Dr. John's take on Vit D

Interesting article from Dr. Jonn of Intermountain Healthcare in Salt Lake City, Utah.

His article

He's saying that Vit D supplementation is shown NOT to be effective.

Que

Hi Que - I personally would probably not be as healthy as I am today (at my age) without vitamin D supplementation, as I've previously posted, due to the failure of doctors 15 - 20 years ago to test for 25 OH D levels. I can't say that it helped or didn't help with arrhythmia, but I certainly know that the drugs I was given for symptoms of "fibromyalgia" ... severe muscle pain and weakness, didn't work and when was finally tested for Vitamin D, my level was 18, I began aggressively supplementing with both Vitamin D3 (cholecalciferol) and several years later, Vitamin K2 MK7. I maintain that level of dosing to this day and I have had but one cold and no flu for 15 seasons. It's difficult to get out in the sun during the peak noon exposure for the few minutes required each day to maintain repletion. Aging skin is less likely to absorb the D. Those using sunscreen circumvent the benefits of sun exposure. My FM MD also monitors the 1,25(OH)₂D levels to be sure that serum calcium doesn’t become elevated…which would tend to stimulate arrhythmia.

It's useful to learn about vitamin D from some of the reliable experts who've been at this a long time. A highly reliable source of reporting on the importance of vitamin D status is the Vitamin D Council founded by John Cannell, MD... [www.vitamindcouncil.org]. Joseph Mercola, DO, has an abundance of well-researched reports by various Vitamin D experts including an interview with Robert Heaney, MD and veteran researcher on this topic. At the Mercola website there are many significant reports on the consequences of low vitamin D status. He offers the following ranges as a guideline.

<50 ng/ml is considered Deficient
50 - 70 ng/ml - Optimal
70 - 100 ng/ml - Used to treat Cancer and Heart Disease
>100 ng/ml - is considered Excess.

Mercola reports: [www.google.com]


Life Extension published a report warning about high D levels noting that atrial fibrillation can be a consequence of too much vitamin D.

New Study Warns Against Excessive Vitamin D Intake
May 2012 by William Faloon

….” At the annual conference of the American Heart Association held near the end of 2011, a study was presented that measured 25-hydroxyvitamin D blood levels in a large group of Americans.1

The data corroborates previously published findings showing that people with higher vitamin D blood levels have lower risks of degenerative disease. For example, compared to people in the deficient range, those with higher blood levels of 25-hydroxy- vitamin D had significantly lower risk of heart failure, depression, coronary artery disease, and kidney failure.1

Those whose 25-hydroxyvitamin D levels ranged 81–100 ng/mL had a 36% reduction in hypertension incidence when measured against the deficient group.

There was a warning issued, however, when blood 25-hydroxy-vitamin D exceeded 100 ng/mL. These individuals showed a higher risk of atrial fibrillation.

Even though the data presented at the American Heart Association conference is not yet published, we immediately sent an advisory to our members to ensure they maintain sufficient 25-hydroxyvitamin D levels to protect their health, but not exceed upper limit levels long ago established by Life Extension® and other experts.

How This Study Compares to Life Extension’s Protocol

In the January 2010 issue of Life Extension Magazine®, we reported startling findings that 85% of our members had less than optimal levels of vitamin D in their blood (as measured by 25-hydroxyvitamin D).

Based on a large volume of published data, we recommended that the optimal range of 25-hydroxy-vitamin D to protect against disease is between 50–80 ng/mL. Yet the vast majority (85%) of our dedicated members were below 50 ng/mL.

As people age their skin converts less sunlight into vitamin D. For instance, a 70-year-old will make about 25% of the vitamin D that a 20-year-old will make given equal exposure to sunlight.2,3 There are also absorption problems aging people encounter that usually requires they supplement with 5,000–7,000 IU of vitamin D a day to get their 25-hydroxyvitamin D level over 50 ng/mL.4

In the study presented at the American Heart Association conference, 25-hydroxyvitamin D blood levels were measured in 132,000 patients. Out of this large group, a small number (291 or 0.22%) had 25-hydroxyvitamin D levels over 100 ng/mL. This level exceeds what Life Extension® (and most others) has long recommended.

Those whose 25-hydroxyvitamin D level exceeded 100 ng/mL had an atrial fibrillation incidence 2.5 times greater than people in the safe ranges (below 100 ng/mL).

