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Diagnosis and Treatment of Vitamin D Deficiency Seminar December 2, 2008

Vitamin D, nervous system and aging. P. Tuohimaa, T. Keisala, A. Minasyan, J. Cachat and A. Kalueff. . Psychoneuroendocrinology, Volume 34, Supplement 1, December 2009, Pages S278-S286 NEUROACTIVE STEROIDS: EFFECTS AND MECHANISMS OF ACTION doi:10.1016/j.psyneuen.2009.07.003 This is a mini-review of vitamin D3, its active metabolites and their functioning in the central nervous system (CNS), especially in relation to nervous system pathologies and aging. The vitamin D3 endocrine system consists of 3 active calcipherol hormones: calcidiol (25OHD3), 1α-calcitriol (1α,25(OH)2D3) and 24-calcitriol (24,25(OH)2D3). The impact of the calcipherol hormone system on aging, health and disease is discussed. Low serum calcidiol concentrations are associated with an increased risk of several chronic diseases including osteoporosis, cancer, diabetes, autoimmune disorders, hypertension, atherosclerosis and muscle weakness all of which can be considered aging-related diseases. The relationship of many of these diseases and aging-related changes in physiology show a U-shaped response curve to serum calcidiol concentrations. Clinical data suggest that vitamin D3 insufficiency is associated with an increased risk of several CNS diseases, including multiple sclerosis, Alzheimer's and Parkinson's disease, seasonal affective disorder and schizophrenia. In line with this, recent animal and human studies suggest that vitamin D insufficiency is associated with abnormal development and functioning of the CNS. Overall, imbalances in the calcipherol system appear to cause abnormal function, including premature aging, of the CNS.

My doctor advised us to give Vitamin D to both our children, though our son is more than 4 year old. I decided to find out more about it. I surfed the Internet, read the description of the vitamin (here Canadian Pharmacy site https://www.canadapharmacy.com/ helped me a lot). Finally, I decided to give it to my children. But I didn't know, it is good for adults. Thanks for sharing this information, it is very useful for me!

Opinion of the Scientific Committee on Food on the Tolerable Upper Intake Level of Vitamin D (expressed on 4 December 2002)

M. F. Holick Vitamin D Deficiency: What a Pain It Is Mayo Clin. Proc., December 1, 2003; 78(12): 1457 - 1459.

Tufts University Confirms That Vitamin A Protects Against Vitamin D Toxicity by Curbing Excess Production of Vitamin K-Dependent Proteins Tufts University confirmed my hypothesis that vitamin A protects against vitamin D's induction of renal calcification (kidney stones) by normalizing the production of vitamin K-dependent proteins in December, 2008, without citing my hypothesis or telling me they had confirmed it. I am, of course, very grateful that they thought it significant enough to investigate.

Vitamin D is safe when used in physiological doses (those used by Nature). Physiological doses are 3,000-5,000 IU/day, from all sources (sun, diet and supplements). Should hypercalcemia occur with such doses, it is due to vitamin D hypersensitivity syndrome, not vitamin D toxicity. Vitamin D hypersensitivity syndromes include conditions such as primary hyperparathyroidism, occult cancers (especially lymphoma) or granulomatous disease (especially sarcoidosis). In such cases, treatment of vitamin D deficiency should be done under the care of a knowledgeable physician. A serum 25(OH)D, serum 1,25(OH)D, PTH and SMA will lead the clinician in the right direction.

Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. JAMA. 2006 Dec 20;296(23):2832-8. PMID: 17179460

"Thursday, 17 December 2009 This blog is in response to Dr Briffa's post here. as I keep having problems commenting on his blogs. While 44ng/ml is sufficient to not only maximize uptake of calcium (>32ng/ml) and ensure maximum bone mineral density (>42ng/ml), pregnant and nursing mothers should be aware that in order to maximize the amount of vitamin D3 in human breast milk 6400iu/daily was found to be necessary to raise (>58ng/ml) at latitude 32. This is detailed in the Taylor, Wagner and Hollis paper. Vitamin D supplementation during lactation to support infant and mother. Although 4000iu/daily met the mothers daily needs in full it left babies being born with lower 25(OH)D status than required for optimum calcium absorption They also found DAILY use of supplements was required by pregnant and nursing mothers to ensure an even daily Vitamin D3 supply to the foetus & baby. It makes virtually no measurable difference for everyone else if you supplement daily or weekly. While Dr Briffa will not be lactating he may be interested seeing in the Grassrootshealth chart showing disease incidence by 25(OH)D status. this may encourage him to go just another 10ng/ml higher and a bit nearer to the natural level at which human breast milk flows replete with D3."

Vitamin D3 and calcium to prevent hip fractures in the elderly women. Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ. N Engl J Med. 1992 Dec 3;327(23):1637-42. PMID: 1331788 CONCLUSIONS. Supplementation with vitamin D3 and calcium reduces the risk of hip fractures and other nonvertebral fractures among elderly women.

