Grandkids on the beach
MD and I just got back from yet another cross-country trip, which gave me the opportunity to catch up on my reading.  While reading a golf magazine, of all things, I came across an article that demonstrates why all such articles should be taken with a grain of salt.  I can’t tell you how many letters MD and I get from people who become concerned because they read a piece in a magazine or newspaper that, for whatever reason, got under their skin.  So, I thought dissecting this article like I did a while back with a scientific study would be instructive.
Before taking these kinds of pieces seriously, you’ve got to realize how they are structured.  And believe me, they are as structured as a sonnet.
Freelance writers are always trying to get their pieces sold, and they write them to a formula that most magazines demand, which is why most of them are pretty much the same.  Just switch the experts and the subjects and you’ve got an article on most anything.  Magazine editors give writers assignments often telling them what they want the article to say and how many words they want it said in.  The writer’s job is to follow the format, cram the info into the required number of words and sound authoritative.
Your job as a reader is to realize this structure and plumb it for any valid info while not being distracted by the authorial sleight of hand.
This particular article, appearing in the July 2009 edition of Golf Digest, is cleverly titled “The vitamin D-bate,” and was written by an author with the initials RK.  I’m not trying to hide the name of the author to prevent embarrassing him or her – that’s how the author was listed at the end of the article
These pieces typically hew to the following format: they start with a lede that poses a dilemma followed by an introductory paragraph or two expanding upon the problem; they then have a statement from one ‘expert’ followed by a dissenting statement by another ‘expert;’ then they neatly tie the whole thing up with a pronouncement by the ultimate ‘expert’ who sagely answers the question posed in the lede.  All neat and tidy – and typically wrong.  In the case of the article under discussion, not only wrong, but breathtakingly stupid.
The lede for The vitamin D-bate is the subtitle of the piece.

Sun exposure is a source, but how much is necessary to stay healthy?

Since most golfers spend a fair amount of time in the sun, this should be of interest to them.  So, let’s read on to see how much vitamin D we really need.
After the lede we get the introductory paragraph.

In the vitamin world, D has become a rock star of late, with some experts claiming it might protect against cancer and reduce high blood pressure.  And we already know it’s essential for maintaining bone density and a functioning immune system.

Okay, articles are popping up all over about the benefits of vitamin D, and we’re convinced of its importance.  So how do we get it?
RK turns to the first ‘expert’ for advice.

It’s such an important vitamin that in May, the Skin Cancer Foundation doubled the recommended minimum daily intake from 10 micrograms to 25 (or 1,000 iu) for anyone younger than 50 who has limited sun exposure (including those who always wear sunscreen to protect their skin against the sun’s harmful rays). Ideally, the SCF says, people 18 or older should get up to 50 micrograms [2000 IU] per day.
Although the sun’s ultraviolet B rays help the body synthesize vitamin D, the SCF insists that the sun is not necessary to obtain sufficient amounts.  It suggests getting vitamin D from supplements and food such as milk, yogurt, egg yolks and oily fish (salmon, mackerel, cod).

At this point we need to ask ourselves ‘what is the expertise of the Skin Cancer Foundation?’  If we go to the SCF website, we discover that this foundation has been around for about 30 years and is underwritten by the cosmetics and skin care product companies.  Hmmm.  Maybe not the most reliable ‘experts’ on vitamin D.
But our freelancer has the needed quote to set up the debate.  Now RK decides to call the Vitamin D Council to come down on the opposite side of the debate. (The vitamin D Council really is the expert in this debate.) To get the debate going, however, RK needs to ask something provocative of whomever he speaks to at the Vitamin D Council. If this spokesperson tells RK essentially the same thing that the spokesperson from the SCF did, then there is no debate.  So, RK has to ask the right question to get the needed quote.
RK probably tees the question up much like this: I’ve been told by others that sun exposure isn’t necessary and that all one has to do to get enough vitamin D is to take a daily multivitamin and drink plenty of milk.  Is this true?
Of course the Vitamin D Council spokesperson is going to heartily disagree (and rightfully so) because it takes much more than that if there is no sun exposure.  (The Vitamin D Council recommends somewhere in the neighborhood of 5,000 IU per day, followed up with blood tests for levels.)  Now RK has the other side of the debate because the Vitamin D Council obliges.

However, the Vitamin D Council disagrees: “If one regularly avoids sunlight exposure…to obtain this amount from milk, one would have to drink 50 glasses.  With a multivitamin, more than 10 tablets would be necessary.  Neither is advisable.”

MD and I have played this little game countless times with freelancers.  So much so, in fact, that we’re really reluctant to speak with them because we never know where we’re going to end up in the article.  Usually the interviews are 20-30 minutes long, and end up with one sentence being quoted, and often quoted out of context.  I imagine RK spoke with someone from the Vitamin D Council for that much time, if not longer.  And used this one short quote.
RK really had to work to make this a debate to follow the format. The SCF spokesperson said that people who got little sun exposure needed to take supplements, and, in fact, recommended that ideally people should get up to 2,000 IU per day, which is way more than any daily multivitamin contains.  So, the SCF and the Vitamin D Council are more in agreement than they are apart, but RK has selectively quoted to make it seem like a disagreement.
Now, following the format, RK has to bring in a moderator and give us the final answer we’ve all been waiting for.

So, what should you believe?

Are you ready?

According to dermatologist Michael Kaminer, who treats hundreds of patients with skin cancer annually, the best thing to do is find a middle ground.

Well, the SCF recommends 2,000 IU per day and the Vitamin D Council recommends 5,000 IU per day, so is the middle ground 3,500 IU per day, an amount that splits the difference?
Not quite.

“During long, dark winters where we are covered in clothes, I take vitamin D supplements,” says Kaminer. “But in the summer, grease up with sunscreen, drink some milk, and hit the golf course! You’ll be swimming in vitamin D.”

Oh, really?
I told you it was breathtakingly stupid.
Does this guy understand that ultraviolet B (UVB) rays are what both make vitamin D and burn the skin?  If you put on sunscreen that blocks UVB, then you block the production of vitamin D.  Pretty much completely. Even weak sunscreens with an SPF of 8 block 95 percent of vitamin D synthesis.  So greasing up with sunscreen is definitely not going to have you “swimming in vitamin D.”
In fact, if you’re not careful, you’ll end up more prone to the worst kind of skin cancer: melanoma.  Why?  Because a sunburn is nature’s way of telling you you’re getting too much sun.  Unless you’re a moron, you get out of the sun before you get badly burned.  With graduated sun exposure you develop a tan, which prevents burning because the tan blocks the UVB much like a sunscreen does.  But the tan blocks UVA also.  UVA is the wavelength that doesn’t really burn but does stimulate the melanocytes (the pigment producing cells), which can cause melanoma.  If you slather on the sunscreen and stay out in the sun all day, you don’t get burned, but you do get a ton of UVA, which, until fairly recently, wasn’t blocked by sunscreen.  Now sunscreens contain agents that block both UVB and UVA, but no one knows yet whether these will prevent melanoma in the long run.
The paradox of melanoma is that this cancer typically develops as a response to too much sun but people with chronic sun exposure incur it less frequently than those with sporadic sun exposure.  This paradox can be easily explained.  Those who are out in the sun a lot develop a tan.  The tan blocks UVA, so there is less of the simulation for melanoma.  Those who go into the sun occasionally – office workers who vacation at the beach for a week – use sunscreen and stay out too long, receiving way too much UVA. UVA that increases the risk for melanoma.
I didn’t intend this to be a discourse on melanoma, sunscreens and vitamin D, but the idiotic response given by the ‘ultimate’ authority in our Golf Digest article got me going.
The take-home message from this post is to look for the pattern in these kinds of articles because they’re pretty much all the same.  You end up with a freelance writer arranging the experts to prove whatever the freelance writer – who is certainly no expert – wants to prove.  Or it may not even be what the freelancer wants to prove, but it is a function of how the best quotes fit with the structure of the piece.  “Grease up,” “hit the golf course,:” “swimming in vitamin D” – all are more pithy and memorable than any of the quotes above them.  Chances are RK wanted to end the piece with a bang, so he/she used the better quote giver as the ultimate expert.
Just remember, these kinds of pieces are put together more for their style than their content, so don’t put much faith in their accuracy.
More on vitamin D:
For info on the sun, vitamin D and its relationship with folate, click here.
Also, here is a great calculator designed by Norwegian scientists to determine how long you need to spend in the sun at various times of the year and various latitudes to get 1000 IU of vitamin D.  I recommend at least 5 times this amount to get 5,000 IU.
Click here to get a chart of US latitudes and longitude.
H/T to Annlee Hines for providing the link.

128 Comments

  1. With the recent popularity of Vitamin d, I have wondered if these experts ever think about the fact that Vitamin d only comes from two sources: the sun and animal fats, the very two things we are supposed to avoid.
    Taking vitamin D supplements may be fine, but our need for vitamin d should teach us something about what our diet and sun exposure should be.

    1. Dr Eades,
      do you have any idea as to what effect UVB-blocking antioxidants such as carotenoids have on vitamin D intake from sunlight?
      I understand that studies have shown no statistical increase in melanoma (as we might expect if they block tan but not UVA – if this is in fact the case), but I cannot find any linking antioxidants to vitamin D conversion.
      I find I don’t burn or tan at all due to the antioxidants I take for Hep C. So I am careful to supplement some cod liver oil in summer, extra vit D in winter, regardless of sunlight exposure.
      If antioxidants block vit D conversion even slightly this might be significant for those in high latitudes, on low-saturated fat diets. It might explain the CARET study results, for example.
      I’m surprised that no-one seems to have studied it.

        1. I checked, and carotenoids do block UVA as well as UVB (in fact carotenoid sunscreens – the ubiquitous colourless carotene precursors phytoene and phytofluene – are being developed specifically to block UVA).
          One thing about carotenoids is that, in plants, they are used to catch photon energy and conduct it across the chloroplast; they don’t just quench the solar energy, but pass it on quickly and safely to where it gets used in photosynthesis.
          If this applied to humans, carotenoids might actually facilitate Vit d conversion – but that’s a very big if!
          On the other hand, if lipid-soluble antioxidants are very slightly decreasing vit d conversion in those people who are already very vit d deficient, it might explain the lack of expected benefit in large epidemiological studies – especially those from high northern latitudes, or in hospitalised populations.

  2. Actually, it is most likely this writer never even spoke with anyone from our organization.
    The quote used:
    “If one regularly avoids sunlight exposure…to obtain this amount from milk, one would have to drink 50 glasses. With a multivitamin, more than 10 tablets would be necessary. Neither is advisable.”
    is lifted straight from our homepage, and therefore accessible to anyone, whether they have spoken with the Council or not.
    There is a plethora of mis-information – as well as dis-information – in regards to vitamin D and sun exposure out there, thank you for bringing attention to this matter in your article.
    My pleasure.

