Vitamin D for what ails you
Posted by Dr. Ruth Bar-Shalom ND (ruth) on Jan 29 2010 at 3:40 PM
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Let the Sunshine In!

Vitamin D boosts health, lowers cancer rates

New science on vitamin D is breaking on all fronts. While I’ve written about these developments in the past, it’s time to bring you up to date on the sunshine vitamin. As an action item, I urge you to find out if you're getting enough vitamin D.

According to researchers at McGill University in Montreal "virtually every cell" in the human body has receptors for vitamin D and hundreds of different genes may be regulated by it.

 Vitamin D plays a major role in keeping a broad category of cells healthy. These are the cells that cover the surfaces of our internal organs and line the inside walls of the stomach, intestine and colon. These tissues, called epithelium, amount to only about two percent of the weight of our bodies, but are the source of about 85 percent of cancers called carcinomas. Let me repeat: in two percent of tissue, 85 percent of cancers occur.

Carcinomas develop in the colon, prostate, pancreas and uterus, along with the most common type of breast cancer, ductal carcinoma. (The other main type of cancer called sarcomas, appear in muscles and connective tissue, and don't have a strong association with vitamin D insufficiency.)

Cedric Garland, a professor of preventive medicine at the University of California, San Diego, concurs, saying, "Vitamin D is a particularly effective agent in inhibiting abnormal growth or development of malignancies in epithelial tissues.”

This data bears our immediate attention. It’s clear that vitamin D offers significant cancer risk reductions.

Need more evidence? Consider a 2007 U.S. finding that overall risk of cancer in women was cut by 60 percent when they were given 1,100 IU of vitamin D per day, plus a calcium supplement.

Another study, this one from Canada, estimated the dose needed to cut colon cancer risk by 50 percent was 1,000 IU daily. The study went on to say that the amount of vitamin D needed to cut breast-cancer risk in half is 4,000 IU daily.  

There is some evidence that girls can cut their future risk of breast cancer by taking high levels of vitamin D during their teens. Further studies are under way, however, it’s now clear that the sunshine vitamin is a key feature in body maintenance and in preventing cancer.

Data from a major journal shows that as levels of vitamin D in the blood rise, the odds of getting colorectal cancer go down. According to the numbers, patients with relatively high levels in their blood had a 72 percent lower risk of dying from colorectal cancer. Ref: Gorham et al. Optimal Vitamin D status for Colorectal Cancer Prevention: A Quantitative Meta Analysis. American Journal of Preventive Medicine 2007;32(3)

Vitamin D Improves Mood 

Depression is being treated with vitamin D and the results are exciting. A 2008 study presented in the Journal of Internal Medicine reported that researchers, working in a double-blind protocol, randomly gave vitamin D or a placebo to 441 overweight Norwegians. Results showed that the lower their initial vitamin D blood levels, the more likely they were to be depressed.

Subjects took either 20,000 IU, 40,000 IU or a placebo once a week for a year.  Of the participants who completed the study, the more vitamin D they took, the better they felt.

Depression as measured by a standard questionnaire decreased by 33 percent in the group receiving 40,000 IU per week, by 20 percent in the group receiving 20,000 IU per week and by 5 percent in the placebo group, though the decrease in the last group was not statistically significant. Ref: J Intern Med. 2008 Dec;264(6):599-609. Epub 2008 Sep 10

Vitamin D and Seasonal Affective Disorder (SAD)

While there were only 15 patients with SAD in this study, it reflects the ongoing trends in the research field. Patients were randomly chosen to receive high doses of the vitamin, 100,000 IU of vitamin D-2 or two hours of photo therapy daily (a tanning bed) for a month. The patients who received the vitamin D showed their depression score improve by 43 percent while the photo therapy group was unchanged. Ref: J Nutr Health Aging. 1999;3(1):5-7. Vitamin D vs Broad Spectrum Photo Therapy in the Treatment of Seasonal Affective Disorder. Gloth FM 3rd, Alam W, Hollis B.
 
Menstrual Migraine Relief

Are you troubled by migraine headaches? We know that calcium levels regulate the tone and elasticity of blood vessels. Calcium also plays a role in blood thickness. Guess what? Vitamin D regulates calcium levels. Both blood calcium and blood coagulation numbers are out of whack in people who suffer from migraine headaches. I’m aware of several published reports of menstrual-timed migraine headaches improving over time with vitamin D and calcium supplementation. Ref: Headache. 1994 Oct;34(9):544-6. Vitamin D and Calcium in Menstrual Migraine. Thys-Jacobs S.
 
Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome is seen only in humans and is classically characterized by polycystic ovaries, amenorrhea (absent menstruation), body hair growth, insulin resistance, and obesity. The study group, 13 women with PCOS, were vitamin D deficient. After three months, supplementation with 1500 mg of calcium a day and 50,000 IU of vitamin D2 every week normalized menses and fertility.

