View Full Version : Vitamin D thread -Please use this for your Vit D info.
Low vitamin D is a huge issue for lots of reasons.
I will post some links to previous posts later, and if everybody else could do the same that would be great.
"More than half of North American women receiving therapy to treat or prevent osteoporosis have vitamin D inadequacy, underscoring the need for improved physician and public education regarding optimization of vitamin D status in this population."
"These findings show that free-living elderly Europeans, regardless of geographical location, are at substantial risk of inadequate vitamin D status during winter and that dietary enrichment or supplementation with vitamin D should be seriously considered during this season."
4 must watch videos
Vitamin D Prevents Cancer: Is It True?
Skin Cancer/Sunscreen - the Dilemma
Dose-Response of Vitamin D and a Mechanism for Cancer Prevention
Vitamin D & Cardiovascular Disease- New Frontiers for Prevention
02-10-2010, 01:05 PM
You can also find treatment related info here:
Vitamin D: what is an adequate vitamin D level and how much supplementation is necessary?
Centre on Aging and Mobility, University of Zurich, Department of Rheumatology and Institute of Physical Medicine, Zurich, Switzerland. firstname.lastname@example.org
Strong evidence indicates that many or most adults in the United States and Europe would benefit from vitamin D supplements with respect to fracture and fall prevention, and possibly other public health targets, such as cardiovascular health, diabetes and cancer. This review discusses the amount of vitamin D supplementation needed and a desirable 25-hydroxyvitamin D level to be achieved for optimal musculoskeletal health. Vitamin D modulates fracture risk in two ways: by decreasing falls and increasing bone density. Two most recent meta-analyses of double-blind randomised controlled trials came to the conclusion that vitamin D reduces the risk of falls by 19%, the risk of hip fracture by 18% and the risk of any non-vertebral fracture by 20%; however, this benefit was dose dependent. Fall prevention was only observed in a trial of at least 700 IU vitamin D per day, and fracture prevention required a received dose (treatment dose*adherence) of more than 400 IU vitamin D per day. Anti-fall efficacy started with achieved 25-hydroxyvitamin D levels of at least 60 nmol l(-1) (24 ng ml(-1)) and anti-fracture efficacy started with achieved 25-hydroxyvitamin D levels of at least 75 nmol l(-1) (30 ng ml(-1)) and both endpoints improved further with higher achieved 25-hydroxyvitamin D levels. Founded on these evidence-based data derived from the general older population, vitamin D supplementation should be at least 700-1000 IU per day and taken with good adherence to cover the needs for both fall and fracture prevention. Ideally, the target range for 25-hydroxyvitamin D should be at least 75 nmol l(-1), which may need more than 700-1000 IU vitamin D in individuals with severe vitamin D deficiency or those overweight.
Highly persuasive Videos from UCLA if you have not seen them
09-26-2010, 04:46 AM
Thanks for posting. I am like a broken record with everyone I know about Vit. D. It is hard to convince many folks that they should even be tested. It is clear that some docs out there are not knowledgeable and don't push the issue with patients. Some know about the issue but are not knowledgeable about what would be considered good levels. It is very frustrating.
10-04-2010, 01:28 PM
And thanks R.B.
I had posted that I was adding more vitamin D in the form of Carlson Ddrops D3. I have the 1000 IU per drop kind. They come in 2000 IU as well.
Well, by taking a drop under my tongue each night after dinner along with a food based calcium pill, my D levels went up quite nicely.
By the 25 Hydroxy lab testing method my
TOTAL Vit D rose to 57.2. Up from low 40's.
That was with little effort and pretty much limiting the sun time this summer since I had treated 2 areas of my face for sun damage last winter.
Just wanted to share that this easy and inexpensive way to supplement for D3 has worked well for me.
These D drops are free of soy, corn, wheat, gluten, and preservatives.
Cancer Epidemiol Biomarkers Prev. 2010 Dec 2. [Epub ahead of print]
Joint effects of dietary vitamin D and sun exposure on breast cancer risk: results from the French E3N cohort.
Engel P, Fagherazzi G, Mesrine S, Boutron-Ruault MC, Clavel-Chapelon F.
1Nutrition, Hormones and Cancer, Inserm (Institut National de la Santé et de la Recherche Médicale) ERI 20, EA 4045, and Institut Gustave Roussy.
BACKGROUND: Ecological studies have suggested that vitamin D production through UV solar irradiance could reduce breast cancer (BC) risk. Although studies restricted to dietary vitamin D intake have provided inconsistent results, little is known about the relationship between pre and postmenopausal BC and combined intakes from diet, supplements and sun exposure.
METHODS: Cox proportional hazards regression mvaluated the association between vitamin D intakes, mean daily Ultraviolet Radiation dose (UVRd) at the place of residence and risk of BC among 67,721 women of the French E3N cohort. All analyses were stratified on menopausal status taking into account important confounders including calcium consumption.
RESULTS: During 10 years of follow-up, a total of 2,871 BC cases were diagnosed. Dietary and supplemental vitamin D intakes were not associated with BC risk; however, in regions with the highest UVRd, postmenopausal women with high dietary or supplemental vitamin D intake had a significantly lower BC risk as compared to women with the lowest vitamin D intake (HR = 0.68, 95% CI: 0.54 - 0.85, and HR = 0.55, 95% CI: 0.36 - 0.90 respectively).
CONCLUSIONS: Our results suggest that a threshold of vitamin D exposure from both sun and diet is required to prevent BC and this threshold is particularly difficult to reach in postmenopausal women at northern latitudes where quality of sunlight is too poor for adequate vitamin D production.Impact:Prospective studies should further investigate associations between BC risk, vitamin D status and sunlight exposure.
J Epidemiol. 2010 Dec 11. [Epub ahead of print]
Vitamin D Decreases Risk of Breast Cancer in Premenopausal Women of Normal Weight in Subtropical Taiwan.
Lee MS, Huang YC, Wahlqvist ML, Wu TY, Chou YC, Wu MH, Yu JC, Sun CA.
School of Public Health, National Defense Medical Center.
