More on vitamin D

[copyman]

not sure if this has been posted already but here is more on vit D. I think most people should be supplementing with 2000+ IU's per day.

Vitamin D Has Benefits in Chronic HCV Infection
Megan Brooks

Authors and Disclosures

November 5, 2009 (Boston, Massachusetts) — Supplementing pegylated interferon-alfa2b and ribavirin with a daily dose of vitamin D might increase virologic response rates, according to results of a late-breaking abstract reported here at The Liver Meeting 2009, the 60th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD).
"Vitamin D is a potent immunomodulator whose impact on virologic response rates of interferon-based treatment of chronic HCV [hepatitis C] is unknown," lead investigator Saif M. Abu-Mouch, MD, from the Department of Hepatology, Hillel Yaffe Medical Center, in Hadera, Israel, and colleagues note in their abstract.

"This preliminary study confirms the benefit of adding vitamin D to conventional antiviral therapy in patients with chronic HCV," Dr. Abu-Mouch told meeting attendees.

In the study, 58 patients with confirmed chronic HCV (genotype 1) were randomly assigned to peginterferon-alfa2b (1.5 µg/kg once weekly) plus ribavirin (1000 to 2000 mg/day). Thirty-one patients also received vitamin D (1000 to 4000 IU/day; serum level >32 ng/mL).

The vitamin D group had a higher mean body mass index (27 vs 24 kg/m2; P < .01), viral load (68% vs 58%; P  F2, 55% vs 18%; P < .001) than the group that did not receive vitamin D. Demographics, disease characteristics, ethnicity, baseline biochemical parameters, and adherence to treatment were similar in the 2 study groups.

A rapid virologic response was seen at week 4 in 44% of the vitamin D group and in 18% of the control group. At week 12, Dr. Abu-Mouch told Medscape Gastroenterology, 96% of the vitamin D group (26 of 27 patients) were HCV RNA-negative, as assessed by reverse-transcriptase polymerase chain reaction, as was 48% of the control group (15 of 31 patients), which was a significant difference (P < .001), he said.

The combination of peginterferon and ribavirin, the standard of care for chronic HCV, achieves a sustained virologic response in 40% to 50% of naïve patients with genotype 1, the investigators explain in a meeting abstract. Vitamin D in combination with peginterferon-ribavirin "may have synergistic effects," Dr. Abu-Mouch said.

Meeting attendee Laurent Tsakiris, MD, from the Centre Hospitalier Universitaire de Melun in France, who was not involved in the study, told Medscape Gastroenterology that "the study is surprising and promising because vitamin D is something very easy to use and there is no toxicity."

"It's also interesting," he said, "that the group treated with vitamin D had more severe disease than the control group. I think this can be considered a strong result from a small study.

The study did not receive commercial support. Dr. Abu-Mouch and Dr. Tsakiris have disclosed no relevant financial relationships.

The Liver Meeting 2009: 60th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD): Abstract LB20. Presented November 2, 2009.

http://www.medscape.com/viewarticle/711902

[mikesimon]

October 6, 2010 — Vitamin D deficiency (VDD) has been linked to bacterial vaginosis (BV) among pregnant women, according to the results of a study reported online October 4 in the American Journal of Obstetrics & Gynecology.

"Recent data suggest ...VDD is associated with ...BV during pregnancy," write Katherine J. Hensel, MPH, from the College of Physicians and Surgeons at Columbia University in New York, NY, and colleagues. "We hypothesized that VDD is a risk factor for BV in nonpregnant women."

The investigators conducted multivariable logistic regression analyses stratified by pregnancy, using data from the National Health and Nutrition Examination Survey.

In pregnant women, but not in nonpregnant women, VDD was associated with an increased risk for BV (adjusted odds ratio [AOR], 2.87; 95% confidence interval [CI], 1.13 - 7.28).

