I talk to people about vitamin D all the time. When I tell them how much I take and what I recommend their eyes get big. Then I tell them how much you get in 20 min of noon day sun during the summer and when a little pink. I also point out that our ancestors ran around naked in the sun and we evolved in the sun. My advice: get your level up, go out in the sun, do not burn,have fun in the sun, do not get red and read this study. Remember redness and burning is skin DAMAGE. The evidence is that burning and redness is the cause of skin cancer many years later, not normal skin exposure!

Public release date: 22-Feb-2011
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Contact: Kim Edwards
kedwards@ucsd.edu
619-543-6163
University of California - San Diego
Higher vitamin D intake needed to reduce cancer risk Researchers at the University of California, San Diego School of Medicine and Creighton University School of Medicine in Omaha have reported that markedly higher intake of vitamin D is needed to reach blood levels that can prevent or markedly cut the incidence of breast cancer and several other major diseases than had been originally thought. The findings are published February 21 in the journal Anticancer Research

While these levels are higher than traditional intakes, they are largely in a range deemed safe for daily use in a December 2010 report from the National Academy of Sciences Institute of Medicine.

"We found that daily intakes of vitamin D by adults in the range of 4000-8000 IU are needed to maintain blood levels of vitamin D metabolites in the range needed to reduce by about half the risk of several diseases - breast cancer, colon cancer, multiple sclerosis, and type 1 diabetes," said Cedric Garland, DrPH, professor of family and preventive medicine at UC San Diego Moores Cancer Center. "I was surprised to find that the intakes required to maintain vitamin D status for disease prevention were so high – much higher than the minimal intake of vitamin D of 400 IU/day that was needed to defeat rickets in the 20th century."

"I was not surprised by this" said Robert P. Heaney, MD, of Creighton University, a distinguished biomedical scientist who has studied vitamin D need for several decades. "This result was what our dose-response studies predicted, but it took a study such as this, of people leading their everyday lives, to confirm it."

The study reports on a survey of several thousand volunteers who were taking vitamin D supplements in the dosage range from 1000 to 10,000 IU/day. Blood studies were conducted to determine the level of 25-vitamin D – the form in which almost all vitamin D circulates in the blood.

"Most scientists who are actively working with vitamin D now believe that 40 to 60 ng/ml is the appropriate target concentration of 25-vitamin D in the blood for preventing the major vitamin D-deficiency related diseases, and have joined in a letter on this topic," said Garland. "Unfortunately, according a recent National Health and Nutrition Examination Survey, only 10 percent of the US population has levels in this range, mainly people who work outdoors."

Interest in larger doses was spurred in December of last year, when a National Academy of Sciences Institute of Medicine committee identified 4000 IU/day of vitamin D as safe for every day use by adults and children nine years and older, with intakes in the range of 1000-3000 IU/day for infants and children through age eight years old.

While the IOM committee states that 4000 IU/day is a safe dosage, the recommended minimum daily intake is only 600 IU/day.

"Now that the results of this study are in, it will become common for almost every adult to take 4000 IU/day," Garland said. "This is comfortably under the 10,000 IU/day that the IOM Committee Report considers as the lower limit of risk, and the benefits are substantial." He added that people who may have contraindications should discuss their vitamin D needs with their family doctor.

"Now is the time for virtually everyone to take more vitamin D to help prevent some major types of cancer, several other serious illnesses, and fractures," said Heaney.

### Other co-authors of the article were Leo Baggerly, PhD, and Christine French.

More facts are available from Anticancer Research: www.GrassrootsHealth.net; and the National Academy of Sciences - Institute of Medicine: www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D.aspx

I have subscribed to this newsletter and will post it here if it is legal for me to do so in the future. Just a reminder if you multivitamin contains a lot of vitamin A ( most say 69%) this plus some carrots or other suitable veggie can block the effects of vitamin D. There has never been a study that shows a multivitamin has a significant benefit! Eating your vitamins is the best way!
Bruce Bennett




 Vitamin D Newsletter


March 20, 2011

In This Issue
Dr. Cannell reviews five studies in this preview edition of the new members-only Vitamin D Newsletter.


