Robyn, the research you've done for this four-part (so far) series is impressive and, as usual, the articles are well-written and easy to follow even for lay people like me. Thank you, as I'm among those who have been interested in knowing more about the usefulness of vitamin D supplementation. I look forward to your next installment where I understand you'll be addressing diet and lifestyle approaches for maintaining adequate vitamin D levels.
Meantime, I have a couple of questions. First, and while I recognize your vitamin D series is not promoting vitamin D supplementation as a general means for improving health, I wonder what you think about the fact that commercially available vitamin D supplements are in fact identical to what is used as rat poison. Do you think that's simply a matter of the dose making the poison, or are commercially available vitamin D supplements toxic regardless of dose?
Second, your series makes a compelling case based on published medical literature, including a number of RCTs, that with certain exceptions vitamin D supplementation is not generally associated with improvements in health or reductions in mortality. I'm also familiar more generally with much of your other work over the past few years, including things you've written (and said) about critical thinking and conducting research. In that regard, it is becoming well known, especially among those who are awake to the fraud and corruption that infects governments and institutions around the world, that the pharmaceutical industry long ago compromised the public health establishment, which now is completely corrupt and does the bidding of the pharmaceutical industry without regard for the welfare of the general public that it is supposed to serve. The corruption extends to the biggest and supposedly best medical journals. Even former editors of some of the most highly-regarded journals began warning many years ago that the pharmaceutical industry had so corrupted the journals that they can not be relied upon as accurate sources of medical information. Clinical studies often are designed to fail, published results often are intentionally misleading, and it is not unheard of for study results and even the underlying data sets to be entirely falsified. We saw that in spades during the Covid-19 event, with corrupt insiders using designed-to-fail studies and falsified data sets to disparage safe and effective medications like hydroxychloroquine and ivermectin and to promote highly profitable and very dangerous alternatives like the experimental Covid-19 injections and toxic therapeutics like remedesivir. Similar but less well known fraud and corruption has been going on for decades and infected the clinical studies and medical journal reporting that ultimately led to the licensing and approval of other toxic drugs like SSRIs, statins, and more recently the new-fangled and extremely dangerous weight loss drugs.
In short, the pharmaceutical industry does not exist primarily to help people improve their health. To the contrary, it is profit-driven and derives benefit from chronic illness (and, arguably, keeping people sick). Given that it controls what the medical journals publish, I've concluded nothing they publish can be trusted. With that in mind, I wonder whether medical literature that discounts the utility of vitamin D supplementation is reliable -- after all, it would not seem to be in the best interests of the pharmaceutical industry if something like vitamin D supplementation actually helped improved people's health and made them less reliant on toxic pharmaceuticals.
Stated differently, if Robyn Chuter designed a study to determine whether vitamin D supplementation is safe and effective for improving immune system function and general health, I would have no doubt the study would be well designed, the reported data would be genuine, and the reported results would honestly and accurately reflect actual outcomes. I have no confidence in other researchers whose motivations and backgrounds are unknown to me, and the fact their work might get published in a medical journal I already know to be corrupt likely would cause me to disregard their study before reading the first sentence.
Thanks for prompting me to research this issue - it's been a fascinating journey and has caused me to rethink my recommendations to clients re vitamin D supplementation.
On the 'rat poison' issue, it is definitely an example of the dose making the poison. Bad things happen to humans who take cholecalciferol in very large doses, but that's not relevant to people who are taking the generally-recommended dose.
On the question of the integrity of the clinical trials of vitamin D supplementation, I completely understand your cynicism - but bear in mind, widespread testing for vitamin D generated a ton of money for the medical industry, and major drugmakers, including Pfizer, Unilever, Novartis, GlaxoSmithKline, sell vitamin/mineral/other supplements in general (see https://www.elsevier.com/en-au/connect/the-link-between-big-pharma-and-the-supplement-industry), while Sanofi-Aventis and Shire specifically sell vitamin D supplements.
