With the understanding that vitamin D improves muscle strength and endurance, sports teams across the world and athletes in general should maintain a serum vitamin D of a ‘sunny country’.
Blackhawks and Vitamin D Win!
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Vitamin D Council International Q&A
Below is a recent newsletter from Dr. Cannell of the Vitamin D Council for a Q&A on international issues with vitamin D. I found the letter on acne, accutane, and the interaction to be of particular interest. It is amazing to think how we have ignored the science since 1938. Check out the letter from Eric, Scotland and the response to read the 1938 paper on acne.
International Questions and Answers
| From: | John Cannell, M.D. |
| Sent: | Fri 5/14/10 2:05 AM |
The Vitamin D Newsletter May 14, 2010 International Questions and Answers This is a periodic newsletter from the Vitamin D Council, a non-profit trying to end the epidemic of vitamin D deficiency. If you want to unsubscribe, go to the end of this newsletter. If you have not subscribed, you can do so on the Vitamin D Council’s website.
Dear Dr. Cannell: As a nutritionist, I am preparing my own website to spread the word about vitamin D to the German speaking parts of Europe. Germans are not allowed to import pharmaceuticals into Europe on our own. Higher dose supplements are declared medication by customs. Customs has the right to search every parcel from foreign countries and if products are found inside that are deemed medication they might be destroyed without further notice to the recipient. That means that a European government agency decided which vitamins and minerals in which forms and doses are necessary for the European people and may be used as supplements. Thank you for your good work! Hans, Germany
Dear Hans: What you describe may be coming to the USA. For now, sunshine during the German summers, safe and sensible use of sun-tanning booths in the winter, or taking 12 of the 400 IU tablets/day of the vitamin D that is available in Germany may be the only legal way to obtain enough vitamin D in Germany. However, I believe Bio Tech Pharmacal ships overseas. E-mail their customer service at customerservice@bio-tech-pharm.com. Remember, if you use sun-tanning beds; ask for either the full-spectrum or the older type of low-pressure beds; do not use the high-pressure UVA beds. John Cannell
Dear Dr. Cannell: My father and I have had our 25 OH Vitamin D tests in Canada, but have received the results in nmol/L. I am stunned that your website does not appear to address how to convert these units to the units you use, ng/ml. I found a web blog that claimed that to convert you divide nmol/L by 2.5 to get ng/ml, but I would greatly appreciate a confirmation of this, and I strongly suggest this tidbit needs to be added to your web site. Thank you, Seth, Vancouver
Dear Seth: Yes, divide nmol/L by 2.5 to get ng/ml. In the USA, all labs report 25(OH)D levels as ng/ml so no division is needed. As far as our website goes, the conversion is now on it, thank you. The English company Minervation is well into a two-year project of greatly improving our website. Dr. William Grant, a member of our Board, is working closely with Minervation to get the science right. The current website began in 2003 when I spent several months writing it and my son then published it on the internet, so it is far from perfect. John Cannell
Dear Dr. Cannell: This is so impressive what this kid is doing, it would be neat if there were some way the Council could endorse him: http://www.shineonscotland.org.uk/ Mary, Scotland
Dear Mary: Thanks for the link. Quite a kid. We will take steps to endorse and encourage him. John Cannell
Dear Dr Cannell: I have been reading your newsletter with great interest for a few years. I am a French doctor, specialist in Rehabilitation Medicine, and am very much aware of the crucial role of vitamin D.
Having followed your action to promote vitamin D, I have written a book on this subject called “Soleil, Mensonge et Propagande,” which means “Sun, Lies and Propaganda.”
It gives the same message as yours, to the French public. Again “bravo” for the Vitamin D Council!
Dr Brigitte Houssin, MD, France
Dear Dr. Houssin: Congratulations on your book. Readers who want to buy your book in French should just Google the French title and buy it on Amazon. John Cannell
Dear Dr. Cannell: I am mother of 7 year-old boy with autism, I am medical doctor, we live in Rome Italy, I have read most of your papers, and I was happy to read your theory regarding autism and low vitamin D. I am originally from Somalia, and as you know already the research done in Minneapolis and Sweden documented high incidence in Somali emigrants, probably due to low level of Vitamin D. The Somali people usually are not fish consumers, even though the most important thing to add is about Somali women/mothers, most of these women cover themselves in Muslim tradition more in Europe than in Somalia, and some of them even use lightening creams that makes there skin more light and most of women that use these creams avoid the sun, because it can cause skin discoloration. Actually, I have been treating my autistic son with Vitamin D for 11 months, local product that contains 5 mcg per 1 drop of Calcifediolo. He takes 10 drops a day and I see his language more fluent, and he is really happier and more social. Do you think this dose is enough? My son is suspected to have mitochondrial disorder, his muscle enzymes are alliterated, so he is seeing mitochondrial expert to decide soon if we should do muscle biopsy? Do you think there could be any correlation about mitochondrial issue and Vitamin D?? Sincerely, Dr. Awolla Fur, Italy
Dear Dr. Fur: Calcifediolo is 25(OH)D, not vitamin D 3, and is no longer available for prescription in the USA. The dose of 25(OH)D is considerably less than the dose of vitamin D3. Your son appears to be on 50 mcg (2,000 IU) of 25(OH)D, which is too much, reduce the dose by half and obtain frequent 25(OH)D levels and then titrate the dose up until his 25(OH)D is between 100 and 150 ng/ml (250 – 375 nmol/L). So-called “mitochondrial disorders” are common in autism; I suspect – but do not know – that they will improve with chronic vitamin D treatment. I doubt a muscle biopsy will add any useful information to his treatment. John Cannell