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Contact us   Studies of Interest 1

This is the first in a new edition on the Vitamin D Council’s newsletters. Unlike the general newsletter, this newsletter will eventually only be available to those who subscribe as members of the Vitamin D Council, but it will be posted on our website four months after being sent to subscribers. Lack of adequate donations made this necessary but we believe the cost of membership (five dollars per month) is not excessive.
 
Become a member of the Vitamin D Council now for only $5.00/month with an automatic recurring charge every month, which lets us budget better!




 
The format of this subscribers-only newsletter will usually be my explanation and analysis of recently published vitamin D studies. Sometimes the studies will only be a few days old, others a few weeks or months. Some, if not well-known, may be several years old. All of the studies discussed will be notable.
 
We will also consider printing replies by the authors, as some may not like my commentary. So, it should be interesting to those interested in vitamin D and useful as the list of diseases connected to vitamin D continues to grow.
 
The second advantage of becoming a member of the Vitamin D Council will be access to a new feature, videos of Dr. Cannell answering questions and discussing vitamin D. Be on the lookout for an email in several days with a link to such a video.  $5.00/month is a wise investment in your health.
 
Become a member of the Vitamin D Council now for only $50.00/year. This is a one time charge that will need to be redone every year to maintain membership.




 
Studies
 
McKinney JD, Bailey BA, Garrett LH, Peiris P, Manning T, Peiris AN. Relationship between vitamin d status and ICU outcomes in veterans. J. Am Med Dir Assoc. 2011 Mar;12(3):208-11.
 
Dr. Jason McKinney and colleagues of the Eastern Tennessee State University and the Mountain Home VA Medical Center asked a simple question, do ICU patients die more frequently if they are vitamin D deficient? The authors reviewed records of 136 veterans who were hospitalized in the intensive care unit and who happened to have a vitamin D blood level done a within a month of that hospitalization. No matter the reason for the hospitalization and no matter whether the vitamin D level was drawn before or after the hospitalization, the answer is yes, vitamin D deficient ICU patients are almost twice as likely to die. I particularly liked their tongue in cheek conclusion, ". . . it appears current dosing does not satisfactorily address vitamin D deficiency in the severely ill."
 
My advice is to have some 50,000 IU capsules from Bio Tech Pharmacal on hand in the house, in the medicine cabinet not the vitamin cabinet. If someone you love is in the hospital (not just the ICU) and they have not been taking adequate doses of vitamin D, give them 50,000 to 100,000 IU/day for the first 3-4 days of their hospitalization.


 
McGrath JJ, Eyles DW, Pedersen CB, Anderson C, Ko P, Burne TH, Norgaard-Pedersen B, Hougaard DM, Mortensen PB. Neonatal vitamin D status and risk of schizophrenia: a population-based case-control study. Arch Gen Psychiatry. 2010 Sep;67(9):889-94.
 
Professor John McGrath is getting closer to proving his theory that schizophrenia is connected to vitamin D deficiency. He is, of course, saying that African Americans have higher rates of schizophrenia than do Whites, a fact every psychiatrist knows to be true but a fact that violates the politically inviolate "no racial differences in diseases above the neck" rule. In this paper, he and his colleagues add to the evidence vitamin D is involved in schizophrenia, finding low vitamin D levels at birth increase risk in teenagers and young adults (14-27 years old). However, the dreaded U-shaped curve again reared its head. The authors found that levels of 16-20 ng/ml at birth afforded the best protection 14-27 years later. That’s right, 16-20 ng/ml, but levels above and below that were associated with increased risk decades later.
 
I smell cod liver oil. It turns out that most, but not all, of the U-shaped curves come from Nordic countries, like this study came from Denmark. When found, the U-shaped curve is usually more dramatic in Nordic countries. Again, ask yourself where did the mothers of these kids get their vitamin D? From the seasonal variation, we can estimate that the mothers got about, on the average, 400-600 IU/day from the sun. The rest had to be obtained from diet or supplements. In Denmark, during the 1980s and 90s, the supplement most likely to raise vitamin D levels would have been cod liver oil, which contains all that toxic vitamin A.
 
