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Vitamin D: Cheap Wonder Drug?
Milwaukee Journal Sentinel
02-23-07
MILWAUKEE - It seems too simple to be true: Expose most of your body to about 15 minutes of sunlight a day during the summer and take large doses of inexpensive vitamin D pills during the winter and maybe, just maybe, you will substantially reduce the risk of getting various cancers, the flu, diabetes, heart disease, autoimmune diseases and neurological disorders.
A flurry of research in the last few years suggests that low levels of vitamin D, a fairly common occurrence in those who live in northern locales much of the year, may be partly to blame for much of the ill health of many Americans.
"Vitamin D is not just for bones anymore," said Hector Deluca, a pioneering vitamin D researcher at the University of Wisconsin-Madison. "The questions are: How much do we take and do we expose ourselves to sunlight?"
Deluca noted that the vitamin plays a role in shutting down or activating at least 100 genes, many of which are involved in preventing diseases.
Consider these recent developments:
-A small observational study by University of Wisconsin researchers published online last month showed a significant association between low levels of vitamin D in the blood of Alzheimer's patients and poor performance on a cognitive test.
The study was prompted after family members of the Alzheimer's patients reported how well they were performing and acting within weeks of being put on large doses of prescription vitamin D, said lead author Robert Przybelski, an associate professor of geriatric medicine at the University of Wisconsin.
"We hypothesize that good vitamin D levels might prevent or mitigate the disease," Przybelski said.
The study noted that neurons, like many other cells, have vitamin D receptors. It said vitamin D might enhance levels of important brain chemicals and that it also might help protect brain cells.
-Earlier this month, an analysis in the American Journal of Preventive Medicine looked at vitamin D levels in the blood and concluded that daily intake of 1,000 to 2,000 international units of the supplement could reduce the incidence of colorectal cancer by about 50 percent with little risk. The current recommended intake ranges from about 200 IU in children to 600 IU in the elderly.
-Also this month, many of the same researchers concluded in a separate analysis that intake of 2,000 IU of vitamin D and, when possible, about 12 minutes a day of sun exposure could reduce the incidence of breast cancer by about 50 percent.
Vitamin D has the potential to reduce at least half of serious invasive cancers and make the remaining ones milder and far more treatable, said Cedric Garland, a co-author on both papers and professor of family and preventive medicine at the University of California-San Diego and the Moores Cancer Center.
Garland and others have estimated that 15 minutes a day of sun exposure would prevent 10 cancer deaths for every one skin cancer death it would cause.
-In December, a study involving 7 million whites in the U.S. military found that those with the highest levels of vitamin D in their blood were 62 percent less likely to develop multiple sclerosis years later than those with low levels of the vitamin.
The study echoes earlier research showing that MS, the most common nerve disease among young adults, is much less common in people who live closer to the equator.
-Even seasonal flu now is being linked to the lack of sun exposure that occurs each year at northern latitudes.
A September review article in the Epidemiology of Infection noted how seasonal flu peaks dramatically between November and February while, at about the same time, vitamin D levels in the blood drop off substantially, a decline attributed to the lack of sun exposure that occurs during winter months. Vitamin D is synthesized in skin when it is exposed to ultraviolet radiation.
The paper noted that vitamin D, which is considered a steroid prehormone, plays a profound role in regulating the immune system. It dramatically stimulates the expression of anti-microbial substances in cells lining the surface of the respiratory tract and it helps prevent over-production of inflammatory substances produced by certain immune system cells.
The paper said a lack of sun exposure during the winter also may contribute to susceptibility to other respiratory viral infections, including many of the more than 200 viruses that cause the common cold.
And the older a person gets, the more susceptible they are.
Although sun exposure can produce huge amounts of vitamin D, the elderly make only about 25 percent as much of the vitamin D in their skin as a 20-year-old who is exposed to the same amount of sunlight.
Blacks also are significantly less able to convert sunlight to vitamin D in their skin. Vitamin D shots?
