281 replies to this topic

[torrential]

It's little convoluted, but I think it's progress. This committee was not tasked with setting a new DRI. Rather, they were tasked with determining if sufficient information exists to justify consideration of a review of the existing recommendations. Their conclusion appears to be "yes, there is sufficient information available" to justify reviewing the existing DRI. That review, however, is left to another committee. This is good news: The committee to consider the existing recommendations could only be formed after this determination was made.

It's a good article, very encouraging. Thanks, Kismet.

[krillin]

What does that mean? They are not going to change the DRIs?

I'm with William Davis when he says

Now the FNB, in light of new data, wants to set new AI's, or even RDA's, for vitamin D for the U.S. This is an impossible--impossible--task. There is no way a broad policy can be crafted that serves everyone. It is impossible to state that all men or women, categorized by age, require X units vitamin D. This is pure folly and it is misleading.

[torrential]

Krillin, thanks for referencing Dr. Davis' spot-on analysis (with which I concur). There are two different questions here:

First, is the U.S. dietary recommendation for daily allowance (minimum and recommended) of vitamin D going to be reviewed. The answer here is probably Yes.

Second, will the review result in a change that is meaningful at an individual level across the entire population. The answer here is very likely to be No.

A lot of folks are rooting for the current number to be lifted and I've often seen 2,000 IU / day bandied about. But, as we've read, that number could be too high or too low for any given person at any particular time in their life. However, a new dietary recommendation coupled with a blood level recommendation AND a recommendation that regular testing become standard practice might actually have widespread benefit and reduce the impact of limitations inherent in a one-size-fits-all dietary guideline.

While I'm dreaming, I might as well ask that this bold multidisciplinary commission mandate cholecalciferol as the treatment of choice for improving D levels.

[balance]

Anyone got access to the Am J Clin Nutr?
Am J Clin Nutr. 2009 Mar;89(3):719-27. Epub 2009 Jan 28.
Dietary reference intakes for vitamin D: justification for a review of the 1997 values.
Yetley EA, Brulé D, Cheney MC, Davis CD, Esslinger KA, Fischer PW, Friedl KE, Greene-Finestone LS, Guenther PM, Klurfeld DM, L'Abbe MR, McMurry KY, Starke-Reed PE, Trumbo PR.
"...Members of the working group concluded that significant new and relevant research was available for reviewing the existing DRIs for vitamin D while leaving the decision of whether the new research will result in changes to the current DRIs to a future IOM-convened DRI committee."
http://www.ncbi.nlm....pubmed/19176741

What does that mean? They are not going to change the DRIs?

Kismet,

I got the full article for you if you want it.

[kismet]

piet3r, thank you.

What does that mean? They are not going to change the DRIs?

I'm with William Davis when he says

Now the FNB, in light of new data, wants to set new AI's, or even RDA's, for vitamin D for the U.S. This is an impossible--impossible--task. There is no way a broad policy can be crafted that serves everyone. It is impossible to state that all men or women, categorized by age, require X units vitamin D. This is pure folly and it is misleading.

I cannot second that statement. It's true that we can't set RDAs which are sufficient for all (at any given intake it will be toxic to some, while insufficient for others), but we can and must set "RDAs" which are less inadequate than the current ones. This can be easily done and the Canadian Cancer Society already updated their recommendations. There is only one important qualifying question: "What is your sun exposure?", everything else is secondary to that question. They recommend 1k IU in Winter and Fall, and 1k IU all year round for those who avoid the sun. There's no way in hell that amount will be toxic to anyone.

So I am wondering what is the task of the current committee? They got 24 months to do the job and I think Dr. Cannell implied they could actually review and change the DRI. I'm a little confused, because this document was released only 5 months after initiation of the committe. Does "leaving the decision of whether the new research will result in changes to the current DRIs to a future IOM-convened DRI committee" mean a future committee which will be formed after this one (= which will take years) or are they able to change the DRIs within the 24 months if they deem it necessary?
I have read that cynical POS, but I must have missed that part.

