Rhein HM (1,2), Johnson G (1).
1. Sighthill Health Centre, 380 Calder Road, Edinburgh EH114AU, Scotland, UK.
Centre for Population Health Sciences: GP Section, University of Edinburgh, Edinburgh EH8 9AG, Scotland UK.
Background: After we became aware of the widespread vitamin D deficiency in our Scottish general practice population in Edinburgh at a latitude of 56; our patients have received for the past few years the offer of prescriptions for vitamin D supplements:
- 20,000 IU weekly for most adults
- 2,000 IU daily for pregnant women,
- 1,000 IU daily for children aged 5-12,
- 400 IU daily for babies and children aged 0 - 5.
All cancer patients with new or previous diagnosis were particularly targeted for the past 4-5 years.
Methods: Some adults, including all cancer patients, had their 25(0H)D estimated after supplementing for at least 3 months. The sizes of supplements were then adapted to aim for levels between 75 and 150 nmol/l. Collected figures are displayed.
Results: Of 124 adults tested 71 took 20,000 IU weekly, 45 took 40,000 IU weekly and 8 took 60,000 IU weekly in order to reach a satisfactory 25(DH)D concentration of above 75 nmol/l. Of 35 patients who took vitamin D at the start of their cancer diagnosis, 23 are still alive, 12 have died. Types of cancer and months of survival are charted. Of interest might be that the 5 lung cancer patients who died survived 60,11, 8 and 8 months respectively, one survived only 1 month because of a heart attack. Two lung cancer patient are still alive and have survived 43 and 8 months so far. This compares well with the known lower median Scottish lung cancer survival of 6 months after diagnosis. We have received frequently positive patient feedback: less aches and pains, fewer cold and coughs, less fatigue, one significant improvement of severe IBS. Several nurses in the health centre's treatment room were found to be profoundly deficient and improved significantly after taking supplements. Most of the cancer patients tested at the start of their diagnosis were severely vitamin D deficient. It is our impression that quality of life in most cancer patients was good after vitamin D supplementation, and in those who died this was right up until their final stage.
Conclusions: In a Scottish general practice (56' latitude) most adults need 20,000 IU weekly to reach an optimal range of 75 -150 nmol/l, but a significant number (43% in our sample) might need more, 40,000 IU or 60,000 IU weekly. Cancer patients appear to have an improved quality of life after vitamin D supplementation. In the absence of any known negative effects of vitamin D supplementation and while waiting for conclusive trials it could be beneficial for many cancer patients to be tested and treated for vitamin D deficiency
Poster presented at Vitamin D conference in England - April 23-25 2014
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