Vitamin D
by John Cannell
The Vitamin D Council
October 2, 2005
I love ignored facts. Aldous Huxley
once said, “Facts don’t cease to exist just because they are ignored.”
I decided to look for ignored facts. Were there any ignored facts that would
tell me how to protect my three-year-old from the infection-of-the week
from her day-care center? Tucked away in an ignored journal was an ignored
fact.
In 1994, Dr. Rehman gave 60,000 units of vitamin D a week to 27 children
(aged 3-12) with frequent childhood infections and compared them to controls.
The children also had elevated alkaline phosphatase (like many American
children), which usually indicates vitamin D deficiency. He gave the kids
vitamin D for six weeks along with calcium. He didn’t say if he used
real vitamin D (cholecalciferol) or if he used ergocalciferol. Anyway, he
gave them 60,000 units a week for six weeks, about 9,000 units a day.
J Trop Pediatr. 1994 Feb;40(1):58
Within a few weeks, “infections were fully controlled and no recurrences
were reported for six months.” The kids just stopped getting sick!
An ignored study, ignored facts, not repeated, not remembered. The author
didn’t measure vitamin D levels, but 9,000 units a day of vitamin D
for six weeks should bring most vitamin D deficient children to 50 ng/ml,
probably higher.
I’m skeptical by nature. So I decided to experiment on myself - physicians
experimenting on themselves are one of the great traditions in medicine.
I bought some 50,000 unit capsules of real vitamin D from Bio-Tech. The
next time I got the crud, I took a single capsule (50,000 units) of cholecalciferol,
which is perfectly safe for adults. In Europe, they give ten times that
amount as "stoss therapy” all the time. I was amazed how much
better I felt the next day. If you decide to experiment on yourself, do
it once or twice. Don’t keep taking 50,000 units every day or you will
get toxic. Also, keep close tabs on your vitamin D level.
Children don’t need the 60,000 units a week to improve their immune
system, although Dr. Rehman found that amount safe for six weeks. 60,000
units per week for a young child is a pharmacological dose, not a physiological
dose. If vitamin D could be patented, we would already have lots of studies
using pharmacological doses as drug companies explored dosage ranges to
find the maximal effects of vitamin D. However, it can’t be patented
and studies using pharmacological doses are decades away.
For now, vitamin D deficiency is easily treated with physiological doses.
More to the point, you probably know someone dying of vitamin D deficiency.
Lawyers may be interested in knowing that most oncologists in this country
- in spite of what is known about vitamin D and cancer - let their cancer
patients die vitamin D deficient. A group of scientists got together last
week in San Diego and looked at the issue. I liked Professor Garland’s
conclusion: “Almost no one is being made sick by Vitamin D toxicity,
but literally millions are dying from Vitamin D deficiency.”
Not only do we have no studies using pharmacological doses, we are still
waiting for additional studies using physiological doses (2,000 to 10,000
units a day). Vieths’ studies showing that 4,000 units of cholecalciferol
a day helped depression, and that 2,000 units a day stopped PSA increases
in the majority of men with prostate cancer, are two of the few.
Nutr J. 2004 Jul 19;3:8.
Nutr Cancer. 2005;51(1):32-6.
By the way, the government says
2,000 units a day are safe for children over one year of age. In fact, 1,000
units a day will give most young children normal vitamin D levels. Children
who weigh more than 60 pounds may need 2,000 units a day to obtain normal
levels (50 ng/ml). It is unlikely vitamin D prevents infection, it probably
just calms our immune system, especially our macrophages, our internal Pac-Men
that keep zapping the invaders - and our insides - with oxidative bursts until
something tells them to stop.
Along those lines, Drs. Laura Helming, Andreas Lengeling, and their German
colleagues announced an important discovery last month. They discovered that
vitamin D does indeed tell the Pac-Men to stop; otherwise those oxidative
bursts can cause autoimmune illness.
Blood. 2005 Aug 23; [Epub ahead of print]
The Germans explained why autoimmune illness is so common in vitamin D deficient
patients. Without enough vitamin D, the immune system can’t make enough
activated vitamin D to tell macrophages enough already. The authors concluded
their discovery “might be an important mechanism to prevent uncontrolled
and excessive reactions in local inflammatory environments . . . Since macrophages
play important roles in several autoimmune diseases, this may be of special
clinical importance.” Way to go Germany.
