Physicians and Scientists Decry Inaccurate and Harmful Vitamin D Recommendations and Guidelines

Provided by Sunil Wimalawansa to Popular Rationalism

Physicians and scientists say that an update to Vitamin D Guidelines recently issued by the Endocrine Society (June 2024), is a step backward, will contribute to chronic illness, and requires urgent and necessary action from all researchers, educators, healthcare workers, and advocates in the vitamin D scientific community.

The new Endocrine Society guidelines, entitled “Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline,” For a short explanation of these updated guidelines, read their list of recommendations included here, the Endocrine News article here, or watch the Endocrine Society’s press conference video here.

These updated guidelines suggest that most adults should take no more than the recommended daily allowance set by the outdated (2011) Institute of Medicine (IOM) document. This recommendation has led to massively high rates of deficiency and associated diseases, harming the population. In addition, the new guidelines do not support testing 25(OH)D levels among any population, even for the vulnerable, nor do they define a sufficiency level. This recommendation is short-sighted, dangerous, and confusing. It is a significant step backward from what the Endocrine Society previously recommended for vitamin D in 2011.

It is time to collaborate to counter these erroneous public health recommendations before additional harm is done to the health of individuals.

Over fifteen years ago, GrassrootsHealth founder Carole Baggerly took action to define a scientific consensus, through the agreement of 40 leading vitamin D scientists and researchers, that the vitamin D level necessary for the optimal human health of the general population should be 40-60 ng/ml (100-150 nmol/L). Back then, it was well known among vitamin D experts that the recommendations made by the IOM were inadequate to support these levels and were part of the driving force behind the worldwide vitamin D deficiency epidemic. She met with vitamin D researchers and scientists across the US and Canada to create the first Scientists’ Call to D*action to solve the deficiency epidemic and improve public health. This was primarily via promoting vitamin D inputs necessary to achieve and maintain a target 25(OH) vitamin D serum level of 40-60 ng/ml (100-150 nmol/L). Since then, 48 senior vitamin D researchers have signed this Call to Action.

Since then, we have gained more than 15 years of additional research and findings from peer-reviewed publications to support and validate this recommended target vitamin D level of 40-60 ng/ml, the vitamin D doses necessary to achieve it safely and effectively, and the newly updated (2024) Scientists’ Call to D*action.

Scientists’ Call to D*action – The Vitamin D Deficiency Epidemic

Staggering deficit: 40-75% of the world’s population is vitamin D deficient at any given time

[The Scientists’ Call to D*action was first issued in 2008 and last updated in 2024]

The causal link between severe vitamin D deficiency and rickets or the bone diseases osteomalacia, osteopenia, osteoporosis, and increased risks for falls and fractures is overwhelming.

Research has highlighted the newly appreciated, vital associations between vitamin D insufficiency or deficiency and extra-skeletal diseases. Examples of these include breast cancer, intestinal and other cancers, multiple sclerosis, Type 1 diabetes, metabolic disorders such as Type 2 diabetes and metabolic syndrome, hypertension, increased risk of heart failure, prenatal and neonatal complications, and acute infections, including having a beneficial impact on survival and hospitalization in influenza and SARS-CoV-2, and a favorable role in treating chronic infections such as tuberculosis and moderation of inflammatory bowel disease. Recommended daily intakes, as set by the Institute of Medicine (IOM) in 2011, are too low to adequately support the role of vitamin D for such extra-skeletal processes and disorders mentioned above, leading to increased risk of such diseases, even in healthy people.

Based on the evidence we now have at hand, action is warranted.

It is projected that the incidence of many of these diseases could be reduced by 20% to 50% if vitamin D deficiency is eradicated by increasing vitamin D3 intakes through fortified foods or vitamin D3 supplements or with daily moderate safe sun exposure when feasible based on skin type, medical history, and latitude.

The established way to determine vitamin D status is by measuring the serum 25-hydroxyvitamin D [25(OH)D] concentration. Testing is indicated among specific groups of individuals based on body weight, disease status, digestive health, life stage, concurrent medications, and other factors. The intake of vitamin D3 required for sufficiency and resulting substantial disease reduction and to prevent complications of disease depends on the individual’s age, race, lifestyle, latitude of residence, genome, body weight, BMI, and other factors. The latest IOM report (2011) indicated that 10,000 IU/day is considered the NOAEL (no observed adverse effect level). While 4000 IU was considered the safe upper intake level for nine years and older, research has shown no toxicity from vitamin D below a serum 25(OH)D level of 125 ng/ml (312 nmol/L).