  3. Great post. Many thanks, Dr. Eades!!
    I’m a believer! I started taking 1,000 IU of Vitamin D per day early last year, and found that an unexplained chronic pain I’d had in my foot for many years disappeared within two weeks. After that, I followed up with some research, and now take a daily dose closer to the 5,000 IU you recommend. My Vitamin D supplementation was like a *last straw* on the camel’s back that tipped my health profile from worsening to improving!! I continue to feel better and better all the time.
    On another note: A month ago, I read The Rosedale Diet. While reading, I was wondering if a bit of fasting or meal skipping would improve letpin and insulin sensitivity even more than always eating the recommended 3 meals a day. But Rosedale doesn’t address that in the book. So I cut my meals from 6 to only 3 per day, and increased the time between meals, in an effort to improve leptin & insulin sensitivity. After only one week of eating fewer meals, I started to feel better. I also felt my clothes loosen a little, but did not seem to lose much actual weight. Overall, the change seemed to be an improvement, so I kept up the increased time between meals.
    Last week, I read your archived posts about imtermittent fasting. I googled around a bit, and decided to try it out. I’m happy to report that I’m now feeling better than I have in a few years. I fasted extensively before I had blood sugar issues, but when my blood sugar got to a certain level of instability, I mostly had stopped fasting and started eating frequent meals in an effort to stabilize my blood sugar without going on the meds. I was already eating Low Carb, of course!
    IF seems to start reducing insulin resistance very quickly, though I have not tested that hypothesis with labwork. I do know that I feel great, I’m starting to lose some weight again (which has been nearly impossible since the onset of menopause). Now, I don’t have to eat when I’m not hungry. I don’t have to panic when my food is delayed. I don’t have to run my whole life by my feeding schedule. What a huge burden has been lifted!
    I’m glad to hear you’ve done so well. Keep it up.

  4. Great post Dr. Mike. I look forward to reading all your blog posts. Would love it if you would do a post regarding vitamin D, calcium and osteoporosis. I read this article “Why dairy products won’t help you maintain your bones” but there were some statements in it that were a bit “off” I think. http://www.milksucks.com/osteo.asp
    Thank you for sharing your reading and research with your blog readers. I for one really appreciate your point of view on the health and medical topics.

  5. I found the calculator very useful, thanks.
    I also find it amusing that the same people who will sit out in the sun all day, covered in spf 75, will raise an eyebrow when they hear that I try to get 20-30 minutes of direct exposure any day I can.
    The today show had a similar piece a few weeks ago, no doubt paid for by milk farmers, that drew the same conclusions as this piece. The only way to get the necessary 1k IU without getting cancer or heart disease, is to drink skim milk and take a multivitamin.

  6. Dr Eades,
    An excellent post.
    Slightly off topic, as a lay person, I read the article by Oh et al in the Journal Circulation, to which you recently referred in a tweet. As the title suggests, this study appears to set out the bio-chemical mechanism, supported by quite good evidence, by which Vitamin D sufficiency discourages heart disease in obese Type 2 diabetics. It also suggests that Vitamin D does not play this role in non-diabetic subjects, with or without sufficient Vitamin D.
    All of this inferred to me that reasonably tight regulation of blood sugar levels was the key to avoiding conversion of cholesterol into macrophages in nearly everyone, followed by Vitamin D supplementation, particularly if one was a Type 2 diabetic. However, instead of mentioning anything along these lines, in the article the suggestion was made that there was a need to develop a drug to modify Vitamin D signaling (via VDR).
    Assuming that I have read the study correctly, the recommendation to develop a therapeutic (which will inevitably be expensive and take years) seems a little weird, as it does not address the root cause, namely excessive glucose in the blood stream, which appears to feed the whole cycle, or the cheaper remedy of increasing Vitamin D levels for Type 2 diabetics.
    Any thoughts?
    I think your analysis is correct. People that do these studies are always interested in using the data to come up with some kind of drug instead of using it to encourage people to follow a lifestyle change that solves the problem.

  7. “Freelance writers are always trying to get their pieces sold, and they write them to a formula that most magazines demand, which is why most of them are pretty much the same. Just switch the experts and the subjects and you’ve got an article on most anything. Magazine editors give writers assignments often telling them what they want the article to say and how many words they want it said in. The writer’s job is to follow the format, cram the info into the required number of words and sound authoritative.”
    The above is one of the reasons I keep coming back to your blog. Not only is it exceptionally informative on the subject of medicine, biology, metabolism, nutrition and anthropology (amongst many other disciplines), but you also expose the seedy underbelly of the media. Excellent stuff!
    Keep up the good work,
    *One thing, your wrote “slight of hand” rather than “sleight of hand” 😛
    Thanks for the heads up on the typo. I got it fixed.

  8. Question: If you get sun regularly, and have a nice tan, are you blocking the UVB that gives you the Vitamin D? Do you need a supplement even if you keep a good tan?
    The tan does cut it down some, but if you are out long enough to maintain the tan, I think you’re okay.

  9. What a terrific post. I wish it could be read by all the pasty-faced heliophobes who chastise my suntanned family, especially our children- they are little brown bugs by this point in the summer and the only sunscreen they use regularly is a physical zinc oxide barrier for their faces. Apparently their sun exposure is akin to child abuse in some circles. Wait ’til they find out how much grass-fed beef my kids eat…somebody call Children’s Services…
    Better be careful or the do-gooders will have you in for something.

  10. I’m glad the webmaster of the Vitamin D Council website chimed in here. By pure coincidence I was browsing their website yesterday and remembered seeing those exact sentences. So, the “interview” was just a lazy-ass copy/paste job.
    But having worked for a multi-magazine publisher for a number of years, I know their response to any complaints about their content would be: “Huh what? We’re a golf magazine. What do we know about freakin vitamins. Now, did you say you want a full-page back cover ad for your vitamin D product? We’re reserving this spot just for you. Hurry though, someone else wants that spot.”

  11. Now that you’ve spelled it out in all capitals, I recognize that pattern you are talking about. It is in articles all the time!

  12. Vit D tested at 15 Sep08: 50K D2 for 8 wks, then D3 1K/day. Dec08, tested at 28, so upped intake D3 to 2K/day. Jun09 tested 30; just upped D3 to 4K/day. I avoid sunshine as I burn in 6 mins (over a day) exposure…better living thru drugs *sigh* and a childhood of blistering sunburns in So Fla. Mom has had a squamous cell cancer on forehead excised successfully and have 2 friends whose visits to Derms sees them coming away with less skin each trip. It’s a real dilemma now for those of us who took the sunshine is good to heart in the ’50s. I’m hoping the 4K/day will see my levels rise.
    Thanks for the analysis of how these articles are structured…interesting. No wonder readers are easily suckered, er…manipulated into the pre-determined PC views, esp if they read little beyond these entertainment fluff, er…’articles’ which seems the norm these days.
    OT: 125 mgs Grape Seed Extract has eliminated my outta control appetite making it so much easier to stick to very low carb…hadn’t done a thing for keeping me off the wt loss plateau I’ve been on for 6 mos…9/8 release can’t come too soon for your book and maybe some help. Might try reducing frequency of eating a la posters having success with that tactic IF my BGs remain stable. Considering taking iodine (seaweed yuck) to lower TSH from the 4+ it’s been since Dec08; however, with normal free T4 & T3, I’m not sure it’d accomplish much. Feel so frustrated by stall! Could my barely normal levels of D be tied to this stall?
    I’m not sure that the blame can be laid at the doorstep of low vitamin D, but I don’t think it helps any.

  13. And doesn’t it just make you want to tear your hair out that articles like this is where most people get their health information?

  14. Thanks for the tip on magazine articles; now that you explain it, I realize I’ve read lots with that formula, usually in fluff mags.
    A question about melanoma–doesn’t it tend to appear randomly, not necessarily in sun exposed parts of the body? My brother who always wears long pants got it on his lower leg (doing well now). Thanks
    Doesn’t always appear randomly but can.

  15. I try to get D for myself and kids from the sun in the summer months, but I have one question about this. I have read that to synthesis D one must be in the sun in the PTHs (11ish-2ish). Is this true? If so, would it be better to use a zinc oxide block After 2 o’clock to block UVA (since you may not be getting much D anymore anyway…)?
    Sure.

  16. Cardiologist William Davis says D3 tablets often don’t actually raise your D level, it needs to be gelcaps. I think this would be a good research program that would cost practically nothing and take a few weeks, Then we would know if it’s true or not. Lots of people take tablets because it’s cheaper.

  17. Dr. Mike, I have at least 5 books on what it takes to be a freelance writer, and none of them explained how to write an article as well as you just did. And I would have the advantage of actually doing real research to present real information. But now that I think about it, maybe the editors wouldn’t think real information was such a good thing.. any way thanks for pulling aside the curtain.. another Oz has been exposed. 🙂
    BTW I love your blog!

  18. Thank you Dr. Eades.
    FWIW, I live in a tropical climate, I’m not retired yet, so still spend 5 days a week in the office (I try and spend 20-30 minutes a day outside mid-day) I still supplement with 2000 iu a day. Should I be taking more?
    Very apreciative of your part in my education about so many things 😉
    Marc
    Can’t tell precisely unless you get your 25(OH)D levels checked. But it’s probably enough.

  19. Would it not be perfectly fine to “grease on the sunblock” as long as you use the appropriate amount for the situation? For instance, according to that calculator you linked, I will get 5000 IU’s of Vitamin D in about 15-20 minutes where I am. If I am going to “hit the golf course” for 3 or 4 hours, I would be burnt to a crisp by then! So of course I am going to “grease on the sunscreen” – I presumably will get enough Vit D in that time, and not be burnt… I don’t see the issue with that quote, unless I am missing something…
    You’re missing something. If you “grease on the sunscreen” before you go out, you won’t get much of any vitamin D. If you want to go ungreased for a few holes, the grease up, you’ll probably be okay. But you need 25(OH)D levels checked to know for sure.

  20. Thinking I spotted a typo, I became less convinced after you had used “lede” four times at the top of this article. So I had to look it up. Apparently journalists changed the spelling of “lead” to “lede” years ago after people consistently got it confused with “pencil lead” vs. “follow my lead.” Interesting that I had never noticed this before.
    Oh, and thanks for exposing the Vitamin D fluff piece. As in most “fluff” pieces, I rolled my eyes when I read this one too. Unfortunately, this particular magazine is increasingly relying on these types of pieces and straying from their main content … golf. I can barely read it any more … or hardly find the content amongst the advertising.

