#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.

#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.  

27) MYASTHENIA GRAVIS ASSOCIATION AND VITAMIN D

The Myasthenia Gravis association has a web site and a discussion blog online. It can easily be accessed by goggle: Myasthenia Gravis Association.

My entry on this Health Letter #19 is titled: Case History: Subjective and Objective Improvement in Myasthenia Gravis following aggressive treatment of Vitamin D insufficiency. It tells the story about Debbie, a woman with myasthenia gravis.

This entry was different than when I wrote about other illnesses, such as osteoporosis and multiple sclerosis, which have a significant amount of medical research supporting their connection with vitamin D. I was unable to find any medical study that investigated myasthenia gravis(MG) and vitamin D. However myasthenia gravis is known to be an autoimmune illness felt to be caused by abnormal antibodies, and there has been much research done on vitamin D having a beneficial effect against such antibodies.

I precipitated a discussion of Vitamin D and myasthenia. Many members of the forum with MG were aware that they had very low levels of vitamin D, and were aware of the problems that can arise with osteoporosis, made worse because prednisone frequently used to treat MG often accelerates osteoporosis. One member in particular felt there was a possibility that an improvement in the MG that coincided with taking significant doses of vitamin D were related. Some members of the forum indicated they were going to get a 25-hydroxyvitamin D level done for the first time.

One member of the forum summarized the discussion on the Myasthenia Gravis Forum:

"I think Dr Baker has been given a good hearing on this Forum and his argument has been well made. Maybe it’s time to let it sink in. And .. I have taken what he says about vitamin D deficiency very seriously. I think there may well be something in it and think it worthy of further investigation. The MS (Multiple Sclerosis) Trust and MS Society have taken on board the possible link with vitamin D deficiency and autoimmune diseases and I think we should too."

Best wishes to the members of the forum who suffer from MG and I hope as a result of the discussion, more people with MG have an experience with vitamin D that is similar to that of Debbie's positive experience.

#26) ANTICANCER RESEARCH ARTICLE FINALLY GETS SOME PUBLICITY

I have made several references to the fact that there has been no publicity in newspapers about the recent landmark crucial study that proved that a blood level of 25-hydroxyvitamin D of 47 ng. will slash the incidence of breast cancer in women 50%.
Earlier this week I was emailed by a friend of mine in Lowell, Massachusetts, about an article in the Lowell Sun newspaper. (I grew up in Lowell).The article interviewed a non-physician non-researcher who quoted the thoroughly discredited Institute of Medicine report of about a year ago. I wrote a letter to the editor setting the record straight, and it was published today. I mentioned in the letter the Anticancer Research article. The letter is below.
The circulation of the Lowell Sun is over 100,000. So finally there has been some publicity about this study.
You don't have to read the Lowell Sun to know about the study. You know about it now.

Vitamin D has benefit
The Lowell Sun
Updated: 12/17/2011

The conclusions of "Popping vitamin D? Not so fast" seem to be based on the Institute of Medicine's report of late 2010, which has been criticized by many vitamin D experts, including the Harvard School of Public Health.

The ability of adequate vitamin D levels to prevent osteoporotic fractures has long been proven with medical studies. Symptoms of many illnesses are lessened by ideal vitamin D levels. Recently, the September 2011 issue of the medical research journal Anticancer Research demonstrated beyond any doubt that a serum level of 47 mg. of 25-hydroxyvitamin D resulted in a 50 percent lower risk of breast cancer. This study got practically no publicity in newspapers.

I have ordered more than 6,000 25-hydroxyvitamin D levels in seven years, and treated more than 4,000 individuals with insufficiency. The benefits I have seen are too numerous to list in this letter.

ROBERT BAKER, M.D.
(Lowell High School graduate)
Cherry Hill, N.J.

Although I still can't find any other newspaper that makes reference to the 47 ng. level vitamin D study, I have found other publications that write about the details of the study. Just a few of them are:

1) Foodforbreastcancer.com
2. People Beating Cancer
3. MND (Men's News Daily)

#25) MORE VITAMIN D: (WHO WANTS TO GET OSTEOPOROSIS?)

Vitamin D remains underused and not fully understood by many people. This column will review news and information regarding vitamin D.

