[HN Gopher] Reduced cancer mortality with daily Vitamin D intake
       ___________________________________________________________________
        
       Reduced cancer mortality with daily Vitamin D intake
        
       Author : geox
       Score  : 269 points
       Date   : 2023-05-09 15:40 UTC (7 hours ago)
        
 (HTM) web link (www.dkfz.de)
 (TXT) w3m dump (www.dkfz.de)
        
       | dboreham wrote:
       | Wouldn't we know this already if populations in sunny areas had
       | less cancer (controlled for genetics)?
        
         | atwebb wrote:
         | Would especially sunny areas not produce people with more
         | cancer (or certain types)?
        
           | kpw94 wrote:
           | https://mediad.publicbroadcasting.net/p/kuow/files/styles/x_.
           | ..
           | 
           | Sunnier areas have _less_ skin cancers, if that 's what you
           | were wondering.
           | 
           | Now is it because of the Vitamin D, or because of a more
           | systemic application of sunscreen?
        
             | throw_pm23 wrote:
             | ..or something else entirely
        
         | francisofascii wrote:
         | Maybe. Some studies have shown people in sunnier areas have
         | less risk of certain types of cancer.
        
         | vharuck wrote:
         | It'd be hard to control for everything relevant. Diet would be
         | indirectly affected by sunlight (sunny areas would naturally
         | have different crops). Amount of exercise, too. Genetics play a
         | large role in some cancers, but behaviors and choices are
         | strongly linked to many common cancers like lung or colorectal.
         | Breast cancer has been linked to a woman's history of pregnancy
         | (higher risk for those who were pregnant when very young or
         | never had been pregnant past middle age).
         | 
         |  _mini-rant_
         | 
         | Even if we could design an experiment to know how much sunlight
         | affects cancer mortality, it might not be worth the time and
         | money. We already know ways to reduce cancer incidence in a
         | population: less tobacco, less alcohol, less obesity, more
         | exercise, sunscreen if you have light skin. We could further
         | reduce cancer mortality by getting people to follow screening
         | guidelines.
         | 
         | We've reached a point where public policy and outreach are the
         | most valuable efforts to preventing cancer incidence and
         | mortality. Quitting bad habits is hard. Going to the doctor for
         | screening can be scary, expensive, or logistically difficult.
         | 
         | /mini-rant
        
         | [deleted]
        
       | tpoacher wrote:
       | The article seems to imply that lots of p-hacking took place
       | before they found a "positive" result worth reporting. Not sure
       | how to feel about that.
       | 
       | Also, why on earth would one talk about mortality "from cancer"
       | and not mention overall mortality from all causes? This is
       | classic "smoking cures most diseases of old age" statistical
       | thinking...
        
       | lynx23 wrote:
       | It took me a long time, and virtually no help from outside, to
       | discover that vitamin D effectively cures my winter depression. I
       | was never really feeling good around that time of the year, but
       | it wasn't problematic enough to actually do something about it.
       | But when my gut started to revolt around that time too, I started
       | to feel distinctly unwell. So I went to my doctor, who gave me an
       | approintment with a nutrition specialist. That chat was totally
       | and wholy unhelpful, and the sympoms persisted. Out of sheer
       | luck, I insisted on having my vitamin D tested. It turns out I
       | was truly hitting bottom. Even that didn't make my doctor say
       | heureka. No, he kind of casually brushed the test result away,
       | but casually said I could take some D, ideally from october to
       | easter...
       | 
       | Next hurdle was the dose. Most things I could get at the pharmacy
       | without prescription are actually very low dose, and then there
       | is this fresh panic going about, "vitamin D users overdose" or
       | something. But with luck, I found dekristolmin. 20k i.e. in a
       | single small pill. I take one every sunday since two years, and
       | my mental health couldn't be better. Also, most of the gut
       | irritation is also gone.
       | 
       | Why I type this here? I found it interesting that I had to
       | discover this cure on my own. The medical system wuldn't have
       | figured that out on their own, let alone accept that it was the
       | single solution.
        
         | jjav wrote:
         | > I found it interesting that I had to discover this cure on my
         | own.
         | 
         | This is sadly true for so many things in medicine. The doctor
         | may or may not care, but either way they only have 10 minutes
         | for you and are highly incentivized to push some very expensive
         | pills to make you go away instead of being able to analyze the
         | issue in any depth.
         | 
         | I used to suffer greatly from gout, to the level of being
         | bedridden for a month+ unable to move from the pain. All the
         | doctors could offer were some pills that helped a little but
         | didn't cure it and had somewhat nasty side effects. And I'd
         | have to take them for life, almost guaranteeing liver problems
         | later in life.
         | 
         | With so much time unable to move, I spent it doing all the
         | research I could and one day randomly happened upon research on
         | childhood diabetes that noted that increased fructose intake
         | leads to higher uric acid (which causes gout). So it wasn't
         | even a case where the research didn't exist, it's just that it
         | lived under the folder "childhood diabetes" instead of in the
         | folder "non-diabetic adult with gout", so no doctor made the
         | connection.
         | 
         | I cut as much fructose off my diet as possible and within a
         | month my blood uric acid was lower than ever and the gout
         | completely cured, no need for any pills. That was over a decade
         | ago, still doing great.
        
           | nradov wrote:
           | Peter Attia's interviews with Dr. Rick Johnson have some
           | detailed scientific information about how fructose metabolism
           | increases uric acid levels and causes gout.
           | 
           | https://peterattiamd.com/rickjohnson/
        
         | moffkalast wrote:
         | Just wondering, have you had any tests done regarding arterial
         | plaque since? Supposedly one also needs a vitamin K supplement
         | along with D to avoid that.
        
           | comte7092 wrote:
           | Unlike vitamin D, it's not that hard to get plenty of vitamin
           | K from diet alone.
           | 
           | People will say that it's not "the right kind" k1 instead of
           | k2, but your body can make the conversion even though it's
           | fairly inefficient.
        
         | avgDev wrote:
         | I had discovered something similar.
         | 
         | I've had some nerve issues after a medication. First, my
         | physicians were in complete denial that it was impossible.
         | Then, I had to push them for tests. This includes Mayo clinic.
         | It wasn't until I learned about neurological diseases and tests
         | myself until I found the tests I needed. Then I had to search
         | for a physician willing to listen.
         | 
         | Ended up finding a neurologist at a University who straight up
         | agreed that due to my history of tests and not coming up with
         | anything he is open to hearing what I think and ordering what I
         | want as long as it is within reason. We ordered autonomic test
         | and QSART(sweat test). My autonomic tests were unremarkable
         | like I suspected but we found issues on the sweat tests
         | confirming my self-diagnosed small fiber neuropathy.
         | 
         | I have then found other people having significant improvements
         | from nerve supporting supplements, ALA, l-carnitine and high
         | dose b1(which is relatively safe).
         | 
         | I also stumbled upon Pirenzepine, I met a chemist online who
         | reversed his neuropathy with Pirenzepine. It is not FDA
         | approved but available in Japan with a good safety profile. I
         | want to try this next.
         | 
         | Later I discovered that there is company which is in phase 3
         | trials I believe with a cream with the main ingredient being
         | Pirenzepine to treat neuropathy. In one of their studies they
         | discovered that cream seemed to work systemically when it came
         | to healing the nerves.
         | 
         | At this point my physician who is a professor is excited to
         | hear from me. I told him I am debating obtaining pirenzepine
         | because supplement and gabapentin offer temporary relief thus
         | far.
         | 
         | The point is.....I would never receive proper diagnosis or
         | suggestion for supplements from a physician unless I kept
         | pushing and doing a lot of research on my own. I have seen many
         | many doctors over the years.....Then as I expanded my knowledge
         | I slowly began to notice that some doctors are clueless and
         | incorrect(using outdated knowledge). It has forever changed my
         | perspective on physicians.
        
         | liendolucas wrote:
         | > That chat was totally and wholy unhelpful, and the sympoms
         | persisted. Out of sheer luck, Iinsisted on having my vitamin D
         | tested.
         | 
         | This happened me countless times. You go for help maybe having
         | a hunch that something is not right. Describe symptoms and so
         | on, only to be lightly dismissed. I honestly can't understand
         | why isn't the rule for doctors when you visit them to at least
         | ask: "When was your last blood test?" and then act accordingly
         | either re-testing or analyzing previous tests. I'm not saying
         | that all doctors proceed this way, but sometimes if you
         | actually do not politely ask them to further analyse you, they
         | won't. One of my siblings is celiac and it literally took many
         | years to actually discover that if it wasn't for my mum
         | endlessly trying to understand why at the time he was extremely
         | tired spending way too many hours a day sleeping. All the
         | technology that is available today that testing can discard
         | options or at least follow clues on pursuing something else.
        
         | Arete314159 wrote:
         | Me too, I went to doctors when I was in Seattle, they
         | recommended complicated stuff...no Vitamin D though.
         | 
         | I also had a B12 deficiency that contributed to depression, and
         | it was a decade before that was figured out too. But doc's are
         | super eager to prescribe SSRI's.
        
           | Arete314159 wrote:
           | SSRI's make money, B12 shots and Vitamin D don't. Just a
           | coincidence I'm sure.
        