If you have an autoimmune illness, take enough real vitamin D (cholecalciferol)
to get your level to about 50 ng/ml. Keep it at 50 ng/ml year around. For
most adults, that means about 4,000 units a day, a little more in the winter
and less in the summer, depending on sun exposure. Big people need more than
little people. African Americans need more than whites. Sunphobes need more
than those who enjoy God’s invention. No one knows if pharmacological
doses would effectively treat autoimmune disease.
Of course, it is a good idea to keep your level around 50 ng/ml, even if
you don’t have autoimmune illness. Professor Bruce Hollis points out
that 50 ng/ml is close to the normal human level.
J Nutr. 2005 Feb;135(2):317-22.
Bruce is one of the few scientists who saw vitamin D clearly 20 years ago.
Down at the Medical University of South Carolina, he is making sure pregnant
women get around 4,000 units of real vitamin D a day. He and Carol Wagner
were the ones that discovered most human breast milk doesn’t contain
vitamin D for a very good reason: most human mothers are vitamin D deficient,
a major discovery. We can only hope that widespread vitamin D maternal deficiency
doesn’t cause birth defects in baby brains like it does rat brains. If
it does, it won’t be the children whose mothers were under Dr. Hollis’
care.
If you know anyone who is pregnant, make sure she sunbathes a few minutes
around noon every day in the late spring, summer and early fall and uses a
Sperti sunlamp the rest of the time. (Sperti is the only manufacturer of UVB
lamps that has UVB data on their website). Alternatively, pregnant women could
take enough real vitamin D (cholecalciferol) to obtain normal human vitamin
D levels of around 50 ng/ml. Their child may be at risk if they don’t
keep normal levels. The sun and sunlamps are easier for pregnant women because
their bodies will optimize levels and neither they nor their obstetricians
have to worry about the pills.
Two Austrians, Meinrad Peterlik and Heidi Cross, had a great review several
months ago of all the diseases associated with vitamin D and calcium deficiency.
Vitamin D and calcium go together. Vitamin D can’t do what it needs to
do without adequate calcium. The Austrians concluded, “Hypovitaminosis
D is a widespread phenomenon in the adult population of Central and Western
Europe as well as in North America . . . and an important public health problem
because of numerous implications for the development of common diseases.”
They reviewed the evidence that deficiencies contribute to colon cancer,
breast cancer, prostate cancer, diabetes, metabolic syndrome, hypertension,
infectious disease, inflammatory bowel disease, rheumatoid arthritis, lupus,
and MS. When calcium and vitamin D deficiencies were combined, they found
only 11% of the population had adequate intakes/levels of both. That is, 89%
of us are deficient in one or the other or both. I know Heidi from vitamin
D conferences; she’s a good scientist.
Eur J Clin Invest. 2005 May;35(5):290-304.
When combined with other recent papers, the point is: take enough real vitamin
D (about 4,000 units of cholecalciferol per day for adults) to maintain vitamin
D levels of around 50 ng/ml and make sure you get at least 1,000 mg of calcium
every day. If you want to enjoy your daily vitamin D and calcium, check out
what Paul Stitt, owner of Natural Ovens, is doing in Milwaukee. He’s
making a candy supplement containing 2,000 units of real vitamin D together
with calcium. I've had them; they are yummy. They are for sale in much of
the country or you can order online.
Vitamin D, as in our daily deficiency
Want some more ignored facts? In 1969, Voors and Johnson looked at mortality
from heart disease in the largest cities in the United States and discovered
the higher you live, the less likely you were to die from heart disease. Several
of the cities at highest altitude had about half the deaths of sea level cities.
This is consistent with Leaf’s 1973 finding that long-lived communities
are all at high altitude, where UVB light makes a lot more vitamin D. By the
way, Italian researchers found strong seasonal variations in blood clots and,
you guessed it, clots are much less common in the summer, when vitamin D levels
are higher. These correlations with heart disease and blood clots are probably
not strong in the USA these days, as American dermatologists have sun-scared
the people in Denver as well as New York. Maybe folks are smarter in Italy.