Osteoporosis remains a multi-billion dollar health problem. For 15 years calcium and a small dose of vitamin D were recommended, but studies have shown this is insufficient. It is now known that levels of Vitamin D over 32 ng (and preferably over 50 ng)) will prevent most osteoporosis. At the same time, amounts of 400 units of vitamin D have been shown repeatedly to have practically no benefit. 800 Units a day is only slightly better. Obtaining several thousand vitamin D levels from people in the last 7 years have given me the opportunity to compare this experience with the research studies. About 400 levels had osteoporosis or osteopenia on a DEXA scan. Of these 400, only 3 people have had levels less than 32 ng. (less than 1%). So want to prevent osteoporosis? (who doesn’t?). Get your doctor to order a 25-hydroxyvitamin D level (it’s still not done routinely), and get the level up to over 32 ng.-preferably over 40 ng, 50 ng. if even better. With these levels, most of the calcium you eat in your diet will now be absorbed (80% instead of 15%). The few populations that do have levels this high (and don’t take calcium supplements) have a very low level of osteoporosis. How important is this? How many people do you know over 70 that have broken a hip? Mostly it’s not a case of falling and breaking a hip. It’s been shown that often the hip breaks spontaneously and the person falls, and everything happens so quickly the person doesn’t realize the pain came a split second before the fall.

Cedrick and Frank Garland are two scientists/doctors who went to a lecture in the 1980’s as students where they learned that the amount of sunlight is strongly related to the incidence of a number of cancers. They devoted several years to research the subject, and they changed history. They published their data in the 1990’s, and this is the reason you have heard so much about vitamin D in the newspapers the past 7 years; a great deal of further research was stimulated by this. Breast, prostate, and colon cancer have been most studied and the proof is substantial that the incidence of these cancers can be greatly decreased with higher vitamin D levels. A critical “earth shattering” study was just published a few months ago. The only 12 studies on vitamin D levels and breast cancer were combined and it was determined that if a woman maintains a level of over 47 ng. of vitamin D, her chance of breast cancer is reduced by 50%. This is the type of information that we should have read on front pages of newspapers, but unfortunately in medical research, sometimes the most important discoveries get the least publicity. It is estimated that this 50% reduction in breast cancer could occur within 5 years.

Late last year the important sounding Institute of Medicine came out with a report on Vitamin D in which they admitted they were disregarding every major study Vitamin D study done in the past 15 years. They tried to make the case that vitamin D was “no big deal.” Since then this has become the most repudiated document I have seen in my career. Every true vitamin D expert in the country has specifically pointed out why it is invalid. The Harvard School of Public Health proved point by point that the study was a collection of wrong conclusions based on no evidence or incorrect evidence. The Endocrine Society disagrees with the report. Many other prominent organizations have repudiated it. As far as the motivation of the committee members, that’s a very long story, but suffice it to say that most of the members had financial interests in industries who stand to be hurt if the population increases their vitamin D level. For instance, a pharmaceutical company has been working over a decade on new Vitamin D ”look-alike” drugs that can be patented. If they ever succeed, it would only be a financial success if the general population doesn’t take vitamin D on their own. Some people who authored the report had financial interests in this company. (I don’t make this stuff up, I only tell you about it). One person has told me she heard that Vitamin D is “controversial.” There is no honest controversy involved with vitamin D. It should be noted that Vitamin D has absolutely nothing to do with Vitamin E, which has recently again been publicized as having a negative effect on good health. Vitamin E NEVER had any valid studies backing up its use as a supplement.

I’ve written about many other benefits of vitamin D in the previous updates. From the research that’s been published, and reinforced by follow up levels in the people I have on vitamin D, in order to reach a level of 47 ng. of higher, it is often necessary to take 5000 Units of Vitamin D daily. (available for $2 a month over the counter). I often am told that some people are still taking a dose far lower than this. The often talked about dose of 2000 units a day is something that some organizations have recommended for people who never have had a blood test.I recommend blood levels for everyone. I only occasionally see someone who attains an adequate level at the lower 2000 unit dose.

So my final question is this: What are you waiting for?

#24) SUBJECTIVE & OBJECTIVE IMPROVEMENT IN RHEUMATOID ARTHRITIS WITH VITAMIN D

Rheumatoid arthritis is one of the most common autoimmune connective tissue diseases. However it is far less common than osteoarthritis, which commonly occurs with age. (Although several factors are involved in the genesis of osteoarthritis, it is the “wear and tear” arthritis.)

