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Newsletter: From cancer to mental health

Posted on: September 10, 2005   by  John Cannell, MD

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Question: How can I use vitamin D to murder my undeserving husband?
Answer: By starting early in the morning.

Last month we learned vitamin D is used as a rat poison. If it will kill a rat, it will kill a husband. How much would it take? The Institute of Medicine’s (IOM) 1997 report says anything above 2,000 units a day may be toxic. Let’s see.

This month we learned how much it takes to sicken a child. Doctors at the University of Maryland School of Medicine report a case of accidental overdose of ergocalciferol – a vitamin D like drug1.

(Ergocalciferol is not vitamin D; it is a vitamin D analog whose patent expired years ago. Trader Joe’s sells it as a vegetarian vitamin D. It is usually obtained by radiating fungi, a fact the health food crowd ignores. Ergocalciferol does not occur naturally in the human body, nor do its numerous metabolic byproducts. It was nice to see the authors refer to ergocalciferol as a vitamin D analog. Ergocalciferol is not vitamin D. Cholecalciferol is vitamin D.)

Anyway, mom was giving her 32-lb son a liquid preparation of ergocalciferol made in Latin America. The direction stated adults should take one drop (2,500 units) per day but mom mistakenly gave junior four bottles (2,400,000 units or 60 mg) over four days. The child developed abdominal pain, mild high blood pressure, and high blood calcium but made an uneventful recovery once the correct diagnosis was made.

At least four studies have incidentally found that demented patients have lower 25(OH)D levels.So, we still don’t know how much it takes to murder a husband. The authors say 21 mg/kg is the lethal dose. If the same is true in humans, a 220-lb death deserving husband would require about 200,000 pills. Ladies, to get that much down him you’ll have to start lacing his beer early in the day.

However, this child got quite sick taking one-fifth that amount (4 mg/kg). His calcium peaked at 15 mg/dl, high enough to be concerning. Vitamin D kills rats by causing high blood calcium. A 110-lb adult would have to take 200 bottles (20,000 of the 400 unit capsules) to match the child’s intake.

So, don’t take 200 bottles at a time; don’t take 50 bottles at a time; don’t take 25 bottles at a time. I would say don’t take 15 bottles at a time but:

1. This month doctors at the University of New South Wales reported giving 50 elderly patients the equivalent of 15 bottles (600,000 units) in a single injection and concluded it was a good idea to do it every year.

A. True
B. False

True. Due to sun scare, vitamin D deficiency is sunny Australia is now quite a problem, so the authors were looking for an easy, cheap way to maintain blood levels for an entire year. It worked pretty well but I wouldn’t do it. It is not physiologic2.

Remember, a 25-hydroxy-vitamin D is the blood test you should have at least twice a year – spring and fall. Take enough cholecalciferol to maintain normal levels of around 50 ng/ml (125 nmol/L), year-round. It will take about 5,000 units/day from all sources (sun, supplements, and diet) to do so.

2. Professor Kay Colston, of St. Georges Hospital Medical School in London, was the coauthor of two remarkable vitamin D papers over the last few months.

A. True
B. False

True. Dr. Colston was senior author on that dramatic paper that showed breast cancer was five times more frequent in the women with the lowest blood levels3.

Dr. Colston helped Dr. Kelly Townsend, of the University of Birmingham, write a review of the ability of cancerous tissues to make activated vitamin D or calcitriol. Calcitriol is a remarkable anticancer agent, but no one knows for sure if levels of vitamin D in the blood will increase calcitriol levels in tumors. The take away point is that some tumors still have the ability to make calcitriol while other tumors may get calcitriol from nearby cells, especially immune cells. The amount of calcitriol in your tumor may depend on the amount of vitamin D in your blood4.

We don’t yet know if vitamin D will help fight cancer. It looks as if it will help. Until we know more, the real question is: Should oncologists allow their cancer patients to die vitamin D deficient? Most do5.

Some cancer patients tell me they are taking 10,000 units of vitamin D a day in hope it will retard their cancer’s growth. If you e-mail me, asking me if vitamin D will help your cancer, I will e-mail you back saying I don’t know. 10,000 units a day has never been shown to cause high blood calcium in healthy people, lifeguards get about that much every day. There is no known reason to take more. If you have cancer and take vitamin D, remember to get your calcium checked periodically as a few cancers can activate too much vitamin D and cause high blood calcium.

3. In July, researchers at the University of Quebec showed that breast density
(associated with malignancy) is lower in women with higher vitamin D intakes.

A. True
B. False

True. The authors speculated that even 400 units of vitamin D, when taken with calcium, reduce breast cancer risk more than Tamoxifen6.