Factors associated with BV in nonpregnant women were douching (AOR, 1.72; 95% CI, 1.25 - 2.37), smoking (AOR, 1.66; 95% CI, 1.23 - 2.24), and black race (AOR, 2.41; 95% CI, 1.67 - 3.47). Use of oral contraceptives was inversely associated with BV (AOR, 0.60; 95% CI, 0.40 - 0.90). In nonpregnant women, VDD modulated the association between smoking and BV.

"Risk factors for BV differ by pregnancy status," the study authors write. "VDD was a modifiable risk factor for BV among pregnant women; evaluation of vitamin D supplementation for prevention or adjunct therapy of BV in pregnancy is warranted."

Limitations of this study include cross-sectional design, sexual behavior data limited to women 20 years or older, and information on unprotected sex asked only of women reporting multiple sexual partners in 1 year. In addition, changes in laboratory methods with time may result in variability in the vitamin D assay, and this analysis did not examine the association between VDD and BV by trimester of pregnancy.

"Because antimicrobial treatment for BV has failed to reduce some adverse sequelae of this disease in pregnancy, BV prevention is paramount," the study authors conclude. "[I]dentification of VDD as a modifiable risk factor for BV among pregnant women may be important in improving health outcomes among this population....In addition, optimization of strategies for the use of prenatal vitamins, including preconceptual use, may aid in the prevention of BV during pregnancy."

Senior author Adam J. Ratner, MD, MPH, is supported by the Doris Duke Charitable Foundation, Flight Attendant Medical Research Institute, John M. Driscoll Children's Fund Scholar Award (Columbia University), Louis V. Gerstner Jr Scholar Award (Columbia University), and Irving Scholars Award (Columbia University).

Am J Obstet Gynecol. Published online October 4, 2010.

http://www.medscape.com/viewarticle/729965?src=mp&spon=3&uac=39980BG

[mikesimon]

"Conclusion

The question addressed by this study was whether air pollution affects the blood level of 25-OH-D in healthy women. We found that the place of living, as a surrogate of air pollution, has a significant influence on vitamin D status. Hence, controlling air pollution levels will promote the body vitamin D status."


http://www.medscape.com/viewarticle/729223

[blondie717]

Thanks Im going to get some vitimin D. Just started taking E. I have the silyarin, havnt touched it though, because some trials dont want you to take it.

[spontcumb]

"Well, we all know about opinions - everyone has them just like everyone has an ..........."

To mikesimon: I wish I had more than my own opinion, but my GI refuses to acknowledge any possible link between the meds and what's happening to me.  Every bodily system has been affected.  Of course, it's possible that some of these things could be age related, but to have all of them start to appear immediately upon beginning treatment....?  My Primary Care Doc has finally gotten my attention and has referred me to an Infectious Disease doctor and a Neurologist with a sub specialty, (can't remember what it's called).    

To: nygirl7:  I was treated twice for Hep C, genotype 1a.  First was in 2004.    Made it to week 22, developed pneumonia,was hospitalized for a week and tx was stopped.  Second treatment was in 2006.  Made it to week 44, developed pneumonia, was hospitalized and tx was stopped, (I have cleared the virus!)!.  I won't go through the entire list of symptoms, side effects, problems....too many.  I started loosing my teeth two months into the first treatment and now I have only 2 teeth remaining.  At that same time, I lost most of the hearing in my left ear.  Cognitive loss, a series of mini-strokes, loss of bladder and bowel control and a host of others........ So finally, my family doc is "back on the case".  He did a bunch of lab work a month ago.  That's when he found that I'm severely low in Vitamin D so I'm on 10,000 IU weekly.  

Anyway, sorry for the babbling and thanks for your input.  Much appreciated!        

[nygirl7]

PS Most of us are extremely low in Vitamin D but then so it most of 'older' America as it is which is why we are pretty routinely tested for it. And why I have a bottle of the stuff right here at my desk.