Dear Dr. Cannell: I am the Somali medical doctor from Italy. My son was responding well with Calcifediolo treatment, no Candida, no regression, just doing fine, I got your email and got him a 25(OH)D test. The result was more than 150ng/ml (in our laboratory normal value is 8.6-54.8ng/Ml). We stopped the Calcifediolo and repeated the testing 6 weeks later and his 25(OH)D was 80ng/ml and other vitamin D was 101. After stopping the Calcifediolo he started to regress, he was not at all improving, he started to have hyperactivity, and started to have new symptom, which is chewing his shirt, so we decided recently to introduce 4,000 IU of Ddrops D3 Carlson ( 2 drops a day), for 20 days, and we have seen really good improvement. He is more connected, talking much more, and responding more quickly the questions that are asked. At the moment he is taking only 1 drop a day with only 2.0000 IU Carlson, I will appreciate if you can give me any support how we proceed from now, and what doses we can use? And for how long? Thank you again. God bless you Dr. Awolla A.Fur, Italy
Dear Dr. Fur: I am glad he is now on Ddrops, which is vitamin D3. As he has already demonstrated a treatment response, I suspect his autism will steadily improve on vitamin D. Autistic children need between 2,000 and 5,000 IU per every 25 pounds of body weight of vitamin D3, per day. I suspect the other vitamin D you wrote about was 1,25(OH)2D. Only obtain a 25(OH)D blood test as a 1,25(OH)2D will add nothing to his treatment. Once you find a vitamin D3 dose that stabilizes his 25(OH)D between 100 and 150 ng/ml, keep that dose indefinitely with frequent checks of his 25(OH)D levels. In spite of his dark skin, his 25(OH)D levels may increase some in the summer if he is outside, so the apparent 25(OH)D response to vitamin D3 may appear to be more robust in the spring/summer than the fall/winter. I suspect, but do not know, that after several years of levels between 100 and 150 ng/ml, you can begin to slowly lower the dose without an exacerbation of symptoms. Avoid rapid changes in dose, once he is in the range of 100 to 150 ng/ml. John Cannell
Dear Dr. Cannell: I have a four-month-old infant and I am worried because I only took a prenatal vitamin during my pregnancy but no extra vitamin D. I am breastfeeding but I give him formula as well as breast milk. Do I need to give him extra vitamin D? Jeanne, England
Dear Jeanne: Yes, you do. In fact, CDC researchers just announced that less than 25% of U.S. infants are getting the outdated recommended amount of vitamin D (400 IU/day). I suspect the situation is worse in England. Dr. Cria Perrine and her colleagues at the CDC analyzed questionnaires sent to over 15,000 mothers with infants ranging in age from 1-10 months. Perrine CG et al.Adherence to Vitamin D Recommendations Among US Infants. Pediatrics. 2010 Mar 22. [Epub ahead of print] The breast milk of vitamin D deficient mothers contains little vitamin D and virtually all mothers are deficient, thus breast milk usually has little vitamin D. Dr. Perrine found that only about 10% of breast-feeding infants are supplemented to meet the 400 IU/day recommendation; more surprising, only about 30% of formula-fed infants were getting 300 IU/day, mainly because few infants consume the one liter of formula needed to do so. One bad sign, Dr. Perrine reiterated the 1999 American Academy of Pediatrics sunshine warning, which amounts to child abuse, stating, “children under the age of 6 months should be kept out of the sun altogether and that those aged 6 months or older should wear protective clothing and sunscreen to minimize sun exposure.” One good sign, WebMD mentioned that adequate amounts of vitamin D might prevent respiratory infections in infants. Boyles S. CDC: Babies Don’t Get Enough Vitamin D. WebMD, March 22, 2010 The vitamin D Council recommends that breastfeeding infants under one year of age take 1,000 IU/day unless the mother takes 5,000 IU/day, in which case the infants will get all they need from breast milk. Formula fed infants need an extra 600 IU/day. Carlson Ddrops, either 400, 1,000 or 2,000 IU/drop are available at most health food stores and on the internet; they are an easy way to keep your infant vitamin D sufficient. I understand that similar dropper products are available in England’s health food stores. By the way, Dr. Carol Wagner and Bruce Hollis have just presented their data about pregnant women and vitamin D. Boyles S. High Doses of Vitamin D May Cut Pregnancy Risks: Study Shows 4,000 IU a Day of Vitamin D May Reduce Preterm Birth and Other Risks. WebMd, May 4, 2010. Their study had two treatment arms; pregnant women took either 2,000 IU/day and 4,000 IU/day. In Belgium, Dr. Hollis reported their findings forced them to discontinue the 2,000 IU/day treatment arm for ethical reasons: it was associated with more obstetrical complications than the 4,000 IU/day treatment arm. John Cannell
Dear Dr. Cannell: Is there anything out there about vitamin D and libido? I am asking because I have noticed an increase in my libido (I am a 48-year-old male who has been getting 5,000 IU/day shipped to me in France from Bio Tech Pharmacal for about a year.) Philippe, France
Dear Philippe: I know of no studies measuring male libido and vitamin D but Dr. Wehr and colleagues, at the Medical University of Graz in Austria, just published a surprising study showing that testosterone levels are directly associated with vitamin D levels (measured with the DiaSorin technique) and testosterone levels vary with the seasons, in concert with vitamin D levels. Furthermore, the men with very low testosterone levels had very low vitamin D levels. This study does not prove, like any association study, that vitamin D increases testosterone levels. It may be that sun-exposure in the summer is responsible for both higher vitamin D levels and higher testosterone levels. Wehr E et al. Association of vitamin D status with serum androgen levels in men. Clin Endocrinol (Oxf). 2009 Dec 29. [Epub ahead of print] By the way, the New York Daily News got it wrong, nothing in the Wehr study talks about vitamin D increasing male libido. Dominguez R. Suntanning, and the doses of vitamin D it provides, found to boost male sex drive: study. February 2nd 2010 John Cannell
Dear Dr. Cannell: Thanks for all your work on Vitamin D, I have been supplementing with vitamin D and also found a doctor who will test get my blood levels regularly. I am wondering, does the vitamin A drug, Isotretinoin, compete similarly to vitamin A with vitamin D receptors?
Isotretinoin is often prescribed for inflammatory skin conditions; it is supposed to shrink the sebaceous glands and act as an anti-inflammatory, therefore helping acne and rosacea. Do you think it can have similar negative effects as retinol on Vitamin D usefulness? I am quite concerned after reading your February Newsletter: “Vitamin D, Vitamin A, and Cancer”
Many people might be taking or have taken Isotretinoin for acne and I would greatly appreciate your insights on the effects of Accutane (even low doses like 2.5mg/day) on Vitamin D.