4. Researchers recently reported patients with Hodgkin’s lymphoma live longer if they are diagnosed in sunny weather.

A. True
B. False

True. The authors implied it is time to stop testing the expensive vitamin D analogs in cancer patients and start testing plain old vitamin D. So we add Hodgkin’s lymphoma and colon cancer to lung cancer, breast cancer and prostate cancer, all of which have a better prognosis if diagnosed when vitamin D blood levels are the highest. These papers are important because they strongly imply a treatment effect with vitamin D7, 8.

5. One makes quite of bit of vitamin D in the shade.

A.True
B. False

True. At least in the subtropics, vitamin D producing UVB light was only 50% less under umbrellas or shade trees owing to the fact that a lot of UVB light is reflected. This study was conducted at latitude 27 degrees, and the authors were quick to point out the amount made in the shade at higher latitudes, such as U.S. and Europe, will be less9.

6. You are much more likely to die from a heart attack in the winter than the summer.

A. True
B. False

True. The dramatic decrease in deaths from myocardial infarction over the last 20 years is only partially explained by improved medical care and remains something of a mystery. The reason for the large seasonal variations in death rates (you are much more likely to die from a heart attack in the winter) is more of a mystery, although many experts believe that colder temperatures cause heart attacks. If cold weather causes heart attacks, then people who live at higher altitudes, where it is generally colder, will be more likely to die from heart attacks. Let’s see if this is so10.

7. Greek researchers recently confirmed that those who live at higher altitudes are much less likely to die from heart disease.

A. True
B. False

True. Both the men and women living at 950 meters, where vitamin D producing UVB light is much more intense, had significantly lower total and cardiac mortality than their lowland cousins. The lowland men were more than twice as likely to die from a heart attack in spite of having lower blood pressure and lower cholesterol11.

Three epidemiological facts about heart attacks cry out for a simple explanation, a single theory that explains all the facts. The three facts: heart attacks are less common closer to the equator, less common in the summer, and less common at higher altitudes. Three more facts: vitamin D producing UVB light is higher closer to the equator, higher in the summer, and higher at higher altitudes.

8. After getting 50,000 units of ergocalciferol twice a week for eight weeks (800,000 units), 100% of vitamin D deficient patients with cystic fibrosis remained vitamin D deficient.

A. True
B. False

True. Unfortunately, ergocalciferol is not vitamin D and we will never know if these patients with poor absorption would have absorbed real vitamin D, probably not. 50,000 units of ergocalciferol a week for 8 weeks is common treatment of vitamin D deficiency in the USA because ergocalciferol is the only vitamin D like drug available in prescription strength. Real vitamin D, cholecalciferol, is not available in prescription strength12.

9. Researchers have repeatedly found lower 25(OH)D levels in demented patients.

A. True
B. False

True. The obvious explanation is that demented patients don’t go outside as much. However, Dhesi found associations between 25(OH)D and cognition within a narrow range of cognition, harder to explain by outdoor behavior. Flicker found the association, even after adjusting for outdoor exposure13, 14, 15, 16.

Recently the Australians showed that multiple areas of the human brain contain both the vitamin D receptor and the ability to activate vitamin D into the powerful steroid hormone, calcitriol. This has implications for a wide variety of neurological and psychiatric illnesses17.

Of course all this is more interesting after Irish researchers announced last month that vitamin D reverses the inflammation associated with age related dementia. Should we add dementia to the list of diseases caused by vitamin D deficiency18?

10. Researchers gave African Americans women 2,000 units of cholecalciferol a day for a year and found no effect on bone mineral density.

A. True
B.False

True. A New York group treated 81 healthy African American women with 800 units/day for two years and then with 2,000 units/day for another year. They found no effect on bone loss. Examination of their data showed that more than ninety-five percent of the women were still vitamin D deficient (<40 ng/ml) at the end of three months of treatment with 2,000 units. It looked as if forty percent still had levels less than 32 ng/ml at the end of the three years. That said, this was a good study19.

Some authors have suggested African Americans have developed decreased sensitivity to vitamin D. For example, low blood levels were strongly associated with diabetes (one-fourth the risk with the highest levels) in whites, but not in African Americans20.

Perhaps adequate doses (4,000 units a day) would have had an effect on African American women – we will never know because the researchers followed the archaic guidelines from the Institute of Medicine (IOM). The 1997 IOM guidelines state anything over 2,000 units may be toxic. Those same IOM guidelines for daily supplementation recommend 200 units/day for those less than 50 years old, 400 units/day between 50 and 70, and 600/day units above age 70.

Not only have these guidelines kept undeserving husbands alive, they have hindered research by forcing scientists to use inadequate doses of vitamin D in scientific studies. More importantly, they are inadequate to maintain healthy blood levels. To paraphrase Professor Robert Heaney, the 1997 IOM recommendations are both irrelevant and inadequate. Every month, the scientific literature makes the IOM recommendations look more and more dangerous to your health. The longer it takes the IOM to correct their mistake, the grosser their error becomes.

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