Health demographers guesstimate that if human populations in Northern Europe were to achieve adequate vitamin D3 levels (40 nanograms per milliliter of blood sample) this would save 17.7% in direct and indirect healthcare costs, saving hundreds of billions of dollars/Euros per year.Complete paper here (pdf).
If these Northern European statistics can be extrapolated to the United States, the U.S. would save about $4.4 trillion in healthcare costs over the next decade.
What to do about the flu? Dr. Cannell, than whom hardly anyone knows more about vitamin D, says:
Take enough Vitamin D3 to get your 25(OH)D level above substrate starvation levels (50 ng/mL or 125 nmol/L). Levels of 50 ng/mL usually require at least 5,000 IU per day for adults, some adults will require more. Children should take 1,000 IU per every 25 pounds of body weight.I want to emphasize this next bit, as it could save lives:
Stock your home's pharmacy with several fresh bottles of 50,000 IU capsules of Vitamin D3 (a medicine at this dosage, not a supplement) and if you get this flu, take 2,000 IU per kg of body weight per day for a week. As I weigh 220 pounds, I would take 200,000 IU per day for seven days if I thought I had an infection with a 1918-like influenza virus.
You take other food supplements too, Dennis?
ReplyDeleteI myself take Multivatimin Davitamon, Minami MorEPA+ Fish Oil (best in the world, they say) and, also, a Vitamin D supplement. (All this with a low-carb diet.)
Yes. IMO, everyone ought to be taking D and magnesium, and perhaps iodine. I also take n-acetylcysteine and some others.
ReplyDeleteMiles here Dennis,
ReplyDelete5 minutes of sunshine? Can it be "done" through a window? Here is an article discussing it (full disclosure: Im not "up" on this area of research at all. I really don't know what to think, but have noticed on sunny days just the drive home from work makes me "feel" a little more upbeat---if I have my sunglasses handy and am not blinded like the oversized vampire bat I am):
Vitamin D - sunlight or supplements?
By Stephen Daniells, 01-Feb-2006
Related topics: Research, Vitamins & premixes, Cancer risk reduction
Supplements and diet, and not sunlight, should be your source of vitamin D, dermatology experts have concluded after reviewing studies from both sides of the on-going debate.
UK researchers recently proposed 10 to 15 minutes of unprotected exposure to the midday sun as a good source of the vitamin. In the US, where over 1.5 million people are diagnosed with skin cancer every year, experts are pushing supplements, claiming recommendations for sun exposure are "highly irresponsible".
Some studies have shown that sunshine levels in some northern countries are so weak during the winter months that the body makes no vitamin D at all, leading some to estimate that over half of the population in such countries have insufficient or deficient levels of the vitamin, prompting some people to recommend tanning beds.
In the new review published in the Journal of the American Academy of Dermatologists (on-line, doi:10.1016/j.jaad.2005.11.1057), Deon Wolpowitz and Barbard Gilchrest from the Boston University School of Medicine wrote: "At noon in June in Boston, a fair-skinned individual will maximize his or her vitamin D photosynthesis in well less than five minutes, and additional sun exposure will produce only photageing."
From an evolutionary point-of-view, the trade-off between obtaining vitamin D from sunlight exposure and the effects of photoageing and skin cancer was sensible since lifespans were not very long. It does not make sense, the scientists argue, in a society where life expectancy has doubled and thirty per cent of Caucasians will develop skin cancer.
"Fortunately, there is a noncarcinogenic alternative - intestinal absorption of vitamin D fortified foods and/or dietary supplements," said Wolpowitz and Gilchrest.
The authors also discussed calls to increase the RDA for the vitamin. A study from the University of California Moores Cancer Research Center said the RDA should be increased from the current 400 IU per day for adults to 1000 IU per day. Other investigators have called for a RDA of 2000 IU per day.
The study is yet more music to the ears of supplement makers, coming quickly after reports linked vitamin D to lower risks of certain cancers and osteoporosis. Vitamin D sales have rocketed in the UK with some retailers reporting 400 per cent increases in supplement sales.