Eric, Scotland
Dear Eric: Isotretinoin or 13-cis-Retinoic Acid (Accutane in the USA) is a retinoid used in severe acne and rosacea as well as in cancer chemotherapy. It may have the same effects on the vitamin D receptor as other retinols. It certainly interferes with vitamin D metabolism. Rødland O, et al. Serum levels of vitamin D metabolites in isotretinoin-treated acne patients. Acta Derm Venereol. 1992;72(3):217-9. For those taking Isotretinoin for cancer, continue doing what your oncologist says to do, but also get your 25(OH)D to at least 100 ng/ml. If you are taking Isotretinoin for acne, my advice is to stop the Isotretinoin and take adequate doses of vitamin D. In 1938, Dr. Merlin Maynard showed vitamin D helped acne more than one of the most effective treatments of all time, x-ray treatment. You can download his entire paper for free. Maynard MT. Vitamin D in acne, a comparison with x-ray treatment. California and Western Medicine: 49 (2);127-132 Dr. Maynard wrote beautifully: There is probably no skin disease of greater importance to the human race than acne. It is undoubtedly our commonest skin disease, and it is rare that any individual reaches maturity without having had it in one of its phases. It is a disease of considerable economic importance, as the disfiguring scars of a severe case are never completely obliterated. It is also a disease of youth. It attains its most noxious form at the time the individual first has to earn his own living. It is undoubtedly responsible for many failures in getting business positions. It is also the basis for inferiority complexes and discouragement in young people. Dr. Maynard published a long case series. In his earlier days, he used x-ray treatment for acne, but when he started using viosterol (vitamin D2) he stopped using x-ray treatment. In reviewing his cases, he found x-ray treatment led to favorable results 48% of the time but vitamin D did so 76% of the time; he used between 5,000 and 14,000 IU per day. Vitamin D3 may work even better than D2, if acne patients take adequate doses, like 10,000 IU/day with frequent 25(OH)D levels. In summary, he said: I believe I may say that at no time in my dermatological experience have I felt such complete satisfaction with a treatment as I have with the cases of this series. I know that vitamin D is an imperfect weapon to slay this disfiguring disease, but it undoubtedly gives one a feeling of being well defended. From the patients’ viewpoint, it has left little to be desired, as they find themselves improving, both in appearance and in general well-being. Many have expressed the sentiment, ‘Never felt better.’ In 2008, the mechanism of action of vitamin D in the skin was the subject of a lengthy review: Schauber J, Gallo RL. The vitamin D pathway: a new target for control of the skin’s immune response? Exp Dermatol. 2008 Aug;17(8):633-9. Theoretically, rosacea should not respond to vitamin D, just the opposite, but readers have told me it does. However, if you have been on Isotretinoin, it may take months or years for the excessive vitamin A to get out of your system. The excess vitamin A may continue to compete for the vitamin D’s receptors attention and, until the vitamin A is gone, one may not see the full effects of vitamin D. By the way, just ask any acne patient if their acne gets better after a week of sunning at the beach. John Cannell
Dear Dr. Cannell: Why are you against vitamin A? People need to take all vitamins for good health. Susan, Australia
Dear Susan: The body needs all vitamins for good health but this hardly means one has to take all vitamins as supplements for good health. A balanced diet with varied food consumption, including vegetables, seeds and nuts, cold water fatty fish, dairy, red meat, and fruit, will supply almost all needed vitamins with the absolute exception of vitamin D, and possible exception of magnesium, zinc, potassium, and vitamin K2. Remember, nature never intended you to put vitamin D in your mouth; nature intended you to make it in your skin. As far a vitamin A, the question is, do we get enough in our diet. The answer appears to be that we do, maybe way too much due to widespread food fortification and the use of vitamin A supplements, vitamin A in multivitamins, and cod liver oil. Beta-carotene is fine but if your multivitamin says retinyl acetate or retinyl palmitate, 5,000 IU, do not take it. The problem of widespread vitamin A toxicity is so perverse; it includes the monkeys and apes we use in experiments, perhaps those we keep in our zoos. Drs. Joseph Dever and Sherry Tanumihardjo, of the University of Wisconsin, reported that liver biopsies of such primates show evidence of liver damage from the vitamin A. The reason is that way too much vitamin A is added to primate chow. Dever JT, Tanumihardjo SA. Hypervitaminosis A in experimental nonhuman primates: evidence, causes, and the road to recovery. Am J Primatol. 2009 Oct;71(10):813-6. This is an excellent paper for other reasons. Dr. Dever reminds us that blood retinol levels are useless to detect either vitamin A deficiency or vitamin A toxicity, and that the rate limiting step (how the body controls vitamin A levels) occurs with an enzyme in the intestine (carotenoid monooxygenase). The body simply makes the amount of retinol needed from orange-colored vegetables and fruit, but does not make retinol if you do not need it. That is why you can turn yourself yellow by drinking large amounts of carrot juice but you apparently cannot make yourself vitamin A toxic by doing so. When you take retinyl acetate or retinyl palmitate, or cod liver oil, you bypass this intestinal regulatory system and dump preformed retinol into a closed system that has no good way of getting rid of it. This also explains why many studies from developed countries (where vitamin A toxicity is common) show one does not make much retinol from carotenoids, while studies from underdeveloped countries (where vitamin A deficiency is the rule) show that one does make it. In 2008, Dr. Anthony Mawson, of the University of Mississippi, discussed evidence that taking vitamin A, especially during pregnancy, may account for some of the aggressive disorders (like ADHD, irritability, and conduct disorders). In fact, he discusses the numerous case reports associating vitamin A, including Accutane, with aggression. Mawson AR. On the association between low resting heart rate and chronic aggression: retinoid toxicity hypothesis. Prog Neuropsychopharmacol Biol Psychiatry. 2009 Mar 17;33(2):205-13. I am no friend of the “lots of all vitamins” crowd. Take what you need and leave the rest, and the only way to know what you need is to do an accurate dietary evaluation of what you are eating. John Cannell
Dear Dr. Cannell: I am a naturopath in Montréal, Canada. I work primarily in mental health. I did a search on MDConsult recently for “Differential diagnosis of psychosis.” One of the differential diagnoses in the list was vitamin D deficiency. I am unable to find any research that supports that, and that list had no citations. Do you know anything about it? I have a patient who recently experienced some of the most extreme psychosis of his life. During that time, I measured his Vitamin D. It was too low to be detected! I started him on 5,000 IU per day and had measured it a few months later, when he was doing much better, and it was 22 ng/ml. I thought there was a relationship between the deficiency and the psychosis, but could not find anything on PubMed or anywhere else about the connection. Any thoughts on that? Melissa, Canada
