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Vit D - Australian MS Society advice

Postby bromley » Fri May 16, 2008 1:54 am

This one is for the beautiful Jimmylegs, but I don't mind if others read it.

Ian


http://www.msra.org.au/news/documents/M ... ebsite.pdf
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Vitamin D and Type 1 diabetes

Postby Frank » Thu Jun 05, 2008 4:00 pm

It seems that as with MS, high vitamin D levels do correlate with low disease incidence in type 1 diabetes:

Link

--Frank
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Vitamin D News

Postby NHE » Wed Jun 25, 2008 3:53 am

Not MS related but still interesting nonetheless...

Low vitamin D seen more in patient deaths
http://seattlepi.nwsource.com/national/ ... ins24.html

Research backs importance of dose of 'sunshine'

Last updated June 23, 2008 9:13 p.m. PT
By Lindsey Tanner, The New York Times

CHICAGO -- New research linking low vitamin D levels with deaths from heart disease and other causes bolsters mounting evidence about the "sunshine" vitamin's role in good health.

Patients with the lowest blood levels of vitamin D were about two times more likely to die from any cause during the next eight years than those with the highest levels, the study found. The link with heart-related deaths was particularly strong in those with low vitamin D levels.

Experts say the results shouldn't be seen as a reason to start popping vitamin D pills or to spend hours in the sun, which is the main source for vitamin D.

For one thing, megadoses of vitamin D pills can be dangerous and skin cancer risks from too much sunshine are well-known. But also, it can't be determined from this type of study whether lack of vitamin D caused the deaths, or whether increasing vitamin D intake would make any difference.

Low vitamin D levels could reflect age, lack of physical activity and other lifestyle factors that also affect health, said American Heart Association spokeswoman Alice Lichtenstein, director of the Cardiovascular Nutrition Laboratory at Tufts University.

Still, she said the study is an important addition to an emerging area of research.

"This is something that should not be ignored," Lichtenstein said.

The study led by Austrian researchers involved 3,258 men and women in southwest Germany. Participants were aged 62 on average, most with heart disease, whose vitamin D levels were checked in weekly blood tests. During roughly eight years of follow-up, 737 died, including 463 from heart-related problems.

According to one of the vitamin tests they used, there were 307 deaths in patients with the lowest levels, versus 103 deaths in those with the highest levels. Counting age, physical activity and other factors, the researchers calculated that deaths from all causes were about twice as common in patients in the lowest-level group.

Results appear in Monday's Archives of Internal Medicine.

The study's lead author, Dr. Harald Dobnig of the Medical University of Graz in Austria, said the results don't prove that low levels of vitamin D are harmful "but the evidence is just becoming overwhelming at this point."

Scientists used to think that the only role of vitamin D was to prevent rickets and strengthen bones, Dobnig said.

"Now we are beginning to realize that there is much more (to) it," he said.

Exactly how low vitamin D levels might contribute to heart problems and deaths from other illnesses is uncertain, although it is has been shown to help regulate the body's disease-fighting immune system, he said.

It has been estimated that at least 50 percent of older adults worldwide have low vitamin D levels, and the problem is also thought to affect substantial numbers of younger people. Possible reasons include decreased outdoor activities, air pollution and, as people age, a decline in the skin's ability to produce vitamin D.

Some doctors believe overuse of sunscreen lotions has contributed, and say just 10 to 15 minutes daily in the sun without sunscreen is safe and enough to ensure adequate vitamin D, although there's no consensus on that.

Diet sources include fortified milk, which generally contains 100 international units of vitamin D per cup, and fatty fish -- 3 ounces of canned tuna has 200 units.

The Institute of Medicine's vitamin D recommendations are 200 units daily for children and adults up to 50, and 400 to 600 units for older adults.
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Low Vitamin D

Postby GeoGuy » Wed Jun 25, 2008 6:23 pm

Hi Gang,

I don't normally haunt this board but I was recently diagnosed with low Vitamin D levels. My Primary Care Doc had me start on 2000 IU of Vit D . After 8 weeks, my blood work last week showed my D levels had increased, but were stilll below normal. She wants me to take 3000 IU and go back for a check in 8 weeks. What have you guys done to up your vitiamn D levels?

Thanks,

Jack.
RRMS since 01/07.
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Postby gwa » Wed Jun 25, 2008 7:15 pm

Now is a good time to go out in the sun 3 or 4 times a week for 15 minutes a pop. Supposedly spending time in the sun will provide more Vit D than taking a few thousand units of supplements.

