Vitamin D deficiency – Physicians Assistants Continued Medical Education

1. Here are some of the errors 1. Commission errors Vitamin D2 is as good as Vitamin D3 * Vets decided over a decade ago that Vitamin D2 should never be used on any mammal. * There are scores of human studies which showed vitamin D2 being poorer than D3, * and sometimes D2 actually decreased D3 levels in the body * The Vitamin D2 references in this CME (from before 2010) have been disproven Regulating up to 200 genes * Low levels of vitamin D have been proven to regulate 291 genes. * Higher levels are anticipated to regulate > 1,000 genes No dose-response relationship of vitamin D with Breast Cancer * There have been 12 meta-analysis of Vitamin D and Breast Cancer, * several of which found a dose-response relationship Optimal fracture prevention at 800 IU * There have been more than 24 meta-analysis of Vitamin D and Fracture * – am unaware of any that considered 800 IU optimal – typically 800 IU is the bare minimum 9 concurrent vitamin D deficiency diseases mentioned * There are >30, not just 9 rickets, characterized by leg-bowing * 3 other indications which are more common to rickets Maintenance therapy of 800 IU daily * Far too little. Even children, who weigh far less, need at least 1,600 IU JAMA Calcium supplementation should include 1.5 to 2 g/day * This much Calcium when person is taking vitamin D causes many medical problems Vitamin D given in frequencies of three times a year * No – Major medical problems result when vitamin D is given so infrequently. * Anything frequencyt less often than 18 days provides a decreased benefit * Only active Vitamin D can treat psorasis * Inactivated Vitamin D can treat psorasis. This has been known for many years. * Recently it was proven that the the skin can active vitamin D 1. Omission Errors * Vitamin D production in the skin decreases with age * Yes, 10,000 IU from the sun – but ONLY IF: young, bathing suit, lying down, all sides of the body * No mention of the extremely important cofactors: Magnesium, Omega-3, Vitamin K2, etc. * No mention that Medicare now only pays for a single vitamin D test per lifetime * No mention of the 5+ additional forms of vitamin D which can be used * No mention of the importance of genes in risk of disease nor amount of vitamin D needed 1. Conflict errors 20 minutes (of sun) in the winter CME stated earlier: no vitamin D in the winter above a certain latitude (which is correct) Black patients may require twice as long of a duration of sun exposure CME stated earlier: 3X to 5X longer duration is needed (which is correct) Vitamin D level for health: > 20 ng in many places, but > 40 ng in others (which is correct) Note: The author has NO previous Vitamin D publication in PubMed 1. See also VitaminDWiki * Nurses continuing education – Vitamin D Overview $9, June 2014 1. See also web * Comment on article in PubMedby Dr. Grant * Overview for Doctors category listing has items includes some CME credit items