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Bhandari SK, Pashayan S, Liu IL, Rasgon SA, Kujubu DA, Tom TY, Sim JJ. 25-hydroxyvitamin d levels and hypertension rates. J Clin Hypertens (Greenwich). 2011 Mar;13(3):170-7. doi: 10.1111/j.1751-7176.2010.00408.x. Epub 2010 Dec 22.
 
What a paper, just when we are worrying about levels of 20 ng/ml being too high, along comes Southern California, Dr. Simran Bhandari, and his associates at Kaiser Permanente.  Using a now defunct Nichols Advantage analyzer, the Kaiser folks asked a question that Nichols Advantage cannot answer, what is the best absolute vitamin D level? However, it is a great question.
 
What they found was remarkable, the crude odds ratio (risk) of being hypertensive was almost five times higher for those with 25(OH)D levels less than 15 ng/ml compared to those above 40 ng/ml. The same was true for renal function. However, as Nichols Advantage was used, all we can say is look at the differences, not the absolute levels. If you believe Nichols, you believe that 1,812 of 2,722 patients tested had vitamin D levels higher than 40 ng/ml. I doubt it, even in Southern California.
 
No U-shaped curve in Southern California, not even a suggestion of one. Of course these patients were tested between 2004 and 2006 so some were already on pure vitamin D, not vitamin D contaminated with retinol (cod liver oil). Too bad the authors couldn’t tell us more about the sample, like how many were taking vitamin D? Some of the Kaiser hospitals are in the forefront of vitamin D supplementation. Kaiser Permanente seems to know that vitamin D is the answer to those vexing medical care cost questions.


 
Lindh JD, Andersson ML, Eliasson E, Bjorkhem-Bergman L. Seasonal variation in blood drug concentrations and a potential relationship to vitamin D. Drug Metab Dispos. 2011 Feb 24. [Epub ahead of print]
 
From the Karolinska Institute in Stockholm, Sweden comes the first of what I hope will be many studies on how vitamin D affects the prescription drugs people take. Dr. Jonatan Lindh and his colleagues found that some commonly prescribed immunosuppressants have seasonal variations in their blood levels and that seasonality is directly related to vitamin D levels. It turns out that vitamin D increases levels of a key enzyme made by the liver (CYP3A4) and increased levels of CYP3A4 means that blood concentrations of certain prescription drugs will be lower.
 
Theoretically those drugs include a long list, including the SSRIs citalopram, escitalopram, fluoxetine, norfluoxetine and sertraline, and the antipsychotics aripiprazole, haloperidol, risperidone and ziprasidone. I only mention those because I am a psychiatrist. For a full list of drugs that may have lower blood levels because of vitamin D increasing CYP3A4, look up CYP3A4 in Wikipedia and read about the enzyme. Again, vitamin D increases the liver’s production of this vital enzyme, an enzyme which then lowers levels of the drugs it catabolizes (breaks down).
 


Neyestani TR, Hajifaraji M, Omidvar N, Eshraghian MR, Shariatzadeh N, Kalayi A, Gharavi A, Khalaji N, Haidari H, Zowghi T, Nikooyeh B. High prevalence of vitamin D deficiency in school-age children in Tehran, 2008: a red alert. Public Health Nutr. 2011 Feb 28:1-7. [Epub ahead of print]
 
A few weeks ago someone finally issued a red alert for our children, how vitamin D deficiency may be injuring them in ways we can’t imagine. I love how the authors wrote that their findings should be "regarded as a public health emergency by all stakeholders." Indeed, who is not a stakeholder when it comes to our 9-12 year-old children?
 
At 35 degrees North, Dr. Tirang Neyestani and colleagues in Tehran, Iran, found that in the winter, 91% of the children had vitamin D levels lower than 20 ng/ml, 86% lower than 15 ng/ml, and an unbelievable 38% had vitamin D levels lower than 5 ng/ml. For reasons I will not repeat, low levels are usually more reliable than high levels and this study used the German made "Immunodiagnostik" method to measure vitamin D levels.
 
