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Information on the latest vitamin D news and research.

Find out more information on deficiency, supplementation, sun exposure, and how vitamin D relates to your health.

Vitamin D: just another vitamin C or E?

Vitamins and minerals, in the form of supplements, are notorious for getting overhyped. Some of the best examples are beta-carotene, vitamin C and vitamin E. In the 1980s, it was widely thought that beta-carotene and vitamin E could prevent cancer after scientists discovered their anti-oxidant properties. It was widely thought that supplementation of either could reduce mortality.

Although the doses used in studies have been all over the map, randomized controlled trials show that there is no consistent benefit in supplementing with these nutrients and may even increase mortality. A meta-analysis of randomized controlled trials of a handful of nutrients by Dr Bjelakovic and company found that both beta-carotene (RR, 1.07; 95% CI, 1.02-1.11) and vitamin E (RR, 1.04; 95% CI, 1.01-1.07) increase risk of all-cause mortality.

Bjelakovic G, et al. Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention: Systematic Review and Meta-analysis. JAMA, 2007.

Perhaps the most famous case of overhype is Linus Pauling’s foray into vitamin C, and it is a story nutritionists and health professionals love to recite. Pauling is one of only four individuals to ever receive more than one Nobel Prize for his work in chemistry and peace. Later in his career, Pauling became intrigued by vitamin C after he noticed an improvement in his own well-being after taking three grams of vitamin C daily. He was so convinced that he wrote several books on vitamin C and even founded an institute dedicated to vitamin C research. The public and medical field called him a quack, and while vitamin C may be important (we’ll decline to comment), the vitamin, like others, turned out to be no panacea.

While the Vitamin D Council will decline to make recommendations on these nutrients (it’s outside of our expertise), the history of research on these nutrients only puts vitamin D under the same scope of healthy skepticism. In reference to previously hyped nutrients, JoAnn Manson, lead investigator of the VITAL Study, says, “You have to look at these previous randomized trials as cautionary tales because they show that time and time again, everyone jumped on the bandwagon and then the randomized trials did not have favorable results, and in fact, the risks outweighed the benefits.”

It begs the question, is vitamin D overhyped? Does the current hype outweigh the evidence? Is vitamin D the next vitamin C?

Just about every major media outlet attempts to answer these questions when a study they find interesting comes out. I think it’s important to have perspective here, however, and understand the grand scheme of vitamin D research. While the level of interest from the academic community certainly does not define the merits of a nutrient or drug, it can give you a sense of how much the public is hyping a vitamin relative to the amount of research that is being conducted. Let’s take a look at some figures on “vitamin C” and “vitamin D” for example at www.gopubmed.com.

The bar graphs show raw numbers of publications on the topics in any given year. As you can see, the academic interest in vitamin D has always been higher than vitamin C, dating all the way back to 1970. Even in 1970, over a thousand publications came out on vitamin D, compared to less than 800 on vitamin C in 2011. Even more telling is the relative research interest (lines) that compare the amount of publications to the amount of publications listed on PubMed in general. The keyword “vitamin D” appeared in .00325 of total publications last year, while the top year for “vitamin C” was about .0010, about a third of the amount of publications on vitamin D.

You can also see the trend of relative research interest in vitamin D and how it has skyrocketed in the last 3 or 4 years, while research on vitamin C peaked around 2003-2005. When we see a news outlet publish a story on the dangers of vitamin D or how it is the panacea of nutrients, it is important to understand that vitamin D research, while not in its infancy, is just taking off now, and there are a lot of questions to be answered. It is not fair to say that it’s overhyped (the interest in the academic community is too high); it is also not fair to say that it’s not hyped enough (amount of research hasn’t peaked).

While there are some flaws in using PubMed to gauge the direction of research, it gives us a vague idea where we’re heading. In this year to date, I have seen more randomized controlled trials come out on vitamin D than my prior seven months working for the Council. It’s an exciting time in the field of vitamin D and the Council is excited to relay the research that’s coming out in a hurry.

Only time will tell, but we don’t believe vitamin D is the next E or C, and the shear amount of research the academic community is pumping out supports that we’re not alone in this thought.

