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Vitamin D and sepsis: A review of what we know

Posted on: July 30, 2013   by  John Cannell, MD

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Sepsis (coming from the Greek meaning putrefaction and decay) is a severe inflammatory state caused by an infection that can deteriorate into organ failure and death if not contained by the immune system or medical intervention. Sepsis is caused by the immune system’s response to an infection in the blood, urinary tract, lungs, skin, or other tissues.

Sepsis causes millions of deaths globally each year. In the United States, sepsis contributes to more than 200,000 deaths per year. There were 4.07 million cases of septicemia – infection of the blood – from 1995 to 2000, of which 730,000 died. In 1995, the average costs per case were $22,100, with annual total costs in the U.S. of $16.7 billion. It is the second-leading cause of death in the ICU, and the tenth-most-common cause of death overall (the first being heart disease). Premature infants and elderly have the highest incidence of severe sepsis. It accounts for about 25% of all ICU bed utilization.

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12 Responses to Vitamin D and sepsis: A review of what we know

  1. Rita and Misty

    “In addition, I believe it is also increasingly hard ethically to withhold adequate vitamin D from placebo groups.”

    So true.

    And that is a huge dilemma…as it really should be criminal, shouldn’t it?

  2. mbuck

    Sent an email to the President today. Maybe he’ll read it.

    Tuesday, July 30, 2013

    To The President and First Lady
    The White House
    Washingtom D. C.

    President Obama and First Lady Mrs. Michelle Obama,

    Have you ever wondered how to vastly improve the lives of your family and all americans from this moment forward and save hundreds of billions of dollars in health costs each year in the bargain? Please read on and discuss this with your family.

    Humanity’s ancestors came from the general region in Africa from which half of your own family sprang. We lived mostly nude under the strong year-round sun, and we thrived through natural selection by evolving a kind of photosynthesis in our skin that made high levels of vitamin D, also known as 25(OH)D, (25 hydroxycholecalciferol, aka: cholecalciferol pre vitamin D and pro hormone vitamin D).

    Studies have shown levels of vitamin D3 dramatically go up in pregnant women in that region, and breast milk has abundant levels of D3 to nourish their babies. We can consider these levels as ‘natural levels’ that all humans ought to have. However, in the U. S., D3 levels drop in pregnant women and vitamin D is almost non-existent in breast milk.

    A 2012 Dutch study measured these natural levels among Maasai and Hadzabe folks in East Africa:

    Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l. Luxwolda MF, Kuipers RS, Kema IP, Janneke Dijck-Brouwer DA, Muskiet FA.

    https://www.ncbi.nlm.nih.gov/pubmed/22264449

    Quoting from the abstract: “The mean serum 25(OH)D concentrations of Maasai and Hadzabe were 119 (range 58-167) and 109 (range 71-171) nmol/l, respectively.”

    Note: Europe uses nmol/l (nanomole/liter), we in the U. S. use ng/ml (nanogram/milliliter).

    Converting nmol/l to ng/ml: 47.6 (range 23.2 – 66.8) and 43.6 (range 28.4 – 68.4) ng/ml

    { divide nmol/l by 2.5 = ng/ml } .

    So normal levels are 50 – 70 ng/ml or 125 – 175 nmol/l of 25(OH)D.

    These same levels are found among lifeguards, roofers, and those who work in the sun here in the U. S.

    Our bodies of all colors today are direct descendents of those early peoples. But we are no longer bathed in the constant strong, year-round sunshine of our forebears. Additionally, there is very little vitamin D found in foods. Even the spoonful of cod-liver oil our mothers gave us was only enough to prevent rickets but nowhere near the amounts synthesized by the sun in the cradle of humanity.

    The body can produce 10,000 IU – 40,000 IU of D3 in an afternoon if most of the skin is exposed to summer sun when it is highest in the sky. Compare this with the meager 400 IU in a multivitamin, or the 100 IU found in a glass of milk.

    This, then, is the problem: a great majority of americans are chronically deficient in this vitamin D3. Even worse, because many have dark skin, this makes it even harder to produce D3 through sunshine. But worst of all, dark-skinned women who are pregnant or have babies have lower D3 levels than anyone else. Think of your daughters.