             | hackermatic wrote:
             | Most SSRIs don't make money. I just ordered a 90-day supply
             | of the generic version of my SSRI (actually an SNRI) for
             | $45. And in looking it up, I realized that I overpaid
             | because I went through my insurance, while GoodRx would get
             | me the same pills from a local pharmacy for $20.
        
         | panax wrote:
         | 20,000 is way too high even though you are doing only
         | once/week. 2000 or less daily is more appropriate.
         | 
         | Doses that are too high can also cause blood calcium to spike
         | and can pull it out of bones and deposit into soft tissue.
        
           | basisword wrote:
           | Curious on what basis you're making this recommendation. It's
           | the kind of thing I would normally read and recall at a later
           | stage as good info, but my doctor prescribed me 20k IU a week
           | recently for a period of a couple of months.
        
             | panax wrote:
             | If your doctor prescribed you that then that is fine you
             | should follow your doctor's advice. They might have
             | specific reasons for the high dose.
             | 
             | I was once prescribed a 50k dose by my doctor but had very
             | noticeable negative effects and I know that was far too
             | high for me.
             | 
             | The recommended daily allowance is like 400 and that should
             | cover the needs of most people. If you are deficient then
             | you probably want quite a bit more than that until you get
             | back to normal. The safe upper limit is 4000 /day so I
             | would probably try to stick to doses below that. If you
             | take 2000 per day that should be well within the safe
             | range, and even if you take 2000 on as few as 2 days/week
             | that probably covers your needs. Some individuals might
             | have trouble absorbing it and might need higher doses
             | though.
        
               | xk_id wrote:
               | > if you take 2000 on as few as 2 days/week that probably
               | covers your needs
               | 
               | Well the linked study actually found that taking the
               | supplement once a week or month didn't provide the
               | benefits of dosing daily. Also the daily dose which was
               | effective was up to 4000.
        
             | KSS42 wrote:
             | The only way to tell is to do a blood test. It took me
             | taking 10k IU a day to get to the mid point recommended
             | range. On the plus side, daily 10K IU is covered by my drug
             | plan. I get my levels tested every 3 months.
        
           | nu11ptr wrote:
           | I take 10,000 IUs daily (recommended by my dr) every single
           | day of the winter/spring/fall and get 20 minutes of
           | unrestricted, full body sun during the summer. I have done
           | this for years. I have a level of ~70 which my doctor says is
           | just fine and I never, ever get sick.
        
         | joseph_grobbles wrote:
         | [dead]
        
         | kerkeslager wrote:
         | I had a fairly similar experience with winter depression being
         | cured by 10,000IU Vitamin D3 daily.
         | 
         | I wouldn't say it's the single solution, which might be because
         | my depression wasn't limited by season. I'm speaking in the
         | past tense because my depression is largely managed by diet and
         | exercise (rock climbing). The diet aspect is basically covered
         | by the AFS in Table 2 here[1], with some additional natural
         | probiotics (frequent yogurt and occasional kombucha).
         | 
         | Like you, I basically figured this out with some luck in
         | stumbling across information, some self-experimentation, and
         | little help from medical professionals. What little help I did
         | receive was in NY. In TN where I currently reside, I likely
         | would not have received even that help, because medical care is
         | unaffordable for _most_ people. Additionally, there are an
         | inordinate number of horror stories here about prescribers
         | getting people onto a huge number of medications--this seems to
         | particularly happen to young women who aren 't comfortable
         | advocating for themselves. I suspect this is due to
         | pharmaceutical kickbacks, but haven't found any data to back
         | that hypothesis up.
         | 
         | [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6147775/
        
           | huehehue wrote:
           | Isn't 10,000IU way above the recommended limit? I went
           | through a bottle this past winter (at the recommended dosage)
           | and didn't notice a change in either direction, but was a bit
           | confused during the research phase since everyone seems to
           | use a wildly different dosage.
           | 
           | https://ods.od.nih.gov/factsheets/VitaminD-Consumer/
           | 
           | https://www.hsph.harvard.edu/nutritionsource/vitamin-d/
           | 
           | edit: I also found
           | https://news.ycombinator.com/item?id=35878761 which suggests
           | higher levels are safe, as long as you're not eating D3 pills
           | like kettle chips. So I guess that answers it, though my
           | points stands about there being such a wide range of info
        
         | kyleyeats wrote:
         | The biggest thing to know is the six-week lag time of effects
         | either way.
         | 
         | You aren't at peak sadness around the solstice, or around
         | Christmas, you're sad six weeks after that-- around Valentine's
         | Day.
        
           | hn8305823 wrote:
           | Are we talking about depression or the weather?
           | 
           | For me peak depression occurs right around the solstice and
           | starts improving immediately - yet slowly - right after. I'm
           | definitely in a better place by mid Feb.
        
             | kyleyeats wrote:
             | IIRC, the effects of not getting enough and supplementing
             | take six weeks. Sunshine actually manufactures it right
             | away on your skin.
        
           | ipaddr wrote:
           | I thought third Monday in Jan is the saddest day.. most
           | likely to take your life
        
             | kyleyeats wrote:
             | Good point, see the sibling comment. If you're getting
             | regular sun, your low point for the year will be the
             | solstice. If you aren't, it'll be six weeks after that.
        
         | kwhitefoot wrote:
         | The usual rule in Norway is to take vitamin D in months that
         | end in R. That is, all the time except the summer. Nothing
         | specifically to do with SAD, just that in the winter you don't
         | get enough sunshine.
        
           | grugagag wrote:
           | Don't know any Norvegian but are there more months that end
           | in R than September through December in your language?
        
             | jo6gwb wrote:
             | Looks like Januar and Februar.
             | 
             | https://norwegianacademy.com/learn-months-and-seasons-in-
             | nor...
        
         | foxes wrote:
         | But if you get a blood test you can probably see if you are
         | deficient.
         | 
         | I asked a GP, just a general Dr here where I live, and they had
         | no problem checking and were well aware of vitamin D levels and
         | what it can cause.
         | 
         | Maybe you should state what country you are from before making
         | some broad statement about the medical system.
        
         | alfalfasprout wrote:
         | I had a similar experience. It was night and day too.
        
         | BeetleB wrote:
         | > Why I type this here? I found it interesting that I had to
         | discover this cure on my own. The medical system wuldn't have
         | figured that out on their own, let alone accept that it was the
         | single solution.
         | 
         | It's because studies showing correlation between Vitamin D
         | level and winter depression/SAD are mixed.
         | 
         | I'm not saying it's a placebo. If it works for some people -
         | great! But you can't expect doctors to recommend it when the
         | data is quite unclear.
        
           | lynx23 wrote:
           | I am a high risk cancer patient who is blind, i.e. doesn't
           | necessarily get a lot of sun exposure due to disability +
           | occupation. Given the discussion in this thread regarding
           | correlation with lattitude and cancer risk, me being around
           | 47 deg, and my personal history, I would have expected a
           | caring medical system to suggest vitamin D to me roughly 30
           | years ago already. But alas, it turns out you have to do your
           | own studies to improve life expectency with our western
           | medical system. I could tell you a lot more, regarding being
           | abused as a subject for a medical experiment at the age of 7!
           | But people like you will always step up and defend the
           | system. Observe and learn, I say.
        
             | psychlops wrote:
             | I don't usually defend the western system, but there are
             | plenty of other systems out there that will caringly
             | prescribe you snake oil. Simply understand that the western
             | system is science based within a limited range. It is
             | usually excellent if the cause of an illness is defined on
             | a black and white test. If not, time for the patient to do
             | the research.
        
               | agumonkey wrote:
               | This is the issue raised by comments like the one above.
               | We understand that evidence based medicine handles
               | statistical averages very well. But if you fall out of
               | that, all you're left with is snake oil salesmen. There's
               | a need for an intermediate layer of evidence yet
               | "taylored" (and not kidney-costing if possible).
        
             | stringfood wrote:
             | [dead]
        
             | BeetleB wrote:
             | Consider that while you are one person, a doctor sees many
             | patients. They see that prescribing Vitamin D helps almost
             | none of their patients in the short term, and they can only
             | rely on research for the long term (i.e. they are not
             | seeing the same patient over decades).
             | 
             | Doctors run the whole gamut. There certainly are doctors
             | who will recommend Vitamin D for any issue under the sun.
             | I've been subjected to that, and it totally didn't impact
             | the issues I was going to the doctor to see. At the other
             | end you'll get doctors who will stick to the official
             | guideline (as long as your Vitamin D levels are "normal").
             | And you have those in between, who will discuss it with
             | you, give you the pros and cons, and will support you in
             | your decision.
             | 
             | I've had enough doctors recommend treatments that have
             | little backing that I'll happily take the risk and stick to
             | the studies. ("No thanks, I won't go for that surgery which
             | studies have not shown tackle the problem" (an assessment
             | the doctor admitted to only when I asked him directly)). I
             | know I'll be wrong on occasion, but I suspect I'll be wrong
             | more often if I follow the other path.
             | 
             | Still, you'll get all sorts of doctors, and it shouldn't be
             | hard to find one who will happily reflect back to you
             | whatever you want to hear.
             | 
             | As for 30 years, the major study associating Vitamin D with
             | mortality came out about 15 years ago.
        
