10 Points About Vitamin D From A Prime Proponent

http://www.youtube.com/watch?v=xhYmdg58AT8

From: The Journal of D-I-Y Medical Research (which I just made up).
Number of subjects: 1.
Intervention: 2,000 units of Vitamin D per day over one month, after I heard a primary care doctor attest that since he’d started taking more Vitamin D, his aches and pains of middle age had largely disappeared.
Outcome: Subject (yours truly) no longer has to walk stiffly down the stairs in the mornings like a toddler, planting both feet onto each stair before moving on to the next one. Foot and ankle pain mostly gone.
Conclusions: None. You can’t conclude anything from a study with an “n” of 1. But the results were intriguing enough to make me attend a lecture today by Dr. Michael Holick, director of the Vitamin D, Skin and Bone Research Laboratory at Boston University. It was titled, “The Solution For Good Health: Rx Vitamin D.”

For context, Dr. Holick is clearly a controversial figure. He tends to be hated by some dermatologists because he advocates (moderate, carefully calibrated) sun exposure. He discloses an array of financial ties with various companies — as well as NIH support — and has written two books on Vitamin D, the latest called “The Vitamin D Solution.”

But he is not a fringe figure. He remains a professor of medicine, physiology and biophysics at B.U., and he led the Endocrine Society team that issued new practice guidelines on Vitamin D this summer. (They recommended more than a 2010 Institute of Medicine report, which had tripled the recommended levels.)

Here in Boston, our bodies make virtually no Vitamin D from November to February no matter how long we stay outside.

I must confess, I had Linus Pauling on my mind when I went to see Dr. Holick speak. For all Pauling’s Nobel-winning chemistry brilliance, time appears to have proven him wrong on his great enthusiasm for Vitamin C.

But lately, time seems to be on Dr. Holick’s side. Evidence of a broad array of health benefits — and lack of harm — from appropriate doses of Vitamin D has been accumulating, and more studies are in the works. I quake when I pass along recommendations of a vitamin that can have toxic effects if overdone — and the dangers are very real, as the Wall Street Journal’s Health Blog reported here. But here are two recent positive signs:

A recent study found a link between vitamin supplements and slightly higher death rates among older women, but  D looked better than some other vitamins. The New York Times wrote, “Some supplements, like iron, were associated with a substantial increase in the risk of death, while others — vitamin A and vitamin D, for example — had no effect.”

And check out this 2009 report in one of my most trusted sources of nutrition information, the Nutrition Action newsletter put out by the Center for Science in the Public Interest. The study involves subjects taking 2,000 units of Vitamin D a day:

The article, which is sadly not available online, goes on:

Manson is a principal investigator for the new VITAL trial (VITamin D and OmegA-3 TriaL), which will test vitamin D and omega-3 fats from fish oil on heart disease, stroke, and cancers, especially of the colon, breast, and prostate. But the trial will also look at the supplements’ effect on other illnesses.

“We’re also interested in studying diabetes, high blood pressure, bone density, vision, memory loss, depression, autoimmune diseases, and other health outcomes,” says Manson.

Why launch a brand new trial to test high doses of vitamin D and omega-3s from fish? Don’t we already know they’re worth taking?

“Some people believe the evidence is already strong enough to recommend much higher intakes,” notes Harvard’s JoAnn Manson. “But we tend to forget the lessons of other nutrients—like vitamin E, vitamin C, B vitamins, folic acid, selenium, and beta-carotene.

“Large-scale trials didn’t confirm their benefits and even found some risks when they were consumed at high levels. So let’s not just jump on the bandwagon until we have clinical trials.”

It sounds like Dr. Manson has taken her own tentative step onto that bandwagon; The Boston Globe’s Kay Lazar reported here last year:

“I do think vitamin D is one of the most promising nutrients for prevention of cardiac disease and cancer, and I believe in it strongly,’’ Manson said. “But the evidence is far from conclusive.’’
How much D does Manson take?
“I try to take whatever I am testing to see if there [are] side effects and to see if it’s well tolerated,’’ said Manson. Her new study is testing a level of 2,000 IU daily.

I’ve touched my toe to the Vitamin D bandwagon, too, though I wouldn’t dare recommend it to others until studies like JoAnn Manson’s come out. Still, Dr. Holick’s talk was fascinating, and I wanted to share a brief brain-dump.

He told audience members who had trouble keeping up with his breakneck speed that a similar lecture could be watched on his Website, drholick.com, and I found it here. (Nutrition Action also ran a long Q&A with him in 2003.)

Nine points from my notes:
•”My argument is that our hunter gatherer forefathers were making thousands of units of vitamin D a day that played an important role in their overall health. As a result, throughout evolution humans required several thousand IU of vitamin D either from sun exposure or diet to maximize their overall health and well-being.”

•The lay press has been pushing patients to ask doctors to have their Vitamin D tested. Doctors have tended to be resistant, but the assay for Vitamin D is now the most-ordered assay by American doctors today.

•Studies find the majority of American mothers and newborns deficient in Vitamin D. Breast milk does not contain enough Vitamin D. One symptom of Vitamin D deficiency in babies is heavy head-sweating at night.

•Here in Boston, our bodies make virtually no Vitamin D from November to February no matter how long we stay outside. Ethnicity makes no difference.

•Obesity causes Vitamin D deficiency. Obese people need double or more the usual amount of Vitamin D. African Americans are at higher risk for vitamin D deficiency but they need the same amount of vitamin D to prevent and treat vitamin D deficiency as a Caucasian.

