-A Hormone For All People
-The Silent Epidemic

By Royce K. Bailey M.D., M.P.H., F.A.A.C.

The Sunshine Vitamin

Children are taught in first grade that vitamin D is the "sunshine vitamin." Vitamin D was discovered in 1930 and is both a vitamin and a hormone. It is oil/fat-soluble.* The best source of vitamin D is allowing sunshine to contact your skin. Vitamin D can not be directly produced by our bodies. We humans do not have a requirement for vitamin D when sufficient sunlight is available. Once your body has synthesized enough vitamin D from sunlight exposure, it will produce no more.** "Adults need 10-15 minutes of sunlight (to hands, face and legs) , two or three times a week to ensure proper vitamin D levels." Journal of Pediatrics, 1985; 107. Your skin can produce up to 12,000 International Units (IU) of vitamin D in 20 minutes of sunshine.

Why Are We Lacking In Vitamin D

I haven’t seen rickets in 30 years, but most of my patients are deficient in vitamin D. 36% of healthy people and 57% of hospitalized patients had vitamin D deficiency. We have been brain washed to fear skin cancer and wrinkles from sun exposure. We block sunlight by wearing long sleeves and hats, live in cities with tall buildings that block adequate sunlight from reaching the ground, live indoors, use synthetic sun screens that block ultraviolet rays, and live in northern regions of the world that do not receive adequate sunlight, all contributing to the inability of our skin to biosynthesize sufficient amounts of vitamin D3. The requirement for vitamin D3 is dependent on our age (older than 60), degree of exposure to the sun, season (winter blood levels drop), obesity (have reduced blood levels) and the amount of pigmentation in our skin (darker skin makes less vitamin D).

What Does Cholesterol Have To Do With Vitamin D?

The basic molecular structure of vitamin D comes from the much maligned hormone cholesterol. Other hormones that use cholesterol as its precursor include: cortisol, estradiol (estrogen), progesterone, aldosterone, and testosterone. All steroid hormones are chemically related to vitamin D2 , D3 and cholesterol.

The Two Vitamin Ds

There are two chemical forms of vitamin D, namely vitamin D2 (sometimes referred to as ergocalciferol) and vitamin D3 (sometimes referred to a cholecalciferol). The natural form of vitamin D for mammals (animals and man) is vitamin D3 that is produced in their bodies from cholesterol and 7-dehydrocholesterol. An equally effective alternative is plant based vitamin D2, which is derived from the yeast sterol ergosterol. I was taught in medical school that D3 was superior for supplemental replacement, but vitamin D experts at Boston University (11/07) reported that D2 and D3 were equally effective in maintaining adequate vitamin D levels. Harvard Health Letter, 4/08;33(6):8

Where Does Commercial Vitamin D3 Come From?

Observant Jews, Muslims, Seventh-day Adventists and vegetarians never eat pork, or so they think. In the 1940s, milk was supplemented with vitamin D2 which reduced the incidence rate of juvenile rickets by 85% in the United States. Vitamin D2 is manufactured by exposing bacteria and algae to ultraviolet light. D2 imparted a bitter taste to dairy products, and so was replaced by vitamin D3. Commercially available vitamin D3 always is derived from non kosher sources (Leviticus 11). The pro-vitamin known as 7-dehydrocholesterol is extracted via solvent from pig, sheep or cow skin, raw fish liver, and pig brains. It is then exposed to ultraviolet light to produce vitamin D3. Most of the time, 7-dehydrocholesterol is extracted from pig skin and sold to dairy processors. Once chemically pure it is impossible to determine the original animal source (sheep lanolin, pig skin, cow skin, etc.) of crystalline 7-dehydrocholesterol. The exact process is patented (thus secret). Other food sources of vitamin D3 include eggs and fatty fish, like cod, salmon, halibut, etc.

How Do I Know If There Is Vitamin D3 Added?

The US Food and Drug Administration (FDA) requires a notice on the label that states "400 IU of added vitamin D3". However, it is not required by law to indicate either the manufacturer or the sources of the D3.

The major producers of vitamin D3 used for milk and other food supplementation are the companies F. Hoffman La Roche, Ltd (Switzerland) and BASF (Germany). In the United States, fortification of foods with vitamin D include milk (both fresh and evaporated), margarine, butter, soy milk, bread, orange juice, cereals, and chocolate mixes. Other dairy products (cheese, yogurt, etc.) are not fortified with vitamin D, unless labeled.

What’s So Good About Vitamin D?