             | nicenewtemp84 wrote:
             | People are so indoctrinated they for some reason actually
             | think most doctors want to help them. I assume they also
             | trust their dealerships service advisor.
        
               | jewayne wrote:
               | It's so much worse than you think. Almost ALL doctors
               | _want_ to help. It 's system (in this case, the
               | reimbursement system) that makes it impossible to help,
               | even though they want to. The doctors themselves have far
               | less agency than you think.
        
               | nicenewtemp84 wrote:
               | I actually dated a med student all through medical school
               | and thus made a huge social circle of doctors I've kept
               | in touch with for over a decade as they all became
               | doctors and now have almost a decade of experience too.
               | 
               | I'd say about half want to help, but can not due to the
               | system. The other half enjoy maximizing their income
               | through the system and don't care either. So that leaves
               | very very few that are actually able and willing to
               | actually help an average person.
               | 
               | Now, do they help their family and close friends? Yes, as
               | much as they still care to and remember how to. Which
               | isn't at a very high level either IMO.
               | 
               | Recent example, my friend dislocated his shoulder.
               | Immediately was recommended to have surgery and attempts
               | were made to schedule. With his insurance, he'd have to
               | come out of pocket $7500, which he doesn't really have.
               | 
               | I told him I know many motorcyclists at the pro level
               | that dislocate shoulders in crashes, and without surgery
               | are back competing on the bike. Only a handful have
               | surgery to repair it, usually to stop it from reoccurring
               | (since they crash often).
               | 
               | He pressed his doctor on if he really needs the surgery
               | and for an explanation why many athletes don't have it
               | done and what the reasoning for auto recommending him to
               | get it done. Their tone instantly shifted and he chose to
               | wait it out. Shoulder back to normal now. Thousands
               | saved, and potential medical mistakes saved during the
               | surgery.
        
               | pvaldes wrote:
               | Shoulder surgery should not be delayed. The probable
               | retraction of some damaged parts is not a joke. Your
               | friend could have been the lucky one in the pool, but
               | there is also a possibility that in a few years the
               | problem will grow and the surgery required will be much
               | heavier and expensive.
               | 
               | > and without surgery are back competing on the bike.
               | 
               | My bet is that they are on painkillers for life
        
               | nicenewtemp84 wrote:
               | Are you saying that the doctor, upon closer questioning
               | simply flopped and gave bad medical advice to my friend
               | when they told him that yes it's reasonable to expect to
               | regain full shoulder straight again without surgery?
               | Because if so maybe my friend should sue? What is this
               | blanket statement of "shoulder surgery should not be
               | delayed" based on?
        
               | InitialLastName wrote:
               | > My bet is that they are on painkillers for life
               | 
               | Also, they are professional athletes at the peak of their
               | bodies' physical fitness capacity with teams of doctors,
               | physical therapists, and trainers looking after their
               | health with a focus that few of us can imagine, and an
               | overriding ethos of sacrificing their future health on
               | the altar of present performance.
               | 
               | In general, professional athletes' healthcare decisions
               | should probably not be used as a gauge for healthcare
               | decisions by people with priorities other than "maximal
               | physical performance right this moment".
        
               | nicenewtemp84 wrote:
               | If a group of great doctors lets people crashing at
               | 180mph ride again without surgery after a shoulder
               | dislocation, doesnt that mean that maybe his doctor in
               | nonametown USA might be able to learn a thing or two from
               | them? Or are they just trying to keep their operating
               | room billing hours maxed out? I guess we won't know for
               | sure but I have a hunch.
        
               | pvaldes wrote:
               | Sure. That doctor could suggest his patients to wear
               | kevlar reinforced biker jackets all the time.
        
               | nicenewtemp84 wrote:
               | A kevlar jacket isn't going to help stop your shoulder
               | from dislocating as your flail around tumbling end over
               | end at 100mph.. which is what dislocated the shoulder in
               | the first place.
        
               | ipaddr wrote:
               | I would say they are the least caring group of society
               | followed by nurses. Not their fault. When everyone around
               | you is sick all of the time you have to turn off that
               | part that cares or you will burn yourself out.
               | 
               | Yourself, family, friends, favourite waitress cares about
               | you more than your doctor.
        
               | robertlagrant wrote:
               | This is far too US-centric. Western medicine is a lot
               | broader than that.
        
               | JoshTko wrote:
               | Having experienced several dozen healthcare providers I'd
               | say it's more like 50/50. Half clearly have a profit as a
               | primary motive.
        
             | robertlagrant wrote:
             | > But alas, it turns out you have to do your own studies to
             | improve life expectency with our western medical system
             | 
             | It's a shame this possibility wasn't suggested before to
             | you, but I have never seen any evidence that western
             | medicine isn't one of the primary drivers of global life
             | expectancy increases.
        
               | nradov wrote:
               | Western medicine is one of the primary drivers of global
               | life expectancy increases only though vaccines,
               | antibiotics, and trauma care. Other than that it has had
               | very little effect: we could eliminate all other forms of
               | medical care and average life expectancy would decrease
               | only marginally. Public sanitation and food safety
               | enforcement have had much larger effects.
               | 
               | Where western medicine has had larger effects is
               | increasing _quality_ of life. Now you can get a hip
               | replacement to restore your mobility or take a pill to
               | fix your erectile dysfunction.
        
           | tornato7 wrote:
           | The studies are mixed because there is no one-size-fits-all
           | solution to these problems, and a simple remedy that works
           | for one person may not work for another. Antidepressants are
           | sort of a one-size-fits-all solution because they tackle the
           | problem, not the cause of the problem.
           | 
           | Medical doctors will usually jump right to a pharmaceutical
           | solution to any problem, even though a little experimentation
           | with simpler remedies doesn't hurt. For example, I was
           | prescribed a $30k/yr drug with lifetime dependence for a
           | problem that I managed to solve with a simple change in diet.
           | 
           | Liability and economic incentives will almost always lead
           | doctors to prescribing the most expensive solution to an
           | issue, so it's unfortunately up to the patient to figure out
           | if there's an alternative solution to their problem.
        
         | casenmgreen wrote:
         | As I've become older, I've also found that in winter, my skin
         | starts to be a bit unhappy (fingertips on the right hand
         | getting rough and a bit broken up, usually, but it can also be
         | a bit below the eyes), and my gut starts to be rather unhappy.
         | When the sunshine returns, and I get some sun-on-skin time
         | during the day, it all goes away. I'm now experimenting with
         | vitamin D supplementation.
         | 
         | Regarding your comments about doctors; yes.
         | 
         | I may be completely wrong, but I think they have a revolving
         | door of patients, and are restricted to actions which are
         | permitted and/or supplied by their institution, or larger,
         | national regulator.
         | 
         | I've found that doing my own investigations, usually via
         | Eurakalert, leads me to finding a considerable number of
         | modern, up to date, wel designed studies, and as a result, and
         | also knowing my own body properly, and over all of my life, and
         | caring for it in a way which is impossible for a doctor with a
         | large number of patients all of whom he gets to see for an
         | appointment every month or whatever it is, I give myself
         | infinitely better treatment than a doctor.
         | 
         | My experience of institutionalized medicine has been high
         | prices, rote treatments, lack of insight or imagination, and on
         | one occasion, completely unnecessary full chest x-ray (which I
         | would no longer stand for, but I was younger at the time).
         | 
         | The only use I see for them is access to larger treatments,
         | such as surgical treatments, which cannot otherwise be
         | obtained.
        
         | dcow wrote:
         | This (among other things) makes me wonder why we don't have
         | better metrics and monitoring solutions for the human body.
         | Your option is anecdotal self-diagnosis, or a full blood panel
         | after seeing a doctor and convincing them that you need to be
         | tested. It seems there's room for a product that monitors your
         | health and sends you notifications when you need to address any
         | metrics that are falling out of normal tolerances. Or at least
         | something that helps you keep on top of preventative health
         | visits. Holmes showed it can't really be invasive technology. I
         | wonder if some sort of embedded blood monitoring device is
         | feasible.
        
           | DocTomoe wrote:
           | Depending on your location, it is virtually impossible to get
           | any real metrics.
           | 
           | A few years ago, inspired by some books I've read about
           | nutrition, I tried to get a whole bloodwork done - and then
           | another one after a few weeks of the new nutrition regime.
           | The idea was to have a data-based approach to changing my
           | life.
           | 
           | My doctor was less than helpful ('We only do full bloodwork
           | if there is a medical indication, no I won't take your
           | money'), and medical labs refused to do so because 'they only
           | work with medical practitioners'. Apparently, in Germany,
           | there is no way to get some data on my own goddamn body other
           | than my height and my weight (things I can determine myself).
           | 
           | I would love to have a service where I send in a blood sample
           | / have a blood sample taken, and get back a report, with all
           | the values, on an easy to understand bar graph, with lower
           | and upper bond of 'healthy'.
           | 
           | Startup idea, anyone?
        