They are worried by a possibly increased risk of "pancreatic cancer" and "renal stones", to me this seems like ridiculous ignorance of biological systems, do they expect a free lunch? Vitamin D is a hormone and as such it could have side-effects within the physiologic range (it's called trade-offs). Why didn't they consider all-cause mortality?
Ironically the government sponsored committee is crying about a lack of RCTs, so why didn't the government sponsor any RCTs? The evidence to initiate them has been there.
I'm wondering why are they crying about this lack of RCTs to begin with? Are there really RCTs for every single vitamin and mineral proving their efficacy and safety at the current RDAs? If such studies exist, how come the government did not sponsor any RCTs to determine the efficacious and safe levels of vitamin D? Did they think "vitamin D, mhm, sounds kinda unimportant, I think we can make do without an RDA... at least for the next ten or twenty years" (I'm sure Bush and the other Bio-luddites in the goverment did, but there must have been some intelligent people at the IOM at least?)
Personally I'm convinced there are some beautiful RCTs demonstrating benefits. I could be wrong, but I am wondering if Holick, Cannell, Dawson-Hughes, Garland, Giovanucci, Heany, Hollis, Vieth and Zittermann are wrong too?

People are dying. Hesitation is unacceptable and unforgivable. I don't understand the gap between the IOM recommendations and the recommendations of every single expert having been involved in the vitamin D research of the last 25 years. Oh, right most of the people on that committee never published any vitamin D research in peer-reviewed journals!

Edited by kismet, 16 March 2009 - 02:04 PM.

[nowayout]

They are worried by a possibly increased risk of "pancreatic cancer" ...

Oopsy! Any references on this one? I think lots of people would rather take their chances with a quantified small increase in skin cancer risk through UV exposure than an unquantified or even theoretical increase in pancreatic cancer risk. The latter disease is quite likely to kill you, the former very unlikely with regular screening.

[FunkOdyssey]

andre: If Vitamin D increases the risk of pancreatic cancer, it increases the risk of pancreatic cancer. Meaning, the source (oral vs. skin) is irrelevant. We discussed the equivalency of both forms of administration in a recent Vitamin D thread. If anything, you'd be safer with oral supplementation because it allows better control over serum levels that might be linked to increased risk at the high end.

I would be interested to see the reference though. I do think you have to filter this information through the lens of overall mortality, because there's generally no free lunch with any health intervention, you get your pro's along with your con's.

Edited by FunkOdyssey, 16 March 2009 - 03:36 PM.

[kismet]

They are worried by a possibly increased risk of "pancreatic cancer" ...

Oopsy! Any references on this one? I think lots of people would rather take their chances with a quantified small increase in skin cancer risk through UV exposure than an unquantified or even theoretical increase in pancreatic cancer risk. The latter disease is quite likely to kill you, the former very unlikely with regular screening.

It's not a possible risk inherent to supplemental vitamin D (cholecalciferol), but to vitamin D levels. So in the latter case you are likely to die from either pancreatic cancer (which, indeed, seems to be one of the most fatal cancers) and/or skin cancer. However, both breast and colorectal cancers have a higher incidence and overall mortality than pancreatic and they are the two which most convincingly have been shown to be prevented by vitamin D and somtimes vitamin D and calcium (quite strong, but slightly weaker evidence exists for lung cancer prevention/improved survival; lung cancer accounts for most cancer deaths).
The NHANES III showed something to that effect, overall cancer mortality was not lower (though, all-cause mortality was much lower at 40-49ng/ml), but it was too small and short a study to assess (overall) cancer mortality subdivided for each type of cancer. NHANES III showed reduced breast and colorectal cancer incidence, but if overall cancer mortality was similar there must have been more of other kinds of cancers in vitamin D replete individuals. I guess it could be skin cancer, but also increased pancreatic cancer and aggressive prostate cancer (this has me worried, but it's only one nested case-control study so far, while others are neutral and positive). All-cause mortality is most important, there is no free lunch.
Pancreatic cancer is one of the few cancers were vitamin D has shown mixed (not negative!) results and at which I've not looked in depth. A cursory glance at the literature revealed the following:

