Monthly Archives: June 2012

Magnesium – Heart Arrhythmias – Mardy Fish?

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Deficiency disease from poor nutrition that leads to chronic disease is one of the least addressed issues in modern medicine.  When a problem arises, modern medicine looks for everything but an issue with the person’s diet and nutrition.  Now there have been so many people that have in essence healed themselves by just changing their diet, it is time for a change in the culture of treatment.  With lots of fun tools for doctors, the thought of addressing simple deficiencies is mundane.  First prescribe the drugs quinidine, lidocane, propranol, or amiodarone and on and on with no success.  Do a heart catheterization along with a heart ablation or maybe even open heart with an ablation which is even more fun.  “That arrhythmia was fixed by scarring the muscle that was causing the issue.  We just kill off that sucker – it was a structural problem.”  The conversation in the doctor’s lounge then turns to what is happening with the yacht on the Chesapeake.

There have been so many people that I know that have healed their arrhythmia with magnesium that it is just amazing to me.  Why is not asking the person with the heart issue what their diet is like be the very first question out of the doctor’s mouth.  “Oh hell, people are going to have bad habits and there is nothing you can do about it – did you see the speed I got when I raised my second sail?  Here, just try several of these drugs first for you jumpy heart and we will go from there.”

As a first course take 400 mg of magnesium as a chelate twice a day, be sure to eat lots of greens to get enough potassium, and let’s try three cups of sulfur containing vegetables per day or 1000 mg of MSM per fifty pounds of body weight to be sure you are getting enough sulfur to move the waste products out of your heart muscle.  We will also do a 25(OH)D to be sure you are getting enough vitamin D.  We will then evaluate your heart to see if your condition has changed.  The first day on magnesium and the heart arrhythmia is gone.  By US law, magnesium, greens, and cabbage become drugs.  Food is medicine and is much better at healing than killing off part of the heart because the muscle is not acting right.

When I was in college, I played tennis for two to three hours every day to relieve the stress.  After several years of this, I noticed that when I rested, I would get ‘jumpyness’ in my heart.  This scared the dodo out of me the first few times that it happened and it would come and go.  After I got out of college and started to eat better, it just went away.  And now I hear that Mardy Fish has had a heart catheterization and ablation it makes me wonder.  Mardy, did any of your doctors ask if you had been getting enough magnesium? – Pandemic Survivor

Eliminate Statin Drugs and Eat at McDonalds

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The use of statin drugs to control cardiovascular disease is not even close to science and is really even bad “medicine” for the dark arts.  Arterial plaque is mostly calcium plaque and only a very small percentage of fatty material.  Your arteries plug up because you do not have enough vitamin D (and possibly vitamin K2) in your body to properly move calcium around. Also you are very low on the things that release gases that allow the artery walls to relax.  The gases include nitric oxide from l-arginine, niacin, etc. and sulfur dioxide from garlic, onions, egg yolks, etc.

You may remember that last year, my serum 25(OH)D level was 40 ng/ml which is outside of my goal range of 60 to 80.  Normal clinical laboratory range for 25(OH)D has always been or at least for the last thirty five years 20 to 100 ng/ml.  I had consistently taken the ten thousand IU’s of vitamin D3 but had switch to the Pharmassure brand from CVS.  Evidently the Pharmasure brand was not as effective in raising my storage level of vitamin D.  There have been reports of a similar happening with Nature Made brand.  I don’t think these companies intentionally tried to sell an inferior product, I think the issue is in the chemistry and which epi form of vitamin D3 is being measured.  I used Swanson brand as ten thousand IU capsules and my serum 25(OH)D was 92 during my last physical exam.

The thing I have noticed over the last six years I have been replete with vitamin D is that my lipid profiles (fats as cholesterol and triglycerides) have returned to excellent after many years of major concern.  Before vitamin D, I had total cholesterol that was over 240 and triglycerides as high as 700 – a walking heart attack, primarily because the triglycerides were so high.  I am sure there was so much fat in my serum that the fat was floating in the tube before centrifuge. Last year with my serum level of vitamin D at 40 ng/ml, my cholesterol was 210 and triglycerides were 195.  This year with my serum level of vitamin D of 92 ng/ml, my triglycerides were 145 and my cholesterol was 185.  I believe that once your vitamin D level gets high enough, feed back in your endocrine system tells you skin and liver to stop making cholesterol that you have enough.  When you vitamin D level is low your skin and liver are making large amounts of cholesterol screaming at you to go into the sun to make vitamin D.  The vitamin D level also affects the triglycerides to keep them normal as well.