A blood test, the rheumatoid factor, correlates with the severity of the rheumatoid arthritis, and is a measure of the antibody activity.

Precipitating factors are multiple and have been known for decades. Some cases are simply allergies to certain foods – milk and other dairy products have been proven to be the major factor in some cases that have gone away with abstinence from dairy foods. However the precipitating factors have not been embraced by the medical industry, and few sufferers of rheumatoid arthritis have even tried a dairy free diet nor are they told about it.

Because of research that has been done in the past decade, it has been shown that correction of a vitamin D insufficiency lowers the production of abnormal antibodies in autoimmune diseases.

Mrs. X is a 55 year old female who was diagnosed with rheumatoid arthritis in February, 2005. Her rheumatoid factor was 23. In July, 2009, she obtained a vitamin D level for the first time, and it was low at 21 ng. She was treated with 5000 units of vitamin D daily. In April, 2011, she reported that there had been a significant improvement in her joint pain and stiffness, and her repeat vitamin D level was 31 (still low, but much better than 21), and her rheumatoid factor was down to 18, a 22% decrease. No other changes in her medications had been made during that 4 year time span.

Poorly publicized medical studies have shown improvements in rheumatoid arthritis with treatment of vitamin D insufficiency. In this case, the individual had not yet reached anything close to an ideal level of vitamin D, it can be speculated that she may continue to improve with a higher level. The drop in the rheumatoid factor with vitamin D alone indicates a 22% decrease in antibody activity.

#23) PREVENTION OF BREAST CANCER WITH VITAMIN D HAS BEEN QUANTIFIED; A LEVEL OF 47 NG REDUCES THE RISK BY 50%.

What are you waiting for?

It has been known for many years that vitamin D prevents hyper-proliferation of cells in the human body. Research has shown that actual breast cancer responds in a test tube to activated vitamin D. But can vitamin D PREVENT breast cancer? A study just published in the September 2011 issue of Anticancer Research answers that question clearly.

There are 11 case-control studies on the risk of breast cancer by 25-hydroxyvitamin D levels that have been published. The authors of this meta-analysis combined the data to relate the risk of breast cancer to 25-hydroxyvitamin D levels.

The study confirmed the connection. This meta-analysis provides proof. A serum level of 47 ng. resulted in a 50% lower risk of breast cancer.

The studies did not determine the maximal beneficial effort of vitamin D on preventing breast cancer. It would be expected that the prevention of breast cancer would keep increasing with a higher level of vitamin D above 47 ng. Vitamin D levels in nature are higher than 47.

The study also did not look at the treatment of established breast cancer with vitamin D.

Do many women have a blood level of 47 ng of vitamin D? I have obtained about 4000 blood levels of 25-hydroxyvitamin D in men and women over the past 7 years, mostly people from Southern New Jersey but also some from California, Florida, Massachusetts, Rhode Island, and Texas were included. Only a very occasional person has that high a level. One woman who gardened all summer had a level of 70 ng. One woman who walked 6 miles a day all year round was quite memorable; she had a level of 110 ng. A fisherman had a level of 60 ng. I’ve seen less than 20 people who had a level of 47 ng or higher without taking a major dose of vitamin D. About 2/3rds of men and women have very low vitamin D levels below 32 ng.

In order to obtain a level of 47 ng, most people need to take at least 5000 units of vitamin D daily. Only occasionally do some people require less. The well publicized dose of 2000 units a day is intended for people who are healthy, and who have never obtained a blood level. In most cases, it will not raise a level below 32 ng to 47 ng. I’ve seen many people who already take 2000 units a day who have levels below 32 ng.

There are several breast cancer fund raising organizations that raise many millions of dollars to cure breast cancer. Much of the money is used for research grants to cancer researchers. I have seen their spokespeople on television, and they have made it clear they are not interesting in devoting their efforts to PREVENTION. They have no plans to publicize studies such as these.

If there was one well publicized “RACE FOR PREVENTION” publicizing the facts in this study, instead of the usual “RACE FOR THE CURE”, more women would be saved from breast cancer over 5 years than have been helped by chemotherapy since 1974, the year that the “War on Cancer” started.

Although this particular study was done on breast cancer, there are extensive somewhat similar studies done on men with prostate cancer. There are also many studies done with various type of cancers including cancer of the uterus and pancreas.

In a perfect world, this medical study should be publicized in newspapers and television news. As so often happens, unfortunately it will most like not be publicized.