On November 30, 2010, the Institute of Medicine's Food and Nutrition Board (FNB) released their updated recommendations for vitamin D (and calcium), which has sent shockwaves of disappointment through natural health community.
According to the FNB, the new recommended daily allowance (RDA) for pregnant women and adults up to 70 years of age is the same as that for infants and children – a measly 600 IU's. This despite the overwhelming evidence showing that vitamin D is extremely important for a wide variety of health conditions besides bone health, and that most people need about ten times this amount or more.
In this interview, Dr. Cannell, founder of the Vitamin D Council, and Carole Baggerly, founder of GrassrootsHealth, share their concerns about this recent development.
Dr. Mercola's Comments:
In their latest vitamin D report, the Institute of Medicine's Food and Nutrition Board (FNB) claims the only evidence for the benefit of vitamin D they could document was the improvement of bone health.
How they could come to this conclusion is truly beyond belief, because there are literally hundreds if not thousands of studies showing that it benefits dozens if not hundreds of clinical conditions.
Based on their limited findings, the FNB's updated recommended daily allowance (RDA) for vitamin D is as follows:
|Infants 0-12 months||0 IU/day|
|1-18 years||600 IU/day|
|Over 70 years old||800 IU/day|
|Pregnant women aged 14-50||600 IU/day|
As Dr. Cannell points out in our interview, these recommendations do not take into account the amount of vitamin D you need to prevent influenza, heart- or liver- disease, respiratory infections, cancer, or any of the numerous diseases that have a clearly documented link to vitamin D deficiency.
Why should we care about the IOM's recommendations?
Well, as the Alliance for Natural Health states:
"Unless these findings are challenged, the public will accept it as true. Doctors, medical institutions, the media, and governmental agencies will all parrot these ultra-low recommendations on vitamin D dosage, pooh-poohing its important therapeutic benefits, and keeping the American public dangerously deficient in the vitamin.
This will mean more colds, more flu, greater dependence on dangerous flu shots and antibiotics, more illness in general, more weak bones, more cancer, and many more deaths. Some experts calculate that proper vitamin D supplementation could save Americans $4.4 trillion over a decade—about $1,346 per person every year."
Scientific Evidence Supports FAR Higher RDA for All Age Groups
Dr. Heaney is widely believed to be one of the most prominent and well respected researchers on vitamin D. He's authored more than 400 vitamin D papers in his lifetime, including the 2007 cancer study that showed a full 77 percent of all cancers could be prevented with a vitamin D level of at least 40 ng/ml.
Dr. Heaney was also part of the previous FNB vitamin D panel (but not this one as previous panel members are excluded from future panels). Here's what he had to say about the latest IOM/FNB recommendations:
"There is an impressive body of scientific evidence supporting levels higher than the Institute of Medicine panel is currently recommending. For reasons that are not entirely clear, the panel has discounted that evidence.
The public needs to know that evidence exist so that they can make up their own minds. It is helpful in making those decisions to know that intakes higher than the recommendations are safe.
For me that decision is easy even if the evidence for higher intake were uncertain. And I don't believe it is. Intakes two to five times their recommendations would carry a good chance for benefit at essentially no cost and no risk.
… Finally, I believe that the presumption of adequacy should rest with vitamin D intakes needed to achieve the serum levels (40–60 ng/mL) that prevailed during the evolution of human physiology.
Correspondingly, the burden of proof should fall on those maintaining that there is no preventable disease or dysfunction at lower levels. The IOM has not met that standard."
Clearly, the FNB moved their recommendations in the right direction. As Dr. Cannell points out, the recommended dose for infants, children and pregnant women was tripled, from 200 units to 600 units, and the dose for older people was increased by about 33 percent. The upper limits were also doubled.
However, these recommendations still leave a lot to be desired.
"What's shocking to me is that the levels they are recommending will not even approximate what you would get if you were exposed to healthy levels of sunshine," Dr. Cannell says.
A more appropriate way to analyze vitamin D requirements would indeed be to look at the vitamin D levels of early man. Those are the levels we want to have, because that's what the human genome is designed for, or used to, from an evolutionary perspective.
