Who’s At Risk from the Vitamin D Deficiency Epidemic?

How did a humble vitamin that can be obtained free from sunshine make Time Magazine’s Top 10 Medical Breakthroughs for 2007? The other nine medical breakthroughs were all high-tech medications, vaccines and medical equipment. Vitamin D is about as low tech as you can get. It’s natural, it’s free, it comes from sunshine and it’s been known for over a hundred years. What’s so important about it now?

The First Vitamin D Deficiency Epidemic–Rickets

Vitamin D was identified in the early 20th century as an essential requirement of normal bone development. For several hundred years, children who lived in cities in northern Europe had been plagued by a devastating bone disease called rickets. Lack of sunshine as the cause was suspected as early as 1822. It was also noticed that children along the coastlines who were given a daily dose of cod liver oil did not develop the disease.[1]

By the beginning of the 20th century, more than 80% of children living in industrialized cities in North America and Europe suffered from rickets.[2] In 1921, two doctors in New York City demonstrated that sunlight could cure rickets when they exposed sick children to sunlight on the roof of a New York City hospital. Soon after that a way was found to fortify milk with vitamin D and this helped eradicate rickets in the United States.[3]

Scientists now know that when human skin is exposed to sunlight, it creates a natural compound called cholecalciferol—a form of vitamin D called D3. Almost every cell in your body must have vitamin D3 to stay healthy. Not enough vitamin D3 and you’re going to have problems. Lots of problems in lots of cells.

My Doctor Told Me That Taking Too Much Vitamin D Was Dangerous

Up until the last fifteen years, doctors and scientists believed that humans only needed a very small amount of D3 and that larger amounts were actually toxic. Although extremely high amounts of vitamin D can be toxic, the safe levels have been set far too low—resulting in millions of children and adults being vitamin D deficient.[4]

Unfortunately, government regulatory agencies have not kept up with the current research. (See “One of The Biggest Medical Mistakes of All Time” in this issue.) They are still recommending small doses. These low daily intake recommendations plus lack of sunshine due to our modern indoor lifestyle and the use of sunscreen, has created a new health epidemic. Our cells are starving for vitamin D3.

The Current Vitamin D Deficiency Epidemic—
Inflammation, Pain, Cancer, Heart Disease, Diabetes, Arthritis, Osteoporosis, Multiple Sclerosis and more

The amount of vitamin D to prevent rickets is much lower than the amount of vitamin D required to maintain health and prevent heart disease, osteoporosis, cancer and other diseases that have a slow and insidious onset. For example, randomized trials using 400 IU of vitamin D did not reduce fracture risk, but 800 IU did. [5]

Vitamin D deficiency can vary according to many variables—color of skin, where you live, use of sunscreen, age, obesity and other factors. A major study of over 18,000 adolescents and adults living in northern latitudes in the U.S. found that vitamin D insufficiency was “very common” — reaching as high as 42% in some populations. A Harvard study of male physicians found 77% had low levels during the winter. Another study found 30% of healthy men and women in Boston had low levels of vitamin D at the end of winter.[6] Scientists from all over the world are alarmed at this widespread nutrient deficiency that can be corrected with a little sunshine and a simple vitamin D3 supplement. Will you be a victim of the vitamin D deficiency epidemic? Supplementing with at least 1,000 IU daily of vitamin D3 may be able to save you from some of the most dreaded diseases of our time.

Vitamin D3 Lowers Inflammation

Dr. William Gruss, M.D., states in his newly released book, A Cardiologist’s Guide to Anti-Aging, Antioxidants and Resveratrol that chronic inflammation is at the root of all chronic disease. Recent research shows that low levels of vitamin D deficiency are associated with increased inflammation in otherwise healthy people. Inflammation is significantly reduced following vitamin D supplementation.[7]

German researchers found that patients with chronic heart failure who were given 2,000 IU of vitamin D for nine months had increased concentrations of anti-inflammatory IL-10 and reduced concentrations of the inflammation-producing TNF-alpha.[8]

