Update on Corona virus

August 26, 2020

Since the last newsletter from May 28, things have gone well here in Denmark.
On the other hand, viruses have become widespread, especially in those countries that have not taken the spreading of infection seriously.
In the past month, however, localized infection clusters have emerged in various places here in Denmark as well, especially in immigrant communities.
The reasons for this have been mentioned in the previous newsletters, whose advice is still valid, so I will not repeat it here, but instead focus on what has happened in the last 3 months.

Studies
In a literature study(1) from Norwegian, Russian and Swedish public health institutes six researchers have concluded that early intervention with Zinc, Selenium and Vitamin-D can alleviate the course of the disease, and virtually prevent the cytokine storm, which is the process responsible for the destruction of tissues, microthromboses, inflammation, etc. -the whole cascade that can take the life of the Covid-19 sick persons.

An almost simultaneous study(2) from Germany analyzed Serum-Selenium and Serum-Selenoprotein P, and both values were significantly lower in those who did not survive Covid-19.
(Selenium: 53.3 ± 16.2 vs. 40.8 ± 8.1 μg / l, Selenoprotein-P: 3.3 ± 1.3 vs. 2.1 ± 0.9 mg / L p<0.001). These results must be said to be highly relevant in our country, where we consume so little selenium. This study falls nicely in line with the former study.

On August 3, an article was published in the Lancet(3) which strongly calls for increased intake of vitamin D based on solid literature reviews.
This also falls in line with the first study mentioned above.

And, finally, there is a meta-analysis(4) of the role of vitamin D in the development of acute respiratory infection. It includes 30,000 people in controlled trials (RCTs), and has shown significantly reduced risk of acute respiratory infection already at 10-25 µg of vitamin D daily.
This confirms a previous meta-analysis(5), which also found a significant inverse correlation between the risk of acute respiratory infection and the vitamin D content in the blood.
All of the above studies are nicely in line with the advice mentioned in the five newsletters from May.

Authorities distribute vitamins
Azerbaijan has registered 35,000 Covid-19 cases in a population of 10 million. Of these, 1,800 were hospitalized and 508 died.
Here, the Ministry of Health has provided more than 3,500 Covid-19 patients with a free “medicine package” containing: Vitamin C, Vitamin D, Magnesium, Selenium, Zinc and Paracetamol.
The idea is then that the patients stay at home and treat themselves there.
Every day they are then contacted by the local hospital clinic and have to answer a series of questions, just as the doctor checks that they are taking their pills.
So far, a significant reduction in the number of hospitalizations in this group has been observed(6).

You can only shout cheers when you see authorities who can think outside the box and dare to start such a project. My guess is that the trend will continue and that home treatment will continue to reduce hospital admissions in Azerbaijan.

The idea is not bad because you initiate a completely harmless treatment of a, for some people, -dangerous disease.
But why wait until they get sick?

With timely care, one can improve the immune system of the entire population if one simply provides information about these supplements and their significance.

What could be done here in Denmark is to provide subsidies to the vulnerable groups, especially residents of the country’s nursing homes, who are completely dependent on the public perception of vitamins and minerals. If their own doctor does not prescribe a vitamin supplement, then residents are often denied help to get the supplements, despite their own desire. They are completely dependent upon the doctor’s knowledge or lack thereof. I think Danish authorities and medical staff would be shocked if we measured the level of vitamin D in the country’s nursing home residents.
If you do not want to use public funds to donate these subsidies to the residents, then you can at least make sure that both residents and their relatives are informed.

These newsletters on Covid-19 are unfortunately necessary as this knowledge and the scientific back-up are neglected in the public advice to the Danish population.

Take care of yourself and others

Claus Hancke MD
Specialist in general medicine

References

  1. Alexander J, Alehagen U et al. (2020) Early Nutritional Interventions with Zinc, Selenium and Vitamin D for Raising Anti-Viral Resistance Against Progressive COVID-19. Nutrients 2020, 12, 2358.
  2. Moghaddam A, Heller R et al. (2020) Selenium Deficiency Is Associated with Mortality Risk from COVID-19. Nutrients 2020, 12, 2098.
  3. Martineau A, Forouhi N (2020) Vitamin-D for Covid-19: a case to answer. Lancet 2020;8:735-6.
  4. Joliffe D, Martineau A, Damsgaard Camilla et al. (2020) Vitamin D supplementation to prevent acute respiratory infections: Systematic review and meta-analysis of aggregate data from randomised controlled trials. medRxiv BMJ (endnu ikke peer reviewed) 17.juli 2020.
  5. Martineau A et al. (2017) Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data.
    BMJ 2017;356:i6585.
  6. lmahamad A, (2020) 3.500 covid-19 patients provided with free medication. Azernews 18.august 2020. https://www.azernews.az/healthcare/168099.html

Be prepared for the next Corona epidemic

The population is not

May 29, 2020

The Corona is spreading more slowly now, and, here in Denmark, Covid-19 is gradually infecting fewer and fewer people and we are more aware of protecting ourselves against it.

There have been good effects from keeping our distance and from maintaining good hygiene in which we have all been well instructed.

Much to the surprise of the Danish Serum Institute, less than 2% of the Danish population has had the disease, and only a few of these individuals may have obtained immunity to SARS-CoV-2, which the virus is called.
This means that more than 98% have not been infected and are completely without immunity. So forget about herd immunity.

The Danish population is just as vulnerable it was were in March when it all started.

Let’s try to summarize what we know and what we can do about it.

What do we know now?
SARS-CoV-2, which is the virus responsible for the current Covid-19 pandemic, is characterized in that it – like the influenza virus – triggers a reaction with the release of a number of signaling molecules such as interleukins, interferons, and lymphokines.

