On May 14, 2011, I posted #19) CASE HISTORY: SUBJECTIVE AND OBJECTIVE IMPROVEMENT IN MYASTHENIA GRAVIS FOLLOWING AGGRESSIVE TREATMENT OF VITAMIN D INSUFFICIENCY. I wrote about Debbie, a lady who was diagnosed with MG at age 41 in 2001. http://robertbakermdhealthnewsletter.blogspot.com/2011/05/case-history-subjective-and-objective.html
I first saw her in November, 2008 when she was on a high dose of prednisone for her disease, and also had vitamin D insufficiency diagnosed with a blood level. It made sense that MG should respond to vitamin D. It is a disease caused by production of abnormal antibodies that attack receptors located between muscles and nerves. I had previously searched MEDLINE and the internet using several search engines and was unable to find any research study or case history reporting on a connection. There simply were none. So I told Debbie we need to treat her vitamin D insufficiency to treat and improve her osteoporosis promoted by the steroids. I added that if there was a positive effect on her illnesses, that would be a bonus. I wrote up the response that Debbie had in the above mentioned Health Letter.
In mid-2012 I saw patient Sara who was 27 and had been diagnosed with myasthenia gravis the previous year,
confirmed by special tests. She had been advised by her neurologist to have her thymus gland removed, a procedure
that often helps relieve symptoms of myasthenia gravis. (It is felt that myasthenia gravis is caused by antibodies that are produced by the thymus gland, which is a gland in the neck related to the immune system.) She was holding off on the final decision.
At that time her 25-hydroxyvitamin D level was low. I discussed with her the treatment of vitamin D deficiency, the experience of my patient Debbie, and the possible beneficial effect it can have on myasthenia gravis. She started 5000 units of vitamin D with instructions for getting up follow up levels.
I saw Sara again about a year later. She had not had any surgery. Her symptoms were 80% improved. No change was made from a year before except the addition of 5000 units of vitamin D. She has given me her kind permission to use her first name in this write-up of her case.
Three months before seeing Sara a second time, a group of neurologists from Sweden published a study in the European Journal of Neurology (December 19, 2012). They studied 33 patients with MG. 13 patients were started on Vitamin D 800 units a day with a follow up an average of 6 months later. Neurologists use an objective test called the MGC
to measure the severity of fatigue with MG. (Fatigue is a prominent symptoms of MG). The MGC score in the 800 Unit vitamin D taking subjects improved 38%.
I emailed one of the authors and supplied to her the link of the case history report involving Debbie. She responded by telling me another doctor had shared with them a similar case also using 5000 units of vitamin D daily. She indicated that her group was planning further studies involving a dose close to what Debbie and this other case she heard about received.
The Swedish study was published in December. 2012. Up to that point no study had been published in a medical journal regarding the use of vitamin D to treat MG. The case report on Debbie that I published on my internet health letter represents the first case report ever published anywhere on the subject. My 2 case studies had far more than 38% improvement, but the dose I used was much higher than the 800 units used in Sweden.
My 2 case histories using 5000 units of vitamin D (and the Swedish study showing lesser improvement with 800 units) leads to the following recommendations that apply to every patient with MG:
1. Every MG patient should receive a 25-hydroxyvitamin D test (it will be low), and have the insufficiency treated, preferable to a level of 50 to 80 ng (125 to 200 nM.) (Treatment of vitamin D insufficiency is already recommended by vitamin D experts for the prevention of osteoporosis and other illnesses).
2. Other treatments for MG may need to be given as should be determined by the patient’s neurologist. However if the improvement is substantial enough, other treatments may not be necessary.
Showing posts with label Vitamin D. Show all posts
Showing posts with label Vitamin D. Show all posts
6/5/13
9/30/12
#29) LEARNING ABOUT VITAMIN D
Many people who access this web site do so in order to find out about vitamin D. They may have a specific illness that they have heard is connected to vitamin D deficiency, or they may have been told by their doctor that their vitamin D level is low. It takes time to scroll through all these entries, so this is a guide on how to find out about vitamin D in the most efficient way.
Entry #7: Update on Vitamin D – 2010.
This is a very concise summary of some of the major actions of vitamin D. This would be the FIRST thing to read. In fact, if you read only this, you will know quite a bit about vitamin D. In the last year there have been similar articles published in medical journals with documentation of dozens of references.
#15 and #23 : both give details regarding breast cancer.
#17 and #25: osteoporosis and documentation of improvement in bone strength with vitamin D.:
#9, #12, and #21: multiple sclerosis, including the details of a total remission. One of the best web sites on the subject is available at www.VitaminDMSCure.com. Anyone who is interested in MS should the several pages on this this web site.
#14: influenza
#24: rheumatoid arthritis
#19: myasthenia gravis
#28: scleroderma
Entry #2 and #18 give further updates with a list of some vitamin D related conditions.
5/7/12
#28) CASE HISTORY: MARKED IMPROVEMENT IN SCLERODERMA WITH TREATMENT OF VITAMIN D DEFICIENCY
(revised August 26, 2013) (revised November 14, 2013)
Kathy is a lady who was diagnosed with scleroderma in January, 2005 at the age of 45. Her initial illness was very serious; she was in acute renal failure as a result of it, and was on hemodialysis for months. She has been under the care of a rheumatologist and is on multiple medications including prednisone from early on. The first several years, in addition to her acute renal failure, she lost the fingers of her right hand, a characteristic manifestation of scleroderma. She also suffered from severe chronic fatigue.
Scleroderma is a rare disease and I have seen only a small number of patients with the condition during my career. However I know it is thought to be a disease caused by the production of abnormal antibodies. I also knew that studies had been done previously that showed that scleroderma is associated with very low vitamin D levels. This was not a surprise when I learned this, since scleroderma is a connective tissue diseases like rheumatoid arthritis, systemic lupus, and Sjogren’s syndrome also shown to be associated with very low vitamin D levels, lower than the general healthy population; and in some cases medical research studies showed an improvement of symptoms with these illnesses with the treatment of vitamin D deficiencies.
I first saw her as a patient in January, 2010. I told her it may be important to get a 25-hydroxyvitamin D level. The results showed a level of 15 nanograms (ng.), equivalent to 22.5 nMol., (a unit more commonly used in Great Britain). I started her on 50,000 units of vitamin D2 a week, (an average of 7143 units a day). Vitamin D2 is a prescription drug in the United States. An alternative dose of 5,000 units of Vitamin D3 daily can be used also ( a total of 35,000 units a week). Vitamin D3 is over the counter, and in the United States is extremely inexpensive ($2 a month in a prominent chain pharmacy). In my practice of medicine, I have over 7,000 patients with vitamin D insufficiency or deficiency who are on this dose of vitamin D2 or D3.)
She continued to see her rheumatologist and primary care doctor. I saw her again on May 2, 2012. She told me that within a few months of starting the vitamin D, her years of fatigue improved and then resolved. Her kidney function before the vitamin D showed a creatinine of 1.4 mg.; a recent one was now 1.2 mg. In September, 2013, it improved significantly further to a level of 0.8 mg. Her creatinine is now normal. It has improved 42.8%. (Serum creatinine is a very important measure of kidney function, and renal impairment sometimes occurs with scleroderma). Immediately prior to the vitamin D, her prednisone dose as prescribed by her rheumatologist, was 40 mg. a day. Once the vitamin D was started, because of an improvement in her overall symptoms, her doctor was able to slowly the dose to 5 mg. a day. (40 mg. of Prednisone a day for an extended period of time almost always causes major serious side effects; in comparison 5 mg. is associated with much less severe side effects). Since 2010, Kathy has had follow up levels of 25-hydroxyvitamin D and the level indicates a sufficient level.
On May 11, 2011, I posted: #19, a case history regarding myasthenia gravis (MG) and vitamin D.. and since then it's been updated. http://robertbakermdhealthnewsletter.blogspot.com/2013/06/35-index-case-of-improvement-of.html This is the first case history ever reported of MG being treated and improving with vitamin D. On July 1, 2010, I posed a case history of a complete remission of progressive multiple sclerosis with Vitamin D, a remission that is still complete as of June, 2013.. However in this case, there is a large volume of medical studies that have documented improvement of MS with Vitamin D. Many have been published AFTER my report of 2010, but many were published before.
So is this case report of scleroderma more similar to a new finding in the case of MG, or just a demonstration of a previously discovered connection, as in the case of MS? To find out, I had to search the internet.
Vitamin D levels in scleroderma have been found to be remarkably low. There is direct correlation between the severity of the disease and levels of vitamin D. Especially important is that lung manifestations of scleroderma are more common and severe the lower the level. Fibrosis (scar tissue) which can be widespread in advanced scleroderma has been show to be inversely related to vitamin D concentration. The abnormal deposition of calcium deposits in the tissues (called metastatic calcification), found in the most severe cases of scleroderma, is related to high parathyroid levels and very low vitamin D levels om patients without scleroderma, and a study that looked at parathyroid levels found in fact that parathyroid levels in scleroderma was very high. As far as case reports, there are some, but not the “perfect” prospective double blind study.
There are various theories about some of the causes of scleroderma, not having anything to do with vitamin D. But the theory based on substantial evidence with medical studies is that vitamin D prevents the production of abnormal antibodies caused by a wide variety of illnesses,
Most people reading this do not know anyone with scleroderma because fortunately it is a rare disease. But everyone knows someone with an autoimmune disease. Help them out, send this link to them.
Kathy is a lady who was diagnosed with scleroderma in January, 2005 at the age of 45. Her initial illness was very serious; she was in acute renal failure as a result of it, and was on hemodialysis for months. She has been under the care of a rheumatologist and is on multiple medications including prednisone from early on. The first several years, in addition to her acute renal failure, she lost the fingers of her right hand, a characteristic manifestation of scleroderma. She also suffered from severe chronic fatigue.
Scleroderma is a rare disease and I have seen only a small number of patients with the condition during my career. However I know it is thought to be a disease caused by the production of abnormal antibodies. I also knew that studies had been done previously that showed that scleroderma is associated with very low vitamin D levels. This was not a surprise when I learned this, since scleroderma is a connective tissue diseases like rheumatoid arthritis, systemic lupus, and Sjogren’s syndrome also shown to be associated with very low vitamin D levels, lower than the general healthy population; and in some cases medical research studies showed an improvement of symptoms with these illnesses with the treatment of vitamin D deficiencies.
