HealthCommentary

Exploring Human Potential

A Disturbing Pattern: From OxyContin to Vitamin D

Posted on | October 5, 2018 | 4 Comments

Mike Magee

Winter is fast approaching, a time to bundle up and a grim reminder for many to load up on Vitamin D. Osteoporosis, osteomalacia, rickets, fragile fractures – there’s no end to the misery awaiting you if you fail to take this supplement. Or so we’ve been told, by many every-day doctors with the same assurance as they once used to explain that “pain is the 5th vital sign” and OxyContin is non-addictive.

If you’ve been oversold on Vitamin D, you can thank AMA Federation member, the Endocrine Society, and one specific Boston endocrinologist. Oprah loves this guy. So does Gwyneth Paltrow and Dr. Oz. And so do the drug makers, the blood testers, and the owners of tanning salons whose trade association, the Indoor Tanning Association which disbanded in 2017 gave BU $150,000 from 2004 to 2006 specifically to fund his research.

His bio says that  “He served as the chair for the Endocrine Society’s Practice Guidelines on Vitamin D, authored more than 400 peer-reviewed publications, and has written more than 200 review articles, as well as numerous book chapters.” What it doesn’t say is that he is credited for almost single-handedly launching the “billion dollar vitamin D sales and testing juggernaut.”

Michael Holick, MD, PhD is an endocrinologist from Boston University. He chaired the Endocrine Society’s clinical guidelines publication in 2011 that concluded that “vitamin D deficiency is very common in all age groups” and that normal levels should be between 30 and 100 nanograms per milliliter. That was only months after an IOM consensus group concluded that “all individuals meet their needs at intake levels provided in this report” and that 20 nanograms per milliliter were more than enough.

As with the new tighter levels for cholesterol, Holick’s team greatly expanded the list of Americans who were vulnerable and would require treatment. The new Endocrine Society pronouncement targeted the majority of U.S. population for testing, and gullible physicians were more than happy to comply. Quest and LabCorp immediately adopted Holick’s normal level of 30, making an estimated 80% of the adult US population deficient of Vitamin D. By 2016, doctors were ordering more than $10 million worth of the tests at a cost of $345 million, with patient co-pays varying from $40 to $235 dollars.Vitamin D tests were now the 5th most common test reimbursed by Medicare.

Since then, here’s what we’ve learned about Dr. Holick:

1. He has been a consultant for Quest for over four decades and is still paid $1000 per month.

2. Between 2013 and 2017, he received $163,000 from Sanofi-Aventis, Amgen, Roche, and others.

3. He has described “tanning beds” as a “recommended source” of vitamin D.

4. Recent studies have found no link between low levels of Vitamin D and fractures in elderly, heart disease or cancer.

5. However, studies have revealed that levels of 50 nanograms per milliliter or above carry an increased risk of death. The United States Preventive Services Task Force in 2018 recommended that older Americans outside of nursing homes not take vitamin D supplements to avoid falls.

There will always be Sackler’s and Holick’s in medicine. That’s probably unavoidable. But overselling opioids or vitamin D tests wouldn’t have been possible without AMA specialty society cooperation and an army of naive physician prescribers.

Endocrine Society: 2018 Corporate Liaison Board:

Comments

4 Responses to “A Disturbing Pattern: From OxyContin to Vitamin D”

  1. Fitzhugh Mullan
    October 8th, 2018 @ 4:52 pm

    Mike –
    What an instructive and awful story. Keep at it!
    Fitz

  2. Mike Magee
    October 8th, 2018 @ 5:09 pm

    Thanks, Fitz!

  3. Honorio Silva
    October 9th, 2018 @ 5:32 pm

    Mike,
    Concise and descriptive article revealing the current and past complicity among key stakeholders and the need for continuing review of clinical databases during the product lifecycle. Well done.
    Honorio

  4. Mike Magee
    October 9th, 2018 @ 6:07 pm

    Thanks, Honorio! Wonderful to hear from you. Wishing you well! Best, Mike

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