Cytokine Storm & Vitamin D relationship?

[The Mountains Voice]

http://www.medicalnewstoday.com/articles/154759.php

The Possible Roles Of Solar Ultraviolet-B Radiation And Vitamin D In Reducing Case-Fatality Rates From The 1918-1919 Influenza Pandemic In EU
Article Date: 22 Jun 2009 - 1:00 PDT

An estimated 675,000 Americans died from the A/H1N1 pandemic influenza in the United States in 1918-1919. Many of these deaths were from ensueing bacterial pneumonia rather than directly from the viral infection. The United States Public Health Service conducted surveys in twelve cities and rural areas of the country in late 1918 to early 1919 to determine the case-fatality rate in each city or area. Case-fatality rates varied from 0.78 deaths/100 cases in San Antonio, Texas to 3.14 deaths/100 cases in New London, Connecticut. The strong variation with location suggested that solar ultraviolet-B (UVB) irradiance, through production of vitamin D, reduced the risk of death following infection by this pandemic influenza.
To investigate this possibility, the case-fatality rate data were compared statistically with solar UVB doses in July and January. Strong correlations with UVB doses were found for both indices.

There are two mechanisms whereby vitamin D can reduce the risk of death once the pandemic influenza virus infection took hold: reduced production of proinflammatory cytokines and reduced risk of bacterial pneumonia. The hormonal metabolite of vitamin D, 1,25-dihydroxyvitamin D, reduces the production of cytokines from T-helper 1 type (proinflammatory). 1,25-dihydroxyvitamin D also induces the production of human cathelicidin, LL-37, which has both antimicrobial and antiendotoxin properties. LL-37 has been found effective in reducing the risk of several types of bacteria, and is also thought to reduce the risk of respiratory viral infections including seasonal influenza.

Whether this finding is relevant to the current A/H1N1 influenza virus outbreak is unknown but should be evaluated.

"The authors propose a very interesting hypothesis based on intriguing observations that vitamin D deficiency and influenza infection share a similar pattern in incidence during the year. Recent work by several groups have demonstrated that vitamin D induced anti-microbial peptides that may be important for the immune defense against pathogens such as virus. As we are entering the fall and winter season, it may be worth considering addressing vitamin D status in individuals at risk for influenza infection."

[the doctor]

Yes, Vitamin D and the immune system is very hot right now.

The interaction goes much farther than what was mentioned above however.

When the skin is radiated by UV light, cholesterol is converted to ergocalciferol AKA Vitamin D2, the substance most commonly found in OTC vitamins. D2 is the storage form of the vitamin (BTW, vitamin D is actually a hormone not a vitamin but lets just stick with the word vitamin because it might get confusing to use the proper term at this point). Any vitamin D2 in excess of current needs is stored in the fat tissue with very little being found in the blood.

Ergocalciferol is converted in the body to cholecalciferol, Vitamin D3. This is transported in the blood to the liver where it is converted to 25 hydroxyvitamin D3. This is where it gets interesting because the liver also makes a bunch of other similar 25 OH D3s, like 24-25 Vitamin D3. These other compounds have no effect on bone. We in the bone community tried to figure out what they did for years but never could find any use for them.

Then, about 10 years ago, researchers discovered that lymphocytes and other immune cells had specific receptors for these "useless vitamin D compounds". When vitamin D was deficient, cellular immunity was impaired and when vitamin D was replaced, cellular immunity was restored.

This was the basic observation that led to the breakthrough which is now well advanced but it will be years before we know just how important this discover is.

The study cited above is not proof that vitamin D prevented deaths during the 1918 pandemic. It is simply an association. Associations are not proof of anything though it is an interesting observation.

The same observation was made for solid tumor incidence in the late 1940s when a young doctor first proposed that the higher levels of sunlight seen in the southern US might explain his findings that cancer rates were lower there than in the US north. This was the first person to propose this hypotheses but it was rejected later on only to be resurrected now with the current findings.

Anyway, it seems pretty safe to take pretty large doses of vitamin D2. The reason is that it is not active until the liver changes it into 25 OH Vit D3 and even that is not very active until it is changed again in the kidney to 1,25 dihydroxyvitamin D3 which is the active form of the hormone from the bone POV.

You can buy vitamin D2 OTC in doses of 400iu (international units) or even higher. I have seen capsules in some health-food stores with as much as 10,000iu.

How much should someone take to prevent flu? It is not know if vitamin D will do anything to prevent flu or cancer or anything else except for osteoporosis and osteomalacia, two bone problems.

