[HN Gopher] Regular use of Vitamin D supplement is associated wi...
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       Regular use of Vitamin D supplement is associated with fewer
       melanoma cases
        
       Author : bookofjoe
       Score  : 78 points
       Date   : 2023-07-30 20:01 UTC (2 hours ago)
        
 (HTM) web link (pubmed.ncbi.nlm.nih.gov)
 (TXT) w3m dump (pubmed.ncbi.nlm.nih.gov)
        
       | HPsquared wrote:
       | Use of vitamin D supplement is also probably correlated with
       | sunscreen use. That is, health-conscious people use both.
        
       | accrual wrote:
       | Nice to see more benefits of Vitamin D. Highly recommend the
       | supplement for tech workers who spend a lot of time indoors. I
       | take 125mcg/5000IU a day when I wake up and it's subtle, but I
       | just feel a little better with it. Sports Research is a good
       | brand (not affiliated).
       | 
       | Nothing better than getting some real sun though, especially in
       | the morning.
        
         | cheald wrote:
         | A lot of people in the first world are heavily deficient in
         | vitamin D, and deficiency is linked to a whole host of health
         | issues and vulnerabilities. It's dirt cheap and essentially
         | completely safe below toxicity levels (which are quite
         | difficult to hit - I take 10,000 IU daily, and even with that
         | my bloodwork shows me in the lower quartile of the normal
         | range).
         | 
         | Its metabolite is a steroidal hormone, so it's pretty obvious
         | why it would be beneficial for anti-inflammatory purposes, but
         | it also modulates some key cardiovascular gene expression, too.
        
           | globular-toast wrote:
           | That seems like far too much, especially if you ever go
           | outside. In the UK doctors recommend no more than 1,000
           | IU/day during the winter months. Any more than that is only
           | if you are actually deficient. It seems really hard to get
           | clear answers on it, though. People taking 10x the
           | recommended dose of something seems strange. It makes me
           | think it's being stored somewhere that isn't your blood. It's
           | fat-soluble after all. Why on earth would you take so much
           | anyway?
        
             | pigeonhole123 wrote:
             | He is actually deficient, and 10k IU is not that unusual.
        
             | cheald wrote:
             | I get bloodwork done twice annually, so I have a very
             | accurate idea of what my levels are. The dosage is the
             | recommendation from my doctor based on my bloodwork. The
             | goal isn't just staving off seasonal affective disorder,
             | but actually trying to get me roughly into the middle of
             | the ideal range because of its myriad health benefits.
        
         | lambdaba wrote:
         | I second the Sports Research brand it's my favorite based on
         | their obvious careful choice of fillers.
         | 
         | Anyway, yes the full spectrum of the sun provides much more,
         | not only UV for vitamin D but the red/infrared part of the
         | spectrum which is great for cellular energy.
        
         | kstrauser wrote:
         | Also, ask your doctor to get yours tested! A couple years ago,
         | my D was on the low end (31.7ng/mL; 30-100 is normal). I've
         | been taking 5000IU of D3 since then, and a lab last month had
         | me at 59.1. That seems to be about the perfect dose for me, and
         | it's dirt cheap.
        
           | lowmagnet wrote:
           | I just take D3 50K a week, what a doctor once recommended
           | when I was tested and found almost with something like 6
           | ng/dL of D in my system.
           | 
           | BTW, did they tell you to back off or cut your dose? at 59
           | ng/mL you're in the danger zone.
        
       | fsh wrote:
       | I can only read the abstract, but this doesn't look very solid at
       | all. It's a self-reported non-randomized study, and an absurdly
       | large number of participants has had some type of skin cancer
       | (184 out of 276). This makes the results extremely susceptible to
       | selection bias.
        
       | thenerdhead wrote:
       | I see research on essential vitamins all the time on HN. It
       | really makes you think. There's cohorts who will debunk the
       | studies based on methodology or glaring flaws. There's cohorts
       | who will provide anecdotal evidence in support. There's even
       | cohorts who will bring up a history lesson/"conspiracy" we all
       | forgot about.
       | 
       | It really makes you wonder about essential vitamins though.
       | There's so many of these types of studies that continue to show
       | benefits of getting the right amount of vitamin D, but there's
       | equally enough noise to tell you that you don't need it.
       | 
       | But for countries like America, experts continue to weigh in that
       | we don't get enough essential vitamins and minerals through our
       | diets, so wouldn't it just be common sense that many people are
       | deficient and therefore should supplement?
       | 
       | Wasn't this the entire controversy of Pauling for example when he
       | pushed Vitamin C? That the RDA amounts are not enough and should
       | be highly personalized?
       | 
       | https://www.ncbi.nlm.nih.gov/books/NBK56068/table/summarytab...
       | (Recommendations)
       | 
       | https://www.nature.com/articles/s41430-020-0558-y (Deficiency
       | Worldwide)
        
