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Despite the findings that you will read about below, the American Cancer Society published a booklet about breast cancer in 2007 that makes no mention of Vitamin D deficiency and its relationship to the disease.

Breast cancer and Vitamin D

Breast tissue has Vitamin D receptors so if there is sufficient Vitamin D available, it can be activated in the breast. This activation sets up a series of events in the breast. The presence of activated Vitamin D is believed to help protect cells from cancer, help repair cells that may be mutating with cancer, and help slow the proliferation of cancer cells that may be present. Cancer cells can be more prone to die when Vitamin D helps to maintain the cells’ function of apoptosis. Activated Vitamin D is believed also to interfere with tumors building blood vessels to feed themselves, thus starving the tumors.

Women who have a of Vitamin D blood level of less than 20 ng/ml may have a higher incidence of breast cancer by up to 50 percent. Research in human and animal studies suggests that inadequate exposure to Vitamin D during puberty could affect normal breast development. . In my opinion, optimizing Vitamin D levels is a healthy option for people who have been told that they are at risk for developing breast cancer.

A 1999 study was the first to link breast cancer with sun exposure, concluding that sun and Vitamin D could potentially reduce the risk of breast cancer. By combining sun, supplements, and Vitamin D rich food, it is estimated in this study that between 70,000–150,000 new cases of breast cancer could be prevented per year, and that up to 37,500 deaths from breast cancer could be averted each year.

In another study, published in 2008, researchers measured the Vitamin D levels of 103 premenopausal women from the northeastern United States when they were newly diagnosed with breast cancer and found that 84 percent of them were deficient in Vitamin D (median levels of 15.2 ng/ml). Fewer women who were white had Vitamin D deficiency (78 percent) than women who were Black (90 percent) or Hispanic (91 percent).

For one year, the women were given the recommended daily allowance (RDA) of Vitamin D (400 IU/day). When tested again, only 10 percent of the white and Hispanic women had achieved sufficient levels of Vitamin D (above 30 ng/ml). None of the Black women had increased their levels of Vitamin D to sufficiency. The study concluded that the current RDA of Vitamin D was insufficient to raise Vitamin D levels to 30 ng/ml in women with breast cancer.

Goodwin’s Breast Cancer and Vitamin D Study

In my opinion, the most important recent study showing the association between breast cancer and Vitamin D was conducted by Dr. Pamela Goodwin and her associates and reported in the Spring of 2008 when it caused quite a stir in the media. This was a retrospective study conducted in Toronto, Canada where the researchers looked back at blood that had been taken from 512 women when they were diagnosed with breast cancer between 1989–1995.

In retrospect, the researchers saw that a startling 76 percent of the women had had insufficient or deficient levels of Vitamin D when they were initially diagnosed with breast cancer. Only 24 percent of the women had had sufficient levels of Vitamin D at the time of initial diagnosis.

The researchers made the association that the women who had had low levels of Vitamin D at the time they were diagnosed with breast cancer were 73 percent more likely to die from breast cancer within 10 years than the women with sufficient levels of Vitamin D were. Furthermore, women with insufficient or deficient Vitamin D levels at the time of diagnosis were twice as likely to have a recurrence, or spread of the cancer within 10 years of diagnosis. However, women with normal levels of Vitamin D in their blood had an 85 percent chance of surviving without further spread of cancer after 10 years. To quote the conclusion of the study: “Vitamin D deficiency is common at breast cancer diagnosis and is associated with poor prognosis.” Dr. Goodwin, lead author of the study said it appeared that having a vitamin D level of 32–48 ng/ml was ideal.

In my opinion…

My wife and I had the privilege of hearing a vitamin D expert discussing this study on the radio. In the interview, this expert advised women with the diagnosis of breast cancer against taking vitamin D until prospective randomized-controlled trials could be run.

At a staff conference, I presented this startling information about the association between vitamin D and breast-cancer prognosis to my mostly female staff.  I explained that this study was only associating higher vitamin D with a better prognosis, but that it did not actually prove that taking vitamin D would have any benefit.

