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4,000 IU Vit D3 takers...measuring your levels?

Postby Wonderfulworld » Thu Jul 16, 2009 3:36 am

Hi
of those of you who take high doses of Vit D3 - greater than 2,000 IU, do you regularly test your levels?

Finally I have got my Vit D3 up to 134 nmol/L after years of insufficiency and I'm hoping it might have a good effect on the MS. Many thanks to Jimmylegs in her help on this - thanks JL! More importantly my 17 month old son's D3 levels were 75nmol/L earlier in the year after supplementing for 6 months, so hopefully he will have less of a risk of MS.

I have seen the recent articles that say 4,000IU was given to PWMS over a long period, along with 1,200mg calcium.

Just wondering how frequently do you check your 25(0H) nmol/L levels?
~~~~~~~~~~~~~~~
Concussus Resurgo
~~~~~~~~~~~~~~~
RR-MS dx 1998 and Coeliac dx 2003
~~~~~~~~~~~~~~~
Copaxone, Cymbalta. EPO, Fish Oils, Vitamin D3 2000 IU daily, Cal/Mag/Zinc, Multivitamin/mineral, Co-Enzyme Q10, Probiotics, Milk Thistle.
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Postby jimmylegs » Thu Jul 16, 2009 7:41 am

hi ww, you are welcome!

to answer your question, i can't say i test d3 regularly, but i do test it sporadically depending on the situation. for instance when i'm going to megadose, i have usually had an unsatisfactory baseline test. after i megadose, i do a follow-up test. it is very important to do this.

from the current state of the research, i consider the range for immune system health to be 100-250nmol/L.

early on, i had a test result 72. i megadosed for 10 days and got up to 149.

recently - after spending the winter taking 25,000/IU every one to two weeks, so probably just under 2000 - 4000 IU/d - i had a test result of only 103.

i decided i would be happier at 150 so i did about 8 days of megadosing (50,000IU/d), thinking it would be similar to the first experience and boost me into the 150 range.

instead this time my d3 shot up from 103 to 271. it appears that some of my other deficiencies, having been identified and corrected since my first mega D3 experience, have had a dramatic effect my body's d3 absorption.

monitoring is worth it - especially when a few thousand IU a day doesn't cut it and you take megadose short cuts!!
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Postby Wonderfulworld » Fri Jul 17, 2009 12:34 pm

Thanks JL, useful info.
I have never megadosed like you, just gradually done 5000IU for the winter until about April, then 2000IU since. That's interesting you went up to 271! - gosh that's high! - did you have to do anything to bring it down, or did you just leave off the supplements for a while?

I agree about getting the other vits/minerals correct and it increasing the absorbtion - I made negligable progress until I got the cal/mag/zinc sorted too and the timing info you gave me about splitting the vit d dose helped I think, taking mag at one time with d, then calcium and mag later too.

Think I'll go twice a year to keep an eye on things.
~~~~~~~~~~~~~~~
Concussus Resurgo
~~~~~~~~~~~~~~~
RR-MS dx 1998 and Coeliac dx 2003
~~~~~~~~~~~~~~~
Copaxone, Cymbalta. EPO, Fish Oils, Vitamin D3 2000 IU daily, Cal/Mag/Zinc, Multivitamin/mineral, Co-Enzyme Q10, Probiotics, Milk Thistle.
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Postby jimmylegs » Sat Jul 18, 2009 11:48 am

heya ww, i just stopped supplementing since the high result. actually, since about a week before the blood was taken - around june 12th i think? i was waiting for my results before starting up again.

i'm going aug 10 for follow-up bloodwork. i think the zinc might have had a lot to do with the sudden skyrocketing. d3 receptors have "zinc fingers" - maybe the body only builds so many of them when zinc levels are low??

ww i'm curious - how long were you having trouble before adding the cal/mag/zinc? once you started it, how long did it take for your d3 levels to come up?

twice a year sounds about right for monitoring. glad to hear that the levels have normalized/optimized!

JL
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Postby Wonderfulworld » Sun Jul 19, 2009 9:33 am

Yes you might be right about the zinc.

