Search Results for: vitamin D

Jun
06
2020

Adequate Vitamin D Level Strengthens the Immune System

By | immune system, Infectious Disease, Inflammation, kidney disease, Lung Disease, Mortality, Prevention, Vitamins and supplements

The Covid-19 coronavirus crisis is teaching us that an adequate vitamin D level strengthens the immune system.

When we age, our resistance to infections weakens, but this may be because our immune system needs more vitamin D3. I have reviewed the super powers of vitamin D3 before in 2014. In the past the thought was that the human body would need only 400 IU of vitamin D3 every day to cure rickets. And these were the daily vitamin D3 recommendations from medical authorities for several decades. Gradually it became known that for cancer prevention, infection prevention, cardiovascular illness prevention and for diabetes prevention much higher doses of vitamin D3 were necessary. As pointed out in the previous link, almost 50% of the world population is deficient in vitamin D. This is due to a lack of exposure to sunlight and due to inadequate supplementation with vitamin D3.

History of vitamin D

Dr. Adolf Windaus received the Nobel prize for chemistry in 1928. It was to acknowledge “… his studies on the constitution of the sterols and their connection with vitamins”. His work involved the metabolism of vitamin D and the precursors of vitamin D.

Rickets

As the above link shows, rachitic children were treated since the mid 1800’s with cod liver oil and since the early 1900’s also with ultraviolet light. But we know now that 400 IU of vitamin D3 per day is just enough to cure rachitic children, but it is not enough to strengthen the immune system to fight influenza viruses or the Covid-19 coronavirus. I will discuss further below what vitamin D blood levels are important to achieve a healthy state of the immune system.

Adequate vitamin D level strengthens the immune system

The immune system is very complicated and consists of many cell types that interact with each other and the rest of the body. It is important to recognize that the innate immune system immediately inactivates intruding viruses. But the vitamin D blood concentration has to be high enough. The acquired immunity consists of antibodies that are produced by B cells. The antibodies were produced during prior infections that you have survived and you are now immune to. However, other antibodies that circulate in your blood may have originated from vaccines you received in the past (whooping cough, measles, tetanus, diphtheria etc.). With the Covid-19 coronavirus it is the innate immunity that plays the biggest role until a vaccine will be found in the future.

Vitamin D is a hormone

This 2013 paper explains that vitamin D is a hormone that stimulates its own vitamin D receptor. This is a nuclear receptor that has close relations to the cell DNA and can stimulate more than 900 polypeptides. They are messenger molecules that are involved in a variety of physiological functions. One of the key functions is the immune system. This link explains that T cells that have vitamin D receptors can develop into cytotoxic T cells (also known as “killer T cells”). They are important in fighting cancer, but also parasites.

The key is that the hormone vitamin D can release more than 100 polypeptides that have the power to fight virus attacks including the Covid-19 coronavirus.

Three mechanisms how vitamin D works against the virus

The researchers outlined 3 mechanisms of how vitamin D works:

  • Maintaining tight epithelial junctions making it more difficult for the Covid-19 coronavirus to penetrate.
  • “Killing enveloped viruses through induction of cathelicidin and defensins.” These powerful antiviral polypeptides can kill viruses that have invaded the blood stream within 1 to 2 days.
  • “…And reducing production of proinflammatory cytokines by the innate immune system, thereby reducing the risk of a cytokine storm leading to pneumonia.” It is people who get the viral pneumonia that are at a high risk of death. By bringing the blood level up to the higher range of normal, between 50 and 80 ng/mL, patients that have encountered Covid-19 coronavirus are more likely to survive.

Two polypeptides, cathelicidin and defensins

Again, I like to emphasize that it is not vitamin D that has a direct effect on the virus. It is two polypeptides, cathelicidin and defensins, which are powerful antiviral polypeptides, that are released by vitamin D.

They can kill viruses that have invaded the blood stream and can eliminate the cytokine storm. This all happens very fast, within only 1 to 2 days. But you have to have an adequate vitamin blood level for this to occur (about 50-80 ng/mL).

Sources of vitamin D

First of all, vitamin D is readily absorbed from food. But there are not many foods that contain enough vitamin D for the immune system. The ones that contain vitamin D are as follows:

  • “Fatty fish, like tuna, mackerel, and salmon.
  • Foods fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals.
  • Beef liver.
  • Cheese
  • Egg yolks. “

Sun induced amount of vitamin D

Secondly, vitamin D can be synthesized in the skin from exposure to sunlight. But for this to happen all the necessary enzymes need to be present.  This link explains that many older people above the age of 65 have low vitamin D blood levels because of a lack of sun exposure and a lack of cutaneous synthesis because of enzyme issues.

Vitamin D supplements

The most reliable source of vitamin D are vitamin D3 supplements. When people supplement with the same dose of vitamin D3 there will be people who get higher vitamin D blood levels than others, as absorption in the gut is different for different people.  The ones who have relatively low vitamin D blood levels are often called “slow vitamin D absorbers”. But when the vitamin D3 dosage is increased even those people will reach the recommended high normal range (50-80 ng/mL).

Vitamin D blood level

The vitamin D blood test has the scientific name “25-hydroxy vitamin D level”. This is now the recognized gold standard for determining who is deficient or has normal levels with respect to vitamin D. The following 2013 publication has studied the vitamin D level of 1,470 healthy Swiss men and women, 60 years or older. Vitamin D levels were classified as severely deficient when the level was below 10 ng/mL. The vitamin D level was deficient between 10 and 20 ng/mL. The level was insufficient when between 21 and 29 ng/mL. A level above 30 ng/mL is normal.

8 % of the subjects were severely insufficient and 66% had insufficient vitamin D levels. Only 26.1% of the subjects had normal levels. Over 50% of healthy older Swiss (above the age of 70) had insufficient vitamin D levels.

Which vitamin D level is safe and which is not?

A peer-reviewed publication of the effects of vitamin D in health and disease contains 269 references.

What vitamin D level is optimal? This question was reviewed in this paper.

  • Below 15 ng/mL the immune system is paralyzed
  • With a level above 30 ng/mL the immune system is working
  • A level of 50-80 ng/mL has the immune system working optimally
  • Above 150 ng/mL toxic vitamin D levels start
  • With 300 ng/mL severe toxicity begins

Vitamin D toxicity

It is only with high levels of vitamin D (more than 150 ng/mL) that you have to worry about high calcium levels in the blood or kidney stones (toxic levels). But the key is to not exceed 80 ng/mL regarding the vitamin D blood level. This gives you a lot of flexibility before you reach toxic levels (above 150 ng/mL). For those who want more information, here is a thorough, peer reviewed publication about vitamin D toxicity with 59 references.

Vitamin D supplement compliance

The question is why not more people take adequate vitamin D3 supplements.  We know that vitamin D can prevent so many chronic diseases including serious viral infections. The answer is complex, but it includes a fear of the population of vitamin toxicity (kidney stone and high calcium levels). However, as pointed out before, this occurs only above a vitamin D level of 150 ng/mL. With proper vitamin D blood level monitoring you never reach toxic levels of vitamin D.

Denial

Denial likely is another major factor. People feel that if they have a balanced diet, they would be protected from vitamin D insufficiency. As pointed out before this is a grave error to think as our food does not contain sufficient vitamin D to strengthen our immune system.

False security with low doses of vitamin D

Finally, there are people who think that low doses of vitamin D, like 1000 IU of vitamin D daily, would be enough. But it is not enough. This is why testing vitamin D blood levels is so important. It is a reality check. The blood level must be in the high normal range (50-80 ng/mL). At this level the immune system functions optimally.

Compliance issues

In this context there was an interesting study done by LifeExtension, a company that publishes monthly health magazines. In this study the company examined the vitamin D blood levels of LifeExtension members. They are the ones who should be knowledgeable in how important it is to have good, preventative vitamin D blood levels. The study showed that 38% of the vitamin D test results were less than 30 ng/mL. In addition, 69% of the vitamin D tests were less than 40 ng/mL. Finally, 85% of the vitamin D test results were less than 50 ng/mL. What this means is that LifeExtension members were non-compliant when it came to taking regular adequate vitamin D3 doses. This resulted in levels that were too low for the majority to protect them from the Covid-19 coronavirus.

Covid-19 coronavirus infections and vitamin D blood level

There is a tight relationship between vitamin D blood levels and the strength of the immune system. Essentially, coronavirus mortality measures who is vitamin D deficient. Without enough vitamin D on board the virus penetrates into the blood stream and penetrates the lining of the respiratory tract. Next the cytokine storm develops, which leads to viral pneumonia. Higher doses of vitamin D3 will mitigate the course of Covid-19 coronavirus.