Lets though assume there might be a role for vitamin D and survival from flu and also lets consider that there are many people, especially people of color that are vitamin D deficient and don't even know it. To replace a vitamin D deficent person, I usually give them 50,000iu of Vitamin D2 daily for 2 weeks, others give 50,000iu weekly or monthly for 4 to 5 times. There are many ways to do this and they all seem to work. You need a Rx for the 50,000iu dose but not that found in the health-food store.

So, I might think about taking 10,000iu a day for a month or two. That is a whopping dose and should "fill my vitamin D tank" (storage sites in the fat tissue) pretty well.

I would recommend taking 2000iu per day to keep my tank full. This is 5x the RDA for vitamin D but is not a dangerous thing to do for the reasons mentioned above.

Normally I would advise people to talk this over with their doctor but most doctors are pretty clueless about vitamin D and although some are beginning to pay attention, they really know nothing about it for the most part. So, it probably won't do much good to ask them about this. I fact if you read and understood what I have shared with you above, you probably know more about vitamin D than your doctor does!

Grattan Woodson, MD

[AlaskaDenise]

the original aritlce had a link at the bottom for the original study here.

The possible roles of solar ultraviolet-B radiation and vitamin D in reducing case-fatality rates from the 1918–1919 influenza pandemic in the United States
William B. Grant and Edward Giovannucci

Volume 1, Issue 4
July/August


Deaths during the 1918–1919 influenza pandemic have been linked to both the influenza virus and secondary bacterial lung infections. Case fatality rates and percentage of influenza cases complicated by pneumonia were available from survey data for twelve United States locations in the 1918–1919 pandemic. This study analyzes case fatality rates and cases complicated by pneumonia with respect to estimated summertime and wintertime solar ultraviolet-B (UVB) doses as indicators of population mean vitamin D status. Substantial correlations were found for associations of July UVB dose with case fatality rates (r = -0.72, p = 0.009) and rates of pneumonia as a complication of influenza (r = -0.77, p = 0.005). Similar results were found for wintertime UVB. Vitamin D upregulates production of human cathelicidin, LL-37, which has both antimicrobial and antiendotoxin activities. Vitamin D also reduces the production of proinflammatory cytokines, which could also explain some of the benefit of vitamin D since H1N1 infection gives rise to a cytokine storm. The potential role of vitamin D status in reducing secondary bacterial infections and loss of life in pandemic influence requires further evaluation.

Authors
William B. Grant
Corresponding author: wbgrant@infionline.net

Sunlight, Nutrition and Health Research Center (SUNARC)

Edward Giovannucci
Departments of Nutrition and Epidemiology; Harvard School of Public Health; and Department of Medicine; Brigham and Women’s Hospital; Boston, MA USA

.

[snow hope]

This seems to me to be very relevant information in terms of building up defenses to the flu.

So far all 5 (adult) members of my family are taking one Vitamin C tablet (500mg) per day and I will add a Vitamin D2 source of 1000-2000 iu per day as well. I consider these to be sensible precautions alongside other preps.

Thanks for the information.

[cartski]

Originally Posted by the doctor

Yes, Vitamin D and the immune system is very hot right now.

The interaction goes much farther than what was mentioned above however.

Any vitamin D2 in excess of current needs is stored in the fat tissue with very little being found in the blood.

Then, about 10 years ago, researchers discovered that lymphocytes and other immune cells had specific receptors for these "useless vitamin D compounds". When vitamin D was deficient, cellular immunity was impaired and when vitamin D was replaced, cellular immunity was restored.

This was the basic observation that led to the breakthrough which is now well advanced but it will be years before we know just how important this discover is.

The study cited above is not proof that vitamin D prevented deaths during the 1918 pandemic. It is simply an association. Associations are not proof of anything though it is an interesting observation.

The same observation was made for solid tumor incidence in the late 1940s when a young doctor first proposed that the higher levels of sunlight seen in the southern US might explain his findings that cancer rates were lower there than in the US north. This was the first person to propose this hypotheses but it was rejected later on only to be resurrected now with the current findings.

Anyway, it seems pretty safe to take pretty large doses of vitamin D2. The reason is that it is not active until the liver changes it into 25 OH Vit D3 and even that is not very active until it is changed again in the kidney to 1,25 dihydroxyvitamin D3 which is the active form of the hormone from the bone POV.


Lets though assume there might be a role for vitamin D and survival from flu and also lets consider that there are many people, especially people of color that are vitamin D deficient and don't even know it. To replace a vitamin D deficent person, I usually give them 50,000iu of Vitamin D2 daily for 2 weeks, others give 50,000iu weekly or monthly for 4 to 5 times. There are many ways to do this and they all seem to work. You need a Rx for the 50,000iu dose but not that found in the health-food store.

So, I might think about taking 10,000iu a day for a month or two. That is a whopping dose and should "fill my vitamin D tank" (storage sites in the fat tissue) pretty well.