J Chronic Dis. 1979;32(1-2):157-62.
Sci Am. 1973 Sep;229(3):44-52.
Med Sci Monit. 2004 May;10(5).
Again, the take-away point is to get your vitamin D blood level (25-hydroxy-vitamin
D) up to about 50 ng/ml and keep it there year around. About 4,000 units of
cholecalciferol every day should do it. I’d take more if I had cancer
or heart disease or autoimmune disease (enough to get my level up to 60 ng/ml
year around) but there are no studies to prove that’s a good idea. If
you have a serious illness, you can read the current literature and decide
for yourself, or you can die waiting for definitive interventional studies.
How much does vitamin D deficiency cost, besides the millions of lives? Three
other good scientists, Bill Grant, Cedric Garland, and Michael Holick, recently
attempted to answer that question. They came up with a figure of about 40
– 60 billion dollars every year in the USA alone. I think that is a conservative
number.
Photochem Photobiol. 2005 Jan 1; [Epub ahead of print]
Also, check out Dr. Grant’s organization, SunArc. Bill was a NASA scientist
until he retired and started his own non-profit to do research into vitamin
D. He is doing just that and making a difference.
No, facts don’t cease to exist because they are ignored. But they make
little difference when policy advisors, like the Institute of Medicine, ignore
scientific facts. The Institute recommends 400 units a day, instead of 4,000.
They are making a full order of magnitude error; millions of people are dying
needlessly, especially African Americans. E-mail Dr. Harvey Fineberg, President
of the Institute of Medicine: hfineberg @ nas.edu. Ask him to stop ignoring
the facts.
John Cannell, MD
The Vitamin D Council
9100 San Gregorio Road
Atascadero, CA 93422
http://www.thenhf.com/articles_197.htm
Actually, both. By one estimate,
fair-skinned people in strong midday sun need as little as five or 10 minutes
of exposure on their legs and arms three times a week to make all the vitamin
D they'll need. Dark-skinned people may need several times that long.
The problem is that the recommended
amount varies according to time of day, season, latitude and the person's
age and skin tone. And there is no agreement on precisely what length of sun
exposure is considered safe. Dermatologists are adamant that no amount of
tanning is a good idea.
For that reason, most researchers
say it's best to get your vitamin D from a supplement -- specifically as vitamin
D3.
"You don't need the sun,"
says Susan Harris, a scientist at the USDA Human Nutrition Research Center
at Tufts University. "The sun is a really efficient way to get it because
you get a really big dose from sun exposure. But if you take enough supplement,
it's just as good."
It's only a simple vitamin, but
it sounds like a miracle drug -- one that top researchers say may help you
stave off everything from osteoporosis to multiple sclerosis to diabetes,
schizophrenia and breast cancer.
A series of recent studies has found
that vitamin D, the so-called sunshine vitamin -- once thought to be critical
only to bone health -- is useful throughout the body to strengthen the immune
system and control cell growth. Yet researchers estimate that as many as half
of all Americans are likely deficient in utrient. The problem is particularly
serious in people with dark skin, the elderly and those who are diligent about
avoiding sun exposure, especially if they adhere to the federal government's
current recommended dietary allowance of the vitamin, which many say is far
too low.
"What we're finding is really
challenging physicians' long-standing knowledge about vitamin D," says
Dr. Lisa Bodnar, assistant professor of epidemiology at the University of
Pittsburgh. She is co-author of a recent study that found more than 80 percent
of pregnant black women and nearly half of pregnant white women -- and their
subsequent newborn babies -- to be vitamin D-deficient. The women lived in
the Pittsburgh area, but Bodnar says the findings likely apply throughout
the northern United States, where there is little wintertime sun, and perhaps
to the South, as well.
"If people go to their doctor
and say, 'I think I should be taking more vitamin D,' it's very likely their
doctor will say they don't need it. But what people have to understand is
that the [current] dietary recommendation is not based on the best science.
And more science is coming out now confirming that vitamin D intake has got
to be higher if we're going to prevent some of these problems."