I first saw her as a patient in January, 2010. I told her it may be important to get a 25-hydroxyvitamin D level. The results showed a level of 15 nanograms (ng.), equivalent to 22.5 nMol., (a unit more commonly used in Great Britain). I started her on 50,000 units of vitamin D2 a week, (an average of 7143 units a day). Vitamin D2 is a prescription drug in the United States. An alternative dose of 5,000 units of Vitamin D3 daily can be used also ( a total of 35,000 units a week). Vitamin D3 is over the counter, and in the United States is extremely inexpensive ($2 a month in a prominent chain pharmacy). In my practice of medicine, I have over 7,000 patients with vitamin D insufficiency or deficiency who are on this dose of vitamin D2 or D3.)
She continued to see her rheumatologist and primary care doctor. I saw her again on May 2, 2012. She told me that within a few months of starting the vitamin D, her years of fatigue improved and then resolved. Her kidney function before the vitamin D showed a creatinine of 1.4 mg.; a recent one was now 1.2 mg. In September, 2013, it improved significantly further to a level of 0.8 mg. Her creatinine is now normal. It has improved 42.8%. (Serum creatinine is a very important measure of kidney function, and renal impairment sometimes occurs with scleroderma). Immediately prior to the vitamin D, her prednisone dose as prescribed by her rheumatologist, was 40 mg. a day. Once the vitamin D was started, because of an improvement in her overall symptoms, her doctor was able to slowly the dose to 5 mg. a day. (40 mg. of Prednisone a day for an extended period of time almost always causes major serious side effects; in comparison 5 mg. is associated with much less severe side effects). Since 2010, Kathy has had follow up levels of 25-hydroxyvitamin D and the level indicates a sufficient level.
On May 11, 2011, I posted: #19, a case history regarding myasthenia gravis (MG) and vitamin D.. and since then it's been updated. http://robertbakermdhealthnewsletter.blogspot.com/2013/06/35-index-case-of-improvement-of.html This is the first case history ever reported of MG being treated and improving with vitamin D. On July 1, 2010, I posed a case history of a complete remission of progressive multiple sclerosis with Vitamin D, a remission that is still complete as of June, 2013.. However in this case, there is a large volume of medical studies that have documented improvement of MS with Vitamin D. Many have been published AFTER my report of 2010, but many were published before.
So is this case report of scleroderma more similar to a new finding in the case of MG, or just a demonstration of a previously discovered connection, as in the case of MS? To find out, I had to search the internet.
Vitamin D levels in scleroderma have been found to be remarkably low. There is direct correlation between the severity of the disease and levels of vitamin D. Especially important is that lung manifestations of scleroderma are more common and severe the lower the level. Fibrosis (scar tissue) which can be widespread in advanced scleroderma has been show to be inversely related to vitamin D concentration. The abnormal deposition of calcium deposits in the tissues (called metastatic calcification), found in the most severe cases of scleroderma, is related to high parathyroid levels and very low vitamin D levels om patients without scleroderma, and a study that looked at parathyroid levels found in fact that parathyroid levels in scleroderma was very high. As far as case reports, there are some, but not the “perfect” prospective double blind study.
There are various theories about some of the causes of scleroderma, not having anything to do with vitamin D. But the theory based on substantial evidence with medical studies is that vitamin D prevents the production of abnormal antibodies caused by a wide variety of illnesses,
Most people reading this do not know anyone with scleroderma because fortunately it is a rare disease. But everyone knows someone with an autoimmune disease. Help them out, send this link to them.
9/2/11
#22) VENUS WILLIAMS HAS SJOGREN'S SYNDROME
Riddle:
Question: What does Venus Williams and Sjogren's have to do with Vitamin D?
Answer: Everything
Sjogren’s syndrome is an autoimmune illness involving dry mouth, dry eyes, joint pain and inflammation, and fatigue. It is considered incurable. It is in the class of rheumatological diseases such as rheumatoid arthritis and systemic lupus. It is a rare disease.
A study was published in the Annals of Rheumatic Diseases in which vitamin D levels were measured in 35 patients with Sjogren’s syndrome and normal controls. This study was done because of other previous studies that suggested that Vitamin D may have a regulatory role in the immune system.
The results were clear cut. Severely diminished blood concentrations of vitamin D was found in patients with Sjogren’s syndrome compared to those without Sjogren’s.
In some cases of Sjogren’s, a harmful antibody called IgM rheumatoid factor is found. In this study,patients who did have an elevated level of IgM rheumatoid factor, there was a significant correlation with vitamin D – the higher the harmful levels of IgM rheumatoid factor, the lower the vitamin D level.
Venus Williams has been diagnosed with Sjogren’s syndrome. It forced her to withdraw from the U.S. tennis open. The media is reporting that she had symptoms for over a year.
The initial studies on vitamin D were the first and second steps. The next step is taking a number of patients with Sjogren’s syndrome, treating half of the subjects with major doses of vitamin D, and half with placebo. When is this study going to be done, now that the preliminary studies have been done.
There are problems. The initial study mentioned above on vitamin D was published in 1983; the one published in the Annals of Rheumatic Diseases was published in 1990. I have reviewed MEDLINE and have found NO studies treating Sjogren’s with vitamin D; not even a case report.
It looks like there is never going to be a proper study to evaluate vitamin D in Sjogren’s. Every person with Sjogren’s should obtain a 25-hydroxyvitamin D level and treat with vitamin D supplements to an ideal level. We know that the vitamin D will have a positive effect on bone density, along with many other beneficial effects. It hasn’t been studied in people with Sjogren’s sufferers. Because it’s over the counter, what’s stopping anyone with Sjogren’s from taking it to evaluate the effect on their Sjogren’s. Vitamin D has been shown to lead to improvements in other autoimmune diseases - rheumatoid arthritis, multiple sclerosis. What would happen if it ended up being a very effective inexpensive treatment for Sjogren's?
Do you hear me, Venus?
Question: What does Venus Williams and Sjogren's have to do with Vitamin D?
Answer: Everything
Sjogren’s syndrome is an autoimmune illness involving dry mouth, dry eyes, joint pain and inflammation, and fatigue. It is considered incurable. It is in the class of rheumatological diseases such as rheumatoid arthritis and systemic lupus. It is a rare disease.
A study was published in the Annals of Rheumatic Diseases in which vitamin D levels were measured in 35 patients with Sjogren’s syndrome and normal controls. This study was done because of other previous studies that suggested that Vitamin D may have a regulatory role in the immune system.
The results were clear cut. Severely diminished blood concentrations of vitamin D was found in patients with Sjogren’s syndrome compared to those without Sjogren’s.
In some cases of Sjogren’s, a harmful antibody called IgM rheumatoid factor is found. In this study,patients who did have an elevated level of IgM rheumatoid factor, there was a significant correlation with vitamin D – the higher the harmful levels of IgM rheumatoid factor, the lower the vitamin D level.
Venus Williams has been diagnosed with Sjogren’s syndrome. It forced her to withdraw from the U.S. tennis open. The media is reporting that she had symptoms for over a year.
The initial studies on vitamin D were the first and second steps. The next step is taking a number of patients with Sjogren’s syndrome, treating half of the subjects with major doses of vitamin D, and half with placebo. When is this study going to be done, now that the preliminary studies have been done.
There are problems. The initial study mentioned above on vitamin D was published in 1983; the one published in the Annals of Rheumatic Diseases was published in 1990. I have reviewed MEDLINE and have found NO studies treating Sjogren’s with vitamin D; not even a case report.
It looks like there is never going to be a proper study to evaluate vitamin D in Sjogren’s. Every person with Sjogren’s should obtain a 25-hydroxyvitamin D level and treat with vitamin D supplements to an ideal level. We know that the vitamin D will have a positive effect on bone density, along with many other beneficial effects. It hasn’t been studied in people with Sjogren’s sufferers. Because it’s over the counter, what’s stopping anyone with Sjogren’s from taking it to evaluate the effect on their Sjogren’s. Vitamin D has been shown to lead to improvements in other autoimmune diseases - rheumatoid arthritis, multiple sclerosis. What would happen if it ended up being a very effective inexpensive treatment for Sjogren's?
Do you hear me, Venus?
8/1/11
#21) A MAJOR ADVANCE IN MULTIPLE SCLEROSIS
Multiple sclerosis is a serious illness. Almost everyone knows someone personally who has multiple sclerosis. Many remember Annette Funicello, the unfortunate case in which Annette has been wheelchair bound for many years.
Multiple sclerosis is an autoimmune disease in which abnormal antibodies are produced that attack the central nervous system. It is believed that many factors contribute to these antibodies being produced – genetics, (although parent-child cases or cases in two siblings are very rare), dietary factors, and other factors have been researched with various degrees of proof.
In 1974 Dr. P. Goldman published a medical article in the International Journal of Environmental Studies which noted a very strong connection between higher rates of MS and distance from the equator. How this could affect the incidence of MS was not understood at the time, and it has taken over 3 decades for scientific discoveries to catch up and explain this connection.
Because of medical research done in the last decades, it is now known that vitamin D in the human can decrease or eliminate the production of abnormal antibodies produced when the human body turns on itself. Vitamin D is produced almost exclusively from the sun’s action on our skin. (Very little vitamin D is added to milk, and it’s present in some other foods such as fish, but there is not enough in food to supply the human body with the amount it needs.) Connecting the dots of this research done over 3 decades explains the sun connection. Distance from the equator is strongly correlated to the amount of vitamin D produced by humans.
There are over 350 studies of vitamin D and multiple sclerosis listed in MEDLINE. They approach the subject in dozens of various ways. Vitamin D levels are in general very low in patients with MS; higher levels in childhood and adulthood lead to a lower incidence of MS; vitamin D is shown to modify the harmful antibodies; and most importantly, giving vitamin D to MS sufferers shows improvements in the symptoms and objective positive changes in a high percentage of cases. One article summarizes the studies: “Vitamin D: a natural inhibitor of multiple sclerosis.” Another article asks: “Managing MS – are we forgetting something?” Another article finds evidence that vitamin D should be given prenatally to expectant mothers, and to infants, to prevent a variety of illnesses. One research study shows an improvement in 80% in MS patients with vitamin D. And finally a well respected neurological journal in 2010 has recommended that every MS patient get a 25-hydroxyvitamin D level, and deficiencies should be treated. Vitamin D is now mainstream medical treatment for MS.
