VITAMIN D 4/25/13 HISTORY OF VITAMIN D SUPPLEMENTS NEW INFORMATION SOURCES COMPILATION OF SCIENTIFIC DATA VITAMIN D COMMON FACTS

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1 HISTORY OF VITAMIN D SUPPLEMENTS VITAMIN D Since 1998, the Reference Daily Intake of vitamin D has been 400 IU. NEW SCIENCE OFFERS IMPROVED HEALTH AND DISEASE PREVENTION OPPORTUNITIES Historically evidence had not yet emerged to suggest any changes were necessary. That is no longer the case. 400 IU is no longer considered adequate other than to protect against rickets NEW INFORMATION SOURCES ANOTHER ORGANIZATION FOR VITAMIN D Vitamin D Council is a non-profit organization whose mission is to educate the public and health professionals on Vitamin D using evidence based science Founded by Dr. John Cannell, M. D. in 2003 Located in San Louis Obispo CA. Check out their website at vitamindcouncil.org Grassroots Health San Diego CA Founded by Carole and Leo Baggerley Carol is a breast cancer survivor who now believes that Vitamin D levels can curb breast cancer by 77%. (Details of this study coming in a later slide) Grassroots Health panel consists of 40 leading Vitamin D experts from around the world. COMPILATION OF SCIENTIFIC DATA VITAMIN D COMMON FACTS Both the Vitamin D Council and Grassroots have compiled all the science relating to vitamin D and disease prevention. Most of it is available for viewing by registrants on their websites Two basic forms Vitamin D-2 and Vitamin D-3 D-2 is found in fungi (mushrooms) and zooplankton and some milk. It is called Ergocalciferol D-3 found in humans and animals Cholecalciferol D-3 is the real vitamin D important in human nutrition and is the type produced in human skin in response to sun exposure 1

2 MORE VITAMIN D FACTS THE AMAZING FACT D measured in International Units One IU is equal to only milligrams or 40 IU is equal to one microgram Vitamin D-3 is the form that effectively treats vitamin D deficiency (87% more effective than D-2 according to the vitamin D council). Vitamin D-2 has been the pharmaceutical grade vitamin D prescribed by doctors. Now the Vitamin D council and other experts report that Vitamin D-2 is inefficient in correcting Vitamin D deficiency Vitamin D Council is no longer recommend using the prescription form D-3 CHEMICAL STRUCTURE D-2 CHEMICAL STRUCTURE MORE VITAMIN D FACTS SUNLIGHT EXPOSURE A Fat soluble vitamin (Actually secosteroid hormone) This hormone unlocks binding sites on the human genome which control genes which are involved in every known major disease. Can only be synthesized by a photochemical process From sunlight or fungi type plants and zooplankton Correct sunlight exposure is beneficial in producing Vitamin D-3. Rays from the sun contain UVA and UVB wavelengths. UVB begins vitamin D-3 synthesis UVA causes cancer And UVB rays are usually only effective in summer, not winter. And no sunscreen 2

