Cures rickets and osteomalasia Improves treatments for cancer,

osteoporosis, diabetes, cardiovascular disease, and more!

Vitamin D3: The Wonder Vitamin!

The Importance of Vitamin D has been known for more than 75 yearsVitamin D reverses Rickets, a softening of the

bones in children, and osteomalacia (Rickets in adults)Rickets has been described since the middle-ages

and is the most common childhood disease in many developing countries

Predominant cause is poor diet and also lack of exposure to sunlight

Cod-liver oil, which contains vitamin D, has been used medicinally since the early 1800s

Other cures were found in the early 1920s Malnourished children were cured with whole milkOther studies found that Rickets could be cured

with long exposure to sunlight

The Importance of Vitamin D has been known for more than 75 years Nobel prize for chemistry awarded to Adolf Windaus in 1928 for

his “studies on the constitution of sterols and their connection with vitamins.”

Other scientists, before and after, contributed to our current understanding of how Vitamin D functions in the body and relates to human health1920s, rickets was caused by seasonal variations of sunlight1930s, various foods fortified with vitamin D to prevent rickets1970s, vitamin D was found to be metabolized in the liver and

kidneys and controlled calcium levels through its action in the intestines

1980s, vitamin D receptors are found in many tissues and organs and interface with more than 200 genes

1990s, low levels of vitamin D contribute to various illnesses and various conditions from autism and the common cold to cancer and chronic pain

2000s, higher dosages may be required to prevent and treat many diseases of the immune, cardiovascular and nervous systems

FDA will be increasing their daily dosage requirements for vitamin DFinal report with recommendations will be issued in 2010

Just what is Vitamin D?By definition, a vitamin is..

a substance regularly required by the body in small amounts

the body cannot make on its own is required to be supplied by the daily diet

Vitamin D can be absorbed from some foods…Highest amounts from cod liver oil, salmon,

mackerel, tuna, and sardinesLess amounts from whole milk, cheese, and eggsSome foods, such as such as milk, cereal, and

orange juice, are now fortified with small amounts of vitamin D to prevent Rickets

Vitamin D is also a hormoneVitamin D can be made by the body rather

being absorbed just from foodVitamin D3 form is made by the skin after

exposure to sunlight.It represents 90% of the vitamin D circulating

in our body!For nutritional and public health reasons,

vitamin D continues to be classified as a vitamin

The three important forms of vitamin D in the bodyVitamin D3 or Cholecalciferol

Is made in the skin after exposure to the sun. Non-toxic: Once you have made 20,000 units, a mechanism in

the skin destroys excess amounts25D or Calcidiol

A prehormone made from the vitamin D3 in your bloodThis form helps the body absorb calcium and maintain healthy

bonesThis is the blood circulating form that is and should be

measured by doctors1,25D3 or Calcitriol

A steroid hormone also made from vitamin D3Manufactured in many cells, tissues and organs in the bodyThis form helps the intestine absorb more calcium and

phosphorusSince this form comes from the kidneys, a 1,25D3 test does

not reflect how much vitamin D3 is in other organs and should not be used to measure healthy circulating levels of vitamin D

Vitamin D3: Leads to other forms that help create healthy bones, prevent cancer, and much, much more!

Other Vitamin D termsVitamin D1

Found to be a mixture of compounds rather than a vitamin D product.

A term no longer usedVitamin D2 (ergocalciferol)

Produced by plants and fungi when exposed to sunlight.

Not produced naturally in the human body. It is similar but not identical to vitamin D3Less potent and less effective than Vitamin D3,

yet is still prescribed by many doctors.Vitamin D4 and D5

Derivatives of vitamin D3

What is the role of Vitamin D?The major biological function of Vitamin D

is to maintain normal blood levels of calcium and phosphorous

Healthy levels of Vitamin D in the blood help the body absorb calcium to maintain strong bones Rickets – softening of the bones in children

which can cause skeletal deformities, is due to vitamin D deficiency

Osteomalacia – muscle and bone weakness in adults, is due to vitamin D deficiency

What is the role of Vitamin D?Additional research suggests that healthy

levels of Vitamin D also aid in the treatment or prevention of many other diseasesOsteoperosisCancerDiabetesHypertension (high blood pressure)Several autoimmune diseasesInfluenza

Levels of Vitamin D and how it relates to Vitamin D Deficiency

Level of Vitamin D Deficiency / Sufficiency

< 10 ng/ml Severe deficiency

10 - 20 ng/ml Deficient

20 – 30 ng/ml Insufficient

30 ng/ml and above “Normal”

40 – 70 ng/ml Optimal (at time of writing)

Over 100 ng/ml Overdose

Over 150 ng/ml Toxic

Source: pg 50, The Vitamin D Revolution, by Soram Khalsa, MDHay House, Inc. 2009.

