Tag Archives: vitamin-d

What is the Right Vitamin D Level?

July 4, 2010 Karen S. Vaughan 3 Comments

The symptoms of low vitamin D levels are subtle and difficult to distinguish, given that receptors are found in most organ systems in the body and affect genetic transcription in cells. For chronic pain the Mayo clinic suggests that Vitamin D deficiency is the first thing that should be considered. Vitamin D deficiency contributes to depression, osteoporosis, osteopenia, osteomalacia, rickets, periodontal disease, seasonal affective disorder, increased susceptibility to colds and flu, colon cancer, lung cancer, ovarian cancer, malignant melanoma, recurrence of all cancers, cardiomyopathy, cardiovascular disease, fibromyalgia, hypertension, asthma, psoriasis, MS, type 1 diabetes and it probably plays a role in type two diabetes as well. At least 78% of Americans suffer from D hypovitaminosis.

People vary widely in their absorption and use of Vitamin D which is why there is no RDA. It is more important to know how much is circulating in your blood. Why? If you are light skinned, live south of Atlanta and spend time out of doors during midday without sunscreen, you will need less supplementation than if you are dark skinned in the same situation. People with dark skin need three times the sun exposure as people with light skin to get the same benefit. If you are elderly you do not absorb or convert the vitamin as well and should take care to consume the vitamin with fat, magnesium and Vitamin K2. If you have celiac, IBS, Crohn’s or leaky gut, your absorption may be impaired. If you lack a gallbladder or have impaired fat absorption you will absorb less orally supplemented Vitamin D and may need a dry form. If you are overweight you need more because you will sequester Vitamin D in your fat, leaving less circulating in your blood. If you have cancer, diabetes or autoimmune disease, you use your Vitamin D stores faster and need to supplement more. So the best way to see if you have enough Vitamin D is to get the right blood test.

If your doctor isn’t up on the latest research, he may not be aware of which Vitamin D blood test to order. There are two common tests, only one of which is useful. The test you want is a 25 Hydroxy D test, also called 25 (OH)D. This measures the active form circulating in your blood. There is also a 125 Dihydroxy D test, also called a or 1,25(OH)(2)D. Studies show that the Vitamin D, 1,25 Dihydroxy level does not significantly change until the normal Vitamin D level, or 25(OH)D, drops to severely low levels. If you get the wrong test, it will look like your levels are normal until you are severely deficient.

Then there are two ways to express the results of the test. In the US, results are expressed as nanograms/mililiter. In other countries the results are expressed in nanomoles/liter. 1 ng/ml = 2.5 nmol/L 25 hydroxy D lab ranges of 20-56 ng/ml are the equivalent of 50-140 nmol/L.

When you get your lab values back, they tend to have reference ranges labeled “high,” “medium,” and “low.” Ignore those and ask for the number. These are average ranges of people who are apparently in good health and get blood tests. If you have a population where most people are deficient, the average reference ranges are too low. Based upon the newest research, you want levels that are at least 50ng/ml or 140 nmol/L.

According to vitamin D researcher Carole Baggerley, research shows that if we could get Americans to increase their Vitamin D3 levels to 50-80 ng/ml, we could virtually eliminate Type 1 diabetes, reduce breast and co-rectal cancer deaths by 75%, reduce psoriasis by 65%, significantly reduce MS, heart attacks, lymphoma, fibromyalgia and pain and a host of other diseases. This is based on research that did not even look at some of the higher levels indicated by newer research. As you can see in the chart below, only rickets is prevented by the relatively low amounts found in multivitamins. (You can click on the picture to enlarge the chart.)

vitamin D Deficiency Diseases by Blood Level — Vitamin D Deficiency Diseases by Blood Level

Across the top are increasing blood levels of 25 Hydroxy D. Down the rows are diseases that were shown to be affected by Vitamin D. The vertical black line is 25ng/ml, which is the level at which most diseases show some improvement. Most Americans have levels below 25, far below those needed for cancer and autoimmune disease prevention on the right side of the line. This will not protect you.

