Breakthrough Updates You Need to Know on Vitamin D
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The compound we call vitamin D
can no longer properly be considered a vitamin. For most mammals, it is not in
any sense even a nutrient. Nevertheless, vitamin D resembles true vitamins
inasmuch as humans -- who are cut off from the critical solar ultraviolet
wavelengths by reason of latitude, clothing, or shelter -- depend on an
external source of the substance, just as they do for the true essential
nutrients.
What is Vitamin D?
Vitamin D, calciferol, is a
fat-soluble vitamin. It is found in food, but also can be made in your body
after exposure to ultraviolet rays from the sun. Vitamin D exists in several
forms, each with a different activity. Some forms are relatively inactive in
the body, and have limited ability to function as a vitamin. The liver and
kidney help convert vitamin D to its active hormone form.
The major biologic function of
vitamin D is to maintain normal blood levels of calcium and phosphorus.
Vitamin D aids in the absorption of calcium, helping to form and maintain
strong bones. It promotes bone mineralization in concert with a number of
other vitamins, minerals, and hormones.
Without vitamin D, bones can
become thin, brittle, soft, or misshapen. Vitamin D prevents rickets in
children and osteomalacia in adults, which are skeletal diseases that result
in defects that weaken bones.
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What
are the sources of vitamin D?
Food sources
Fortified foods are the major
dietary sources of vitamin D. Prior to the fortification of milk products in
the 1930s, rickets (a bone disease seen in children) was a major public health
problem in the United States. Milk in the United States is fortified with 10 micrograms (400 IU) of vitamin D per
quart, and rickets is now uncommon in the US.
Exposure to sunlight
Exposure to sunlight is an
important source of vitamin D. Ultraviolet (UV) rays from sunlight trigger
vitamin D synthesis in the skin.
Season, latitude, time of day,
cloud cover, smog, and suncreens affect UV ray exposure. For example, in
Boston the average amount of sunlight is insufficient to produce significant
vitamin D synthesis in the skin from November through February.
Sunscreens with a sun protection
factor of 8 or greater will block UV rays that produce vitamin D.
Vitamin D supplements are often
recommended for exclusively breast-fed infants because human milk may not
contain adequate vitamin D.
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Vitamin D and Bone Health
It is estimated that over 25
million adults in the United States have, or are at risk of developing
osteoporosis. Osteoporosis is a disease characterized by fragile bones. It
results in increased risk of bone fractures.
Rickets and osteomalacia were
recognized as being caused by vitamin D deficiency 75 years ago; their
prevention and cure with fish liver oil constituted one of the early triumphs
of nutritional science. The requirement for vitamin D has been pegged to these
disorders ever since.
Having normal storage levels of
vitamin D in your body helps keep your bones strong and may help prevent
osteoporosis in elderly, non-ambulatory individuals, in post-menopausal women,
and in individuals on chronic steroid therapy.
Researchers know that normal bone
is constantly being remodeled (broken down and rebuilt). During menopause, the
balance between these two systems is upset, resulting in more bone being
broken down (resorbed) than rebuilt.
Vitamin D deficiency has been
associated with greater incidence of hip fractures. A greater vitamin D intake
from diet and supplements has been associated with less bone loss in older
women. Since bone loss increases the risk of fractures, vitamin D
supplementation may help prevent fractures resulting from osteoporosis.
The use of vitamin D is well
accepted, but the mere absence of clinical rickets can hardly be considered an
adequate definition either of health or of vitamin D sufficiency.
The fact that it takes 30 or more
years to manifest itself makes it no less a deficiency condition than a
disorder that develops in 30 days. It is easy to understand how long-period
deficiency diseases could never have been recognized in the early days of
nutritional science, but with modern methods and a better grasp of the
relevant physiology, failing to recognize a slowly developing condition as a
true deficiency state, can no longer be justified.
Vitamin D nutrition probably
affects major aspects of human health, as listed below, other than its
classical role in mineral metabolism. The rest of the article addresses some
of the newly recognized uses of vitamin D.
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Cancer
Today, it is well established
that besides playing a crucial role in the establishment and maintenance of
the calcium in the body, the active form of vitamin D also acts an effective
regulator of cell growth and differentiation in a number of different cell
types, including cancer cells.
Laboratory, animal, and
epidemiologic evidence suggest that vitamin D may be protective against some
cancers. Clinical studies now show vitamin D deficiency to be associated with
four of the most common cancers:
- Breast (23)
- Prostate 24-27
- Colon 28-31
- Skin 32,33
Diabetes
Vitamin D deficiency has been
associated with insulin deficiency and insulin resistance. (1-3) In fact, last
year it was shown that vitamin D deficiency is likely to be a major factor for
the development of type one diabetes in children. (4)
Heart Disease
Insulin resistance is also one of
the major factors not only leading to the cancers mentioned above, but also to
the number one killer in the US, heart disease. Northern countries have higher
levels of heart disease and more heart attacks occur in the winter months.
