Posts Tagged ‘vitamin D’

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Vitamin D Debacle

Monday, December 6th, 2010

Vitamin D Debacle
We have heard a lot of questions this week concerning the recently released Institute of Medicine’s (IOM) ‘new and improved’ recommendations for vitamin D and calcium intake.  While the Institute’s recommendations about calcium seem to be agreed upon by most, the recommendations released for vitamin D have caused quite a stir in groups of health care providers across the country.
To begin with, let’s review what Vitamin D does for us.  Whether through dietary intake or good old sunshine, once active Vitamin D has gotten into our systems, it plays a very valuable role.  Our immune system is greatly influenced by D, to the tune of increased and enhanced immune cell function. Vitamin D also assists with the very intricate regulation of calcium in the body— so without it, calcium cannot be absorbed nor integrated into our bones, therefore decreasing the integrity of our skeletal system (which, as it turns out, is actually pretty important to us).   The uncontrolled dividing of cells (AKA: rapid proliferation) and lack of cellular differentiation, which leads to the formation of cancers in the body, can be halted by the active form of Vitamin D.  It also plays a role in blood pressure regulation and insulin secretion as well as a host of other functions.  (To find out more, read a little here: http://lpi.oregonstate.edu/infocenter/vitamins/vitaminD/)
The actual IOM report is quite a tome, weighing in at total of 990 pages long.  (If you have a free weekend, take a gander for yourself: http://books.nap.edu/openbook.php?record_id=13050)  To be honest, I did NOT comb through all 1000 of the research articles that the IOM used in its decision making process.  Here are the basics: They have raised the suggested daily intake from 400 to 600 IUs of Vitamin D.
The other half of the research is focused on the suggested calcium supplement intakes (Not taking into account food-based calcium, how you prepare that food and what types of foods….).  At the end of it all, the researchers are saying that the recommended intake is 600 IUs (800 in the elderly, 400 in wee ones), but the upper tolerable limit, where “the risk of harm increases,” is 4,000 IU per day.  I feel that the intake recommendations are overly conservative, and quite limiting in light of the potential benefits that Vitamin D can offer.
The IOM is also recommending that threshold for Vitamin D testing be at the 20 ng/ml level. We generally like to see the levels around 80 ng/mls, but most people in the Northwest clock in around 20-30 on an initial screen.  Many of the studies quoted and used to formulate the new recommendations are based in toxicity studies.   It looks like the toxicity studies that they used for adults all included doses of Vit D of 100,000 to 150,000 IUs of Vitamin D a day for anywhere from 3-4 weeks to several years years….increasing the blood levels up anywhere from 150 to the 1000’s.  This is way too high! Other studies used are based off of cases of accidental over-fortification, which is very different than the supplemental Vitamin D that our patients have come to know and love.   Overall, not the most convincing body of evidence to base new lab levels on.
The best rebuttal to the statements made in the research came from the Vitamin D Council.  Here is that link:
http://www.vitamindcouncil.org/vdc-statement-fnb-vitamin-d-report.shtml
It is fairly humorous and mildly thick with disgust for claimed data mis-interpretation and deletion that is in the IOM statement.  Here are the salient response jabs:
–”After 13 year of silence, the quasi governmental agency, the Institute of Medicine’s (IOM) Food and Nutrition Board (FNB), today recommended that a three-pound premature infant take virtually the same amount of Vitamin D as a 300 pound pregnant woman.”
–“As a single, 30 minute dose of summer sunshine gives adults more than 10,000 IU (250 micrograms), the FNB is apparently also warning that natural Vitamin D input — as occurred from the sun before the widespread use of sunscreen — is dangerous. That is, the FNB is implying that God does not know what she is doing.”
–“Today, the FNB has failed millions of pregnant women whose as yet unborn babies will pay the price. Let us hope the FNB will comply with the spirit of “transparency” by quickly responding to our Freedom of Information requests.”
Another great article was on the Huffington Post by Dr. David Katz, whose work I generally enjoy and his articles seem to have a good enough natural-based-bent to them.
http://www.huffingtonpost.com/david-katz-md/vitamind–andcalcium-shouldwe–becautious_b_789842.html
His summary is as follows:
“Calcium and vitamin D are important nutrients. As with all nutrients, enough is good — too little or too much is bad. The IOM invokes the precautionary principle to offer recommendations that are reasonable, and willfully conservative. But a relative absence of evidence means that guidance is as much about judgment as science.”
I think at the end of it all, what I am falling back on is that checking patients’ blood levels, like any therapy we initiate, is key.  Yes, 5,000 to 10,000 IUs of Vitamin D for YEARS and YEARS might be too much (again, not enough data to support or negate).
But keeping people on 1000 to 4000 daily as a maintenance dose (and, of course, using higher doses when clinically needed) while keeping blood levels in check, is JUST FINE.
Especially in Portland, where our 2 months of partial sun in 2010 has us all a little cranky and seasonally affected.