I would recommend taking 2000iu per day to keep my tank full. This is 5x the RDA for vitamin D but is not a dangerous thing to do for the reasons mentioned above.

Grattan Woodson, MD

This is fascinating. Thank you.

Canadians now believe that they are all Vit D deficient due to some major articles in the Globe and CMAJ, I believe.

I don't understand the "tank" concept. If the liver and kidney are demanding a source of the hormone for conversion, would not the daily intake be a sufficient source withouth the need for a full tank?

How can one measure how full the tank is? How can one measure deficiency?

When gas tanks are overfilled, the car gets messy and stinky. So how does the body spill the excess amounts and are there any messy side effects?

Associations are not proof, but the level of the association, and separately whether or not that level could reasonably have arisen by chance, can be a major piece of evidence for decision making. So what is the stregth of the association?

If D is synthesized when a person is exposed to sunlight, could not dosage + sunlight could produce a whopping amount?

J.

[Shannon]

Another interesting statistic was the flu patients who were sequestered in canvas tents in New York during the 1918 pandemic, had a much better chance of surviving than did those who found room in the hospital wards. Whether this was due to vitamin D finding its way thorough the woven tent or for some other reason is unknown but, it is an interesting hypothesis.

[cartski]

Originally Posted by Shannon

Another interesting statistic was the flu patients who were sequestered in canvas tents in New York during the 1918 pandemic, had a much better chance of surviving than did those who found room in the hospital wards. Whether this was due to vitamin D finding its way thorough the woven tent or for some other reason is unknown but, it is an interesting hypothesis.

The tents may not have been canvas, as we commonly think about it.

My parents have a very old tent, with bamboo poles and no floor. Likely it can from England where my dad's step-father had a tent and awning company. The tent material was very light, almost parachute cloth, which is a very high thread count, but not thick.

But, when you buy shirts that claim to be SPF 30, that's not due to a chemical, but to the cloth itself. And there's not much to that cloth either.

The question is the equation: how many joules of sunlight is needed to "fill the tank" of vitamin D for the average male/female?

J.

[St Michael]

For whatever its worth, here are some interesting comments from Dr. Mercola on Vitamin D. (I don't give him much credence either way, but I'm inclined to think he has a point regarding Vitamin D3):

Dr. Mercola''s Comments

Basically there are two types of oral vitamin D supplements. The natural ones are D3, and they contain the same vitamin D your body makes when exposed to sunshine. The synthetic ones are vitamin D2, which are sometimes called ergocalciferol.

Once either form of the vitamin is in your body, it needs to be converted to a more active form. Vitamin D3 is converted 500 percent faster than vitamin D2. Interestingly, it was previously thought that the kidney exclusively performed this function, as least that is what I was taught in med school.

However, in 1998 Dr. Michael Hollick, the person who discovered activated vitamin D, showed that many other cells in your body can make this conversion, but they use it themselves, and it is only the kidney that makes enough to distribute to the rest of your body.

While there have been no clinical trials to date demonstrating conclusively that D2 prevents fractures, every clinical trial of D3 has shown it does.

However, nearly all the prescription-based supplements contain synthetic vitamin D2, which was first produced in the 1920s through ultraviolet exposure of foods. The process was patented and licensed to drug companies for use in prescription vitamins. In case you didn't know, the vitamin D that is added to milk is NOT D3 but the highly inferior vitamin D2.

The study linked above concluded that "vitamin D2 should no longer be regarded as a nutrient appropriate for supplementation or fortification of foods."

That being said, optimizing your sun exposure and levels of vitamin D3 may, indeed, be one of the most important physical steps you can take in support of your long-term health. Conventional medicine is finally beginning to get on board the vitamin-D3 bandwagon, using the natural power of sunshine to treat type 2 diabetes, osteoporosis during a woman's pregnancy and even tuberculosis.

It is important to understand that the ideal and STRONGLY preferred method of increasing your vitamin D3 level is through appropriate sun exposure. I really do not advise oral supplements, not even cod liver oil now, UNLESS you can have your blood levels regularly monitored.

It just is too risky. I have seen too many potentially dangerous elevations of vitamin D levels, including my own, from those that are taking oral supplements.

But when you get your vitamin D from appropriate sun exposure your body can indeed self-regulate and greatly reduce vitamin D production if you don't need it, which makes it very difficult to overdose on vitamin D from sun exposure.

[kiwibird]

There was much discussion about Vitamin D actually preventing you from getting influenza here

I guess our hospital was under luckier stars as only about 12% of our patients were infected and no one died. However, as the epidemic progressed, I noticed something unusual. First, the ward below mine was infected, and then the ward on my right, left, and across the hall - but no patients on my ward became ill. My patients had intermingled with patients from infected wards before the quarantines. The nurses on my unit cross-covered on infected wards. Surely, my patients were exposed to the influenza A virus. How did my patients escape infection from what some think is the most infectious of all the respiratory viruses?