"One thing that did concern me is they have 15 vitamin D experts to review their report before they released it. But they refuse to let anybody look at the vitamin D experts' opinions about their reports," Cannell says.
" Yesterday, we instructed our attorney to try to obtain them under the Freedom of Information Act."
Time will tell whether or not that documentation will be released. I too am very curious to see what the vitamin D experts' opinions were about the FNB's conclusions…
Officially Sanctioned or Not, Higher Vitamin D Levels ARE Beneficial to Your Health
Please remember that you have the freedom to do your own research and are not obligated in any way to adhere to "government sanctioned" nutrient recommendations.
In this case, conventional medicine is still lagging far behind in their implementation of what the science shows about vitamin D.
"[P]eople need to remember about this report is that these are recommendations for those who want to proceed on their own without a doctor's advice," Cannell says.
"If you're under the care of a physician, this report is almost meaningless… It doesn't in any way preclude a physician from prescribing the usual dosages that they do; the 50,000 units once or twice a week. [The report] is not designed to prevent that."
So, if what the Vitamin D Council and I have been posting about the health benefits of vitamin D and the optimal vitamin D levels make sense to you, then you can choose to flat out ignore this new recommendation from the Institute of Medicine.
As Carole Baggerly points out in the interview above, the FNB is recommending a vitamin D blood serum level of just 20 ng/ml, which, based on more appropriate parameters for optimal health, signifies a state of severe deficiency!
To me, it borders on criminal negligent malpractice to ignore the abundance of scientific evidence that suggest that the deficiency levels are far above 20 ng/ml.
This serum level may not even be sufficient to maintain bone health, as the IOM/FNB claims.
According to a statement issued by Dr. Heaney:
"The statement by the IOM that skeletal health can be maintained at serum 25(OH)D levels of 20 ng/ml is incorrect. 30 ng/ml should be looked at as the lower end of the acceptable range for bone health.
There have been randomized controlled trials showing major reductions in fractures by getting the serum level to 29 ng/ml. Fracture reduction does not reliably occur at levels less than 30 ng/ml and in some cases as high as 40 ng/ml.
Osteoid seam width, a measure of vitamin D deficiency, only reaches normal values when the level is above 30 ng/ml. There is significant evidence above the IOM panel's "adequate" level of 20 ng/ml."
This is further supported by Drs. Heike Bischoff-Ferrari and Walter Willett. You can read their entire critique of the IOM recommendations here.
Negative Vitamin D Results Frequently Due to Vitamin A in Cod Liver Oil
Dr. Cannell brings up additional food for thought with regards to some of the studies that suggest detrimental effects from vitamin D.
"It's important for people to realize that of the several hundred studies that have come out in the last couple of years, not all of them are positive, for reasons that I believe has to do with vitamin A.
There is a U-shaped curve in some of the studies, especially the ones that come from Scandinavian countries… Most of the cohorts that were studied in these papers had their dietary information taken in the 80s and 90s and their blood drawn at that time. The intake of cod liver oil especially in the Scandinavian countries in that time was substantial.
When you take cod liver oil, you'll increase your vitamin D level but with it you'll get toxic amounts of vitamin A. There are a number of studies that shows that vitamin A is not a good thing to have an excess of."
That said, the randomized control trials that have been done have not shown any damage or any danger from high amounts of vitamin D. In fact, most studies that are now using higher vitamin D dosages are showing significant, positive treatment effects.
The Latest Vitamin D Studies Find Even More Health Benefits…
Dr. Cannell's passion is to carefully review the medical literature on vitamin D, and there's no shortage of vitamin D studies showing its benefits. One of the latest studies to be published on vitamin D found that it is also linked to your risk of developing macular degeneration, which many have mistakenly attributed to 'normal aging,' as well as cataracts.
Dr. Cannell says:
"It turns out that the higher your vitamin D level the less likely it is for that [macular degeneration] to happen. There is even a cross-sectional study that indicates that the lower your vitamin D level the more likely you are to get cataracts (and one of the reasons you've always been told to stay out of the sun is because you'll get cataracts)."
