Wednesday, February 13, 2008

Vitamin D supplementation: Bad?

There's a new discussion paper out on vitamin D which deserves serious reading:

Vitamin D discovery outpaces FDA decision making

Some of it is very interesting if you want an opinion that suggests vitamin D supplementation, at any level, is bad and that low levels of 25 OH D3 are a product of disease, not a contributor. And as such are a marker of good things happening in the immune system. He includes the changes in gut flora as a source of obesity as being triggered by D2 supplementation (not had time to read all of this in detail) and I'm not sure I agree with him on what's happening (anywhere!), but there's plenty there to think about here. You have to look at both sides of a decision making process.

No time to read it in detail today, arghhhh

Peter

EDIT later in the day

By the time you've been through enough of the easily available references to realise that they don't actually say what the author claims they say, you tend to bin the review. There's the bin, dump goes the review. Gimme the D3.

15 comments:

ttlaitin said...

hi,

the ideas/theories of Trevor Marshall have been discussed also in the lowcarber.org-forum:
"Vitamin Vitamin D Supplements Considered Harmful?

the conclusion seemed to be that Marshall is a dubious character not to be trusted.

hope they are right!

Peter said...

Hi ttlaitin,

Thanks for the link

I've skimmed the paper and his references about the body synthesising vitamin D using "energy" in all sorts of dark places (like the intestine!) are three, two specifically state UVB in keratinocytes, the third is self citation in a book. I'm not dumping my D3 on the basis of this but I'll need time to take the review to pieces.

Interesting discussion thread. Whenever I've been talking to people with auto immune diseases I've always suggested that dropping carbs improves things long term but getting your immune system back after years of glucose induced damage can be a little uncomfortable. Never come across the flares in AA diseases on sunlight exposure though, very interesting. My psoriasis always improved with the sun, back when I had it in my gluten sugar days...

Peter

g said...

Absolutely interesting par for the course!

D2 is a synthetic vitamin (ergo-calciferol)... ergo, it 'sucks' and hurts people. Below doctor noticed D2 worsened glycemic control (in Indo-Asian subpop) instead of improving it -- which vit D3 normally does.
Dr. Gerry Schwarfenberg, MD, CCFP
http://www.cfp.ca/cgi/reprint/53/9/1435

much like the benzene structure in artificial beta-carotene Lurotin (by BASF in Germany) which caused statistically more all-cause mortality and lung cancer in smokers in trials ATBC (in Finland -- hey that Finland 'factor') and the CARET.

much also like synthetic alpha-tocopherol Vitamin E in the latest Women's Health Study!

(sorry, no time today for links! arrgghh)

take care! g

Sasquatch said...

I find it hard to believe that vitamin D, at physiological levels, is harmful. Homo sapiens evolved under the African sun. Vitamin D is so important, we rapidly lost our skin pigmentation when we migrated North, probably to improve our D status. Dark-skinned people at latitudes further from the equator are much more likely to be D deficient than light-skinned people.

Then again, maybe simply stuffing down D3 isn't a physiological way of raising vitamin D status. Vitamin D is present in a few foods, but always with other nutrients, most notably vitamin A. Vitamin A protects against D toxicity, and vice versa. Plus, there are other forms of vitamin D found naturally that you won't get in a pill. Who knows if these are biologically relevant. Probably.

I'm always skeptical of isolated and synthetic nutrients. I take cod liver oil and eat pork lard and butter in the winter and get as much sun as possible the rest of the year.

I've seen a few compelling studies on D3 supplementation. It seems to be capable of doing some beneficial things, so that softens me up a bit.

I've been considering adding a supplement for a little while just to see how I feel. I'm still going back and forth about it.

James said...

I believe in the use of vitamin D and there is ways to get it nuturally. I have been taking a teaspoon of cod liver oil a day and it contains up to 1300(international units) in every serving and have been thinking about also moving on to a supplement. For the time being though I will continue to do what I am doing becasue it is wokring for me. There is an alright amount of food with D in it but it is mostly fish that are the really good sources. Here are a few sources of vitamin D:

Tuna (canned in the oil)
Salmon (cooked)
Mackerel(cooked)
eggs (the yolk contains the vitamin D)
Milk, nonfat, reduced fat, and whole, vitamin D fortified

Varangy said...

Hi Peter,

Sorry to go off topic but I am very excited and interested in hyperlipid-ing, if you will.

Wanted to ask you a couple questions, hopefully you have the time to answer them.

1) You have repeatedly mentioned that you lost a lot of weight rapidly on this diet --- excuse my execrable vanity, but I would like to get, for lack of a better description, 'ripped'. Do you feel that the hyperlipid eating model and exercise would get me there?

2) You also mention that you eat just enough carbohydrates to stay out of ketosis --- just so that I am on the same page, one can go into ketosis on a hyperlipid diet, correct?

More importantly, why avoid ketosis?

Thanks in advance.

Varangy said...

