Vitamin D Can Do So Much for RunnersThis article, by Alan Roth, first appeared in Runner’s Gazette, October, 2015.

Vitamin D is an integral part of the body’s chemical processes. All of our cells have vitamin D receptors which leads to the expectation that they need Vitamin D. It is well-proven that vitamin D plays a crucial role in the health of our bone cells. There is a growing body of evidence that vitamin D plays an important role in all of our cells.

The genetic response to vitamin D

Dr. Michael Holick, a pioneer of vitamin D research and a recipient of many awards for that, is a Professor of Medicine, Physiology and Biophysics at Boston University School of Medicine. An article of his was published in March of 2013 explaining the results of a clinical trial he led to understand more about how vitamin D works inside our cells. [http://goo.gl/qLg0i1] The study found that vitamin D influenced the activity of 291 genes in white blood cells (immune cells). Seventeen of those genes are important for transcriptional regulation, immune function, response to stress and DNA repair. It is believed that vitamin D influences about 2,000 to 3,000 of our genes. This study was the first to actually see vitamin D at work influencing DNA. His placebo group received 400 IU of vitamin D daily while the treated group received 2,000 IU daily. Dr. Holick is now repeating the study to see if groups receiving 4,000 IU and 10,000 IU daily show an increased genetic response.

Location, location, location

Vitamin D experts have reported that there is now a global vitamin D deficiency epidemic. [http://goo.gl/PDsNFi] Too many people spend their days indoors or cover their skin to avoid the sun’s UV radiation, an important source of vitamin D. We don’t realize that many of the disease epidemics we see are due to vitamin D deficiency. When you look at a geographical map of cancer prevalence, you will see that there is much more of it where there is less sun. The same for many other diseases including the autoimmune diseases. For example, when individuals spend the first ten years of their lives below a latitude of 37 degrees (skirts the southern borders of Virginia, Colorado and Utah) where there is more sun, epidemiological studies show they reduce the risk of MS by 50% for the rest of their lives. Living below the 37th parallel makes a big difference in our health, although less so in recent years as we’ve been indoctrinated to avoid the sun.

Sun exposure and tanning beds: Are they worth the risk?

Another source of vitamin D is tanning beds. People who use them have healthy levels of vitamin D in their blood and better bone density than non-users. The Mayo Clinic opined that if everyone in the U.S. used tanning beds for their vitamin D, 11,000 people would die each year from skin cancer. That might seem like too high a price to pay. It is also estimated that this would keep 400,000 people from dying of cancer and heart disease. [http://goo.gl/s6ZTf5] It would also save people from dying of many other diseases and greatly enhance quality of life as morbidity would also drop precipitously and emotional, psychological and cognitive health would improve. Many thousands of epidemiological/observational studies have shown that people with higher levels of vitamin D are that much healthier.

A problem with clinical trials

A problem has been that observational studies don’t prove cause and effect and doctors want to see that before they prescribe large amounts of vitamin D. You can see cause and effect from randomized controlled trials (RCTs) but unfortunately too many of these have shown no effect from vitamin D. This dissonance between the observational

studies and the RCTs have created a dilemma as the vitamin D experts are confident that vitamin D works but they haven’t been able to explain the negative results. Finally, in late 2013, an explanation was proclaimed but the news of this has not spread. It has to do with a metabolite of vitamin D, 25(OH)D, that was considered the workhorse of vitamin D and also could be easily measured in our blood serum. It turns out that 25(OH)D is good for our bones but not for other bodily tissue and cells. When we take vitamin D, the liver converts some of it to 25(OH)D. A big dose of vitamin D was often used and, when converted in the liver to the metabolite, it has a long life in our blood serum but was not helping these other cells when we thought it was. What these other cells need is the original vitamin D we take in but that only has a very short life so it was gone quickly in these studies using big doses and these showed failure. But now we know better. Vitamin D needs to be taken on a daily basis. You can learn more about this at: https://goo.gl/4Ywz4S

