all things vitamin D

Discuss herbal therapies, vitamins and minerals, bee stings, etc. here

Postby cheerleader » Thu Apr 03, 2008 4:29 pm

OK....I live in southern California, and the weather is really beautiful here all year round (Please don't hate me!) I was just in West Palm last week too, visiting my Dad. We played tennis, and I got quite a burn!

My Californian husband has had three basal cell sites cut off his face and torso. He's been outside in the sun his whole life, and he got MS. I KNOW his MS isn't from lack of vitamin D thru his skin, but maybe through his digestive system. I think leaky gut and malabsorption were the culprits in his vitamin imbalances.

Lew, PLEASE put sunscreen on your precious daughter...fifteen minutes w/out suncreen a day is all she needs. You can also give her more vitamin D fortified food and milk. Melanoma isn't any better than MS. My socal son is at the beach all summer, and he wears a rash guard shirt and sunscreen...and I'm not worried about his vit. D levels, because he's outside everyday. No need to burn, folks!

-the very fortunate Calfornian cheerleader
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby ssmme » Thu Apr 03, 2008 5:35 pm

I do wear sunscreen especially on my face at SPF 30. I put SPF 50 on my kids when they go outside especially when swimming and they still come home with a beautiful tan. Of course I do not. I am as fair skinned as they come. My freckles get darker but that's all. I'm of germanic descent with brown hair, blue eyes, and fair skin. Do you think my skin might just have problems accepting vitamin D?

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Postby jimmylegs » Thu Apr 03, 2008 6:18 pm

nope i don't think so... light young skin makes vit d the best. the older you get, the less you make. the darker you are, the more clothing you wear (duh), the more you are inside, the worse your vitamin d status.
of course vitamin d is not the single determining factor in whether someone gets cancer (or other inflammatory condition) but it's looking like it's a big chunk.
if your levels are low after being out in the sun with pale skin, then i'd have to hypothesize some kind of failure in the hydroxylation processes in the liver and kidney?

hmm let me see if i can find that reference... it's about clothing and skin colour and d... ah ha, grover and morley... WOW awesome i can link you right to a table (box 2) i used in an essay in '06!
http://www.mja.com.au/public/issues/175_05_030901/grover/grover.html#box2
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Results of Direct-MS' sponsored trial on vitamin D safety

Postby Nick » Mon May 05, 2008 10:39 am

G'day people. The results are in from Direct-MS'ssponsored trial outlined here.

A Phase I/II Dose Escalation Trial of Oral Vitamin D3 with Calcium Supplementation in Patients with Multiple Sclerosis

Jodie M. Burton, Samantha Kimball, Reinhold Vieth, Amit Bar-Or, Montreal, QC, Canada, Hans-Michael Dosch, Louise Thibault, Sally Kilborn, Ste. Anne de Bellevue, QC, Canada, Cheryl D'Souza, Melanie Ursell, Paul O'Connor, Toronto, ON, Canada

OBJECTIVE: The main objective of the trial was to determine the safety of high-dose vitamin D3 (VD3) in Multiple Sclerosis (MS).

BACKGROUND: A clear inverse relationship exists between VD3 status and the probability of developing MS, likely through VD3 s immunoregulatory effects. If VD3 plays a role in MS development, it may also play a beneficial role after MS has developed, but a safe, effective dose must be established.

DESIGN/METHODS: This prospective controlled phase I/II 52-week trial matched clinically definite MS patients for age, gender, MS duration, EDSS, disease modifying drugs, and MS subtype. Patients were randomized to treatment or control groups. Treatment patients started at VD3 doses of 4,000 IU/d and escalated over 28 weeks to 40,000 IU/d. They were then maintained on 10,000 IU/d for 12 weeks, 4,000 IU/d for 8 weeks and a 4-week wash out. Calcium was given throughout the trial. The primary endpoint was mean change in serum calcium concentration in treatment patients over the year. Secondary endpoints included change in 25(OH)D, parathyroid hormone and urinary calcium/creatinine. EDSS and relapse rate were also evaluated, as were cytokine profiles, lymphocyte assays and matrix metalloproteinases across VD3 doses and between treatment and control groups.