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Postby jimmylegs » Fri Jun 27, 2008 4:39 pm

half an hour unprotected white young skin in summer sun can supposedly generate 10000 IU. i'd go 15 minutes if it was during peak hours midsummer. haze, cloud cover, pigment, age, and clothing impair cutaneous d3 production. of course the time of year and latitude are also relevant.

when i wanted to whack my level up 50 nmol/L fast, i got a liquid, a drop in the morning and a drop at night. total, 50000 IU per day for 10 days. it worked my followup test had levels of 149. i kept on taking a daily maintenance dose of d3 but i was not taking enough calcium, magnesium, zinc, and potassium with it and i got myself out of balance. if you can, consider intensifying your consumption of mineral-intense foods to go with your sunshine. you still might need some supplements. from the number of ppl on here that they help, our routine daily food intakes generally just don't cut it. good luck getting it straightened out fast!

curious: what number is defined as "low" by your lab?
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Postby daverestonvirginia » Mon Jun 30, 2008 9:16 am

I have gone up to 6,000 iu's a day in the winter months.
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Postby GeoGuy » Mon Jun 30, 2008 7:06 pm

Thanks for your input, I really appreciate it. I get more than 15 minutes of sun a day while I wait outside for the bus every weekday, so I don't think just exposure to the sun will be enough. During summers here in North Carolina it can be tough to balance sun exposure and staying out of the heat and humidity.

I'm not sure what level is considered low. I should have asked for specifics and will when I go back mid-August for more testing. I'll let you know.

Jack
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Postby jimmylegs » Tue Jul 01, 2008 6:13 am

hi GG, cutaneous production will be less if you are covered with clothing, darker skinned, and/or deeply tanned. if you can find a way to get some lighter parts exposed without getting in trouble, that might help some.

do find out what low is though, it would be good to know. i had been supplementing for some time when i got my first test and it was only 72. the docs would have said that was fine but by that time i had a stack of literature that supported a different view. 72 might be okay for preventing osteoporosis, but for immune health, gotta be higher. the intended boost of 50 nmol/L from that high octane liquid i took ended up being more like 75 since i got up to 149 but i've never been that high since and i was back down in the 70s at my last test. i'm not getting enough sun either so i should probably try to make a point of it.

by the way my units are in metric but there is a conversion site called SI Units for Clinical Data and vitamin D3 is at the bottom.

http://www.unc.edu/~rowlett/units/scale ... _data.html
Vitamin D
25-Hydroxyvitamin D ng/mL 2.496 nmol/L

which i take to mean you divide my numbers by 2.496 to get values in ng/mL.
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Postby jimmylegs » Tue Jul 01, 2008 6:28 am

oh i just re-read about the heat and humidity, that must make it tougher for sure.

the literature advises that the body uses 4000IU per day. one would hope some of that comes from food. maybe with your 2000IU plus food, you were only getting enough for a small boost. so 3000IU will surely make it climb faster.

if you find out what your numbers are, there is a paper out there which lets you calculate how much you need to take for your body weight in order to reach your desired level of vitamin D in a specified time.

i had used it to figure out it would take months and months for me to make it from 72 to where i wanted to be, which i why i started asking questions and found out from the hospital about the 50,000IU x 10d idea.

it was the pharmacist that looked up the specific product i ended up with. first he handed me a bottle of 50,000IU pills, but they turned out to be D2, so then he went to his product tome and found the intense liquid D3, which is what i used. i have a prescription for it right now but i thought hey, it's summer - turns out i'm spending so much time writing on the computer i should probably just take it.

but do take care when you up your D3 intake, to balance with calcium and magnesium. i think the best bet diet recommends 1200mg calcium and 600-1200mg magnesium. i certainly didn't take enough and i think that's why my throat got so bad, and why the magnesium fixed it so quickly.

personally, when i tried to up my minerals to match my 4000 d3, it made my back hurt. kidneys didn't like it, is what i thought. next time, i might try the cal-mag mix the other way around, with 1 cal to 2 mag. will report on how this strategy works out, in regimens under Mega D :)
cheers

hope that helps!
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Vitamin D Supplementation in the Fight Against MS

Postby Nick » Mon Jul 07, 2008 6:27 pm

Below is an article writen by Ashton Embry for the New Pathwaysmagazine's January, 2008 edition.