When this release is powerful, it is called a “cytokine storm”, and with Covid-19, it is so powerful that immune cells begin to damage the tissues where the process is taking place, and, in this case, it is primarily the lung tissue that is damaged.

During the cytokine storm, a violent inflammatory response and increased release of free oxygen radicals are created, which further damages the lung tissue due to the subsequent inflammatory microcoagulation seen in the pulmonary vessels. Adding too much oxygen at this stage will only aggravate the situation, which several anesthesiologists have experienced when Covid-19 patients’ conditions worsen when they are put on a respirator.

What can we do about it
Thus, it is primarily about attenuating the fatal cytokine storm.
Here vitamin D, magnesium, selenium, and vitamin C are particularly important as they specifically inhibit this cytokine storm and the subsequent inflammatory microcoagulation in the pulmonary vessels.
If the level of these essential substances in the body is high enough then you will have a subdued cytokine storm and thus attenuated symptoms, as seen during influenza infection. Fresh extract of Coneflower (Echinacea) has also been documented in several scientific studies to effectively inhibit this cytokine storm.

It should be obvious to protect ourselves by promoting such harmless and inexpensive remedies, but unfortunately in the medical and pharmaceutical world, one tends to stare blindly at the most expensive solutions.
Medical professionals were first intrigued by the antiviral drug Remdesivir, which could shorten the disease period of Covid-19 from 15 to 11 days. This fascination has now been replaced by a new one, another drug, an experimental cancer drug, Bemcentinib that may prevent viruses from entering the cells. A phase II trial is underway for 120 people, and we hope we will be able to get the result in a few months.

Well, it is excellent that medical professionals try to find a medicine that can help in this situation, but is it absolutely necessary to find a new, expensive medicine with side effects, when there are other far cheaper options without side effects?

The long awaited vaccine
While all this is going on, the pharmaceutical industry is working full speed on a vaccine. A vaccine against an RNA virus is very difficult to make, and using a vaccine is especially problematic because viruses constantly mutate and thereby often change the immune response.

No vaccine has ever been safety-tested, in the same way that medicine is tested, and this is a bit problematic because in recent years, the industry has started to add substances whose purpose is to stimulate the immune system for effective antibody formation. And stimulating antibody formation is good enough, too, but the safety of these substances has never been investigated. In Denmark, the use of mercury (thimerosal or thiomersal) in childhood vaccines was stopped from 1992 and in influenza vaccines from 2004, with the exception of the vaccine in 2009, which was an embarrassing exception. The toxic mercury should never be used again for human use – neither in the teeth, for that matter.

But in recent years aluminum has been added in the form of nanoparticles as well as squalene emulsions. These adjuvants have not been safety tested. It has just been noted (WHO has noted) that the number of side effects is not greater than is usually seen with vaccination. Aluminum is a neurotoxin, but it has been used in vaccines in the form of various aluminum salts since 1930, so in that form it probably isn’t particularly harmful. The problem is that nanoparticles are now being used that cannot be stopped by a cell membrane. They can penetrate all tissues.
It cannot be ruled out that it is safe to use these additives. It’s just never been investigated.

It should be a simple task to make a study with each of these ingredients against a real placebo such as brine.
We have many excellent vaccines, so let’s not be vaccine deniers. Let’s welcome a SARS-CoV-2 vaccine when it arrives, and then just hope it is properly safety tested. Of course, this hope becomes a requirement if we are to be mandatory vaccinated.

Of course, the Coronavirus will return
When and how bad we do not know, but it will come.
As mentioned in the Vitamin C newsletter, one of Europe’s experts in Covid-19, Professor Christian Drosten from the University of Berlin, has stated that the second wave could be tougher than the current one.
And since more than 98% of the Danish population is without immunity against it, we should not sit with our hands in our laps and wait for a vaccine.

We need to be proactive.
We need to make sure that we have enough of the nutrients that can reduce the risk of our getting sick, and especially the nutrients that can dampen the cytokine storms, so that we get a mild course of illness if we get sick anyway.

Especially old people and people who eat only very little, who may also be weakened by chronic disease, will do well by supplementing the diet in order to be well equipped with an optimally functioning immune system as the next virus threat approaches.

An appropriate daily dose for a normal-weight adult will typically be:

  • Vitamin A: 1-2 mg
  • Vitamin B6: 4-5 mg
  • Vitamin C: 2-3,000 mg
  • Vitamin D3: 75-100 µg
  • Selenium: 100-200 µg
  • Zinc: 20-30 mg
  • Magnesium: 200-300 mg

Note: The low dose is for those weighing less than 70 kg (155 pounds / 11 stones).

If you start now, you will be prepared in the fall. This is an obvious strategy for the country’s nursing homes.

This is the fifth and final Covid-19 newsletter.

Unfortunately, the five newsletters are necessary as this knowledge and scientific back-up are neglected in the public counseling of the population.

Take care of yourself and others,

Claus Hancke, MD,
Specialist in general medicine

Refs:

  • McGonagle D et al. (2020) Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia. Lancet May 7, 2020:1-9
  • Zhang Y, Leung D, Richers B, et al. (2012) Vitamin D Inhibits Monocyte/Macrophage Proinflammatory Cytokine Production by Targeting MAPK Phosphatase-1. Journal of Immunology. 2012;188(5):2127-2135.
  • Alberto Boretti, Bimal Krishna Banik (2020) Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome PharmaNutrition.
    2020 Jun;12:100190. Published online 2020 Apr 21.
  • Sharma M, Anderson A et al.(2009) Induction of multiple pro-inflammatory cytokines by respiratory viruses and reversal by standardized Echinacea, a potent antiviral herbal extract. Antiviral Research, 2009;83(2):165-170.
  • Cannell JJ, Zasloff M, Garland CF et al. (2008) On the epidemiology of influenza.
    Virol J. 2008;5:29.
  • Gorton HC, Jarvis K (1999) The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manip Physiol Ther, 22:8, 530-533
  • Hemilä H (2003) Vitamin C and SARS coronavirus Journal of Antimicrobial Chemotherapy, Volume 52, Issue 6, December 2003, Pages 1049–1050
  • WHO Global advisory committee on vaccine safety 2020 (ikke ændret siden 2006). https://www.who.int/vaccine_safety/committee/topics/adjuvants/squalene/Jun_2006/en/

Severe Covid-19 disease can be prevented

But we don’t hear about it.