Various researchers have suggested different levels, although they seem to be climbing over time. Most just look at deficiency without suggesting optimal levels. John Cannel of the Vitamin D Council suggests a 25 Hydroxy D level of 50-80 ng/ml. Bruce Hollis defines deficiency under 32 ng/ml although he has suggested higher levels in recent speeches. So does Ferrari Bishoff. Dr. Mercola who is not a scientific researcher, suggests 50-65 ng/ml. The lab reference range that some of my patients are bringing in is between 50-100ng/ml. No credible studies show danger with levels under 200ng/ml and toxicity is often much higher.

It should be noted that there is an innate conservatism about changing reference levels too fast from what most everyone realizes were grossly inadequate levels from the past. But too many people are suffering.

My recommendation, based on the 2007 chart and newer research is that you keep your blood levels of 25 Hydroxy D between 50 and 100 ng/ml ( 125-250 nM/L.)

The amount you would get from a day in the sun, a physiological dose is approximately 25,000 iu. Because there is so much difference in absorption and use of stores, oral doses for adults can vary from 5,000 iu to 50,000 iu. You probably need levels over 10,000 iu (under half of a physiological sun dose) to budge deficiency levels, but can taper off after your stores are built up. I personally found that 10,000 iu daily doses of Vitamin D3 in an oil form did not raise my levels above the mid 30s so take 50,000 iu in the winter, at least until my goal of 60ng/ml can be reached. Maintenance doses can be considerably lower so long as the person does not have a condition that increases use or impairs absorption into the blood stream. But that is why we test periodically.

Although there is a theoretical possibility of toxicity from a fat soluble vitamin, this is virtually never seen with Vitamin D in people without specific diseases. You cannot overdose on Vitamin D from the sun because your body will break down the excess. Aside from people who suffer from hyperparathyroidism, sarcoidosis, lupus or abnormal calcification, problems from too much Vitamin D are not found under levels of 200ng/ml. (A single study which is widely believed implausible because it is out of range of other studies showed kidney stones at 150ng/ml, but most researchers disregard it.) And in one case where someone took a million iu per day because he had undiluted powder, a month of sunblock, a diuretic and ceasing the supplementation took him out of toxicity without lasting problems. Researchers believe that Vitamin D3 (cholecalciferol) may be less likely to cause problems than D2 (ergocalciferol) in large doses.

Low vitamin D linked to the metabolic syndrome in elderly people (eurekalert.org)
How to Make the Most (Vitamin D) from the Summer Sun (acupuncturebrooklyn.com)
Vitamin D Regulates the Immune System (acupuncturebrooklyn.com)
(Nursing Mothers, Infants and Vitamin D (acupuncturebrooklyn.com)
How to Get Vitamin D from the Sun (acupuncturebrooklyn.com)
And More On Vitamin D (acupuncturebrooklyn.com)
Vitamin D Prevents Cancer, Type 1 Diabetes, MS, Heart Attack and Pain (acupuncturebrooklyn.com)
Vitamin D (Calcitrol) (vivo.colostate.edu)
What’s A Normal Vitamin D Level? (easy-immune-health.com)
Also see the videos of the 2007 UCSD Conference on Vitamin D on YouTube or the GrassrootsHealth.net site
Vitamin D Council

4 people like this post.

Unlike

pregnancy, vitamin-d

Vitamin D During Pregnancy Reduces Pre-Eclampsia

September 17, 2009 Karen S. Vaughan 6 Comments

Several studies in different parts of the world have shown that there is a benefit to a baby when the mother takes Vitamin D in excess of the amount in prenatal vitamins. This shows that there is a benefit to pregnant mothers in reducing the complications of pregnancy. While the study only looked at a fairly low dose of Vitamin D, probably from cod liver oil and diet, it indicates that supplementation reduced pre-eclampsia by 25%. Based upon Finish studies, I wonder how much less pre-eclampsia would be found if blood levels were raised to 50.

Vitamin D may reduce pre-eclampsia risk: Study

By Stephen Daniells, 20-Aug-2009

Increased intakes of vitamin D during pregnancy may reduce the development by about 25 per cent, suggests a study with over 20,000 Norwegian women.

The risk of pre-eclampsia was 27 per cent lower in women who consumed vitamin D supplements with daily doses of 10 to 15 micrograms, compared to women who did not take supplements, according to researchers from the Norwegian Institute of Public Health.