There are a number of powerful medications used to treat MS with varying results, varying side effects, and they tend to be extremely expensive. Neurologists are the experts on these drugs. Vitamin D should be used as an additional treatment with virtually everyone with MS. It costs a few dollars a month, and at the doses involved, is free of side effects. All the treatments of MS strive to prevent further antibody damage; unfortunately nothing has been found that regenerates the nerve cells that have already been irreversibly damaged. So no one is claiming that wheelchair bound people could walk again, but further damage may be prevented.
I started off by saying that almost everyone knows someone with MS – a friend, or relative. If that is the case with you, tell them about these findings. I still come across people who suffer from MS, and in one case, die from it, without ever having had a vitamin D level drawn or without receiving vitamin D. This has got to stop!
Multiple sclerosis is an autoimmune disease in which abnormal antibodies are produced that attack the central nervous system. It is believed that many factors contribute to these antibodies being produced – genetics, (although parent-child cases or cases in two siblings are very rare), dietary factors, and other factors have been researched with various degrees of proof.
In 1974 Dr. P. Goldman published a medical article in the International Journal of Environmental Studies which noted a very strong connection between higher rates of MS and distance from the equator. How this could affect the incidence of MS was not understood at the time, and it has taken over 3 decades for scientific discoveries to catch up and explain this connection.
Because of medical research done in the last decades, it is now known that vitamin D in the human can decrease or eliminate the production of abnormal antibodies produced when the human body turns on itself. Vitamin D is produced almost exclusively from the sun’s action on our skin. (Very little vitamin D is added to milk, and it’s present in some other foods such as fish, but there is not enough in food to supply the human body with the amount it needs.) Connecting the dots of this research done over 3 decades explains the sun connection. Distance from the equator is strongly correlated to the amount of vitamin D produced by humans.
There are over 350 studies of vitamin D and multiple sclerosis listed in MEDLINE. They approach the subject in dozens of various ways. Vitamin D levels are in general very low in patients with MS; higher levels in childhood and adulthood lead to a lower incidence of MS; vitamin D is shown to modify the harmful antibodies; and most importantly, giving vitamin D to MS sufferers shows improvements in the symptoms and objective positive changes in a high percentage of cases. One article summarizes the studies: “Vitamin D: a natural inhibitor of multiple sclerosis.” Another article asks: “Managing MS – are we forgetting something?” Another article finds evidence that vitamin D should be given prenatally to expectant mothers, and to infants, to prevent a variety of illnesses. One research study shows an improvement in 80% in MS patients with vitamin D. And finally a well respected neurological journal in 2010 has recommended that every MS patient get a 25-hydroxyvitamin D level, and deficiencies should be treated. Vitamin D is now mainstream medical treatment for MS.
There are a number of powerful medications used to treat MS with varying results, varying side effects, and they tend to be extremely expensive. Neurologists are the experts on these drugs. Vitamin D should be used as an additional treatment with virtually everyone with MS. It costs a few dollars a month, and at the doses involved, is free of side effects. All the treatments of MS strive to prevent further antibody damage; unfortunately nothing has been found that regenerates the nerve cells that have already been irreversibly damaged. So no one is claiming that wheelchair bound people could walk again, but further damage may be prevented.
I started off by saying that almost everyone knows someone with MS – a friend, or relative. If that is the case with you, tell them about these findings. I still come across people who suffer from MS, and in one case, die from it, without ever having had a vitamin D level drawn or without receiving vitamin D. This has got to stop!
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.
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.
4/5/11
#17) MARKED IMPROVEMENT OF OSTEOPENIA AND OSTEOPOROSIS ON DEXA SCANS WITH VITAMIN D ALONE OVER 5 YEARS 4 MONTHS
Dory is a lady who in May, 2005, at the age of 50, received her first DEXA scan as a screening test for osteoporosis. After her initial test she was told by her physician there were areas of osteoporosis and osteopenia in the scan. No treatment was recommended at that time. Her physician’s plan was to repeat the DEXA scan in 2 years. The DEXA scan and the 2 subsequent scans were obtained at Massachusetts General Hospital in Boston.
Dory and her husband are acquaintances of mine. So they called me to get another opinion on the scan. I recommended to Dory that she obtain a 25-hydroxyvitamin D level. Her first level was in the low 20’s. I initially recommended she take 5000 units of vitamin D and repeat the level in 6 months.
2 years and 2 months later Dory got her second DEXA. It showed improvement in most of the bone densities tested. Her Massachusetts General Hospital physician was surprised that the bone strength had improved without taking any prescription anti-osteoporosis drugs. By then Dory was noticing that she felt so much better since taking the vitamin D, and noticed the increased strength and growth in her fingernails. I discussed with her the ideal level of vitamin D, told her about the high levels that lifeguards and fishermen and women have in the summers. She has adjusted her dose in the last few years and she has reached what many vitamin D experts consider an ideal level of 70 to 90 ng, and she has kept her level at that number.
Almost 3 years later, in September, 2010, she received her third DEXA scan. All areas tested were very much improved.
Dory’s Dexa Results -
Improvement in Bone Density
May, 2005 to September, 2010 (5 years, 4 month interval)
(L refers to lumbar vertebrae).
Hip-----Femur----L1------L2-------L3--------L4-----Ave.Increase
7.5%-----13.5%----33.6%--13.3%--22.2%--8.13%----17%
Dory’s documented results are quite remarkable. The public (and many doctors) feel it’s inevitable that bone density decrease with age.
Are these results unique? Studies haven’t studied serial bone density in subjects taking vitamin D alone in the absence of anti-osteoporosis prescription drugs. I have seen 2 additional patients in the past 5 years and both had improvements of 15% taking vitamin D alone in DEXAs taken two years apart.
History of Vitamin D and osteoporosis
Sunlight (which produces vitamin D in the skin) was discovered in 1850 to prevent rickets, and cod liver oil (which contains vitamin D) was recognized as preventing rickets in 1877. Rickets is a severe malformation of the bones occurring in young children. Vitamin D itself wasn’t discovered until 1922. Rickets continued to be common well until the 20th century.
It wasn’t until 1970 that Vitamin D’s role in calcium regulation was recognized. For several decades vitamin D was considered to be just one of many minor risk factors in osteoporosis. The medical profession repeated its error that had been made with cholesterol (in 1978 cholesterol of 250 mg. was considered normal). Similarly a 25-hydroxyvitamin D level was considered normal from 20 to 30 ng/ml. This led, erroneously, to minimizing of the importance of vitamin D as a cause of osteoporosis. Ordering 25-hydroxyvitamin D levels, stimulated by the release of research reports, didn’t become common until about 2005. It has only been since about 2005 that laboratories no longer report a normal level starting at 20 ng. Even today, many people even with osteoporotic fractures don’t get a level ordered. I know of many extreme cases; including a case in which a woman with a hip fracture at 75 stayed in a nursing home for a year without a level being obtained, suffering increasing weakness and falls, and then being discovered to have an level of 8 ng once she was out of the nursing home.
A most remarkable and very sad case of osteoporosis was a 70 year old woman who I saw in 2005, only a few months after I started ordering levels. She walked totally bent over at the waist with her upper body at a 90% angle to the floor. This type of thing has shown to be caused by microscopic fractures that occur over decades that start at a young age. I ordered a vitamin D level, her first ever. Out of the over 3000 levels I have ordered before and since, it is the only one in which the result was “no detectable vitamin D.” Unfortunately the vitamin D she now takes, although it has relieved some of her pain, can not completely rebuild and straighten her broken spine.
Many studies until recently showed that osteoporosis was common with what was called normal levels of 25-hydroxyvitamin D 20 to 30 ng/mg. Even to this day, studies are published and reported to the public in newspapers falsely claiming that vitamin D doesn’t prevent fractures because of the fractures that occur with levels in the 20’s.. For example, it has been shown repeatedly in studies that 400 units a day of vitamin D raises the level only an average of 5 ng,, and doesn’t significantly reduced the fracture rate. The truth is that in the last decade virtually EVERY study done comparing fracture rate above and below 32 ng has shown a significant reduction in fracture rates.
A landmark study in elderly patients from age 70 to 90 showed that in less than six months the number of falls and fractured decreased very significantly with very significant doses of vitamin D that raised the level, often over 40 ng. (Vitamin D was compared to placebo). Hundreds of well designed studies have demonstrated an extreme benefit of significant doses of vitamin D in terms of preventing osteoporosis).
Studies have shown that the parathyroid glands can have a detrimental effect on bone density up to a level of vitamin D of 40 ng. (The parathyroid glands produce their hormone to dissolve microscopic areas of bone in order to maintain a normal calcium level. A further beneficial effect with higher levels has not been studied, simply because not enough people have these higher levels. Many vitamin D experts consider an ideal level as 70 to 90 ng. Levels of vitamin D with sun exposure alone will not go up greater than 150 ng. At that level, there is a feedback mechanism which breaks down the chemicals in the skin that synthesize vitamin D.
No side effects occur with vitamin D at levels below 150 ng. There is a very specific situation in the rare disease of saroidosis and a few other illnesses in which the disease causes of disorder of vitamin D metabolism, so there is sometimes a hypersensitivity to vitamin D in these few rare cases that can be easily managed by monitoring blood chemistries.
Many studies have shown that taking calcium supplements increase the rate of kidney stones. Because these supplements are given with Vitamin D, some studies have erroneously concluded that vitamin D also raises the incidence of kidney stones. The truth is that all studies using vitamin D alone have NEVER shown an increase in kidney stones. In fact, with low vitamin D levels leading to an increase in calcium released from the bone, it is likely that treating vitamin D insufficiency leads to a DECREASE, not an INCREASE, in the rate of kidney stones.
Conclusions from my Clinical Practice:
I have obtained 3,500 25-hydroxyvitamin D levels on patients since 2005. About 700 of these patients had the diagnosis of osteoporosis or osteopenia on DEXA scan or examination. 697 out of 700 (99.57%) of these people had initial levels of less than 32 ng. Out the 3 with levels above 32 ng., one female had an oophorectomy in her 40’s, and all 3 had levels below 36 ng. Rheumatologists at a major medical center in NJ have had similar results testing everyone with osteopenia or osteoporosis.