             | tick_tock_tick wrote:
             | > Startup idea, anyone?
             | 
             | There are a few of these in the USA especially the Bay
             | Area. Hell you can even pay for a full check up that even
             | includes an MRI. Last checked the full service was like
             | ~$5-6k and that includes pretty much everything you could
             | want to know.
             | 
             | I've also been told you can get the same work done in Korea
             | for a fraction of the price if your willing to take a
             | vacation.
        
             | baristavibes wrote:
             | "private" or "self-paid" lab blood tests are pretty common
             | here, just across the border in Czech Republic, I'm
             | surprised to find out they're unavailable in Germany, do
             | you have to route every foreigner through a medical
             | professional? Or is the catch that they won't do a "full"
             | blood panel?
        
           | hombre_fatal wrote:
           | You don't have any wellness centers or clinics around you
           | that offer blood tests? A full panel costs $80-100 but its
           | not expensive for something you can do every few months to
           | make sure you're in good health. No need to convince a
           | doctor.
        
           | lynx23 wrote:
           | I have never digged into the matter, but the closest existing
           | thing which resembles your idea is that apparently, in Japan,
           | there are toilets which do automatic testing and reporting.
           | That seems like a neat idea because it does not require any
           | kind of invasive procedure, but it is likely also a bit
           | limited in what it can test for.
        
           | lm28469 wrote:
           | Half of the western world is overweight/obese (75%+ in the
           | US), the vast majority of people are massively malnourished
           | and under exercise
           | 
           | The market for that is very small, most of the things that
           | kill are known, the solutions are known, there is nothing
           | cost effective, no magic pill
           | 
           | Optimize for the basics, you have a long way to go before
           | individual tests bring anything to the table. If you don't
           | exercise vigorously 5+ times a week, walk 20k steps a day,
           | skip alcohol, stop eating processed food, &c. no amount of
           | vitamins will extend your life. It's like changing your tires
           | every 5000km while skipping oil changes until the engine dies
        
           | loeg wrote:
           | Blood panels are expensive and laborious to do with any
           | frequency. Your body does a reasonably good job of monitoring
           | and remediation on its own.
        
             | dmonitor wrote:
             | > Blood panels are expensive and laborious to do with any
             | frequency
             | 
             | I believe their implication is that there should be some
             | engineering effort to reduce the expense and labor
        
       | alejohausner wrote:
       | The global distribution of many types of cancer is strongly
       | related to latitude. The farther you are from the equator, the
       | higher the rate of disease. The more sun you get, the less
       | cancer. It's hard not to infer that sun exposure and thus
       | synthesis of vitamin D helps prevent many cancers.
       | 
       | We've been urged to avoid sun exposure because it can cause skin
       | cancer. But those cancers are squamous and basal cell carcinomas.
       | Those carcinomas are easily cured, and don't usually kill you.
       | Melanoma, the truly deadly skin cancer, is more prevalent in
       | populations with _less_ sun exposure.
       | 
       | There are lots of interesting graphs on Jeff Bowles' site [^1].
       | He's an absolute fan of vitamin D.
       | 
       | ^1:https://jefftbowles.com/vitamin-d3-deficiency-causes-most-
       | hu...
        
         | vharuck wrote:
         | >Melanoma, the truly deadly skin cancer, is more prevalent in
         | populations with less sun exposure.
         | 
         | It's vastly more prevalent in white people versus other skin
         | colors. Even at the same latitude. Even in the same country.
         | The incidence rate of malignant melanoma in the US is about 30
         | times higher for Whites than Blacks.
         | 
         | https://seer.cancer.gov/statfacts/html/melan.html
         | 
         | If somebody is White, getting more sun won't prevent melanoma;
         | it does the opposite. Sunlight and vitamin D are still good
         | things, so White people should spend time outside with
         | sunscreen or protective clothing.
        
           | dcow wrote:
           | Neither of you are advocating for getting sun burn. That's
           | bad. I think what GP is saying is that the overcorrection in
           | worrying about skin cancer where people act like they're
           | straight up allergic to the sun and avoid it, is actually
           | harmful. I've seen this attitude in white people so I know
           | what GP is referring to.
        
         | konschubert wrote:
         | The statistics you are presenting - have they been corrected
         | for life expectancy? Do they also hold across North America ,
         | eg comparing Florida to Boston?
        
         | travisporter wrote:
         | FYI the tuberculosis chart is actually type 1 diabetes
        
         | subsubzero wrote:
         | As someone who spends alot of time outside(as much as I can
         | while still working!) and also takes 5000iu of vitamin D, I
         | just wanted to say there is moderation in everything. Getting
         | too much sun can lead to skin cancer so make sure you are
         | wearing sunscreen.
        
           | dagw wrote:
           | I worked on a project related to modelling UV and skin cancer
           | rates. And what I learnt there is that that big thing that
           | causes skin cancer isn't so much total UV exposure over a
           | year, but a sudden switch for long periods of no sun to a
           | period of intense sun. You see this especially in the Nordic
           | countries where it isn't uncommon to go from 4 month of
           | getting essentially no sun to 10 days of spending 10 hours a
           | day in a bathing suit on a beach in Thailand or Bali.
        
             | andrekandre wrote:
             | > essentially no sun to 10 days of spending 10 hours a day
             | in a bathing suit on a beach in Thailand or Bali.
             | 
             | is that because there isn't enough melanin built up in the
             | skin to prevent damage?
        
         | bitL wrote:
         | Taking D3 without K2 gives you atherosclerosis though so it's
         | wise to combine the two.
        
           | bilsbie wrote:
           | And magnesium!
        
             | millzlane wrote:
             | That's true. https://pubmed.ncbi.nlm.nih.gov/29480918/
        
           | BobbyJo wrote:
           | Source?
        
             | bitL wrote:
             | https://www.healthline.com/nutrition/vitamin-d-and-
             | vitamin-k...
        
         | francisofascii wrote:
         | Also sunlight during the day helps with melatonin synthesis at
         | night, leading to better sleep, leading to less cancer.
        
         | sateesh wrote:
         | Can you be specific about what kind of Cancer incidences is
         | related to the latitude ? In general I don't think there is a
         | good correlation between Cancer incidences and latitude, for
         | example India gets plenty of sunshine year around, but Cancer
         | incidences are no less.
        
       | evo_9 wrote:
       | D3 + MK7 if you really want to amplify its effectiveness.
        
         | unethical_ban wrote:
         | What's the source of this? I've seen a lot of D3+k2 caps now.
        
       | ekianjo wrote:
       | Not new results. It's been known for a long time.
        
       | nicenewtemp84 wrote:
       | We were told that almost everyone that had a covid death was
       | either obese or had a vitamin D deficiency, by the CDC itself,
       | and yet people will argue if it's important or not to get enough.
        
       | kypro wrote:
       | A few thoughts from an autistic bro scientist...
       | 
       | Not being deficient in Vitamin D is not the same as having
       | optimal levels of Vitamin D. Optimal levels of Vitamin D are
       | probably around 60-70ng/ml, with a bias to upper end of that
       | range (in my opinion anyway). I say this because individuals with
       | a lot of sun exposure will typically have Vitamin D levels around
       | 70ng/ml so this is in my opinion is likely closer to the levels
       | of our ancestors. However, a lot of experts would argue 50ng/ml
       | is optimal, but I disagree with this primarily because the number
       | is based on population averages in populations that are largely
       | Vitamin D deficient.
       | 
       | In comparison, to be considered deficient you would generally
       | need levels below 20ng/ml which less than a third of what I
       | suspect is optimal (and natural).
       | 
       | Again, I'm just an autistic bro scientist, but my understanding
       | is that low levels of Vitamin D are strongly associated to higher
       | levels of inflammation in the body. We also know that higher
       | levels of inflammation in the body are linked to various negative
       | health outcomes like depression, impaired immune function, and
       | increased cancer risk.
       | 
       | If I were to guess most individuals who develop cancer are older
       | and generally less healthy. Given that most people in the West
       | don't have optimal levels of Vitamin D in the first place we can
       | only assume that those with cancer have even less optimal levels.
       | 
       | Therefore the idea that supplementing Vitamin D in a population
       | highly likely to have suboptimal levels of Vitamin D would reduce
       | cancer mortality should not be surprising at all. If you live in
       | the West you really should consider taking 1,000 - 2,000 IU of
       | Vitamin D a day - and perhaps more if you're able to monitor your
       | levels to ensure you're not taking too much.
       | 
       | I'm really not a fan of taking supplements in general, but
       | Vitamin D is one of the few most people in the West probably
       | would benefit from taking at a low dose.
        
         | monkey_monkey wrote:
         | What's an autistic bro scientist and why is that relevant?
        
       | ddlutz wrote:
       | Anybody vitamin D deficient even after supplementation? I had
       | mine checked September of last year, it was low even when taking
       | 2000 IU a day, so DR gave me a 50,000 IU pill to take once a
       | week. It's still considered deficient, but not as deficient. I
       | live in Seattle, so not much sun has been out the past 6 months,
       | not sure if that's skewing numbers lower than they are in the
       | summer.
        