This year from January, I had eaten as much junk food as I could tolerate.  Sausage biscuits at McDonald’s, when you could buy two for three dollars, are my favorite.  It was also my habit to have a sweet snack or desert before going to bed at night.  Oh yes, and the Angus burger meal is really tasty too.  Obviously I don’t recommend this as a regular diet and I am not suggesting that you can eat this diet if you are replete with vitamin D.  I was curious to see what would happen to my lipids.  We have basically been lied to over the years because of the desire to keep a thriving health economy as this was believed to be more important than our health.

Instead of measuring lipid profiles as a measure of cardiovascular health, it would make more sense to test the level of plaque in the arteries and measure vitamin D including vitamin D sulfates.  A simple measure would be the amount of plaque in your carotid arteries as determined through ultrasound as suggested by these folks from the University of Wisconsin.    I mean after all, who would know better an indicator of CV disease than the lovers of beer and brats. Ah, the fat and happy life. – Pandemic Survivor

Action Alert for Physicians and Researchers to Comment on Government Clinical Guidelines for Vitamin D

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The US Protective Services Task Force has issued a draft for a statement on vitamin D and calcium.  There is a comment period that runs from June 12 until July 10 for Vitamin D and Calcium Supplementation to Prevent Cancer and Osteoporotic Fractures in Adults: U.S. Preventive Services Task Force Recommendation Statement – DRAFT

There is a link in the upper right hand corner of the draft page to go to the comment page or you can follow this link directly to the comment page.

The importance of this task force is to help the Agency for Healthcare and Research Quality (AHRQ), a department for Health and Human Services, set clinical practice guidelines for preventative care.  This task force is at the heart of what needs to be achieved as health policy for vitamin D.  Here are the current members of the task force.    Also here is their current preventative guidelines summary as provided by AHRQ to primary care providers.

The statement as drafted should not be issued because the news media does not know how to interpret what is being said based on the draft release headlines.  Also it may mislead doctors into not understanding that 400 IU of vitamin D3 will work for a baby but not for an adult where 4000 IU of vitamin D3 is a more accurate amount to achieve bone health and cancer prevention.

Thank you for your action in this matter and your timely comment to USPSTF. – Pandemic Survivor

USPSTF, Government Panel Sends Up Trial Balloon for Negative Vitamin D Findings

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Panel to post menopausal women: Don’t take vitamin D, Calcium – USA Today:  “A government advisory panel’s recommendation Tuesday that healthy postmenopausal women should not take daily low doses of vitamin D and calcium to prevent bone fractures is a wakeup call to millions of Baby Boomer women that more is not always better.”

“In its draft recommendations, the U.S. Preventive Services Task Force also said existing research is insufficient to assess the risks or benefits of taking vitamin D — with or without calcium — to prevent cancer in adults.”

Older Women Should Not Take Calcium, Vitamin D, Task Force – Philadelphia Inquirer

Panel: Postmenopausal women shouldn’t take vitamin D, calcium to prevent bone fractures – CBS News

Government Panel Says Calcium, Vitamin D Won’t Prevent Bone Fractures – USA News & World Report

Vitamin D Doesn’t Prevent Osteoporosis in Healthy Women, Task Force Says – Huffington Post

On and on and on and beat me with a stick!  What goes on here?  Why has this government panel come out now and what have they really said?  US Preventative Services Task Force (USPSTF) is sponsored by the Agency for Healthcare Research and Quality (AHRQ), a division of Health and Human Services (HHS).  Of course this is ultimately your President, but I suspect he does not have a clue as to what is going on with his health agencies.  AHRQ is the same agency that provided the package for the Institute of Medicine’s (IOM) Food and Nutrition Board that says you only need to take 800 IU vitamin D per day.  As I have warned you in the past to ignore studies that use such small amounts, the USPSTF review as based on 400 IU vitamin D and 1000 mg of calcium per day.

The Endocrine Society (ES) was bothered by the IOM’s suggestions and said the IOM was wrong.  This was based on practice experience where women have much worse osteoporosis and bone fractures with low levels of vitamin D.  The ES suggested that 25(OH)D levels be above 30 ng/ml and not the 20 ng/ml suggested by IOM.   My sister-in-law benefited from this understanding.  She had multiple bone breaks per year and planter fasciitis.  After her endocrinologist went to hear Michael Holick speak, he put her on 4000 IU per day of vitamin D and she healed.

