Interesting. At one time was thought Tylonal was safe, until people started taking large amounts (ie Nicholette Larson) and dying from liver damage, then warning labels were put on everything that contained acetaminophen, stating that we shouldn’t take several meds containing the drug. I think safety and efficacy applies with all drugs whether they are considered “safe” or not, because large quantities of any medication or supplement is dangerous. Even Advil could be dangerous if you get too much or mix drugs that contain Ibuprofen. So I think, macgyver, you may want to rephrase what you said, slightly, because “additional amounts” of any drug is not safe and there is no efficacy for “additional amounts” of many drugs. Celebrex, an arthritis medication, even has it’s problems and entirely safe. Codeine is safe, IF taken as your dr Rx it, but can be addictive too. So there are dangers with all drugs.
What we're saying is that we don't know if taking additional amounts above what is in our diet is either safe or beneficial based on the existing evidence.As an online Doctor here, are you recommending people cease taking vitamin D supplements? Are you recommending that people stop taking any and all supplements until "further evidence" can satisfy you and McKenzie regarding their "efficacy"?
As with all drugs, if there is no clear safety and efficacy data they probably shouldn't be used until we know more.The FDA does NOT classify vitamin supplements as drugs. As an online doctor here, are you saying supplements are drugs? Finally, please explain why everyone should believe you and McKenzie. What if their doctor prescribed a certain supplement for them? What if you are scaring them off of their prescribed and necessary treatments? Are you saying that you know more than most doctors? What you and McKenzie are saying: "we don't know if taking additional amounts above what is in our diet is either safe or beneficial based on the existing evidence." You don't know?!?!?! You don't know either way?!?! So then why the heck are you coming on here giving people medical advice if you don't know?!?! Is that safe? People are supposed to just heed your medical recommendations over other studies and findings because you have a bone to pick with the Supplement Industry?!?! The kicker is we have a frickin' Animal Doctor giving advice here too!
Vyazma I am not an online doctor. I am a real life doctor who is happy to discuss the scientific evidence here for those who are interested. I believe the same is true for Mckenizie. We both have extensive training in science, medicine, and experience interpreting medical literature. Your comment about mckenzie being an animal doctor is obviously meant to be derogatory but comes off just making you sound foolish. For what its worth when I was applying to med school it was actually more difficult to get into vet school. Mackenzie’s grasp of the medical literature is at least as good as mine so you should give him the respect he has earned and deserves.
Getting to more factual issues, the FDA’s classification of vitamins as supplements has to do with regulatory issues rather than biology and medicine. It does not change the fact that they ARE drugs. Anything you put into your body which alters the biochemistry of the body by inhibiting or promoting biochemical pathways or altering cell or organ system function is a drug whether it is commonly referred to that way or not. There is absolutely no question that vitamins are drugs. From a practical standpoint this definition is the only one that matters. Anything which affects the bodies biochemical pathways may have both beneficial effects as well as unintended side effects. This has been well established to be the case with vitamins and supplements just as it is the case with all drugs. It may make you uncomfortable to think of them as drugs but that’s what they are.
I never said no one should take supplements. We have gone over this before, there are cases where supplements may be advisable but for MOST people that is not the case. I am also not advising people to do anything. I don’t give medical advice here. As I said, I am happy to discuss the science and I can tell you what I and the medical community generally recommend to patients but as I do not have a doctor patient relationship with anyone on here I have never suggested to anyone that this was meant as personal advice for them to follow. If your doctor told you to do something different you should follow their advice since they know your specific conditions and I don’t. The things I discuss here are for informational purposes only and they may serve as food for thought to discuss with your own doctor but that’s all.
Let me make one other thing clear. I am not asking people to "heed (my) medical recommendations over other studies and findings ". I am asking people to question the advice of less knowledgeable individuals who are making these recommendations exactly because the studies and findings as you put it DON’T support the notion that taking vitamin D supplements is beneficial. If you read the metaanalysis that Mckenzie quoted above it pretty clearly says just that. Not only do we not know whether vitamin D supplementation is safe or effective, the fact is NO ONE knows, and that is the point. Since no one knows then no one should be advising people do take these supplements without a good reason especially people in the supplement industry, media personalities, or celebrities who know even less.