In fact, current research indicates
vitamin D deficiency plays a role in 17 varieties of cancer, plus heart disease,
stroke, hypertension, diabetes, depression, chronic pain, osteoarthritis,
osteoporosis, muscle weakness, muscle wasting, birth defects, periodontal
disease and auto-immune diseases such as lupus. It may not be the lone cause
of these problems, the experts caution, but it appears to be a contributor.
One study in Finland, for instance,
followed children given a whopping 2,000 international units (IU) of vitamin
D per day -- 10 times what the U.S. government currently suggests -- from
birth through their first birthday. After three decades, those who had received
the supplements were found to have reduced their chance of getting Type I
diabetes by 80 percent compared with those who were given no supplement.
"The data are also pretty strong
in relating adequate vitamin D levels to decreased risk of developing and
dying of colon, prostate, breast and pancreatic cancer," says professor
Dr. Michael Holick, director of the Bone Health Care Clinic at Boston University
Medical Center and considered one of the world's foremost authorities on vitamin
D. "We also [think] now that the reason African-Americans are more prone
to getting tuberculosis and have more aggressive disease is that they're more
prone to vitamin D deficiency."
Beware of fortified foods
Historically, mankind's main source
of vitamin D has been sunlight, which penetrates the skin's uppermost layer
and, after processing in the liver and kidneys, becomes cholecalciferol --
the hormone responsible for vitamin D's healthful benefits.
Such a system worked well as long
as man spent most of his days outdoors with little clothing. But our relatively
recent indoor lifestyle -- as well as dark pigmentation, aging and using sunscreen
-- can all interfere with that process. A mere SPF-8 sunscreen, for instance,
cuts vitamin D synthesis by roughly 95 percent.
Complicating matters is the fact
that few foods offer even modest amounts of natural vitamin D, and those that
do are often high in fat so should be consumed in moderation. They include
cream, egg yolks, cod liver oil and fatty fish.
And though milk and some cereals
are fortified with D in this country, the vitamin is often delivered in the
form of synthetic D2, which is more stable but not easily used by the body.
Many multivitamins also use D2.
"Make sure you're taking
D3, . . . the same compound that is made in sun-exposed skin," advises
best-selling author Dr. Andrew Weil, a physician and strong proponent of holistic
medicine. "So often, you see orange juice or foods that say they're vitamin
D-fortified. But many times, those are fortified with D2. [And] vitamin D
has to be taken with fat. Taking a vitamin D pill with orange juice isn't
going to work; it won't stick to you."
Too much of a good thing?
Vitamin D has long been known to
prevent rickets -- a disease that can leave children with soft and misshapen
bones. For years, the United States has based its advice on how much vitamin
D people need on the minimum necessary to prevent rickets. Too much D, they
warned, could be toxic.
But scientists now say those warnings
have been overblown.
"Even at 10,000 units of vitamin
D, I know of no adverse health consequences seen in studies," Bodnar
says. "There's a study right now going on in pregnancy, for instance,
that is looking at the safety and effectiveness of supplementing pregnant
women with up to 4,000 units a day. And they're doing it in both black and
white women to see, for instance, if black women need more vitamin D simply
because of the dark pigment in their skin."
The consensus at this point, though,
is that 1,000 to 2,000 units a day is probably a good amount to maintain health.
Holick says he -- and everyone in his family -- now takes 1,000 units daily.
Still, the government's official
recommendation, last revised a decade ago, is a mere 200 IU for people age
50 and younger, 400 IU for those 51 to 70 and 600 IU for those 70 and older.
Why the discrepancy?
"It has taken science and medicine
a long time to figure out how vitamin D really works," explains Dr. Luke
Bucci, a biochemist and vice president of research for Schiff Nutrition International.
"People were afraid because they thought it accumulates in the body.
Well, no, it doesn't.''
If you want to know whether your
vitamin D levels are already adequate, ask your doctor for a blood test to
measure 25-hydroxy vitamin D, the storage
form of the vitamin in the body. 25(OH)D
http://articles.orlandosentinel.com/2007-04-17/news/VITAMIND_1_sunshine-vitamin-vitamin-d-bone-health
Listen: Your body might be asking
for more vitamin D Contrary to current advice, studies show we need a larger
dose of the nutrient in order to reap its benefits.
Kate Santich | Sentinel Staff Writer
Posted April 17, 2007