Inflammation is a natural part of the body’s immune response. It goes up in response to illness or injury, and then is supposed to come back down. When inflammation does not return to normal levels, it can eventually damage tissue and cause disease. As people age, their inflammation does not go down as efficiently. Eating an anti-inflammatory diet high in fruits, vegetables, lean meats, whole grains, legumes, and nuts plus supplementing with anti-inflammatory supplements such as vitamin D3 may dramatically improve your health, especially as you get older. (See Breaking News—Anti-Inflammatory Diet. Also see January 2008 issue)

Vitamin D3 Reduces Pain

Researchers at the Mayo Clinic have been leading the way in understanding how vitamin D affects pain. A study in 2007 found that patients low in vitamin D needed twice as much morphine to relieve their pain as people who had adequate levels, and they took morphine for longer periods of time. [9] In other words, low levels of vitamin D makes any pain you have much worse and last longer.

A groundbreaking study at the Mayo Clinic found that of 150 patients who had severe pain in muscles and bones, 93% had deficient levels of vitamin D.[10] All had been misdiagnosed over a period of two years. A Swiss study confirmed these findings. Over 90% of patients who had complained of severe “all-over” pain for over two years were diagnosed as having emotional, not physical, problems. After treatment with vitamin D, 66.7% no longer had any symptoms of pain.[11]

Low back pain is one of the most difficult types of pain to treat. Doctors often can find no physical cause. Now, research is showing it may be caused by low levels of vitamin D. Researchers in one study gave vitamin D to 360 men and women who had suffered low back pain lasting for more than six months. Tests showed that 83% of the participants had abnormally low levels of vitamin D. After three months, all those who were deficient in vitamin D reported improvement in their pain.[12]

A small case-study reported improvement in premenopausal women with menstrually related migraine when they were treated with vitamin D and calcium.[13]

More Vitamin D3=Less Cancer

It’s almost hard to believe that a simple vitamin could actually be critical in protecting your cells from cancer. However, it appears that is Nature’s plan. Vitamin D3 is a critical part of a process that helps control the growth of cells and decreases the risk of malignancy.[14]

As early as the 1940s, doctors observed that people living in southern states with more sun exposure were more likely to have non-lethal skin cancer, but much less likely to have lethal breast, colon and prostate cancers. In fact, this correlation was so strong that some scientists suggested giving patients skin cancer in order to protect them from other cancers. Well, this wasn’t such a good idea, but it has been well-documented that living in northern latitudes with less sunlight gives you a greater risk of developing and dying of colon, prostate, breast, ovarian, esophageal, and non-Hodgkin’s lymphoma.[15] [16] [17] Observational studies have determined that there is a 30-50% decreased risk of developing and dying of colon, prostate and breast cancer if you maintain a level of vitamin D of 20 ng/mL.[18] Even the conservative Fact Sheet on Vitamin D published online by the Office of Dietary supplements says, “In fact, for over 60 years researchers have observed an inverse association between sun exposure and cancer mortality.”[19]

Vitamin D3 Reduces Risk of Breast Cancer

For over 60 years, observational studies have pointed to a link between low levels of vitamin D and cancer. However, in June, 2007, a leading researcher, Dr. J. Lappe, published a landmark “gold standard” randomized, double-blind, placebo-controlled trial of over 1,000 women that showed a reduction of up to 77% in breast cancer in those who took 1,100 IU daily of vitamin D3. (See “One of The Biggest Medical Mistakes of All Time” in this issue.)

Vitamin D3 Protects Against Prostate Cancer

Researchers at Harvard Medical School followed nearly 15,000 male physicians for 18 years. They found that up to 77% had insufficient levels of vitamin D3 in the winter. Men who had the lowest levels of vitamin D3 had a significantly increased risk of aggressive prostate cancer. They concluded that a large proportion of US men had suboptimal vitamin D status (especially during the winter/spring season), and that vitamin D3 may play an important role in preventing prostate cancer progression.[20]

Vitamin D3 Lowers Mortality from Colon Cancer

A large group of people (16,818) had their levels of vitamin D measured. Ten years later researchers found that those with the lowest levels of vitamin D were four times more likely to die from colon cancer.[21]

Cancer expert Dr. Cedric Garland, cancer prevention specialist at the Moores Cancer Center at the University of California, San Diego and his colleagues estimate that 250,000 cases of colorectal cancer and 350,000 cases of breast cancer could be prevented by increasing intake of vitamin D3. Dr. Garland recommends taking 2,000 IU a day for a meaningful reduction in colorectal cancer.[22]