         | hn_throwaway_99 wrote:
         | Two points:
         | 
         | > experts continue to weigh in that we don't get enough
         | essential vitamins and minerals through our diets
         | 
         | First, would be better to list some specifics rather than
         | "experts say". But even if so, saying that people don't get
         | enough of some micronutrient X from food, it doesn't
         | necessarily follow that supplementation with pills will lead to
         | better health (except in some specific and extreme
         | circumstances that rarely affect people these days, e.g.
         | scurvy).
         | 
         | Second, this was _not_ the entire controversy around Pauling 's
         | vitamin C fantasy. His recommended doses were orders of
         | magnitude larger than recommended amounts - it wasn't just
         | about being "more personalized". Nevermind that Pauling's
         | vitamin C theories have been thoroughly disproven.
        
         | mandmandam wrote:
         | I think it's absolutely bonkers - it really blows me away -
         | that we have such debate on the effects of single molecules,
         | studied for untold millions of human hours.
         | 
         | And yet many people think we can improve on nature; tinkering
         | and toying with vastly more complex machinery and life, that we
         | barely understand.
         | 
         | We are still discovering entire structures in the human body,
         | ffs, yet are seemingly happy to allow vast monocultures of
         | corporate and for-profit GM crops; 'trusting the science'.
         | 
         | The lies are as thin as our topsoil's gonna be soon. I love the
         | idea of scientific progress, and understanding things, but this
         | attitute of 'trust the men in white coats with everything even
         | though we don't understand Vitamin C or D all that well' is
         | truly mind-boggling.
        
           | JumpCrisscross wrote:
           | > _we have such debate on the effects of single molecules_
           | 
           | Most complex systems have simple limiters, almost by
           | definition of the latter. You don't need to solve fluid
           | dynamics and combustion physics to understand that more air
           | through a carburettor causes an internal combustion engine to
           | run faster.
        
       | docflabby wrote:
       | People who avoid the sun more likely to take vitamin D
       | supplements?
        
         | reader5000 wrote:
         | People who avoid the sun are less likely to care about health
         | overall and therefore less likely to take vitD supplements?
        
         | jmckib wrote:
         | I don't have access to the full paper, but I would expect that
         | they at least tried to control for sun exposure.
         | 
         | In general, if you can think of an obvious confounding factor
         | in about five seconds, then it's a safe assumption that
         | professional researchers thought of it too.
        
           | Calavar wrote:
           | > In general, if you can think of an obvious confounding
           | factor in about five seconds, then it's a safe assumption
           | that professional researchers thought of it too.
           | 
           | I work in academic medicine. I read a lot of papers. This is
           | not at all a given in my experience, except maybe in the
           | tippy top journals (Nature, NEJM). When in doubt, read the
           | paper, see if they mention the confounder you thought of.
        
           | surfpel wrote:
           | > safe assumption that professional researchers thought of it
           | too
           | 
           | Research should be able to stand up to scrutiny. The
           | scientific process _depends_ on it.
           | 
           | Given the ongoing reproducibility crisis and plethora of
           | garbage research coming out of academia, I'm not assuming
           | anything about any research I see.
        
           | Gimpei wrote:
           | They probably have, but that doesn't mean they have the
           | necessary data to actually address the confounds. Often there
           | is a trade off between what is most provable and what is most
           | novel. Publishing incentives being what they are, novel
           | invariably wins.
        
         | ericmcer wrote:
         | Yeah... doctors recommend supplementing vitamin D if you don't
         | get much sun. This almost feels comedic.
        
           | lowmagnet wrote:
           | Doctors recommend supplementing vitamin D if you have a
           | measured deficiency. Most people naturally settle to 20 ng/mL
           | or higher, and just incidental exposure, or eating certain
           | foods can help you either absorb or synthesize it.
           | 
           | There are also people, like me, who no matter what, we can't
           | make as much vitamin D for whatever cluster of genetic
           | factors causes that. Some of us are always tired unless we
           | take 50,000 IU of D3 a week.
        
             | garciasn wrote:
             | That's over double the dose considered "safe". Obviously,
             | I'm not suggesting you do otherwise; it's just way outside
             | the bounds of what most adults would do unless directed to
             | by their physician.
        
           | cj wrote:
           | Did the study not control for confounding factors?
        
             | alsobrsp wrote:
             | It did, they state that right in the summary.
        
         | psychphysic wrote:
         | Conversely, those people who refuse to ever cover up "cause you
         | need vitamin D".
        
