I have written before about the dosage of vitamin D that I should be taking, and the toxicity of vitamin D, but here is a new study from the University of Kentucky that indicates that levels of vitamin D that are too low may be associated with brain damage.

The researchers studied animals, so it remains to be seen whether the same effects would be seen in humans. However, I do know that I feel better when I have been able to spend at least some time in the sunshine, so maybe there is a bit of truth here?

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This post started off with doing some research on PubMed on what studies have actually been conducted into what supplements I might need. The result was total confusion. Some studies say that vitamins may prevent this or that, while other studies say that the same vitamins cause this or that. So, I ended up totally confused. I trained as a pharmacist, and have learned a bit about the macro- and micronutritional needs of my body over the years, so I can only imagine how confused everyone else must be.

A few years ago now I started taking vitamins produced by a company called USANA. I like these because they are produced in a FDA-certified facility, and are backed by a lot of research. I also like them because they have kept me healthy even though I have had a lot of stress in my life. The range of products they have is impressive, but a little while ago they introduced a True Health Assessment that allowed me to assess just what products I needed. Whether I take them or not is up to me, but at least I have a good starting point. The really good thing about the True Health Assessment is that it is free. The products are not, and I do have to say that if you decide to order products after your assessment, I will receive a commission (thank you!). Read the rest of this entry

I saw today that the World Congress on Sleep Apnea is holding it’s tenth congress in Rome. They only meet every 3 years, so don’t look for one next year. The last one was in Seoul, Korea, but that web site is no longer active.

I am not going, as I am not a physician, and do not work in the sleep apnea world – I just live in it as a patient. I was particularly interested in a couple of items on the agenda for discussion on Rodshealth.

1. Philips Respironics is organizing a symposium on CPAP compliance. Participants are going to be hearing about the rationale for using CPAP, with the question of how much is enough being asked. They are also going to hear about interventions that will improve CPAP compliance from a PR person, then something about the role of behavioral interventions in improving CPAP compliance.

   I wonder if they will address what seems to be a frequent mantra of those who work in this area that the straps should be pulled as tight as possible? Getting the patient set up right at the start of their treatment is extremely important for improving adherence to the treatment program (I prefer adherence to compliance because I choose to follow the treatment). 
    

2. In the introduction to the Congress, Dr. Christian Guilleminault notes that sleep disordered breathing is responsible for many health-related problems, especially cardiovascular diseases. There will be no arguments from those who have sleep apnea that inattention, daytime sleepiness, systemic inflammation, and grinding of the teeth are associated with sleep apnea – they were in my case.

   Dr. Guilleminault goes on to note that sleep apnea “is induced or enhanced by obesity leading to fat deposition within the tongue and neck.” As pointed out, which comes first is not easy to identify.

The last point raises a question that I have often seen in the forums – will my sleep apnea be cured if I lose weight? My own opinion is that it all depends on which came first. I am not obese, although I am overweight. As a child I was definitely not overweight – almost the opposite, in fact. Yet I had symptoms that I now recognize as being possibly related to sleep apnea. There is no way to confirm that I had sleep apnea that long (50+ years!), but the possibility of being able to stop using the CPAP through weight loss is intriguing.

This looks like a scientifically very interesting meeting, and I hope I will be able to go through the abstract book over the next few months and highlight some of the interesting studies. Meantime, I will continue to work on my exercise program, my diet, and taking good quality vitamins to support my diet and exercise program.

A member of my wife’s family was diagnosed with colon cancer a while ago. We have been looking at the value of various supplements in support of the treatment she is reading. Several studies have linked low vitamin D levels to reduced risk of many diseases, including colon cancer.

My training as a pharmacist warned me that vitamin D can be dangerous if taken at very high levels. What levels are dangerous? I found a study that was published in the journal Anticancer Research in February of this year. The researchers believe that intake of up to 40,000 international units/day are not likely to result in signs of significant toxicity (poisoning). This is a huge dose, and closer reading of the abstract shows that the dose required to get the serum 25(OH)D level above 40 ng/mL was almost 10,000 international units/day.