If we don’t know whether a drug is beneficial and we don’t know if its harmful then we shouldn’t be advising people to take it. Its as simple as that.
The United States does NOT regard vitamin supplements as drugs MacGeyver.
Just like milk. Milk isn’t a drug either…unless you want it to fall under your criteria of what a drug is.
But that still doesn’t matter, The FDA says supplements are NOT drugs.
Who’s a better authority? You or the FDA?
I’m going with the FDA seeing as how you exist only in cyber-space on a publicly accessed Forum/Blog.
MacGeyver, how about you do me a favor an explain why the human body needs Vitamin D?
But that still doesn't matter, The FDA says supplements are NOT drugs. .Perhaps you will show me where the FDA says that supplements and vitamins are not a drug first. Even if there is such a statement it does not affect the medical definition of a what a drug is. Aspirin is not suddenly "just a supplement" because you obtain it by sucking on bark form a willow tree instead of getting it from a bottle, and vitamins are not suddenly not a drug simply because someone decides to classify it as something else. Anyone who states that Vit D is not a drug would in fact be wrong. If there is a statement form the FDA stating that supplements are not drugs they are using the definition just in a regulatory manner. The FDA is required to treat items designated as supplements differently not because science says they are different but because An ignorant senator from Utah managed to push a law through congress in 1994 creating an artificial distinction between supplements and other pharmaceuticals. The distinction is entirely artificial and unscientific and was opposed very strongly by the FDA. However as a government agency they are required to follow the law no matter how wrong it is.
MacGeyver, how about you do me a favor an explain why the human body needs Vitamin D?I don't have time to give you an education in vitamin D metabolism here nor is it relevant to the point. No one here said the human body doesn't need vitamin D. What I said is that there is no current evidence that Vitamin D supplements are beneficial or necessary for most people to take. They could be helpful, harmful, or harmless. The fact is that no one knows at this point and anyone who says they do is misinformed.
Mriana,
Dose is always relevant to safety, not just for drugs. Your can die from ingesting too much water or breathing too high a concentration of oxygen. Nothing is perfectly safe, and almost nothing is absolutely toxic. It’s almost always about the dose.
Vyazma,
What a totally childish response. You really don’t care about this issue at all do you? All you seem to care about is that no one tells you what to do.
I didn’t give you any advice, and I never asked you to take my word for anything. I simply posted the published reviews of the scientific evidence and offered my opinion on them. Why you need to have a tantrum every time I do is beyond me, but the evidence is here for anyone to look at and draw their own conclusions. They don’t need to take macgyver’s word for what it means, whether he’s an MD or not. They don’t need to believe my interpretation, whether or not I’m really an “Animal Doctor.” And they don’t need to blindly follow your opinion, whether you have a Nobel Prize or absolutely no medical education or credentials at all. See, aren’t we all nice and free to think and do as we please? So what’s the beef?
And as a medically ignorant retired biochemist, I’ll quietly continue taking my 3000 i.u. of vitamin D daily as long as my mind and body are functioning well. I figure that if it hasn’t killed me yet (at 83.5) it can’t be TO harmful. :lol:
Occam
3000 I.U. daily? 
That’s an awfully high dose, Occam. I’m not at all against taking supplements, but I believe in taking them within reason. I do 1000 I.U./day in the winter, unless I eat mushrooms or something else high in D, but once the weather gets warmer and I’m in the sun more, I quit, instead of skipping taking it. I’ve done this for the last 3 winters, since I got pneumonia and haven’t suffered a severe respiratory infection since, but I know better than to over do it. 3000 I.U., I think is way over doing it. More than over doing it and potentially dangerous, esp if you also take that much during warmer weather, because you get vitamin D from the sun. That said, 3000 I.U./day and the vitamin D you get from the sun, could potentially exceed human tolerance. Not saying you won’t see 100 doing that, but depending on how many years you’ve been doing that, you might not see 100. There’s moderation, common sense, reason, and knowledge about supplements and then there is total unreason and lack of knowledge. Occam, what you’re doing, esp since vitamin D is stored in fat cells, is bordering on risking not living to being 100 y.o. I don’t think you’re doing yourself any favours taking that much every day, year around. I’d be very interested in looking at your diet to see how much you are actually ingesting every day, esp since you’re not a vegetarian. If you were a vegetarian or even vegan, I’d still say you’d need to cut that dose by a third at least.