Hi Peter,

Sorry to go off topic but I am very excited and interested in hyperlipid-ing, if you will.

Wanted to ask you a couple questions, hopefully you have the time to answer them.

1) You have repeatedly mentioned that you lost a lot of weight rapidly on this diet --- excuse my execrable vanity, but I would like to get, for lack of a better description, 'ripped'. Do you feel that the hyperlipid eating model and exercise would get me there?

2) You also mention that you eat just enough carbohydrates to stay out of ketosis --- just so that I am on the same page, one can go into ketosis on a hyperlipid diet, correct?

More importantly, why avoid ketosis?

Thanks in advance.

Peter said...

Hi varangy,

I only ever dropped 8-9kg as I started at 67ish and dropped initially to 58ish over a couple of months on Atkins with lots of exercise. Below 60kg was MUCH too ribby, 62kg was ok but a bit bony and around 64-5kg is where I'm at now and happy with it, so no major weight shifts.

I think it's probably near impossible to avoid dropping in to ketosis at times on this diet, especially if exercising. I keep ketones minimal as there are reports of increased cortisol production in frank ketosis, which I doubt is a good thing.

Peter

Dave Lull said...

Hi Peter,

I'd been persuaded, like you, that D3 is the form of Vitamin D to use for maximum effect. Now comes this study:

"Vitamin d2 is as effective as vitamin d3 in maintaining circulating concentrations of 25-hydroxyvitamin d"

Holick MF, Biancuzzo RM, Chen TC, Klein EK, Young A, Bibuld D, Reitz R, Salameh W, Ameri A, Tannenbaum AD.

Boston University School of Medicine, 715 Albany Street, M-1013, Boston, Massachusetts 02118. mfholick@bu.edu.

J Clin Endocrinol Metab. 2008 Mar;93(3):677-81. Epub 2007 Dec 18.

Dr Holick uses Vitamin d2 in treating his patients.

He was recently interviewed on the radio program the People's Pharmacy; the interview is available as a podcast.

Best,
Dave

Peter said...

Hi Dave,

There is just one extra methyl group (carbon 28) attached to carbon 24 to distinguish between vitamin D3 and the phamaceutical D2. I doubt that many measurement systems would accurately differentiate this relatively small difference. I can't get the full text of the paper so don't know how it was measured. Clearly D2 hits the D3 receptor. Whether it does all of the things D3 does and no "extras" is a complete unknown (to me anyway). From the pragmatic point of view Dr Holick seems very well informed about vitamin D.

If he is genuinely repleting 25(OH) D3 using D2 as the started molecule then there must be a system for demethylating D2 to D3 somewhere along the line. Seems a strange way to work when D3 is freely available, and that's what he uses long term... Oh, and it looks like there is an extra double bond between carbon 22 and 23 in D2 which would have to be hydrogenated to convert it to D3. I guess he's probably measuring D2.

Peter

Dave Lull said...

Thanks, Peter.

I'll continue using D3.

Btw, I just submitted a duplicate of my comment pointing out the D2 study of Dr Holick et al. at Dr Davis's Heart Scan blog, as a comment on his posting "Vitamin D2 vs. vitamin D3" ("posted by Dr. William Davis at 7:32 AM on Apr 26, 2007"). It hasn't been approved yet.

Best,
Dave

moblogs said...

Although that paper is peer reviewed, it's just an opinion than a study. If there was data that suggested D isn't good for us I'd swallow (pun kind of intended) it.

Humans aren't the only living things to synthesize UVB. Cats make D3 when UVB hits the oils in their fur which they then ingest while cleaning themselves as well as obtaining it from the livers of prey.
Plants also make it; plants need food, water and sunlight just as we do or they wither.

Supplementation, at least as D3 is a good idea as humans have evolved to be clothed and live indoors.

It's important to note that Marshall suffers from sarcoidosis which makes vitamin D trigger hypercalcemia. He seems to have applied his personal illness as the foundation that vitamin D is bad for all. Indeed the treatments in his protocol are antibiotics which could work just as well with or without D depletion.

Peter said...

Hi Mo,

I never got as far as his antibiotic protocols when I found so many problems with his citations. There's peer review and there's peer review.

I have to say that once you read through Ebringer's work on bacterial mimicry of mammalian proteins and the role of commensals in ankylosing spondylitis, rheumatoid arthritis and multiple sclerosis you can see that antibiotic therapy for assorted problems is logical. As is correcting the hypovitaminosis D that pre disposes to the abnormal/excessive reaction to those commensals.

Living with your commensals under adequate vitamin D, maybe starving them a little with LC and low fiber, seems better than throwing antibiotics at them. Might work better in the long term too.

Enjoyed the music blog btw.

Peter

snake said...

i have psoriasis, how long before you improved on gluten free,i so far a month and also nightshade free
thanks

Peter said...

Hi snake,

Can be a long time, one anecdote from a DH patient suggests 6-12 months. But this was on a modern diet of GF crap....

Peter