The idea made a lot of sense, and it was accepted as fact. The bones need to grow and stay healthy in order for the body to absorb calcium.
In the first large randomized controlled study in the United States funded by the federal government, researchers found that taking vitamins with or without calcium did not reduce the incidence of broken bones. The New England Journal of Medicine published the results of blood tests on people who were found to be deficient in vitamins D and E.
There was no support for a long list of purported benefits of vitamins D and D3.
An editorial that was published with the paper has some advice for the millions of Americans who take vitamins and supplements: stop.
People should stop taking vitamins in order to prevent diseases and doctors should stop screening for 25-Hydroxyvitamin D levels. He is an editor at the New England Journal of Medicine.
They say that people with conditions like celiac or Crohn's disease need supplements to get the vitamins they need, as do people who live in conditions where they don't get a lot of sunlight.
It's difficult to get into a state of deficiency in the general population.
The two scientists know that in making such strong statements they are taking on vitamin sellers, testing labs and advocates who have claimed that takingvitamin D, often in huge amounts, can cure or prevent a wide variety of ailments.
As part of a regular blood test, doctors check for vitamins D and E.
The participants in the study were assigned to either take a placebo or take 2,000 international units of vitamins D and D3.
VITAL is a comprehensive study of vitamins D and calcium. An expert group convened by the National Academy of Medicine, a nonprofit organization, looked at the health effects of vitamins and found little evidence. The members of the expert group were supposed to come up with a minimum daily requirement for the vitamins but found that most clinical trials that had studied the subject were not good enough.
At the time, it was thought that vitamins D and calcium were good for bones. The researchers believed that the levels of parathyroid hormone would go up if the levels of vitamins D and D2 went down.
The National Academy of Medicine's expert group set an "arbitrary value" for the amount of vitamins D and E in a person's blood to 600 IU per deciliter of blood.
Almost all of the population in the United States would be considered to be deficient in vitamins D and D2 if the cutoff point for normal levels was set too high by the labs.
The relationship between the two has not held up. The VITAL trial was funded by the National Institutes of Health because of the uncertainty.
In the first part of VITAL, it was found that vitamins D and calcium did not prevent diseases. It didn't prevent falls, it didn't improve cognitive functioning, it didn't improve stroke outcomes, it didn't improve knee pain.
People taking the vitamins did not live longer.
The leader of the main VITAL trial said the study was so large it included thousands of people with osteoporosis. The investigators found that they didn't get any benefit from the supplement for reducing the number of broken bones.
Many will be surprised by that, said Dr. Manson. We don't need a lot of the vitamins for bone health. The benefits of larger amounts do not outweigh them.
Dr. LeBoff said she was surprised by the results of the bone study. She had been expecting something.
She warned that the study didn't address the question of whether people with osteoporosis and low bone mass should be taking vitamins and osteoporosis drugs. She will follow professional guidelines for taking vitamins D and calcium in her own practice.
Patients with osteoporosis and low bone mass will continue to be advised by Dr. Shoback to take vitamins D and calcium.
She said that she would continue to prescribe it.
Some people go further.
The 600 to 800 units a day that Dr. Sundeep Khosla recommends for his patients with osteoporosis is based on the fact that it will do little or no harm.
He said that he would tell his family and friends who didn't have osteoporosis to take a vitamins a day.
He follows that advice. He said that many multivitamin tablets contain a lot of vitamins.
The idea of a vitamins D deficiency for healthy people is still being questioned by Dr. Cummings and Dr.Rosen.
What is a deficiency of vitamins D and D2. The doctor asked. The implication is that you should take the vitamins.
He doesn't believe in 600 units. I don't think you should.
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