Reinhold Vieth Response to IoM

Professor Reinhold Vieth, a University of Toronto scientist that has been studying vitamin D since 1974, had this to say:  “I get a ton of email from the vitamin D community where people are flipping. But it’s no surprise. I’ve kind of thrown in the towel years ago. I’m watching it more bemused than anything else,” says Vieth.  Here is the full article from the Winnipeg Free Press by Shamona Harnett, Confusing With a Capital D

I plead with you Professor Vieth.  It was your works that help to lead me to the understanding of the safety of vitamin D.  It was this understanding that allowed me take enough to heal my diseased body.  You are a Champion of the Vitamin D Revolution.  We all hope you continue the good fight for the health of millions and as those you have helped to heal.  We applaud you as a man of good character and moral fiber.   Coach Jim Valvano, NC State University, died with bone cancer without the vitamin D understanding said these words, “Don’t give up…Don’t ever give up!”  Sometimes when I get discouraged, I go watch his ESPY Awards speech ; delivered with the knowledge that death from cancer was soon.  We continue to need your expertise.  – Pandemic Survivor

Response by Expert’s to IoM’s Vitamin D Standards

Grass Roots Health Maintains serum 25(OH)D levels should be maintained between 40 – 60 ng/ml.  http://www.grassrootshealth.net/recommendation

Comments from Grass Roots Health Scientist:  http://www.grassrootshealth.net/iomquotes

Bone Health not Maintained: http://www.grassrootshealth.net/iombonehealth

Vitamin D Council Statement:  http://www.vitamindcouncil.org/vdc-statement-fnb-vitamin-d-report.shtml

Statement by Dr. William Grant of SUNARC.org:  http://www.vitamindcouncil.org/grant-statement-fnb-vitamin-d-report.shtml

Here we have a number of vitamin D experts that are upset with the statements of the Food and Nutrition Board on vitamin D and calcium for two primary reasons:  First – Millions are suffering from being vitamin D deficiency from our normal relationship to the sun of a serum vitamin D level of 40 to 80 ng/ml because of staying inside more, sunscreens, and sun avoidance in general.  Second – It is really bad science and public health policy.

Vitamin D Ignorance, Incompetence, or Conflict of Interest

As vitamin D science has advanced during the last one hundred years, it has stumped many why we do not routinely treat and prevent disease.  Some have said it is because we ignore the science of vitamin D for the many other opportunities to treat and prevent disease.  Others have thought that it was just incompetence by medical professionals in understanding how the biological processes work with nutrients and especially vitamin D.  However, what is really happening is this huge conflict of interest for everyone that makes any income from the medical industry.

I would like to believe ignoring the science and lack of understanding is not possible because of the mountain of published information available to anyone that would like to read the twenty five thousand or so peer reviewed papers on vitamin D that have been published since 1960.  I would also like to think that our medical professionals and scientists are very bright people.  They have competent understanding of how biological processes work.  What is missing is the will to use the understandings to treat disease.  The intent of the medical profession is to treat and heal disease as long as it makes economic sense.  That is, you perform a task for payment and it sustains or increases the market size.  This is the very heart of capitalism.

So what principles drive the everyday operations of medical institutions, whether it is your local doctor, hospital, medical insurance company, pharmaceutical company, government agencies for health, and medical marketing (think insurance ads and pharmaceutical commercials)?  This could best be summed up by the principles that were stated by former Secretary of Health and Human Services, Michael O. Leavitt.  Of course HHS is the administrative department of government that all medical institutions and individual medical professionals either report directly to or responsible to for medical guidelines, rules, and laws for all the various functions of the medical industry.  These principles are:

1.      National standards, neighborhood solutions
2.      Collaborations, not polarization
3.      Solutions transcend political boundaries
4.      Markets before mandates
5.      Protect privacy
6.      Science for facts, processes for priorities
7.      Reward result, not programs
8.      Change a heart, change a nation
9.      Value life

These principles seem in reverse order for someone that is dying of a chronic disease or everyone.  To ‘value life’ when you are dying would seem to be a number one goal.  However, if you want to maintain a healthy medical economy, then a large sick market is needed.  To maintain this market then the first four principles are absolutely necessary.  The first three keep everyone in ‘locked step’ for moving toward the goal of a healthy economy.  However, number four, ‘markets before mandates’ brings confusions to persons wondering why a miracle medical solution is not implemented.