Background: Evidence for an association between vitamin D status and breast cancer is now more convincing, but is uncertain in subtropical areas like Taiwan. This hospital-based case-control study examined the relationship of breast cancer with vitamin D intake and sunlight exposure.Methods: A total of 200 incident breast cancer cases in a Taipei hospital were matched with 200 controls by date of interview and menopausal status. Information on risk factors for breast cancer was collected in face-to-face interviews and assessed with reference to vitamin D intake (foods and nutrients) and sunlight exposure. Vitamin D intake was divided into quartiles, and threshold effect was evaluated by comparing Q2-Q4 with Q1.Results: After controlling for age, education, parity, hormone replacement therapy, body mass index (BMI), energy intake, menopausal status, and daily sunlight exposure, the risk of breast cancer in participants with a dietary vitamin D intake greater than 5 µg per day was significantly lower (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.24-0.97) than that of participants with an intake less than 2 µg per day. In analysis stratified by menopausal status and BMI, both dietary vitamin D and total vitamin D intakes were associated with a protective effect among premenopausal women. There was a significant linear trend for breast cancer risk and dietary vitamin D intake in premenopausal women (P = 0.02). In participants with a BMI lower than 24 kg/m(2) (ie, normal weight), dietary vitamin D intake was inversely related to breast cancer risk (P for trend = 0.002), and a threshold effect was apparent (Q2-Q4 vs Q1: OR, 0.46; 95% CI, 0.23-0.90).Conclusions: Vitamin D had a protective effect against breast cancer in premenopausal women of normal weight in subtropical Taiwan, especially an intake greater than 5 µg per day.
03-28-2011, 09:48 AM
WebMD's new article on Calcium rich foods mentions Vitamin D:
Top Food Sources for Calcium and Vitamin D
04-12-2011, 02:29 PM
One more benefit of Vitamin D:
By Todd Neale, Staff Writer, MedPage Today
Published: April 11, 2011
Reviewed by Zalman S. Agus, MD (http://her2support.org/reviewer.cfm?reviewerid=30); Emeritus Professor
University of Pennsylvania School of Medicine and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
Vitamin D Again Tied to Lower AMD Risk
Higher levels of circulating vitamin D appear to reduce the risk for early onset of age-related macular degeneration in women ages 50 to 74, an ancillary study of the Women's Health Initiative showed.
Among postmenopausal women younger than 75, those who had the highest concentrations of 25 (OH)D (at least 75 nmol/L) were significantly less likely to develop the eye condition than those with the lowest (38 nmol/L or lower), according to Amy Millen, PhD, of the University at Buffalo in New York, and colleagues.
The odds ratio was 0.52 (95% CI 0.29 to 0.91) after adjustment for age, smoking, iris pigmentation, family history of age-related macular degeneration, cardiovascular disease, diabetes, and hormone therapy use, the researchers reported in the April issue of Archives of Ophthalmology.
Further adjustment for body mass index and physical activity, however, rendered the association nonsignificant, likely because of the strong correlation between those two factors and vitamin D status, Millen and her colleagues wrote.
"More studies are needed to verify this association prospectively as well as to better understand the potential interaction between vitamin D status and genetic and lifestyle factors with respect to risk of early age-related macular degeneration," they wrote.
The findings confirm the strong inverse relationship between serum 25-hydroxyvitamin D concentrations and early age-related macular degeneration found using data from the National Health and Nutrition Examination Survey (NHANES) (http://www.medpagetoday.com/Ophthalmology/GeneralOphthalmology/5641).
Millen and her colleagues looked at data from the Carotenoids in Age-Related Eye Disease Study (CAREDS), which was conducted under the umbrella of the Women's Health Initiative Observational Study. In CAREDS, age-related macular degeneration status was assessed an average of six years after serum samples were analyzed for 25(OH)D status.
The current analysis included 1,313 women ages 50 to 79. Overall, 241 women developed early age-related macular degeneration and 26 developed advanced disease.
The median serum 25 (OH)D level was 30 nmol/L in the lowest quintile and 85 nmol/L in the highest.
In a multivariate analysis of women of all ages, there was no significant relationship between early age-related macular degeneration and 25(OH)D concentration (OR for the highest versus the lowest quintile 0.79, 95% CI 0.50 to 1.24).
There was, however, a significant interaction with age (P=0.002), which suggested a selective mortality bias in women 75 and older, according to the researchers.
Although there was a decrease in the odds of early age-related macular degeneration with increasing 25(OH)D levels in women younger than 75, there was a nonsignificant trend in the opposite direction for older women (OR 1.76, 95% CI 0.77 to 4.13).
Further adjustment for BMI and recreational physical activity, however, weakened both associations.
Also in women younger than 75, increased intake of vitamin D from foods and supplements combined was associated with lower odds of early age-related macular degeneration -- consuming at least 18µg/day was associated with 59% lower odds of developing the condition (OR 0.41, 95% CI 0.20 to 0.78).
The authors noted that that level of intake equals 720 IU/day, which exceeds to Institute of Medicine's recommendation for 600 IU/day.
There was not association between time spent in direct sunlight and the likelihood of developing macular degeneration.
Millen and her colleagues acknowledged some limitations of the study, including the inability to establish causality using an observational study, the limited generalizability beyond postmenopausal white women, possible selection bias, and the lack of information on genetic risk factors for age-related macular degeneration.
Cancer Epidemiol Biomarkers Prev. 2011 Apr;20(4):717.
The Association between Prognostic Demographic and Tumor Characteristics of Breast Carcinomas with Serum 25-OH Vitamin D Levels.
Peppone L, Rickles A, Huston A, Sprod L, Hicks D, Mustian K, Skinner K.
Epidemiologic studies show that women with low 25-OH vitamin D levels have an increased risk of breast cancer incidence and mortality. However, there is a lack of research examining vitamin D levels and prognostic variables in breast cancer patients. The aim of this study is to identify the associations between 25-OH vitamin D levels, demographic variables, and prognostic pathological and genetic characteristics of breast cancers.
This study cohort consists of 155 women who underwent breast cancer surgery at the University of Rochester between 1/2009 and 9/2010. Vitamin D levels were obtained in the 1-year period before and after surgery (74% of vitamin D levels within 6 months). Prognostic variables included age, race, menopausal status, Oncotype DX score, TNM staging, ER/PR status, and HER2 expression. ANCOVA, linear regression, and logistic regression were used to determine the association between prognostic variables and 25-OH vitamin D levels, while controlling for relevant covariates (age, race, and month of blood draw).
