Should we fear Vitamin D deficiency more than we fear the sun?

Courtesy of the Vitamin D Council

Improved Muscular Performance With Vitamin D

Yes. If you remember, I first theorized that Vitamin D would improve athlete’s abilities in our March 2007 Vitamin D Newsletter.

I found evidence vitamin D allowed the Germans and Russians to dominate the Olympics for 30 years, from the mid 1950s until the mid 1980s, when the sun-scare allegedly convinced them to stop irradiating their elite athletes. I’ll be speaking at the American College of Sports Medicine on the subject at their late May conference in Seattle. I’ll be around Wednesday and Thursday; I speak on Wednesday at 4:25 pm. Before and after that I’ll be at the Vitamin D Council’s booth, if the Council has enough money to pay the $1,525 for a booth. If you are in Seattle, stop by.

As far as supporting research, Ward, et al recently found Vitamin D is highly associated with how high young teenage girls could jump. Unfortunately, Dr. Ward, the lead author, and the editors at the Journal of Clinical Endocrinology & Metabolism, did not credit my prior publication. Ward KA, et al. Vitamin D status and muscle function in post-menarchal adolescent girls. J Clin Endocrinol Metab. 2009 Feb;94(2):559–63.

14th Annual Vitamin D Workshop

For those who don’t know, this is the best Vitamin D conference in the world. Tony, I will be there if the Vitamin D Council has any money to finance my trip.

Vitamin D Treats Prostate Cancer!

Yes. Do you remember the press articles last autumn about breast cancer, which showed afflicted women with the highest 25(OH)D levels were much less likely to die from breast cancer than women with the lowest levels? You should, it literally generated 1,500 press stories in English language publications. Well, the same exact study, with even better results, was published last month by Dr. Treti and colleagues in the British Journal of Cancer. This time, it was men with prostate cancer not women with breast cancer.

The study showed that men with biopsy proven prostate cancer, who had the highest vitamin D levels, were up to 6 times less likely to die than men with the lowest levels over the 4 years of the study. Six times! That is a treatment effect, so yes you should take vitamin D. How much, I don’t know. If it was me, I’d take enough to get my levels up to 80–90 ng/mL and I’d do it quick. Be prepared for your body to become a battlefield as the vitamin D attacks and attempts to kill the cancer cells. Also, check your serum calcium frequently, as the macrophages in the battlefield may start producing high amounts of activated vitamin D and drive up your serum calcium. Tretli S, Hernes E, Berg JP, Hestvik UE, Robsahm TE. Association between serum 25(OH)D and death from prostate cancer. Br J Cancer. 2009 Feb 10;100(3):450–4.

Do you know how many press articles Dr. Treti’s prostate cancer study generated? Not one. I followed it closely on Google News Alert for “Vitamin D.” (To view the latest news on vitamin D please visit our Vitamin D News page.) I guess the war between the sexes goes to the grave. Actually, as I have said before: “When I was young, I suspected conspiracy; as I grow older, I know it’s incompetence.” The press simply did not see the publication, but it is not too late for them to correct their sexist mistake.

Vitamin D Testing

Your doctor ordered the wrong test. He ordered a 1,25-dihydroxy-vitamin D, which is usually elevated in vitamin D deficiency. As your deficiency worsened, your 1,25-dihydroxy-vitamin D went up further. You need a 25-hydroxy-vitamin D blood test, which will be very low. You could have saved yourself all this misery by ordering the Vitamin D Council’s in-home test.

By the way, I believe that Quest Diagnostics is now offering reliable 25(OH)D blood tests. Unfortunately, I believe they are reliably 25% higher than the gold standard, DiaSorin RIA, the test used in virtually all the recent studies, so if you use Quest, divide their results by 1.3. Shoot for > 50 ng/mL.

Autism and Vitamin D

1,000–2,000 IU/day for autistic children is inadequate. Aggressive vitamin D deficiency diseases need aggressive vitamin D treatment. Start with a minimum of 5,000 IU/day day in autistic children and check 25(OH)D levels every month. Many autistic children will need even more to see a full treatment effect. Please remember the difference between a treatment effect and a cure.

1,000 IU/day during pregnancy is also entirely inadequate. You need 5,000 IU/day, often more, and a 25(OH)D blood test to assure 5,000 IU/day gets you up above 50 ng/mL. If you are uncomfortable with that dose, buy one of our in-home vitamin D lights. Conventional wisdom is that you should not use sun-tanning parlors during pregnancy as they increase body temperature, which may harm the fetus. Our in-home UV lights are open, hang on the wall like a full-length mirror, and thus will not raise body temperature. As for the reasons pregnant women need 5,000 IU/day, I will soon dedicate an entire newsletter to vitamin D and pregnancy.

The problem is that pregnant women are told not to take any pills or supplements, except prenatal vitamins, which contain truly inconsequential amounts of vitamin D. Most pregnant women will not take vitamin D unless their obstetrician tells them to do so, and not doing so may have devastating effects on their unborn child. If you are pregnant, you need at least 5,000 IU per day. If you live where the sun makes vitamin D this time of year, sunbathe for 10–30 minutes every day. If you can’t do that, and if you will not take it as a supplement, get one of our in-home UV Vitamin D units.

Yes, two recent studies supported my theory. The first showed autistic children have abnormal bones, what one would suspect in children who have a genetic abnormality in metabolizing or catabolizing vitamin D. Hediger ML, et al. Reduced bone cortical thickness in boys with autism or autism spectrum disorder. J Autism Dev Disord. 2008 May;38(5):848–56.