Adequate Vitamin D Level Strengthens the Immune System

Adequate Vitamin D Level Strengthens the Immune System

Conclusion

The Covid-19 coronavirus pandemic has taught us how important an intact immune system is to survive the virus when you get it. We do know for some time how closely related a good vitamin D level is with the functioning of the immune system. I have reviewed here what a desirable vitamin D level is and how we can achieve this with oral vitamin D3 supplements. The goal is to achieve a vitamin D level in the upper range of normal (50-80 ng/mL). With a level like this the virus cannot penetrate the mucous membranes of the respiratory tract and even if it did, it cannot produce a cytokine storm in the blood that would lead to the deadly viral pneumonia or to blood clots. When the virus invades the bloodstream, vitamin D releases powerful antiviral polypeptides that can kill viruses within 1 to 2 days.

Literature

Here are some peer-reviewed publications on vitamin D:

 

May
09
2020

Vitamin D Is the Definitive Link

By | Alzheimer’s disease, Arthritis, Asthma, autoimmune disease, breast cancer, Diabetes, heart attack, Infectious Disease, Osteoporosis, Stroke, Vitamins and supplements

Vitamin D deficiency caused rickets in the past, but now we know that vitamin D is the definitive link for other health problems. The lack of it is the reason for numerous illnesses. A search in my website gives you more than 170 blogs where I am discussing the effect of vitamin D. These describe how vitamin D is the definitive link in a lot of different diseases. In a 2015 study from Brazil the authors noted that a critical vitamin D blood level was 12 ng/mL. All these critically ill patients received treatment in an ICU setting. In vitamin D blood levels of 12 ng/mL the mortality rate was 32.2%. A control group of ICU patients with more than 12 ng/mL had a mortality rate of only 13.2%. The authors concluded that a low vitamin D level on ICU admission was an independent risk factor for mortality in this critically ill patient group.

A few diseases where low vitamin D is the definitive link for a poor outcome

In patients, who have arthritis, cardiovascular disease, breast cancer, diabetes, osteoporosis, influenza and others, the laboratory tests that shows their 25-hydroxy vitamin D level, are usually below 15 ng/mL. This link has 269 peer reviewed references.

A 2015 Italian study showed that microvascular complications in diabetes patients were high, if the vitamin D3 blood levels were low. If patients had high levels of vitamin D, there were no complications such as retinopathy or nephropathy. But if levels were below 20 ng/mL, damages were significant in the capillaries of the eyes and kidneys.

Multiple sclerosis

It has been known for some time that in the northern hemisphere MS is more common because of the lack of sunshine, which in turn leads to less vitamin D3 production in the skin. Multiple sclerosis (MS) is an autoimmune disease where immune cells attack the lining of nerves. Both nerve cells and immune cells have vitamin D receptors. It appears that vitamin D calms down immune cells and remission of an MS relapse is more likely.

Dr. Fitzgerald and colleagues published a study in JAMA Neurology in 2015. Results of this study showed marked differences between MS patients with high and low vitamin D levels.

Multiple sclerosis rates with high and low vitamin D levels

Patients with the highest vitamin D blood levels (more than 40 ng/mL) had the lowest rates of new MS lesions. Previous studies found that a low blood level of vitamin D (less than 25 ng/mL) had an association with a higher risk of developing MS. Dr. Fitzgerald’s study showed that a 20 ng/mL (50.0-nmol/L) increase in serum vitamin D levels associated with a 31% lower rate of new MS lesions. Patients with the highest vitamin D level of more than 40 ng/mL (100 nmol/L) had the lowest amount of new MRI lesions (47% less than the patients with the lowest vitamin D levels).

Dementia and Alzheimer’s disease

A 2014 study showed that patients with a low vitamin D level had a connection with a high risk of dementia and Alzheimer’s disease.

Specifically, the researchers found the following observations.

  • Vitamin D level of less than 10 ng/mL: 122% increased risk of Alzheimer’s
  • A vitamin D level of 10 to 20 ng/mL: 51% increased risk of Alzheimer’s

Vitamin D is the definitive link for the immune system

In a publication of 2006 Dr. John Cannell and co-workers have reviewed why influenza has seasonal outbreaks. They found that the innate immune system was very dependent on vitamin D. Those who did not get enough sunlight in the northern hemisphere during January, February, March and April have an average 25-hydroxy vitamin D level of only 15 to 17 ng/mL. In contrast, from July to September the same volunteers had vitamin D levels of 24 to 29 ng/mL. The authors stressed that this was the reason why spring flus in the late winter/early spring season are common, but disappear in summer.

Vitamin D requirements for immune system is 2000 IU or more per day

Vitamin D is essential for the functioning of the innate and adaptive immune system. They also are the reason why children are not as affected by influenza viruses as adults are. Dr. Cannell said: “The innate immunity of the aged declined over the last 20 years due to medical and governmental warnings to avoid the sun. While the young usually ignore such advice, the elderly often follow it”. Had the older patients taken higher doses of vitamin D3 every day, their immunity would have been as strong as the children’s immunity. The publication cites another paper that found that 2000 IU per day or more will strengthen the immune system. Note that this is a higher dose than  treating rickets. Treatment of rickets responds to only 400 IU of vitamin D3 per day.

Mechanism of action of vitamin D in infectious diseases like influenza or Covid-19 coronavirus

Here is evidence from US researchers that states that higher doses of vitamin D3 will mitigate the course of influenza and of Covid-19 coronavirus. The researchers outlined that vitamin D has 3 effects:

  1. Maintaining tight epithelial junctions making it more difficult for the Covid-19 coronavirus to penetrate them.
  2. “Killing enveloped viruses through induction of cathelicidin and defensins.” These powerful antiviral polypeptides can kill viruses that have invaded the bloodstream within 1 to 2 days.
  3. “…And reducing production of proinflammatory cytokines by the innate immune system, thereby reducing the risk of a cytokine storm leading to pneumonia.” People who get viral pneumonia are at a high risk of death. By bringing the vitamin D blood level up to the higher range of normal, between 50 and 80 ng/mL, patients that have encountered Covid-19 coronavirus are more likely to survive.

Criticism of high dose vitamin D treatment

A common criticism of treatment with higher doses of vitamin D is that people would develop high blood calcium levels and would get kidney stones. Three recent studies have demystified this. A 2012 study looked at patients who were in the higher range of calcium levels, but deficient in vitamin D. They were treated with vitamin D3 und closely supervised. The calcium levels did not change after 1 year of high doses of vitamin D.

This 2018 study observed that there is a small amount of kidney stone formers who will form kidney stone with or without vitamin D3 treatment.  However, the large majority of patients do not form kidney stones with vitamin D treatment and their blood calcium levels stay the same before and after vitamin D treatment.

Toxic vitamin D blood levels

Toxic levels of vitamin D blood levels are above150 ng/mL, or 375 nmol/L. The therapeutic levels discussed here are well below these toxic levels.

Placebo controlled New Zealand study fails to show kidney stones

A placebo-controlled study from New Zealand went on for 3.3 years. 100,000 IU of vitamin D3 monthly (3333 IU per day on average) in the experimental group were compared to a placebo group. There were no vitamin D induced kidney stones and also no changes in calcium levels.

In past studies regarding vitamin D toxicity were done. But with these investigations there were many confounding factors that led to false results.  The investigators at those times mistakenly thought that they were side-effects of vitamin D. Up to this day conventional medicine often warns of hypercalcemia and kidney stones with vitamin D treatment. While the patient is on higher vitamin D levels, the physician can do blood and urine tests to see whether or not there is any concern.

Polypeptides released by vitamin D

There are more than 100 polypeptide hormones that are controlled by vitamin D. The most important ones for control of bacterial and viral infections are the defensin family and the cathelicidin family of polypeptides. They are instrumental in preventing the cytokine storm with a Covid-19 coronavirus infection treated with high vitamin D doses.

Decades after the original description of vitamin D researchers found out that vitamin D actually is a hormone.

There are vitamin D hormone receptors on almost every cell of the body. Vitamin D integrates the body cells and they respond as one unit. It is only recently that researchers found out about the release of polypeptides, particularly defensin and cathelicidin. They are  vital in the defence against the Covid-19 Coronavirus and the various flu types.

Vitamin D Is the Definitive Link

Vitamin D Is the Definitive Link

Conclusion

The detection of vitamin D originally occurred when rickets was examined. But later researchers found that vitamin D has hormone qualities.

You can prevent several diseases, like arthritis, cardiovascular disease, breast cancer, diabetes, osteoporosis and influenza. But you must take adequate amounts of vitamin D to bring the vitamin D blood level up. 25-hydroxy vitamin D blood levels are now recognized as the standard test to measure whether you have enough vitamin D on board. When it comes to fighting infections the vitamin D blood level has to be above 30 ng/mL (above 75 nmol/L). At this level the immune system will release defensin and cathelicidin polypeptides. These are powerful antiviral and antibacterial substances that can even fight Covid-19 coronavirus.

High vitamin D therapy is safe

With careful monitoring of blood vitamin D levels side effects of high vitamin D dosages were not found. Conventional medicine keeps on repeating old studies with confounding errors. This scares people, and as a result they don’t want to take enough vitamin D for prevention. Hypercalcemia and kidney stones were NOT found in randomized newer studies. As long as the vitamin D level does not exceed 50-80 ng/mL (or 125-200 nmol/L) vitamin D therapy is perfectly safe.