In recent years, PCOS has been treated by targeting insulin resistance with the drug Metformin, a drug commonly used to treat Type II diabetes. In a study completed in 1999, vitamin D appears to be more effective at reducing insulin resistance than Metformin. Replacing the drug with vitamin D offers greater effectiveness and lower costs.

Ref: Steroids. 1999 Jun;64(6):430-5.
Vitamin D and Calcium Dysregulation in the Polycystic Ovarian Syndrome.
Thys-Jacobs S, Donovan D, Papadopoulos A, Sarrel P, Bilezikian JP.
 
Persistent Musculoskeletal Pain

People who have persistent aches and pains, without a history of trauma, are likely vitamin D deficient. Researchers at the Mayo Clinic reported that 130 out of 150 patients evaluated for chronic musculoskeletal pain were vitamin D deficient.

A 2003 study in the journal Spine looked at data from Saudi Arabia. Of 360 people with low back pain, 83 percent or 299 had low levels of vitamin D. Vitamin D supplements reduced pain in people who started out with low levels. It also helped a few people who had normal levels. According to the authors, 93 percent of the study participants improved with vitamin D.

Ref: Mayo Clin Proc. 2003 Dec;78(12):1463-70. Prevalence of Severe Hypovitaminosis D in Patients with Persistent, Nonspecific Musculoskeletal Pain. Plotnikoff GA , Quigley JM.

Vitamin D Deficiency Awareness - points to remember!

As people age, the skin is less capable of producing vitamin D from exposure to the sun. The science in this regards is thin; no precise age cutoff has been determined. Supplementation covers this grey area.

People with dark skin, Blacks, American Indians and other races, are at risk because dark pigment acts as a natural sunscreen, making it harder to produce the vitamin. Supplementation is addressed in this feature.

Since there are fewer farmers, less outdoor jobs, and more inside work, people are exposed to less sunlight than a generation ago, supplementation makes sense. Additionally, we wear clothing that covers most of our skin.

Contraindications - when to avoid

If you have abnormal kidney function or  hypercalcemia (high levels of calcium in the blood), vitamin D supplementation is not advised. If you have chronic kidney disease (CKD) and have questions about vitamin D, please contact the clinic.

Is Sun Exposure Enough? - not likely

An Israeli study (keep in mind these people tend to live in shorts and sandals), also showed surprisingly high occurrence of  vitamin D deficiency. In a review of routine hospitals admissions, 57 percent had low vitamin D levels.

Ref: Israel Med Assoc. J. 2004 Feb;6(2):82-7. Hypovitaminosis D Among Patients In a Sunny Country. Hochwald O, Harman-Boehm I, Castel H.

Vitamin D and Heart Disease

The numbers are impressive. Low Vitamin D doubles your risk of a heart attack or the other way around, good vitamin D levels cut your heart attack risk by half.

Based on a study from New Zealand, people with low levels of Vitamin D (25(OH)D of less than 34 ng/ml) have twice the number of heart attacks of people who have a 25(OH)D result greater than 34.

Ref: Int J Epidemiol. 1990 Sep;19(3):559-63. Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study.
Scragg R, Jackson R, Holdaway IM, Lim T, Beaglehole R. Department of Community Health, University of Auckland , New Zealand.

Food Sources of Vitamin D

Few foods contain vitamin D in significant quantities. However, you can find high quality vitamin D in: cod liver oil (1,300 IU per tablespoon); wild salmon (1,000 IU per 6 oz serving); farmed salmon (250 IU); sardines (600 IU); shrimp (600 IU) fortified milk or orange juice (100 IU); egg yolk (25 IU); fresh shiitake mushrooms and some organ meats (traces in both).

Checking Your Vitamin D Levels

Vitamin D blood levels are measured by a test called 25 (OH)D. This is the most accurate measure of the amount of vitamin D in the body.
Standard lab values in the US are currently inadequate for assessing accurate vitamin D status. At our clinic, we use the following values to interpret 25(OH)D test results:

< 20 ng/mL: deficient
< 30 ng/mL: insufficient
40-65 ng/mL: optimal
> 80 ng/mL: excess

This index refers to nanograms per millilitre.  

While I usually think it best to see patients in person before prescribing high doses of vitamins, I’m making an exception with Vitamin D3. The verdict clearly supports the efficacy and safety of this vitamin. 

(Note: several of the studies listed here refer to vitamin D2; I prefer to recommend vitamin D3 for its higher potency and assimilation features.)

If you’d like your D levels checked, e-mail the clinic and we will send you a laboratory order accepted by local testing services. The cost is $42.00, if you pay upfront. Beware of a highly inflated $300.00 fee, if the lab bills you instead. Some insurance policies cover the test; check to see if it’s an allowed expense.  

Personally, I like to see levels between 40-65 ng/ml, and I feel very comfortable, especially during the winter months, recommending a dose of 5,000 units per day. We have capsules that contain that amount, so it is one little capsule a day. One that helps control blood sugars, reduces cardiovascular risk, cuts the chance of cancer by half and improves immune system. Let the sunshine in!