My entire staff looked at me as if I were crazy. It was obvious to them that taking some vitamin D, which is inexpensive and harmless, would in no way hurt them and might significantly benefit them.

I, too, disagree with the expert who was interviewed on the radio. I realize that large, randomized-controlled trials that measure the benefit of vitamin D in the treatment and prevention of illness and disease must be run. Until then, we cannot advertise with certainty that taking vitamin D will help protect people against cancer and the other diseases that I am describing in this book.  However, it is going to take many years, even a decade, to have conclusive results.

Given all the knowledge that we have today, and the strong associations, made by experts in the field, what harm is it for a person to take 2,000 IU/day when Vitamin D is so readily available and inexpensive? Certainly it will do no harm (as we will see in the dosage chapter that up to 10,000 IU/day is safe) and in light of all the studies, it will certainly help optimize the functioning of Vitamin D in the person’s body.

The lack of randomized controlled trials (RCT) may be an argument for a “by the book” doctor to refrain from using Vitamin D for the purpose of helping a woman with her breast cancer. But as John Cannell et al., say in the January 2008 issue of Expert Opinion Pharmacother, “Is that an argument not to diagnose and treat vitamin D deficiency? If human RCTs exist showing cigarette smoking is dangerous, the authors have yet to locate them. Instead, the compelling evidence for the dangerousness of smoking exists in convincing epidemiological data and the demonstration of a mechanism of action. The same is true for vitamin D, although the diseases linked to vitamin D deficiency outnumber those linked to cigarette smoking, … and activated vitamin D, a secosteroid, has as many mechanisms of actions as genes it targets. Some would also argue that the quantity and quality of the epidemiological data for vitamin D is approaching that which existed for cigarette smoking when governments and medical bodies first acted.”

Increased risk of breast cancer, and mortality with lower Vitamin D levels

According to a study presented by a large group of Vitamin D experts, insufficient Vitamin D from either sun or supplements may be associated with a high risk of developing breast cancer, as well as a high risk of death from breast cancer.

The team of researchers analyzed the pooled data collected from two studies that associated breast cancer risk with Vitamin D levels. In both studies, breast cancer risk was lower in women who had higher levels of Vitamin D. Furthermore, it was estimated that a Vitamin D blood level of approximately 52 ng/ml would be necessary to reduce risk of breast cancer by 50 percent from the risk that is present when Vitamin D blood levels are at less than 13 ng/ml. To achieve this level of 25D, an estimated daily dose of 4,000 IU of Vitamin D would be necessary.

The researchers also estimated the number of U.S. breast cancer cases that could potentially be prevented if women maintained certain blood levels of Vitamin D. For example, at levels of 32 ng/ml 66,000 new cases of breast cancer could be prevented whereas Vitamin D levels of 52 ng/ml could potentially prevent 107,000 new cases of breast cancer.

In other words, according to Garland et al., women from these existing studies who had Vitamin D levels of about 52 ng/ml had a 50 percent less risk of breast cancer than those women with Vitamin D levels below 13 ng/ml. This is a major difference and certainly gives us a lot to think about.

Given a choice, I know that my staff, family, and friends would prefer to raise their Vitamin D levels to 52 ng/ml.

Order the Book!

A plethora of press releases have alerted the world about the health implications of Vitamin D deficiency. Reporters are interpreting the findings, and interviewing doctors, nutritionists and health professionals for their opinions regarding the veracity of the scientific findings. Laypersons are voicing their opinions through their blogs and comments on Websites. While it is interesting to read people’s varying voices of reason, it only creates confusion for the average person who is looking for solid information upon which to base their health decisions

There is much conflicting information about the presence of Vitamin D in food. Some avid proponents of healthy eating cling to the belief that all of our nutrition can come from eating a balanced and healthy diet. While this ideal is admirable, there are a few considerations about diet that remain a fact for most North Americans.

