Vitamin D This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to: Frankp@chiro.orgIf there are terms in these articles you don't understand, you can get a definition from the Merriam Webster Medical Dictionary. If you want information about a specific disease, you can access the Merck Manual. You can also search Pub Med for more abstracts on this topic.
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Vitamin D Articles
Vitamin D Deficiency in a Musculoskeletal Practice
ACANews ~ January 2012
Vitamin D deficiency is a silent epidemic in our nation, according to Michael F. Holick, MD, PhD, the director of physiology and biophysics at Boston University School of Medicine. Dr. Holick states, “It’s certainly the most common nutritional deficiency and likely the most common medical problem in the world, affecting 1.5 to 2 billion people.” [1]
Office of Dietary Supplements • National Institutes of Health
Vitamin D is essential for promoting calcium absorption in the gut and maintaining adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and prevent hypocalcemic tetany. It is also needed for bone growth and bone remodeling by osteoblasts and osteoclasts [4–6]. Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Vitamin D sufficiency prevents rickets in children and osteomalacia in adults [3, 7, 8]. Together with calcium, vitamin D also helps protect older adults from osteoporosis.
Life Extension Magazine March 2006
The past year has produced stunning research findings concerning vitamin D’s potential role in preventing and perhaps even treating cancer. Scientists are examining the use of vitamin D to reduce the risk of no fewer than 17 different types of cancer, ranging from colon, breast, and prostate cancers to ovarian, esophageal, renal, and bladder cancers. Moreover, researchers believe vitamin D may even improve treatment outcomes in people already diagnosed with cancer. A recent review article estimated that 50,000-70,000 Americans die prematurely from cancer each year due to insufficient intake of vitamin D. [1]
Life Extension Magazine April 2003
Despite being one of the most crucial components of healthy bones, a protector against cancer and diabetes, and a valuable component of the immune system, vitamin D has gone largely unnoticed in the public eye. To uncover some of the benefits of this underrated nutrient, Life Extension spoke with Dr. Michael F. Holick, a vitamin D researcher at Boston University's Medical Center and the author of The UV Advantage.
Vitamin D Research
Antimicrobial Activity of Human Macrophages
Sci Transl Med. 2011 (Oct 12); 3 (104): 104ra102
These innovative researchers examined the mechanisms that govern the immune system's ability to kill or inhibit the growth of pathogens such as M. tuberculosis, the bacteria that causes tuberculosis. The team found that T-cells, which are white blood cells that play a central role in immunity, release a protein called interferon- that triggers communication between cells and directs the infected immune cells to attack the invading tuberculosis bacteria. However, this activation requires sufficient levels of vitamin D to be effective.
in Children with Asthma
Am J Respir Crit Care Med. 2011 (Sep 15) [Epub ahead of print]
This study evaluated serum vitamin D and lung function in 86 children. 25[OH]D3 levels were significantly lower in children with severe therapy resistant asthma (STRA) compared to those with moderate asthma or controls. Higher 25[OH]D3 levels were associated with improved lung function and the authors suggest that vitamin D supplementation may be useful in pediatric STRA.
International Journal of Medical Sciences 2011 (Mar 2); 8 (3): 180–191
A Comparative Effectiveness Research (CER) study was conducted to compare changes in bone mineral density by following one of three bone health plans. Researchers tested 414 women over 40 years of age and 176 of the women agreed to participate in the study and to follow one of the three programs. One Plan contained a bone-health supplement with 1,000 IUs of vitamin D3 and 750 mg of a plant-sourced form of calcium for one year.
Osteoporosis International 2011 (Feb); 22 (2): 489–498
A randomised controlled trial was used in assessing the impact of 6 months of daily calcium and vitamin-D supplementation on trabecular and cortical bone acquisition at distal tibial and radial sites using peripheral quantitative computed tomography (pQCT). Daily supplementation was associated with increased bone density and bone strength at the distal tibia and radius.