Dear Melissa: This is good news; however, I am not aware of any papers on the treatment of psychosis with vitamin D. At my hospital, which now has a policy to test all new patients for vitamin D deficiency, several of us have noticed that a few psychotic patients seem to get remarkably better on vitamin D, and others can reduce the dose of their meds, once their vitamin D deficiency is treated. However, the vast majority of patients must stay on meds or they relapse. However, no one, to my knowledge, has treated psychotic patients with pharmaceutical doses, like 20,000 IU per day. It would not surprise me at all if researchers found that dose to be effective treatment in some cases of psychosis. The scientific community has never researched the issue of using vitamin D as a drug, that is, as a pharmaceutical. If one was free to use pharmaceutical doses, as psychiatrists in private practice are free to do, they could rapidly lend some light to the subject by treating psychotic patients with both antipsychotic meds and with 20,000 IU per day and carefully follow 25(OH)D, calcium, and clinical course. I suspect they would find a vitamin D treatment effect. If they did such a case series, I would publish their reports in this newsletter, be they negative or positive. John Cannell
Dear Dr. Cannell: I work with the Somali immigrant community in Ottawa. If you see how healthy these immigrants are when they come here and how terrible their health is after a few years it is hard to see how it could be anything but vitamin D. Why do the health officials in Canada do nothing? Gail, Ottawa
Dear Gail: What is going on in Ottawa is a crime against people of color, just as what is going on against African Americans in the USA is a crime. It is not just autism, but schizophrenia, depression, heart attack, stroke, diabetes, and hypertension, are all diseases associated with vitamin D deficiency and also associated with dark skin in temperate latitudes. Starved for Sunlight Immigrants struggle with declining health. CBC News, 2/17/2010 African Americans die almost eight years younger than Whites do, due to the diseases of vitamin D deficiency. I hoped the Obama administration might do something, but so far nothing. Perhaps we should file our civil rights complaint again, like the one we filed in 2005, which then Attorney General Alberto Gonzales summarily dismissed: http://www.vitamindcouncil.org/PDFs/2005pr-doj-civil-rights-complaint.pdf John Cannell, MD Executive Director Vitamin D Council You may reproduce this newsletter as long as you properly and prominently attribute it source. Please reproduce it, post it on Internet sites, and forward it to your friends. Remember, we are a non-profit and rely on your donations to publish our newsletter, maintain our website, and pursue our objectives. Send your tax-deductible contributions to: The Vitamin D Council 1241 Johnson Ave., #134 San Luis Obispo, CA 93401
Vitamin D Toxicity and the Courts
I find it extremely interesting this past week when Gary Null, a health guru, filed suit over an extreme amount of vitamin D in one of his supplements. It seems that what should have been 2,000 IU of D3 turn out to be 2,000,000 IU of D3. It is interesting that the courts would even consider this lawsuit. There is such a tiny amount of difference how could the manufacturer be held accountable. The numbers look large and your body sees them as large but it is still a very small difference. We are talking about the difference in 50 micrograms versus 50 milligrams. Have you ever tried to measure 50 micrograms of material? Here is the article in the LA Times.
Vitamin D has a long history in the courts going all the way back to the height of WWII when manufacturers of over-the-counter vitamin D to prevent rickets were putting such a small amount in the tablets that it would not prevent rickets. The combined lawsuits were settled when the intellectual property rights of D3 became public domain. Here the lawsuit was about not getting enough.
Lawsuits like this continued into the 21st century when the FTC and FDA tried to get the ‘shady’ marketing practices of sunscreen products changed in 2000. It turns out that John Roberts, present Chief Justice of the Supreme Court, lead a group of lawyers that was hired by the sunscreen lobby. This lobby group successfully defeated the lawsuit. Today you can buy sunscreen with no warning label at all. Where is the warning label that says: This product will block the production of one of the most important hormone precursors of the human body, vitamin D3. Not only does the deficiency cause osteoporosis, it is also significant in the course of all chronic disease including the big three killers, diabetes, heart disease, and cancer.
If we consider the lawsuits, we see that they are not the same. One is for two much of a substance that acts to create toxicity and the other is for a deficiency of the substance which causes a significant disease rates. We have historically held institutions that were responsible for putting toxic substances into our bodies accountable like the tobacco or asbestos industries. However, when institutions choose to ignore the benefits of a substance, they seem to skate by scot-free. This ignorance of (ignoring of) vitamin D typically causes about 1,000,000 deaths in the US every year to say nothing about the suffering. Now is the time and it will take government to act.
Let’s consider another institution that seems to be in the news for some apparent wrong doings. That is Goldman Sachs. It seems this market maker puts parties together that are on both sides of a financial vehicle. They know that one side is in significant risk of losing. Does Goldman have a responsibility to inform the party of the significance of the risk? The players at this level are considered to be ‘sophisticated’ investors which means that they fully understand the risk and are willing to play with the ‘big boys’. Gary Null was also a sophisticated health professional. How is that different?
So what are we supposed to do about institutions in the health care industry that are simply ‘market makers’? That is they choose to ignore information that they know would be beneficial to society so as to protect their presumed market rights and the opportunity for intellectual property benefits. This would include manufacturers of sunscreen and researchers that stand to benefit significantly by a large ‘sick market’. That is everyone in the healthcare industry including and especially insurance providers. This is such a large group and the lobby so powerful that the possibility of legal action in our lifetime is small.
The best thing that could happen at this point is for A. Cathrine Ross, Chairman of the FNB for Vitamin D and Calcium, make such a statement in the release of their forth coming report that the president of the US and prime minister of Canada will be forced to declare a national emergency. The rest of the countries of the world will follow suit. And you Chief Justice Roberts, what will you allowed to be heard in the Supreme Court?
Sunday Musing
Well there you have it, the CDC claiming that increased vaccination was the reason for so few seasonal flu deaths this year. But how do they explain that influenza like illness is as low now as it normally is at week 35 of the flu season and we are only at week 15? Keep taking your vitamin D folks because the wellness is just beginning.
