance

Alternatively, many people have found that a short treatment on a professional sun-bed works for them
Some people with Chronic Fatigue Syndrome find that a monthly sun-bed session makes a big difference

If you can eat more oily fish like Salmon at least twice a week it may help
Some people also suggest that Vitamin B12 helps

If you are taking drugs for depression then eating oily fish may help you to take lower doses ! Researchers in Holland found that people taking SSRI drugs for Depression responded better when they also eat oily fish

Instead of sunshine and food you might try Vitamin D capsules or high-strength Omega-3 Fish Oil
See other pages here for “How Much Do I Need ?” and how to test yourself

Read more at:

* http://www.vitamindwiki.com/depression
* http://www.expertomega3.com/omega-3-study.asp?id=38
* http://articles.mercola.com/sites/articles/archive/2003/12/17/vitamin-b12-depression.aspx

Which type of Vitamin D should I take and where can I buy it ?

https://vitaminduk.com/buy-vitamin-d/

Where can I buy Omega-3 Fish Oil and Vitamin B12 ?

http://www.greenvits.eu

What works for you ?
Let us have your comments

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Does Vitamin D protect against Melanoma ?

In his book Athlete’s Edge, Dr John Cannell of www.vitamindcouncil.org  describes how his daughter has fair skin and used to burn easily.  He suggested that she took 10,000 IU of Vitamin D3 a day for a month before she went into the sun, and she then found that she was not as sensitive to the sun as she used to be.

You can buy 25 micrograms ( 1,000 IU ) of Vitamin D3 over-the-counter from a chemist or supermarket.

You can buy anything from 1,000 IU to 50,000 IU from most Health Stores or online from eBay, Amazon or other specialist supplier of Vitamins and supplements.

You can take tablets, capsules, sprays or drops.

The other alternative is to expose your body, without sunscreen, to direct sunlight

– but only when your shadow is shorter than your height.

This is only possible in the UK between April and September between about 10:00am and 4:00pm.  Do not burn your body and cover up if your body begins to become pink.  A white skinned person will receive 20,000 IU within 15 minutes, but an Asian person might need 30-60 minutes and an African person might need 1-2 hours in the direct sun.

Check out:

http://vitamindwiki.com/Overview+Suntans+melanoma+and+vitamin+D or:

http://www.vitamindwiki.com/Solar+UVB+reduces+Cancer+Risk+%E2%80%93+Grant,+Jan+2013

You can read www.vitamindwiki.com in 50+ languages

Find the yellow SEARCH box and see what is returned for: “Melanoma” or “Skin Cancer”

One of the premier UK researchers about Melanoma is Professor Julia Newton-Bishop.  A search for “Newton-Bishop” gave 32 results

Which type of Vitamin D should I take and where can I buy it ?
https://vitaminduk.com/buy-vitamin-d/

Do read more and post your comment

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Vitamin D or Tamoxifen to prevent Breast Cancer ?

This is a slightly edited version of a personal message to me from Professor Cedric Garland about the NICE & NHS decision to offer Tamoxifen or Raloxifene to UK women who may have a higher than average risk of Breast Cancer:

“This is a great example of an organization selecting the a completely wrong solution to a problem.

It must be this approach that the big breast cancer organizations have in mind when they mention eradication of breast cancer by 2020.

This is probably driven mainly by Big Pharma who stand to make billions from patented drugs that people have to take every day to prevent a disease, even if they cause other diseases. If their aproach is used, it will be an empty promise by 2020 or any year.

If anyone could send me any citations they may have seen touting the efficacy of Tamoxifen or Raloxifene in preventing breast cancer, I’d love to read them.

Since very big money is involved, these two risky drugs will be the well-funded competition against vitamin D in the field of breast cancer prevention.

Without concerned scientists, physicians and engineers, such as members of the international vitamin D scientific and clinical community, Big Pharma exceutives would win this battle and the people would lose.

