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Comment: Although lower risk associated with vitamin D exposure was shown most consistently for ER+/PR+ tumors, the result might simply reflect that this tumor subtype was the most common. Nonetheless, these findings support vitamin D's beneficial effects on breast cancer risk, regardless of hormone-receptor status. Sun exposure and dietary intake (Table 1) are key sources of vitamin D.

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.

Novel role of the vitamin D receptor in maintaining the integrity of the intestinal mucosal barrier. Kong J, Zhang Z, Musch MW, Ning G, Sun J, Hart J, Bissonnette M, Li YC. Am J Physiol Gastrointest Liver Physiol. 2008 Jan;294(1):G208-16. Epub 2007 Oct 25. PMID: 17962355 These observations suggest that VDR plays a critical role in mucosal barrier homeostasis by preserving the integrity of junction complexes and the healing capacity of the colonic epithelium. Therefore, vitamin D deficiency may compromise the mucosal barrier, leading to increased susceptibility to mucosal damage and increased risk of IBD.

I have been inundated with letters asking about Professor Marshall's recent "discovery." Some have written that to say they have stopped their vitamin D and are going to avoid the sun in order to begin the "Marshall protocol." The immediate cause of this angst is two publications, a press article in Science Daily about Professor Marshall's "study" (which is no study but simply an opinion) in BioEssays. Dr. Trevor Marshall has two degrees, both in electrical engineering

Robert P. Heaney is John A. Creighton University Professor, Creighton University, Omaha, Nebraska, United States. Hominid evolution took place in an environment (equatorial East Africa) that provided a superabundance of both calcium and vitamin D, the first in available foods and the second through conversion of 7-dehydrocholesterol to pre-vitamin D in the skin, a reaction catalysed by the intense solar ultraviolet (UV) radiation. Seemingly as a consequence, the evolving human physiology incorporated provisions to prevent the potential of toxic excesses of both nutrients. For vitamin D the protection was of two sorts: skin pigmentation absorbed the critical UV wavelengths and thereby limited dermal synthesis of cholecalciferol; and slow delivery of vitamin D from the skin into the bloodstream left surplus vitamin in the skin, where continuing sun exposure led to its photolytic degradation to inert compounds. For calcium, the adaptation consisted of very inefficient calcium absorption, together with poor to absent systemic conservation. The latter is reflected in unregulated dermal calcium losses, a high sensitivity of renal obligatory calcium loss to other nutrients in the diet and relatively high quantities of calcium in the digestive secretions. Today, chimpanzees in the original hominid habitat have diets with calcium nutrient densities in the range of 2 to 2.5 mmol per 100 kcal, and hunter-gatherer humans in Africa, South America and New Guinea still have diets very nearly as high in calcium (1.75 to 2 mmol per 100 kcal) (Eaton and Nelson, 1991). With energy expenditure of 3 000 kcal per day (a fairly conservative estimate for a contemporary human doing physical work), such diets would provide substantially in excess of 50 mmol of calcium per day. By contrast, median intake in women in North America and in many European countries today is under 15 mmol per day. Two factors altered the primitive situation: the migration of humans from Africa to higher latitude

Vitamin D: a D-Lightful health perspective. Holick MF. Nutr Rev. 2008 Oct;66(10 Suppl 2):S182-94. Review. PMID: 18844847 DOI: 10.1111/j.1753-4887.2008.00104.x Sunlight provides most humans with their vitamin D requirement. Adequate vitamin D(3) by synthesis in the skin or from dietary and supplemental sources is essential for bone health throughout life. Vitamin D deficiency is defined as a 25(OH)D concentration 30 ng/mL (75 nmol/L), and insufficiency as 21-29 ng/mL. Vitamin D deficiency and insufficiency has been linked to a wide variety of chronic diseases including common cancers, autoimmune, cardiovascular, and infectious diseases. Healthcare professionals need to be aware of the vitamin D deficiency pandemic. Guidelines for sensible sun exposure and supplemental vitamin D of 800-1000 IU/day are needed.

Designed with practicing dermatologists, dermatology trainees, physicians, and scientists interested in photoprotection in mind, this concise and highly illustrated guide provides the latest knowledge of photoprotection in dermatology and cosmetic science. Clinical Guide to Sunscreens and Photoprotectionalso addresses recent important international and domestic regulatory activity and requirements on the use of novel sun protective chemicals and proper labeling of products to ensure increased consumer awareness.This concisely written, problem-oriented text explores See chapter by Bischoff-Ferrari et al. from page 119 dealing with what dose is needed for 25(OH)D level of 80 nmol/l in 97% of population

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.