If you had to give up your job or source of income to save a life, would you do it? This seems almost too simple of a question that ultimately drives the medical industry.  It is a huge conundrum for persons in administrative positions including the president of the US.  It is a huge conundrum for the individual whether you work for the medical profession or have a number of friends and family whose income is derived from the medical industry.  Another way to ask this question: would you be worse off to have a chronic disease that takes 50 years to kill you or no income to sustain a nice life style.  As a society we have decided on the former.

So a miracle cure comes along for all chronic disease.  One that impacts more than ten percent of the genome and in particular the part of the genome that is responsible for disease – vitamin D.  You are the secretary of HHS and you meet with the president of the US to decide whether to implement the solution or try to cover it up to prevent a reduction of eight percent (represents fifty percent reduction of the medical economy or a true miracle cure) of an already failing economy- a reduction that could collapse the economy.  What would you do?

Yes everyone has a conflict of interest when it comes to reducing the medical economy by half.  If the science had been allowed to come forward as it was discovered and we grew the economy into it, then the decision to ‘value life’ would be number one on our priority.  Why didn’t this happen?

‘Markets before mandates’ is sad if you are dying.  If you derive your income from medical practice then million dollar houses on South Beach and million dollar yachts on the Chesapeake is the order of the day.   Ah character and a moral conscience are truly prized qualities to look for as you are trying to find a doctor to treat your illness with vitamin D.  The government, disguised as the IoM Food and Nutrition Board, implemented the principle of ‘markets before mandates’, and has put the responsibility for your health squarely on the character and competence of your doctor.  If the doctor cannot tell you his own level of serum vitamin D and how much he gets everyday to get there, and his level is not that of a sunny country or a serum 25(OH)D above 50 ng/ml find another doctor.    If your doctor starts to talk about the IoM rules on vitamin D and has a large house and a boat then run – run hard and fast.  – Pandemic Survivor

Is IoM’s Food and Nutrition Board Wrong?

As doctors scruple over the amount of vitamin D that we need as humans, the best approach is common sense.  I started to write this blog because my back healed after 25 years of pain.  It turns out that by following the standards that were just set by the IoM; my spine failed.  I had two surgeries and was looking at the possibility of many more.  I started to take 5,000 IU of vitamin D3 in the summer and 10,000 IU in the winter.  This kept my serum level of 25(OH)D at 50 to 80 ng/ml.  It turns out that people who live between the latitude of +/- 30 degrees have this value of vitamin D as normal as long as they do not intentionally avoid the sun (54 to 90 ng/ml reported by Dr’s Grant and Holick).  At this level of supplementation my spine healed.  I just had another MRI done after five years and the discs in my lumbar region are twice as thick now as they were five years ago.  Let me repeat that in case you missed it.  They are TWICE AS THICK now as they were five years ago.  Yes and I did grow three inches taller in my mid-fifties as my spine healed.  If I had followed the advice of the IoM’s recent report I would definitely be in a wheel chair or most likely dead either from a heart attack or sleep apnea.

I reasoned that the degenerative disc disease or arthritis of the spine was similar to rickets and should be treated with vitamin D.  How is it that doctors do not routinely treat patients with DDD in this manner?  Because of institutions like the IoM that are nothing but puppets ‘working for the man.’  No reasonable scientist could read the large body of literature on vitamin D and come to the conclusion that was achieved except for intent to manipulate the population to maintain the HHS’s ‘markets before mandates’.  What I found in the literature is that at the higher levels of vitamin D3, 24,25 di-hydroxyvitaminD3 one of the many metabolites and not the 1,25, moves the cartilage stem cells to maturity.   MY SPINE HEALED!  Yes, there it was in the literature for the scientist to read.  Thank God that I read it!

How could this board say that they considered bone health only and yet we are a country that has an epidemic of osteoporosis?  If the present population has an adequate amount of vitamin D how could this be?  Take another look at my post on osteoporosis.  Bone Fractures Suspected with Osteoporosis Drug Would you rather take a safe supplement that causes your bone density to improve by more than 20 percent in one year or a pharmaceutical, that gives you  cancer, causes your bones to become brittle, and necrosis of the jaw while only increasing your bone density about 3 percent per year.  On yeah this normal substance that we get from the sun, vitamin D3, also prevents cancer, heart disease, diabetes, and most chronic disease.  And yes it will keep you from getting infectious disease like colds, the flu, and tuberculosis.

