Vitamin D may only benefit ICU patients with severely low levels, says new trial

Posted on: October 10, 2014   by  Amber Tovey

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A recent study published in JAMA found that administration of high dose vitamin D did not significantly reduce hospital length of stay, hospital mortality, or six-month mortality among critically ill patients, but did see a reduction in hospital mortality in those who were severely vitamin D deficient [25(OH)D < 12 ng/ml] at admission.

They used what is called an intention-to-treat analysis, which arethe results of an experiment based on the initial treatment group assignment and not on those who actually received treatment. That means their analysis included patients who did not take their vitamin D.

Hospitalized patients are at high risk for vitamin D deficiency. Being confined to a hospital bed means limited access to outdoor sun exposure and subsequent vitamin D production.

Vitamin D is very important to this patient population who are also at risk for complications from surgery and hospital-acquired infections. These, among other things, may increase length of hospital stay, and risk for morbidity and mortality.

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1 Response to Vitamin D may only benefit ICU patients with severely low levels, says new trial

  1. Anh Phan says

    Yes I agree with this notice, if the patients of placebo group was told that they get vitamin D treatment because vitamin D is important, this may have positive attitude to the sun and vitamin D, they may have confident to enjoy the sun more often, go outside, sun bathing, ect…or they take vitamin D supplement from primary care doctors, or other supplements or health food with vitamin D…Did the researchers really look closely to the patients diets and lifestyle. Why the researchers failed to discuss the significant increasing of vitamin D level of placebo group.
    Wonder if the Vitamin D does not benefit for critically ill, or the vitamin D does not being absorbed well by critically ill patients. The researchers should ask why only 50% of the patients had a vitamin D level above 30ng/ml after supplementation. The method of application also affects the absorption. And the present of other many important nutrients also play critically role on the effectiveness of vitamin D. Again, researchers also need to look closely at patient’s diets and life style.
    Yes, White group people have better vitamin D production in shorter time of sun exposure than other group. Wonder why increasing of vitamin D level in placebo group?
    The dose of “D3 or placebo was given orally or via nasogastric tube once at a dose of 540 000 IU followed by monthly maintenance doses of 90 000 IU for 5 months” given at one is too high out of human body natural biochemical function. In nature, human skin exposed to the sun, and our body make up to 20,000 IU themselves, longer exposure doesn’t make more vitamin D, because our body naturally produce melatonin to darken skin, (your skin get tanned) to prevent further penetrating of UV rays. (Mother Nature is very smart, she makes human body in to perfection!!!) . The extra vitamin D will be stored in liver, and the rest of vitamin D after do their work, they can be excreted out within 1-2 weeks (again depend on patients’ situation, some can retains or recycles vitamin D well in blood, some doesn’t). Apply at once the amount of 540,000 IU 27 times the amount human body can make in optimum condition 27 times is very dangerous for human, specially for critically ill patients, whose liver and kidney function already compromised, may not retains and reuse vitamin D effectively, in worse, this bolus dose might make body work harder to excrete these extra amount. This can explain why “ only 50% of the patients had a vitamin D level above 30 ng/ml after supplementation” and “ administration of high-dose vitamin D3 compared with placebo did not reduce hospital length of stay, hospital mortality, or 6-month mortality”, no significant side effect were noted on high dose of vitamin D, but if look closely researchers may find some side effect on liver and kidney failure by high dose given at once. If this research intends to make vitamin D supplement sound ineffective, they achieve their goal, otherwise, there should be consider about the method of application and other supplements support vitamin D absorption.
    Yes, Further and better designed randomized controlled trials should continue, the factors such as race, lifestyle, diet, method of application, and other nutrients should consider carefully in the study. For me, I do not need to wait for all of these expensive trial results to prove the effectiveness of vitamin D. I try to do sun expose when I have time, and take vitamin 1000 IU D daily with good diet to prevent disease.

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