Cheers
Nick

Vitamin D Supplementation in the Fight Against MS


On the 28th December 2007, vitamin D made Time magazine’s top 10 list of medical breakthroughs for that year, after a twelve month period in which the solid scientific support for the linkage with Multiple Sclerosis grew considerably.

When this latest information, summarized below, is combined with all the previous work it essentially leaves very little doubt that MS is a long latency vitamin D deficiency disease. Once this is accepted then it becomes obvious that adequate vitamin D intake from birth onward can protect a person from MS regardless of genetic susceptibility or exposure to other environmental factors involved in MS.

A year ago researchers at Harvard University (Munger et al) compared vitamin D levels in stored, blood samples of soldiers later diagnosed with MS to vitamin D levels of matched, healthy controls. This work demonstrated that “the risk of multiple sclerosis significantly decreased with increasing levels of 25 hydroxvitamin D” (the form of vitamin D which circulates in the blood). Furthermore, the researchers found that this correlation “was particularly strong for vitamin D levels measured before age 20”. Harvard researchers led by Alberto Ascherio followed up this paper with a comprehensive review article on environmental risk factors for MS and the evidence linking vitamin D to MS covered 5 pages. At the same time, George Ebers of Oxford University co-authored a major review paper on environmental causes of MS and pointed to vitamin D as one of the main factors. When researchers at two of the top universities in the world are touting vitamin D as a significant causal factor of MS in mainstream medical journals, you know that the concept is finally being taken seriously by the MS research establishment some 33 years after it was first proposed.

A study of regional differences in MS prevalence for French farmers was published in April 2007 by Vukusic et al. It is clear that the differences in MS prevalence, which are over two fold, are readily explained by variations in ultraviolet radiation/vitamin D supply over France. Such an interpretation is hard to challenge because genetics is not a confounding factor and the farmers are distributed evenly throughout the country. Additional convincing evidence of the MS/vitamin D linkage was provided by a study of childhood sun exposure and MS risk of identical twins in North America by Islam et al. The results demonstrated that “the risk of MS was substantially lower for the twin who spent more time suntanning in comparison with the co-twin”.
A third study by Kampman et al. looked at the risk of MS and differences in outdoor activities and diet of children and adolescents born and living in northern Norway. They found that increased outdoor activities in early life as well as cod liver oil supplementation were associated with a lower risk of MS. I would emphasize that these three, solid studies from different parts of the world all strongly support the concept that the higher one’s supply of vitamin D, the lower the risk of MS.

Also of importance were three other studies published in 2007, all of which looked at vitamin D status and disability in persons with MS. Van der Mei et al measured vitamin D levels in persons with MS in Tasmania and found that “increasing disability was strongly associated with lower levels of 25(OH)D (circulating vitamin D) and with lower levels of sun exposure”. In Finland, Soilu-Hanninen et al demonstrated that, for MS patients, there was “an inverse relationship between serum vitamin D levels and MS clinical activity”. Finally Woolmore et al in a British study found that there was an association between skin type and disability in female MS patients. Those with sun-sensitive skin types, which produce vitamin D faster, had lesser disability. These studies all point to the same conclusion that increased vitamin D, lessens disease progression and resulting disability.

Another key paper published in 2007 was that by Holmoy who came to the same conclusion I had in my 2004 paper on MS causal factors. He interpreted that adequate vitamin D in childhood prevents MS by regulating the immune system such that it does not produce myelin-sensitive immune cells during and after infections with childhood viruses such as Epstein-Barr. To me, this is by far the simplest and most reasonable explanation of how adequate vitamin D ensures MS does not develop in later life.

Perhaps the most important paper on vitamin D published in 2007 did not address MS but cancer. Lappe et al convincingly demonstrated with a 4 year, double blind, clinical trial involving over 1000 post-menopausal women that supplementing with 1000 IU of vitamin D reduced all-cancer risk by a very impressive 60%. One can only wonder what the result would have been with an adequate supplement of 4000-5000 IU. In terms of MS, cancer prevention is a welcome “side effect” of maintaining adequate vitamin D levels

The last publications I’ll mention deal with safety issues. A study by Hathcock et al provided clear evidence that an intake of 10,000 IU of vitamin D per day is perfectly safe and that such an amount should be adopted as the safe upper limit for vitamin D intake. Kimball et al showed that up to 40,000 IU a day did not result in any adverse side effects.