This is very common but all of your teeth in your head falling out is certainly not and has nothing really to do with interferon or treatment - this is not a few cavities this is something completely different I would be worried about my bones and getting a hump on my back and stuff like that you really need to get to the bottom of this.

[nygirl7]

I just found out from my doc that I am "severely" deficient in Vitamin D.  Now, if I can find out why all of my teeth have "died" and fallen out, I would be a happy camper. "


Sounds like there might be a reason for you right there. Vitamin D deficiency isn't that rickets and the sailors in the olden day lost all their teeth....................bingo.

Rickets
Google Health   Mayo Clinic   Medline Plus   WebMD  
Rickets is a disorder caused by a lack of vitamin D, calcium, or
phosphate. It leads to softening and weakening of the bones.
Symptoms: Bone pain or tenderness (Arms; Legs; Pelvis; Spine) ...
www.google.com/health

[mikesimon]

Well, we all know about opinions - everyone has them just like everyone has an ...........

I think you're right about darker skinned people and vitamin d by the way.

Peace out

Yo,
Mike

[spontcumb]

From what I've read, people with darker skin, such as Blacks, Hispanics,etc, have more difficulty obtaining Vitamin D via sunlight than Caucasians.  It has to do with the level or amount of Melatonin in a person.  Those with darker skin have more melatonin, relative to whites, and this makes exposure to sunlight much less effective for dark skinned individuals to obtain Vitamin D via sunlight.
Also, it has been documented that interferon can cause Vitamin D deficiency in people.  I just found out from my doc that I am "severely" deficient in Vitamin D.  Now, if I can find out why all of my teeth have "died" and fallen out, I would be a happy camper.  I believe that the combo drugs for tx can cause other diseases/disorders, which were being "contained" by our immune systems prior to putting those 2 poisons into our bodies......just MHO.  Peace!  

[Diane12855]

All of the above comments are very informative, and I'm going to be tested too. I do think that we should pay attention to the warnings about over dosing. That can be very damaging to our liver and kidneys. Some people may read about the benefits and run out and buy some at the store and load up like people did with vitamin C when it was discovered that it helped with immunity. At least vitamin C is water soluble and could be flushed out when they over dosed. Vitamin D is fat soluble, so an overdose will be much harder to deal with.

Just be careful.

[smaug48]

Thanks for the links.  I found the following about which test to take on the Vitamin D Council's website, which prompted me to ask you for your source.

You'll have to make your own decision on whether this site is objective or not.

http://www.vitamindcouncil.org/health/deficiency/am-i-vitamin-d-deficient.shtml

You can have your doctor order the test—some insurance companies will pay for a 25(OH)D test, some will not. Unfortunately, about 20% of United States doctors order the wrong test. They order a 1,25-dihydroxy-vitamin D, thinking that by measuring the most potent steroid in the human body, calcitriol, they are getting useful information. They are not. 1,25-dihydroxy-vitamin D is an adaptive hormone; it goes up and down with calcium intake. So these doctors see the 1,25-dihydroxy-vitamin D is normal or high and tell their patients that they are ok when really, they are vitamin D deficient—advice that may prove fatal. Furthermore, most doctors who see a 25(OH)D of 30 ng/ml (75 nmol/L) will tell you that level is fine when it is not—that is, few doctors know how to correctly interpret the test results.

[Cheesegrater]

Some sites I found of interest and of help in an article I wrote.

http://www.merck.com/mmpe/sec01/ch004/ch004k.html

http://ncp.sagepub.com/cgi/content/full/22/3/305
Nutrition in Clinical Practice, Vol. 22, No. 3, 305-322 (2007)
DOI: 10.1177/0115426507022003305

http://www.hepatitis-central.com/mt/archives/2008/10/hepatitis_c_and_11.html

http://vitamind.ucr.edu/biochem.html

http://ncp.sagepub.com/cgi/content/full/22/3/305

http://en.wikipedia.org/wiki/Vitamin_D, http://vitamind.ucr.edu/biochem.html

[smaug48]

Cheesegrater, can you post the source of the previous post?  I'd like to pass it on to a medical professional.

smaug

[Cheesegrater]

Vitamin D (vitamin D3) is produced by the skin when exposed to the "proper"  level and intensity UV radiation (ie the sun). This compound has to be converted to 1,25 Dihydroxy-Vitamin D3  to be of use to the body. 1,25 Dihydroxy vitamin D3 is made by the kidney, and it is made from 25 hydroxy vitamin D3 which is produced by the liver from Vitamin D3.