  About: Brant Cebulla

Brant Cebulla was a staff member for the Vitamin D Council from May 2011 to April 2014. He has keen interests in nutrition and exercise.

14 Responses to Vitamin D: just another vitamin C or E?

  1. James says:

    Brant,
    Before you dismiss the importance of Vitamin C, and since you admit you are not an expert in it, you must read “Primal Panacea”, by Dr. Tom Levy. After you read from this expert, and the citations at the end, feel free to comment.
    Thank you

  2. mjpent says:

    Just a minor correction, Dr. Pauling received a Nobel prize for Chemistry as you stated, but the second prize was in Peace, not Physics.

  3. rejmd says:

    The comparisons between vitamin C and vitamin D are obviously totally valid because they rhyme (or at least they sort of sound alike). Never mind the insignificant facts that their molecular structures are in no way similar, and that their physiological activities in the human body are completely different. Therefore, all vitamin D research can reasonably be dismissed as fad or quackery, because many of the older vitamin C theories and research findings were irreproducible in larger and better controlled trials.

  4. Comments on Vit C from my memory. In the 80’s a study was done in an English hospital claiming that Vit. C. had a large benefit when used in advance cancer patients. In the days before the internet, I remember reading about this study in a major Philadelphia newspaper. About 6 months or so later, it turned out an independant group had receieved permission to study the medical records of the study’s subjects. They went to England, interviewed the staff, and reviewed the records. They found widespread inaccuracies. Subjects reported as in remission of their cancer had in fact died from their cancer. They found no evidence of any benefit. Interestingly, I read about the evaluation of the study in some medical newsletters. I never saw it appear in general circulation newspapers. Probably to this day there are many people who remember the report of the initial study and don’t know about the follow up report discrediting it.

  5. Also, the theory of the benefit of vitamin C was never based on an objective blood level. The theory went that the human body was defective, couldn’t synthesize vitamin C, and couldn’t get enough from the diet. And don’t forget Vitamin C really is a vitamin; it’s natural source is the diet. Vitamin D is NOT a vitamin, and it’s natural source was sunlight near the equator by near naked humans in the absence of suncreen. Robert Baker MD

  6. Derek says:

    Brant,
    I would echo James’ comments. You might also subscribe to the free newsletter of the Orthomolecular News Service from http://www.orthomolecular.org.
    Finally, I detect in your self-description that your views are very similar to those of Dr Joseph Mercola, who promotes similar ideas as well as optimal blood levels of Vitamin D.
    Thanks.

  7. Brant Cebulla says:

    The point of the post is not to debate the clinical importance of vitamin C compared to vitamin D, but rather discuss the “hype” behind vitamin D and how that parallels with past hype of nutrients. In no way am I stating in the above post whether or not you should supplement with beta-carotene, C or E, or whether these supplements are efficacious in warding off illness.

    mjpent, thanks for the correction on his Nobel prizes. I edited the post to make the correction.

    rcbaker, interesting tidbit. Here is an article you may enjoy “Vitamin C: Do High Doses Prevent Colds”: http://www.quackwatch.com/01QuackeryRelatedTopics/DSH/colds.html

    I believe it was written in 90s (the author died in ’97), but it runs through a series of well designed vitamin C studies in the 70s, and a few from the 80s and 90s.

  8. JBG says:

    As James and Derek have indicated, the situation with respect to vitamin C remains controversial. That is, vitamin C has not been conclusively debunked. And, so far as I know, there has never been a finding about vitamin C that “the risks outweighed the benefits”, although various dark claims are frequently heard. In my own case, when I read Pauling’s book in 1970, taking vitamin C had no discernible effect on my colds, but it instantly stopped the bleeding gums that had been a concern since grade school (and that no dentist had had an answer for).

    The situation with respect to vitamin E and beta carotene is different. Vitamin E is made up of eight distinct substances that compete to some extent for absorption. Supplying a huge excess of one of them, alpha-tocopherol, results in deficiencies in the others, all of which have a nutritional role to play. So the results of the vitamin E trials are solid, but the implications are totally different from those ascribed to them.

    Beta carotene is a similar case in point, except that in that case the number of related substances is much larger.

    By now, these things are well understood by the nutritional community, but the people who would rather you didn’t know have bigger megaphones than those who would prefer to share the truth.

