The ‘truth’ about vitamin D


Ask five doctors about the benefits of vitamin D and you're likely to get five different answers. This seemingly innocuous vitamin has become the source of intense debate. Some proponents recommend supplementing your diet with massive amounts of vitamin D and believe it can prevent diseases from cancer to schizophrenia. Meanwhile, most others who aren't so sure about vitamin D's long-term effects urge caution and moderation. Further complicating matters, most of the existing evidence on D is observational and epidemiological, so definitive answers, even about something as seemingly simple as adequate daily intake, aren't yet available. In our cover story, Stacey Butterfield tackles the controversy behind this nutrient, summarizing the main points of contention and detailing the arguments behind each group's stance.

Irritable bowel syndrome (IBS) is a common problem in internists' practices, but the ideal treatment can be a moving target. It's essential, experts say, to treat the whole person rather than just the disease. IBS symptoms can originate in the brain or the gut, and knowing which is true in your patient can go a long way toward helping you craft an appropriate treatment plan. Paula S. Katz distills recent research on IBS, including which alternative therapies are gaining traction and why drugs aren't always the answer.

Also in this issue, our latest Mindful Medicine column, Jerome Groopman, FACP, and Pamela Hartzband, FACP, focus on the potential consequences of an uncertain diagnosis in this case, metastatic cancer that turned out not to be cancer at all. Drs. Groopman and Hartzband discuss how the treating physician dealt with this situation and why it's important to be aware of the emotional effects of your diagnoses on your patients.

We're always looking for more cases to feature in our Mindful Medicine column. If you have a challenging diagnosis to submit to Drs. Groopman and Hartzband for consideration, let us know.

Sincerely,
Jennifer Kearney-Strouse