May 6, 2020

“Immunity! Well, that comes naturally.”
Does it?

Now we are so far into the corona crisis that the first serious scientific results are beginning to emerge, and since no one else does, the Vitality Council will try to disseminate these results.
“Just throw people into the water. They will swim by themselves ”.
A foolish claim. It is well known that the chances of surviving a dive into the water increases if you have learned to swim.
But that is, in fact, what the (Danish) authorities are saying, now that they are opening up the country while coronavirus is still circulating.
They are throwing people into increased viral exposure because then it is thought that people automatically get built-up immunity.
Well, this may be true if people can defend themselves, that is, have a well-functioning immune system.
Without good immune defence, people have no chance.

The (Danish) authorities  know very well that there are large groups in the population that have a impaired immune system. And yet, they expect us all to sit with our hands in our lap without doing anything while we wait for a vaccine that stands as an angel of salvation on the horizon.
A vaccine may be excellent, but firstly, it takes at least a year before we have it, and secondly, a vaccine can never keep up with a virus in the many mutations that make its immune profile so varied that a vaccine quickly becomes obsolete as we have seen with the flu vaccine.
The only thing that can keep up with an adequate immune response against a virus’ mutations is a well-functioning immune system in the individual.
Despite the knowledge that many people have an impaired immune system, we have in the months that the corona crisis has lasted, not once heard the (Danish) authorities give the public advice on how to optimize the immune system.
If the population has a fundamentally strong immune system, then a virus will do less harm as the individual course of disease will be milder.
People still get infected and maybe sick too, but they don’t have to die from it.

Let’s start with the simple, Vitamin D3.

It is quite evident that the Covid-19 disease is massively over-represented in the northern hemisphere. Just like the annual flu epidemic, which ravages the northern hemisphere in precisely December to March, whereas it ravages the southern hemisphere from August to October – and why is that?
We can thank the Sun for that. It is high in the sky in the summer and charges our stores of vitamin D, so we have a strong immune system from June to November, and of course the other way around in the southern hemisphere. We never get the flu in July-August.

A second indication is that elderly people are at particular risk. Older people more often have a very low level of vitamin D in their blood, as they do not get much out in the sun.

A third indication is that obesity is at particular risk. Vitamin D accumulates in the adipose tissue, where it does not benefit the immune system. Overweight people must therefore have a significantly higher dose of vitamin D to achieve the same blood concentration as slim persons.

A fourth indication is that the disease is over-represented in immigrants, who often have severe vitamin D deficiency. On the one hand, most immigrants have dark skin, which allows less passage of sunlight, and on the other hand, many immigrant women are covered, even in the summer, when they need to get their annual vitamin D dose.

A fifth indication is that diabetics are also a special risk group. On the one hand, diabetics often have an impaired immune system, and, on the other, many diabetics receive cholesterol-lowering medication. If people lack cholesterol, you cannot produce vitamin D, even though the sun is shining sufficiently.

A sixth indication is approaching evidence in the case of a recently published observational study that compared mean vitamin D levels in 20 European countries with prevalence and mortality caused by Covid-19. There was significant negative correlation between vitamin D level and both prevalence and mortality. It was interesting to see that both morbidity and mortality approached 0 in those populations where the vitamin D level was above 75 nmol/L.
Vitamin D levels are seriously low in the aging population, especially in Spain, Italy and Switzerland. This is also the most vulnerable group of the population in relation to Covid-19.

A healthy diet with green vegetables is also important, as they contain magnesium, which is a prerequisite for activating vitamin D.
Magnesium is included four places in the synthesis as well as the activation and deactivation of vitamin D, so without magnesium, vitamin D is ineffective.

If you combine these indices with solid evidence that vitamin D3 is essential for a functioning immune system, it is not far off to propose a solid dose of vitamin D3 to optimize a suffering immune system in immigrants, diabetics, older and overweight people in particular.

In the past, people were nervous about overdosing on Vitamin D, but this has proved unfounded. Extremely high doses need to be taken over a long period of time before there is any risk. In the past, it was also thought that a vitamin D level of 50 nmol/L was sufficient in the blood, but this is too low.
If people want to be sure that the vitamin D level is sufficient for an optimal immune system, the level should be between 75 – 150 nmol/L.

This newsletter is the first about some of the factors in our environment, nature, surroundings and diet that can optimize our immune system and thus reduce the risk of serious Covid-19 disease.
The next will deal with the latest research on selenium and Covid-19 disease.

