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Dude, you do NOT know medicine. It's not the first thread where you're advertising your ignorance. People like you do make me angry, because I see them hurt patients all the time. ALL THE TIME. And most patients are way too uneducated to even suspect it, even when they keep feeling worse (it's the disease, never the doctor).If someone cannot have a constructive dialogue and must be attack like a ***** flailing around in the dark, you will just be blocked. I enjoy critical feedback. Attention starved individuals needing confrontation to fill the void in their empty lives, aren’t my cup of tea. Social media feeds this unmet need of anger present in many people’s lives. My guess is the people who get wildly angry at random people on the internet are most like addictive personalities. My guess they have a drug addiction or are in recovery. I don’t have time for the bull****
Sometimes there is harm. Just because something exists in nature, it doesn't mean it's harmless, especially when given IV (the body seems to have better defenses against PO human stupidity).As a physician scientist who believes there is no such thing as settled science, I always weigh risk vs benefit. Unless I see risk in the aforementioned supplements at said doses beyond expensive urine, and there is plausible benefit, I see no harm in taking and recommending them. This doesn't imply that they are a cure or a substitute for an effective vaccine.
The only positive trial had 16 patients in the treatment arm? That is just wrong. I am not sure why people insist on stating falsehoods in order to make their arguments. If you are going to misrepresent facts in order to make an argument, it doesn't help bolster your case, it just weakens it. Your last statement is another throw out there statement with no basis to the topic at hand.
The cohorts were not even matched in the study.If you’re referring to the Spain pilot study, I’m not sure you want to hang your hat on that. The effect size is absolutely enormous and there was like a 48% absolute risk reduction for ICU admission with zero deaths in the treatment arm. Clearly something is amiss there.
You are committing libel. This is in fact libel.
There is a degree of gaslighting that occurs on this forum if you think outside the box. I personally find alternative opinions refreshing, lest we find ourselves in an echo chamber. Some ideas I consider, some I discard. None do I find threatening to me professionally or personally.You are committing libel. I am presenting information put forth in journal articles, these are not even my own words, but the words repeated from articles.
You state that before we can recommend treatments we need to have research done to ensure that the treatment is not causing harm and that those studies need to be reproducible. And yet you are sounding the drum on a novel drug that has not been thoroughly studied and is being given to all populations throughout the world based on very little data. However to question your dogma, is advertising ignorance.
Hurt patients all the time? You are such an ass. Many of the docs where I work ask for me to personally perform their anesthetic. These are docs from all throughout the hospital, internists who receive my patients on the wards. I have, what I believe to be a good reputation. You are carefree with your characterization of my professional abilities. This is in fact libel. I have never questioned anyones clinical competence or skills in this or in any forum as it would not be my place to do so. This is completely unacceptable, although with the mob like behavior and lack of administrative oversight present on this forum, it appears the administrators care more for being popular and part of the crowd then they do for moderation.
As a physician scientist who believes there is no such thing as settled science, I always weigh risk vs benefit. Unless I see risk in the aforementioned supplements at said doses beyond expensive urine, and there is plausible benefit, I see no harm in taking and recommending them. This doesn't imply that they are a cure or a substitute for an effective vaccine.
The only positive trial had 16 patients in the treatment arm? That is just wrong. I am not sure why people insist on stating falsehoods in order to make their arguments. If you are going to misrepresent facts in order to make an argument, it doesn't help bolster your case, it just weakens it. Your last statement is another throw out there statement with no basis to the topic at hand.
I learned that high dose Vitamin C causes renal failure from precipitation. And this is PO 50mg/kg as recommended by CDC. Not the crazy doses that Marik recommends IV. And IV Vit C is ridiculously expensive.Have long term adverse effects of these supplements at these doses been studied? Do they get the same followup as vaccines? If nobody looks....
Oh, please! Nobody gets gaslighted for being a good doctor. On the contrary, that's how people make their names here. The more we learn from somebody, the more we respect them.There is a degree of gaslighting that occurs on this forum if you think outside the box. I personally find alternative opinions refreshing, lest we find ourselves in an echo chamber. Some ideas I consider, some I discard. None do I find threatening to me professionally or personally.
FFP is back with the hammer ( and the sickle )Oh, please! Nobody gets gaslighted for being a good doctor. On the contrary, that's how people make their names here. The more we learn from somebody, the more we respect them.
It's not by chance that some of OP's most vehement critics are anesthesiologist-intensivists. It's the nature of our subspecialty to be skeptical about most medical "science", because the number of "conclusions" that we can't reproduce IRL is higher by many degrees of magnitude than those which truly change outcomes. We have learned to be very skeptical about most papers and claims, and to always look for secondary gain, biases etc. We would be 90+% right even if we said that a paper was useless sight unseen, that's how bad most published medical studies are, even in the big journals. Nobody has ever gotten fired for publishing a medical paper whose results could not be reproduced. Right now, we are downright allergic to anybody pushing vitamin therapies, given the recent failure to prove that Marik's HAT protocol was superior to hydrocortisone in sepsis. If I were to guess, MATH+ won't be superior to just M+H either.