    What vitamin D advocates can learn from all this is that those who see their interests being served by public ignorance will use any available instrument to further obscure and befuddle the issue. We don’t have to help them.

  9. Brant Cebulla says:

    I was just reading Vieth’s 1999 paper, “Vitamin D supplementation, 25-hydroxyvitamin D concentrations and safety.” He discuss how RDAs for nutrients that come from food have traditionally been set based on what the average diet consumes. Since vitamin D doesn’t come from food, public health policy makers have approached vitamin D like a drug, which, needless to say, has created a lot of controversy on the RDA for vitamin D. The Council holds the belief that vitamin D policy should be set using the same philosophy for other nutrients — if sun exposure is the source, then what are levels of people that get decent year round sun exposure, and how much vitamin D does it take to get to that level in absence of sun exposure? Instead we have to wait for the RCTs, a standard that other vitamins have not had been held to, per se.

    It does make you wonder if the population was equally deficient in other vitamins, would RCTs with those nutrients prove just as positive as vitamin D? In most controlled trials using vitamin D, the populations almost always start deficient. There was an Italian study on bone mineral density comparing 800 IU and 6500 IU/day. They found no difference. Heaney wrote a highly critical response, arguing that since the participants started at a mean of 30 ng/ml, of course there was no difference in the doses. http://www.ncbi.nlm.nih.gov/pubmed/22113323 (sorry for the lack of access). When we run these RCTs, it’s not a question of dosage, it’s a question of, were they deficient and are they now sufficient and is there now a difference in outcome?

  10. lharms@careprohs.com says:

    I am disappointed to see that the author has forayed into topics he knows nothing about (vitamins C and E). The vitamin E studies used a form of vitamin E (alpha-tocopherol) that would be expected to cause adverse outcomes. The vitamin C situation only requires that you understand that humans are one of only 3 species that don’t make their own. Squirrels and dogs don’t get ear infections. Maybe we wouldn’t either if we took sufficient vitamin C.

  11. Rita and Misty says:

    Here are my thoughts on why it is essential to supplement with vitamin D3:

    1. Although we were created to get our vitamin d thru sunshine via skin mechanisms, our indoor lifestyles and the use of sunscreen make this pretty much impossible now-a-days. A typical vitamin d serum level for those living an indoor lifestyle is around 25 ng/ml….many (many) individuals have levels much lower.
    2. Those individuals living in current hunter/gatherer societies have 25(OH)D levels of approximately 50 ng/ml, indicating that this would be a natural vitamin d serum level.
    3. There are absolutely no food sources which will provide us with adequate amounts of vitamin d, if using 5,000 iu d3 daily as a point-of-reference.

    What choice(s) do we have: supplement or sunlamp, in my opinion.

    Vitamin C…Vitamin E…Beta Carotene…these are all good, but available thru a healthy diet.

    I do routinely supplement with Vitamin C and occasionally supplement with E and Beta Carotene–depending on my diet.

    I am devoted to my D3, magnesium, zinc, boron and K (and iodine and selenium too).

    Be well,
    Rita

  12. Rita and Misty says:

    I’d like to add to my #1: being elderly, or of darker skin pigmentation…or carrying a few additional pounds (like who doesn’t?) all make getting vitamin d via sunshine even more difficult (as if it weren’t difficult enough already)…And, in winter if you live above latitude 32 north, the sun’s rays aren’t strong enough…

    It is a very complicated process, clearly….

  13. Magic says:

    Linus Pauling lived in the town I grew up in, Oregon City, Oregon. When he came out with his findings on vitamin C I took them. I wanted them to work. I got no pacebo effect and really no help.

    I can say that the D3 is entirely different. It cures what ails me, at least until now. I feel great at 79 and a half.

    Why should people not want to grow old? I find most people my age take many pills, see many doctors and are not very happy.

    Why should they expect to have some form of arthritis? I can say that I had the usual run of ills throughout my life. IMO……Dr Cannell and others preaching D3 are on to something.

    If I have any problem, I take just enough to “cure” it as long as It is within the safe limit. ..I also keep my pill box full of other vitamins that keep me healthy.

    Magic