Vitamin D ScandalDr. Zoltan P. Rona, MD, M.Sc. November 1, 2010
Ontario Government Cancelling OHIP Coverage for Vitamin D Testing
“We estimate that vitamin D deficiency is the most common medical condition in the world.” – Dr. Michael F. Holick, Vitamin D expert
Although it’s not official yet, Ontario will soon be stopping OHIP/Medicare coverage for vitamin D tests for all but certain individuals already suffering from proven vitamin D deficiency diseases. By the time you read this, it may already be too late to save vitamin D blood testing coverage.
This does not mean that you won’t be able to get vitamin D testing, just that you will be out of pocket $51.70 to your friendly neighbourhood laboratory. Other nutritional lab tests that you already have to pay for in a similar way are homocysteine, gluten food allergy tests, IgG RAST food allergy tests, lipoprotein “a”, red cell magnesium, and urinary indican (bowel toxemia) tests. These are just the ones that are done by Ontario labs and do not include tests done by any American laboratory (e.g. comprehensive stool and digestive analysis).
Other provinces (Manitoba, Nova Scotia, Newfoundland and Labrador, Prince Edward Island, and Saskatchewan) have already stopped paying for vitamin D testing unless the individual suffers from a vitamin D deficiency-related disease such as osteoporosis. British Columbia has recently requested that doctors order fewer vitamin D blood tests under a new “voluntary protocol.”
According to the OMA (Ontario Medical Association), vitamin D testing coverage will remain only for those suffering from “conditions such as osteoporosis, rickets, osteopenia, malabsorption syndromes, and renal disease, or drugs that affect Vitamin D metabolism.”
In other words, if you are healthy or have cancer, heart disease, hypertension, diabetes, arthritis, any autoimmune disease, fibromyalgia, recurrent infections of unknown cause, depression, autism, or any other mental or physical disorder, you are out of luck to get Medicare coverage for vitamin D testing.
You are therefore, in a sense, penalized $51.70 for vitamin D testing just because you are healthy or suffer from the wrong disease. Now, if that sounds unfair or weird in some way, you are not alone in thinking that.
Not long ago, I authored a book on vitamin D (Vitamin D, The Sunshine Vitamin; The Book Publishing Company: 2010). In the book, I discussed the thousands of published studies supporting the importance of adequate vitamin D blood levels in hundreds of health and clinical conditions. In fact, there are studies proving that vitamin D deficiency may be responsible for death from all causes. Wouldn’t it then make sense to cover the cost of a test that could lead to the prevention of unnecessary illness in millions of people? The savings for Medicare in the long run would be substantial at the very least.
PENALIZING GOOD HEALTH
“Because vitamin D is so cheap and so clearly reduces all-cause mortality, I can say this with great certainty: Vitamin D represents the single most cost-effective medical intervention in the United States.” – Dr. Greg Plotnikoff, Medical Director, Penny George Institute for Health and Healing, Abbott Northwestern Hospital in Minneapolis.
You are a healthy person and visit your family doctor once a year for a complete check-up. Many sources have told you that if you have adequate blood levels of vitamin D, you can prevent cancer, heart disease, osteoporosis, arthritis, diabetes, and numerous autoimmune disorders. Sheepishly, you ask your family doctor to test your vitamin D blood levels. He agrees to do so, but also tells you that the cost will be $51.70 because OHIP coverage has been discontinued unless you happen to have one of the accepted medical conditions or diseases for which vitamin D blood testing receives coverage. Puzzled but unwilling to argue with the lab, you pay the $51.70 and wonder why you are being penalized for being healthy. This is a scenario that will be increasingly reported by millions of prevention-oriented people in Ontario in the years to come.
PROMOTING DEPRESSION AND SEASONAL AFFECTIVE DISORDER
As you read this article, it is November and those in Canada who are not in some way supplementing with vitamin D are suffering from the effects of the ever-dwindling blood levels of vitamin D that occur at this time of the year. Some are starting to notice that their moods and energy are waning. A visit to the doctor fails to reveal any underlying cause for this except a low blood level of vitamin D. That will be $51.70, please. Now you should know that there are hundreds, if not thousands of studies indicating a correlation between depression, or what’s known as SAD (Seasonal Affective Disorder), and vitamin D deficiency. Yet Medicare will refuse to cover the cost of the lab test. Rather, why not pay hundreds of dollars for expensive prescription antidepressants that cause numerous side effects and are nearly impossible to quit without dangerous consequences?