Oct
28
2017

Take Enough Vitamin D3

By | Arthritis, Cardiovascular disease, Diabetes, Heart Disease, Inflammation, Multiple sclerosis, schizophrenia, Stroke

Many people supplement with 300 to 400 IU of vitamin D3, but do they take enough vitamin D3? There is a simple way of finding out: ask your doctor to order a 25-hydroxyvitamin D blood test.   This will show whether the gut absorbed enough of the essential vitamin. It will also show whether or not your vitamin D3 capsules or tablets were strong enough. It is now generally accepted that a good range of the vitamin D blood level is between 50 and 80 ng/ml. Unfortunately many Americans who come down with various diseases have blood levels of less than 30 ng/ml. Here are some facts about what a lack of vitamin D3 can cause.

Increased risk of mortality with lower vitamin D levels in ICU patients

  1. A New England Journal study from 2009 reported about 1100 patients in Intensive Care Units (ICU). Their average vitamin D blood level was only 16 ng/ml. They tracked the mortality rates depending on the vitamin D blood level. Insufficient vitamin D levels showed an association with a mortality rate of 45%. An intermediate level had a mortality rate of 35%. And a satisfactory level of vitamin D had a mortality of only16%. Between the low level of vitamin D and the normal level there was a 3-fold difference in mortality!
  2. Another study from 2015 repeated the mortality study with 135 ICU patients. Researchers correlated Vitamin D blood levels with mortality rates of patients. When vitamin D levels were below 12 ng/ml, there was a mortality rate of 32.2%. Patients with higher levels of vitamin D had a mortality rate of 13.2%. The authors concluded that vitamin D blood levels were an independent risk factor for mortality. Patients less than 12 ng/ml had a 2.4-fold higher risk of dying than patients with normal vitamin D levels.

Do patients with multiple sclerosis take enough vitamin D3?

Perhaps one of the earliest results of vitamin D3 research was the following observation. More than 90% of patients with multiple sclerosis were deficient in vitamin D blood levels. Their levels were below 20 ng/ml. Other researchers showed that vitamin D could directly tone down the aggressiveness of the immune cells of MS patients. These were the ones that attacked the myelin sheath. As a result of this knowledge it is important for MS patients to take high enough vitamin D3 supplements. When they reach good vitamin D blood levels their MS is better controlled.

Canada as a northern country has 291 MS patients per 100,000 people. Contrast this to 110-140 MS patients per 100,000 people in the northern US (between the 37th parallel and the US/Canadian border). In addition south of the 37th parallel there are only 57-78 cases of MS per 100,000 people. Researchers have concluded that the less sun light people get, the higher the rate of MS in the population will be. However, instead of sun exposure you can supplement with vitamin D3 capsules to get the blood vitamin D levels up to the range of between 50 and 80 ng/ml.

Do stroke patients take enough vitamin D3?

Strokes are very common. About 6.8 million Americans survive a stroke and live with various disabilities. 15% die shortly after their stroke. 40% are left with moderate to severe disabilities. Many require special care.

  1. Studies have shown that patients with the lowest level of vitamin D have the poorest functional outcomes. Moreover, for every 10 ng/ml decrease in vitamin D levels the odds of a healthy recovery 3 months after the stroke fell by about half. This was independent of age and the initial stroke severity.
  2. In another 2015 study from South Korea 818 stroke patients took tests to evaluate whether they had adequate vitamin D blood levels. There was a clear division between those whose levels were higher than 10 ng/ml or lower. When the vitamin D level was higher, there was a 90% better recovery from their stroke after 3 months. In comparison those whose vitamin D levels were below 10 ng/ml had poor recovery rates. Experts say that vitamin D levels should stay in the range between 50 and 80 ng/ml. This will prevent numerous diseases.

Do diabetics take enough vitamin D3?

  1. Vitamin D3 can silence diabetes genes in connection with the right diet and cofactors of zinc and magnesium. A Mediterranean diet can stabilize the metabolism and fight inflammation. Zinc and magnesium are important cofactors in enzymes necessary to prevent diabetes. Vitamin D3 and omega-3intake are helping to control inflammation and preserve beta cells in the pancreas in diabetes patients. This is important for continued production of insulin.
  2. A Chinese research team found that vitamin D3 protects beta cells in the pancreas from dying off. The finding was that vitamin D3 receptors in the insulin producing cells prevented the dying off of these cells, as long as there was enough vitamin D available. Insulin production by the pancreas remained effective. And insulin is vital for long-term survival of diabetes patients. The key for diabetes patients is to take adequate doses of vitamin D3 to protect their insulin producing beta cells.
  3. A 2015 Italian study showed that micro vascular complications in diabetes patients were high, if the vitamin D3 blood levels were low. If patients had high levels of vitamin D3, there were no complications such as retinopathy or nephropathy. But if levels were below 20 ng/ml, damages were significant in the capillaries of the eyes and kidneys.

Do patients with inflammatory conditions take enough vitamin D3?

What do the lining of the arteries, the inflamed joints, a degenerative meniscus and heart attacks and strokes have in common? It is the inflammation that changes the body chemistry. It gets even more complicated, because the extra calories that we consume get stored as visceral fat. This is done automatically when you eat too much sugar and starchy foods. When the glycogen stores are full, any surplus sugar gets metabolized by the liver into triglycerides, fatty acids and LDL cholesterol and gets stored as body fat. The most active fat is the visceral fat between our guts and around our body organs. This produces interleukins and other inflammatory cytokines that circulate in the blood causing inflammation in all our arteries. Interleukin-6 is an inflammatory cytokine. High interleukin-6 levels contribute to causation of various cancers.

This 2015 study from Seattle University followed 218 obese postmenopausal women with a body mass index of larger than 25.0 for 12 months. Both received weight loss intervention and either 2000 IU of vitamin D3 daily or a placebo pill. Both groups lost about 5 to 10% of weight in 12 months. However, the interleukin-6 level of the vitamin D3 group had a reduction of 37.3%. This was in stark contrast to the placebo group where the interleukin-6 level reduction was only 17.2%. This type of research shows the incredible power of vitamin D3. This likely is the reason why several cancer frequencies can show a reduction with regular vitamin D3 supplementation.

Attention deficit disorder and vitamin D3

  1. Other research compared a group of 37 children with attention deficit hyperactivity disorder (ADHD to 37 normal children. Blood levels of vitamin D were 19.11±10.10 ng/ml in the ADHD group and 28.67±13.76 ng/ml in the normal group. Other researchers have found similar findings, establishing that very low vitamin D levels have a connection with ADHD.
  2. A prospective study from Spain involving 1,650 mother-child pairs investigated the effect of mother’s vitamin D level during her pregnancy with the risk for ADHD by the time the child was 4 to 5 years old. Schoolteachers followed the standard test procedures to establish the ADHD diagnosis. The study showed that for every 10-ng/ml increment of the mother’s blood vitamin D level during her pregnancy the children had 11% less ADHD-like symptoms. The authors cautioned that it takes mega doses of vitamin D3 to reach these kinds of results. The usual 400 IU of vitamin D3 per day will not achieve the desired increase of vitamin D3 levels, but amounts of 5,000 IU to 8,000 IU are necessary to achieve this.

Schizophrenia and vitamin D3

A 2014 Meta analysis found that low vitamin D levels have an association with a 2.16-times higher probability of having schizophrenia than controls with normal vitamin D levels. Another study examined whether those patients who had an acute psychosis would have lower vitamin D blood levels than schizophrenia patients in remission or control patients without schizophrenia. Studies compared 40 patients with an acute psychosis to 41 patients in remission and 40 healthy controls. Patients with an acute psychosis had extremely low vitamin D blood levels, while patients in remission had much better vitamin D levels. Healthy controls had the best vitamin D levels.

Absorption and metabolism of vitamin D3

Magnesium plays a central role in activating vitamin D3. This publication points out that magnesium is also necessary for absorption of vitamin D3 in the gut. The activation of vitamin D3 is also partially responsible for vitamin D absorption. Both vitamin D3 and magnesium play an important role in bone and calcium metabolism. The fact that every body cell has vitamin D3 receptors shows how important it is for the maintenance of the body. Many researchers say that vitamin D3 qualifies as a hormone because of the specific effects on cells via vitamin D3 receptors.

Take Enough Vitamin D3

Take Enough Vitamin D3

Conclusion

Vitamin D3 is an important signaling hormone and vitamin that regulates the body’s calcium absorption and is responsible for bone metabolism. Research has shown that the lack of vitamin D3 causes several unrelated diseases, like rickets, multiple sclerosis, and schizophrenia. But other diseases, where a lack of vitamin D3 was present, were diabetes, attention deficit disorder and strokes. When patients with elevated inflammatory markers take vitamin D3 their interleukin-6 levels dropped by 37.3%. To achieve this, patients needed to consume at least 2000 IU. We all should have our vitamin D blood level measured from time to time. It should be between 50 and 80 ng/ml. Too many Americans are deficient in vitamin D3 and come down with the diseases mentioned! Prevention and supplementation go hand in hand. You can prevent a lot of diseases this way.