It is well-documented that the darker the skin, the less vitamin D is produced in the skin, and thus, the higher the risk of vitamin D deficiency. Even in southern US climates, at least 55% of African Americans and 22% of Caucasians are vitamin D deficient, and they are vulnerable to developing new disorders and worsening existing diseases.

More than 4.5 billion people worldwide are affected at some time of the year by vitamin D deficiency, resulting in many adverse health events and premature deaths.

This Scientists’ Call to D*action is issued to alert the public and medical community to the importance of maintaining serum vitamin D levels—25(OH)D—between 40 and 60 nano-grams/milliliter (100-150 nanomoles/liter) to reduce risks of and help prevent these diseases and their complications. Recommended doses of vitamin D are those necessary to achieve and maintain this target serum level of 25-hydroxyvitamin D. Implementing this would be safe, effective, and inexpensive.

Adequate vitamin D status will promote better health, leading to a healthier population, less sickness, a more productive workforce, and substantially reducing health care costs.

The D*action project aims to serve as a model for public health action on vitamin D and is a scientific test bed for techniques and outcome evaluations at a community level.

Vitamin D Scientists: Sign the Call to D*action Here

Donate to Support this Effort Here

Stay tuned for more on how you can help support this effort and help combat the confusing and harmful information contained in these updated guidelines.

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The following figure, by Dr. Sunil Wimalawansa (https://doi.org/10.3390/nu15173842), illustrates the desired physiological range of 25(OH)D, shown as 40-80 ng/mL, that covers 99.7% of disorders.[1,2]

Figure References:

1. Wimalawansa, S. Overcoming infections including COVID-19, by maintaining circulating 25(OH)D concentrations above 50 ng/mL. Pathology & Lab. Medicine Int. 2022, 14, 37–60.
2. Wimalawansa, S.J. Physiological basis for using vitamin D to improve health. Biomedicines 2023, 11, doi:10.3390/biomedicines11061542.

Additional References:

Amon U, Yaguboglu R, Ennis M, Holick MF, Amon J. Safety Data in Patients with Autoimmune Diseases during Treatment with High Doses of Vitamin D3 According to the “Coimbra Protocol”. Nutrients. 2022; 14(8):1575. https://doi.org/10.3390/nu14081575

Dawson-Hughes B, Staten MA, Knowler WC, et al. Intratrial Exposure to Vitamin D and New-Onset Diabetes Among Adults With Prediabetes: A Secondary Analysis From the Vitamin D and Type 2 Diabetes (D2d) Study. Diabetes Care. 2020;43(12):2916-2922. doi:10.2337/dc20-1765

Grant WB, Al Anouti F, Boucher BJ, Dursun E, Gezen-Ak D, Jude EB, Karonova T, Pludowski P. A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health. Nutrients. 2022; 14(3):639. https://doi.org/10.3390/nu14030639

McCullough PJ, Lehrer DS, Amend J. Daily oral dosing of vitamin D3 using 5000 TO 50,000 international units a day in long-term hospitalized patients: Insights from a seven year experience. J Steroid Biochem Mol Biol. 2019;189:228-239. doi:10.1016/j.jsbmb.2018.12.010

McDonnell SL, Baggerly CA, French CB, et al. Breast cancer risk markedly lower with serum 25-hydroxyvitamin D concentrations ≥60 vs <20 ng/ml (150 vs 50 nmol/L): Pooled analysis of two randomized trials and a prospective cohort. PLoS One. 2018;13(6):e0199265. Published 2018 Jun 15. doi:10.1371/journal.pone.0199265

Mirhosseini N, Vatanparast H, Kimball SM. The Association between Serum 25(OH)D Status and Blood Pressure in Participants of a Community-Based Program Taking Vitamin D Supplements. Nutrients. 2017;9(11):1244. Published 2017 Nov 14. doi:10.3390/nu9111244

Shirvani A, Kalajian TA, Song A, Holick MF. Disassociation of Vitamin D’s Calcemic Activity and Non-calcemic Genomic Activity and Individual Responsiveness: A Randomized Controlled Double-Blind Clinical Trial. Sci Rep. 2019;9(1):17685. Published 2019 Nov 27. doi:10.1038/s41598-019-53864-1

