Hypovitaminosis D: A common deficiency with pervasive consequences
Journal of the American Academy of Physician Assistants:, February 2015 - Volume 28 - Issue 2 - p 20–26, doi: 10.1097/01.JAA.0000459810.95512.14
CME: Primary Care Medicine
Podd, Daniel MPAS, PA-C
Daniel Podd is an associate professor at St. John's University in Queens, N.Y.
ABSTRACT: Hypovitaminosis D is a common syndrome with well-established risk factors. Only recently, however, are the expansive implications of vitamin D deficiency becoming recognized, including cardiovascular complications, cancer, and dementia. The increased attention to the role of vitamin D has made its assessment more crucial in comprehensive patient management.
Here are some of the 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
rickets, characterized by leg-bowing
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
- 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
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
See also VitaminDWiki
- Nurses continuing education – Vitamin D Overview $9, June 2014
See also web
- Comment on article in PubMed by Dr. Grant
- Overview for Doctors category listing has
121 items includes some CME credit items
CME which was on VitaminDWiki were removed at request of the publisher (Feb 2015)
Click HERE for the full CME
Short url = http://is.gd/CMEPoddVitamin D deficiency – Physicians Assistants Continued Medical Education Feb 2015
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