I'm not against supplementation as a policy. However, the very word 'supplement' implies that it should be something that you do IN ADDITION to, and not instead of, taking responsibility for your health by adopting healthy eating and lifestyle habits. More often than not though, supplements are recommended INSTEAD OF a healthy diet and lifestyle.
I totes agree with below writers comments. This is an excellent article..and as uusual Im so impressed by the indepth research you have done robyn. Changes my view on vit d.
I like the diet n lifestyle theory personally...I think thats why we have those receptors...but eagerly await your nxt publication. Well done.
My own views on vitamin D have changed significantly as a result of doing this research. I would not recommend against supplementation across the board, but I have concluded that we need to be much more cautious and thoughtful about it. Scientists almost always conclude their papers by calling for more research, and that's desperately needed in the case of vitamin D.
I haven’t commented on this episode because I was waiting for the end which I now know is at least another week away. This was the one I was waiting for because most of your previous posts were already known to me, although not in as great a detail.
To relate reverse causation to a more personal experience, my wife had knee replacement surgery back in April. The surgery itself went fine, but that evening she began having chest pain and difficulty breathing. I called 911 and she was transported to ER where they ran all the usual tests and were able to say she didn’t have a coronary event, but admitted her to run more tests. Turns out she had pneumonia, probably from aspiration of regurgitation when being anesthetized, before they could intubate her. She spent 3 days there while running more tests. I tell this because when I was looking at her blood work I saw that her vitamin D was low(20s) and her CRP was high. So, after reading this post, I know why. Inflammation, although it could be from the surgery or because of the pneumonia. Thank you once again for giving us all the knowledge in order to make wise decisions regarding our health.
Sorry to keep you in suspense! Each part has taken me a ridiculous number of hours to write because of the enormous amount of literature I've had to plough through.
And yes, you're spot on about your wife's bloodwork. The surgery by itself would trigger the acute phase response; add pneumonia to that and you would expect a big spike in CRP and fall in 25-hydroxyvitamin D. I hope she has made a full recovery.
I don't have time at present to go through all you have written, but please see my comments on your previous articles and the research cited and discussed at: https://vitamindstopscovid.info/00-evi/.
If you and your readers can't recognise that we would all be better off with 50 ng/mL (125 nmol/L) 25-hydroxyvitamin D than 20 ng/mL (50 nmol/L, like many people have today) by the Massachusetts General Hospital research https://vitamindstopscovid.info/00-evi/#00-50ngmLhttps://jamanetwork.com/journals/jamasurgery/fullarticle/1782085 I don't know what evidence will convince you. *Pre-operative* 25-hydroxyvitamin D levels of 50 ng/mL or more resulted in a 2.5% risk of hospital acquired infections and a 2.5% risk of surgical site infections. Those with 20 ng/mL had about 23% risk of each type.
While infection / inflammatory immune responses probably do lower circulating 25-hydroxyvitamin D levels to a certain degree, as reported in the hip / knee surgery article (also, the patients would not have got much sun for a while) this is a minor concern and also an argument for better supplementation, since it is obvious the the immune system needs 50 ng/mL or more to work properly.
You wrote:" Furthermore, the persistence of low 25-hydroxyvitamin D levels in obese patients despite aggressive supplementation regimes is exactly what one would expect if 25-hydroxyvitamin D was an acute phase reactant.
The article you cite concerned people who had the Roux-en-Y gastric bypass surgery, which is specifically intended to reduce fat absorption and so significantly reduces the absorption of vitamin D3, which is more soluble in fats than water.
In addition, while it may well be true that general inflammation in people suffering from obesity, is part of the reason for their low 25-hydroxyvitamin D, two mechanisms are reasonably assumed to be at work which contribute to this problem: lower rates of hydroxylation of vitamin D3 cholecalciferol in the liver to circulating 25-hydroxyvitamin D and the absorption of 25-hydroxyvitamin D (and vitamin D3) into the fat cells of the large amounts of excess adipose tissue in a way which these are not returned to the circulation. See detailed references at: https://5nn.info/temp/250hd-obesity/.