         | antimora wrote:
         | You could try with vitamin K2 mixed. It helps with absorption.
         | I tried this: https://www.amazon.com/gp/product/B00ECH40MQ
        
       | thijser wrote:
       | There have been many vit D studies before, e.g., this one with
       | 25K participants in the USA, which found no effect:
       | https://www.nejm.org/doi/full/10.1056/NEJMoa1809944
       | 
       | It's best to look at a meta analysis of all existing data/trials
       | instead of focusing on one trial that happens to be positive.
        
         | D13Fd wrote:
         | Yeah. I don't know why people seem so invested in pushing
         | Vitamin D as a cure for everything.
        
       | felixg3 wrote:
       | Nice to see a publication of my literal neighbours posted here.
       | Yeah, it's important to mention that this of course only applies
       | to people suffering from deficiency, which in Europe is quite
       | prevalent.
        
       | generalenvelope wrote:
       | Lots of people here are assuming that supplementing vitamin D
       | will "treat" a low level of it, which isn't necessarily true. The
       | level might not change, but you also might care a lot less than
       | you think about the level specifically. Many problems can cause
       | the level to be low, and won't be affected by raising it. Highly
       | recommend the Barbell Medicine podcast on Vitamin D:
       | https://soundcloud.com/user-344313169/vitamin-d-mixdown-1
        
       | lez wrote:
       | For the overcautious theoretic thinkers here, I recommend reading
       | about Coimbra protocol, where 50,000 IU daily is not rare. It can
       | go up to 300,000 IU per day.
       | 
       | At levels above 10,000 IU per day you should take precautions to
       | prevent calcification of the soft tissues: Take Vitamin K
       | (100-200ug), Boron (10-20mg) to prevent calcification. Vitamin A
       | should be dosaged at a ration 1:1 - 1:4 compared to Vit D (same
       | amount or 4 times more of vitamin A) because A and D are
       | anthagonists.
       | 
       | Below 10,000 IU there's only benefits of better health and no
       | risk or precautions needed.
        
         | ufo wrote:
         | I'm not sure if a quack doctor's miracle cure "protocol" is a
         | good point of comparison...
         | 
         | https://veja.abril.com.br/saude/medicos-questionam-tratament...
        
       | hannob wrote:
       | "When all 14 studies were pooled, no statistically significant
       | results emerged. However, when the studies were divided according
       | to whether vitamin D3 was taken daily in a low dose* or in higher
       | doses administered at longer intervals*, a large difference was
       | seen."
       | 
       | This sounds fishy. Sounds like their primary result was nothing,
       | and then they looked for something else. Would require some
       | checking if they had a preregistration, if this was registered as
       | a secondary resuld and if they had done a proper statistica
       | analysis of multiple outocmes.
        
         | cscheid wrote:
         | Yes, exactly. There's a real-life example of an author group
         | who got sufficiently annoyed at a reviewer requesting an
         | inappropriate subgroup analysis:
         | https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
         | Reviewers asked for the subgroup analysis; authors said "no,
         | this is statistically nonsense"; reviewers said "yes, but we'll
         | reject the paper otherwise"; reviewers said "ok, but only if
         | you let us also split on astrological sign".
         | 
         | Result: paper reports that aspirin has an effect, but only if
         | you're not a Gemini or Libra. Too good.
        
           | anonymouskimmer wrote:
           | The two signs bracketing the summer months (I presume this
           | was in the northern hemisphere?). That's a potentially
           | interesting finding.
           | 
           | > inappropriate subgroup analysis
           | 
           | No subgroup is inappropriate unless you know all of the
           | values of all of the parameters. But sure, the intent they
           | tried to demonstrate (take all sub-group analyses with a
           | grain of salt) is a good thing to remember.
           | 
           | Edit: To whoever downvoted me, time of year of birth does
           | have real-world effects.
           | https://www.livescience.com/13958-birth-month-health-
           | effects...
           | 
           | > Previous studies have found similar links between spring
           | births and various disorders, including schizophrenia,
           | multiple sclerosis and even Type 1 diabetes. It's possible
           | these diseases are linked to some environmental influence
           | during gestation or the first few months of life, though
           | researchers aren't sure what that could be.
           | 
           | > The leading candidates including vitamin D levels,
           | infections that come and go seasonally, changes in nutrition,
           | and even possibly weather fluctuations, Handunnetthi told
           | LiveScience.
           | 
           | Now perhaps all of this is just bad science and these
           | correlations are just statistical anomalies. But perhaps they
           | aren't.
        
             | throwaway646465 wrote:
             | I think you got downvotes because you misunderstood what
             | people were taking umbrage with in the first example.
             | 
             | It's not that birth time can never have real effects. It's
             | that if you keep rolling a die long enough, eventually
             | you'll hit a "statically unlikely" event like rolling 4
             | fives in a row or hitting 1 2 3 4 in order.
             | 
             | Extraneous sub group analysis are like rolling the die
             | again. Say you're searching for a p-value of .05 with a
             | confidence interval of 95%. That means 19 out of 20 times
             | it's indicative of a real relationship and 1 out of 20
             | times it was due to random chance.
             | 
             | If you do a bunch of extraneous sub group analyses like the
             | reviewer wanted, you're banking on the statistical
             | likelihood that eventually you'll get the result you want
             | even if it's not a real relationship.
        
             | cscheid wrote:
             | > No subgroup is inappropriate unless you know all of the
             | values of all of the parameters
             | 
             | I don't know how to put it less bluntly: you're incorrect.
             | 
             | > But sure, the intent they tried to demonstrate (take all
             | sub-group analyses with a grain of salt)
             | 
             | That's not what they intended to demonstrate. They intended
             | to demonstrate that you need a _reason_ to want to split,
             | and that reason needs to be given _ahead_ of the analysis.
             | If you see the results _and then choose_ a new data
             | analysis (that includes new subgroup analyses), your
             | procedure is no longer statistically sound.
             | 
             | This is a specifically bad statistical practice called
             | HARKing https://en.wikipedia.org/wiki/HARKing
        
             | bsder wrote:
             | Your understanding of significance is flawed, and there is
             | an XKCD for that: https://xkcd.com/882/
        
           | SoylentYellow wrote:
           | That's great for Geminis and Libras, but what if you're a
           | Sagittarius?
        
         | cypress66 wrote:
         | https://xkcd.com/882/
        
         | itsoktocry wrote:
         | > _Would require some checking if they had a preregistration,
         | if this was registered as a secondary resuld and if they had
         | done a proper statistica analysis of multiple outocmes._
         | 
         | You should do that. Meanwhile, I'm going to (continue to) take
         | a daily vitamin D, because I recognize not everything can be
         | confirmed by a double-blind experiment, and the cost is low.
        
           | [deleted]
        
           | pella wrote:
           | > _" I'm going to (continue to) take a daily vitamin D,
           | because I recognize not everything can be confirmed by a
           | double-blind experiment, and the cost is low."_
           | 
           | Or it may be possible to prove the opposite, as with the
           | parachute.
           | 
           | bmj: "Parachute use to prevent death and major trauma when
           | jumping from aircraft: randomized controlled trial"
           | 
           | https://www.bmj.com/content/363/bmj.k5094
           | 
           |  _Results: Parachute use did not significantly reduce death
           | or major injury (0% for parachute v 0% for control; P >0.9).
           | This finding was consistent across multiple subgroups.
           | Compared with individuals screened but not enrolled,
           | participants included in the study were on aircraft at
           | significantly lower altitude (mean of 0.6 m for participants
           | v mean of 9146 m for non-participants; P<0.001) and lower
           | velocity (mean of 0 km/h v mean of 800 km/h; P<0.001)._
           | 
           |  _" Conclusions: Parachute use did not reduce death or major
           | traumatic injury when jumping from aircraft in the first
           | randomized evaluation of this intervention. However, the
           | trial was only able to enroll participants on small
           | stationary aircraft on the ground, suggesting cautious
           | extrapolation to high altitude jumps. When beliefs regarding
           | the effectiveness of an intervention exist in the community,
           | randomized trials might selectively enroll individuals with a
           | lower perceived likelihood of benefit, thus diminishing the
           | applicability of the results to clinical practice."_
           | 
           | disclaimer:
           | 
           | I am pro-Parachute! I believe 100% in the effectiveness of
           | the parachute!
        
         | amatecha wrote:
         | Yeah, in addition to the XKCD comic it also reminds me of
         | "Spurious Correlations" lol https://tylervigen.com/spurious-
         | correlations
        
         | tuukkah wrote:
         | > _This systematic review was registered in PROSPERO before
         | data collection to preclude data-driven analyses and selective
         | reporting (CRD42020185566). In addition, the methods, including
         | the selection criteria, the statistical analysis, outcomes, and
         | subgroup and sensitivity analyses, were published in advance in
         | a study protocol (Schottker et al., 2021)._
         | 
         | EDIT: And in the protocol, the first subgroup analysis they
         | list is relevant:
         | 
         | > _Daily dose versus weekly /monthly bolus dose versus bolus
         | dose at the beginning of the trial followed by a daily dose_
         | https://bmjopen.bmj.com/content/11/1/e041607
        
         | CodeWriter23 wrote:
         | D3 (animal-based) > D2 (plant-based) > D1 (synthetic), at least
         | in humans if you read the literature, that is.
         | 
         | The fishy thing is how actual scientists do whole studies using
         | only D1 and then draw conclusions.
        
