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Dermatologists: get off the “Vitamin D deficiency” bandwagon

<p>The term "Vitamin D deficiency" points to a disturbing trend.<br /></p>

The term "Vitamin D deficiency" points to a disturbing trend.

A recent article in the Archives of Dermatology “High prevalence of Vitamin D deficiency in basal cell nevus syndrome patients” points to a disturbing trend.  The authors use the phrase “Vitamin D deficiency” seven times in the opening paragraphs, and liberally throughout the article.  The authors even site an “increased risk of autoimmune disease, fractures, cancer, cardiovascular disease, and all-cause mortality from Vitamin D deficiency” in the first sentence.

Deficiency is defined as a shortage of substance necessary to health.  However, the authors state that they did not measure calciferol, calcium, or parathyroid hormone levels or perform bone density scans on their patients.  The authors have not shown that the patient’s Vitamin D levels in any way affected their health.

Buried in the “Methods” section in smaller font is the disclaimer: “Although there is no consensus on optimal levels of 25(OH)D, vitamin D deficiency is defined by most experts as a 25(OH)D level of 20 ng/mL or less.”

Thus, the entire article is predicated on an arbitrary definition of “Vitamin D deficiency.”  In their “limitations” section of the article, they do not acknowledge that they used an arbitrary Vitamin D cut-off level.  This is weak science at best, and the authors should acknowledge that fact.  Rather than using the misleading phrase “Vitamin D deficiency” repeatedly, “low Vitamin D levels” should be substituted, and the meaning of the phase should be emphasized.

This also points to a larger trend in medicine and the population at large.  Both doctors and their patients are concerned that by using photoprotection, they are at risk for purported negative health consequences from “Vitamin D deficiency.”  

Dermatologists should encourage dietary intake of Vitamin D.  Also, dermatologists should be at the forefront of discouraging arbitrary use of the word “deficiency” from clouding the ongoing debate about sun exposure, skin cancer, and Vitamin D.

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