Susan McFie was told by GPs that it was too expensive to test blood for vitamin D levels. Yet current health policy aims to increase spending on preventing illness, and vitamin D deficiency has been associated with almost all our modern ills. So why are GPs being told to cut back on testing?

SOMETHING FISHY
Vitamin D has long been known for its role in bone development. Deficiency resulted in the bowed legs and malformed skeletons associated with rickets. Children of the post-war baby boom may remember being given a daily spoonful of smelly fish oil followed by orange syrup to take the taste away. This supplied vitamins D, A and C in natural form and supported bone growth and immunity. This preventive care disappeared long ago, as did universal free school milk. 

Over the last decade or so, increasing numbers of people in the UK and around the world have been getting diagnoses of vitamin D deficiency. Childhood rickets has made a major comeback. In adults, D deficiency can lead to bone conditions osteomalacia and osteoporosis. 

WHEN IS A VITAMIN NOT A VITAMIN?
The discovery that almost every cell in the body has receptors for this vitamin has led to extensive research, revealing that vitamin D is not a vitamin but a hormone precursor. We can absorb a certain amount by eating oily fish, liver and eggs but our main intake is from sun exposure. Just as plants interact with the sun to produce the vital green stuff called chlorophyll, humans need sunlight in order to produce vitamin D. 

D not only regulates calcium levels but is also a natural anti-inflammatory agent and controls cell proliferation and the spread of many cancers. It has been trialled in the treatment of MS, lupus, asthma, arthritis, depression and sepsis. It is involved in everything from cartilage repair to immune regulation. Indeed, D deficiency is now associated with most modern health problems and, worryingly, most people now lack adequate levels.

SUNSHINE SUPER VIT
So why are most humans now deficient in something as vital to us as chlorophyll is to plants? The main reason given for the phenomenon is lack of sun exposure and use of sunscreens – and kids playing video games rather than climbing trees. It would presumably follow that people with regular sun exposure have higher levels of vitamin D. But, intriguingly, studies show this isn’t necessarily the case.

It seems that vitamin D deficiency is equally prevalent in hot countries. In Iran, we’re told its because women’s bodies are extensively covered. But the problem is not just amongst women and it’s not just in Iran. D deficiency is being reported in India, China, Turkey and Saudi Arabia. In Australia, the deficiency has been recorded in 50% of women and 31% of men.  A study of young people in Honolulu with ‘habitually high sun exposure’ found that more than 50% of the group had low vitamin D status. The researchers concluded that we “should not assume that individuals with abundant sun exposure have adequate vitamin D status.” So what’s going on?

SPANNER IN THE WORKS? 
Is something disrupting our ability to make or process the D-substance? We know that pharmaceutical drugs can cause deficiencies of both vitamins and minerals. Drugs known to interfere with vitamin D metabolism include steroids, anti-seizure meds and anti-oestrogens. Statin drugs reduce cholesterol, the substance from which vitamin D and other hormones are made. Severe muscle pain is a side effect of both statins and D deficiency. 

And it’s not just drugs. The chemical glyphosate in the weed-killer Roundup has been shown to damage gut bacteria and hoover up important minerals. Numerous independent studies have also implicated glyphosate as a hormone disruptor, interfering with thyroid function and the production of oestrogen, progesterone, testosterone and vitamin D. Due to prolific use on our food crops the chemical is now turning up in everything from bread and beer to ice cream and disposable nappies. Levels in human blood have risen by over 1,000% in the last two decades. 

DEADLY D-WEAPONS
The immune system uses vitamin D to make defence weapons that pierce holes in undesirable viruses and bacteria. London’s Queen Mary University led an international study of vitamin D and respiratory infection. In people with very low levels, D supplements were 10 times more effective than flu vaccines. Professor Adrian Martineau commented: “Assuming a UK population of 65 million, and that 70% have at least one acute respiratory infection each year, then daily or weekly vitamin D supplements will mean 3.25 million fewer people would get at least one acute respiratory infection a year.”

Some may be tempted to dash to the nearest health food store to stock up on supplements. The more cautious may ask their GPs to do a blood test. Testing for D deficiency has been common practice over the last decade, but recent guidelines discourage doctors from requesting tests. The reason given is the cost involved. Confusingly, UK guidelines recommend treatment of patients with blood levels less than 50 nmol/L. So how is the doctor supposed to know?

PREVENTION, BETTER THAN CURE 
In 2017, the House of Lords told the government to refocus the NHS towards preventive care. The ‘Prevention is Better than Cure’ plan was launched in November 2018. Only 5% of the NHS budget is spent in preventive measures. Matt Hancock, Secretary for Health says this approach “doesn’t stack up”. So what exactly do they have in mind? 

There’s ‘talk’ of action on air pollution and even ‘prescription golf’ along with limiting alcohol and eating your ‘five a day’. GP health checks were mentioned. These screenings often result in costly drug prescriptions. Screening for vitamin deficiencies and prescribing supplements would seem to be a ‘no-brainer’ in terms of disease prevention and cost effectiveness, and yet it is now being side-lined as ‘too expensive’. In fact, finger prick vitamin D tests evaluated in NHS certified labs are available for just over £20.00.

Vitamin D deficiency is linked not just to bone disease, colds and flu, but also to asthma, thyroid problems, depression, arthritis, fibromyalgia, diabetes, dementia, liver disease, multiple sclerosis, Alzheimer’s and cancer. Considering the huge cost of treating all these conditions, wouldn’t it make sense to address nutrient deficiencies as part of a cost-effective and sustainable strategy? Perhaps a good starting point would be to better educate doctors in nutritional medicine. 

Dr Rupy Aujlia writing in the Telegraph revealed that his 5-year medical training included just ten hours study of nutrition. He has been contacted by ‘hundreds of medical students’ concerned that they are not being educated in nutrition and fearing their patients will suffer as a consequence.

Consult a practitioner for nutritional advice.


• UK guidelines recommend 400 IU of D3 a day for most adults and children, with a maximum adult dose of 4000 IU. But consensus is lacking. The US Vitamin D Council recommends 5000 IU of D3 daily. The US Endocrine Society states that 10,000 IU of vitamin D3 daily is safe for most adults. 

• High doses of D may require supplementation of co-factors vitamin K and magnesium (needed to activate D). The benefits of vitamin D supplements may not be achieved in people with magnesium deficiency. 


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