However, British charity Cancer Research UK played down the use of supplements. Sara Hiom, head of health information, told NutraIngredients.com: "In general, most people should be able to achieve a healthy balance that enables them to get enough UV radiation to make adequate Vitamin D but not enough to increase their skin cancer risk."
Hiom suggests that supplements may only be necessary for people who don't get adequate sun exposure, such as elderly people who are house bound or women who cover most of their skin for cultural reasons.
Vitamin D refers to two biologically inactive precursors - D3, also known as cholecalciferol, and D2, also known as ergocalciferol. The former is produced in the skin on exposure to UVB radiation (290 to 320 nm) and can also be consumed from oily fish. The latter is derived from plants and only enters the body via the diet.
Both D3 and D2 precursors are hydroxylated in the liver and kidneys to form 25- hydroxyvitamin D, the non-active 'storage' form, and 1,25-dihydroxyvitamin D, the biologically active form that is tightly controlled by the body.
Miles: The doctor Gilchrest quoted in that article is one of the most notorious solarphobes around, and her statement about "five minutes in Boston in June" being enough solar exposure is incorrect. Five minutes in Hawaii in June would be alright. Also, no you can't get exposure through glass. If you care enough about this topic, I urge you to read at the Vitamin D Council website, where you will get accurate unbiased info.
ReplyDeleteThe Yellow Face - it burns us! Hide in our cave and take Vitamin D supplements, my precious.
ReplyDeleteHere comes the cavalry.
ReplyDeletehttp://www.independent.co.uk/life-style/health-and-families/health-news/revealed-the-best-protection-against-cancer-1693138.html
Dennis,
ReplyDeleteI've been meaning to ask you for some advice for selecting vitamins. Do you have any advice on how to find quality vitamins or any thing in particular I should look out for? Do you have any brand you'd recommend?
Carlos.
the article dearieme linked says:
ReplyDelete"Revealed: the best protection against cancer
Global study discovers astonishing power of vitamin made by the sun
By Jeremy Laurance, Health Editor
Saturday, 30 May 2009
Boosting levels of vitamin D could cut the incidence of breast cancer by a quarter, bowel cancer by a third and it should be offered to the population as part of a public health drive, scientists say.
The finding is based on a review of 2,750 research studies involving vitamin D, sometimes called "bottled sunshine", which show that taking daily supplements of the vitamin could do more for cancer prevention than a library full of lifestyle advice.
Vitamin D is made by the action of sunlight on the skin but the gloomy weather and long winter in countries north of 30 degrees latitude, such as the UK, means that a large part of the earth's population is deficient between October and March. " Etc.
Dennis here: There is in fact an inverse relation between skin cancer and other cancers, IOW, if you get skin cancer - from sun exposure - the chances of any other kind of cancer goes way down. Doesn't mean that you should try to get skin cancer, only that warnings about sun avoidance are vastly exaggerated.
Carlos: Seems that most of what I take ends up being from NOW Foods; they seem to be of reasonable quality and price - but I don't know for a fact that they're superior. Also, the online store iHerb has good prices and fast shipping.
Even if one starts from the premise that the reason Europeans have white skin is that their skins maximize vitamin D synthesis (and attach no significance to the following fact.
ReplyDelete"melanin content does not alter the amount of vitamin D that can be produced"(Hollis 1991).
Or that far from maximizing vitamin D synthesis all humans, even the palest of the pale limit it. -
" within about 20 minutes of ultraviolet exposure in light skinned individuals (3–6 times longer for pigmented skin) the concentration of vitamin D precursors produced in the skin reach an equilibrium, and any further vitamin D that is produced is degraded.[47] Maximum endogenous production with full body exposure to sunlight is 250 µg (10,000 IU) per day." (Vieth 99).
How explain that almost all the European specific skin lightening alleles date from 20,000 years after modern humans entered northern Europe. How could the people lived there without the putative extra vitamin D (that they do not in reality make)?
The way out of this is to accept that, unlike brown skin, the extremes of skin color (black Africans and north Europeans) have nothing to do with any need for UVB which is everywhere over abundant.
SEXUAL SELECTION AND HUMAN GEOGRAPHIC VARIATION.