The other thing that is alarming about the USPSTF’s suggestions is that all of the news stories are based on a draft recommendation release.  In other words, the government is sending up a trial balloon and maintains deniability.  I suspect a real recommendation will never come forward.  They have accomplished what they had set out to do – keep people from taking vitamin D because its positive effects are already being seen in the health statistics. Shame on you Kathleen Sebelius, Secretary HHS, for allowing markets before mandates!  The medical economy is not more important than our health.

By the way, there is a study showing better than twenty five percent improvements in bone density in a year with 5000 IU/d of vitamin D.  Beat me with a stick!  Ouch!  – Pandemic Survivor

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Vitamin D Deficiency Survivor

This post was originally written three years ago, July 19, 2009.  Since we have been discussing D3 and D2, I thought that would be a good idea to revisit my thoughts at that time.

Well it seems like almost since the start of understanding vitamin D in the 1930’s that vitamin D3, cholecalciferol, is equal to vitamin D2, ergocalciferol. This thought continues on today even by some of the best researchers on vitamin D.

Now before we dive right into this discussion let’s just say that vitamin D3 is better than D2 for humans because of the impact on genes and it is less toxic. In other words, take D3 and not D2 as D3 is better. If your doctor prescribes D2, ask him if it is okay for you to take an equal amount of D3 as it will be more effective to your health. Vitamin D3 is readily…

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Vitamin D2 Should Not be Used by Humans

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“Food is medicine.”  – Randy Jirtle

Vitamin D3 is naturally made in our skin by exposure to sunshine. The practice of prescribing vitamin D2 should be stopped.

Into the new understanding of epigenetics, troubled by the ever menacing difference in the two primary types of vitamin D, leaves me somewhat in a state of great questioning.  The confusion over nomenclature of vitamin D is troubling but not as troubling as the confusion of what vitamin D does in the body.  As you most likely know, vitamin D2 and vitamin D3 have long been considered as equals in the world of biological research, more importantly for you, in the practice of medicine. These two compounds were treated as equals basically because they were considered to have an equal effect on stopping rickets and the ability to ‘move calcium.’  Rickets, a bone disease, was the first disease that was identified as a result of vitamin D deficiency.  This was the most important function identified and the only important function of our connection to the sun that was considered by medicine.  Things then got spicier as it was discovered in the sixties and seventies the importance of calcium signaling in biological processes.  The importance of this signaling included calcium gates opening to allow calcium into the cell to start the RNA/DNA cellular processes, but also important neurological functioning as the opening of a calcium gate on the end of a neuron results in the release of neurotransmitters.

In the last five years, the spice has become an exotic blend of calcium signaling and the control of our genome by vitamin D.  Vitamin D has now been recognized as an important ‘switch’ for the action of our genes.  The way to think about this epigenetic action is to consider our genes as the hardware of a computer and the epigenetic switches as the software.  It has been discovered that there are over 2700 genes, about ten percent of the total genome, with vitamin D ‘pathways’.  There have been over 200 genes that are directly related to chronic disease that are controlled by vitamin D.  So the question that brings confusion is what happens when we substitute a compound with an extra methyl group for one that occurs naturally in our body as an important ‘switch.’

Here is the troubling factor.  Randy Jirtle has discovered at Duke University that methyl donors have significant impact on whether genes are activated in our biology.  He calls this epigenetic action methylation of genes.  He shows that methylation will blind receptor sites on the genes to have an effect on cellular differentiation.  The troubling part about vitamin D2; it has one more methyl group and an extra double bond than vitamin D3.  So the question then becomes, does vitamin D2 act as a methyl donor to impact the epigenetic action of vitamin D?

This question of biological action of D2 versus D3 needs to be answered.  Until this question is answered, we should stop the practice of treating vitamin D2 as equal of vitamin D3.  This includes specifically that vitamin D2 should no longer be allowed as a prescription drug or as an additive to food products.  The IOM has already raised the alarm by stating that our 25(OH)D level should be no higher than 50ng/ml as a higher level may increase the opportunity for disease.  I believe this finding is directly related to the lack of separation in published papers about the difference in D2 and D3 biological results.  There was no problem with toxicity in the 1930’s until vitamin D2 was introduced into the research.  After vitamin D2 was introduced, the reports of toxicity started coming every month.

