5-6 years ago a lot of the people I know, including myself, started getting diagnosed with low vitamin d levels based on blood-work. It seems the issue didn’t come up much before then, and all of a sudden everyone and their mother was low on vitamin d. Anyone aware of any changes in AMA guidelines or testing methods that might have caused doctors all over the place to think people are short on vitamin d? Or is it that me and my cohort have gotten older and its just an age thing? Confirmation bias? Sinister big vitamin conspiracy? Inquiring minds want to know.
I don’t think it’s an age thing since my 30 year old daughter was diagnosed with vitamin D deficiency big time recently. I don’t think the testing has changed, I just think doctors are now routinely looking for it where 20 years ago that rarely, if ever, happened.
I was diagnosed with low vitamin D as well. Before that it was low-testosterone, and before that it was low-something else. Now I’m told my testosterone level is miraculously normal, but there’s too much calcium and potassium in my blood.
I no longer take any of it seriously.
People are staying out of the sun more? My doctor has told me to stay out of the sun to reduce the risk of skin cancer. The downside is that my Vitamin D levels are low and I have to take supplements. I’d rather take a couple of Vitamin D tablets every day than have to have skin cancer removed.
I asked my doctor about this a few years ago when she gave me instructions to start taking Vitamin D supplements. She said that doctors have become more aware of the health issues that Vitamin D deficiency can cause and are more actively screening for it now.
A recent on topic NYT bit.
There are lots of people who by current definitions meet criteria as vitamin D insufficient. Some of the increase is much more testing and some is change in definition, some may be less sun exposure, and some may be caused by increases in other things that result in low Vitamin D levels.
FWIW my take is that low vitamin D is a marker for disease risk but not etiologic for it. My specific suspicion is that things that cause inflammation and inflammation itself decreases blood levels modestly (even before ill health is manifest) and that the fad is due to mistaking a reverse causation, pretty much as this Lancet article suggests.
I was tested and told I had a Vitamin D deficiency and told to take supplements. Then last week I read an article that even though they didn’t have symptoms to justify it, the rate of tests for patients suspected of having a Vitamin D deficiency kept rising over the last 10 years.
The normal 20 to 30 nanograms per milliliter of blood was considered to be too low, but I got the idea from the article that yes, that is normal. I looked at the result from my last blood test and it turns out my Vitamin D level isn’t low.
It mentions a few doctors who were writing books and articles about it. My Dad was hoodwinked by Kevin Trudeau (Natural Cures “They” Don’t Want You to Know About"), looks like the snake oil salesmen are still at it.
https://www.nytimes.com/2017/04/10/health/vitamin-d-deficiency-supplements.html?_r=0
I know a few people who had prolonged illness that doctors couldn’t figure out. In desperation they decided to test for vitamin D and low and behold they were deficient. They started taking supplements and their symptoms gradually went away. I don’t think it’s snake oil. Some people just don’t have enough natural vitamin D being produced by their skin. I moved from sunny California to NW Montana where the winter days are extremely short. I started taking vitamin D when I moved here and my levels remained in the normal range. I take one pill a day, and don’t have to worry about it anymore.
Sounds like some sort of change in what is considered “healthy” vitamin d levels by doctors is the cause. And it appears their view of it is not going unchallenged. Interesting. My gp has had me on these little green pills once weekly for the last few months, I go in tomorrow to see if they helped. If they did, I can’t really tell the difference based on how I feel, hopefully the blood work will be more informative.
My latest physical showed a vitamin D deficiency. I was prescribed Cholecal 50,000U capsule, taken twice a week.
I go back for more blood tests in 4 months.
I’ll be outside more during the warmer weather. That should help too.
I was told that vitamin D deficiency effects how much calcium we absorb. Leading to soft bones later in life.
It’s easily remedied with a few months of medication.
Good medical article.
At my last child’s last physical, the doctor did indeed say that the guidelines had changed for healthy Vit D levels. His comment, more or less, was that everyone in the Pacific Northwest who wasn’t already deficient became deficient at that time.