Non-Caucasian (OR = 3.8; P < 0.01) and premenopausal (OR = 3.5; P < 0.01) breast cancer patients were significantly more likely to have suboptimal 25-OH vitamin D levels than Caucasian and postmenopausal patients, respectively. Women with invasive breast tumors were more likely to have suboptimal vitamin D levels (invasive OR = 2.4; P = 0.10) and lower mean 25-OH vitamin D levels (invasive: 30.5 ng/mL vs. in situ: 36.9 ng/mL; P = 0.04). A significant correlation (r = -0.42; P = 0.04) between decreasing vitamin D levels and increasing Oncotype score was noted. Breast cancer patients who had ER- and triple-negative breast tumors were more likely to have suboptimal levels of 25-OH vitamin D (ER-OR = 2.4; P = 0.07; triple-negative OR = 2.6; P = 0.09).
Breast cancer patients with suboptimal vitamin D levels were more likely to have tumors with more aggressive tumor profiles, worse prognostic markers (ER- and triple-negative tumors), and higher recurrence risk (Oncotype scores), lending support to previous research that found decreased breast cancer survival among vitamin D deficient individuals. Further research is needed to elucidate the biological relationship between vitamin D and prognostic breast cancer markers.
[PubMed - in process]
Breast Cancer Res Treat. 2011 May;127(1):171-7. Epub 2011 Mar 8.
The effect of various vitamin D supplementation regimens in breast cancer patients.
Peppone LJ, Huston AJ, Reid ME, Rosier RN, Zakharia Y, Trump DL, Mustian KM, Janelsins MC, Purnell JQ, Morrow GR.
Department of Radiation Oncology, University of Rochester Medical Center, 601 Elmwood Ave, Box 704, Rochester, NY, 14642, USA, email@example.com.
Vitamin D deficiency in the patients treated for breast cancer is associated with numerous adverse effects (bone loss, arthralgia, and falls). The first aim of this study was to assess vitamin D status, determined by 25-OH vitamin D levels, among women diagnosed with breast cancer according to demographic/clinical variables and bone mineral density (BMD). The second aim of this study was to evaluate the effect of daily low-dose and weekly high-dose vitamin D supplementation on 25-OH vitamin D levels. This retrospective study included 224 women diagnosed with stage 0-III breast cancer who received treatment at the James P. Wilmot Cancer Center at the University of Rochester Medical Center. Total 25-OH vitamin D levels (D(2) + D(3)) were determined at baseline for all participants. Vitamin D deficiency was defined as a 25-OH vitamin D level < 20 ng/ml, insufficiency as 20-31 ng/ml, and sufficiency as ≥32 ng/ml. BMD was assessed during the period between 3 months before and 6 months following the baseline vitamin D assessment. Based on the participants' baseline levels, they received either no supplementation, low-dose supplementation (1,000 IU/day), or high-dose supplementation (≥50,000 IU/week), and 25-OH vitamin D was reassessed in the following 8-16 weeks. Approximately 66.5% had deficient/insufficient vitamin D levels at baseline. Deficiency/insufficiency was more common among non-Caucasians, women with later-stage disease, and those who had previously received radiation therapy (P < 0.05). Breast cancer patients with deficient/insufficient 25-OH vitamin D levels had significantly lower lumbar BMD (P = 0.03). Compared to the no-supplementation group, weekly high-dose supplementation significantly increased 25-OH vitamin D levels, while daily low-dose supplementation did not significantly increase levels. Vitamin D deficiency and insufficiency were common among women with breast cancer and associated with reduced BMD in the spine. Clinicians should carefully consider vitamin D supplementation regimens when treating vitamin D deficiency/insufficiency in breast cancer patients.
[PubMed - in process]
Pretreatment serum concentrations of 25-hydroxyvitamin D and breast cancer prognostic characteristics: a case-control and a case-series study.
Yao S, Sucheston LE, Millen AE, Johnson CS, Trump DL, Nesline MK, Davis W, Hong CC, McCann SE, Hwang H, Kulkarni S, Edge SB, O'Connor TL, Ambrosone CB.
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, United States of America. firstname.lastname@example.org
Results from epidemiologic studies on the relationship between vitamin D and breast cancer risk are inconclusive. It is possible that vitamin D may be effective in reducing risk only of specific subtypes due to disease heterogeneity.
METHODS AND FINDINGS:
In case-control and case-series analyses, we examined serum concentrations of 25-hydroxyvitamin D (25OHD) in relation to breast cancer prognostic characteristics, including histologic grade, estrogen receptor (ER), and molecular subtypes defined by ER, progesterone receptor (PR) and HER2, among 579 women with incident breast cancer and 574 controls matched on age and time of blood draw enrolled in the Roswell Park Cancer Institute from 2003 to 2008. We found that breast cancer cases had significantly lower 25OHD concentrations than controls (adjusted mean, 22.8 versus 26.2 ng/mL, p<0.001). Among premenopausal women, 25OHD concentrations were lower in those with high- versus low-grade tumors, and ER negative versus ER positive tumors (p≤0.03). Levels were lowest among women with triple-negative cancer (17.5 ng/mL), significantly different from those with luminal A cancer (24.5 ng/mL, p = 0.002). In case-control analyses, premenopausal women with 25OHD concentrations above the median had significantly lower odds of having triple-negative cancer (OR = 0.21, 95% CI = 0.08-0.53) than those with levels below the median; and every 10 ng/mL increase in serum 25OHD concentrations was associated with a 64% lower odds of having triple-negative cancer (OR = 0.36, 95% CI = 0.22-0.56). The differential associations by tumor subtypes among premenopausal women were confirmed in case-series analyses.
In our analyses, higher serum levels of 25OHD were associated with reduced risk of breast cancer, with associations strongest for high grade, ER negative or triple negative cancers in premenopausal women. With further confirmation in large prospective studies, these findings could warrant vitamin D supplementation for reducing breast cancer risk, particularly those with poor prognostic characteristics among premenopausal women.
05-04-2011, 06:56 AM
Vitamin D is as important as other vitamins but the vitamin D is not used commonly by the people... People are just conscious about the vitamins A & B.
05-05-2011, 05:05 AM
Good point Conway. Unfortunately, it is estimated that 90% of American's a not getting sufficient amounts of Vitamin D from the sun or food. There are many factors in this fact ranging from limited seasonal exposure to the sun, use of sunscreen and even skin pigmentation differences. If possible it is best to have Vitamin D levels tested and supplement accordingly-plus trying to get at least 15 minutes of sun and some good, high calcium/vit D food sources daily.