Testing the levels of Vitamin D3 will only give data on the levels of vitamin D3, not the needed 1, 25 dihydroxy form that is the active form.

The liver converts Vitamin D3 to 25 hydroxy vitamin D3. If the liver is diseased (cirrhosis, hep C or other form of hepatitis) there may be plenty of vitamin D3 but it can not convert it into 25 hydroxy Vitamin D3. You might be getting normal doses of vitamin D3, but you can still be deficient in 25 hydroxy or 1,25 dihydroxy vitamin D3 due to metabolic problems.

Tests for 25 hydroxy vitamin D3, while probably very accurate and precise, can only be said to measure a form that is not the active form.

The kidney converts 25 hydroxy vitaminD3 to the active form, 1,25-dihydroxy vitamin D3. It is conceivable that disease or other factors can cause some people to have a problem with this conversion as well.

For these reasons I think that while a test for 25 hydroxy vitamin D3 may be a good indicator, we should be measuring the active form, the 1,25 dihydroxy vitamin D3.  

cheese

[IMstacie]

"Vitamin D May Influence Cognitive Dysfunction and Dementia "  Based on that quote, I know I'm deficient!

Seriously though, I am going to get tested.  I am just amazed how many people I work with that are Vit D deficient.  It's becoming an epidemic.

[Magnum]

Doctor wants me on 1000mg vitamin D with Omega 3 on a daily dosage. He recommends it wether you're on treatment or not...

Magnum

[Diane12855]

I am amazed at the amount of research people on this site must be doing. Your info is very helpful.

[Marcia2202]

From what I've read, it takes quite a long time (some months) for the levels to come up, even if you take a high dose. So, some patience is required.

Don't Be Fooled -- Order the Correct Test
There are two vitamin D tests -- 1,25(OH)D and 25(OH)D.
25(OH)D is the better marker of overall D status. It is this marker that is most strongly associated with overall health.
The correct test is 25(OH)D, also called 25-hydroxyvitamin D
Please note the difference between normal and optimal. You don't want to be average here; you want to be optimally healthy.
Primitive man likely developed in tropical and sub-tropical conditions with large exposure to UV-B and its secondary consequence to skin exposure, vitamin D.
Primitive environmental availability of a nutrient does not necessarily establish the higher requirements, but these exposures would have influenced the evolution of the relevant physiology, and such concentrations should at least be considered presumptively acceptable.
Some experts may disagree with the following healthy ranges, but they are taken from healthy people in tropical or subtropical parts of the world, where they are receiving healthy sun exposures. It seems more than reasonable to assume that these values are in fact reflective of an optimal human requirement.
(Holick MF. Calcium and Vitamin D. Diagnostics and Therapeutics. Clin Lab Med. 2000 Sep;20(3):569-90)

If you have the above test performed, please recognize that many commercial labs are using the older, dated reference ranges. The above values are the most recent ones based on large-scale clinical research findings.
Make Sure Your Lab Uses the Correct Assay
There are a number of different companies that have FDA approval to perform vitamin D testing, but the gold standard is DiaSorin. Their radioimmunoassay (RIA) method for measuring total vitamin D levels has become the gold standard, not because it’s more accurate than the others, but because it’s the one used in almost every major vitamin D study, on which the recommended blood levels for clinical efficacy are based.
Therefore, in order for any other testing method to offer clinically relevant results, the test values must agree with DiaSorin RIA results, since those were used to establish the recommended levels.

