VITAMIN D

Its Role in

Cancer Prevention

& Good Health

RICKETS

• There have been children in Juneau with it !

• From Vitamin D deficiency in childhood

• Bones become soft, can fracture, and are painful

• Growth problems, muscle weakness, and spasms

• In adults a similar problem is called osteomalacia

• Even animals can get rickets

THE ENGLISH DISEASE

Epidemic in England in the 18th and 19th centuries

• Rare in ancient times

• Industrial revolution in 18th century

• Agrarian population became urbanized

• People, including children, worked long hours

• Air in cities became polluted

• England is a low-sunlight country and is far north

JUNEAU

• We are indoors most of the time

• We often go to work in the dark and home in the dark

• We drive to work, not walk

• We live far north

• We are a low sunlight city with lots of cloud cover

WHY VITAMIN D IS

IMPORTANT

YOU HAVE VITAMIN D

RECEPTORS IN MOST TISSUES

IN YOUR BODY

Low Vit D increases your risk of these cancers

• Breast

• Colon

• Prostate

• Lung

• Pancreatic

• Ovarian

• Esophageal

• Hodgkin’s lymphoma

• Non-Hodgkin’s

lymphoma

• Bladder

• Uterine

HOW IT HELPS

• We all have cancerous cells in our body

• Vitamin D helps cells develop and differentiate normally

• It can kill off some cancer cells

• It can inhibit proliferation of cancer cells

& Autoimmune Diseases

• Grave’s Disease

• Psoriasis

• Lupus

• Type 1 Diabetes

• Rheumatoid Arthritis

• Inflammatory Bowel

Disease

• Multiple Sclerosis

• Scleroderma

Vitamin D Helps Prevent

• Hypertension

• Tuberculosis

• Osteoporosis

• Osteomalacia

• Falls

• Muscle Weakness

• Heart Disease

• Benign Prostatic

Hypertrophy

• Parkinson’s

• Type 2 Diabetes

Adequate Vit D Helps

• Depression

• SAD

• Resistance to

pneumonia

• Progression of

arthritis

• Lower blood pressure

• Calcium absorption

• Bolster your immune

system

• Prevent colds and flu

• Wounds heal

INTRIGUING POSSIBILTIES

• Vitamin D may help suppress spontaneous food intake and burn fat

• It may help memory decline/cognition by its neuroprotective effects.

CHILDREN

• Have an increased risk of type 1 diabetes and multiple sclerosis if born in late spring or early summer

• Infants given 2,000 IU of vitamin D a day in their first year of life had an 80% reduced risk of being diagnosed with type 1 diabetes by age 30

• Studies have found a significant relationship between maternal Vitamin D insufficiency and asthma, low bone mineral accrual, and increased fracture incidence

Vitamin D

is not a vitamin

VITAMIN D

• Is a hormone (vitamins cannot be made in the body)

• Is made in the skin the presence of sunlight ( UVB)

UVB

• You can get a sunburn and still not make Vitamin D

• You can make Vitamin D from tanning beds

• UVB is the major cause of skin damage including malignant melanoma

Factors affecting Vit D production

• Time of year

• Time of day

• Latitude

• Clouds or air pollution

• Clothing

• Sunblock

• Aging

• Melanin in the skin

• Glass

• Plexiglas

SUN EXPOSURE

• A healthy adult in a swim suit after enough sun (in Arizona anytime or Juneau in summer) or tanning bed exposure to get a bit pink will make 10,000 to 20,000 IU of Vitamin D

• North of Boston-Vit D production declines after August, there is none from November through mid-March

• Bergen, Norway- can only make it from 11AM-4 PM April-September (with the most in June)

SUN EXPOSURE

Those who live in Australia produce

3.4 times as much Vitamin D from sun

exposure as people who live in the United

Kingdom, and 4.8 times as much as

Scandinavians.

FOOD SOURCES OF VIT D

• Fatty fish (mackerel, salmon, herring,

tuna) - 200-350 IU in 3 oz

• Eggs - 20 IU per egg

• Fortified milk - 100 IU per cup (maybe!)

• Fortified food - cereal, orange juice etc.