           | [deleted]
        
           | tuukkah wrote:
           | Plant-based D3 exists, extracted from seaweed.
        
             | miles wrote:
             | Vegan D3 can also be derived from lichen; here's one such
             | product:
             | 
             | https://www.futurekind.com/products/vegan-vitamin-d3
        
             | CodeWriter23 wrote:
             | I was unaware, thanks.
        
           | Filligree wrote:
           | My takeaway is to keep eating fish.
        
             | nomel wrote:
             | Thanks to our polluted waters, there are pretty harsh
             | limits to fish consumption [1] these days.
             | 
             | [1] https://www.hsph.harvard.edu/nutritionsource/fish/#:~:t
             | ext=E....
        
             | crazygringo wrote:
             | No, you'd basically have to eat salmon all day long every
             | day to have any meaningful effect.
             | 
             | Eating fish is not a viable or realistic way of maintaining
             | healthy vitamin D levels. You have to either get sunlight
             | or take a supplement.
             | 
             | (And I love fish, I eat salmon daily sometimes, but I still
             | supplement with D3.)
        
               | reaperman wrote:
               | For D3, yes. But for Omega-3's, a little bit of salmon
               | goes a looooong way.
        
             | ramoz wrote:
             | Be careful with that (if you're treating cancer):
             | https://www.cancernetwork.com/view/fish-oil-consumption-
             | link...
             | 
             | Im not sure where this study landed in cancer communities
             | or what subsequent studies concluded. But it's worth
             | noting.
        
             | AlecSchueler wrote:
             | Overfishing is serious enough at this point that I'd rather
             | take a small health risk than contribute to it.
        
               | SoftTalker wrote:
               | A lot of fish you would buy at the supermarket is farm-
               | raised. Especially catfish, salmon, and tilapia.
        
               | timeon wrote:
               | Good thing about farm-raised fish is that it is less
               | contaminated, because it is usually mostly plant-fed. But
               | it also makes it less nutritious.
        
               | CodeWriter23 wrote:
               | Depends on what materials one classifies as a
               | "contaminant".
        
               | [deleted]
        
               | bt4u wrote:
               | [dead]
        
               | onlyrealcuzzo wrote:
               | Does aquaponic tilapia not have D3?
        
               | vixen99 wrote:
               | I hope I've not misunderstood but if you are saying
               | vitamin D deficiency is a 'small health risk' then that
               | needs correction. Never mind the validity or not of the
               | paper in question. Anyone reviewing the peer-reviewed
               | literature on vitamin D for the last decade or so would
               | conclude it's a very bad idea indeed to be deficient. For
               | those who don't get much sun exposure, a blood test is
               | recommended and will put people on the right track.
        
               | candiddevmike wrote:
               | Not sure why you are being downvoted. Salmon (mentioned
               | in other siblings) is a perfect example of over fishing,
               | and the farmed stuff tends to be of terrible quality and
               | fed absolute garbage/treated terribly.
        
               | tablarasa wrote:
               | Salmon is found in high-latitude systems around the globe
               | in both hemispheres. Overfishing is something that occurs
               | to populations, not species. Most of the salmon
               | populations that I am familiar with are not over-fished,
               | but have suffered from spawning habitat loss due to dams
               | and logging. Those are major issues and they continue to
               | negatively affect those populations; you are doing the
               | loggers and dam builders a favor by blaming fishing,
               | which is far easier (and more politically palatable) to
               | regulate.
        
             | apomekhanes wrote:
             | Fish seem to be a very important component of the most
             | healthful human diets, AFAIK, likely/mostly grounded in
             | various aspects of evolution - some more on the side of
             | actual 'selection pressure', some more on the side of
             | chance and 'doesn't break things in a way that really
             | matters' (i.e., successful enough reproduction / survival
             | until ages required for reproduction).
             | 
             | That said, and in light of the comment from
             | https://news.ycombinator.com/user?id=AlecSchueler, in
             | particular - many of the most essential nutrients /
             | 'micronutrients' that are obtained from eating fish are
             | actually not made by fish themselves. Rather, fish
             | 'concentrate' these substances as they go about their own
             | business of survival. For example, vitamin D3, DHA, EPA,
             | etc. Consequently, there are much more readily available
             | 'vegan' sources of these substances, derived directly from
             | the fundamental source(s) - microalgae and the like.
             | 
             | FYI (to all).
             | 
             | Overfishing IS a serious problem. Our activities, in
             | general, are at a scale, and grounded in processes, these
             | days, that produce significant impacts on the environment.
             | Frankly, in the 'great scheme' of things, it doesn't matter
             | a whit. Humans, and even this planet, are not even a
             | droplet in the ocean of the universe, as far as we / I can
             | even get any sort of a solid handle on _that_ concept, now.
             | But, that doesn 't absolve us of any responsibility for
             | trying not to absolutely annihilate OUR home.
             | 
             | It's disgusting to be GIVEN so much (none of us had much
             | hand in almost anything that exists now, even what we've
             | 'built' - we can't create atoms, we don't choose when,
             | where, or to whom we are born, many of the opportunities we
             | are afforded in a 'given life', etc.), and treat it as
             | casually as so many do - to be so entitled as many seem to
             | be.
             | 
             | But then, the universe (/ God / gods / whatever concept you
             | prefer) will always have the final say. It'd just be nice
             | to not F things up for everyone else, IMO.
             | 
             | EDIT: I hope the latter bits, above, don't come off as too
             | moralizing - not my intention ... it's difficult to avoid
             | some frustration with some of what the news inundates us
             | with every day, I find.
             | 
             | More importantly - vitamin D3 is also readily produced in
             | our own bodies with enough of the right kind of sunlight
             | (dependent also on skin tone, age, kidney & liver function
             | [etc.], and, ultimately, 'height of the sun in the sky' -
             | i.e., enough ~290-300nm UV rays penetrating the atmosphere
             | at the angle of inclination / solar zenith angle /
             | whichever concept/quantification you prefer). And, this is
             | actually not much at all. While skin cancer is, itself, a
             | risk - this should, of course, be weighed against the
             | importance of vitamin D3 itself. This comment is already
             | REALLY long, but basically, for latitudes close enough to
             | the 'Tropics', typically only 10 - 20 minutes of sun around
             | noon in summer would be necessary. Winter is trickier. Here
             | are a few links that may be useful for more info (in
             | general, Pubmed - searching for review articles, etc. - is
             | usually a good place to start, IMO - depending on how
             | comfortable you are with reading these types of articles,
             | otherwise, backtracing to those that cite them, especially,
             | the efforts at more 'popular press' descriptions of
             | research now produced by journals like Science etc.):
             | 
             | https://pubmed.ncbi.nlm.nih.gov/32918212/
             | 
             | https://pubmed.ncbi.nlm.nih.gov/28516265/
             | 
             | https://academic.oup.com/ajcn/article/110/1/150/5487983
             | 
             | ... The 'Linus Pauling Institute' also seems to have, in my
             | past experience, quite good information on
             | 'micronutrients', in particular (with good citations,
             | etc.), for all of Pauling's actual more tenuous beliefs
             | (himself, in later life) about vitamin C:
             | 
             | https://lpi.oregonstate.edu/mic/vitamins/vitamin-D
        
         | phkahler wrote:
         | >> This sounds fishy. Sounds like their primary result was
         | nothing
         | 
         | If you combine results from a bunch of studies that really
         | didn't do anything, it's going to mask the results from the
         | ones that did.
        
           | mlyle wrote:
           | Sure... but conversely, if you keep dividing up and analyzing
           | in different ways, eventually you'll get a p<0.05 result.
           | 
           | This is why you "call your shot" before beginning the
           | analysis. Otherwise, people will be suspicious you just
           | jiggered things around until you found something.
        
           | oldgradstudent wrote:
           | Maybe, but with 14 studies you have ~2^14 ways to split the
           | studies into two groups.
           | 
           | If you test multiple hypotheses, you have too adjust the
           | p-value accordingly.
           | 
           | Have the authors disclosed how many alternative hypotheses
           | were tested until the result in the article was found to be
           | significant?
        
             | anonymouskimmer wrote:
             | P-values don't prove anything about whether an effect is
             | real or not. They, at most, provide some degree of
             | confidence with the presumption that the independent and
             | dependent variables are indeed independent and dependent.
             | 
             | P-values should, at most, be used to direct further
             | mechanistic studies (if possible). Only use them on their
             | lonesome if this hasn't yet been done, or isn't possible.
             | And if that's the case, reverify them independently (such
             | as by doing another meta-analysis using different data).
        
         | [deleted]
        
         | trevorkoob wrote:
         | 15 minutes of full-body UV exposure from the sun is estimated
         | to provide the equivalent of 20-30,000 IU Vitamin D3.
         | 
         | There is a definite need for studies that better determine the
         | effective dose for D3.
         | 
         | My research led me to the conclusion that studies should be
         | done based not on standardized supplementation, but instead
         | supplementation to a standardized blood serum level.
        
         | bitL wrote:
         | Simpson's paradox is well known - aggregate often has different
         | statistical properties than individual parts.
        