________________________________________________
by Dr. Leslie Fuller

Nature Cures Clinic physician

We have heard a lot of questions this week concerning the recently released Institute of Medicine’s (IOM) ‘new and improved’ recommendations for Vitamin D and Calcium intake.  While the Institute’s recommendations about Calcium seem to be agreed upon by most, the recommendations released for Vitamin D have caused quite a stir in groups of health care providers across the country.  2646438199_b309cffd65

To begin with, let’s review what Vitamin D does for us.  Whether through dietary intake or good old sunshine, once active Vitamin D has gotten into our systems, it plays a very valuable role.  Our immune system is greatly influenced by D, to the tune of increased and enhanced immune cell function. Vitamin D also assists with the very intricate regulation of calcium in the body— so without it, calcium cannot be absorbed nor integrated into our bones, therefore decreasing the integrity of our skeletal system (which, as it turns out, is actually pretty important to us).   The uncontrolled dividing of cells (a.k.a. rapid proliferation) and lack of cellular differentiation, which leads to the formation of cancers in the body, can be halted by the active form of Vitamin D.  It also plays a role in blood pressure regulation and insulin secretion as well as a host of other functions.  (To find out more, read a little here)

The actual IOM report is quite a tome, at a total of 990 pages long.  (If you have a free weekend, take a gander for yourself.)  To be honest, I did NOT comb through all 100 of the research articles that the IOM used to make its recommendations.  But here are the basic recommendations:

Raise the suggested daily intake from 400 to 600 IUs of Vitamin D. The other half of the research is focused on the suggested Calcium supplement intakes (Not taking into account food-based Calcium, how you prepare that food and what types of foods…).  At the end of it all, the researchers are saying that the recommended intake is 600 IUs (800 in the elderly, 400 in wee ones), but the upper tolerable limit, where “the risk of harm increases,” is 4,000 IU per day.  I feel that the intake recommendations are overly conservative, and quite limiting in light of the potential benefits that Vitamin D can offer.

The IOM is also recommending that threshold for Vitamin D testing be at the 20 ng/ml level. We generally like to see the levels around 80 ng/mls, but most people in the Northwest clock in around 20-30 on an initial screen.  Many of the studies quoted and used to formulate the new recommendations are based in toxicity studies.   It looks like the toxicity studies that they used for adults all included doses of Vit D of 100,000 to 150,000 IUs of Vitamin D a day for anywhere from 3-4 weeks to several years years… increasing the blood levels up anywhere from 150 to the 1000’s.  This is way too high! Other studies used are based off of cases of accidental over-fortification, which is very different than the supplemental Vitamin D that our patients have come to know and love.   Overall, not the most convincing body of evidence to base new lab levels on.

The best rebuttal to the statements made in the research came from the Vitamin D Council. It is fairly humorous and mildly thick with disgust for claimed data mis-interpretation and deletion that is in the IOM statement.  Here are the salient response jabs:

–”After 13 year of silence, the quasi governmental agency, the Institute of Medicine’s (IOM) Food and Nutrition Board (FNB), today recommended that a three-pound premature infant take virtually the same amount of Vitamin D as a 300 pound pregnant woman.”

–“As a single, 30 minute dose of summer sunshine gives adults more than 10,000 IU (250 micrograms), the FNB is apparently also warning that natural Vitamin D input — as occurred from the sun before the widespread use of sunscreen — is dangerous. That is, the FNB is implying that God does not know what she is doing.”

–“Today, the FNB has failed millions of pregnant women whose as yet unborn babies will pay the price. Let us hope the FNB will comply with the spirit of “transparency” by quickly responding to our Freedom of Information requests.”

Another great article  on the topic came from the Huffington Post , from Dr. David Katz, whose work I generally enjoy and whose articles seem to have a natural-based-bent to them.

His summary is as follows:

“Calcium and vitamin D are important nutrients. As with all nutrients, enough is good — too little or too much is bad. The IOM invokes the precautionary principle to offer recommendations that are reasonable, and willfully conservative. But a relative absence of evidence means that guidance is as much about judgment as science.”

I think at the end of it all, what I am falling back on is that checking patients’ blood levels, like any therapy we initiate, is key.  Yes, 5,000 to 10,000 IUs of Vitamin D for YEARS and YEARS might be too much (again, not enough data to support or negate).  But keeping people on 1000 to 4000 daily as a maintenance dose (and, of course, using higher doses when clinically needed) while keeping blood levels in check, is JUST FINE.

Especially in Portland, where our 2 months of partial sun in 2010 has us all a little cranky and seasonally affected.

Getting your Vitamin D levels checked should be part of every person’s winter health regimen. If you haven’t been tested this year, call the clinic today at (503) 287-4970, or email info@naturecuresclinic.com for an appointment.

Image courtesy: SeanMcGrath

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Cold and Flu Season 2010: Are you ready for the onslaught?

Friday, October 15th, 2010

by Dr. Greg Eckel

Nature Cures Clinic physician

Well it’s that time of year again.  The marketing machine rolls on with the public health campaign that says the only protection you have against the deadly flu is to get your flu shot. We have been reporting on this since the avian flu scare of 2005 (see podcast here).  1108486420_dccf9d415d

We recently just produced a new flu vodcast/ podcast.  Dr. Nigh and I really try to have fun while (hopefully) giving you some sane (and entertaining) commentary on the current climate of information.