I would say it’s both: the guidance changed, and that led to higher physician awareness.
Whew! I was worried for a second there! 
Or by drinking milk rather than soda pop.
Drink a glass of whole milk(or whatever) every day and take a multivitamin. That should do the trick. I think maybe it is because people are staying indoors a lot more these days. Gadgets, computers, TV, cheaper to stay in, safer, etc… Maybe that is why GP’s are checking for it more.
My son’s first doctor said it’s from slathering on sunscreen from dawn to dusk. She said that we should sunscreen him only from 11am to 5pm in the summer, and not at all in the winter (he was a winter baby). She said that breastmilk doesn’t contain vitamin D, so one comfort I could take in the fact that for his first month I could get enough milk into him, and he needed a bottle of formula every day, was that formula has vitamin D in it, so he was getting a supplement he might need. It turned cold right after he was born, so aside from worrying about airborne illnesses, we didn’t get him out much his first few weeks.
She said a lot of pediatricians were starting to give D supplements to breastfed babies. I read a few online posts, though, where a few women (woo-homebirth-breastfeed-till-they’re-six types) were saying that babies shouldn’t be given ANY kind of supplement, pediatrician be damned, because breastmilk is the PERFECT food for babies. :eyeroll:
That’s great… unless you’re also diagnosed as having too much calcium, which can also lead to soft bones.
Virtually everyone in northern states (if I may be US-centric) are at high risk. I didn’t know about the guidelines change, thanks for the info.
Also, nice username/post combo.
mmm
The New York Times article linked to above has an amusing title “Why Are So Many People Popping Vitamin D?”. For myself, the answer is simple; because of the articles I read in the New York Times! If you do a search on “vitamin d” (you probably need a subscription to do this) you find articles like “Low Vitamin D Tied to Premature Death”.
Apparently they are shocked, shocked to find that people are taking vitamin D.
This being GQ and all actual data, even limited such as it is, is called for.
Observation - lowish 25-OH vitamin D (the form economically tested for, turned into the active 1,25 OH vitamin D in the kidney) is correlated with markers of inflammation and risk for various disease states. And at some level of low even associated with increased risk of earlier death (as that NYT bit immediately above had reported).
Observation - roughly 1/3 of Americans have 25-OH vitamin D levels low enough to be labelled as insufficient or deficient.
One hypothesis, and one not unreasonable on its face, is that low vitamin D levels cause inflammation and the disease states associated with excess inflammation and that Americans have low levels because of too little sun and low intake. (The alternatives of course include that inflammation and early disease states leads to low vitamin D levels and that low D levels are more a function of that than of sun exposure or intake, or some bidirectional combination.)
If the first part is true, low D causes excess inflammation and disease, then then supplementing vitamin D should lower the risk of those disease states … but as noted any such impact is at least too small to be found in studies done so far.
If the second part was true then we should see less vitamin D insufficiency and deficiency in sunnier areas and those who are outside more.
Funny then that this study of distance runners and triathletes living in and training outdoors in Baton Rouge, LA (latitude = 30° 27′ N) who reported training between 30 and 85 km/week, found vitamin D insufficiency in 42% of the group. The correlation was higher levels of a marker for inflammation with lower levels of vitamin D. Huh.
Another sunny locale, Australia, has 58% with low vitamin D levels.
Even in Saudi Arabia … sure more prevalent in women wearing clothing that blocks the sun, but even in men, 39% with deficient or insufficient levels (split pretty much 50/50). And in this one even worse pretty much to the same degree in both healthy young men and women despite documented sun exposure and good intake.
Spain with 33% at the under 20ng/ml deficient mark and nearly 90% in the over 30 ng/ml range. A cross sectional study in Crete found vitamin D levels of 19.48±9.51 and 18.01±9.01 (ng/mL+SD) in males and females, respectively.
So living in a sunny area and doing outdoor activities does not reliably mean vitamin D levels above the insufficient or even the deficient cut-offs.
So far it seems that the story going that excess inflammation messes up vitamin D metabolism and/or absorption has more support than the other way around.
And there may even be risks associated with supplementation.