Vitamin D Council May 29th, 2012 This newsletter is in part made possible by the support of our sponsors

Study: Low vitamin D linked to psychosis in teens
May 24, 2012 -- John Cannell, MD
Psychosis, or loss of touch with reality, is difficult to see in any loved one but is particularly difficult to deal with if it’s your teenager. Dr. Barbara Gracious and colleagues recently discovered that of 104 teenagers assessed at an acute mental health clinic, the teenagers with the lowest vitamin D levels were more likely to be psychotic. In what must be a tribute to video games and the like, 72% of the teenagers had vitamin D levels lower than 30 ng/ml and 34% had levels lower than 20 ng/ml.

The magnitude of the vitamin D effect was not minor; if the teenager had low vitamin D levels, he or she was almost four times (OR=3.5) as likely to be psychotic.

Gracious BL, Finucane TL, Freidman-Campbell M, Messing S, Parkhurst MM. Vitamin D deficiency and psychotic features in mentally ill adolescents: A cross-sectional study. BMC Psychiatry. 2012 May 9;12(1):38. [Epub ahead of print]

I was disappointed with their usual call for more studies instead of the needed call to treat vitamin D deficiency now. Compare Dr. Gracious’s approach to that of Dr. Mats Humble’s approach at Sweden’s Karolinska Institute. Dr. Humble and colleagues assessed 117 mental health outpatients of all ages and found that teenagers had the lowest levels. Teenage females had vitamin D levels of around 20 ng/ml and, in another nod to video games, teenage Swedish males attending a mental health clinic had average vitamin D level of around 10 ng/ml.

Humble MB, Gustafsson S, Bejerot S. Low serum levels of 25-hydroxyvitamin D (25-OHD) among psychiatric out-patients in Sweden: relations with season, age, ethnic origin and psychiatric diagnosis. J Steroid Biochem Mol Biol. 2010 Jul;121(1-2):467-70. Epub 2010 Mar 7.

Dr. Humble also found that depressed, psychotic and autistic patients had the lowest vitamin D levels and anxiety patients had the highest levels. Instead of just calling for more trials, he treated the deficient patients with up to 4,000 IU/day of cholecalciferol or, in other cases, up to 70,000 IU weekly of ergocalciferol, which resulted in “considerable improvement” in psychosis and depression.

No doubt, Dr. Humble is busy conducting a randomized controlled trial. At least I hope so. Moreover, I hope he is using pharmacological doses of vitamin D, not physiological doses. That is, I hope he is using 10,000 IU/day and not 5,000 IU/day, although some may claim 10,000 IU/day is physiological.

I predict the day will come when using 50,000 IU/day for ten days in very ill people with a vitamin D responsive disease, such as sepsis, congestive heart failure, and perhaps psychosis, to name but a few, will be commonplace. Now, 50,000/day is a pharmacological dose, which simply means the vitamin D is being used as a drug and not as a supplement for good health.

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Review: Vitamin D and polycystic ovary syndrome
May 25, 2012 -- John Cannell, MD
A recent review of the research on vitamin D and polycystic ovary syndrome (PCOS) reveals a plethora of potential benefits from a number of symptoms associated with the disorder. Continue reading → (membership required)

The future in sun exposure recommendations
May 25, 2012 -- Brant Cebulla
Brant Cebulla recalls previous sun exposure recommendations and reviews the evidence suggesting a new recommendation be introduced. Continue reading → (open access)

UV light and non-melanoma skin cancer
May 23, 2012 -- John Cannell, MD
Dr Cannell discusses UV exposure and sunburns and their effect on squamous cell carcinoma, a non-melanoma skin cancer. Continue reading → (open access)

Review: an antioxidant?
May 26, 2012 -- John Cannell, MD
New research suggests vitamin D is a powerful natural antioxidant and aids in DNA repair. Continue reading → (membership required)


Osteoporosis Prevention month
May 23, 2012 -- Kate Saley
May is national osteoporosis prevention month, recognized by the National Osteoporosis Foundation to encourage people to talk about bone health and family history as the first step in protecting themselves and future generations from developing osteoporosis. Continue reading → (news story)

Meta analysis of RCTs compares efficacy of D2 vs D3 supplementation
May 15, 2012 -- Kate Saley
Kate Saley discusses a meta-analysis in which Professor Tripkovic and colleagues reviewed 10 randomized controlled trials comparing vitamin D2 and vitamin D3 in raising serum 25(OH)D status. Continue reading → (open access)