You can’t eat enough fish, eggs or mushrooms to get adequate—let alone optimal Vitamin D

1. If ‘food experts’ don’t know that the Vitamin D content in food is inadequate to reap health benefits, how can the average person be expected to know about the Vitamin D content in food?
2. Most people do not eat healthy balanced diets and will never achieve adequate Vitamin D levels from diet alone.
3. There simply are not enough foods that naturally contain enough Vitamin D to raise your blood levels of Vitamin D to an optimal level.
4. Foods fortified with Vitamin D do not contain uniform amounts of the substance and may not contain the amount of Vitamin D reported on the packaging.

For some people, getting their Vitamin D from sunshine alone, feels like the right and natural choice. For others, sun exposure is a scary thing and is avoided at all costs; and you spend more time indoors, wear protective clothing or sunscreen.

How Do we Get our Vitamin D?

Step One—Sun hits your skin It all begins when the skin is exposed to the sun. The UVB light in the sun interfaces with a form of cholesterol in your skin called 7-dehydrocholesterol, and this substance is synthesized into pre-vitamin D3. The pre-vitamin D3 immediately converts into Vitamin D3. This is the Vitamin D that circulates through the body, but it still isn’t empowered into its activated form.

Vitamin D3 is made in large quantities when you are in the sun during peak UV times. In fact it is estimated that 30 minutes in the sun in a bathing suit, midday in summer can make up to 20,000 IU of Vitamin D. If you get too much sun, the skin is able to convert the excess Vitamin D to other inactive molecules. In this way the body does not get overdosed with Vitamin D from sun exposure.

For my patients who don’t get enough sun, I advise them to take Vitamin D as a supplement, in carefully selected dosages.

Step Two—Vitamin D3 becomes 25D The Vitamin D3, either from sun or supplement makes its way to the liver where it undergoes a process (hydroxylation) turning it into 25D to store in your body. Having optimal stores of 25D in your body is very important, as these stores will enhance your body’s ability to make the best use of Vitamin D’s capabilities. If your body does not store enough Vitamin D in the form of 25D, then you will have low or deficient levels of Vitamin D in the blood. Ideally your Vitamin D levels should be optimal.

Step Three—25D becomes 1,25D3 The first priority for the health of your body is to send 25D from your liver to the kidneys where it is transformed into 1,25D3. 1,25D3 is the active and potent form of Vitamin D. As 1,25D3 this form of Vitamin D has the job of circulating in your blood to ensure that you maintain appropriate levels of calcium. This function of 1,25D3 is vital to our health—so much so that scientists didn’t expect it to have other functions.

In 1970, Vitamin D researcher Michael Holick and his colleagues discovered that the kidneys were not the only place in the body where 25D was metabolized into the potent and vital substance 1,25D3. When your body has enough stores of 25D, and has maintained the proper functioning of calcium levels in the blood, something exciting happens to the “excess” 25D.

It is only in the last ten years that scientists have come to understand this newfound function of the 25D form of Vitamin D. They have discovered that most tissues and cells of the body have the ability to metabolize 25D from the liver and turn it into 1,25D3. When researchers discovered these extra steps in the metabolizing of Vitamin D, they realized that many organs, tissues, and cells in the body have receptors for Vitamin D.

This means that Vitamin D circulates throughout the body and has the ability to land, and affect the cells, tissues, and organs that receive the Vitamin D. It is the only substance of its kind in the body and researchers are finding that Vitamin D has many repair and maintenance functions in most tissues and cells. Vitamin D isn’t just about healthy bones anymore.

It is this new fact about the 1,25D3 form of Vitamin D that has researchers so excited. According to Dr. John Cannell, director of the Vitamin D Council, 1,25D3 affects more than 200 genes in the body and can be found in most tissues in the body. He states on his Website, “This explains why the same substance may have a role in preventing cancer, influenza, autism, asthma, multiple sclerosis, and cardiovascular disease, not just curing rickets and osteomalacia.”

Children’s diseases like autism, asthma, and juvenile diabetes have become pervasive in the years that we have been told to avoid the sun. Vitamin D deficiency has come to be suspected to have an association with these diseases in children.

The chart prepared by Cedric Garland Ph.D. and Carole Baggerly of the Grassroots Heath shows a summary of what the statistical studies have shown for the possibility of higher levels to reduce disease. There is one typographical error on this chart which is the reduction for breast cancer is 50% not 83% as written on the chart.