Feb. 23, 2009 -- A walk in the sun may be better than popping a vitamin C tablet for boosting your chances of preventing the common cold or flu.\n\nA new study adds to mounting evidence that vitamin C may have been stealing the spotlight all these years from the real cold fighter, vitamin D.

This is a very long newsletter. I will answer questions about oil versus water-soluble Vitamin D, depression, mental clarity, malignant melanoma, Crohn's disease, an imagist poet, multiple sclerosis, sun-exposure, high-intensity red light and collagen repair in the skin, non-alcoholic fatty liver disease, influenza, the 1918 influenza pandemic, statins, the new Food and Nutrition Board, thyroid disease, chronic fatigue syndrome, athletes, the upcoming 14th Vitamin D Workshop, prostate cancer, the wrong blood test, pregnancy, autism, Alzheimer's disease, soap and sebum, asthma, sleep, the co-factors vitamin D needs to work (all contained in spinach), and-my favorite-UVC light and Vitamin D

Use of vitamin D in clinical practice. Cannell JJ, Hollis BW. Altern Med Rev. 2008 Mar;13(1):6-20. PMID: 18377099 The recent discovery--from a meta-analysis of 18 randomized controlled trials--that supplemental cholecalciferol (vitamin D) significantly reduces all-cause mortality emphasizes the medical, ethical, and legal implications of promptly diagnosing and adequately treating vitamin D deficiency. Not only are such deficiencies common, and probably the rule, vitamin D deficiency is implicated in most of the diseases of civilization. Vitamin D's final metabolic product is a potent, pleiotropic, repair and maintenance, seco-steroid hormone that targets more than 200 human genes in a wide variety of tissues, meaning it has as many mechanisms of action as genes it targets. One of the most important genes vitamin D up-regulates is for cathelicidin, a naturally occurring broad-spectrum antibiotic. Natural vitamin D levels, those found in humans living in a sun-rich environment, are between 40-70 ng per ml, levels obtained by few modern humans. Assessing serum 25-hydroxy-vitamin D (25(OH)D) is the only way to make the diagnosis and to assure treatment is adequate and safe. Three treatment modalities exist for vitamin D deficiency: sunlight, artificial ultraviolet B (UVB) radiation, and vitamin D3 supplementation. Treatment of vitamin D deficiency in otherwise healthy patients with 2,000-7,000 IU vitamin D per day should be sufficient to maintain year-round 25(OH)D levels between 40-70 ng per mL. In those with serious illnesses associated with vitamin D deficiency, such as cancer, heart disease, multiple sclerosis, diabetes, autism, and a host of other illnesses, doses should be sufficient to maintain year-round 25(OH)D levels between 55 -70 ng per mL. Vitamin D-deficient patients with serious illness should not only be supplemented more aggressively than the well, they should have more frequent monitoring of serum 25(OH)D and serum calcium. Vitamin D should always be

This web site is dedicated to vitamin D and cancer. This is because exciting new research indicates that vitamin D-whether produced in the skin as a result of exposure to ultraviolet radiation (from sunlight or sun lamps) or obtained from supplementation with cholecalciferol (vitamin D3)-may help cancer patients. However, the research is far from complete.

Vitamin D Toxicity Fears Unwarranted Is vitamin D toxic? Not if we take the same amount nature intended when we go out in the sun. Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentration, and safety. Am J Clin Nutr. 1999;69:842-56. Vieth attempted to dispel unwarranted fears in medical community of physiological doses of vitamin D in 1999 with his exhaustive and well-written review. D-Lite, Renew, & SunSplash UV/Tanning Systems Sunsplash Tanning System Is toxicity a concern for you? If so, then increase your levels the way nature intended, with ultraviolet B light! His conclusions: fear of vitamin D toxicity is unwarranted, and such unwarranted fear, bordering on hysteria, is rampant in the medical profession. Vieth R, Chan PC, MacFarlane GD. Efficacy and safety of vitamin D3 intake exceeding the lowest observed adverse effect level. Am J Clin Nutr. 2001 Feb;73(2):288-94. Even Ian Monroe, the chair of the relevant IOM committee, wrote to the Journal to compliment Vieth's work and to promise his findings will be considered at the time of a future Institute of Medicine review. Munro I. Derivation of tolerable upper intake levels of nutrients. Letter, Am J Clin Nutr. 2001;74:865. That was more than two years ago.

Research finds people with gene variant who lack vitamin D, produced from sun exposure, can develop condition

Vitamin D, found in fish and produced by sun exposure, can help stave off the mental decline that can affect people in old age, a study has suggested. UK and US researchers looked at 2,000 people aged 65 and over.

