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Vitamin D deficiency – Physicians Assistants Continued Medical Education Feb 2015

Hypovitaminosis D: A common deficiency with pervasive consequences

Journal of the American Academy of Physician Assistants:, February 2015 - Volume 28 - Issue 2 - p 20–26, doi: 10.1097/01.JAA.0000459810.95512.14
CME: Primary Care Medicine
Podd, Daniel MPAS, PA-C
Daniel Podd is an associate professor at St. John's University in Queens, N.Y.

Earn Category I CME Credit by reading both CME articles in this issue, reviewing the post-test, then taking the online test at http://cme.aapa.org. Successful completion is defined as a cumulative score of at least 70% correct. This material has been reviewed and is approved for 1 hour of clinical Category I (Preapproved) CME credit by the AAPA. The term of approval is for 1 year from the publication date of February 2015.


ABSTRACT: Hypovitaminosis D is a common syndrome with well-established risk factors. Only recently, however, are the expansive implications of vitamin D deficiency becoming recognized, including cardiovascular complications, cancer, and dementia. The increased attention to the role of vitamin D has made its assessment more crucial in comprehensive patient management.

Here are some of the errors

Commission errors

Vitamin D2 is as good as Vitamin D3

  • Vets decided over a decade ago that Vitamin D2 should never be used on any mammal.
  • There are scores of human studies which showed vitamin D2 being poorer than D3,
    and sometimes D2 actually decreased D3 levels in the body
  • The Vitamin D2 references in this CME (from before 2010) have been disproven

Regulating up to 200 genes

No dose-response relationship of vitamin D with Breast Cancer

Optimal fracture prevention at 800 IU

9 concurrent vitamin D deficiency diseases mentioned

rickets, characterized by leg-bowing

Maintenance therapy of 800 IU daily

  • Far too little. Even children, who weigh far less, need at least 1,600 IU JAMA

Calcium supplementation should include 1.5 to 2 g/day

  • This much Calcium when person is taking vitamin D causes many medical problems

Vitamin D given in frequencies of three times a year

  • No – Major medical problems result when vitamin D is given so infrequently.
    Anything frequencyt less often than 18 days provides a decreased benefit

*Only active Vitamin D can treat psorasis

  • Inactivated Vitamin D can treat psorasis. This has been known for many years.
    Recently it was proven that the the skin can active vitamin D

Omission Errors

  • Vitamin D production in the skin decreases with age
  • Yes, 10,000 IU from the sun – but ONLY IF: young, bathing suit, lying down, all sides of the body
  • No mention of the extremely important cofactors: Magnesium, Omega-3, Vitamin K2, etc.
  • No mention that Medicare now only pays for a single vitamin D test per lifetime
  • No mention of the 5+ additional forms of vitamin D which can be used
  • No mention of the importance of genes in risk of disease nor amount of vitamin D needed

Conflict errors

20 minutes (of sun) in the winter
CME stated earlier: no vitamin D in the winter above a certain latitude (which is correct)
Black patients may require twice as long of a duration of sun exposure
CME stated earlier: 3X to 5X longer duration is needed (which is correct)
Vitamin D level for health: > 20 ng in many places, but > 40 ng in others (which is correct)

Note: The author has NO previous Vitamin D publication in PubMed

See also Vitamin D Life

See also web

CME which was on Vitamin D Life were removed at request of the publisher (Feb 2015)

Click HERE for the full CME


Short url = http://is.gd/CMEPodd

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