My new PCP, after getting the results of my initial bloodwork, prescribed vitamin D. No surprise, really, as I rarely get much sun. What was a surprise was the prescription dose of 50,000 IU once per week. When I expressed my surprise, he gave a little laugh, as if I were being naïve (I like the guy, and I don’t have a problem with him thinking me to be naïve in medical matters), and explained that we need to fill up the tank, and can then lower the dosage. Notwithstanding his explanation, I looked up possible bad effects of high doses of Vit. D. I found “hypercalcemia” to be a possibility that I really didn’t want, but also found that it is unlikely to occur unless one is taking even higher doses than my PCP had prescribed for me.
Anyway, I will be finished with the prescription in about a month. I can’t tell any obvious difference (good or bad) in how I feel from taking this high dose. It was a generic prescription and my insurance paid for it, so I am not out any cash.
That’s new information, but at the same time, you are involved with a dr about this, TimB. Occam isn’t, as far as know from what he’s said.
My new PCP, after getting the results of my initial bloodwork, prescribed vitamin D. No surprise, really, as I rarely get much sun. What was a surprise was the prescription dose of 50,000 IU once per week. When I expressed my surprise, he gave a little laugh, as if I were being naïve (I like the guy, and I don't have a problem with him thinking me to be naïve in medical matters), and explained that we need to fill up the tank, and can then lower the dosage. Notwithstanding his explanation, I looked up possible bad effects of high doses of Vit. D. I found "hypercalcemia" to be a possibility that I really didn't want, but also found that it is unlikely to occur unless one is taking even higher doses than my PCP had prescribed for me. Anyway, I will be finished with the prescription in about a month. I can't tell any obvious difference (good or bad) in how I feel from taking this high dose. It was a generic prescription and my insurance paid for it, so I am not out any cash.I will reiterate what I have said previously, that I do not know your specific situation and can not advise you what to do. Taking 50,000 iu once a week for a month will most likley cause no harm but by the same token there is no evidence at all that it will do any good. The practice of measuring and supplementing Vit D levels has become a popular fad over the past 5 years or so. I post on a medical forum and have challenged my colleagues on this practice repeatedly. It seems that a bit of herd mentality has taken over here. Doctors are doing it because other doctors are doing and also because patients are asking about it because they hear about it on TV and read about it in magazine articles. There are absolutely no studies that support this approach and the physicians I have discussed this with on the medical forum all admit this but essentially rely on correlations demonstrated in population studies and the fact that so many others are doing it. They also say they are getting a lot of pressure from patients and don't want to look like they aren't up on the latest medical trends. As stated before there are population based studies showing a correlation between Vit D intake and lower rates of certain diseases but there are no studies supporting a causative role and absolutely none showing any benefit to measuring levels and then supplementing them into a somewhat arbitrarily determined normal range. For what its worth I did my own informal study and ran Vit D levels on the first 50 or so patients who inquired about it. Only one person had normal Vit D levels. These were all perfectly healthy people who had no complaints. That statistic alone makes me suspect that there is something wrong with this whole approach.