(5,6)
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Arthritis
Progression of degenerative
arthritis of the knee and hip is faster in people with lower vitamin D
concentrations (33-34)
Infertility and PMS
Infertility is associated with
low vitamin D(7), and PMS has been completely reversed by addition of calcium,
magnesium and vitamin D.(8)
Fatigue, Depression and
Seasonal Affective Disorder
Activated vitamin D in the
adrenal gland regulates tyrosine hydroxylase, the rate limiting enzyme
necessary for the production of dopamine, epinephrine and norepinephrine.
Low vitamin D may contribute to
chronic fatigue and depression. (9-10) Seasonal Affective Disorder has been
treated successfully with vitamin D. In a recent study covering 30 days of
treatment comparing Vitamin D and 2 hour daily use of 'light boxes',
depression completely resolved in the D group, but not in the light box
group.(11)
Autoimmune Disorders
Multiple Sclerosis, (12)
Sjogren's Syndrome, rheumatoid arthritis, thyroiditis and Crohn's disease have
all been linked with low vitamin D levels.
Single, infrequent, intense, skin
exposure to UV-B light suppresses the immune system and causes harm.
However chronic low-level
exposure normalizes immune function and enhances immune cell production. This
reduces abnormal inflammatory responses such as found in autoimmune disorders,
and reducing occurrences of infectious disease. (14-18)
Obesity
Vitamin D deficiency has been
linked with obesity. (18, 19) Vitamin D has recently been shown to lower
leptin secretion. (20) Leptin is a hormone produced by fat cells and is
involved in weight regulation. It is thought that the hormone signals the
brain when fat cells are "full," but exactly how the hormone
controls weight is not entirely clear.
Additionally, obesity by itself
probably further worsens vitamin D deficiency due to the decreased
bioavailability of vitamin D(3) from skin and dietary sources, because of its
being deposited in body fat. (36)
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Syndrome
X
Vitamin D deficiency has been
clearly linked with Syndrome X. (21) Syndrome X refers specifically to a group
of health problems that can include insulin resistance (the inability to
properly deal with dietary carbohydrates and sugars), abnormal blood fats
(such as elevated cholesterol and triglycerides), overweight, and high blood
pressure.
Vitamin D and Steroids
Steroids, like prednisone, are
often prescribed to reduce inflammation from a variety of medical problems.
These medicines may be essential for a person's medical treatment, but they
have potential side effects, including decreased calcium absorption.
There is some evidence that
steroids may also impair vitamin D metabolism, further contributing to the
loss of bone and development of osteoporosis associated with steroid
medications. For these reasons, individuals on chronic steroid therapy should
consult with their physician or registered dietitian about the need to
increase vitamin D intake through diet and/or dietary
supplements.
The above document was edited
from:
National Institutes
of Health Document on Vitamin D
DR. MERCOLA'S COMMENT:
I wish to express my sincere
appreciation to nutritionist Krispin Sullivan for the years she researched
this subject, which provided me with so much of the foundational background
for this review. She is publishing the definitive resource for vitamin D later
this year called Naked at Noon.
References
1. Hypponen E, Laara E, Reunanen A, Intake of
vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet. 2001 Nov
3;358(9292):1500-3.
2. Billaudel B, Barakat L, Faure-Dussert A.
Vitamin D3 deficiency and alterations of glucose metabolism in rat endocrine
pancreas. Diabetes Metab 1998;24:344-50.
3. Bourlon PM, Billaudel B, Faure-Dussert A.
Influence of vitamin D3 deficiency and 1,25 dihydroxyvitamin D3 on de novo
insulin biosynthesis in the islets of the rat endocrine pancreas. J.Endocrinol.
1999;160:87-95.
4. Ortlepp JR, Lauscher J, Hoffmann R, The
vitamin D receptor gene variant is associated with the prevalence of type 2
diabetes mellitus and coronary artery disease. Diabet Med. 2001
Oct;18(10):842-5.
5 Segall JJ. Latitude and ischaemic heart
disease [letter]. Lancet 1989;1:1146.
6 Williams FL, Lloyd OL. Latitude and heart
disease [letter]. Lancet 1989;1:1072-3.
7. Panda DK, Miao D, Tremblay ML, Targeted
ablation of the 25-hydroxyvitamin D 1alpha -hydroxylase enzyme: evidence for
skeletal, reproductive, and immune dysfunction. Proc Natl Acad Sci U S A. 2001
Jun 19;98(13):7498-503.
8. Thys-Jacobs S. Micronutrients and the
premenstrual syndrome: the case for calcium. J.Am.Coll.Nutr. 2000;19:220-7.
9. Puchacz E, Stumpf WE, Stachowiak EK,
Stachowiak MK. Vitamin D increases expression of the tyrosine hydroxylase gene
in adrenal medullary cells. Brain Res.Mol.Brain Res. 1996;36:193-6.
10. : Gloth FM 3rd, Alam W, Hollis B. Vitamin
D vs broad spectrum phototherapy in the treatment of seasonal affective
disorder. J Nutr Health Aging. 1999;3(1):5-7.