Given all the evidence which ties vitamin D to MS onset and progression and the recent data on the safety of 10,000 and perhaps as much as 40,000 IU/d, I would strongly recommend persons with MS consider using 6000 IU/d as an adequate supplement. This will ensure their circulating 25D level will always be in the 125 -200 nmol/l range and such a level may well have significant benefit. Furthermore I would recommend that all first degree relatives of persons with MS maintain a 25D level of at least 100 nmol/l and preferably closer to 150 nmol/l.


Ashton Embry PhD
http://www.DIRECT-MS.org



Vitamin D Supplementation in the Fight Against MS(cont’d).


Online Presentations.

The Vitamin D Pandemic and its Health Consequences
Presented by Michael Holick, PhD, MD, Professor of medicine, physiology and biophysics and director of the General Clinical Research Center at Boston University Medical Center. (Keynote address at the opening ceremony of the 34th European Symposium on Calcified Tissues, Copenhagen 5 May, 2007)
http://www.vitamind-holick.ms-diet.org/


Prospects for Vitamin D Nutrition
Presented by Rheinhold Veith, associate professor of nutritional sciences and pathobiology and laboratory medicine, University of Toronto.
http://www.vitamind-veith.ms-diet.org/



Relevant Research Papers

Diagnosis and Treatment of Vitamin D Deficiency
JJ Cannell , BW Hollis, M Zasloff & RP Heaney
Atascadero State Hospital, 10333 El Camino Real, Atascadero, California 93422, USA
http://www.vitamind-cannell.ms-diet.org


References

Ascherio A, Munger KL., 2007, Environmental risk factors for multiple sclerosis. Part II: Noninfectious factors. Ann Neurol. 61(6):504-13.

Giovannoni G, Ebers G., 2007, Multiple sclerosis: the environment and causation.
Curr Opin Neurol; 20(3):261-8.

Hathcock JN, Shao A, Vieth R, Heaney R., 2007, Risk assessment for vitamin D.
Am J Clin Nutr 85(1):6-18.

Holmøy T., 2008, Vitamin D status modulates the immune response to Epstein Barr virus: Synergistic effect of risk factors in multiple sclerosis.
Med Hypotheses.70(1):66-

Islam T, Gauderman WJ, Cozen W, Mack TM., 2007, Childhood sun exposure influences risk of multiple sclerosis in monozygotic twins. Neurology. 69(4):381-8.

Kampman MT, Wilsgaard T, Mellgren SI., 2007, Outdoor activities and diet in childhood and adolescence relate to MS risk above the Arctic Circle. J Neurol. 254(4):471-7.

Kimball SM, Ursell MR, O'Connor P, Vieth R., 2007, Safety of vitamin D3 in adults with multiple sclerosis. Am J Clin Nutr. 86(3):645-51.

Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP., 2007, Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 85(6):1586-91.

Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A., 2006, Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA.296(23):2832-8.

Soilu-Hanninen M, Laaksonen M, Laitinen I, Eralinna JP, Lilius EM, Mononen I., 2007, A longitudinal study of serum 25-hydroxyvitamin D and intact PTH levels indicate the importance of vitamin D and calcium homeostasis regulation in multiple sclerosis.
J Neurol Neurosurg Psychiatry.

Van der Mei IA, Ponsonby AL, Dwyer T, Blizzard L, Taylor BV, Kilpatrick T, Butzkueven H, McMichael AJ., 2007, Vitamin D levels in people with multiple sclerosis and community controls in Tasmania, Australia. J Neurol. 254(5):581-90

Vieth R., 1999, Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 69(5):842-56.

Vukusic S, Van Bockstael V, Gosselin S, Confavreux C., 2007, Regional variations in the prevalence of multiple sclerosis in French farmers. J Neurol Neurosurg Psychiatry. 78(7):707-9.

Woolmore JA, Stone M, Pye EM, Partridge JM, Boggild M, Young C, Jones PW, Fryer AA, Hawkins CP, Strange RC., 2007, Studies of associations between disability in multiple sclerosis, skin type, gender and ultraviolet radiation. Mult Scler.13(3):369-75.





Vitamin D Supplementation in the Fight Against MS.

Practical Information Sheet – Issue 1(Jan 2008)

Introduction: The most reliable indicator of circulating vitamin D levels is the 25(OH)D test and regular testing of this, both before and during supplementation, is essential.

