Information on harm is missing

doi:10.1136/bmj.b4395

Published 28 October 2009, doi:10.1136/bmj.b4395
Cite this as: BMJ 2009;339:b4395

Letters

Vitamin D and falls

Information on harm is missing

The first 150 words of the full text of this article appear below.

We read Bischoff-Ferrari and colleagues’ meta-analysiswith astonishment, because it does not consider potential sideeffects of vitamin D and its toxicity.¹ This is further evidencethat treatment harms are regularly under-reported, even whenthe information is accessible in primary studies.²

As long as data on harm are missing, Bischoff-Ferrari and colleagues’meta-analysis does not permit an unbiased and objective assessmentof the balance between risks and benefit of vitamin D.¹ Thisis especially important in preventive options because patientsare confronted with decisions on long term treatment that might(or might not) prevent events in the remote future.

Vitamin D and its analogues are not harmless—gastrointestinalsymptoms and renal disease have been reported.³ We thereforerequest Bischoff-Ferrari and colleagues to prepare an amendmenton the side effects and toxicity of vitamin D. Because randomisedcontrolled trials often do not reflect the underlying risk-benefitprofiles of treatment options,⁴ inclusion of . . . [Full text of this article]

Gabriele Meyer, professor of clinical nursing research¹, Sascha Köpke, research fellow and senior researcher²

¹ University of Witten/Herdecke, 58453 Witten, Germany, ² University of Hamburg, Unit of Health Sciences and Education, Hamburg, Germany

Gabriele.Meyer@uni-wh.de