It Seems They Just Can't Help It,

The 3 Ways the IOM (Institute of Medicine) Failed Us on Vitamin D

David M. Marquis, DC, DACBN

We really can only have an influence within our own sphere or circle but if we do our part that influence will be carried by others and the sphere of influence increases.  It is with that knowledge that I continue my attempt to share the truth which the media is being paid to distort.

So what am I harping on you might ask?  I suspect most of you are aware of the recent IOM (Institute of Medicine) report that discussed vitamin D and unfortunately confused most anyone who is not familiar with the topic.

Before I totally throw the report "under the bus" I must comment on the one good thing the IOM accomplished.  It did raise the recommended upper limit for daily intake of D to a range of 1000IU to 4000IU for children (depending on age) and 4000IU for adults so all the doctors out there who have been afraid of recommending D above the ridiculously low levels previously suggested now have no excuse to get on board.

So, here are the 4 ways the IOM failed us in a nutshell, read it and judge for yourself.
1. Still too low on Daily dosing
2. False fear of excess D with unsubstantiated claims of toxicity
3. Avoids the vast health benefits of D and focuses on bone health
4. Ignored and suppressed data and input from worlds leading Vitamin D researchers

1. The IOM report recommends that nearly the same RDI (Recommended Daily Intake) dose of vitamin D be used for a 3 pound premature infant (400IU) and an adult pregnant female (600IU).

Now the 400IU dose that is recommended for the infant may be satisfactory for a short period of time but the 600IU dose recommended for the adult pregnant female is window dressing at best.

Studies such as those done at the University of South Carolina have shown dramatic health benefits with no downside to doses ranging from 4000IU to 6400IU per day in pregnant and lactating women. 

To quote the professor behind the USC study: " I'm telling every pregnant mother I see to take 4000 IUs and every nursing mother to take 6,400 IUs of Vitamin D.    I think it is medical malpractice for obstetricians not to know what the Vitamin D level of their patients is.  This study will put them on notice."-Dr. Bruce W. Hollis

2. The next point is the discussion on toxicity.  The IOM implied that toxicity might occur at doses of 10,000IU per day but were unable to produce any research to substantiate that claim.  The one study they did produce showed that serum calcium elevation may occur at doses of 20,000IU per day but no indication of actual toxicity. 

3. This IOM report failed to address the thousands of studies that have shown doses of vitamin D greater than 1000IU per day helps the health of so many structures such as: heart, brain, breast, prostate, pancreas, muscle, nerve, eyes, immune system, colon, liver, skin, and especially fetal health. In addition it has shown great benefit for improving mood, fighting infection, reducing asthma, and recently the largest pediatric journal in the world reported the benefits of vitamin D in cases of autism!  If you would like to reference information on vitamin D please see the "Vitamin D Council" here. 

Here is a diagram from the Current Opinions in Clinical Nutrition and Metabolic Care 10:12-19, 2007 depicting the various tissues in the body that Vitamin D receptors have been identified in:

Handmade Software, Inc. Image Alchemy v1.11.1d73

As you can see Vitamin D is necessary for life on virtually every level.  Study after study has shown this to be the case.

So why would this group (the IOM) who's slogan is "Advising the Nation. Improving Health” advise us by perpetuating old information essentially regurgitated from their past consensus report from "experts" back in 1997?

3. Well, this next factoid will really make you raise an eyebrow and possibly answer the last question.  In making this report the IOM did one thing that showed promise initially then totally put the nail in the coffin for any respect I had for the group.

