Pregnancy Not Included for Serum Vitamin D Testing

The U.S. Preventative Services Task Force has an opportunity for Public Comment for vitamin D testing. In the draft proposal, pregnancy is not listed. Based on the work of Bruce Hollis of the Medical University of South Carolina and others, this is a very serious error. According to this work, higher vitamin D levels prevents very serious conditions during pregnancy and improved birth weight of the baby. Please take the time to read the drafts and make comments.

U.S. Preventive Services Task Force Opportunities for Public Comment

Draft Recommendation:

Under Importance, the Draft Recommendation states that ”low levels of vitamin D are associated with increased risk for fractures, functional limitations, cancer, diabetes, cardiovascular disease, depression, and mortality.”

The USPSTF is working in conjunction with the Health and Human Services AHRQ’s Effective Health Care Program. This group writes the medical guidelines for medical care.

Following is a paper that was written by the Endocrine Society Task Force in 2011:

Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline (pdf)

Authors: Michael F. Holick, Neil C. Binkley, Heike A. Bischoff-Ferrari, Catherine M. Gordon, David A. Hanley, Robert P. Heaney, M. Hassan Murad, and Connie M. Weaver

First published in Journal of Clinical Endocrinology & Metabolism, July 2011, 96(7): 1911–1930

Conclusions: Considering that vitamin D deficiency is very common in all age groups and that few foods contain vitamin D, the Task Force recommended supplementation at suggested daily intake and tolerable upper limit levels, depending on age and clinical circumstances. The Task Force also suggested the measurement of serum 25-hydroxyvitamin D level by a reliable assay as the initial diagnostic test is patients at risk for deficiency. Treatment with either vitamin D2 or vitamin D3 was recommended for deficient patients. At the present time, there is not sufficient evidence to recommend a screening individuals who are not at risk for deficiency or to prescribe vitamin D to attain the noncalcemic benefit for cardiovascular protection.

Note in the Endocrine Society guidelines that it includes D2 as being equal to D3. This was considered good practice since the 1940’s at resolution of the US government law suit against seventeen multinational corporations for conspiracy to manipulate the vitamin D market. According to Bruce Hollis research, pregnant women should take at least 4000 IU of vitamin D3 per day to reach sufficiency. Most vitamins for pregnancy only contain 1000 IU of D3.

kids

It is my belief that the serum 25(OH)D level should be tested for any chronic disease, syndrome, or other conditions. There are some very serious diseases that were not included like tuberculosis. Vitamin D Wiki shows that vitamin D works on 47 health issues as of May, 2014 . Please take the time to comment. Women that I know that have taken serious consideration for vitamin D testing have had very successful outcomes. – Pandemic Survivor

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Breast Cancer Survivor Takes on the Issues

Carole Baggerly had her own experience with breast cancer. She then started to research the reason why. Her discovery; scientists have expressed the understanding that breast cancer is a deficiency disease. That is over her life time, her intake of vitamin D was not adequate. She was so upset and concerned about the issues that she started GrassrootsHealth. This is a consortium of more than forty scientists and doctors that are experts in vitamin D and nutrition. She discovered that it was not only breast cancer, but a host of chronic illness related to deficiencies. Take the time and watch her explain the issues in the first thirty minutes of this video presentation.  Carole Baggerly and Dr. Heaney, September, 2012  Presentation to Direct-MS Canada.

If you are concerned about the health of your children, yourself, your parents, the next hour is Dr. Heaney who has contributed significantly to the understanding of vitamin D. He talks about the longevity issues and decline with chronic disease because of nutritional deficiencies. There are many diseases that have now been linked to deficiencies that number into the hundreds. This is particularly pointed to vitamin D deficiency.

This discussion is fairly non-technical and is understandable by the average person. Dr. Heaney expresses the understanding that “things go better with vitamin D”. That is that vitamin D deficiency may not be the cause of a disease like TB, but not having enough vitamin D will prevent your body from properly healing. However, this understanding falls into the logic of the chicken versus the egg. In other words, if you had enough vitamin D would you have gotten TB in the first place? Dr. Heaney discusses everything from diabetes, heart disease, MS, pregnancy, and cancer to infectious diseases like TB. I give the video presentation six stars out of a five star rating system for understanding of chronic disease and the effect of vitamin DPresentation to Direct-MS Canada.