The high prevalence of vitamin D insufficiency across Australian populations is only partly explained by season and latitude. van der Mei IA, Ponsonby AL, Engelsen O, Pasco JA, McGrath JJ, Eyles DW, Blizzard L, Dwyer T, Lucas R, Jones G. Environ Health Perspect. 2007 Aug;115(8):1132-9. PMID: 17687438 doi: 10.1289/ehp.9937. Conclusion Vitamin D insufficiency is common over a wide latitude range in Australia. Season appears to be more important than latitude, but both accounted for less than one-fifth of the variation in serum 25(OH)D levels, highlighting the importance of behavioral factors. Current sun exposure guidelines do not seem to fully prevent vitamin D insufficiency, and consideration should be given to their modification or to pursuing other means to achieve vitamin D adequacy.

Seasonality of UV-radiation and vitamin D status at 69 degrees north. Brustad M, Edvardsen K, Wilsgaard T, Engelsen O, Aksnes L, Lund E. Photochem Photobiol Sci. 2007 Aug;6(8):903-8. Epub 2007 Jun 27. PMID: 17668121 The generally high dietary intakes of vitamin D, especially in winter, mask largely the effect of seasonal variation in UV-exposure, causing an atypical seasonal variation in vitamin D status. The UV-hour variable significantly predicted 25(OH)D levels in blood when adjusted for intakes and artificial UV-radiation exposure and sun holidays abroad.

Athletic performance and vitamin D. Cannell JJ, Hollis BW, Sorenson MB, Taft TN, Anderson JJ. Med Sci Sports Exerc. 2009 May;41(5):1102-10. Review. PMID: 19346976 doi: 10.1249/MSS.0b013e3181930c2b Conclusions: Vitamin D may improve athletic performance in vitamin D-deficient athletes. Peak athletic performance may occur when 25(OH)D levels approach those obtained by natural, full-body, summer sun exposure, which is at least 50 ng·mL-1. Such 25(OH)D levels may also protect the athlete from several acute and chronic medical conditions.

"Last Wednesday night I gave a lecture to my clients on hunter-gatherer diets. The turnout was great and the information was well-received. I had it professionally video-recorded and will probably offer this as a DVD for sale (with the handout included). Watch for it in the future. Part of what I discussed was vitamin D3 supplementation. Since I have been supplementing with 4,000-10,000 Units of D3 per day I have noted enhanced recovery and size response from my training. Apparently, skeletal muscle has both surface receptors and nuclear receptors for D3 that augment calcium flux during contraction (from surface receptors) and have steroid-like effects at the nuclear level WRT protein synthesis. This D3 supplementation is not really "supplementation" but is instead "augmentation" to levels that would be normal if we got normal sun exposure as we did in our evolutionary past. Check out www.vitamindcouncil.org for more information. Also, check out this abstract below for your consideration. Also, check out this article."

Diagnosis and treatment of vitamin D deficiency. Cannell JJ, Hollis BW, Zasloff M, Heaney RP. Expert Opin Pharmacother. 2008 Jan;9(1):107-18. PMID: 18076342 The recent discovery - in a randomised, controlled trial - that daily ingestion of 1100 IU of colecalciferol (vitamin D) over a 4-year period dramatically reduced the incidence of non-skin cancers makes it difficult to overstate the potential medical, social and economic implications of treating vitamin D deficiency. Not only are such deficiencies common, probably the rule, vitamin D deficiency stands implicated in a host of diseases other than cancer. The metabolic product of vitamin D is a potent, pleiotropic, repair and maintenance, secosteroid hormone that targets > 200 human genes in a wide variety of tissues, meaning it has as many mechanisms of action as genes it targets. A common misconception is that government agencies designed present intake recommendations to prevent or treat vitamin D deficiency. They did not. Instead, they are guidelines to prevent particular metabolic bone diseases. Official recommendations were never designed and are not effective in preventing or treating vitamin D deficiency and in no way limit the freedom of the physician - or responsibility - to do so. At this time, assessing serum 25-hydroxy-vitamin D is the only way to make the diagnosis and to assure that treatment is adequate and safe. The authors believe that treatment should be sufficient to maintain levels found in humans living naturally in a sun-rich environment, that is, > 40 ng/ml, year around. Three treatment modalities exist: sunlight, artificial ultraviolet B radiation or supplementation. All treatment modalities have their potential risks and benefits. Benefits of all treatment modalities outweigh potential risks and greatly outweigh the risk of no treatment. As a prolonged 'vitamin D winter', centred on the winter solstice, occurs at many temperate latitudes, ≤ 5000 IU (125 μg) of vitamin D/d