Red alert it should be in the USA but no, we have just been subjected to the opinion of a seemingly well-intentioned group of apparently unbiased scientists from the Food and Nutrition Board who said that vitamin D is for bone and bone alone and levels of 20 ng/ml are just fine. Natural selection will take care of those who actually believe that.
 
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John Cannell, MD


Executive Director, Vitamin D Council



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From time to time I will post a article that I posted on my other website. This is a article on a team that started winning. Guess why? Well this article is a from a news letter posted on vitamindcouncil.org. I love things that work. When you get right down to it, is there anything else? Enjoy!

May 2010 go to newsletter archives

Vitamin D and the Chicago Blackhawks The Chicago Blackhawks are the first vitamin D team in modern professional sports history.

According to my sources, the Chicago Blackhawk team physicians began diagnosing and treating vitamin D deficiency in all Blackhawk players about 18 months ago. Apparently, most players are on 5,000 IU per day.

After many losing seasons, last year the Blackhawks came out of nowhere to get to the Western conference finals. This year they are playing even better.

According to my sources, improved athletic performance is only one of the benefits for the Blackhawk players. The other is a reduction in the number and severity of colds and flu and a reduction in the number and severity of repetitive use injuries.

I start talking to people about vitamin D and they ask me what the normal is for the vitamin. Normal levels of vitamin D are not what we are looking for because with very few exceptions the normal in today's society is not healthy or optimum..When talking about dosage it is important to understand we are supplementing to create a level of vitamin D in our bodies that existed in our ancestors many hundreds of thousand or millions of years ago. We did evolve in the sun without clothes or shelter. The only way we can get close to understanding that is to understand what kind of environment they lived in,   I am referring to our ancestors in Africa where the origin of our species started. 
It is also a fact that these people were black. Consider this. These people wore no clothes nor did they live in caves. This all came later and thus they were in the sun a lot of  the time. It is a fact a person with black skin will take up to five times longer to absorb the same amount of vitamin D as a white person.
A black person will absorb about 10,000 IU ( international units) of vitamin D in about 2 to 2.5 hours. So how much time did these early people actually spend in the sun. There is not way to find out, but I think it was difficult to avoid the sun. One study I read suggest it takes over 30,000 IU a day to induce toxicity. So it not illogical to assume that skin color was evolved, in Africa, to control vitamin D levels at a level that was proper and healthy by this feed back mechanism of skin color. Conversely white skin evolved to allow more absorption of vitamin D at latitudes where there is less available from the sun. 
As people moved out of Africa away from the equator, and a constant year around sun that was full of vitamin D, there skin became lighter. This was a survival necessity. As the skin lightened they were able to absorb more vitamin D quicker and more  survived to reproduce. (One of the extreme things that happens with very low vitamin D is rickets. Rickets will cause the female pelvis to be misshapen and vaginal delivery to be impossible). Surely you have noticed that those in southern Europe are darker than those in Norway.
Where I live,there is very small to inadequate amounts of vitamin D obtainable September to May. To receive vitamin D from the sun you have to have a shadow length that is shorter than your height. If it is longer it maybe possible to tan, but you will not receive significant amounts of vitamin D. Tanning sun wavelengths and vitamin D wavelengths are not of the same frequency.
This lack of the vitamin, in areas away from the equator was made up by eating foods that are high in vitamin D and some summer sun. Believe me you do not want their diet. Basically they ate the whole animal and a lot of roots and fruit in season. Animal organs are high in vitamin D. Farming came later.
Dosage. I recommend 1,000 IU per 25 lbs body weight, everyday for three months. It takes that long for the level in the blood to stabilize. Get tested and adjust your dosage to get a level of 80 ng/ml year around. As the number of ng goes up so does pain relief, but I would stay below 100ng unless there is a very good reason to go above. More on that subject later, Only the 25(oh)D test is valid for this purpose. There are other test for vitamin D that are not useful in otherwise healthy people.
If you want to read more on this subject, I recommend www.vitamindcouncil.org   They are non profit organization and there are many links to studies there.
One more thing; vitamin D obtained over the counter varies in quality. One brand, according to a study,  contained only one third of the amount marked on the label. Changing brands may adversely effect your ability to effectively control your vitamin D level. So find a good brand and stick with it.
Bruce Bennett