Vitamin D Articles

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This page contains medical journal articles and/or doctors' commentaries on the role of mineral deficiencies and other factors in illness, and the value of minerals, vitamins, and a proper diet for healthy living.

Vitamin D Articles...

Winter is Approaching and Your Vitamin D is Falling

Counting on the sun alone for vitamin D will leave most people deprived of adequate amounts of this nutrient, especially during the winter in the northern parts of the US. This is true even for people who work outside during the summer and get plenty of sun in the warmer months but not in the winter.

Vitamin D is formed in the skin, but it requires ultraviolet rays of the sun to activate it to a form the body can use. Vitamin D, which assists the intestines in absorbing calcium and phosphorus, is also contained in some fortified foods.

Dr. Robert Heaney from Creighton University calculated the daily skin dose of vitamin D that 26 men who worked outdoors during the summer would have received. They brought the men back about 6 months later to assess how much vitamin D they may have lost over the winter. The team estimated that the amount of vitamin D that the group had received from the sun during the summer was equivalent to approximately 2800 international units (IU) of vitamin D a day. Current RDAs of vitamin D are 200 IU per day for adults aged 19 to 50, 400 IU for those aged 51 to 70, and 600 IU for those over 70. When the men were reassessed during February and March of the following year For the purposes of this study, vitamin D insufficiency was defined as a serum 25 OH D concentration of 15 n/ml. Over one-third had serum 25 OH vitamin D concentrations of less than 15 ng/ml, while the mean total 25 OH D concentration was 19.4 ng/ml.

The researchers concluded that vitamin D deficiency is more common than previously thought and it is not restricted to high-risk groups such as the homebound elderly.

24th Annual Meeting of the American Society for Bone and Mineral Research San Antonio, Texas September 24, 2002

DR. MERCOLA'S COMMENT:
(©Copyright 1997-2002 Dr. Joseph Mercola. All Rights Reserved. Web site: http://www.mercola.com. Newsletters are based upon the opinions of Dr. Mercola. They are not intended to replace a one-on-one relationship with a qualified health care professional and they are not intended as medical advice. They are intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.)

Now is the time for most of us to start back on the cod liver oil. The only exceptions in the US are those who have regular access to sunshine in the warmer southern states. As the above studies show most of us become quite deficient in vitamin D. I have been measuring levels in nearly all my patients since February. Towards the end of the winter well over 95% of patients had suboptimal levels of vitamin D. I have a lecture to about 350 high-powered nutritionists in August and was quite surprised to find that only one person was regularly measuring vitamin D levels.

Folks vitamin D is one of the most important vitamins you can optimize, largely because it is not a vitamin. It is the "only" vitamin that even traditional experts advise breast fed babies to be on in the winter. That is because it is not transferred in breast milk at all. The grand design was to get it from sun exposure to the skin, but that just doesn't happen for most of us in the winter. The dose of cod liver oil for infants is the same as adults, one teaspoon for every 50 pounds of body weight. So a 10-pound newborn would take 1/5 of a teaspoon. This is about 25 drops if you use a dropper.

The liquid is far easier to take then capsules as a 150 pound adult would need to take one tablespoon and this would be the equivalent of about 15 standard fish oil capsules. Additionally my experience is that most of the liquids are higher quality than the capsules and also less expensive.

Breakthrough Updates You Need to Know on Vitamin D

What is Vitamin D?
Vitamin D, calciferol, is a fat-soluble vitamin. It is found in food, but also can be made in your body after exposure to ultraviolet rays from the sun. Vitamin D exists in several forms, each with a different activity. Some forms are relatively inactive in the body, and have limited ability to function as a vitamin. The liver and kidney help convert vitamin D to its active hormone form.

The major biologic function of vitamin D is to maintain normal blood levels of calcium and phosphorus. Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones. It promotes bone mineralization in concert with a number of other vitamins, minerals, and hormones. Without vitamin D, bones can become thin, brittle, soft, or misshapen. Vitamin D prevents rickets in children and osteomalacia in adults, which are skeletal diseases that result in defects that weaken bones.

What are the sources of vitamin D?
Food sources
Fortified foods are the major dietary sources of vitamin D. Prior to the fortification of milk products in the 1930s, rickets (a bone disease seen in children) was a major public health problem in the United States. Milk in the United States is fortified with 10 micrograms (400 IU) of vitamin D per quart, and rickets is now uncommon in the US.

Exposure to sunlight
Exposure to sunlight is an important source of vitamin D. Ultraviolet (UV) rays from sunlight trigger vitamin D synthesis in the skin. Season, latitude, time of day, cloud cover, smog, and suncreens affect UV ray exposure. For example, in Boston the average amount of sunlight is insufficient to produce significant vitamin D synthesis in the skin from November through February. Sunscreens with a sun protection factor of 8 or greater will block UV rays that produce vitamin D. Vitamin D supplements are often recommended for exclusively breast-fed infants because human milk may not contain adequate vitamin D.