A few years ago, we were asked to write up what you can do for viral illness for the state of Oregon.  We wrote this while working with the Alliance Working for Antibiotic Resistance Education (AWARE), a group working towards educating the public and doctors about improper antibiotic prescriptions and how they lead to antibiotic resistant strains of bacteria.  There is pressure at doctor’s offices to do something when their patients are sick.  The doctors in general will write a prescription for antibiotics, even though the majority of cases are viral in nature.  This improper prescribing of antibiotics in turn leads to the creation of super bugs, that are resistant to antibiotics.  The current medical system has very little to offer patients with viral illnesses.

The Centers of Disease Control, in the name of public health, has their 1,2, 3 list of what to do to increase your odds of not getting the flu this year:
1) Get a flu shot.
2) Stay away from those that are sick, wash your hands often.
3) Take anti-virals if you get the flu.

As far as public policy, this is lacking considerably.  Here I will once again reference our position paper linked above as another view of what you can do to increase your immune system’s vitality.

Let’s look at the research.  The conservative group the Cochrane Review, a consortium of scientists around the globe has done a great job in collecting the data on the effectiveness of the flu vaccine.  If we were to believe the propaganda machine of the mainstream media, you’d experience a 100% effective rate against getting the flu.  It is repeated by most of the medical societies so much so it must be true.  On review of the literature, we find, “Authors’ conclusions influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.
WARNING:
This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding.”

Last year during the swine flu (H1N1) hysteria, I got into several debates with conventional doctors, who continually referred to websites of their professional organizations, saying they were supporting the flu vaccine.  I kept asking for the research to support their conclusions. In reality, the data is very slim and suspect, as the Cochrane review suggests.

The second recommendation is actually not bad; washing your hands often is a very good hygienic practice.  I like to have our patients focus more on their own terrain, rather than being paranoid of others’ illnesses.  But I do agree with the CDC recommendation number 2.

Let’s look at the third recommendation.  Take anti-virals if you get sick.  This seems to be more of a sanctioned ad for the pharmaceutical industry.  The research shows these anti-virals produce at best one day less of illness.  This is hardly enough for a national public health policy.  (Here is the citation that goes with this information: Antiviral medications are adjunctive agents for the prevention of influenza. They also are used early in the course of uncomplicated influenza infection to reduce the duration of illness by approximately 1 day. 12 12. Gubareva LV, Kaiser L, Hayden FG. Influenza virus neuraminidase inhibitors. Lancet. 2000;355:827-835. )

We have talked a lot through the years about the issue of terrain versus the bug.  Unfortunately, Louis Pasteur won the debate on germ theory and we are currently stuck with the outlook that the bug is the issue.  His contemporary at the time was Beauchamp, who argues that we are all exposed to the bug, why do only some of us get sick.  His point was that is the terrain that matters.

In practice of course it is both of these theories.  Our public policy only views the bug, holistically we consider both of them.  In recent times there is more and more research to support Vitamin D’s usefulness for immune system response.  We encourage all of our patients to have their vitamin D level checked at least once per year.  This gives you an opportunity to make sure you are in the ideal range for vitamin D’s effectiveness.

If you are interested in optimizing your immune system this cold and flu season, please call the office and schedule an appointment.  For more information be sure to watch or listen to our current vod/podcast here.

Here’s to a healthy and happy fall!

In health and sanity,  Dr. Eckel

photo courtesy: Trumanlo

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Posted in Articles by our Doctors, Colds, Flu, General, H1N1, Respiratory infections, Swine flu | 1 Comment »

Vitamin D Protects Against Obesity-Induced Endometrial Cancer, Study Suggests

Tuesday, September 21st, 2010

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Vitamin D proven far better than vaccines at preventing influenza infections

Thursday, September 16th, 2010

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Vitamin D Is A Prognostic Marker In Heart Failure

Thursday, September 2nd, 2010

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Vitamin D really does prevent cancer, autoimmune diseases

Monday, August 30th, 2010

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Vitamin D may treat and prevent allergic reaction to mold in cystic fibrosis patients

Thursday, August 26th, 2010

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Vitamin D Found to Influence Over 200 Genes, Highlighting Links to Disease

Tuesday, August 24th, 2010

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Vitamin D Linked To Autoimmune And Cancer Disease Genes, Underscoring Risks Of Deficiency

Tuesday, August 24th, 2010

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Even a low-dose vitamin D pill cuts breast cancer risk by 24 percent

Sunday, August 15th, 2010

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Higher 25-hydroxyvitamin D is associated with lower relapse risk in multiple sclerosis.

Wednesday, August 11th, 2010

Study shows that there is an inverse relationship between 25-OH-D levels and risk of relapse in MS patients.

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Vitamin D improves overall immune function

Monday, August 9th, 2010

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Vitamin D best taken with largest meal of day, study finds

Tuesday, July 27th, 2010

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Lack of sunlight exposure causes mothers to give birth to babies with multiple sclerosis

Friday, July 16th, 2010

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Large-Scale, Long-Term Studies Support Roles Of Physical Activity And Diet In Dementia And Cognitive Decline

Tuesday, July 13th, 2010

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