Here is the story from the Baltimore Sun Overall flu deaths down during H1N1 pandemic
From the article: “Overall flu deaths are down this year because H1N1 flu crowded seasonal flu out,” said Jeff Dimond of the CDC. Please Mr. Dimond, give me a small personal break! – Pandemic Survivor
Vitamin D is having its time in the sun The Vancouver Sun Now I just wonder why the The Vancouver Sun decided to name their newspaper ‘the sun’?
Let the confusion truly begin in earnest. We have talked about the three stages of paradigm change in the past. Ridicule, violent opposition, and accepting as if it has always been. Here you have two newspapers in Canada releasing opposing stories about whether Canadians are replete in vitamin D. This is how the battle will be fought as stories by ‘experts’ try to maintain you at some level that is not adequate so the disease state can prevail which means that sales in the medical/pharma/medical insurance industries are maintained. It will be interesting to see how much confusion revolves (as in major spin) around the FNB on vitamin D and calcium findings are published this year.
Do I sound a little perturbed or less than happy about what is being said about vitamin D then you are wrong. I am extremely grateful for how far the medical profession has come in such a short amount of time. I just wish it had happened before I suffered 25 years of pain, ten of them severe pain, loss of income and loss of friends because no one could stand to see me in pain.
I do get perturbed when I hear doctors make statements like: “And Mark, you may think I’m a skeptic, but with all the supplementation that is now being done for those on (list any med for many of the chronic diseases), wouldn’t you think if Vit D were of great benefit that we’d know by now?”
My answer to this question is of course NO! I first thought that I was just being bated by this person and then I realized she was being serious. Modern medicine is so great how could you think that we are not giving you the best there is to offer in other words. Here is a doctor that has totally forgotten that the institutions of medicine practice for profit and not always for customer satisfaction. If they can keep the spin going that they are ‘giving the best that there is to offer’ then perhaps their customers will be happy. Even if they just die along the way.
Be prepared for the continued spin and how you are going to deal with it. With a replete population we are talking about a 25 to 50% reduction in disease and then what will happen to the medical economy and social security? – Pandemic Survivor
Letters to the Vitamin D Council
Here are more letters to Dr. John Cannell. Topics include a person that became toxic which is really unusual. Others include: depression, reduction of c reactive protein, sleep disorders and the D2 imposter, 2 letters on asthma, resistance to sunburn, severe anxiety and depression, dermatitis in Finland, magnesium deficiency, ethnic minorities and autism in northern latitudes. Subscribe to his newsletter and consider donating to the cause of having every patient tested for serum 25(OH)D at the Vitamin D Council. http://www.vitamindcouncil.com
I hope that you enjoy reading Dr. Cannell’s newsletter. It is another good day in the land of vitamin D when we hear that people are being healed and relay their stories. This helps other begin to understand the action of what Oliver Gillie describes as a ‘magic shot gun’.
More letters
| From: | John Cannell, M.D. (vitamindcouncil@vitamindcouncil.org) |
| Sent: | Wed 4/21/10 2:08 AM |
The Vitamin D Newsletter
April 21, 2010
More letters
This is a periodic newsletter from the Vitamin D Council, a non-profit trying to end the epidemic of vitamin D deficiency. If you are not subscribed, you can do so on the Vitamin D Council’s website.
This newsletter is now copyrighted but you may reproduce it for non-economic reasons without prior permission as long as you properly attribute its source.
Dear Dr. Cannell:
I was taking a vitamin D3 liquid oil supplement 60,000 IUs/day regularly and 180,000 IUs/day fairly occasionally for about 8 months in ’09 in an attempt to get over a chronic sinus infection and prevent cold/flu. Last November ’09, I started having symptoms for irregular heartbeats, nervousness, insomnia, weight loss, difficulty concentrating, and muscle weakness. I met with my physician and had blood work done. My vitamin D3 level was 406 ng/mL and my calcium elevated and probably had been that high for several months. I stopped taking the supplement immediately. But my physician didn’t recommend anything else at the time except to recheck the blood levels in a few months. I am 46 and have been in excellent health all my life with no previous medical issues.
The symptoms have not gone away entirely. I was not aware of the potential toxic effects of D until a few weeks ago. I recently found out that vitamin D toxicity can cause hypercalcemia.
Is there anything more I can do now to reverse the effects of vitamin D toxicity and possible hypercalcemia that may have been present for several months last summer/fall? Should I have my kidney function and heart function checked? What can I do to reverse effects on my nervous system and brain now? What tests can I do to keep checking the levels or know if I did any permanent damage to these soft tissues?
Finally, my daughter (5 yrs. old at the time) was also taking about 20,000 IUs/day fairly regularly over the same period of time. She didn’t appear to have had any adverse symptoms but now I’m really concerned and scared she may have been toxic too. What tests should I ask to be done to check her for Vitamin D toxicity and hypercalcemia?
Please respond and help if you can, I’m having a hard time finding good sources of information for my questions! Any information or help would be greatly-greatly appreciated!
Thank you,
David, Utah
Dear David:
Congratulations, you have indeed made yourself toxic by knowingly taking too much supplemental vitamin D, one of the first such cases I am aware of in the modern literature. Have your daughter’s 25(OH)D and serum calcium checked; she was also taking potentially toxic doses.
The treatment for you and your daughter to not take any vitamin D and both of you should stay out of the sun until your 25(OH)D levels return to normal. Drink 8 eight-ounce glasses of water a day and have your daughter drink four. You both should have a chemistry panel periodically to see if kidney function is normal and to check serum calcium although I doubt that your calcium is still elevated. I doubt you have permanently damaged any internal organs as most cases of toxicity, with 25(OH)D levels higher than yours, did not result in permanent damage to the kidneys or other internal organs.
Also, readers should be aware, if they are not already, that vitamin D does not prevent all viral respiratory infections. As we noted in correspondence to our first influenza paper, rhinoviruses, the most common cause of the common cold, are not seasonal; that is, they are just as common in the summer as in the winter, and they do not have a lipoprotein coat for antimicrobial peptides to destroy. Also, in a recent Japanese paper, influenza B was not prevented by vitamin D, only influenza A. Although many people get influenza symptoms and are worried enough to go to their doctors, and their doctors worried enough to get an influenza A test, only about 3% of the specimens submitted to CDC surveillance centers are positive for influenza A.