Osteoporosis is a multi-billion dollar public health problem that is largely and inexpensively preventable.
DEFNITIONS:
All references to vitamin D levels refer to 25-hydroxyvitamin D.
All vitamin D measurements above are ng/ml. Some medical research uses the measurement nmol/L.
Conversion:
25-hydroxyvitamin D in ng/ml multiplied by 2.5 = nmol/L.
25-hydroxyvitamin D in nmol/L multiplied by 0.4 = ng/ml.
example: 25-hydroxyvitamin D: 40 ng/ml = 100 nmol/L.
DEXA scan is an x-ray test for bone density used to diagnose osteoporosis or osteopenia. It has become popular only in the past 10 years.
Dory and her husband are acquaintances of mine. So they called me to get another opinion on the scan. I recommended to Dory that she obtain a 25-hydroxyvitamin D level. Her first level was in the low 20’s. I initially recommended she take 5000 units of vitamin D and repeat the level in 6 months.
2 years and 2 months later Dory got her second DEXA. It showed improvement in most of the bone densities tested. Her Massachusetts General Hospital physician was surprised that the bone strength had improved without taking any prescription anti-osteoporosis drugs. By then Dory was noticing that she felt so much better since taking the vitamin D, and noticed the increased strength and growth in her fingernails. I discussed with her the ideal level of vitamin D, told her about the high levels that lifeguards and fishermen and women have in the summers. She has adjusted her dose in the last few years and she has reached what many vitamin D experts consider an ideal level of 70 to 90 ng, and she has kept her level at that number.
Almost 3 years later, in September, 2010, she received her third DEXA scan. All areas tested were very much improved.
Dory’s Dexa Results -
Improvement in Bone Density
May, 2005 to September, 2010 (5 years, 4 month interval)
(L refers to lumbar vertebrae).
Hip-----Femur----L1------L2-------L3--------L4-----Ave.Increase
7.5%-----13.5%----33.6%--13.3%--22.2%--8.13%----17%
Dory’s documented results are quite remarkable. The public (and many doctors) feel it’s inevitable that bone density decrease with age.
Are these results unique? Studies haven’t studied serial bone density in subjects taking vitamin D alone in the absence of anti-osteoporosis prescription drugs. I have seen 2 additional patients in the past 5 years and both had improvements of 15% taking vitamin D alone in DEXAs taken two years apart.
History of Vitamin D and osteoporosis
Sunlight (which produces vitamin D in the skin) was discovered in 1850 to prevent rickets, and cod liver oil (which contains vitamin D) was recognized as preventing rickets in 1877. Rickets is a severe malformation of the bones occurring in young children. Vitamin D itself wasn’t discovered until 1922. Rickets continued to be common well until the 20th century.
It wasn’t until 1970 that Vitamin D’s role in calcium regulation was recognized. For several decades vitamin D was considered to be just one of many minor risk factors in osteoporosis. The medical profession repeated its error that had been made with cholesterol (in 1978 cholesterol of 250 mg. was considered normal). Similarly a 25-hydroxyvitamin D level was considered normal from 20 to 30 ng/ml. This led, erroneously, to minimizing of the importance of vitamin D as a cause of osteoporosis. Ordering 25-hydroxyvitamin D levels, stimulated by the release of research reports, didn’t become common until about 2005. It has only been since about 2005 that laboratories no longer report a normal level starting at 20 ng. Even today, many people even with osteoporotic fractures don’t get a level ordered. I know of many extreme cases; including a case in which a woman with a hip fracture at 75 stayed in a nursing home for a year without a level being obtained, suffering increasing weakness and falls, and then being discovered to have an level of 8 ng once she was out of the nursing home.
A most remarkable and very sad case of osteoporosis was a 70 year old woman who I saw in 2005, only a few months after I started ordering levels. She walked totally bent over at the waist with her upper body at a 90% angle to the floor. This type of thing has shown to be caused by microscopic fractures that occur over decades that start at a young age. I ordered a vitamin D level, her first ever. Out of the over 3000 levels I have ordered before and since, it is the only one in which the result was “no detectable vitamin D.” Unfortunately the vitamin D she now takes, although it has relieved some of her pain, can not completely rebuild and straighten her broken spine.
Many studies until recently showed that osteoporosis was common with what was called normal levels of 25-hydroxyvitamin D 20 to 30 ng/mg. Even to this day, studies are published and reported to the public in newspapers falsely claiming that vitamin D doesn’t prevent fractures because of the fractures that occur with levels in the 20’s.. For example, it has been shown repeatedly in studies that 400 units a day of vitamin D raises the level only an average of 5 ng,, and doesn’t significantly reduced the fracture rate. The truth is that in the last decade virtually EVERY study done comparing fracture rate above and below 32 ng has shown a significant reduction in fracture rates.
A landmark study in elderly patients from age 70 to 90 showed that in less than six months the number of falls and fractured decreased very significantly with very significant doses of vitamin D that raised the level, often over 40 ng. (Vitamin D was compared to placebo). Hundreds of well designed studies have demonstrated an extreme benefit of significant doses of vitamin D in terms of preventing osteoporosis).
Studies have shown that the parathyroid glands can have a detrimental effect on bone density up to a level of vitamin D of 40 ng. (The parathyroid glands produce their hormone to dissolve microscopic areas of bone in order to maintain a normal calcium level. A further beneficial effect with higher levels has not been studied, simply because not enough people have these higher levels. Many vitamin D experts consider an ideal level as 70 to 90 ng. Levels of vitamin D with sun exposure alone will not go up greater than 150 ng. At that level, there is a feedback mechanism which breaks down the chemicals in the skin that synthesize vitamin D.
No side effects occur with vitamin D at levels below 150 ng. There is a very specific situation in the rare disease of saroidosis and a few other illnesses in which the disease causes of disorder of vitamin D metabolism, so there is sometimes a hypersensitivity to vitamin D in these few rare cases that can be easily managed by monitoring blood chemistries.
Many studies have shown that taking calcium supplements increase the rate of kidney stones. Because these supplements are given with Vitamin D, some studies have erroneously concluded that vitamin D also raises the incidence of kidney stones. The truth is that all studies using vitamin D alone have NEVER shown an increase in kidney stones. In fact, with low vitamin D levels leading to an increase in calcium released from the bone, it is likely that treating vitamin D insufficiency leads to a DECREASE, not an INCREASE, in the rate of kidney stones.
Conclusions from my Clinical Practice:
I have obtained 3,500 25-hydroxyvitamin D levels on patients since 2005. About 700 of these patients had the diagnosis of osteoporosis or osteopenia on DEXA scan or examination. 697 out of 700 (99.57%) of these people had initial levels of less than 32 ng. Out the 3 with levels above 32 ng., one female had an oophorectomy in her 40’s, and all 3 had levels below 36 ng. Rheumatologists at a major medical center in NJ have had similar results testing everyone with osteopenia or osteoporosis.
Osteoporosis is a multi-billion dollar public health problem that is largely and inexpensively preventable.
DEFNITIONS:
All references to vitamin D levels refer to 25-hydroxyvitamin D.
All vitamin D measurements above are ng/ml. Some medical research uses the measurement nmol/L.
Conversion:
25-hydroxyvitamin D in ng/ml multiplied by 2.5 = nmol/L.
25-hydroxyvitamin D in nmol/L multiplied by 0.4 = ng/ml.
example: 25-hydroxyvitamin D: 40 ng/ml = 100 nmol/L.
DEXA scan is an x-ray test for bone density used to diagnose osteoporosis or osteopenia. It has become popular only in the past 10 years.
9/12/10
14) PREVENTION OF INFLUENZA WITH VITAMIN D
Vitamin D stimulates the production of antimicrobial peptides, a class of natural antibiotics. The antibacterial effect has been known for over a century. The best known example of this is the treatment of tuberculosis prior to the discovery of antibiotics. Patients were sent to sanitariums where they stayed outside on sunny porches during the day. The explanation of the beneficial effect wasn’t fully understood at the time. We now know that the increased sunlight led to increased production of vitamin D and led to some arrest or even cures of the tuberculosis because of the production of these anti-microbial peptides.
There have been reports in the past few years on the effect of vitamin D and influenza. 7) UPDATE ON VITAMIN D–2010 (from this web site) noted that the terrible pandemic of swine flu that lasted over a 2 year period “took the summer off” (when vitamin D levels were higher) before restarting. There is a well known story of an English long term care facility in which one ward of the entire facility had no cases of influenza during a flu epidemic. The physician in charge of that ward had given all his patients a significant dose of vitamin D daily.
For the first time, as published in the May, 2010 issue of the American Journal of Clinical Nutrition, a rigorously designed randomized, double-blind, controlled clinical trial evaluated the effect of vitamin D on seasonal influenza A. Over 4 months children were given either 1200 units of vitamin D or placebo. Each case of influenza A was confirmed with influenza antigen testing with a nose/throat swab. 18 of 167 children given vitamin D compared to 31 of 167 children given placebo were diagnosed with the flu. This represents a reduction of 41.9%. The reduction was even more prominent in those children that previously weren’t taking any vitamin D supplements (most American children aren’t). It should be stressed that this study was double blind, so that the medical personnel diagnosing the flu and doing the laboratory flu studies did not know which children took the placebo and which children took the vitamin D.
A second result of the vitamin D supplements was an 83% reduction of asthma attacks in children with a diagnosis of asthma. Positive effects of vitamin D and asthma have been widely reported in research studies over the past 5 years.
It should be noted that 25-hydroxy vitamin D levels weren’t obtained. Previous studies have reported that 70% of American children have low levels of 25-hydroxyvitamin D (less than 32 ng.) Many of the 167 children were probably so low that the 1200 units of vitamin D didn’t give them ideal or even normal levels of vitamin D. So the 41.9% reduction is a very conservative figure of the percentage of influenza that could be prevented by achieving ideal 25-hydroxyvitamin D levels.
And finally, it should be also emhasized that you probably didn't hear about this study until today. I found out about it by chance on the day I am writing this. This emphasizes that unfortunately we can NOT rely on the press to keep us informed of critically important medical studies.
