HIGH-DOSAGE VITAMIN D

Just when you finally got it right -- "it isn't SAFE to go in the sun without sun screen," new research being published in the last few months is telling us that we've been wrong for a long time!  What?  How can that be?  Let's talk about what happens when you expose your bare skin to the suns rays!  Following exposure to the sun or other sources of UV-B radiation, such as tanning beds, your body will produce Vitamin D!  So what does that mean for your goals of optimum health?

Vitamin D Consumption Today:  Most of us are indoors during the day, and when we go outside we are shielded from the sun by lotions with varying amounts of sunscreen, clothes, hats, shades, umbrellas, and clouds.  The end result is that the vast majority of North Americans are not getting enough Vitamin D to prevent deficiency, let along promote optimum health.  It's a stark reality!  Numerous scientific studies among North Americans in different social groups have consistently shown that Vitamin D is at an epidemic low.  That's right...most studies report 40 percent to 80 percent of study populations showed deficient levels of Vitamin D in their blood.

A study published in Mayo Clinic Proceedings in December 2003 showed that among 150 patients with persistent nonspecific musculoskeletal pain, 93 percent of them showed abnormally low levels of Vitamin D in their blood.  Similarly, a study published in Spine showed that 83 percent of patients with low-back pain had an abnormally low level of Vitamin D as proved by blood tests.

Even though many doctors and patients are using multivitamin supplements these days, the vast majority of consumers are unaware that even with daily supplementation, they are almost certainly not receiving enough Vitamin D.  Most multivitamin supplements contain 400 - 800 IU of Vitamin D -- this is only 10 - 20 percent of what is necessary for optimum physiologic function.

There have been many scientific articles published in the passed ten years that indicate that athletic performance can be seriously compromised by a deficiency in Vitamin D.  Here is a MUST READ link to the Vitamin D Council Peak Athletic Performance and Vitamin D that sites numerous studies dating as far back as 1938 through 1956 that showed how the effects of Vitamin D production were being used in many athletic training camps.   Vitamin D-producing UVB radiation improves athletic performance and may have been widely practiced by German and Russian Olympic athletes in the 1960's and 1970's.   This article will open your eyes about the relationship between Vitamin D and physical performance.   After all athletic performance is the same as physical performance.   What happens when physical performance is impaired?   The Vitamin D Council has pointed out that "People fall and break their hips, resulting in death, disability, or nursing home admission."  In 2003, the CDC reported 13,700 persons over 65 in the USA died from their falls, and 1.8 million ended up in emergency rooms for treatment of nonfatal injuries from falls.   Falls cause the majority of hip fractures, which -- if they don't result in death -- often result in admission to a nursing home.  13,700 deaths, hundreds of thousands of surgeries, countless nursing home admissions, and tens of billions in health care costs every year from impaired physical performance.

So, Vitamin D deficiencies matter!   For every age, even for the young man referred to in the Vitamin D Council newsletter (above) who said to Dr Cannell when he told the young man he needed to take 4,000 IU per day, "Look doc, all this stuff may be important to old guys like you.   I'm 22.   All I care about are girls and sports.   When I get older, maybe I'll think about it.   I'm too young to worry about it."

HOW DID WE GET SO CONFUSED?

The evidence in support of sun exposure as a source of Vitamin D was first published in 1941 by Apperly in the journal of Cancer Research.  He showed that cancers of various types were much less frequent in populations that lived closer to the equater.  Since then, additional research has shown that Vitamin D deficiency is a risk factor for:

-- Breast Cancer
-- Prostate Cancer
-- Multiple Sclerosis (autoimmune disease)
-- Rheumatoid Arthritis (autoimmune disease)
-- Type-1 Diabetes

The most convincing study ever published on this topic was authored by Hypponen and colleagues in the November 2001 issue of the prestigious UK medical journal The Lancet.  In that study the investigators administered 2,000 IU of Vitamin D daily to more than 10,000 infants, who received the Vitamin D supplement every day for the entire first year of life.  Thereafter, calculating a dose-responsive relationship it showed their risk of type-1 diabetes was reduced by an amazing 88 percent!  No adverse affects were noted.