"Vitamin D may be the most potent antibiotic that exists," said lead author John Cannell, a psychiatrist at Atascadero State Hospital in California and executive director of the non-profit Vitamin D Council. "Maybe the shot people need to get in the fall is not a flu shot, but a vitamin D shot. Our ancestors got it every day in Africa."
Given the strong body of evidence linking excessive sun exposure to skin cancer, taking a supplement might be the safest way to increase vitamin D levels.
While 15 to 20 minutes a day probably will not lead to a significant increased risk of skin cancer, the risk will vary depending on whether the person is fair-skinned and the time of day they are exposed, said Thomas Russell, interim chairman of the dermatology department and clinical professor of dermatology at the Medical College of Wisconsin. Increased dosage
Russell said a more sensible approach for adults is to take an additional 1,000 to 2,000 IU a day with supplements.
"There is no definite answer about how much sun you can tolerate," Russell said. "If you are trying to generate vitamin D, just take it by mouth."
Indeed, a growing number of researchers now are saying that taking up to 2,000 IU a day, and possibly more, is safe for adults.
The Institute of Medicine says that is the tolerable upper limit, or the highest daily intake that is likely to pose no adverse health risks for a healthy adult.
Researchers say exposure to intense sunlight was mostly a year-round occurrence for our prehistoric ancestors who, for eons, existed naked near the equator. It has been only in relatively recent human evolutionary history that people moved north, began wearing clothing and spent more time indoors, resulting in vitamin D deficiencies.
However, despite theories about why many people may not be getting enough vitamin D, much of the research pointing to its disease-preventing ability is observational in nature. Its possible benefits often are implied and not derived from the gold standard of research: randomized, double-blind clinical trials.
It remains to be seen whether researchers will ever do those trials. Scientists say drug companies aren't likely to conduct the trials because there is little money to be made off a non-proprietary substance such as vitamin D.
"There is nobody who is going to promote it with doctors," said Garland, of the University of California-San Diego.
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Milwaukee Journal Sentinel
02-23-07
MILWAUKEE - It seems too simple to be true: Expose most of your body to about 15 minutes of sunlight a day during the summer and take large doses of inexpensive vitamin D pills during the winter and maybe, just maybe, you will substantially reduce the risk of getting various cancers, the flu, diabetes, heart disease, autoimmune diseases and neurological disorders.
A flurry of research in the last few years suggests that low levels of vitamin D, a fairly common occurrence in those who live in northern locales much of the year, may be partly to blame for much of the ill health of many Americans.
"Vitamin D is not just for bones anymore," said Hector Deluca, a pioneering vitamin D researcher at the University of Wisconsin-Madison. "The questions are: How much do we take and do we expose ourselves to sunlight?"
Deluca noted that the vitamin plays a role in shutting down or activating at least 100 genes, many of which are involved in preventing diseases.
Consider these recent developments:
-A small observational study by University of Wisconsin researchers published online last month showed a significant association between low levels of vitamin D in the blood of Alzheimer's patients and poor performance on a cognitive test.
The study was prompted after family members of the Alzheimer's patients reported how well they were performing and acting within weeks of being put on large doses of prescription vitamin D, said lead author Robert Przybelski, an associate professor of geriatric medicine at the University of Wisconsin.
"We hypothesize that good vitamin D levels might prevent or mitigate the disease," Przybelski said.
The study noted that neurons, like many other cells, have vitamin D receptors. It said vitamin D might enhance levels of important brain chemicals and that it also might help protect brain cells.
-Earlier this month, an analysis in the American Journal of Preventive Medicine looked at vitamin D levels in the blood and concluded that daily intake of 1,000 to 2,000 international units of the supplement could reduce the incidence of colorectal cancer by about 50 percent with little risk. The current recommended intake ranges from about 200 IU in children to 600 IU in the elderly.