•The bone disease associated with Vitamin D deficiency is called osteomalacia, and includes bone pain, muscle aches, stiffness in joints in the morning. It is sometimes misdiagnosed as fibromyalgia.

•Dr. Holick wears sunscreen on his face but allows his arms and legs to get limited sun exposure, and he takes 2,000 units a day of  Vitamin D.

•Vitamin D could help explain some of the striking geographical differences in disease; for example, that multiple sclerosis and Type 1 Diabetes are more common in northern climates.

•Dr. Holick ripped through a long series of studies suggesting that Vitamin D may help with everything from cancer to infections to diabetes to simple longevity.

•Post-lecture question: As with so many things, mightn’t we hear in a few years that we’ve all been taking too much Vitamin D?
Dr. Holick’s answer: My argument is that our hunter-gatherer forefathers were making thousands of units a day. I think evolutionarily we’ve always needed to be there.

And my own final question, heart on sleeve as usual: But what about Linus Pauling?
Dr. Holick:  I received the Linus Pauling prize for human nutrition. I think he would agree today that he may have been off by one letter and that he would likely be promoting vitamin D today.

Readers, have you done any DIY research on Vitamin D of your own? Please share your results but whatever you do, don’t overdo it. As the WSJ notes, the Institute of Medicine set the upper limit at 4,000 units a day.

For a broader discussion about vitamin supplements in general, please check out this recent “On Point” show. 

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  • http://www.vitaminddeficiencysymptomsblog.com/ Vitamin D Deficiency

    What about vitamin D overdose? Is it possible to take too much and if so what are the consequences? I’m taking 1000 IU/day and I’m also consuming food rich in vitD such as tuna, salmon, mackerel, ..

    Regards,
    Paul

  • http://pulse.yahoo.com/_OKRHU2OGEA53HIMPR2FFLJRVYE Wayne Kennedy

    wear a wide brim hat and 1000 iu vit. D caps are available

  • http://pulse.yahoo.com/_OKRHU2OGEA53HIMPR2FFLJRVYE Wayne Kennedy

    excessive UV actually shuts down skin production of Vit D. The solar activity and weaker magnetic shield [poss. 10% lower magnetic field intensity] caused this . Supplements are needed now as a result.

  • Slavalyuba

    I have been struggling with fibromyalgia for 5 years: stiffness, pain, dry mucosa, insomnia, irritable bowel, memory loss, the works. Since I started taking 2000 IU of Vitamin D daily, these symptoms have dramatically improved in just 2 months. 

  • Alexander Mac Donald

    I took Dsub3 for three years after I developed a melanoma.  I took 2000 IU/diem, sometimes 3000.  I also applied generous amounts of sunscreens (plural) to any exposed skin, including my ears but not the backs of my hands.  During that period, I was  also supplementing my diet with calcium in low amounts.  At the end of that period, I had a vitamin D definciency that was remedied by taking 25000 IUs twice a week for six weeks.  I, with the agreement of my dermotologists (plural), added about 15 minutes of sun to my upper body twice a week, and, on the advice of my PCP, have continued to take 2000 IUs/diem.  From what I have been able to read about D, the pathways of absorption differ for supplemental D and solar generated D.  I should add that I experienced a broken rib caused by a minor fall, at the end of the three period of very low solar generated intake and pretty high supplemental intake of D.  I accept that as evidence that low Dsub2 weakens bones. The injury has healed without intervention (as it was not painful or debilitating), and my D levels came back to welll within normal, and remain there..  It should be evident, without double blind experimenting, that the pathways for the two sources of D are not the same, and that dosage of sunlight and supplemental D should be coordinated accordingly  My melanomas, by the way, remain in remission.  I agree that n=1 an experiment does not make, but if you=1, it might, if only because the alternative to 1 is 0..  For me the mix is working, and I think I may safely say that my psyche is influencing neither the blood assays nor the condition of my skin.  Care; however, is required.  Some longitudinal studies might help end this debate.

  • Catnap

    Vitamin D helped a lot with some otherwise unexplainable pain I experienced. 2000 IU for two weeks and I noticed dramatic improvement.  Blood tests later confirmed that I was deficient.  It would be nice if pain clinics tested for this — their drugs do not always help and I can’t imagine that any of them are safer than the chemical equivalent of a few minutes in the midday summer sun.  Higher amounts of Vit. D seem to prevent me from getting head colds, but I’m less sure of that.

    Holick’s evolution-based theory is interesting.  It seems plausible since we evolved to live in a part of the world where we can produce vitamin D from the sun year-round.

  • Dave Holzman

    Carey,

    I’ve been taking 3,000 IU/day in the darker six months of the year for about six years. In the last year I’ve upped it to 4,000. I taper down to nothing in summer, when I run shirtless 40 minutes/day. I’ve had almost no colds or flu in those six years, and those I’ve had have been exceptionally mild (I have gotten flu shots in about half of those years). Here’s a press release on yet another potential benefit from vitamin D

    http://www.asm.org/index.php/news-room/jt0611d.html?title=More+Evidence+Vitamin+D+Boosts+Immune+Response

    Best, –David

    • careyg

      Very interesting, David! And I trust your grasp on the scientific literature more than my own…!

  • Henry Lahore

    4000 IU of vitamin D is great!
    It is a minimum for people at high risk of being vitamin D deficient, such as
    seniors living in the North, people with dark skins, people who are overweight, etc.
    The Vitamin D Wiki has information on all aspects of vitamin D
    http://www.vitamindwki.com
    Such as a review of vitamin D books -http://www.vitamindwiki.com/tiki-index.php?page_id=2123 many of which are free