There is also an interesting new paper about Parkinsonism that suggests that low vitamin D levels exacerbate the disease.
"So if you know of anyone with Parkinsonism make sure their vitamin D levels are in the high range; higher than normal, between 50-80 ng/ml," Cannell suggests.
This would also hold true for other chronic neurological diseases, such as Alzheimer's.
"That's a really important point," Cannell says. "People are asking me, "What's the right vitamin D level?"
If you're otherwise perfectly healthy, then a level of around 50 is fine… But many people who have heart disease, Parkinsonism, Alzheimer's, emphysema, or cancer… It's my opinion that [those] people should get their levels up into the high range of normal.
The rationale for that is that there are a number of studies with cancer now that show that the blood level of vitamin D you have at the time you're diagnosed with cancer predicts how long you're going to live. That is, high vitamin D levels at the time of diagnosis prolongs life.
… [I]f you're sick, you want to keep your levels at 80-90 ng/ml."
Why Pregnant Women Need to Take IOM's Recommendations with a Grain of Salt
Likewise, there's very compelling evidence backing up the advice that pregnant women should optimize their vitamin D levels prior to and during pregnancy to prevent neurological problems, such as autism, in their children.
There's even evidence suggesting the child is significantly protected from type 1 diabetes if the mother has sufficient vitamin D levels during gestation, and/or if the infant receives sufficient amounts of vitamin D.
From my perspective, with the mountain of scientific evidence we now have on the benefits of optimal vitamin D levels in pregnancy it is reprehensible malpractice to not routinely check a pregnant woman's vitamin D level during the pregnancy.
Of course, it is still not the "standard of care" at this point and no physician will lose his or her license for failing to do this check.
According to Dr. Cannell:
"[I]f you're thinking of having a child, both parents should take the steps necessary to be vitamin D sufficient. Once a woman is pregnant, she's going to need probably 7,000-8,000 IU's a day while she's pregnant and lactating. And then when the infant is off breast milk, the infant needs an independent source of vitamin D.
The Food and Nutrition Board now say 400 IU is adequate [for pregnant/lactating women]. Four hundred is pretty good, but 1,000 IU's is better."
Is there a Hidden Agenda?
Interestingly enough, while the importance of sunlight and oral vitamin D supplements are being suppressed, a patentable vitamin D drug is currently in the works, the Alliance for Natural Health reports
"A pharmaceutical company is developing a patentable man-made vitamin D analog—yes, a synthetic drug version of vitamin D. And Glenville Jones, PhD, one of the committee members who determined the new vitamin D guidelines and who is quoted as saying that under these guidelines, most people "probably don't have vitamin D deficiency" and "We think there has been an exaggeration of the public's interest in vitamin D deficiency," is an advisor for that same pharmaceutical company."
Might this have anything to do with the IOM's blatant disregard for the evidence at hand?
Carole Baggerly's Take on the IOM/FNB Recommendations
The second part of the video above features Carole Baggerly, the founder of GrassrootsHealth. She has been instrumental in managing and implementing a massive effort to educate Americans and Canadians about the importance of vitamin D, both on a consumer and government level.
For example, she was a primary force behind getting Canadian health authorities to investigate the use of vitamin D against the swine flu last year.
She brings up several shocking facts about the manner in which the IOM/FNB came to their final conclusions. According to Baggerly, the panel carefully selected the type of data they wanted to review, and excluded a wide variety of important data.
"They did not look at epidemiological data at all," she says, "of which there are decades of research substantiating that people die of all kinds of diseases that are impacted by vitamin D.
… They excluded all kinds of data that would be, in the public health field, considered very relevant data.
… [T]he agenda was very clearly set from the very beginning, and those of us who looked to see what kind of data they were choosing to include… knew the outcome would not be favorable for the implementation of vitamin D health."
Exactly who set this agenda is still unclear. What is clear is that the IOM/FNB decided to ignore certain sets of pertinent data. Clearly, had it been included, it would have been impossible to justify their current position.
Carol has been working as a consultant to the Ontario government, primarily pertaining to what they should do about their vitamin D testing. They have, as of December 1, "de-listed" vitamin D, which means the government will no longer include payments for vitamin D testing as part of their health insurance.