(It so happens that the Massachusetts Hospital research was on 770 generally morbidly obese patients undergoing Roux-en-Y surgery for weight loss. I know of no reason to believe that people suffering from obesity need more circulating 25-hydroxyvitamin D to run their immune systems than people not suffering from obesity, so the results of this research can reasonably be interpreted as applying to all people.)
The inverse relationship between CRP and 25-hydroxyvitamin D levels surely involves causation in both directions. This is probably part of the reason it is difficult to reverse obesity. High 25-hydroxyvitamin D reduces excessive, harmful, inflammation - and this inflammation consumes more 25-hydroxyvitamin D as immune cells use it to drive their intracrine and paracrine signaling systems, so lowering the circulating level, reducing the efficiency of these systems and so further increasing immune system dysfunction and so excessive inflammation.
Of course forcibly raising circulating calcitriol (1,25-dihydroxyvitamin D) levels doesn't combat sepsis. These researchers believed the same thing you have been stating - regarding all three compounds as "vitamin D", thinking that "vitamin D is a hormone" and therefore assuming that the immune system would somehow be boosted by higher levels of circulating calcitriol. As I wrote in my previous comments, this is not the case at all. The immune system is not significantly affected by the very low level of circulating calcitriol. It needs a good supply of 25-hydroxyvitamin D in the bloodstream so that individual cells can hydroxylate it into calcitriol *inside* the individual cell, where it acts as an intracrine agent, not a hormone, to alter that individual cell's behaviour. This intracrine signaling system is only activated by the cell detecting a cell-type specific condition. The changes in cellular behaviour, when the process works properly (which requires at least 50 ng/mL 125 nmol/L circulating 25-hydroxyvitamin D), this calcitriol changes the cell behaviour in a way which is different for each cell type.
You would not continue to make the mistakes that you keep making, if you actually read the vitamin D literature with an open mind, rather than with the intention to prove yourself right. If you're not going to go through the research that I cite, why bother commenting at all? I'm rather tired of hearing you play your one-note flute.
Robyn, the research you've done for this four-part (so far) series is impressive and, as usual, the articles are well-written and easy to follow even for lay people like me. Thank you, as I'm among those who have been interested in knowing more about the usefulness of vitamin D supplementation. I look forward to your next installment where I understand you'll be addressing diet and lifestyle approaches for maintaining adequate vitamin D levels.
Meantime, I have a couple of questions. First, and while I recognize your vitamin D series is not promoting vitamin D supplementation as a general means for improving health, I wonder what you think about the fact that commercially available vitamin D supplements are in fact identical to what is used as rat poison. Do you think that's simply a matter of the dose making the poison, or are commercially available vitamin D supplements toxic regardless of dose?
Second, your series makes a compelling case based on published medical literature, including a number of RCTs, that with certain exceptions vitamin D supplementation is not generally associated with improvements in health or reductions in mortality. I'm also familiar more generally with much of your other work over the past few years, including things you've written (and said) about critical thinking and conducting research. In that regard, it is becoming well known, especially among those who are awake to the fraud and corruption that infects governments and institutions around the world, that the pharmaceutical industry long ago compromised the public health establishment, which now is completely corrupt and does the bidding of the pharmaceutical industry without regard for the welfare of the general public that it is supposed to serve. The corruption extends to the biggest and supposedly best medical journals. Even former editors of some of the most highly-regarded journals began warning many years ago that the pharmaceutical industry had so corrupted the journals that they can not be relied upon as accurate sources of medical information. Clinical studies often are designed to fail, published results often are intentionally misleading, and it is not unheard of for study results and even the underlying data sets to be entirely falsified. We saw that in spades during the Covid-19 event, with corrupt insiders using designed-to-fail studies and falsified data sets to disparage safe and effective medications like hydroxychloroquine and ivermectin and to promote highly profitable and very dangerous alternatives like the experimental Covid-19 injections and toxic therapeutics like remedesivir. Similar but less well known fraud and corruption has been going on for decades and infected the clinical studies and medical journal reporting that ultimately led to the licensing and approval of other toxic drugs like SSRIs, statins, and more recently the new-fangled and extremely dangerous weight loss drugs.
