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Vitamin D levels again linked to length of survival in ICU

Posted on: March 15, 2012   by  John Cannell, MD


You never know when you will end up in the ICU. Your life will be clinging to remarkable technology, medical skills and wonder drugs of today’s intensive care units, but you’ll also be using your own innate defense mechanisms to cling to life.

More and more it looks as if vitamin D is the most important innate defense mechanism that humans can control. That is, your vitamin D level will either be high or low based on choices you have made. You either get UVB photons or you don’t; you either take vitamin D or you don’t. That nature leaves those choices to us, in order to make such a powerful downstream steroid hormone, is astonishing.

Drs. Arnson and Amital and colleagues of the Sheba Medical Center in Israel measured the results of the choices of 130 such patients. Even the ones that skipped the vitamin D articles in their local newspapers had made a choice. Some decided to avoid the sun or sunbeds, yet others believed their doctors when they were told, “You can get all the vitamins you need from a good diet.” Their average vitamin D level was 14 ng/ml with about 45 of the 130 critically ill patients having vitamin D levels below 10 ng/ml. The rest were not much better. Despite the small differences between the highest and lowest, the ones with the highest levels outlived the ones with low levels.

Arnson Y, Gringauz I, Itzhaky D, Amital H. Vitamin D deficiency is associated with poor outcomes and increased mortality in severely ill patients. QJM. 2012 Feb 12. [Epub ahead of print]

The 130 patients in the study included adults suffering the results of everything from car crashes to strokes to heart failure. The researchers measured vitamin D levels from stored blood on all patients at the beginning of their mechanical ventilation. They wanted to see if vitamin D levels had any effect on death rates, and it did. Virtually everyone died, but the ones with the highest vitamin D levels lived 24 days compared to an average of 15 days for the vitamin D deficient group.

First, as I like to say when I speak, everyone who takes vitamin D will die. It’s just a question of when. If all of a sudden, by magic, everyone in the USA had a vitamin D level of 50 ng/ml, we don’t know what people would eventually die from. It would probably be the same diseases that kill us now, only those diseases would occur later in life. Vitamin D is not a panacea; the best we can hope for is that it will let us live to our genetic potential, called squaring off the mortality curve.

How do you decide how much vitamin D to take? How do you make such an important decision for your family and yourself? How do you know? Scientists have never given 5,000 IU/day for five years to see if it is safe. True, and they will not be doing so for quite a while. The answer is firmly embedded in common sense.

Five thousand IU is about 50% of what you get when you sunbathe at noon in the summer in your bathing suit for 30 minutes. As the molecules made in the skin from the sun and the ones in vitamin D supplements are identical (cholecalciferol), it is hard to make a case that 5,000 is too much. On the other side of the argument, a typical Pascal’s Wager, is the growing scientific publications indicating not taking 5,000 IU/day is a decision you may not live to regret.

2 Responses to Vitamin D levels again linked to length of survival in ICU

  1. [email protected]

    Dr Cannell might be interested in someone who has been taking 5000 iu’s, or more, for more than 5 years. I started out taking 5k iu in Feb of 2007 and gradually increased my dosage to 12k iu’s, which I have been taking for the last 2 years. My blood work, which I have done every 6 months or so, shows my calcium levels remain within normal limits, and no changes in kidney or liver function. My 25(OH)D level has increased from about 45 ng/ml to the mid 90’s. I am a 91 year old retired utility executive, try to walk a mile each day, and play a little tennis still. I also have prepared and shown a Power Point presentation about vitamin D to friends and my Rotary Club. I also try to limit my calcium intake to keep my parathyroid-kidney relationship from getting our of balance. From my 6 years of studying about vitamin D, and my own experience, I think the experts are shortchanging the public when they recommend 60 ng/ml as a good vitamin D level. MF

  2. Kate Saley

    Wow MF! Keep up the healthy lifestyle and great work spreading vitamin D awareness.

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