Antivaccine nonsense Medicine Quackery

Vitamin D: COVID-19 quacks embrace more general quackery

COVID-19 antivax quack Dr. Paul Marik has embraced vitamin D quackery. What does this say about the COVID “contrarian”-to-quack pipeline?

Remember how I said that I’d get back to normal posting this week? I lied. Well, not exactly. My intentions were good, but family and life interfered. (I won’t provide any further details.) That is why next week is more likely to be when I get back to normal blogging. Still, I couldn’t leave you hanging until next week without commenting on at least one thing I’ve been noticing in the COVID-19 “contrarian” (translation: antimask, antivax, science-denying) crankosphere, namely a little post in which a prominent COVID-19 contrarian and antivaxxer decided that vitamin D is the answer to nearly everything. It came in the form of a post by someone who’s been a dominant subject even during my current posting drought, namely Dr. Paul Marik, cofounder of the quack group Frontline COVID-19 Critical Care Alliance (FLCCC).

What does vitamin D have to do with a bunch of right-wing COVID-19 antivax quacks like the FLCCC? The title of the article is the giveaway. It’s on a Substack, albeit not Dr. Marik’s Substack, by “The Vigilant Fox” (a pseudonymous COVID-19 antivax antimask crank) who describes itself as a “pro-freedom citizen-journalist,” allegedly with “12 years of healthcare experience,” whatever that means. The article is entitled The Healing Power of Vitamin D: What Big Pharma Doesn’t Want You to Know—because of course it is—and leads to an article on Vigilant News with the same title. The tagline just cracked me up, too:

We know the medical establishment lied to us about COVID. And according to esteemed physician Dr. Paul Marik, they are also lying to you about the sun.

Yes, Dr. Marik is the featured physician interviewed for the piece, and the ad that preceded the video was for some sort of “chakra balancing” mat:

Chakra mat for vitamin D
It looks like just a yoga mat to me…

If there’s one thing that the last three and a half years of pandemic has taught me, it’s that there really is a “rabbit hole” effect when it comes to misinformation, pseudoscience, and quackery and that physicians are just as prone to it as anyone else. Early in the pandemic, seemingly respectable physicians with ideological views that went counter to the sorts of public health interventions being instituted to slow the spread of COVID-19 started believing somewhat “contrarian” things, such as the idea that COVID-19 was not as big a threat as advertised, that masking is not as effective as promoted, and that perhaps the economic effects of “lockdowns” (although the US never had a true “lockdown” anywhere) outweighed the benefits.

It’s the sort of beliefs that led formerly respected doctors like Dr. John Ioannidis to publish lowball estimates for COVID-19 case fatality rates very early in the pandemic and advocate for a “natural herd immunity” approach to the pandemic, the sorts of ideas that by October 2020 had gelled into the Great Barrington Declaration (GBD), in which a trio of “contrarian” doctors and researchers brought together by a right wing think tank proposed a “let ‘er rip” approach to the pandemic in which the young and healthy (and presumably at low risk for COVID-19 complications) allowed to go on with their lives and catch COVID-19 whenever they catch it to contribute to “natural herd immunity,” with an ill-defined strategy of “focused protection” proposed to keep those at very high risk of COVID-19 complications safe. (Also, remember that the GBD was issued months before any vaccine was expected to be available and more than two months before the vaccines did arrive much faster than expected.) It was a eugenicist approach to the pandemic that never would have worked, as one of its proponents ultimately accidentally sort of admitted, albeit inadvertently.

In any event, I watched as formerly respected physicians, particularly those with large social media followings, went further and further down the rabbit holes of misinformation, becoming more and more indistinguishable from “old school” antivaxxers (and even embracing many of their claims, while others increasingly embraced quackery not just for COVID-19 but for cancer and other diseases as well; e.g., when Tess Lawrie embraced ivermectin for cancer and homeopathy for, well, everything. The point is simple: Once you embrace the Dark Side of medical misinformation, forever will it dominate your destiny, and it’s rare for physicians who’ve started down that path to reverse themselves. Quite the opposite, in fact. Nearly all of them keep going further and further down the dark path.

Which brings us back to Dr. Marik and vitamin D:

“I think everyone on this planet should take vitamin D, and I don’t think that’s an underestimate,” expressed accomplished physician and author of 500 peer-reviewed journal articles Dr. Paul Marik.

In an interview with Children’s Health Defense, Dr. Marik explained — similar to how Big Pharma doesn’t like the “I drug” (Ivermectin) for treating COVID-19 — they also don’t like Vitamin D for general health and well-being. Because if you are in good health and devoid of chronic disease, there’s less money to be made.