 

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Oct
08
2016

Vitamin D3 Protects Your Brain

By | Alzheimer’s disease, Cancer, Dementia, Multiple sclerosis, Parkinson’s disease, Vitamins and supplements

More and more studies are showing that vitamin D3 protects your brain. It protects against MS, but also against Parkinson’s disease and Alzheimer’s disease. In the following I will review what evidence there is to support each of these topics.

Vitamin D3 protects your brain from multiple sclerosis (MS)

It has been known for some time that in the northern hemisphere MS is more common because of the lack of sunshine, which in turn produces less vitamin D3 in the skin.

MS is an autoimmune disease where immune cells attack the lining of nerves. Both nerve cells and immune cells have vitamin D receptors. It appears that immune cells are calmed down by vitamin D3 and remission of an MS relapse is more likely.

There are two forms of MS, the relapsing-remitting MS and the progressive MS. The first one (relapsing-remitting) is more common. After a bout of active MS, the illness calms down and the condition of the patient is stable for some time until the next relapse occurs.

With progressive MS there are two forms, primary progressive MS and secondary progressive MS. The primary form is a case of MS where symptoms steadily worsen, without any remission. The secondary form of progressive MS occurs at the end of fairly stable relapsing-remitting MS. Symptoms become more pronounced and the condition deteriorates steadily from there.

Progression and disability in MS patients with various vitamin D3 levels

Dr. Fitzgerald and colleagues published a study in JAMA Neurology in 2015.

They took 1482 men and women who were on interferon beta-1b treatment. This treatment utilizes the immunomodulator interferon beta-1b and reduces the number of relapses in patients with MS. The study took place between November 2003 and June 2005. Results were analyzed between June 2013 and December 2014. The researchers measured vitamin D levels (as 25-hydroxy vitamin D). The vitamin D levels were obtained at baseline, at 6 months and 12 months.

The number of brain lesions were measured by MRI scans. All of the patients also underwent a functional test, called expanded disability status scale. This measured impairment of ambulation, ability to communicate and activity levels.

Results of this study showed marked differences between patients with high and low vitamin D levels. Those patients who had the highest vitamin D blood levels (more than 40 ng/mL) had the lowest rates of new MS lesions. Previous studies had found that a low blood level of vitamin D (less than 25 ng/mL) in patients was associated with a much higher risk of developing MS. Dr. Fitzgerald’s study showed that a 50.0-nmol/L increase in serum vitamin D levels associated with a 31% lower rate of new MS lesions. Patients with the highest vitamin D level of more than 100 nmol/L had the lowest amount of new MRI lesions (47% less than the patients with the lowest vitamin D levels).

Another study showed that a low-dose vitamin D level accelerated MS. There was a 5.9-fold risk converting the initial relapsing-remitting form of MS into the secondary progressive form of MS.

All these studies show that vitamin D3 can decrease the risk of getting MS. In addition vitamin D3 also delays progression in those who have MS.

Vitamin D3 protects your brain from Parkinson’s disease

Vitamin D3 plays a role in preventing Parkinson’s disease.

Parkinson’s disease is a neurodegenerative disease that causes tremor in muscles, causes balancing problems and eventually can lead to dementia. A metaanalysis was done in 2014 and 7 studies where identified to be relevant. The authors were looking for correlation of vitamin D levels with Parkinson’s disease. The study included 1008 patients in the metaanalysis with 4,536 controls.

  • Patients with a vitamin D level of less than 75 nmol/L had a 1.5-fold higher risk of developing Parkinson’s disease than the controls.
  • Patients with a vitamin D level of less than 50 nmol/L were at a 2.2-fold higher risk of developing Parkinson’s disease.

Another metaanalysis utilized 5,690 Parkinson’s disease patients and 21251 matched controls.

It found that vitamin D levels of less than 20 ng/ml were associated with a risk of 2.08-fold to develop Parkinson’s disease. Interestingly, vitamin D3 supplementation reduced the risk of Parkinson’s disease by 38%. Outdoor work reduced the risk of developing Parkinson’s disease by 28%.

Vitamin D3 protects your brain from Alzheimer’s disease

Alzheimer’s disease is a neurodegenerative disease of old age. We know that it is much more common in patients with type 2 diabetes where insulin levels are high. Studies have shown that Alzheimer’s disease can be termed type 3 diabetes.

The resulting neurofibrillary tangles and amyloid-beta deposits damage nerve cells, which are responsible for the memory loss and the profound personality changes in these patients.

What does vitamin D3 have to do with this?

A 2014 study showed that a low vitamin D level was associated with a high risk of dementia and Alzheimer’s disease.

Specifically, the researchers found the following observations.

  • Vitamin D level of less than 10 ng/ml: 122% increased risk of Alzheimer’s
  • Vitamin D level 10 to 20 ng/ml: 51% increased risk of Alzheimer’s

The same research group found in two trials that vitamin D deficiency leads to visual memory decline, but not to verbal memory decline.

Vitamin D3 combined with metformin suppresses cancer

The newest development with respect to vitamin D3 is the finding that it also has anti-cancer effects. Dr. Li demonstrated that vitamin D reduced prostate cancer cell line growth by 45% while metformin alone reduced it by 28%.

But when both vitamin D and metformin were present in the cell cultures there was growth inhibition of 86%. Dr. Li explained that vitamin D potentiated the growth inhibitory effect of metformin.

Vitamin D3 protects your brain: guidelines to proper vitamin D3 dosing

For years the medical profession stated that 400 IU of vitamin D3 would be enough supplementation. It may be enough to prevent rickets in children. But these low doses will be insufficient in many patients who are deficient for vitamin D to prevent MS, Parkinson’s disease, Alzheimer’s disease or cancer.

A study on medical staff in Northern India showed that 85% of the staff had very low vitamin D levels of less than 10 ng/ml.

It took high doses of vitamin D3 to increase the vitamin D level in the blood.

Generally supplements of vitamin D3 of 5000 IU to 8000 IU are the norm now. But some patients are poor absorbers and they may require 15,000 IU per day. The doctor can determine the patient’s requirement for vitamin D by doing repeat vitamin D blood levels (as 25-hydroxy vitamin D). The goal is to reach a level of 50-80 ng/ml. The optimal level with regard to nmol/L is 80 to 200 (according to Rocky Mountain Analytical, Calgary, AB, Canada).

Vitamin D3 Protects Your Brain

Vitamin D3 Protects Your Brain

Conclusion

Many people are deficient with regard to vitamin D, and they do not know it. The most important thing is to do a vitamin D blood test to assess your vitamin D status.

We know for a long time that vitamin D plays a role in bone metabolism and this is why women approaching menopause often need vitamin D3 supplementation. But it may come to you as news that vitamin D3 also protects from MS, Parkinson’s disease and Alzheimer’s disease. In addition, as indicated above, we know that vitamin D3 when taken regularly suppresses many cancers.

When you realize that all body cells have vitamin D receptors on their surface, it is no surprise that vitamin D3 is so important to take. The vitamin D3 receptors must be there for a reason. When you deprive your body of this valuable vitamin, the high risk of degenerative diseases will be the consequence.

Jun
18
2016

High Vitamin D3 Prevents Cancer

By | Cancer, Heart Disease, immune system, Osteoporosis, Vitamins and supplements

In the last few years we learnt a lot about vitamin D3, but the newest thing is that high vitamin D3 prevents cancer.

Researchers at the University of California, San Diego School of Medicine reported that with respect to several cancer types higher doses of vitamin D3 led to less cancer over a period of time.

The cancers investigated were colon cancer, breast cancer, and lung and bladder cancer. People absorb vitamin D3 differently.  The researchers found that the best way to measure vitamin D3 concentration in the body is to use serum 25-hydroxyvitamin D (25(OH)D). In the past people did not pay much attention to this matter. However, several studies including the present study showed that in patients who had a lower level of 20 ng/ml cancer rates were higher.

Comparison of two cohort studies

The researchers used data from two prior studies, a randomized clinical trial of 1,169 women and a prospective cohort study of 1,135 women. The researchers found that the age-adjusted cancer incidence was 1,020 cases per 100,000 person-years in the randomized clinical trial, called “Lappe cohort”. The other prospective cohort study was called the “GrassrootsHealth cohort” where cancer incidence was 722 per 100,000 person-years. The interesting fact was that the Lappe cohort median blood serum level of 25(OH)D was 30 nanograms per milliliter, while the GrassrootsHealth cohort had a higher level of 25(OH)D of 48 ng/ml.

Higher vitamin D levels correlate with lower cancer incidence

This likely explains the lower cancer rate in the GrassrootsHealth cohort. Researchers combined the two trials in order to increase the statistical significance . The striking finding was that above 40 ng/ml the overall cancer risk was more than 71% lower than for the group of people whose level of 25(OH)D was 20 ng/ml or lower. The above ScienceDaily article was based on this scientific study.