However, a correlation between vitamin D intake and omega-3 fatty acid intake was observed, and the researchers noted that “further research is needed to disentangle the separate effects of these nutrients”.

Pre-eclampsia, affecting two to three per cent of all pregnancies, occurs when a mother’s blood pressure rises to the hypertensive range, and excretion of protein in the urine becomes too high. It is estimated to be responsible for about 60,000 deaths worldwide.

It is not known why some expectant mothers develop pre-eclampsia, although oxidative stress has been proposed to play a part. The role of antioxidants to reduce oxidative stress had been supported by a small clinical trial that linked vitamin C and E intake to fewer biomarkers for pre-eclampsia for predominantly low-risk participants.

However, subsequent studies, including a study published in The New England Journal of Medicine (Vol. 354, pp. 1796-1806) and a Cochrane Systematic Review (2007, Issue 4), found that vitamins C and E had no effects on the risk of pre-eclampsia.

The new study, published in Epidemiology suggests that vitamin D supplementation may reduce the risk of developing the potentially fatal condition.

Led by Helle Margrete Meltzer, the researchers examined the relationship between vitamin D intakes during pregnancy and the risk of pre-eclampsia in 23,423 would-be first time mothers participating in the Norwegian Mother and Child Cohort Study.

The women answered a general health questionnaire at the fifteenth week of pregnancy and again at the thirtieth week, while a food frequency questionnaire was administered at week 22.

According to the Norwegian findings, women with a daily intake of between 15 and 20 micrograms of vitamin D from diet and supplements had a 24 per cent lower risk of developing pre-eclampsia compared to women who consumed less than 5 micrograms per day.

The overriding benefits were observed for vitamin D from supplements, with a daily dose of 10 to 15 micrograms linked to a 27 per cent reduction, compared to women who did not take supplements.

“These findings are consistent with other reports of a protective effect of vitamin D on pre-eclampsia development,” wrote Meltzer and her co-workers.

“However, because vitamin D intake is highly correlated with the intake of long chain omega-3 fatty acids in the Norwegian diet, further research is needed to disentangle the separate effects of these nutrients,” they concluded.

Source: Epidemiology
September 2009, Volume 20, Issue 5, Pages 720-726, doi: 10.1097/EDE.0b013e3181a70f08
“Vitamin D Supplementation and Reduced Risk of Preeclampsia in Nulliparous Women”
Authors: M. Haugen, A.L. Brantsaeter, L. Trogstad, J. Alexander, C. Roth, P. Magnus, H.M. Meltzer

http://www.nutraingredients-usa.com/Research/Vitamin-D-may-reduce-pre-eclampsia-risk-Study

See Related Posts:

Vitamin D Regulates the Immune System

Nursing Mothers, Infants and Vitamin D

How to Get Vitamin D from the Sun

And More On Vitamin D

Vitamin D Prevents Cancer, Type 1 Diabetes, MS, Heart Attack and Pain

cholesterol, diet, heart-disease, herbs, sunlight, Uncategorized, vitamin-d, western-medicine

Vitamin D, Statins and Red Yeast Rice

September 11, 2009 Karen S. Vaughan Leave a comment

As those of you who read my blog are aware, I am not a big fan of statins. The first reason is that cholesterol is not really the problem. The second is that statins depress the body’s own anti-inflammatory compound CoQ10. But recent research shows that, against our logical assumptions, Vitamin D levels may rise when statins are taken.

Cholesterol is good? Yes. Cholesterol is the building block of hormones, and it is the body’s own bandage for inflamed arteries. When the inflammation is high, cholesterol rises and if it isn’t enough to lower you get cardiovascular disease. It doesn’t get rid of the inflammation to remove the body’s bandage, you need to look at diet and stress and other causes of inflammation. Besides if you block cholesterol with statins, you block the body’s formation of CoQ10 which is our natural antioxidant. And that can cause a painful disease called rhabdomyolysis where the muscles ache and cramp.

But isn’t it helpful to prevent heart disease? Sort of. You are less likely to get a second heart attack, but not a first one. You may be less likely to die from a heart attack but no less likely to die from other causes within a normal study period. And it probably isn’t because it reduces cholesterol, but because it is anti-inflammatory (replacing your body’s own anti-inflammatory coenzyme with its own effect).

