17 reasons why are doctors reluctant to accept vitamin D

1. Myth: Excess vitamin D will turn the human body into marble
   Until recently medical students were told that > 2,000 IU of vitamin D could cause toxicity and Calcifications
   It is difficult to unlearn something.
   See Myth for 50 years: 2000 IU of vitamin D is toxic - still taught as fact in 2010
   • Williams Syndrome mistaken diagnosis
   • Or. perhaps due to a ancient translation error 1000 IU of vitamin D (per kg) can indeed be toxic – 1947
2. Would require ignoring the position of the medical profession on supplements.
   Medical societies first supported then reversed themselves on the need for supplements
   Doctors got burned by first telling patients to take supplement X and then later having the patients stop taking supplement X
   Doctors are reluctant to endure yet another supplement reversal
    
3. Risk being sued if exceed guidelines
   Increase risk of being sued for Malpractice if exceeds current medical guidelines
   Example: prescribe 6,000 IU of vitamin D during pregnancy instead of the 400 IU in most guidelines
    
4. Experts do not agree on how much is needed
   There is a worldwide agreement that 400 IU of vitamin D is needed to prevent Rickets, but little else is agreed upon
   (Raised to 600 IU in the US in 2010, most countries are still at 400 IU, and some are still at 200 IU)
   Some improvement: 4,000 IU of Vitamin D is OK - 19 organizations agree - 2018
    
5. Doctors are rarely been trained in nutrition
   When I went to medical school, nutrition was not really on the radar,
       and taking vitamins was even trivialized by some as a great way to “make expensive urine.”
   Vitamin D is arguably the most complex supplement - the amount needed varies with:
      Weight, Skin color, Latitude, Season, Co-factors, Current meal, Recent surgery/trauma, Neighborhood, etc.
       see also Why isn’t nutrition a bigger part of conventional medical school education? The question at Research Gate 2013 with > 400 responses
    
6. Medical training has an emphasis on treatment, not prevention
   Medical training and practice emphasizes treatment, not prevention.
   The primary benefit of vitamin D is prevention. (but Vitamin D does treat 70+ diseases) but typically need >5,000 IU
   They have learned that most patients are either reluctant to change so as to prevent a future problem (lose weight, stop smoking, . . )
   or will often not continue with the change. So why should the doctor try?
    
7. Doctors have tried prescribing small vitamin D doses recommended by govts., but with minimal success
   A frequent sequence of events:
   1) A doctor hears that people might have low Vitamin D
   2) The doctor recommends a vitamin D test for some of his patients
   3) The test result often shows low
   4) The doctor prescribes the RDA (far too little)
   5) Retesting finds that the levels did not rise and patient-reported no health improvement (too little dose or test too soon)
   6) The country/health profession decides that tests are costly and do not improve health
8. Doctors often can only prescribe D2 anyway (true in US before March, 2012)
   Kaiser Health research continues to only use Vitamin D2 (2019)
   Some doctors are aware that D2 does not help nearly as much as D3
   And, in some cases, Vitamin D2 actually lowers levels of D3
    
9. Doctors have too little time to read outside of their specialty
    
10. Seems like too much of a “wonder drug”
    ‘Nothing can be that great’
     
11. Fear possible loss of income
    If Vitamin D is truly a ‘wonder drug’, it would reduce the number of patient visits, and therefore reduce income.
    Note: in 2012 one doctor reduced patient visits from 4 per year to 1 per year by getting all 2,000+ patients to have >80 ng     Net result of vitamin D: Lost too much business and retired early.
    • "It is difficult to get a man to understand something when his salary is dependent upon his not understanding it”  Upton Sinclair
    • See also Do not expect a doctor to recommend a pill which will eliminate his job (vitamin D)
    • Note: getting everyone >40 ng should not endanger medical jobs the way that >80 ng does
12. Might fear the loss of control and respect if people can deal with some of their own health problems
     
13. No profit for Big Pharma, so doctors not rewarded
     
14. The Vitamin D dose needed often varies by 4X between individuals for many health problems
    Doctors prefer using a single dose of a drug for all patients
     
15. Doctors are uncomfortable prescribing 4,000+ IU of vitamin D
     
16. in many countries doctors can only prescribe D2 (which does not work as well), not D3
     
17. Doctors often just want to use a monotherapy
    Reluctant to also prescribe Zinc or Resveratrol or Magnesium or Omega-3. etc. when needed

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See also VitaminDWiki

• Would you be opposed to my getting more vitamin D a question to your doctor that minimizes his risk
• 20 reasons for not taking Vitamin D debunked
• Do not expect your doctor to know about vitamin D
• Do not expect a doctor to recommend a pill which will eliminate his job (vitamin D)
• Overview Evidence for vitamin D
• Curing patients is not a sustainable business model – Goldman Sachs – April 2018
• VITAMIN D: Public Shouldn’t Wait For Doctors To Usher In New “Golden Era” Of Preventive Medicine
• Let 1000 die from vitamin D deficiency rather than incur 1 lawsuit
• Should people at high risk for vitamin D deficiency wait 5 years -Feb 2013
• Survey Shows Dogma Not Data Can Dictate Doctors' Decisions - June 2010
• Consensus Vitamin D category listing has 70 items along with related searches
• Hospitals do not want to lose income
  • Insurance companies would also lose income if medical costs were reduced since their income is a % of the billing

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