As a consumer of medicine, your response should be to not consume or take any prescription of vitamin D that is not vitamin D3.  In other words, vitamin D3 will make you feel great and heal disease; vitamin D2 may make you feel awful and even cause disease.  – Pandemic Survivor

Pain in Shades of Ultra Violet – Appendicitis

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Up in the March chilled morning and something is just not right.  There is this gnawing feeling that seems to float from one part of the body to the next.  It is difficult to realize the origin and yet it seems to be overtaking my senses in a ubiquitous fervor.  A hot coffee and a handful of aspirin and you are off to start the day.  As the morning goes on the coffee and the analgesics start to fade and the gnaw returns.  By eleven AM the ‘gnaw’ has turned into a full blown ache in the gut.  Gaseous rumbles dance around your insides like a hot summer afternoon rolling of thunder that comes in increasing alarm as you know the storm is on its way.  By two in the afternoon you are waiting patiently in the infirmary for someone, anyone to come and tell you what is going on.   Then the news you did not want to hear; we are sending you to the hospital as your white cell count is really high and we think you have appendicitis.

At the fortress of greater understanding where those who have spent their life trying to heal and allow wellness await in anticipation of what their next case is going to like.  A really cool patient who tries their best effort at diagnosis or just a whiner that would be better if they were sent somewhere else in the ‘whinbulance’ awaits their years of training.  “What was the ride over here like?  Were there any bumps in the road,” the surgeon, with years of experience, asks. The gnaw chews at your insides as you wonder what kind of question is that for a medical professional to ask. There was too much pain to consider whether there were any bumps or not.  This guy must be an idiot, but he has a beautiful assistant with dark lovely hair and you know there has to be something going on.  The assistant returns after a few minutes and says we think you just have the flu and we are going to send you home.  If the pain gets worse then you should come back to see us.  There were no bumps in the road so you must not have appendicitis.  Of course not having medical insurance even in 1971 and the need to keep dark lovely hair in beautiful fashion may have had something to do with not wanting to keep me around.

Racked with the constant numb of gnaw slows the entire world down to where everything is happening as if the movie speed has been turned down to extreme slow motion.  Even the sound of a fly is amplified to a fleet of B-52 bombers going overhead.  Was this what the surgeon was talking about?  What bumps in the road?  But that damn fly needs a good dose of antiaircraft fire.  The experience of pain is different for everyone and ranges through the full spectrum of bright red to the invisible ultra violet.

Decision was made that I was not going back to see the man with the lovely-dark-haired assistant.  A phone call to my parents at four in the morning less than eighteen hours from the start of anxiety was made hastily before I begin the long drive home of about an hour and half.  Dad said he would meet me at the emergency room of the hospital closest to my entrance into the city and find a surgeon.  About two thirds of the way to comfort, a stop was necessary to throw up an ugly yellow substance that was later described as bile.  The appendix had ruptured and waves of pain followed and preceded tsunamis’ of anxiety.   The new surgeon, Dr. Marks, said he thought I had appendicitis but did not think it had ruptured.  Besides, he had a busy schedule already planned for the day and he could not have a nineteen year old college student interrupt.  A shot of Demerol and two o’clock in the afternoon and the surgery finally began – ten hours after the rupture.  Two days later the scrub nurse comes into the room to inquire if I was still alive.  She was amazed as she said she had spent more than an hour mopping up the toxins in my chest cavity with Betadine.  I most likely would have died from the infection if not for her efforts.

A shot of antibiotic every hour for three days and the infection was prevented.  Nine days later I was to be discharged and a new surgeon shows up.  He is amazed that my cavity drain tubes have not been removed.  He said that the tubes were to be removed a few inches at a time over several days.  But if I didn’t mind he would like to just pull them out now and release me.  I was amazed as he removed the three tubes with the longest at eighteen inches.  No offer of pain meds until he saw me go whiter than the freshly starched sheet on the bed.  Five days later I was back at college playing tennis.  Ah, the resilience of youth.

Could this episode of “pain on steroids” have been averted with an adequate level of vitamin D?  I suspect so.  This is just one of many illnesses that have occurred in the spring when my level was the lowest.  It gives me shivers even now as I think this was just a four on my pain scale of zero to ten.  If I can overcome the fear, I may someday describe the pain episode that is a ten.  – Pandemic Survivor

Vitamin D – Hormone or Vitamin?