3 VITAMIN D FROM SUNLIGHT EXPOSURE VITAMIN D METABOLISM Self limiting in itself Plus it takes 48 hours after exposure for the D-3 to be absorbed. D from sunlight or diet moves to the liver where it is converted to 25-OH Vitamin D (calcidiol) Circulating 25-OH D is the measurement data point for determining Vitamin D status. Washing or bathing during that period literally washes the Vitamin D away. 25-OH D moves to the kidneys and is partially converted to 1.25-di-OH D (calcitriol) which is circulated as a hormone in the blood and is important in bone health and cellular activity. VITAMIN D NEEDS TO BE TESTED FOR THE MEASURMENTS Too much can be toxic, but toxicity is rare compared to thinking years ago. Whole blood or recently simple blood spot testing can test for circulating 25-OH Vitamin D which combines D-2 and D-3. Only the composite number is important. Levels are reported in ng/ml of blood. Laboratories typically report vitamin D tests in nanograms/ml (ng/ml) This is the measurement of circulating 25-Hydroxy Vitamin D (D-2 and D-3 combined) In some foreign literature and clinical work the same measurment may be listed as nonomoles per liter. If so, 1 nmol/liter = 0.4 ng/ml WHAT DO THE RESULTS INDICTATE MAXIMUM RECOMMENDED VITAMIN D A Result of <20 ng/ml indicates a deficiency A Result of ng/ml indicates probable deficiency A Result of ng/ml indicates sufficient levels Result of is Ideal and probably disease reducing > ng/ml approaching toxic levels The office of dietary supplements recommends the following upper limits: 1. Infants IU 2. Children IU 3. Children 9 or older and adults 4000 IU Result of for treating cancer and heart disease Lawrence Killingsworth, Ph. D. Sacred Hearth Medical Center Spokane 3

4 INSTITUTE OF MEDICINE GUIDELINES VITAMIN D TOXICITY Tolerable Upper Level intake to protect against toxicity: 0-6 months 1000 IU 7-12 months 1500 IU 1-3 years 2500 IU 4-8 years 3000 IU 9 + or pregnant/lac 4000 IU Extremely rare Published cases of toxicity all involve intakes of over 40,000 IU per day Two cases involve intakes of over 2,000,000 IU per day Keep you levels below 150 ng/ml to protect against toxicity REMEMBER WHY DO WE NEED THESE LEVELS It s the serum level that is important---not the dosage That s why we test! Science over the last 7-8 years has shown that most diseases can be reduced by raising vitamin D levels to these recommended levels. Improved overall health as well. Help guard against childhood developmental disorders (Maybe autism) Cognition improvement including Alzheimers PREVENTION OR IMPROVEMENT OF CHART OF DISEASE IMPROVEMENTS 1. Cancers 16 types 2. Cardiovascular disease 3. Alzheimers 4. Multiple Sclerosis 5. Diabetes 6. Immune Disorders and autoimmune diseases 7. Osteoporosis 8. Developmental disorders Nature Reviews Drug Discoveries 9, December 2010 Grassroots Health

5 SELECT STUDIES DIABETES SELECT STUDIES CANCER Youths with type I diabetes (128 in study) 25% were vitamin D deficient Creighton University study in 2007 had a group of 1100 post menopausal women with no cancer monitored for four years 1. Some got vitamin D supplementation, some placebo 2. After four years 77% less cancer incidence in vitamin D group. Svoren BM et al, J. Pediatrics, 2009 Jan; Lappe, Joan, 2007, Creighton University SELECT STUDIES PARKINSON S SELECT STUDIES ALZHEIMER S men and women w/o Parkinson s studied Vitamin D levels measured and patients followed for 29 years Individuals with higher serum Vitamin D levels showed a reduced risk of Parkinson s to the 95% confidence level Knekt, P et al, Arch Neurol 2010 July; 67 (7) Women low in vitamin D are at greater risk of mental decline and developing Alzheimer s disease Journals of Gerontology, Nov. 30, 2012, Cedric Annweiler, M.D., Angers University Hospital in France 6257 older women underwent mental ability test examinations. Low levels of vitamin D (less than 20 ng/ml) were associated with higher odds of mental decline Slinin, Yelena, M. D. VA medical Center, Minneapolis, Journals of Gerontology, Nov. 30, 2012 SELECT STUDIES IMMUNOLOGY DEVELOPMENTAL DISORDERS AUTISM Vitamin D functions to influence immune function and prevent autoimmune disease States with high UVB rays (sunlight) had ½ the autism rates In states with lowest sunlight, African American children had an autism rate 40% higher Cell Mol Biol (Noisy-le-grand), 2003 March; 49 (2) : Univ. of Wisconson Acta Med Indones, 2007 Jul-Sep; 39 (3): Univ. of Indonesia Dermato-Endocrinology 2010; 4:4 Vitamin D Council Study 5

