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Weeping for Scotland

Posted on: March 9, 2012   by  John Cannell, MD

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Scotland is beginning to move on its vitamin D deficiency problem. Several months ago, Oliver Gillie pulled no punches in what he had to say: Scots die younger because of vitamin D deficiency.

Scotland’s Health Deficit: an explanation and a plan

Scotland’s response to its countrywide problem of vitamin D deficiency reminds me of theater, a tragedy. Dr. Mark Findlay and colleagues of the Dumfries and Galloway Royal Infirmary surveyed Scottish doctors to ask what they were doing, asking what they did after they tested their patients’ vitamin D blood levels and found they were low.

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3 Responses to Weeping for Scotland

  1. hlahore@gmail.com

    Blog post on the same article was titled
    Scottish doctors ignoring vitamin D? http://www.vitamindwiki.com/tiki-view_blog_post.php?postId=65
    summary:
    282 people had vitamin D test results less than 10 nanograms
    Only 61% were getting any vitamin D replacement therapy after 3-15 months
    Mean dose was an inadequate 800 IU of vitamin D
    Maximum dose with 2000 IU
    Only 1.4 % got a loading dose of vitamin D

  2. helga.rhein@blueyonder.co.uk

    Dear John,
    I am a general practitioner (GP) in Scotland. And i am prescribing daily preventative vitamin D and high doses most certainly to those who are deficient.
    But, in defense of my fellow GPs, we here in Scotland have a bit of an uphill struggle:
    1. UK guideline STILL say 25 nmol/l (=10 ng/ml) is sufficient.
    2. There are no UK licensed preparations which we could easily prescribe, unless low dosed together with calcium. And many of them are D2. Our prescribing advisers strongly advise us NOT to prescribe the UK-unlicensed preparations and tell us if we do we, the individual GP, would be personally liable in cases of mishaps. So, most GPs are put prescribing this. I am an exception, since they recognized me as a ‘specialist’.
    3. Testing for 25(OH)D is restricted – because GPs did understand the significance and country-wide requests for testing have hugely increased. This is a funding issue.

    So, it is a bit like a conspiracy. And I’m sure big pharma loves it. Lots of diseases in Scotland, as Oliver says. But we are ‘working’ at it.
    And, just in case of doubt, I am still a strong defender of the NHS, which I hope we can keep in Scotland, unfortunately England just moves towards breaking it up.
    best wishes – Helga

  3. Brant Cebulla

    Helga, thanks for your insight. How does this approach in the UK compare to other European countries? In what kind of doses do “unlicensed preparations” come in?

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