To clarify the results from the ATBC trial, recently another analysis was performed "Vitamin D concentrations were not associated with pancreatic cancer overall (highest versus lowest quintile, >82.3 versus <45.9 nmol/L: OR, 1.45; 95% CI, 0.66-3.15; P trend = 0.49)." The CI is very broad, so vitamin D may have increased risk in some sub-groups, but I have not read the full study. (11.7y, 184 incident cases) (1)
The trial in question (ATBC) was performed in smokers (the issue of using smokers was addressed in a letter)
"Higher vitamin D concentrations were associated with a 3-fold increased risk for pancreatic cancer (highest versus lowest quintile, >65.5 versus <32.0 nmol/L: OR, 2.92; 95% CI, 1.56-5.48, P(trend) = 0.001)" (nested case-control study within the ATBC trial, smokers, 16.7 y follow-up) (2)
All (or most) earlier studies demonstrated clear benefits from vitamin D, e.g. the Health Professionals Follow-up Study and the Nurses' Health Study. "Compared with participants in the lowest category of total vitamin D intake (<150 IU/d), pooled multivariate relative risks for pancreatic cancer were 0.78 [95% confidence interval (95% CI), 0.59-1.01] for 150 to 299 IU/d, 0.57 (95% CI, 0.40-0.83) for 300 to 449 IU/d, 0.56 (95% CI, 0.36-0.87) for 450 to 599 IU/d, and 0.59 (95% CI, 0.40-0.88) for 600 IU/d" (3)
Furthermore pancreatic cancer incidence is lower with higher solar exposure. (4)

(1) Cancer Res. 2009 Feb 15;69(4):1439-47. Epub 2009 Feb 10.
Serum vitamin D and risk of pancreatic cancer in the prostate, lung, colorectal, and ovarian screening trial.
Stolzenberg-Solomon RZ, Hayes RB, Horst RL, Anderson KE, Hollis BW, Silverman DT.
(2) Cancer Res. 2006 Oct 15;66(20):10213-9.
A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers.
Stolzenberg-Solomon RZ, Vieth R, Azad A, Pietinen P, Taylor PR, Virtamo J, Albanes D.
http://cancerres.aac...ull/66/20/10213
(3) Cancer Epidemiol Biomarkers Prev. 2006 Sep;15(9):1688-95. 
Vitamin D intake and the risk for pancreatic cancer in two cohort studies.
Skinner HG, Michaud DS, Giovannucci E, Willett WC, Colditz GA, Fuchs CS.
(4) Pancreas. 2009 Mar 6. [Epub ahead of print]
Latitude Variation in Pancreatic Cancer Mortality in Australia.
Neale RE, Youlden DR, Krnjacki L, Kimlin MG, van der Pols JC.

Edit: added information on NHANES III

Edited by kismet, 16 March 2009 - 04:01 PM.

[kismet]

That one cought my attention. How often do you see such an editorial by the most influential and well-respected authorities in one field? The urgent need to recommend an intake of vitamin D that is effective. Right. No matter how loudly you shout the deaf and dumb won't hear you.

Am J Clin Nutr. 2007 Mar;85(3):649-50.
The urgent need to recommend an intake of vitamin D that is effective.
Vieth R, Bischoff-Ferrari H, Boucher BJ, Dawson-Hughes B, Garland CF, Heaney RP, Holick MF, Hollis BW, Lamberg-Allardt C, McGrath JJ, Norman AW, Scragg R, Whiting SJ, Willett WC, Zittermann A.
http://www.ajcn.org/...t/full/85/3/649

[Victor05]

Hi, I think a person's body requires a variety of supplements and food for it to function in a good way.There are wide range of vitamins available from which many people can choose depending on what their health standards require. Below is a sample of the vitamins available -Vitamin A, Vitamin B, which can be further subdivided to B1(Thiamin), B2(Riboflavin), B3(Niacin), B5(Pantothenic acid), B6(Pyridoxine) and Vitamin B12(Cobalamin). The others are Biotin, Folic acid Inositol and Choline. Beta-Carotene, Vitamin C, Vitamin D, Vitamin E, Vitamin K. I have been taking supplements and it is truly helping me a lot.