A Worldwide Problem:Children and Vitamin D deficiencyStudies conducted in Main and Mass, found over

half of these groups were deficient in Vitamin D52% of African –American and Hispanic teenagers48% of white pre-adolescent girls

Studies conducted in the winter throughout the US supported these findings of vitamin D deficiency42% of females aged 15-49

Even in sunny parts of the world such as Indian, Turkey and Lebanon, found vitamin D deficiency30-50% of the children had deficient vitamin D

levels (<20 ng/mL)

A Worldwide Problem: Vitamin D DeficiencyPregnant and Nursing MothersIn a study of women giving birth…despite taking

prenatal vitamins with 400 IU of vitamin D..73% of the mothers were severely deficient80% of the babies were severely deficient at birth

A Canadian study found that in the second trimester…Only 11% had adequate levels of vitamin D

Another study in New York showed that…69% of paired infants and mothers were vitamin D

deficientVitamin D penetrates a mother’s milk in correlation

with her own blood levelsTaking only 400 IU/day is not sufficient to raise the D

levelsHowever, 4,000 IU/day can raise the blood levesl of

their babies to > 30 ng/ml

A Worldwide Problem: Vitamin D Deficiency and ObesityVitamin D is fat-soluble and is therefore, stored in fat

cellsObese individuals have more fat cells to collect the

vitamin DAs a result, there is less vitamin D available to the

kidneys and intestines and therefore, less calcium available to maintain strong bones

Correlation between obesity and vitamin D deficiency-related osteomalacia [Michale Holic, MD, PhD]

A study in the UK (2008) found that levels of postmenopausal women were lowest in those with the highest mass index23 ng/ml in the Fall (highest sunshine time at 57 degrees

north latitude)19 ng/ml in the Spring

A worldwide problem: Vitamin D Deficiency in the ElderlyMore than half of Americans > 65 years

are deficient, putting them at risk for more bone fractures50% have < 30 ng/mlAs people age, they lose muscle mass and

strength.This weakening can lead to an increased

risk of fallingBy age 65, 1 in 3 people fall each yearBy age 80, 1 in two people fall each year

A worldwide problem: Vitamin D Deficiency in Other DiseasesSince vitamin D is fat soluble, people who

have illnesses that prevent them from absorbing could be at risk for vitamin D deficiencyCrohn’s diseaseCystic fibrosisThose who have undergone gastric-bypass

surgeryLiver or kidney failure – impairs the ability of

these organs to process vitamin D

Vitamin D and CancerResearches in the US have drawn the following conclusions

about cancer and insufficient levels of Vitamin D60,000 premature deaths in the US from cancer or 10% of total

cancer deaths7,000 premature deaths in Canada

Study in 2007 by the American J. Clinical Nutrition supports these findingsStudied 403 postmenopausal women over a period of four yearsThose taking vitamin D and calcium had a reduced risk of any

kind of cancer by 77% compared to those receiving the placeboRetrospective studies ongoing further support these findings

People living at higher latitudes are at higher risk for developing cancer

Seasonal studies show that people diagnosed with cancer (colon, breast, and prostate) in the summer or the fall had a better chance of survival than those diagnosed with cancer in the winter or spring

Vitamin D has been linked to the risk reduction of 17 different cancer

Breast Uterine

Colon Cervical

Prostate Gall bladder

Bladder Laryngeal

Esophageal Oral

Gastric Pancreatic

Ovarian Non-Hodgkin’s lymphoma

Rectal Hodgkin’s lymphomas

Renal

Source: page 81, The Vitamin D Revolution. Soram Khalsa, MD. Hay House, Inc. 2009Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am. J. Clin Nutr. 2004 Mar; 79(3): 362-371.