Vitamin D and Bone Health
It is estimated that over 25 million adults in the United States have, or are at risk of developing osteoporosis. Osteoporosis is a disease characterized by fragile bones. It results in increased risk of bone fractures.

Rickets and osteomalacia were recognized as being caused by vitamin D deficiency 75 years ago; their prevention and cure with fish liver oil constituted one of the early triumphs of nutritional science. The requirement for vitamin D has been pegged to these disorders ever since.

Having normal storage levels of vitamin D in your body helps keep your bones strong and may help prevent osteoporosis in elderly, non-ambulatory individuals, in post-menopausal women, and in individuals on chronic steroid therapy. Researchers know that normal bone is constantly being remodeled (broken down and rebuilt). During menopause, the balance between these two systems is upset, resulting in more bone being broken down (resorbed) than rebuilt. Vitamin D deficiency has been associated with greater incidence of hip fractures. A greater vitamin D intake from diet and supplements has been associated with less bone loss in older women. Since bone loss increases the risk of fractures, vitamin D supplementation may help prevent fractures resulting from osteoporosis.

The use of vitamin D is well accepted, but the mere absence of clinical rickets can hardly be considered an adequate definition either of health or of vitamin D sufficiency. The fact that it takes 30 or more years to manifest itself makes it no less a deficiency condition than a disorder that develops in 30 days. It is easy to understand how long-period deficiency diseases could never have been recognized in the early days of nutritional science, but with modern methods and a better grasp of the relevant physiology, failing to recognize a slowly developing condition as a true deficiency state, can no longer be justified. Vitamin D nutrition probably affects major aspects of human health, as listed below, other than its classical role in mineral metabolism. The rest of the article addresses some of the newly recognized uses of vitamin D.

Cancer
Today, it is well established that besides playing a crucial role in the establishment and maintenance of the calcium in the body, the active form of vitamin D also acts an effective regulator of cell growth and differentiation in a number of different cell types, including cancer cells. Laboratory, animal, and epidemiologic evidence suggest that vitamin D may be protective against some cancers. Clinical studies now show vitamin D deficiency to be associated with four of the most common cancers:
· Breast (23)
· Prostate (24-27)
· Colon (28-31)
· Skin (32,33)

Diabetes
Vitamin D deficiency has been associated with insulin deficiency and insulin resistance. (1-3) In fact, last year it was shown that vitamin D deficiency is likely to be a major factor for the development of type one diabetes in children. (4)

Heart Disease
Insulin resistance is also one of the major factors not only leading to the cancers mentioned above, but also to the number one killer in the US, heart disease. Northern countries have higher levels of heart disease and more heart attacks occur in the winter months. (5,6)

Arthritis
Progression of degenerative arthritis of the knee and hip is faster in people with lower vitamin D concentrations (33-34)

Infertility and PMS
Infertility is associated with low vitamin D(7), and PMS has been completely reversed by addition of calcium, magnesium and vitamin D.(8)

Fatigue, Depression and Seasonal Affective Disorder
Activated vitamin D in the adrenal gland regulates tyrosine hydroxylase, the rate limiting enzyme necessary for the production of dopamine, epinephrine and norepinephrine. Low vitamin D may contribute to chronic fatigue and depression. (9-10) Seasonal Affective Disorder has been treated successfully with vitamin D. In a recent study covering 30 days of treatment comparing Vitamin D and 2 hour daily use of 'light boxes', depression completely resolved in the D group, but not in the light box group.(11)

Autoimmune Disorders
Multiple Sclerosis, (12) Sjogren's Syndrome, rheumatoid arthritis, thyroiditis and Crohn's disease have all been linked with low vitamin D levels. Single, infrequent, intense, skin exposure to UV-B light suppresses the immune system and causes harm. However chronic low-level exposure normalizes immune function and enhances immune cell production. This reduces abnormal inflammatory responses such as found in autoimmune disorders, and reducing occurrences of infectious disease. (14-18)

Obesity
Vitamin D deficiency has been linked with obesity. (18, 19) Vitamin D has recently been shown to lower leptin secretion. (20) Leptin is a hormone produced by fat cells and is involved in weight regulation. It is thought that the hormone signals the brain when fat cells are "full," but exactly how the hormone controls weight is not entirely clear. Additionally, obesity by itself probably further worsens vitamin D deficiency due to the decreased bioavailability of vitamin D(3) from skin and dietary sources, because of its being deposited in body fat. (36)

Syndrome X
Vitamin D deficiency has been clearly linked with Syndrome X. (21) Syndrome X refers specifically to a group of health problems that can include insulin resistance (the inability to properly deal with dietary carbohydrates and sugars), abnormal blood fats (such as elevated cholesterol and triglycerides), overweight, and high blood pressure.