Other studies showing high vitamin D3 prevents cancer

AfroAmerican men had less prostate cancer, if vitamin D level was higher

In a 2015 study Afro American men were found to have 71% less prostate cancer, if their serum 25-hydroxyvitamin D level was at least 30 ng/ml or higher.

Prospective study showing high vitamin D levels cancer protective

This 2006 study reported a 14-year prospective follow-up in men where all cancers were counted and blood serum 25-hydroxyvitamin D levels were correlated to cancer incidence. An increase of 25 nmol/L (=10 ng/ml) in predicted serum 25(OH)D level showed an association of a 17% reduction in total cancer incidence, with a 29% reduction in total cancer mortality and a 45% reduction in digestive-system cancer mortality. These investigators stated that it takes about 1500 IU of vitamin D3 increase per day to achieve an increment of serum 25(OH)D increment of 25 nmol/L (=10 ng/ml).

University of Arizona Cancer Center study

A publication from the University of Arizona Cancer Center in Jan. 2016 is more critical of the evidence regarding vitamin D3 and the claim that it lowers cancer rates. The researchers reviewed the cancer literature and found that for colorectal cancer there is a clear inverse relationship between serum 25(OH)D levels on the one hand and rates and mortality of colorectal cancer on the other hand. However, with breast cancer the literature was more divided. Only higher vitamin D levels were related to a lower risk for progression of breast cancer and a lower mortality rate. Randomized, double-blind clinical trials with regard to breast cancer failed to show effectiveness on cancer prevention or reduction of mortality. For prostate cancer conditions were similar with the exception of a study using 4000 IU of vitamin D3 per day, which inhibited progression of prostate cancer.

Mouse model regarding ovarian cancer and vitamin D

In a mouse model using a carcinogen to induce ovarian cancer there was an inverse dose-relationship between vitamin D3 and ovarian tumor development both in tissue culture and in the animal.

How high vitamin D3 prevents cancer

Immune stimulating effect of vitamin D3

Several studies have attempted to speculate how vitamin D3 may prevent cancer. Chirumbolo summarized the literature and noted that vitamin D3 has been shown to function as an immune cytokine stimulating the immune system non-specifically.  Vitamin D3 is also anti-inflammatory and counters insulin resistance and inflammatory kinins in obesity. Flavonoids with their antioxidant activity are also cancer preventing. We know that low levels of vitamin D have an association with higher cancer frequency. This means,. it is important to use vitamin D3 as supplements in our diet.

Chinese study describing action of vitamin D3 in detail

This Chinese study examined the effects of vitamin D3 on cancer prevention. It found that vitamin D3 combines three specific actions in one. Vitamin D3 is anti-proliferative meaning that it stops uncontrolled cell division. Secondly, it has an apoptotic (cell death) effect, which means it supports the removal of cells that are dying. If they are dying, but not removed, cancer can occur from these cell remnants. The third effect of vitamin D3 is that it has differentiating effects in several malignant cell types. When cancer cells are non-differentiated (=more immature cells) cancer can multiply quickly. Mature cells find it more difficult to turn cancerous. This is an effect that controls the speed by which cancer cells divide and how quickly cancer metastasizes.

High Vitamin D3 Prevents Cancer

High Vitamin D3 Prevents Cancer

Conclusion

There still is some confusion about the effects of vitamin D3 regarding cancer prevention. In colorectal cancer the statistics are clear: vitamin D3 can significantly prevent colorectal cancer to a large extent. There are also preventative effects in breast cancer and prostate cancer. But individuals may have to take at least 4000 IU of vitamin D3 or more. This is particularly true in higher latitudes where sunlight exposure is lower in the wintertime. Also, people absorb vitamin D3 differently. For this reason it is important to at least check your serum 25-hydroxyvitamin D levels on a few occasions. This will tell you whether your vitamin D3 supplementation is sufficient. Aim for levels in the 50-80 ng/ml, which is health promoting.

Apart from cancer prevention vitamin D3 is also important for prevention of cardiovascular disease. This is particularly true for diabetes, osteoporosis and Alzheimer’s disease.

Jan
18
2014

The Superpowers Of Vitamin D

By | Alzheimer’s disease, Arthritis, Asthma, Autism, Cancer, fractures, heart attack, Heart Disease, High Blood Pressure, Infectious Disease, Infertility, Medical Condition, Multiple sclerosis, Nutrition, Osteoporosis, Other neurological conditions, Prevention, Vitamins and supplements

Introduction

This article deals with the superpowers of vitamin D. Originally, researchers found that vitamin D was the missing ingredient in preventing rickets in growing children. They established that 400 IU of vitamin D daily prevented rickets. Medical investigators determined that the active metabolite was vitamin D. The body has receptors on all vital organs for vitamin D. This includes the heart, brain, bones, kidneys and liver. In recent years new findings showed that the RDA of 400 IU of vitamin D3 daily was too low for many diseases. In other words, many diseases can develop when vitamin D intake is too low, particularly in the aging population. Researchers showed that higher doses of vitamin D3 in the range of 800 to 1000 IU per day prevent osteoporosis, falls and fractures in older adults and in nursing home populations.

The immune system requires higher doses of vitamin D3

But the immune system of everybody is dependent on higher doses of vitamin D3. Recently (Dec. 12 to 15, 2013) I attended a lecture at the A4M conference in Las Vegas where Dr. Eisenstein reviewed the latest on vitamin D3. It is now known that 2/3 of the US population is deficient for vitamin D as measured by blood tests (less than 25 ng/ml).  The standard test is the 25-hydroxy-vitamin D level (abbreviated as 25(OH)D level). It is now known that you require at least a level of more than 40 to 60 ng/ml of 25(OH)D as measured in the US, which translates to more than 100 to 150 nmol/L measured in metric units in other countries, to prevent cancer.

The Super Powers Of Vitamin D

The Super Powers Of Vitamin D

Metabolism of vitamin D3

90% of the vitamin D3 that we need comes from exposure to sunlight. This transforms a cholesterol metabolite (7-dehydrocholesterol) into the vitamin D precursor (vitamin D3 or cholecalciferol). We absorb this from naturally occurring fish oil and oily fish. Otherwise this does not naturally occur in foodstuffs (Ref. 1). Dr. Eisenstein pointed out that it is well known that people living north of the 37th degree latitude lack vitamin D3 because of a lack of sun exposure, particularly in the winter season. People south of the 37th degree latitude have enough sun exposure. But wherever you live, it is advisable to have your vitamin D3 level measured (as 25(OH)D level). If you do not eat enough fish or fish oil, the levels likely are too low as is the case for 2/3 of the US population.

Oral vitamin D3 supplements

Patients whose vitamin D levels are too low have to take vitamin D3 supplements. Vitamin D3 is further metabolized by the liver and then by the kidneys into the active vitamin D compound, called 1,25(OH)2D3 (which is called “calcitriol”). The main effect of calcitriol is to absorb calcium and phosphate from the intestine into the blood stream. Together with vitamin K2 as explained in a prior blog these minerals are then taken up by the bone to prevent osteoporosis or rickets in the growing child. What has not been known for a long time is that vitamin D3 is also necessary for normal cell metabolism by most of your body cells, but particularly by the vital organs like the brain, the heart, the kidneys, the liver, the immune system and the bone.

Some people require higher doses of vitamin D3

However, doses of 5000 IU to 10,000 IU of vitamin D3 capsules per day are necessary for optimal vitamin D3 health. This leads to levels of below 150 ng/ml of 25(OH)D levels, which were shown by researchers to be safe. According to Dr. Eisenstein no toxicity has been found below 30,000 IU of vitamin D3 per day, but based on other authors a dose of 10,000IU should be adequate for most people. Strangely enough colored people also have to take vitamin D3 supplements as the higher melanin pigment in the skin filters out UV light so effectively that their 25(OH)D level can be low. Always err on the cautious side and have your vitamin D3 blood level taken. Vitamin D3 has a characteristic stereotactic configuration (cis-triene structure), which allows it to bind free radicals and function as an antioxidant (Ref.2).

What are some of the clinical effects of vitamin D3?

  1. Vitamin D3 has diverse effects on organs systems as Dr. Eisenstein summarized: vitamin D3 lifts depression and is of particular value for drug resistant depression. Take 5000 to 10,000 IU of vitamin D3 per day.
  2. Muscle power increases with vitamin D3, particularly in those who work out regularly.
  3. Many fertility clinics pay attention to vitamin D3 levels, as the higher the blood levels of vitamin D3 in a man, the faster this sperms move! And the more vitamin D3 she has on board, the better she ovulates. The end result is a higher pregnancy success rate when both partners take 5000 to 10,000 IU of vitamin D3 per day

Vitamin D improves teeth in offspring, helps with chronic pain

  1. Also, if a woman takes vitamin D3 during her pregnancy, the first set of teeth in the offspring will have fewer cavities.
  2. Brain development in autistic children is much improved with vitamin D3 in higher doses. This needs to be combined with detoxification methods and supervised by one of the DAN physicians.

6.Chronic pain typically improves when physicians treat vitamin D3 deficiency, which almost always is present in patients with chronic pain.

