5/17/11

#20) INDEX FOR VITAMIN D ARTICLES

Welcome to the members of Cherry Hill Chamber of Commerce, who on May 19th were interested in asking about vitamin D especially with it's connection with multiple sclerosis.

#2) UPDATE ON VITAMIN D 2009 - 5/1/09

#7) UPDATE ON VITAMIN D 2010 - 6/1/10

#9) CASE HISTORY-COMPLETE REMISSION OF 16 YEARS
OF PROGRESSIVE MS WITH VITAMIN D - 7/1/10

#11) VITAMIN D, TELEMERES, LONGEVITY - 7/7/10

#12) UPDATE ON MULTIPLE SCLEROSIS AND VITAMIN D - 7/24/10

#13) GENES AND VITAMIN D, HOW VITAMIN D HAS SUCH A
WIDESPREAD EFFECT ON HUMANS - 9/1/10

#14) PREVENTION OF INFLUENZA WITH VITAMIN D - 9/12/10

#15) BREAST CANCER AND VITAMIN D - 9/20/10

#17) MARKED IMPROVEMENT OF OSTEOPENIA AND OSTEOPOSIS ON DEXA SCANS WITH VITAMIN D ALONE OVER 5 YEARS,4 MONTHS - 4/5/11

#18) UPDATE ON VITAMIN D 2011 - 5/1/11

#19) CASE HISTORY – SUBJECTIVE AND OBJECTIVE
IMPROVEMENT IN MYESTHENIA GRAVIS - 5/11/11

#21) A MAJOR ADVANCE IN MULTIPLE SCLEROSIS - 8/1/11

#22) VENUS WILLIAMS HAS SJOGREN'S SYNDROME - 9/2/11

#23) PREVENTION OF BREAST CANCER WITH VITAMIN D HAS BEEN QUANTIFIED; A LEVEL OF 47 NG

#24) SUBJECTIVE 7 OBJECTIVE IMPROVEMENT IN RHEUMATOID ARTHRITIS WITH VITAMIN D REDUCES THE RISK BY 50%

5/14/11

#19) CASE HISTORY:SUBJECTIVE AND OBJECTIVE IMPROVEMENT IN MYASTHENIA GRAVIS FOLLOWING AGRESSIVE TREATMENT OF VITAMIN D INSUFFICIENCY

Myasthenia gravis (MG) is a rare autoimmune disease in which the body produces antibodies against the receptor that transmits chemicals from the nerves to the muscle. It is believed that these antibodies are produced by the thymus gland, and often excessive lymphoid tissue (similar to that found in lymph nodes) are found in the thymus glands of myasthenia patients. (Lymphoid tissue consists of cells that produce antibodies). Celebrities sometime define rare disease to the public. In this case, Aristotle Onasis (Jackie Kennedy’s second husband) suffered from it and in fact eventually died from it's complications.

Debbie is a patient who was diagnosed with MG in 2001 at the age of 41. She has kindly given me permission to use her first name. She was getting frequent infections and suffered from increasing weakness. Her primary doctor referred her to a neurologist, who did a series of tests including the tensilon test; and myasthenia gravis was diagnosed. She was treated at various times with prednisone, immuran, and mestinon, with some positive results.

From early on she suffered from intermittent double vision, common in MG. She wasn’t able to drive because of her fear of suddenly getting the vision problem. This greatly affected the quality of her life.

She was first seen by me in November, 2008. I told her at that time there is no medical research on MG and vitamin D, but many other autoimmune diseases are benefited by vitamin D, and the positive effects of vitamin D on the immune system in other autoimmune diseases have been studied.

Debbie’s vitamin D level then was 22 ng/ml. I convinced her to take a significant dose of vitamin D and her level increased to 64 ng/ml on July 15, 2009. She noticed improvement in her symptoms within a few months of starting the vitamin D. In a stunning development, the double vision that had plagued her for 7 years was gone and has not returned; she has been able to resume driving. She noticed a decrease in her frequent infections and increase in muscle strength. In general she felt much better. Her dose of prednisone was cut significantly because of the improvement. However she then decreased her vitamin D dose, her level dropped in a few months to 57, and she noticed the beginning of the return of many of her symptoms. In January, 2011, I saw her again and encouraged her to increase the dose of her vitamin D to maintain a level that approaches what I call the “lifeguard level.” (Full time male lifeguards in August frequently have levels of 60 to 80 ng. or even higher.)

