Why are doctors reluctant to accept vitamin D

  1. Myth: Excess vitamin D will turn the human body into marble
    Until recently medical students were told that > 2,000 IU of vitamin D could cause Calcium problems
    It is difficult to unlearn something. It is typically much easier to learn something totally new
    See Myth for 50 years: 2000 IU of vitamin D is toxic – still taught as fact in 2010

  2. Would require reversal of position on supplements.
    Medical societies first supported, then reversed themselves on the need for supplements
    Doctors got burned by first telling patients to take supplement X then later having the patients stop taking supplement X
    Doctors are reluctant to endure yet another supplement reversal
  3. Risk being sued if exceed guidelines
    Increase risk of being sued for Malpractice if exceed current medical guidelines
    Example: prescribe 6,000 IU of vitamin D during pregnancy instead of the 400 IU in most guidelines
  4. Experts do not (yet) agree
    There is a worldwide agreement that 400 IU of vitamin D is needed to prevent Rickets, but little else is agreed upon
    (Raised to 600 IU in the US in 2010, most countries are still at 400 IU, and some are still at 200 IU)
    Some improvement: 4,000 IU of Vitamin D is OK – 19 organizations agree – 2018
  5. Doctors were rarely been trained in nutrition
    When I went to medical school, nutrition was not really on the radar,
    and taking vitamins was even trivialized by some as a great way to “make expensive urine.”
    Vitamin D is arguably the most complex supplement – the amount needed varies with:
    Weight, Skin color, Latitude, Season, Co-factors, Current meal, Recent surgery/trauma, Neighborhood, etc.
    see also Why isn’t nutrition a bigger part of conventional medical school education? Question at Research Gate 2013 with > 400 responses
  6. Medical training has an emphasis on treatment, not prevention
    Medical training and practice emphasizes treatment, not prevention.
    The primary benefits of vitamin D are prevention. (but Vitamin D does treat some diseases) but typically need > 5,000 IU
    They have learned that most patients are either reluctant to change so as to prevent a future problem (lose weight, stop smoking, . . )
    or will often not continue with the change. So why should the doctor try?
  7. Doctors often can only prescribe D2 anyway (true in US before March, 2012)
    Some doctors are aware that D2 does not help nearly as much as D3
    And in some cases Vitamin D2 actually makes things worse
  8. Doctors have too little time to read outside of their specialty
  9. Seems like too much of a “wonder drug”
    ‘Nothing can be that great’
  10. Fear possible loss of income
    If Vitamin D is truly a ‘wonder drug’, it would reduce the number of patient visits, and therefore reduce income.
    Note: in 2012 one doctor reduced patient visits from 4 per year to 1 per year by getting all 2,000+ patients to have >80 ng     Net result of vitamin D: Lost too much business and retired early.