Your take away from this, is you, your friends, and your family should not suffer from vitamin D deficiency.   Standards within the medical industry have long been 20 ng/ml to 100 ng/ml.   There have not been any cases of toxicity below 200 ng/ml or 500 nmol/l.  There does not appear to be any downside at this level of vitamin D.  Some laboratories have decreased the upper number, 100 ng/ml, to whatever they are measuring the population. Best health for you can be reached with a vitamin D serum level, 25(OH)D between 40 ng/ml to 80 ng/ml; note this is still within the normal range as defined by medicine. It is not how much you take; it is where you maintain your serum level. Everyone responds differently to their intake from all sources of vitamin D. The only way to know is to test.  Dr. Heaney says to maintain a level above 40ng/ml will require an intake from all sources of 5000 IU or more of vitamin D3 per day.

Please note this presentation is in Canada. The measurements used are in nanamoles per liter or nmol/l. To convert ng/ml to nmol/l multiply ng/ml by 2.5. So the normal range of 20 to 100 ng/ml is 50 to 250 nmol/l. Get your serum level tested to give your body a chance to thrive. If you choose to do it through GrassrootsHealth, you become part of the study that will help to advance health in the population. – Pandemic Survivor

Test by GrassrootsHealth: banner_ad_long5company postingVideo of how to do the test:  bscvideothumbnailv3web

Wellness from the Sun has Changed Forever

Henry Lahore of Vitamin D Wiki and with the help of others is putting out a video to help people understand how our relationship to the sun has changed over the last fifty years.  We have moved from outdoors to indoors.  Activities including work and play have all moved inside.  All of our energy for health which includes all the food that we eat comes from the sun.  Now, with sunscreens to shield us from the sun and sheltering inside, chronic diseases have increased significantly.

Highlights of the video include:

  • Diseases from low sun exposure
  • How food sources from decades ago were higher in vitamin D
  • How much vitamin D to take to get started
  • Blood test should be used to determine if your vitamin D level is high enough
  • The science behind the understanding of how vitamin D works for wellness
  • The video is to be made available so that it can easily be provided with voice over for eighty eight different languages
  • All of this in only five minutes in an easily understood format

One of the features of the video is a doctor that raised serum levels of vitamin D for his patients to 80 ng/ml.  This is well within the normal ranges of 30 to 100 ng/ml.  The patients in his clinic went from an average of four visits per year to one visit per year.  This statement should be significant in raising your awareness of the power of the sun and how it affects us and society as a whole.  I will let you know when this video becomes available. When it is available, please pass it along on face book, twitter, and any other public means that you have available. – Pandemic Survivor

Grassroots Health Webinars on Vitamin D

The scientist, researchers, and doctors at Grassroots Health have been presenting webinars on vitamin D and various topics.  This is a wealth of information about how a given disease works with vitamin D as well as the interaction of calcium.

I highly encourage you to go to the website and watch and listen to the webinars.  There is a new one every Tuesday at 1PM eastern time.  Also after becoming familiar with the information, I encourage you to ask your doctor to watch, if he is giving you a hard time about supplementing with vitamin D.  It is important that you maintain your 25(OH)D level above 40 ng/ml.

If you don’t watch and listen to any of the others, I highly suggest that you watch – Why Test Vitamin D!?  The question is always – How much should I take?  This gives you and understanding that everyone responds differently to amounts.  At the Grassroots Health home page you can find a table of how to start supplementing before testing.     There is also a downloadable chart as a PDF.

Here is the link to the Video Page http://www.grassrootshealth.net/index.php/videos

  • Diabetes & Vitamin D
  • The Sun & Vitamin D I and II
  • Pregnancy & Vitamin D  I and II
  • Upper Respiratory Infections & Vitamin DI and II
  • Ethic Disparities & Vitamin D
  • Premenopausal Breast Cancer & Vitamin D
  • The Cost of Vitamin D Deficiency: In Dollars & Disease
  • Vitamin D & Calcium, Fractures, & Kidney Stones  What do we know?
  • Why Test Vitamin D!?
  • Prostate Cancer Positive Core Biopsies Reduced with Vitamin D
  • Prostate Cancer Lesions Reduced with Vitamin D
  • Vitamin D Stops Breast Cancer
  • Vitamin D & Gene Expression
  • Vitamin D & Treatment of Autism
  • Pregnancy & Vitamin D Interview
  • Alzheimer’s Prevention & Vitamin
  • Interaction of Vitamin D and Calcium
  • Vitamin D Requirements for Breast Feeding Mothers
  • Vitamin D & Breast Cancer
  • Vitamin D & Cardiovascular Disease
  • Vitamin D & The Immune System
  • Vitamin D & Cystic Fibrosis

Be well and stay healthy – Pandemic Survivor

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

All Vitamin D Brands are not Equal!