Alternative Medicine Review 2008 (Jun); 13 (2): 153–164 ~ FULL TEXT
Vitamin D is a secosteroid molecule which, in its active 1,25 di-hydroxylated form, has hormone activities in humans. Most cells and tissues in the body have vitamin D receptors (VDRs) that stimulate the nuclear transcription of various genes to alter cellular function or provide a rapid response in cellular membranes. Vitamin D appears to have an effect on numerous disease states and disorders, including chronic musculoskeletal pain, diabetes (types 1 and 2), multiple sclerosis, cardiovascular disease, osteoporosis, and cancers of the breast, prostate, and colon. According to many researchers there is currently a worldwide vitamin D deficiency in various populations, including infants, pregnant and lactating women, the elderly, individuals living in latitudes far from the equator, persons who avoid the sun or ultraviolet radiation in the blue spectrum (UVB), and populations with dark skin pigmentation. Vitamin D in the food supply is limited and most often inadequate to prevent deficiencies. Supplemental vitamin D is likely necessary to avoid deficiency in winter months; however, all forms of vitamin D supplementation may not be equal in efficacy for maintaining optimal blood levels.
J Bone Miner Res 2008 (May); 23 (5): 741–749
Stress fractures (SFx) are one of the most common and debilitating overuse injuries seen in military recruits, and they are also problematic for nonmilitary athletic populations. The goal of this randomized double-blind, placebo-controlled study was to determine whether a calcium and vitamin D intervention could reduce the incidence of SFx in female recruits during basic training. We recruited 5201 female Navy recruit volunteers and randomized them to 2000 mg calcium and 800 IU vitamin D/d or placebo. SFx were ascertained when recruits reported to the Great Lakes clinic with symptoms. All SFx were confirmed with radiography or technetium scan according to the usual Navy protocol. Using intention-to-treat analysis by including all enrolled subjects, we found that the calcium and vitamin D group had a 20% lower incidence of SFx than the control group (5.3% versus 6.6%, respectively, p = 0.0026 for Fisher's exact test).
Alternative Medicine Review 2008 (Mar); 13 (1): 6–20 ~ FULL TEXT
The recent discovery--from a meta-analysis of 18 randomized controlled trials--that supplemental cholecalciferol (vitamin D) significantly reduces all-cause mortality emphasizes the medical, ethical, and legal implications of promptly diagnosing and adequately treating vitamin D deficiency. Not only are such deficiencies common, and probably the rule, vitamin D deficiency is implicated in most of the diseases of civilization.
An Evaluation of the Existing Research
Alternative Medicine Review 2008 (Mar); 13 (1): 21–33 ~ FULL TEXT
The analysis outlined in this article leads to a series of striking conclusions. First, most of the available clinical trials and meta-analyses of vitamin D and fracture underestimate the true fracture reduction potential of vitamin D. Second, achievement of vitamin D serum sufficiency levels (now set in the United States, Europe, and many other places at a minimum of 32 ng per mL) could provide for a 50- to 60-percent fracture reduction. And third, providing for vitamin D sufficiency is the simplest, most life-supporting, and most cost effective means of significantly reducing the incidence of osteoporotic fractures worldwide. Given the urgent need, the Osteoporosis Education Project (OEP) has initiated a call for universal vitamin D repletion as the primary basis for osteoporotic fracture prevention worldwide.
Alternative Medicine Review 2005; 10 (2): 94–111 ~ FULL TEXT
Vitamin D sufficiency is required for optimal health. The conditions with strong evidence for a protective effect of vitamin D include several bone diseases, muscle weakness, more than a dozen types of internal cancers, multiple sclerosis, and type 1 diabetes mellitus. There is also weaker evidence for several other diseases and conditions. There are good reasons that vitamin D sufficiency be maintained during all stages of life, from fetal development to old age. Adequate calcium intake is also recommended. The current vitamin D requirements in the United States are based on protection against bone diseases. These guidelines are being revised upward in light of new findings, especially for soft-tissue health. The consensus of scientific understanding appears to be that vitamin D deficiency is reached for serum 25-hydroxyvitamin D (25(OH)D) levels less than 20 ng/mL (50 nmol/L), insufficiency in the range from 20-32 ng/mL, and sufficiency in the range from 33-80 ng/mL, with normal in sunny countries 54-90 ng/mL, and excess greater than 100 ng/mL.
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