Best wishes,
Cedric Garland”

Professor of Public Health
University of California at San Diego

If anyone would like to send comments directly to me I will be pleased to forward them to Professor Garland

You can read more about his work with Vitamin D at: http://grassrootshealth.net/

Learn more about Vitamin D and Breast Cancer at:

http://vitamindwiki.com/Cancer+-+Breast

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How much Vitamin D ?

There are 4 parts to this:

  • What do I need ?
  • What do I have already ?
  • How do I add to what I have already ?
  • What can I eat or take ?

What do I need ?

The UK Department of Health says that Deficiency is when your blood serum level of Vitamin D [ 25(OH)D) ] is less than 25 nmol/L ( nanomols per Litre )

( 25 nmol/L = 10 ng/mL ( nanograms per millilitre ) in the American scale )

The USA Institute of Medicine ( IOM ) set the equivalent level at 50 nmol/L in their report issued in November 2010

Many experts say that there are biomarkers that change just above 75 nmol/L, so they suggest that the level should be set there.

Professor Robert Heaney, who is a world expert in Osteoporosis, says that Vitamin D “enables the body to absorb calcium” and that the level should be set at 100 nmol/L

Dr John Cannell, of www.vitamindcouncil.org in his book Athlete’s Edge, says that there is “extreme substrate deprivation” below 125 nmol/L

Professor Bruce Hollis, who is a world expert in Vitamin D for pregnant women and their babies, says that the baby takes nutrients from the mother and that pregnant women should have 125 nmol/L

A group of 40 eminent experts at www.grassrootshealth.net have issued a “Call-To-Action” calling for optimum blood serum levels to be between 100-150 nmol/L

You can watch videos about this at:  www.vitamindassociation.org/events or www.grassrootshealth.net

So, you choose your expert and you set your own levels

I am following the 40 eminent experts and have set my personal target at 100-150 nmol/L

What do I have already ?

The only reliable way to know is to have a blood test for 25-hydroxyVitaminD or 25(OH)D

The options are:

  • Ask your doctor for a test.
  • Have the test done privately

Many doctors are under pressure to save the cost of testing, or they have been told that they are only allowed one test per year for each patient.

If your doctor does do a test, ask them for a copy of the result and file it carefully away for comparison with later tests.

If you want to have the test done privately there is an NHS hospital in Birmingham that offers the test direct to the public.

Check out www.vitamindtest.org.uk or phone +44 (0)121 507 4278

www.vitamindproject.co.uk provide a direct-to-the public testing service

You can also order a Vitamin D test at:  www.grassrootshealth.net   This is more expensive, but you are contributing your results to their database of a world-wide intervention trial.  Doctors and other health professionals who would like to enter batches of results from multiple tests done locally in their practice are invited to contact Grass Roots Health.

www.biolab.co.uk and www.tdlpathology.com provide testing services, but they need a referral from a health professional, like a doctor, dietitian or qualified nutritionist.

How do I add to what I already have ?

When you have received the results of your Vitamin D blood test you will have a number that probably ranges from 10 nmol/L to 200 nmol/L, plus an opinion from the testing laboratory of how your result compares to their target.

If you compare that to the new target that you and your doctor want to set, which will hopefully be at least 75 nmol/L and could be between 100-150 nmol/L, you will probably find that there is a difference.

A rough rule of thumb is that you will need to take 25 micrograms ( = 1,000 IU ) of Vitamin D3 per day for 3 months to raise your level by 25 nmol/L.  This guide works well when you are below 100 nmol/L, but you will need increasingly large amounts above 100 nmol/L as the body self-regulates.

Here are some examples:

Result ( nmol/L )                25                    50                    25                    50

Target ( nmol/L )                75                    75                    100                 150

Requirement ( IU / day )    2,000              1,000              3,000              4,000

( Micrograms per day )       50                    25                    75                   100

I have been taking 5,000 IU ( 125 micrograms ) each day for the past 2 years and my level was 143 nmol/L when it was last tested in August 2011.

Vitamin D can be taken once a week, since the half-life of Vitamin D in the body is 14-30 days.  Multiply the daily amount by 7 and take approximately that amount once a week.

