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Vitamin D benefits, problems with Endocrine 2024 recommendations - Dec 2024


Vitamin D: Evidence-Based Health Benefits and Recommendations for Population Guidelines

Preprint
William B. Grant **, Sunil J. Wimalawansa , Pawel Pludowski and Richard Z. Cheng *

  1. Sunlight, Nutrition, and Health Research Center, 1745 Pacific Ave., Ste. 504, San Francisco, CA 94109, USA, wbgrant@infionline.net
  2. Endocrinology & Human Nutrition, Department of Medicine, Cardiometabolic & Endocrine Institute, North Brunswick, NJ, USA; suniljw@hotmail.com
  3. Department of Clinical Biochemistry, The Children's Memorial Health Institute, 04-730, Warsaw, Poland, p.pludowski@ipczd.pl
  4. Orthomolecular Medicine News Service, Columbia, SC, USA; Low Carb Medicine Alliance, Shanghai, China. DrCheng@drwlc.com
    * Correspondence: wbgrant@infionline.net, DrCheng@drwlc.com

Vitamin D offers a wide range of under-recognized health benefits beyond its well- established role in musculoskeletal health. It plays a crucial role in extra-renal and skeletal tissues, prenatal and newborn health, brain health, immune function, cancer prevention, cardiovascular disease, etc. Current clinical guidelines, particularly the Endocrine Society's 2024 recommendations, remain limited in scope and have not addressed the vital extra-skeletal benefits of this vitamin nor the thresholds for vitamin D assays. Their recommendations were based on conclusions from randomized controlled trials of the benefits of vitamin D, which were infrequently found. Most such trials included participants with above average 25-hydroxyvitamin D [25(OH)D] concentrations and treated with low vitamin D doses and analyzed based on intention to treat. This review considers the role of vitamin D in reducing the risk of incidence and death for eight of the top ten causes of death in the US illustrating that serum concentrations above 30 ng/mL (75 nmol/L) compared to <20 ng/mL are associated with significantly reduced risk of incidence and mortality rates for many health outcomes. Since about a quarter of the US population and 60% in Central Europe have 25(OH)D concentrations <20 ng/mL, significant reductions in disease rates and deaths could be achieved by raising those values above the minimum of 30 ng/mL. Daily vitamin D supplementation with 2000 international units (IU) (50 pg) of vitamin D3 is recommended for prevention of vitamin D deficiency/insufficiency (i.e, serum 25(OH)D < 30 ng/mL)—suffident for musculoskeletal system functions. However, intake above 4000 IU/day are recommended to raise serum 25(OH)D to the range 40-70 ng/mL to achieve protection against many adverse health outcomes. This review aims to pave the way for more inclusive, evidence-based guidelines that enhance public health and personalized care.
 Download the PDF from VitaminDWiki


Please summarize the attached study in a couple of pages - asked Perplexity AI, Dec 2024

This comprehensive review examines vitamin D's wide-ranging health benefits and critiques the 2024 Endocrine Society guidelines.
The study makes several key points:
Major Health Benefits
Cardiovascular Disease

  • Vitamin D influences calcium homeostasis and gene transcription, supporting heart health and reducing atherosclerosis risk
  • Higher vitamin D levels are associated with reduced cardiovascular mortality, with studies showing up to 24% reduction in risk

Cancer Prevention

  • Vitamin D supplementation shows promise in reducing cancer risk, particularly for those with BMI <25 kg/m²
  • Studies indicate an 80% lower risk of breast cancer in women with 25(OH)D concentrations ≥60 ng/mL compared to <20 ng/mL

Immune System Support

  • Vitamin D enhances innate and adaptive immunity by boosting antimicrobial peptides
  • Higher vitamin D levels reduce risk of respiratory infections, including COVID-19 and pneumonia

Brain Health

  • Adequate vitamin D levels are associated with improved cognitive function and reduced risk of dementia
  • Studies show vitamin D deficiency increases dementia risk by up to 2.9 times in the first years of follow-up

Recommended Levels
The study suggests different optimal levels for various health outcomes:

  • Minimum recommended level: 30 ng/mL
  • Optimal range for most health benefits: 40-70 ng/mL
  • Higher levels (80-150 ng/mL) may be beneficial for specific conditions under medical supervision

Critique of 2024 Guidelines
The authors criticize the new Endocrine Society guidelines for:

  • Focusing too narrowly on bone health while ignoring broader benefits
  • Recommending against routine vitamin D testing for adults aged 18-74
  • Using overly conservative dosage recommendations
  • Relying too heavily on randomized controlled trials while ignoring observational studies

Recommendations
The study advocates for:

  • Daily supplementation of 2000 - 4000 IU for most adults
  • Higher doses (up to 10,000 IU) for specific conditions or obesity
  • Regular monitoring of serum 25(OH)D levels
  • Personalized supplementation based on individual factors like genetics, BMI, and lifestyle

This review emphasizes the need for more comprehensive vitamin D guidelines that consider its full range of health benefits beyond bone health, and argues for higher supplementation levels than currently recommended by major health organizations.


VitaminDWiki – Consensus Vitamin D category contains:

71 Vitamin D consensus publications

VitaminDWiki – Optimum category contains:

The RDA is barely enough for the bones to survive.
   Need an optimal level for the body to thrive

99 items in Optimum Vitamin D category

Example pages


VitaminDWiki – The body often needs more than 30 ng of vitamin D and a review of 12 recommendations – Nov 2024


VitaminDWiki – Endocrine Society recommends for the healthy: no Vitamin D tests, just RDA (many object) - July 2024


VitaminDWiki - Vitamin D Roles - more than just help the immune system contains:

         The classic roles

  1. enhancing intestinal absorption of calcium, magnesium, and phosphate
  2. calcium regulation and bone health maintenance
    The non-classic roles
  3. immunomodulatory effect
  4. cardiovascular health
  5. improvement of insulin function
  6. regulation of blood pressure
  7. anticancer effect

Attached files

ID Name Comment Uploaded Size Downloads
22110 Grant etc preprint Dec 2024.pdf admin 21 Dec, 2024 600.77 Kb 6