Vitamin D2 Should Not be Used by Humans

“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

Advertisements

Vitamin D – Hormone or Vitamin?

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

The Vitamin D2 Debacle

Modern medicine has long considered that vitamin D3, cholecalciferol, and vitamin D2, ergocalciferol, to be equal.  That is these two compounds will give you exactly the same clinical response.  This has been a huge mistake.  This extreme error in medicine has cost tens of millions of lives and an unbelievable amount of suffering.  It is true that in small amounts, vitamin D2 will cure rickets. In larger amounts it becomes extremely toxic at much-much lower levels than vitamin D3.  When the IOM’s Food and Nutrition Board set standards for vitamin D, they address this issue by saying that a serum level for 25(OH)D of twenty nanograms per milliliter made from vitamin D2 was adequate for bone health. They then warned that levels above fifty nanograms per milliliter could result in health issues.  This is absolutely correct when using vitamin D2 or the stuff that your doctor typically prescribes.  Until recently, vitamin D3 was not available for prescriptions.  Under US law, if a doctor prescribes a vitamin to prevent, cure, or treat a disease, it becomes a drug.  The medical profession has been extremely concerned of this issue of toxicity from either vitamin D2 or toxisterols that occur from over irradiation when making D2.

It gets even more complicated because vitamin D3 is not a vitamin but a prohormone.  It is the substance that our body produces when we are exposed to the UV rays from the sun or our natural connection to the sun that was forever altered with the introduction of sunscreen products.  Consider the importance of hormones.  Would you give a person estrogen if they had a testosterone deficiency?  They are very similar in molecular weight and only differ by the placement of oxygen and OH groups.  They are hormones and typically affect the expression of over one hundred fifty genes.  The mix up of these two hormones would cause a significant failure of biological functioning.  Vitamin D3 affects the expression of over two hundred genes and over twenty seven hundred genes have been found to have vitamin D pathways.  So would you want to mix up D2 with D3 that could cause your health to fail?

If you are totally deficient in vitamin D, then a small amount of D2 may be acceptable medical practice until you can get an adequate amount of D3 from either supplementation or spending time in the sun.  To show you how the medical schools have taught physicians, my doctor told me that if I took five thousand IU’s per day of vitamin D that my organs would turn to stone.  Of course this was before I encouraged him to read the research.  The calcification of organs and soft tissue has long been an issue with vitamin D2 and rightly so.  However, this has lead to a huge problem with vitamin D3 deficiency where the importance of this vitamin or if you prefer hormone, is not just about bone health.  To think that our venerated institutions that we depend on to give us scientific direction for health stated that they only considered bone health when reviewing vitamin D is outrageous.  One of the most important hormones in our body and our health institutions give it a ‘one note’ function.  It is time that the medical profession gets on with orchestrating the symphony.

I recently had a friend tell me his doctor had just prescribed D2 because his 25(OH)D was 15 ng/ml.  I tried to explain the difference between D2 and D3 but it seemed to fall on deaf ears.  He kept asking the medical difference and he did not seem to believe the answer.  Do not allow yourself to fall into this trap.  If your doctor tells you to take fifty thousand IUs of vitamin D2 per week, ask if you can use the natural substance your body makes, vitamin D3.  If he says no, then find a new doctor because the one you have does not know what he is doing.   – Pandemic Survivor

For the best explanation, The Vitamin D Problem, by Moon and Reich from 1975 that includes the history.  A PDF file.

Mesmerized by Epimerization

Franz Mesmer was a German born physician that had interest related to human and animal behavior.  He contended that through ‘animal magnetism’, significant physical results could be realized.  His name is the basis for the word Mesmerized.  It has been an unfortunate occurrence in vitamin D science that the medical professionals and the general population have been hypnotized like chickens with a line drawn in the dirt. (We did this as kids – check it out Chicken Hypnotized) We all need a nudge to wake up from this surreal dream.  The following is not for the faint of heart or for those that do not have the curiosity to pursue a deeper understanding.  If not curious, then just watch the chicken video and have a good day.