Edited by Victor05, 28 March 2009 - 07:17 AM.

[Barksdale]

I haven't read the whole thread, but a person can take up to 10,000 i.u before it's toxic. According to this article:

http://www.skincarec...ens-about-.html

[Anges]

Vitamins are organic compounds in a nutrient and are vital to our bodies. In this case vitamins will help our bodies to manage our health status. The main source of vitamins is from vegetables and fruits. The vitamins strengthen our body defense mechanisms and hence ensuring security for our health. So it is good to take vitamin supplements.

[VespeneGas]

Vitamins are organic compounds in a nutrient and are vital to our bodies. In this case vitamins will help our bodies to manage our health status. The main source of vitamins is from vegetables and fruits. The vitamins strengthen our body defense mechanisms and hence ensuring security for our health. So it is good to take vitamin supplements.

I can't tell if this is a troll, a spammer, or just a n00b... they make a pretty convincing argument though

WRT the DRI, I think 1k qd is pretty reasonable, given that there have been no recorded cases of toxicity at such a low dose, and this study showed a clear benefit for 1100 units + calcium. Furthermore, as the culture of medicine changes to reflect the urgency of getting vitamin d to healthy levels, I believe/hope that regular 25(OH)D testing will become ubiquitous, at least for those with access to healthcare. That would eliminate the problem of variable D metabolism, preventing over- or under-shooting of the mark through blind supplementation.

[ajnast4r]

take vitamin D dammit. heres a good read

http://www.thorne.co...text/13/1/6.pdf

Attached Files

•  vitD.pdf   462.46KB   67 downloads

[sUper GeNius]

http://www.msnbc.msn...s/health-aging/

[kismet]

Only (and hypothetically because we're talking epidemiologic data) if you are old, though. There's no association in the young. It's easier to fix something that is broken. But we can assume that vitamin D will prevent you from getting dumber, which is a good a thing.

[kismet]

Two interesting papers:

South Med J. 2009 May 29. [Epub ahead of print]
The Lack of Vitamin D Toxicity with Megadose of Daily Ergocalciferol (D2) Therapy: A Case Report and Literature Review.
Stephenson DW, Peiris AN.
"We report a case of a 56-year-old woman who received supratherapeutic doses of ergocalciferol (150,000 IU orally daily) for 28 years without toxicity. We discuss the possible mechanisms which may account for a lack of toxicity despite intake of massive daily doses of ergocalciferol in this patient."

Ann Oncol. 2009 Jun 1. [Epub ahead of print]
Dietary vitamin D and cancers of the oral cavity and esophagus.
Lipworth L, Rossi M, McLaughlin JK, Negri E, Talamini R, Levi F, Franceschi S, La Vecchia C.
"Adjusted ORs for SCCE and oral/pharyngeal cancer were 0.58 (95% CI 0.39-0.86) and 0.76 (95% CI 0.60-0.94), respectively, for the highest tertile of vitamin D intake. Using a reference group of those in the highest tertile of vitamin D who were never/former smokers, ORs were 8.7 (95% CI 4.1-18.7) for SCCE and 10.4 (95% CI 6.9-15.5) for oral/pharyngeal cancer among heavy smokers in the lowest vitamin D tertile; similarly, compared with those in the highest tertile of vitamin D who drank <3 alcoholic drinks/day, corresponding ORs were 41.9 (95% CI 13.7-128.6) for SCCE and 8.5 (95% CI 5.7-12.5) for oral/pharyngeal cancer, among heavy alcohol drinkers in the lowest vitamin D tertile."

[brunotto]

I read Marshall once said he sees no reason why the body needs vitamin D from sun/supplementation.

Does he drink blood ?

[pro-d]

The circus comes to China: http://www.eurekaler...f-sat072109.php

Hopefully trial data will be public.

