Regular use of Vitamin D supplement is associated with fewer melanoma cases
pubmed.ncbi.nlm.nih.gov
pubmed.ncbi.nlm.nih.gov
2009: > Epidemiological data show an inverse relationship between vitamin D levels and breast cancer incidence. In addition, there is a well-documented association between vitamin D intake and the risk of breast cancer. Low vitamin D intake has also been indicated in colorectal carcinogenesis. A vitamin D deficiency has also been documented in patients with prostate cancer, ovarian cancer, as well as multiple myeloma. Larger randomized clinical trials should be undertaken in humans to establish the role of vitamin D supplementation in the prevention of these cancers.
Quite the odd take given the last sentence in the abstract of this paper is essentially "correlation is not causation":
> In conclusion, regular use of vitamin D associates with fewer melanoma cases, when compared to non-use, but the causality between them is obscure.
It's easy for me to imagine tons of confounding factors that are associated with vitamin supplementation, e.g. wealth (wealth is associated with better health outcomes nearly everywhere you look), diet in general, exercise levels, etc. I highly doubt they accounted for all of these.
There are also people, like me, who no matter what, we can't make as much vitamin D for whatever cluster of genetic factors causes that. Some of us are always tired unless we take 50,000 IU of D3 a week.
https://www.ncbi.nlm.nih.gov/pubmed/19667143
Must be much higher in sunnier regions.
In general, if you can think of an obvious confounding factor in about five seconds, then it’s a safe assumption that professional researchers thought of it too.
Research should be able to stand up to scrutiny. The scientific process depends on it.
Given the ongoing reproducibility crisis and plethora of garbage research coming out of academia, I’m not assuming anything about any research I see.
I work in academic medicine. I read a lot of papers. This is not at all a given in my experience, except maybe in the tippy top journals (Nature, NEJM). When in doubt, read the paper, see if they mention the confounder you thought of.
It's a safe assumption that they though of it
BUT
Testing for it and getting useful data of something like a survey is a different story.
For example for a thing like that a survey could do more harm than good if the principles aren't really strict.
It wouldn't surprise me that some researchers could have just ignored not measurable data like that for the analysis. (staring if ofc)
Recent letter to the editor in NEJM about that paper that showed 90% drop in Covid-related mortality after the first booster:
https://www.nejm.org/doi/full/10.1056/NEJMc2306683
It turns out that there was also a similar non-disclosed drop in non-Covid-related mortality. Either we discovered a magic elixir, or the entire effect is probably just confounding.
The original authors even say in their response that
> However, boosters were generally not administered to hospitalized patients who were at high risk for death from any cause.
They never even attempted to control for it.
Edit: at least NEJM accepts letters to the editor about the crap it publishes.
And indeed, it seems they did survey for sun exposure and include it in their analysis, and they caveat a lot of their references to other work in their introduction noting where other studies didn't.
https://www.naturalhealthresearch.org/wp-content/uploads/202...
This would immediately kill about half of the comments on any research article posted to HN.
The issue with this is that the amount of vitamin D someone might take is correlated with how much sun exposure is available. And the amount of available sun exposure can impact what is considered a little / a lot to each person.
> The issue with this is that the amount of vitamin D someone might take is correlated with how much sun exposure is available. And the amount of available sun exposure can impact what is considered a little / a lot to each person.
That could be case but not necessarily in this study.
A loved one is fighting this right now - if something simple like supplements, dietary practices or drug development could reduce the risk, it could potentially prevent alot of suffering. Even if it doesn’t work, perhaps it’s a line of inquiry with some value.
Not even trying to consider the confounding variables is really sad.
Honestly I’m don’t feel qualified to evaluate the study.
It attracted my attention because the risk factors for melanoma are different than other skin cancers. A smaller number of severe sunburn incidents is correlated with melanoma while ongoing exposure to more moderate sunlight drives other cancers. We already know that the palest skin types (ie your redhead relatives, etc) are at higher risk than even slighter less pale people.
I hope there’s more research and we learn more about ways to help bend the risk curve.
Tweedledum: Low Vitamin D weakens your immune system. Having a weakened immune system increases your odds of skin cancer.
> The exposure of skin to UV radiation was clarified with different questions. The self-estimated lifetime exposure was studied with the following question ‘How often have you exposed yourself to sunlight during your lifetime?’ The answer options were (1) ‘seldom’, (2) ‘occasionally’, (3) ‘often’, or (4) ‘very often’. The sunburn history was studied with the following question: how often has your skin been burned due to sunlight during your lifetime? The answer options were (1) ‘seldom’, (2) ‘occasionally’, or (3) ‘often’. The answer options for the question of ‘Main environment in working history’ were (1) ‘outdoor’, (2) ‘indoor’, or (2) ‘variably both’.
They saw approximately the same distribution of sun exposure across the different test groups, it looks like.