My patients were no younger, no healthier, and in no obvious way different from patients on other wards. Like other wards, my patients are mostly African Americans who came from the same prisons and jails as patients on the infected wards. They were prescribed a similar assortment of powerful psychotropic medications we use throughout the hospital to reduce the symptoms of psychosis, depression, and violent mood swings and to try to prevent patients from killing themselves or attacking other patients and the nursing staff. If my patients were similar to the patients on all the adjoining wards, why didn't even one of my patients catch the flu?

A short while later, a group of scientists from UCLA published a remarkable paper in the prestigious journal, Nature. The UCLA group confirmed two other recent studies, showing that a naturally occurring steroid hormone - a hormone most of us take for granted - was, in effect, a potent antibiotic. Instead of directly killing bacteria and viruses, the steroid hormone under question increases the body's production of a remarkable class of proteins, called antimicrobial peptides. The 200 known antimicrobial peptides directly and rapidly destroy the cell walls of bacteria, fungi, and viruses, including the influenza virus, and play a key role in keeping the lungs free of infection. The steroid hormone that showed these remarkable antibiotic properties was plain old vitamin D.

All of the patients on my ward had been taking 2,000 units of vitamin D every day for several months or longer. Could that be the reason none of my patients caught the flu? I then contacted Professors Reinhold Vieth and Ed Giovannucci and told them of my observations. They immediately advised me to collect data from all the patients in the hospital on 2,000 units of vitamin D, not just the ones on my ward, to see if the results were statistically significant. It turns out that the observations on my ward alone were of borderline statistical significance and could have been due to chance alone. Administrators at our hospital agreed, and are still attempting to collect data from all the patients in the hospital on 2,000 or more units of vitamin D at the time of the epidemic.

http://www.flutrackers.com/forum/sho...lement+patient

I have actually been giving this some thought as people in Canterbury are very deficient in Vitamin D during the winter. It would explain why colder climes, where people wrap up, and possibly why darker skinned people are more inclined to suffer from more severe cases of influenza. This should be obvious if we can find information on people from tropical climates, who cover up for modesty's sake, also suffering disproportionately.

[AlaskaDenise]

Originally Posted by cartski

.........How can one measure how full the tank is? How can one measure deficiency?...............

There's a blood test. I had it done recently. It measures both D2 and D3. The following explanation is taken from the test results:

Vitamin D, 25-Hydroxy, LC/MS/MS

reference range 20-100

25-OHD3 indicates both endogenous production and supplementation. 25-OHD2 is an indicator of exogenous sources such as diet or supplementation. Therapy is based on measurement of Total 25-OHD, with levels <20 ng/mL indicative of Vitamin D deficiency, while levels between 20 ng/mL and 30 ng/mL suggest insufficiency. Optimal levels are >30 ng/mL.

For comparison, I was taking 2000 IU/day and my level was 41 - that's with very little sun exposure most of the year.

My internist recommended I take 3000 IU/day during the winter as a cancer preventative. He want to aim for a level of 50!

.

[AlaskaDenise]

Sun exposure levels:

For a typical fair-skinned Caucasian individual, adequate vitamin D could be photosynthesized safely by spending 10 to 15 minutes in the noontime sun on a clear day with 50 percent of skin area exposed to the sun. Darker skinned individuals may require more time in the sun, such as 25 minutes

http://www.sciencedaily.com/releases...0206100608.htm
(very good article about how Vitamin D prevents many illnesses)

Sun levels assume you're NOT in the northern latitudes. Here in Alaska, we're told that after mid-August, the sun is too low to get sufficient Vitamin D from the sun. So we only have 4 months/year where sun exposure is sufficient.

.

[AlaskaDenise]

from http://ods.od.nih.gov/factsheets/vitamind.asp#h7

Health Risks from Excessive Vitamin D

Vitamin D toxicity can cause nonspecific symptoms such as nausea, vomiting, poor appetite, constipation, weakness, and weight loss [74]. More seriously, it can also raise blood levels of calcium, causing mental status changes such as confusion and heart rhythm abnormalities [8]. The use of supplements of both calcium (1,000 mg/day) and vitamin D (400 IU/day) by postmenopausal women was associated with a 17% increase in the risk of kidney stones over 7 years in the Women's Health Initiative [75]. Deposition of calcium and phosphate in the kidneys and other soft tissues can also be caused by excessive vitamin D levels [5]. A serum 25(OH)D concentration consistently >200 ng/mL (>500 nmol/L) is considered to be potentially toxic [15]. In an animal model, concentrations ≤400 ng/mL (≤1,000 nmol/L) were not associated with harm [16].