Prevention of flus and Covid-19, asthmatics improve

  1. To prevent flus and colds and other infectious diseases, take higher doses of vitamin D3. When you come down with a flu, it is safe to increase your daily vitamin D3 intake to 30,000 IU of vitamin D3 for a few days until your symptoms improve, then resume your maintenance dose of 5000 IU to 10,000 IU per day.  This year’s dominant flu is the type A, subtype H1N1 – also known as the swine flu. Children should get 50% of the dose regimen detailed for adults when they develop a flu (for children: 15,000IU for three to five days , with tapering to a maintenance dose of 2500 to 5000 IU until blood levels of 25(OH)D are available). Here is a website about the pros and cons of vitamin D where dosages are also discussed.
  2. Asthmatic patients do better with vitamin D3 supplements requiring less maintenance anti-asthmatic medicine to keep them balanced with regard to their airways.

Partial prevention of Alzheimer’s disease with vitamin D

  1. Chronic low vitamin D3 levels cause brain damage including Alzheimer’s disease. In this context it is important to know that the enzymatic conversion in the liver and kidneys slow down as we age.  Older patients require higher doses of vitamin D3. This may have been the reason for the confusion about relatively low doses of 400 IU of vitamin D3 preventing rickets in children versus the need for much higher doses of vitamin D3 in middle aged and older patients.
  2. There is a link of high blood pressure to vitamin D3 deficiency and it is better manageable with medication when vitamin D3 levels are normal.

Vitamin D lengthens telomeres and increases longevity

  1. Live longer with vitamin D3. How is this possible, you might ask: the answer has been found in the telomeres, the shoelace like structures at the end of the DNA strand of each cell. Vitamin D3 lengthens the telomeres and promotes telomere repair; there is an association of vitamin D3 and a longer life span. Centenarians have longer telomeres. You can measure telomere length, but it is a pricey test, which is not for everyone, contrary to supplementation with vitamin D3 that should be taken by everyone!

Vitamin D fights inflammation

  1. As already indicated, vitamin D3 strengthens the immune system. But it also modulates the inflammatory response from muscle damage, so athletes can perform better. Patients with multiple sclerosis will improve as it slows down the inflammatory process. But other inflammatory diseases like arthritis, inflammatory bowel disease and even cancer respond favorably to higher doses of vitamin D3. In these cases physicians use 20,000 to 30,000 IU of vitamin D3 daily. This information has not yet percolated into mainstream medicine.
  2. Higher percentages of cardiovascular disease occur in patients who have lower than 15 ng/ml  25-Hydroxy-vitamin D levels in their blood meaning that vitamin D3 supplementation prevents heart disease (Ref.3).

What are toxic vitamin D levels?

What is known about the safety of vitamin D3, particularly the higher vitamin D3 doses? First, it is wise to have your 25(OH)D blood levels taken from time to time. If vitamin D blood levels exceed 150 ng/mL reducing the vitamin D dose or stopping supplementation is prudent. Otherwise it has been difficult to establish a toxic range. Most publications about toxic levels of  vitamin D point out that anything above 150 ng/mL would be in the toxic range.

This website claims that 40,000 IU of vitamin D3 or more would lead to toxic levels where the blood calcium levels would be increased, which can be measured as hypercalcemia. However, another study done in 2007 showed in MS patients that took 40,000 IU per day and that led to a blood level of 400 ng/ml of 25(OH)D did not lead to increased calcium levels and did not lead to hypercalciuria (too much calcium in the urine).

Toxic vitamin D levels difficult to find

The papers that indicated that it would be unsafe or unnecessary to take vitamin D3 were untrue. It seems that they had other agendas than communicating the truth. There was no release of calcium from the bones and calcium absorption from the gut was not too high. This would have caused calcification of the bones, soft tissues, heart and kidneys. Also, kidney stones would have developed. However, a low calcium diet combined with corticosteroid drugs usually leads to a full recovery within a month. Interesting that all of the dire predictions regarding toxic vitamin D3 levels did not materialize. Here is another website discussing vitamin D3 dosing.

Patient taking unintentional high doses of vitamin D3 survived

I talked to a participant of the conference with a fellowship degree in anti-aging medicine what knowledge we have about vitamin D3 toxicity. He told me that there has been an unintentional overdose. In this case a compounding pharmacy made a mistake. A patient accidentally received a dosage of 500,000 Units of vitamin D3 per day for a full three months. The patient felt sluggish, but did not have any other symptoms. His physician told him to stop the vitamin D3 compound. He had an uneventful recovery with no detrimental effects. At this point no documented overdose of vitamin D3 exists.

Conclusion

Vitamin D3 is a vital supplement. Initially researchers showed that it prevents rickets in children. Subsequently physicians found that it also prevents depression, MS, infections and many cancers (Ref. 4). As usual there will be many critiques that doubt the validity of the above statements. But I have found that all of these effects described above were confirmed in several sources of various medical information. Keep in mind that negative rumours have a tendency to linger on for years.

More information on vitamin D3 for prevention of osteoporosis and hardening of arteries: https://www.askdrray.com/calcium-vitamin-d3-and-vitamin-k2-needed-for-bone-health/

Vitamin D3 deficiency can cause pancreatic cancer: http://nethealthbook.com/news/insufficient-vitamin-d3-linked-to-pancreatic-cancer/

References

1. McPherson: Henry’s Clinical Diagnosis and Management by Laboratory Methods, 22nd ed.,  © 2011 Saunders

2. Rheumatic Diseases Clinics of North America – Volume 38, Issue 1 (February 2012) , © 2012 W. B. Saunders Company

3. Wang TJ, Pencina MJ, Booth SL, et al:  Vitamin D deficiency and risk of  cardiovascular disease.   Circulation 117. (4): 503-511.2008.

4. “Recognition and Management of Vitamin D Deficiency”: American Family Physician – Volume 80, Issue 8 (October 2009),  © 2009 American Academy of Family Physicians

Mar
17
2013

Calcium, Vitamin D3 and Vitamin K2 Are Needed For Bone Health

By | Fitness, fractures, Hormones, Osteoporosis, Prevention, Vitamins and supplements

Introduction

I am reviewing in this blog why calcium, vitamin D3 and vitamin K2 are needed for bone health. Recently there has been a lot of coverage in the press regarding postmenopausal treatment of women to prevent osteoporosis. It is all based on this original publication February 26, 2013.

Essentially, there are a number of studies where researchers did a meta-analysis of several trials. They studied osteoporotic bone fracture frequency in female subjects taking 400 IU vitamin D and 1000 mg calcium daily. The researchers measured the frequency of osteoporotic fractures as the indicator  for osteoporosis in these postmenopausal women. The conclusion was that there was no value in taking these supplements to prevent osteoporosis. Many other media publications carried this story.

No kidney stones in study with calcium and vitamin D3

Just two days earlier (Feb. 24, 2013) another study was released with a much larger patient base of 36,282 postmenopausal women of the Women’s Health initiative in the US who were followed up for 7 years. Initially there confusion how compliant the patients were taking their supplements. The required supplementation consisted of 1000 mg of calcium carbonate and 400 IU of vitamin D3. 7 years into the trial the researchers compared the supplement compliant group with the control group taking placebos.

Calcium and vitamin D3 supplementation significantly reduces risk of hip fractures

The study group had 35% to 38% less fractures of the hip than the placebo group. This supplementation did not cause kidney stones in the study group. This was in contrast to what previous smaller studies showed. Some physicians insisted citing the older studies that vitamin D3 and calcium supplementation would cause kidney stones. But the above study refutes the causation of kidney stones by supplementing with vitamin D3 and calcium. In other words, all of these kidney stone concern you have so often read in the media are not true.

Outline of this review

In order to make sense of supplementation as osteoporosis prevention I will first review what a normal bone metabolism requires.  I will then comment on what is missing in some of the studies and why it still makes sense to supplement to prevent osteoporosis. In addition, at the end of this blog I will also recommend a sensible supplementation regimen.  All this is based on a balanced review of the medical literature.

Calcium, Vitamin D3 and Vitamin K2 Needed For Bone Health

Calcium, Vitamin D3 and Vitamin K2 Needed For Bone Health

Bone metabolism

But vitamin D3, vitamin K2 and strontium together have also been shown to build up bone density within one year.

So, how does vitamin K2 deposit calcium into the bone? Vitamin K2 stimulates a hormone, called calcitonin, which is produced by specialized C cells (parafollicular cells) inside the thyroid gland and released into the bloodstream. Calcitonin arrives in the bone where it binds firmly with receptors of osteoclasts (bone remodeling cells), which stops breakdown of bone. Calcitonin is helped by another hormone, called osteocalcin, which is produced by the bone producing cells with the name osteoblasts.

Vitamin K2 controls osteocalcin, which is a calcium-regulating hormone

The physician can measure osteocalcin levels in the blood and use this as a research tool to see whether a medication is effective in building up bone mass density (BMD). Vitamin K2 control osteocalcin as a calcium-regulating hormone. If vitamin K2 is present, carboxylation of osteocalcin will lead to mineralization of the bone (new bone formation); if vitamin K2 is absent, osteoporosis sets in.

