Saturday, October 18, 2008

On Vitamin D

By Diana Hsieh

Wowee, via Free the Animal, I found a fascinating story on Vitamin D in Canada's Globe and Mail: Vitamin D casts cancer prevention in new light. Here's the first section:

For decades, researchers have puzzled over why rich northern countries have cancer rates many times higher than those in developing countries -- and many have laid the blame on dangerous pollutants spewed out by industry.

But research into vitamin D is suggesting both a plausible answer to this medical puzzle and a heretical notion: that cancers and other disorders in rich countries aren't caused mainly by pollutants but by a vitamin deficiency known to be less acute or even non-existent in poor nations.

Those trying to brand contaminants as the key factor behind cancer in the West are "looking for a bogeyman that doesn't exist," argues Reinhold Vieth, professor at the Department of Nutritional Sciences at the University of Toronto and one of the world's top vitamin D experts. Instead, he says, the critical factor "is more likely a lack of vitamin D."

What's more, researchers are linking low vitamin D status to a host of other serious ailments, including multiple sclerosis, juvenile diabetes, influenza, osteoporosis and bone fractures among the elderly.

Not everyone is willing to jump on the vitamin D bandwagon just yet. Smoking and some pollutants, such as benzene and asbestos, irrefutably cause many cancers.

But perhaps the biggest bombshell about vitamin D's effects is about to go off. In June, U.S. researchers will announce the first direct link between cancer prevention and the sunshine vitamin. Their results are nothing short of astounding.

A four-year clinical trial involving 1,200 women found those taking the vitamin had about a 60-per-cent reduction in cancer incidence, compared with those who didn't take it, a drop so large -- twice the impact on cancer attributed to smoking -- it almost looks like a typographical error.
While that doesn't sound like a randomized, controlled study, it's still highly suggestive. For more on the importance of Vitamin D, you can check out the the relevant posts from the Heart Scan blog.

I've been taking supplemental Vitamin D for a few months. My physician recommended that I increase my dose at my last visit, based on some new research on its importance to bone health. Given what I've read about its wide-ranging effects on health, I think that I might want to get my levels tested. Plus, according to the Heart Scan Doc, unpredictable variation between individuals makes testing a necessity:
It's probably the number one most common question I get today:

"How much vitamin D should I take?"

Like asking for investing advice, there are no shortage of people willing to provide answers, most of them plain wrong.

The media are quick to offer advice like "Take the recommended daily allowance of 400 units per day," or "Some experts say that intake of vitamin D should be higher, as high as 2000 units per day." Or "Be sure to get your 15 minutes of midday sun."

Utter nonsense. ...

[V]itamin D requirements can range widely. I have used anywhere from 1000 units per day, all the way up to 16,000 units per day before desirable blood levels were achieved.

Vitamin D dose needs to be individualized. Factors that influence vitamin D need include body size and percent body fat (both of which increase need substantially); sex (males require, on average, 1000 units per day more than females); age (older need more); skin color (darker-skinned races require more, fairer-skinned races less); and other factors that remain ill-defined.

But these are "rules" often broken. My office experience with vitamin D now numbers nearly 1000 patients. The average female dose is 4000-5000 units per day, average male dose 6000 units per day to achieve a blood level of 60-70 ng/ml, though there are frequent exceptions. I've had 98 lb women who require 12,000 units, 300 lb men who require 1000 units, 21-year olds who require 10,000 units. (Of course, this is a Wisconsin experience. However, regional differences in dosing needs diminish as we age, since less and less vitamin D activation occurs.)

Let me reiterate: Steroid hormone-vitamin D dose needs to be individualized.

There's only one way to individualize your need for vitamin D and thereby determine your dose: Measure a blood level.

Nobody can gauge your vitamin D need by looking at you, by your skin color, size, or other simple measurement like weight or body fat. A vitamin D blood level needs to be measured specifically -- period.
I've also just begun taking high quality cod liver oil and butter oil, based on the recommendation of Weston A. Price and others. (I got my supply here.) Given the cost of the butter oil, I'm definitely looking for noticeable results -- as I've heard other people report. I'm particularly hoping for an improvement to my dental health, as I'm very prone to cavities and inflamed gums. That would be huge for me.

Update: It's Vitamin D Day! Mark Sisson has a post on the association between Vitamin D and Parkinson's disease. As he's careful to observe, the question is: which comes first?

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