Legend:

All percentages reference a common baseline of 25 ng/ml as shown on the chart.

• %’s reflect the disease prevention % at the beginning and ending of available data. Example: Breast cancer incidence is reduced by 30% when the serum level is 34 ng/ml vs the baseline of 25 ng/ml. There is an 83% reduction in incidence when the serum level is 50 ng/ml vs the baseline of 25 ng/ml.

• The x’s in the bars indicate ‘reasonable extrapolations’ from the data but are beyond existing data.

References:

• All Cancers: Lappe JM, et al. Am J Clin Nutr. 2007;85:1586-91. Breast: Garland CF, Gorham ED, Mohr SB, Grant WB, Garland FC. Breast cancer risk according to serum 25-Hydroxyvitamin D: Meta-analysis of Dose-Response (abstract).American Association for Cancer Research Annual Meeting, 2008.Reference serum 25(OH)D was 5 ng/ml. Garland, CF, et al. Amer Assoc Cancer Research Annual Mtg, April 2008,. Colon: Gorham ED, et al. Am J Prev Med. 2007;32:210-6.
• Diabetes: Hyppönen E, et al. Lancet 2001;358:1500-3.
• Endometrium: Mohr SB, et al. Prev Med. 2007;45:323-4. Falls: Broe KE, et al. J Am Geriatr Soc. 2007;55:234-9.
• Fractures: Bischoff-Ferrari HA, et al. JAMA. 2005;293:2257-64.
• Heart Attack: Giovannucci et al. Arch Intern Med/Vol 168 (No 11) June 9, 2008.
• Multiple Sclerosis: Munger KL, et al. JAMA. 2006;296:2832-8.
• Non-Hodgkin’s Lymphoma: Purdue MP, et al. Cancer Causes Control. 2007;18:989-99.
• Ovary: Tworoger SS, et al. Cancer Epidemiol Biomarkers Prev. 2007;16:783-8. Renal: Mohr SB, et al. Int J Cancer. 2006;119:2705-9. Rickets: Arnaud SB,

What is Vitamin D?

The first thing to understand about Vitamin D is that it is not a vitamin. By definition, a vitamin is a substance that is essential to human health but cannot be produced by the body. Vitamin D, in its most obvious and fundamental function, is essential to the metabolism of calcium and phosphorous in the body and without Vitamin D, we would not have healthy bones. So it is essential to our bodies, but Vitamin D is produced by our bodies when we are exposed to UVB rays of the sun. Because Vitamin D is produced by the body, it does not meet both of these above criteria. Vitamin D is not truly a vitamin.

Vitamin D was named a vitamin in 1920 when a researcher raised dogs without any exposure to sunlight. He fed fish liver oil to dogs and prevented rickets. The researcher assumed that the substance responsible for preventing rickets was in the fish liver oil—and not producible by the body. He named this essential nutrient a vitamin. It was four years later when other researchers found that Vitamin D was produced in the body when exposed to sunlight. So to call Vitamin D a vitamin is a misnomer but for the benefit of public health and nutrition, as well as its name’s long tradition, Vitamin D is still officially called a “vitamin.”

Although the term Vitamin D is used in reference to different substances associated with Vitamin D, there are two main types of Vitamin D. Vitamin D2 is known as ergocalciferol and Vitamin D3 is called cholecalciferol.

A recent study published in the British Medical Journal looked at the association between people’s vitamin D blood levels, their dietary intake of vitamin D and calcium, and their risk of colorectal cancer in European populations. 520,000 people from 10 Western European countries participated in this study. This is an enormous number! The people who were in the study gave blood samples and completed dietary and lifestyle questionnaires between the years 1992 and 1998.

The findings confirm what other studies, which I talk about in my book have shown us. Lower levels of vitamin D in the blood were associated with a higher risk for colorectal cancer. Higher concentrations of vitamin D in the blood were associated with a lower risk for this cancer. Specifically, people who had the highest blood levels of vitamin D in this study, had a 40% lower risk of colorectal cancer than those in the lowest levels of vitamin D in the blood.