The skeleton of an average adult contains 1–1.3 kg of calcium and 99% of this is mostly in the form of hydroxyapatite.

The key vitamins for bone metabolism are vitamin D and vitamin K2

Calcium absorption from the small intestine requires vitamin D3 (Ref.1). To transport calcium from the blood into the bone we require both vitamin D3 and vitamin K2 (=menaquinone). This blog explains that several studies have shown that vitamin K2 (or MK-7) plays a double role of preventing calcification of the arteries and bringing the calcium into the bones of osteoporotic women.

Apart from Vitamin K2 that is necessary for osteoporosis prevention other factors have shown to be of importance. For instance, testosterone is an anabolic hormone (meaning a hormone that builds up) and it has clearly been shown that it is bone building: It does so by stimulating osteoblasts, which are bone producing cells that reside inside the bone.

Vitamin D3, vitamin K2, Calcitonin and osteocalcin

But vitamin D3, vitamin K2 and strontium together have also been shown to build up bone density within one year.

So, how does vitamin K2 deposit calcium into the bone? It does so by stimulating a hormone, called calcitonin, which is produced by specialized C cells (parafollicular cells) inside the thyroid gland and released into the blood stream. Calcitonin arrives in the bone where it binds firmly with receptors of osteoclasts (bone remodeling cells), which stops breakdown of bone. Calcitonin is helped by another hormone, called osteocalcin, which is produced by the bone producing cells with the name osteoblasts.

Vitamin K2 controls osteocalcin, which is a calcium-regulating hormone

Osteocalcin levels in the blood can be measured and used as a research tool to see whether a medication is effective in building up bone mass density (BMD). Vitamin K2 controls osteocalcin as a calcium-regulating hormone. If vitamin K2 is present, carboxylation of osteocalcin will lead to mineralization of the bone (new bone formation); if vitamin K2 is absent, osteoporosis sets in.

Vitamin K2 also prevents heart attacks and strokes

Vitamin K2 has a second function: it removes calcium from the arterial walls and tissues. How does it do this?

Matrix GLA protein is found in tissues of the heart, lungs, kidneys and blood vessels. When vitamin K2 stimulates carboxylation of this protein, it will function like a broom and clean out calcium deposits (calcification) from blood vessels and organ tissues. As vitamin K2 is needed for this carboxylation process, it appears that nature had in mind to remove calcium from soft tissue organs and blood vessels and form hydroxyapatite in the bone for bone strength.

Vitamin K2 is the key to deposit calcium into the bone

It seems that vitamin K2 is the key vitamin necessary to do this job. Another player is magnesium, which is part of of the normal function of more than 300 cellular enzyme systems. In terms of hormones the three hormones parathyroid hormone (PTH), vitamin D3 and calcitonin need to interact normally, all requiring magnesium as cofactor. In addition, zinc, copper, boron, and manganese are also essential as trace minerals. They act as cofactors with regard to specific enzymes of the bone metabolism (Ref. 1).

Bioidentical hormone replacement essential after menopause and andropause

In the aging person hormonal deficiencies are also factors for causing osteoporosis to develop. As this link shows, Dr. John Lee found bioidentical progesterone topical cream very helpful in women with respect to increasing bone mass density by 15% over 3 years.

When bloods tests show testosterone depletion men need to replace what is missing with bioidentical testosterone. So, bioidentical hormone replacement in both men and women is part of a bone health management program to prevent osteoporosis.

Some trials that demonstrate how you can build up bone

  • In this paper parathyroid hormone  was used in combination with 1000 mg of calcium and 400 IU of vitamin D3 in a group of postmenopausal women with osteoporosis. Within 3 month of treatment there was an increase of bone mass density in the lower back (lumbar spine) of 4.7%, which translates into a yearly increase of bone mass density of 18.8%. In the past when physicians tested other agents for bone regeneration, this type of result never occurred. There is a  variation of this hormone,  a parathyroid hormone look-alike with the name Teriparatide (PTH 1-34). The patient administers this once daily as an injection of 20 mcg up to 2 years. Physicians found this useful in treating fractures of the vertebrae and other fractures in osteoporotic postmenopausal women (Ref.2).

Effect of Vitamin K2, estrogen and calcium citrate supplementation

Calcitonin and calcium strontium

  • Calcitonin is very effective in reducing bone pain when the patient has compression fractures from osteoporosis; the physician can prescribe it as an intranasal spray of 200 units daily (Ref. 2). However, on March 5, 2013 the FDA announced that salmon calcitonin would not be safe for humans as there is a slight risk that cancer can develop as a “side-effect”.
  • According to Ref. 2 physicians sometimes use strontium ranelate in Europe for the treatment of postmenopausal osteoporosis. Researcher showed that strontium ranelate builds up bone and decreases the amount of bone resorption. Side effects include nausea and diarrhea.

The team players of bone metabolism to build strong bone

We are now in a position to analyze why the researchers of the first paper (citation above) concluded that calcium and vitamin D3 supplementation were not enough to make a statistical difference in the treatment of postmenopausal women in comparison to placebos. As explained bone metabolism is a complex process involving several team players, where the key player is vitamin K2, which the researchers of that study ignored completely. The examples I mentioned above in point form show that exercise and calcium are also important. Vitamin K2 by itself worked quite well as it is so powerful. Hormones like PTH and calcitonin are effective, but more difficult to take for the average consumer and the FDA now has banned calcitonin.

Importance of vitamin D3 as a supplement

Vitamin D3 is important for absorption of calcium from the intestine, but also for depositing calcium into the bone in addition to vitamin K2. The WHI study mentioned above is highly significant because of a 1/3 reduction of hip fractures after 7 years of vitamin D3 and 1000 mg of calcium per day supplementation. If you add vitamin K2, exercise and bioidentical hormone replacement in postmenopausal women who need it, the prevention of hip fractures, wrist fractures and vertebral compression fractures likely will be as high as 50% in those who are taking their supplements regularly (compliance issues like forgetting the supplements or deliberately not taking them were mentioned in several of the studies).

Vitamin K2 helps to reduce heart attacks, strokes and osteoporosis

With the right supplementation, which includes vitamin K2 as mentioned above, you achieve that you lower your heart attack and stroke risk as the vitamin K2 removes the calcium from the blood vessels and deposits it into the bones, while at the same time strengthening your bones. Attention to proper nutrition, exercise and your hormone balance (using only bio-identical hormones to replace what’s missing) will also reinforce osteoporosis prevention. The bonus of using bioidentical hormone replacement therapy is that you prevent heart attacks and strokes in addition to preventing osteoporosis. I think that this is a good deal!

An easy-to-follow osteoporosis prevention program

The best combination is 1000 mg (or 1200 mg as per National Osteoporosis Foundation recommendation) of calcium per day together with 400 to 800 IU of vitamin D3 (for cancer prevention you may want to take 4000 IU to 5000 IU of vitamin D3 per day instead monitored by a 25-hydroxyvitamin D blood level test through your physician) and 100 to 200 micrograms of vitamin K2 (also called MK-7). In the age group above 50 several hormones can be missing.

Hormone depletion in menopause and andropause

That’s why the doctor recommends bioidentical testosterone in men and bioidentical progesterone/estrogen combinations in women with hormone depletion. This works best, if you also watch your weight and cut down your alcohol consumption to a minimum. Cutting alcohol out completely would be even better. In addition, exercise regularly as this builds up bone and muscle strength.  It also helps, if you stick to a balanced diet (Mediterranean or Zone type diet). These diets are low-glycemic, low fat, wheat free and without sugar).

If you want to age gracefully, you need not only a healthy heart and a healthy brain. You also need healthy bones as this prevents disabilities.

References

  1. McPherson: Henry’s Clinical Diagnosis and Management by Laboratory Methods, 22nd ed. Copyright © 2011 Saunders, An Imprint of Elsevier
  2. Rakel: Integrative Medicine, 3rd ed. Copyright © 2012 Saunders, An Imprint of Elsevier

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I received the following feedback (Originally on Nov. 10, 2013)

 Dr. Ray, I read your March 17 Blog entry which suggested 100 ug of Vitamin K2 with 5000 IU of D3.   I have atherosclerosis and have radically changed my diet (plant only), but also now take an average of about 3000 IU of Vitamin D3. Dr. Kate Rhéaume-Bleue (book on K2) recommended taking about 200 ug per day of K2, but increasing K2 to about 1,000 ug if taking around 5,000 IU of D3 to ensure proper activation of MGP. What is your opinion with regard to a D3/K2 ration?  Thank you

 Answer from Dr. Ray (Originally on Nov. 12, 2013, modified April 29, 2021)

I appreciate your question about what doses of vitamin K2 to take. There are varied recommendations, but I like to go by human trials and what they have actually shown. In this review in 2010 from the Life Extension Magazine a study is cited that showed that only 45 micrograms of vitamin K2 was enough to get the calcium out of the arterial walls and into the bones.