Bare with me, I will get to the vitamin D, but first the story. In July, 2010, I fell when descending stairs in an unfamiliar house. It was really a sort of a stupid thing as I was talking to another person as I descended the stairs. The stair was wide enough so that we were almost side by side. I was totally engrossed in our converstation. Thinking that I was on the bottom step, I took a large step forward to find that I was two steps ups. This resulted in a forward lunge. Let me also say that I had been working hard for the three hours prior. I had lost a singificant amount of body fluid from perspiration, almost seven pounds of weight ( I had weighed before starting this job because I was interested in how much fluid loss would occur under severe heat and work conditions. During the three hours, I had drank three twenty ounce bottles of water). This combination of muscles on the verge of cramping and a clumsy fall resulted in a nasty muscle pull and perhaps an injured spine.

Of course I did not know which at the time. I thought that I had totlly destroyed my back again. After a few days of trying to resolve the pain, I went to my neurosurgeon. After an MRI, it was discovered that I had ‘no change in the appearance of my spine.’ The doc left me alone in the room prior to his arrival with the MRI on the computer screen. It so happened that the 2005 MRI was also on the screen. When comparing the two images, It was apparent that the thickness of my vertebral disc in the lumbar region was twice what it was in 2005. No change was a statement saying that my back had actually improved, but since we know that ‘you cannot grow cartilage,’ we will just not comment on the improvement. Let me be very specific here as the statement of no change was from the radiologist that had read the MRI and not my neurosurgeon. The neurosurgeon was in disblief and amazed.

The spacing between the L4-L5 had not improved and it was apparent that there had been more distortion of the vertibra (hammer shaped). The surgeon felt that the pain I was experiencing was a direct result of this issue. I felt that he was partially right, but what I was experiencing for pain was not like what I had felt before. The pain would initiate in my hip and then descend the leg. Now neural pathways are tricky and to try to pin point the origins of pain is difficult at best. I had decided that my pain was originating from a strained piriformis muscle. This muscle is under the glut muscle and the nerve bundle that recombines and descends the leg goes through the middle of this muscle. Muscle relaxants would make the pain completely go away.

The pain and numbness got much better six months later but was still going on which was not a good thing. I continued to deal with it through the spring until my physical the thrird week in April. I was shooked to see that my serum vitamin D level was 42 ng/ml. I had been taking 10,000 of D3 per day since June of 2005. How was it that my vitamin D level had dropped from an average of 85 ng/ml to 42 ng/ml. It was apparent that the vitamin D3 that I was now using was not the same as before.

I had switched to Pharmassure’s brand that I could purchase from the local drug store. It is apparent that this brand does not have the required 5.000 IU of D3 in the product as described on the label. I had been using the Bio-Tech Pharmacal brand for the 5 years prior with good results. It is obvious to me that the lack of qualily control on such a tiny amount of vitamin D is a very real issue. It could be that one bottle or lot was bad and the rest of Pharmassure’s product is fine. However, you can bet that I will never use this brand again. This is a similar story that was reported by Dr. Davis that writes the Heart Scan Blog. In that case his patients had switched from Vitamin Shoppe brand to Walgreen’s Nature Made brand and it was like the Nature Made product had no vitamin D. For you in trying to maintain an adequate vitamin D level, YOU MUST HAVE YOUR SERUM LEVEL TESTED!

I wonder now if the large range of vitamin D3 intake to achieve an adequate serum level that was reported by the study at Grass Roots Health may partially be due to the fact that all brands that claim 5,000 IU may not be 5,000 IU. I had been part of this test through the spring of 2010, but had not had my serum level tested for over a year. Anytime you change brands or habits, like how much you sun bath or change diet in like how much liver you eat ( more vitamin A an antagonist of vitamin D), you should have your serum level tested.