My heart aches for the masses as I am living easy in the sun!  You doctors with a moral conscience that have been given the responsibility for patient health, take heed – ‘the man does not have your back.’   A. Catherine Ross, I am sorry for the many nights of restless sleep that you will have over these decisions – how much vitamin D do you get each day?  You really looked ashen during the video presentation.  Have back pain?   Get some sun!  – Pandemic Survivor

Millions have been failed, says Vitamin D Council

The Vitamin D Council is not satisfied with the Food and Nutrition Board on vitamin D.  Here is their press release: Today, the Food and Nutrition Board has failed Millions

I am still stunned at the release by the IOM’s Food and Nutrition Board on the amount of vitamin D suggested.  To consider bone health only and ignore the rest of what vitamin D does for the body is outrageous.  The expert reviewer reports, fourteen in all, were suppressed by the FNB.  If the FNB had got it right there would have been no reason to suppress these reviews.  The Vitamin D Council has requested these reports under the freedom of information act.  It will be interesting to see what they contain.

As I viewed the report presentation on Tuesday, I was amazed at the double standards of the committee.  First a question was raised about the amount of vitamin D that pregnant women should have. The response was that the body was so conservative with vitamin D during pregnancy that additional supplementation was not required.  There is no science to support this statement or just a ‘shot from the hip.’  There was concern by one of the panel members as a few minutes later the statement was made that breast feeding mothers should take 6,400 IU’s of vitamin D3 per day so that the infant would get 400 IU per day.  The risk to the mother was less than the significant need for the infant to get at least 400 IU per day stated the panel member.  What is interesting is that the same research that said that lactating mothers should get 6,400 IU per day also stated that the needs of the mother during pregnancy was more than 4,000 IU per day.  If the risk to mother and child at 6,400 IU per day is less than the needs, then I suspect their fear mongering about vitamin D risk was just that.  In other words, the panel member does not mind that you get chronic disease from vitamin D deficiency as you age, but was filled with guilt at the thought of damaging a baby.

It is definitely clear from the science that one size does not fit all.  It is totally amazing that 400 IU is the requirement for a baby but a 300 pound person needs only 600 IU.  There is only one explanation for getting it so wrong, fear that a healthy population would decimate the medical economy.  Next we will continue to explore the government policy first stated by Michael Leavitt, former Secretary HHS, ‘markets before mandates’.  The economy is more important to your well being than your physical health?

IOM Reports on Vitamin D and Calcium

The Institute of Medicine, a division of the National Academy of Science has presented their report on vitamin D and calcium.  They choose to not ‘rock the boat’.  They made it perfectly clear in the report summary and at the report presentation at 10 AM EST this morning that they considered bone health only.  I viewed the presentation online and noticed that attendance at the meeting was sparse.  I suspect this was because of their news release on Monday stating that they were considering bone health only and that the DRI’s were not changed significantly.

Highlights of the report included:

  • Bone health only was considered for setting the DRI’s
  • The ‘one size fits all’ remains in place because they considered bone health only
  • The amounts of vitamin D is from all sources with the idea that sun exposure is limited
  • Serum 25(OH)D was considered as adequate at a level of 20 ng/ml
  • Vitamin D from all sources at 600 IU per day should achieve this level
  • Suggested range for 25(OH)D was from 20 to 50 ng/ml
  • No improvement to bone could be found above 50 ng/ml
  • They felt that regular serum testing was not necessary
  • The upper limit of daily intake was doubled to 4,000 IU of D3 per day
  • They were excited about the new research on vitamin D but decided there was too much uncertainty to increase levels
  • They encouraged continue research
  • There was emphasis of damage that could occur from an excess of vitamin D with fear about kidney damage and increased pancreatic cancer at higher levels among smokers
  • The amount of calcium intake was left about the same at approximately 1000 mg per day
  • They only considered 1000 papers (this seems odd as there will  be more than 2500 published this year – I would suppose this is because they considered bone health only)
  • Treatment and prevention of disease with vitamin D was left firmly in the domain of health care providers

The only really good thing that happened was that the upper limit of daily intake from all sources was increased to 4000 IU per day from 2000 IU per day.

After further digestion of their statements, I will give you my thoughts on Thursday.