05-08-2011, 11:47 AM
Just took my first 50,000 UNT Capsule Vitamin D last night. The oncologist nurse called me yesterday and told me that besides the antibiotics I was getting for the UTI, a prescription of Vitamin D had also been written by my oncologist. It'd been more than a week since my blood draw and a whole week since the urine sample, wondered why it had been taking so long.
I was brought up in the semi-tropical Island of Taiwan. Migrated to Sunny Texas in 1984. Felt a little bit 'insulted' to be found deficient in Vitamin D. But I guess curling in the couch for almost three years will do it. Fellow BC survivors be aware! :)
Hopeful had put this link in another thread. Thought I'd listed it here. My onco has put me on 50,000 UNT Capsule weekly for 6 weeks and than monthly for 4 months.
05-22-2011, 10:46 AM
WebMD just posted a slide show about Vitamin D:
05-23-2011, 11:53 PM
Hello I just stunbled on this thread and went to the webmed link.Just a point is okra a good souce for Vitamin D.As vegetarians are options are limited.
05-24-2011, 07:31 PM
Found this old thread where many members had shared their stories/opinion/information of Vitamin D:
05-30-2011, 06:05 AM
Some very short (compared to the four 'must watch videos' listed on the first posting by R. B.) videos on the subjects of bones, Vitamin D, and osteoporosis:
07-03-2011, 05:38 AM
Newsmax also listed 6 reasons for getting adequate Vit. D:
Breast Cancer Res. 2011 Jul 26;13(4):R74. [Epub ahead of print]
Serum 25-hydroxyvitamin D and postmenopausal breast cancer survival: a prospective patient cohort study.
Vrieling A, Hein R, Abbas S, Schneeweiss A, Flesch-Janys D, Chang-Claude J.
Division of Cancer Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany. email@example.com.
Vitamin D has been postulated to be involved in cancer prognosis. Thus far, only two studies reported on its association with recurrence and survival after breast cancer diagnosis yielding inconsistent results. Therefore, the aim of our study was to assess the effect of post-diagnostic serum 25-hydroxyvitamin D [25(OH)D] concentrations on overall survival and distant disease-free survival.
We conducted a prospective cohort study in Germany including 1,295 incident postmenopausal breast cancer patients aged 50-74 years. Patients were diagnosed between 2002 and 2005 and median follow-up was 5.8 years. Cox proportional hazards models were stratified by age at diagnosis and season of blood collection and adjusted for other prognostic factors. Fractional polynomials were used to assess the true dose-response relation for 25(OH)D.
Lower concentrations of 25(OH)D were linearly associated with higher risk of death (hazard ratio (HR) = 1.08 per 10 nmol/L decrement; 95% confidence interval (CI), 1.00 to 1.17) and significantly higher risk of distant recurrence (HR = 1.14 per 10 nmol/L decrement; 95%CI, 1.05 to 1.24). Compared with the highest tertile (≥ 55 nmol/L), patients within the lowest tertile (< 35 nmol/L) of 25(OH)D had a HR for overall survival of 1.55 (95%CI, 1.00 to 2.39) and a HR for distant disease-free survival of 2.09 (95%CI, 1.29 to 3.41). In addition, the association with overall survival was found to be statistically significant only for 25(OH)D levels of blood samples collected before start of chemotherapy but not for those of samples taken after start of chemotherapy (P for interaction = 0.06).
In conclusion, lower serum 25(OH)D concentrations may be associated with poorer overall survival and distant disease-free survival in postmenopausal breast cancer patients.
[PubMed - as supplied by publisher]
Serum 25-hydroxyvitamin D is inversely associated with body mass index in cancer
Pankaj G Vashi,1 Carolyn A Lammersfeld,1 Donald P Braun,1 and Digant Guptacorresponding author1
1Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center, 2520 Elisha Avenue, Zion, IL, 60099, USA
(Full Free Text)
Obese cancer patients (BMI >= 30 kg/m2) had significantly lower levels of serum 25(OH)D as compared to non-obese patients (BMI <30 kg/m2). BMI should be taken into account when assessing a patient's vitamin D status and more aggressive vitamin D supplementation should be considered in obese cancer patients.
Serum 25-hydroxyvitamin D [25(OH)D] is the major circulating form of vitamin D and a standard indicator of vitamin D status [1,2]. Several studies have described an inverse relationship between serum 25(OH)D and cancer risk [3-5]. The relationship between regular vitamin D intake and reduced cancer incidence has also been reported . Furthermore, higher plasma 25(OH)D levels are associated with improved survival in prostate , breast , lung , colorectal  and ovarian  cancers. A better vitamin D status at the time of diagnosis and treatment, adjusted for season of diagnosis, has been shown to improve survival [12,13].
Several factors are involved in the regulation of 25(OH)D including: age; gender ; race ; dietary intake ; season ; and sunlight exposure . Recently, the relationship between obesity and vitamin D status has been investigated suggesting decreased bioavailability of 25(OH)D from cutaneous and dietary sources in association with obesity . "
Ann Surg Oncol. 2011 Jul;18(7):1830-6. Epub 2010 Dec 14.
Vitamin D deficiency is correlated with poor outcomes in patients with luminal-type breast cancer.
Kim HJ, Lee YM, Ko BS, Lee JW, Yu JH, Son BH, Gong GY, Kim SB, Ahn SH.
Department of Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
(Full Free Text)
Vitamin D deficiency may be an indicator of poor prognosis in patients with breast cancer before surgery. We investigated the association between serum vitamin D concentration and breast cancer prognosis according to intrinsic cancer subtypes.
From June to December 2006, serum 25-OHD was measured in 310 Korean women with breast cancer who were treated at the Asan Medical Center, Korea. Clinicopathologic data were examined to determine the prognostic effects of serum 25-OHD. Expression of estrogen receptor (ER), progesterone receptor (PR), and epidermal growth factor receptor 2 (Her2) were measured using tissue microarrays. Patients were classified with luminal A, luminal B, Her2-enriched, or basal-like subtypes of breast cancer.
