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Below came from posting on another blog. It was posted by someone who i consider one of the best natural teachers i have ever met. I thought many would appreciate her insights and approach to the question.
David Wetzel of Green Pasture came to the San Francisco Bay Area this September and spoke three times. I heard two of the talks. I am of the mind now, personally, as a result of the talks, that I won't continue to test Vitamin D levels nor to supplement with any vitamin D beyond taking fermented cod liver oil and x-factor butter as we had historically -- in addition to consuming other vitamin D rich foods. Having tested "low" for Vitamin D, I was following a vitamin D supplement protocol promoted by Marcey Sharpiro, M.D. http://www.marceyshapiro-md.com/ which entailed taking this product: http://www.orthomolecularproducts.com/ProductDetails.aspx?id=78c7c111-ae9c-4899-\b3f0-1b75c21b5ab2 and my levels did rise considerably but, I am no longer convinced about the value of this kind of supplementation and have decided to just consume food at present.
From David Wetzel ... for those of you who missed his talks, and/or would like a summation:
http://www.greenpasture.org/community/?q=node%2F296
"The concern that facilitated the discussion [about what nutrient content to list on the FCLO label] is there are a wide range of test results on method and lab. In addition, there are thousands of nutrients within FCLO including many minor forms of A/D that are not currently discussed.
The FDA views a dietary supplement like a drug and the FCLO is more like a food. Drugs have 'known' amounts of very specific ADDED nutrients (if one wants to call lab made molecules nutrients). Lab nutrients can be easily measured and reported.
After working with the product for 5 years my conclusion is that media medicine and FDA label requirements do not fit the FCLO. It is like putting a square peg in a round hole. It is beyond vitamin A and D. It is not proper to tie FCLO into a standard CLO discussion nor can the product accurately be defined in these terms. We get question about A/D/EPA/DHA and we do discuss openly and as a result sometimes people struggle to understand the concept that the FCLO is not a drug and it is not as easy as it has exactly 842 iu's of vitamin D per ml and this will do this or that in your body.
It took me 3 years to come to the conclusion that the product can not be defined in standard media medicine terms and there is no need to know these things other than discussion/intrigue as the product is what it is as it has been for thousands of years (prior to the industrialization of fish oils). Not knowing this or that does not change the product nor how one should use/consume the product."
For those of you interested, I really encourage you to talk to David and let him recount his labeling journey with you: (402) 858-4818
He has tested his products for years and depending on the lab and the method used, the numbers are quite different.
More ...
"Our new labels will have the familiar design you’ve come to recognize, however, quantities of Vitamins A & D will no longer appear on the label. Instead, we’ve moved detailed information about our testing results to our web site. Along with random testing results of Vitamin A & D found in our products, we’ll also be providing information on pollutants like heavy metals and PCBs - none of which fits into the small space of a label.
There are numerous forms of Vitamin A & D. Nutrient pioneer, Dr. Royal Lee, identified over 160 forms of Vitamin A alone. We test our products for just two of those forms – a daunting enough task.
In testing our fermented cod liver oil, we noticed some of the minor forms of Vitamin A identified by Dr. Lee. Since Vitamin A is broken down into minor forms during the natural digestion process, our research results are not surprising. We believe these minor forms have additional health benefits that can’t be represented on a label.
Similar variability and testing struggles are present in Vitamin D. Hundreds of forms are possible, but in the end only two are commonly measured.
Our former label reported the average amounts of Vitamins A & D present in the random testing of our fermented cod liver oil, but this is no longer permitted by the FDA. Current standards call for the testing of each batch produced to meet minimum FDA requirements. But as we’ve pointed out, the variables of natural foods are too numerous to ensure that each batch will contain a consistent amount. And it is not practical to test each batch – as our batches are small compared to mainstream manufacturers.
Because of this, the challenge we face is determining how to present this informationon a label.
In general, the industrialized food model meets label requirements by adding specific amounts of synthetic vitamins that are easily measured in a lab and reporting those on their labels. Green Pasture Products is committed to providing high quality real food and will not use synthetic vitamins, regardless of the consequences.
One option we considered would be to show the lowest possible amount of Vitamins A& D based on any batch, but this does not give you an accurate picture of the nutritional value of our products. As such we have decided to remove this information from our labels and make it available on our website – where it makes sense. The random test data that will be provided will not be for any one specific lot or jar but is for general discussion.
We will not compromise our products simply to satisfy FDA labeling requirements. We prefer to offer products as they have been available for thousands of years – without regard to today's industrialized media-driven, food-labeling requirements."
http://www.greenpasture.org/community/?q=node%2F299
This is what I took from the article which some have expressed was not clear and challenging to understand (a list of excerpts the summarize, from my reading):
A decade ago, the main reason physicians ordered a vitamin D test was if there was a concern about the patient’s bone density. However, a flurry of research now has implicated the prohormone in a host of conditions, including among others, certain cancers, type 1 diabetes, multiple sclerosis, tuberculosis, Alzheimer’s disease, psoriasis, and all-cause mortality, while also indicating that vitamin D insufficiency is prevalent. Even though vitamin D’s mechanism of action in the prevention or progression of various diseases has not been established definitively, these studies have been picked up by the popular press, causing demand for vitamin D testing to skyrocket. At the same time, there have been notable technological advancements in vitamin D testing, controversies surrounding certain tests, and considerable confusion about both analytical considerations and clinical interpretation of vitamin D results, leaving laboratorians and clinicians unsure about how to implement or interpret the test properly.
“There’s significant confusion out there,” agreed Hershel Raff, PhD, director of the endocrinology research laboratory for ACL Laboratories and professor of medicine at the Medical College of Wisconsin in Milwaukee. “Vitamin D testing’s becoming part of the routine physical in Wisconsin, but some doctors don’t really understand what they’re ordering, so they check off anything that looks close.” Raff believes the vitamin D naming conventions only muddy the waters: 25-hydroxyvitamin D2 also is known as ergocalciferol, 25-hydroxyvitamin D3, as cholecalciferol, and 1,25 (OH)2 D, as calcitriol. Some doctors mistakenly think 25-hydroxyvitamin D2 or 25-hydroxyvitamin D3 is the same as 25-OH-D or 1,25 (OH)2 D.
In concert with the confusion about which vitamin D test to order, there is no consensus about the appropriate reference range and cut-offs for deficiency or insufficiency, as well as optimal and possible toxicity status.
Yet another level of confusion exists as a result of several lingering analytical issues with the various assays.
According to Rao, it is not uncommon for physicians to receive vitamin D test results for the same patient but from different labs that have used different assays and produced different results, putting laboratorians in a spot to explain the discrepancies. [I have actually had this experience myself on more than one occasion with hormonal testing.]
Even as there has been a trail of confusion in vitamin D analytics, there is, in the eyes of many, hope on the horizon.
While LCMS is becoming the preferred analytical method of many reference labs and has been called the gold standard for measuring vitamin D, not all lab directors see it that way.
As the vitamin D field continues to evolve, there are steps laboratorians can take to improve vitamin D testing proficiency and inform the medical community about the test’s appropriate use. Raff spends a good bit of time educating physicians one-on-one, in group presentations, and in writing, including in an internal newsletter that detailed the biochemistry of vitamin D and the differences between 25-OH-D and 1,25 (OH)2 D testing and their respective indications.
While the industry awaits analytical improvements and further clinical evidence about vitamin D, laboratorians will be challenged to maintain high-quality testing and keep physicians well-informed about testing indications. As Carter put it, “We’ll just have to grit our teeth.”
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