If you’re the subject of fawning interviews with Robert F. Kennedy, Jr.’s antivax organization, you really have lost any claim to being a science-based physician.

In addition, Dr. Marik makes some rather bold declarations that would not be out of place over at Natural News:

“What you may not know is if you’re vitamin D deficient, it increases your risk of getting cancer,” Dr. Marik revealed.

“There’s a linear relationship between vitamin D deficiency and cancer. And the further you go away from the equator, the less UVB you get, the greater your risk of cancer. This has been well established!” Dr. Marik stressed.

“And now there’s really good data, really good data. If you take vitamin D, it prevents cancer. Isn’t that amazing?” he asked. In a previous article from Vigilant News, Dr. Marik explained how a daily regimen of taking Vitamin D, fish oil, and a simple exercise program could reduce your risk of cancer by 60%.

“Cancer is going to become the single most important cause of morbidity and death. It’s going to take over from cardiovascular disease, and it’s related to our lifestyle and all the toxins we’re exposed to,” Dr. Marik concluded.

I was curious about the article referenced. Unsurprisingly, it was also published on Vigilant News and entitled Reduce Your Cancer Risk by 60%: 10 Things You Can Do, Per Dr. Paul Marik. Naturally, it begins with an appeal to (false) authority:

Dr. Marik is the world’s second-most published critical care physician and has written over 500 peer-reviewed journal articles.

Even if this were true, let’s just say that a record of publishing a lot on critical care medicine doesn’t make Dr. Marik an expert on cancer prevention. It shows, too:

Conventional medicine suggests mutations in the DNA within cells are the primary cause of cancer, but “it’s really due to lifestyle changes, insulin resistance, vitamin D deficiency, obesity, and processed foods that [are] driving this exponential increase in the risk of cancer,” refuted Dr. Marik.

This is a narrative that cancer quacks have been pushing ever since I started paying attention to cancer quackery back in the 1990s, although this part about the Warburg effect is a bit more recent, dating back to the early 2000s when there was a resurgence of interest in the metabolic contributors to—not “causes” of—cancer:

In 1927, Otto Warburg observed a particular effect present in every cancer cell: they have faulty mitochondrial metabolism and rely on anaerobic means for fuel consumption. As such, cancer cells are heavily reliant on glucose. Dr. Warburg “won the Nobel Prize in 1931 for this finding,” reported Dr. Marik.

Building on Dr. Otto Warburg’s research on cancer cell metabolism, Prof. Thomas Seyfried has further advanced the understanding of cancer. He has compellingly shown that cancer should be viewed primarily as a metabolic disorder rather than a mere chromosomal defect. As such, he argues treatments should target the disease’s metabolic nature rather than just its genetic anomalies.

This narrative is, of course, very attractive for the same reason that a lot of claims about “lifestyle” and health are attractive, because it suggests that we have near-total control over our health, in this case whether we get cancer or not. Of course, I’ve written about the Warburg effect before. Remember dichloroacetate to treat cancer 13 years ago? Let me just recount a bit about the Warburg effect. In brief, Otto Warburg first described this effect in 1928 and reported in Science back in 1956. In the early 2000s, cancer researchers increasingly appreciated the role of abnormalities in metabolism, in particular the mitochondria, in cancer. To put it briefly, many cancers (approximately 60-90%) favor glycolysis, even in the presence of adequate oxygen for oxidative phosphorylation, leading to a voracious appetite for glucose. Indeed, it is this very avidity of cancer cells for glucose that is the basis of the PET scan, which detects the high uptake of a radiolabeled form of glucose by cancer cells relative to the surrounding normal cells.

The problem, of course, has boiled down to a sort of “chicken or the egg” argument about what is more important and what is the first abnormality leading to cancer. The traditional view has long been that mutations in DNA lead to the activation of protooncogenes into cancer-initiating and causing oncogenes and to the shutdown of tumor suppressor genes. Under this model, mutations leading to cancer also lead to the observations of abnormalities in metabolism. In the wake of the DCA furor, there have been data reported suggesting that the metabolic derangements may actually occur first or simultaneously with the mutations. p53, for instance, the granddaddy of tumor suppressor genes, can trigger the Warburg effect when mutated. Whatever the case, it has become fairly clear that abnormalities in cancer cell metabolism are also very important in driving cancer growth and could well represent targets for cancer therapy. AS a result of these new data, studying the metabolism of cancer cells has become a much hotter topic of research than it has been in the past. Everything old is new again, it seems. However, I also note that since 2010 interest in targeting the Warburg effect seems to have waned, likely for the same reasons that interest in targeting tumor angiogenesis, which was all the rage in the 1990s, waned: Real world results in humans didn’t live up to the hype.