In short, the pharmaceutical industry does not exist primarily to help people improve their health. To the contrary, it is profit-driven and derives benefit from chronic illness (and, arguably, keeping people sick). Given that it controls what the medical journals publish, I've concluded nothing they publish can be trusted. With that in mind, I wonder whether medical literature that discounts the utility of vitamin D supplementation is reliable -- after all, it would not seem to be in the best interests of the pharmaceutical industry if something like vitamin D supplementation actually helped improved people's health and made them less reliant on toxic pharmaceuticals.
Stated differently, if Robyn Chuter designed a study to determine whether vitamin D supplementation is safe and effective for improving immune system function and general health, I would have no doubt the study would be well designed, the reported data would be genuine, and the reported results would honestly and accurately reflect actual outcomes. I have no confidence in other researchers whose motivations and backgrounds are unknown to me, and the fact their work might get published in a medical journal I already know to be corrupt likely would cause me to disregard their study before reading the first sentence.
Thanks for prompting me to research this issue - it's been a fascinating journey and has caused me to rethink my recommendations to clients re vitamin D supplementation.
On the 'rat poison' issue, it is definitely an example of the dose making the poison. Bad things happen to humans who take cholecalciferol in very large doses, but that's not relevant to people who are taking the generally-recommended dose.
On the question of the integrity of the clinical trials of vitamin D supplementation, I completely understand your cynicism - but bear in mind, widespread testing for vitamin D generated a ton of money for the medical industry, and major drugmakers, including Pfizer, Unilever, Novartis, GlaxoSmithKline, sell vitamin/mineral/other supplements in general (see https://www.elsevier.com/en-au/connect/the-link-between-big-pharma-and-the-supplement-industry), while Sanofi-Aventis and Shire specifically sell vitamin D supplements.
I'm not against supplementation as a policy. However, the very word 'supplement' implies that it should be something that you do IN ADDITION to, and not instead of, taking responsibility for your health by adopting healthy eating and lifestyle habits. More often than not though, supplements are recommended INSTEAD OF a healthy diet and lifestyle.
I totes agree with below writers comments. This is an excellent article..and as uusual Im so impressed by the indepth research you have done robyn. Changes my view on vit d.
I like the diet n lifestyle theory personally...I think thats why we have those receptors...but eagerly await your nxt publication. Well done.
My own views on vitamin D have changed significantly as a result of doing this research. I would not recommend against supplementation across the board, but I have concluded that we need to be much more cautious and thoughtful about it. Scientists almost always conclude their papers by calling for more research, and that's desperately needed in the case of vitamin D.
I haven’t commented on this episode because I was waiting for the end which I now know is at least another week away. This was the one I was waiting for because most of your previous posts were already known to me, although not in as great a detail.
To relate reverse causation to a more personal experience, my wife had knee replacement surgery back in April. The surgery itself went fine, but that evening she began having chest pain and difficulty breathing. I called 911 and she was transported to ER where they ran all the usual tests and were able to say she didn’t have a coronary event, but admitted her to run more tests. Turns out she had pneumonia, probably from aspiration of regurgitation when being anesthetized, before they could intubate her. She spent 3 days there while running more tests. I tell this because when I was looking at her blood work I saw that her vitamin D was low(20s) and her CRP was high. So, after reading this post, I know why. Inflammation, although it could be from the surgery or because of the pneumonia. Thank you once again for giving us all the knowledge in order to make wise decisions regarding our health.
Sorry to keep you in suspense! Each part has taken me a ridiculous number of hours to write because of the enormous amount of literature I've had to plough through.
And yes, you're spot on about your wife's bloodwork. The surgery by itself would trigger the acute phase response; add pneumonia to that and you would expect a big spike in CRP and fall in 25-hydroxyvitamin D. I hope she has made a full recovery.
I don't have time at present to go through all you have written, but please see my comments on your previous articles and the research cited and discussed at: https://vitamindstopscovid.info/00-evi/.