I had been trying to raise Vit D for a year but I think I was only taking 1-2000 IU so probably not enough. Last winter I got the other vits/mins sorted out as per your information, and increased dose to 5000 IU from about November to April and then it normalised.
Yay! :lol:

Going for a bone density scan this week too because it looks as if I might have had low calcium/vit D for a few years....got a low result in 2005 but never followed it up. Good luck on Aug 10th.
~~~~~~~~~~~~~~~
Concussus Resurgo
~~~~~~~~~~~~~~~
RR-MS dx 1998 and Coeliac dx 2003
~~~~~~~~~~~~~~~
Copaxone, Cymbalta. EPO, Fish Oils, Vitamin D3 2000 IU daily, Cal/Mag/Zinc, Multivitamin/mineral, Co-Enzyme Q10, Probiotics, Milk Thistle.
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Postby jimmylegs » Mon Jul 20, 2009 7:39 am

awesome ww!

since the d3/cal/mag/zinc are all beneficial for bones too, i wonder how much time will be needed to see improvement (given that you've been low for a few years now)? i hope, with all the supplementing, that you get a better bone density result this time - let me know :)

potentially useful link:
Other Nutrients and Bone Health At A Glance
http://www.niams.nih.gov/Health_Info/Bo ... rients.asp

take care :)
JL
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Postby Wonderfulworld » Tue Jul 21, 2009 1:32 pm

Thanks JL that link is very informative.

Forgot to say that I encouraged another MS-friend who is not as "into" the research as I am to go for her D3 levels too. She was sceptical she would be deficient but her results came back at 49nmol/L too - identical to my levels last year. She is now also supplementing to get her levels up. So 2 people are in your debt. :wink:
~~~~~~~~~~~~~~~
Concussus Resurgo
~~~~~~~~~~~~~~~
RR-MS dx 1998 and Coeliac dx 2003
~~~~~~~~~~~~~~~
Copaxone, Cymbalta. EPO, Fish Oils, Vitamin D3 2000 IU daily, Cal/Mag/Zinc, Multivitamin/mineral, Co-Enzyme Q10, Probiotics, Milk Thistle.
Wonderfulworld
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Postby jimmylegs » Wed Jul 22, 2009 7:57 am

great to hear that she's aware and working on it now! :)
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Postby Wonderfulworld » Fri Jul 24, 2009 12:16 pm

Hi JL
you said to let you know about th bone density - it's normal. I am delighted. It wasn't actually bone density that I had tested previously, just calcium levels in my blood and they were low. I had so many risk factors for osteoporosis yet I have escaped!