NIH Response: IOM Report on Vitamin D

As we speculate on the many options of institutions to respond to the Institute of Medicine report on vitamin D, the most important is how the NIH and its various departments respond.  Driving the response most likely will be the Dietary Supplement and Health Education Act of 1994.  This act does several things, but the most important is to limit the authority on dietary supplements by the FDA.  As long as a dietary supplement makes no claims about healing or preventing disease, then preapproval for sale by the FDA is not required.  So is vitamin D a nutrient or a drug.  The DSHEA states that anything shown to prevent or cure disease most be defined as a drug and regulated as such.  This is where the language on vitamin and nutrient labels gets tricky.  You can suggest that the nutrient may help your body to heal, but you cannot state outright that the nutrient will cause you to heal or prevent a disease.

I really think that Dr. Robert P. Heaney, MD had this in mind when he did the presentation on the physiological action of vitamin D.  The title is “Vitamin D: Nutrient, not a Drug.”  But by definition according to DSHEA, vitamin D does prevent and treat disease, therefore is a drug.  You can watch the presentation through Grass Roots Health and UCSD tv.  Dr. Heaney makes the argument that vitamin D does not heal disease.  The vitamin D allows the body to respond with its natural healing processes or innate immunity.  Vitamin D does this by opening the DNA library that is contained in every cell.  This was confirmed in August this year by a report from Oxford University saying that there are over 2700 genes or more than ten percent of the genome with vitamin D pathways.

There is a mountain of research that shows that vitamin D does cure and prevent disease.  The only reason that the FDA may not be able to step in and regulate this nutrient as a drug is because of the history of this nutrient and the general safety that has been shown through the use of cod liver oil over many decades.  Of course the drug manufacturers will not like the fact that they could have large market losses because of the reduced amount of disease.  The other issue of course that must be considered by government is the impact on the economy with a healthy population.

I know the statement above may be counter intuitive when thinking about health and the economy.  However, the largest segment of our economy is the health segment.  If disease were reduced by twenty five percent then most likely the health segment of the economy would be reduced accordingly.  With the present state of the economy in general this could be disastrous.  You will not get to decide if you would rather be healthy or have a healthy economy.  The government or more specifically, Secretary Kathleen Sebelius of Health and Human Services will decide this for you.  I suspect through the guidance of the President since she reports directly to him.  Is there any evidence that the government considers the economy more important than your health?  Yes the predecessor of Sebelius was Michael Leavitt and his number four principle was ‘markets before mandates’.  His last principle of nine was to ‘value life.’

With the economy more important than mandated health, I suspect that there will be an attempt to limit the understanding of vitamin D for the general population.  However, there may be significant guilt because of the length of time that this information has already been suppressed.  Or if you prefer, the understanding of vitamin D has been ignored.  Saying that it has been ignored is a much nicer way to say that we have maintained a medical economy of trillions of dollars from your bad health over the last fifty years.  In other words, you had jobs, but your health could have been much better – a true conundrum!  Mandate serum testing of the entire population or let them remain in a much worse disease state to maintain the medical economy.  I’m glad that is not my decision.  You can make your own personal decision about maintaining your vitamin D at a summertime level all year.  – Pandemic Survivor

Reaction to the IOM Report on Vitamin D

In email communications with Heather Breiner, information contact for the FNB on vitamin D, the most likely release date for the report on vitamin D and calcium is November 30, 2010.  I am sure that many institutions are prepared to react to whatever the report suggest.  It is almost a certainty that daily required intakes will be increased.  However, there are some reactions that would definitely benefit the economy and not the health of the individual.  We need plain language to better understand what can happen.

Over the last fifty years there have been two major concerns associated with vitamin D.  Both of these concerns kept the general population from getting an adequate amount.  First there was the issue of toxicity.  I remember when I told my doctor that I was going to supplement with enough vitamin D so that I would have the same serum level that you would maintain in the summertime.  He was startled at the 8,000 IU per day that I was suggesting and said that he thought my organs ‘would turn to stone’.  This biblical warning really scared me, but I felt that my reading of the peer reviewed medical journal articles was enough assurance that I was on sound footing.  This same conversation will happen billions of times around the world over the next years.  No large institution will be willing to admit to being so wrong for so long without extreme fear of legal action.  There have really been no major incidences of vitamin D toxicity.  The issue of death from acetaminophen toxicity with the associated liver failures is the major concern of any substance available for general use of the population.  Of course the use of acetaminophen would not be so large if everyone had enough vitamin D which would significantly reduce chronic pain.