Atrial Fibrillation and Excess Vitamin D Status

As the population ages, an increasing percentage develops an irregular rhythm in the upper chambers of the heart called atrial fibrillation. It is the most common type of heart arrhythmia and approximately 5% of persons over 65 years of age are expected to be diagnosed with it.5

Continue: [www.lifeextension.com]

Jackie

Hi Que,

Are you referring to Dr John Day at Intermountain?? I just heard a highly impressive two hour summary of all the latest studies from around the world underscoring the benefits of 'sufficient' Vitamin D3 levels.

There was also much discussion of the concerted big Pharma effort to discredit Vitamin D or at least say the results are equivocal by selectively reporting on only those studies where therapeutic blood levels of D3 [the 25(OH) D3 test] were not achieved in the majority of test subjects or for too little time to show clear benefit and/or from the mix of studies that were clearly structured for failure from the outset to deliver a null equivocal result from the outset.

When you add in the strong studies using solid dosing protocols over sufficient times you get a far most consistently positive support so many of us have experienced personally over many years now.

Big Pharma has had a pretty tight iron grip on what gets published in the official allopathic oriented press and what studies do not. Some dedicated effort to look beneath the headlines will readily show an ocean of mostly supportive small to medium to large investigations indicating from medium to strong support for vitamin D.

Again, no single nutrient or pro hormone is a cure all. And shooting for a modest rise of D levels when your levels have been depleted will not have a big impact on overall health... You need to include eating well as a habit and avoiding most bad habits as well while taking a more holistic view of your own self health care for all these elements to translate into a good longer term story.

And maintaining sufficient Vitamin D status is a significant element in such an overall good health plan everyone who does not have a contraindication to Vit. D and has less than optimum levels should all add to their dietary intake by supplementing with D either in pills or via sun exposure.

And that is true regardless of which well meaning, but in this case not so well informed, 'Dr John' it is that you are referring too.

Shannon



Edited 1 time(s). Last edit at 12/19/2015 09:13AM by Shannon.

Shannon, Que's one sentence summary is a little misleading. Clearly Vit D is critical to overall nutritional health and not just about AF, although stress from not being in good health is probably a big risk factor in AF by itself. John Day reviewed the data because his level was below range. So he wrote about options to fix it. His biggest message from my read is that you can over do it as above range is correlated to AF.

Hello,

Yes, that is Dr John Day at Intermountain. He absolutely agrees that Vit D is essential, however he points to a number of studies that show that supplementation isn't therapeutic. He advocates for sunlight and food as sources of Vit D.

Jackie, thanks. I haven't had a chance to read your post. I will and will write back.

Thanks,
Q

Thanks researcher and Que,

Certainly excess vitamin D, like with all pro-hormones and full hormones have a More of a bell shaped efficacy curve. Either too little or too much on either side of a broad optimal healthy range can cause real problems. And Dr Day is right that excessive D is not good and can contribute to pro-arrhythmia likely due to increased cellular calcium loading from excessive serum Vitamin D3 ( a fair degree above 100ng/ml of 25(OH)D3 blood levels.

Staying in the sweet spot of 60-80 ng/ml will unlock the fuller range of Vitamin D benefits in most people though folks with darker skin often need less due to they having developed darker skin to help maintain optimal ranges for human populations that evolved mostly in very sunny climates near the equator.

I do reject the idea that supplementation is not therapeutic. While sun-based or even proper sun lamps with the correct balance of UV spectrum can give ideal absorption provided one either levels in tropical or semi tropical latitudes and exposes the full upper, at least, of skin to the sun between 10am to 2pm for at least 20 minutes to 30 minutes (time spent dependent on latitude under unblocked sun as well as skin color) and with zero sunscreen on each day. Or at least 4 days a week alternating days.

But there is plenty of evidence of Vitamin D3 supplemental intake having significant beneficial effects across a wide range of organ systems so long as the dose is sufficient to raise 25(OH)D into the therapeutic range mentioned above.

The problem with these meta analysis conclusions including many smaller studies from around the world of widely variable quality, is that dosing is very inconsistent in some of these studies as is insuring a consistently therapeutic blood level being achieved in the majority of the studies being included for analysis.

One of the Vit D experts at the large A4M Congress conference last year ( the same conference I am at now in Vegas now on the last day here on Sunday as I type this) showed an insightful chart comparing the results from combining well done studies in which rigor in consistent dosing and confirmation of target range blood levels were criteria for selection of studies to include for meta analysis, versus the all too common combination of a mismatch of weaker studies with widely variable dosing and blood level range and even inconsistent Vitiman D intake at all among a good number of subjects being compared has on end results and such general conclusions thus derived.