Take care of yourself and others,

Claus Hancke; MD,
Specialist in general medicine

Refs:

  • Hewison M. Vitamin D and innate and adaptive immunity. Vitam Horm, 2011; vol 86:23-62.
  • Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020 Jan 16;12(1).
  • Schwalfenberg GK. A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol Nutr Food Res. 2011 Jan;55(1):96-108.
  • Dancer RC, Parekh D, Lax S, D’Souza V, Zheng S1, Bassford CR, et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax. 2015 Jul;70(7):617-24.
  • Urashima M, Segawa T, Okazaki M, et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010 May;91(5):1255-60.
  • Sabetta JR, DePetrillo P, Cipriani RJ, Smardin J, Burns LA, Landry ML. Serum 25-hydroxyvitamin d and the incidence of acute viral respiratory tract infections in healthy adults. PLoS One. 2010 Jun 14;5(6):e11088.
  • Uwitonze AM, Razzaque MS. Role of Magnesium in Vitamin D Activation and Function. J Am Osteopath Assoc. 2018 Mar 1;118(3):181-189.
  • Valint S. Vitamin D and Obesity. Nutrients. 2013 Mar; 5(3): 949–956.
  • McCartney DM, Byrne DG. Optimisation of Vitamin D Status for Enhanced Immuno-protection Against Covid-19. Ir Med J. 2020 Apr 3;113(4):58.
  • Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, Bhattoa HP. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020 Apr 2;12(4). pii: E988.
  • Aldridge RA, Lewer D, Beale S, et al. Seasonality and immunity to laboratory-confirmed seasonal coronaviruses (HCoV-NL63, HCoV-0C43, and HCoV-229E): results from the Flu Watch cohort study 30 March 2020.
  • McCullough PJ, Lehrer DS, Amend J. Daily oral dosing of vitamin D3 using 5000 TO 50,000 international units a day in long-term hospitalized patients: Insights from a seven year experience. J Steroid Biochem Mol Biol. 2019 May;189:228-239.
  • Ilie PC, Stefanescu S, Smith L. The role of Vitamin D in the prevention of coronavirus disease 2019, infection and mortality. Aging Clinical and Experimental research (https://doi.org/10.1007/s40520-020-01570-8) Springer Switzerland. 2020 May 6.

Vitamin D protects against colon cancer

January 26, 2010

A huge European study now confirms that vitamin D may lower the risk of colon cancer by 40%.

The Danish Vitality Council has in several previous newsletters refered to scientific studies showing that vitamin D may lower the risk of cancer, and we have even been urged by journalists to withdraw those statements. Fortunately we have not complied.

A few days ago British Medical Journal published the largest study ever of the link between diet and health, known as the EPIC study, and this is just one of many results, we will see in the near future from this huge study.
More than half a million mostly healthy people from ten European countries have been closely studied and followed over 10 years by researchers from across Europe.

Participants completed detailed dietary questionnaires, and they have been checked with blood tests to identify their nutritional status.

At the time of analysis 1,250 cases of colon cancer had occurred and after comparison with a healthy control group researchers found that those who were low in vitamin D in their blood had significantly higher risk for this type of cancer.

Unlike many other studies this is characterized by being a prospective study. Thus looking-forward from the start time, and based on a group of healthy people. The study also distinguishes itself by involving so many different countries, cultures and – not least – food cultures.

Vitamin D, we primarily get from the sun, and a little bit from the diet. Danes are not the most tenacious fish eaters and much of the fish we eat is farmed and therefore does not include the fatty acids and other substances, we think they contain.

So we’re back at sunlight as the main natural source of vitamin D.

However, some of our ancestors for inscrutable reasons have found reason to settle north of the Alps, and it leads to midday sun high enough in the sky to make enough vitamin D in the skin for only 3-4 months a year (providing we have enough cholesterol).

So we must therefore tend to sunbathing when the Sun is at its highest point, ie the middle of the day, without sunblock, and therefore only half an hour, so we do not risk burning.

If it gets too complicated, you can also just grab a vitamin D capsule as a supplement. It is perhaps a little easier, and it can be done the whole year.
The dosage is somewhat controversial and should ideally be measured in a blood sample, but most serious scientists recommend between 2,000 and 4,000 IU, equivalent to 50-100 micrograms daily.

It will take a long time before we again will see such a thorough, multi-national study including so many people over such a long period.

So it is not just any study. It has high validity and ought to push the critically low RDA-value we have today.

By: Vitality Council

 

Litterature:
Jenab, M. et al (2010). Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations: A nested case-control study BMJ, 340 (jan21 3)
Can be downloaded directly at: www.bmj.com/cgi/content/abstract/340/jan21_3/b5500

Vitamin D against atherosclerosis

January 28, 2008

Vitamin D counteracts the development of atherosclerosis and prevents fatal complications of high blood pressure – but vitamin D deficiency is very widespread.

We are not done with vitamin D. More and more information is streaming in about this amazing substance, which is actually not a vitamin but a hormone created in skin exposed to sunlight.

Now we will look at vitamin D’s effects on the heart and circulation. It seems as though the risks of blood clots in the heart and the brain are far lower in people who get enough vitamin D, which is to say people who get more than most. This “vitamin” is especially effective at lowering the risk in people with high blood pressure.

This find appears in a recent report from Farmingham, a little town in Massachusetts where the health and lifestyles of thousands of people (and their descendents) has been registered since 1948 in order to find lifestyle related reasons for cardiovascular disease. The Farmingham study is, without a doubt, the most famous of its kind. When we today take for granted that exercise, healthy diet, and aspirin prevents cardiac death it is the Farmingham project that we should thank.

The report in question is on a part of the study involving 1,739 people aged 50 – 70 who were free of cardiovascular disease at the beginning of the study. From 1996 to 2000 their vitamin D status was measured with blood tests after which their health was monitored for an average of 5.4 years (up to 7.6 years). Who suffered blood clots?