Excessive sun exposure does not result in vitamin D toxicity because the sustained heat on the skin is thought to photodegrade previtamin D3 and vitamin D3 as it is formed [11,30]. High intakes of dietary vitamin D are very unlikely to result in toxicity unless large amounts of cod liver oil are consumed; toxicity is more likely to occur from high intakes of supplements.

Long-term intakes above the UL increase the risk of adverse health effects [5] (Table 4). Substantially larger doses administered for a short time or periodically (e.g., 50,000 IU/week for 8 weeks) do not cause toxicity. Rather, the excess is stored and used as needed to maintain normal serum 25(OH)D concentrations when vitamin D intakes or sun exposure are limited [15,76].

Table 4: Tolerable Upper Intake Levels (ULs) for Vitamin D [5]
(ed. see chart on web site)

Several nutrition scientists recently challenged these ULs, first published in 1997 [76]. They point to newer clinical trials conducted in healthy adults and conclude that the data support a UL as high as 10,000 IU/day. Although vitamin D supplements above recommended levels given in clinical trials have not shown harm, most trials were not adequately designed to assess harm [6]. Evidence is not sufficient to determine the potential risks of excess vitamin D in infants, children, and women of reproductive age.

Interactions with Medications

Vitamin D supplements have the potential to interact with several types of medications. A few examples are provided below. Individuals taking these medications on a regular basis should discuss vitamin D intakes with their healthcare providers.

Steroids

Corticosteroid medications such as prednisone, often prescribed to reduce inflammation, can reduce calcium absorption [77-79] and impair vitamin D metabolism. These effects can further contribute to the loss of bone and the development of osteoporosis associated with their long-term use [78-79].

Other medications

Both the weight-loss drug orlistat (brand names Xenical® and alli™) and the cholesterol-lowering drug cholestyramine (brand names Questran®, LoCholest®, and Prevalite®) can reduce the absorption of vitamin D and other fat-soluble vitamins [80-81]. Both phenobarbital and phenytoin (brand name Dilantin®), used to prevent and control epileptic seizures, increase the hepatic metabolism of vitamin D to inactive compounds and reduce calcium absorption [82].

.

[the doctor]

Originally Posted by cartski

This is fascinating. Thank you.

Canadians now believe that they are all Vit D deficient due to some major articles in the Globe and CMAJ, I believe.

I don't understand the "tank" concept. If the liver and kidney are demanding a source of the hormone for conversion, would not the daily intake be a sufficient source withouth the need for a full tank?

How can one measure how full the tank is? How can one measure deficiency?

When gas tanks are overfilled, the car gets messy and stinky. So how does the body spill the excess amounts and are there any messy side effects?

Associations are not proof, but the level of the association, and separately whether or not that level could reasonably have arisen by chance, can be a major piece of evidence for decision making. So what is the stregth of the association?

If D is synthesized when a person is exposed to sunlight, could not dosage + sunlight could produce a whopping amount?

J.

Why Cartski, you ask the most interesting questions. Bravo!

A lot of people are vitamin D deficient. IMO, about 1 in 7 US caucasians are and as many as i in 4 US African Americas are.

The tank concept simply refers to the place vitamin D2 is stored in the body. It turns out that this place is the body's fat tissue. In normal (not over or underweight) people, about 25% of their body weight is composed of fat. Of course, those that are overweight or obese have much higher percentages of the body weight as fat. Even in very thin people, fat makes up about 10% of their weight. So, for almost everyone, there is a large number of kg of fat available to store vitamin D2. It is a truly enormous potential storage space that would almost be impossible to fill when you consider that 50,000iu of vitamin D2 is only 1.25mg. So, taking 6,000,000iu of vitamin D2 over a 2 month time would only mean the consumption of 15mg of vitamin D2, not very much when you consider that a healthy 170lb man has about 19kg of potential fat storage area or 19,000,0000mg or fat. There is no way to completely fill the tank but all you really need to do is fill it enough to get well more than you will need such that it for all intents and purposes it is "full".

The intake of vitamin D2 in the diet and that obtained due to sunlight exposure is obviously inadequate for many people or the prevalence of this condition would not be as high as it is. The RDA for vitamin D2 is 400iu. The bone folks are now recommending 1200iu. If you want to try and affect your immune system, filling the tank and following that with 2000iu might be one way but this is only a guess on my part.

I can tell you that bone patients I treat who are treated this way have post-treatment 23 OH vitamin D3 levels in the 50ng to 60ng range which is where we want them for the optimal health of bone. I don't know what the optimal level might be for immune function but have invited Dr. Grant, the author of the article that stimulated this thread to come here and share his insights with us and possibly answer some of the questions I can't.

