HealthTalk
Doctor ’ s notes
Dr Rik Heymans is a general practitioner in Nerja and writes on developments in the world of medicine
Superstition testing
Self-experimentation is a long and continuing tradition in medicine . Determined to test the superstition that saying the word “ quiet ” increases a clinician ’ s workload on their shift , a medical microbiology team in the United Kingdom ran a randomized controlled trial on themselves . Each morning for two months , team members opened an opaque envelope and followed the instructions inside . The instructions were either to say the phrase , “ Today will be a quiet day ” or to refrain from saying the word “ quiet ” in any context . The researchers analyzed their clinical workload during the study period and reported the results . They found no effect . Same goes for any predictions for - especially - the weather ( a main topic in social activities ).
Vitamin D
There appears to be a growing discrepancy between the observational studies on the benefits of having sufficient levels of vitamin D , and the randomised clinical trials of vitamin D intake . For example , the observational studies are showing a fairly consistent relationship between low blood levels of vitamin D and an increased risk for heart disease , cancer , diabetes , and many other chronic diseases .
Yet , the randomised clinical trials of vitamin D supplementation to date have been generally disappointing . This includes several randomised trials published over the past few months , including a large analysis of randomised trials of vitamin D supplementation showing minimal , if any , benefit on lowering blood pressure ; a trial of high-dose vitamin D supplementation showing no clear benefit for muscle strength , bone mineral density , or even the risk for falls ; and , most recently , a randomised trial of vitamin D supplementation with and without calcium showing no clear benefit in reducing the risk for colorectal adenomas .
Vitamin D is one of these vitamins which is stored in the body , and accumulates there - unlike Vitamin C or B , where any excess ingested is easily washed out ; so when taking in too high doses Vitamin D will have toxic effects .
The Institute of Medicine ( IOM ) and the US Preventive Services Task Force do not endorse routine universal screening for vitamin D deficiency . They also recommend more moderate intakes of vitamin D . For example , the IOM recommends 600-800 IU a day for adults and also recommends avoiding daily intakes above 4000 IU , which has been set as the tolerable upper intake level .
However , some patients may have higher vitamin D requirements . This may include patients with bone health problems ( osteoporosis , osteomalacia ) or poor diets ; those who spend minimal time outdoors ; those with malabsorption syndromes ; or those who take medications that may interfere with vitamin D metabolism ( long-term cortisone , anticonvulsant medications , and antituberculosis drugs ). All in all , here in sunny Spain there would be little need for additional Vitamin D supplements , since one tends to live a more outdoors life , walking about , or enjoying the sun on a terrace !
© Dr RIK HEYMANS c / Angustias 24 , Nerja .
Tel : 95 252 6775
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