Vitamin D deficiency may contribute to Graves' disease
May 25, 2012 -- John Cannell, MD
New research shows that those with Graves' disease, an autoimmune disorder which affects 2% of the population, are more likely to be vitamin D deficient. Continue reading →   (membership required)

Case report: Autistic teen with rickets
May 16, 2012 -- John Cannell, MD
Dr Cannell reviews a case study of a young boy with both rickets and autism, published just a few months after Dr Cannells medical hypothesis paper proposing autism and vitamin D are associated. Continue reading → (membership required)
  A detailed look at the vitamin D levels of outdoor soccer players
May 17, 2012 -- Brant Cebulla
A recent study by Dr James Morton and colleagues measured vitamin D levels during the summer time in one of the world’s most famous professional soccer teams. Continue reading → (membership required)
 

I have always recommended sun exposure that avoids burning or skin reddening. Apparently the VDC feels the same way. While I am on the subject, please remember the darker the skin the less vitamin D is produced. Also, if you are older the ability to produce vitamin D drops even though you still tan. Tanning is achieved with different wavelengths of light than vitamin D production. Also recall that ( this is recent information to me) taking a shower or bath with soap will remove skin oils and vitamin D. So avoid doing so for two days after sun exposure. Of course, washing areas with soap not exposed to the sun will not effect vitamin D production. And now the article!
The future in sun exposure recommendations Posted on May 25, 2012 by Brant Cebulla In the past 30 years, recommendations regarding sun exposure have been simple. To counteract skin cancer, public health organizations and agencies have led the charge with campaigns focusing on sun and UVB avoidance. These recommendations have always been made with skin cancer and only skin cancer in mind.

In the early 1980s, Australia led the way with the famous slogan:

• Slip (on a shirt)
• Slop (on some sunscreen)
• Slap (on a hat)

Soon thereafter, the World Health Organization (WHO) started a Global UV Project called INTERSUN, which aimed to encourage countries to follow this lead and take action to reduce skin cancer.

In 1992, the United Nations supported and furthered this message at the Conference on Environment and Development when they announced that the ozone layer was depleting. They claimed we would see an increase in skin cancers all around the world.

"Slip on a shirt, slop on some sunscreen, and slap on a hat!"

The first decade of the new millennium slowly started to challenge these recommendations with the outburst of research in vitamin D. With a general attitude to avoid the sun, researchers pointed out that the average person’s vitamin D level in the 21st century is less than half of what it would be if they got regular full body sun exposure. The question arose, if our vitamin D levels are so low, what are the health consequences?

Future research in this decade will better be able to answer this question, but to date we know that vitamin D deficiency – and sun avoidance – is a risk factor for a wide array of diseases. These diseases include major internal cancers, cardiovascular diseases like stroke and hypertension, types I and II diabetes, inflammatory bowel diseases, dementias, respiratory illnesses like asthma and COPD, and several other autoimmune diseases including multiple sclerosis.

The challenge moving forward is changing the sun exposure message. In 2005, Cancer Council Australia was the first national cancer council to recognize a balanced recommendation in a statement titled, “Risks and benefits of sun exposure.” Still, the majority of other organizations have been slow to act.

The American Cancer Society states, “It is better to get vitamin D from your diet or vitamin supplements rather than from sun exposure.” This advice ignores that sun exposure is the natural and historical source for over 90% of vitamin D production/intake. To boot, researchers believe that sun exposure is likely beneficial beyond vitamin D production.

Even when skin cancer is the only issue on the table, the vitamin D crowds and skin cancer crowds may not be so far apart. Some research has shown that chronic moderate sun exposure is protective against melanoma versus short-term intense exposure.

What we need is a clear, consistent and safe message regarding sun exposure that takes into account both the benefits of sun exposure and the risks. A message that takes into account that:

• Sun exposure is the natural source for vitamin D requirements.
• There are many benefits in disease prevention and treatment with both sun exposure and vitamin D.
• There are some risks in sun exposure in regards to skin cancer, but frequent moderate exposure eases this issue.

The Vitamin D Council has always believed that today, research shows that the benefits of sun exposure outweigh the risks. In the future, we find it likely that research will quantifiably show that the benefits of sun exposure outweigh the risks. Given this, the sun exposure recommendation of the Vitamin D Council today is:

Be sure to get regular and moderate sun exposure. When sunbathing, expose a good amount of your skin to the sun for just half the time it takes for your skin to turn pink. Avoid burning.

Moreover, we believe this will be the recommendation of the future.