Mean patient age was 48.7 years, and mean serum 25-OHD concentration was 31.4 ± 16.1 ng/ml. The 25-OHD levels were deficient (< 20 ng/ml) in 75 patients (24.2%), insufficient (20-29 ng/ml) in 95 (30.6%), and sufficient (30-150 ng/ml) in 140 (45.2%). Women with deficient 25-OHD levels were at increased risk of recurrence compared with those with sufficient vitamin D levels (P = 0.002). The 25-OHD concentration was inversely associated with prognosis of patients with cancer of the luminal A (P = 0.012) and luminal B subtypes (P =0.023), but not with the prognosis of patients with Her2/neu-enriched (P = 0.245) or triple-negative (P = 0.879) cancer subtypes. This association remained valid after adjustment for age, tumor size, nodal status, and estrogen receptor status (hazards ratio = 3.97; 95% confidence interval = 1.77-9.61).
Vitamin D deficiency may be associated with poor outcomes in patients with luminal-type breast cancer.
11-03-2011, 08:51 AM
I wouldn't disagree that sunlight is the "most natural" way to get vitamin D, however for many reasons people can become deficient (those who do not spend much time outside or live in high latitude climates, or have other conditions which may deplete vit D). So in some cases, people may benefit from supplementation - of course with the concurrence of their doctor.
75% of a group of early cancer sufferers were either vit d insufficient or plain deficient !, which is scary given the importance of vitamin D, and its wider involvement in cellular function than is generally realised
J Clin Oncol. 2009 Aug 10;27(23):3757-63. Epub 2009 May 18.
Prognostic effects of 25-hydroxyvitamin D levels in early breast cancer.
Goodwin PJ, Ennis M, Pritchard KI, Koo J, Hood N.
Mount Sinai Hospital, 1284-600 University Ave, Toronto, Ontario M5G 1X4, Canada. firstname.lastname@example.org
Vitamin D has been linked to breast cancer risk, but prognostic effects are unknown. Such effects are biologically plausible given the presence of vitamin D receptors in breast cancer cells, which act as nuclear transcription factors to regulate gene activity.
PATIENTS AND METHODS:
The study was conducted in a prospective inception cohort of 512 women with early breast cancer diagnosed 1989 to 1996. Vitamin D levels were measured in stored blood. Clinical, pathologic, and dietary data were accessed to examine prognostic effects of vitamin D.
Mean age was 50.4 years, mean vitamin D was 58.1 +/- 23.4 nmol/L. Vitamin D levels were deficient (< 50 nmol/L) in 37.5% of patients, insufficient (50 to 72 nmol/L) in 38.5% of patients, and sufficient (> 72 nmol/L) in 24.0% of patients. There was little variation in mean vitamin D levels between summer and winter months. Mean follow-up was 11.6 years; 116 women had distant recurrences, and 106 women died. Women with deficient vitamin D levels had an increased risk of distant recurrence (hazard ratio [HR] = 1.94; 95% CI, 1.16 to 3.25) and death (HR = 1.73; 95% CI, 1.05 to 2.86) compared with those with sufficient levels. The association remained after individual adjustment for key tumor and treatment related factors but was attenuated in multivariate analyses (HR = 1.71; 95% CI, 1.02 to 2.86 for distant recurrence; HR = 1.60; 95% CI, 0.96 to 2.64 for death).
An interview with Dr Michael Holick a leading light and source of important original research into vitamin D. which includes discussion on breast cancer
I have mixed views about the paleo diet as often portrayed, and some of the opinions expressed in interviews on this site, but Holick is a leading researcher into vitamin D.
You can also find a truly excellent video lecture at UCLA by him here as mentioned below which I would recommend you watch before listening to the interview.
01-15-2012, 01:35 PM
Thank you so much, RB, for never forgetting us, and keeping us aware of the basis for some of the things we can do that are not difficult to help ourselves.
^ Thanks for your kind words - you are very welcome AA.
I have just found this a passionate understandable very punchy lecture to doctors by Dr Holick.
(-: A MUST WATCH (-:
Pass it on please (-:
03-28-2012, 05:08 AM
It is a better post and it is fantastic thing to look at and thanks for sharing.
03-28-2012, 08:04 AM
That UCTV link by Dr. Holick is wonderful. Thank you.
If you found the Holick lecture above interesting you may also like this paper. It is a bit technical but if you ignore the bits that are complex you will get the gist that greater sun exposure may = lower risk of a range of cancers, that most if not all tissues use and can make the active form of vitamin D from the vitamin D precursor made by the action of sunlight in the skin, and that it appears that Vit D helps regulate cell division.
Vitamin D: Its role in cancer prevention and treatment
Michael F. Holick
Prog Biophys Mol Biol. 2006 Sep;92(1):49-59. Epub 2006 Mar 10.
Vitamin D: its role in cancer prevention and treatment.
Boston University Medical Center, 715 Albany Street, M-1013, Boston, MA 02118, USA. email@example.com
Vitamin D, the sunshine vitamin, has been recognized for almost 100 years as being essential for bone health. Vitamin D provides an adequate amount of calcium and phosphorus for the normal development and mineralization of a healthy skeleton. Vitamin D made in the skin or ingested in the diet, however, is biologically inactive and requires obligate hydroxylations first in the liver to 25-hydroxyvitamin D, and then in the kidney to 1,25-dihydroxyvitamin D. 25-Hydroxyvitamin D is the major circulating form of vitamin D that is the best indicator of vitamin D status. 1,25-dihydroxyvitamin D is the biologically active form of vitamin D. This lipid-soluble hormone interacts with its specific nuclear receptor in the intestine and bone to regulate calcium metabolism. It is now recognized that the vitamin D receptor is also present in most tissues and cells in the body. 1,25-dihydroxyvitamin D, by interacting with its receptor in non-calcemic tissues, is able to elicit a wide variety of biologic responses. 1,25-dihydroxyvitamin D regulates cellular growth and influences the modulation of the immune system. There is compelling epidemiologic observations that suggest that living at higher latitudes is associated with increased risk of many common deadly cancers. Both prospective and retrospective studies help support the concept that it is vitamin D deficiency that is the driving force for increased risk of common cancers in people living at higher latitudes. Most tissues and cells not only have a vitamin D receptor, but also have the ability to make 1,25-dihydroxyvitamin D. It has been suggested that increasing vitamin D intake or sun exposure increases circulating concentrations of 25-hydroxyvitamin D, which in turn, is metabolized to 1,25-dihydroxyvitamin D(3) in prostate, colon, breast, etc. The local cellular production of 1,25-dihydroxyvitamin D acts in an autocrine fashion to regulate cell growth and decrease the risk of the cells becoming malignant. Therefore, measurement of 25-hydroxyvitamin D is important not only to monitor vitamin D status for bone health, but also for cancer prevention.