Here
Lets look at how high serum 25(OH)D actually goes, or rather is allowed to go because it is tightly limited no matter what your ethnicity or where you live.
"The highest individual serum 25(OH)D concentration obtained from sunshine was 225 nmol/L ; in a farmer in Puerto Rico"(Vieth 99)
This was at 18º 15' North of the Equator "Sunrise/Sunset Average: 6:54 am to 6:21 pm. Because of the latitude of Puerto Rico( 18º 15' North of the Equator) the sun is high overhead all year, there are no great variations from day to day between the times of sunrise and sunset."
What is the highest serum 25(OH)D level attained at the latitude of Berne, Switzerland ?
"Of the 30 outdoor workers in whom we measured 25(OH)D in late summer, 3 had levels above 200 nmol/liter (i.e. 211, 205, and 203 nmol/liter); their sun exposure occurred in Nebraska, Kansas, and North Dakota, at 41.2°, 39.0°, and 46.8°N latitude, respectively".
The modest difference between the world record highest serum 25(OH)D concentration obtained from sunshine and that of a minority of those working outdoors at 46.8°N latitude shows how for those of the same skin color and actual UVB exposure, there is in fact variation in serum 25(OH)D concentrations. One would assume the extent to which an individuals physiology and metabolism limits their serum level when in abundant sunshine is a characteristic that is not only variable but heritable.
Vieth in a 2005 presentation says that humans have not genetically altered in 100,000 years. Although he mentions lightening of skin in northern latitudes for him white skinned northern Europeans are still adapted to Africa's massive over abundance of UVB which is the reason for vitamin D deficits in higher latitudes with weaker UVB which is absent in some months.
The outdoor worker at 46.8°N latitude in whose measured serum 25(OH)D in late summer, was at 203 nmol/liter at 46.8°N latitude had a higher than average limit on vitamin D synthesis. What I think this shows is a basic weakness in the contention that Europeans still deal with vitamin D in a way than hasn't changed in 100,000 years.
Thinking the implications of this putative nulifying of evolution specific to the system of vitamin D contol through makes it impossible to accept. It would require a belief that the known variation in vitamin D levels for people of the same UVR exposure an skin colour is in no way influenced by heritable characteristics, or that the system is somehow inaccessible to natural selection.
(cont.)
ReplyDeleteNatural selection would have made people like Mr. 203 nmol/liter at 46.8°N the majority if it was trying to maximize vitamin D production. He is somewhat unusual for his limit on vitamin D synthesis not for his white skin.
Another way of looking at the continuation of what Dr. Vieth describes (Ref 1b) as -
"a system better designed to cope with an abundance of supply, not a lack of it".
"remarkably inefficient."
"no way to correct for deficiency"
There must have been stabilizing selection operating in northern Europe that winnowed out the rare mutants who lacked any kind of limit on their vitamin D levels otherwise people with no defence against ever increasing serum 25(OH)D concentrations would have become the majority. The lack of ill effects in north Europeans who spend their lives at the equator proves purifying selection has continued to operate against any maximizing of vitamin D levels for 30,000 years. This is despite the lack of UVB for several months in the winter.
"Based on the average rate of decline observed in our subjects, it can be estimated that in individuals for whom summer sun exposure is the principal source of vitamin D, a late summer 25(OH)D level of approximately 127 nmol/liter is needed to avoid levels falling to less than 75 nmol/liter by late winter."
Huge amounts of vitamin D are available in the N. European summer to store for the UVB-less months when levels are dependant on the vit' D the body has stored. If after entering northern Europe evolution's purifying selection treated Vitamin D as a substance that it was worth paying a price to limit it is reasonable to assume that higher levels have a very big down side.
Serum 25-hydroxyvitamin D3 levels are elevated in South Indian patients with ischemic heart disease. here
Hypervitaminosis D and premature aging: lessons learned from Fgf23 and Klotho mutant mice.
"Recent in vivo genetic-manipulation studies have shown increased serum level of vitamin D and altered mineral-ion homeostasis in mice that lack either fibroblast growth factor 23 (Fgf23) or klotho (Kl) genes. These mice develop identical phenotypes consistent with premature aging. Elimination or reduction of vitamin-D activity from Fgf23 and Kl mutant mice, either by dietary restriction or genetic manipulation could rescue premature aging-like features and ectopic calcifications, resulting in prolonged survival of both mutants. Such in vivo experimental studies indicated that excessive vitamin-D activity and altered mineral-ion homeostasis could accelerate the aging process."