[Jay]

Ann Oncol. 2009 Jun 1. [Epub ahead of print]
Dietary vitamin D and cancers of the oral cavity and esophagus.
Lipworth L, Rossi M, McLaughlin JK, Negri E, Talamini R, Levi F, Franceschi S, La Vecchia C.
"Adjusted ORs for SCCE and oral/pharyngeal cancer were 0.58 (95% CI 0.39-0.86) and 0.76 (95% CI 0.60-0.94), respectively, for the highest tertile of vitamin D intake. Using a reference group of those in the highest tertile of vitamin D who were never/former smokers, ORs were 8.7 (95% CI 4.1-18.7) for SCCE and 10.4 (95% CI 6.9-15.5) for oral/pharyngeal cancer among heavy smokers in the lowest vitamin D tertile; similarly, compared with those in the highest tertile of vitamin D who drank <3 alcoholic drinks/day, corresponding ORs were 41.9 (95% CI 13.7-128.6) for SCCE and 8.5 (95% CI 5.7-12.5) for oral/pharyngeal cancer, among heavy alcohol drinkers in the lowest vitamin D tertile."
[/quote]

There are series of studies conducted in China on squamous cell esophageal cancer that find that higher vitamin D levels are associated with higher rates of this cancer. http://cebp.aacrjour...tract/16/9/1889

"Two-hundred and thirty of 720 subjects (32%) had squamous dysplasia. Subjects with dysplasia had significantly higher median serum 25(OH)D concentrations than subjects without dysplasia, 36.5 and 31.5 nmol/L, respectively (Wilcoxon two-sample test, P = 0.0004). In multivariate-adjusted models, subjects in the highest compared with the lowest quartiles were at a significantly increased risk of squamous dysplasia (RR, 1.86; 95% CI, 1.35-2.62). Increased risks were similar when examined in men and women separately: men (RR, 1.74; 95% CI, 1.08-2.93); women (RR, 1.96; 95% CI, 1.28-3.18)."

From the discussion: Confounding is always a potential explanation for associations reported in observational epidemiologic studies. It is possible that vitamin D could be correlated with intake of an environmental contaminant that co-occurs with a vitamin D food source. However, this seems unlikely because the typical diet in Linxian provides little vitamin D: fatty fish and liver are rarely consumed (6) and median egg intake is also low (19). A second possibility is that our result is due to some unmeasured confounder that is correlated with outdoor activity, which is the major contributor to vitamin D status other than constitutional differences between individuals. The majority of the Linxian population and the members of this cohort are subsistence farmers, however, and all spend large amounts of time outdoors. Finally, although there is some variation in socioeconomic status, and household income is associated with risk of esophageal squamous dysplasia (13), we saw no association between household income and serum 25(OH)D status.

Edited by Jay, 26 July 2009 - 02:01 PM.

[pro-d]

There's not really much difference between 36.5 and 31.5 nmol/L, and in any case both those figures would class as deficient.

[kismet]

Eur J Cancer. 2009 Jul 15. [Epub ahead of print]Related Articles, Links
Vitamin D receptor gene polymorphisms, serum 25-hydroxyvitamin D levels, and melanoma: UK case-control comparisons and a meta-analysis of published VDR data.
Randerson-Moor JA, Taylor JC, Elliott F, Chang YM, Beswick S, Kukalizch K, Affleck P, Leake S, Haynes S, Karpavicius B, Marsden J, Gerry E, Bale L, Bertram C, Field H, Barth JH, Silva ID, Swerdlow A, Kanetsky PA, Barrett JH, Bishop DT, Bishop JA.
"These data provide evidence to support the view that vitamin D and VDR may have a small but potentially important role in melanoma susceptibility, and putatively a greater role in disease progression."

Most impressively, more data to support the hypothesis that vitamin D reduces falls and enhances muscular peformance:

Osteoporos Int. 2009 Jul 24. [Epub ahead of print]
Association between vitamin D receptor gene polymorphisms, falls, balance and muscle power: results from two independent studies (APOSS and OPUS).
Barr R, Macdonald H, Stewart A, McGuigan F, Rogers A, Eastell R, Felsenberg D, Glüer C, Roux C, Reid DM.
"In APOSS, this was statistically significant for visit 3 multiple falls (p = 0.047) and for recurrent falls (p = 0.043). Similar results were found in OPUS for visit 1 falls (p = 0.025) and visit 1 multiple falls (p = 0.015). Bsm1 polymorphisms were also associated with balance and muscle power measurements."

