Vitamin D Deficiency: A Global or a Bogus Pandemic

Written by Meguid El Nahas on Sunday, 02 April 2017. Posted in OLA Blog

Vitamin D Deficiency: A Global or a Bogus Pandemic

N Engl J Med. 2016 Nov 10;375(19):1817-1820.

Vitamin D Deficiency - Is There Really a Pandemic?

Prof Arif Khwaja quoted from the article:
A common misconception is that the RDA functions as a “cut point” and that nearly the entire population must have a serum 25(OH)D level above 20 ng per milliliter to achieve good bone health. The reality is that the majority (about 97.5%) of the population has a requirement of 20 ng per milliliter or less. Moreover, by definition of an average requirement, approximately half the population has a requirement of 16 ng per milliliter (the EAR) or less
This article may rebalance the debate suggesting that the majority of dark skinned individuals have native Vitamin D insufficiency or deficiency:
All too often norms are defioned in young, caucasian, western populations...and applied across the world's various and heterogeneous populations with different:
genetic background
different binding protein levels
different free and bound vitamin D levels
different activation levels to 1-25D
different VDR responses
Before we accept that there is a global pandemic of VitaminD deficiency causing all the world's may be judicious to examine the evidence critically....and temper the drive to over prescribe 25D to whole populations...
Big Pharma may want us to...we need to exert caution!
Meguid El Nahas

Professor Meguid El Nahas PhD, FRCP

Chief Editor, OLA Director

Professor El Nahas was born in Cairo, Egypt and undertook his undergraduate medical education in...
Posted: 10 months 2 weeks ago by JoseMario #21410
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Dear Ariff:

:I Also agree with you!

The young physician starts life with 20 drugs for each disease, and the old physician ends life with one drug for 20 diseases. William Osler

All best,.

Posted: 10 months 2 weeks ago by JoseMario #21411
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Dear Arif; I meant

Posted: 10 months 1 week ago by elnahas #21412
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It is true that in my 50 years of medical practice...the number of diseases have increased considerably....

not as much because of breakthrough and major discoveries, as much as re-labelling and re-definition of old diseases...

and also, the generation of diseases based on new definition...such as CKD...

or the generation of abnormalities by deviation from "normality"....such as CKD, Pre-DM, Osteoporosis, heart failure (Diastolic),...etc...
Posted: 10 months 20 hours ago by drwazeer1 #21420
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Because vit D supplelments are very cheap, doctors prescribe it without a second thought.... i think the Bigpharma does not make money by selling Vit D supplements BUT by selling the Vit TESTING KITS which are expensive.......I simply do not bother checking vit D levels for anyone unless strictly indicated otherwise. The funniest thing is even the most ardent non-compliant diabetic patients with horrendouse HBA1c insist on checking their Vit D level...!!
Posted: 10 months 18 hours ago by arif.khwaja #21421
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Actually Wazeer I think over the counter vitamin D is relatively expensive.... if you persuade a large number of people to take it there are big profits to be made... in the U.K there is huge marketing for big D in health shops...
You should write up your experience of vitamin d deficiency as there is little published data from the GCC
Posted: 10 months 17 hours ago by tukaram #21422
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Agree with you all. Although vitamin d therapy may not cost much to an individual patient, the number of people consuming it (for various reasons) makes it a profitable business for pharma. Therapy is not necessarily benign in disorganised health care systems. I see patients taking vit d from neurologist, physician, cardiologist, Nephrologist-all with different brand names which made our series of 12 cases of AKI related to hypercalcemia (vit d intoxication)

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