    So, this is what you ought to do: order a 25(OH)D test from your doctor for yourself, and your family. Do NOT settle for a 1,25-dihydroxyvitamin test. it’s the wrong test, even if your doctor may suggest that instead. Insist on the 25(OH)D test. If he refuses, you can order 4 tests that you can do at home from ZRT labs for about $200. Results come back about ten days after sending in the tests.

    http://store.zrtlab.com/

    I bought four for us. If your levels are not in the range 40-50 ng/ml or 100-125 nmol/L (these are in the mid-range of ancestral and present levels), then your family is deficient in D3.

    And if your family is deficient, imagine what the rest of the country must be like.

    After supplementing with 10,000 IU /day for a month, my ZRT test came back as 50 ng/ml. This is in the low end of the optimal range of ancestral, and present-day levels, of the Maasai and Hadzabe, 50 – 70 ng/ml.

    In the United States, and anywhere away from equatorial regions, and in more polluted areas such as eastern U. S., only a few months of the year are suitable for sunlight-produced D3 from the sun’s Ultra Violet-B (UV-B) rays, hence the dire need to supplement vitamin D3 up to ancestral levels. While the body stores D3 in fat and muscle tissue, by December, such stores are largely used up leaving the population vulnerable to influenza and other infections and diseases. This winter’s death toll from flu, the overwhelming pressure on hospitals and first responders and the economic repercussions from sick leave is a classic example of such a vulnerable population.

    Insufficient D3 levels are found in folks suffering from influenza, autism, schizophrenia, bipolar and depression, ‘diseases of civilization’, various cancers–including breast and colon cancer, respiratory diseases, multiple sclerosis, IBS and Crohn’s, allergies, osteoporosis, diabetes, obesity—in short, an astonishing number of disorders have direct causal relationship with low cholecalciferol (vitamin D3) levels. Darker-skinned folks are even more at risk than the rest of the population. Babies born to deficient mothers are at an even greater risk for all kinds of ailments, please read some posts by Dr John Cannell at:

    http://blog.vitamindcouncil.org

    Contact Dr. John Cannell (vitaminDcouncil.org) and professor Reinhold Vieth (Toronto U.), professor Cedric Garland (UC San Diego), Dr. Michael Holick (Boston U) — these researchers, among many others, have been sounding the alarm for decades. I know Dr. Cannell has tried to contact you. They are increasingly being joined by researchers from all over the world, adding large numbers of studies in peer-reviewed medical journals over the last few decades.

    I certainly hope this letter has found a receptive ear. The physical and mental health of the nation is at stake. And of course, since vitamin D3 is cheap to make, hundreds of billions of dollars could be saved each year on greatly reduced health costs and sick leave. Not to mention creating a happier, healthier, more robust society, with greater economic activity and healthier children in particular.

    On a personal note, a few days after beginning a course of D3 (Carlson’s Daily D3 drops, 1000 IU per drop) supplementation, I began having flu symptoms. However, two days later, the symptoms were gone and my energy had returned. (I have no financial interest in any company providing vitamin D3 nor serum testing.) I am 62, of European descent and I am below the poverty line. My D3 regimen began 28 Dec and consists of 10 drops of Carlson’s D3 per day. Each drop is 1000 IU, for a total of 10,000 IU / day. This is the only supplement I take.

    We could, in just a few months, dramatically improve the physical and mental health of the nation. This improved state of health could even help ameliorate horrific gun violence by bringing folks back to their senses as mental and emotional health has been shown to be improved with D3 supplements and adequate exposure to the UVB rays in sunlight.

    Mr. President, your own high level of intelligence might be due in part from the fact that you were born in Hawaii, and that your mother received exposure to enough sunlight, even sitting in the shade, for a very healthy baby. It has been found that about half the vital UVB rays could have shone on her skin indirectly from Hawaii’s strong reflected sunlight.

    Mr. President, if you implement the following recommendations, this could well be the single most beneficial change that you could confer upon the people of the country, and you, Mr. President, might go down in the history books as the ‘Sunshine President’.

    I’d sure like to see that.