Those who had the least vitamin D in the blood! After seven years blood clots in the heart or the brain (stroke) was registered in one in ten with vitamin D levels over 37 nmol/l, but in no less than one in four of those with levels under 37. After correcting for differences within the group such as age, sex, cholesterol levels, smoking, diabetes, and so on, the group with the highest vitamin D levels still had a cardiovascular risk 60 % less than that of the group with the lowest levels. If these numbers are right, vitamin D is more important for cardiovascular health than aspirin or cholesterol medicine.

Strong immune system
The beneficial effects of vitamin D seem to be even greater for those with high blood pressure, which is the most important cause of cardiovascular disease. Among participants with high blood pressure the risk for those with vitamin D levels over 37 was half that of those with levels under 37.

This result is similar to that of other studies which have shown that low vitamin D status and high blood pressure and clogged cardiac arteries are related. The Farmingham has an even stronger message: If you lack vitamin D you are at risk of a heart attack within the foreseeable future.

Does this mean that vitamin D prevents atherosclerosis? Yes, this seems to be the case. This fits in well with other known effects including: that vitamin D counteracts an important hormone (renin) which is responsible for raising blood pressure and that when heart cells which normally use vitamin D are prevented from using vitamin D (through genetic manipulation) in experiments on mice, blood pressure rises quickly.

Without eating fatty fish is you get almost no vitamin D from October to May. Deficiency is therefore very widespread. In a European study of teenage girls more than one out of every three had severe anemia (blood percent of under 25 nmol/l). Over 90% of these girls would have, if they lived in Farmingham, ended up in the study group with severe atherosclerosis.

How much vitamin D is it wise to take? There is no rule of thumb, but it should be considered that a typical vitamin pill contains 200 units whereas one out of every two adult Americans need 1,000 units in order to have an “acceptable” vitamin D status (which is a concentration of 75 nmol/l – most American researchers recommend 75 – 150 nmol/l). It is also understood that it is completely safe to take up to 2,000 units daily.

Luz Tavera-Mendoza and John White, two molecular biologists from the American McGill University have shown that vitamin D causes the skin and the immune system to form antibiotics (cathelicidin and more) which kill bacteria, including tuberculosis bacteria. This is probably the explanation for the earlier idea that it is possible to cure tuberculosis with sunlight. These two researchers have written an easy to read summery of recent research and even reveal what they take as supplements during the dark months.

Luz, who is a younger woman, takes 1,000 unites (25 micrograms).
John, who is a younger man, takes 4,000 units (100 micrograms).

By: Niels Hertz, MD

References:
1. Wang TJ et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008;117:000-000.
2. Tavera-Mendoza L, White J. Celle defences and the sunshine vitamin. Scientific American 2007 (11):36-44.

circ.ahajournals.org
www.sciam.com

Vitamin D inhibits cancer

June 26, 2007

An overlooked but very sensational study suggests that vitamin D could inhibit almost 80% of all cancer cases. We just need much more than we normally get (1).

One out of every three people in Britain die of cancer and a world without this feared disease seems utopian. But if an American study is correct, we can approach this unattainable goal with a historic leap forward. We just need more, much more, vitamin D, and maybe also more calcium. According to the study, a combination of calcium and vitamin D can reduce the risk of cancer by about 60%. Additionally, it seems that if cancer is avoided during the first year of taking supplements, then the risk of cancer the following year is reduced by nearly 80%! It is hard to expect more.

It is strange that such sensational news has received almost no official consideration. Especially because it comes from a highly trustworthy double blind, randomised trail published by highly respected researchers.

The participants in the study were 1,180 women with an average age of 67. They were from Nebraska, which is just as far south as southern Italy and receives a lot of sun. Not surprisingly the women had on average good blood levels of vitamin D before the study.

In the study 446 of the women received an advantageous daily supplement of as much as 1,100 units (27.5 micrograms) vitamin D. This is at least five times more than the contents of a normal vitamin pill and about three times the recommended dosage for people over age 60. They also received 1.5 gr. calcium (as carbonate or citrate), which is about the amount of calcium in a litre of milk.

Another 445 women received only calcium and 288 received placebo. Neither the women nor the researchers knew who got what. The study lasted for four years while it was noted who and how many got cancer.

We now have the results. The group which received the vitamin D and calcium was subject to many fewer cases of cancer than the group which received placebo. The difference was not coincidence! It was statistically extremely solid. The biggest difference (77% lower risk) was shown during the last three years of the study. The researchers surmised that this was because some of those who got cancer in the beginning of the study already had undetected cancer before the study started.

It could be true
The women who just received calcium also had a lower risk of cancer (40%). This finding was not completely certain statistically. The cancer risk for these women did not, as in them who received both vitamin D and calcium, become more reduced after the first year. It is therefore uncertain if this effect is actual or just the result of coincidence.

On the other hand, at least two further arguments indicate that vitamin D actually works. The first is that the women who had the poorest vitamin D status before the study, were those helped the most, their risk was the most reduced. The vitamin D status of the participants during the study also played a role, the lower the status, despite the supplements, the larger the cancer risk. The second argument that vitamin D has this effect is that the risk was directly link to the amount of vitamin D used.

Can it really be true that something as cheap as vitamin D can be so beneficial? We know that the vitamin regulates at least 200 genes, many of which control the cells’ growth and degree of specialisation. Animal studies have shown that vitamin D deficiency promotes cancer growth. For more than 60 years it has been known that cancer is less common in countries where the sun is high in the heavens leading to the production of more vitamin D in the skin. It has also be proven time and time again that low vitamin D status and high cancer risk in people go hand in hand (2,3).

The only thing that has been missing is a proper study with sufficient supplements so that cause and effect could be analysed. We now have just that study!

The women in Nebraska had a typical vitamin D status (25-hydroxy-vitamin-D3 in the serum) of 71 nanomolsl/L before the study. This is a very acceptable value. But the supplement increased this value to an average of 96. This is normally regarded as too high.

