I'm looking at the systematic review by Autier from Lancet Diabetes and Endocrinology. It finds basically zero effect of vitamin D supplementation for any health outcome. Except overall mortality. Vitamin D supplementations trials have consistently shown a reduction in death rate by about 7 percent. Autier believes this is mostly due to supplementation in elderly people who are debilitiated.
I've got to say, in clinical practice, what I see largely mirrors what Autier has found, in terms of vitamin D's effects on diseases. There are no real miracles here - except in the cases where the vitamin D level is profound, and supplementing it helps musculoskeletal weakness and pain. For example, there's the 2000 case series by Dandona's folks, reporting people who got up out of wheelchairs after being given vitamin D supplementation. Only a case series, but a compelling story.
But the real news is the decrease in mortality. This showed up in a meta-analysis I read years ago, and it struck me that if this was an outcome for a patentable drug, this news would be widely marketed and every elderly American would be on this drug. The news take on this story is that "vitamin D supplementation is irrational," but I think it should be, "vitamin D supplementation reduces mortality by a mechanism we don't understand."
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