  21. I’ve always avoided the sun because I burn easily, so I assume I’ve been deficient in vitamin D pretty much my whole life. The glass of milk a day (which I later gave up) contains a ridiculously small amount of vitamin D. Taking 5,000 IU of vitamin D3 supplements for a few months got me up to 45 ng/ml:
    http://inhumanexperiment.blogspot.com/2009/07/blood-test-analysis-my-experience-with.html
    Which is in the optimal range and with almost no sun exposure. Whenever I tell people about the 5,000 IU I’m taking, they say it must be way too much, because the strongest supplements they sell here in Finland are only 400 IU per capsule (and really expensive). So they take the 400 IU, and spend a little time in the sun (no full body exposure, of course) and think they must have optimal serum levels. I don’t blame them for not getting tested, though, because it costs 100 euros!
    Btw, what’s your opinion on the necessity of vitamin A and vitamin K when supplementing with vitamin D?
    – JLL
    Too much for a comment. I should do a post on it.

  22. I have a minor hypothesis about sugar. I’m very fair and I have Northern European ancestors. (By the way, sucrose is plant antifreeze.) We of the transparent skin -I like to say I can sunburn in a full moon- tend to have higher blood sugar and that acts as antifreeze for us as well as plants. Why? This is postulated to have been protective and adaptive during ice ages for the northern dwelling folks. Fast forward to the late 20th and early 21st centuries and now I’m being poisoned by excess blood sugar. My forebears also cultivated cows and other milk producers earlier than Middle Easterners and Africans because the north had a shorter growing season. The majority of the people on the planet can’t tolerate milk, but I can. Milk consumers of yore got most of their vitamin D, fat and calories in the cold, dark north this way probably.
    Anyway, I have some health problems that I think were caused because of all the sugar, wheat flour and Frankenfats I consumed up until about 1 year ago. I’m annoyed further.
    I forwarded the lecture (Sugar:the Bitter Truth, Dr. Lustig, UCSF mini med school) to a science colleague. She read Taubes on my suggestion and says she will be showing the lecture in her class after the unit on metabolism. Another colleague says he will be using Taubes for teaching “Good Science, Bad Science”. I’m preaching the low-carb gospel to anyone and everyone who will listen, and to some who don’t at first appear interested.
    On a lighter, unrelated note, from Jimmy Moore I’ve gotten a recipe for cauliflower fauxtatoes I can’t stop making. Steam a head until mushy; mash in a pot with melted butter and add 1/4 cup heavy cream. Then add salt and pepper and as much grated cheese of any variety you like until the cheese melts. I go through a couple of heads of ‘liflower per week and I drive my kids nuts by using the word fauxtatoes too much and every chance I get.
    MD has a number of fauxtato recipes. That’s what we called them on our TV show. You can also do it with celery root, which I like better.

  23. Hi Mike,
    Thanks for another article on Vitamin D… something I’m very interested in (actually I did my biochemistry thesis on finding new transcriptional control elements in the promoter region of CYP24 which bind to RXR and the vitamin D receptor years ago, before I changed fields).
    Anyway, I recently came across a paper by Trevor Marshall which mentioned a potential difference between biochemical results of sun-exposure vs dietary vitamin D3 — for example VDR activity can be suppressed apparently by oral doses, but enhanced by sun. I am a novice in vitD research these days as I’ve moved on and forgotten a lot… but this has changed my approach AWAY from supplmentation towards daily sun-exposure (I live in a tropical climate) as Marshall implies oral vitD3 in large doses may be very counter-productive as is over-simplistic in it’s approach.
    Just wondering if you have any take on this since the article I came across was very lacking in detail and I haven’t tracked down more research yet. Seems interesting though.
    Thanks again,
    Michael
    P.S. Abstract below
    ———————–
    Vitamin D discovery outpaces FDA decision making
    Trevor G. Marshall *
    School of Biological Sciences and Biotechnology, Murdoch University, Western Australia
    email: Trevor G. Marshall (trevor.m@autoimmunityresearch.org)
    *Correspondence to Trevor G. Marshall, Autoimmunity Research Foundation, California Foundation, 3423 Hill Canyon Ave. Thousand Oaks, California 91360.
    ABSTRACT
    The US FDA currently encourages the addition of vitamin D to milk and cereals, with the aim of reducing rickets in children and osteoporosis in adults. However, vitamin D not only regulates the expression of genes associated with calcium homeostasis, but also genes associated with cancers, autoimmune disease, and infection. It does this by controlling the activation of the vitamin D receptor (VDR), a type 1 nuclear receptor and DNA transcription factor. Molecular biology is rapidly coming to an understanding of the multiplicity of roles played by the VDR, but clinical medicine is having difficulty keeping up with the pace of change. For example, the FDA recently proposed a rule change that will encourage high levels of vitamin D to be added to even more foods, so that the manufacturers can claim those foods reduce the risk of osteoporosis. The FDA docket does not review one single paper detailing the transcriptional activity of vitamin D, even though, on average, one new paper a day is being published on that topic. Nor do they review whether widespread supplementation with vitamin D, an immunomodulatory secosteroid, might predispose the population to immune dysfunction. This BioEssay explores how lifelong supplementation of the food chain with vitamin D might well be contributing to the current epidemics of obesity and chronic disease. BioEssays 30:173-182, 2008. © 2008 Wiley Periodicals, Inc.
    This has been kicking around for a while. The Vitamin D Council deals with it on their site.

  24. “But in the summer, grease up with sunscreen, drink some milk, and hit the golf course! You’ll be swimming in vitamin D.”
    I would characterize this assertion as nothing short of gross negligence. Without data on 25-OH-D levels in a cross section of the population there is no proof to support this statement. To the contrary numerous studies suggest that around 90% of those in Northern countries such as Canada are deficient in terms of meeting the minimal blood levels of vitamin which is 40 nmol/L in Canada. A recent study found 32% of Canadian toddlers were deficient in terms of meeting US blood level standards which for some reason are lower than Canadian standards. If Canadian standards were to applied 78% would be deemed deficient. The impetus for the study is that researchers know very little about vitamin D levels in toddlers.
    More recently the New York Times reported on a study that showed American children, especially those with dark skin, are alarmingly deficient in vitamin D with some children having no detectable trace in their blood.
    The only way to determine how much sun exposure or vitamin D exposure is enough is to have a 25-OH-D test done every 6 months. A consortium of concerned scientists operating under D-Action are sponsoring a 5 year study on the health benefits of maintaining optimal blood levels of vitamin D (40-60ng/mL). The study currently has approximately 1000 participants of which I am one. My first 25-OH-D test was 127.5 nmol/L (51 ng/mL for US). Interestingly, 60% of the participants in the study who are presumably trying to keep their blood levels in the optimal range were below the minimal level of 40 ng/mL. So this should tell us something about how difficult it is to reach optimal levels of vitamin D.
    D-Action says that 1,000 IUs of D3 will raise total vitamin D levels by 10 ng/mL. You can sign up for the 5 year study at https://www.grassrootshealth.net/questionnaire-welcome?c=1&js=1
    I assume golf magazines sell advertisements for sunscreens which have far greater commercial value than sun which is free or vitamin D supplements which are dirt cheap. If so, this would go a long way toward explaining the asinine statement in the article.
    As more and more research emerges on the benefits of maintaining optimal levels of vitamin D (which are more than 300% of the current official levels) campaigns seem to be ramping up in lock step against sun exposure. Sun beds were recently labeled ‘dangerous’ while dermatologists in Canada warn against any form of sun exposure claiming that even a tan represents ‘skin damage’ and should be avoided at all costs. I interpret all this as an indication that correcting the epidemic of vitamin D deficiency threatens the market for many lucrative products.

  25. Doc, you gotta do a critical analysis of this one: http://www.sciencedaily.com/releases/2009/08/090824151300.htm
    My question: mice? Why would you expect the digestion of mice to have any similarity at all to the digestion of humans? This is as dumb as, say, feeding rabbits a high-cholesterol diet and projecting the resulting atherosclerosis as a logical consequence for humans.
    Sorry that I don’t have a better place to suggest items of interest for you.
    It is dumb, but it takes more than a comment answer to deal with.

  26. One other question Mike please… Mercola states on his website that washing can wash away newly synthesized vit D3 in the skin. I can’t find ANYTHING on this in the literature so far… is this rubbish, or do is there something to it?
    Thanks a lot,
    Michael
    I don’t buy it for a host of reasons, primarily because the synthesis of vitamin D occurs within the skin, not on it.

  27. I have doubts about the vitamin D calculator. I was under the impression that no amount of sun could produce vitamin D at northern latitudes in the winter, the UVB couldn’t get through the atmosphere at winter sun angles—a Vitamin D winter. The calculator says I could spend 1 1/2 hrs in the sun in January by Lake Superior to give me a blood level of 25, I don’t know if I believe that.

  28. Pardon my cynicism, but vitamin D sounds like another in the series of vitamin fads we’ve been seeing since the 1970s.
    The vitamin C fad lasted a long time. Starting with Linus Pauling vs the common cold, we took vitamin C by the tablespoon for decades. Despite the lack of evidence of its effectiveness (http://tinyurl.com/m2q5xk)
    Vitamin E was another fad, supposed to enhance sexual performance, at least until it was shown not to. Not much good for anything, actually (http://tinyurl.com/c3um6t). And vitamin A, too. Until it was shown that vitamin A and E supplements increase the risk of death. (http://tinyurl.com/6jnz3r)
    B vitamins are recommended for anything and everything; just google “vitamin B” and any condition or organ you care to name.
    Now it’s vitamin D’s turn in the sun. In a few years I expect to see the headline, “Vitamin D Not As Beneficial As Believed”.
    Pardon my cynicism.
    The astute person would notice that the hype around vitamins C, E and B has been primarily created and driven by the alternative health community with very little confirmation in the scientific literature whereas the excitement about vitamin D has been generated by the many, many papers in the mainstream scientific literature. I doubt you’ll see the headline you predict anytime soon.

  29. In reply to:
    “You’re missing something. If you “grease on the sunscreen” before you go out, you won’t get much of any vitamin D. If you want to go ungreased for a few holes, the grease up, you’ll probably be okay. But you need 25(OH)D levels checked to know for sure.”
    But doesn’t sunscreen only “screen” the sun, and not completely “block” it? In other words, 5 minutes worth of UVB would take 40 minutes if using SPF-8? So 4 hours “greased” would be like half an hour of unprotected exposure?
    Or am I totally misunderstanding how SPF works?
    It almost completely blocks the UVB that makes vitamin D. An SPF of 8 will block 95 percent of vitamin D synthesis.