         | mholm wrote:
         | That's what's confusing me: 105,000 participants in a study
         | should have resulted in thousands of cancer deaths, a 12% drop
         | should be pretty noticeable even with 10% of the data.
        
           | kelseyfrog wrote:
           | How exactly are you getting "should have resulted in
           | thousands of cancer deaths"?
           | 
           | A population of 100,000 should expect to see 144.1 deaths[1].
           | 
           | If you evenly divide the study group into two 52,500-sized
           | groups(treatment + control), each group should expect to see
           | 72 deaths. A 12% drop in one of the groups is 8.6 deaths. As
           | a colleague would say, that's very few clams from which to
           | make a chowder.
           | 
           | Perhaps the researchers are using more advanced tools than I
           | am, but even assuming a 12% difference between treatment and
           | control does not result in a chi-squared test with any
           | reasonable significance. ie: the null-hypothesis(there is no
           | difference between groups) cannot be rejected.
           | 
           | 1. https://www.cdc.gov/cancer/dcpc/research/update-on-cancer-
           | de...
        
             | mholm wrote:
             | 144.1 deaths per year. Presumably these studies lasted
             | multiple years. Though I'll admit this was less than I
             | expected, which would explain the differing results.
        
               | kelseyfrog wrote:
               | Thank you! Yes, the time frame is important, d'uh lol.
        
       | craig_s_bell wrote:
       | In that circumstance, I've heard that vitamins and supplements
       | can be tricky; the additional nutrition may feed the cancer,
       | before it feeds you. Just one more factor to consider.
        
       | beefman wrote:
       | As usual the abstract of the source paper is clearer, easier to
       | read, and more detailed
       | 
       | https://pubmed.ncbi.nlm.nih.gov/37004841/
        
       | ramoz wrote:
       | > However, when the studies were divided according to whether
       | vitamin D3 was taken daily in a low dose* or in higher doses
       | administered at longer intervals*, a large difference was seen.
       | In the four studies with the infrequent hogher doses, there was
       | no effect on cancer mortality. In contrast, in the summary of the
       | ten studies with daily dosing, the researchers determined a
       | statistically significant twelve percent reduction in cancer
       | mortality.
       | 
       | What exactly is the recommendation here, low or higher doses? or
       | something else because Im struggling to understand this
        
         | belltaco wrote:
         | If you read further they found that lower daily doses were
         | better.
         | 
         | > In contrast, in the summary of the ten studies with daily
         | dosing, the researchers determined a statistically significant
         | twelve percent reduction in cancer mortality
         | 
         | > In the studies, daily low doses were 400 to 4000 IU per day,
         | and higher-doses administered at longer intervals were 60,000
         | to 120,000 IU once per month or less.
        
           | ramoz wrote:
           | ah, daily==lower
        
           | secondcoming wrote:
           | I'm in the UK and the max dosage I can get for Vitamin D in
           | my local supermarket pharmacy is 1000 IU
        
         | nairboon wrote:
         | Frequent low doses. The other time/quantity combinations were
         | either not studied or had no effect.
        
         | Filligree wrote:
         | Did they test "high dose taken frequently" at all? Bearing in
         | mind that the guideline vitamin-D daily dose target is set at
         | just about the lowest possible value that doesn't cause obvious
         | deficiencies.
        
           | nanofortnight wrote:
           | Vitamin D is fat soluble, and thus you can overdose on it.
           | High dose frequently is not recommended, and most high dose
           | supplements will have warning labels about vitaminosis.
        
             | ramoz wrote:
             | I've also been told to be careful with any vitamin
             | supplements while on chemo, and to consult a cancer
             | dietician before conducting you're own science... the
             | reason, as I understand it as a patient, is that high
             | oxidation can actually keep cancer cells strong and healthy
             | enough to create chemoresistance.
        
             | ben7799 wrote:
             | You need to take extreme amounts of it for months to
             | overdose.
             | 
             | Something like 40,000-100,000IU/day for several months.
             | 
             | That's 8-20 pills per day of the most potent D3 commonly
             | available.
        
           | tuukkah wrote:
           | From the footnotes:
           | 
           | > _In the studies, daily low doses were 400 to 4000 IU per
           | day, and higher-doses administered at longer intervals were
           | 60,000 to 120,000 IU once per month or less._
        
         | generalenvelope wrote:
         | There is no recommendation made here. These are observations
         | and far from clinical guidelines, or anything any doctor would
         | recommend you do.
        
       | kstrauser wrote:
       | Given that D3 is dirt cheap and lots of us are low in it, is
       | there any downside to taking a reasonable daily dose?
        
         | generalenvelope wrote:
         | It costs money and won't necessarily do anything about the
         | levels / the things that were causing the levels to be low in
         | the first place. Highly recommend this deep dive:
         | https://soundcloud.com/user-344313169/vitamin-d-mixdown-1
        
         | atombender wrote:
         | Your skin releases around 10,000 IU if you spend an hour
         | outside in full sun in the summer. So that, at least, should be
         | quite safe. This article from the Mayo Clinic argues that
         | vitamin D toxicity has been vastly overstated. [1]
         | 
         | [1]
         | https://www.mayoclinicproceedings.org/article/S0025-6196%281...
        
         | funnym0nk3y wrote:
         | Besides unneccessary expenses? I don't think so. 2000 IE should
         | be fine, and thats with a safety margin of 2.
        
         | icedchai wrote:
         | I was taking 3000 IU of D3 for years. When COVID hit, I upped
         | that to 5000 and have kept it there since.
        
         | reducesuffering wrote:
         | Depends on the definition of reasonable. D3 is fat soluble and
         | if you take too much for years it can accumulate too much in
         | your body.
         | 
         | I'd say 2,500 IU is max to take daily without infrequent blood
         | tests to calibrate the optimum.
        
       | tric wrote:
       | I think vitamin D deficiency explains moderate hair loss in some
       | people. Just based on my own experience. I don't think enough
       | people mention it.
        
       | nabla9 wrote:
       | TL;DR Vitamin D * _deficiency*_ is cancer risk and relatively
       | common. High doses don 't work.
       | 
       | >When all 14 studies were pooled, no statistically significant
       | results emerged. However, when the studies were divided according
       | to whether vitamin D3 was taken daily in a low dose* or in higher
       | doses administered at longer intervals*, a large difference was
       | seen. In the four studies with the infrequent hogher doses, there
       | was no effect on cancer mortality. In contrast, in the summary of
       | the ten studies with daily dosing, the researchers determined a
       | statistically significant twelve percent reduction in cancer
       | mortality.
       | 
       | >"We observed this twelve percent reduction in cancer mortality
       | after untargeted vitamin D3 administration to individuals with
       | and without vitamin D deficiency. We can therefore assume that
       | the effect is significantly higher for those people who are
       | actually vitamin D deficient,"
        
       | ck2 wrote:
       | Last century they insisted Vitamin C prevents/cures cancer.
       | 
       | This century it's Vitamin D with the same level of insistence.
       | 
       | Don't hold your breath.
       | 
       | Abstract says it all: https://pubmed.ncbi.nlm.nih.gov/20799507/
        
         | thenerdhead wrote:
         | Abstract literally says vitamin C has potential as a cancer-
         | fighting agent and protective against certain types of cancers
         | too.
        
         | reducesuffering wrote:
         | You know that both of these are called "Vitamins" because they
         | are essential to human health? You will have increased risk of
         | many health problems with deficiencies.
        
           | bregma wrote:
           | Not enough is bad so more than enough must be better?
        
             | reducesuffering wrote:
             | TFA starts with "Vitamin D deficiency is widespread
             | worldwide and is particularly common among cancer
             | patients."
             | 
             | and concludes "in the summary of the ten studies with daily
             | dosing, the researchers determined a statistically
             | significant twelve percent reduction in cancer mortality."
             | 
             | So yes, not enough is bad, and many require supplementation
             | to get to an ideal level. Nowhere was anyone proposing
             | overdosing.
        
       | SoftTalker wrote:
       | I've been taking a daily vitamin D supplement since COVID-19
       | broke out in the USA. I believe there's a lot of evidence that
       | many people are deficient in vitamin D. I don't know if
       | supplements are the best way to attack that but it's one of the
       | easiest ways. Getting daily sun exposure isn't always convenient
       | and not really possible for a good chunk of the year since we
       | have real winter here.
        
         | scottlamb wrote:
         | > I don't know if supplements are the best way to attack that
         | but it's one of the easiest ways.
         | 
         | I've also tried to get my RDA of Vitamin D every day. Often I
         | get it from fortified (coconut) milk and a multi-vitamin. But I
         | prefer to include fish. I'm particularly fond of canned
         | sardines [1] because they're a long-shelf-life pantry item,
         | they're a relatively inexpensive protein, they have lots of
         | omega-3s and fit my low-carb diet, and (unlike tuna) they're
         | low enough on the food chain that you can eat them daily
         | without excess heavy metal intake, and iiuc they're a more
         | sustainable fish option. I think sardines have a bad reputation
         | for taste because people lump them in with anchovies, which can
         | be incredibly salty and fishy. I find sardines to be much more
         | mild and versatile. I find they taste best alongside acids
         | (lemon juice, vinegar, tomato) and maybe creamy fats
         | (avocado/guac, cream cheese). You can add them to salad, toast,
         | pasta, pizza, or even just inside a bell pepper.
         | 
         | Here's a good simple recipe for someone trying sardines for the
         | first time: https://www.foodnetwork.com/recipes/alton-
         | brown/sherried-sar...
         | 
         | [1] the tiny, two-layer per can kind
        
           | hattmall wrote:
           | Sardines are good, I love them, but they definitely smell
           | strongly and so will you if you eat them frequently. I wonder
           | if there anything similar without the smell? Honestly for the
           | reasons you listed though sardines are kind of a super food
           | imo.
        