How about Red Yeast Rice? Red Yeast Rice is a kind of statin, and is the source for lovastatin which it contains. Red Yeast Rice is somewhat less dangerous- it spreads itself out among liver detoxification pathways without clogging a few important pathways. And the dosage is lower, which is common in a whole herb and does not impair its action. But it still reduces CoQ10, and adds some liver taxation I use it rarely.

The information about Vitamin D and statins is a surprise. Vitamin D and cholesterol have the same precursor, and those of us in the natural medicine field assumed that statins would reduce absorption of Vitamin D if you took a medication that reduced the precursor. In a Turkish cardiology study, 91 patients with high blood lipids were tested before and after an eight week course of Rosuvastatin (Crestor). Their blood levels of Vitamin D (25 hydroxy D) went from 14 to 36 on average, and a number of other measures of Vitamin D improved. Why? Well we don’t know, but it could have to do with the breakdown products of the drug and the precursor fitting into the receptors.

Do I recommend asking your doctor for Crestor to build Vitamin D? No. There are several formulations of high value D3 on the market, from drops to fast-dissolving dry pills. They go from a tiny pill with 5000 iu to capsules of 50,000 iu. If one doesn’t work well to increase your serum (25 Hydroxy D) Vitamin D levels to a level of 50, look at others. You may build up your dose to a higher level. And you should consider supplementing your D3 vitamins with even a little midday sun exposure without sunscreen because sunlight energy can’t be reduced to one isolated vitamin. (Your body will not make too much.)

If all else fails, then I would try taking the Vitamin D with some Red Yeast Rice for a period of up to two months while you load Vitamin D. Red Yeast Rice has not been studied like the Rosuvastatin so you are experimenting on yourself but chances are good that it will work. Add extra Co-enzyme Q10 to protect your liver and your muscles. And when you get your levels up, stop the Red Yeast Rice.

flu, Uncategorized, vitamin-d

Vitamin D Regulates the Immune System

September 2, 2009 Karen S. Vaughan Leave a comment

I am an herbalist, and that is where I turn first, in most cases. But Vitamin D is an exception. It is a hormone used by most of our cells in over 2000 functions,. As humans ranged north of the African savannah where we evolved and started wearing more clothing, we started lowering our D levels.

Vitamin D has the ability to kill off bacteria and that property has been so important that we have retained that property as primates for over 60 million years

Vitamin D also prevents the over stimulation of our immune system which could cause it to attack ourselves. This is important for the Swine Flu which can be dangerous if there is an excessive inflammatory response, called a cytokine storm.

Most deaths in the 1918 flu pandemic and more recently from SARS, happened when young healthy people who had a strong immune response provoked a cytokine storm which allowed an excessive response that quickly killed them off. We speculate that with higher levels of Vitamin D, the regulatory function that caused the excessive inflammation might not have occurred.

This article tells how the process works, but the takeaway is to keep your Vitamin D levels high (blood level around 60) which may require 10,000 iu or more daily and if you get the flu increase it.

Aug 19 2009, 10:20 AM EST

Regulation of Antimicrobial Peptide by Vitamin D Found to Have Been

Conserved for 60M Years Continue reading Vitamin D Regulates the Immune System →

breast-feeding, pregnancy, vitamin-d

Nursing Mothers, Infants and Vitamin D

August 26, 2009 Karen S. Vaughan 5 Comments

While I used to think otherwise, I firmly believe that nursing mothers should supplement both themselves and their babies with Vitamin D. The exceptions to this are mothers who live south of Atlanta, who together with their babies are out of doors without sunscreen between 11:00 am and 1:00pm and who don’t use soap when they wash (because it washes away the D2 oil involved in the process of making D3.) We used to have government programs to encourage parents to take children out into the sun. See this informative and entertaining video from UCSD.

In Finland, babies were routinely given cod liver oil providing 4500 iu of D (and modern cod liver oil is NOT recommended for it due to lower D/A ratios). Then, since research showed that rickets could be prevented at 400 iu, the recommended daily amount was lowered. As a result, Type 1 Diabetes skyrocketed. We have very good data showing that 90% of Type 1 Childhood Diabetes can be eliminated by Vitamin D supplementation.