I tell my family to take their vitamins C and D, and zinc, because it probably won't hurt them, absent an alternative (but it won't help them that much either - there are no RCTs on the subject). I also tell them to get vaccinated against Covid-19 if they get the chance (because THAT has 32,000 cases in its favor, not to mention the hundreds of thousands of awful cases, many dead). At this point, there is no medication that can consistently change outcomes in Covid-19 (even the monoclonal antibodies are hit and miss). So let me be skeptical about anybody who pleads against vaccination in one thread and for vitamin therapy in another.
Btw, I was one of the guys who voted No about getting a Covid-19 vaccine, just weeks ago, and still ended up getting one.
This.They’re making inferences based on correlation, that low vitamin D levels are correlated with worse outcomes. That does NOT mean supplementing vitamin D will improve outcomes. It could have the opposite effect or no effect. We cannot know without a RCT.
There’s no trial I know of that shows vitamin D supplementation prevents or improves outcome in COVID 19 like we have for dexamethasone and the vaccines. If you know of one, please post it.
This.
Since I'm not as learned as most of y'all, I'll pull in a primary care example.
We know that high HDL is protective against CV disease. We know niacin raises HDL.
Multiple trials have shown that niacin doesn't reduce CV risk.
I think taking some supplements during this crazy period of Covid 19 is reasonable provided the amount isn't massive. For example, I am taking Zinc 15 mg PO per day plus some low dose VIt C and Vit D. This is in addition to my vaccine shot. Once the crisis blows over I will drop the extra supplements.
First do no harm. That means avoiding massive doses of unproven supplements and use some common sense. These supplements may NOT be benign when given in large doses over a long period of time.
Another excellent survey of data regarding VitD3
42% of Americans are vitamin D deficient. The vaccine is not entirely effective in preventing severe COVID infection in patients. It would seem that ensuring that all Americans are non vitamin D deficient would be a positive public health initiative (or at a minimum high risk populations such as the elderly). I take vitamin as does everyone in my household as the risk is negligible but the benefit could certainly be life saving.
Some people should google "post hoc ergo propter hoc".
Within the first 30 seconds they already show their bias. The evidence is not continuing to grow for the use of vitamin D in preventing COVID. There is a growing body of evidence that vitamin D deficiency is correlated with increased risk of COVID and in morbidity and mortality in COVID. There is still no good evidence that supplementation of vitamin D has any benefit in COVID. There is one extremely small trial that shows a benefit, another trial that shows no benefit on LOS (primary outcome was length of hospital stay, and secondary outcome was mortality, but since it wasn’t powered for that we can’t really say much more than that), and a bogus study out of Spain that clearly has problems given it’s insane results.
There is also a study that looked at folks with a genetic predisposition to vitamin D deficiency and COVID, and they actually had better outcomes.
So no, there isn’t a growing body of evidence that vitamin D supplementation is beneficial, unless you want to completely forget everything we learned about stats and research and just pretend correlation = causation. I am highly suspicious of anyone pushing supplements that have no data.
Again, you are making a statement I have not made. I never said the vaccine is not the way forward. What I have said is that we have no information on the long term risks of this vaccine. I have said, for me, the risk of the virus is extremely low, but I have zero ability to quantify the long term risk of the vaccine as there is zero data on the long term risks of the vaccine.
What I have said is that the data on VitD is thus far showing it may be beneficial, and that many people in the US are deficient. The risk of correcting VitD levels is low, and may have a major benefit.
Vitamin D has been touted as some magic bullet for years now. I remember in residency hearing some "groundbreaking " research that Vit D deficiency was associated with poor pregnancy outcomes and all we had to do was supplement people and we could cure pre eclampsia. That was 7 years ago and nothing has come of it.42% of Americans are vitamin D deficient. The vaccine is not entirely effective in preventing severe COVID infection in patients. It would seem that ensuring that all Americans are non vitamin D deficient would be a positive public health initiative (or at a minimum high risk populations such as the elderly). I take vitamin as does everyone in my household as the risk is negligible but the benefit could certainly be life saving.
Actually there is data, you just chose to not believe it. There have been vaccines in production (non mRNA) that have not had issues, but then RSV vaccine caused issues. I am done responding to you. You didnt ask me a question. You lie to yourself. I am not interested.
Lol what? Anyone who calls you out on your logical fallacies gets accused of libel, but you feel free to misrepresent data and attack people personally. The mental gymnastics here are staggering.
Actually that isn't what is happening at all. Dr John Campbell is also adamant about VitD3. He is asking why there is not any large randomized trials in queue from major health organizations, and rightly so.He's Donald Trump in a white coat. He posts for an echo chamber. When he doesn't get it he ignores and dismisses. He'd rather pander nonproven vitamins, zinc, and melatonin over the only real hope this country has of getting through COVID in 2021 - a vaccine. Because, well, you know, long term data and all. As if there's long term data to support vitamins, zinc, melatonin, and other hand waving that cures ARDS, sepsis, and COVID19.