It really makes you wonder about essential vitamins though. There's so many of these types of studies that continue to show benefits of getting the right amount of vitamin D, but there's equally enough noise to tell you that you don't need it.
But for countries like America, experts continue to weigh in that we don't get enough essential vitamins and minerals through our diets, so wouldn't it just be common sense that many people are deficient and therefore should supplement?
Wasn't this the entire controversy of Pauling for example when he pushed Vitamin C? That the RDA amounts are not enough and should be highly personalized?
https://www.ncbi.nlm.nih.gov/books/NBK56068/table/summarytab... (Recommendations)
https://www.nature.com/articles/s41430-020-0558-y (Deficiency Worldwide)
And yet many people think we can improve on nature; tinkering and toying with vastly more complex machinery and life, that we barely understand.
We are still discovering entire structures in the human body, ffs, yet are seemingly happy to allow vast monocultures of corporate and for-profit GM crops; 'trusting the science'.
The lies are as thin as our topsoil's gonna be soon. I love the idea of scientific progress, and understanding things, but this attitute of 'trust the men in white coats with everything even though we don't understand Vitamin C or D all that well' is truly mind-boggling.
*: I assume the people down-voting this think I'm talking smack on science - read again. I'm talking about scientism, and hubris, and appeals to authority. Which if you were paying any attention whatsoever the last 3 years you ought to know are big problems right now.
Most complex systems have simple limiters, almost by definition of the latter. You don’t need to solve fluid dynamics and combustion physics to understand that more air through a carburettor causes an internal combustion engine to run faster.
We have broad strokes - take C for a cold. Take D in winter. But there are trained scientists who disagree with even these statements! We have people making a mockery of Nobel Prize winners over it! Where have you ever seen such debate about combustion engines.
Sure. But we know they are important. Despite being “single molecules.”
> We have broad strokes - take C for a cold. Take D in winter. But there are trained scientists who disagree with even these statements!
Because they appear unsubstantiated. You’re describing treatments. That’s a different ball game.
> We have people making a mockery of Nobel Prize winners over it
Pauling did not win his Nobel for vitamin C.
The point is that there's huge debate on how they work, why they work, whether they work for this and that, etc, despite them being about as tiny and simple in form as you could ask for.
And as far as I know no one has ever claimed that Vitamin C and D are not single molecules, so I've no idea why you put that in quotes. It's relevant that they're not, for example, the mixture of hundreds or even thousands of synergistic and antagonistic compounds, in various quantities, found in every single plant.
> Because they appear unsubstantiated. You’re describing treatments. That’s a different ball game.
Taking C for a cold, or D in winter, is NOT unsubstantiated - there are studies that show effect, and studies that show no effect. It's debated. That's exactly my point, that even these simple and tiny molecules inspire massive confusion and debate. It's in no way like an engine. The body and how it processes things like vitamins is so, so much more complex.
You can say this same thing about thousands of molecules and simple substances, which the scientismic community stands behind despite huge debate - SSRIs, anti-psychotics, glyphosate, etc. We don't understand them, and vested interests in white coats want us to believe otherwise. Remember tobacco being promoted by doctors? It wasn't that long ago.
The point, again, is this: that if we can have so much uncertainty about such tiny and simple things, why would we believe it's safe to muck about with our food supply (GMO monocultures), or to declare glyphosate safe and cover the planet with it, or claim that mRNA vaccines are utterly harmless (despite immediate evidence to the contrary, as now proven beyond doubt). Remember CFCs, PFAS, thalidomide?
These things are fundamentally different from your example of a simple combustion engine. They're complex on a level far beyond our current ability to comprehend. Even if we think we know what's going on, we really, really don't. We have hints, we have hunches, we have incomplete models with giant and dangerous holes in.
> experts continue to weigh in that we don't get enough essential vitamins and minerals through our diets
First, would be better to list some specifics rather than "experts say". But even if so, saying that people don't get enough of some micronutrient X from food, it doesn't necessarily follow that supplementation with pills will lead to better health (except in some specific and extreme circumstances that rarely affect people these days, e.g. scurvy).
Second, this was not the entire controversy around Pauling's vitamin C fantasy. His recommended doses were orders of magnitude larger than recommended amounts - it wasn't just about being "more personalized". Nevermind that Pauling's vitamin C theories have been thoroughly disproven.
2. Maybe consider looking at modern research. https://www.cancer.gov/research/key-initiatives/ras/ras-cent...
> Nevermind that Pauling's vitamin C theories have been thoroughly disproven.
Nothing in science is proven. Only re-evaluated.
That is, taken intravenously, Vitamin C generates free radicals like hydrogen peroxide that are particularly dangerous to cancer cells. This is the exact opposite of oral administration of Vitamin V where it acts as an antioxidant.