Wagner CL, Hulsey TC, Ebeling M, et al. Safety Aspects of a Randomized Clinical Trial of Maternal and Infant Vitamin D Supplementation by Feeding Type Through 7 Months Postpartum. Breastfeed Med. 2020;15(12):765-775. doi:10.1089/bfm.2020.0056

Wimalawansa SJ. Infections and Autoimmunity—The Immune System and Vitamin D: A Systematic Review. Nutrients. 2023; 15(17):3842. https://doi.org/10.3390/nu15173842

Wimalawansa SJ. Non-musculoskeletal benefits of vitamin D. J Steroid Biochem Mol Biol. 2018;175:60-81. doi:10.1016/j.jsbmb.2016.09.016

Wimalawansa SJ. Physiological Basis for Using Vitamin D to Improve Health. Biomedicines. 2023; 11(6):1542. https://doi.org/10.3390/biomedicines11061542.

Related: Update to Vitamin D Guidelines Leads to Confusion and an Urgent Call to Action

The Endocrine Society's latest guideline update sparks disagreement among top vitamin D experts leading to confusion and potential harm to public health

Tuesday, July 2, 2024 (Encinitas, CA – GrassrootsHealth) – An update to Vitamin D Guidelines recently issued by the Endocrine Society (June 2024), titled "Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline," is a step backward and requires urgent and necessary action from all researchers, educators, healthcare workers, and advocates in the vitamin D scientific community.

These updated guidelines suggest that most adults should take no more than the recommended daily allowance (RDA) as set by the outdated (2011) Institute of Medicine (IOM) document. This suggests vitamin D intakes of 400 IU per day for infants, 600 IU/day for all non-pregnant and pregnant adults, and 800 IU/day for adults above 70 years of age. However, this recommendation has led to high rates of deficiency and associated diseases, harming the population worldwide.

In addition, the new guidelines do not advise testing 25(OH)D levels among any population, even for the vulnerable, nor do they define a sufficiency level. This recommendation is short-sighted, dangerous, and confusing. It is a significant step backward from what the Endocrine Society previously recommended for vitamin D in 2011, with a daily allowance of 1500-2000 IU vitamin D per day, an upper intake of 10,000 IU/day, and a recommended minimum 25(OH)D level of 30 ng/ml (75 nmol/L).

Determining a 25(OH)D level of sufficiency for overall health should be a key consideration when formulating vitamin D guidelines. The IOM's suggested 20 ng/ml minimum level for sufficiency was determined based only on data for bone health, specifically for the prevention of rickets and osteomalacia – a fact that is not well-known even among healthcare providers. This definition of sufficiency does not include years of additional data from published research showing a physiological need for vitamin D within other body systems and highlighting newly appreciated, vital associations between vitamin D insufficiency or deficiency and extra-skeletal diseases. Examples of these include breast cancer, intestinal and other cancers, multiple sclerosis, Type 1 diabetes, metabolic disorders such as Type 2 diabetes and metabolic syndrome, hypertension, increased risk of heart failure, prenatal and neonatal complications, autoimmune diseases, and acute infections. The latter includes beneficial impact on survival and hospitalization in viral infections like influenza and SARS-CoV-2, and a favorable role in treating chronic infections such as tuberculosis and inflammatory bowel disease.

Over fifteen years ago, GrassrootsHealth founder Carole Baggerly took action to define a scientific consensus, through the agreement of 40 leading vitamin D scientists and researchers, that the vitamin D level necessary for optimal health in the general population should be 40-60 ng/ml (100-150 nmol/L). Back then, it was already well known among vitamin D experts that the recommendations made by the IOM were inadequate to support these levels and were part of the driving force behind the ongoing worldwide vitamin D deficiency epidemic.

Ms. Baggerly met with vitamin D researchers and scientists across the US and Canada to create the first Scientists' Call to D*action to solve the deficiency epidemic and improve public health. This was primarily via promoting vitamin D inputs necessary to achieve and maintain a target 25(OH) vitamin D serum level of 40-60 ng/ml (100-150 nmol/L). Since then, 48 senior vitamin D researchers have signed this Call to Action, becoming part of the GrassrootsHealth consortium of scientists, institutions, and individuals committed to solving the worldwide vitamin D deficiency epidemic – a project called D*action.