The full article was available at no charge. So I took a look at it. The authors enrolled more than 3600 patients and measured their 25(OH)D levels. They found that most people were taking less than 500 international unit each day. The authors noted that this is the first analysis of a relation between vitamin D levels and vitamin D supplements measured in a community of patients. The patients were not taking a single brand of vitamin D, so it is not possible to say which brand anyone should take. The study raises a lots of questions, but they made it clear that what was thought to be a high dose a few years ago may actually be what most people need.

Of course, an individual should not be taking the second day without consulting with a physician. There are just too many things that should be considered to be able to suggest a dose that will work for everyone. Some of the things include where you live, how much time you spend in the sunshine, and any dietary sources of vitamin D. Other research has suggested that some diseases may be associated with low levels of vitamin D, but whether the disease or the low vitamin D levels come first is not known.

Vitamin D is found everywhere in the body. It is essential for many body functions. It has been shown to be important in helping to

• Avoid complications of pregnancy
• Avoid Parkinson’s disease
• Maintain cognition (this may help reduce the effects of Alzheimer’s disease)
• Prevent cancer of several types
• Prevent type 1 diabetes, especially in babies
• Increase the risk of heart attacks and stroke
• Increase the body’s ability to fight Clostridium difficile infections (that is a nasty infection that is resistant to many antibiotics. Help avoid it by making sure you wash your hands frequently when visiting someone in hospital)
• Increase your response to exercise
• Increase the chances of migraine (possibly)
• Increased risk of fibromyalgia (a painful condition that has sometimes been linked to chronic fatigue syndrome)

There are probably many other health problems possibly associated with not enough vitamin D in the body. Autism has been suggested by some experts as being related to lack of vitamin D, but there needs to be a lot more research done to confirm the link – it might be that the lack of vitamin D is actually the result of something else.

The problem with all of these possible ill effects of not enough vitamin D is that it takes a long time to show the effects of supplementation with vitamin D on the health problem. There is also disagreement over the type of vitamin that should be used for supplementation.

So, how much vitamin D do I need?

Unfortunately, that is not possible to answer in a post – it all depends. How much vitamin D do you actually have in your body? How much sun to you allow to reach your skin (without sun blocker or clothes)? How dark is your skin? How far north (or south) of the equator do you live (the higher the latitude, the less effective sun exposure is in increasing vitamin D levels). How old are you (older people make less vitamin D)? How much vitamin D do you get in your food?

The answer to the last question is actually easy – not much. The only way to know how much vitamin D you need is to have a health care provider request a lab test for you. Once you know the levels, then you can plan for getting more vitamin D. The majority of people in the higher latitudes do not have enough vitamin D, so I can be fairly certain that you will need more.

Options for increasing vitamin D levels

Really, there are only two ways to increase vitamin D levels:

• More sun exposure
• Supplementation

The sun exposure can be difficult – you need about 15-20 minutes of full sun exposure every day during. As I write this post there has been no sun all day! In doing this, you have to be careful to avoid burning your skin. You may need to increase the time if you are dark skinned, and as you get older. See how difficult it is? The amount of vitamin D you can get from food is limited. Maybe a bit from calcium and vitamin D that is added to some orange juice or milk, but that is not a reliable amount.

Supplementation is easier, but you need to work with your health care provider to determine the dose. You don’t need to use a prescription form of vitamin D. What you can buy at the health food store is usually enough. Just make sure you buy a good brand, and have your vitamin D levels checked. Probably at the beginning and end of winter.

Blood levels of vitamin D

Blood levels should ideally be kept above 15 ng/ml (37.5 nmol/L), but less than 200 ng/ml (500 nmol/L) according to the Office of Dietary Supplements. My physician recommends keeping my levels closer to the lower level to avoid side effects. I take 1000 units per day, but some people may need 10,000 units/day, at least for a short time. It is important to work with your health care provider to determine YOUR correct level of supplements.