The key is to ensure a level of circulating vitamin D - 25(OH)D - of between 125 and 150nmol/l which is considered to be the optimum range to maintain good health and to reduce the risk of autoimmune reactions developing into full-blown autoimmune disease.
The advised procedure is this.
1. Arrange for a 25(OH)D blood test at your doctors before beginning supplementation. You will need to obtain your GP's continued support for this and, in the circumstances, it would seem advisable to show him/her the attached letter(Jan 2008), with the very latest research linking MS with vitamin D deficiency. Indeed, it would make sense to send this to the surgery, marked for the attention of your GP, a few days in advance of your appointment to allow time to peruse both the online presentations and the latest paper by Cannell et al.
2. In the UK, this test should be available free of charge from your GP although some group members have had to pay a nominal fee in the past so don't be surprised if this is the case.
3. Make sure they order the correct test. It is the 25(OH)D test, NOT the 1,25(OH)D test.
4. Be warned, it can take several weeks to obtain the results and, as mentioned previously, you should also have your serum calcium levels checked at the same time and these should remain in the range 2.2-2.6 nmols/L, at all times, to ensure hypercalcemia does not develop.
5. When the results are back, make sure they give you the actual figures. You will need this to compare with future readings. The aim is to raise your levels to the range 125-150 nmols/L as quickly as possible and, as a starting point, the current advice is to use a daily supplement of 2000iu in summer and 4000iu in winter.
6. Different labs can use different units and while many will give the results in nmols/L, just as many will quote ng/ml(nanogramms per millilitre) but there is a simple conversion factor between the two. When the figures are given in the latter units, just multiply by 2.5 to convert to nmols/L. (Please note that ug/l and pg/ul are the same as ng/ml and, as such, the same conversion factor applies.)
7. We would ask that you remember to record your 25(OH)D and serum calcium test results on our website, as part of our online BBD Questionnaire(s). [Available March 2008] If you do not have internet access, just call (0)800 783 0518 and the MSRC staff will do this on your behalf.
8. It is essential(to prevent osteoporosis), that while supplementing with vitamin D3(cholecalciferol), you have an adequate intake of calcium/magnesium. If you are avoiding dairy(Best Bet Diet) you must also supplement with 1200mg essential calcium and 600-1200mg magnesium.
9. If you have children and intend to use vitamin D as a protection against them developing the condition, it is important to discuss this with your doctor as well and have their levels of 25(OH)D and serum calcium checked BEFORE starting the process.
10. Once again, we would ask that you let us know their figures for our study.
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Re: Vitamin D supplementation in the fight against MS

Postby NHE » Tue Jul 08, 2008 2:39 am

Hi Nick,
Thanks for sharing this article.
He interpreted that adequate vitamin D in childhood prevents MS by regulating the immune system such that it does not produce myelin-sensitive immune cells during and after infections with childhood viruses such as Epstein-Barr.

This quote makes me wonder what vitamin D may or may not do for other autoimmune diseases?

NHE
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Re: Vitamin D supplementation in the fight against MS

Postby Nick » Tue Jul 08, 2008 7:30 am

NHE wrote:Hi Nick,
Thanks for sharing this article.
He interpreted that adequate vitamin D in childhood prevents MS by regulating the immune system such that it does not produce myelin-sensitive immune cells during and after infections with childhood viruses such as Epstein-Barr.

This quote makes me wonder what vitamin D may or may not do for other autoimmune diseases?

NHE


N

I believe vitamin D is the common denominator to most if not all of the AI disorders. For instance Hypponen et al demonstrated that infants given 2,000 IU/d via CLO for the first year of life had a risk reduction of 80 % for type 1 diabetes.

Cheers
N
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Postby cheerleader » Tue Jul 08, 2008 11:50 am

Thanks for all the info, Nick.
I really appreciate your posts.
I began giving my 13 yr. old son vitamin D supplements when my husband was dx last year. This, and lots of so cal sunshine, should help protect his immune system.
My husband grew up in California, and spent alot of time outside in the sun. (He has the basal cells to prove it.) His serum vit. D levels are normal with supplementation. I continue to wonder if there is something interfering with vit D production and absorption in MSers. Perhaps a melanin disorder, cholesterol or liver problem? Could vit. D depletion be part of the autoimmune disease process?
AC
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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