If you and your readers can't recognise that we would all be better off with 50 ng/mL (125 nmol/L) 25-hydroxyvitamin D than 20 ng/mL (50 nmol/L, like many people have today) by the Massachusetts General Hospital research https://vitamindstopscovid.info/00-evi/#00-50ngmL https://jamanetwork.com/journals/jamasurgery/fullarticle/1782085 I don't know what evidence will convince you. *Pre-operative* 25-hydroxyvitamin D levels of 50 ng/mL or more resulted in a 2.5% risk of hospital acquired infections and a 2.5% risk of surgical site infections. Those with 20 ng/mL had about 23% risk of each type.
While infection / inflammatory immune responses probably do lower circulating 25-hydroxyvitamin D levels to a certain degree, as reported in the hip / knee surgery article (also, the patients would not have got much sun for a while) this is a minor concern and also an argument for better supplementation, since it is obvious the the immune system needs 50 ng/mL or more to work properly.
You wrote:" Furthermore, the persistence of low 25-hydroxyvitamin D levels in obese patients despite aggressive supplementation regimes is exactly what one would expect if 25-hydroxyvitamin D was an acute phase reactant.
The article you cite concerned people who had the Roux-en-Y gastric bypass surgery, which is specifically intended to reduce fat absorption and so significantly reduces the absorption of vitamin D3, which is more soluble in fats than water.
In addition, while it may well be true that general inflammation in people suffering from obesity, is part of the reason for their low 25-hydroxyvitamin D, two mechanisms are reasonably assumed to be at work which contribute to this problem: lower rates of hydroxylation of vitamin D3 cholecalciferol in the liver to circulating 25-hydroxyvitamin D and the absorption of 25-hydroxyvitamin D (and vitamin D3) into the fat cells of the large amounts of excess adipose tissue in a way which these are not returned to the circulation. See detailed references at: https://5nn.info/temp/250hd-obesity/.
(It so happens that the Massachusetts Hospital research was on 770 generally morbidly obese patients undergoing Roux-en-Y surgery for weight loss. I know of no reason to believe that people suffering from obesity need more circulating 25-hydroxyvitamin D to run their immune systems than people not suffering from obesity, so the results of this research can reasonably be interpreted as applying to all people.)
The inverse relationship between CRP and 25-hydroxyvitamin D levels surely involves causation in both directions. This is probably part of the reason it is difficult to reverse obesity. High 25-hydroxyvitamin D reduces excessive, harmful, inflammation - and this inflammation consumes more 25-hydroxyvitamin D as immune cells use it to drive their intracrine and paracrine signaling systems, so lowering the circulating level, reducing the efficiency of these systems and so further increasing immune system dysfunction and so excessive inflammation.
Of course forcibly raising circulating calcitriol (1,25-dihydroxyvitamin D) levels doesn't combat sepsis. These researchers believed the same thing you have been stating - regarding all three compounds as "vitamin D", thinking that "vitamin D is a hormone" and therefore assuming that the immune system would somehow be boosted by higher levels of circulating calcitriol. As I wrote in my previous comments, this is not the case at all. The immune system is not significantly affected by the very low level of circulating calcitriol. It needs a good supply of 25-hydroxyvitamin D in the bloodstream so that individual cells can hydroxylate it into calcitriol *inside* the individual cell, where it acts as an intracrine agent, not a hormone, to alter that individual cell's behaviour. This intracrine signaling system is only activated by the cell detecting a cell-type specific condition. The changes in cellular behaviour, when the process works properly (which requires at least 50 ng/mL 125 nmol/L circulating 25-hydroxyvitamin D), this calcitriol changes the cell behaviour in a way which is different for each cell type.
You would not have made any of these mistakes if you had read the research cited and discussed at: https://vitamindstopscovid.info/00-evi/.
You would not continue to make the mistakes that you keep making, if you actually read the vitamin D literature with an open mind, rather than with the intention to prove yourself right. If you're not going to go through the research that I cite, why bother commenting at all? I'm rather tired of hearing you play your one-note flute.