A couple of decades ago, we docs “learned” that vitamin D deficiency was rampant, and there were many studies correlating that with bone loss, asthma, autoimmune disease, cancer, etc. etc. We all embarked on testing folks and recommending vitamin D. I personally got my level checked and started taking 1000 IU daily. Until the original reason was shown to be a complete misinterpretation of the recommended daily allowance recommendations. Sunlight exposure of only 5-30 minutes daily to the bare head and forearms does the same. I took to getting 20 minutes without sunscreen on a WA sunny day. Here ALL the sunburns take place between the end of April and August….either side of the solstice.
There are folks who have specific needs: newborns, pregnant women, gastric bypass patients, some with inflammatory bowel disease, vegans, and so on. They are not the norm. These comments are about the bulk of Americans eating a typical omnivorous diet. What supplements are recommended?
None.
Yup. No vitamin D, no multivitamins, no minerals.
Why not? Because we get enough of everything in our diets. Requirements are quite low. Vitamin C, for instance, is just 75mg daily for women, 90mg for men. Excess vitamin C is NOT used by the body. It is metabolized into oxalic acid, which when combined with excess calcium, forms kidney stones in the urinary tract in some folks. So supplements have no downsides?
In 2022, the US Preventive Services Task Force updated its recommendations on supplements. Who are these bureaucrats? They are among the best scientists on prevention we can find. I have had three colleagues I greatly respect serve on the USPSTF. They review evidence, and make population side recommendations. These usually become guidelines, for example, for screening. When should one get colonoscopy, or mammography, Pap smears, etc.
Beta carotene, the root of Vitamin A: The harms outweigh any potential benefits. The risk is increase in cancer. Vitamin E: no significant benefit in prevention of cardiovascular disease. For the rest, they decided that there is “insufficient evidence” to recommend for or against. That leaves it up to you.
For me, that’s easy: I don’t waste my money on stuff that lacks evidence. Probably, I’m spoiled by privilege and not anxious about my longevity since I have long lived parents and grandparents. You might choose differently, but don’t fool yourself that this is a big or important decision. There’s insufficient evidence despite decades of research looking for benefit. There’s less data on looking for harm.
Some time back, selenium and vitamin E were touted as a preventive for prostate cancer, until research showed that that combination INCREASED the risk of the very disease that some theory suggested it should prevent. So much for theory! Science progresses more when theory is disproven than when it is confirmed, since it reveals our ignorance.
So, did this change anyone’s mind? If you have a scientific mindset, perhaps. If instead, you are a person of faith in your own beliefs, formed perhaps on the recommendations of others, probably not. But then, that is NOT scientific, to be sure.
Isn’t it true that vitamin D is soluable and whatever your body doesn’t need is excreted? No harm, no foul?
Thank you. So confusing a subject. calcium and Vit D needs for osteopenia. ? And AREDS recommended for macular degeneration? Relief to stop buying Vit C and daily Vit. What about Magnesium for sleep? Gratitude
Thanks, Pat! Yes, there are good recommendations for adequate dietary calcium and vitamin D for bones, especially for women. These are enabling, not improving. That is, there’s good evidence that deficient levels of both will promote bone loss, but there is NO evidence that higher than minimum levels REDUCE bone loss. Drugs like alendronate do that, and others, but not supplements.
Sorry but no, just the opposite. Vitamin D is one of the fat soluble vitamins, with A, E, and K. I have seen patients who accidentally overdosed on vitamin D into toxic levels by taking multiple different supplements, each containing NON toxic levels of vitamin D. Toxicity can cause bone pain and muscle pain, but most importantly accelerates calcification, including kidney stones and hardening of the arteries. Who needs those?!!!