In my reading of the literature and comments of toxicity by the researchers on D, the major bad actor has been vitamin D2, the most prescribed form of vitamin D by the medical practitioners. Vitamin D2 is made from the sterols of fungus that is irradiated.  Why do they prescribe D2 and not D3?  You cannot patent D3.  In medical practice D3 and D2 have always been considered as equal in there action in the body.  This is somewhat true at very low levels required to prevent and to heal rickets.  However, at higher levels of D2 because of the thousands of genetic pathways for vitamin D, D2 causes serious issues and leads to failure of many systems.  This has been the major issue of toxicity over the years.  Doctors have seen the bad results of D2 and associated all vitamin D with toxicity.

The use of the steroid form of vitamin D has caused misinterpretation that all vitamin D is toxic as well.  In trials where the steroid form was given instead of D3 there usually appears to be issues with too much calcium in the blood.  It turns out that the body’s mechanism is to produce a substance that destroys the steroid form at the same time the steroid form is produced to keep it from over acting in the body.  Vitamin D should never be supplemented as a nutrient or as a substance to heal disease unless it is vitamin D3.  Vitamin D3 is what your body makes in the skin from exposure to the sun.

The second concern that has caused the population to have low levels of vitamin D has been the issue with sun exposure and skin cancer.  When using sunscreen, almost all vitamin D production in the skin is stopped.  As it turns out, the melanoma rate in the US has increased by a factor of four since the 1960’s and the increased use of sun block.  So does sun block cause more skin cancer?  We will let the courts decide that if sense can be made of the convoluted research that has been presented to date.  There is too much money involved for clear thinking.  Some manufacturers of sunscreens have taking action to protect them from extreme liability in fear of the existing class action suit that is presently in the California courts.  The manufacturers of sunscreen skated by in the legal actions taken by the FDA and FTC in 2000 with good luck over the ruling by now Chief Justice John Roberts. It seems the real truth in the matter is that the amount of skin cancer caused by too much sun exposure is nothing compared to the deaths that result from all the chronic disease that is created by vitamin D deficiency.

All that the researchers are suggesting is for the population to maintain a serum level as if it was summer all year.  How could having summer all year be a bad thing?  Only for the medical economy- We will try to address this issue next post.

The IOM Report on Vitamin D – What Then?

The Institute of Medicine is a part of the National Academies which places itself as the “advisers to the nation on science, engineering, and medicine.”  When Food and Nutrition Boards are established by the IOM, they are to review the latest information available on the study item and give a comprehensive report of the findings.  For nutrients, this includes the daily required intake or DRI.  Ten years ago the FNB on vitamin D left the DRI, as it had been for years, as the amount required to keep children under one year old from getting rickets.  This really does not make sense for adults, but that is what we got.  So what can we expect from the November report?

Scenario One:  The IOM finds that there is not enough research to make a change to the DRI’s so that the present DRI’s are maintained.  This would mean that no doctor would be able to tell you that you should take more than 2000 IU per day without violated standard practices or guidelines.  This would also mean that anytime a research project would like to use larger amounts then special permission would have to be obtained.  Over a million people in the US alone would continue to die every year from vitamin D deficiency.

Scenario Two:  The IOM decides based on the current research that adults should be sure to get 2000 IU per day with a maximum daily intake of no more than 5000 IU.  I do not know how they could come to this conclusion based on the science as I have just chosen that number out-of –the air.  However, this falls in line with what happened ten years ago.  It was a number pulled out of the air for adults.  If they did decide to do this the good news would be a significant reduction in chronic disease and 350,000 less deaths per year in the US.

Scenario Three: The IOM finds based on the research that everyone needs a minimum of 75 IU/kg/d to maintain the healthy functions of the body.  They then translate this to a DRI of 35 IU/lb/d from all sources.  This would be difficult for the average person understand and maintain an intake at this level because of the creation of vitamin D through sun exposure, a very complicated process to estimate the amount created.  The DRI would most likely be set at 5000 IU per day for adults in the winter and 2000 IU per day in the summer with a maximum intake of 10,000 IU per day supplemental.  The board would then recommend that everyone have their serum 25(OH)D tested once to twice per year to maintain adequate intake for health or the level of people in a sunny country of 54 ng/ml to 90 ng/ml.  Of course this would be the ideal.

The response by governments and health institutions would be difficult to determine.  You can bet that the various institutions have already decided how they will react depending on the recommendations of the IOM.  There are huge changes in health results of the general population to be considered with associated socioeconomic outcomes.  One example would be that most medical studies would become invalid as there has typically been no control on vitamin D.  We will try to explore the possibility of reactions in the next post.