6 AUTISM VITAMIN D LEVELS DURING PREGNANCY Children with autism have lower vitamin D levels that normal children Pregnant women who are deficient in D are more likely to give birth to children with slower brain development and decreased mental and motor skills With Vitamin D levels affecting immunity, brain development and disease prevention it is simple to comprehend the fact that levels during pregnancy need to be adequate. This can obviously affect the health of the child later in life News, Vitamin D, Children s Health Research, Sept 2012 Hollis, B and Wagner, C, Am J Clin Nutr, August 2006, vol 84 no WHAT VITAMIN LEVELS ARE COMMON? ADULT VITAMIN D LEVELS 70% of US Children were either deficient or clinically insufficient in Vitamin D Stores 42-54% of pregnant women were insufficient in vitamin D even though they took prenatal vitamins. Average of 25 ng/ml in caucasions Average of 16 ng/ml in African Americans Similar findings in Canada Journal of Pediatrics, Volume 156, pp American Academy of Pediatrics, Oct. 17, 2012 Mark Hyman, M.D., Huffington post, April 4, 2013 ECONOMIC BURDEN WHY ARE VITAMIN D LEVELS SO LOW Based on previous slide information, it is estimated that the medical economic burden due to vitamin D insufficiency is $40-$53 billion per year Corrected for pennies per day If entire population achieved level of 45 ng/ml we could lower premature death by 400,000, cancer by 35%, type II diabetes by 33% and all mortality by 7%. Most of us are not exposed to enough sunshine geographical area obviously plays a part And when we are in the sun, we usually use sunscreen SUNSCREEN CAN BLOCK UP TO 97% OF VITAMIN D FROM THE SUN As we age, your skin ages and only makes a fraction of the vitamin D that a young person makes Mark Hyman, M. D., Huffington Post, April 4,

7 FOODS HIGH IN VITAMIN D RAISING VITAMIN D TO DESIRED LEVELS Not your everyday type of food (except for eggs) Fish oils, wild salmon, cooked mackerel, sardines, mushrooms and egg (lowest) Remember, its serum levels that are the important measurement, not how much we take as supplements. So step one is GET TESTED. Blood spot test is simple and accurate. 1. ZRT Labs Portland OR 2. Purity Labs Portland OR 3. There are others Get a kit, prick your finger and send in the sample. RESULTS DICTATE SUPPLEMENT REGIMEN AVERAGE CHANGE IN D BY IU PER DAY Vitamin D Council Grassroots Health Have monitored needed supplemented levels needed to achieve desired ranges. Blood Test ng/ml Of course this will vary if you get a lot of sunlight or get substantial D from your diet Retest every 3 to 6 months Data of Grassroots Health 2012 REMEMBER FDA AND AMA ACCEPTANCE It s the serum level that is important, not the dosage That s why we test As with all research, there is still skepticism FDA has done nothing to increase % Daily Value Institute of Medicine has raised their recommended maximum levels and their recommended daily intake 7

8 INSTITUTE OF MEDICINE MEDICAL COMMUNITY Many of these cited studies need to be repeated and eventually probably will Until then skepticism will continue depending on what physicians have read Some doctors are increasing their recommended Vitamin D levels---some are not Recommended Daily Allowance means little. Test Serum Levels! HUNDREDS OF HEALTH CONDITIONS PROPER GUIDANCE FOR D The vitamin D council has now reviewed literature and studies on over 100 health conditions Their summaries are available as a reliable starting point for your own personal research Because vitamin D is so cheap and so clearly reduces all-cause mortality, I can say this with great certainty: Vitamin D represents the single most costeffective medical intervention in the United States Dr. George Plotnikoff, Medical Director, Penny George Institute for Health and Healing, Abbott Northwestern Hospital, Minneapolis MN 8