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Vitamin D metabolism and deficiency in critical illness

Posted on: September 30, 2011   by  John Cannell, MD


Sometimes many of us despair, as with the recent Food and Nutrition report. However, I just read a paper due to be published in October of 2011, a spirited call for more vitamin D for the critically ill from an Australian researcher who began writing about vitamin D 4-5 years ago.

Dr. Paul Lee, a Senior Lecturer at the University of Queensland in Australia, clearly believes people all over the world are needlessly dying in the ICUs and the CCUs because they have vitamin D deficiency. This also applies to anyone having elective surgery; make sure your vitamin D level is high normal beforehand, as the stress of healing uses up (metabolically clears) tremendous amounts of vitamin D.

Lee P. Vitamin D metabolism and deficiency in critical illness. Best Pract Res Clin Endocrinol Metab. 2011 Oct;25(5):769-81.

It is such a joy to read someone who “gets it,” especially when that someone is in a position of academic power. First, he quotes several studies to make the argument that almost everyone with a critical illness is vitamin D deficient.

“Collectively these results provide unequivocal evidence that vitamin D insufficiency and deficiency are highly prevalent among critically ill patients.”

Next, he takes parental nutrition to task (that is when they feed you through an IV). He notes that such nutrition only contains 300 IU/day of vitamin D. By comparing input to resultant vitamin D levels, he concludes,

“These results demonstrate current replacement regimes are grossly inadequate.”

Don’t you love it?

He goes on to write of severe immune dysfunction, both the immediate immune system (innate) and the antibody immune system (adaptive), bone hyper-resorption (rapidly weakening your bones), blood poisoning, and hyper-inflammation in critically ill patients and clearly believes the answer is simply to give them enough vitamin D.

He ends by citing studies showing death in the ICU and the CCU is 2-3 times higher for the vitamin D deficient. He thinks simple substrate starvation (Professor Heaney’s discovery of not enough vitamin D building blocks) explains these deaths. Dr. Lee’s paper (a sight for sore eyes) is yet another reason to find and treat your vitamin D deficiency.

2 Responses to Vitamin D metabolism and deficiency in critical illness

  1. [email protected]

    My sister was recently diagnosed with M D S and she is going to begin treatment (Chemotherapy) in a couple of weeks . It seems that she would benefit by taking 10,000 units of D3 per day without any ill effects.
    Her Doctor said to take in moderation . Wonder what he considers moderate?


    • Brant Cebulla

      Does anybody here have experience taking vitamin D during chemotherapy? If so, please share. How about experience with Myelodysplastic Syndromes and vitamin D?

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