The link between Vitamin D and Type 2 diabetes in children is less supported but there is good evidence that it may also play a role.

Vitamin D deficiency may also play a role in some autism. The blood levels of Vitamin D in autistics is generally low.

Vitamin D Council’s John Cannell, MD, (http://www.vitamindcouncil.org/health/autism/ is convinced that vitamin D deficiency is linked to autism and that the autism “epidemic” started at the exact same time that the vitamin D deficiency epidemic started. As soon as we started limiting sun exposure and using sunscreens, the number of autism cases shot up. Science Magazine published a similar article. There are groups of Somali children in Sweden and Minnesota who are hugely overrepresented among autistics, with the only real difference between their lighter skinned peers is that their skin color prevents Vitamin D absorption. It is correlation, but is compelling.

I have here a number of articles on Vitamin D and its health benefits. While theoretical toxicity is a potential problem, it is hard to get high enough to be toxic. And since 13,000 Finnish babies managed on 4500 iu, then we have good evidence that isn’t so high.

While it is very important that a pregnant or nursing mother have high D levels, it isn’t easy to do that from diet alone. Most of us drink less milk, eat less liver or organ meat, don’t go out into the sun around noon without sunscreen and we wash the oils off of our skin that might be turned into the vitamin. We are also heavier, which reduces Vitamin D. Our foods used to have a lot more D: cattle grazed in the sunlight foraging for wild plants, wild fish ate plankton instead of Purina fish meal, and pigs and chickens weren’t penned indoors. The supplementation of Vitamin D from irradiated milk is insufficient to make up for the loss. And your prenatal vitamins won’t have enough because the RDA is too low.

If your skin is dark, chances are that your D levels are low. The National Health and Nutrition Examination Survey) found African Americans were low: just 3 percent of blacks sampled in 2004 were found to have the recommended levels compared with 12 percent two decades ago. If you don’t have it, you can’t pass it through your milk. Breastfed infants have been taken away from nursing African American mothers on suspicion of abuse because they had hidden fractures from rickets and were not tested for them. Since we are out of our ecological niche, we no longer have the natural sources of Vitamin D at our disposal and we probably need to supplement.

I would personally take 10,000 iu during pregnancy and lactation, more if I had conditions that reduce Vitamin D like dark skin, autoimmune disease, diabetes or obesity. I would personally give my baby 2000 iu, and would massage in a D-supplemented skin oil (even if I had to add it in myself.) We would both spend time in the noonday sun without sunscreen. And just to be safe, I would ask for 25-hydroxy-D blood tests to make sure I was getting it high enough.

Research on D in Pregnancy and Lactation from the Vitamin D Council.

alternative-health, cancer, sunlight, vitamin-d

How To Get Vitamin D from the Sun

August 23, 2009 Karen S. Vaughan Leave a comment

How do you get enough Vitamin D from the sun? If you can fulfill the following, you might get enough: vitamin-d

You live south of Atlanta in the winter.
You are in the sun from 11:00 am to 1:00 pm.
Your body is mostly uncovered.
You go without sunscreen for at least 15-20 minutes.
You don’t use soap for 48 hours.
You repeat the process in 72 hours.
Your skin is not dark, either from genetics or suntanning. (You may need six times as much exposure if your skin is dark.)

Unless you fit all of these conditions, you need to supplement. And a multi-vitamin or calcium plus D supplement will NOT have enough Vitamin D, nor will your milk. You need to supplement with high iu Vitamin D3, preferably above 4000 iu. If your blood 25 hydroxy D test is below 70 (ignore “high”, “medium” and “low” because that is based on the averages of a D-deficient population,) then supplement it. The exception is if you have scleroderma or similar abnormal calcium metabolism.

Other ways to supplement: frequent consumption of liver, preferably from organic animals. Shitake or other mushrooms dried gill side up in the sun on a daily dose of about one ounce dry weight, cooked long and low.

Calculations from studies on Vitamin D show that, for every person who dies of skin cancer from UV overexposure, more than two hundred will die from other cancers, like lung, breast, prostate and colon, as a result of low vitamin D levels.