Warnings:

There are a very few people who have a genetic problem with Vitamin D, such as sufferers from Thyroid problems or Sarcoidosis ( too sensitive ) or Coeliac or Crohn’s disease ( not sensitive enough )  You will need detailed advice from your doctor or specialist.

The current advice for pregnant women from the NHS is to take only 10 micrograms ( 400 IU ) a day.  Please read other sections of this site and then you can be more informed to discuss this subject with your midwife, doctor or other health professional.

What can I eat or take ?

It is very difficult to get enough Vitamin D from food.  For example, you would have to eat about 300-500g of mackerel or salmon to get 25 micrograms of Vitamin D.  The best result of Vitamin D from food that I have heard of is a lady from Bangladesh who was eating 3 pieces of sun-dried fish from Bangladesh each day.

The other alternative is to expose your body, without sunscreen, to direct sunlight – but only when your shadow is shorter than your height.  This is only possible in the UK between April and September between about 10:00am and 4:00pm.  Do not burn your body and cover up if your body begins to become pink.  A white skinned person will receive 20,000 IU within 15 minutes, but an Asian person might need 30-60 minutes and an African person might need 1-2 hours in the direct sun.

In his book Athlete’s Edge, Dr John Cannell of www.vitamindcouncil.org  describes how his daughter has fair skin and used to burn easily.  He suggested that she took 10,000 IU of Vitamin D3 a day for a month before she went into the sun, and she then found that she was not as sensitive to the sun as she used to be.

You can buy 25 micrograms ( 1,000 IU ) of Vitamin D3 over-the-counter from a chemist or supermarket.

You can buy anything from 1,000 IU to 10,000 IU from most Health Stores or online from eBay, Amazon or other specialist supplier of Vitamins and supplements.

You can take tablets, capsules, sprays or drops.

Doctors can prescribe 500 micrograms ( 20,000 IU ) of Vitamin D3 for weekly use, but these are “specials” which may cause problems in sourcing or payment via the NHS.

Comments ?

Do you have any comments about this ?

 

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Vitamin D reduces complications in pregnancy

If a woman starts pregnancy with a lack of Vitamin D and continues to be deficient throughout pregnancy she is at an increased risk of complications.

A lack of Vitamin D has been linked to an increased risk of pre-eclampsia, insulin resistance, gestational diabetes mellitus and of needing emergency C-section. She is also more likely to suffer from anaemia and bacterial vaginosis, which is associated with pre-term delivery and miscarriage, and also post-natal depression.

I will look at the evidence for the effect of Vitamin D levels for each of these complications in more details in future blogs, but for now every midwife, doctor and nurse should be sensitive to the recent advice sent out by the Chief Medical Officers of England, Wales, Northern Ireland and Scotland.

This has also recently been endorsed by NICE at: http://www.nice.org.uk/newsroom/features/MakingSurePregnantAndBreastfeedingWomenReceiveVitaminD.jsp

This advice is that every pregnant woman should take 10 micrograms of Vitamin D3 every day.  This is also measured as 400 IU ( International Units ).

The first question that everyone asks is:  “Is it safe ?”

However, the more important question is:  “Is it enough ?”

The Canadian Paediatric Society currently advises every pregnant woman to take 50 micrograms ( 2,000 IU ) of Vitamin D3 per day

Professor Bruce Hollis has been running trials since 2005 in which he has given pregnant women 100 micrograms ( 4,000 IU ) per day.

This has proven to be totally safe and very effective.  Babies were bigger and healthier and the pregnancy was easier in many ways, with reduced pre-eclampsia and less gestational diabetes.

In 1999 Professor Reinhold Vieth wrote:  “If there is published evidence of toxicity in adults from an intake of 250 micrograms ( 10,000 IU ) per day, and that is verified by the 25(OH)D concentration, then I have yet to find it.” 

