BMJ Vitamin D & Fish Oil vs Autoimmune

[sengsational]

As we age, many of us will encounter autoimmune issues, so I thought this study would be of interest to members of this forum.

This is a five year, double blind, prospective study, funded by the NIH, so not your basic cr*p epidemiology correlation observation that we see in the news all of the time (half of which turn out to be wrong). It's also published in a world-class journal. They were looking specifically for rheumatoid arthritis, PMR, thyroiditis, psoriasis, crohns, ulcerative colitis. And there was a "write in" option too.

So what they did was divide a big group of older Americans into 4 groups. One group got two placebos, one group got both D and Fish Oil, one group got D and placebo, and the last got Fish Oil and placebo. The dosage were pretty reasonable at 2000 IU of vitamin D and 1g of fish oil (460mg EPA, 380 DHA).

The result: It looks like both Fish Oil and vitamin D kept quite a few people from getting autoimmune diseases. The authors note that if you look at the last 3 years of the study, the vitamin D group had 39% fewer people with autoimmune issues. The bad news for some of us, is that this effect was strongest in the skinnier people; if the subject's BMI was 30, for instance, the effect of vitamin D supplementation was not statistically significant. This relationship with BMI was footnoted as being observed before, but I didn't keep digging on that one.

This is a pointer to a scientific finding that I thought was note worthy. All caveats for checking with your own doctor apply, obviously.

https://www.bmj.com/content/bmj/376/bmj-2021-066452.full.pdf

 

[MarieIG]

Thanks. These are two of my supplements. I did up Vit D during Covid.

More and more info supporting a healthy BMI . . .

 

[ERObjd]

My vitamin D blood levels were tested by my VA doc and were very low, in the teens, VA doc advised me to take 5000IU per day, so I did, now blood levels are in 80's so I aim to stay at least in 80's .In summer i drop down to 2000 IU a day since I work part time outside installing windows and doors( Pella )and am getting plenty of vitamin D from the summer sun. Now i am taking 5000 IU a day during winter and until about May then I will drop down to 2000IU again. I tried various brand of fish oil and always tend to get reflux no matter what brand so i just cook fish once or twice a week to get those fish oils. lots of people work inside and don't get much vitamin D or when they are outside they use sunscreen and the body can't make vitamin D from the sun with sunscreen on the b ody.

 

[timbervest]

I take these as my only supplements (also no meds so far). Have been doing so for years. It isn't an imposition on my daily routine, keeps by Vit D levels up and seems to help with cholesterol. Blood tests from annual physical all good. Can't say they are definitely doing good but do not appear to be doing harm.

 

[braumeister]

The dosage were pretty reasonable at 2000 IU of vitamin D and 1g of fish oil (460mg EPA, 380 DHA).

Thanks for posting that. Makes me feel good (I'm obviously susceptible to confirmation bias ).

Actually, I consider those dosages to be kind of on the low side, but I agree they are certainly reasonable.

 

[Turbo29]

Been taking that for years, except 3000 IU of D instead of 2000 IU.

 

[Jerry1]

I take 8000 IU of D every day and my last test in October was 65. I should probably move up to 10000 IU. I'll put that on my questions for my next Dr. visit.

 

[braumeister]

I take 8000 IU of D every day and my last test in October was 65. I should probably move up to 10000 IU. I'll put that on my questions for my next Dr. visit.

Isn't it interesting how different we all are. I take 5000 IU and my last test was 79.

 

[ncbill]

As we age, many of us will encounter autoimmune issues, so I thought this study would be of interest to members of this forum.

This is a five year, double blind, prospective study, funded by the NIH, so not your basic cr*p epidemiology correlation observation that we see in the news all of the time (half of which turn out to be wrong). It's also published in a world-class journal. They were looking specifically for rheumatoid arthritis, PMR, thyroiditis, psoriasis, crohns, ulcerative colitis. And there was a "write in" option too.

So what they did was divide a big group of older Americans into 4 groups. One group got two placebos, one group got both D and Fish Oil, one group got D and placebo, and the last got Fish Oil and placebo. The dosage were pretty reasonable at 2000 IU of vitamin D and 1g of fish oil (460mg EPA, 380 DHA).

The result: It looks like both Fish Oil and vitamin D kept quite a few people from getting autoimmune diseases. The authors note that if you look at the last 3 years of the study, the vitamin D group had 39% fewer people with autoimmune issues. The bad news for some of us, is that this effect was strongest in the skinnier people; if the subject's BMI was 30, for instance, the effect of vitamin D supplementation was not statistically significant. This relationship with BMI was footnoted as being observed before, but I didn't keep digging on that one.

This is a pointer to a scientific finding that I thought was note worthy. All caveats for checking with your own doctor apply, obviously.

https://www.bmj.com/content/bmj/376/bmj-2021-066452.full.pdf

But did the fish oil supplement work for us fatties?

 

[6miths]

But did the fish oil supplement work for us fatties?

The fish oil didn't work at all according to the study. The difference between the fish oil and placebo groups are not significant.

The Vitamin D groups had a slight reduction in autoimmune disease (and it did not look like those who got both Vitamin D and fish oil had any added benefit over Vitamin D alone). The result for Vitamin D was just barely statistically significant. The results in Table 2 show that one has to treat almost 13,000 people to prevent 22 cases of autoimmune disease. Thus the Number Needed to Treat (NNT) was 406 people treated to prevent 1 case of autoimmune disease. 405 people did not benefit (with respect to autoimmune disease) from taking Vitamin D.

Thank you for posting the study. I was very surprised to find that an article in the BMJ did not give Absolute Risk Reduction and NNT but instead gave only Relative Risk Reduction. I had thought at authors had been mandated years ago to include the former figures - obviously I was incorrect.

Previous trials suggest possible small health benefits for routine Vitamin D supplementation. There is less evidence that omega-3 supplementation is of any benefit.

 

[tmm99]

Interesting you mention Vitamin D and fish oil. I read about it just yesterday when I read about it on the website by Rebecca Fett who wrote this book.

The Keystone Approach: Healing Arthritis and Psoriasis by Restoring the Microbiome
https://www.amazon.com/Keystone-App...estoring+the+Microbiome&qid=1644691907&sr=8-1

According to her website, vitamin D and fish oil are the strongest anti-inflammatory supplements that work better than glucosamine and even more than the bio-available kind of curcumin.

https://keystonebook.com/supplements/anti-inflammatory-supplements/

 

[chris2008]

The dosage were pretty reasonable at 2000 IU of vitamin D and 1g of fish oil (460mg EPA, 380 DHA).....

The bad news for some of us, is that this effect was strongest in the skinnier people; if the subject's BMI was 30, for instance, the effect of vitamin D supplementation was not statistically significant. This relationship with BMI was footnoted as being observed before, but I didn't keep digging on that one.

Maybe the dosage should be increased for high BMIs?

 

[eytonxav]

Is this regimen more for preventing the onset of an autoimmune condition and/or is it more for alleviating symptoms of an existing autoimmune condition?

 

[sengsational]

The study endpoint was onset of autoimmune symptoms; I don't think it's of much use in knowing whether the compounds have an effect on existing conditions.


And the previous comment... Vitamin D is fat solid soluble, so a good theory. As is typical for me, when I read study results, I always want different doses because a dose response is such a powerful indicator. But 5 years ago, 2000 IU of vitamin D was probably jaw-dropping for an IRB (they are still thinking 800 IU, the 'prevent rickets' level is good, lol). Now they'd probably get away with 5000 IU.