Matsuoka, L. Y., Wortsman, J., Hanifan, N. & Holick, M. F. (1988) Chronic sunscreen use decreases circulating concentrations of 25-hydroxyvitamin D: a preliminary study. Arch. Dermatol. 124:1802-1804

Wintertime vitamin D insufficiency is common in young Canadian women, and their vitamin D intake does not prevent it. Vieth R, Cole DE, Hawker GA, Trang HM, Rubin LA. Eur J Clin Nutr. 2001 Dec;55(12):1091-7. PMID: 11781676 INTERPRETATION: The self-reported vitamin D intake from milk and/or multivitamins does not relate to prevention of low vitamin D nutritional status of young women in winter. Recommended vitamin D intakes are too small to prevent insufficiency. Vitamin D nutrition can only be assessed by measuring serum 25(OH)D concentration.

Vitamin D and skin physiology: a D-lightful story. Holick MF, Chen TC, Lu Z, Sauter E. J Bone Miner Res. 2007 Dec;22 Suppl 2:V28-33. PMID: 18290718 doi: 10.1359/jbmr.07s211 Very few foods naturally contain vitamin D, and those that do have a very variable vitamin D content. Recently it was observed that wild caught salmon had between 75% and 90% more vitamin D(3) compared with farmed salmon. The associations regarding increased risk of common deadly cancers, autoimmune diseases, infectious diseases, and cardiovascular disease with living at higher latitudes and being prone to vitamin D deficiency should alert all health care professionals about the importance of vitamin D for overall health and well being. Humans have depended on sunlight for their vitamin D requirement. The impact of season, time of day, and latitude on vitamin D synthesis is well documented.(2,3) We now report that altitude also has a dramatic influence on vitamin D3 production and that living at altitudes above 3500 m permits previtamin D3 production at a time when very little is produced at latitudes below 3400 m. It was surprising that, at 27° N in Agra (169 M), little previtamin D3 production was observed. However, there was significant air pollution that caused a haze over the city. It is likely the ozone and other UVB-absorbing pollutants in the air prevented the solar UVB photons from reaching the earth's surface to produce previtamin D3.

Overview of general physiologic features and functions of vitamin D. DeLuca HF. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1689S-96S. Review. PMID: 15585789

Use of cod liver oil during the first year of life is associated with lower risk of childhood-onset type 1 diabetes: a large, population-based, case-control study. Stene LC, Joner G; Norwegian Childhood Diabetes Study Group. Am J Clin Nutr. 2003 Dec;78(6):1128-34. PMID: 14668274 Conclusion: Cod liver oil may reduce the risk of type 1 diabetes, perhaps through the antiinflammatory effects of long-chain n-3 fatty acids.

This month, the authoritative International Agency for Research into Cancer (IARC) have weighed in on the issue. By gathering a group of expert scientists, they have looked at all the available evidence and published a detailed report on vitamin D and cancer. The massive tome weighs in at 465 pages, but we'll take a look at the key points in the first of two posts looking at the vitamin D debate. It is impossible for us to get more than about five percent of the vitamin D we need from our diet - unless, like Eskimos, we eat oily fish three times a day.

To conclude, our findings suggest an association between large-dose vitamin D supplementation in infancy and an increased risk of atopy, allergic rhinitis, and asthma later in life. Further study is required to determine whether these observations could imply that vitamin D supplementation in infancy may have long-term effects on immune regulation, or if they reflect some unmeasured determinants of vitamin D supplementation Infant vitamin d supplementation and allergic conditions in adulthood: northern Finland birth cohort 1966. Hyppönen E, Sovio U, Wjst M, Patel S, Pekkanen J, Hartikainen AL, Järvelinb MR. Ann N Y Acad Sci. 2004 Dec;1037:84-95. DOI: 10.1196/annals.1337.013 PMID: 15699498

In the last post, we talked about the new report on vitamin D and cancer from the International Agency for Research into Cancer (IARC). In this one, we'll summarise what the report has to say on the balance between getting enough vitamin D through sun exposure and reducing the risk of skin cancer by being SunSmart. IARC calls for more trials to really pin down the effects of vitamin D supplements - either positive or negative - depending on how much vitamin D people already have in their system. Until then, they feel that there is no solid basis for changing any existing recommendations about vitamin D.

Relationship between serum 25-hydroxyvitamin d and pulmonary function in the third national health and nutrition examination survey. Black PN, Scragg R. Chest. 2005 Dec;128(6):3792-8. PMID: 16354847

Upper levels of vitamin D intake were set at 50 microg/d (2000 IU/d) for all ages. Some individuals would require higher levels than these to achieve serum 25-hydroxyvitamin D concentrations for optimal calcium absorption. So much new information on vitamin D and health has been collected since the requirements were set in 1997 that this nutrient is likely the most in need of revised requirements. Vitamin D requirements: current and future. Weaver CM, Fleet JC. Am J Clin Nutr. 2004 Dec;80(6 Suppl):1735S-9S. Review. Erratum in: Am J Clin Nutr. 2005 Mar;81(3):729. PMID: 15585797

For many years, vitamin D was boring--even to doctors. Because it was considered good for bones and not much else, multitaskers like vitamin A, B vitamins and vitamin E hogged all the press. But recent studies have thrust this long-neglected nutrient into the spotlight. Scientists now think vitamin D may affect everything from diabetes to cancer. They're also finding that many people don't have enough of it.