We have since gained more than 15 years of additional research and findings from peer-reviewed publications to support and validate this recommended target vitamin D level of 40-60 ng/ml, the vitamin D doses necessary to achieve it safely and effectively, and the newly updated (2024) Scientists' Call to D*action.

Read the Updated Call to Action Here

It is time to collaborate to counter these erroneous public health recommendations before additional harm is done to the health of individuals.

GrassrootsHealth and leading vitamin D experts are now asking for support from others, especially asking those in the vitamin D scientific field to acknowledge this Call to Action and join the effort to counter the information set in these outdated guidelines for vitamin D.

Ways vitamin D scientists and experts can support this initiative include:

1) Adding your acknowledgment of this updated Scientists Call to D*action

• Indicate if you would like to add your signature of acknowledgment and support of this Scientists Call to D*action by completing the form at https://www.grassrootshealth.net/support-scientists-call-daction/

• Comment on the justification for maintaining the consensus mentioned in the updated Scientists Call to D*action over those of the IOM and the recently released Endocrine Society recommendations

• Short comments can be added to the form; email longer comments or documents to jen@grassrootshealth.org

2) Showcase yourself as a vitamin D expert to the public by sending the following information to Jen Aliano, jen@grassrootshealth.org to be posted on grassrootshealth.net

• Send your current (or most recent if retired) one-page bio with related publications (up to 20 most recent ones, on page 2, related to vitamin D), your affiliations, as well as what dose of vitamin D you take, and how long you have been taking that dose (optional)

• Additional information may be requested

3) If you are interested in being interviewed about the advancements in vitamin D research along with your contributions to the research, email jen@grassrootshealth.org with your preferred interview type

• To schedule a video interview, please let us know your availability over the next few months

• To complete a written interview, send a request to jen@grassrootshealth.org to receive a list of interview questions to choose from or add other questions you would like to include

• To offer your information in a short 5 to 10 minute video for us to share with the public, discussing your knowledge about vitamin D and/or why this new recommendation by the Endocrine Society is damaging to public health and why the recommendations of this Scientists Call to D*action are necessary, please email it to jen@grassrootshealth.org or let us know when would be a good time to record your video over zoom

For additional questions or comments, contact Jen Aliano at jen@grassrootshealth.org.

The public needs to hear from vitamin D experts on this important health matter.

Anyone can help support this initiative by:

1) Following updates and news about this and other vitamin D research by joining the GrassrootsHealth newsletter at https://www.grassrootshealth.net/project/newsletter-sign-up/

2) Download, read, and share the free, IRB approved "Patient and Provider Guide to Understanding Vitamin D, Testing & Results" from GrassrootsHealth at https://www.grassrootshealth.net/document/know-d-number-patient-provider-guide-understanding-vitamin-d-testing-results-booklet/ or any of the other free resources found on grassrootshealth.net

3) Following and sharing information about this initiative posted on GrassrootsHealth social media accounts

https://www.facebook.com/GrassrootsHealth

https://twitter.com/Grassroots4VitD

https://www.instagram.com/grassrootshealth/

https://www.youtube.com/@vitaminDaction

4) Donating to support the efforts of GrassrootsHealth at https://www.grassrootshealth.net/donate-to-grassrootshealth/

About GrassrootsHealth

GrassrootsHealth is a nonprofit public health research organization dedicated to promoting optimal health worldwide through research, education, and advocacy, with a primary focus on the role of vitamin D. Through evidence-based education, resources, and our citizen-science approach to research, we empower individuals to make informed decisions about their health and healthcare providers to move research into practice.

With a panel of international vitamin D researchers and other experts contributing to its operations, GrassrootsHealth has been running the world's largest public health intervention study – the D*action field trial – to solve the vitamin D deficiency epidemic worldwide since 2007. Learn more at grassrootshealth.net.

Full Press Release Online Here

References Here

Support this important initiative by donating today!

Donate Here

In Health,

Jen Aliano, MS

Executive Director

GrassrootsHealth

Carole Baggerly

Founder

GrassrootsHealth

GrassrootsHealth | 760-579-8141 | customerservice@grassrootshealth.org

www.grassroots health.net