Anyway, the article I linked summarizes it fine too:
> So why did the Pauling and Mayo Clinic trials have different results? There are at least two crucial differences. First, the Mayo Clinic trials abruptly stopped the ascorbate administration, switching to traditional chemotherapy, when the patient developed signs of tumor progression. Thus, the overall median time of vitamin C treatment under the Mayo Clinic trials was only 2.5 months, while the Pauling and Cameron trials treated patients for the duration of the entire study period or as long as 12 years. Secondly, the Mayo Clinic trials administered 10 g of daily ascorbate to patients only orally, while the Cameron and Pauling trials administered their vitamin C both orally and intravenously. This difference in the two dosage routes proved highly consequential.
That's the thing with a lot of vitamin d and c associations anyway.
Nothing better than getting some real sun though, especially in the morning.
Its metabolite is a steroidal hormone, so it's pretty obvious why it would be beneficial for anti-inflammatory purposes, but it also modulates some key cardiovascular gene expression, too.
You're mixing two pieces of advice:
1) everyone 'should consider' taking 400IU daily over winter (under-4s year-round);
2) infants should not take more than 1,000IU daily (adults: 4,000IU)
https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-...
Of course, 4,000 daily is still only 28,000 weekly, not 50k, but GP is doing it on the basis of blood work & physician review; the NHS website certainly isn't intended to contradict that, it's generic advice in lieu of it.
Daily Recommend Values for basic nutrients aren't the same as medicinal dosages. Nobody ever gets Daily Recommended Values for all the essential nutrients anyways, and many of them are regularly exceeded by a single multivitamin or dish. They're also somewhat arbitrarily defined. Like the food pyramid, you should take them with a grain of salt.
I mean, yeah, sure, don't chug bottles of the stuff without measuring for years on end, but you have to take a lot to hit toxicity levels. And periodic bloodwork to keep an eye on numerous metrics is a generally good idea anyhow.
Not really. If your blood work shows shows you're low, you'll get a prescription for a very high dose. 100x is normal for some vitamins
Anyway, yes the full spectrum of the sun provides much more, not only UV for vitamin D but the red/infrared part of the spectrum which is great for cellular energy.
BTW, did they tell you to back off or cut your dose? at 59 ng/mL you're in the danger zone.
* Levels of 50 nmol/L (20 ng/mL) or above are adequate for most people for bone and overall health.
* Levels below 30 nmol/L (12 ng/mL) are too low and might weaken your bones and affect your health.
* Levels above 125 nmol/L (50 ng/mL) are too high and might cause health problems.
Although there is a weird confusion of units. The results I'm looking at right now use ng/mL, but lists the numbers for nmol/L. The report includes a graph like:
30 ng/mL --- 59.1 ng/mL (in range) --- 100 ng/mL
Most men never use sunscreen, including those who spend a great deal of time outdoors. I seriously doubt that cohort takes vitamin D.
In Scotland we get insufficient sunshine to produce natural vitamin D for around 6 months of the year, and there's discussion about whether everyone should be supplementing to the point it's been mooted as an addition to the water supply.
That's relevant because nobody uses sun screen during those months. I wouldn't expect any kind of correlation through sheer lack of use.
It would seem to me that those who self medicate with vitamin D are those who know they do not get sufficient sun exposure, and would necessarily also be those at reduced risk of melanoma.
Mushrooms are very good for many other reasons and should be a staple in most weekly diets.
If such an authoritative source claims pseudo science and danger, your annecdote could very well be true.
I think any doctor would tell you to take supplements if your lab tests showed that you're low. There's nothing controversial in that advice.
> In one case of a child who had suffered broken bones in which Holick defended the accused parent, the child later went on to suffer severe brain injury, for which the parent has been indicted.
as well as this interesting theory:
> Holick has speculated that the dinosaurs may have died of rickets and osteomalacia caused by a lack of vitamin D in reduced sunlight
https://en.wikipedia.org/wiki/Michael_F._Holick
and the only repercussion he has faced was the place he works not allowing him to treat children anymore.
If he hasn't had his medical license revoked I doubt any doctor simply recommending vitamin d would have theirs revoked.
There is basically no legitimate insight on things in medicine that kind of work (you need very stringent measures for lack of bias, huge varied cohorts, lots of studies, major controls, etc.) so, to this day, most studies on supplements/vitamins are low quality and highly inconclusive.
Things that have a huge effect are much easier to study, but that type of fruit is mostly picked by pharmaceutical companies and patented.
After years, many, many, many studies, billions of dollars, huge cohorts, lots of analysis, the medical industry can say that vitamin d supplements maybe possibly are helpful for some things but could also be harmful, but probably aren't, but also probably don't help unless you're very deficient.
https://www.mayoclinic.org/drugs-supplements-vitamin-d/art-2...
When you start talking about other supplements, you go into crazy-world.
It's not even clear that most pharmaceuticals do anything unless the effect size is very significant.