Epimerization is simply the difference in the positioning or bond angle of the OH group in the Carbon 3 position of the vitamin D compound.  What do we know about how much difference a bond angle will make?  It seems that this bond angle is of significance in genetic expression, so let’s explore.  Check out this example for the sugar glucose: Epimers

It came to my attention several years ago that one of the local hospitals that was attached to a state university was doing vitamin D testing only on D2 and its metabolites.  The reasoning was that the clinicians wanted only to know the level of the drug, vitamin D2, because this is what had been prescribed.  The logic was that the level of the hormonal metabolites of natural vitamin D3 were so low that it was of no consequence.  After all, there had been a great job done for the last fifty years of scaring people out of the sun.  Or maybe, this was not exactly the logic, but I am sure this is close.  So the mixture of treating D3 and D2 as equals and ignoring the total effect of the metabolites of these pre-hormones has done the practice of medicine and the population as a whole a great disservice.  It is only through the separation of these two compounds and not allowing peer reviewed papers to be published without designating what is being used that we can achieve our goal of being reconnected to the sun.

I had always thought that the complications of not having accurate serum vitamin D levels or 25(OH)D was a matter of the different test methods not giving either totals of the two or only values for one or the other  –  25(OH)D2 or 25(OH)D3.  In the later case I was right as is suggested by what was being done at one of our university hospitals.  But it turns out that it is a lot more complicated.  Consider the recent release by the American Chemical Society – “New Standard for vitamin D testing to assure accurate test results”, January 25, 2012.  The paper describes the storage metabolites of vitamin D:  “The researchers developed four versions of the standard, with different levels of the vitamin D metabolites 25(OH)D2 and 25(OH)D3 in human serum. They also determined the levels of 3-epi-25(OH)D in the adult human serum samples. Surprisingly, they found that this metabolite — previously thought to only exist in the blood of infants — was present in adult serum. “This reference material provides a mechanism to ensure measurement accuracy and comparability and represents a first step toward standardization of 25(OH)D measurements,” say the researchers.”  It seems that these epi-metabolites have a less effect on calcium.  In order of effect on increasing hypercalcemia, it is 3-epi-25(OH)D3, 25(OH)D3, 3-epi-25(OH)D2, and 25(OH)D2 (and don’t forget the toxisterols that can be made during manufacture of D2 from over irradiation of fungus).  It also seems that the epi-compounds are just as effective as the original.  Did I get this correct?  Here is a starting place for you to begin your consideration. 1α,25(OH)2-3-Epi-Vitamin D3, a Natural Physiological Metabolite of Vitamin D3: Its Synthesis, Biological Activity and Crystal Structure with Its Receptor  This is an open access to the full paper.  Do you begin to see the need for the separation of D2 and D3 and metabolites?

Now does this really get us to a better place in the understanding of our natural hormone D?  Consider the recent attention on cholesterol sulfate and the resulting compounds of hormones that are made from cholesterol sulfate, in particular vitamin D3 sulfate.  So now are we looking at eight storage metabolites instead of four?  How confusing can it get?  Consider what the writers of this paper:  HPLC Method for 25-Hydroxyvitamin D Measurement: Comparison with Contemporary Assays, March 2006, had to say: “According to Shimada et al., nearly equal amounts of 25(OH)D3 sulfate and 25(OH)D3 are usually present in patient sera.”  The Shimada paper: Shimada K, Mitamura K, Higashi T. Determination of vitamin D3 metabolites using high-performance liquid chromatography or immunoaffinity chromatography. J Chin Chem Soc 2000;47:285-228.  

Only after the clinical outcomes related to the levels of the eight compounds, 3-epi-25(OH)D3, 25(OH)D3, 3-epi-25(OH)D2, 25(OH)D2, 3-epi-25(OH)D3 sulfate, 25(OH)D3 sulfate, 3-epi-25(OH)D2 sulfate, and 25(OH)D2 sulfate are determined will we be able to accurately assess the health benefits  of vitamin D. 

Just think of the confusion of test methods to determine the amounts of the various vitamin D compounds and correlating clinical outcomes with one thing that we call 25(OH)D.  Researchers and reviewers, it is really up to you.  If you fail in allowing papers to be published without making the necessary distinctions, then, the population will continue to suffer at your ineptness. Kathleen Sebelius, Secretary HHS   –  Carolyn M. Clancy, M.D., Director Agency for Healthcare Research and Quality, are you listening?  Okay, all you chickens, GET UP!

If you really were not curious and you made it this far anyway, then may God bless you and go spend some time in the sun.  – Pandemic Survivor

Vitamin D3 Good, Vitamin D2 Good for Rats

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 available even in 50,000 IU quantities (since this post was written, the FDA has approved 50,000 IU of D3 from Bio Tech Pharmacal to fill scripts). If your doctor says no,  then get a second opinion or at least have him read from the journals listed below.