Is prevention of cancer by sun exposure more than just the effect of vitamin D? A systematic review of epidemiological studies.
van der Rhee H, Coebergh JW, de Vries E.
Department of Dermatology, Hagaziekenhuis, P.O. Box 40551, Leyweg 275, 2504 LN Den Haag, Zuid-Holland, The Netherlands. Electronic address: firstname.lastname@example.org.
The number of studies reporting on the association between sunlight exposure, vitamin D and cancer risk is steadily increasing. We reviewed all published case-control and cohort studies concerning colorectal-, prostate-, breast cancer, non-Hodgkin's lymphoma (NHL) and both sunlight and vitamin D to update our previous review and to verify if the epidemiological evidence is in line with the hypothesis that the possible preventive effect of sunlight on cancer might be mediated not only by vitamin D but also by other pathways. We found that almost all epidemiological studies suggest that chronic (not intermittent) sun exposure is associated with a reduced risk of colorectal-, breast-, prostate cancer and NHL. In colorectal- and to a lesser degree in breast cancer vitamin D levels were found to be inversely associated with cancer risk. In prostate cancer and NHL, however, no associations were found. These findings are discussed and it is concluded that the evidence that sunlight is a protective factor for colorectal-, prostate-, breast cancer and non-Hodgkin's lymphoma is still accumulating. The same conclusion can be drawn concerning high vitamin D levels and the risk of colorectal cancer and possibly breast cancer. Particularly in prostate cancer and NHL other sunlight potentiated and vitamin D independent pathways, such as modulation of the immune system and the circadian rhythm, and the degradation of folic acid might play a role in reduced cancer risk as well.
02-06-2013, 07:22 AM
Vitamin D and the mammary gland: a review on its role in normal development and breast cancer
Thanks Hopeful - great article (=:
Here is a study suggesting vitamin D may have a particular relevance in ER (estrogen receptor) based cancers.
Alterations in Vitamin D signalling and metabolic pathways in breast cancer progression: a study of VDR, CYP27B1 and CYP24A1 expression in benign and malignant breast lesions Vitamin D pathways unbalanced in breast lesions
Nair Lopes1, Bárbara Sousa1, Diana Martins1, Madalena Gomes1, Daniella Vieira2, Luiz A Veronese3, Fernanda Milanezi1, Joana Paredes1, José L Costa1 and Fernando Schmitt1,4*
From this study, we conclude that there is a deregulation of the Vitamin D signalling and metabolic pathways in breast cancer, favouring tumour progression. Thus, during mammary malignant transformation, tumour cells lose their ability to synthesize the active form of Vitamin D and respond to VDR-mediated Vitamin D effects, while increasing their ability to degrade this hormone.
Paragraph re ER cancers
Vitamin D receptor (VDR)
"An interesting finding is the correlation between the expression of the VDR and the ER in both in situ and invasive carcinomas. In fact, the VDR is expressed in most ER-positive cases (54.7% in in situ carcinomas and 65.5% in invasive tumours). It is thought that one of the VDR functions is to counteract oestrogen-mediated proliferation and maintain differentiation . Indeed, data support the concept that the anti-tumour effects of Vitamin D and its analogues on ER-positive human breast cancer cells are mediated through the down regulation of the ER itself and the attenuation of oestrogen responses, such as breast cancer cell growth [29,30]. Thus, being the VDR mostly expressed in ER-positive carcinomas, Vitamin D or its analogues may become an alternative therapy for these tumours in cases of resistance to ER-targeted therapy. "
A trial looking at a vitamin D analogue and HER2 cancers and showing positive outcomes.
Above it appears that vitamin D is relevant to estrogen positive cancers, and below an analogue shows promise in a estrogen negative HER2 positive cancer . . .
Sadly they do not report / nobody appears to have looked at natural Vitamin D and HER2, probably as usual because there is no money to be made, and if they did find it works effectively it would reduce any interest in analogues . . .
Situation 'Human condition' normal . . . )-:
Gemini Vitamin D Analog Suppresses ErbB2-Positive Mammary Tumor Growth via Inhibition of ErbB2/AKT/ERK Signaling
Hong Jin Lee,1 Jae-Young So,1 Andrew DeCastro,1 Amanda Smolarek,1 Shiby Paul,1 Hubert Maehr,1 Milan Uskokovic,1 and Nanjoo Suh1,2
Numerous synthetic vitamin D analogs have been studied for their effects on the prevention and treatment of breast cancer. However, the inhibitory effects of naturally occurring 1α,25-dihydroxyvitamin D3 or its synthetic analogs on ErbB2 overexpressing mammary tumorigenesis have not been reported. Gemini vitamin D analogs are novel synthetic vitamin D derivatives with a unique structure of two six-carbon chains at C-20. We have previously shown that Gemini vitamin D analogs significantly inhibited carcinogen-induced estrogen receptor (ER)-positive mammary tumorigenesis and reduced ER-negative MCF10DCIS.com xenograft tumor growth without hypercalcemic toxicity. In the present study, we have determined the inhibitory effect of a potent Gemini vitamin D analog BXL0124 (1α,25-dihydroxy-20R-21(3-hydroxy-3-deuteromethyl-4,4,4-trideuterobutyl)-23-yne-26,27-hexafluoro-cholecalciferol) on the ErbB2/Her-2/neu overexpressing mammary tumorigenesis. The Gemini BXL0124 inhibits ErbB2-positive mammary tumor growth and down-regulates the phosphorylation of ErbB2, ERK and AKT in tumors of MMTV-ErbB2/neu transgenic mice. These effects of Gemini BXL0124 in vivo were confirmed by using the ErbB2 overexpressing tumor cells derived from the mammary tumors of MMTV-ErbB2/neu mice. In conclusion, the Gemini vitamin D analog BXL0124 inhibits the growth of ErbB2 overexpressing mammary tumors through regulating the ErbB2/AKT/ERK signaling pathways, suggesting that Gemini vitamin D analog may be considered for translational studies.