The second showed cloudy and rainy weather (which is a proxy for reduced UVB) is associated with autism. Waldman M, Nicholson S, Adilov N, Williams J. Autism prevalence and precipitation rates in California, Oregon, and Washington counties. Arch Pediatr Adolesc Med. 2008 Nov;162(11):1026–34.

Vitamin D, Dementia, and Cognitive Function

Yes, increase the dose to 7,000 IU per day and test 25(OH)D levels until her level gets to 70–90 ng/mL. More aggressive treatment is indicated in aggressive diseases. While several studies have shown an association between dementia and vitamin D, two recent studies showed cognition in dementia patients is better in those with higher 25(OH)D levels. As a physician, I’m sure you know the difference between a treatment effect and a cure. Oudshoorn C, et al. Higher serum vitamin D3 levels are associated with better cognitive test performance in patients with Alzheimer’s disease. Dement Geriatr Cogn Disord. 2008;25(6):539–43. Llewellyn DJ, Langa K, Lang I. Serum 25-Hydroxyvitamin D Concentration and Cognitive Impairment. J Geriatr Psychiatry Neurol. 2009 Feb 4.

Ultraviolet Light Produces Vitamin D

UVB, right? Actually, it may be UVC, not UVB. Of course that is irrelevant on earth as UVC does not penetrate the earth’s atmosphere. But if you ever want to sunbathe on the moon, read on. In fact, the belief that UVC radiation does not produce vitamin D is firmly rooted in the scientific community, but is a widespread misconception. While UVC radiation does not produce vitamin D in the skin upon exposure to sunlight, it is not because UVC radiation fails to trigger production of vitamin D; it is because UVC radiation is not present in the sunlight reaching earth—two very different facts.

I am unaware of any human studies using only UVC light to see if it increases 25(OH)D levels. However, animal studies clearly indicate wavelengths in the UVC range are very effective in producing vitamin D; in fact, UVC appears to be equal to—or more efficient—than UVB for production of vitamin D. For example, Bunker, et al found UVC radiation effective in both photochemically activating 7-dehydrocholesterol into vitamin D and in treating rachitic rats. Three of the following four references allow full version downloads of the papers, so you can read them yourself. Bunker JWM, et al. Relative efficiency of active wave-lengths of ultraviolet in activation of 7-dehydrocholesterol. J. Am. Chem. Soc. 1940, 62(3):508–511.

Knudsen and Benford studied numerous UV wavelengths in rachitic rats, finding UVC was more effective in curing rickets than any of the UVB wavelengths studied. They also found that larger doses of UVC, “even up to 8 times the dose required to produce healing, did not produce any more healing; in fact, somewhat less.” Excessive doses of UVC, like UVB, degrade more vitamin D than they produce. Knudsen A and Benford F. Quantitative studies of the effectiveness of ultraviolet radiation of various wavelengths in rickets. J. Biol. Chem. 1928,124;287–299.

Some correctly say that UVC does not penetrate the outer layer of the skin very well, implying that fact would prevent vitamin D production even if UVC were effective in producing vitamin D. They fail to point out that such UV penetration of the skin is not necessary for vitamin D production. Hume, et al demonstrated that rabbits and rats respond equally well to topical vitamin D as they do to UV irradiation, both methods rapidly curing rachitic animals. That is, vitamin D is absorbed readily through the skin. Gaylor, et al found sebum contains large amounts of vitamin D’s precursor, 7-dehydrocholesterol; up to 75% of 7-dehydrocholesterol in rat skin occurs in sebum. Hume EM, et al. LII. On the absorption of vitamin D from the skin. Biochem J. 1927, 21:362–367. Gaylor JL, Sault FM. Localization and biosynthesis of 7-dehydrocholesterol in rat skin. J Lipid Res. 1964,5(3):422–31. (PDF format)

These last two studies raise the possibility that sunbathing or using UV lights may not produce much vitamin D if you shower with soap after exposure. Water cleans the body but does not destroy as much sebum, human body oil. When you think about it, God made the perfect body oil for humans—sebum—but humans wash off her body oil and then apply body oils made by the cosmetic industry. I doubt she likes that.

Vitamin D and Ovarian Cancer

I am not sure the Vitamin D had anything to do with it. She could have been cured by conventional treatment; such cures occur every day. The Vitamin D may or may not have helped. However, why take a chance?

Vitamin D Helps Asthma

I have heard of numerous similar asthma cases. She should slowly stop her medication, if her doctor agrees. A paper was recently presented showing exacerbations in asthmatic children were associated with low 25(OH)D levels. In the adjusted models, children with insufficient vitamin D were about 70% more likely than those with sufficient vitamin D to have exacerbations. The levels of only a few of the children, asthmatic or not, were adequate. Zoler, M. Low vitamin D linked to asthma exacerbations. Pediatric News. 2008, July 1.

By the way, instead of taking 62 capsules per day of the 2,000 IU, she could have taken 2 or 3 or the 50,000 IU capsules that Bio-Tech Pharmacal sells.

Vitamin D and Depression

Glad to be of help, don’t worry about a contribution, we will find it somewhere. Be sure to eat a lot of spinach with your vitamin D. To work properly, vitamin D needs magnesium, vitamin K, zinc, and probably boron. We hope to soon have a complete vitamin D on the market with all these co-factors but you can save some money by just eating spinach every day.

John Jacob Cannell MD Executive Director

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