The following article is from the Vitamin D Newsletter by Dr John Cannell.
In a recent clinical review on autism and vitamin D, Dr. Eva Kocovska and colleagues from the University of Glasgow called for “urgent research” on vitamin D’s role in autism.
The body of the paper consisted of a review of the 35 papers published to date that deal directly with autism and vitamin D. Here were their areas of interest and the studies they reviewed.
On vitamin D blood levels
Four studies have looked at vitamin D levels in autistic children or their mothers and all have found low levels (<30 ng/ml) in autistic children. One found no difference in vitamin D levels between autistic children and boys with acute inflammation (a curious control), while the other three found differences, some significant and some not. One study found Somali mothers with autistic children had average vitamin D levels of 6.7 ng/ml, about 30% lower than Somali mothers without autistic children.
On vitamin D intake
The authors examined about a dozen papers that looked at vitamin D intake in autistic children, all finding that most autistic children do not meet vitamin D intake requirements for their age. On a side note, the authors also mention that magnesium has a crucial role in brain development and function. As readers know, magnesium deficiencies are the rule, not the exception in most Americans.
On brain development and function
The authors reviewed the numerous ways vitamin D is involved in brain development and function, including:
- Synaptic development
- Nerve migration and growth
- Neurotransmission, both excitatory and inhibitory
- Preventing excessive cell proliferation
- Orchestrating signaling pathways in the brain
- Cell differentiation
- Nerve growth factor expression
- Regulation of inflammatory cytokines
- Neurotransmitter synthesis
- Intra-neuronal calcium signaling
- Anti-oxidant activity
- Control of the expression of genes involved in brain structure and metabolism
- Regulation of glutathione, the master antioxidant and heavy metal remover
- Protection from glutamate toxicity
On autism, vitamin D and seizures
I was surprised at the number of studies showing the connection between vitamin D, seizures and autism. Up to 30% of children with autism have seizures, and it may be as easy as giving a vitamin D supplement to reduce seizures.
On breastfeeding
A recent study showed in a statistically significant finding that in States where exclusive breastfeeding is the highest, autism incidence is also the highest. Remember, unless the mother takes 5,000 IU/day and has a vitamin D level > 40 ng/ml, breast milk contains little vitamin D.
Yes, as I have been saying since 2006, there is a need for “urgent research in the field.”
The May 2012 edition of The Health Gazette Ezine will be published as scheduled on May 1st.
This month’s edition concludes a brief series on aging. In part four we briefly discuss the reality of anti-aging prospects and methods.
Subscribers will find the ezine in their mailbox on publication. It will be posted in the subscribers’ archive around the same time.
From the Vitamin D Council Newsletter by Dr John Cannell
Prostate cancer tends to develop in men over the age of fifty and, although it is one of the most prevalent types of cancer in men, many men never have symptoms and die of other causes. On the other hand, more aggressive prostate cancers account for more cancer-related deaths than any cancer except lung cancer. About two-thirds of cases are slow growing, the other third are more aggressive and fast growing.
The decision to treat a tumor contained within the prostate is a trade-off between the risk and expected benefits, especially quality of life. More and more often physicians and patients are electing to do nothing but wait (and hopefully enjoy life) for slow growing tumors.
The decision to wait is a calculated risk. Urologists look at a number of factors in prostate cancer to decide how to treat (if at all) prostate cancer. These factors include:
- Gleason Score: score given to prostate cancer based upon its microscopic appearance. Cancers with a higher Gleason score are more aggressive and have a worse prognosis. The Gleason scores range from 2 to 10, with 10 having the worst prognosis.
- Core biopsies positive: usually urologists take 6-12 total biopsies at a time, called cores. The percentage of positive cores varies and often changes over time.
- PSA: a tumor marker that, taken with the other two factors above, may indicate prostate cancer. The higher the score, and the more rapidly it climbs, the worse the prognosis. It usually slowly increases over time in men with low-grade prostate cancer.
All of these factors, along with the presence or absence of cancer spread, change over time and influence whether or not an urologist and patient decide to treat the prostate cancer.
To give you an idea about how this works, if you took 20 men with low risk prostate cancer and do nothing but biopsy them again in a year, about 10% of the men will no longer have any cores positive. That’s right, about 10% of men will no longer have demonstrable cancer. However, most men will have either more cores positive or a higher Gleason score or higher PSA or all three.
This week, Drs. David Marshall, Sebastiano Gattoni-Celli and their colleagues from the Medical University at South Carolina published a study that reported administering vitamin D for a year, measuring cancer markers before and after. The results were astounding.
This study administered 4,000 IU/day of vitamin D for one year to 44 men. The scientists chose 44 men with low risk prostate cancer, so they chose 44 men with identical Gleason scores of 6, anywhere from 1-6 cores positive (out of 12 possible), and a PSA < 10.