Now that your doctor has established that your blood level of vitamin D is low, he prescribes 10,000 IU of vitamin D3 and asks you to repeat your vitamin D blood tests again in six weeks. That’s $51.70 again, please. Your blood levels of vitamin D have barely budged upwards, even with the high supplemental doses. So the doctor agrees to increase your supplement dosage to 20,000 IU daily and asks you to check those vitamin D blood levels again in another six weeks. That’s $51.70 again, please. So on it goes.
What I am trying to illustrate is that one cannot possibly tell how much vitamin D should be supplemented without doing a lab test. Further, it is impossible to assess the efficacy of that supplementation without repeating the blood test. Does the patient not absorb the vitamin D? Does he or she use it up in the body too rapidly? It’s impossible to tell without frequent and regular blood tests. And each time you will pay $51.70. Medicare won’t cover it and if you cannot afford the cost of the lab tests, and you are unsure of how much to take to curb your seasonal depression problem, you are out of luck.
PREVENTING CANCER PREVENTION
“No other method to prevent cancer has been identified that has such a powerful impact.” – Dr. Cedric Garland, Vitamin D expert
The relationship between the presence of cancer and low levels of vitamin D is now a well-established fact. I am not going to quote the thousands of studies proving a direct connection between vitamin D deficiency and cancer incidence or the fact that the higher the blood levels of vitamin D, the less likely the spread of cancer, especially of the breast, prostate, and bowel. Regardless, please pay $51.70 for that vitamin D blood test in Ontario. The name of this game is “Let’s prevent cancer prevention.” What we really need to do, as the government is now telling us, is just spend a few billion dollars blasting those cancer cells with radiation and chemotherapy instead. By the way, if you have bone cancer, vitamin D testing will still not be covered, unless you also develop osteoporosis.
HAVE SOME HEART DISEASE
“Vitamin D deficiency is an unrecognized, emerging cardiovascular risk factor, which should be screened for and treated. Vitamin D is easy to assess, and supplementation is simple, safe, and inexpensive.” – James H. O’Keefe MD, cardiologist and Director of Preventive Cardiology, Mid America Heart Institute, Kansas City, Missouri.
The March 2010 version of the Vitamin D Council newsletter reports on a number of studies linking low blood levels of vitamin D with higher incidences of heart attacks and other cardiovascular problems. These were reported in such prestigious journals as the Annals of Internal Medicine.
In one of these studies (reported at the meeting of the American College of Cardiology’s annual scientific session in Atlanta), it was found that people with the lowest blood levels of vitamin D had a 170% greater risk of heart attacks than those with the highest levels. So, wouldn’t it make sense to check everyone’s vitamin D blood levels, especially those with a strong family history of heart disease? What the kind folks at Medicare headquarters are saying is that we should instead spend millions doing coronary bypass surgeries, heart transplants, and prescribing Lipitor.
BOOST THOSE DIABETES COMPLICATIONS
According to a recently-published study presented on October 17, 2010 at the Annual Meeting of the American Academy of Ophthalmology, vitamin D deficiency is associated with the development of eye disease in diabetics (diabetic retinopathy). Vitamin D plays an important role in the prevention of diabetic retinopathy because it is essential for normal insulin release and glucose metabolism. Vitamin D also decreases the levels of inflammatory cytokines that are up-regulated in diabetes and cause tissue damage just about everywhere, including the retina of the eye. If you are a diabetic, however, you are out of luck if you want Medicare coverage for vitamin D testing. That will be $51.70, please. Otherwise, check in with your nearest over-worked ophthalmologist and get in line for those sight-saving surgeries.