Vitamin D and Steroids
Steroids, like prednisone, are often prescribed to reduce inflammation from a variety of medical problems. These medicines may be essential for a person's medical treatment, but they have potential side effects, including decreased calcium absorption. There is some evidence that steroids may also impair vitamin D metabolism, further contributing to the loss of bone and development of osteoporosis associated with steroid medications. For these reasons, individuals on chronic steroid therapy should consult with their physician or registered dietitian about the need to increase vitamin D intake through diet and/or dietary supplements.

The above document was edited from: National Institutes of Health Document on Vitamin D

References
1. Hypponen E, Laara E, Reunanen A, Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet. 2001 Nov 3;358(9292):1500-3.
2. Billaudel B, Barakat L, Faure-Dussert A. Vitamin D3 deficiency and alterations of glucose metabolism in rat endocrine pancreas. Diabetes Metab 1998;24:344-50.
3. Bourlon PM, Billaudel B, Faure-Dussert A. Influence of vitamin D3 deficiency and 1,25 dihydroxyvitamin D3 on de novo insulin biosynthesis in the islets of the rat endocrine pancreas. J.Endocrinol. 1999;160:87-
4. Ortlepp JR, Lauscher J, Hoffmann R, The vitamin D receptor gene variant is associated with the prevalence of type 2 diabetes mellitus and coronary artery disease. Diabet Med. 2001 Oct;18(10):842-
5 Segall JJ. Latitude and ischaemic heart disease [letter]. Lancet 1989;1:1146.
6 Williams FL, Lloyd OL. Latitude and heart disease [letter]. Lancet 1989;1:1072-3.
7. Panda DK, Miao D, Tremblay ML, Targeted ablation of the 25-hydroxyvitamin D 1alpha -hydroxylase enzyme: evidence for skeletal, reproductive, and immune dysfunction. Proc Natl Acad Sci U S A. 2001 Jun 19;98(13):7498-503.
8. Thys-Jacobs S. Micronutrients and the premenstrual syndrome: the case for calcium. J.Am.Coll.Nutr. 2000;19:220-7.
9. Puchacz E, Stumpf WE, Stachowiak EK, Stachowiak MK. Vitamin D increases expression of the tyrosine hydroxylase gene in adrenal medullary cells. Brain Res.Mol.Brain Res. 1996;36:193-6.
10. : Gloth FM 3rd, Alam W, Hollis B. Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. J Nutr Health Aging. 1999;3(1):5-7.
11. Gloth FM, III, Alam W, Hollis B. Vitamin D vs broad spectrum phototherapy in the treatment of seasonal affective disorder. J.Nutr.Health Aging 1999;3:5-7.
12 : Hayes CE. Vitamin D: a natural inhibitor of multiple sclerosis. Proc Nutr Soc. 2000 Nov;59(4):531-
13. McMichael AJ, Hall AJ. Multiple sclerosis and ultraviolet radiation: time to shed more light.Neuroepidemiology. 2001 Aug;20(3):165-7.
14. Deluca HF, Cantorna MT. Vitamin D: its role and uses in immunology. FASEB J. 2001 Dec;15(14):2579-85.
16. Long KZ, Santos JI. Vitamins and the regulation of the immune response. Pediatr.Infect.Dis.J. 1999;18:283-90.
17. Ghezzi A, Zaffaroni M. Neurological manifestations of gastrointestinal disorders, with particular reference to the differential diagnosis of multiple sclerosis. Neurol Sci 2001 Nov;22 Suppl 2:S117-22
18 Cantorna MT. Vitamin D and autoimmunity: is vitamin D status an environmental factor affecting autoimmune disease prevalence? Proc.Soc.Exp.Biol.Med. 2000;223:230-3
19 Shi H, Norman AW, Okamura WH, Sen A, Zemel MB.1alpha,25-Dihydroxyvitamin D3 modulates human adipocyte metabolism via nongenomic action. FASEB J. 2001 Dec;15(14):2751-3
20 Speer G, Cseh K, Winkler G, Vitamin D and estrogen receptor gene polymorphisms in type 2 diabetes mellitus and in android type obesity. Eur J Endocrinol. 2001 Apr;144(4):385-9.
21 Henendez C, Lage M, Peino R, Retinoic acid and vitamin D(3) powerfully inhibit in vitro leptin secretion by human adipose tissue.J Endocrinol. 2001 Aug;170(2):425-31
22 Boucher BJ. Inadequate vitamin D status: does it contribute to the disorders comprising syndrome 'X'? [published erratum appears in Br J Nutr 1998 Dec;80(6):585]. Br.J.Nutr. 1998;79:315-27.
23 Grant WB An ecologic study of dietary and solar ultraviolet-B links to breast carcinoma mortality rates.Cancer 2002 Jan 1;94(1):272-81
24 Polek TC, Weigel NL. Vitamin D and prostate cancer. J Androl. 2002 Jan-Feb;23(1):9-17.
25 Luscombe CJ, French ME, Liu S, Prostate cancer risk: associations with ultraviolet radiation, tyrosinase and melanocortin-1 receptor genotypes.Br J Cancer. 2001 Nov;85(10):1504-9.
26 Hansen CM, Binderup L, Hamberg KJ, Vitamin D and cancer: effects of 1,25(OH)2D3 and its analogs on growth control and tumorigenesis. Front Biosci. 2001 Jul 1;6:D820-48.
27 Tuohimaa P, Lyakhovich A, Aksenov N, Vitamin D and prostate cancer. J Steroid Biochem Mol Biol. 2001 Jan-Mar;76(1-5):125-34
28 Mokady E, Schwartz B, Shany S, A protective role of dietary vitamin D3 in rat colon carcinogenesis. Nutr Cancer. 2000;38(1):65-73.
29 Platz EA, Hankinson SE, Hollis BW, Plasma 1,25-dihydroxy- and 25-hydroxyvitamin D and adenomatous polyps of the distal colorectum.Cancer Epidemiol Biomarkers Prev. 2000 Oct;9(10):1059-
30 Tangpricha V, Flanagan JN, Whitlatch LW, 25-hydroxyvitamin 1alpha-hydroxylase in normal and malignant colon tissue. Lancet. 2001 May 26;357(9269):1673-4.
31 Lamprecht SA, Lipkin M. Cellular mechanisms of calcium and vitamin D in the inhibition of colorectal carcinogenesis. Ann N Y Acad Sci. 2001 Dec;952:73-87.
32 Majewski S, Kutner A, Jablonska S. Vitamin D analogs in cutaneous malignancies.Curr Pharm Des. 2000 May;6(7):829-38.
33 Braun MM, Tucker MA. A role for photoproducts of vitamin D in the etiology of cutaneous melanoma? Med Hypotheses. 1997 Apr;48(4):351-4.
34 McAlindon TE, Felson DT, et al. Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among participants in the Framingham Study. Ann Intern Med 1996; 125: 353-359
35 Lane NE, Nevitt MC, Gore LR, Cummings SR. Serum levels of vitamin D and hip osteoarthritis in elderly women: a longitudinal study. Arthritis Rheum 1997; 40(suppl): S238.
36. Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000 Sep;72(3):690-3)