         | Gibbon1 wrote:
         | Tweedledee: People with less sun exposure both intentional or
         | unintentional may supplement more.
         | 
         | Tweedledum: Low Vitamin D weakens your immune system. Having a
         | weakened immune system increases your odds of skin cancer.
        
         | krona wrote:
         | I think just as likely is the general problem of people who
         | take supplements being generally more conscientious and less
         | likely to engage in risky behaviours (e.g. wearing sunscreen in
         | summer)
        
           | DoesntMatter22 wrote:
           | Or they are supplementing because they don't get much sun to
           | begin with
        
             | [deleted]
        
         | nemo44x wrote:
         | Yeah my immediate thought too. Give 2500 rabid tanners vitamin
         | D and let's look at skin cancer rates in 10 years vs the
         | population of rabid tanners.
        
         | jasonsb wrote:
         | This is the most plausible reason.
        
           | experimenting wrote:
           | The most plausible reason is that the scientific peer-
           | reviewed result is correct, not the tiring "correlation does
           | not imply causatian" commenter on HN who at most skimmed the
           | paper.
           | 
           | 2009: > Epidemiological data show an inverse relationship
           | between vitamin D levels and breast cancer incidence. In
           | addition, there is a well-documented association between
           | vitamin D intake and the risk of breast cancer. Low vitamin D
           | intake has also been indicated in colorectal carcinogenesis.
           | A vitamin D deficiency has also been documented in patients
           | with prostate cancer, ovarian cancer, as well as multiple
           | myeloma. Larger randomized clinical trials should be
           | undertaken in humans to establish the role of vitamin D
           | supplementation in the prevention of these cancers.
        
             | wouldbecouldbe wrote:
             | it's a small difference in a small group. And relying on
             | self reporting for sun exposure.
        
         | beowulfey wrote:
         | Here is the description how they measured the impact of sun
         | exposure to the results:
         | 
         | > The exposure of skin to UV radiation was clarified with
         | different questions. The self-estimated lifetime exposure was
         | studied with the following question 'How often have you exposed
         | yourself to sunlight during your lifetime?' The answer options
         | were (1) 'seldom', (2) 'occasionally', (3) 'often', or (4)
         | 'very often'. The sunburn history was studied with the
         | following question: how often has your skin been burned due to
         | sunlight during your lifetime? The answer options were (1)
         | 'seldom', (2) 'occasionally', or (3) 'often'. The answer
         | options for the question of 'Main environment in working
         | history' were (1) 'outdoor', (2) 'indoor', or (2) 'variably
         | both'.
         | 
         | They saw approximately the same distribution of sun exposure
         | across the different test groups, it looks like.
        
       | bravoetch wrote:
       | Vitamin D is also readily available in food. You can get plenty
       | by eating brown portabella mushrooms. I often read sunshine vs
       | supplements discussed, and rarely food sources.
        
         | gochi wrote:
         | Vitamin D isn't in high enough sources in foods. Not unless
         | you're eating a ~cup of them a day or in the days you aren't
         | taking the supplement. This is important because the study went
         | into differences between "occasional" and "regular" vitamin D
         | supplement users.
         | 
         | Mushrooms are very good for many other reasons and should be a
         | staple in most weekly diets.
        
       | gp wrote:
       | Unfortunately I cannot get full article access, but from the
       | abstract it sounds like they did not control for actual sun
       | exposure.
       | 
       | It would seem to me that those who self medicate with vitamin D
       | are those who know they do not get sufficient sun exposure, and
       | would necessarily also be those at reduced risk of melanoma.
        
       | zaptheimpaler wrote:
       | Like most nutrition/diet studies it's entirely correlational.
       | Equally likely that people who take Vitamin D also just take
       | better care of their health in other ways like just using
       | sunscreen. Maybe it is true but it's so hard to draw any
       | conclusion from a study like this.
        
       | mistrial9 wrote:
       | I was told recently that US Doctors have lost their license over
       | this topic; no idea if that is true.
        
         | kstrauser wrote:
         | No. My memory of the news stories were that some doctors
         | preached it as a miracle preventative/cure, which let to
         | patients neglecting other more effective preventatives because
         | they thought they were safe from getting sick.
         | 
         | I think any doctor would tell you to take supplements if your
         | lab tests showed that you're low. There's nothing controversial
         | in that advice.
        
         | experimenting wrote:
         | For a long time, the Mayo Clinic claimed vitamin D
         | supplementation to combat SARS infections had no scientific
         | proof and was possibly dangerous.
         | 
         | If such an authoritative source claims pseudo science and
         | danger, your annecdote could very well be true.
        
           | lowmagnet wrote:
           | Low vitamin D reduces correct responses by the immune system,
           | and contributes to autoimmune disorders and results in higher
           | possibility of infection.
        
         | [deleted]
        
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