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This question needs to be resolved as medical practitioners determine patient treatment.  The complexity in the nomenclature of vitamin D has caused many errors.  The general thought in medical practice is that vitamins do nothing for illness and hormones are very effective.  Government medical guidelines are not reliable because of the conflicts of interest at the IOM.  There are several levels of people writing about vitamin D where people tend to get information.  Let’s take four examples: Level one – researchers, level two – medical activists and practicing doctors, level three – new discoverers of vitamin D as practicing doctors, and level four – people that have experienced healing with vitamin D as novices in the world of biochemistry.  We will ignore the government for now because they are more concerned about the economy than your health.

Your take away from this discussion is that you should never take or give vitamin D as anything other than high quality vitamin D3 as you may overcome the biological controls of the body and cause illness.  If you are an innocent health consumer then do not bother to read the rest of this post as it is technical and may confuse you.

Level One

Reinhold Vieth: A clinical researcher specializing in vitamin D nutrition on faculty at the University of Toronto Canada.  Why Vitamin D is not a Hormone   The importance of this paper written in 2005 is to help prevent practitioners from making mistakes in the nomenclature and administering the wrong compounds of vitamin D to patients.  If you are a doctor or other medical practitioner, then this is a must read.  Note that Vieth clearly states that vitamin D is a vitamin and then describes 25(OH)D as a prehormone.  He says that prohormone has no place in the vitamin D system.

Anthony W. Norman: A biomedical researcher and Distinguished Professor of Biochemistry & Biomedical Sciences, Emeritus at the University of California Riverside.  From Vitamin D to Hormone D: fundamentals of the vitamin D endocrine system for good health.  The importance of this paper is to help medical practitioners properly assist patients with vitamin D deficiency diseases.  This is a must read for medical practitioners. Written in 2008.  Dr. Norman is concerned that the new understandings of vitamin D are not translated to medical practice. Dr. Norman describes vitamin D as a prohormone produced photochemically in the skin from the prohormone 7-dehydrocholesterol and then goes on to describe the importance of its derivatives as hormones.  He then describes vitamin D3 as both a vitamin and a prohormone.  Note the distinction between vitamin D and vitamin D3.  This in essence groups the family of all “prohormone” vitamin D system molecules as vitamin D which includes more sterol derivative molecules than most practicing doctors can imagine. This probably provides more confusion than clarification to practitioners that are not expert biochemist, but read it anyway.

Level Two:

John J. Cannell, MD: Dr. Cannell is head of the  Vitamin D Council and has been a general practitioner and psychiatrist.  He launched his understanding of vitamin D in 2003 from a paper written by Reinhold Vieth.  Cannell describes vitamin D as a prohormone .  Note that he does not say vitamin D3.  I am guessing that he has adopted the nomenclature of Dr. Norman.  In his description of the vitamin D system he shows D2 and D3, pharmaceutical vitamin D, and vitamin D metabolites.

 

Level Three:

Stasha Gominak, MD:  A practicing neurologist in Tyler, Texas that discovered in 2009 the value of vitamin D3 and magnesium in treating neurological diseases, in particular sleep apnea.  Dr. Gominak describes vitamin D as a hormone  that is made in the skin.  She likes to use D hormone as it helps her understand the importance of the vitamin D system and that vitamin D hormone is made in our skin and not something that is obtained from outside her body.  She references the Vitamin D Council as her primary source of information.  She clearly states that vitamin D is not a vitamin.  This is somewhat dangerous because of the confusion that can be created between vitamin D3 and calcitriol with other doctors that she contacts or reads her info.

 

Level Four:

Mark Pegram, A Vitamin D Deficiency Survivor:  Yeah, that’s me, a health activist.  I will tell you now that this discussion is complex.  The importance of writing about vitamin D is to help you the innocent health consumer and medical practitioners to implement the new understandings of the vitamin D system in combination of other nutrients in which we are deficient.  It is never just one nutrient.  It is the combination of nutrients and minerals that allows our bodies to be healthy. The expression and control of our genome by the combination of nutrients is extremely important to health.  A proper combination of vitamins, minerals, proteins, fats, and carbohydrates is more important to prevent disease and to heal disease than most pharmaceuticals. Vitamin D3 is a vitamin and I believe the confusion is in the definitions.