    ===
    Recommendations:

    – Include the aforementioned professors in a panel like Clinton’s economic summit during his first term, to review all the latest science of D3 deficiency and come up with new guidelines for D3 levels that approach ancestral, ‘normal’ levels.

    – If necessary, based on the panel’s recommendations, declare a state of national health emergency and have your Surgeon General promote the goal of adequate, natural, vitamin D3 levels.

    – Educate the public through media outlets, public service announcements, etc., about the new findings.

    – Conduct a timely cost/benefit analysis of D3 supplementation through the GAO.

    – Implement these higher levels through choice-based (some will think it’s conspiracy), properly labeled, much fortified D3 supplementation in foods such as dairy products, cereals, processed foods, fast foods, etc.

    – Provide access to low-cost supplements covered by Medicare, health insurance, and savings for consumers, through the economics of high-volume purchasing.
    ===

    Congratulations on your landslide victory,

    [name and address here]

    Refs:
    ——
    Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l.
    Luxwolda MF, Kuipers RS, Kema IP, Janneke Dijck-Brouwer DA, Muskiet FA.

    https://www.ncbi.nlm.nih.gov/pubmed/22264449
    ——-

    Dr. Michael Holick Ph. D., on Vitamin D and prevention of chronic diseases

    https://www.youtube.com/watch?feature=endscreen&v=Cq1t9WqOD-0&NR=1
    —–

    Dr. Cedric Garland, UC San Diego, on How vitamin D reduces incidence of cancer: DINOMIT model.

    https://www.youtube.com/watch?v=3GM0CnO6-ds
    —-

    Dr. John Cannell on vitamin D

    https://www.youtube.com/watch?v=–NqqB2nhBE
    ——

    Book review: New Insights into Vitamin D
    Posted on December 21, 2012 by John Cannell, MD

    http://blog.vitamindcouncil.org/2012/12/21/book-review-new-insights-into-vitamin-d/

    “Vitamin D is the substrate precursor to one of the most powerful hormones in the body, which has profound effects on metabolism and immune function.”
    ——

    Vtamin D studies of interest.

    http://blog.vitamindcouncil.org/2010/03/15/newsletter-even-more-vitamin-d-studies-of-interest/

    Researchers from Austria concluded their review paper on vitamin D and high blood pressure by stating:

    “In view of the multiple health benefits of vitamin D and the high prevalence of vitamin D deficiency, as well as the easy, safe, and inexpensive ways in which vitamin D can be supplemented, we believe that the implementation of public health strategies for maintaining a sufficient vitamin D status of the general population is warranted.”
    ——

    D3 is not just a vitamin, it is a powerful hormone:

    Stumpf WE. Vitamin D and the scientific calcium dogma: understanding the ‘Panacea’ of the sun. Eur J Clin Nutr. (2012) 1-2

    Is it a panacea? In the paper, he reports that vitamin D is a:

    ‘Hormone of reproduction and fertility’
    ‘Hormone of growth and development’
    ‘Hormone of immune and stress response’
    ‘Hormone of the digestive system’
    ‘Hormone of endocrine regulation’
    ‘Hormone of central nervous system’
    ——

  3. Rita and Misty

    @mbuck,

    I keep on saying I’m going to take some time to myself to rest, to care of my sick friend, and to simply chill out…but somehow I still find myself here…or in my real-life community…chatting about D. I am beginning to wonder if this is a side effect of my very high 25(OH)D level….

    Regardless, I wanted to respond to your post. 🙂

    What a well-written email to the Obama family! I love to write, but I would not have been able to write such an excellent letter. In other words, you certainly covered those bases very nicely.

    But, someone still needs to go swing that bat.

    Someone (not me, please, I’m exhausted, I really need to crawl into a cave and rest for 1,000 years 🙂 ) …Someone (there must be someone other than me) from the Vitamin D Community needs to take this email to DC and request a meeting with perhaps Michelle Obama to discuss the very seriousness of vitamin d deficiency….

    Change such as this must occur at the personal level. A human connection has to be made. Eye contact, physical touch, and a personal sharing of stories.

    A trust bond has to be established.

