Men's Osteoporosis Support Group

DrugWatch.com and several vitamin D items

I have added drugwatch.com, particularly their Drug News & Alerts, to the Medical Links on this site. It provides a single source to track the latest news on drugs: alerts, recalls, approvals, lawsuits, and clinical trials, plus much more.

Noteworthy is the fact that the most recent news shows that the FDA has approved Fortesta (testosterone) Gel for men for hypogonadism. See the company's website for more information. There is also information about Axiron, a testosterone gel that is applied to the armpits, that was also recently given FDA approval. Here is the company's website for more information. [NOTE 10-23-11, Drugwatch.com isn't updating their website, so I have removed it from the Medical Links webpage].

Arch Intern Med. 2009 Mar 23;169(6):626-32. Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004.Ginde AA, Liu MC, Camargo CA Jr. PMID: 19307527. Full free text available here. This study compared serum vitamin D levels from individuals tested in NHANES III (1988-1994) and NHANES data collected from 2001 to 2004, which included 13,369 individuals. Of interest is that multiple segments of vitamin D levels were decreased in the 2004 test group compared to the 1994 group. Particularly, the mean serum level in the early study was 30 ng/mL, which is considered to be normal. But that dropped by six points to 24 in the 2004 study group. And there were more individuals in the very low level of less than 10 ng/mL. The authors concluded, “Current recommendations for vitamin D supplementation are inadequate to address the growing epidemic of vitamin D insufficiency.”

Editor's comments. If you'll spend some time viewing Table 2 in the full article you'll see how significant the change was in the two comparison groups. As well, the the charts in Figure 1-3 show this, too. The full article notes the following important information regarding non-whites and vitamin D-associated diseases, “Although socioeconomic status, health care access, lifestyle, and cultural factors contribute to racial/ethnic disparities in disease incidence and outcomes, vitamin D insufficiency may provide a plausible biological explanation for health differences. In particular, black and, to a lesser extent, Hispanic Americans have a markedly higher prevalence of vitamin D insufficiency and higher incidence and worse outcomes for cardiovascular disease, certain cancers, diabetes mellitus, and renal disease, all of which have been linked to vitamin D insufficiency.”

The study suggests the following as reasons for the drop in serum vitamin D levels, “Because exposure to UV-B rays is the primary determinant of vitamin D status in humans, this is more likely the primary cause of the increasing prevalence of vitamin D insufficiency. Although widespread campaigns for sunscreen use and sun avoidance, including Healthy People 2010, have reduced the incidence of skin cancers, sunscreen with a sun protection factor of 15 also decreases the synthesis of vitamin D3 by 99%. Increased sunscreen use with a higher sun protection factor likely contributed to the reported trend of lower 25(OH)D levels. In addition, decreased outdoor activity and obesity have been associated with vitamin D insufficiency. The increased inactivity and obesity in the US population has likely contributed to the observed rise in vitamin D insufficiency.”

In summary, this study shows a marked drop in serum vitamin D levels across all racial and age groups in the 2004 NHANES population. It appears that over 75% of the population would benefit from increased sun exposure in the midday or from vitamin D supplements.

Information is Beautiful website vitamin D information.

A friend of mine referred me to this site and I found it to be very interesting and informative. It appears to turn the normal information format of lots of text and a little bit of graphics on its head. This site presents the information graphically, and then supplies just a little text. I found “The True Size of Africa” to be an excellent example of this method. And the graphics can be very hard-hitting. What is special is that the site also provides links to the source of the information, often in the form of an online spreadsheet. Here is that spreadsheet for the vitamin D graphics. Here is another very interesting graphic and the data for it, on the topic of Snake Oil Supplements.

Vitamin D Fact Sheet.

For a very extensive vitamin D discussion, The National Institutes of Health Office of Dietary Supplements has a Dietary Supplement Fact Sheet: Vitamin D online that you can read.

Free Institutes of Medicine online vitamin D report.

On November 30, 2010 this extensive report on vitamin D was released. It is available for free online, but it will take you a while to read the entire thousand-page report. For a summary, here is a New York Times article on it. The report concludes that the evidence is not strong enough to warrant taking vitamin D and calcium supplements. The committee concluded that 20-30 ng/mL would be adequate serum vitamin D, not 30 ng/mL, as virtually all the literature that I have read and posted here says. And, if so, most people would fall into that category, they say,

The Ginde and others study above found, “The prevalence of 25(OH)D levels of less than 10 ng/mL in non-Hispanic blacks rose from 9% during NHANES III to 29% during NHANES 2001-2004, with a corresponding decrease in the prevalence of levels of 30 ng/mL or more from 12% to 3%.” So this would tend to dispute some of the committee's conclusions, at least for certain racial/ethnic groups.

Regarding calcium intake, the committee noted, “Most people, they concluded, get enough calcium from the foods they eat, about 1,000 milligrams a day for most adults (1,200 for women ages 51 to 70).”

Editor's comments. The vitamin D issue is a complex one that will take years to get all the answers for, if ever. In the mean time we have to decide what to do to maximize and protect our health. The conclusions I reached in the Osteoporosis Issues vitamin D article still appear to be correct to me. Here is what I concluded from my readings, “Bottom Line: Get your serum vitamin D level tested, then adjust by either UV radiation or supplements to keep it at or above 30 ng/ML.” Discuss this with your care provider to decide what is right for you.

You will probably want to discuss the calcium supplement issue with your care provider, too. Note that I have reported in a recent Update that individuals taking calcium supplements without concomitant vitamin D had a 31% increased risk of myocardial infarction. So if you are taking calcium supplements, you'll also want to take vitamin D supplements.

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