By the way I had to stop cal/mag/d3/zinc and my multivit for a few days prior to the Dexa scan. I have been in discomfort since, with cramping and cricks in my neck and shoulders, keeping me awake at night. So I think the cal/mag is really helping my tight muscles.
~~~~~~~~~~~~~~~
Concussus Resurgo
~~~~~~~~~~~~~~~
RR-MS dx 1998 and Coeliac dx 2003
~~~~~~~~~~~~~~~
Copaxone, Cymbalta. EPO, Fish Oils, Vitamin D3 2000 IU daily, Cal/Mag/Zinc, Multivitamin/mineral, Co-Enzyme Q10, Probiotics, Milk Thistle.
Wonderfulworld
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Posts: 773
Joined: Sun Aug 27, 2006 3:00 pm
Location: Ireland

Postby jimmylegs » Fri Jul 24, 2009 12:32 pm

that's so great ww!!

the cal and mag are definitely requirements for proper muscle function. and sleep for that matter :)

glad to hear your good news!
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Millions of US children low in vit D

Postby Frank » Mon Aug 03, 2009 5:40 am

Treatment: Gilenya since 01/2011, CCSVI both IJV ballooned 09/2010, Tysabri stopped after 24 Infusions and positive JCV antibody test, after LDN, ABX Wheldon Regime for 1 year.
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Postby peekaboo » Mon Aug 10, 2009 8:01 am

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Date: 20090810

Dear holly



Due to some technical difficulties, a poorly formatted version of the recent newsletter on vitamin D supplements was sent out to subscribers. We apologise for the inconvenience. Here is the newsletter as it was supposed to look. We hope it helps.

It seems a sensible time of year in the Southern Hemisphere at least to remind people of the benefits of vitamin D supplementation. This is the time when people who have not been careful about their vitamin D status are at risk of relapse.

Vitamin D Supplementation
It seems clear that we in the medical profession have been overly concerned with the potential for toxicity from supplementing with vitamin D, and that we have under-estimated the doses required for optimal health quite significantly. Vitamin D levels in the body can be easily measured with a simple blood test. A level of less than 25nmol/L is considered currently to represent moderate to severe deficiency, a level of 25-50nmol/L mild deficiency, and a level of 50-75nmol/L borderline deficiency.

There is quite a bit of evidence that we have set these levels too low and that optimal levels are really quite a bit higher.(1) Even at these levels, it has been shown that 80% of women and 70% of men living in hostels in Victoria, New South Wales and Western Australia are deficient.(2) In women in Geelong, 30% had deficiency in summer, and 43% in winter, and the rate of falls and fractures was higher in winter.(3, 4)

Key point: People with MS should check their level of vitamin D annually and keep it around 150nmol/L or higher

The recommended daily allowance of vitamin D in Australia is 200IU. This amount of vitamin D is way too low. It is based on the amount required to prevent rickets. It is equivalent to the amount of vitamin D your skin would make in 6 seconds of all over sun in Perth on a summer’s day. Vieth and others have shown that in sunny countries where these diseases are uncommon, the vitamin D levels are at least 100-140nmol/L, and more like 135-225nmol/L, and that a level of 200nmol/L may actually be optimal.(5) Others have suggested a level as high as 250nmol/L may be optimal.(6)
Australian laboratories have changed their recommended ‘normal’ vitamin D levels considerably in recent years. Previously, above 50nmol/L was suggested as normal. Then more recently the range of 50-150nmol/L was being defined as the therapeutic range for optimal bone health, although it is likely that optimal immune function is achieved at levels higher than those required for bone health. And very recently, the normal range is being quoted as 75-250nmol/L as more information about the beneficial effects of ‘high normal’ levels comes in.
People with MS should aim to be above the middle of that range. To achieve a level of 100nmol/L requires daily intake of about 4 000IU of vitamin D for people who are not getting any sun. To get to 140nmol/L needs about 10 000IU a day in the absence of sunlight. It has been shown that average healthy men’s bodies use about 3 000 to 5 000IU a day.(7)
It is not possible to get toxicity from vitamin D if it all comes from the sun. Only supplements can potentially produce toxic levels. The only published toxicity however is from supplements of 40 000IU a day.(8) Indeed, Vieth and colleagues reported via the internet a groundbreaking dose escalation study of vitamin D3 in people with MS.(9) More recently this has been published in a major journal.(10) They gave increasing doses of the hormone to 12 people over 28 weeks, increasing the dose from 4 000IU per day up to 40 000IU per day. Measured levels of vitamin D in the blood of these people were extraordinarily high, much higher than what we have previously regarded as toxic, with average levels increasing to around 400nmol/L and the highest measured level 800nmol/L.