RESULTS: Fifty patients were enrolled, with mean age 40.5y (21-54), EDSS 1.25 (0-6.5), and baseline 25(OH)D of 78nmol/L ( 27). Groups were balanced at baseline on all relevant parameters. Two patients dropped out, one before screening and one (treatment) at visit 3 for reasons unknown. With a mean serum 25(OH)D of 409nmol/L ( 152) at 40,000 IU/d, no hypercalcemia occurred nor did persistent hypercalciuria, with no significant differences in serum calcium values between the two groups. A trend of greater reduction in annualized relapse rate favoured treatment patients. Immunological results will be presented.

CONCLUSIONS/RELEVANCE: High-dose VD3 appears to be safe and tolerable in MS patients. Supported by: Direct-MS.

Category - MS and Related Diseases

SubCategory - Clinical Science

This following is another study conducted by some of the same researchers as the above trial. It was NOT funded by Direct-MS. Sorry for the confusion.

1: Am J Clin Nutr. 2007 Sep;86(3):645-51.

Safety of vitamin D3 in adults with multiple sclerosis.

Kimball SM, Ursell MR, O'Connor P, Vieth R.

Department of Nutritional Sciences, University of Toronto, Toronto, Canada. samantha.kimball@utoronto.ca

BACKGROUND: Vitamin D3 may have therapeutic potential in several diseases, including multiple sclerosis. High doses of vitamin D(3) may be required for therapeutic efficacy, and yet tolerability--in the present context, defined as the serum concentration of 25-hydroxyvitamin D [25(OH)D] that does not cause hypercalcemia--remains poorly characterized. OBJECTIVE: The objective of the study was to characterize the calcemic response to specific serum 25(OH)D concentrations.

DESIGN: In a 28-wk protocol, 12 patients in an active phase of multiple sclerosis were given 1200 mg elemental Ca/d along with progressively increasing doses of vitamin D3: from 700 to 7000 microg/wk (from 28,000 to 280,000 IU/wk). RESULTS: Mean (+/- SD) serum concentrations of 25(OH)D initially were 78 +/- 35 nmol/L and rose to 386 +/- 157 nmol/L (P < 0.001). Serum calcium concentrations and the urinary ratio of calcium to creatinine neither increased in mean values nor exceeded reference values for any participant (2.1-2.6 mmol/L and <1.0, respectively). Liver enzymes, serum creatinine, electrolytes, serum protein, and parathyroid hormone did not change according to Bonferroni repeated-measures statistics, although parathyroid hormone did decline significantly according to the paired t test. Disease progression and activity were not affected, but the number of gadolinium-enhancing lesions per patient (assessed with a nuclear magnetic brain scan) decreased from the initial mean of 1.75 to the end-of-study mean of 0.83 (P = 0.03).

CONCLUSIONS: Patients' serum 25(OH)D concentrations reached twice the top of the physiologic range without eliciting hypercalcemia or hypercalciuria. The data support the feasibility of pharmacologic doses of vitamin D3 for clinical research, and they provide objective evidence that vitamin D intake beyond the current upper limit is safe by a large margin.
PMID: 17823429 [PubMed - indexed for MEDLINE]


As the abstact states, the subjects were initally given 4,000 IU/d and at trial end, 40,000 IU/d. For optimal immunoregulation as suggested here and here, Direct-MS advocates taking 4,000 IU/d.

Cheers
Nick
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Results of Direct-MS' sponsored trial on vitamin D safety

Postby Nick » Mon May 05, 2008 10:49 am

G'day people. The results are in from Direct-MS'ssponsored trial outlined here.

A Phase I/II Dose Escalation Trial of Oral Vitamin D3 with Calcium Supplementation in Patients with Multiple Sclerosis

Jodie M. Burton, Samantha Kimball, Reinhold Vieth, Amit Bar-Or, Montreal, QC, Canada, Hans-Michael Dosch, Louise Thibault, Sally Kilborn, Ste. Anne de Bellevue, QC, Canada, Cheryl D'Souza, Melanie Ursell, Paul O'Connor, Toronto, ON, Canada

OBJECTIVE: The main objective of the trial was to determine the safety of high-dose vitamin D3 (VD3) in Multiple Sclerosis (MS).

