The prestigious New England Journal of Medicine, which has recently tarnished its reputation by refusing to publish articles unfavorable to popular prescription drugs, is barreling forward this week with its anti-natural, anti-health approach to medicine in asserting that vitamin D not be universally recommended for postmenopausal women with low levels of vitamin D, and stating that we need a 5 year randomized trial before we can safely recommend its use for reducing the risk of heart disease or cancer.*
The journal describes a postmenopausal women in her sixties with low bone density but not outright osteoporosis who has less than 1% risk of sustaining a hip fracture in the next 10 years, and recommends against giving her supplemental vitamin D to reduce her risk because a 1% risk is, apparently, too low to fuss over and so there is no need to treat the low vitamin D level.
When it comes to using drugs, in contrast to vitamin D, it seems no risk is too low to treat.
Let’s say this same postmenopausal women also has a less than 1% chance of a heart attack. Previous journal articles have made the recommendation to prescribe a cholesterol-lowering medication to treat this level of risk. In fact, if her risk of heart attack were as low as 1 in 1000, that is one tenth of a percent, the recommendation would still be to write a prescription for a pill that, unlike vitamin D, has side effects and risks including but not limited to depression, memory problems, joint pains, fatigue, liver inflammation, immune system alteration, heart failure, kidney problems, and more. Read the package insert.
This is the kind of attitude that disgusts people. What the NEJM and the what’s-good-for-patients-is-what’s-good-for-business oriented medical leadership fails to consider is that it also drives patients away from their primary care doctors towards alternative practitioners who think in more pro-active, pro-natural terms. And this is not good for the business of medicine.
Promoting An Unethical Approach to Healthcare
The real problem is this mentality violates the doctor’s prime directive First do no harm by requiring people get sick before we step in to help.
For goodness sake, we know we don’t get as much sun as people used to, and we don’t eat liver or eggs from pastured animals like people used to, so our intake of vitamin D is less than it used to be. It is wildly irresponsible to suggest, as the journal does, that we need to do a 5 year randomized controlled trial before we can safely advise people to supplement with D. During those five years, thousands of study participants with known low levels of vitamin D will continue to lose bone mass, suffer suboptimal immune function, and develop calcium deposits in their arteries and tendons.
We have, for the last decades, stood by and watched as more and more people get sick, and, in no small measure, this continued non-action is threatening to destroy the fabric of health in this country by ruining our economy.
Back to basics: When “randomized controlled trials” don’t exist, use common sence
Along with Dr. Michael Hollick, former Harvard physician who is a leading expert on Vitamin D, I advise everyone to take 2000 I.U. per day, and to never take calcium supplements without also taking magnesium and vitamin D. We do have plenty of science telling us that three nutrients work together, along with protein, vitamin K, and vitamin A, to help keep your body strong, healthy, and away from the emergency room!
* Vitamin D Insufficiency, Supplement to the NEJM 2011: 364:248-254