I do think it would have been helpful if you had addressed the fact that the current NHS guidance, (www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/), is for everyone in the UK to consider taking a small vitamin D supplement during winter months, and what is the likely reason for that discrepancy with your conclusions in the show (to not bother with vitamin D as a supplement). For example, whether it is related to the fact that the UK is at a higher latitude than the USA (excluding Alaska, and so the studies on the population of the USA might not be relevant to the UK) or if the guidance is likely to be based on faulty expectations of what would be a "good" level of vitamin D (for bone, teeth and muscle health). The page review history of the NHS site indicates that the guidance was last updated in August 2020, so it predates the interventions of Rupa Huq and David Davis arguing for supplements of vitamin D to be provided by the NHS.
Yes, I’ve been following that NHS guidance (just for the bone benefits) but it looks like even those benefits are pretty marginal in someone who eats well and spends time outdoors. Probably won’t bother with supplements next winter… spend the money on some posh tinned fish instead 🙂
A propos of Tom's review of Johann Hari's book on Semaglutide, I started reading Hari's article in the Times magazine about this, when I came across the bit where he is shocked to discover that the drug has an effect on the brain. Er, how else did he think an appetite suppressant was going to make you want to eat less? At that point I gave up. I see from Tom's review of the book that he is similarly confused about genes.
I too am struggling to understand why I had to prescribe Ca and Vit D for post menopausal women with osteoporosis or osteopenia. Any evidence there please guys?
A lot of my GP colleagues use vitamin d testing to help manage the frequent consultations around vague nonspecific symptoms in otherwise healthy people, particularly "tired all the time". Likewise B12.
Both have poorly delineated normal ranges and supplements are very safe.
Do lots of blood tests, find a slightly "low" result and hey presto - diagnosis, treatment, and goodbye. Next!
Enjoyed listening to this. It’s bothered me for years that when I get the test results from my annual blood tests that they show the “normal” range to be 30-100 ng/mL. Means that lots of people unnecessarily think they are low.
Just last week I found another blood test where the range given for normal doesn’t coincide with the science and it’s got me wondering how many others are out there. My anion gap was labeled low at 7 mmol/L but when I googled it seems the normal range is 4-12, so I’m clearly not low. Unless of course I’m not following this correctly? I did find some conflicting info but it seems the normal range changed in the 80’s: “Until the 1980s, the reference range for the anion gap was between 8 and 16 mEq/L. When new serum electrolyte assays were introduced, the reference range was revised to between 3 and 9 mEq/L.3 A low anion gap is defined as less than or equal to 3 mEq/L.4” https://www.ccjm.org/content/90/10/619
Are there other examples where labs are using outdated normal ranges?
I do think it would have been helpful if you had addressed the fact that the current NHS guidance, (www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/), is for everyone in the UK to consider taking a small vitamin D supplement during winter months, and what is the likely reason for that discrepancy with your conclusions in the show (to not bother with vitamin D as a supplement). For example, whether it is related to the fact that the UK is at a higher latitude than the USA (excluding Alaska, and so the studies on the population of the USA might not be relevant to the UK) or if the guidance is likely to be based on faulty expectations of what would be a "good" level of vitamin D (for bone, teeth and muscle health). The page review history of the NHS site indicates that the guidance was last updated in August 2020, so it predates the interventions of Rupa Huq and David Davis arguing for supplements of vitamin D to be provided by the NHS.
Yes, I’ve been following that NHS guidance (just for the bone benefits) but it looks like even those benefits are pretty marginal in someone who eats well and spends time outdoors. Probably won’t bother with supplements next winter… spend the money on some posh tinned fish instead 🙂
A propos of Tom's review of Johann Hari's book on Semaglutide, I started reading Hari's article in the Times magazine about this, when I came across the bit where he is shocked to discover that the drug has an effect on the brain. Er, how else did he think an appetite suppressant was going to make you want to eat less? At that point I gave up. I see from Tom's review of the book that he is similarly confused about genes.
I too am struggling to understand why I had to prescribe Ca and Vit D for post menopausal women with osteoporosis or osteopenia. Any evidence there please guys?
In bone health - I forgot to add
Is there any evidence, or lack of, that is specific to post menopausal women?
A lot of my GP colleagues use vitamin d testing to help manage the frequent consultations around vague nonspecific symptoms in otherwise healthy people, particularly "tired all the time". Likewise B12.
Both have poorly delineated normal ranges and supplements are very safe.
Do lots of blood tests, find a slightly "low" result and hey presto - diagnosis, treatment, and goodbye. Next!
When I was a medical student hypervitaminosis D was a thing.
Enjoyed listening to this. It’s bothered me for years that when I get the test results from my annual blood tests that they show the “normal” range to be 30-100 ng/mL. Means that lots of people unnecessarily think they are low.
Just last week I found another blood test where the range given for normal doesn’t coincide with the science and it’s got me wondering how many others are out there. My anion gap was labeled low at 7 mmol/L but when I googled it seems the normal range is 4-12, so I’m clearly not low. Unless of course I’m not following this correctly? I did find some conflicting info but it seems the normal range changed in the 80’s: “Until the 1980s, the reference range for the anion gap was between 8 and 16 mEq/L. When new serum electrolyte assays were introduced, the reference range was revised to between 3 and 9 mEq/L.3 A low anion gap is defined as less than or equal to 3 mEq/L.4” https://www.ccjm.org/content/90/10/619
Are there other examples where labs are using outdated normal ranges?