If you are already taking 5,000 IU a day and you get a cold, chances are that more vitamin D will not help much. No one should take large doses for more than a few days and then only if the infection is severe. Certainly the doses you took were toxic and it sounds as if you still suffered from viral respiratory infections.
Dear Dr. Cannell:
Thanks for taking time for my e-mail. I heard Dr. Cannell on the radio about a month ago talking about his vitamin D formula and as someone who has been involved in holistic nutrition and natural health most of my life as a layperson, I really appreciate what you do for people, and have upped my D on your recommendation. I absolutely have noticed more of an attitude of wanting to participate in life and less a feeling of “why bother,” after a month of increased dosage. I will get my levels tested sometime this year.
Currently I do homecare and my present client/friend doesn’t get outdoors at all. She was taking 2000 iu of D per day for general purposes until I spoke with her about Dr. Cannell’s radio spot. She upped it to 5000 iu with your formula and said she felt a difference in her mood within a week! Bear in mind this is someone who was on antidepressants for decades and has struggled with depression all that time, despite the meds. She wants to wean herself off her meds and for her to say something has helped her mood is anywhere from extraordinary to miraculous!
Keep up the good work!
Jesse, Pendleton, OR
Dear Jesse:
Tell your friend to keep taking her meds. As much as I like to hear what you said, it is more likely that this improvement in your friend’s mood will not be permanent. If she does decide to go off her meds, do it very slowly with the help of her doctor. Vitamin D deficiency is but one cause of major depression; there are lots of others. However, I now recommend that anyone struggling with depression should take at least 10,000 IU /day with frequent 25(OH)D blood tests to assure levels of at least 100 ng/ml and to monitor for toxicity.
Depression is a serious illness with a known morbidity and mortality and thus it warrants more aggressive treatment than someone in good health. Some readers have written that they require 50,000 IU/day to alleviate depressive symptoms but that should only be done under the care of a knowledgeable physician, with frequent 25(OH)D levels, as such doses may cause toxicity.
John Cannell, MD
Dear Dr. Cannell:
I just wanted to share. I take 20,000 unites per day for 2 years now. I have experienced only positive results. My levels are currently 91 ng/ml. My high sensitive CRP decreased from 25 to .01. All the people I provide health coaching to (as an occupational therapist) are deficient or have absolutely none at all as a blood level.
Mary, Long Island, NY
Dear Mary:
Great but keep checking your 25(OH)D levels. Several studies are confirming that vitamin D lowers CRP. I’m so glad you are doing this on your own for patients, as an occupational therapist, but are you putting all your patients on 20,000 IU/day? I hope not. The proper dose for healthy adults is 5,000 IU/day.
John Cannell, MD
Dear Dr. Cannell:
I am a neurologist in Oklahoma. I wrote to you a few months ago about the observation that all of my patients with sleep disorders had low vitamin D and that when I was able to replace D, and get the level above 50, their sleep and secondarily several of their neurologic problems, improved, especially their headaches.
I have since stumbled into a few unexpected holes and have learned a lot but now have some questions regarding the D2 imposter. My medical colleagues that are using D2 (Drisdol) for bone health have no symptoms to follow in response to supplementing and think that they have accomplished what they want when they get the 25(OH)D2 above 50. The problem is that I am using D3 supplement for other things and have learned that the sleep and headaches improve with the right dose of D3 but that the same dose of D2 does not work at all.
On several patients even though the 25(OH)D2 level is up, their sleep and headaches are no better. For example, today I saw a woman who has all the same symptoms as all my other patients; poor sleep, indigestion, daily headache, all worsening after her second pregnancy 4 years ago. Her 25(OH)D2 was 52 and she was not supplementing, so I did not ask her to take D3. After receiving several calls from her about her headaches not getting any better I decided to try supplementing D3 the way I am in all the other patients at 20,000 IU for one month. Since starting D3 supplement her sleep is better and her headaches are gone.
Why is D2 used at in a prescription when it is not natural to our body? What has been the motivation for using it? Why is it used in milk instead of D3? I am about to look into the literature about whether it has some exclusive effect on bone health but I’m noticing that most of the literature is sloppy about which D they’re talking about in terms of the 25OH. Why are they sloppy about this? Has there been literature that supports the fact that D2 and D3 are actually identical?
The sleep effect ties to many of the neurologic disorders that get better with D3, improved sleep, seizures, headaches, vertigo, tremor, gait, Parkinson’s, depression, psychosis, hypertension. I’m interested in anyone else watching similar effects on their patients?
Thanks for your comments, explanations, and exclamations.
Gormon Servasta M.D., Oklahoma
Dear Dr. Servasta:
That is great news for millions of headache sufferers, as well as those suffering from other neurological disorders. I always recommend D3 and see no reason for anyone to take D2, it is not human vitamin D. It is a vitamin D analogue that happened to be discovered before D3 by the University of Wisconsin, which patented it and it was then sold, and still is, as the only available prescription vitamin D, Drisdol.
Currently, most scientists are specifying whether they use D2 or D3 in their studies but that was not always the case in the past. All studies done with D2 will need to be repeated with D3; if the studies were negative, they need to be repeated to see if they are also negative with D3; if they were positive, they need to be repeated with D3 to see if the effect size is the same or not. Most milk now contains D3. If your patient had a 25(OH)D2 of 52 and had not been on D2 supplements or eating large amounts of irradiated Shitake mushrooms, the result was a lab error.
D2 or ergocalciferol does not exist in detectable quantities in the human body, only in tiny quantities in some plants and, as such, is “unnatural” when in the human body. You cannot get any appreciable D2 by eating vegetables except for some irradiated mushrooms. D2 is metabolized to various substances in the body, many of which are not normally present in humans, although these metabolites have never been shown to be dangerous.
There is also some evidence that D2 is more toxic in overdose, which is curious as it is only about half as potent as the naturally occurring vitamin D3, cholecalciferol. I have seen evidence that humans prefer D3 over D2, in that, if both 25(OH)D2 and 25(OH)D3 are present in serum, over time the 25(OH)D3 falls faster than the 25(OH)D2, suggesting the body preferentially uses 25(OH)D3, if it is available. For any scientist readers, this would be an easy and important study to do.