Vitamin D status is measured with a blood test! It is most important during the winter, when it is the lowest. According to the Nebraska study, this level should be no less than 100.

By: Vitality Council

References: 

1) Lappe J M et al. Vitamin D and calcium supplementation reduces cancer risk: Results of a randomized trial. Am J Clin Nutr 2007;85:1586-91.

2) Feskanich D et al. Plasma vitamin D metabolites and risk of colorectal cancer in women. Cancer Epidemiol Biomarkers Prev 2004;13:1501-8

3) Ahonen M H et al. Prostate cancer risk and prediagnostic serum 25-hydroxyvitamin D levels (Finland). Cancer Causes Control 2000;11:847-52

www.ajcn.org
cebp.aacrjournals.org
www.springerlink.com/content/0957-5243

Summer sun prevents multiple sclerosis

April 10, 2007

Still more supports the theory that vitamin D can prevent multiple sclerosis. Enjoy the sun while its there.

Multiple sclerosis (MS) is a feared disease. Many believe that sclerosis is synonymous with a life in a wheelchair, and many have heard about tragic examples of how the disease can progress. It is worth remembering that even 20 years after the emergence of the disease, 75% of patients can walk unaided. Also, the death rate for those suffering from sclerosis is not much higher than that of the rest of the population.

On the other hand, MS affects especially younger people, primarily women. It is disquieting that the frequency of this disease has increased in the last 50 years and continues to increase. Over 80,000 people in the UK suffer from MS, which at a prevalence of over 140 people per 100,000 the highest in the industrialised world.

MS is an “autoimmune” disease, which is to say a disease where the body’s immune system turns against the body itself. In the case of MS the so called myelin sheaths which coat and isolate the nerves are attacked. On average, every fourth person with MS also suffers from another autoimmune disease, for example psoriasis, arthritis, or metabolism diseases.

Can one prevent MS? It is tempting to have this thought when one notices the enormous geographic variations. In England, Denmark, Norway, Sweden, Finland, Germany, and Canada the frequency is about the same. In Greece and Turkey it is about half as common while in northern Spain and Italy the frequency lies in between that of these areas.

These and other figures support a growing belief that MS has something to do with lack of sunlight; or more accurately, lack of vitamin D, of which the sun is the most important source. Vitamin D has in studies prevented an experimental form of MS (EAE, Experimental Autoimmune Encephalitis). In countries north of a latitude of 42, corresponding to Corsica, the sun is so low during the winter months that vitamin D practically cannot be produced in the skin. The result is widespread vitamin D deficiency.

Less than half the risk
Researches from Harvard University among others analyzed the problem in more detail. They studied 257 blood tests from military personnel who contracted MS between 1992 and 2004. The blood tests were taken and frozen before these people became sick. The question was whether they had remarkably little vitamin D in their blood when compared to people who did not contract MS.

It was shown that they did. 25-OH-D, the best measure for vitamin D status, was measured in both the sick and a large number of healthy people who were randomly chosen from 7 million personnel. It was found that “high circulating levels of vitamin D are associated with a lower risk of multiple sclerosis.” Low vitamin D levels were especially risky for people under 20 years of age.

How much vitamin D is enough? When the level of 25-OH-D was at least 99 nannomol/litre serum, the risk of MS was the lowest at about 40% average. The difference was statistically certain. For comparison, levels under 50 are indicative of insufficient levels of vitamin D. Such values can be found in most people during the winter.

The theory that vitamin D prevents MS is thus strengthened. One should attempt to distance oneself from vitamin D deficiency. This is easy during the summer, but from October to April it requires, for the majority of those in our latitudes, supplements.

By: Niels Hertz MD

References:
1. Munger L et al. Serum 25-Hydroxyvitamin D levels and risk of multiple sclerosis. JAMA 2006;296:2832-2838.
2. MS prevalence data for selected countries: http://www.mult-sclerosis.org/prev_tab.html
3. Newsletter from Vitalrådet dec. 27. 2006

jama.ama-assn.org

Vitamin D Can Be Used As Heart Medicine

May 23, 2006

The warnings against direct sunlight in the summer should be taken with a grain of salt. The vitamin D synthesized in the skin in the wonderful sunshine, prevents, amongst other things, weakening of the heart, if we look at the latest research.

Sooner or later in the course of the summer a dermatologist will appear on television to warn against direct exposure to the sun. It may lead to skin cancer and also threatening is the feared, deadly birthmark cancer, the incidence of which has risen dramatically in step with more and more people desiring a tan. This is partly true.

On the other hand it is prudent to be skeptical when someone advices us to act against what is natural. Can it really be true that the sun is so dangerous when people in our part of the world have been far more exposed to the sun through thousands of years?

Vitamin D is made in the skin when it is in the sunlight, but not from September till May, when the sun is too low on the horizon to be used for this in our part of the world. Since our diet only contains minimal amounts of this vitamin, in the wintertime we use the vitamin which has been built up in the skin in the course of the summer. During the winter approximately 85 % of the daily D-vitamin usage is taken from reserves, even in cases where the diet is rich in D-vitamin. All in all, approximately 100 mcg. is used in a day.

But what happens if the reserves are too small?

In the past half-year a number of studies have shed light over the mysteries of vitamin D. According to one study, the vitamin can help against tuberculosis, which we know was a widespread disease in the 19th and beginning of the 20th century, when many people lived under dire conditions in the cities.

Another study of over 14,000 Americans showed that the people with the largest D-vitamin reserves generally had far better lung function than those with the smallest stores. The difference is as big as the difference between ex-smokers and people who have never smoked before. A possible explanation is that the D-vitamin secures the necessary repairs of worn-out cells.