  30. People shouldn’t rely too much on their climate or location to estimate their Vitamin D status – a sunny climate is no guarantee of adequate Vit D levels (those of us in sunny mild climes may use sunscreen and sun-avoidance tactics even more), though a location north of Atlanta is probably a better indication that deficiency is likely without adequate supplementation. I was always told by our pediatrician and my dermatologist that our mild and sunny San Diego location practically assured us of enough Vitamin D production. Ha!
    After two years of supplementing and testing every family member at least twice a year I have determined that everyone in my family needs about 1000iU for *each* 25 pounds of body weight to keep our 25 (OH)D levels in the 60-80 ng/mL range, year-round. That’s the Vitamin D Council’s recommendation, too. So my husband takes 8000iU daily, I take 5000iU, and our son takes 4000iU (our son used to take only 2000iU when school was out for summer recess, but a 25 (OH)D just last week indicated his level dropped 20% this summer, despite *lots* of outdoor play with infrequent use of sunscreen).
    If we take half that dosing formula or skip the D3 too often, our 25 (OH)D levels go down to the 40s or lower, which I don’t consider adequate anymore. If we don’t supplement in the summer at all, our level never gets higher than the 40s by late summer/early fall. I’m quite sure before we supplemented and tested (and when we used a lot more sunscreen and sun avoidance tactics) we were quite deficient by mid-winter. I’m sure I was very deficient when I avoided the sun like the plague for 8 years after a basal cell carcinoma removal (yes, my teen and young adult years included too many sunburns; I don’t avoid the sun so much now but I do avoid burning).
    My NYS extended family members ( and avid sunblock users) were all seriously deficient in Vitamin D last winter, which wasn’t a surprise to me, but it was to their doctors (my 70-something dad was the exception; he takes the D3 supplements I send him). My San Diego gynecologist says fully 80% of the patients she tests are deficient. Nearly everyone I know in the SD are who tests their 25 (OH)D level is very low or deficient. Testing is the only way to know for sure. Twice a year in late winter/early spring and again in late summer/early fall seems to be the best schedule.
    An easy, convenient, and economical way to test is to participate in a University of California study on Vitamin D levels and health – http://www.grassrootshealth.net. Only a mail-in blood drop is needed.
    Interesting. Thanks for the instructive family history.

  31. Yeah, this is a classic sort of “puff piece” article on Vitamin D, isn’t it? I gave up on articles about health and nutrition in popular magazines years ago. In fact I gave up magazines altogether! Well, except for Smithsonian magazine which I still love. But they don’t have this sort of puff piece.

  32. Tom, the Vitamin D Council refuted the article you linked to about Professor Marshall’s “discovery” that claims Vitamin D supplements are immunosuppressive:
    http://www.vitamindcouncil.org/newsletter/2008-april.shtml
    Look near the bottom of the newsletter. The Vitamin D Council’s reaction to this article was that:
    1. “Dr.” Marshall holds only electrical engineering degrees
    2. He didn’t do a study and therefore has no data to publish
    3. This is merely an opinion
    Read their entire rebuttal.
    Even the Vitamin D Council doesn’t believe that the fact that Marshall is an electrical engineer has anything to do with his theories. But the fact that there is no study, no data, only opinion is critical, especially when compared to the huge amount of data showing the benefit of vitamin D.

  33. Dear Dr Eades,
    Oh what a blog this is for me…always interested in vitamin D. I have been taking 2,000 IU D3 per day (Carlson’s) for the past year and putting sunscreen on whenever I go out and my current level of 25(OH)D is 250 nmol/L (100 ng/ml) and I live in the UK where the sun is pretty poor anyway. I know I must be unusual because previously, last year, when I took 4,000 IU D3 per day, during winter for only four months, my 25(OD)D level reached 384 nmol/L (154 ng/ml) !
    “Swimming in vitamin D” – that I am ! I am totally mystified by this and so is my endocrinologist. He has asked me to continue taking 2,000 IU per day while I am on holiday in the south of France where I am now – and we’re having lots of sun so goodness knows what my 25(OH)D level will be when I get back and have it tested again the week after next !
    Btw – we stopped at a motorway aire recommended in the Guardian newspaper by your friend Heston Blumenwhatsit (sorry I forget his full name) of the Fat Duck in Bray – an aire at the beautiful Millau Viaduc. Fabulous gourmet food there ! We only had a coffee as it was too hot for food but even the coffee was better than normal !
    Anne

  34. Someone said:
    “Thinking I spotted a typo, I became less convinced after you had used “lede” four times at the top of this article. So I had to look it up. Apparently journalists changed the spelling of “lead” to “lede” years ago after people consistently got it confused with “pencil lead” vs. “follow my lead.” Interesting that I had never noticed this before.”
    Sorry, but the reason you didn’t notice it before is because it isn’t true. No journalist spells it “lede”. They would laugh at you I’m afraid. There was never any “lead” confusion between the newsroom and the composing room. They were separate entities. I started working for newspapers in 1975 and I know whereof I speak. There’s some dipstick wannabe online who explains it as having something to do with confusion about amount of lead in the ink which is incredibly silly! It is lead (pronounced leed) and always has been.
    I guess I’m a dipstick who uses ‘lede’ because I’ve read it a zillion times.

  35. Dr. Mike,
    again my comment has been hijacked and shows another website. I’m sorry to ask, but can you please remove it. I won’t post again as someone is obviously targeting me. You can also delete this request as well.
    I guess I don’t understand what you mean by this. Please explain. Remember, I’m a techno dolt.

  36. Dr. Eades,
    I am asking you this here out of desperation, and I cannot find any doctor to listen to me. My father is in the hospital with a pulmonary embolism (blood clots in his lungs), and congestive heart failure. I believe that his condition is mostly due to lack of exercise while taking many long plane flights, but his doctor insists that he stay on his statin (which was merely prescribed to him as “preventative care”). I am of the belief that his heart is weak due to years of inhibited CoQ10 production due to the statin, and that since the doctors won’t let him take CoQ10 while on Coumadin (for the clots), I believe that he should immediately quit the statin to strengthen his heart.
    Am I way off base here? Is there anything I can say or do to help my father? Sorry to ask you this in a comment, but I don’t know where to turn at this point. The doctors have convinced my mother that they are right, and I can’t bear to see my dad suffer.
    -Kevan Riley-
    I can’t make medical diagnoses over the internet for patients I’ve never seen. His doctors on the scene are much better able to diagnose and treat them than I am. I doubt that in his case – if he has a pulmonary embolism – that the statins have anything to do with his condition. I do think CoQ10 in large doses can help his congestive failure, but his doctors need to be the ones to give it.

  37. Dr. Eades
    I am new to your blog, and found yours through another.
    So far, I do like what I have read, especially your piece about London. My husband grew up there and we visit as often as we can.
    Also, I was pleased to see that you have a link to WAPF. I have been a member for five years. But, I was shocked when I looked at your wife’s blog the day she had her recipe for homemade mayonnaise, and discovered Splenda in the recipe. Are y’all familiar with stevia? It is has no carbs and most importantly, no side effects.
    The beach scene of your grandchildren is lovely….paradise is the way I describe Santa Barbara. I will be vacationing there in two weeks and can’t wait!
    Regards,
    Brenda M. Morris
    Austin, Texas
    Welcome aboard. Hope you enjoy your time in Santa Barbara.

  38. hi dr. eades,
    i just had to update you…and since this post is about vitamin d i’m not too off topic (!). i had emailed you about not being able to tolerate supplements and you suggested i stop taking multis and take separate supplements…and guess what? it works! no nausea and no stomach upset. thank you very much!
    best,
    ida
    Glad it worked for you.

  39. Dr. Eades, this is OT I know but don’t know where else to ask it.
    In your experience with patience in ketosis is there a lowering of body temperature. My morning temps have been running under 97 and I am thinking maybe my thyroid is sluggish. I have been in ketosis for about 2 months.
    Thanks ,
    James
    Although I’ve had a lot of patients who were in ketosis, I’ve never had them take their temps in the AM, so I have no basis to give an answer.

  40. Tom Gossard has provided a link that is essentially a metalink to this Science Daily article:
    http://www.sciencedaily.com/releases/2008/01/080125223302.htm
    In which Trevor Marshall states that Vitamin D supplementation may be harmful. This is a rehash of the abstract that Michael posted just previous to Tom. First, we should be clear that Dr. Marshall’s PhD is in electrical engineering (which happens to also be my field), not in medicine. Second, Dr. Marshall is a rather famous quack who believes that all/most/many infectious diseases are caused by excess Vitamin D and its influence on the Vitamin D receptor.
    The confusion lies here: some variants of sarcoidosis (http://en.wikipedia.org/wiki/Sarcoidosis) involve malfunctioning macrophages that convert the less active form of Vitamin D (25-hydroxy-vitamin D) to the much more active form (1,25 dihydroxy-vitamin D) via an unregulated process, making the sufferers extremely sensitive to 25-hydroxy-vitamin D levels, and making supplemental D3 or even excess sunlight dangerous. Dr. Marshall has improperly extended this etiology from exactly one condition to everything that ails man, and has therefore entered “quack” terrority.
    The resolution is probably not, “Everyone should avoid Vitamin D3.” but is much more likely to be something like, “For people diagnosed with some variants of sarcoidosis, supplemental Vitamin D3 is contraindicated as it is much more likely to cause hypercalcemia than in the general population. For individuals who are not suffering from sarcoidosis, supplemental Vitamin D3 in the range of 2000-10,000 IU/day is likely to be unambiguously beneficial.”
    YMMV.
    Had it not been for this one Science Daily article, no one would even know who Trevor Marshall is. This thing has had unbelievable circulation. I can’t tell you how many times I’ve seen it referenced. Marshall’s original article was nothing but an opinion piece – not original research, but for whatever reason it has got everyone concerned.

  41. Okay, now I’m upset. The second paragraph on the link below condemns high fat and red meat as carcinogenic. I know I person who was diagnosed with colon cancer and I was going to send him this link. Now I don’t know.
    http://www.vitamindcouncil.org/cancerColon.shtml
    The philosopher Sidney Hook once correctly noted that:

    It always comes with an impact of surprise to discover that a person who is highly knowledgeable and eminently reasonable in one domain may be an extraordinary fool in other domains.

    In my opinion, the vitamin D advice from the Vitamin D Council is top notch because that’s what they know about, but their nutritional advice is totally misguided and off the rails.

