Table of Contents. Your Individual Result Report. Your Test Result. When should you supplement Vitamin D?

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2 Table of Contents Your Individual Result Report Your Test Result When should you supplement Vitamin D? Why are Vitamin D Levels permanently low in many People? Vitamin D Effects Supplementation of Vitamin D Synthesis of Vitamin D by Exposure to Sunlight Vitamin D Intake with Food References / 10

3 1 Your Individual Result Report Patient Max Mustermann Date of Birth Weight 81 kg Sample No. UB4RRP / P26427 Receipt of Sample Posting of Report Dear Max Mustermann, upon your request, we have measured the concentration of vitamin D in the form of the storage molecule hydroxy-cholecalciferol (25(OH)D) in your capillary blood. This storage form of vitamin D is also called Calcidiol. 2 Your Test Result Our diagnostic laboratory has measured the storage form of vitamin D, the so-called 25(OH) vitamin D, because this molecule has the highest informative value with regard to the basic supply of the vitamin. Values between 31 and 90 ng/ml are within the acceptable range, with 31 ng/ml representing the lowest acceptable limit. General nutrition recommendations still regard a concentration of 20 ng/ml as normal, but experts from the field of the orthomolecular medicine recommend a level of ng/ml as the target for an optimal and preventative supply. Sometimes, vitamin D concentrations are also given as µg/l or nmol/l. The conversion is: 1 ng/ml = 1µg/l = 2,5 nmol/l We have measured a vitamin D concentration (25(OH)D) of 20,0 ng/ ml in your blood sample. 3 / 10

4 According to the following table which is based on the views of the orthomolecular medicine, this value implicates that, in the long term, your current vitamin D supply will lead to a vitamin D deficiency. You should try to reach a vitamin D level of 40 ng/ml in order to ensure a good provision. To reach this goal, your vitamin D level has to be raised by approximately 20,00 ng/ml. How can you move your Vitamin D Level to an Optimal Range? Based on your current vitamin D status of 20,0 ng/ml, which we have determined for you, Max Mustermann, you would have to raise your vitamin D level by 20,00 ng/ml in order to reach a preventative level. The supply needs to be adjusted individually to your body weight. With your current weight of 81 lb, you need ,6 IU vitamin D in addition to the maintenance dose. In order to achieve this, you need to do one of the following things in addition to taking your maintenance dose of IU per day: a) intensive whole body sunbathing without sun cream for 23 days for at least 10 min b) daily intake of IU vitamin D in the form of a balanced diet or a purchasable product (5 x 1 capsule/tablet à IU) for 46 days c) intake of vitamin D tablets with a higher dosage (needs to be prescribed by a physician in most countries), e.g IU per tablet, 1 tablet per day for 12 days It is worth to check your vitamin D level on a regular basis and to reach an optimal range. It is very likely that you will notice the effects yourself after a short period of time. Thank you very much for your trust and for using our service. Your cerascreen team 4 / 10

5 3 When should you supplement Vitamin D? From the physician s point of view, a balance diet or a direct supply of vitamin D is recommended, when the vitamin D level decrease below 20 ng/ml. Some bodily functions are already affected at levels below 31 ng/ml. According to the orthomolecular medicine, a good supply is reached when the vitamin D levels are between ng/ml. You can raise your vitamin D level by an increased solar irradiation of your skin (UVB rays) or an external supplementation. Please note that the vitamin D synthesis is already blocked by very weak sun creams. In order to keep your vitamin D level stable, you need to supply units of vitamin D every day. Sometimes, it is recommended to increase the supply to units per day during the winter months in order to compensate the increased needs of your body and to keep the vitamin D level stable. It is quite normal that the vitamin D levels fluctuate throughout the year. The reason for this effect is that the body can make vitamin D from cholesterol, if the skin is exposed to the sun (UVB rays). If you want to optimize your vitamin D intake, the vitamin concentrations should be checked several times during the year, because the supply needed can vary from individual to individual. Vitamin D is fat-soluble. Depending on the amount of fatty tissue, vitamin D is taken from the body`s circulation thereby creating an increased need of vitamin D to keep an optimal blood concentration. This means that the necessary supply can be calculated based on the body weight, but it is nevertheless advisable to perform a control measurement on a regular basis. If you supply vitamin D by following a balanced diet or by supplementing vitamin D, an over dosage can occur in extreme cases. If your weight (especially the percentage of body fat), or the duration of sun exposure change, this may also influence your individual vitamin D level. In all of these cases, a regular check of your vitamin D level is recommended. Concentrations of more than 150 ng/ml lead to a vitamin D intoxication. 5 / 10