This is a major setback. However, Canadians can still purchase vitamin D tests on their own. And Grassroots Health has initiated several vitamin D initiatives to help Canadians get their tests at a reduced cost, by enrolling them in a Grassroots Health vitamin D study.
The Canadian government may use the latest IOM/FNB recommendations as justification for taking out vitamin D testing.
However, there's still some good news.
Heather Chappell of the Canadian Cancer Society (CCS) has stated that the organization will not lower their recommendations -- which is currently 1,000 IUs per day, based on the vitamin D cancer research done by Dr. Heaney and Lappe – because the IOM recommendations cover bone health only. And the CCS is still concerned about vitamin D deficiency and cancer.
The:Expert: Vitamin D Panel is Not Even Made Up of Vitamin D Experts
So, just who's on the IOM's vitamin D panel?
Contrary to common sense, the panel did not consist primarily of vitamin D experts.
According to Carol:
"They did have a few people on the panel with a little bit of vitamin D experience but not much. (The full list of panel members is available on www.IOM.edu.)
Their experience certainly was not in the epidemiological realm at all like Dr. Garland.
What was disturbing to some of our panel, the vitamin D researchers, was that a number of them have been recommended or volunteered previously on the panel and they were explicitly rejected.
That is disturbing."
Again, the position of the Vitamin D Council, GrassrootsHealth and myself is that you need to adhere to the scientific vitamin D panel recommendation, which is a vitamin D level of 40 ng/ml at minimum.
In my view, many people still would not be able to reach a therapeutically healthy range taking 4,000 IUs of vitamin D a day, which is the maximum dosage now recommended by the IOM. I've seen people who need double that, or more, to get to a level that's going to make a difference in their health.
How Much Vitamin D Must You Take to Reach Therapeutically Healthy Levels?
Dr. Hollis has released preliminary findings of a brand new study that has not yet been formally published. In the interview above, Carol shares some of those details:
"One of the most significant findings is how much intake it takes to get to these higher levels.
For example, there has been a rule of thumb that for each 1,000 IUs of vitamin D you take you would get a serum level rise of about 10 ng/mL…
Well, it doesn't work that way.
What we are finding is that once you get above the age of 30, the amount of rise that you get for each dosage [of oral vitamin D] is considerably less than that.
For example, between the age of 40 and 50, you'd have to take about 2,000 IU to reach a serum level of 10 ng/ml. You only get a 5 ng/mL rise for each 1,000 IU, not 10 ng/ml.
… What this means is that people have to take a lot more. It's going to take about 6,000 IU a day to get about 90-95 percent of the population above 40 ng/mL."
Some people will clearly need more.
Improve Your Health and be Part of Worldwide Public Health Campaign
D*Action is a worldwide public health campaign created by GrassrootsHealth, aiming to solve the vitamin D deficiency epidemic in one year through focus on testing, education, and grassroots word of mouth.
You can participate in the D*action study, if you like! Best of all, Mercola subscribers will receive a 15 percent discount on the 5-year sponsorship.
To sign up, and get your discount, follow these instructions:
When you sign up, at the beginning of the Payment Options (The area where it says "Please input any CLINIC ID or COUPON CODE assigned to your organization and click Apply:") on the Order form, please enter 'Mercola.' Then continue with your payment process.
When you join D*action, you agree to test your vitamin D levels twice a year during a 5 year program, and share your health status to demonstrate the public health impact of this nutrient.
There is a $60 fee for every 6 months for your sponsorship of the project (Mercola sponsors get a 15 percent discount), which includes a complete new test kit to be used at home (except in the state of New York), and electronic reports on your ongoing progress.
When you finish the questionnaire, you can choose your subscription option. You will get a follow up email every 6 months reminding you "it's time for your next test and health survey."
To join now, please follow this link to the sign up form.
I, along with GrassrootsHealth, expect this study will demonstrate the real significance of this nutrient on your health and, of course, its value in the prevention of many diseases. So please sign up today so you can be part of a team of Mercola subscribers setting out to demonstrate that PREVENTION WORKS!