Misdiagnosed child abuse, yet again
August 25, 2011

I have written about false allegations of child physical abuse due to infantile rickets, until my own tears dried and turned to anger, all to no avail. I have tracked down the seminal papers on child physical abuse, only to see that some of the allegedly abused children actually have advanced rickets. (See Dr. Ayoub’s critiques of diagnoses of child abuse, by downloading the .pdf files here and here)

This week, readers can follow a family with a related bone disease, Osteogenesis imperfecta, one that, unlike rickets, fails to fully disappear when the infant is given vitamin D-rich baby formula. The medical condition stays around, and the child abuse industry has to explain persisting evidence of spontaneous fractures of abnormal bones.

Weathers H. They branded us abusers, stole our children and killed our marriage: parents of a boy with brittle bones attack social workers who claimed they beat him. Daily Mail. August 19, 2011.

However, with spontaneous fractures from infantile rickets, the evidence of the family’s innocence slowly fades away. The infant, under State care, is taken off the breast and put on the bottle; a bottle filled with the vitamin D the child needed to prevent rickets in the first place; a bottle filled with the vitamin D that will cure the infantile rickets in the several months it takes for the State to prepare to prosecute the innocent family. By that time, all evidence of infantile rickets has vanished, together with most friends and family.

If this story upsets you, multiply it by a thousand – my estimate of the number of families utterly destroyed every year by false allegations of physical abuse due to infantile rickets. Again, unlike Osteogenesis imperfecta, the medical evidence for the existence of infantile rickets begins to disappear as soon as the infant begins drinking the tiny amount of vitamin D contained in infant formula. Eventually, the parents of the now thriving child are left with no evidence, no defense, no recourse, no justice, and no child.

At least the above family has one thing that the falsely accused vitamin D deficient infantile rickets families will never have, the one thing the innocent value above all else: their innocence.

-John J. Cannell, M.D.

Nurses in NY state are required to report "apparent" parent child abuse

http://www.dailymail.co.uk/news/article-2028101/They-branded-abusers-stole-children-killed-marriage-parents-boy-brittle-bones-attack-social-workers-claimed-beat-him.html?ito=feeds-newsxml

The effect of vitamin D on estrogen levels in women
August 18, 2011
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8/18/11

I have written before that vitamin D increases testosterone levels in men. It is not a minor effect.

Pilz S, Frisch S, Koertke H, Kuhn J, Dreier J, Obermayer-Pietsch B, Wehr E, Zittermann A. Effect of vitamin D supplementation on testosterone levels in men. Horm Metab Res. 2011 Mar;43(3):223-5.

Now, a group in Canada, led by Dr. Julia Knight at Mount Sinai Hospital, discovered that administration of 24,000 IU/week for four weeks was associated with lower estrogen levels and progesterone levels. Per 4 ng/ml increase in vitamin D, progesterone levels decreased by 10% and estrogen decreased by 3%. Unlike men, the study was confounded by what estrous cycle phase the women were in.

Knight JA, Wong J, Blackmore KM, Raboud JM, Vieth R. Vitamin D association with estradiol and progesterone in young women. Cancer Causes Control. 2010 Mar;21(3):479-83.

The favorable implications for breast cancer come immediately to mind, but as an old GP, I can tell you that lower female hormones sometimes help women in all kinds of ways, including psychologically. I suspect the women also became more fertile.

The studies about vitamin D are pouring out, and I am happy to summarize these studies and offer my personal insight to the general public through these pieces. Soon, these write-ups will only be offered in full to members of the blog we're launching (by the end of the month!). This new system will help the Vitamin D Council continue its work and support our programs. So take a minute, consider donating or becoming a member. It is not expensive, but it really does make my day to see that people still care in these rocky economic times.

-John J. Canne

Low vitamin D levels could cause liver disease 08 August 2011

Dr. Simi Paknikar
Med India

We are all aware that low levels of vitamin D can cause weak bones. A recent study indicates that it could be associated with liver disease as well!

Researchers claim that low vitamin D could be one of the reasons behind the development of non-alcoholic fatty liver disease (NAFLD). NAFLD occurs due to accumulation of triglycerides in the liver cells.