Despite these apparently ‘toxic’ levels, no patient developed high calcium levels or any side effects. Although this study aimed to look at the safety of high dose vitamin D supplements, and was not primarily designed to detect outcomes in the medical condition of these people with MS, it is interesting to note that the mean number of new MS lesions more than halved over the short period of the study from 1.75 to 0.83 (p=0.03). And in data presented to the American Academy of Neurology meeting in 2009, the researchers showed that people with MS who took the larger doses (averaging 15 000IU per day) in the study had two-thirds fewer relapses than those taking ‘standard’ doses through their GPs of 1 000IU a day. It is clear now that supplementation with vitamin D at quite high doses is very safe, and the way is now clear to use these larger doses in research situations to examine the effect on relapse rates and disease progression.

The right form of vitamin D to take is vitamin D3 or cholecalciferol. This is the natural form that is made in the body in response to sunlight. In Australia, because it is such a sunny country, regulators have not in the past allowed vitamin D to be sold at any reasonable dosage level. Health food shops have been able to sell D3 at 1 000IU doses. Until recently, the only form available from doctors in Australia was vitamin D2 or ergocalciferol. This is synthetic, available on prescription only, and is not the optimal form to take. It is also expensive. Vitamin D3 on the other hand is cheap, and because it is naturally occurring cannot be patented by drug companies. The easiest way to obtain supplies at a reasonable strength is over the internet. A 5 000IU capsule is available quite cheaply at www.vitamin-D-max.com, a US company, or www.seeknatural.co.uk/product-1798.html, a UK company, and a 2 400IU capsule from www.iherb.com. Both are fine for children as the capsules can be broken apart and the powder sprinkled on food like morning cereal, and the softgel capsule in olive oil can be squeezed onto food or into drinks.
My recommendation is that when first diagnosed, people should ask for a vitamin D level immediately. It is very common for this first level to be low, and often this is why the attack happened. Australian researchers are now calling for ‘Active detection of vitamin D insufficiency among people with MS and intervention to restore vitamin D status to adequate levels … as part of the clinical management of MS’.(11) Many neurologists I know are now doing this routinely at diagnosis. If the level is very low, it can be brought up very quickly with a one-off megadose of vitamin D followed by regular capsules.(12)
For people with initial levels indicating severe deficiency (less than 12.5nmol/L), a one-off megadose of 600 000IU raised levels to an average of 73nmol/L.(12) This is still probably half the level which may be optimal in MS, but it can be seen that even large doses of this vitamin are quite safe. My suggestion is to get a one-off dose like this if the initial level is low, and then take a regular supplement of around 5 000IU a day in winter, or more if required, to get the level to around 150nmol/L. The level should be checked at the end of each winter of supplementation to make sure it is not being overdone. It may in fact be more important for men to keep their vitamin D levels high and check their levels frequently as it has been shown that women with MS have considerably higher levels than men with MS.(13) Holick, a world authority on vitamin D suggests annually checking one’s vitamin D level as a routine.(14)

Key point: A very low vitamin D level can be raised quickly and safely with a one-off megadose of vitamin D

Supplementing with vitamin D of up to 10 000IU per day is now thought to be very safe, although in the past many medical authorities have been concerned about the possibility of side effects with doses of this magnitude. Hathcock et al have applied the risk assessment methodology used by the Food and Nutrition Board in the USA to derive a revised safe Tolerable Upper Intake Level (UL) for vitamin D3.(15) Their risk assessment based on relevant, well-designed human clinical trials of vitamin D3 concluded that the UL is 10 000IU vitamin D3 per day, that is, it is safe to take up to 10 000IU of vitamin D3 per day. Even with plenty of sun exposure, supplementing even up to this dose appears to be quite safe.

To illustrate the safety limits of supplementation, Kimball and Vieth reported in 2008 the cases of two men who had been supplementing with vitamin D.(16) One had been taking 8 000IU per day for three years. This resulted in a blood level of 260nmol/L, and no changes in any measured parameters of calcium. The second, a 39 year old man with MS, had been steadily increasing his self-prescribed dose of vitamin D over four years, from 8 000IU per day to a whopping 88 000IU per day. This latter level would be expected to produce some toxic effects. In fact, the amount of calcium in his urine started to rise, and then blood calcium levels started to go up, with a vitamin D level in his blood of 1126nmol/L. He displayed no symptoms though. At that point he stopped taking vitamin D, and within two months, all his blood tests were normal, although vitamin D levels remained high at 656nmol/L. While not recommended, this at least shows that it takes very large doses of vitamin D to produce any increase in calcium levels and toxicity.

Vitamin D and Bone Health