MS and Vitamin D
The Health Science Institutes recommends you take between 200 and 400 IU of vitamin D daily(1,000,000 IU is 25 milligrams).
The Health Sciences Institute e-Alert
April 11, 2001
*********************************************************
Dear Member,
If you or someone you love is among the 330,000 Americans suffering from multiple sclerosis (MS), you know just how mystifying this disease can be. The cause of MS remains unknown, making treatment options very limited.

Over the years, the Health Sciences Institute has reported on a variety of very promising alternative treatments for this condition, including a recent article on oral myelin in the October 2000 issue of Members Alert. And now, we've come across some exciting research that suggests a common vitamin may have the power to stop MS dead in its tracks.

In a past study at the University of Wisconsin, mice injected with experimental version of MS were given supplemental vitamin D one day before symptoms were expected to appear. The results of this treatment were nothing short of astounding: NONE of the mice developed a single symptom of disability!

With this encouraging start, researchers tested the ability of vitamin D to delay the progress of symptoms. When mice treated with experimental MS began to show the first signs of the disease, they were divided into two groups: one group was given vitamin D while the other was not. After 40 days, the group given vitamin D showed few symptoms, while the untreated mice were completely paralyzed. When researchers discontinued the vitamin D supplementation in the first group, the mice quickly acquired symptoms of paralysis. So, is vitamin D the missing link in MS prevention and treatment? Clinical trials on humans are still in the early stages, but have shown positive results in suppressing symptoms and lowering levels of Interleukin-2, which is believed to be associated with the development of MS.

While vitamin D shows great promise, it's hard to get adequate levels of the nutrient. The best source is exposure to the sun's UV rays, which causes the skin to synthesize its own vitamin D. However, as you know,these same UV rays can produce very damaging secondary effects. In fact, many MS patients are advised to stay out of the sun. Fish like mackerel, salmon, and sardines are the best dietary sources of vitamin D. Nevertheless, since most people don't eat enough of these foods to reach necessary levels, taking supplemental vitamin D is probably your best option. We recommend you take between 200 and 400 IU of vitamin D daily.

We'll continue to keep you updated on these exciting studies. In addition, we're currently working on a Health Sciences Institute special report on MS. It has information on the best, most effective breakthrough treatments for this debilitating disease, and should be available by summer.

Amanda L. Ross Research Associate Health Sciences Institute

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VITAMIN D ARTICLES