I would like to say thank you to the journals and to the authors who have made their papers open access to help in the understanding of treating chronic disease.

Consider this article that was written in 2008: “D2 as Effective as D3 in Maintaining Circulating 25(OH)D Levels” Holick et al, : J Clin Endocrinol Metab 2008 Mar;93(3):677-81. Epub 2007 Dec 18 Now this article was written in part by Dr. Michael Holick and I consider him to be one of the best researchers of vitamin D. After all he did get fired from his job after writing the book the “UV Advantage.” But the above paper really puzzles me and you have to read the abstract carefully to understand what Dr. Holick is saying.

First, he is talking about levels of serum 25(OH)D that are necessary to heal rickets. That is that 99% of all rickets is healed at 25(OH)D level of 20 ng/ml or less. So here is where the problem begins. Also read this statement carefully from the Conclusion: “A 1000 IU dose of vitamin D2 daily was as effective as 1000 IU vitamin D3 in maintaining serum 25-hydroxyvitamin D levels and did not negatively influence serum 25-hydroxyvitamin D3 levels. Therefore, vitamin D2 is equally as effective as vitamin D3 in maintaining 25-hydroxyvitamin D status.”

Note very carefully in this statement how 25(OH)D, 25(OH)D2, and 25(OH)D3 are used. This is the language of confusion that has always been used in vitamin D research where everything that even closely resembles a D compound is called vitamin D. The sum of 25-hydroxyvitamin D2 plus 25-hydroxyvitamin D equals the total value of 25-hydroxyvitamin D. In the future, you should be very careful at the higher serum levels above 50 ng/ml because most of the work with vitamin D is now being done with D3. When you go to the higher levels,  then the above conclusion no longer holds.

At higher levels, the effect of serum 25(OH)D is better understood from this paper:

The Journal of Clinical Endocrinology & Metabolism Vol. 89, No. 11 5387-5391 Copyright © 2004 by The Endocrine Society, Vitamin D2 Is Much Less Effective than Vitamin D3 in Humans, Laura A. G. Armas, Bruce W. Hollis and Robert P. Heaney

Consider this statement from the abstract: “Vitamin D2 potency is less than one third that of vitamin D3. Physicians resorting to use of vitamin D2 should be aware of its markedly lower potency and shorter duration of action relative to vitamin D3.”

As you read the two papers you see that they are talking about two different ranges of 25(OH)D. The efficacy of disease prevention and treatment only begins’ at the higher ranges. And many researchers think that to get the best benefit, the 25(OH)D level should be above 60 ng/ml and that it should be 25(OH)D3. Now the normal of a sunny country according to a paper, Benefits and Requirements of Vitamin D for Optimal Health: A Review   by Dr. William Grant of SUNARC,  is a level of 25(OH)D3 of 54 ng/ml to 90 ng/ml. This sounds like a target for a normal range and is much more predictive of preventing disease than the range that the medical professions currently use of 20 to 100 ng/ml. It’s just that the minimum level needs to be raised.

I may have used the word efficacy above and should not have. Equal potentcy does not mean equal efficacy. That is that they treat disease at the same level of quality or with the same outcome. So even at the lower levels of potency where D2 and D3 are equal at raising 25(OH)D levels, I suspect that 25(OH)D3 is more efficacious in treating disease. Ah, the language of misdirection and the medical profession should be a blog on its own.

Equal potent does not mean equal efficacy!

Efficacy is what opponents to the population taking enough vitamin D to have an effect on disease are screaming about. “There is not enough research on the efficacy of vitamin D they scream,” but they have much thinner research on the various drugs that they are touting. “Heal the population but do not heal the portion that I have targeted for my drug because I have spent millions in research and we would not want something like sunshine to keep me from making a profit.”  Boy, I believe I was a lot angrier three years ago than I am now.  Of course this practice of confusing the population for profit goes on as shown by the conflicts of interest allowed by the Institute of Medicine’s Food and Nutrition Board in 2011.

Of course it is forgotten that the test on efficacy was run during the twentieth century when most of the population was taking two tablespoons full of cod liver oil per day or about 2600 IU of D3. Ever hear of anyone dying from vitamin D toxicity? The Vitamin D Council on toxicity.  Neither have I. How about have you ever heard of anyone dying from liver failure where consumption of acetaminophen is the number one cause?