But back to vitamin D. Leave it to Dr. Marik to parrot all the usual quack tropes about vitamin D, such as cleaning that “They” don’t want you to know about its amazing anticancer properties. (If that’s true, then why are there thousands of articles in PubMed that study just that?) He even doubles down on the conspiracy theory:

They design Vitamin D studies to fail, declared Dr. Marik. “So, when they design studies, they design them to fail using very low doses. To give 2000 units a day in these randomized trials is an absurdity. It’s a tiny dose. But they do that because they want the studies to fail, and they [conclude] it doesn’t work.”

Because of course “they” do. Why else would the expend the years of effort and millions of dollars to study whether vitamin D prevents cancer other than that “they” want the studies to fail? Then, “brave maverick” that he is, Dr. Marik goes all sun worshiper and claims:

Dr. Marik brought up a “really interesting study” about women who were sun averse, or afraid of the sun. What was discovered in that study was “If you avoid the sun, it increases your risk of dying [prematurely] by about 25%,” revealed Dr. Marik.

Dr. Marik recommended going into the sun for about 30 minutes a day. He advised not to use sunscreens because “it defeats the purpose.” “In fact, there’s some data that sunscreens increase your risk of melanoma — paradoxically.”

Going against the medical orthodoxy again, Dr. Marik shared an interesting perspective on sunshine and melanoma.

“Sunshine is really good. Something even more interesting is that sunshine prevents cancer. If you have melanoma, the best thing you can do for melanoma is to go into the sunshine. Isn’t that paradoxical?” he asked. “And, in fact, in Italy, there are spas that offer suntanning excursions for people with melanoma to suntan. Isn’t that remarkable?”

Notice how the article describing the interview with Dr. Marik didn’t include any actual studies to back up those last two claims that sunscreens increase the risk of melanoma and that sunshine prevents cancer. Maybe Dr. Marik lists them in his book that he’s hawking about repurposed drugs to treat cancer. (I wonder if he mentions my favorite one, riluzole, about which I’ve done actual bench research? Probably not.)

Perhaps I should write a more detailed discussion of vitamin D in cancer. Until then, let me just say that the question of vitamin D and cancer is far more complex than vitamin D cancer quacks like Dr. Marik let on. For example, a recent study examining data for the risk of 14 different cancers based on vitamin D levels in the blood came up with disappointing results. It only found a definite association between vitamin D levels and the risk of one cancer suggesting causality: melanoma. It also found a suggestion of a correlation for colorectal cancer. For the other twelve cancers, it found no evidence of a potential causal relationship. One other study suggests that elevated vitamin D levels are associated with an increased risk of melanoma.

The bottom line is that, whatever effect vitamin D levels have on cancer risk, it is nowhere near as simplistic as Dr. Marik’s assertion that vitamin D is always anticancer and that sun exposure is good for you with respect to cancer risk. Not that that stops him from citing elsewhere a study that supports his claim that you can easily reduce your risk of cancer by 60%, specifically three interventions: Supplemental 2000 IU/day of vitamin D3, and/or 1 g/day of marine omega-3s, and/or a simple home strength exercise (SHEP) programme compared to placebo and control exercise.

The interesting thing about this study is that no one argues that exercise can’t modestly decrease your risk of cancer. It can. However, in this study, none of the interventions tested individually produced a statistically significant reduction in cancer risk. They all produced a modest decrease in risk, but it wasn’t statistically significant. For example, for vitamin D, the adjusted hazard ratio was 0.70 (0.44–1.09, 32 vs. 49). Note that confidence interval. It overlaps 1.0, indicating that the effect size did not reach statistical significance. Only combinations of interventions started to reach statistical significance, and for all three the adjusted hazard ratio was 0.39 (0.18–0.85; 4 vs. 12 cases). (That’s where the 60% reduction comes in, a hazard ratio of 0.39, which would correspond to a 61% risk reduction.) Given the small number of cases and the lack of statistical significance for individual interventions tested, color me unimpressed. Also color me completely unimpressed with the vitamin D arm of this study, which basically showed that vitamin D doesn’t work.