There have been reports in the past few years on the effect of vitamin D and influenza. 7) UPDATE ON VITAMIN D–2010 (from this web site) noted that the terrible pandemic of swine flu that lasted over a 2 year period “took the summer off” (when vitamin D levels were higher) before restarting. There is a well known story of an English long term care facility in which one ward of the entire facility had no cases of influenza during a flu epidemic. The physician in charge of that ward had given all his patients a significant dose of vitamin D daily.
For the first time, as published in the May, 2010 issue of the American Journal of Clinical Nutrition, a rigorously designed randomized, double-blind, controlled clinical trial evaluated the effect of vitamin D on seasonal influenza A. Over 4 months children were given either 1200 units of vitamin D or placebo. Each case of influenza A was confirmed with influenza antigen testing with a nose/throat swab. 18 of 167 children given vitamin D compared to 31 of 167 children given placebo were diagnosed with the flu. This represents a reduction of 41.9%. The reduction was even more prominent in those children that previously weren’t taking any vitamin D supplements (most American children aren’t). It should be stressed that this study was double blind, so that the medical personnel diagnosing the flu and doing the laboratory flu studies did not know which children took the placebo and which children took the vitamin D.
A second result of the vitamin D supplements was an 83% reduction of asthma attacks in children with a diagnosis of asthma. Positive effects of vitamin D and asthma have been widely reported in research studies over the past 5 years.
It should be noted that 25-hydroxy vitamin D levels weren’t obtained. Previous studies have reported that 70% of American children have low levels of 25-hydroxyvitamin D (less than 32 ng.) Many of the 167 children were probably so low that the 1200 units of vitamin D didn’t give them ideal or even normal levels of vitamin D. So the 41.9% reduction is a very conservative figure of the percentage of influenza that could be prevented by achieving ideal 25-hydroxyvitamin D levels.
And finally, it should be also emhasized that you probably didn't hear about this study until today. I found out about it by chance on the day I am writing this. This emphasizes that unfortunately we can NOT rely on the press to keep us informed of critically important medical studies.
9/1/10
13) GENES AND VITAMIN D; HOW VITAMIN D HAS SUCH A WIDESPREAD EFFECT ON HUMANS
Positive effects that vitamin D has on bones has been known for a long time. The connection with rickets (the ultimate bone weakening disease caused by profound vitamin D deficiencies in childhood) was discovered a century ago. The connection with osteoporosis wasn’t begun to be appreciated until late in the 20th century. It has only been in the last ten years that the strength of the connection has been appreciated. During this time the other non-bone effects of vitamin D have begun to be realized based on facts discovered by vitamin D research. (For a summary, see #7, Update of Vitamin D -2010.) A study published August 24, 2010, in the online version of Genome Research helps explain how one simple compound produced by the sun can have such a widespread effect.
The study used DNA technology to create a map of where Vitamin D receptors are in our genes. They found 2,776 binding sites for the vitamin D receptor. These sites were concentrated near genes associated with many autoimmune conditions such as MS, Crohn’s disease, lupus, rheumatoid arthritis, type I diabetes, and also various cancers. In all, this study showed that vitamin D had a significant effect on the activity of 229 genes. Compared to what is known about all other vitamins and other chemicals in the human body, these findings are profound. The importance of these findings is magnified by the appreciation that there is a pandemic of vitamin D deficiency worldwide due to insufficient exposure of humans to the sun. Studies have also shown that vitamin D levels in Americans are actually decreasing over the past 3 decades.
One of the authors of the study, Dr. Sreeram Ramagopalan, from the University of Oxford in Great Britain, has made critical observations about the meaning of this study. Vitamin D supplements during pregnancy and during infancy could have widespread beneficial effects on a child’s health later in life. (A study in Finland several decades ago showed correcting low levels with vitamin D supplements resulted in an incredible 85% reduction in the incidence of type I diabetes during childhood.)
Unfortunately the United States is behind in making full use of the last decade’s vitamin D discoveries. Dr. Ramagopalan makes the point that some countries such as France have taken steps to institute this as a routine public health measure.
What can you do? The recommendation that everyone should obtain a routine 25-hydroxyvitamin D level and correct any insufficiency is at least five years old, (and is still widely ignored). Spread the word to your friends and relatives, especially pregnant females,that they need to obtain a level and correct any insufficiency.
The study used DNA technology to create a map of where Vitamin D receptors are in our genes. They found 2,776 binding sites for the vitamin D receptor. These sites were concentrated near genes associated with many autoimmune conditions such as MS, Crohn’s disease, lupus, rheumatoid arthritis, type I diabetes, and also various cancers. In all, this study showed that vitamin D had a significant effect on the activity of 229 genes. Compared to what is known about all other vitamins and other chemicals in the human body, these findings are profound. The importance of these findings is magnified by the appreciation that there is a pandemic of vitamin D deficiency worldwide due to insufficient exposure of humans to the sun. Studies have also shown that vitamin D levels in Americans are actually decreasing over the past 3 decades.
One of the authors of the study, Dr. Sreeram Ramagopalan, from the University of Oxford in Great Britain, has made critical observations about the meaning of this study. Vitamin D supplements during pregnancy and during infancy could have widespread beneficial effects on a child’s health later in life. (A study in Finland several decades ago showed correcting low levels with vitamin D supplements resulted in an incredible 85% reduction in the incidence of type I diabetes during childhood.)
Unfortunately the United States is behind in making full use of the last decade’s vitamin D discoveries. Dr. Ramagopalan makes the point that some countries such as France have taken steps to institute this as a routine public health measure.
What can you do? The recommendation that everyone should obtain a routine 25-hydroxyvitamin D level and correct any insufficiency is at least five years old, (and is still widely ignored). Spread the word to your friends and relatives, especially pregnant females,that they need to obtain a level and correct any insufficiency.
5/1/10
7) UPDATE ON VITAMIN D - 2010
(Revised 9/20/10 with the addition of the information on heart failure.)
Last year’s update on vitamin D mentioned studies that documented various benefits of correcting the recently recognized pandemic of vitamin D insufficiency. There have been additional dozens of important studies since the 2009 update. However instead of writing about the individual studies, this column will give an overview of vitamin D and will try to answer the question, “How can one substance have so many beneficial effects on humans?”
First, vitamin D is not a vitamin. A vitamin is something that is supplied to humans from food. Vitamin D is not supplied by food in a significant amount, it is produced in the skin by sunlight. There is NO vitamin D naturally found in cow’s milk; the practice of adding 100 units to every 8 oz. of cow’s milk started almost a century ago was done to stop rickets in children. This dose does prevent rickets, but does little else. 400 units of Vitamin D a day only raises the level 5 nanograms (ng). Most Americans have levels that are 10 to 20 ng. below the “normal” level of 32 ng. and way below an ideal level, We’ve all seen people with high levels of vitamin D. Lifeguards in August have levels frequently have levels over 100 ng.
Vitamin D increases calcium absorption taken in from the diet. With insufficiency, only 10-20% of calcium is absorbed. With proper vitamin D levels, 60-80% of calcium is absorbed. Since calcium goes to the bones, this explains the prevention of rickets. However now it is known that virtually all osteoporosis is associated with a level of vitamin D below 32 ng. Prior to 10 years ago, almost every study done on osteoporosis used a dose of 400 units a day, and most showed no effect on osteoporosis or fractures. As late as a few years ago, newspapers trumpeted the wrong information that vitamin D didn’t prevent fractures. However all studies using larger doses of vitamin D have shown a large reduction in fractures. In fact, one critical study showed that large doses given to elderly hip fracture patients reduced further fractures and reduced falls within 6 months. (Muscles also contain vitamin D receptors and correction of insufficiencies increases muscle strength in the elderly).
Hyper-proliferation of cells is what occurs with cancer. Vitamin D has repeatedly been shown to prevent this. Many large studies have now shown that various types of cancers are associated with very low vitamin D levels. In a well publicized cancer study that spanned 8 years, the lowest levels of vitamin D were associated with the worst outcome and highest mortality in breast cancer. Many other studies have measured vitamin D in various types of cancer, and the results have always shown lower levels with the cancer. One study showed the incidence of breast cancer continued to decrease up to levels of 52 ng. Some vitamin D experts have predicted that the breast cancer rate would be reduced 50% if every woman’s vitamin D level was only 40 ng. Similar studies exist with prostate cancer and colon cancer. PSA levels in prostate cancer were shown to decrease with Vitamin D over 20 years ago. Thyroid cancer cells stop multiplying in a test tube when vitamin D is added. Lung cancer in smokers is less common the higher the vitamin D level, and in fact prognosis is better with higher vitamin D levels once lung cancer occurs. No one should misunderstand this data; it does not invalidate the many known causes of some various cancers. It is simply a factor that prevents the formation of a cancer in the presence of various known causes.
It was known in the 1970’s that MS and juvenile diabetes were less common the closer to the equator (more sunlight, more vitamin D). A study in Finland showed that giving a large number of infants high doses of vitamin D cut down the incidence of juvenile diabetes by a remarkable 80% a decade later. A recent study showed an 85% improvement in MS. These diseases, along with rheumatoid arthritis, lupus, and many other autoimmune diseases,involve cells within the body becoming modified by unknown factors and attacking the body, causing the illness. Vitamin D has been shown to keep our important immune system normal, and prevent any harmful changes to it.
Vitamin D has been shown to stimulate the production of antimicrobial peptides, a class of natural antibiotics. These have activity against bacteria and viruses. Think about it; why do flu epidemics occur during the winter and not the summer? Why do these epidemics occur in June and July in the southern hemispheres where the seasons are reversed? (Answer -lower vitamin D levels). In fact, the horrible pandemic of swine flu epidemic in the few years before 1920 tapered off in the summer before restarting. There are many published studies demonstrating this property of vitamin D.
Vitamin D levels have been shown to correlate with survival many years after bypass surgery.
In September, 2010, an 8 year study showed that deaths from heart failure were 3.4 times higher in patients with vitamin D levels less than 20 ng. and 2.0 times higher with levels 20 to 29 ng. vs.>30 ng.
Although much more research is being done, the existing research is convincing and totally unlike the anti-oxidant research (Vitamin C and B's)that has been called into question. Granted, it sounds too good to be true. Vitamin D is very inexpensive, so there are no advertising budgets to help spread the word. Vitamin D could have a profound effect on health care expenditures; it has been called a national health care plan in itself. It makes sense that Vitamin D is so basic to life and health. Scientists agree that life began near the equator. Early humans had unlimited access to sunlight, and didn’t have sunscreen or a wardrobe, so at one time humans’ vitamin D levels were very high.
