The bottle on the counter is not doing it

Feel-good Friday

Somebody handed me vitamin D for my balance. It took me two years to go and look it up.

It is the most reasonable sounding advice in the world. Bones, muscles, older people, falls. Take the vitamin.

And the pill is cheap, so nobody argues about it. Mine sat on the windowsill for two years, doing its job… or so I assumed.

Here is what turned up when it was tested properly.

The numbers

A national panel of experts gathered up the trials. Nine of them, 36,744 people, on whether vitamin D cuts falls.

The answer came out at 0.99. That is not a small benefit. That is nothing at all.

These were not scraps of studies. 36,744 people is a very large room. When a number that size lands on 0.99, it is not waiting for more data to rescue it.

Then they looked at how often people fell, across four trials and 28,519 people. 0.98, with a range sitting across no effect.

So that panel now recommends against taking vitamin D to prevent falls. They grade it a D, which in their system means do not do this.

And there is a small bill

Across ten trials and 99,036 people, vitamin D raised the chance of kidney stones a little. Around two more people in every thousand.

Small, that. But it sits on the wrong side of the ledger… and there is nothing on the other side to set against it.

Now the small print, because it matters

This is about taking vitamin D to stop yourself falling. It is not about everything.

People with osteoporosis were not in this question. Neither were people who are genuinely short of vitamin D. Nor was anybody taking it on their doctor's say so for a stated reason.

Those are real groups with real reasons, and they were set aside on purpose so the question could be answered cleanly.

So if your doctor put you on it, this is not a letter telling you to stop. Ask them why you are on it. That is a different question and a better one.

What does work costs nothing

Here is the other half, and it is the cheerful one.

That same panel recommends exercise to prevent falls, and grades it a B, which is a positive recommendation.

The big review we opened the week with is stronger still. 23% fewer falls, graded high certainty.

A pill you can buy in any store did nothing. Standing heel to toe at the kitchen counter did something. That is not the way these stories usually run.

Meanwhile the pill keeps its shelf in every drugstore in the country, right by the door… and the counter is free and already in your house.

That was the week. Monday, heel to toe for ten seconds at the counter. Tuesday, the three feeds and why the dark is harder. Wednesday, seventeen dull exercises three times a week. Thursday, the bedroom to bathroom route, for the people it actually helps.

Not one of those costs a dollar. The counter is already there and so are your feet.

If you only keep one thing from the week, keep the ten seconds. It is a measure and a treatment in the same motion, and you can do it while the kettle goes on.

Here is to standing on one foot,
Walt