  42. Evelyn wrote:
    No journalist spells it “lede”. They would laugh at you I’m afraid. There was never any “lead” confusion between the newsroom and the composing room. They were separate entities. I started working for newspapers in 1975 and I know whereof I speak.
    I guess Evelyn knows more about journalism than the NY Times does, which has titled its blog on journalism “The Lede”:
    http://thelede.blogs.nytimes.com/

  43. Ross Bagley:
    Word!
    In my own blogging “career” (and I’ve done lots on D), I get more emails (from new readers, typically) about Marshall than anything. The man is wasting my time.
    I’m sure it pails in comparison to what the Doc suffers.

  44. Hi Dr. Mike,
    here’s the explanation about the hijacking.. when I post on your blogs, my user name is Ellen and it has my healthy-eating-politics.com website link associated with it. If you go down the list of comments for this Vit D blog, you’ll see there is a post from Ellen saying:
    “Dr. Mike, I have at least 5 books on what it takes to be a freelance writer, and none of them explained how to write an article as well as you just did. And I would have the advantage of actually doing real research to present real information. But now that I think about it, maybe the editors wouldn’t think real information was such a good thing.. any way thanks for pulling aside the curtain.. another Oz has been exposed. :)”
    I wrote those words, and my website should be linked to my name but it isn’t. It’s some other website that I have nothing to do with. This has happened three times in the past 2 months. I am assuming it’s someone wanting a free ride without actually participating in the conversation. Most times they just copy my words and post a second time, so my post is listed and then their post saying my words but linking to their website. This time though, my original post with my website is missing, and only the copy shows with the bogus site link. I don’t know how that happened, but I don’t want to give scummy internet marketers a free ride, so I would rather the comment just be deleted.
    I really would like to be able to post, but I don’t want my words associated with some other website. Hope that helps explain and I’m sorry to take up your time with this.
    Ah, I didn’t understand. I just now realized when I went back and looked at the comments as they actually appear in the blog instead of as they appear in my comment moderation queue and realized for the first time that anyone who puts down a URL has his/her name highlighted in the comment so that anyone clicking on that name gets taken to the URL behind the name. I see what’s happened to you now.
    Until I realized this, I figured, who cares? because no one sees the URL but me anyway. But, that’s not the case. See, I told you I was a techno dolt.
    I’ve gone back and pasted your URL into the URL spot for the highjacking comment. From time to time I see duplicated comments, but I always figured somebody thought it didn’t go through and so posted again. I usually delete the oldest one, but now I’ll be more careful and check the URLs.
    Thanks for the heads up on this.

  45. I am new to this blog, and my question re: what Trevor Marshall wrote has been answered to my complete satisfaction. It is rare indeed, in my experience, to come across a blog about diet and nutrition that neither pulls my leg nor bends my ear with fiction and rumors (usually liberally mixed with politics). This blog’s a keeper. Many thanks.

  46. Thankyou for clarifying something which I have for my entire adult life intrinsically known to be true, but which I have never seen so simply and usefully explained.

  47. Michael said:
    “One other question Mike please… Mercola states on his website that washing can wash away newly synthesized vit D3 in the skin”
    I read this too… from WAPF:
    “It takes about 24 hours for UV-B-stimulated vitamin D to show up as maximum levels of vitamin D in the blood. Cholesterol-containing body oils are critical to this absorption process. Because the body needs 30-60 minutes to absorb these vitamin-D-containing oils, it is best to delay showering or bathing for one hour after exposure. The skin oils in which vitamin D is produced can also be removed by chlorine in swimming pools. ”
    Is this incorrect? It would be good to know – I have also wondered if sunscreen would be better on beach/pool days if D is not taken in as well…
    As I understand it the synthesis of vitamin D takes place within the skin not on the skin. I guess I need to check this out to make absolutely sure, but I would be willing to bet I’m right. If I am right, it makes no difference if one showers after sun exposure.
    I would think sunscreen would be better on days that vitamin D was taken. Unless, that is, I didn’t understand your question.

  48. Dr. Eades,
    I agree with you 100% on the benefits of sun exposure, since I read about it in Protein Power. Nevertheless, I am concerned about the aging effects on the skin that happens with any sun exposure, according to some dermatologists. I mean, I wanna be healthy and free of wrinkles, saggy skin and, to tell you the truth, look forever young. Is it possible to be out in the sun, with creams or oils, and still avoid the aging effects of sun exposure?
    It’s a double-edged sword. Long sun exposure gives you plenty of vitamin D but it also damages your skin. Depending upon where you live, you can get plenty of vitamin D before you reach the point at which you are inflicting aging damage to your skin. Once you’ve reached the point at which you’ve produced your vitamin D, you can slather on the sunscreen (the kind that blocks both UVB and UVA) for the rest of your sun exposure. Or, you can resort to moisturizers and skin antioxidants.

  49. Dr. Eades, You convinced me of the health importance of vitamin D in Protein Power Lifeplan, but I’m still worried about wrinkles. It seems, at least from my personal observation, that tanning causes skin wrinkling. Are there any good studies that you are aware of that addresses this? Is there a downside to sunscreen so long as it is broad spectrum and you are supplementing with vitamin D? (Sorry, I’m vain I guess!)
    See my answer to the comment right before yours.

  50. Mike – thought about signing up to be available as a Kindle download? Thanks. Paul
    I assume you’re talking about this blog. If so, I don’t have a clue as to how to go about doing it.

  51. Hi Doc,
    Just got this via email: AHA’s latest advice on sugar consumption.
    http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.109.192627v1.pdf
    The writers panel happily includes Lustig (sorry for the pun), and they’re now recommending less sugar — a mere 150 cals per day for men (what, 10 teaspoons! Yikes) and 100 cals for the gals.
    I guess this is an improvement, from extremely bad to very bad.
    Yep, I tweeted on this. Kind of lame for those of us in the know, but it’s a small step in the right direction.

  52. Is there any feedback loop between vit D levels and tan? That is, will a tan subside as you need more D, or only coincidentally?
    No, a tan subsides over time irrespective of vitamin D levels. The only correlation with a tan is that the tan actually blocks UVB and thus vitamin D, so if you have a tan, you need to spend more time in the sun to get the same amount of vitamin D. Which usually isn’t a problem since the fact that you’ve got a tan means you spend plenty of time in the sun.

  53. Doc, is it possible to have Idiopathic reactive hypoglecymia while on low carb? I always experience nasty symptoms right after I eat some foods, particularly gassy vegetables. I develop nasty palps, disturbed hear rhytm and lightheadness. My doctor recommended me to limit heavy consumption of carb. I said ” I have been low carb for years”. He explained that even cheese can trigger it. How is it possible to have low blood sugar post meals when low carbing? Is it adrenalin induced? I just dont want to go cave man route! I love my chocolate, cheeses and dairy. Please advise!
    I would avoid the vegetables that cause the problems. Avoiding a few vegetables still leaves a ton of foods you could still eat, so I wouldn’t think it would be a large sacrifice.

  54. Sorry to be unclear… If D is washed off with water, it might be a good idea to grease up the kids to protect the skin from UVA when swimming (since D will not be absorbed well anyway, just like after 2pm…). I would give them D orally on such a day as well.
    I have found multiple links claiming washing off oils does hinder D absorption…but , maybe they all are using WAPF as a source?? Here’s something from the Vitamin D Council:
    http://www.vitamindcouncil.org/newsletter/more-vitamin-d-questions-and-answers.shtml

  55. I also was going to ask about showering before taking a sunbath because I recalled reading in an Adelle Davis book that doing so would prevent D absorption. A person on Wikipedia asked the same question:
    Vitamin D3 created ‘in’ or ‘on’ the skin?
    in her 1954 book, Adelle Davis wrote, “Most medical textbooks say that vitamin D is formed by sunlight on the oils IN the skin although it was proved 16 years ago [A.C. Helmer and C.H. Jansen] that the oils must first be ON the skin, then exposed to ultraviolet light, and later absorbed back into the body. If persons take a bath before going into the sunshine, the oils are washed off, and no vitamin D is formed; if they do not bathe before exposure to sunshine but bathe immediately afterward, the oils are removed before the vitamin can be absorbed into the body.”
    The learned reply states:
    Vitamin D is produced photochemically IN the skin from 7-dehydrocholesterol (not an “oil”).
    First off some background about the skin: It consists of two primary layers: the inner dermis, composed largely of connective tissue, and the outer thinner epidermis (see image). The thickness of the epidermis is <25 um and it contains five strata; from outer to inner they are the stratum corneum, (sometimes the lucidum), granulosum, spinosum, and basale.
    "The highest concentrations of 7-dehydrocholesterol are found in the stratum basale and stratum spinosum. Accordingly, these two layers have the greatest capability for production of previtamin D3 and vitamin D3, whereas the other layers have a lesser capability."
    Bathing removes dead skin cells from the stratum corneum, you can't "wash off" the deeper spinosum, and basale layers of the skin.
    On another note "UVB affects the epidermis, and the two principal determinants [of generating Vitamin D] are the quantity (intensity) and quality (appropriate wavelength) of the UVB irradiation reaching the 7-dehydrocholesterol deep in the stratum basale and stratum spinosum."

  56. excellent post. would like to hear your view on iodine/thyroid. are we getting enough through diet, do we need to supplement, etc.
    Thanks!
    The short answer is that I don’t think most people get nearly enough iodine. I take it myself.

  57. Dr. Mike,
    I’m having labs done in a few days and wondered if you have a recommended level of Vitamin D I could compare mine to? My labs are sent to Mayo, but I understand that the reference level for most labs appears to be too low.
    Thanks for any information you can give. Love your blog, your books and your study analysis.
    David
    I like to see levels above 60 ng/ml.

  58. Thank you for the information on Vitamin D as well as Folate-VitaminB12=ANEMIA.
    I’ve been taking a recommended 6g Folate Acid and 1g B12 and am also ANEMIC. Will immediately quit Folate and up B12 (sublingual) and recheck iron anemia. I don’t know how well I absorb B12 since additional hydrochloric acid gives me severe cramps (as do many things including digestive enzymes). I would very much appreciate learning how much is too much of all vitamin/mineral supplements.

