So, is vitamin D all it’s cracked up to be? You might have read that headline and thought that you were sure that you had read countless articles proclaiming the benefits of vitamin D. Well, you have. My understanding was that there was so much evidence out there to show that low vitamin D levels contributed to disease that it was a bit of a no-brainer to get it tested.
What you might not have heard is that the medical community is having a turn-about on vitamin D currently. Australian doctors have forgone the right to bulk bill patients for a vitamin D blood test unless some very strict criteria are met. This means that unless you have osteoporosis (or are at high risk), chronic lack of sun exposure or have coeliac disease, weight loss surgery or another reason that could mean you can’t absorb fat soluble vitamins, then you will have to pay out of pocket for this test. For most people though, it won’t even be offered to patients anymore.
So why has this happened? Well it turns out that a Medicare review found that there was a 4000% increase in the amount of vitamin D tests that have been ordered over the last decade. This doesn’t really surprise me, given that most of the research that has come out about the importance of vitamin D has happened in the last 10 years and that we are now more aware of it than ever.
In addition to this, a report published in the annals of internal medicine, found that there was not sufficient evidence to prove that taking vitamin D when your levels were low would help prevent disease, and there is currently a study in progress to assess this. The study will look at 26,000 people who are given 2000IU of vitamin D a day and fish oil and follow them over several years to assess if they develop cardiovascular disease, cancer and stroke. Until the results are published, it has been recommended to stop screening for low vitamin D.
What puzzles me, is why they can stop a public health initiative based on the fact that there is weak evidence, for a hypothesis that would seem to have no evidence. And if the study published shows that those who take vitamin D have less instances of cancer, heart disease and stroke, then we have let a whole bunch of people get sick and potentially even die from not addressing the vitamin D deficiency.
The critics of vitamin D research say that studies that link low vitamin D to disease could simply be because those that are unhealthier do not get outdoors, and therefore it is a marker of poor health rather than disease. My clinical observations do not support this – there are plenty of people who are very active and have low vitamin D levels. I think that more research does need to be done but I don’t see the need to hit the pause button on assessment of vitamin D status, at the risk of the health of the population.