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Reduced cancer mortality with daily Vitamin D intake

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Re: Reduced cancer mortality with daily Vitamin D intake

#211

Post by BeetleB »

9935c101ab17a66 wrote: post #203
agumonkey wrote: post #162

Earlier quoted context omitted.

This is the issue raised by comments like the one above. We understand that evidence based medicine handles statistical averages very well. But if you fall out of that, all you're left with is snake oil salesmen. There's a need for an intermediate layer of evidence yet "taylored" (and not kidney-costing if possible).

Ya, but I think most good doctors operate with a balance of probabilities framework. Yah, there may not be conclusive evidence showing it’s widely effective, but based on this case, it’s obvious the person isn’t getting enough sunlight, and they communicated that to the doctor, and so why not do a trial of something like vitamin d? It’s widely studied, has very few serious downsides, and is cheap.

> but based on this case, it’s obvious the person isn’t getting enough sunlight, and they communicated that to the doctor, and so why not do a trial of something like vitamin d?

Can we get to the specifics? How would you propose the doctor do it? Let's say the doctor prescribes a certain dosage per day. How will the doctor know it is helping this particular patient? How long should the trial continue before he sees results?

Most studies showing Vitamin D benefits are very long term (unless it is bone related).

Re: Reduced cancer mortality with daily Vitamin D intake

#212

Post by nradov »

MVissers wrote: post #201
nradov wrote: post #198

Earlier quoted context omitted.

Western medicine is one of the primary drivers of global life expectancy increases only though vaccines, antibiotics, and trauma care. Other than that it has had very little effect: we could eliminate all other forms of medical care and average life expectancy would decrease only marginally. Public sanitation and food safety enforcement have had much larger effects. Where western medicine has had larger effects is in…

Really curious about your sources, because it doesn’t vibe with me at all (trained MD). Statins have a phenomenal improvement in outcome on cardiovascular disease. So do many cancer drugs nowadays. Diabetes also has great improvement with good treatment. Removing these would reduce life expectancy drastically.

Fair enough. It's true that modern drugs are fairly effective at extending the lives of patients with certain serious chronic conditions by a few years. But at the same time, ASCVD and T2D were much less serious problems prior to the establishment of modern medicine. So to a large extent we are just patching over problems that we have created for ourselves rather than fixing the root causes.

https://www.thelancet.com/gbd

Re: Reduced cancer mortality with daily Vitamin D intake

#213

Post by KiwiJohnno »

nicenewtemp84 wrote: post #182
pvaldes wrote: post #164

Earlier quoted context omitted.

Shoulder surgery should not be delayed. The probable retraction of some damaged parts is not a joke. Your friend could have been the lucky one in the pool, but there is also a possibility that in a few years the problem will grow and the surgery required will be much heavier and expensive. > and without surgery are back competing on the bike. My bet is that they are on painkillers for life

Are you saying that the doctor, upon closer questioning simply flopped and gave bad medical advice to my friend when they told him that yes it's reasonable to expect to regain full shoulder straight again without surgery? Because if so maybe my friend should sue? What is this blanket statement of "shoulder surgery should not be delayed" based on?

Where I grew up, with a comprehensive taxpayer funded healthcare system that works I believe standard is you are given the option of surgery after dislocating your shoulder 3 times.

The thinking is a lot of people dislocate their shoulder, it pops back in with or without help and heals with no long-term damage. For a lot of patients it never happens again and surgery is not needed.

However, each time you dislocate your shoulder it gets easier to dislocate and is more likely to do doing damage that won't heal. So, don't go in for shoulder surgery until you are showing a pattern of dislocating it or have other lasting damage that requires repair.

Re: Reduced cancer mortality with daily Vitamin D intake

#214

Post by rendaw »

lynx23 wrote: post #97
BeetleB wrote: post #94

Earlier quoted context omitted.