And from the body of the text
"In conclusion, the Gemini vitamin D analog BXL0124 inhibits ER-negative/ErbB2 positive mammary tumorigenesis without hypercalcemic toxicity via regulating ErbB2/ErbB3-driven downstream signaling, ERK, AKT and cell cycle regulator, cyclin D1. Taken together with our previous study , Gemini vitamin D analogs, especially BXL0124, may be potent agents in the prevention of different types of human breast cancer without toxicity, and should be considered for translational studies."
07-15-2013, 04:35 PM
Thank you so much for all the posts here on vitamin D. It looks like all of the studies have shown that a low vitamin D level is associated with poorer outcomes for cancer patient. Is it possible that the vitamin D levels are low because these patients have more aggressive cancers which "use up" the vitamin D. In other words, is the low vitamin D a result of the worse cancer or does it increase the risk of more cancer? I guess the only way to know for sure would be to do a randomnized study of cancer patients where half the patients received vitamin D and the other half a placebo. Is anyone aware of a study like that?
07-15-2013, 04:45 PM
I just found a randomnized study showing that taking vitamin D lowers the risk of cancers (although the number of cancers in the study was relatively low).
Does cancer increase the metabolism of vitamin D - good question ! I have no idea; but from observations in this paper indeed it might, or at least significantly so when cancer has spread to regional areas, which raises interesting questions.
It appears much is still not known, and sufficient research has still not been done, presumably in part because there is limited funding for research into treatments that cannot be patented.
(I have only just found this paper as a result of your question, and only skimmed it - I will read it more fully at a later point)
says in the introduction
"Numerous observational studies have reported an inverse association between vitamin D status, including circulating 25-hydroxyvitamin D (25(OH)D) levels, and breast cancer risk. "
"In spite of the substantial literature on the topic of vitamin D and breast cancer risk and survival, future studies need to focus on gaining a better understanding of the biologic effects of vitamin D in breast tissue. If the antitumor effects of vitamin D are confirmed in human studies, then a more accurate dosage of vitamin D for both prophylactic and therapeutic purposes needs to be established. Based upon the current literature, the Institute of Medicine (IOM) concluded that for cancer and vitamin D, the evidence was “inconsistent and insufficient to inform nutritional requirements” . Therefore, the benefits of routine monitoring of serum 25(OH)D and vitamin D supplementation for breast cancer prevention or to reduce recurrence among breast cancer survivors are uncertain. Given the high prevalence of vitamin D deficiency among high-risk women and breast cancer survivors [84, 170, 239] and the relatively low toxicity and low cost of supplementation, vitamin D is a potentially modifiable risk factor to target as a strategy for breast cancer prevention and treatment."
There does seem to be quite a lot of interest in the topic which is hopeful viz an ACS article which contains some useful information.
I also have just found this research based video, which is authoritative understandable and fascinating
In the MUST WATCH category (-:
And another must watch Vitamin D lecture on breast cancer from Grass Roots Health
Another must watch video, particularly for those with at interest in ER positive breast cancer.
Vitamin D may have estrogen inhibition qualities through a number of mechanisms
08-08-2013, 01:21 PM
how much should we be taking? im on 2000iud daily
how often should our levels be tested?
HI all (-:
There is more information here http://her2support.org/vbulletin/showthread.php?t=58793
(I started this new / follow-on vitamin D thread on the main board in the hope it may get a wider audience, and over time a greater number of visitors)
roz123 hopefully the additional information of the thread above may help :)
The recent press comment on vitamin D made my heart sink. The summary is much more measured, and certainly the paper does not warrant the press headlines; maybe the author made statements . . . - I do not know.
The paper reports that many studies associate higher vitamin D with lower occurrence of many diseases.
They failed to manage to link fairly modest supplementation to change in disease profile, which is not altogether surprising for a variety of reasons, including that maybe the levels of supplementation tried were insufficient.
It is very clear that increasing numbers of people are vitamin D deficient; maybe increasing numbers have poor digestion too, but none of this alters the facts that there are only two way to get high level of vitamin D sunshine or supplementation, (even fish at every meal will not provide the sort of vitamin D levels achieved with modest sun exposure, without sunscreen when UVB can penetrate the atmosphere etc etc) and logically if you are not absorbing it or using more because the body is under stress, then surely the answer is more vitamin D, not less ?????? which brings us back to a choice between sunshine or supplementation - there is no other way - and for most the luxury of stripping off a good proportion of our clothes for a little siesta in the sun at midday is not in reality an option, even if the sun obliges and the skies are not too smogy . . . the reality is supplementation may not be optimal but other than sun it is the only "game in town".
Unfortunately I have not seen the full paper as yet as it is expensive to look at them on a regular basis.
5o micrograms=1000 iu is not going to have a huge effect on vitamin d levels as the table on the Grass Roots site shows. http://grassrootshealth.net/ (20 nanograms =50nmol/l), and according to the papers they drew together health benefits are not seen until blood levels get into the 40ng/l +
An alternate conclusion might have been are there other reasons why people who are supplementing are unexpectedly low in vitamin D if that is what is being implied; do people have poor digestion and so are not absorbing properly / and or were participants taking the supplements regularly (according to Dr Holick by their own admission in one trial no) / and or are higher doses are needed to see significant effect / or is this in any was a reflection in part that the growing number who are obese have a higher vitamin D requirement / or that sun exposure sunscreen blocker use is rising / or dairy intake and or other foods that contain vitamin D is falling / and as mentioned in the paper might those who have illness sub-clinical or full blown illnesses may use more vitamin D . . .