Of the 44 men they followed, 60% showed a decrease in the number of positive cores or a decrease in their Gleason scores, or both. Only 34% showed an increase in the number of positive cores or an increase in their Gleason scores. 6% were unchanged over the year. PSA levels did not go up over the year. The authors classified 60% of the men as “responders” to vitamin D and 40% as “non-responders.”
Fifteen of the 44 men (34%) no longer had any cores positive. However, PSA did not go down so they may or may not still have prostate cancer. It also appeared that baseline vitamin D levels were important because men with higher baseline vitamin D levels had fewer cores positive for cancer and lower Gleason scores.
The authors report that the main problem with the study was the lack of a control group, other than historical groups of men treated conservatively. However, with 60% of the men responding to vitamin D, I wonder if an ethics committee would allow a randomized controlled trial, knowing some men in the control group would be vitamin D deficient.
The MedWatch March 2012 Safety Labeling Changes posting includes 39 products with safety labeling changes to the following sections: BOXED WARNINGS, CONTRAINDICATIONS, WARNINGS, PRECAUTIONS, ADVERSE REACTIONS and PATIENT PACKAGE INSERT.
The “Summary Page” available via the link below provides a listing of drug names and safety labeling sections revised: http://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm299284.htm
The following drugs had modifications to the BOXED WARNINGS, CONTRAINDICATIONS and WARNINGS sections:
- Atacand HCT (candesartan cilextetil/hydrochlorothiazide)
- Benicar (olmesartan medoxomil)
- Sporanox (itraconazole)
- Twynsta (telmisartan/amlodipine)
- Zestoretic (lisinopril/hydrochlorothiazide)
- Zestril (lisinopril)
- Benlysta (belimumab)
- Celexa (citalopram hydrobromide)
- Enablex (darifenacin)
- Incivek (telaprevir)
- Janumet (sitagliptin and metformin fixed-dose combination)
- Januvia (sitagliptin)
- Kombiglyze XR (saxagliptin/metformin hydrochloride extended-release)
- Lidocaine in 5% Dextrose Injection
- Magnevist (brand of gadopentetate dimeglumine)
- Revlimid (lenalidomide)
- Reyataz (atazanavir sulfate)
- Treximet (sumatriptan and naproxen sodium)
- Votrient (pazopanib)
- Zometa (zoledronic acid)
- Zmax (azithromycin extended release)
Do not be fooled. The FDA calls them “Safety Labels” which inspires trust. The truth is, they would much more aptly be called “Danger Labels” and you would do well to regard them as such. Remember, all drugs are dangerous. Consume only what you absolutely must and then do so with the utmost care.
Dr. Terry Diamond and colleagues of St. George’s Hospital in New South Wales just published the first head-to-head comparison of 5,000 IU/day to 2,000 IU/day. Remember, the Food and Nutrition Board says 4,000 IU/day is the upper limit, but Dr. Diamond knows the pharmacology of vitamin D well enough to know that quite a few people will still have inadequate levels at 4,000 IU/day.
He recruited 30 patients with vitamin D levels less than 20 ng/ml and put half on 5,000 IU/day and half on 2,000 IU/day for three months. He measured a number of things, the most important of which was muscle strength.
After 3 months of 2,000 IU/day the vitamin D levels averaged 30 ng/ml (75 nmol/L), meaning about half the patients were still vitamin D deficient. Not so with the 5,000 IU/day group. The average vitamin D level was 45 ng/ml (114 nmol/L), right in the “natural range.” In addition, 93% of the patients had levels higher than 30 ng/ml compared to the 2,000 IU/day group, where only 45 % had levels above 30 ng/ml. Remember, one of the problems with daily dosing is that you must rely on the patient to take their medication. As an old GP, I am here to tell you not all patients take their meds; the ones that get me are the ones who look me straight in the eye and tell me something I know is not true.
In Dr. Diamond’s well-designed study, changes in grip strength compared to baseline were very significant, while the improvements in timed tests of sitting to standing and the 6-meter walk test also improved, but not significantly. What surprised me was that the improvements did not vary with dosage. That is, the 2,000 IU/day had the same improvements in grip strength as did the 5,000 IU/day, meaning muscle strength improvements are the most dramatic at changes in lower ranges of vitamin D levels. By that, I mean if your level is 5 ng/ml to start out and you get to up to 20 ng/ml, your percentage improvement in muscle strength will be much more dramatic than someone who went from 20 to 35 ng/ml.
I am glad to see Australians using daily dosing of vitamin D. Many of the “Stoss” doses, 100,000 IU/month or 600,000/year are not physiological, and are dangerous. Vitamin D was made every day in the skin of our ancestors and we should strive to replicate such dosing schedules. How much do we need? To quote Dr. Diamond, “This study demonstrates that the administration of oral vitamin D at 5,000 IU daily is superior to 2,000 IU daily for 3 months to treat mild to moderate vitamin D deficiency.”
Source: Vitamin D Council Newsletter by Dr John Cannell
Tags: Viatamin D