  59. Dr. Eades–
    Thank you for helping bring attention to the issue of vitamin D.
    As you point out, there is an enormous quantity of misinformation on vitamin D, often inadvertently propagated by a 30-something reporter trying to grasp the issues for 2 minutes of media attention.
    Having assessed the vitamin D blood level status in patients thousands of times over the past 4 years, I’ve learned what works, what doesn’t, what vitamin D does, what it doesn’t.
    After thousands of vitamin D assessments, I can confidently say that I have never–NEVER–come across anything quite as potent to enhance health as this crazy, simple, cheap, and accessible thing mislabeled “vitamin” D. (It’s actually a prohormone.)
    Benefits I have personally witnessed include: improved osteoarthritis, 20-30 mg/dl increases in HDL (though it requires 1 years to develop), enhanced insulin responses/reduced blood sugar, elimination of winter “blues,” enhanced mental clarity, inflammation-suppressing effects. I’ve seen unexpected diseases reverse, including HLA B27-proven ankylosing spondylitis, depression, and chronic headaches.
    In my experience, vitamin D restoration using oil-based gelcaps to achieve a serum level of 25-hydroxy vitamin D of 60-70 ng/ml is nothing short of miraculous.
    I agree. Thanks for bringing up the issue of the oil-based gelcaps. I use inexpensive vitamin D in capsule form but since vitamin D is an oil-soluble vitamin, I make sure to take it with a fatty meal.

  60. Is this of any interest?
    Journal of Food Composition and Analysis
    Volume 16, Issue 5, October 2003, Pages 575-585
    Vitamin D3 and 25-hydroxyvitamin D3 in raw and cooked pork cuts
    Ina Clausen, Jette Jakobsen, Torben Leth and Lars Ovesen,
    The Danish Veterinary and Food Administration, Institute of Food Safety and Nutrition, 19 Mørkhøj Bygade 19, Søborg DK-2860, Denmark
    Received 25 July 2002; revised 17 February 2003; accepted 17 March 2003. ; Available online 24 July 2003.
    Abstract
    The contents of vitamin D3 and its metabolically active metabolite 25-hydroxyvitamin D3 (25OHD3) were examined by HPLC in different parts of four common raw pork cuts (loin boneless, leg inside, thin belly, neck) and in cooked meat (loin boneless). In whole raw pork cuts, varying in fat content from 2.2 to 26.5 g/100 g, concentrations of vitamin D3 from 0.05 to 0.21 μg/100 g were measured. Pork cuts also contained significant amounts of 25OHD3, from 0.07 to 0.14 μg/100 g. Further, the study demonstrated that most of the vitamin D3 and 25OHD3 is located in the fatty tissues, and that rind, despite its limited fat content, has a high concentration of vitamin D3 and 25OHD3. Cooking increased vitamin D3 and 25OHD3 calculated per 100 g of tissue in all parts and in the whole cut (in whole cuts in raw and cooked meat, respectively: vitamin D3: 0.15 (0.08–0.24) μg/100 g and 0.18 (0.11–0.28) μg/100 g; P=0.33; 25OHD3: 0.09 (0.06–0.18) μg/100 g and 0.13 (0.10–0.18) μg/100 g; P=0.02); however, correcting for differences in dry matter content, ameliorated all significant differences. 25OHD3 has a higher (from 1.5 to 5 times) biological activity than vitamin D3. Meat 25OHD3 contributes significantly to vitamin D activity. Food databases should include concentrations of both vitamin D and 25OHD.
    http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WJH-494S5FP-3&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=993138343&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=d83c859d9d134729d089a7222d333e2c
    Journal of Food Composition and Analysis
    Volume 20, Issue 2, March 2007, Pages 90-98
    Original Article
    Concentrations of vitamin D3 and 25-hydroxyvitamin D3 in raw and cooked New Zealand beef and lamb
    Roger Purchas, a, , Maggie Zoua, Philip Pearcea and Felicity Jacksona
    Institute of Food, Nutrition and Human Health, Massey University, Palmerston North, New Zealand
    Received 24 September 2005; revised 29 June 2006; accepted 3 July 2006. Available online 14 August 2006.
    Abstract
    Meat from four lamb cuts and four beef cuts was assayed for vitamin D3 and 25-hydroxyvitamin D3 (25OHD3) before and after cooking. Vitamin D3 was measured by HPLC, while 25OHD3 was assayed using a radioimmunoassay method developed for blood plasma. Concentrations of both these compounds tended to increase with cooking for most cuts, but retention levels were often less than 100%. Positive relationships between fat percentage and vitamin D3 were shown before and after cooking, but not for 25OHD3. For lamb, the highest levels of vitamin D3 were in the shoulder chop both before and after cooking, while levels were lowest in the rack muscle. Similar cut differences were shown for 25OHD3 concentrations. For beef there were no significant differences between the cuts for vitamin D3, but concentrations of 25OHD3 were lower in the striploin before and after cooking, Vitamin D3 levels tended to be higher in beef cuts than in lamb cuts, but the opposite held for 25OHD3. Concentrations of vitamin D3 were similar to those in other reports, but the 25OHD3 levels were at the high end of reported ranges. With 25OHD3 being more potent than vitamin D3, it is concluded that meat can make a useful contribution of this vitamin to the human diet.
    http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WJH-4KMYM38-1&_user=10&_coverDate=03%2F31%2F2007&_rdoc=5&_fmt=high&_orig=browse&_srch=doc-info(%23toc%236879%232007%23999799997%23638059%23FLA%23display%23Volume)&_cdi=6879&_sort=d&_docanchor=&view=c&_ct=13&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=6abe5776a0df6f46096620d610646edb

  61. This is off subject, but I’ve just noticed that Dean Ornish is writing in the Huffington Post about healthcare reform. Among other things, he seems to be urging the government to prod people into following healthy lifestyles, which sounds on the surface like a noble ideal. However, you can almost hear the barrage of information coming about the low-fat lifestyle and how we’ll all be so much healthier for it. In particular, the Take Back Your Health Act would pay for intensive lifestyle changes that are “clinically proven to beneficially affect or even reverse the progression of many chronic diseases,” according to one politician. What exactly would those be? There are obvious ones like smoking cessation, but what else? How are they ever going to enforce such a thing anyway, especially when it comes to diet?

  62. Dr. E.,
    I’m not sure I understand the chart for calculating sun exp. times. I’m not in London or any of those places and don’t know the answers to some of the fields. So I just plugged in my long./alt. numbers and it gave me a 0:5. I’m in Arizona and swim quite early in the morning to avoid burning. I’m light skinned and I have a very light tan right now. Is there another way to figure out sun exposure times? Anyone have charts for the North America?
    Thank you!

  63. Since I live at 114 WEST longitude, I was trying to figure out how to enter that in the calculator, which is only designed for East longitudes. But apparently longitude has no effect on the calculation since the result was the same for all the values I tried.

  64. Being African-American I quit using sunscreen altogether. I even encourage my adult children to not use sunscreen. My husband who is caucasian and rarely outside, does not use sunscreen. What I find interesting is many people have commented that increasing their vitamin D intake they noticed a better resistance to burning. Looks like vitamin D is the best sunscreen.

  65. Obee wrote:
    I’ve just noticed that Dean Ornish is writing in the Huffington Post about healthcare reform.
    He isn’t just writing in the HuffPo, he’s wriggled his way into the position of Medical Editor.
    God, what a piece of work he is!
    You can be a scientist, or you can be a politician. You can’t be both. And, to my thinking, there’s no question about what Ornish is.
    I agree. Let’s hope he’s as inept as a politician as he is a scientist.

  66. Dr Eades, I love your ideas, and I’m a comment-fiend. I learn so much from these and from your responses.
    Just some thoughts about our sick-care system. I feel horrible for all the innocent, eager children out there who are being poisoned, slowly and torturously by sugar and margarine, too much wheat, and any amount of soy. “The Vegetarian Myth” is an amazing book and I learned about it a month ago from a comment on FATHEAD blog and then I was happy to see your review. I just got a library copy of Weston A. Price’s “Nutrition and Physical Degeneration”. It’s not as easy a read as Taubes, or yours, or Keith, but it is a must-read and a classic (and stunning). Now to “health-care”. We’re facing a bankrupting crisis in the US. We don’t have’ health-care’ here. We have a spectacularly expensive sick-care- break-it-and-fix-it system. This is to the tune of staggering trillions of dollars. We don’t have ANY meaningful prevention. Prevention is NOT billions of dollars spent on lipitor to ‘prevent’ CVD. Health care is not cracking open peoples’ chests and re-plumbing their hearts. It’s so perverted it makes me want to scream. Prevention is eating nuts, meats, fish, greens, berries, dairy, eggs and in some places bugs and reptiles. Sickness is eating wheat, sucrose, HFCS, soy, Frankenfats, margarines and ‘foods’ made in a lab. Dr. Weil suggested that if he is in an accident, he wants to be taken to a well-equipped hospital emergency room, but if he developed some chronic ailment, let him consult a shaman priest first. But don’t take him to a shaman priest for an accident and the chronic ailment deserves a look at alternatives before allopathic medicine charges in and starts cutting, medicating, irradiating, burning, testing and slicing. UGH.
    I agree with you, but I doubt that things will change much. Why? Because there is no money in prevention. And it really isn’t the medical profession’s fault. Prevention is a demand-driven business, and there’s not a lot of demand. Just as no one spends legal fees preparing for divorce when a marriage is going well, most aren’t really into spending time or money or sacrifice on prevention in the absence of health problems. If a doctor set up a clinic in preventative medicine, he/she would go broke quickly. So when no one wants the services, no one really sets up to provide them.
    But, have a heart attack, develop diabetes, or even discover and elevated cholesterol level, and people want all the stops pulled out to treat them. In medicine, that’s where the money is, so that’s where the focus is.

  67. What about tanning booths and beds? I’m surprised no one has asked this yet.
    I wrote to you quite a while back that I seem to have lost much of my ability to burn (for which I am eternally grateful). I was in Florida on vacation with hubby. We went deep-sea fishing for the entire day, and I had forgotten to pack the sunscreen in our bag. So, I was out on the water all day long, figuring I’d get fried. Nope. The tops of my shoulders got a wee bit pink, but that was it. I had a bit of a tan beforehand, but not much.
    Since that time I’ve not used sunscreen. We have 45 acres in the country and I mow about 5 acres every week. It takes about 4 hours to do it all, and although I never use sunscreen, I never burn.
    In recent years, however, I start going to a stand-up tanning booth in late March to lay down a good base tan.
    What is your opinion of tanning booths? Is there a type of bulb that is better than another?
    THANKS! By the way, I love the new format of the blog, but don’t like the light-gray vertical line throught the text. Oh, and that’s a GREAT picture of you!
    As I understand it, most tanning beds use primarily UVA, which is the wavelength that stimulates the melanocytes. But, I’m far from an expert on tanning beds, so take everything I say about it with a grain of salt.
    I don’t know where the gray vertical line you’re talking about comes from. As far as I can tell, it’s only visible to those using Internet Explorer as a browser on a PC. I can’t see it on either Firefox (my browser of choice) on my Mac nor on Safari on my Mac. I just checked my business partner’s PC laptop, which is running IE, and there it was. I’ll have to check with the tech guys Monday to get rid of it. Thanks for the heads up.
    As to the photo, I was surprised to see it there. I’ve been whining to all my tech and design folks about not having the new site up, so they all of a sudden put it up late on a Friday afternoon while I’m traveling and can’t really evaluate it and they won’t be back until Monday. My guess is that the whole thing will need some real tweaking.