Vitamin D3 is essential for life in higher animals. Vitamin D3 is a regulator of calcium. It stimulates the absorption of calcium from food across the intestine. It helps incorporate the absorbed calcium into your bones. Many studies have looked at the potential of vitamin D to reduce the risk of everything from cancer to diabetes. These benefits from vitamin D are linked to high levels; unfortunately, higher than the usual levels seen in North America. Did you know that persistent, nonspecific musculoskeletal pain correlates with a high risk of unrecognized and untreated vitamin D deficiency? Mayo Clin Proc 2003;78:1463-70.

Autism

Recently even autism has been blamed on low vitamin D levels. Both the brain and the blood of autistic individuals show evidence of ongoing chronic inflammation and oxidative stress. Autism is more common in children born to mothers who were vitamin D deficient. “Children with vitamin D rickets have several autistic markers that apparently disappear with high dose vitamin D treatment.” says Dr. John Cannell. “Autism and vitamin D,” Med hypotheses, Oct 4, 2007. Activated vitamin D stimulates neurotrophin release (neurotrophins induce the survival of nerve cells), reduces toxic calcium levels in the brain, and inhibits the production of nitrous oxide (nitrous oxide destroys brain cells). Besides reducing inflammatory cytokines, vitamin D does one more thing: it increases concentrations of glutathione, the brain’s master antioxidant.

Cancer

North easterners have higher rates of cancer than those in the Southwest because of sunshine! These include: colon, breast, prostate, bladder, esophagus, stomach, kidney, pancreas, rectal, uterine, ovary and non-Hodgkin’s lymphoma (there are 17 cancers tracked so far). Active vitamin D fights cancer by slowing or stopping unregulated cell growth (by affecting the growth factors and receptors), it increases the death rate of cancer cells and reduces the blood supply to the tumors. Researchers analyzed multiple studies and found that people with the highest level of D had 50% lower risk of colon and breast cancer. Am J Prevent Med, 3/07; J Steroid Biochem Molecul Biol, 3/07. An 18 year study found that men with the lowest level of vitamin D had twice the rate of prostate cancer. PLoS Med, 3/07. Treating prostate cancer with high levels of vitamin D reduced the prostate specific antigen (PSA) by 50%. The PSA is a measure of the cancer’s aggressiveness.

Hypertension And Your Heart

The farther you live from the equator, the greater your risk of having elevated blood pressure (BP). Vitamin D helps regulate the kidney’s production of renin, an enzyme that controls the relaxation and constriction of your arteries. Boston University School of Medicine took one group of people and exposed them to UVB radiation in a tanning bed three times a week for three months. Then they took another group and exposed them to UVA radiation which doesn’t boost vitamin D levels. The UVB group had a six point drop in their systolic and diastolic blood pressure (top and bottom BP numbers) and a 180% increase in their blood level of vitamin D. The UVA group had no change in BP or vitamin D levels.

The Framingham study found that the lowest levels of vitamin D correlated with the worst vascular disease (including coronary artery disease). Low levels of vitamin D were also correlated with abnormal blood clotting and abnormal heart rhythms (related to the body’s supply of calcium and phosphorus).

Osteoporosis

Low levels of vitamin D can cause and worsen osteoporosis-the bone eroding disease that often leads to hip fractures. Your vitamin D status is more important than your calcium intake in maintaining your parathyroid hormone levels. One in six North Americans will have a hip fracture before they die. For the elderly, one in three men and one in five women with hip fractures will die within one year. More than 50% of those being treated for osteoporosis have low blood levels of vitamin D. Wake Forest University School of Medicine found those with the lowest level of vitamin D had the worst balance and strength, thus the highest rate of falls and fractures. J Geront: Med Sci, 4/07. By adding 800 IU of vitamin D in nursing home patients, over five months, reduced falls by 72% vs. placebo. J Am Geriatric Soc, 2/07. By getting more vitamin D you will increase your muscle strength and stability.

Multiple Sclerosis (MS) And Autoimmune Disorder

MS is a slowly developing autoimmune disease in which the body’s immune system attacks the myelin sheaths that surrounds nerve fibers, brain and your spinal cord. The common symptoms include fatigue, poor balance, memory problems and depression. Harvard School of Public Health found that veterans with the highest levels of vitamin D had a 62% lower risk of developing MS. JAMA 12/20/06. MS patients with the highest levels of vitamin D had the least disability. J Neur 5/07. Why does vitamin D help? Vitamin D stimulates transforming growth factor (TGF beta-1) and interleukin 4 (IL-4) production, which suppresses inflammatory T cell activity. Any autoimmune disorder (there are over 80) will benefit from vitamin D’s powerful anti-inflammatory properties including: thyroiditis, Crohn’s disease, inflammatory bowel disease, skin (like psoriasis, eczema, dermatitis), pernicious anemia, lupus, Sjogren syndrome, autism fibromyalgia and rheumatoid arthritis.