Outpatients of suspected metabolic syndrome with normal liver enzymes, no excessive alcohol intake, negative for hepatitis B and hepatitis C, no cirrhosis or chronic liver disease were subjected to liver ultrasound to estimate the presence and degree of fatty liver disease. 25(OH) vitamin D levels were measured to estimate any deficiency of vitamin D.

The researchers found that patients with NAFLD had low levels of 25(OH) vitamin D. They also found that the lower 25(OH) vitamin D levels, the worse is the degree of fatty liver disease. This association was independent of other possible influencing factors like age, sex, triglycerides, HDL and fasting blood glucose levels...

Read rest of article at www.medindia.net

Vitamin D Council comment: Dr. Cannel reported on vitamin D and non-alcoholic fatty liver disease in the March 2009 edition of the Vitamin D Newsletter.

A blurb by Dr. Cannell on a recent peer-reviewed jounral article and Subway's new bread.
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August 4, 2011

Last month Professor Rebecca Mason of the University of Sydney and her co-authors wrote an excellent review of vitamin D.
 
Mason RS, Sequeira VB, Gordon-Thomson C. Vitamin D: the light side of sunshine. Eur J Clin Nutr. 2011 Jul 6. doi: 10.1038/ejcn.2011.105. [Epub ahead of print]
 
With two references, she confirmed what I always thought likely: higher calcium intake increases vitamin D levels. It makes sense, as less vitamin D is used up for absorbing calcium if calcium intake is high enough to trigger only passive calcium absorption.
 
I also liked her reiteration of vitamin A’s ability to interfere with the function of vitamin D, something I have written about in detail. I continue to think cod liver oil is confounding many vitamin D studies.
 
In several places, Professor Mason questions whether ethical concerns will mean that randomized controlled trials will never be done. After all, do you want to be randomized to the 600 IU/day control group? Not me.
 
I also liked her brief discussion of a wonderful paper that I wrote about last year on the study of 675 fresh cadavers. The authors compared bone biopsies and vitamin D levels of the cadavers to conclude that vitamin D levels of at least 35 ng/ml are needed for healthy bones, a study the recent FNB must have missed.
 
My only criticism is her failure to realize that food fortification is essential for large subgroups of the globe’s population. For example, African Americans are unlikely to seek sun exposure or take vitamin D supplements, proven by the fact that so many black women of childbearing age have vitamin D levels less than 10 ng/ml.
 
It appears as though some food companies are picking this up. Yesterday, Subway (the world’s largest food chain in terms of restaurant units) announced they will begin adding about 100 IU of vitamin D to the bread they use to make their subs.
 
Subway's 'Healthy' New Bread Will Include Vitamin D, Calcium
 
Although 100 IU is a menial amount of vitamin D, every little bit helps. And with Subway’s large and global influence, they might even help spread a little awareness.
 
-John J. Cannell, M.D.


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Low vitamin D impairs strength recovery after knee surgery
August 1, 2011

This weekend, scientists from an American medical institution published a study that has practical implications for patients undergoing ACL (Anterior Cruciate Ligament) surgery.

The study, by a group in Utah, may have answered in part the long sought question of why some patients do well after knee surgery (quickly regain strength in their quadriceps) and some do not. Dr. Tyler Barker, of the Orthopedic Specialty Hospital in Murray, Utah, and his colleagues at the University of Utah (where I did a surgical internship back in 1976) discovered that vitamin D levels are associated with muscle strength recovery after knee surgery (anterior cruciate repair). Those with levels above 30 ng/ml recovered much better than those with levels below 30 ng/ml.

Tyler Barker, Thomas B. Martins, Harry R. Hill, Carl R. Kjeldsberg, Roy H. Trawick, Lindell K. Weaver, and Maret G. Traber Journal of Evidence-Based Complementary & Alternative Medicine. published 29 July 2011, 10.1177/2156587211413768

I found it somewhat disappointing that the authors refused to say that vitamin D deficiency should be treated before knee surgery. All they would say was that Americans should fund more studies before any action is taken. Of course this is neither practical or ethical, as physicians are (and always have been) obligated to act on what is known now -- not on what may or may not be discovered in the future. Randomized trials of vitamin D supplemention need to be undertaken to discover what the optimum vitamin D level for knee surgery is. But such trials will take years, while orthopedists need to act, or not, now.

-John J. Cannell, M.D