INFLATING INFLAMMATORY BOWEL DISEASE
If you suffer from Crohn’s disease or ulcerative colitis (collectively known as Inflammatory Bowel Disease or IBD) and want to get your vitamin D blood level tested in Ontario, it will also cost you $51.70. This is despite the fact that a recent study indicates that those who suffer from IBD are at a very high risk for osteoporosis, and the disease is likely to damage their skeletons without adequate vitamin D supplementation. There is absolutely no way of knowing what your level of vitamin D is without a blood test, and you will have to pay to find out. How do you know how much to take without a blood test? It’s only when you can actually prove that you have osteoporosis that Medicare will cover your vitamin D blood tests. Is there something wrong with this picture? Or, are doctors just going to swallow the absurd dictates of the so-called experts that work for the government?
WHAT I RECOMMEND
“In terms of getting more bang for your health care buck, Vitamin D testing and supplementation for the population is one solution which is guaranteed to improve overall health of the population at a ridiculously low cost.” – Jeffrey Dach, MD
There are at least 50 diseases that can be prevented with adequate vitamin D blood levels. Why, then, is it that provincial governments refuse to cover the cost of testing that could not only save lives, but also save millions of Canadians from untold suffering? Government medical advisors and spokesmen are lying to the public when they say that there is no evidence for wide scale vitamin D blood testing. Either these people are utter idiots or there is a financial benefit to someone somewhere. I have to say this because the evidence is that overwhelming.
The cessation of Medicare coverage for vitamin D testing is more than unfortunate, and must be protested by anyone truly concerned with prevention. My suggestion is to write letters to the Minister of Health advising him/her that their so-called medical advisors are wrong about vitamin D testing coverage. Send him a copy of this article.
For the best supportive literature to use in backing up this claim, refer to the Vitamin D Council website (http://www.vitamindcouncil.org). This will give you a great deal of supportive scientific documentation to demonstrate the folly of cancelling Medicare coverage for vitamin D testing.
Rona, Zoltan P. Vitamin D, The Sunshine Vitamin. Tennessee, USA: Alive Books, 2010 http://www.amazon.com/Vitamin-D-Sunshine-Zoltan-Rona/dp/0920470823
The OHTAC (Ontario Health Technology Advisory Committee) Recommendation On The Clinical Utility Of Vitamin D: http://www.health.gov.on.ca/english/providers/program/ohtac/bulletins/ bul_07_2010.pdf
Vitamin D Testing Should Be Covered: Groups: http://www.ctv.ca/CTVNews/Health/20101001/ vitamin-d-testing-1001001/
Vitamin D Testing Should Be Covered For Everyone in Ontario, Groups Urge: http://www.winnipegfreepress.com/life/home_family/vitamin-d-testing-should-be covered-for-everyone-in-ontario-groups-urge-104106439.html
Vitamin D Therapeutic Overview & Evaluation of Evidence for Current Claims: http://www.rxfiles.ca/rxfiles/uploads/documents /Vitamin-D-Overview-QandA.pdf
Ontario Assn Of Medical Laboratories: Guideline For The Appropriate Ordering Of Serum Tests For 25-Hydroxy Vitamin D And 1,25-Dihydroxy Vitamin D (CLP026); June 2010. http://www.oaml.com/PDF/
Vitamin D Newsletter, March 2010 from The Vitamin D Council on Cardiovascular Disease: http://www.vitamindcouncil.org/newsletter
Vitamin D Deficiency Linked to Proliferative Diabetic Retinopathy: Presented at AAO: http://www.docguide.com/news/content.nsf/news/852576140048867C852577BF00738B4D
Doctors asked to cut back on vitamin D tests: http://www.timescolonist.com/health/Doctors+asked+back+vitamin+tests/3692595/story.html#ixzz12qyGVUqa
Vitamin D deficiency puts IBD patients at risk of osteoporosis: http://www.eurekalert.org/pub_ releases/2010-10/acog-vdd101510.php
Dr. Zoltan P. Rona practises Complementary Medicine in Toronto and is the medical editor of The Encyclopedia of Natural Healing. He has also published several Canadian best-selling books, including Vitamin D: The Sunshine Vitamin. Visit his website at: http://www.highlevelwellness.ca For appointments, call (905) 764-8700; Office: 390 Steeles Ave. W. Unit 19, Thornhill, ON