I took fifty thousand IU of D3 per day for two weeks to get my serum level back up and am now taking 10,000 IU of Bio-Tech Pharmacal’s vitamin D3 per day. Interestly enough, the pain in my leg has gone and my hip seems to be healed. I now have over six thousand hours of studying vitamin D, it is obvious that the single most important thing that you can do in this new medical paradigm is to have your serum level tested! – Pandemic Survivor

How Much Vitamin D? How Much is Safe?

This question keeps coming up for good reason.  It is so convoluted how the medical profession has treated vitamin D over the last hundred years because all types were called the same thing.  First was finding the marker for vitamin D that told the story about how it affects chronic disease or the storage form 25(OH)D, twenty-five hydroxyvitaminD, or calcidiol.  Typically and historically the industry has tried to use the steroid form or 1,25(OH)2D or one, twenty-five dihydroxyvitaminD or cacitriol to treat and the body’s mechanisms do not handle this real will.  Second there was the problem with toxicity because they were using too much of the steroid and with the issue of over irradiation when the pharmaceutical industry processes D2.  Typically the type that your body makes naturally, D3, when processed from lamb’s wool and fat does not require radiation.  Here is the blog where I talk about the serum level of the storage form and testing.

So as not to confuse you further, please consider only taking D3 or cholecalciferol as a supplement as this is what the body makes naturally.  If your doctor prescribes D2, ask him if it would be okay to take an equivalent amount of D3.  D2, unfortunately, is the only type that you can get prescription.  However, you can buy equivalent amount of 50,000 IU of D3 in a capsule thanks to the efforts of the Vitamin D Council.  Thank you Dr. John Cannell!!!  Just search the web for 50,000 IU of D3 and you will find several sources.

Now everybody cannot take the same amount and expect the same results.  I always thought this was just wrong for other pharmaceuticals.  Two aspirin for example for a 250 lb person will give a different effect than for a 100 lb person.

Everybody processes vitamin D differently so the only way that you can tell if you are getting enough is to have a serum test done.  On the serum test you will only be concerned with your 25(OH)D.

So where should this level be? Let’s look at three practicing doctors because this is the best method for understanding what they have discovered in their practices.  This is really how the art of medicine is practice anyway through trial and error in practice.

Dr. Elizabeth Vaughan from Greensboro, NC has a practice in integrated medicine.  She has been a practicing physician since 1979.  She also writes articles for one of the local health magazines, Natural Triad.  She is board certified and is a fourth generation physicians on both sides of the family.  I will not bore you with all of her credentials but if you want to read them they are here:

In her article for Natural Triad, “Lumpy, Bumpy, Painful Breast”, she stated that a serum 25(OH)D of 40 ng/ml is a minimum and that 70 ng/ml is the best protection.

Dr. William Davis is a practicing cardiologist in Milwaukee and writes the Heart Scan Blog.  If you have concerns about your heart this is a must read.  Here is what he has to say about vitamin D in his blog ‘A Healthy Level of Vitamin D’.   He agrees with Dr. Vaughn that 60 to 70 ng/ml is the right level of 25(OH)D.

Dr. John Cannell of the Vitamin D Council is a practicing psychiatrist and here is what he has to say after studying  papers and in discussion with other doctors about cancer.  In his January 2008 newsletter about the possibility of treating cancer he says that your serum 25(OH)D should be above 60 ng/ml.

So there you have it with three practicing physicians all saying to get the best benefit that you really should be above 60 ng/ml with 25(OH)D.  The amount of D3 that will you need to take to reach this level will be different for everyone and the only way that you know you have achieved this level is to test.  Start with about 1000 IU of D3 per 25 lbs of body weight per day and then have your serum tested after three months.  Your supplementation will by necessity be different in the summer and winter.  Before taking anything be sure to consult with your doctor about any preexisting conditions and treatment protocols that you have.  Most likely he will say that there will be no effect.  If he tells you that you will turn your organ to stones show him the NIH material Vitamin D Fact Sheet that says that a serum level of 25(OH)D (Table 1) of 200 ng/ml or less on a consistent basis is safe.  So there is a safety factor of three and if you consider animal studies from the NIH info at less than or equal to 400 ng/ml as safe then you have a safety factor of 6+.

In love, life and the pursuit of wellness always go into the sun!!!  – Pandemic Survivor