11. Gloth FM, III, Alam W, Hollis B. Vitamin
D vs broad spectrum phototherapy in the treatment of seasonal affective
disorder. J.Nutr.Health Aging 1999;3:5-7.
12 : Hayes CE. Vitamin D: a natural inhibitor
of multiple sclerosis. Proc Nutr Soc. 2000 Nov;59(4):531-5.
13. McMichael AJ, Hall AJ. Multiple sclerosis
and ultraviolet radiation: time to shed more light.Neuroepidemiology. 2001
Aug;20(3):165-7.
14. Deluca HF, Cantorna MT. Vitamin D: its
role and uses in immunology. FASEB J. 2001 Dec;15(14):2579-85.
16. Long KZ, Santos JI. Vitamins and the
regulation of the immune response. Pediatr.Infect.Dis.J. 1999;18:283-90.
17. Ghezzi A, Zaffaroni M. Neurological
manifestations of gastrointestinal disorders, with particular reference to the
differential diagnosis of multiple sclerosis. Neurol Sci 2001 Nov;22 Suppl
2:S117-22
18 Cantorna MT. Vitamin D and autoimmunity:
is vitamin D status an environmental factor affecting autoimmune disease
prevalence? Proc.Soc.Exp.Biol.Med. 2000;223:230-3
19 Shi H, Norman AW, Okamura WH, Sen A, Zemel
MB.1alpha,25-Dihydroxyvitamin D3 modulates human adipocyte metabolism via
nongenomic action. FASEB J. 2001 Dec;15(14):2751-3
20 Speer G, Cseh K, Winkler G, Vitamin D and
estrogen receptor gene polymorphisms in type 2 diabetes mellitus and in
android type obesity. Eur J Endocrinol. 2001 Apr;144(4):385-9.
21 Henendez C, Lage M, Peino R, Retinoic acid
and vitamin D(3) powerfully inhibit in vitro leptin secretion by human adipose
tissue.J Endocrinol. 2001 Aug;170(2):425-31
22 Boucher BJ. Inadequate vitamin D status:
does it contribute to the disorders comprising syndrome 'X'? [published
erratum appears in Br J Nutr 1998 Dec;80(6):585]. Br.J.Nutr. 1998;79:315-27.
23 Grant WB An ecologic study of dietary and
solar ultraviolet-B links to breast carcinoma mortality rates.Cancer 2002 Jan
1;94(1):272-81
24 Polek TC, Weigel NL. Vitamin D and
prostate cancer. J Androl. 2002 Jan-Feb;23(1):9-17.
25 Luscombe CJ, French ME, Liu S, Prostate
cancer risk: associations with ultraviolet radiation, tyrosinase and
melanocortin-1 receptor genotypes.Br J Cancer. 2001 Nov;85(10):1504-9.
26 Hansen CM, Binderup L, Hamberg KJ, Vitamin
D and cancer: effects of 1,25(OH)2D3 and its analogs on growth control and
tumorigenesis. Front Biosci. 2001 Jul 1;6:D820-48.
27 Tuohimaa P, Lyakhovich A, Aksenov N,
Vitamin D and prostate cancer. J Steroid Biochem Mol Biol. 2001
Jan-Mar;76(1-5):125-34
28 Mokady E, Schwartz B, Shany S, A
protective role of dietary vitamin D3 in rat colon carcinogenesis. Nutr
Cancer. 2000;38(1):65-73.
29 Platz EA, Hankinson SE, Hollis BW, Plasma
1,25-dihydroxy- and 25-hydroxyvitamin D and adenomatous polyps of the distal
colorectum.Cancer Epidemiol Biomarkers Prev. 2000 Oct;9(10):1059-65.
30 Tangpricha V, Flanagan JN, Whitlatch LW,
25-hydroxyvitamin D-1alpha-hydroxylase in normal and malignant colon tissue.
Lancet. 2001 May 26;357(9269):1673-4.
31 Lamprecht SA, Lipkin M. Cellular
mechanisms of calcium and vitamin D in the inhibition of colorectal
carcinogenesis. Ann N Y Acad Sci. 2001 Dec;952:73-87.
32 Majewski S, Kutner A, Jablonska S. Vitamin
D analogs in cutaneous malignancies.Curr Pharm Des. 2000 May;6(7):829-38.
33 Braun MM, Tucker MA. A role for
photoproducts of vitamin D in the etiology of cutaneous melanoma? Med
Hypotheses. 1997 Apr;48(4):351-4.
34 McAlindon TE, Felson DT, et al. Relation
of dietary intake and serum levels of vitamin D to progression of
osteoarthritis of the knee among participants in the Framingham Study. Ann
Intern Med 1996; 125: 353-359
35 Lane NE, Nevitt MC, Gore LR, Cummings SR.
Serum levels of vitamin D and hip osteoarthritis in elderly women: a
longitudinal study. Arthritis Rheum 1997; 40(suppl): S238.
36. Wortsman J, Matsuoka LY, Chen TC,
Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin
Nutr. 2000 Sep;72(3):690-3)
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