More later in this, I have to run but will return to answer some of the other questions raised by Cartski in a bit.

Grattan Woodson, MD

[wbgrant]

Originally Posted by the doctor

Yes, Vitamin D and the immune system is very hot right now.

The interaction goes much farther than what was mentioned above however.

When the skin is radiated by UV light, cholesterol is converted to ergocalciferol AKA Vitamin D2, the substance most commonly found in OTC vitamins. D2 is the storage form of the vitamin (BTW, vitamin D is actually a hormone not a vitamin but lets just stick with the word vitamin because it might get confusing to use the proper term at this point). Any vitamin D2 in excess of current needs is stored in the fat tissue with very little being found in the blood.
No, it is not vitamin D2 but D3 that is formed from UVB interacting with 7-dehydrocholesterol followed by a thermal process. Vitamin D2 (ergocalciferol) is a related molecule manufactured by yeast and mushrooms.

Ergocalciferol is converted in the body to cholecalciferol, Vitamin D3. This is transported in the blood to the liver where it is converted to 25 hydroxyvitamin D3. This is where it gets interesting because the liver also makes a bunch of other similar 25 OH D3s, like 24-25 Vitamin D3. These other compounds have no effect on bone. We in the bone community tried to figure out what they did for years but never could find any use for them.

Vitamin D3 is converted to 25(OH)D3 in the liver, and 1,25(OH)2D3 in the kidney and other organs as needed, and it is 1,25(OH)2D3 that is the hormonal metabolite that does most of the work.

[prepdeb]

I have bottles of Vitamin D3 that are 2000 IU strength softgels.

Would these be appropriate supplements to enhance the immune system then?

[wbgrant]

Originally Posted by cartski

This is fascinating. Thank you.

Canadians now believe that they are all Vit D deficient due to some major articles in the Globe and CMAJ, I believe.

I don't understand the "tank" concept. If the liver and kidney are demanding a source of the hormone for conversion, would not the daily intake be a sufficient source withouth the need for a full tank?
Answer: the daily requirement for vitamin D is estimated to be 3600 IU; thus, unless there is a reserve, a lower daily input is rapidly depleted.

How can one measure how full the tank is? How can one measure deficiency?
I suggest going to www.grassrootshealth.org and going to the bottom where you will find "Join D-Action". For $40 US, you can order a kit with a lance and a piece of paper on which you can deposit 2 blood spots. They will be sent to ZRT Labs in Oregon for an accurate test using GCMS. You can also participate in a study of serum 25(OH)D levels and health outcomes. We are now recommending serum 25(OH)D levels be in the 40-60 ng/mL level; Canadians generally fall in the 25+/- ng/mL range. Thus, it would take 2000-3000 IU/day of vitamin D3 to reach the optimal levels.

When gas tanks are overfilled, the car gets messy and stinky. So how does the body spill the excess amounts and are there any messy side effects?
Vitamin D and 25(OH)D have a 4-6 week half life in the body; adverse effects generally start at levels of 25(OH)D well over 100 ng/mL and are generally due to hypercalcemia. Those with sarcoidosis and granulomous diseases produce too much 1,25(OH)2D3 in the serum, so should limit their intake.

Associations are not proof, but the level of the association, and separately whether or not that level could reasonably have arisen by chance, can be a major piece of evidence for decision making. So what is the stregth of the association?
In my study, the adjusted r-square was over 0.7, i.e., more than 70% of the variance was explained by summer or wintertime UVB doses.

If D is synthesized when a person is exposed to sunlight, could not dosage + sunlight could produce a whopping amount?
In England, 45-year olds make about 1000-1500 IU/day in summer through casual exposure. That is not a whopping amount. However, full body exposure in summer can produce 10,000 IU per day.

J.

I've included my responses in the quote and used red.

[AlaskaDenise]

Thank you Dr. Grant for taking your time to answer our questions about this very important subject.

.

[gsgs]

test it, give vitamin D to some people in some city now and test how many get panflu. Sounds easy.

[kiwibird]

Perhaps we could do a poll of our own members and find out who was taking Vitamin D supplements and whether symptoms were severe or indeed if they caught the flu at all.

[zimagail]

snow hope said "So far all 5 (adult) members of my family are taking one Vitamin C tablet (500mg) per day and I will add a Vitamin D2 source of 1000-2000 iu per day as well. I consider these to be sensible precautions alongside other preps."
Dr. Linus Pauling suggested 2 to 10 grams per day in divided doses of calcium ascorbate. Start with a couple of grams and back off one gram when diarrhea strikes. This varies for each individual. He used a lab that provides C in crystal form which is far cheaper than tablets and no worry about binders. However, 500 mg per day or half a gram is better than a poke in the eye with a sharp stick.