The understanding of the importance of Vitamin D remains the most important preventive medicine development in over a century.
Last year’s update on vitamin D mentioned studies that documented various benefits of correcting the recently recognized pandemic of vitamin D insufficiency. There have been additional dozens of important studies since the 2009 update. However instead of writing about the individual studies, this column will give an overview of vitamin D and will try to answer the question, “How can one substance have so many beneficial effects on humans?”
First, vitamin D is not a vitamin. A vitamin is something that is supplied to humans from food. Vitamin D is not supplied by food in a significant amount, it is produced in the skin by sunlight. There is NO vitamin D naturally found in cow’s milk; the practice of adding 100 units to every 8 oz. of cow’s milk started almost a century ago was done to stop rickets in children. This dose does prevent rickets, but does little else. 400 units of Vitamin D a day only raises the level 5 nanograms (ng). Most Americans have levels that are 10 to 20 ng. below the “normal” level of 32 ng. and way below an ideal level, We’ve all seen people with high levels of vitamin D. Lifeguards in August have levels frequently have levels over 100 ng.
Vitamin D increases calcium absorption taken in from the diet. With insufficiency, only 10-20% of calcium is absorbed. With proper vitamin D levels, 60-80% of calcium is absorbed. Since calcium goes to the bones, this explains the prevention of rickets. However now it is known that virtually all osteoporosis is associated with a level of vitamin D below 32 ng. Prior to 10 years ago, almost every study done on osteoporosis used a dose of 400 units a day, and most showed no effect on osteoporosis or fractures. As late as a few years ago, newspapers trumpeted the wrong information that vitamin D didn’t prevent fractures. However all studies using larger doses of vitamin D have shown a large reduction in fractures. In fact, one critical study showed that large doses given to elderly hip fracture patients reduced further fractures and reduced falls within 6 months. (Muscles also contain vitamin D receptors and correction of insufficiencies increases muscle strength in the elderly).
Hyper-proliferation of cells is what occurs with cancer. Vitamin D has repeatedly been shown to prevent this. Many large studies have now shown that various types of cancers are associated with very low vitamin D levels. In a well publicized cancer study that spanned 8 years, the lowest levels of vitamin D were associated with the worst outcome and highest mortality in breast cancer. Many other studies have measured vitamin D in various types of cancer, and the results have always shown lower levels with the cancer. One study showed the incidence of breast cancer continued to decrease up to levels of 52 ng. Some vitamin D experts have predicted that the breast cancer rate would be reduced 50% if every woman’s vitamin D level was only 40 ng. Similar studies exist with prostate cancer and colon cancer. PSA levels in prostate cancer were shown to decrease with Vitamin D over 20 years ago. Thyroid cancer cells stop multiplying in a test tube when vitamin D is added. Lung cancer in smokers is less common the higher the vitamin D level, and in fact prognosis is better with higher vitamin D levels once lung cancer occurs. No one should misunderstand this data; it does not invalidate the many known causes of some various cancers. It is simply a factor that prevents the formation of a cancer in the presence of various known causes.
It was known in the 1970’s that MS and juvenile diabetes were less common the closer to the equator (more sunlight, more vitamin D). A study in Finland showed that giving a large number of infants high doses of vitamin D cut down the incidence of juvenile diabetes by a remarkable 80% a decade later. A recent study showed an 85% improvement in MS. These diseases, along with rheumatoid arthritis, lupus, and many other autoimmune diseases,involve cells within the body becoming modified by unknown factors and attacking the body, causing the illness. Vitamin D has been shown to keep our important immune system normal, and prevent any harmful changes to it.
Vitamin D has been shown to stimulate the production of antimicrobial peptides, a class of natural antibiotics. These have activity against bacteria and viruses. Think about it; why do flu epidemics occur during the winter and not the summer? Why do these epidemics occur in June and July in the southern hemispheres where the seasons are reversed? (Answer -lower vitamin D levels). In fact, the horrible pandemic of swine flu epidemic in the few years before 1920 tapered off in the summer before restarting. There are many published studies demonstrating this property of vitamin D.
Vitamin D levels have been shown to correlate with survival many years after bypass surgery.
In September, 2010, an 8 year study showed that deaths from heart failure were 3.4 times higher in patients with vitamin D levels less than 20 ng. and 2.0 times higher with levels 20 to 29 ng. vs.>30 ng.
Although much more research is being done, the existing research is convincing and totally unlike the anti-oxidant research (Vitamin C and B's)that has been called into question. Granted, it sounds too good to be true. Vitamin D is very inexpensive, so there are no advertising budgets to help spread the word. Vitamin D could have a profound effect on health care expenditures; it has been called a national health care plan in itself. It makes sense that Vitamin D is so basic to life and health. Scientists agree that life began near the equator. Early humans had unlimited access to sunlight, and didn’t have sunscreen or a wardrobe, so at one time humans’ vitamin D levels were very high.
The understanding of the importance of Vitamin D remains the most important preventive medicine development in over a century.
10/1/09
4. VITAMIN D AND PREVENTIVE MEDICINE
With the national debating health care, there has been much talk on "preventive medicine."
Well, how's this for preventive medicine? Would this be good for the country? The rate of breast cancer, prostate cancer, and colon cancer drops 30 to 50% in 5 years (2014) at the cost of $5 a month.
Early humans lived near the equator, didn't wear many clothes, and didn't go to the nearest CVS for sunscreen. Noone was low in Vitamin D (it is made by sunlight). It is so prevelent that at least 20% of the genes rely on it to function (although as they do more research, that figure rises). Without a sufficient level, calcium isn't absorbed sufficiently (result - osteoporosis), cells hyperproliferate -(result - cancer) and inflammatory cells hyperproliferate (result - autoimmune diseases - MS, lupus, rheumatoid arthritis, type I diabetes). Also a natural class of antibiotics made by the body does't get produced. With all the concern about swine flu this season, I have read many studies with evidence that a level of Vitamin D of at least 50 nanograms lessens the chance greatly of contracting seasonal and Swine(H1N1)flu.
If we don't live near the equator,(north of Georgia, practically no vitamin D can be made 8 months of the year), we wear a lot more clothes, and we use sunscreen or don't go out much in the sun during the summer. (I'm not advocating we do sunbathe - skin cancer interacts with many factors such as Westernized diet, early humans didn't get skin cancer, Americans do). In fact, levels didn't just drop over thousands of years; a recent study proved that levels have dropped 20% nanograms in just 28 years in the United States.
After 20 years of being in primary care practice and never ordering a vitamin D level (noone else did), I have been surprised since 2005 as to what I didn't know. It involves tested 1700 people so far for 25-hydroxyvitamin D, and finding out first hand that virtually everyone with osteoporosis or osteopenia has a low level, 90% of people who had gotten various types of cancer have a low level, practically all people with lupus, MS, type I diabetes.. And the levels aren't just low, they are VERY low. Oh yes, 70% of normal healthy people also have low levels.
This information in no ways changes what we already know about the many risk factors for various cancers. If an individual has the risk factors and genetics in place putting them at risk for cancer, then low Vitamin D is the "straw that broke the camel's back."
And everything I found has been discovered by medical researchers in the last 15 years (85% of all Vitamin D research has been done in that time period.
So as researchers and vitamin D experts have said - wave a magic wand and make everyone's vitamin D level 32 nanograms ----- that would eliminate 50% of these diseases.
Although there has been much progress in awareness the past 5 years, there are several problems holding the progress back.
1) doctors and various aspects of the medical profession stand to lose a lot of income.
2) at $5 a month, noone is in line to make a lot of money from people taking vitamin D. Vitamin D3 available in vitamin stores is the same vitamin D, the same molecule that is made by the sun. (prescription Vitamin D2 is available for vegetarians).
3) just the act of testing vitamin D along with the routine blood work is a pain for doctors, because it means calling back 70% of patients and explaining to them they need to take vitamin D.
4) the enemies of vitamin D and preventive medicine (and yes, there are enemies) promote "Vitamin D toxicity derangement syndrome" (VDTDS). Toxicity can occur at levels greater than 200 nanograms. Those levels are impossible to obtain unless very enormous amounts of Vitamin D are taken over at least 8 months. No side effects occur at less than 200 nanograms. Unfounded fear of this keeps many people from taking sufficient vitamin D.
The actual "normal level" is considered 32 to 100 nanograms (as per Labcorp and others), but experts note that maximal bone density requires a level of 40 nanograms, and increased anti-cancer effect has been noted at 52 nanograms. These experts recommend an ideal level of 50 to 80 nanograms.
Full time male lifeguards have had their level tested at the end of the summer. Their levels are 100 ng. (and think about it - that would mean this is the level that humans had for thousands of years). Not coincidentally, this is the maximal level the body can reach by sun alone. After this level is reached, the chemicals break down and the level doesn't go any higher.
Vitamin promoters have "cried wolf" several times over the past 3 decades. Vitamin C was supposed to cure cancer, vitamin E was supposed to prevent heart disease. These claims were never based on valid research; and many were outright fradulent. The evidence of Vitamin D's connection in preventing these various diseases is greater than the evidence that cigarette smoking is a main cause of lung cancer.
The 4 step program for "recovery":
1. insist that your doctor order a 25-hydroxy vitamin D level. It is covered by insurance like any other blood test; it is non-fasting. Many insurance companies pay the laboratory a negotiated rate of about $50. Don't assume your doctor has already gotten if for you along with other tests. If he or she didn't specifically tell you what your vitamin D level was, he or she didn't get the test.
2. insist on getting a copy of the written results. Don't rely on anyone telling you "it's normal." (In New Jersey, the law states a person can request a copy of the results be sent to them from the laboratory).
3. decide what level you want. Minimal "normal" is 32 nanograms. Ideal is 50 to 80 nanograms. There levels can be reached within a maximal of 6 months. Remember, the average lifeguard in August has a level of over 100 ng.) Levels can be repeated in 6 months and then perhaps once a year to ensure the level is high enough.
4. Without a level, it's impossible to recommend the correct dose for a particular person. More people are taking Vitamin D than 2005, but most of those people are taking small insufficient doses that won't get the level up to even 32 ng.