“Adequate Intake”

• Set by the government 1997

• There is no Recommended Daily Allowance

• Young children - was based on the amount needed to prevent rickets

• Young adults - was based on the average Vit D intake of 52 young women living in Omaha, Nebraska

“Adequate Intake”

• Infants to age 50 200 IU a day

• Adults 51-70 400 IU a day

• Adults over 70 600 IU a day

1997 Dietary Reference Intake Upper Limit

• Infants (0-12 mos) 1000 IU a day

• Everyone else 2000 IU a day

Intake Recommendations

• Canadian Pediatric Society- 2,000 IU a day for pregnant and breastfeeding mothers

• Canadian Cancer Society- non-white adults should take 1,000 IU daily year-round and whites take that amount in fall and winter

• National Osteoporosis Foundation- adults under 50: 400-800/day, Over 50: 800-1,000 IU/day

Infants and Children

• “Breast milk may not contain enough Vitamin D to prevent rickets.” (It typically contains 25 IU/liter or less.)

• The American Academy of Pediatrics recommends Vitamin D supplements for all children, and all breastfed babies, until they are drinking at least 17 oz of Vit D fortified milk a day.

Risk factors for low Vitamin D levels

• Little sun exposure, northern latitude etc.

• Obesity

• Kidney disease

• Chronic liver disease

• Fat malabsorption

Celiac disease Cystic fibrosis

• Gastric bypass surgery

Blood levels of Vit D (25 OH)

ng/ml nmol/L Health Implications

< 20 < 50 Deficiency

20-30 50-80 Insufficiency

32-100 80-250 Sufficiency

54-90 135-225 Normal in sunny countries

>100 > 250 Excess

>150 > 325 Intoxication

Blood Levels of Vitamin D

• Below 32ng/ml calcium absorption is suboptimal

• Vitamin D metabolism is not normalized until levels are above 40, and often 50ng/ml

• If you have had cancer, some authorities recommend keeping your level at 60ng/ml or above.

Vitamin D Blood Testing

• Costs about $160 to $230

• Insurance generally covers it for conditions such as multiple sclerosis, osteoporosis, osteopenia, and thyroid conditions.

• Your insurance may not cover it for general screening.

• It is moving slowly towards being covered for screening, such as cholesterol often is.

SUPPLEMENTS

• D2 (ergocalciferol) may not be as potent as D3.

From plants. Often used for fortification of foods.

• D3 (cholecalciferol)

• We only absorb about 75% of Vit D taken orally.

VITAMIN D TIPS

• It is fat soluble so you can take it once a day, or once a month.

• It is stored in body fat and slowly released into your circulation.

• You will not absorb as much unless you have some food with fat in it in your stomach when you take it.

Oral Vitamin D Intake

• 400 IU a day does not raise blood levels

• At least 2,000 IU a day, after getting receptors saturated, is probably necessary for full disease-fighting effects (unless you are making Vitamin D from sun exposure)

Vitamin D Toxicity

• You cannot overdose on making Vitamin D from UVB exposure

• Increased calcium in your urine is the first sign of too high levels. At this point, you are beginning to calcify your organs.

• Elevated blood calcium levels are a late sign of toxicity

My Recommendations

• Get your Vit D (25 OH) blood level checked if you can.

• If low, discuss a high dose, short term, weekly Vit D supplement with your health care provider to get your level up. Ask him/her what daily dose they recommend you take after that.

• Get your level rechecked several months after you have finished the weekly supplement (wait until you have not had significant sun exposure for two months)

OROR

Take a vacation in Arizona, Take a vacation in Arizona,

Mexico, Hawaii, Africa or Mexico, Hawaii, Africa or

somewhere sunny every 2 months somewhere sunny every 2 months

and do a little sunscreen free and do a little sunscreen free

sunbathing!sunbathing!

RECOMMENDED REFERENCES

• Vitamin D Second Edition Elsevier Academic Press, 2 vol., Edited by Feldman, Pike, and Glorieux

• http://www.kanthakkarate.com/docs/AJNPVitaminDArticle.pdf

• http://www.vitamindcouncil.com/

QUESTIONS?