> Why I type this here? I found it interesting that I had to discover this cure on my own. The medical system wuldn't have figured that out on their own, let alone accept that it was the single solution. It's because studies showing correlation between Vitamin D level and winter depression/SAD are mixed. I'm not saying it's a placebo. If it works for some people - great! But you can't expect doctors to recommend it w…

I am a high risk cancer patient who is blind, i.e. doesn't necessarily get a lot of sun exposure due to disability + occupation. Given the discussion in this thread regarding correlation with lattitude and cancer risk, me being around 47 deg, and my personal history, I would have expected a caring medical system to suggest vitamin D to me roughly 30 years ago already. But alas, it turns out you have to do your own st…

GP wasn't defending the system, just this specific decision. I'm no fan of the medical system myself, but this is an unfair take. There are plenty of examples of the medical system doing the wrong thing... no need to twist other examples to fit.

TBF though this could have been avoided if the doctor explained that studies were mixed (and even gave you a few studies as examples), and I'm not sure I believe the doctor actually knew studies were mixed.

Re: Reduced cancer mortality with daily Vitamin D intake

#215

Post by m463 »

BeetleB wrote: post #94
lynx23 wrote: post #85

It took me a long time, and virtually no help from outside, to discover that vitamin D effectively cures my winter depression. I was never really feeling good around that time of the year, but it wasn't problematic enough to actually do something about it. But when my gut started to revolt around that time too, I started to feel distinctly unwell. So I went to my doctor, who gave me an approintment with a nutrition s…

> Why I type this here? I found it interesting that I had to discover this cure on my own. The medical system wuldn't have figured that out on their own, let alone accept that it was the single solution. It's because studies showing correlation between Vitamin D level and winter depression/SAD are mixed. I'm not saying it's a placebo. If it works for some people - great! But you can't expect doctors to recommend it w…

studies also say correlation between vitamin d and nearsightedness are mixed, but I still wonder...

Re: Reduced cancer mortality with daily Vitamin D intake

#216

Post by chii »

BeetleB wrote: post #211
9935c101ab17a66 wrote: post #203

Earlier quoted context omitted.

Ya, but I think most good doctors operate with a balance of probabilities framework. Yah, there may not be conclusive evidence showing it’s widely effective, but based on this case, it’s obvious the person isn’t getting enough sunlight, and they communicated that to the doctor, and so why not do a trial of something like vitamin d? It’s widely studied, has very few serious downsides, and is cheap.

> but based on this case, it’s obvious the person isn’t getting enough sunlight, and they communicated that to the doctor, and so why not do a trial of something like vitamin d? Can we get to the specifics? How would you propose the doctor do it? Let's say the doctor prescribes a certain dosage per day. How will the doctor know it is helping this particular patient? How long should the trial continue before he sees r…

This is why most doctors don't start recommending such medication until it is proven to work.

They cannot and don't want to be held liable for damages. For example, if it did turn out that prolonged vitamin D supplementation causes an unexpected issue, what then? Would the patient have been OK with that? Or would their response have been the exact opposite of what the OP was suggesting?

Self-medication is acceptable, and the patient should be made aware; the doctor should give advice, but not prescribe, in this case. Most doctors prefer not to get into this level of liability.

Re: Reduced cancer mortality with daily Vitamin D intake

#217

Post by kadoban »

BeetleB wrote: post #211
9935c101ab17a66 wrote: post #203

Earlier quoted context omitted.

Ya, but I think most good doctors operate with a balance of probabilities framework. Yah, there may not be conclusive evidence showing it’s widely effective, but based on this case, it’s obvious the person isn’t getting enough sunlight, and they communicated that to the doctor, and so why not do a trial of something like vitamin d? It’s widely studied, has very few serious downsides, and is cheap.

> but based on this case, it’s obvious the person isn’t getting enough sunlight, and they communicated that to the doctor, and so why not do a trial of something like vitamin d? Can we get to the specifics? How would you propose the doctor do it? Let's say the doctor prescribes a certain dosage per day. How will the doctor know it is helping this particular patient? How long should the trial continue before he sees r…

> Let's say the doctor prescribes a certain dosage per day. How will the doctor know it is helping this particular patient?