Vitamin D Council May 15th, 2012 This newsletter is in part made possible by the support of our sponsors


May is national high blood pressure and stroke awareness month
May 14, 2012
May is National High Blood Pressure Education Month and Stroke Awareness Month. Nearly 1 in 3 Americans have high blood pressure, and it is a significant risk factor in stroke, a medical emergency that 800,000 people will endure per year. Learn more about risk factors and how better vitamin D levels may be an important step in improving your high blood pressure and stroke risk. Continue reading → (open access)

Metabolic clearance of vitamin D after heart attack
May 9, 2012 -- John Cannell, MD
This week, Dr. Julian Barth, and colleagues, of the University of Leeds, discovered that vitamin D levels do not decline after a heart attack. At least they do not decline beginning 2 days after the heart attack. This implies vitamin D is not being “used up” or metabolically cleared during the healing of the heart attack.

Barth JH, Field HP, Mather AN, Plein S. Serum 25 hydroxy-vitamin D does not exhibit an acute phase reaction after acute myocardial infarction. Ann Clin Biochem. 2012 Apr 27. [Epub ahead of print]

Dr. Barth studied 48 patients with an acute myocardial infarction (MI) and measured 25(OH)D levels after 2 days, 7 days, 30 days and 90 days post-MI. Inflammation was occurring during this time, as evidenced by rise and fall of CRP, but they found no relationship between CRP and 25(OH)D.

They did not measure vitamin D levels before the heart attack (understandably), so we don’t know if 25(OH)D levels declined from before to after the heart attack (that is, during the acute event). We do know they don’t decline when a damaged heart is healing. Dr. Barth cited a study that found the same thing with an acute malarial infection: vitamin D levels don’t decline during the acute phase of a malaria infection.

(The good news is that people in Leeds are going outside more than during the sun scare. In the winter average 25(OH)D levels were 9.6 ng/ml; in the spring, 15.8; in the summer 30; and in the fall 18 ng/ml, although the numbers were small.)

Compare the lack of metabolic clearance of vitamin D after a heart or malaria attack to what occurs after a knee replacement. Dr. Reid and colleagues of the University of Glasgow found 25(OH)D fell dramatically after a knee replacement. I have reported on this before.

Reid D, Toole BJ, Knox S, Talwar D, Harten J, O’Reilly DS, Blackwell S, Kinsella J, McMillan DC, Wallace AM. The relation between acute changes in the systemic inflammatory response and plasma 25-hydroxyvitamin D concentrations after elective knee arthroplasty. Am J Clin Nutr. 2011 May;93(5):1006-11. Epub 2011 Mar 16.

They measured 25(OH)D before and after a knee replacement on 33 subjects and found 25(OH)D reduced by 40% from before to 2 days after the surgery. Even at three months, 25(OH)D was still 20% lower than preoperative levels indicating, perhaps, the healing knee was “using up” or metabolically clearing the vitamin D. Again, since we don’t know what the 25(OH)D levels were before the MIs in Dr. Barth’s paper, we don’t know if acute MI’s metabolically clear any vitamin D. I suspect they do, although nothing like a knee replacement, which involves major damage to a large joint.

While we only definitively know about the effects of knee replacement surgery on 25(OH)D, I think in the meantime it’s important to be sufficient in vitamin D for lots of reasons when going to the hospital. The take home message is that if you are going into the hospital for any reason, especially surgery, make sure you have plenty of vitamin D reserves by having your 25(OH)D at around 50 ng/ml before admission.
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Study: Vitamin D lowers blood pressure during winter
May 10, 2012 -- Brant Cebulla
Brant Cebulla discusses the highly publicized recent finding that vitamin D helps lower blood pressure during winter months. Continue reading → (membership required)
 

Vitamin D aids in maintaining telomere length
May 12, 2012 -- John Cannell, MD
Dr Cannell reviews a study which suggests vitamin D and its metabolites aid in keeping telomeres long, an indication of improved health. Continue reading → (membership required)
  Professor Vieth and the vitamin D era
May 14, 2012 -- John Cannell, MD
Dr Cannell looks back at the review which changed his life, opening his eyes to a world of vitamin D benefits. Continue reading → (open access)

  World Lupus day
May 10, 2012
May 10th was World Lupus Day, a day to recognize the disease and the 5 million people worldwide who suffer from it. Research shows that vitamin D may play a role in improving the quality of life and disease activity in patients with lupus. Continue reading → (open access)