I have reviewed MEDLINE and done internet searches and cannot find any research that has been done on vitamin D and myasthenia gravis. If anyone who is reading this knows of any, please let me know. I have gone to patient support web sites and have found many patients blogging that their vitamin D level was extremely low (10 to 20 ng./ml seems to be common), but most of them take small doses of 1000 to 2000 units a day in an attempt to correct it, and many have a hard time raising their level significantly. One lone woman noted on the blog that since taking vitamin D, her double vision stopped and hasn’t returned over many months.

It is felt that myasthenia involves an ongoing antibody reaction and the damage to the muscles could be reversible if the antibody production can be stopped. The evidence indicates that vitamin D affects the immune system in a beneficial way, and can prevent the body from producing cells that attack itself.

A study of treating MG patients with significant doses of vitamin D and measuring their muscle strength with objective tests needs to be done. Whether this will be done in 1 year, or 20 years, I don’t know. MG patients shouldn’t wait. In the mean time, Debbie’s quality of life has increased and her need for some medications that cause significant side effects has decreased. I cannot find any report in medical literature that a person with MG took vitamin D not only to prevent osteoporosis but to see if there was a positive effect on the MG.

I will be posting this link on various patient support web sites for myasthenia gravis. I thank Debbie for allowing me to post her story in order to help other myasthenia gravis patients.

5/1/11

#18) UPDATE ON VITAMIN D - 2011

It has been two years since my first update on Vitamin D. Research on vitamin D has continued to explode in this time. I see about 3 major articles a week that have been published on vitamin D. Rarely do the important studies make the newspapers.

One of vitamin D’s most basic properties is increasing calcium absorption, bone density, and muscle strength. Studies have shown that it’s never too late to be beneficial; in double blind studies elderly nursing home patients decrease their falls and fractures within 6 months of being given a significant dose of vitamin D. Studies show that bone density at 40 ng is better than at lower levels. I have collected several case histories in which people have increased their bone density by 15% on vitamin D alone over a few years. In 6 years of my ordering vitamin D levels, only 4 out of 700 (1 out of 175) had osteoporosis or osteopenia with an initial level of vitamin D over 32 ng (and all 4 were just barely over 32). Other physicians I have spoken to have seen the same results. Conclusion: want to have almost complete protection against osteoporosis? Keep your vitamin D level over 32 ng. (although 40 ng or higher would be better). (see #17 on osteoporosis).

My 2010 update listed information about vitamin D preventing hyper-proliferation of cells, and therefore cancer. A landmark study has been published specifically on breast cancer and the results were nothing short of incredible. Women diagnosed with breast cancer with vitamin D levels over 30 ng. were 73% less likely to die and 94% less likely to have their cancer recur compared to those with levels less than 20 ng. during the 10 year length of the study. The evidence in other studies indicate that if the vitamin D level is raised with supplements after the diagnosis of breast cancer is made, the prognosis will improve substantially. (see #15 on breast cancer for details of the study.

It has been shown that vitamin D prevents autoimmune disease by interfering with the production of abnormal antibodies that attack the body. Extensive studies have shown that the incidence of type I diabetes (juvenile), and multiple sclerosis can be greatly decreased by giving infants vitamin D. Many research articles on MS have shown improvements in the progress of the disease with vitamin D. My MS patients are few since I’m not a neurologist, but I’ve seen improvement in my several patients with MS who have their low level treated. (see #9 and #12 on multiple sclerosis).

Vitamin D allows the body to make a class of natural antibotics. In the May,2010
issue of the American Journal of Clinical Nutrition, a rigorously designed randomized, double blind, controlled study gave children either vitamin D or placebo during the flu season. The diagnosis of influenza A was made only when it was confirmed by culture. The vitamin D children had 42% less influenza A than the placebo children. An unexpected result was that the vitamin D children had an 83% reduction in asthma attacks. Previous studies have shown that 70% of children have vitamin D levels of less than 32 ng., and that the average vitamin D level is 20% lower in this decade than when we were children. (see #14 on influenza).

The findings on vitamin D sound “too good to be true” In the past several decades there has been wild claims about vitamin C and E that were known by some to be inaccurate shortly after they were published. There was always a great deal of skepticism by experts and there was never a consensus. In contrast. the vitamin D studies are extensive and accurate. An international consortium of vitamin D experts in a worldwide vitamin D call to action on March 31, 2011.

Should it be a surprise that vitamin D has such a profound effect on humans? The human body has about 2000 genes. A study in the August, 2010, Genome Research explained that vitamin D has been identified as having a significant effect on the activity of 229 genes (about 10%) by binding to 2776 sites on these genes. Humans have gone through periods of time of food shortages, but for a very long time humans had a very much higher level of vitamin D, as there was never a shortage of this near the equator.