  68. Can you commet with regard to VitD3 supplementation and affect on thyroid. Have seen blogs say supplementing with high doses of D3 say 8,000 to 10,000 per day may raise TSH levels. Thank you.
    I’ve not had this experience, so can’t really comment on it.

  69. Dr. Eades –
    slightly off-topic question.
    Ever seen anybody who gets nauseous regularly after protein powered meals?
    i’ve been on PP for about a year. a month or so ago, i started noticing that 1-2 hours after many meals, i would start feeling like there’s a brick in my stomach. over the course of a half hour, the feeling gets worse and worse until it gets so debilitating that i just have to lay down and wait it out. then, i start to feel better pretty quickly and soon after, “nature calls.”
    i am concerned because this only happens when i am on-plan. i was travelling recently and strayed off-plan. while i was off-plan, this never happened.
    IBS possibly? fat or protein intolerance?
    i know a blog comment is no substitute for a doctor visit, but i thought you might be able to help if this has been a common ailment over your PP years. LC has been very good to me, as Sammy Sosa might say, but if every meal is going to cause me to get sick.
    I don’t really know what’s going on here. You said that the symptoms occur 1-2 hours after many meals, which implies that it doesn’t always occur. If this is the case, I would try to keep some records to see which meals it occurs after and which it doesn’t. Knowing the difference may shed some light on the problem. I haven’t had this experience myself nor have I had it reported by any of the thousands of patients I’ve cared for, so I’m in the dark without a lot more info.

  70. ..then why not take a nap after the meal anyways.
    Does size of meal alter its manifestation?
    Not as much as its composition.

  71. I am using Firefox on a Mac notebook and it looks like two design formats are competing here. One has square corners, one has round corners. One is taller. One is wider. Where they overlap is where a verticle line appears.
    Also, one is also a slightly different shade of blue than other. None of this interferes with the ability to read the comments though. Hope this helps. BTW, nice photo.
    Thanks. I’ve passed all this along.

  72. Kathy from Maine:
    I am certainly no expert, but I have googled and read about Vitamin D lights a little. If you want to get Vitamin D from a tanning bed, you have to make sure it has the right wavelength of UVB. I think there is a fairly narrow range of UVB wavelengths that gets the job done.

  73. “As far as I can tell, it’s only visible to those using Internet Explorer as a browser on a PC. I can’t see it on either Firefox (my browser of choice) on my Mac nor on Safari on my Mac.”
    I use Safari and I can see the line. On my Mac, each comment appears to be spread over two blue panels, very close together, with the narrow RH panel being a little shorter than the broad LH one.
    I’ve been supplementing with Vitamin D since about January this year and among the benefits I’ve noticed is an increase in reaction times. I don’t think my reactions were slow before, but they seem even faster now. I have no precise way of measuring them, but if I knock something off the shelf now, I *always* catch it long before it gets to the ground!

  74. Doc, I like your new web site. I am running XP & IE 7. I can now no longer increase the text size by selecting View, Text Size, then Larger. I have some what limited vision. Do you know if I up grade to a later OS or Browser, that I would be able to increase the text size.
    Thank you,
    I know you can increase it in Firefox, which you can download free for the PC. And for all I know, you can do it in IE as well. Readers?

  75. Of course, I meant a *decrease* in reaction times after supplementing with Vitamin D.
    Of course. I figured that’s what you meant.

  76. Dr Mike,
    Hope you are right on target to unveil the news about the new project you were working on for the past so many months!!
    Thanks
    Venkat
    As I mentioned in my most recent post, the unveiling has been put off until Sept 15. Nothing I can do about it. Sorry.

  77. COUNTDOWN to tomorrow’s WORLD-CHANGING announcement!!
    Personally, I’m hoping for a magic weight-loss pill.
    Keep counting for a couple more weeks. It’s now Sept 15. Sorry. And, no, it’s not a magic weight-loss pill. Not even close.

  78. What’s up with the unreadable font used for reader comments? I can no longer read the comments.
    We’re working on getting it fixed. Sorry.

  79. Dr. Eades,
    Any chance you could have your tech guys check out Opera 10? The comments section is messed up in Opera with the new design — adjacent lines of text are so close together that it’s really hard to read. This wasn’t an issue with the old design.
    Thanks!
    Will do. It’s screwed up in more than Opera.

  80. Ugh, I can’t read the comments anymore. Most of the lines are compressed vertically, with no vertical spaces between the lines. I hope this is just temporary.
    I hope so, too. It’s being worked on.

  81. I love the content of this blog, but the new fonts are…
    under-helpful.
    They are too small, especially in the comments section, and if I increase font size in my browser (Firefox 3.5.2), the larger letters overlap too much, so even though they’re larger, there’s no improvement in legibility. I hope your web designers will fix this, as I really do appreciate the fabulous job you do keeping us all informed.
    Thanks. Yes, they are working on it. Had I known a new look would be this much of a PITA I never would have done it.

  82. Regarding the tanning beds and Vitamin D absorption, I just had my level of Vitamin D checked and it came back as 65 on a scale of 18 – 78. I take D3, but on a semi-irregular basis, so I’m assuming I’m getting some D from the tanning booth. We’ve had virtually no sun here in Maine all summer (just rain, rain, and more rain), so I’m not getting it outside. Even when it’s sunny, I only seem to be able to be in the sun on the weekends when I mow the grass. We have 45 acres, and mow about 5 acres; it takes me about 4 hours to finish the job, and I use no sunscreen.
    Anyway, what I wanted to say was that the tanning booths MUST have a good ratio of UVB to UVA or else you wouldn’t tan in them, right? I plan to visit the tanning salon today or tomorrow and talk with them about the bulbs they use. She insists that she orders “the kind that don’t cause cancer” but who knows. I believe she THINKS that’s what she’s doing, but she’s a bit of a “dim bulb” herself, if you know what I mean!
    You can be getting vitamin D from food as well.

  83. Dear Dr. Mike,
    You’re probably already on to this, but I’m sending links to a couple of fascinating videos on vitamin D, micro-darwinian carcinogenesis, and epithelial tight junctions. They are presentations by Cedric Garland, who is on the Vitamin D Council’s list of world’s leading authorities. Vitamin D looks to be more potent in fighting active cancers than chemotherapy (as well as warding off type 1 diabetes, multiple sclerosis, osteoporosis, rickets, and more).
    http://www.youtube.com/watch?v=1PsyaYNX1dw
    http://www.youtube.com/watch?v=3GM0CnO6-ds
    Hope you find it useful!
    Thanks for the links.

  84. Another quick question. I just read back a ways, and you said you like to see readings above 60 ng/mL. I just noticed that the results from my recent test showed as pg instead of ng (pg/mL, not ng/mL). What’s the difference?
    Different labs have different standards.

  85. Interesting article on vitamin D just posted at http://www.sciencedaily.com/releases/2009/08/090821211007.htm
    “Why Low Vitamin D Raises Heart Disease Risks In Diabetics
    ScienceDaily (Aug. 25, 2009) — Low levels of vitamin D are known to nearly double the risk of cardiovascular disease in patients with
    diabetes, and researchers at Washington University School of Medicine in St. Louis now think they know why.
    They have found that diabetics deficient in vitamin D can’t process cholesterol normally, so it builds up in their blood vessels, increasing the risk of heart attack and stroke. The new research has identified a mechanism linking low vitamin D levels to heart disease risk and may lead to ways to fix the problem, simply by increasing levels of vitamin D.”
    Statins sales are threatened!
    As I posted on previously, some of the benefits of statins probably arise from the fact that the drugs increase the levels of vitamin D. So, why not just take vitamin D?

  86. So, if my Vitamin D result is 65 PICOgrams, that’s only 0.065 NANOgrams, and if Dr. Mike says the reading should be ABOVE 60 NANOgrams, I have almost no Vitamin D in my system?
    And yet, according to the lab range (18 – 78 PICOgrams/mL), I’m fine.
    The test wass called “Vit D, 1,25-Dihydroxy.” Is that the right kind of test to get?
    Sorry for all the questions.
    You got the wrong test. You should get 26(OH)D checked. The test you got was for actual vitamin D levels, which fluctuate and, strangely enough, are an inaccurate measure of vitamin D levels. Doctors who don’t really understand the vitamin D testing process typically order the test you got thinking that they are getting a true measurement of vitamin D. You need to get retested for the right stuff.

  87. OK, so I got the wrong test. Story of my life! My recent hormone panel was using blood not saliva, so that’s not terribly helpful either.
    So, how do I get these tests done without a doctor’s orders? Are there self-referred labs I can go to for the Vitamin D test (the 26(OH)D), the hormone panel, and the lipid panel? My LDL reading says “calculated” and I thought I read recently in these comments that this is not the best way to go. Also, I’d like to know if mine are clumpy and small or fluffy and large (the better kind, right?).
    It was funny. When the nurse called with my test results, she said everything was “fine.” She said my total cholesterol and “bad” cholesterol were a bit high, but that the doctor didn’t want to put me on medication for it yet. I asked what the actual readings were: Total cholesterol was 223, triglycerides 121, HDL 59, and LDL calculated was 140. I told her that I would HOPE he wouldn’t consider statins for me!
    I also said that I wanted the full test results sent to me. When the envelope arrived, I eagerly opened it. Inside was a sheet of paper that said “Everything is fine” and was signed by the nurse. No numbers at all! I called and complained, and they finally sent me everything.
    Dr. Mike, you and your lovely wife would sure make things a LOT easier for us if you went back into private practice!
    You can get all kinds of labs done – including the correct vitamin D test – through the Life Extension Foundation.

  88. ME: “Because there is no money in prevention. And it really isn’t the medical profession’s fault. Prevention is a demand-driven business, and there’s not a lot of demand.”
    I wholeheartedly agree. I don’t think there is the faintest hope that we will ever see a contemporary health care system (a misnomer if there ever was one) that embraces true preventive medicine on any kind of scale, if at all, for one simple reason – the public at large doesn’t want it. People tend to have an overly simplistic view of complex systems. And the human tendency is to be reactive as opposed to proactive. In a paradigm where illness is viewed as being caused by a single entity (i.e. cholesterol) as medications tend to make sense to most people. Powerful drugs impart a sense of control by providing the user with a weapon to use against what is viewed as ‘the enemy’. Hence names for drugs such as ‘Lipitor’ which evoke images of power.
    In the province in which I live spending on health care (arrrgh, I hate the term), driven mostly by drugs such as Lipitor, is projected to reach 50% of the total provincial budget within a few years. Hang on we are going down! As Pogo said “We have met the enemy and he is us”.