[wiserd]

I think you're taking this in a direction which will mislead people. The lower study seems to be talking about people with malfunctioning vitamin D receptors, which says little about what more D3 will do in a healthy individual.

I've read a fair bit of stuff put out by the Marshall protocol folks. While I don't agree that their ideas have universal application I do think that they make several good points. Dysregulation of the VDR may only apply to a few diseases like sarcoidosis. But there is good evidence that infection reduces 25D levels via conversion to 1,25D.

Inflammation -> TLR-4 upregulated -> CYP271B upregulated -> 25D converted to 1,25D

= lower 25 D.

Only a small handful of studies tested both 25D and 1,25D.

If 1,25D is included we start to see various groups of people emerge; some have low levels of 25D and high levels of 1,25D. Some (such as diabetics) have low 25D and low 1,25D.

And yes, the least healthy were those with low 25D. Why? Because they would include those somehow unable to make 25D for whatever reason, those who don't get enough sunlight, and also those who had chronic infections.

So showing that people with lower 25D have more sickness doesn't mean that raising 25D levels orally will fix all the associated sicknesses, and in some cases it makes things worse. The rah rah vitamin D articles I've read consistently gloss over this fact.

Similarly, sunlight does more than just raise 'vitamin' D levels. It effects serotonin (which impacts the immune system), the breakdown of bilirubin, etc. This actually gives the data we see a bit more coherance than assuming that sunlight only effects D3; there are more pathogens in the south so people get more cancer, but less depression so people don't die from the cancer as readily.

While the VDR 'models' that Trevor Marshall parades have not, so far as I know, ever been peer reviewed
the Marshall protocol folks have this much unequivocally right; D3 puts calcium into the bloodstream, not the bones. You need vitamin K, and especially K2, to put calcium into your bones. Otherwise you calcify soft tissue. D3 without calcium does nothing to increase bone mineral density. The oft repeated assertion that low 25D CAUSES heart attacks is a giant blood-red flag that the author doesn't know the difference between correlation and causation.

And if anyone is still hesitating at the importance of 25D in causing heart attacks, it's worth considering that your body makes the D3 from cholesterol.

Edited by wiserd, 21 August 2009 - 02:23 AM.

[kismet]

I think you're taking this in a direction which will mislead people. The lower study seems to be talking about people with malfunctioning vitamin D receptors, which says little about what more D3 will do in a healthy individual.

On the one hand I think you're wrong, receptor polymorphisms provide valuable data IAC, but on the other hand I never made any misleading statements. The study just goes to show that VD signalling is most probably linked to neuromuscular performance. Nothing more and nothing less.

So showing that people with lower 25D have more sickness doesn't mean that raising 25D levels orally will fix all the associated sicknesses, and in some cases it makes things worse. The rah rah vitamin D articles I've read consistently gloss over this fact.

Yes! Sans the little fact that interventional trials consistently show that cholecalciferol is benign or benefical. Other than that, great hypothesis.
Oh boy, I don't really have time to address some of those Marshal fallacies right now...

But I like your rant about calcium metabolism:
"fortified with 125 microg (5000 IU) vitamin D(3) and 320 mg elemental calcium...No changes in serum calcium or cases of hypercalcemia were observed at the follow-up assessments...Between baseline and the 12-mo visit, z scores for bone mineral density at the lumbar spine and the hip both increased significantly (P < 0.001)... Fortification of bread with much more vitamin D than used previously produced no evident adverse effects on sun-deprived nursing home residents and improved bone density measures. "
Am J Clin Nutr. 2009 Apr;89(4):1132-7. Epub 2009 Feb 25.
Long-term effects of giving nursing home residents bread fortified with 125 microg (5000 IU) vitamin D(3) per daily serving.
Mocanu V, Stitt PA, Costan AR, Voroniuc O, Zbranca E, Luca V, Vieth R.