Again, in an article published in the November 2003 issue of the American Journal of Clinical Nutrition, Heaney distinguished "acute nutritional deficiencies" from "long-latency deficiency diseases" and helped us understand how even mild, subclinical nutritional deficiencies directly contribute to the development of:

-- Cancer
-- Cardiovascular Diseases
-- Other problems that plague our modern society

We have probably all heard how rickets is the manifestation of acute Vitamin D deficiency.  Now we are able to understand how long-latency diseases caused by Vitamin D deficiency includes even more symptoms (the list is getting longer).  We now know through numerous epidemiological studies and clinical trails that Vitamin D supplementation prevents or alleviates all of the following conditions.

-- Cancers
-- Cardiovascular Diseases
-- Hypertension
-- Depression
-- Polycystic Ovary Syndrome
-- Migraine Headaches
-- Chronic Musculoskeletal Pain
-- Insulin Resistance
-- Multiple Sclerosis (autoimmune disease)
-- Rheumatoid Arthritis (autoimmune disease)

There are numerous eye-opening studies in recent years that have helped us understand the significance of getting enough Vitamin D on a daily basis.

Alleviation of Depression and the Enhancement of Well-Being:

Numerous studies have shown that Vitamin D has a mood-elevating effect that begins within just a few days of supplementation.  The most recent study showed that the administratin of 4,000 IU per day of Vitamin D was superior to a lower dose of 600 IU per day, and provided additional benefits for patients in terms of increasing feelings of overall health, sociability, and ability to deal with stress.

Anti-Inflammatory Benefits:

Clinical trials have documented an anti-inflammatory benefit of Vitamin D supplementation, suggesting that Vitamin D may be used as part of a comprehensive approach for the prevention and treatment of inflammatory disorders.  One study showed that even a modest dose of Vitamin D reduced blood levels of C-reactive protein (CRP) by 23 percent, which is remarkable considering CRP is considered one of the most sensitive markers for predicting the risk of cardiovascular disease.

Alleviation of Chronic Musculoskeletal Pain:

Researchers have known for years that Vitamin D deficiency is particularly common in patients with chronic musculoskeletal pain, including what is commonly labeled "fibromyalgia."  One study showed administration of 5,000 - 10,000 IU daily of Vitamin D alleviated low-back pain in 95 percent of patients, 83 percent of whom had already been diagnosed with Vitamin D deficiency!

HOW MUCH IS ENOUGH?

Let's look at research published by Robert Heaney and colleagues in the American Journal of Clinical Nutrition in January 2003 which showed that the physiological requirement for Vitamin D in adult men is between 3,000 - 5,000 IU daily (see * Note below).  Sadly, there is no way to meet physiologic needs for Vitamin D based on consumption of a reasonable eating plan and an average multivitamin supplement!  That said -- for people who are not able to obtain 20 - 30 minutes of full-body sun exposure on an almost daily basis, it is clear that a high-dosage Vitamin D supplementation is necessary to ensure that physiologic needs are met and optimum health can be obtained and maintained.

* Note:  Doctors and patients need to be aware that certain drugs (namely thiazide diuretics) and certain conditions known as "Vitamin D hypersensitivity syndrome," seen with conditions such as tuberculosis, Crohn's disease, sarcoidosis, adrenal insufficiency, and thyroid disease, increase the risk of elevating blood calcium levels (hypercalcemia), which is the only mechanism of toxicity for Vitamin D.  When working with these higher-risk people, serum calcium levels should be checked frequently (every 12 months) and supplementation should be initiated slowly and increased over time.  The ultimate goal is to ensure safety (by measuring serum calcium) and effectively (by measuring 25-OH-Vitamin D levels in the blood).  According to research the optimum range of 25(OH)D is 40 - 65 ng/mL (100 - 160nmol/L).

Jenni Ross-Wilkinson, author of
"NUTRITION - THE MISSING LINK:   Personalizing Optimum Performance"


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