4. don't look back, look forward. Most people's worlds would be different if everyone had known about this 20 years ago, (I know mine would be) but gong forward is what we have to emphasize.
WHAT INSURANCE COMPANIES COULD DO NOW TO EASE THE HEALTH CARE CRISIS
Some pilot programs have given discounts for maintaining a good cholesterol level, or a certain weight. The programs are working! Insurance companies could announce a pilot program offering discounts of 5% off the health care insurance premium if the customer produces proof that their total 25-hydroxyvitamin D level is 32 nanograms. I predict what would happen is that the insurance companies would find out within a few years that the discount could be increased as they would save far more than 5%. (Osteoporosis alone is a multi-billion health care cost).
Well, how's this for preventive medicine? Would this be good for the country? The rate of breast cancer, prostate cancer, and colon cancer drops 30 to 50% in 5 years (2014) at the cost of $5 a month.
Early humans lived near the equator, didn't wear many clothes, and didn't go to the nearest CVS for sunscreen. Noone was low in Vitamin D (it is made by sunlight). It is so prevelent that at least 20% of the genes rely on it to function (although as they do more research, that figure rises). Without a sufficient level, calcium isn't absorbed sufficiently (result - osteoporosis), cells hyperproliferate -(result - cancer) and inflammatory cells hyperproliferate (result - autoimmune diseases - MS, lupus, rheumatoid arthritis, type I diabetes). Also a natural class of antibiotics made by the body does't get produced. With all the concern about swine flu this season, I have read many studies with evidence that a level of Vitamin D of at least 50 nanograms lessens the chance greatly of contracting seasonal and Swine(H1N1)flu.
If we don't live near the equator,(north of Georgia, practically no vitamin D can be made 8 months of the year), we wear a lot more clothes, and we use sunscreen or don't go out much in the sun during the summer. (I'm not advocating we do sunbathe - skin cancer interacts with many factors such as Westernized diet, early humans didn't get skin cancer, Americans do). In fact, levels didn't just drop over thousands of years; a recent study proved that levels have dropped 20% nanograms in just 28 years in the United States.
After 20 years of being in primary care practice and never ordering a vitamin D level (noone else did), I have been surprised since 2005 as to what I didn't know. It involves tested 1700 people so far for 25-hydroxyvitamin D, and finding out first hand that virtually everyone with osteoporosis or osteopenia has a low level, 90% of people who had gotten various types of cancer have a low level, practically all people with lupus, MS, type I diabetes.. And the levels aren't just low, they are VERY low. Oh yes, 70% of normal healthy people also have low levels.
This information in no ways changes what we already know about the many risk factors for various cancers. If an individual has the risk factors and genetics in place putting them at risk for cancer, then low Vitamin D is the "straw that broke the camel's back."
And everything I found has been discovered by medical researchers in the last 15 years (85% of all Vitamin D research has been done in that time period.
So as researchers and vitamin D experts have said - wave a magic wand and make everyone's vitamin D level 32 nanograms ----- that would eliminate 50% of these diseases.
Although there has been much progress in awareness the past 5 years, there are several problems holding the progress back.
1) doctors and various aspects of the medical profession stand to lose a lot of income.
2) at $5 a month, noone is in line to make a lot of money from people taking vitamin D. Vitamin D3 available in vitamin stores is the same vitamin D, the same molecule that is made by the sun. (prescription Vitamin D2 is available for vegetarians).
3) just the act of testing vitamin D along with the routine blood work is a pain for doctors, because it means calling back 70% of patients and explaining to them they need to take vitamin D.
4) the enemies of vitamin D and preventive medicine (and yes, there are enemies) promote "Vitamin D toxicity derangement syndrome" (VDTDS). Toxicity can occur at levels greater than 200 nanograms. Those levels are impossible to obtain unless very enormous amounts of Vitamin D are taken over at least 8 months. No side effects occur at less than 200 nanograms. Unfounded fear of this keeps many people from taking sufficient vitamin D.
The actual "normal level" is considered 32 to 100 nanograms (as per Labcorp and others), but experts note that maximal bone density requires a level of 40 nanograms, and increased anti-cancer effect has been noted at 52 nanograms. These experts recommend an ideal level of 50 to 80 nanograms.
Full time male lifeguards have had their level tested at the end of the summer. Their levels are 100 ng. (and think about it - that would mean this is the level that humans had for thousands of years). Not coincidentally, this is the maximal level the body can reach by sun alone. After this level is reached, the chemicals break down and the level doesn't go any higher.
Vitamin promoters have "cried wolf" several times over the past 3 decades. Vitamin C was supposed to cure cancer, vitamin E was supposed to prevent heart disease. These claims were never based on valid research; and many were outright fradulent. The evidence of Vitamin D's connection in preventing these various diseases is greater than the evidence that cigarette smoking is a main cause of lung cancer.
The 4 step program for "recovery":
1. insist that your doctor order a 25-hydroxy vitamin D level. It is covered by insurance like any other blood test; it is non-fasting. Many insurance companies pay the laboratory a negotiated rate of about $50. Don't assume your doctor has already gotten if for you along with other tests. If he or she didn't specifically tell you what your vitamin D level was, he or she didn't get the test.
2. insist on getting a copy of the written results. Don't rely on anyone telling you "it's normal." (In New Jersey, the law states a person can request a copy of the results be sent to them from the laboratory).
3. decide what level you want. Minimal "normal" is 32 nanograms. Ideal is 50 to 80 nanograms. There levels can be reached within a maximal of 6 months. Remember, the average lifeguard in August has a level of over 100 ng.) Levels can be repeated in 6 months and then perhaps once a year to ensure the level is high enough.
4. Without a level, it's impossible to recommend the correct dose for a particular person. More people are taking Vitamin D than 2005, but most of those people are taking small insufficient doses that won't get the level up to even 32 ng.
4. don't look back, look forward. Most people's worlds would be different if everyone had known about this 20 years ago, (I know mine would be) but gong forward is what we have to emphasize.
WHAT INSURANCE COMPANIES COULD DO NOW TO EASE THE HEALTH CARE CRISIS
Some pilot programs have given discounts for maintaining a good cholesterol level, or a certain weight. The programs are working! Insurance companies could announce a pilot program offering discounts of 5% off the health care insurance premium if the customer produces proof that their total 25-hydroxyvitamin D level is 32 nanograms. I predict what would happen is that the insurance companies would find out within a few years that the discount could be increased as they would save far more than 5%. (Osteoporosis alone is a multi-billion health care cost).
9/6/09
Links
Robert Baker MD Health Newsletter
http://RobertBakerMDHealthNewsletter.blogspot.com
Getting Vitamin D Results
This link contains an audiotape that can be listened to rather than reading.
http://GettingVitaminDResults.blogspot.com
Twitter:
Various facts on Vitamin D
http://www.twitter.com/RobertBakerMD
Links to Research on Vitamin D
http://www.twitter.com/VitaminDWebSite
Other health information can be obtained by clicking on "View My Complete Profile" on the left hand side of this blogspot
http://RobertBakerMDHealthNewsletter.blogspot.com
Getting Vitamin D Results
This link contains an audiotape that can be listened to rather than reading.
http://GettingVitaminDResults.blogspot.com
Twitter:
Various facts on Vitamin D
http://www.twitter.com/RobertBakerMD
Links to Research on Vitamin D
http://www.twitter.com/VitaminDWebSite
Other health information can be obtained by clicking on "View My Complete Profile" on the left hand side of this blogspot
6/1/09
2. UPDATE ON VITAMIN D - 2009
Why our daughters need their D level checked: It’s been know for decades that vitamin D deficiency weakens muscles. A study in the Dec, 2008. issue of Journal of Clinical Endocrinology & Metabolism reports its association with Cesarean delivery. Vitamin D levels were measured in 253 mothers. The rate of C-section was 14% for levels over 15 ng., and 28% for levels less than 15 ng. Normal is 32 to 100 ng). Many pregnant women would benefit if physicians ordered D levels for all their pregnant patients and treated to at least a level of 32 ng.
As for yourself - Vitamin D receptors are present in the brain. A recent study in the Journal of Geriatric Psychology and Neurology studied 2000 people over 65. Those with the lowest Vitamin D levels were more than twice as likely to have cognitive problems (an early sign of Alzheimers disease) than those with the highest. This shows that D deficiency may be an important not previously recognized link to Alzheimers.
And for infants- Autism is an epidemic that didn’t exist when we were born. It is a complex disease with various factors, as yet not fully understood, contributing to its origins. Studies have shown a higher incidence of autism in women who were pregnant during the winter when Vitamin D levels are lowest. Other studies have shown higher autism rates within the same state in counties that have more rainfall (and therefore less sunshine). Autism is higher in African Americans (who have levels 10 to 15 ng. lower because less sunlight is absorbed through darker skin). The New York Times in March, 2009, reported a surge of autism in Minneapolis among Somalian immigrants. Sweden is now reporting a rate of autism among Somalians at 3 times the rate of non-Somalians.. This is just some of the growing evidence that vitamin D deficiency is an important factor in autism. It will take decades to prove it, studies are only being talked about at this point, and the theory is relatively new. Some case reports have shown some improvements with correction of vitamin D insufficiency, but no large studies have been done. The tests done for an autistic child are quite extensive but routinely don’t include a 25-hydroxyvitamin D level. The Vitamin D Council is recommending that every such child should be tested; and any insufficiency should be treated by their physician. For this and many other reasons, 25-hydroxyvitamin D levels should be a routine pre-natal test. Any pregnant woman should be proactive and insist her obstetrician get the test.
The missing link- Why didn’t we hear of vitamin D deficiency 30 years ago? A March, 2009 study in Archives of Internal Medicine did a vitamin D level on about 15,000 blood samples that had been stored from both 1990 (average 30 ng.) and 2003 (average 24 ng.) The drop was 20%, and only 25% of 2003 levels were normal. Less sunlight exposure is felt to be the main explanation. This largely explains the increasing incidence of osteoporosis and other conditions associated with vitamin D deficiency.