Both these experts spoke at a scientific conference about Vitamin D & Obstetrics held at the Wellcome Trust in London in May 2011.  www.vitamindassociation.org/events ( Select May 17 )

If a white-skinned woman goes into the mid-day summer sun in the UK in her bikini she will receive the equivalent of about 20,000 IU within 15 minutes.  An Asian woman might need 30-60 minutes and an African woman would need 1-2 hours to receive the same effect, because the melanin in their skin acts as a sun screen.

The take-home message is:

Every pregnant woman should take Vitamin D – and it is safe

The question that every midwife, doctor and nurse should be asking is: “what is the correct target blood serum level for a pregnant woman and how much Vitamin D does she need to reach this level”

Watch this space !

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Vitamin D for babies

The Vitamin D Association has identified a serious error in the NHS guidelines on vitamin D supplementation of breastfed infants in the UK

QUOTE:

The UK guidelines do not recommend vitamin D supplementation of breastfed infants during the first five months of life as standard.

This early supplementation is needed, and is standard practice in most other comparable countries.

What does this mean to you and what should you do about it ?

If you are a white mother anywhere in the UK breastfeeding in Winter or Spring:

The risk: if you follow all of the current guidelines, our analysis is that your baby is at significant risk of vitamin D deficiency or serious vitamin D deficiency during the first five months of life. The main health consequences to be concerned about are a risk of impaired bone development, and impaired ability to avoid or manage infections.

If you are a South Asian or African in England or Wales and are pregnant or breastfeeding:

The risk: if you follow all of the current guidelines, your baby is at serious risk of acute vitamin D deficiency during the first five months of life. The health consequences to be concerned about are a serious risk of rickets, seizures, heart problems, and even death.

Action:

Please go to:

http://vitamindassociation.org/pregnant-and-breastfeeding-mothers.html

Read their information very carefully and follow the advice.

Here is a suitable Vitamin D product for babies:

You can get suitable Baby Ddrops from the Ddrops Company

These provide 10 micrograms ( = 400 IU ) per drop

The directions state:

Infants less than 2 years old:

Place 1 drop daily onto mother’s nipple, or a pacifier, and allow baby to suck for 30 seconds.  Or mix 1 drop daily with formula, juice or other food.

Infants over 2 years of age:

Take 1 drop daily.  May be put on food or taken from a clean surface such as a spoon or the back of a washed hand.

These are available in the UK from most larger branches of http://www.boots.com

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Vitamin D in pregnancy

Advice sent out February 2, 2012 from the UK Chief Medical Officer to all Health Professionals reminds them that pregnant women should take a supplement of Vitamin D3 each day ( 10 micrograms = 400 IU )

There are strong arguments why this should be much more, ( maybe 100 micrograms = 4,000 IU ), since higher Vitamin D levels in the blood of the mother will give her an easier pregnancy and a healthier baby and child

You can read the detailed advice from the UK CMO buried deep in this link:

http://cno.dh.gov.uk/2012/02/06/vitamin-d-adivice-on-supplements-for-at-risk-groups/

Half the chance of Diabetes in the child:

A study looked at 29,072 women in Norway and examined 109 of them whose child developed Type 1 Diabetes before age 15, and compared them to a control group of 219 others.

They divided the 109 into 4 groups and found that the odds of Type 1 Diabetes in the child were halved – compared to children of the mothers in the group who had the highest Vitamin D levels

You can read this at:

http://diabetes.diabetesjournals.org/content/early/2011/11/22/db11-0875.abstract

You can see a video about a related study at www.ucsd.tv ( search for: Frank Garland )

Half the chance of language difficulties in the child:

Another recent study has looked at the language development of the child at age 5-10 when compared to the Vitamin D level in the blood of the mother at 18 weeks.

This found that the risk of having a child with language difficulties was nearly doubled in the group with 46 nmol/L or less, compared to the group with Vitamin D levels of more than 70 nmol/L

You can read this study at:

http://pediatrics.aappublications.org/content/early/2012/02/08/peds.2011-2644.abstract

Reduce the chance of wheeze or asthma:

1194 mother-child pairs were studied in USA and it was found that when mothers took more Vitamin D during pregnancy their child was less likely to suffer with Asthma or Wheeze  – when 3 years old.