It is interesting to note that most Western societies have overdone their public health messages about sun avoidance so much that a very large proportion of their populations are low in vitamin D or frankly deficient. As the main effect of vitamin D in the body is to extract calcium from food we eat and incorporate it into bone, this has resulted in a virtual epidemic of osteoporosis in Western countries. Rather than modify the messages to promote modest sun exposure, which we have seen has a range of health benefits, the response has been to recommend calcium supplementation and to develop ‘bone-hardening’ drugs like Fosamax. As a result, we have a huge food industry growing up around adding calcium to foods and encouraging substantial dairy consumption.
The evidence however is that this is not making an impact on osteoporosis and bone fractures. In fact, there is evidence that populations that eat mainly vegetarian or vegan diets have lower rates of osteoporosis and fractures. A study from Harvard in the late 1990s for instance showed that the incidence of forearm and hip fractures in men was no lower in those with high calcium intakes than those with low intakes.(17) Likewise a very large prospective study from Boston of over 77 000 women showed that there was no difference in fracture rates in women with high calcium intakes compared with those with low intakes.(18) Indeed there was a trend to higher fracture rates in those with high calcium intakes. A detailed review of the literature shows that there is no evidence that increasing cow’s milk consumption has any beneficial effect on children’s bone health.(19) The Centre for Nutrition and Food Safety at the University of Surrey recommended that a 'fruit and vegetable' approach to osteoporosis may provide a very sensible alternative therapy for osteoporosis, and is likely to have many other health benefits.(20)
McCarty suggests that vegan diets in combination with vitamin D supplementation represent the best alternative to getting adequate sun exposure, in terms of achieving the wide-ranging health protection conferred by optimal sun exposure.(21) This seems to be related to the amount of phosphate in the diet; phosphate is low in vegan diets, whereas calcium supplements tend to raise the phosphate.
The problem with widespread calcium supplementation for populations of people with low vitamin D levels is that most of the calcium that is added to food is not absorbed into the body because of the low vitamin D. It has been shown that people with a blood level of vitamin D of 86.5nmol/l for example, absorb two thirds more calcium than those with blood levels of 50nmol/L, yet both levels are currently considered reasonable.(22) For people with osteoporosis, the best thing to do is get out in the sun regularly as per the guidelines on this website, not eat more calcium. And of course, it’s easier to exercise more when outside, further strengthening bones. MS and osteoporosis often go hand in hand, especially for people with advanced disease, because they don’t exercise much, and don’t get outside much. People with MS must get out in the sun.

The Risks Associated with Calcium Supplementation
As we have discussed, the main job of vitamin D in the body is to absorb calcium from the diet and lay it down in bone, thus forming normally strong, healthy bones. Unfortunately, given the evidence that we are in the midst of an epidemic of vitamin D deficiency and that vitamin D levels are falling in the community, and hence not enough calcium is being absorbed, osteoporosis has become widespread, resulting in a large number of fractures of long bones and the hip, particularly in our elderly.
Instead of treating the cause of this problem, that is getting people out in the sun more often, or failing that, supplementing with adequate doses of vitamin D, a whole industry of calcium supplementation has appeared. As consumers, we now face constant advertisements about whether we are getting enough calcium, designed to get us to take calcium supplements. The dairy industry has seen an opening here to market its products as high in calcium and therefore healthy, obscuring the very real health risks associated with dairy products, particularly for people with multiple sclerosis.

It has actually taken a long time for researchers to begin to investigate whether this widespread calcium supplementation is doing any good, or more particularly, whether it is possibly doing harm. After all, many of our elderly are on drugs called calcium channel blockers, particularly those with heart and vascular disease, and intuitively it seems problematic to be giving them the very mineral whose effects we are trying to block in the body.

Recently, a number of well designed trials and meta-analyses have raised serious doubts about the safety of calcium supplementation. A major randomised controlled trial from the University of Auckland, published in 2008 in the British Medical Journal, examined 1471 postmenopausal women.(23) Of these, 732 were randomised to calcium supplementation and 739 to placebo. Heart attacks were more common in the calcium group than in the placebo group (45 versus 19, p=0.01). The investigators also looked at the combined end point of heart attack, stroke, or sudden death, and found that this was also more common in the calcium group (101 versus 54, p=0.008). It should probably come as no surprise that calcium supplementation in these elderly women was associated with increases in serious cardiovascular event rates.