BACKGROUND: A clear inverse relationship exists between VD3 status and the probability of developing MS, likely through VD3 s immunoregulatory effects. If VD3 plays a role in MS development, it may also play a beneficial role after MS has developed, but a safe, effective dose must be established.

DESIGN/METHODS: This prospective controlled phase I/II 52-week trial matched clinically definite MS patients for age, gender, MS duration, EDSS, disease modifying drugs, and MS subtype. Patients were randomized to treatment or control groups. Treatment patients started at VD3 doses of 4,000 IU/d and escalated over 28 weeks to 40,000 IU/d. They were then maintained on 10,000 IU/d for 12 weeks, 4,000 IU/d for 8 weeks and a 4-week wash out. Calcium was given throughout the trial. The primary endpoint was mean change in serum calcium concentration in treatment patients over the year. Secondary endpoints included change in 25(OH)D, parathyroid hormone and urinary calcium/creatinine. EDSS and relapse rate were also evaluated, as were cytokine profiles, lymphocyte assays and matrix metalloproteinases across VD3 doses and between treatment and control groups.

RESULTS: Fifty patients were enrolled, with mean age 40.5y (21-54), EDSS 1.25 (0-6.5), and baseline 25(OH)D of 78nmol/L ( 27). Groups were balanced at baseline on all relevant parameters. Two patients dropped out, one before screening and one (treatment) at visit 3 for reasons unknown. With a mean serum 25(OH)D of 409nmol/L ( 152) at 40,000 IU/d, no hypercalcemia occurred nor did persistent hypercalciuria, with no significant differences in serum calcium values between the two groups. A trend of greater reduction in annualized relapse rate favoured treatment patients. Immunological results will be presented.

CONCLUSIONS/RELEVANCE: High-dose VD3 appears to be safe and tolerable in MS patients. Supported by: Direct-MS.

Category - MS and Related Diseases

SubCategory - Clinical Science

This is another study conducted by some of the same researchers as the above trial. It was NOT funded by Direct-MS. Sorry for the confusion.

1: Am J Clin Nutr. 2007 Sep;86(3):645-51.

Safety of vitamin D3 in adults with multiple sclerosis.

Kimball SM, Ursell MR, O'Connor P, Vieth R.

Department of Nutritional Sciences, University of Toronto, Toronto, Canada. samantha.kimball@utoronto.ca

BACKGROUND: Vitamin D3 may have therapeutic potential in several diseases, including multiple sclerosis. High doses of vitamin D(3) may be required for therapeutic efficacy, and yet tolerability--in the present context, defined as the serum concentration of 25-hydroxyvitamin D [25(OH)D] that does not cause hypercalcemia--remains poorly characterized. OBJECTIVE: The objective of the study was to characterize the calcemic response to specific serum 25(OH)D concentrations.

DESIGN: In a 28-wk protocol, 12 patients in an active phase of multiple sclerosis were given 1200 mg elemental Ca/d along with progressively increasing doses of vitamin D3: from 700 to 7000 microg/wk (from 28,000 to 280,000 IU/wk). RESULTS: Mean (+/- SD) serum concentrations of 25(OH)D initially were 78 +/- 35 nmol/L and rose to 386 +/- 157 nmol/L (P < 0.001). Serum calcium concentrations and the urinary ratio of calcium to creatinine neither increased in mean values nor exceeded reference values for any participant (2.1-2.6 mmol/L and <1.0, respectively). Liver enzymes, serum creatinine, electrolytes, serum protein, and parathyroid hormone did not change according to Bonferroni repeated-measures statistics, although parathyroid hormone did decline significantly according to the paired t test. Disease progression and activity were not affected, but the number of gadolinium-enhancing lesions per patient (assessed with a nuclear magnetic brain scan) decreased from the initial mean of 1.75 to the end-of-study mean of 0.83 (P = 0.03).