    In other words, cyberspace has its limitations.

    n my opinion, vitamin D deficiency is the #1 public health problem in this country…physicians haven’t been properly trained to look for the signs and symptoms…so it’s kind of invisible..or silent…I compare it to a HUGE invisible elephant…..

    Truly, though, if we were to correct for this deficiency, there would be a major savings in healthcare costs. And I do think that food fortification would nicely solve vitamin d deficiency. Food fortification would economically ensure that the vast majority of our population was sufficient in vitamin d. This would be especially wonderful for expectant mom, children, the elderly and those without financial means.

    Be well,
    Rita

  4. mbuck

    @Rita,

    Well, emails to the White House are limited to 2500 words. This one was less than 2000. It was sent this afternoon.

    But it was accepted as it was. We’ll see if the folks who run his email system will pass it on to him and Mrs. Obama. I tried to be direct, as logical as I could be, and as brief as possible, with references for further study.

    If he reads the first paragraph or two there’s a good chance he’ll read the rest and maybe follow up on the recommendations for a Clinton-like summit of the best minds. I hope he orders the blood serum tests in spite of what aides, advisors or his physician may say.

    Nothing like seeing for oneself.

    No doubt he has a bunch of ‘flappers’ (see Gulliver’s Travels), who ‘filter’ what they consider the chaff from the wheat.

    My hope is that it was written well enough to warrant being passed on to the First Family. What was that saying about ‘six degrees of separation’? On the other hand he may not even see it until long after he is out of office and is preparing the Obama Library and reading all the correspondence he received while president.

    Sorry to hear about your ailing friend. I’d say about 90% of the people I speak to are not receptive to the message, even when I point them to compelling studies such as are often found in this blog and others. This is a testament to the efficiency of the scare tactics and propaganda of the last several decades. Hence the emphasis on what constitutes ‘natural levels’ of D3, as a starting point. This is crucial to any logical arguments that would follow.

    Because of the extremely slow dispersion of humans poleward, the gradual onset of ailments was not noticed, or ascribed to other causes. This point is made startlingly clear when immigrants from equatorial regions emigrate poleward and develop a plethora of ailments their kin back home never encountered, many of which are just like the ailments of their new neighbors. These data should be emphasized, citing several carefully documented examples, including diets, lifestyles, work environments, clothing worn, and blood serum levels of the immigrants and their kin back in the old country. Care should be taken to find groups who wore less clothing in equatorial regions, in order to drive the point home. Such groups can be found between the Tropics of Cancer and Capricorn, where the sun is always high in the sky.

    Showing such stark before-and-after contrasts among groups who have made the leap from tropics to temperate climates in the same lifetime will improve and speed up the understanding of the effect of solar synthesis of D in the skin and the consequences of drastic reductions of D production, and hence the urgent need to mitigate D levels.

    Well, I’m done pontificating for the night.

    mbuck

  5. Rita and Misty

    @mbuck,

    1. “Ouch” on the Lilliput reference.

    2. I agree about the “six degrees of separation.” Apparently, it’s an even smaller world than first I may have realized (why is that Disney tune stuck in my head?).

    3. I’d like to see the “enlightened” in the Vitamin D Community develop “Six Sigma” strategy towards ending this pandemic (approach this as the business it is…).

    4. My friend is sick, but she isn’t as sick as mainstream medicine would like her to believe. (mainstream does a very good job of brainwashing-the Vitamin D Community would do well to copy such strategies).

    5. The Vitamin D Council is an impeccable nonprofit organization, and it is not a blog. (do not call it a blog. In other words–it is not a blog–not a blog–not a blog).

    6. There are 100 X 1M blogs out there…to develop another blog in an attempt to end the vitamin d pandemic is incorrect, useless, and similar to “spitting in the wind.” (so, in my opinion, another blog is a waste of time–we here in the Vitamin D Community do not have time to waste).

    7. We need to unit, support, direct and push forward (think battle strategy rather than religious mission).

    8. Change that is required to end the vitamin d pandemic will require the medical community, researchers, and policy makers to work together.