The difference in the two comparative examples he showed were strictly with the less rigorous selection process meta anaylsis showing mostly an equivocal or null result , where those in which the subjects blood levels where largely within or close to the therapeutic range showed sinificany greater evicacy for supplemental Vitamin D.

You really need to peal the skins of the onion back a few layers when deciding how much value to assign to such studies. Especially when so many of these smaller nutritional studies are under funded or poorly designed overall from the outset. A fair number are structured for failure from the outset as well by folks with a very definite agenda to show a null or at least mixed message when it comes to supplements or even hormones that, were they widely adopted, would likely cut deeply into Big Pharma sales.

Keep in mind to, the quality of the supplemental Vitamin D is important and most experts strongly recommend sticking with reputable supplement sources that use oil based soft-gel Vitamin D3 and avoid white powder-based D caps.

Shannon



Edited 1 time(s). Last edit at 12/14/2015 09:41AM by Shannon.

Shannon, Dr Day wrote that lighter skin equates to faster rate of absorption. I thought like you before I read his blog. I checked a few medical sites and he is right. The darker the skin, the slower the rate of absorption. It probably has something to do with human adaptation to latitude dependent exposure.

Researcher - I recall from one of my biochemistry classes long ago that the reason is dark skin naturally contains more melanin which then slows the rate of absorption like a natural sunscreen and then, that limits the skin's ability to produce vitamin D. Obviously, latitude and seasons in Northern latitudes would enter into exposure and absorption limits it as well.

Similarly, people who are out in the sun a lot, but always use sunscreen tend to be low in vitamin D. That's why in Krispin Sullivan's book, "Naked at Noon," she offers the ideal time to expose as much skin as possible for just short periods to take advantage of the natural production (by the skin) of vitamin D but not so much that there is the risk of skin damage promoting skin cancer.

Jackie

Hi researcher,,

Yes that is what I meant above ... that darker skinned people evolved to absorb less total Vitamin D from the sun due to their abundant exposure to sunlight in the equatorial regions over the last few million years of evolution, other wise they could get overdosed if they had such fair skin and too much exposure. The body is wise beyond our expectations.

And fair skin people of which the fair re- heads of northern Scotland and some of the islands jsut north of there are renowned for their ability to absorb Vitamin D from their skin with small doses of sunlight and yet still the vast majority of dramatically Vitamin D deficient due to the near constant overcast where they have evolved and due to the sharp angle of the UVrays bouncing off the upper layers of the atmosphere and thus making sun sourced Vitamin D absorption very difficult indeed.

Over time though these very fair red-heads have developed a way to eke out just enough systemic 25(OH)D levels in the blood and other Vitamin D metabolites to prevent overt rickets and other gross deficiency symptoms for the most part. And there is a big campaign by the government there to encourage greater Vitamin D supplementation to improve overall health status due to their very low levels overall.

Shannon

Shannon - and yet there are numerous studies on the vitamin D deficiency in adolescents and adults living in northern latitudes to the extent that the vitamin D researchers ... such as John Cannell and Michael Holick have been saying there is an epidemic in areas of Northern Europe and Scandinavia of low vitamin D status....so yes, they are definitely encouraging testing and supplementing. Makes sense.

Jackie

Hi All,

Ok, so I got my Vit D levels back. This is where I'm at over time:

VITAMIN D
• 6-22-15 (baseline): 20.2 ng/ml
• 8-21-15 (spending 30+ minutes/day in the sun during summer): 33.5 ng/ml
• 12-11-15 (added 5000 IU daily of Vit D3 and Vit K1/K1 2200 mcg daily and getting some sun but less due to winter): 46 ng/ml.

CALCIUM (Serum test)
• 12-12-15 Calcium 9.3 mg/dL (standard range 8.7 - 10.2 mg/dL)
• 9-1-15 Calcium 8.9 mg/dL (standard range 8.5 - 10.1 mg/dL)

I'm going to meet my Functional MD tomorrow. Should I ask to increase my Vit D intake? Jackie, you mention a 1,25(OH)₂D test. How do I know if this the one I had. My calcium level came from a basic Metabolic panel and only report, "Calcium 8.9 mg/dL (standard range 8.5 - 10.1 mg/dL)."

Thanks

Que - Glad to see you are making good progress on your vitamin D levels. Definitely ask when you see your doctor if you should maintain dosing through the winter. Mine likes to see my level at least 60. I feel best when mine is closer to 70.

As for the 1,25 test which is a separate measurement for Calcitrol, and is separate, but the main test is the one you had... the 25 OH D.

Jackie