6 4 Why are Vitamin D Levels permanently low in many People? About 95 % of the vitamin D can be made by the body itself from cholesterol, if the skin is regularly and sufficiently exposed to the sun (UVB rays). Please note that a sun cream with protection factor 8 is able to more or less completely block the vitamin D synthesis. Radiation in the solarium is only effective, if the irradiation also contains UVB rays. In case of inadequate sunlight, it is very difficult to reach sufficient levels with a healthy diet, because the natural vitamin D levels in food are usually very low. Exceptions are fatty fish, such as eel, herring or salmon. The conditions that led the evolution of modern man indicate that a vitamin D concentration of 60 ng/ml used to be normal. One professional group that still reaches this high level are the lifeguards on the coasts of the United States of America and Australia. The current value that is regarded as being normal was derived from a random sample of office workers who had an average value of approximately 27 ng/ml. This means that the value currently regarded as the normal value reflects in reality a vitamin D insufficiency compared to the evolutionary situation. The lower limit of 10 ng/ml was defined, because at levels lower than this, serious diseases such as bone softening (osteomalacia, rickets) can always be observed. This leads to extreme damages and is the reason why every newborn is prophylactically treated with vitamin D. Every value below 31 ng/ml already leads to a restriction of certain functions that are induced by vitamin D. From the orthomolecular medicinal point of view, this is not acceptable. 5 Vitamin D Effects Vitamin D plays an important role in a large number of bodily functions. In reality, vitamin D is not a vitamin, but a hormone which explains the large number of its control functions. The number of positive effects that are achieved by an optimal vitamin D supply emphasizes its central role. Some of these effects are listed below. Muscles A vitamin D sufficiency leads to a reduction of jumping power, maximum power and maximum speed. An increase of vitamin D promotes the generation of new muscle fibers and muscle cells. Furthermore, the calcium release in the muscle is enhanced. 6 / 10

7 Geriatrics The strengthening of muscles and bones is of particular importance in people of old age. A premature need of care can be prevented by a sufficient supply of vitamin D. Furthermore, vitamin D can lower the risk of falls and this decreases the danger of femoral neck fracture. Nervous System The lack of vitamin D negatively influences illnesses such as Alzheimer s disease, Parkinson s disease, multiple sclerosis, depression, schizophrenia and autism. In general, an optimised level of vitamin D leads to an improved mood. Immune System Vitamin D promotes the production of the body s own defence molecules (kallikrein, defensin). It positively influences the activity of the immune system. Malfunction or overreactions of the immune system, such as autoimmune disorders or allergies, are attenuated. Diabetes Type-1 diabetes is an autoimmune disorder that leads to the destruction of the insulin producing cells. A vitamin D supply of units per day can lower the risk of developing type-1 diabetes by 78 %. This is traced back to the positive effect of vitamin D on the normal functioning of the immune system. For pregnant women, a preventative dose of units is recommended in order to supply the embryo with a sufficient amount of vitamin D. Type-2 diabetes is cause by a resistance to insulin which may be caused by overweight, lack of exercise, lack of sleep, stress or smoking. Vitamin D can have a positive effect by stimulating the synthesis and the function of insulin receptors on muscle and fatty cells. A vitamin D concentration of 32 ng/ml can lower the risk of developing type-2 diabetes by 75 % compared to a concentration of 14 ng/ml. Vascular Tension, Arteriosclerosis Vitamin D leads to an improved elasticity of the vessel walls and a reduction of the inclination to inflammations. Vitamin D concentrations of more than 30 ng/ml lower the risk of high blood pressure by 600 %, compared to people with a vitamin D level of only 15 ng/ml. Cardiac Function Vitamin D positively influences the function of the heart muscle. The risk for heart attacks and cerebral infarctions is 200 % higher at low vitamin D concentration (lower than 15 ng/ml) compared to people with a vitamin D concentration of more than 30 ng/ml. 7 / 10