I am not bitter from the 25 years of chronic pain I suffer, just using this energy of healing to try to help the rest of you folks. Sorry if sometimes it sounds like whining but I will repeat from a previous blog that standing in Germany and watching the holocaust without taking action does not sit well with me and neither does watching people suffer and needlessly die from chronic disease.

And second so what do rats have to do with vitamin D2 and D3. Well it seems like rats just love vitamin D2 as it works better for them than does vitamin D3. Rats are nocturnal animals and get their vitamin D primarily from eating plants and fungi that have made D2 after being irradiated with sunshine. Isn’t it interesting that we have used rats extensively in testing for vitamin D when vitamin D2 is more efficacious in rats than vitamin D3 and this is the opposite for humans?

In the following paper, Dr. Vieth, a real hero in vitamin D research from the University of Toronto, shows how in other species that D3 is more effective by a factor of 10 at potency and that D2 is more effective for rats.

Here is the open access paper: The case against ergocalciferol (vitamin D2) as a vitamin supplement Lisa A Houghton and Reinhold Vieth, American Journal of Clinical Nutrition, Vol. 84, No. 4, 694-697, October 2006

So why and when did we start to use D2 and not D3. JY Moon and Dr. CJ Reich considered this very problem from a 1975 paper entitled “The Vitamin D Problem” . This is a most read and explains how the cases of toxicity did not start until we started to use D2 and how D2 can lead to more disease. Now this is in 1975 just prior to the time that I begin to start suffering pain and there was not one doctor good enough to ask about my serum vitamin D level – D2 or D3!  Don’t go into the sun and if you do wear sunscreen as it will prevent skin cancer, but what about the disc disease in my spine that is very similar to rickets?

Where are the government agencies that are supposed to protect us from the misadventure of profiteers? Oh yeah, they are protecting the profits and the economy for Wall Street.

Go into the sun!!!!!!!!!!!!!!!!!!!! When you cannot, supplement with D3 only!!!!!!!!!!!!!!                                         – Pandemic Survivor  Well, it does not look like much has changed over the last three years in the clinical practice of treating vitamin D2 and D3 as equals!  I suspect there will be a lot of papers become unless when the effects of 25(OH)D2 versus 25(OH)D3 are finally determined.

Toxicity of Vitamin D

This is my own opinion about toxicity and how we got to such a state as the doctors were trained to fear vitamin D.  It seems there are multiple areas where mistakes were made about the issue of toxicity.

I think that one of the issues that everything that resembled vitamin D was called vitamin D.

There is D2 or ergocalciferol which is made from fungus when it is irradiated with UV light. This version has a higher molecular weight, an additional double bond, and one additional methyl group if that means anything to you.  The medical professionals still considers this as equivalent to D3 even though there have been many papers saying that it does not act the same in our body.   Rodents seem to thrive on vitamin D2 as they are noctournal animals and eating fungus that has been exposed to sunlight seems to be a reasonable way for them to get vitamin D and their bodies have adapted.  I observed a squirrel just really munching down on what I assumed was a morel mushroom this past weekend when I was camping.

Hey researchers! – beware when using rodents for vitamin D test as they most likely do not react the same as humans.  The case against using ergocalciferol  (vitamin D2) as a supplement – Houghton and Vieth American Journal of Clinical Nutrition, Vol. 84, No. 4, 694-697, October 2006th

There is D3, cholecalciferol, which our body produces from the sun with cholesterol in our skin. Our bodies love this particular version of D and it is the substance in our bodies that allows the sun to give us energy and health.

There is the storage form prehormone of vitamin D which has been found to correlate with lots of chronic diseases.  It is called twenty-five hydroxy vitamin D and you usually see it written 25(OH)D.  It can be either 25(OH)D2 or 25(OH)D3.  This adds to the confusion when running test in the lab.  Let’s say that a hospital runs only the test for 25(OH)D2 becuase that is what is being prescribed by their doctors and yet ignores the 25(OH)D3 that you are getting naturally.  The better lab test will give you total and I will write another blog on testing.

Certainly if you take the activated steroid form of vitamin D or one twenty-five di-hydroxy vitamin D (1,25(OH)2D) then you will have problems if the dose is too high or administered over a period of time.  This is yet one more form of vitamin D that the body uses as a steroid to do all the good stuff.   This form in the blood stream allows our body to absorb more calicium and will ultimately drive your serum calcium too high.