-Also this month, many of the same researchers concluded in a separate analysis that intake of 2,000 IU of vitamin D and, when possible, about 12 minutes a day of sun exposure could reduce the incidence of breast cancer by about 50 percent.
Vitamin D has the potential to reduce at least half of serious invasive cancers and make the remaining ones milder and far more treatable, said Cedric Garland, a co-author on both papers and professor of family and preventive medicine at the University of California-San Diego and the Moores Cancer Center.
Garland and others have estimated that 15 minutes a day of sun exposure would prevent 10 cancer deaths for every one skin cancer death it would cause.
-In December, a study involving 7 million whites in the U.S. military found that those with the highest levels of vitamin D in their blood were 62 percent less likely to develop multiple sclerosis years later than those with low levels of the vitamin.
The study echoes earlier research showing that MS, the most common nerve disease among young adults, is much less common in people who live closer to the equator.
-Even seasonal flu now is being linked to the lack of sun exposure that occurs each year at northern latitudes.
A September review article in the Epidemiology of Infection noted how seasonal flu peaks dramatically between November and February while, at about the same time, vitamin D levels in the blood drop off substantially, a decline attributed to the lack of sun exposure that occurs during winter months. Vitamin D is synthesized in skin when it is exposed to ultraviolet radiation.
The paper noted that vitamin D, which is considered a steroid prehormone, plays a profound role in regulating the immune system. It dramatically stimulates the expression of anti-microbial substances in cells lining the surface of the respiratory tract and it helps prevent over-production of inflammatory substances produced by certain immune system cells.
The paper said a lack of sun exposure during the winter also may contribute to susceptibility to other respiratory viral infections, including many of the more than 200 viruses that cause the common cold.
And the older a person gets, the more susceptible they are.
Although sun exposure can produce huge amounts of vitamin D, the elderly make only about 25 percent as much of the vitamin D in their skin as a 20-year-old who is exposed to the same amount of sunlight.
Blacks also are significantly less able to convert sunlight to vitamin D in their skin. Vitamin D shots?
"Vitamin D may be the most potent antibiotic that exists," said lead author John Cannell, a psychiatrist at Atascadero State Hospital in California and executive director of the non-profit Vitamin D Council. "Maybe the shot people need to get in the fall is not a flu shot, but a vitamin D shot. Our ancestors got it every day in Africa."
Given the strong body of evidence linking excessive sun exposure to skin cancer, taking a supplement might be the safest way to increase vitamin D levels.
While 15 to 20 minutes a day probably will not lead to a significant increased risk of skin cancer, the risk will vary depending on whether the person is fair-skinned and the time of day they are exposed, said Thomas Russell, interim chairman of the dermatology department and clinical professor of dermatology at the Medical College of Wisconsin. Increased dosage
Russell said a more sensible approach for adults is to take an additional 1,000 to 2,000 IU a day with supplements.
"There is no definite answer about how much sun you can tolerate," Russell said. "If you are trying to generate vitamin D, just take it by mouth."
Indeed, a growing number of researchers now are saying that taking up to 2,000 IU a day, and possibly more, is safe for adults.
The Institute of Medicine says that is the tolerable upper limit, or the highest daily intake that is likely to pose no adverse health risks for a healthy adult.
Researchers say exposure to intense sunlight was mostly a year-round occurrence for our prehistoric ancestors who, for eons, existed naked near the equator. It has been only in relatively recent human evolutionary history that people moved north, began wearing clothing and spent more time indoors, resulting in vitamin D deficiencies.
However, despite theories about why many people may not be getting enough vitamin D, much of the research pointing to its disease-preventing ability is observational in nature. Its possible benefits often are implied and not derived from the gold standard of research: randomized, double-blind clinical trials.
It remains to be seen whether researchers will ever do those trials. Scientists say drug companies aren't likely to conduct the trials because there is little money to be made off a non-proprietary substance such as vitamin D.
"There is nobody who is going to promote it with doctors," said Garland, of the University of California-San Diego.
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