Vitamin D3 Halves Risk of Pancreatic Cancer

A study of 46,771 men and 75,427 women led by Harvard and Northwestern researchers found that the risk of getting pancreatic cancer, the fourth-leading cause of cancer deaths in the U.S., can be reduced by half by taking vitamin D. The subjects in this study took 400 IU daily.[23]

Vitamin D3 Increases Survival from Malignant Melanoma

Interestingly, having low levels of vitamin D is also associated with having the most malignant type of skin cancer—melanoma.[24] [25] Higher levels of sun exposure are associated with increased survival of malignant melanoma.[26]

What About Skin Cancer?

There is a great deal of awareness that excess sun exposure may lead to non-lethal skin cancers, skin damage and wrinkling. Hours of baking in the sun are not recommended as a way of getting enough vitamin D3. Optimum sun exposure for maintaining healthy levels of vitamin D3 is 10-15 minutes during midday for light-skinned persons. If this is not possible, make sure you take a supplement with at least 1,000 IU a day of D3.

There is some intriguing research being done on the how antioxidants such as resveratrol may protect against skin cancer and skin damage caused by sun exposure. We will be covering this topic in future issues of Natural Health News Report.

What Else Does Vitamin D3 Do?
Reduces the Pain of Arthritis

Researchers in Boston studied 221 patients with an average age of 67 years with osteoarthritis of the knee. Patients with low baseline vitamin D levels had significantly more pain and disability compared with patients with higher levels. Nearly half of the patients recruited had deficient levels of vitamin D [20 ng/mLo or less].[27]

Reduces Heart Disease

Researchers studied data about vitamin D levels for over 7,000 men and nearly 8,000 women. They found that people who had low levels of vitamin D (less than 21 ng/mL) had a 30% increased prevalence of hypertension; 98% increased prevalence of diabetes; and 47% increased prevalence of high serum triglycerides compared to those with higher levels of vitamin D (at least 37 ng/mL). Levels were generally lower in women, the elderly, racial/ethnic minorities, obese, hypertensive, and diabetic people

The researchers concluded that the “normal” levels of vitamin D are set too low to prevent heart disease. Doctors may think their patients have sufficient vitamin D based on out of date standards and not recommend supplementation. Scientific experts in vitamin D recommend changing the “normal” standard and taking enough vitamin D3 to prevent high blood pressure and heart disease—at least 1,000 IU a day. [28]

A research review found that too little vitamin D may contribute to the worldwide prevalence of cardiovascular disease through several mechanisms including increasing inflammation.[29]

Dr. Joseph Cannell, a practicing physician and one of the leading proponents of vitamin D3 supplementation, states that he raises blood levels to 50 ng/mL using vitamin D supplementation, plus fish oil and L-arginine in order to reverse coronary plaque and heart disease. He found that most of his patients require 2,000-4,000 IU per day in winter and half that dose in summer. Some require as much as 8,000 IU a day, while a few only require 1,000 IU. He states that reductions of plaque of 20-30% are not uncommon.[30]

Strengthens Bones and Prevent Osteoporosis

Having sufficient levels of vitamin D help absorb calcium and strengthen bones. Osteoporosis greatly increases the risk of bone fractures. Experts believe that osteoporosis is an example of the long-term effect of vitamin D deficiency.[31]

Reduces Risk of Multiple Sclerosis

Having higher levels of vitamin D may reduce the risk of developing multiple sclerosis by as much as 62% say Harvard researchers. The report was published in the Journal of the American Medical Association. Researchers said that the main protective effects were seen for people of white ethnicity.[32]

Reduces Risk of Diabetes

Vitamin D deficiency has been associated with having too little insulin and insulin resistance. Children with low levels of vitamin D were found to be a greater risk for the development of type one diabetes.[33] A study based on over 83,000 nurses found that 800 IU of vitamin D and 1200 mg of calcium daily may lower risk of diabetes 2 by 33%.[34]

Helps You Live Longer and Healthier

The evidence is overwhelming. Taking a modest supplement of vitamin D3 can help reduce your risk of all the major chronic illnesses. It can help prevent falls—one of the most dangerous things that can happen as you age. More than one third of people over 65 fall each year and the main problem is muscle weakness. Taking at least 800 IU a day can help. One randomized trial with older women given 800 IU of vitamin D showed a 47% reduction in falls and fractures over 12 months! In another study, the incidence of falls was cut in half—by taking 800 IU of vitamin D. Other studies showed the recommended daily intake of 400 IU of vitamin D did not help. [35]

Researchers in London discovered that vitamin D may even help you live longer. Women with higher levels of vitamin D were more likely to have a chromosome length that predicts living longer without chronic disease.[36]

How Much Do I Take?