Mechanism of action in autism
May 7, 2012 -- John Cannell, MD
Dr Cannell reviews a recent study by Dr. Peter Schnatz and colleagues which supports the mechanism of action in autism he proposed in 2007. Continue reading → (open access)
      Cystic fibrosis awareness month
May 1, 2012
Remember, May is cystic fibrosis awareness month! Take a look at our news article to learn more about cystic fibrosis and what you can do to help. Also, a randomized controlled trial published in Dermato-Endocrinology suggests vitamin D may benefit adult patients with cystic fibrosis. Read the blog here → (membership required)
Did vitamin D treat an autoimmune disease?
May 8, 2012 -- John Cannell, MD
Dr. Gerry Schwalfenberg of the University of Alberta just published the first case report of a woman with a treacherous autoimmune disorder, idiopathic thrombocytopenic purpura or ITP, that vitamin D apparently cured.

Schwalfenberg GK. Solar radiation and vitamin d: mitigating environmental factors in autoimmune disease. J Environ Public Health. 2012;2012:619381.

More than 160 known autoimmune disorders exist in humans and more than 5% of the population has at least one of the disorders. They occur when your immune system malfunctions and attacks your own organs or tissues. No known cure exists. In the above publication, Dr. Schwalfenberg reviewed an extensive number of newer medical papers and concluded that, “Evidence that autoimmune disease may be a vitamin D-sensitive disease comes from many sources.”

He then reports on a 48-year-old female with one of the rarest and more perilous autoimmune disorders, ITP, which destroys platelets. Platelets help with blood clotting, and doctors follow platelet counts closely in ITP. She had been ill since 1998, had her spleen taken out to help elevate her platelet count and was on the best medicine for the disease, danazol. However, she continued to suffer from dangerously low platelet counts.

Visible symptoms of ITP include bruises, bleeding from the nostrils, bleeding at the gums, and excessive menstrual bleeding. A very low platelet count may result in blood masses in the mouth or on other mucous membranes. Bleeding time from minor cuts is usually long. Possibly fatal complications include bleeding inside the skull or brain or internal bleeding.

Knowing all the evidence that vitamin D is involved in autoimmune disorders, Dr. Schwalfenberg tested her vitamin D level in 2006 and found it to be 26 ng/ml. He started his patient on 2,000 IU of vitamin D per day. Her platelet count increased but not to normal. For the next two years, she had no symptoms of her ITP except for a moderately low platelet count. Unfortunately, a neighbor told her that 2,000 IU/day would make her toxic, so she stopped the vitamin D and her platelet count promptly fell dangerously low.

Dr. Schwalfenberg reassured her that her neighbor was incorrect and restarted her vitamin D, this time at 4,000 IU/day. She did well, and for the first time in a decade, was able to stop her danazol. She was given 10,000 IU/day of vitamin D for several days for an upper respiratory infection and her platelet count became normal for the first time in 14 years. It remains normal to this day and she is doing fine with a vitamin D level of 40 ng/ml taking 4,000 IU/day.

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Is UV radiation exposure correlated with cancer?
May 2, 2012 -- Dr William Grant
Dr William Grant reviews a study published by Stephen W. Lin and colleagues which found solar UVB doses in July inversely correlated with incidence of 12 types of cancer. Continue reading → (open access)

The evolution of skin color
April 27, 2012 -- Brant Cebulla
Brant Cebulla reviews differing theories regarding skin pigmentation. One in particular is gaining momentum with the increase of vitamin D research. Continue reading → (open access)




Can vitamin D be increased inside a cell?
May 5, 2012 -- John Cannell, MD
Dr Cannell discusses Professor Heidi Cross’s life work. Professor Cross’s most recent publication focuses on increasing the production of vitamin D inside our cells, which could be beneficial for colorectal cancer treatment. Continue reading → (membership required)

So lots of interesting things here. One thing I will again emphasize is the importance of taking a magnesium supplement as practically everyone is deficient and more so if they use a vitamin D supplement.  I recommend magnesium malate and not magnesium oxide. Magnesium oxide is a laxative and does not significantly improve magnesium levels. Magnesium malate is beneficial in minimizing muscle spasms in the neck and back.
I should also add a magnesium blood level is not a accurate test. Magnesium in the blood represents less than one percent of total body magnesium. For this reason it does not represent a true reading about magnesium sufficiency. Many Doctors are not aware of this. If you do not believe me check this website out.
http://www.vitamindcouncil.org/about-vitamin-d/vitamin-d-cofactors/magnesium/

BB


     Vitamin D Council May 2nd, 2012
This newsletter is in part made possible by the support of our sponsors
  Examining the relationship between vitamin D and autism
April 26, 2012 -- John Cannell, MD
In a recent clinical review on autism and vitamin D, Dr. Eva Kocovska and colleagues from the University of Glasgow called for “urgent research” on vitamin D’s role in autism.