“The higher dose reduced nonvertebral fractures in community-dwelling individuals (-29%) and institutionalized older individuals (-15%), and its effect was independent of additional calcium supplementation.”
Arch Intern Med. 2009 Mar 23;169(6):551-61.
Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials.
Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, Thoma A, Kiel DP, Henschkowski J.

Edited by kismet, 21 August 2009 - 03:10 PM.

[pro-d]

Wiserd, you have to remember that vitamin D deficiency is an epidemic. There are tons of people with the potential to become ill rather than actually being ill.

It is true that in some cases that vitamin D won't help everyone. However, I do think it will prevent a lot of things if utilised early.

And yes, we don't know all the effects of sunlight but knowing about vitamin D is enough for the timebeing. And it does actually increase bone density, because by maintaining calcium in the blood it doesn't have to be stolen from the bones.

A British Dr. has an interesting book on vitamin D and cholesterol: vitamindandcholesterol.com

Edited by pro-d, 22 August 2009 - 10:47 AM.

[castrensis]

I don't think that this has been cited yet but it is a pretty recent randomized placebo controlled clinical trial involving close to 1200 women (age > 55). Results show that Ca + Vitamin D supplementation reduced cancer by 60%. I have briefly read over the design and I didn't see any real problems; This seems pretty open and closed to me.

Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial^1,2
Joan M Lappe, Dianne Travers-Gustafson, K Michael Davies, Robert R Recker and Robert P Heaney ¹ From the Osteoporosis Research Center, Creighton University, Omaha, NE



Background: Numerous observational studies have found supplemental calcium and vitamin D to be associated with reduced risk of common cancers. However, interventional studies to test this effect are lacking.

Objective: The purpose of this analysis was to determine the efficacy of calcium alone and calcium plus vitamin D in reducing incident cancer risk of all types.

Design: This was a 4-y, population-based, double-blind, randomized placebo-controlled trial. The primary outcome was fracture incidence, and the principal secondary outcome was cancer incidence. The subjects were 1179 community-dwelling women randomly selected from the population of healthy postmenopausal women aged >55 y in a 9-county rural area of Nebraska centered at latitude 41.4°N. Subjects were randomly assigned to receive 1400–1500 mg supplemental calcium/d alone (Ca-only), supplemental calcium plus 1100 IU vitamin D₃/d (Ca + D), or placebo.

Results: When analyzed by intention to treat, cancer incidence was lower in the Ca + D women than in the placebo control subjects (P < 0.03). With the use of logistic regression, the unadjusted relative risks (RR) of incident cancer in the Ca + D and Ca-only groups were 0.402 (P = 0.01) and 0.532 (P = 0.06), respectively. When analysis was confined to cancers diagnosed after the first 12 mo, RR for the Ca + D group fell to 0.232 (CI: 0.09, 0.60; P < 0.005) but did not change significantly for the Ca-only group. In multiple logistic regression models, both treatment and serum 25-hydroxyvitamin D concentrations were significant, independent predictors of cancer risk.

Conclusions: Improving calcium and vitamin D nutritional status substantially reduces all-cancer risk in postmenopausal women. This trial was registered at clinicaltrials.gov as NCT00352170.

I've been pubmed-ing away & a paper stating the same but for all-cancer risk.

Calcium, vitamin D and cancer.


