Aa
More on vitamin D
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
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
That is great news, especially since vitamin D is so easy to get. According to an article I read in the AARP magazine, 10 minutes of exposure to sunshine gives you a day's requirements. I started making a conscious effort to get my 10 minutes and I definitely felt better that day.
as rocker said , vit D is a must !
and getting tested therefore is a must to !
bring it up to 60 , that is agreed as optimal
above 100 is toxic below 30 is deficient
simple thing to do , great for your immunity and apparently SOC response
I am up to 6000 IUs now
and getting tested therefore is a must to !
bring it up to 60 , that is agreed as optimal
above 100 is toxic below 30 is deficient
simple thing to do , great for your immunity and apparently SOC response
I am up to 6000 IUs now
I have read the same thing. I haven’t quite figured out how our bodies can absorb vitamins by exposure to the sun but it does explain why we feel better when the sun comes out after a few days of gloomy weather. I always thought it was just psychological. Now I can’t get that damned song “Sunshine on My Shoulders Makes Me Happy” out of my mind.
Nice to see people are finally starting to take this Vitamin D stuff seriously.
Cheese
Cheese
run a VitD test
recommended level of 60 comes from several MDs I spoke to plus lab reference range.
recommended level of 60 comes from several MDs I spoke to plus lab reference range.
copyman
Thanks for posting this interesting info on vit d related to tx
all
I had my vit d levels tested before starting, during and after tx. My levels were low
(35 ng/ml) to start with and I was put on a quite high dose of vit d. It corresponded to 4000 units, as we use other units here.
Here is a link to some general info on vitamin.
http://blogs.mercola.com/sites/articles/archive/2002/02/23/vitamin-d-deficiency-part-one.aspx
If you find the video annoying, just turn it off and read the text instead.
and here is a page with a lot of different articles on vit d
http://search.mercola.com/Results.aspx?k=vitamin%20d
Thanks for posting this interesting info on vit d related to tx
all
I had my vit d levels tested before starting, during and after tx. My levels were low
(35 ng/ml) to start with and I was put on a quite high dose of vit d. It corresponded to 4000 units, as we use other units here.
Here is a link to some general info on vitamin.
http://blogs.mercola.com/sites/articles/archive/2002/02/23/vitamin-d-deficiency-part-one.aspx
If you find the video annoying, just turn it off and read the text instead.
and here is a page with a lot of different articles on vit d
http://search.mercola.com/Results.aspx?k=vitamin%20d
i suppose you will say ng/ml now, whereas before you said nothing, you have not even been tested yourself yet you are telling people they should be tested , ! why ?
I have done 3 VitD tests so far.
First my GP ordered it , came back 34 (low). He gave me VitD shot and I started
4000 IUs/daysuppl. Next test was 53 (much better) than tested again 2mo later
still 50 even though I went in the sun a lot (did not do anything) so I upped it to 6000
IUs. Need to test again soon want to be at 60.
Sorry about not listing units do not have lab report in front of me.
First my GP ordered it , came back 34 (low). He gave me VitD shot and I started
4000 IUs/daysuppl. Next test was 53 (much better) than tested again 2mo later
still 50 even though I went in the sun a lot (did not do anything) so I upped it to 6000
IUs. Need to test again soon want to be at 60.
Sorry about not listing units do not have lab report in front of me.
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.
I am planning to go on SOC soon and Vit D levels are part of my prep. for it.
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
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
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
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
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.
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.
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.
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.
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.
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.
I am amazed at the amount of research people on this site must be doing. Your info is very helpful.
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
Magnum
"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.
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.
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
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
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