It has been both fascinating and distressing to watch so many physicians dip their toes in COVID-19 contrarian waters, only to wade deeper and deeper into the pool before pounding headfirst into the depths of quackery and pseudoscience. It suggests a process of radicalization with respect to denying medical science that is near-inexorable, at least if the physician (like Dr. Marik) is left to his own devices. The question is: Are there points in the process where an intervention might reverse the quack radicalization? Are there strategies of teaching critical thinking that might—dare I say?—inoculate young physicians against starting down the path to become a quack like Dr. Marik? These are not new questions, but the pandemic has made answering them more urgent.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

26 replies on “Vitamin D: COVID-19 quacks embrace more general quackery”

One other study suggests that elevated vitamin D levels are associated with an increased risk of melanoma.

Serious question: is there a correlation because people who go in the sun a lot:
a) have elevated Vitamin D levels, and;
b) are more likely to develop melanomas due to that exposure?
This strikes me an obvious explanation for the correlation.

Pierre and Paul both look ugly, but well, they are more supervillains than superheros.

Orac, you are citing a very interesting study by Bischoff-Ferrari et al.

HR for single interventions, compared by product of individual probabilities if these factors act independently:

D3: 0.76
O3: 0.70
SHEP: 0.74

D3+O3: 0.53 | 0.760.70 = 0.53
D3+SHEP: 0.56 | 0.76
0.74 = 0.56
O3+SHEP: 0.52 | 0.70*0.74 = 0.52

For all three

D3+O3+SHEP: 0.39 | 0.760.700.74 = 0.39

It is very spooky that these HR factors, when multiplied, neatly match HR’s of combined interventions.

Either the study was fake, or there is something very profound at play.

The number of participants, 2,157 was not that small. That the HR’s multiply suggests that the effect are not a result of random chance, PROVIDED THAT THE STUDY IN QUESTION WAS NOT FRAUDULENT.

I discussed this study and why I’m suspicious of studies where the effects of individual interventions do not reach statistical significance, but the combined effect does. The most important observation is that the effect size for vitamin D alone was not statistically significant.

I am personally suspicious of this study, and it might just be entirely fake. But if it isn’t fake, it is amazing.

Harumph! Ivermectin is not useless! I know a guy who took it and it cured him!

He’d picked up an intestinal parasite in sub-Saharan Africa. Cleared it right up!

Also, the “sunlight is good!” thing of course reeks of the naturalistic fallacy.

If you call it “high exposures to near-ultraviolet radiation”, it sounds a lot more ominous. And of course, that’s what it is.

Science-nerd moment: All opaque objects above absolute zero emit electromagnetic radiation, because the electric charges present in all matter are shaking back and forth, and a shaken charge emits electromagnetic radiation. This is called thermal radiation, or black body radiation in some circumstances.

All EM radiation is made up of quanta of energy, called photons. If a photon is low-frequency and long-wavelength, it carries little energy, but high-frequency, short-wavelength photons carry higher energy — it’s an exact proportionality, first suggested by Max Planck to explain the observed distribution of blackbody radiation with frequency.

At room temperatures, blackbody radiation is mostly in the infrared, longer than what the eye can see. But as you heat an object up, it starts to emit visible light — an ordinary light bulb filament is an example. They run at about 2700 Kelvin, and produce a fair amount of visible light.

The sun’s surface is 5800 Kelvin, so sunlight is much bluer than a light bulb — it’s hot enough to make lots of those short-wavelength, high energy blue photons. And more to the point here, it ALSO is hot enough to produce a fair amount of UV light, with higher energy per photon than visible light. And that high energy, when absorbs, delivers a concentrated “punch” of energy that can damage cells (that’s Orac’s bailiwick). The melanin pigment in our skin helps protect against this, which is why light-skinned people manufacture melanin on exposure to sunlight, and why populations in sunny climates tend to rather quickly evolve dark skin.

LED light bulbs are often marked with a “color temperature” — a 2700 K bulb reproduces the ‘warm’, i.e., reddish, light of an old filament bulb. A 6000 K bulb is much bluer, though not being a real blackbody does not produce appreciable UV.

This has been your science-nerd moment.

It IS remarkable, but when you’re guided by your political/religious/economic ideology, those considerations must always come before evidence. And when you find you’re wrong, your ego demands that you embrace the nonsense more tightly rather than admit that you’re wrong. The real disaster is when the people who really ARE experts go astray, and take their ideological allies with them. COVID has cemented this phenomenon in our culture, and humans will fail the next pandemic even worse than they did this one.