A low vitamin D status and inadequate calcium intake are important risk factors for various types of cancer. Ecological studies using solar UV-B exposure as an index of vitamin D3 photoproduction in the skin found a highly significant inverse association between UV-B and mortality in fifteen types of cancer. Of these, colon, rectal, breast, gastric, endometrial, renal and ovarian cancer exhibit a significant inverse relationship between incidence and oral intake of calcium. In addition, lung and endometrial cancer as well as multiple myeloma are considered calcium and vitamin D sensitive. Studies on tissue-specific expression of the CYP27B1-encoded 25-hdroxyvitamin D-1alpha-hydroxylase and of the extracellular calcium-sensing receptor (CaR) have led to an understanding how locally produced 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) and extracellular Ca2+ act jointly as key regulators of cellular proliferation, differentiation and function. Thus, impairment of antimitogenic, proapoptotic and prodifferentiating signaling from the 1,25(OH)2D3-activated vitamin D receptor (VDR) and from the CaR in vitamin D and calcium insufficiency has been implicated in the pathogenesis of the aforementioned types of cancer. 1,25(OH)2D3 and calcium interact in modulating cell growth in different ways: (i) Signaling pathways from the VDR and the CaR converge on the same downstream elements, e.g. of the canonical Wnt pathway; (ii) high extracellular calcium modulates extrarenal vitamin D metabolism in favor of higher local steady-state concentrations of 1,25(OH)2D3; (iii) 1,25(OH)2D3 may up-regulate expression of the CaR and thus augment CaR-mediated antiproliferative responses to high extracellular Ca2+. This can explain why combined supplementation is required for optimal chemoprevention of cancer by calcium and vitamin D.

So, if I understand correctly, Vitamin D + Calcium perform synergistically & are better than Vitamin D alone - anyone able to comment, have corroborating evidence or able to dispute this?

[kismet]

So, if I understand correctly, Vitamin D + Calcium perform synergistically & are better than Vitamin D alone - anyone able to comment, have corroborating evidence or able to dispute this?

We don't know for sure. AFAIK this only (or mostly) applies to colorectal but I'm too lazy to go through my list of studies.

...but... run, run for your lives vitamin D causes teh auto-imminuty disorderz! (and it likely improves cancer survival, but don't tell)

Edited by kismet, 21 September 2009 - 11:10 PM.

[pro-d]

10000IU took me to 141nmol/L, whereas previously 5000IU took me to to 76nmol/L. Will recheck again, but I think 10k is the ideal dose for me.
My calcium went up from 2.59mmol/L to 2.7, which according to a number of sources is the final cut off range for ideal so I'm not going to be experimenting with any higher dosage.

[pycnogenol]

10000 IU took me to 141nmol/L, whereas previously 5000 IU took me to to 76nmol/L. Will recheck again, but I think 10k is the ideal dose for me.
My calcium went up from 2.59mmol/L to 2.7, which according to a number of sources is the final cut off range for ideal so I'm not going to be experimenting with any higher dosage.

Hi pro-d,

Are you going to stay at the 10,000 IU dose? I just went up to 7,500 IU (5,000 IU morning + 2,500 IU evening).

I'll be getting my D levels checked early next year. I was taking 5,000 IU daily and that amount took me to 46 nmol/L.

Do you take a calcium supplement as well?

Edited by pycnogenol, 14 November 2009 - 03:01 PM.

[VidX]

My short story, regarding vit. D deficiency. It runs in my family, from my mothers side (it seems so).. It's a pity there was a no single doctor in 40+ years that advised her to take vit. D, as she clearly showed many signs, and the body type is that of the risk one (brittle, small bones, early osteo..).. At least they prescribed some vit D. when I was a newborn and had that condition, can't name it at the moment. Seems like it probably saved me at least some problems later life. Then in years comming I had a strange thing happening - every winter (starting in late autumn) a dry spots appeared on my skin, everywhere on the body, AND they dissapeared in the first few days I'd spend in the sun on the spring (though correlation has arose just a lot later.. when I personally started reading wtf is happening). Then for some time that condition stopped (in winter) and as I understand now, it was because I've used to visit sunbathes regularly (not doing this anymore) - bingo!
I'm already taking some vit. D "as needed" (try not to overdo it. Is there any kind of adaptation when the same dose does not work anymore?) and I can CLEARLY see how it affects that condition in a matter of a day. I start getting aches and skin dryness here and there, I take 5 drops of liquid (in oil) Vit.D - aout 4000ius, and voilla - it stops and get's back to normal.
Another "test" I'm going to do is checking my teeth again. As the last time my doc said my teeths condition somehow worsened compared to few years ago. My guess - I stopped going to sunbath and avoided sun as much as possible for these few years (trying to "undo" the damage and just prevent a further) that means drastically reduced calcium absorption - here u are, tooth are deprived of minerals. But I'll have to check my theory yet.

Live and learn..