This increased risk might even be considered acceptable by some if the benefits of calcium supplementation were very marked. But there are serious doubts about whether there is really any benefit in terms of bone health from supplementing with calcium. Interestingly, researchers from the same institution showed that calcium supplementation actually increased hip fracture risk by 50%.(24) A 2007 meta-analysis from the Harvard School of Public Health Pooled reported that randomized controlled trials showed no reduction in hip fracture risk with calcium supplementation, and that an increased risk was possible.(25) For other fractures, there was a neutral effect.
It really is time for a re-appraisal of the whole calcium-vitamin D issue in health. Clearly, vitamin D is very important for a variety of reasons, not least its helpful effects on mood, muscle strength, cancer, vascular and autoimmune disease. A real problem is that when we do supplement with vitamin D, we generally use too low a dose. We need to raise the level to a minimum of 75nmol/L to get any benefit at all for bone health(26), and it probably needs to be twice that to really get the full health benefits for other conditions. We know for example that a level of 100nmol/L or so is the threshold level above which there is a great protective effect against developing MS.(27)
As for calcium, like many other heavily-marketed supplements, now that the evidence is coming in, we can see that it pays to be very, very selective about what supplements to take. Supplements need to be taken for a good reason, with a therapeutic aim in mind, and utilising the best available evidence to support their use. For people with adequate vitamin D levels (and for people in most geographic regions this means supplementation with relatively large doses of vitamin D in winter), calcium supplementation is completely unnecessary. For those who avoid the sun or cannot get much sun in winter, and those with osteoporosis, supplementation with at least 5 000IU of vitamin D daily is recommended, rather than with calcium. Calcium supplementation, on the basis of current evidence, poses too great a risk to human health, and is not recommended.

Overview
People with MS can feel comfortable that sunlight and/or vitamin D are likely to improve their outcome from the disease, and protect them from many others in addition. In winter, in most places in the world, a vitamin D supplement is necessary to keep vitamin D levels optimal at around 150nmol/L or higher. In some places in the world, and for those who avoid the sun, year round supplementation is necessary.

References
1. Vieth R. Why the optimal requirement for Vitamin D(3) is probably much higher than what is officially recommended for adults. J Steroid Biochem Mol Biol 2004;89-90:575-9.
2. Flicker L, Mead K, MacInnis RJ, et al. Serum vitamin D and falls in older women in residential care in Australia. J Am Geriatr Soc 2003;51(11):1533-8.
3. Pasco JA, Henry MJ, Nicholson GC, Sanders KM, Kotowicz MA. Vitamin D status of women in the Geelong Osteoporosis Study: association with diet and casual exposure to sunlight. Med J Aust 2001;175(8):401-5.
4. Pasco JA, Henry MJ, Kotowicz MA, et al. Seasonal periodicity of serum vitamin D and parathyroid hormone, bone resorption, and fractures: the Geelong Osteoporosis Study. J Bone Miner Res 2004;19(5):752-8.
5. Grant WB, Holick MF. Benefits and requirements of vitamin D for optimal health: a review. Altern Med Rev 2005;10(2):94-111.
6. Moan J, Porojnicu AC. [The photobiology of vitamin D, a topic of renewed focus.]. Tidsskr Nor Laegeforen 2006;126(8):1048-52.
7. Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ. Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 2003;77(1):204-10.
8. Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 1999;69(5):842-56.
9. A phase I dose escalation study of vitamin D3 with calcium supplementation in patients with multiple sclerosis. Multiple Sclerosis Resource Centre, 2002. (Accessed 26 February 2006, at <shortened url>.)
10. Kimball SM, Ursell MR, O'Connor P, Vieth R. Safety of vitamin D3 in adults with multiple sclerosis. Am J Clin Nutr 2007;86(3):645-51.
11. van der Mei IA, Ponsonby AL, Dwyer T, et al. Vitamin D levels in people with multiple sclerosis and community controls in Tasmania, Australia. J Neurol 2007.
12. Diamond TH, Ho KW, Rohl PG, Meerkin M. Annual intramuscular injection of a megadose of cholecalciferol for treatment of vitamin D deficiency: efficacy and safety data. Med J Aust 2005;183(1):10-2.
13. Barnes MS, Bonham MP, Robson PJ, et al. Assessment of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D3 concentrations in male and female multiple sclerosis patients and control volunteers. Mult Scler 2007;13(5):670-2.
14. Holick MF. The vitamin D epidemic and its health consequences. J Nutr 2005;135(11):2739S-48S.
15. Hathcock JN, Shao A, Vieth R, Heaney R. Risk assessment for vitamin D. Am J Clin Nutr 2007;85(1):6-18.
16. Kimball S, Vieth R. Self-prescribed high-dose vitamin D(3): effects on biochemical parameters in two men. Ann Clin Biochem 2008;45(Pt 1):106-10.