Fear of too much vitamin D

Another concern of doctors has been that too much vitamin D is dangerous. Very high 25(OH)D levels are known to cause hypercalcemia which in turn causes calcification of the body’s soft tissue. It was not clear how much vitamin D results in this serious condition. Just several months ago, the Mayo Clinic announced results of a study of blood serum testing looking at 25(OH)D levels and calcium levels using 20,308 tests over a 10-year period. It showed no link between high-dose 25(OH)D and calcium levels. The Mayo Clinic stated that vitamin D is one of the safest substances you can take with adverse effects being “exceedingly rare.” You can learn about this at http://goo.gl/LuUKTC

Vitamin D from the sun

The best way to get vitamin D is from the sun. Studies have shown that people whose work keeps them outdoors have less skin cancer than people who work indoors. If you can slowly build up melanin in your skin by gradually increasing sun exposure, the tanned skin will be protective. Most people don’t have the opportunity to do that and risk sunburn when they do get sun. It is sunburn that needs to be avoided. If getting UVB rays for vitamin D is your objective, you only need 10-15 minutes of exposure at the right time of day with plenty of skin exposed (e.g. arms and legs). You may prefer to keep your face protected if you fear wrinkling. Age matters. A 20-year old will get 4 times the amount of vitamin D from the sun as a 70-year old with the same exposure. [http://goo.gl/g9U5jZ] Dark skin has more melanin which blocks the UVB rays and the darker the skin, the more difficult it is to get vitamin D from the sun. Seniors who are now getting basal cell and squamous cell carcinomas, have them from sunburns they experienced decades ago. Fortunately, these carcinomas rarely metastasize and can be easily removed. For the more dangerous skin cancer melanoma, it is rarely related to sun exposure and healthy skin exposure can protect against melanoma. [http://goo.gl/L06y1m]

The UVB rays that are needed for vitamin D are only available part of the year in northern latitudes of the U.S. The reason is that these rays don’t penetrate easily through the atmosphere and the lower the sun is in the sky, the more atmosphere it has to penetrate. The sun must be above 45 degrees so if your shadow is longer than you are tall, there are no UVB rays getting through. The window for UVB rays opens and closes over about a 7 month period at the latitude of Washington, DC. It opens on March 5th and closes on October 9th. On March 5th it’s only open for about 20 minutes but this stretches out to almost 7 hours at the peak on June 21st and then narrows back down. You can see the schedule for where you live on the Navy’s azimuth table website at http://goo.gl/voUby.

Vitamin D and calcium

You may be wondering how good are the benefits to keep a high level of vitamin D in your body. Most people including most doctors don’t know how really powerful vitamin D is. There have been enough RCTs to show that bone health depends on vitamin D but most people will do fine with an intake of only about 1,000 to 2,000 IU per day just for their bones and for many people, this level can help more than just your bones. The body first takes care of its need for calcium for bones. Vitamin D regulates calcium and taking calcium with vitamin D provides better results.

Vitamin D for other than bones

For all those other cells in your body, many people need more vitamin D. The Vitamin D Council recommends taking 5,000 IU per day to arrive at a steady blood serum level of 25(OH)D of 50 ng/mL. In an article I wrote on vitamin D for athletes that was published last year by the American Medical Athletic Association, I drew on numerous studies that showed that at a level of about 50 ng/mL, performance improved and it reduced injuries. At that level, you will have significant protection against cancer and many other illnesses. For example, it reduces the risk of breast, colon and pancreatic cancer, among others, by 80%. [https://goo.gl/H26tdW] Just that alone should make it the most important substance to put into your body every day. Every organ that you can think of in your body is helped by vitamin D as those vitamin D receptors are there for a reason.

Vitamin D is critically important for trauma centers

Dr. L.R. Matthews of Grady Memorial Hospital in Atlanta found that patients in their trauma center who were deficient in vitamin D (which turned out to be almost all of them), had worse results and higher costs in treatment and recovery and the more deficient they were the more difficult and costly they were to treat. The differences were dramatic. They subsequently decided to give every trauma patient at the time of admission 50,000 IU of vitamin D3 and followed that up with more D3 during their stay. They were amazed by the results. Dr. Matthews found that the D3 supercharged the immune system which could be seen in dramatic increases in T cells, antimicrobial peptides and other important immune system substances. Equally important, he says, is the resulting down-regulation of the inflammatory response. The Grady trauma center is the largest in the state of Georgia. It is a Level I center that has reduced patient mortality to just about zero.[http://goo.gl/o4vT93]