Dr. Marik is the world’s second-most published critical care physician and has written over 500 peer-reviewed journal articles.

Fact Check: A search in using “Marik PE” came up with more than 400 hits. Dr. Marik is well published.

MJD says,

When it comes to cancer prevention, MJD is not a fan of Dr. Marik. In my opinion, how vitamin D consumption affects immunity is a better indicator. For example, higher levels of vitamin D have been shown to have an inhibitory effect on allergies. Increased allergic manifestations have been shown to have a suppressive effect on cancer.

@ Orac’s minions,

A search in using “Gorski DH” came up with about 50 hits. In comparison, a search in using “Dochniak MJ” came up with 1 hit…quality over quantity?

Comparing dr. Marik with dr. Gorski, it is quality over quantity. Comparing dr Gorski with you, it is quality on the side of dr. Gorski and ? on your side.


blockquote>In comparison, a search in using “Dochniak MJ” came up with 1 hit…quality over quantity?

Re the one hit for your spam article: a flaw in the system allowed it.

In comparison, a search in using “Dochniak MJ” came up with 1 hit…quality over quantity?

LOL. Medical Hypotheses. LOL.

For giggles, I looked up Dochniak in Scopus. Last citation was in 2017. Nobody has found anything he has written useful in the last 6 years.

In comparison, David Gorski 99 has citations to his work this year. I am more prolific in the publishing space, but not being in medicine don’t get as many citations, but have accumulated 321 citations to my work in 2023 so far. This is what real science looks like, MJD. Junk science gets lost without a trace.

@ Idw56old & Chris Preston,

Let’s be honest, epidemiology studies indicate that allergies are a significant etiology of ADHD and Autism Spectrum Disorders (ASD). The 1-hit ‘Dochniak MJ’ publication you both ridicule was an exploratory beginning of allergies and autism. Therefore, quality over quantity is now a statement, and not a question.

@ Orac,

Tell them you were wrong, and let’s move onto teachings about “allergies and cancer.” Thanks!

Cherry picking a citation is no longer required in that allergies and autism has passed the threshold of scientific consensus.

Let’s be honest, epidemiology studies indicate that allergies are a significant etiology of ADHD and Autism Spectrum Disorders (ASD).

You are as uninformed about the meaning of “let’s be honest” as you are about valid science.

From the cited Marik quote:
“Dr. Marik brought up a “really interesting study” about women who were sun averse, or afraid of the sun. What was discovered in that study was “If you avoid the sun, it increases your risk of dying [prematurely] by about 25%,” revealed Dr. Marik.

Dr. Marik recommended going into the sun for about 30 minutes a day. He advised not to use sunscreens…

Going against the medical orthodoxy again, Dr. Marik shared an interesting perspective on sunshine and melanoma.

“Sunshine is really good. …”
[Dr. Marik also endorses setting yourself on fire because fire is “really good” as it warms our domiciles, cooks our food, and helps keeps us alive.
Marik obviously isn’t very good at nuance and seeing the big picture.]
It looks like Marik is encroaching on Joe Mercola’s pro-cancer turf.
I wonder if Dr. Marik is also selling tanning beds and vitamin D supplements…

I wouldn’t let the insane Dr. Marik treat my cat let alone a human…

I wonder if people who stay inside a lot also tend not to get much exercise or have other factors that might explain the observed correlation. I’m just a simple country astrophysicist, but it seems to me that logical rigor isn’t Dr. Marik’s long suit.

Right, other factors could be serious physical or mental illness, poverty or disability which could also affect outcomes.

In my real world experience, there might be something to Vitamin D and severity…then again, there might not. N=about 12

I recall one randomized study that also found a huge benefit to Vitamin D. It was done in Spain 2020. I heard about it from a Youtube video from John Campbell and it was helpful when I had Covid in Nov 2020. That Covid was not super mild, (100+ temp for four days) but I stayed home and recovered just fine.

You of course could go to and search for metaanalysis
Vitamin D deficiency/insufficiency increased the odds of developing COVID-19 (odds ratio [OR] 1.46; 95% CI, 1.28-1.65; P < 0.0001; I2 = 92%), severe disease (OR 1.90; 95% CI, 1.52-2.38; P < 0.0001; I2 = 81%), and death (OR 2.07; 95% CI, 1.28-3.35; P = 0.003; I2 = 73%)

Stopped clock effect in action… Supplementing vitamin D might be a good idea for quite a few people in the developed world due to largely indoor lifestyles. Woo aside, vitamin D deficiency has some real and quite nasty effects.

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