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Statins and vitamin D. Aloia JF, Li-Ng M, Pollack S. Am J Cardiol. 2007 Oct 15;100(8):1329. Epub 2007 Jul 5. No abstract available. PMID: 17920383 A total of 208 women were randomized to receive vitamin D3 (n=104) or placebo (n=104). 51 women were on statins. At baseline, the subjects on statins had a significantly higher 25-OHD level than the subjects who were not on statins (51.2 ± 20.1 nmol/L versus 43.2 ± 18.0 nmol/L respectively, p=0.008). This was also true when averaging 25-OHD levels across the 3-year study period and looking at active and placebo patients separately. 185 subjects had follow-up 25-OHD levels drawn every 6 months during the study. Higher levels were seen in the statin use subgroup whether they were on placebo or active vitamin D (Figure 1Figure 1). There was no interaction seen between vitamin D use and statin use, i.e. the impacts are additive (p=0.5502). This significant difference is comparable to the increase in 25-OHD levels seen in Pérez-Castrillón's study (41 ± 19 versus 47 ± 19 nmol/L, p=0.003) [1]. Although Pérez-Castrillón et al found a statistically significant relation between total cholesterol and 25-OHD (r=0.277, p=0.002), we did not find a significant relation between total cholesterol and 25-OHD in our study population.

Stress fractures in the Israeli defense forces from 1995 to 1996. Givon U, Friedman E, Reiner A, Vered I, Finestone A, Shemer J. Clin Orthop Relat Res. 2000 Apr;(373):227-32. PMID: 10810481 Serum levels of bone specific alkaline phosphatase and osteocalcin were elevated in patients with high grade stress fractures compared with control subjects with no symptoms: 37.6 versus 26.2 units/L, and 10.8 versus 8.8 ng/mL, respectively. Levels of 25-hydroxy vitamin D were lower in patients with high grade stress fractures (25.3 ng/mL) than in control subjects (29.8 ng/mL). This study revealed that several parameters can distinguish soldiers with high grade stress fractures, but their predictive value and precise pathogenetic role remain unclear.

Breastfeeding does not protect against urinary tract infection in the first 3 months of life, but vitamin D supplementation increases the risk by 76%. Katikaneni R, Ponnapakkam T, Ponnapakkam A, Gensure R. Clin Pediatr (Phila). 2009 Sep;48(7):750-5. Epub 2009 Mar 4. PMID: 19264720 DOI: 10.1177/0009922809332588 The relative risk of UTI with breastfeeding versus formula feeding was 1.03 (0.58-1.82), and any breastfeeding versus no breastfeeding was 0.92 (0.58-1.45). Vitamin D supplementation increased the UTI risk, with a relative risk of 1.76 (1.07-2.91, P < .05). However, only formula-fed infants showed an increased risk of UTI after vitamin D supplementation.

A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers. Stolzenberg-Solomon RZ, Vieth R, Azad A, Pietinen P, Taylor PR, Virtamo J, Albanes D. Cancer Res. 2006 Oct 15;66(20):10213-9. PMID: 17047087 Higher vitamin D concentrations were associated with a 3-fold increased risk for pancreatic cancer (highest versus lowest quintile, >65.5 versus <32.0 nmol/L: OR, 2.92; 95% CI, 1.56-5.48, Ptrend = 0.001) that remained after excluding cases diagnosed early during follow-up. Contrary to expectations, subjects with higher prediagnostic vitamin D status had an increased pancreatic cancer risk compared with those with lower status. Our findings need to be replicated in other populations and caution is warranted in their interpretation and implication. Our results are intriguing and may provide clues that further the understanding of the etiology of this highly fatal cancer. In conclusion, contrary to expectation, subjects with higher 25(OH)D concentrations were at greater risk for pancreatic cancer compared with those with lower concentrations in our prospective study with long-term follow-up. Caution is warranted in the interpretation and implication of our findings, however, as vitamin D inadequacy is an important public health problem and adequate status is desirable to prevent bone and other diseases (5). Our results, however, are intriguing and may provide clues that further the understanding of the etiology of this highly fatal cancer.