The most troubling part is that he isn't pandering to the lay public. He's pandering to his physician peer group, and gets frustrated and ignores us when we call out BS for BS.
All physicians should learn to critically evaluate the evidence during their training. Either they don't, or most unfortunate, they do but push it aside for the sake of political belief in a time of strife within our country. Either way, I'm glad some amongst us are calling this out for what it is. Pure BS.
DOCTOR John Campbell? You mean John Campbell, retired Accident and Emergency nurse, Ph.D.?Actually that isn't what is happening at all. Dr John Campbell is also adamant about VitD3. He is asking why there is not any large randomized trials in queue from major health organizations, and rightly so.
I dismiss people who, as you are doing here, who instead of making a counter argument would rather attack me.
Let me reiterate for the nth time, for myself, the risk of COVID is extremely small. The risk of the vaccine is unknown. How can I further decrease my risk from this virus in a way of very little risk and possible huge benefit? That is what I have presented. This has caused people to attack. I am not the one in an echo chamber. I openly support others to dialogue in a respectful way. But I will be leaving, you can go back to everyone in a discussion agreeing. It is better for you that way because you are outside any echo chamber. Having everyone agree with you and viciously attacking the one person with a counter view is most definitely not an echo chamber.
You know what? Scrap my question, I don't even care about your point. I don't want to go back and forth with you or anyone else about nonsense.Yes, you aren't telling me anything I didnt know. Who cares where you get your CME from? He is evaluating data and presenting it to people. He supplies non biased data analysis. What is your issue now?
Prof. John Campbell, PhD
Associate Director, Research and Development
Scottish National Blood Transfusion Service, Edinburgh
Yes, you aren't telling me anything I didnt know. Who cares where you get your CME from? He is evaluating data and presenting it to people. He supplies non biased data analysis. What is your issue now?
Prof. John Campbell, PhD
Associate Director, Research and Development
Scottish National Blood Transfusion Service, Edinburgh
Absolutely. But presenting them as effective therapy or prophylaxis, while badmouthing the vaccines, as the OP did, is ridiculous.You guys are rough crowd. The "evidence" for any of these supplements to prevent Covid 19 isn't there,. I agree with that statement. But, there is some association between these supplements and perhaps lower severity of infection. For those at risk and who refuse the vaccine I do think taking some of the supplements at low doses is a reasonable strategy to possibly reduce the severity of Covid 19.
Like I have posted , I myself take these supplements along with my first shot of an mRNA based Covid 19 vaccine. I believe the risk/benefit curve of taking these supplements (again at reasonable dosages) outweighs the risks.
You guys are rough crowd. The "evidence" for any of these supplements to prevent Covid 19 isn't there,. I agree with that statement. But, there is some association between these supplements and perhaps lower severity of infection. For those at risk and who refuse the vaccine I do think taking some of the supplements at low doses is a reasonable strategy to possibly reduce the severity of Covid 19.
Like I have posted , I myself take these supplements along with my first shot of an mRNA based Covid 19 vaccine. I believe the risk/benefit curve of taking these supplements (again at reasonable dosages) outweighs the risks.
He would have a LOT of spamming to do to compensate for all the good stuff along the years. Nobody's perfect.I remember you spamming the articles about hydroxychloroquine too.
I for one appreciate your dispassionate arguments and am a little surprised at the many all-caps replies. I think in some cases the irrational responses are quite telling.Actually that isn't what is happening at all. Dr John Campbell is also adamant about VitD3. He is asking why there is not any large randomized trials in queue from major health organizations, and rightly so.
I dismiss people who, as you are doing here, who instead of making a counter argument would rather attack me.
Let me reiterate for the nth time, for myself, the risk of COVID is extremely small. The risk of the vaccine is unknown. How can I further decrease my risk from this virus in a way of very little risk and possible huge benefit? That is what I have presented. This has caused people to attack. I am not the one in an echo chamber. I openly support others to dialogue in a respectful way. But I will be leaving, you can go back to everyone in a discussion agreeing. It is better for you that way because you are outside any echo chamber. Having everyone agree with you and viciously attacking the one person with a counter view is most definitely not an echo chamber.
Once again, the deficiency is the problem. We have no evidence that fixing that deficiency with po vitamin d supplementation matters.Zinc Deficiency Linked to Higher Post-op Opioid Consumption
Multiple epidemiological studies in adults and children have demonstrated that vitamin D deficiency is associated with increased risk and greater severity of infection, particularly of the respiratory tract.
The Role of Vitamin D in Prevention and Treatment of Infection
Vitamin D is well known for its classic role in the maintenance of bone mineral density. However, vitamin D also has an important “non-classic” influence on the body’s immune system by modulating the innate and adaptive immune ...www.ncbi.nlm.nih.gov
I for one appreciate your dispassionate arguments and am a little surprised at the many all-caps replies. I think in some cases the irrational responses are quite telling.