Toggle Health Problems and D

Fraser Health in Canada will be giving 20000 IU vitamin D weekly to reduce falls – Nov 2011

News Release

Optional for all Fraser Health 7,500 senior residents in Western Canada
Cost per year to Fraser Health of providing the vitamin D is estimated to about that of the cost of a single hip fracture , $20,000
Before vitamin D they had 1,000 to 1,500 falls per year
They hope to prevent 10% to 25% of the falls per year
Thus they hope to prevent 100 to about 300 falls per year
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Notes from phone conversation with Michael McBryde at Fraser Health Nov 23, 2011

Vitamin D has a problem of following other “wonder drugs” which proved to be not so beneficial – but this time is different. A problem of “cry wolf”.
Great resistance by many doctors to try vitamin D until after extensive and solid evidence.
Their program is somewhat funded by the Canadian govt (after 18 months of effort).
Fraser has issued quarterly reports – such as hip fractures as required in Canada
They should have a large enough dataset – with 7,000 residents – to easily detect the reduction in fractures etc. as a result of adding vitamin D
They will not have vitamin D tests before and during the protocol – too expensive.
All prescriptions are given by nurses to the senior home residents, approximately 85% of whom are demented.
Prescription of 20,000 IU tablet once per week.
  Had considered once per month, but was concerned that the resident might be absent on the day of the month that it was given.
He expects a very high participation rate – as the doctors must give a reason why their patients should not participate. - This might be called an opt-out situation.
A very small percentage of the residents will not participate – probably due being on dialysis or having high levels of Calcium

Future expansion of the program:

– Add co-factors of Vitamin K2 and Magnesium (the residents already get enough Calcium) to improve the effectiveness of the vitamin D on the bones
– Add more vitamin D for those at high risk (dark skin, obese, etc)
– Others in Fraser Health will probably elect in the future to extend vitamin D to some of the 99.9% of Fraser Health who are not in senior facilities

See VitaminDWiki

Possible problems if Fraser Health does not reduce Calcium when increasing Vitamin D

Previously the nutritionists made sure that seniors got > 1 gram of Calcium daily
The literature shows problems with > 750 mg of Calcium when the person has 'enough' vitamin D
IoM again fails to look at interactions - Nov 2010 has the following chart
released Nov 30, 2010

Update July 2012

Dr. Michael McBryde retired Jan 2012
The project in now supported by Dr. Larry Gustafson
It will actually start in the fall of 2012

Update fall 2014

They ran the study and published the results Contact = tim.green at ubc.ca
Read the study ($6) - I was amazed that:

  • They failed to compute mortality vs vitamin D levels
  • They failed to compute falls/fracture vs vitamin D levels - as was initially intended
  • They did not record if the vitamin D was actually taken - just prescribed
  • They stated that there was no benefit, but the PDF failed to show ANY computation of benefit
  • Smokers had HIGHER vitamin D levels than non-smokers
    They thought the higher levels might be due to the requirement that smoking must be done outdoors