You can read more about this at:

www.ajcn.org/content/85/3/788.abstract?sid=ed202bd1-c7fe-46e2-9168-fc407b34ade1

Is 70 nmol/L enough ?

Professor Bruce Hollis says that pregnant women should have blood levels above 120 nmol/L, since the baby takes nutrients from the mother.

You can watch him speak about this at:

www.vitamindassociation.org/events ( select May 17 – Obstetrics )

Professor Hollis gave 100 micrograms ( 4,000 IU ) of Vitamin D3 each day to a large group of pregnant women and found that it was safe.  It was also effective in reducing complications during pregnancy and the babies were bigger and healthier.

At the same conference, Professor Reinhold Vieth spoke about the trials he had done to test the safety of high doses of Vitamin D.  Both of them support pregnant women taking at least 50 micrograms ( 2,000 IU ) per day and Professor Hollis recommends 100 micrograms ( 4,000 IU ) per day.

Winter holiday in the sun !

Dr David Grimes, in his book: Vitamin D and Cholesterol – the importance of the sun suggests that the mother and the father go for a holiday in the sunshine before even trying to conceive.  His advice is to go away for a winter holiday in the sun and try for a baby in the spring, with the birth in the late autumn.  During the summer the mother should take in all the sunshine that she can, without burning.

You can get the equivalent of 20,000 IU of Vitamin D from a little sun-bathing, provided that your shadow is shorter than your height.  This rules out October to March in the UK, when no Ultra-Violet B ( UVB ) rays will reach your body, so you will have to go nearer the equator !

Reduce other complications in pregnancy

If a woman starts pregnancy with a lack of Vitamin D and continues to be deficient throughout pregnancy she is at an increased risk of complications.  A lack of Vitamin D has been linked to an increased risk of pre-eclampsia, insulin resistance, gestational diabetes mellitus and of needing emergency C-section. She is also more likely to suffer from anaemia and bacterial vaginosis, which is associated with pre-term delivery and miscarriage, and also post-natal depression.

You can read more about this at:

http://www.cnelm.com/NutritionPractitioner/Issue/Issue?issueId=53

Scientists call for 100-150 nmol/L

A group of 40 eminent scientists have called for everyone to have a Vitamin D blood level of 100-150 nmol/L.

You can read their Call-To-Action at:  www.grassrootshealth.net

Watch videos of scientific conferences

You can watch videos of a conference organised by the Vitamin D Association and held at the Wellcome Trust in London in May 2011:

www.vitamindassociation.org/events ( select May 17 – Vitamin D & Obstetrics )

There are also good videos about Vitamin D for mothers and babies at:  www.ucsd.tv ( Search for talks by Carol Wagner or Bruce Garland )

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Vitamin D “deficiency” in the UK

On Friday February 10, 2012 I went to a quarterly meeting of the UK Scientific Advisory Committee on Nutrition ( www.SACN.gov.uk )

I was 1 of about 5 members of the public who sat in on their “private meeting, held in public”

Most of the meeting was about Iron & Iodine, with a 10-minute update from the Vitamin D sub-group

After the meeting had officially closed I was allowed to ask a question about Vitamin D, to which the answer was:  “See the latest message from the Chief Medical Officer”

I invite you to follow the labyrinthine links to the recent government messages about Vitamin D:

http://cno.dh.gov.uk/2012/02/06/vitamin-d-adivice-on-supplements-for-at-risk-groups/

Note that the UK definition of “deficiency” is:  25(OH)D less than 25nmol/L ( = 10 ng/mL )

If 25% of the UK population is deficient at this level, I wonder what the percentage would be if the level were set at 50 nmol/L or even 75 nmol/L

The official advice from the government is unlikely to change until the SACN issue their next report in mid 2014

Until then I will keep holding the SACN to account and trying to influence doctors and the general public, whose timescales are much shorter

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