At about the same time, one of the veterans of vitamin-D research, the American Cedric Garland, concluded that now the proof that vitamin D protects against cancer (especially breast cancer, cancer of the colon and prostate cancer) was very strong. Strong enough to make him regard the connection as definite. He has reviewed all relevant research done since 1966.

Weak Heart and Arthritis
His claims can be compared to the fact that David Feldman of Stanford University now wants to conduct an experiment with calcitriol (the active form of vitamin D, which is made in body from vitamin D in the skin or the food) and ordinary arthritis medication against prostate cancer. In laboratory studies he has found that calcitriol slows the growth of prostate cancer by 25 %, while the combination with arthritis medication slows it by 70 %. A true break-through if it is true.

Everyone knows that vitamin D is necessary for the bones, but it is also necessary for the muscles. A deficiency leads to both muscle pain, weak muscles and for example, a tendency to fall in the elderly. But what about the heart? The heart is also a muscle, and weakening of the heart (cardiac insufficiency) because of atherosclerosis or increased blood pressure occurs in as many as 50,000 Danes. It is a dangerous condition with a high mortality rate.

A German study of 123 patients with a weak heart showed that on average they had quite small amounts of vitamin D in their blood stream, close to a deficiency in the traditional sense. Half of them were given supplements of 50 mcg. D3-vitamin each day for nine months. This is five times as much as the elderly are traditionally recommended given, and is also the upper limit, of what is not dangerous to ingest.
The study was too small to show a difference in mortality, but it did show something interesting. It concerns the protein TNF-alpha, which is produced by the white blood cells in connection with inflammation. TNF-alpha is meant to be a major cause of weakening of the heart. In the patients left untreated, the blood’s content of this protein increased by 5 %. In those treated, there was no worsening. This indicates a stabilizing effect on the inflammation.

This is especially interesting for another reason. TNF-alpha is an important cause of pain and swelling in arthritis. So important that new types of arthritis medication, which blocks TNF-alpha, fittingly, are considered wonder-drugs. If vitamin D decreases the effect of TNF-alpha on the weakened heart, maybe the same happens in arthritic joints. This would also confirm the old assumption that vitamin D protects against arthritis.

When in the sun, one should be sensible and avoid sunburns. Stay in the shadow if the sun is very strong and do not lie about for hours in the sun all covered up in greasy sun lotion.

Also important to know is that it is a risk rather than a virtue to stay out of the sun in the summer.

By: Vitality Council

References
1. Schleithof S S et al. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: A double blind randomized placebo-controlled trial. Am J Clin Nutr 2006;83:754-9
2. Heaney R et al. Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 2003;77:304-10.
3. Moreno J, Krishnan AV, Feldman D. Molecular mechanisms mediating the anti-proliferative effects of Vitamin D in prostate cancer. J Steroid Biochem Mol Biol. 2004 Nov;92(4):317-25

www.ajcn.org
www.elsevier.com/wps/find/journaldescription.cws_home/333/description

Vitamin D Could Prevent Every Third Cancer-related Death

April 21, 2006

Several of the World’s leading vitamin researchers advocate a much higher vitamin D-intake. They believe that up to every third death from cancer may be prevented.

“I challenge anyone to find a field or a nutritional substance or any other factor with as effective cancer-fighting properties as vitamin D.”

So said Edward Giovanucci, professor at Harvard University, last year in a speech to the American Society for Cancer Research.

More and more agree with Giovanucci, amongst them, several professors from well-renowned universities. A few months ago Cedric Garland, an absolute pioneer in the field, stated that it has been proved that the risk of cancer can be lowered dramatically with vitamin D. These are big words. Garland is a professor at the University of California in San Diego.

Giovanucci has together with six others, of these, no less than three are professors from Harvard, confirmed the claim further. In a quite laborious study they have confirmed the close connection between a vitamin D deficiency and cancer.

Since World War II it has been known that especially cancer in the alimentary canal is seen relatively seldom in southern countries. Since sunlight is the most important source of vitamin D, it has earlier been guessed that it was vitamin D and not the sun, which offers protection. In numerous studies the incidence of cancer has been found to be highest where sunlight is weakest, and where the content of vitamin D in the blood is lowest. We are children of the sun. At the same time laboratory research in recent years has shown that this vitamin inhibits the growth of abnormal cells, counteracts the spread of cancer and prevents the formation of blood vessels in tumorous masses.

Giovanucci now finds further proof of the connection. Earlier in humans there has only been found an indirect connection between vitamin D and cancer. There has been a lack of data from whole groups of the population, that have had their blood content of vitamin D measured, and have then been followed for a number of years. But Giovanucci has found something to substitute this data.

Mega doses of Vitamin D
They took 1095 men from the big population study “Health Professionals Follow-Up Study”. These 1095 men had had their vitamin D-status measured (this means the content of vitamin D in the blood). In addition, a lot of things were known about their personal habits etc. Would it be possible to go backwards and calculate their vitamin D-status from their personal habits? Yes! An estimation of the approximate vitamin D blood content could be made, when the individual’s skin colour (eg. race), body mass, height, place of residence (southern/northern in the USA), the amount of physical activity, time of year and the content of vitamin D in the test subject’s diet and possibly supplements was known.

In this manner the group worked out a point-system for the direct calculation of vitamin D status. What especially contributed to a low status was a northern place of residence, dark skin colour, overweight and lack of exercise. The calculations proved correct for the 1095 test subjects. But would they be correct for other people? They were checked for another group of men with known vitamin D status. They were consistent!

Every single subject, of the 47,800 men in Health Professionals Follow-Up Study now had their vitamin D status calculated. In the course of approximately four years, about one in ten got cancer. About half that died from it.