Vitamin D status is measured by looking at blood levels of 25-hydroxyvitamin D3. There are three common methods used for measuring vitamin D3:
LC-MS/MS – This test measures 25-hydroxyvitamin D2 and D3 separately
RIA (DiaSorin) -- Developed in 1985, it accurately measures total 25-hydroxyvitamin D (It does not separate D2 and D3)
Liaison (DiaSorin) --  a more recently developed automated immunoassay by DiaSorin that has largely replaced the RIA
The LC-MS/MS (liquid chromotatography-mass spectrometry) method is the preferred method for many labs, including the Mayo Clinic, Esoterix, ZRT, and others, while Liaison is favored by other testing labs like LabCorp.
Recent developments in 2008 have made it clear that there are irregularities in the values obtained from the different testing methods. Although results from any of the three assays may be analytically accurate, they might not be clinically accurate, which is, ultimately, what matters.
Since the DiaSorin assay (RIA) was used in the major clinical studies that led to the recommended vitamin D levels, any lab using the LC-MS/MS  method need to make sure their test correlate with the RIA test values in order to accurately determine your vitamin D status.
Tt’s imperative that you find out if your lab has performed the appropriate recalibrations against DiaSorin’s assays. Otherwise your vitamin D levels may be vastly overstated, in some cases by as much as 40 percent, meaning you may get the green light that your levels are fine, when in fact you are deficient, or perhaps even dangerously low.

[Bali05]

I love the sun yet my VitD was low. I tried sun bathing even got tanned but VitD
did not improve.

My GP got back from a cancer conference in Florida and Vit D was a topic.

The agreed optimum is 60. I asked another MD and he also said 60 was optimum.

That is enough for me. Just asked your doctor. Do not know how many $ per

test because my insurance covers , propably different from lab to lab.

If you are in a "right to know state" you can call requestatest.com for a quote

they usually get better prices for self pay.

[orphanedhawk]

When I was prescribed vitamin D drops due to low levels I was advised not to take them for more than one month before retesting.

No doubt it's better to get it from the sun. In the winter when the sun comes pouring in the window, I roll up my pants and let it bask on my legs.

[Willy50]

About how much is the test to check Vit D levels, approximately?

I have a feeling that this may be a worthwhile Vitamin, especially if it is indeed an "immunomodulator".  It could be good for any of us.

I'm preparing for a check up and may consider this and am kind of checking the waters about a homa test or IR issues.  I work outside often and I rather doubt that I am deficient, still it is often good to get a baseline; it could prove to be a once only lab test.  
I also wonder where one draws the line about how high one should be, if there are any unapparent benefits of getting Vit D from the natural source like the sun versus via pills, and if there is either an optimum range for us, or a "more is better" approach for say, going into TX?

best
Willy

[mikesimon]

Low Vitamin D in Utero May Heighten Multiple Sclerosis Risk
http://tinyurl.com/yzxthuu

Low Vitamin D Worsens Asthma
http://tinyurl.com/yko2te3

Vitamin D May Lower Colon Cancer Risk
http://tinyurl.com/yh9phcc

Could Vitamin-D Deficiency Account for Higher CV Mortality in Blacks?
http://tinyurl.com/yjbu29l

Vitamin D May Influence Cognitive Dysfunction and Dementia
http://tinyurl.com/yfmqbb7

Vitamin D: A Potential Role in Cardiovascular Disease Prevention
http://tinyurl.com/yz6ayyo

Management of Vitamin D Deficiency Reviewed
http://cme.medscape.com/viewarticle/712005?src=cmemp&uac=39980BG

[Bali05]

bottomline it is an easy thing to do and it looks like it is an important Vit.

I am planning to go on SOC soon and Vit D levels are part of my prep. for it.

[jusjames]

if your seults were using ng/ml then your result of 50 is fine,

[jusjames]

typical range is '
20 -110 nmol/L