Your experience that D3, but not D2, helps neurological symptoms is interesting. Such comparisons of the efficacy of D3 versus D2 on neurological symptoms do not exist in the medical literature, another important study to do . Since I have never given anyone D2, I cannot comment further.
John Cannell, MD
Dear Dr. Cannell:
This is a letter of gratitude to you! Ever since I read what you wrote about asthma several years ago, I have taken first 5,000 then 10,000 IU daily of Vitamin D3 from Bio Tech my energy has improved DRAMATICALLY and my asthma is completely gone! It has taken over a year, but it worked!
I have thrown away all of my allergy medicines and all of my asthma medicines and have never gone back!
I am forever grateful to you Dr. John Cannell.
Harry, Pennsylvania
Dear Harry:
You’re welcome. The same Japanese randomized controlled trial just published that showed vitamin D prevent influenza A, also showed that the placebo group was six times more likely to get an asthma attack then the vitamin D group and that was with only 1,200 IU per day in ten-year-olds.
There is a growing literature suggesting that vitamin D may not just help asthma, but may cure it. In my experience, how long it takes to help asthma depends on how long you have had asthma. Adults with asthma should take 10,000 IU per day and shoot for a 25(OH)D of around 100 ng/ml. Children with asthma should take at least 2,000 IU for every 25 pounds of body weight, also shooting for a 25(OH)D of around 100 ng/ml. Like depression, asthma is a disease with a serious morbidity and mortality, thus more aggressive dosing is indicated.
After the asthma disappears, slowly reduce your asthma meds under the supervision of your doctor, then slowly reduce the dose of vitamin D to standard doses of 5,000 IU/day for adults, and 1,000 IU/day for every 25 pounds of body weight in children, keeping 25(OH)D levels between 50 and 80 ng/ml.
John Cannell, MD
Dear Dr. Cannell:
I had asthma for 20 years with allergies and severe breathing issues. After it was too much to bear any longer, I went with very high doses of Vitamin D3 and was able to quit the prednisone. I took about 30,000 IU per day for I think a few weeks then 10,000 IU/day for the last year and have not had ANY asthma again this spring! I threw out all my inhalers and I stay at 10,000 IU per day now! Life is good! I love my vitamin D3!
Thanks for everything.
Trish, California
Dear Trish:
You are welcome. The “Stoss” or short-term high daily dose for a few weeks is a good idea to get your levels up quickly if you have a serious illness. It would have been better to put your asthma meds in a drawer rather than throw them out as asthma is an episodic disease and it is too early to know for sure that it will not come back.
Also, when on 10,000 IU/day get periodic 25(OH)D levels; to date, no one has published literature on long-term safety, years, of 10,000 IU/day.
John Cannell, MD
Dear Dr. Cannell:
I just came back from a vacation in the Caribbean and you are right about what you wrote a few years ago about vitamin D and sun sensitivity. Before, I always burned easily as I am fair-skinned. But, before this vacation I had been taking 5,000 IU per day for about 9 months. My skin was much more resistant to the sun; sometimes it would get red and I thought I was burned but the next morning it was gone.
Thank you, it is so great not having to always worry so much about getting burned.
Justine, New Jersey
Dear Justine:
You’re welcome but don’t throw away your sunblock. If you remember from my past newsletters, my daughter Eliza discovered vitamin D’s ability to prevent sunburn and my fair-skinned river-rafting friend confirmed it. My daughter had been taking 5,000 IU per day for ten months and decided she wanted to tan in a suntan parlor. Instead of burning the first few times, she quickly developed a rich tan.
My friend took high doses of vitamin D for a few weeks before rafting and, for the first time in his life, did not burn when rafting the Snake River. In fact a businessman is now selling a product at sun-tanning parlors to prevent burning; the product’s active ingredient is simply 30 tablets of 10,000 IUs of vitamin D3, to be taken daily for one month before tanning.
This is the time of year many people sunburn. I have thought a lot about the whole issue of sunburning and would like to propose a theory. I do not think sunburning is entirely without an evolutionary benefit. The final conversion of vitamin D in the skin requires heat and the heat of sunburn will increase the amount of vitamin D made by any one sun-exposure. Thus, sunburns evolved for a reason. Nature cares less if you damage your skin with sunburn; Nature cares more that vitamin D deficient people maximize any one sun-exposure. That is, people with low 25(OH)D levels have a reason to burn, they make more vitamin D. Easy sunburning and sun sensitivity may simply be a symptom of vitamin D deficiency. This is also a good study for some young vitamin D scientist to do.
Vitamin D sufficient people do not need any extra vitamin D from the sun, so the extra heat in the skin generated by sunburn is not needed. (As an aside, I also predict that 25(OH)D exerts negative feedback on 7-dihydro-cholesterol, vitamin D’s precursor molecule.) Vitamin D sufficient readers will see, when they go into the sun this spring, that it takes longer to burn, that their skin is less sun-sensitive, and that when redness does occur, it is often gone the next day. However, beware: vitamin D sufficient people can still sunburn, it just takes longer. Sunburns increase your risk of melanoma and other skin cancers.
Also, some fair-skinned people have a genetic variation that prevents their skin from making melanin pigment. Theoretically, vitamin D should not help them from sunburning. But don’t confuse fact with theory. The fact is that some skin type 1 people cannot make much melanin; the theory is that vitamin D will not protect their skin from sunburn. However, I know of some very fair-skinned, blond-headed, blue eyed, skin type 1 people whose skin became less sensitive to the sun after taking 5,000 IU/day.
John Cannell, MD
Dear Dr. Cannell:
Thank-you for all of your hard work! I read what you wrote on your website and my son (at age 15) was diagnosed with D deficiency (his levels were 7 ng/ml), after many long years with severe anxiety and depression and psychiatric meds that didn’t work. Vitamin D3 10,000 IU/day was a miracle for his recovery as he is now a freshman in college!
Sincerely,
Connie, St. Paul, MN
Dear Connie:
You are welcome. Again, vitamin D deficiency is but one cause of depression. How much of it is caused by vitamin D deficiency, how it will respond to adequate doses of D3, and what dose to use is simply not known. Err on the side of higher doses with frequent 25(OH)D blood tests when treating depression. Documented vitamin D toxicity has never been described with 25(OH)D levels below 200 ng/ml. Again, 10,000 IU per day requires periodic 25(OH)D levels.