    9. The public’s best vehicle for force would be legal action.

    10. Quick success will require the change to impact at the personal level. A human connection has to be made. Eye contact, physical touch, and a personal sharing of stories.
    In other words: A trust bond has to be established.

    11. And in further words, cyberspace has its limitations. This change will require a personal touch, eye contact, and physical connection. A trust bond has to be established.

    12. Doesn’t anyone play golf anymore??? (lots of change happens during a game of golf. what about utilizing the “6 degrees of separation to this effect?)

    It concerns me that we here in the Vitamin D Community rely so heavily upon cyberspace for communications…real change occurs in the real world, not in someone’s head (though it certainly does start there!).

    Be well, and respond at your leisure.

    Rita

  6. IAW

    Thanks to mbuck for taking the time to write the letter! Wonder what would happen if all the VDC members wrote letters on same subject and sent them to the same address?

  7. Rita and Misty

    I wonder what would happen if all of us wrote letters and someone MET WITH (in person..in the flesh) President and Mrs. Obama…

    Or a Congressman or Senator.

    Better yet:

    I wonder what would happen via a legal petition???

    Of course, I would follow up with an in-person visit.

    Nothing (nothing) nothing will occur without a human connection.

    A bond trust must be developed.

    Think back to the 60s.

  8. Rita and Misty

    I think I need to emphasize this a bit more:

    The letters need to be hand delivered….

    Listen: I know what happens when someone sends 1,000 pushy emails to someone–THEY GET BLOCKED!

    Only an in-person mail deliver will work here.

    Trust me.

  9. Rita and Misty

    “Since vitamin D insufficiency exists in most people living in mid- or high-latitude countries, vitamin D could exert multiple major preventive actions, simple supplementation is both safe and inexpensive and, for a vitamin-hormone, supplementation seems obligatory from a general preventive medical point of view alone, it follows that vitamin D supplementation should be organized in these countries to treat all those currently in a state of insufficiency, patients and ‘normal’ subjects alike, without further delay.”

    http://www.ncbi.nlm.nih.gov/pubmed/21333483

    (so let us please organize….)

  10. Michael

    Hello all,

    Yes, OBAMA could be a booster for Vitamin D and Vitamin C, but he is more interested in being in the history books for “other” accomplishments.

    Saving America from destruction by illness is not his priority. As things are now going, his efforts to move 40% more people’s money into the pockets of rather dumb doctors (who tell us 5,000 UIs of Vitamin D is toxic and who refuse to write prescriptions for more than 1,000 UIs) will be his only paragraph in the history books.

    Obama will be lucky if he can make it to the end of his tenure without having to publicly polish jack boots. Getting him to speak out on Vitamin D ain’t gonna happen. Perhaps his new-found withdrawal from reality and from being smart and from helping people is a manifestation of his growing Vitamin D deficiency. We can see his medical 25(OH)D records in 100 years, I assume.

    Medical propaganda, much like pizza or candy advertizing, is so powerful and pervasive in commercialized America that I would suspect the Obamas slather on sun screen just to walk out to the helicopter.

    My comments are neither tongue-in-cheek nor sarcasm. My comments are plain talk.

    Michael

  11. Rita and Misty

    I was born in 1965.

    I am old enough to remember both of the following sociological events:

    1. The sun tanning craze of baby oil and iodine (guilty as charged)
    2. The sun tanning fear/smear campaign propagated by the sunblock industry and dermatologists (whom I fear were as a group actually seeking legitimacy for their specialty…just my opinion).

    Mass media campaigns work very well precisely because they target the masses.

    Vitamin D is an essential nutrient; a prohormone, necessary for our overall good health and well being…and for the prevention of many modern-day chronic diseases.

    We in the vitamin D community would do well to study successful media campaigns…such as those utilized by the sunscreen industry, by the anti-smoking crusaders, by mothers against drunk drivers, etc., and apply these same publicity tactics to ending the vitamin D pandemic.

    In my opinion, and my 2 cents worth.

    We can and will facilitate change if we unite, support, direct and push forward.

  12. Rita and Misty

    (many of you here are older than me and must remember both the sun tanning craze and the sunblock fear/smear campaign much, much better than me)

    🙂

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