Vitamin D and aging.
The Vitamin D level is limited no matter how much time you spend outdoors (or in the shade - see below) at the equator you won't push your levels up.
"The assembled data from many vitamin D supplementation studies reveal a curve for vitamin D dose versus serum 25-hydroxyvitamin D [25(OH)D] response that is surprisingly flat up to 250 µg (10000 IU) vitamin D/d. To ensure that serum 25(OH)D concentrations exceed 100 nmol/L, a total vitamin D supply of 100 µg (4000 IU)/d is required."
(cont. 2)
ReplyDeleteTrevor Marshall is very skeptical of the claims being made for vitamin D.
"Vitamin D supplementation of food and baby formula has spread throughout the world, even to the less economically developed countries. It is thus very difficult to find a population which can be studied in order to ascertain whatthe level of natural metabolic homeostasis for 25-D might actually be. Two studies do provide a glimpse, however. The first founda “high prevalence of Vitamin D deficiency in Chilean healthy postmenopausal women(40).” The average level of serum 25-D sampled from 90 “healthy ambulatory women” showed that 27% of premenopausal, and 60% ofpostmenopausal women, had 25-D levels under 50 nmol/L. A study(41)showing “Hypovitaminosis D is common in bothveiled and nonveiled Bangladeshi women” found a 25-D level less than 40 nmol/L in approximately 80% of the healthy young women. These studies show a wide variation in levels of 25-D being generated by populations whose diets have probably not yet been significantly altered by ‘The Sunshine Vitamin,’ indicating that the unsupplemented metabolic homeostasis is probably in the range 23-60 nmol/L, and that it falls with advancing age." (4a)
"When researchers went to an Italian nursing home, they found that 99 of 104 residents had no detectable vitamin D in their blood,"
Bad news for these people ?
All of the 104 resident were over 98 years old. I hate to think how old they would have lived to if they'd kept their vitamin D levels 'normal'.
Here is evidence how abundant UVB is in the summer "Dr. Turnbull, working with Dr. Kimlin in Australia, showed that UVB light in the shade is strong enough to activate vitamin D production in the skin. Think of UVB as a ping-pong ball. It bounces off lots of things. When you go into the sun—if the sun is high enough in the sky—UVB light comes through the atmosphere and then starts bouncing around. It bounces at you from the ground, buildings, cars, and even the bottom of clouds. Sitting under a shade tree delivered about half as much UVB as sitting in the direct sun.
...the damaging UVA radiation under direct sun was three times more than under the shade tree. Sitting in the shade in the summer (and the winter in subtropical and tropical latitudes) is a good way to get vitamin D."
Are low vitamin D levels causing disease or are they actually low as a result of disease as Trevor Marshall contends?
Marshall's argument is complex he seems to attribute most disease including auto-immune conditions to low level infections much like Cochran and Ewald. He maintains that "25-hydroxyvitamin D is immunosuppressive"
"reduction in inflammation, clinical disease markers,
and disease symptoms in patients taking supplemental vitamin D
result from temporary suppression of the innate immune response.!"
References.
1a)Vitamin D supplementation, 25-hydroxyvitamin D concentrations,1, and safety,1999, Reinhold Vieth, University of Toronto.
here
1b)Vieth, in 'Vitamin D'
Second Edition
Editors D. Feldman, F. Glorieux
CHAPTER 61
The Pharmacology of Vitamin D, Including Fortification Strategies. here
1c)
Prospects for Vitamin D Nutrition, Reinhold Vieth 2005 [Video presentation]. here
2)
Effects of Above Average Summer Sun Exposure on Serum 25-Hydroxyvitamin D and Calcium Absorption.
here
4a)
Vitamin D discovery outpaces FDA decision-making.
here
4b)
Vitamin D: the alternative hypothesis;Paul J. Alberta, Amy D. Proalb, Trevor G. Marshall.
here