CONCLUSIONS: Patients' serum 25(OH)D concentrations reached twice the top of the physiologic range without eliciting hypercalcemia or hypercalciuria. The data support the feasibility of pharmacologic doses of vitamin D3 for clinical research, and they provide objective evidence that vitamin D intake beyond the current upper limit is safe by a large margin.
PMID: 17823429 [PubMed - indexed for MEDLINE]


As the abstact states, the subjects were initally given 4,000 IU/d and at trial end, 40,000 IU/d. For optimal immunoregulation as suggested here and here, Direct-MS advocates taking 4,000 IU/d.

Cheers
Nick
Last edited by Nick on Sat May 10, 2008 1:11 am, edited 1 time in total.
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Postby jimmylegs » Mon May 05, 2008 12:48 pm

good stuff nick. is there anything in the works for the magnesium connection to d3 and calcium?
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Postby Nick » Mon May 05, 2008 1:34 pm

Not that I am aware of.
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Re: Results of Direct-MS' sponsored trial on vitamin D safet

Postby cheerleader » Mon May 05, 2008 6:01 pm

Nick wrote: Liver enzymes, serum creatinine, electrolytes, serum protein, and parathyroid hormone did not change according to Bonferroni repeated-measures statistics, although parathyroid hormone did decline significantly according to the paired t test.


Thanks for the info, Nick.

Good catch, JL....they need to add magnesium to the mix in order to avoid hypoparathyroidism.

Low levels of parathyroid can be caused by too little magnesium-

The element magnesium is closely related to the action of calcium in the body. When magnesium levels are too low, calcium levels may also fall. It appears that magnesium is important for parathyroid cells to make PTH normally.
http://parathyroid.com/hypoparathyroidism.htm

mg!
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Postby jimmylegs » Mon May 05, 2008 8:47 pm

thanks cheer! and the cascade just continues. you need zinc to absorb magnesium, and since i've heard that many ms patients are zinc deficient (as am i) you can chuck all the magnesium in that you want but without zinc it won't stick!
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Postby DIM » Tue May 06, 2008 12:04 am

Just to add DON'T take magnesium with calicum as they compete each other during absorption, take magnesium with zinc or alone (better before sleep as it helps relaxation) and calcium with vitamin D.
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Correction to my original post

Postby Nick » Sat May 10, 2008 1:16 am

Please note the correction I have made to my original post. I posted the wrong abstract although the results from both trials are similar. Sorry for the mistake.

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Postby jimmylegs » Sat May 10, 2008 6:26 am

noted; thanks again nick
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Postby Punchy » Sat May 10, 2008 6:59 pm

I feel obligated to point out that too much sun can be much more dangerous than too little.

An amazing, beautiful friend of mine passed away a year ago this month from melanoma at the age of 30. :(
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Postby TwistedHelix » Sun May 11, 2008 5:47 am

Some members of the medical community are ultra cautious if you mention taking vitamin D above the pitifully low amount of 400 IU. They are concerned about hypercalcemia and hypercalcinuria, (excess calcium in the blood and urine), but it seems that most people would have to take enough tablets to sink a battleship for that to happen. Even if it does, somebody, (could have been me), posted a little while ago about research which shows that levels quickly drop as soon as you cut your intake so it's a problem that's easily rectified,I think vitamin D is beginning to look like a panacea that might just live up to the hype .

Punchy, I'm so sorry to hear about your friend: my dad died of skin cancer and although I was too young to know him, I feel for your loss,
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Postby gwa » Sun May 11, 2008 7:21 am

From what I have read, being in the sun for about 15 minutes 3x a week is all it takes to keep your body making adequate Vit D. If a person is out longer than those time frames, a good sunscreen should probably be used.

We have spent a lot of time around pools in Arizona and the number of older people that now look like tooled leather belts is amazing. I sure don't want to end up looking like them and do not lay out in the sun.

A nurse at the dermatologist's office I went to in Hawaii told me that after working for a plastic surgeon for years and seeing so much skin cancer, she avoided long exposure in the sun whenever possible.

Taking supplements makes a lot of sense for most of us.

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