  89. I only purchase magazines once in a while for entertainment. Reading men’s health and fitness type magazines, I realized long ago that the content was inaccurate, and many times just stupid.

  90. Hello Dr. Mike,
    What do you make of this bit of new vitamin D research? My mom has RA and I’ve advised her to supplement with ~3000 IU/day, but i want to make sure it’s the right thing to do.
    Vitamin D may exacerbate autoimmune disease
    Deficiency in vitamin D has been widely regarded as contributing to autoimmune disease, but a review appearing in Autoimmunity Reviews explains that low levels of vitamin D in patients with autoimmune disease may be a result rather than a cause of disease and that supplementing with vitamin D may actually exacerbate autoimmune disease.
    Authored by a team of researchers at the California-based non-profit Autoimmunity Research Foundation, the paper goes on to point out that molecular biologists have long known that the form of vitamin D derived from food and supplements, 25-hydroxyvitamin D (25-D), is a secosteroid rather than a vitamin. Like corticosteroid medications, vitamin D may provide short-term relief by lowering inflammation but may exacerbate disease symptoms over the long-term.
    The insights are based on molecular research showing that 25-D inactivates rather than activates its native receptor – the Vitamin D nuclear receptor or VDR. Once associated solely with calcium metabolism, the VDR is now known to transcribe at least 913 genes and largely control the innate immune response by expressing the bulk of the body’s antimicrobial peptides, natural antimicrobials that target bacteria.
    Written under the guidance of professor Trevor Marshall of Murdoch University, Western Australia, the paper contends that 25-D’s actions must be considered in light of recent research on the Human Microbiome. Such research shows that bacteria are far more pervasive than previously thought – 90% of cells in the body are estimated to be non-human – increasing the likelihood that autoimmune diseases are caused by persistent pathogens, many of which have yet to be named or have their DNA characterized.
    Marshall and team explain that by deactivating the VDR and subsequently the immune response, 25-D lowers the inflammation caused by many of these bacteria but allows them to spread more easily in the long-run. They outline how long-term harm caused by high levels of 25-D has been missed because the bacteria implicated in autoimmune disease grow very slowly. For example, a higher incidence in brain lesions, allergies, and atopy in response to vitamin D supplementation have been noted only after decades of supplementation with the secosteroid.
    Furthermore, low levels of 25-D are frequently noted in patients with autoimmune disease, leading to a current consensus that a deficiency of the secosteroid may contribute to the autoimmune disease process. However, Marshall and team explain that these low levels of 25-D are a result, rather than a cause, of the disease process. Indeed, Marshall’s research shows that in autoimmune disease, 25-D levels are naturally down-regulated in response to VDR dysregulation by chronic pathogens. Under such circumstances, supplementation with extra vitamin D is not only counterproductive but harmful, as it slows the ability of the immune system to deal with such bacteria.
    The team points out the importance of examining alternate models of vitamin D metabolism. “Vitamin D is currently being recommended at historically unprecedented doses,” states Amy Proal, one of the paper’s co-authors. “Yet at the same time, the rate of nearly every autoimmune disease continues to escalate.”
    ###
    For the past five years, Autoimmunity Research Foundation has been running an observational study in which patients are administered pulsed low dose antibiotics and a VDR agonist in order to kill chronic bacteria implicated in their diseases. Specific data on the cohort was recently presented by CAPT Thomas H. Perez, USPHS (ret) at the International Congress on Autoimmunity in Porto, Portugal:
    Transcript: http://autoimmunityresearch.org/transcripts/ICA2008_Transcript_TomPerez.pdf
    Video: http://vimeo.com/1789735
    I don’t think much of it. It is the Marshall Protocol based on an opinion article by Marshall that somehow has gotten way, way too much publicity. You can read about it on the Vitamin D Council site. Enter ‘marshall’ in the search function.

  91. The data on vitamin D preventing cancer is now as extensive as the data on smoking causing cancer!! Over two years ago the Canadian Cancer Society started recommending that everyone take vitamin D to prevent cancer. take a look at http://www.vitaminD3world.com for some good summaries of the data

  92. Dear Dr Eades,
    I just got my latest 25(OH)D results. Taking 2000 ius D3 per day for over a year. In August, with very little sun here in the UK, they were 250 nmol/L (100 ng/ml), and now, after continuing with the same dose of D3 and getting loads of sun in France they fell to 188 nmol/L (75 ng/ml).
    I’m completely mystified !
    Anne
    I would suspect a lab error on one end or the other. Given the situation, nothing else makes sense.

  93. I don’t know much about vitamin D. Recently I have read on vitamin D-binding protein (Gc or DBP) by Nobuto Yamamoto that has a cure for both HIV and some cancers. The problem being that DBP convention to DPB-MAF maybe weak. This is an activation factor for Macrophage. Alot of the problem is that macrophage response is weak. With an injection of DPB-MAF with B-galactosidase, Sialidase and another enzyme produces a strong macrophage and able to cure HIV and some cancers.
    I happen to do research on AIDS but it is on FIV and not HIV. So far I am able to get normalized blood counts using a formula plus immu-25. Next I will be adding B-galactosidase to see if it will clear resting FIV virus. Likely the enzyme will help produce a stronger macrophage which will clear the resting FIV but will take longer than what Yamamoto data shows.
    But all this goes back to the immune system that normally immunosurppresses HIV and FIV and can lead to AIDS. With a normal immune system it does not progress to AIDS. And if Yamamoto is correct a stronger immune system will clear the virus but this is yet to be verified by other researchers. Anyway, I will not know for maybe three years if I can clear the virus but is worth the try. There are other methods that may work. But will try this first since I have now become interested in this project.
    But alot of the problem with vitamin D is with the binding. Without good binding it does not matter how much vitamin D you take. This binding factor comes from the liver.

  94. Close to 2 months ago, I was diagnosed with pre-diabetes. At that time I was taking 10,000 IUs of D3. As an experiment, I wanted to see just what 15,000 IUs would do and my fasting blood glucose did indeed come down. Eventually, I raised my “dose” to 50,000 IUs and my FBS went down from 120-130 to 89-110. However, it is becoming moreso in the mid-90 range. Also, I dropped 7 lbs after I increased my vitamin D. I also take a calcium/magnesium/phosphorus supplement. I added the other supplements after learning that vitamin D can pull these from our bones. When I feel that my blood glucose is stable, I will begin to reduce the amount of D that I am taking.

  95. Thanks for the post Mary Titus. I have had a similar experience.
    Due to vitamin D toxicity fear mongering, many people are afraid to go beyond the RDA for vitamin D or, if they do, to take more than 2 or 3 thousand IUs of D3 per day. Canadian vitamin D scientist, Dr. Rheinhold Veith, has advised that one would have to have a total vitamin D intake of 40,000 IUs a day for months in order to experience toxicity.
    I took a series of doses in the order of 50,000 IUs in combination with a regular supplement of 10,000 or more IUs of D3 per day. After experiencing a myriad of health issues during my life, some quite subtle, I now feel better than I have ever felt. I attribute this to the correction of a chronic, long standing vitamin D deficiency.
    I a enrolled in the GrassRootsHealth 5 year vitamin D study designed to assess the effects of maintaining serum levels of vitamin D between 40 and 60 ng/ml (100 to 150 nmol/L in Canada). Serum levels are tested every 6 months as part of the study. I am awaiting the results of my recent blood test.

  96. Just to put the other side of the story – I took 4,000 IU of D3 per day for four months and my 25(OH)D level reached 154 ng/ml (384 nmol/L). This was in the winter time so I wasn’t getting any sun at all. I live in the UK where we never get much sun anyway. After a complete break from D3 for several months I resumed at 2,000 IU per day and have been taking that for just over a year now – my last reading of 25(OH)D was 100 ng/ml (250 nmol/L). I have now cut down to 1500 IU D3 per day because there are some signs of abnormality – too high alkaline phosphatase levels associated with the 25(OH)D levels.
    Everyone is different and some people need a lot of D3 and some people don’t. The only way to find out is to do lots of testing – I get tested every three months or so.

    1. You make an excellent point. The only real way to monitor how you are doing vitamin D-wise it to get tested regularly. Here is an excellent post on everything you need to know about vitamin D by Dr. William Davis of the Heart Scan Blog that lays it all out.

  97. Anne,
    Am I correct in remembering you posted about your elevated 25 (OH)D result on another blog (Heart Scan blog?)? But i also seem to remember that you also regularly consume a high level of fatty fish compared to most people.
    Fatty fish are one of the few Vit D rich food sources, and a high consumption rate could indeed make a significant difference in a 25 (OH)D test result.

  98. Oh, I know testing is necessary. I will be testing soon but I would wager that my D levels have been quite low for most of my life. My mom had been fighting diabetes for 25 years which eventually lead to kidney failure. She developed pancreatitis and the antibiotic used to treat it caused her to get C-Diff which is comparable to mersa. She was able to survive the C-Diff but died 2 weeks later. Deep down, I will believe for the rest of my days that my mom passed away from vitamin D insufficiency.

  99. Hi Anna,
    That was indeed probably me you remember posting about. I eat at least one portion of oily fish per day and sometimes two (I also have diabetes btw, atypical type 2, I’m thin and not insulin resistant). I wrote to Dr David Grimes, the doctor who Dr Davis had quoted in his blog, about fish and vitamin D. From what he replied to me it is still not clear that this is the reason my 25(OH)D is so high and Dr Grimes went on to advise me to accept injections of vitamin D2 from my endocrinologist ! This is not something I will do I hasten to add ! My endocrinologist’s rationale in wanting me to have D2 injections is that this is the only way he can be sure of the amount of supplemental D I am getting as he thinks the capsules I take are inaccurate. I take Carlson’s so I don’t think they are inaccurate as so many other people take them and don’t get these high levels of 25(OH)D !

  100. There are some attention-grabbing closing dates in this article however I don’t know if I see all of them heart to heart. Theres some validity however I will take maintain opinion till I look into it further. Good article , thanks and we want more!

  101. Good insight by the doctor. I have been curious to know more about Vitamin D and have found that people take utmost care to have the proper intake of vitamin D. I came across one nice article about Vitamin D and you can find it interesting too.
    Boca Wellness and Nutrition

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