Vitamin D and Cardiovascular Health Heart Attack

Men deficient in vitamin D (< 15 ng/ml) were 242% more likely to have a heart attack compared to men with 30 ng/ml circulating vitamin D

Men with lower levels (22 – 29 ng/ml) were still at a heightened risk (160%) compared to those with 30 ng/ml circulating levels of vitamin D

High blood pressureMen and women with < 15 ng/ml were three times more likely to

have diagnosis of high blood pressure compared to those with 30 ng/ml

Congestive heart failureVitamin D levels 50% lower than people with healthy heartPatients with the worst cases of congestive heart failure had the

lowest vitamin D levels Peripheral artery disease (reduced blood flow in the legs)

64% more common in people with low levels of vitamin D

Source: pg 99 - 103

Vitamin D and Bone Health55% of all Americans over the age of 50 have either

osteoporosis or low bone mass (osteopenia)Osteoporosis occurs as bones lose minerals and

become weak, brittle, and prone to breaking33% of women between 60-70 years have osteoporosis66% of women of women over 80 have it

Osteomalacia or adult rickets, is clearly associated with vitamin D deficiencyBones do not harden, resulting in softer bones

Vitamin D’s primary role is to ensure that calcium is metabolized in the body and deposited in your bones

Vitamin D deficiency may only allow you to absorb one half to one third of the calcium that you would absorb with healthier vitamin D levels

Vitamin D and Chronic Pain25% of Americans (75 million) suffer with

chronic painThe following types of chronic pain could be

associated with insufficient levels of vitamin DUnexplained muscle, joint, or bone painFibromyalgiaMyalgiaChronic fatigue syndromeVarious studies suggest that 70% of those

with chronic pain have sufficient vitamin D levels < 20 ng/ml

Vitamin D and Autoimmune Diseases23.5 million Americans have autoimmune diseases

75% are women80 – 100 diseases are autoimmune related

Autoimmunity means that the immune system becomes faulty and attacks the body it is meant to protect

The endocrine system (Type 1 or insulin-dependent diabetes)Strongly associated with a vitamin D deficiency in infants

Nervous system (multiple sclerosis)Strongly correlated with latitude (i.e., amount of sunlight):

N Am, Europe and Southern Australia have higher rates than people in Asia, which is closer to the equator

Joints (rheumatoid arthritis)Recent studies suggest there is a correlation with vitamin

D deficiency but studies are in their infancy

Vitamin D and InfluenzaStudies of flu epidemics in the early 1990’s by Dr.

R. Edgar Hope-Simpson, MD suggested that the affects were seasonal due to how much sunshine people receivedLack of sunshine in winter increased likelihood of

contracting the fluResearch has since shown that vitamin D has a

positive impact on the immune systemBoots the macrophages (bacteria-killing white cells)Enhances the body’s natural antibiotic molecules that

exist in the lining of the respiratory tractHigher doses of vitamin D have shown to reduce

the frequency of respiratory infections in children

Vitamin D Deficiency Levels Related to Specific Health Conditions

Health Issue Vitamin D Levels

Rickets and Osteomalacia 15 ng/ml

Suppress parathyroid hormone levels 20-30 ng/ml

Optimize intestinal calcium absorption 34 ng/ml

Improve neuromuscular performance 38 ng/ml

Reduction of incidence of internal cancer

38 ng/ml

50% lower risk of colon cancer 33 ng/ml

50% reduction in breast-cancer incidence

52 ng/ml

Source: pg 138Originally published in the Expert Opinion Pharmacotherapy journal by Dr. Cannell et al.

If we could correct worldwide vitamin D deficiency….“The first thing we’d see is a reduction by

80% in the incidence of type 1 diabetes, 75% reduction of all invasive cancers combined, and 25% reduction in ovarian cancer”

Dr. Cedric Garland, a vitamin D expertCancer Prevention and Control CenterUniversity of California, San Diego

[ref pg 69 The Vitamin D revolution]

“Vitamin D deficiency is now recognized as a pandemic…”“..causes rickets in children, [other bone

disorders] in adults and is now associated with increased risk of common cancers, autoimmune diseases, hypertension, and infectious diseases.”

Am J Clin Nutri 2008:87(suppl):1080S-6S.