In my opinion, this is just one more reason, further confirmed why everybody should take a basic dose of vitamin D, and should try to optimize their levels of vitamin D if they are able to get blood tests.

For people who do not have a blood test, and who are otherwise healthy adults I recommend 2000 IU of vitamin D daily.

Reference 1

Reference 2

Now an amazing study has proven this. Dr C. Eckstein and colleagues have published an article entitled “Vitamin D content in commercially available oral supplements” that was done at the Consortium of Multiple Sclorosis Centers.

They bought 10 different brands of vitamin D at the health food store and online and measured their actual potency and of course compared it to what it was labeled.

The findings are astonishing.

Unknown ObjectThe labeled dosages were from 400 IU to 10,000 IU. On average, the actual dose was 33.5% of what the label stated. The range of actual dosage in the bottle was from (shockingly ) 0.24% of what the label stated to 81.7% of the labeled dose. None of the products has the dose listed on the label.

This study was done by the Multiple Sclerosis Consortium because of the increasing recognition of the importance of Vitamin D in MS. As one of the authors stated ” As the role of vitamin D in immune regulation in MS gains increasing focus, oral supplementation is growing.”

It was because of this huge problem with most over the counter vitamin D products, that I decided to bring to market my own Vitamin D supplements. As a specialist in Internal Medicine I like to use pharmaceutical quality products for all my patients. The patients I see are sick and need high quality doctor-quality nutrients to get well.

That is why I decided to partner with a major company that only makes products to be sold in physicians’ offices. This is a whole other level of product manufacture and quality compared with a health food store product.

I have been delighted with the results of blood levels achieved with the Vitamin D products I sell on my website. I measure vitamin D levels on my patients with vitamin D associated conditions at least twice a year and keep their blood levels as well mine and my family above 40 ng/ml. I also am gratified by the testimonials I get from people using my vitamin D products.

Have you measured your blood levels after taking your brand of Vitamin D? How are your levels? And your family’s? Let me know because I really am on a mission to get everybody’s Vitamin D levels into normal or optimal range.

REFERENCE

This article which just came out followed almost 200 adults and did monthly vitamin D blood levels on all of the patients from September to early January. The patients were followed for the entire study time for developing upper respiratory infections (common cold or flu).

The findings are completely consistent with what I talk about in my book and here on my blog as well as other articles on Vitamin D and viral infections.

Those patients with a Vitamin D ( 25-Hydroxy-Vitamin D) level of 38 ng/ml or more had half the risk of a viral respiratory infection over the study. The level of statistical significance was extremely significant (p<0.0001). In addition they found that those with levels over 38ng/ml the duration of influenza was on average 2 days vs 9 days for those with low levels of vitamin D. This obviously would also affect the number of missed work days.

This study also found that higher weight individuals had lower vitamin D levels. This is consistant with other studies showing the same thing.

Another finding in the study was that over 80% of the patients in the study did have levels less then 38 ng/ml. This further emphasizes the magnitude of Vitamin D insufficiency in the United States.

The authors comment ” The data in this study suggests that supplementing with vitamin D to raise the concentrations in the general population to above 38 ng/ml could result in a significant health benefit by reducing the burden of illness from viral infections, at a minimum from viral infections of the respiratory tract in healthy adults living in temperate climates”.

My comment is that the authors should have gone longer with their study. They stopped in January! We know that colds and flus often still occur in February and March and that those patients NOT taking supplementary Vitamin D on their own would have had progressively lower levels in those months without sun. Had they extended their study to another 2 months, their data might have been even stronger showing the benefit of Vitamin D.

Note also that the level of 38 ng/ml in this study is very close to the lowest level (40 ng/ml) of vitamin D that I recommend ( in my book).

When was the last time you checked your vitamin D level? Your children’s? You can ask your doctor or pediatrician to do a level when you go in for your next checkup. Or you can do a self test at home with an at home kit.

Let me know what you do to keep your levels up now that summer is here?
Do you get some some without sunblock? or just take a D pill every day?

Reference