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Important Vitamin D Update
Dear Deflamers:
Below is the current Anti-Inflammatory Newsletter. If you would like, please forward this information to interested friends or patients.
David R. Seaman, DC
We now know that inadequate vitamin D levels can lead to the expression of numerous conditions such as heart disease, cancer, diabetes, neurodegenerative diseases, autoimmune diseases, respiratory tract infections, depression, and musculoskeletal aches and pains (1-4).
Vitamin D levels are most accurately assessed by measuring serum 25(OH)D. Normal levels are considered to be 32-100 ng/dL.
The lower end of normal should be taken seriously – in a recent randomized controlled trial there was a 50-percent reduction in internal cancers when baseline 25(OH)D levels were increased from 29 ng/mL to 38 ng/mL over a period of 2-4 years (5).
Another study found that subjects with the lowest quartile (below 17.9 ng/mL) of serum 25(OH)D had the highest risk of all cause mortality (6).
Patients with fibromyalgia typically have levels below 32ng/mL and often less than 10 ng/mL (7).
Clearly we should all know our vitamin D level. The cost for doing vitamin D tests varies depending on the lab or testing organization. Tests can run as high as $200. However there are options available to keep costs reasonable.
Cost Source of test
$30.00 [http://www.grassrootshealth.org] Anyone can order a vitamin D test through this organization that includes the top vitamin D researchers in North America.
$65.00 [http://www.vitamindcouncil.org] Part of the proceeds of this test go back to the Vitamin D Council. Dr. John Cannell is the Excutive Director and author of many excellent papers on vitamin D.
The $30 test is the directly accessible to individuals, patients, and doctors. All one needs do is go online to http://www.grassrootshealth.com website and purchase the vitamin D test. The grassroots program goal is to chart vitamin D levels during a 5 year period, so we offered several options. We can buy one test, two, or ten tests. If 10 tests are purchased, we are sent one test every 6 months and our credit card will be billed at that time. If you buy 2 tests, then there reminders sent out to order additional tests.
While the lower limit is 32 ng/mL, many researchers believe that 50 ng/mL or higher is desirable. To achieve this level, the average person will need to supplement with at least 4000 IU or more. It is estimated that for every 1000 IU of vitamin D3 (cholecalciferol) supplementation, 25(OH)D will increase by about 10 ng/mL.
Researchers have now estimated the tolerable upper limit to be 10,000 IU (8). I personally take about 10,000 IU per day and my 25(OH)D level is 89.4 ng/mL and my serum calcium is 9.7 mg/dL, which is right in the middle of the acceptable range at LabCorp (8.5-10.6). I am not worried about being close to 100 ng/mL because 25(OH)D levels typically need to be reach 150 ng/mL before we become hypercalcemic (9).
Vitamin D supplementation is contraindicated in patients with hypercalcemia, as vitamin D increases calcium absorption from the gut. The prevalence of hypercalcemia is quite low compared to that of vitamin D deficiency. The most common cause of hypercalcemia is primary hyperparathyroidism. Other causes include granulomatous diseases such as sarcoidosis and tuberculosis, certain cancers, hyperthyroidism, and the use of hydrochlorothiazide diuretics.
Speak with your physician regarding your 25(OH)D levels and appropriate supplementation steps.
For more information, click here to enter the Vitamin D section of deflame.com.
References
1. Vasquez A, Manso G, Cannell J. The clinical importance of vitamin D (cholecalciferol): a paradigm shift with implications for all healthcare providers. Alt Ther. 2004; 10(5):28-36
2. Holick MF. Vitamin D deficiency: what a pain it is. Mayo Clin Proc. 2003; 78:1457-59.
3. Cannell JJ, Zasloff M, Garland CF, Scragg R, Giovannucci E. On the epidemiology of influenza. Virology J. 2008; 5:29
4. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004; 80(6 Suppl):1678S-88S.
5. Lappe JM, Travers-Gustafson D, Davies KM, et al. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007; 85:1586-1591.
6. Melamed ML, Michos ED, Post W, Astor B. 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med. 2008; 168(15):1629-37.
7. Al-Allaf AW et al. Bone health in patients with fibromyalgia. Rheumatology (Oxford). 2003; 42(10):1202-06.
8. Hathcock JN, Shao A, Vieth R, Heaney R. Risk assessment for vitamin D. Am J Clin Nutr. 2007; 85(1):6-18.
9. Holick MF. Vitamin D deficiency. New Engl J Med. 2007; 357:266-81
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