Kočovská E, Fernell E, Billstedt E, Minnis H, Gillberg C. Vitamin D and autism: Clinical review. Res Dev Disabil. 2012 Apr 20;33(5):1541-1550. [Epub ahead of print]

The body of the paper consisted of a review of the 35 papers published to date that deal directly with autism and vitamin D. Here were their areas of interest and the studies they reviewed.

On vitamin D blood levels

Four studies have looked at vitamin D levels in autistic children or their mothers and all have found low levels (<30 ng/ml) in autistic children. One found no difference in vitamin D levels between autistic children and boys with acute inflammation (a curious control), while the other three found differences, some significant and some not. One study found Somali mothers with autistic children had average vitamin D levels of 6.7 ng/ml, about 30% lower than Somali mothers without autistic children.

On vitamin D intake

The authors examined about a dozen papers that looked at vitamin D intake in autistic children, all finding that most autistic children do not meet vitamin D intake requirements for their age. On a side note, the authors also mention that magnesium has a crucial role in brain development and function. As readers know, magnesium deficiencies are the rule, not the exception in most Americans.

On brain development and function

The authors reviewed the numerous ways vitamin D is involved in brain development and function, including:

•  Synaptic development
•  Nerve migration and growth
•  Neurotransmission, both excitatory and inhibitory
•  Preventing excessive cell proliferation
•  Orchestrating signaling pathways in the brain
•  Cell differentiation
•  Nerve growth factor expression
•  Regulation of inflammatory cytokines
•  Neurotransmitter synthesis
•  Intra-neuronal calcium signaling
•  Anti-oxidant activity
•  Control of the expression of genes involved in brain structure and metabolism
•  Regulation of glutathione, the master antioxidant and heavy metal remover
•  Protection from glutamate toxicity

On autism, vitamin D and seizures

I was surprised at the number of studies showing the connection between vitamin D, seizures and autism. Up to 30% of children with autism have seizures, and it may be as easy as giving a vitamin D supplement to reduce seizures.

On breastfeeding

A recent study showed in a statistically significant finding that in States where exclusive breastfeeding is the highest, autism incidence is also the highest. Remember, unless the mother takes 5,000 IU/day and has a vitamin D level > 40 ng/ml, breast milk contains little vitamin D.

Yes, as I have been saying since 2006, there is a need for “urgent research in the field.”

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RCT: Vitamin D, calcium, and vitamin K's affect on activity in postmenopausal women
April 30, 2012 -- John Cannell, MD
Dr Cannell reviews a RCT which shows intriguing results when comparing supplementation with vitamin D and calcium vs vitamin D, calcium and K1 or K2. See which arm of the experiment increased activity! Continue reading → (membership required)



Vitamin D supplementation is crucial for patients taking Forteo
April 24, 2012 -- John Cannell, MD
Dr Cannell reviews a randomized controlled trial conducted by Dr Cosman and colleagues looking into teriparatide (Forteo), used to treat severe osteoporosis, and its effect on vitamin D. Continue reading → (membership required)

How do we measure sun exposure?
April 27, 2012 -- Brant Cebulla
Brant Cebulla discusses how we measure sun exposure and how “experts” decide on recommendations regarding sun exposure. Continue reading → (membership required)




Does it matter how often researchers test serum vitamin D? 
May 1, 2012 -- Dr William Grant
Dr William Grant reviews research in which increased follow-up times for testing serum vitamin D cause results to show little to no effect. Continue reading → (open access)

Professor Harry Steenbock's irradiation patent
April 24, 2012 -- John Cannell, MD
Professor Steenbock “invented” the irradiation of naturally occurring things such as milk and alfalfa. Dr Cannell discusses how the Federal Circuit Court of Appeals stripped Steenbock of his patent in 1943. Continue reading → (open access)


RCT: Vitamin D-fortified yogurt drink shows benefits for patients with type 2 diabetes 
April 28, 2012 -- John Cannell, MD
Dr Cannell reviews a study in which researchers at the University of Medical Sciences in Tehran conducted a RCT comparing a yogurt drink fortified with vitamin D and calcium to a placebo yogurt drink. The results are astounding. Continue reading → (membership required)

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