Is Vitamin D a “secret?” Major publications have written about vitamin D in the past few years. In September,2006, Reader’s Digest published an article entitled:”The Miracle Vitamin: New evidence shows that getting enough D may be the most important thing you can do for you health.” In February, 2008, Parade Magazine listed vitamin D levels as one of “5 Medical Tests That May Keep You Well;” In the same month, Jane Brodie of the New York Times wrote “An Oldie Vies for Nutrient of the Decade.” Suggestions have even been made by prominent experts that the Surgeon General issue a report on Vitamin D because of the beneficial effect public awareness would have on decreasing health care costs and improving public health. I believe that the realization of the pandemic of vitamin D deficiency is the most important medical discovery in at least 40 years.
A guiding principle with taking Vitamin D
For those who like to keep things simple as more information becomes discovered about Vitamin D, the following should be remembered. If preventing osteoporosis was the ONLY thing that Vitamin D did,that would be enough reason to treat Vitamin D levels to at least 40 nanograms, and probably 50 nanograms.
Vitamin D and Cancer
One of Vitamin D's main actions is to prevent hyperproliferation of cells. That term describes what happens with cancer. There are substantial studies over the past several decades that show that low 25-hydroxyvitamin D levels vary inversely with the incidence of breast, prostate, and colon cancer. In a well publicized large study published in 2007, the lower the level, the more agressive the breast cancer. Prostate cancer studies have shown that vitamin D lowers the PSA level, an important tumor marker, and has effective anti-tumor action against prostate cancer.
Other cancers:
There are also many studies showing that vitamin D has activity in actually treating established cancer, especially breast and prostate cancer. Fewer studies have been done with less common cancers.
Thyroid cancer: There are in vitro and animal studies showing that thyroid cancer cells are significantly slowed down in their multiplication with Vitamin D. Thyroid nodules (which are a pre-cancerous lesion) are very common in hyperparathyroidism, and this condition is almost always associated with a low 25-hydroxyvitamin D level, which overstimulates the parathyroid glands.
Pancreatic cancer: Studies show that the incidence of pancreatic cancer is twice as common with low vitamin D levels.
Lung Cancer: Studies show a strong correlation of lung cancer with vitamin D levels, and substantial evidence that vitamin D has an chemotherapeutic effect when used in established cancer.
Vitamin D and the interaction of other risk factors
Many cancers have identified risk factors. Thyroid cancer is strongly associated with radiation to the neck as a child. Breast, prostate,and colon cancer have a number of proven risk factors. It has been well known and proven since 1965 that cigarette smoking causes lung cancer, and it is less well known that cigarette smoking is a strong risk factor of pancreatic cancer. A low vitamin D level works in conjunction with other risk factors. It is a non-specific stimulus to hyperproliferation of abnormal cells, and if these cells are damaged by other risk factors, it is a lot easier for cancer to develop. 25-hydroxyvitamin D levels, along with genetic factors, may be a large part of the explanation of why some smokers never get lung cancer. The same could be said of other cancers with their own risk factors.
What does this means in real terms? In an estimate so shocking it's hard for many to believe; according to leading Vitamin D experts and based on research studies that have been done, if every woman had a 25-hydroxyvitamin D level of 32 nanograms (the lowest level considered as normal, although it's far below the ideal level), the incidence of breast cancer would be cut 50%. The same probably can be said with men and women for colon, and men for prostate cancer. The same is also likely true for other cancers, but research has not been done yet.
Vitamin D and hereditary cancer genes - a theory
There are no studies that can be found regarding the BrCa1 gene, BrCa2 gene, and other heredity cancer symdromes and 25-hydroxyvitamin D levels. The BrCa1 gene has one of the most profound effects on it's carriers of all known hereditary cancer genes. Not all of it's female carriers get breast cancer, (it's frequently in the 30's when carriers that do get breast cancer become diagnosed, although just about all get ovarian cancer by the age of 58 if the ovaries aren't removed.) Would agressively treating 25-hydroxyvitamin D levels preferably to over 50 nanograms reduce the incidence of breast cancer in BrCa1 gene carriers? This is unknown, but could be an easy study to do, given the large amount of BrCa1 female carriers who follow the path of mammograms and MRIs of the breasts starting in their 30's. Unfortunately, I don't think this study is imminent. Carriers shouldn't wait; they should treat their vitamin D insufficiency to ideal levels.
As for yourself - Vitamin D receptors are present in the brain. A recent study in the Journal of Geriatric Psychology and Neurology studied 2000 people over 65. Those with the lowest Vitamin D levels were more than twice as likely to have cognitive problems (an early sign of Alzheimers disease) than those with the highest. This shows that D deficiency may be an important not previously recognized link to Alzheimers.
And for infants- Autism is an epidemic that didn’t exist when we were born. It is a complex disease with various factors, as yet not fully understood, contributing to its origins. Studies have shown a higher incidence of autism in women who were pregnant during the winter when Vitamin D levels are lowest. Other studies have shown higher autism rates within the same state in counties that have more rainfall (and therefore less sunshine). Autism is higher in African Americans (who have levels 10 to 15 ng. lower because less sunlight is absorbed through darker skin). The New York Times in March, 2009, reported a surge of autism in Minneapolis among Somalian immigrants. Sweden is now reporting a rate of autism among Somalians at 3 times the rate of non-Somalians.. This is just some of the growing evidence that vitamin D deficiency is an important factor in autism. It will take decades to prove it, studies are only being talked about at this point, and the theory is relatively new. Some case reports have shown some improvements with correction of vitamin D insufficiency, but no large studies have been done. The tests done for an autistic child are quite extensive but routinely don’t include a 25-hydroxyvitamin D level. The Vitamin D Council is recommending that every such child should be tested; and any insufficiency should be treated by their physician. For this and many other reasons, 25-hydroxyvitamin D levels should be a routine pre-natal test. Any pregnant woman should be proactive and insist her obstetrician get the test.
The missing link- Why didn’t we hear of vitamin D deficiency 30 years ago? A March, 2009 study in Archives of Internal Medicine did a vitamin D level on about 15,000 blood samples that had been stored from both 1990 (average 30 ng.) and 2003 (average 24 ng.) The drop was 20%, and only 25% of 2003 levels were normal. Less sunlight exposure is felt to be the main explanation. This largely explains the increasing incidence of osteoporosis and other conditions associated with vitamin D deficiency.
Is Vitamin D a “secret?” Major publications have written about vitamin D in the past few years. In September,2006, Reader’s Digest published an article entitled:”The Miracle Vitamin: New evidence shows that getting enough D may be the most important thing you can do for you health.” In February, 2008, Parade Magazine listed vitamin D levels as one of “5 Medical Tests That May Keep You Well;” In the same month, Jane Brodie of the New York Times wrote “An Oldie Vies for Nutrient of the Decade.” Suggestions have even been made by prominent experts that the Surgeon General issue a report on Vitamin D because of the beneficial effect public awareness would have on decreasing health care costs and improving public health. I believe that the realization of the pandemic of vitamin D deficiency is the most important medical discovery in at least 40 years.
A guiding principle with taking Vitamin D
For those who like to keep things simple as more information becomes discovered about Vitamin D, the following should be remembered. If preventing osteoporosis was the ONLY thing that Vitamin D did,that would be enough reason to treat Vitamin D levels to at least 40 nanograms, and probably 50 nanograms.
Vitamin D and Cancer
One of Vitamin D's main actions is to prevent hyperproliferation of cells. That term describes what happens with cancer. There are substantial studies over the past several decades that show that low 25-hydroxyvitamin D levels vary inversely with the incidence of breast, prostate, and colon cancer. In a well publicized large study published in 2007, the lower the level, the more agressive the breast cancer. Prostate cancer studies have shown that vitamin D lowers the PSA level, an important tumor marker, and has effective anti-tumor action against prostate cancer.
Other cancers:
There are also many studies showing that vitamin D has activity in actually treating established cancer, especially breast and prostate cancer. Fewer studies have been done with less common cancers.
Thyroid cancer: There are in vitro and animal studies showing that thyroid cancer cells are significantly slowed down in their multiplication with Vitamin D. Thyroid nodules (which are a pre-cancerous lesion) are very common in hyperparathyroidism, and this condition is almost always associated with a low 25-hydroxyvitamin D level, which overstimulates the parathyroid glands.
Pancreatic cancer: Studies show that the incidence of pancreatic cancer is twice as common with low vitamin D levels.
Lung Cancer: Studies show a strong correlation of lung cancer with vitamin D levels, and substantial evidence that vitamin D has an chemotherapeutic effect when used in established cancer.
Vitamin D and the interaction of other risk factors
Many cancers have identified risk factors. Thyroid cancer is strongly associated with radiation to the neck as a child. Breast, prostate,and colon cancer have a number of proven risk factors. It has been well known and proven since 1965 that cigarette smoking causes lung cancer, and it is less well known that cigarette smoking is a strong risk factor of pancreatic cancer. A low vitamin D level works in conjunction with other risk factors. It is a non-specific stimulus to hyperproliferation of abnormal cells, and if these cells are damaged by other risk factors, it is a lot easier for cancer to develop. 25-hydroxyvitamin D levels, along with genetic factors, may be a large part of the explanation of why some smokers never get lung cancer. The same could be said of other cancers with their own risk factors.
What does this means in real terms? In an estimate so shocking it's hard for many to believe; according to leading Vitamin D experts and based on research studies that have been done, if every woman had a 25-hydroxyvitamin D level of 32 nanograms (the lowest level considered as normal, although it's far below the ideal level), the incidence of breast cancer would be cut 50%. The same probably can be said with men and women for colon, and men for prostate cancer. The same is also likely true for other cancers, but research has not been done yet.
Vitamin D and hereditary cancer genes - a theory
There are no studies that can be found regarding the BrCa1 gene, BrCa2 gene, and other heredity cancer symdromes and 25-hydroxyvitamin D levels. The BrCa1 gene has one of the most profound effects on it's carriers of all known hereditary cancer genes. Not all of it's female carriers get breast cancer, (it's frequently in the 30's when carriers that do get breast cancer become diagnosed, although just about all get ovarian cancer by the age of 58 if the ovaries aren't removed.) Would agressively treating 25-hydroxyvitamin D levels preferably to over 50 nanograms reduce the incidence of breast cancer in BrCa1 gene carriers? This is unknown, but could be an easy study to do, given the large amount of BrCa1 female carriers who follow the path of mammograms and MRIs of the breasts starting in their 30's. Unfortunately, I don't think this study is imminent. Carriers shouldn't wait; they should treat their vitamin D insufficiency to ideal levels.
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