Public health at risk as Vitamin D evidence mounts

A group of prevention-focused healthcare organizations has expressed deep concern over recently-proposed restrictions to OHIP coverage of Vitamin D testing in the province.  The proposed new legislation will delist OHIP insured Vitamin D testing for most Ontarians. Exceptions will be made for those with osteoporosis, malabsorption syndromes, and individuals taking medications that interfere with vitamin D absorption or metabolism. The Ontario Medical Association (OMA) Complementary Medicine Section; The Ontario Society of Physicians for Complementary Medicine (OSPCM); and the Holistic Health Research Foundation of Canada (HHRFC) have responded to the Ministry through its public consultation process, which ends September 27.

The group is urging an expansion of the proposed exceptions to include OHIP funded testing of cancer patients, patients with unexplained musculoskeletal pain or generalized muscle weakness, and patients with autoimmune diseases such as multiple sclerosis and rheumatoid arthritis. They also urge annual screening for those 40 years and older to lower the risk of developing osteoporosis and cardiovascular disease. These additional categories reflect mounting evidence suggesting the importance of monitoring and optimizing Vitamin D levels to prevent chronic disease and disease recurrence.

Low blood levels of vitamin D have been associated with an increased risk of many common degenerative diseases, while high levels are considered potentially protective. However, it is impossible to know if someone is vitamin D deficient without a blood test (25-hydroxy D).

"If there were a dependable way to predict someone's vitamin D status without drawing blood that would be wonderful," says Dr. Robert Banner MD, Chair, Complementary Medicine Section of the OMA.  "Unfortunately, recent studies have shown that the daily intake of vitamin D from foods and supplements is not a dependable indicator of a patient's vitamin D status. There is a wide variability in response to supplements from one patient to another, and therefore no specific dosage meets the needs of everyone. We need blood tests to monitor the response of our patients to supplements."

A recent Statistics Canada survey showed that 64.6% of Canadians had insufficient blood levels (less than 75 nmol/L). Current estimates suggest that increasing blood levels of vitamin D to105 nmol/L for everyone in Canada could see the overall annual death rate fall by 37,000 and health care spending reduce by 6.9% or $14.4 billion annually.

The Ontario Government acknowledges the role of vitamin D in osteoporosis, and OHIP payments for vitamin D blood tests will continue for patients with osteopenia and osteoporosis. However, annual screening of Ontarians to detect low levels of vitamins D and prevent the development of osteoporosis will not be covered under the new rules. The current cost to the Canadian health care system of treating osteoporosis and the fractures it causes in Canada is estimated to be $1.9 billion annually.

"It seems extraordinary that although the Ministry of Health recognizes the importance of vitamin D in the development of osteoporosis, they want us to wait until we have acquired this serious degenerative bone disease before providing free vitamin D testing," says Aileen Burford-Mason, PhD, President, Holistic Health Research Foundation of Canada. "We are extremely disappointed that they have failed to seize this important opportunity to prevent a disease, and instead would rather wait and treat it once it is established."

Responses are being invited by the Ministry until September 27, 2010 at http://www.ontariocanada.com/registry/view.do?postingId=3902&language=en

Source: HOLISTIC HEALTH RESEARCH FOUNDATION OF CANADA