Age-related changes in the 25-hydroxyvitamin D versus parathyroid hormone relationship suggest a different reason why older adults require more vitamin D. Vieth R, Ladak Y, Walfish PG. J Clin Endocrinol Metab. 2003 Jan;88(1):185-91. PMID: 12519850 This study shows that all age groups exhibit a high prevalence of 25(OH)D insufficiency and secondary hyperparathyroidism. Older adults are just as efficient in maintaining 25(OH)D, but they need more vitamin D to produce the higher 25(OH)D concentrations required to overcome the hyperparathyroidism associated with their diminishing renal function

Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Vieth R, Kimball S, Hu A, Walfish PG. Nutr J. 2004 Jul 19;3:8. PMID: 15260882 doi:10.1186/1475-2891-3-8 CONCLUSION: The highest AI for vitamin D brought summertime 25(OH)D to >40 nmol/L, lowered PTH, and its use was associated with improved wellbeing. The 100 mcg/day dose produced greater responses. Since it was ethically necessary to provide a meaningful dose of vitamin D to these insufficient patients, we cannot rule out a placebo wellbeing response, particularly for those on the lower dose. This work confirms the safety and efficacy of both 15 and 100 mcg/day vitamin D3 in patients who needed additional 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

"NEW YORK (Reuters Health) - Low vitamin D levels in the body may be deadly, according to a new study hinting that adults with lower, versus higher, blood levels of vitamin D may be more likely to die from heart disease or stroke. Vitamin D is an essential vitamin mostly obtained from direct sunlight exposure, but also found in foods and multivitamins. Dr. Annamari Kilkkinen, at the National Institute for Health and Welfare in Helsinki, Finland, and colleagues compared blood levels of vitamin D and deaths from heart disease or stroke over time in 2,817 men and 3,402 women in Finland."

The bioavailability of vitamin D from fortified cheeses and supplements is equivalent in adults. Wagner D, Sidhom G, Whiting SJ, Rousseau D, Vieth R. J Nutr. 2008 Jul;138(7):1365-71. PMID: 18567762 Compared with baseline, serum parathyroid hormone decreased with both fortification (P = 0.003) and supplementation (P = 0.012). These data demonstrate that vitamin D is equally bioavailable from fortified hard cheeses and supplements, making cheese suitable for vitamin D fortification.

"Kuluttajille on eräillä keskustelufoorumeilla yritelty uskotella, että öljypohjaiset D-vitamiinivalmisteet omaavat paremman biologisen hyväksikäytettävyyden kuin D-vitamiinitabletit, mutta tälle väitteelle ei löydy mitään tukea tieteellisestä kirjallisuudesta. Norjalaistutkimuksessa verrattiin D3-vitamiinia sisältävät multivitamiinitabletin ja D3-vitamiinia sisältävän kalaöljykapselin vaikutuksia seerumin (veren) 25-OH-D-vitamiinipitoisuuteen (S-25(OH)D). Koehenkilöt saivat neljän viikon ajan 10 mikrogrammaa D3-vitamiinia joko tableteista tai öljykapseleista. Tablettiryhmässä S-25(OH)D-pitoisuus nousi keskimäärin 35,8 nmol/l ja kapseliryhmässä 32,3 nmol/l. "We conclude that fish oil capsules and multivitamin tablets containing 10 microg cholecalciferol administered over a 4-week period produced a similar mean increase in s-25(OH)D concentration", päättelivät tutkijat. Vuotta aiemmin julkaistussa suomalaistutkimuksessa havaittiin, että D3-vitamiini imeytyy erilaisista leivistä samalla tehokkuudella kuin D-vitamiinivalmisteesta. Kanadalaistutkijat raportoivat juuston osalta samanlaisia tuloksia. Vuonna 2003 jenkkitutkijat totesivat, että "fat is not required for vitamin D to be bioavailable." Mainittakoon lopuksi, että D3-vitamiinitabletteihin lisätään yleensä D3-vitamiinivalmistetta, jossa on öljy jo valmiina. Ainesosaluetteloissa lukee lähes säännönmukaisesti "D3-vitamiinivalmiste" ja sen jälkeen suluissa pelkkä aktiiviaine eli "kolekalsiferoli" tai "sisältää mm. kolekalsiferolia ja soijaöljyä" tai jotain vastaavaa. Tämä D3-vitamiinivalmiste on sitten ympäröity täyteaineilla, jotka eivät vaikuta D3-vitamiinin imeytymiseen millään tavalla. Tabletti hajoaa hyvin nopeasti maha-suolikanavassa."

A randomised comparison of increase in serum 25-hydroxyvitamin D concentration after 4 weeks of daily oral intake of 10 microg cholecalciferol from multivitamin tablets or fish oil capsules in healthy young adults. Holvik K, Madar AA, Meyer HE, Lofthus CM, Stene LC. Br J Nutr. 2007 Sep;98(3):620-5. Epub 2007 Apr 24. PMID: 17456248 We conclude that fish oil capsules and multivitamin tablets containing 10 microg cholecalciferol administered over a 4-week period produced a similar mean increase in s-25(OH)D concentration.