Diabetes

Type 1 (juvenile) diabetes is caused by the body’s immune system attacking the insulin-secreting cells of the pancreas. A study in Finland gave cod-liver oil (rich in vitamin D) to children during their first year of life and found that they were 78% less likely to develop type 1 diabetes.

Type 2 diabetes (adult onset) is caused by the body becoming resistant to the effects of insulin or not producing enough insulin. It is seen more often in vitamin D deficiency patients. Vitamin D helps regulate insulin secretion and increases insulin production.

Polycystic ovarian syndrome (PCOS)

PCOS results in reproductive and menstrual dysfunction. In normal calcium patients, vitamin D repletion with calcium therapy resulted in normalizing periods and resolution of pain. Abnormal calcium homeostasis, modulated by vitamin D, may be in part responsible for the arrested follicular development seen in PCOS. Thys-Jacobs,S., “Vitamin D and calcium dysregulation in the polycystic ovarian syndrome,” Steroids, 6/99;64(6):430-5.

Peripheral Neuropathy

Peripheral neuropathy can be treated by increasing your sun exposure. Vitamin D3 induces nerve growth factor (NGF) production in the skin, which promotes healing of your painful neuropathy. Fukuoka, M., Skin Pharm Appl Skin Physiol, 7-8/01;14(4):226-33.

Do I Need To Take Vitamin D?

There is an epidemic in clinically proven hypo-vitaminosis D in all age groups, seen even in Florida. One fourth of all teenagers are vitamin D deficient. Should I consider more sunshine or taking a vitamin D supplement (D2 plant-based source or D3 animal-based source)? Vitamin D toxicity is very rare. Your physician can measure a serum 25-hydroxy-vitamin D level for about $100. Most of my patients need sunshine and 2000 IU/day. Vitamin D can be made by your skin from sunlight through the window, so you can stay inside if it is too hot or cold outside. Just expose as much skin as possible!

* There are two general chemical categories of vitamins based on their solubility: water soluble vitamins (the B and C vitamins) and fat soluble vitamins (A, D, E and K).

** Exposure of our skin to sunlight results in the photochemical conversion of 7-dehydrocholesterol into vitamin D3. This sunlight-generated vitamin D3 is a precursor of the steroid hormone 1,25(OH)2D3 which is activated in our livers and kidneys.

References:

Norman, A.W.,“An Introduction To Vitamin D: With Emphasis on the Topics of Chemistry, Sources, Production, Presence in Milk and Nutritional Importance,” Department of Biochemistry & Biomedical Sciences, University of California, Riverside CA 92521:2000.

Holick,M., “High Prevalence of Vitamin D inadequacy and Implications for Health,” Mayo Clinc Proc, 2006:81(3):353-73.

University Of California, Berkeley, Wellness Letter, “Vitamin D: are you getting enough?” Vol24:5; 2/08:1-2.

Harris, S.S. and Dawson-Hughes, B. “Seasonal changes in plasma 25- hydroxy-vitamin D concentrations of young American black and white women.” Am.J.Clin.Nutr. 67 (1998) 1232-1236.

Adams, J.S., Clemens,T.L., Parrish,J.A., and Holick, M.F. “Vitamin-D synthesis and metabolism after ultraviolet irradiation of normal and vitamin-D-deficient subjects.” New Engl.J.Med. 306 (1982) 722-725.

Webb,A.R., Pilbeam,C., Hanafin,N., and Holick,M.F. “An evaluation of the relative contributions of exposure to sunlight and of diet to the circulating concentrations of 25-hydroxy-vitamin D in an elderly nursing home population in Boston.” Am.J.Clin.Nutr. 51(6) (1990) 1075-1081.

http://www.vitamindcouncil.org/health/autism/

Wicherts, I.S., “Vitamin D status predicts physical performance and its decline in older persons,” J Clin Endocrinol Metab, Mar 6, 2007.

Park, S, “Living in low-latitude regions in the United States dose not prevent poor vitamin D status.” Nutr Rev. June 2005; 63(6pt1):203-9.