Dear Dr. Cannell:
I appreciate greatly Dr. Cannell`s good work for this fundamentally important issue of getting the knowledge about the importance of vitamin D for health and prevention of disease, through to the consumers.
I am testing every patient of mine for vitamin D. Not surprisingly, all of us Finns or anybody living here in Finland is vitamin D deficient, the average winter-time blood value being only 18ng/l ( equals 45 nmol/l.) for my patients.
Case: A 30 yr old lady had her first blood test done only 4 months ago. It gave 10ng/l. She has suffered of severe atopic dermatitis since early childhood with a lot of itching and even bleeding of skin after scratching the skin during the night. Additionally, she has obtained severe migraine headaches, leading to vomiting in the end, since the age of 14 onwards. She has got pollen allergies and during the last few years she has developed severe food allergies as well. She has not been able to sunbathe, because it has caused intolerable burning and itching sensation in her skin. The atopic dermatitis has been getting worse by exercise and sweating and sauna. The latter points have come to the picture 5 years ago and have gotten worse by time.
Four months ago, I gave her a detailed supplementation program, in which D3 plays a major role (5,000 IU/day). I have included calcium and the cofactors you have in your formula as well in the treatment, such as magnesium, zinc, boron and K2.
She has made an amazing recovery of almost all of her symptoms. Skin problem is completely cured, no itching, no scaly dead skin, no redness, no inflammation any more. Migraine headaches, which used to be 1-2 times a week, have dramatically diminished. She has had only 1 migraine attack for the last 4 months, compared to average 16-32 attacks previously during the same time period.
She is slowly increasing the number of previously intolerable foods into her diet. She can now exercise with full energy and sweating is not a problem anymore, as it does not cause any burning or itching sensation either. She has had only minor pollen symptoms now, which is also completely new for her. She has not been using any antihistamines so far this spring. Earlier she was forced to use prescription allergy-medications every year.
She looks better, because the skin of her face has become clear and beautiful, with a healthy-looking, shiny complexion. She is so happy of this progress that she cannot stop smiling. She is going to re-test now her vitamin D-value and we will take care of the right dosages accordingly.
This case is just one example of what the right supplementation may do for a severely suffering patient, with no side-effects. This lady had never heard of you but she does now.
Regards from Finland
Jerkko Mause, MD, Finland
Dear Dr. Mause:
That is great news; I wish all patients would experience the same miraculous recovery. I’m glad you used the cofactors, magnesium, zinc, boron, and K2, as deficiencies in these four are probably as common as vitamin D deficiency. That is why I added them to my formula, which Purity Products markets via telemarketing. Beware: my family gets a buck for every bottle sold.
Also, I doubt anyone can get toxic on my formula. For example, if you decide to take 50,000 IU per day of my formula, it would require 20 tablets a day and you will be getting 1,250 mg of magnesium per day and, after a few weeks, you will have so much diarrhea that you will not have time to get to the medicine cabinet.
John Cannell, MD
Dear Dr. Cannell:
Curing magnesium deficiency with seeds and nuts is like curing vitamin D deficiency with egg yolks.
Barry, New York
Dear Barry:
Well said. Eating a handful of seeds and nuts every day and changing to whole grains may add another 100 mg/day of magnesium to total magnesium intake but at least 500 mg/day extra is needed to correct a magnesium deficiency.
As I have written, magnesium has similarities to calcium. Both are stored in the bones and bones need both to be healthy. Deficiencies of neither can be detected by a simple blood test. Total body deficiencies of both are the rule not the exception. Finally, vitamin D is involved in the absorption of both calcium and magnesium.
If the reader is like most Americans, you are deficient in magnesium. I recommend a product made by Trace Minerals (no financial relationship to the Council or my family), in Roy, Utah: (801) 731-6051.
One comes with a 1:1 calcium: magnesium ratio:
http://www.traceminerals.com/products/bone-joint/complete-calcium-magnesium-1-1-bone-joint
It also comes with a 2:1 calcium: magnesium ratio:
http://www.traceminerals.com/products/bone-joint/complete-calcium-magnesium-2-1-bone-joint
What I especially like is the trace minerals it contains from sea salt with the sodium removed. Bones need many of these trace minerals to be healthy. The 500 mg of magnesium will treat a magnesium deficiency but it will take a year or two to replenish your bone stores of magnesium. The amount of calcium that you choose depends on your dietary calcium. If you do not eat dairy products choose the 2:1 Ca:Mg ratio, if you eat dairy at least twice a day, choose the 1:1 ratio.
John Cannell, MD
Dear Dr Cannell:
It was interesting to read your recent newsletter regarding poor vitamin D status of Somali women and risk of autism and I was glad to see that scientists are confirming your autism theory. I am a registered dietitian from the UK and have a very strong interest in Vitamin D research.
I have a particular interest in ethnic minorities, especially Somali women whom I have treated several for vitamin D deficiency. Two of the Somali ladies I have treated are sisters, and both have multiple lists of health complaints from rare autoimmune skin conditions to the obvious aching bones and muscle weakness.
One of the sisters has an autistic son who is 3 years of age now. I am sure this is of no surprise to you the fact that she has an autistic child but her first vitamin D test came back at a staggering 0.5 ng/ml! Which I believe would be an accurate reading as it was carried out via the NHS and all local tests are sent to labs which are DiaSorin compatible.
I have not heard of vitamin D levels that low but I would be interested to hear if you have heard of similar experiences.
I really appreciate the valuable work you undertake in order to get the message out there about such an important autism issue.
Kind Regards
Elliott, UK
Dear Elliott:
Always trust low 25(OH)D levels and always repeat high 25(OH)D levels. Such low levels are not uncommon and indicate the person is at risk for sudden death from hypocalcemic seizures, should their calcium intake falter
As regards the three-year-old Somali child with autism, remember that vitamin D, at 2,000-5,000 IU/day for every 25 pounds of body weight, may have a treatment effect in autism. The sooner it is started, the better.
In Minnesota, the Somali immigrants call autism the Minnesota disease, in Sweden the Somali immigrants call autism the Swedish Disease, but in Somalia, autism has no name.
John Cannell, MD
Executive Director
Vitamin D Council
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Vitamin D Deficiency Survivor 