An RCT in another trauma center found that giving patients 500,000 IU of vitamin D3 combined during their first 5 days reduced their length of stay to half that of the placebo group. [http://goo.gl/dMhb2t]

Vitamin D can bolster the immune system for marathons

There is a lot of discussion among runners of how running a marathon can deplete the runner’s immune system creating more susceptibility to illness. You can see how important it is to have a good level of vitamin D. However, you need to remember that it is the short-lived original vitamin D that is needed compared with the longer-lived 25(OH)D meaning that your last intake of vitamin D should be no more than a day or two before the event. If you are deficient and you start taking 5,000 IU per day just before the event it won’t be enough. You need to start some days earlier to reach the level needed. The experts in vitamin D say that if you start feeling a cold coming on, take 50,000 IU of D3 daily for one to two weeks. The RCTs that used very large doses reported that as much as 500,000 IU had no adverse effects. You could take say 300,000 IU the day before the endurance event and then wait a few days before taking any more D3 at your normal dose levels. I mention D3 specifically as many studies have shown that vitamin D2 is inferior to vitamin D3. It is D2 that doctors prescribe and D3

that you can buy OTC. You can buy 50,000 IU capsules of D3 at Amazon.com. I buy 10,000 IU gelcaps at www.puritan.com.

Be skeptical of negative reports

Please keep in mind that the pharmaceutical industry will be losing hundreds of billions of dollars if more people start to use vitamin D and especially if higher doses become more common. I think it’s reasonable to expect them to be spending considerable financial resources to fight this so be skeptical when you see reports of studies that show too much vitamin D is bad for you or that it works only on bones.

Personal experience on the roads

What I next tell you is not scientific but rather my own personal experience which includes guesswork on my part. I’ve been studying vitamin D extensively for about 5 years and started taking a mega-dose of 20,000 IU per day of vitamin D3 for 4 years now. For about 30+ years of running I had been very prone to overuse injuries. I found that whenever I tried to do runs of more than 12 miles during summer months, I’d experience an injury. During the winter it would take even shorter runs to produce injuries. Three years ago I pushed my limits with this new high D3 intake and did 26 runs of 15 miles up to 21 miles….no injuries. The total for that year was over 1,700 miles. Two years ago and last year I did 1,500 and 1,400 miles respectively without injury. I’ve slowed down considerably as I’m 73 and I struggle with what my neurologist calls “moderately severe” peripheral neuropathy that impairs muscle development and that vitamin D can’t help, or it’s helping but not enough. So I’m thinking more in hours rather than miles although this year looks like it will be somewhat over 1,400 miles. This year so far I’ve done 18 runs averaging 4 hrs 9 mins plus 62 runs averaging 2 hrs 36 mins and many shorter runs as well without overuse injury. I never could have imagined my body could do that. My guess is that the vitamin D is playing a big role here. Also, with all that running for 4 years now, I haven’t been sick.

Closing comments

If you go to the PubMed website at http://www.ncbi.nlm.nih.gov/pubmed and type in vitamin D, you’ll find more than 64,800 articles of which 1,700+ are of clinical trials and dated within the past 5 years. You’ll see the latest research with helpful comments at: https://www.vitamindcouncil.org. Another helpful website is: http://grassrootshealth.net

There are so many reasons to take at least 5,000 IU of D3 per day: to protect against so many diseases, to recover from illness, to help with treatment and recovery from injuries, to run faster with less injury, to be more emotionally and psychologically fit and even to be brainier.

There are very few doctors who are familiar with the findings that I’ve mentioned above about the limits of using the measurements of 25(OH)D for non-bone health, the Mayo Clinic findings on no significant link between vitamin D and hypercalcemia, and the high-dose effects of D3 in trauma care. I’m providing plenty of links for you to educate yourselves and help your doctors learn about this if they will listen.

I am available to speak to groups about vitamin D.

Alan Roth, Ph.D.301 928-6314alan@alanroth.net