[The Mountains Voice]

Originally Posted by kiwibird

Perhaps we could do a poll of our own members and find out who was taking Vitamin D supplements and whether symptoms were severe or indeed if they caught the flu at all.

1st I would like to say that this has been an amazingly informative thread - and I definitely think that some study should be devoted to this.

2nd, My story is actually the 1st story listed in Niman's Thread about Member Symptoms (Can't find it - can't remember exact name). Don't know if I included this - but my wife is sort of a research freak on homeopathic and natural cures. I forwarded her this thread, and she just told me something I didn't know. When my son and I became ill - she was just tailing up about 3 weeks of taking Vitamin D Supplements & Ginseng. She's adamant I include that Ginseng part She is also adamant about my including the fact she took higher doses of C than normal.

She was covered in the virus between me and my 5 year old exposing her. Yet she had little to no obvious symptoms. She felt a little more nauseous, slight headache, and was more tired - but other than that you wouldn't know she had the flu.

I will say that at the time I thought it pretty darn miraculous that she didn't catch what we had - which to this day I am convinced was an early wave of H1N1 (mid April I think?)

Anyway - can't determine anything from this really - but it is ONE sample. For the record she was only taking 200 - 400iu supplement through Calcium tablets - but it was an abnormal fact for her to even be taking that. Which is why she remembers it so clearly. She's one of these human guinea pigs - always testing

[the doctor]

I wish to thank Dr. Grant for being so kind to visit this thread but since he is already a member of the FT community, why shouldn't he.

Anyway it is pretty great to have the author of a contemporary paper of such potential import partcipate with us in the discussion.

I recall recently gsgs making a comment on how discussions like this could become a replacement or supplement to the peer review process. While I think he is right about the significance of discussing issues like this in a public forum open to all is a terrific idea, it does not replace the peer review process.

What the peer review process amounts to is the requirement of the author to run his paper past an editor initially then a set of reviewers who are chosen by the editor usually but not always because they have demonstrated expertize in the topic presented in the scholarly article.

At any rate I can attest to what a long and arguous task this can be and one that for me at least has not always resulted in success.

In summary then, what a pleasure to have Dr. Grant share his views and insights on this very interesting and topical issue. My hat is off to you and your collaborators.

http://www.flutrackers.com/forum/ima...ies/tiphat.gif

Well done!

Grattan Woodson, MD

[The Mountains Voice]

Originally Posted by Shannon

Another interesting statistic was the flu patients who were sequestered in canvas tents in New York during the 1918 pandemic, had a much better chance of surviving than did those who found room in the hospital wards. Whether this was due to vitamin D finding its way thorough the woven tent or for some other reason is unknown but, it is an interesting hypothesis.

I've read this entire thread, and it does seem that there is a very strong correlation here. And then a thought popped into my head - perhaps part of the "holy grail" answer as to why Flu Spreads Seasonally.

Could a part of it simply be sunlight / D related?

It does fit as a solid part of the facts equation.

Perhaps officials should add that into their research charts / questions.....
In all cases, track lifestyle patterns that could indicate greater or less sunshine exposure / D intake.

[the doctor]

Originally Posted by The Mountains Voice

I've read this entire thread, and it does seem that there is a very strong correlation here. And then a thought popped into my head - perhaps part of the "holy grail" answer as to why Flu Spreads Seasonally.

Could a part of it simply be sunlight / D related?

It does fit as a solid part of the facts equation.

Perhaps officials should add that into their research charts / questions.....
In all cases, track lifestyle patterns that could indicate greater or less sunshine exposure / D intake.

That is an interesting suggestion. As I would interpret what you are saying is during the winter months when sunshine exposure is lower, this would be predicted to result in lower winter vitamin D levels compared with those in the summer.

The lower levels of vitamin D during this time would result in an immune system "fitness penalty" to borrow from our influenza lexicon.

This would make humans as a group more susceptible to influenza and other infections resulting in them having a higher incidence during this season of the year than in others.

Anyway, I like it big guy. I agree with you too that it probably is "one of the reasons"l

More importantly IMO it is one of the things we can do something about. Something that is not costly, is widely available both for free (sunlight) or at modest cost (OTC Vit D2 and D3. Vitamin D obtained in these ways has a low potential for toxicity even when take in doses many times the RDA.

All these factors have positive influences from both a health risk vs health benefit and a cost vs benefit prospective.

Nice observation TMV.

Grattan Woodson, MD

[St Michael]

The Vitamin D - influenza link was proposed several years ago by Dr. John Cannell.

See Epidemic Influenza And Vitamin D

[St Michael]

Epidemiol Infect. 2006 Dec;134(6):1129-40. Epub 2006 Sep 7.