17. Owusu W, Willett WC, Feskanich D, Ascherio A, Spiegelman D, Colditz GA. Calcium intake and the incidence of forearm and hip fractures among men. J Nutr 1997;127(9):1782-7.
18. Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Milk, dietary calcium, and bone fractures in women: a 12-year prospective study. Am J Public Health 1997;87(6):992-7.
19. Lanou AJ, Berkow SE, Barnard ND. Calcium, dairy products, and bone health in children and young adults: a reevaluation of the evidence. Pediatrics 2005;115(3):736-43.
20. New SA. Nutrition Society Medal lecture. The role of the skeleton in acid-base homeostasis. Proc Nutr Soc 2002;61(2):151-64.
21. McCarty MF. A moderately low phosphate intake may provide health benefits analogous to those conferred by UV light - a further advantage of vegan diets. Med Hypotheses 2003;61(5-6):543-60.
22. Heaney RP, Dowell MS, Hale CA, Bendich A. Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr 2003;22(2):142-6.
23. Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ 2008;336(7638):262-6.
24. Reid IR, Bolland MJ, Grey A. Effect of calcium supplementation on hip fractures. Osteoporos Int 2008;19(8):1119-23.
25. Bischoff-Ferrari HA, Dawson-Hughes B, Baron JA, et al. Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr 2007;86(6):1780-90.
26. Bischoff-Ferrari HA, Dawson-Hughes B. Where do we stand on vitamin D? Bone 2007;41(1 Suppl 1):S13-9.
27. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA 2006;296:2832-8.






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Postby jimmylegs » Tue Aug 11, 2009 11:20 am

interesting article not on d3 and sami, but other relevant nutrients in ms (and per this article's focus, heart disease)

Titre du document / Document title
High serum alpha-tocopherol, albumin, selenium and cholesterol, and low mortality from coronary heart disease in northern Finland
Auteur(s) / Author(s)
LUOMA P. V. ; NÄYHÄ S. ; SIKKILÄ K. ; HASSI J. ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
Univ. Oulu, Oulu regional inst. occupational health, Oulu, FINLANDE

Résumé / Abstract
Objectives. The mortality from coronary heart disease (CHD) is exceptionally low in northernmost Finland, the Sami (formerly known as Lapp) area. To clarify the reasons for this, the levels of serum cholesterol, other classic risk factors, and major antioxidants, alpha-tocopherol, retinol, albumin and selenium were determined in males living in the low-mortality area and in a reference area. Design. A health survey amongst reindeer herdsmen living in the three northernmost communes of Finland (the Sami area) and in the six neighbouring communities to the south (the reference area). The mortality from CHD in the two areas was determined from death certificates issued during the period 1981-1990. Subjects. A total of 350 participants of the health survey, mean age 46 (SD 14) years. Results. The mortality from CHD was 17% lower in the Sami area than in the reference area [95% confidence interval (CI) for the difference: 4-29]. Subjects living in the low-mortality area showed higher serum-lipid-adjusted alpha-tocopherol (18.4 vs. 16.1 μmol L-1; 95% CI for difference: 0.7-3.9; P<0.001), ALBUMIN (46.9 VS. 46.2 G L-1; 0.2-1.3; P<0.02), SELENIUM (1.59 VS. 1.47 μMOL L-1; 0.02-0.22; P<0.02), CHOLESTEROL (6.76 VS. 6. 34 MMOL L-1; 0.12-0.72; P<0.001) and LDL cholesterol (4.76 vs. 4.45 mmol L-1; 0.05-0.57; P<0.02) than those in the reference area. The HDL cholesterol: cholesterol ratio was lower in the Sami area than in the reference area (0.20 vs. 0.21; -0.02-0.00; P<0.04). The Samis showed higher serum selenium than the Finns. Serum alpha-tocopherol increased with the consumption of reindeer meat and serum selenium increased with fish consumption. Conclusions. Alpha-tocopherol, albumin and selenium may play a role in the low mortality from CHD observed in northernmost Finland. The favourable serum antioxidant status in northerners may be credited to the local diet.
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jimmylegs
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Postby notasperfectasyou » Tue Aug 11, 2009 12:01 pm

patientx wrote:I'm an electrical engineer by trade. And we use computer simulation software on a daily basis. It's easier to change things and try them in software before you actually build something. But the accuracy depends on the models. And, in the end, we also verify on the bench with a real piece of hardware.


Shouldn't much of the debate also be about the assumptions that are made before a model is built? For example, most any medical journal article on MS begins with an assumption. Ken
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Postby notasperfectasyou » Tue Aug 11, 2009 12:17 pm

jimmylegs wrote:i'd be inclined to say they were looking for it harder there, so they found it more.


So might this be an example of needing to look at the base assumptions before reviewing the model? MS is hard to diagnose and when someone says it's low in one place and high in another place, are folks first assessing the ability to get an accurate diagnosis in those places? Might there be other factors that trump diagnosing MS, like famine, war or poor infrastructure? Ken
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