To find the significance of vitamin D, they chose to compare dead men whose plasma values for vitamin D (25(OH)D3) deviated by 25 nmol/L (nanomol/liter). It was found that the risk of dying from cancer was no less than 29 percent lower in men with a high vitamin D status. Concerning cancer of the alimentary canal – it was 45 percent lower for men, who were otherwise identical with regards to age, weight and level of physical activity.

If these results are correct, every third death from cancer may be prevented in the course of a few years. Also in the UK. This is nothing but a sensation. But if one wishes to increase the plasma level of vitamin D by 25 nmol/L, one must receive a supplement of no less than 1,500 units of vitamin D during the winter. This is achieved if a supplement of four vitamin D tablets of 10 mcg (micrograms) is taken daily from August until April.

1,500 units will probably shock many. Is it not toxic? No, it is quite certain that there is no risk, even with a permanent supplement of 2,000 units daily. For comparison, the skin produces 20,000 units during half an hour in the sun in the summer.

Garland, who was mentioned above, recommends 1,000 units (25 micrograms) a day. Others say 2,000. Giovanucci and his colleagues from Harvard strongly recommend 1,500.

Under any circumstances: If you want the full advantage of vitamin D, it seems that the need is far greater than what we have gotten used to believe. Maybe it is close to what stone-age people received naturally from their diet.

By: Vitality Council

References
1. Giovanucci E et al. Prospective study of predictors of vitamin D status and cancer incidence and mortality in men. J Natl Cancer Inst 2006;98:451-9
2. Garland CF et al. The Role of Vitamin D in Cancer Prevention. Am J Public Health. 2006;96(2):9-18. 2005 Dec 27; [Epub ahead of print]

jncicancerspectrum.oxfordjournals.org
www.ajph.org
www.iom.dk

Calcium supplements with vitamin D against colon cancer?

February 18, 2006

A large study attempted to show whether or not calcium and vitamin D prevent colon cancer. It was a strange study, using low doses over a short period.

There are probably those who believe that the latest study on calcium and vitamin D shows that neither is good for anything. But we should hesitate before going to that extreme. One can also believe that the study was not suited to draw this conclusion. Or, as it is stated in a leading editorial in “The New England Journal of Medicine:” the conclusion should be interpreted in light of the study was complicated and in light of the probability that the doses of calcium and vitamin D were too low.

The debate regards the insidious and widespread cancers of the colon and rectum. Half of a group of 36,282 American women between the ages of 50 and 79 took part in a seven year study where they received daily supplements of 1,000 mg calcium and 400 units vitamin D to see if reduced their risk of these diseases. The supplements given are the same as two normal calcium and vitamin D vitamin tablets, which many take to strengthen their bones. After the seven years the researchers assessed the number of women who developed colon and rectum cancer. The result was disheartening: Whether the women received supplements or placebo had not effect on the risk.

There was a single positive find buried in the data. The women who had the least vitamin D in their blood during the study had with statistical certainty the greatest probability of developing colon cancer. This could indicate that vitamin D has a positive effect. There was also a tendency, but only a tendency, that these women had the greatest benefit from the supplements.

Quite a lot of things contribute to that this conclusion be taken with a grain of salt. This is partially due to that the study was very complex.

Possibly the most important objection is that it “only” lasted seven years. It is believed that colon cancer takes 10-20 years to develop before it is diagnosed. It the supplements prevent a new cancer from forming it is clear that for this reason no effects will be found as early as after seven years. This has been considered: Participants in the study will be monitored further for the next five years.

Strong objections
If the goal was to show a difference within the seven year period, those responsible should have at least ended the study by examining the intestines of all of the participants in order to find early cancer stages, or polyps. This did not occur. There was neither the money nor the resources necessary to do over 35,000 intestinal examinations. It was only possible to establish that the number of independently undertaken intestinal exams and the number of discovered cancers in the two groups were about the same. But maybe nothing more can be expected.

One confusing detail is that the study participants were allowed to continue taking the supplements that they had taken before the study along with the supplements that they received as a part of the study. On average they received 1,100 mg calcium and 350 units vitamin D, both close to the recommended dosages, before the study began. Many of them therefore must have received very large doses of calcium, over 2,000 mg, per day. Is it reasonable to guess that this is the reason for the slightly increased frequency of self-reported kidney stones? 2.4% of those who received supplements and 2.1% of those who received placebo, got kidney stones during the seven years.

Also, the average age was relatively low (62), which reduced the risk of cancer, and therefore weakened the study. It was further weakened by the fact that more than one out of four participants did not finish the study. Whether this dropout rate is because calcium pills can cause constipation is not considered in the article.

Just as important, the dose of vitamin D, as referred to in the editorial, may have been too low. Recently it has been estimated that about 1,000 units daily is necessary for most people in order to achieve any supposed cancer preventing effect. This amount of vitamin D (or more accurately 25-(OH)-vitamin D) is necessary to achieve a serum concentration of over 30 nano-grams per litre (75 nanomols per millilitre). Nevertheless, only a minority of the study participants received this amount.

What can be concluded from this? The editorial gives some suggestions for new studies. Much indicates that vitamin D, and maybe calcium, prevents cancer. But we still lack sufficient knowledge.

By: Vitality Council

References:
1. Wactawski-Wende J et al. Calcium plus vitamin D supplementation and the risk of colorectal cancer. N Engl J Med 2006;354:684-96.
2. Forman M C et al. Calcium plus vitamin D3 supplementation and colorectal cancer in women. N Engl J Med 2006;354:752-4.
3. Garland C F et al. The role of vitamin D in cancer prevention. Am J Publ Health 2006;96:9-18.