Initially they consulted with 14 of the greatest minds in biochemistry, orthomolecular medicine, and nutrition.  Each of these 14 scientists presented their position papers for the IOM to review.  What did the IOM do with this information received from this elite group of Vitamin D researchers?........ They SUPPRESSED IT!  Then when the Vitamin D council requested copies of the 14 reports that were contributed for use by the IOM in their research their response was...... wait for it..... wait for it......."You will need to file a federal Freedom of Information (FOI) request to the IOM's FNB for the release of these 14 reports."  This type of response brings the infamous words of Ronald Reagan to mind when he said: "… the 2 scariest sentences you will ever hear are we're from the government and we're here to help"

Why on earth would an organization that is funded by our tax dollars suppress information regarding a public health report on vitamin D and then spread information that is outdated?  Well, and this is my opinion again, when you look at the facts on D and what it treats as well as its broad range of safety you may come to the conclusion as I have that it solves an incredible number of health problems.

Call me a conspiracy theorist but I smell some pharmaceutical dollars vanishing at the thought of a healthier population.  Last year we saw leaders in the World Health Organization (WHO) receiving paybacks from H1N1 vaccine makers shortly after raising the level of alert and a false need for mass vaccination.  We also saw in recent past the makers of the HPV (Gardasil) vaccine who also happen to be employed at the NIH (National Institute for Health) manage to get their vaccine through FDA trials (despite numerous health issues) and in mass production and marketed with public dollars more than any vaccine in history.  Can you say CONFLICT OF INTEREST?

Take it for what its worth as this is my opinion, the IOM recommendations are not based in science but in some undisclosed bias or group preference and someone or some people in that group stand to make money as the public loses out when bad data like this is perpetuated.

As for me, my family and my patients I recommend following the recommendations of the actual researchers (many of whom had their reports suppressed) on Vitamin D and ignoring the IOM's report which was problematic as best. 

Here are recent comments from a number of the 14 researchers in regards to vitamin D.  If you would like to read more of their comments you can find them here. 
“Many persons will require 8,000 IU/day for reducing breast cancer risk, there is no good rationale for a lower UL based on present best evidence."

Cedric F. Garland, Dr. PH, FACE
Professor, University of California San Diego School of Medicine and Moores Cancer Center

"I would strongly hope that the IOM opts for a substantial increase in the DRI for vitamin D. There is now substantial and compelling evidence that, in addition to its requirement for skeletal integrity, vitamin D sufficiency reduces the risk of development of a number of cancers, contributes to cardiovascular health, and stimulates immune responses to infectious diseases, all of which are essential for healthy aging”.

John H. White, PhD
Professor, McGill University

“We can use risk/benefit to our advantage as the risk of taking high doses is highly unlikely even at levels above the UL but certainly at the UL (let's hope for a 5000 IU or more UL). The message can be - there is risk to NOT taking additional vitamin D”.

Susan J. Whiting, Ph.D.
Professor of Nutrition & Dietetics
University of Saskatchewan

“There is an impressive body of scientific evidence supporting levels higher than the IOM panel is currently recommending, and for reasons that are not entirely clear, the panel has discounted that evidence. The public needs to know that that evidence exists so that they can make up their own minds. It's helpful in making those decisions, to know that intakes higher than the IOM recommends are safe. For me, that makes the decision easy. Even if the evidence for a higher intake were uncertain (and I don't believe it is), intakes 2-5 times the IOM recommendations would carry a good chance for benefit at essentially no cost and no risk."

"Finally, I believe that the presumption of adequacy should rest with vitamin D intakes needed to achieve the serum 25(OH)D values (i.e., 40–60 ng/mL) that prevailed during the evolution of human physiology. Correspondingly, the burden of proof should fall on those maintaining that there is no preventable disease or dysfunction at lower levels. The IOM has not met that standard."

Dr. Robert P. Heaney, MD
John A. Creighton University Professor and
Professor of Medicine, Creighton University

My recommendations are still as follows:  Children 2000IU a day and Adults 5,000 to 10,000 per day depending on your blood 25OH D levels.  You must know your blood levels so get them tested annually.

Also remember if you are fighting an infection you can take 25,000 to 50,000IU a day for 3 days to rapidly boost your immune response to infection.

Best wishes,

Dr. Dave