Epidemic influenza and vitamin D.
Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, Garland CF, Giovannucci E.

Atascadero State Hospital, 10333 El Camino Real, Atascadero, CA 93422, USA. jcannell@dmhash.state.ca.us

In 1981, R. Edgar Hope-Simpson proposed that a 'seasonal stimulus' intimately associated with solar radiation explained the remarkable seasonality of epidemic influenza. Solar radiation triggers robust seasonal vitamin D production in the skin; vitamin D deficiency is common in the winter, and activated vitamin D, 1,25(OH)2D, a steroid hormone, has profound effects on human immunity. 1,25(OH)2D acts as an immune system modulator, preventing excessive expression of inflammatory cytokines and increasing the 'oxidative burst' potential of macrophages. Perhaps most importantly, it dramatically stimulates the expression of potent anti-microbial peptides, which exist in neutrophils, monocytes, natural killer cells, and in epithelial cells lining the respiratory tract where they play a major role in protecting the lung from infection. Volunteers inoculated with live attenuated influenza virus are more likely to develop fever and serological evidence of an immune response in the winter. Vitamin D deficiency predisposes children to respiratory infections. Ultraviolet radiation (either from artificial sources or from sunlight) reduces the incidence of viral respiratory infections, as does cod liver oil (which contains vitamin D). An interventional study showed that vitamin D reduces the incidence of respiratory infections in children. We conclude that vitamin D, or lack of it, may be Hope-Simpson's 'seasonal stimulus'.

[The Mountains Voice]

Originally Posted by the doctor

Nice observation TMV.

Originally Posted by St Michael

The Vitamin D - influenza link was proposed several years ago by Dr. John Cannell.

See Epidemic Influenza And Vitamin D

Thanks Doc. And I wanted to comment on Dr. Grant's paper I just downloaded and reviewed - which also pretty much directly makes these observations as well (I just got lucky - but this guy has the data!). Dr. Grant has it posted online at the following page.....
http://www.landesbioscience.com/jour...y/article/9063

You have to log in (free) to read it, but I've downloaded it and attached it to this post in a PDF. It really is good reading. Dr. Grant you write well for a science guy - you folks normally lose me a few words in LOL

Anyway - a very good read.

And in regards to St Michaels link above - VERY informative and thought provoking as well.

I agree with Doc - this is something that is exciting - because WE CAN DO SOMETHING ABOUT THIS!!

I think this whole subject is grounds for an informational press release.

And by golly - I'm going to the pool tomorrow!

PS.... I still suggest everyone read attached PDF, and check out story in Epidemic Influenza And Vitamin D.

[the doctor]

Cartski asked:
"How can one measure how full the tank is? How can one measure deficiency?"

As suggested by other posters, the best way to do this is by checking the 25 hydroxyvitamin D3 level AKA 25 OH vit D3. While indirect, it is the easiest and least costly way to measure tissue stores of vitamin D2.

What is interesting about this relationship is that it is exponential rather than linear. This means that a 25 OH vit D3 level of 20ng indicates a level of stored vitamin D2 that is 10 times higher than a 25 OH vit D3 level of 10ng.

So this means that a bone healthy 25OH Vit D3 level between 50 ng and 60ng means that the vitamin D2 present in storage is about 500,000 times as great as that present when the vitamin D2 level is 10ng.

The reason for this is that vitamin D2 found in the circulation is rather quickly scoffed up by the fat tissue when it is in excess of need. This results in a short serum half-life but a long tissue half-life. The fat tissue preserves the vitamin D2, keeping it fresh. When needed in the future, vitamin D2 is released into the blood where it is converted via several steps to 25 OH vit D3.

I think vitamin D3 might be more accurately seen as an intermediate pre-hormone metabolite that can be produced via UV light or via conversion of Vitamin D2 to D3.

Once vitamin D3 is formed, it appears to rapidly be converted by the liver to 25 OH vit D3. So it too has a short half-life.

I don't recall the half-life of 25 OH Vit D3, maybe someone can chime in here.

Grattan Woodson, MD

[The Mountains Voice]

Originally Posted by St Michael

jcannell@dmhash.state.ca.us

I hope his email is current. I just sent him a link to the thread, and asked him to participate. This subject needs more discussion.

[kiwibird]

PS.... I still suggest everyone read attached PDF, and check out story in Epidemic Influenza And Vitamin D.
Attached Files
File Type: pdf VitaminD-CytokinePaper.pdf (645.1 KB, 0 views)
Edit/Delete Message

Thank you for the link Mountainsvoice and Dr Grant for the paper, obviously. Extremely interesting reading. Does Vitamin D have an effect on the bacterial load then?