200 micrograms of Vitamin K2 daily

Dr. Mercola reviewed the literature and found that most investigators were now using 180 to 200 micrograms. In the past I took 100 micrograms of vitamin K2 per day. However, a few years ago I increased it to 200 micrograms per day. With regard to vitamin D3 absorption my anti-aging doctor found that I have an absorption problem regarding vitamin D3. This is why I need 10,000 IU of vitamin D3 daily. This brings my vitamin D blood level up into the high normal range (between 50 and 80 ng/mL). Toxic vitamin D blood levels start only above 150 ng/mL.

Avoid sugar and too much starch consumption

Remember that other risks for cardiovascular disease are sugar and starch consumption. The liver turns this into triglycerides and too much LDL cholesterol, which plugs up your arteries. Avoid wheat because of the gliadin content. This causes an addiction to wheat and sugary foods. Here is a summary how leaky gut syndrome and autoimmune illnesses may develop from this. If you want to consume beef, reduce your consumption to once or twice per week. It id best to stick to only eat grass fed, antibiotic free beef). But I rather prefer to eat organic chicken, turkey and lean pork. I understand that you have a plant only based diet, but I would recommend to you to reconsider that. Ask your doctor to check your ferritin from time to time. This way you do not miss an iron deficiency that may develop. For other readers: Don’t forget your vegetables (organic, please).

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Apr
01
2006

Vitamin D Deficiency Affects Asthma

By | Asthma, Nutrition, obstetrics, Vitamins and supplements

New findings from an observational study point to the intake of vitamin D during pregnancy as a way to curb childhood asthma.
Dr. Carlos Camargo at Harvard Medical School and his colleagues followed more than 2000 pregnant women and their children, and data on 1,194 subjects over the span of three years are now available. Risk factors for asthma in the children at age 3 showed an inverse relationship with the women’s consumption of vitamin D. The lowest intake of vitamin D was 356 IU; the highest was at 724 IU.
The children of mothers who consumed the highest amount of vitamin D were half as likely to have wheezing in the first three years of life compared to those whose moms had the lowest vitamin D intake.

The children’s vitamin intake did not have any effects on the result, suggesting that it is within pregnancy vitamin D supplementation is of importance.

A study of investigators in London going back to 2005 reaffirms the fact, that vitamin D has a positive impact on respiratory health. Vitamin D was given to steroid-resistant asthmatics. Authors of the study suggested that the therapeutic response to glucocorticoids was increased in this group.

Vitamin D Deficiency Affects Asthma

Vitamin D Deficiency Affects Asthma

Further epidemiological investigations are needed to study the benefits of vitamin D as an inexpensive prenatal supplement to prevent childhood asthma.

More informaation on:

1. Asthma: http://nethealthbook.com/lung-disease/asthma-introduction/

2. Vitamin D3: http://nethealthbook.com/news/higher-vitamin-d-levels-associated-lower-risk-mortality/

Reference: The Medical Post, March 21, 2006, page 1 and 60

Last edited Oct. 31, 2014

Feb
01
2004

Less Multiple Sclerosis (MS) With Vitamin D Supplement

By | Multiple sclerosis, Uncategorized

In multiple sclerosis (MS) the body’s immune system appears to attack the insulation material of nerve cells (called “demyelination”) leading to areas of focal inflammation. These areas can be depicted with MRI scans (see white MS lesions, compared to a normal brain). A new study showed that vitamin D supplementation (as part of a multivitamin supplement) was reducing the risk of developing MS in women when compared to women who did not take supplements. This study was published by Munger et al. from the Department of Nutrition, Harvard School of Public Health, Boston/MA, in the Jan. 13, 2004 edition of Neurology.

The study is based on data from two large nurses health studies (NHS with 92,253 women followed from 1980 to 2000 and NHSII with 95,310 women followed from 1991 to 2001). The study material was pooled into one database. Among these 187,563 women 173 developed MS during the course of the original studies. When the group of women who took 400 IU or more of Vit.D supplements (as multivitamins) were compared to the group who took less than 400 IU or none, the investigators found that they were 40% less likely to develop MS. Other factors that can lead to higher frequencies of MS such as smoking or latitude at birth had been adjusted for. There has not been a change in the results of the protective effect of Vit.D. With food being the only source for vitamin D (skim milk, fish) the protective effect against MS was not demonstrable. However, when food vitamin D was combined with additional multiple vitamin tablets (with vitamin D) the protective effect against MS was observed.

Less Multiple Sclerosis (MS) With Vitamin D Supplement

Less Multiple Sclerosis (MS) With Vitamin D Supplement

In the introduction the authors pointed out that Vit. D has been shown in other studies to be an immune response modulator weakening autoimmune reactions. This effect has been shown clearly in a mouse model of MS, called experimental autoimmune encephalopathy. There are also data available from human research, which showed that certain cytokines are released in the presence of vitamin D so that the immune cells are less likely to attack the brain tissue. There were also seasonal variations that could be demonstrated in this study, which indicated that MS lesions were progressing at times when vitamin D levels were low and that they were regressing when vitamin D levels were high.

The authors of this study stressed that this is the first study to suggest a protective effect of vitamin D against MS, which would have to be confirmed in other studies that preferably would also include males. It shows a very strong statistical connection, but cannot conclusively prove causation. The investigators said that further studies will also be needed to confirm the notion that vitamin D may be beneficial as part of the treatment in MS patients.

Link regarding vitamins and minerals: http://www.nethealthbook.com/articles/vitaminsmineralsandsupplements.php#vitaminsandminerals

Last edited December 8, 2012

Oct
03
2020

Fibrotic Eye Disease Responds to Nicotinamide (Vitamin B3)

By | Dementia, Vitamins and supplements

A new study from Mt. Sinai Hospital showed that fibrotic eye disease responds to nicotinamide (vitamin B3). In general, during wound healing there can be aggressive cell transformations.  This can cause scarring, retinal detachment and finally loss of vision and even blindness. Notably, the following pieces of evidence support the notion that vitamin B3 (nicotinamide) helps to make eye diseases better.

Lab experiments made in Petri dishes

Specifically, researchers performed experiments in Petri dishes with human adult cells. After adding nicotinamide, they found the following.

  • There were no harmful cell transformations
  • Membrane formation in conjunction with scar formation was reversed
  • There is a slow-down regarding the development of eye diseases that lead to loss of vision and blindness

Vitamin B3 was first detected as a cure to Pellagra

Pellagra, the vitamin B3 deficiency was first described by the Spanish physician, Don Gaspar Casal in 1763. Typically, pellagra presents with dermatitis, diarrhea and dementia. If left untreated it will lead to death. The skin showed inflammation, particularly in areas where there was exposure to the sun or to friction. Affected skin may be darker. Pellagra occurs mainly in the developing world, particularly in sub-Saharan Africa.

Experiments with vitamin B3 on mice curing eye disease

In a mouse model researcher showed that vitamin B3 could largely prevent the development of glaucoma in aging mice. According to these researchers 93% of the mice with the higher dose of vitamin B3 did not develop glaucoma. Vitamin B3 (the precursor of nicotinamide) is important for the production of NAD+ and the phosphorylated form NADP, which are cofactors in the energy producing metabolism of mitochondria.  

Experiments on rabbits showing a cure with nicotinamide

In a 1985 publication rabbits were subjected to a vitamin B3 inhibitor, namely 6-aminonicotinamide. This is an antimetabolite of nicotinamide. It was given by intraabdominal injection. The rabbits developed diarrhea, ascending paresis/paralysis and death. They also developed vascular lesions in the eyes, particularly the iris with an acute inflammation of the iris, which physicians call iritis. The ocular lesions could be prevented by administering nicotinamide. The researchers concluded that vitamin B3 deficiency was responsible for the eye lesions.

Clinical trials show a response of glaucoma to vitamin B3

In a clinical trial physicians compared 34 primary open-angle glaucoma (POAG) patients with a control group of 30 age- and sex-matched controls. The researchers measured plasma nicotinamide concentration in both groups. The POAG patients had on average 33% lower nicotinamide plasma levels than the control group. They concluded that glaucoma seems to be associated with lower plasma nicotinamide levels. The research team suggested that these findings need to be confirmed in a larger series of glaucoma patients. They also suggested that vitamin B3 therapy could become one of the treatment modalities.

Fibrotic Eye Disease Responds to Nicotinamide (Vitamin B3)

Fibrotic Eye Disease Responds to Nicotinamide (Vitamin B3)

Conclusion

We know vitamin B3 deficiency mainly as pellagra. It occurs mainly in the developing world, particularly in sub-Saharan Africa. But newer experiments in vitro, in mice and in rabbits showed that vitamin B3 deficiency can also cause eye disease. Other studies showed that fibrotic eye disease responds to nicotinamide (vitamin B3). In addition, a clinical trial in humans showed that glaucoma can develop as a result of a 33% lack of plasma nicotinamide (vitamin B3) level. Regular supplementation in those who are prone to vitamin B3 deficiency may be curative for eye disease.