Michael Holick, MDFirst scientist to isolate the active forms of

Vitamin DProfessor of Medicine, Physiology, and BiophysicsBoston University Medical Campus

“The consequence of low [vitamin D] status include…’“…increased risk of various chronic diseases,

ranging from hypertension to diabetes to cancer. Recent data indicate that Vitamin D3 is substantially more potent than D2. The safe upper intake level of vitamin D3 is 10,000 IU/day.”

Clin J Am Soc Nephrol 3: 1535-1541, 2008

John A. Creighton, MDOver 50 years as a leading researcher on the

study of osteopersosis, vitamin D, and calcium Professor of Medicine, Department of MedicineCreighton UniversityOmaha, Nebraska

More of the World’s Leading Authorities on Vitamin DBess Dawson-Hughes MD, Tufts University, Boston, MACedric Garland, DrPh FACE, Univ. CA San DiegoFrank Garland, PhD, Univ. CA San DiegoEdward Giovannucci, MD, Harvard School of Public HealthWilliam Grant, PhD, NASA Langeley Research Center, San

Francisco, CARobert Heaney, MD, Creighton University Medical Center,

Omaha, NEMichael Holick, PhD, MD, Boston University School of

MedicineBruce Hollis, PhD, Medical Univ. of South CarolinaChristel Lamberg-Allardt, PhD, Univ. Helsinki, FinlandAnthony Norman, PhD, Univ. CA RiversideReinhold Vieth, PhD, University of Toronto, Canada

Many internet sites are devoted to the importance of Vitamin D; below are just a fewwww.vitamindcouncil.orgwww.vitamindhealth.orgwww.vitamin-D.comwww.vitamindsociety.orgwww.uvfoundation.orgwww.vitamind.co.il (in Hebrew)http://vitamind.ucr.edu (Univ. CA Riverside)http://lpi.oregonstate.edu/infocenter/vitamins/v

itaminD (Linus Pauling Institute at Oregon State Univ)

www.uvadvantage.org (web site of Dr. Holick, Vitamin D expert)

The Challenge: Getting enough Vitamin D3 – our primary source is the sunExposure to just 30 minutes of sunlight can

allow the body to generate 10,000 – 12,000 units of vitamin D3. [Heaney and Holick, et al)

However,…In the summer months, use of sun screens (to

protect against skin cancer) decreases our ability to make vitamin D3

In the winter months, we’re not outside enough to generate this amount of vitamin D3

Our modern indoor lifestyle, compared to even 50 years ago, limits our exposure to sunlight and the opportunity to make more vitamin D3

The Challenge: getting enough vitamin D3 – our secondary source is foodFoods naturally rich in vitamin D (cod liver oil,

salmon, makarel, etc) are not commonly consumed by most of the population and even if consumed, do not contain sufficient amounts

The foods which are commonly consumed (milk, eggs), are low in vitamin D content

Even foods fortified with vitamin D such as found in milk, cereal, and orange juice, do not contain enough vitamin D to maintain healthy levels in the blood

While severe forms of some diseases such as Rickets and Osteomalacia can be cured with foods rich in vitamin D, less severe forms of these diseases often go undetected

The Challenge: Getting enough Vitamin D; Supplements, the third & most practical sourceVitamin D3

Naturally produced by the bodyThe recommended and purist form of vitamin

DConsidered safer than Vitamin D2

Vitamin D2 A synthetic, not naturally produced by the

body50% less potent and effective than Vitamin

D3Still often prescribed by physicians

Vitamin D dosage: Addressing Short vs Long-Latency Deficiency DiseasesShort Latency Deficiency Diseases

Symptoms show rather quicklyExamples: rickets and osteomalacia

Long Latency Deficiency DiseasesSymptoms take many years to manifestExamples: Cancer, Cardiovascular Disease,

Central Nervous System degeneration20% of breast cancer cases in Europe were a

result of vitamin D deficiency [pg 69, Paper published by in 2002 by Dr. Willian B. Grant]

Most national nutritional policies are oriented toward short-latency deficiency

Hence, the current daily recommended dosages are ten times too low!