After reading dozens of studies, I conclude that 1,000—2,000 IU a day is a good place to start, in addition to 10-15 minutes in the midday sun for fair-skinned people and 5 to 10 times that for dark-skinned people. If you are someone who is at higher risk (see below), consider taking up to 5,000 IU daily.

Fifteen experts from universities, research institutes and university hospitals around the world recently called upon governmental agencies to “reassess as a matter of high priority” outdated intake recommendations for vitamin D. Based on a review of the scientific evidence, the experts want to increase the current tolerable upper intake level that is currently 2,000 IU a day to 10,000 IU a day.[37]

Are You At Highest Risk for Vitamin D Deficiency?[38]

Dark Skin —84% of African American men and women over 65 years of age were vitamin deficient at the end of the summer in Boston.[39] Age 70 or older—Older people make 25% less vitamin D when exposed to sunlight than they did when they were younger. Overweight —In obese children and adults, vitamin D3 is stored deep in the body fat, making it more difficult for the body to use it. Live in northern latitudes Use sunscreen of SPF 8 or higher regularly Stay indoors most of the time Cover all skin with clothing when outdoors Rarely, if ever, drink fortified milk or eat oily fish like salmon

Best Test for Vitamin D Deficiency

Get tested. The next time you go to the doctor for a checkup request a vitamin D test. According to Dr. Michael Holick, one of the world authorities on vitamin D, the measurement of 25(OH)D is the gold standard for determining vitamin D status. He says that the “normal range” which is typically 25-37.5 nmol/L (10-15 ng/mL) is not an accurate standard of deficiency or toxicity. He recommends the ideal concentration is having a serum 25(OH)D above 80 nmol/L (32 ng/mL). Vitamin D toxicity including hypercalcimia does not occur until the 25(OH)D reach levels of at least 375 nmol/L (150 ng/mL). Your doctor’s laboratory may be using a test that is no longer considered accurate, so please take this newsletter with you and make sure you are getting the right test. The measurement of 1,25(OH)2D provides no accurate insight about vitamin D status.[40] [41]

Best Foods to Eat for Vitamin D

Oily fish including salmon, mackerel and herring Cod liver oil Sun-dried mushrooms Foods fortified with vitamin D

The Easy Way to Age Well

Nutritional science is giving us many answers to living a longer and healthier life. Reducing inflammation with antioxidants and supplements, eating 5 fruits and vegetables daily, getting just a little bit of sunshine every day when possible, and taking a vitamin D3 supplement of at least 1,000 IU daily can make a huge difference between a weak and feeble old age burdened with cancer and chronic illness and a vibrant, healthy and long life. It’s your choice

References

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[4] Vieth R, et al. The urgent need to recommend an intake of vitamin D that is effective. Am J Clin Nutr. 2007 March;85(3):649-50.

[5] Vieth (2007)

[6] Powell HS, et al. Tackling vitamin D deficiency. Symposium on Osteoporosis. Postgraduate Medicine Online. Vol 119, No 1/June-July 2006. Oww.postgradmed.om/issues/2006/06/025/nline

[7] Timms PM, et al. Circulating MMP9, vitamin D and variation in the TIMP-1 response with VDR genotype: mechanisms for inflammatory damage in chronic disorders? QJM. 2002 Dec;95(12):787-96.

[8] Schleitoff SS, et al. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized placebo-controlled trial. Am J Clin Nutr. 2006 Apr;83(4):754-59.

[9] Hooten WM, et al. Prevalence and clinical correlates of vitamin D inadequacy among patients with chronic pain. Annual Meeting October, 2007, American Society of Anesthesiologists. Anesthesiology 2007;107:1380.