Vitamin – One of a group of organic substances, other than proteins, carbohydrates, fats, minerals, and organic salts which are essential to normal metabolism, growth, and development of the body. (Taber’s Cyclopedic Medial Dictionary 13th edition, yes I am an old guy as this was published in 1977)  Please note that in this definition it does not say that it is obtained outside of the body.  However, it later says in the definition that a vitamin is not formed in the body, but gives the exceptions of vitamin A, vitamin D, and vitamin K.

Hormone – A substance formed in an organ, gland, or part of the body and carried in the blood to another part of the body, stimulating it by chemical action to increase functional activity. (Taber’s Cyclopedic Medial Dictionary 13th edition)

Prohormone – A prohormone is a substance that is a precursor to a hormone, usually having minimal hormonal effect by itself. The primary function of a prohormone is to enhance the strength of the hormone that already occurs in the body.  en.wikipedia.org/wiki/Prohormone

Prehormone – A prehormone is a biochemical substance secreted by glandular tissue and has minimal or no significant biological activity, but it is converted in peripheral tissues into an active hormone.

These definitions seem to agree with Dr. Vieth and have a historical content in the practice of research and medical practice.  I do not think our definitions should be changed and I think that Anthony W. Norman has tried to stick with that understanding.  The primary difference is in prohormone and prehormone which are relatively new terms of the last twenty years.  They are not listed in my 13th edition of Taber’s.  The confusion is in the second sentence of the definition of prohormone – “enhance the strength of a hormone that already exists”. This seems to contradict the first statement as being a precursor.  I believe that Dr. Vieth has it correct in calling calcidiol, 25(OH)D,  a prehormone as it is not a hormone itself and is converted in most cells of the body to several steroid hormone forms of vitamin D, the new discovery by vitamin D researchers.

Now, if I could just figure out a way to get doctors to stop prescribing vitamin D2, vitamin D pharmaceuticals like dihydrotachysterol and Alfacalcidiol, and the metabolites; calcidiol(except in the case of liver failure), calcitriol (or Jeff and Geoff as Rich quipped in his comment on last post) then the benefits to health of D3 would be much more apparent and most likely without toxicity except for industrial accidents in manufacturing.  Of course, more important at this point is to get everyone replete in vitamin D3.  Again: Your take away from this discussion is that you should never take or give vitamin D as anything other than high quality vitamin D3 as you may overcome the biological controls of the body and cause illness. – Pandemic Survivor

How to Make a Hormone

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How do you make a hormone?  You put her in the sunshine.  The discussion of the biochemistry of vitamin D is just as convoluted and confounded as the last statement.  To quote the words of Reinhold Vieth, “There is probably no other area of steroid biochemistry so burden by terminology complexity as the field of vitamin D.”  This has always been painfully obvious to me as I have tried to sort through the nomenclature of vitamin D to reach an understanding of what doctors, researchers, and scientist were saying.  The confusion has recently been brought to my attention again in an email conversation with a reader.

It seems that the main fall back word is vitamin D and we do not know what the person using the word is really referring to, or more clearly, what specific compound the communicator is pointing toward.  In some cases and I am afraid more often than not, even the person using the word does not know what compound they are giving for reference.  I have been guilty of that error myself in writing this blog.  To make matters worse, it has been assumed, that various compounds of vitamin D are equal in their biochemistry.  This could not be further from the reality.  Now that Oxford scientist have shown that over 2700 genes can be impacted by vitamin D, the clarity of the various sterols is necessary in order to reach defining realities inside of the human body.

As an undergraduate student, I started as a major in chemistry.  My first year laboratory professor was Dr. Forrest C. Hentz.  Dr. Hentz’s advice to us as we approached the various curricula was to spend as much time as necessary in learning the nomenclature of each subject.  He went on to describe that ninety-seven percent of learning was in the understanding of the physical realities of the words that were being used.  This could not be more appropriated when related to the studies of vitamin D.  Dr. Hentz also went on to say that the many intermediates in chemical reactions might not every be understood, but the importance was in the beginning and ending compounds.  It is time stop playing ‘money games’ with the analogs of vitamin D, and to start looking for the many diseases from the deficiency of vitamin D as formed from UVB light incident on the skin.

The art and science of medicine will always be a slave to the definition of the words that are used to communicate physical realities.  – Pandemic Survivor