So how much Vitamin D3 is enough?The current FDA guidelines recommend that

adults get between 400 – 600 IUs as their Recommended Daily Intake (RDI)This amount barely raises blood concentrations of

circulating 25(OH)D (the form of vitamin D measured by doctors)

This amount is also certainly deficient for those that live in the very northern or southern regions of the globe that have limited exposure to the sun

Under pressure from vitamin D specialists, nutritionists, scientists, and clinicians, the FDA plans to increase their RDITheir report with the final RDI amount will not be

available until 2010

So how much Vitamin D3 is enough?Two leading vitamin D specialists, Drs. Heaney

and Holick, recommend the following levels of circulating 25 OH,D:32 – 48 ng/ml (or 80 – 120 nmol/L)

To obtain these levels, various Vitamin D regimens are recommended2,000 – 5,000 units a day indefinitely10,000 units a day for several monthsHigher dosages, of up to 50,000 units for 30 days,

are recommended to target certain illnesses, such as the flu, at a specific point of their cycle

Monitored by a periodic 25 OH,D blood test

Supplements: how much is really absorbed?It is well known that the body only absorbs

about 10% of any supplement taken in pill form [ref]Most of the supplement is lost during digestion

However, supplements taken in oral spray form (and thus not digested), are almost 100% absorbed through the oral tissues [ref]

Therefore, the daily recommended doses for the Vitamin D supplement in these two forms are differentPill form – 50,000 unitsSpray form – 10,000 units

Spray form of Vitamin D3 has other benefitsHealthy levels of circulating 25, OH-D are

reached more quickly with oral spray [ref]Oral spray – within 5 daysPill form – almost two months

This becomes extremely important when treatment needs are more immediate to address diseases

In Summary - Vitamin D is more than just a treatment for stronger bonesGrowing research supports that Vitamin D can

protect us against many diseases:Diminishing muscle strength / weaknessOsteoperosis and OsteomalaciaAutoimmune diseases such as Multiple Sclerosi

(MS) and Rheumatoid Arthritis (RA)Immunity and energy metabolismDiabetesCancer (prostate, breast, colon, etc)Gum diseasesObesityRenal failureInfertilityPregnancy eclampsia

“Vitamin D has an amazing ability to ward off disease…The problem is, the vast majority of us are not

getting nearly enough vitamin D and it is nearly impossible to get a therapeutic dose from diet and sunlight alone. Only 10% of vitamin supplements taken in pill form are absorbed by the body, where as when taken in oral spray form, are almost 100% absorbed.”

J. Joseph Prendergast, MDEndocrine Metabolic Medical Center, Palo Alto, CABoard Certified in Internal Medicine, Endocrinology

and Metabolism. Graduate of Wayne State University College of Medicine, Detroit, Michigan.

Dr. Joe’s Vitamin D3 SprayAbsorbed by the body 10 times more effectively than pill form [ref]Increases blood circulating levels 8 times faster (~5 days) [ref]

Additional Info slides

How Vitamin D might affect cancerCurrent understanding is that high levels of vitamin D may

enhance the following body processesApoptosis (or programmed cell death)

Cancer cells lose their ability to die off when they become compromised in some way, causing them to grow uncontrollably

Vitamin D makes cells that are turning cancerous die when they are suppose to

Cell differentiation (cells evolve into specialized cell types)Normal cells evolve and stop growing when they reach

maturityCancer cells do not evolve and therefore do not stop growingVitamin D helps make cancer cells evolve and mature into the

cell type they are supposed to becomeCell proliferation (cell growth and division)

Genes that control cell division are affected by vitamin DIf vitamin D levels are low, ability of genes to affect cell

growth are impaired

Source: Lappe…pg 78-80

How vitamin D might affect cancerRegulating cell growth

Vitamin D prevents angiogenesis which is the formation of blood vessels

Cancer cells create new blood vessels so the cancer can grow

Vitamin D impacts the genes that control angiogenesis, blocking cancer cells from creating new blood vessels (so they cannot keep growing)

Reduction of metastasis Metastasis is the ability of cancer cells to enter

the bloodstream and travel to other parts of the bodoy

Animal studies indicate vitamin D may inhibit the ability of cancer cells to spread this way

How Vitamin D might affect cardiovascular diseaseThere are vitamin D receptors in the blood

vesselsVitamin D may relax the blood vessels and

thus reduce blood pressureVitamin D also has anti-inflammatory

propertiesThis may benefit those with congestive heart

failure