Check on them in X weeks and see if they're improved, and maybe measure blood levels just to get some objective measurement going. Doesn't seem too terribly hard. I think I'm missing the issue.

Re: Reduced cancer mortality with daily Vitamin D intake

#218

Post by chii »

jjeaff wrote: post #206
nicenewtemp84 wrote: post #182

Earlier quoted context omitted.

Are you saying that the doctor, upon closer questioning simply flopped and gave bad medical advice to my friend when they told him that yes it's reasonable to expect to regain full shoulder straight again without surgery? Because if so maybe my friend should sue? What is this blanket statement of "shoulder surgery should not be delayed" based on?

Doctors will often change their recommendation if patients express different priorities than the doctor initially assumed. Some people's priorities are no surgery unless absolutely necessary.

> Some people's priorities are no surgery unless absolutely necessary.

which is a good general rule to go by - surgery is not without dangers.

The doctor's role, imho, is to firstly explain all of the available options (pros, cons, etc).

Once the patient understands all of the options, the doctor can recommend one of them, and explain why the option is good. The patient needs to evaluate the other options as well, and think about whether the doctor's recommendation is sound, and what assumptions they might've made (may be unknowingly).

The patient is not, and should not be, a passive party to medical treatment.

Re: Reduced cancer mortality with daily Vitamin D intake

#219

Post by chii »

dcow wrote: post #202
lm28469 wrote: post #160

Earlier quoted context omitted.

Half of the western world is overweight/obese (75%+ in the US), the vast majority of people are massively malnourished and under exercise The market for that is very small, most of the things that kill are known, the solutions are known, there is nothing cost effective, no magic pill Optimize for the basics, you have a long way to go before individual tests bring anything to the table. If you don't exercise vigorousl…

I'm not saying they key to good health is a big secret. I'm saying we're bad as a society or as human beings at objectively tracking this stuff and correcting negative trends often before it's too late. I've experimented with my body and nutrition a lot, with noticeable outcomes. You can't eat and know the next day that what you ate had too much refined sugar, or that it was organic and lacked toxins, just be how you…

> So, again, why would more open access to baseline metabolic metrics be a bad thing?

not a bad thing if you considered it in isolation for a single individual. But for an entire society? The cost of doing so might be quite high, even if there's an economy of scale efficiency improvement for such large amount of testing/diagnostics.

The recommended regime of diet, exercise and such, are a solution for most people that doesn't require you to know your own metric (and the example of pregnancy is a non-sequitur because this isn't a normal state of affairs, and when pregnant people can easily choose to do such bloodwork to measure their metrics).

Re: Reduced cancer mortality with daily Vitamin D intake

#220

Post by anonymouskimmer »

cscheid wrote: post #139
anonymouskimmer wrote: post #77

Earlier quoted context omitted.

The two signs bracketing the summer months (I presume this was in the northern hemisphere?). That's a potentially interesting finding. > inappropriate subgroup analysis No subgroup is inappropriate unless you know all of the values of all of the parameters. But sure, the intent they tried to demonstrate (take all sub-group analyses with a grain of salt) is a good thing to remember. Edit: To whoever downvoted me, time…

> No subgroup is inappropriate unless you know all of the values of all of the parameters I don't know how to put it less bluntly: you're incorrect. > But sure, the intent they tried to demonstrate (take all sub-group analyses with a grain of salt) That's not what they intended to demonstrate. They intended to demonstrate that you need a _reason_ to want to split, and that reason needs to be given _ahead_ of the anal…

> They intended to demonstrate that you need a _reason_ to want to split

No, no, no. FFS no! Sure this is a good thing to do if you are trying to prove a hypothesis. But you you are trying to explore for truly novel and unexpected linkages p-hack to your heart's content, form hypothesis, and then do follow up studies to see whether there's really something there!

Ignoring possibilities is bad exploratory science. And, as a reader, it's quite annoying to read old studies only to find that the author's didn't bother splitting on the parameter you are currently interested in.

Split them all, if only in the supplementary data, and let future studies sort them out.

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