Guest guest Posted November 10, 2010 Report Share Posted November 10, 2010 It would be unethical if we artificially depressed vitamin D levels in one group, and raised them in another group of CLL patients. I don't think it would be unethical to simply divide CLL patients into two groups, and give one group a sham pill and the other 2500 IU of D3, and track them over several years. Testing levels of the vitamin would provide more information as to efficacy of this approach. We've already tracked folks passively for D levels. Meanwhile, I personally don't think it's inappropriate for folks to modestly supplement with 1000 IU or so of vit D. vit. D levels vs. tumor burden or lysis Posted by: " rrfman " rrfurman@... rrfman Wed Nov 10, 2010 5:44 am (PST) We do not know whether vitamin D deficiency plays a role in the development of CLL or whether CLL results in a vitamin D deficiency. What we do know is that over 30% of adults in the US are vitamin D deficient. We have seen reports of patients with adequate vitman D levels doing better with their disease than those who are deficient. What is VERY IMPORTANT to remember, and a very important teaching point that we always have to clarify, is the issue of cauality. Patients with CLL who have more aggressive disease might ingest lower amounts of vitamin due to poor appetite or less interest due to the aggressive of the disease. Right now, we only know that they are associated, and there are many ways they could be associated. The important question will only be answered if we can take one-half of the patients that we would expect to do poorly and replete their vitamin D level, and then see if they do better than those not repleted. This study will obviously never get done given the ethical implications of leaving patients vitamin D deficient. One other aspect that is worthy of emphasis is that we have no information regarding repleting to a particular level. Right now, the only data suggests repletion to adequecy. Any claims of pushing to the dose into the middle or high end of normal are without data. The FDA is examining target ranges for vitamin D at this time, but we do not yet have those data. Rick Furman, MD Quote Link to comment Share on other sites More sharing options...
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