The really cool thing about the understanding of the new research is that each organ cell seems to make the steroid version inside and outside the cell as it is needed.  This means that it does not go through your blood and affect your calcium yet it gives you healthy functions.  This is one of the things that has always confounded the research as researchers were going right for the best benefit or so they thought by using the steroid form of D instead of given just plain old D3 and letting the body make the steroid as it was needed.

The old paradigm was that the D3 was converted in the liver to the storage form, 25(OH)/D3, and then the kidney converted the 25(OH)D3 into the steroid form, 1,25(OH)2D3 and is still a valid path.  However, when every cell that has vitamin D receptors converts its own steroid form as needed most excellant health is achieved.  You have to have enough of the D3 in your body to fill up the stores.

Well let me stop here and say that this is most likely very confusing to you and has confused the medical field also.  You should go read at the Pharmacology of vitamin D at the Vitamin D Council to get a better description.  You can also read at the University of California Riverside as well about Vitamin D.

The amount of vitamin D is also a really large issue because it is active in extremely small amounts.  Now lets see, the serum test for 25(OH)D is measured in ng/ml.  We take D3 is in units of IU where 40 IU equals 1 microgram – that’s mircogram not milligram.  I suspect you are just conformtable using milligrams and do not have a clue about a microgram much less nanograms per milliliter. So to get 1 milligram of vitamin D you would need to take 40,000 IU.

Are you confused yet.  To formulate and to test at these extremely small quantaties is extremely difficult and one major lab has alreadly had a recall this year because of this difficulty.  So that brings us to the one major case of toxicity with vitamin D3.  It was a formulation problem and a mistake on how much should be taken by the person doing the supplementation.  Evidently the person was taking over a million IU per day for over a year. It is my understanding that he recovered and was just fine.

To get more of an understanding on toxicity of D3 please visit the Vitamin D Council’s page on toxicity.

So what is the deal and why were doctors told to be extemely concerned about toxicity with vitamin D?  It seems that D2 drives toxicity much quicker at lower levels in humans than D3.  I found a paper by Moon and Reich at the Orthomolecular library entitled “The Vitamin D Problem An Important Lesson in Orthomolecular Medicine.” This paper was written in 1975.  These writers researched the issue of toxicity and found that reports started p0uring in after vitamin D2 began to be used.  This particular section in the paper is well titled: ‘Origin of the Vitamin D-Problem:  Irradiated Ergosterol is Not Vitamin D’

Irradiated Ergosterol was origianllly used as the fortification of milk.  However, in the 50’s and early 60’s most dairies changed to D3 because of the toxicity issues.  During my early reading I was finding compounds that were in equilibrium with D3 as tachysterol and ichysterol but D2 seemed to have one called toxicysterol.  This should have been a clue.

If all of this was known at least by the mid 70’s why all of the fear of D3.  Because D2 and D3 were considered to be equivalent by the medical profession.  I would say that this is terrible science or chosen to be ignored by the medical profession because there was no money to be made. Interestingly enough, D2 is what is found in vitamin D prescriptions because it can be protected because it is not a natuarlly occurring substance in the body.  You could not obtain D3 in beneficial amounts until a few years ago.  To get equivalent to one day in the sun where your body could make as much as 40,000 IU as a supplement you would have to take 100 of those 400 IU tablets.

I was curious as to a statement made by Hector DeLuca in his presentation to the Wisconsin Alumini Research Foundation on Vitamin D: The New Old Wonder Drug.  This you tube video gives you the understanding of how vitamin D analogs have been very sucessful in helping to fund the programs at Wisconsin University.  The statement that some of the beneficial findings over the years were not published is frightening.  This of course was to protect intellectual property rights or dollars.

So does ignoring the facts for profit make the medical profession seem somewhat callous?    It happens all of the time and you acting as the government protect these profits to the loss of your health and life.  Consider former Secreatary Leavitt of Health and Human Services.  On his bio page he listed his priorities.  Number four was ‘markets before mandates’ and you had to go to his last to find ‘value life’.  Now this is really troubling since I was tortured with pain for 25 years when there was a simple solution.

So is it going to far to say that by scaring people out of the sun and causing a significant increase in chronic disease that we were benefiting the well being of America because of an increased medical economy?  Creating disease by selling sunscreen and profiting from the meds to treat the diseases is for another post.

Go into the Sun until you start to turn pink.  Being in the pink is a good thing!