8 Asthma, COPD The increasing rate of asthmatic illnesses is associated with low levels of vitamin D. A deficiency of vitamin D can also lead to a decrease of the pulmonary function. Furthermore, it can weaken the immune system and can enhance inflammation processes. Rachitis (Rickets) In small children, vitamin D deficiency can lead to bone softening with deformations (rickets). Today, the recommended daily dose of vitamin D for children is between 400 and 500 units. This leads to average blood concentrations of more than 11 ng/ml. Feeding with mother s milk is not able to supply the necessary amount of vitamin D, if the mother does not take at least (!) the recommended daily dose of units per day. For pregnant women, a preventative dose of units is recommended in order to supply the embryo with a sufficient amount of vitamin D. Bone Structure In adults, vitamin D deficiency combined with a calcium deficiency, can lead to a different form of bone softening (osteomalacia) and to a lack of hardening of the bone tissue which is permanently reconstructed. Indications of this can be tiredness, weakness, muscles aches, insomnia or pressure sensitivity. There is an increased risk of falls and bone fractures. 6 Supplementation of Vitamin D You can use different freely available or prescription vitamin D preparations (calciferol), dietary supplements or special balanced diets in order to improve your vitamin D supply. Depending on their classification, vitamin D concentration vary from product to product If you choose vitamin D preparations, products with up to units per tables can usually be obtained without a prescription. The products contain either vitamin D3 (animal vitamin D from wool/lanolin, cholecalciferol) or vitamin D2 (plant vitamin D from mushrooms, ergocalciferol). Special balanced diets may also contain vitamin D. The German Institute for Nutrition (DGE) recommends a daily supplementation of 800 units. Based on the study situation, this value seems to be too low. The Canadian Paediatric Association recommends units for pregnant women and the German Federal Office for Risk Evaluation (Bundesamt für Risikobewertung) gives units as the upper limit for a daily supplementation. Studies show that a supplementation of units can stabilize vitamin D levels. Orthomolecular physicians recommend a daily dose of units per day during the winter times. A replenishment of the vitamin D concentration in the blood is not possible with those doses, if the vitamin D reservoir is not filled by other means. 8 / 10

9 Therapeutic levels of vitamin D go up to units. In order to reach an optimal provision for all body functions influenced by vitamin D, a blood concentration of ng/ml should be aimed at. If the vitamin D concentration in the blood is very low, it might not be possible to sufficiently raise the concentration with freely available products. In these cases, a physician should be consulted and the vitamin D concentration should be monitored. 7 Synthesis of Vitamin D by Exposure to Sunlight The body can make Vitamin D from cholesterol if the skin is exposed to direct sunlight. In this case, the body can product units vitamin D in 10 minutes if no sun cream is used. A sun cream with protection factor 8 is able to more or less completely block the vitamin D synthesis. It therefore seems to be very unlikely that a supplementation with units vitamin D per day leads to an overdose. It is generally recommended to monitor vitamin D levels on a regular basis. 8 Vitamin D Intake with Food Higher amounts of vitamin D are contained in fatty saltwater fish (herring, salmon, sardines), seashells, egg yolk and mushrooms. Small amounts of the vitamin can also be found in milk products. Fish: Eel 25 µg/100g, herring 18 µg/100g, salmon 18 µg/100g, sardines 10 µg/100g Seashells: scallops 5 µg/100g Egg yolk: 4 µg/100g Milk products: Gouda cheese 1 µg/100g, butter 1 µg/100g Mushrooms: porcino (vit. D2) 3 µg/100g, Champinons (vit. D2) 3 µg/100g Please note: 25 µg vitamin D correspond to units vitamin D 9 References Biesalski HK, Köhrle J und Schümann K. (2002) Vitamine, Spurenelemente und Mineralstoffe, pp Georg Thieme Verlag, Stuttgart Lünen Gröber U (2008) Orthomolekulare Medizin: Ein Leitfaden für Apotheker und Ärzte. Wissenschaftliche Verlagsgesellschaft, Stuttgart Spitz J, Reichrath und Lehman D (2012) Vitamin D - Update Dustri-Verlag, München 9 / 10

10 Von Helden R (2011) Gesund in sieben Tagen: Erfolge mit der Vitamin-D-Therapie 11. Auflage Hygeia-Verlag Worm N (2010) Heilkraft D. systemed Verlag 10 / 10