[10] Plotnikoff GA, et al. Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc. 2003;78:1463-70.

[11] De Torrente de la Jara G, et al. Female asylum seekers with musculoskeletal pain: the importance of diagnosis and treatment of hypovitaminosis D. BMC Fam Pract. 2006 Jan 23;7:4.

[12] Al Faraj S, et al. Vitamin D deficiency and chronic low back pain in Saudi Arabia. Spine. 2003 Jan 15;28(2):177-9.

[13] Thys-Jacobs S. Alleviation of migraines with therapeutic vitamin D and calcium. Headache. 1994 Nov-Dec;34(10):590-2.

[14] Holick MF. Vitamin D. Importance in the prevention of cancers, type 1 diabetes, heart disasse and osteoporosis. Am J Clin Nutr. 2004;79:362-71.

[15] Garland FC, et al. Dietary vitamin D and calcium and risk of colorectal cancer: a 19-year prospective study in men. Lancet. 1985;9:307-9.

[16] Grant WB. An estimate of premature cancer mortality in the U.S. due to inadequate doses of solar ultraviolet-B radiation. Cancer. 2002;94:1867-75.

[17] Holick (2005).

[18] Holick (2005).

[19] Dietary Supplement Fact Sheet: Vitamin D. Office of Dietary Supplements: National Institutes of Health. Online at www.ods.od.nih.gov/factsheets/vitamind.asp

[20] Giovannucci EL, et al. A prospective study of plasma vitamin D metabolites, vitamin D receptor polymorphisms, and prostate cancer. PLoS Med. 2007 Mar;4(3):e103.

[21] Freedman DM, et al. Prospective study of serum vitamin D and cancer mortality in the United States. J Natl Cancer Inst. 2007 Oct 30.

[22] Garland CF, et al. What is the dose-response relationship between vitamin D and cancer risk? Nutr Rev. 2007 Aug;65(8 Pt 2):S91-5.

[23] Skinner H, et al. Cancer Epidemiology Biomarkers & Prevention. Sep 2006.

[24] Braun MM, et al. A role for photoproducts of vitamin D in the etiology of cutaneous melanoma?

[25] Osborne JE, et al. Vitamin D and systemic cancer: Is this relevant to malignant melanoma? Br J Dermatol. 2002 Aug; 147(2):197-213.

[26] Berwick M, et al. Sun exposure and mortality from melanoma. J Natl Cancer Inst. 2005 Feb 2;97(3):195-9.

[27] Felson DT 2004 68th annual scientific meeting of the American College of Rheumatology. MacNeil JS.

Vitamin D deficiency linked to pain and disability in knee osteoarthritis. Medscape Medical News. Oct 19, 2004.

[28] Martins D, et al. prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States — Data from the Third National Health and Nutrition Examination Survey. Arch Int Med. 2007;167:1159-1165.

[29] Zitterman A, et al. Putting cardiovascular disease and vitamin D insufficiency into perspective. Br J Nutr. 2005 Oct;94(4):483-92.

[30] Davis W. Vitamin D’s crucial role in cardiovascular protection. LE Magazine, Sept. 2007. Online www.lef.org.

[31] LeBoff MS, et al. Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. J Am Med Assoc. 1999;251:1505-11.

[32] Munger KL, et al. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA. 2006 Dec; 296:2832-2838

[33] Ortlepp JR, et al. The vitamin D receptor gene variant is associated with the prevalence of type 2 diabetes mellitus and coronary artery disease. Diabet Med. 2001 Oct;18(10):842-5.

[34] Anastassios G, et al. The role of vitamin D and calcium in type 2 diabetes. J Clin Endocr & Metab. 2007;92(6):2017-2029.

[35] NutraIngredeints News: Call for vitamin D supplements for housebound elderly. 04/03/05. Online www.nutraingredients.com/news/printNewsBis.asp?id=58509.

[36] Richards B, et al. Higher serum vitamin D concentrations are associated with longer leukocyte telomere length in women. Amer J Clin Nutr. Nov 2007.

[37] Vieth (2007).

[38] Holick (2005).

[39] Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 2004;80(Suppl):1678S-88S.

[40] Holick (2005).

[41] Holick (2004).

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