Vitamin D Quality Alert

As with all consumer products there are sure to be issues that need to resolved.  Dr. Davis who writes the Heart Scan Blog has warned us before that all vitamin D is not created equal.  That is some of the vitamin D will not give you the expected result of serum 25(OH)D.

His earlier warnings was that dry vitamin D in tablet form was not as potent as vitamin D in capsules.  This time he has found through five of his patients that Vitamin D of the Nature Made brand has not given the expected serum 25(OH)D.  Here is the article: Is it or isn’t it Vitamin D

The importance of this warning is that TESTING IS EXTREMELY IMPORTANT to assure that you have an adequate amount of vitamin D in your body.

Food and Nutrition Board Delay

During a recent visit to the Food and Nutrition Board website for vitamin D and calcium I was alarmed to find that the report had been delayed from May of this year until the end of the summer.

Most likely this will continue until the boards deadline of 24 months has ended.  That would put the report to sometime in the fall of 2010.  I would not be so concerned except for the 100,000 or so deaths each month that we delay because of vitamin D deficiency to say nothing of the suffering.

A. Catherine Ross, a vitamin A researcher, as chair most certainly is having a very difficult time in resolving the issues of a board that ultimately could have a huge effect on health as well as more of an impact on the medical economy than the recently passed health care bill.  Don’t you find it strange that a board for the Institute of Medicine that was seated to set standards and guidelines for vitamin D is chaired by a person who’s life’s research has been vitamin A?

I hope this is science and not politics at work.  It is for your health that I am concerned.  The scientist are saying that an upper limit of 10,000 IU per day needs to be set and I say that this may not be enough for an obese person.  However, anything less than this and we know that is more concerned with the medical economy than your health.  It would seem that the best DRI or daily required intake should be set for IU’s/per body weight.  It is the only thing that makes sense.

Doctor’s should also be instructed that long term levels of less than 200 ng/ml is safe for 25(OH)D.  This information already exist in the NIH Fact Sheet on Vitamin D in Table 1. It is also stated that no toxicity has been found in levels of less than 400 ng/ml.  Even though these numbers sound large they are still very small numbers.

Typically an intake from all sources of about 35 IU’s per pound of body weight should get your 25(OH)D above 50 ng/ml.  However, there is no way of knowing for sure without testing and because of the serious health consequences of vitamin D deficiency, testing should become a standard and doctors required to take enough CME’s to understand the complexities.

The longer we delay in not having a national intervention for vitamin D deficiency the suffering will continue.  Number one in this issue is that doctors need to be educated.

Pelvic Floor Disorders

Pelvic floor disorders have been linked to low levels of vitamin D.  Here is an article from Medscape:  Higher Levels of Vitamin D Linked to Lower Risk of Pelvic Floor Disorders.

It seems that vitamin D can improve pelvic muscle strength and reduce pelvic floor disorders including incontinence.

I know my mother had this issue.  It seems that women who have more children, mother had nine, and are obese are more likely to have pelvic floor disorders.  She also did not spend much time in the sun when she was not completely covered up.

Vitamin D is Toxic?

Toxic – Having a chemical substance that is harmful to health or lethal if consumed.   – Wiktionary

I went for my lab test this past Monday in preparation for my physical this coming Monday.  On late Tuesday afternoon there was a message from my doctor’s office that I should call and ask for ‘Buffy’.   (believe me the real name was even better but we most protect the innocent).

Buffy said, “Mr. Pegram your serum vitamin D level is over 100 ng/ml and you most stop taking vitamin D immediately!”  “Okay, I will to talk to the doctor when I come in Monday,”  I said.  “Does that you mean that you are not going to stop taking vitamin D?” inquired Buffy.  “I will talk the doctor when I come in on Monday”, I repeated.  “You most stop taking vitamin D NOW,”  Buffy demanded.  “What is this,” I asked, “has the doctor insisted that you have to get me to say that I am going to stop taking vitamin D”  “Yes”, curt and to the point.  “What was the actual reading and do you use Quest or Labcorp to do your testing,”  I inquired.  “I do not know the exact reading but it is over 100 and we do our own testing in house,” Buffy replied.  I then asked, “what was my serum calcium”.  “They did not run a calcium”, Buffy responded and I knew this was not so because they drew three vials of blood for my annual physical exam.

At this point I realized the conversation was going no where so I again repeated, “Okay, I will just talk to the doctor on Monday”.  Buffy, “Vitamin D is toxic and you most stop now.  It is TOXIC!”

Now from the definition from the start of this post you know and your normal response to toxic is that you have taken something that is about to kill you immediately.  I decided not to have fun with Buffy because my wife, director of a clinical lab of a major hospital, was yelling at me to stop.  “Don’t yell at her she is just the messenger,” my wife scowled.  I guess she could see the ‘evil’ gleam in my eye.  I was indeed angered.

The thoughts that were running through mind was if I stop could you tell me when to start taking vitamin D again.  How long before my hypertension, back pain from degenerative disc disease, sleep apnea, and heart issues come back to kill me?  I knew that she nor the doctor would know how to respond.  This medical practice in particular has benefited financially from vitamin D because they have their own testing equipment.  The patients in this practice have benefited because everyone that walks through the door gets a vitamin D test which is the desire of Dr. Cannell of the Vitamin D Council.  I feel significantly responsible for this as I am vitamin D patient zero at this practice.

However, testing without knowledge of what vitamin D does to the human body is not acceptable clinical practice that leads to successful outcomes of patient health.  A little bit of knowledge is a dangerous thing.

The thought of an emergency call to a patient telling them that they are taking a toxic substance is outrageous when it involves vitamin D.  It could certainly wait until the doctor was face to face with the patient.  I would bet that there are no emergency calls to patients when they find their serum triglycerides over 1000 to tell them to stop eating sugar and all high starchy foods until it comes down that they are a walking heart attack.

I usually like to think of something that is toxic as having about a 50 percent chance of killing you.  From the Vitamin D Council’s page on toxicity, we find a loading dose that has a 50 percent chance of killing you as 88 mg/kg.  That would mean to have a 50 percent chance of death that I would have to take 7,520 of the 50,000 IU capsules to achieve this level of toxicity at 235 lbs of body weight.  I most likely would gag to death before I consumed that much vitamin D.

I new that my serum vitamin D was not high as I had gotten my test results back from just a couple of weeks before and it was 87 ng/ml or just at the top end of what you would find in a sunny country.  I also know of the issues when testing vitamin D and the necessary processes for quality control to get accurate values.  It will be interesting to find out if that office uses mass spec or Diasorin’s Liaison to do their testing.  Mass spec is so operator dependent according to my wife that accuracy is always a question.

Imagine the average person hearing that they are taking a toxic substance.  Monday’s visit should be interesting.

Meanwhile it is to be 85 here today so you will know where I will be with no clothes on just after noon.  No pain and no health issues and forgiveness will be on my mind as I bask in the sublime sun.  –  Pandemic Survivor