             | scottlamb wrote:
             | > Sardines are good, I love them, but they definitely smell
             | strongly and so will you if you eat them frequently.
             | 
             | Not sure I agree. It might help that I buy the smaller
             | sardines (as mentioned above) and combine them with acid. I
             | just did a search and both of those things were recommended
             | as ways to reduce odor. I also generally eat them at room
             | temp rather than cooking them, which I'm sure makes a big
             | difference in their smell. I also haven't had any
             | complaints about _my_ smell, but they 'd be mostly from my
             | family as I'm a remote worker... /shruggie
             | 
             | > I wonder if there anything similar without the smell?
             | 
             | Maybe salmon and mackerel? I think they're in the middle of
             | the food chain (where sardines and tuna are more at the
             | extremes) and similarly between in fat content.
             | 
             | > Honestly for the reasons you listed though sardines are
             | kind of a super food imo.
             | 
             | Yeah, I think if sardines aren't a superfood, the word
             | doesn't mean anything at all...
        
         | Etheryte wrote:
         | Regarding deficiency, your GP can measure this for you for
         | nearly no to no cost. No matter what your reasoning for taking
         | some, it's always good to check what the baseline you're
         | dealing with actually is before. For context, I'm from a
         | country where low vitamin D levels are very common so I had a
         | test done a few times throughout the year and turns out I've
         | never been under the recommended levels.
        
           | hanoz wrote:
           | Your high latitude health service must be better than mine. I
           | can hardly imagine my GP's receptionist's reaction if I tried
           | to book an appointment to check my baseline vitamin D levels!
        
         | oppositelock wrote:
         | I have some hard numbers on this in my own health. I'm a pasty
         | north European living in California and I get plenty of
         | sunshine, as I enjoy the outdoors. As I got older, I got
         | increasingly more viral infections and strep throat was a twice
         | a year affair. It didn't occur to me that I could be vitamin-D
         | deficient, but I was, severely. For some reason, 10+ hours of
         | sunshine a week isn't enough for me to make my own.
         | 
         | Over months, I tracked my blood vitamin D levels as I took
         | supplements, and now I know that the 2500IU dose is enough to
         | keep me at nominal levels - the higher doses cause it to build
         | up too much and would eventually cause liver issues.
         | 
         | I know it's anecdotal, but in the few years since I did this,
         | those recurrent sicknesses have vanished. I'm also taking
         | vitamin B, which is another one you get less efficient at
         | absorbing as you age.
        
           | _trackno5 wrote:
           | Just because you get plenty of sunlight where you live it
           | doesn't mean you get enough exposure to produce vitamin D.
           | 
           | You need to expose large areas of your body like legs, arms,
           | and torso for several minutes to an hour. If those areas are
           | covered, sunlight won't do much.
           | 
           | The Sigma Nutrition podcast has an excellent episode on that:
           | https://sigmanutrition.com/episode438/
        
             | oppositelock wrote:
             | Nah, for me, that wasn't sufficient. I get at least 10
             | hours a week of full sun on my whole arms and legs and
             | sometimes my torso if I decide to bike shirtless; more sun
             | than most people, and still, I was vitamin D deficient.
        
               | nicenewtemp84 wrote:
               | Did you wear sunscreen? I'm pretty sure it blocks vitamin
               | d creation, which really makes me wonder how any of my
               | GFs Ive had ever got any since they wear it religiously
               | in hopes of keeping youthful skin.
        
           | maxk42 wrote:
           | What do you use for tracking your blood vitamin D levels?
        
           | jghn wrote:
           | > Over months, I tracked my blood vitamin D levels
           | 
           | OOC what did you use to do this?
        
             | oppositelock wrote:
             | Monthly blood tests prescribed by a doctor at a local
             | bloodwork lab.
        
               | jghn wrote:
               | Did you have a challenge getting them to initiate that?
               | I'd imagine once you're shown to be severely deficient
               | it's easier, but there's a chicken & egg.
        
               | rocket_surgeron wrote:
               | If your primary care provider won't do at least one
               | vitamin-d test per year, and then periodic tests once a
               | deficiency is identified, you should get a new primary
               | care provider.
               | 
               | If that's not an option, non-prescription at-home tests
               | are available in the US for as low as $49.
               | 
               | I don't know about monthly, I think a 60-day followup
               | after treatment in order to titrate your supplementation
               | might be best (it takes time for supplementation to
               | work), but at-home tests are an option if your provider
               | is for some inexplicable reason, reluctant.
               | 
               | As far as I can tell, the only harm from supplementation
               | comes when the typical adult consistently consumes doses
               | so high as to be absurd (50,000+ IU daily for months) so
               | I don't know why any medical professional would be
               | hesitant to investigate such a common health issue with
               | such an easy, inexpensive, and effective treatment.
        
               | moffkalast wrote:
               | Where is that mythical theranos machine when you need
               | one, smh.
        
         | jghn wrote:
         | > I believe there's a lot of evidence that many people are
         | deficient in vitamin D.
         | 
         | This brings up something I always wonder when these things come
         | up. I agree with what you said, and there's a lot of evidence
         | that this is bad. But I've seen mixed results over time as to
         | whether or not vitamin d _supplementation_ has a beneficial
         | effect. I assume it 's an "it depends on the effect" and
         | sometimes yes and sometimes no
        
         | jcadam wrote:
         | Yep. I live in Alaska and my doc checks vitamin D levels as a
         | routine part of my annual physical.
        
       | pookha wrote:
       | I'm on board with Vitamin D but I've learned from experience that
       | if you over-do it with a D3 supplement (being ill) you'll have
       | some interesting heart palpitations. Which case buckle up.
        
       | andsoitis wrote:
       | > Vitamin D deficiency is widespread worldwide
       | 
       | Even in the Southern Hemisphere?
        
       | qingcharles wrote:
       | I didn't get to go outside for 10 years as I was locked in a
       | cell. Does anyone know if this length of sunlight deprivation has
       | a long-term nonreversible effect?
       | 
       | (I also had no window, no access to supplements, or any choice of
       | nutrition)
        
       | frickinLasers wrote:
       | It's maybe a good time to re-post this in-depth series on vitamin
       | D supplementation. You don't want to take too much.
       | 
       | https://www.devaboone.com/post/vitamin-d-part-2-shannon-s-st...
        
         | ntonozzi wrote:
         | That article is so weird:
         | 
         | > Of course, there is a selection bias in who comes to me.
         | There are people out there doing just fine on 5000 units of
         | Vitamin D daily. I only see the ones who develop high calcium
         | levels. But I see enough of them to know that this is not an
         | exceptionally rare occurrence. I have been to lectures in which
         | physicians have claimed that Vitamin D toxicity almost never
         | occurs. In my experience, this is false. I have seen many cases
         | of Vitamin D toxicity in people who were taking the recommended
         | dose from an over-the-counter bottle.
         | 
         | She is an extremely specialized professional who is referred
         | and treats people with this condition. Of course it's not rare
         | in her experience! For all we know, she could be one of a
         | hundred parathyroid specialists in the country, and only 1 in
         | 100000 people who take Vitamin D get Vitamin D toxicity. The
         | author should really provide some evidence on how common this
         | is.
        
           | frickinLasers wrote:
           | The point is it's a hormone--not, like, ascorbic acid or
           | something. It's good to be aware that it can poison you,
           | especially when the "vitamin" label can make it seem
           | harmless.
        
         | atombender wrote:
         | The Mayo Clinic thinks otherwise:
         | https://www.mayoclinicproceedings.org/article/S0025-6196%281...
         | 
         | Another article about the findings:
         | https://newsnetwork.mayoclinic.org/discussion/vitamin-d-toxi...
        
           | frickinLasers wrote:
           | Your link is broken.
        
             | atombender wrote:
             | Fixed. Don't know what happened there.
        
       | mattchew wrote:
       | Our family started taking Vitamin D at the start of the pandemic.
       | We've all gotten sick a lot less than we used to, despite one of
       | us working at a drugstore constantly exposed to sick people.
       | 
       | Of course I don't know for sure that the Vitamin D is causal
       | here, but it's my best guess. I suspect a lot of people are D
       | deficient and just don't know it.
        
       | counterpartyrsk wrote:
       | Like others, I discovered my mood is significantly increased when
       | consistently taking vitamin D
        
       | chasil wrote:
       | My local grocer offered free Vitamin D tests early this year, and
       | it was my first.
       | 
       | It was quite low.
       | 
       | My physician recommended 5,000 IU for 90 days, then 1,500 after.
       | I'll test again next year for my physical.
        
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