My new PCP, after getting the results of my initial bloodwork, prescribed vitamin D. No surprise, really, as I rarely get much sun. What was a surprise was the prescription dose of 50,000 IU once per week. When I expressed my surprise, he gave a little laugh, as if I were being naïve (I like the guy, and I don't have a problem with him thinking me to be naïve in medical matters), and explained that we need to fill up the tank, and can then lower the dosage. Notwithstanding his explanation, I looked up possible bad effects of high doses of Vit. D. I found "hypercalcemia" to be a possibility that I really didn't want, but also found that it is unlikely to occur unless one is taking even higher doses than my PCP had prescribed for me. Anyway, I will be finished with the prescription in about a month. I can't tell any obvious difference (good or bad) in how I feel from taking this high dose. It was a generic prescription and my insurance paid for it, so I am not out any cash.I will reiterate what I have said previously, that I do not know your specific situation and can not advise you what to do. Taking 50,000 iu once a week for a month will most likley cause no harm but by the same token there is no evidence at all that it will do any good. The practice of measuring and supplementing Vit D levels has become a popular fad over the past 5 years or so. I post on a medical forum and have challenged my colleagues on this practice repeatedly. It seems that a bit of herd mentality has taken over here. Doctors are doing it because other doctors are doing and also because patients are asking about it because they hear about it on TV and read about it in magazine articles. There are absolutely no studies that support this approach and the physicians I have discussed this with on the medical forum all admit this but essentially rely on correlations demonstrated in population studies and the fact that so many others are doing it. They also say they are getting a lot of pressure from patients and don't want to look like they aren't up on the latest medical trends. As stated before there are population based studies showing a correlation between Vit D intake and lower rates of certain diseases but there are no studies supporting a causative role and absolutely none showing any benefit to measuring levels and then supplementing them into a somewhat arbitrarily determined normal range. For what its worth I did my own informal study and ran Vit D levels on the first 50 or so patients who inquired about it. Only one person had normal Vit D levels. These were all perfectly healthy people who had no complaints. That statistic alone makes me suspect that there is something wrong with this whole approach. It's too bad that more physicians don't think these things through. They can be as blindsided as their patients. I'd be very skeptical of any doctor who accepts fads. It would make me wonder what else he or she is accepting blindly. Lois
Well, I didn’t pressure my PCP to prescribe Vit. D. As I said, I questioned it. I did, OTOH, lobby for him to allow me to try fish oil for a few months to address my cholesterol (instead of immediately starting Lipitor or some equivalent). He basically said that the fish oil would not help in a significant way, but went along with my wishes, for the time being, as I stressed my concerns about statins potential effects on the liver.
So you would be skeptical of my PCP’s stance on Vit. D in my case, but I imagine that you would not be skeptical of his stance on the fish oil.
BTW, the vit D was a 3 month prescription.
I try to keep up with biochemical and medical research publications, and I wish I had bothered saving the one a year or so ago that said that the recommended level of vitamin D for those over 80 was increased to 3,000 i.u. daily. While I may kid around, here, I assure you that I base my supplement ingestion on published research. Agreed that there often disagreements like the weird (to me) listing McKenzie quoted earlier, so I have to make my own choices based on the test data and reasoning in the articles.
It occurred to me that this topic is similar to those of politics and theology. We all start out with our views, be it existence or nonexistence of a god, conservative or liberal, or pro or anti supplements, then in our reading we give greater value to those articles which agree with our beginning beliefs. 
Occam
I try to keep up with biochemical and medical research publications, and I wish I had bothered saving the one a year or so ago that said that the recommended level of vitamin D for those over 80 was increased to 3,000 i.u. daily. While I may kid around, here, I assure you that I base my supplement ingestion on published research. Agreed that there often disagreements like the weird (to me) listing McKenzie quoted earlier, so I have to make my own choices based on the test data and reasoning in the articles. It occurred to me that this topic is similar to those of politics and theology. We all start out with our views, be it existence or nonexistence of a god, conservative or liberal, or pro or anti supplements, then in our reading we give greater value to those articles which agree with our beginning beliefs. :) OccamI completely agree, Occam, both on reading as much research as we can on a topic of interest and then making our own informed decisions/choices, as well as our own preconceived views.
Occam, if you’re 83, that’s good enough evidence for me, that you know how to take care of yourself.
Perhaps you will show me where the FDA says that supplements and vitamins are not a drug first.From the FDA's website, under the Q&A section in FDA/Food/Supplements. What is a dietary supplement? Congress defined the term "dietary supplement" in the Dietary Supplement Health and Education Act (DSHEA) of 1994. A dietary supplement is a product taken by mouth that contains a "dietary ingredient" intended to supplement the diet. The "dietary ingredients" in these products may include: vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites. Dietary supplements can also be extracts or concentrates, and may be found in many forms such as tablets, capsules, softgels, gelcaps, liquids, or powders. They can also be in other forms, such as a bar, but if they are, information on their label must not represent the product as a conventional food or a sole item of a meal or diet. Whatever their form may be, DSHEA places dietary supplements in a special category under the general umbrella of "foods," not drugs, and requires that every supplement be labeled a dietary supplement. There you go Macgyver. The FDA considers them under the umbrella of foods-NOT drugs. Who wouldn't think that? Drugs are things designed to cure illnesses, treat symptoms, and relieve people of ailments. Foods are things people eat to supply their bodies with nutrients and calories and vitamins. You and Mckenzie keep getting this mixed up.