There really does need to be a more measured way of communicating scientific reports to the public - no wonder people are confused - more importantly inaccurate communication will have subtle but important health consequences for a large number of people
Vitamin D status and ill health: a systematic review
Prof Philippe Autier MD a b Corresponding AuthorEmail Address, Prof Mathieu Boniol PhD a b, Cécile Pizot MSc a, Prof Patrick Mullie PhD a c
Low serum concentrations of 25-hydroxyvitamin D (25[OH]D) have been associated with many non-skeletal disorders. However, whether low 25(OH)D is the cause or result of ill health is not known. We did a systematic search of prospective and intervention studies that assessed the effect of 25(OH)D concentrations on non-skeletal health outcomes in individuals aged 18 years or older. We identified 290 prospective cohort studies (279 on disease occurrence or mortality, and 11 on cancer characteristics or survival), and 172 randomised trials of major health outcomes and of physiological parameters related to disease risk or inflammatory status. Investigators of most prospective studies reported moderate to strong inverse associations between 25(OH)D concentrations and cardiovascular diseases, serum lipid concentrations, inflammation, glucose metabolism disorders, weight gain, infectious diseases, multiple sclerosis, mood disorders, declining cognitive function, impaired physical functioning, and all-cause mortality. High 25(OH)D concentrations were not associated with a lower risk of cancer, except colorectal cancer. Results from intervention studies did not show an effect of vitamin D supplementation on disease occurrence, including colorectal cancer. In 34 intervention studies including 2805 individuals with mean 25(OH)D concentration lower than 50 nmol/L at baseline supplementation with 50 μg per day or more did not show better results. Supplementation in elderly people (mainly women) with 20 μg vitamin D per day seemed to slightly reduce all-cause mortality. The discrepancy between observational and intervention studies suggests that low 25(OH)D is a marker of ill health. Inflammatory processes involved in disease occurrence and clinical course would reduce 25(OH)D, which would explain why low vitamin D status is reported in a wide range of disorders. In elderly people, restoration of vitamin D deficits due to ageing and lifestyle changes induced by ill health could explain why low-dose supplementation leads to slight gains in survival.
It appears vitamin D helps muscle function too . . .
Vitamin D deficiency puts elite ballet dancers at risk of injury
Researchers say vitamin supplements can help ward off injuries caused by long hours inside with little exposure to sunlight
Vitamin D deficiency caused by their intensive indoor training regime is putting elite ballet dancers at increased risk of injury, a study has found.
Researchers at the Royal National Orthopaedic hospital (RNOH), University of Wolverhampton and the Jerwood Centre at Birmingham Royal Ballet have urged trainers and medical professionals to consider providing dancers with vitamin D supplements during the winter after results showed it had a significant influence on improving muscle function and reducing injury occurrence.
Dr Roger Wolman, consultant in rheumatology and sport and exercise medicine at the RNOH, said: "We know vitamin D [deficiency] can affect the bones. What's become clear … is vitamin D is also important for muscles.
. . .
The research, published on Friday in the Journal of Science and Medicine in Sport, involved 24 dancers at the Birmingham Royal Ballet who dance between six and eight hours a day and a total of 38 hours a week, meaning they get little exposure to sunlight, the main natural source of vitamin D.
Before any were given supplements, all were found to be vitamin D deficient or insufficient (not as severe but still low) during winter and only 15% achieved normal levels during the summer. Subsequently, 17 of the dancers were given oral vitamin D3 and seven were not. Significant increases in muscle strength and vertical jump performance were found among the group taking vitamin D. They also suffered fewer injuries, with 12 reporting no injuries and five a single injury, compared to those not given the supplements, only one of whom suffered no injuries with five reporting one injury and one dancer reporting two.
Although the group assessed was relatively small, Wolman said the results were "still convincing. With years of experience of working with dancers in England, we do see a high number of them come to the clinic with low vitamin D levels". He said the findings could be extrapolated to cover other sports that take place indoors, although many involve at least some outdoor training.
02-09-2014, 09:06 AM
I think COD liver oil is best for Vitamin D...
^ Most modern cod liver oil has the vitamin D taken out as part of the refining process and only a small amount put back in viz 400iu per teaspoon as against sometimes the several thousand units present in unrefined oils.
Things are rarely straight forward!
More on this later (-:
From an excellent vitamin D site and resource
More from Vitamin D wiki :)
^ and this belongs with the post and graph above.
It is hugely significant; it is the only measure I have seen so far of vitamin D levels of groups living as they have for thousands of years, and in dark skinned people who have the equivalent of a factor 15 or more sunscreen built into their skins.
Notwithstanding the very powerful natural sun screen their vitamin D level average 115nmol/l, (and from memory the levels in pregnant women were higher 149nmol/l - there must be another part to this paper, not referenced here).
This dispels the often cited view that people with dark skins do not need as much vitamin D, (and would have significant implications for levels in pregnancy - I will try and find the reference).
Br J Nutr. 2012 Nov 14;108(9):1557-61. doi: 10.1017/S0007114511007161. Epub 2012 Jan 23.
Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l.
Luxwolda MF1, Kuipers RS, Kema IP, Dijck-Brouwer DA, Muskiet FA.
Cutaneous synthesis of vitamin D by exposure to UVB is the principal source of vitamin D in the human body. Our current clothing habits and reduced time spent outdoors put us at risk of many insufficiency-related diseases that are associated with calcaemic and non-calcaemic functions of vitamin D. Populations with traditional lifestyles having lifelong, year-round exposure to tropical sunlight might provide us with information on optimal vitamin D status from an evolutionary perspective. We measured the sum of serum 25-hydroxyvitamin D₂ and D₃ (25(OH)D) concentrations of thirty-five pastoral Maasai (34 (SD 10) years, 43 % male) and twenty-five Hadzabe hunter-gatherers (35 (SD 12) years, 84 % male) living in Tanzania. They have skin type VI, have a moderate degree of clothing, spend the major part of the day outdoors, but avoid direct exposure to sunlight when possible. Their 25(OH)D concentrations were measured by liquid chromatography-MS/MS. The mean serum 25(OH)D concentrations of Maasai and Hadzabe were 119 (range 58-167) and 109 (range 71-171) nmol/l, respectively. These concentrations were not related to age, sex or BMI. People with traditional lifestyles, living in the cradle of mankind, have a mean circulating 25(OH)D concentration of 115 nmol/l. Whether this concentration is optimal under the conditions of the current Western lifestyle is uncertain, and should as a possible target be investigated with concomitant appreciation of other important factors in Ca homeostasis that we have changed since the agricultural revolution.
"85 percent less risk of death from Breast Cancer when vitamin D levels higher than 30 ng – May 2012" (In post menopausal women)
http://www.vitamindwiki.com/85+percent+less+risk+of+death+from+Breast+Cancer+w hen+vitamin+D+levels+higher+than+30+ng+%E2%80%93+M ay+2012
Vitamin D status at breast cancer diagnosis: correlation with tumor characteristics, disease outcome and genetic determinants of vitamin D insufficiency
Carcinogenesis (2012), doi: 10.1093/carcin/bgs187; Received November 29, 2011; First published online: May 23, 2012
Sigrid Hatse*,1, Diether Lambrechts2, Annemieke Verstuyf3, Ann Smeets4, Barbara Brouwers1, Thijs Vandorpe4, Olivier Brouckaert4, Gilian Peuteman2, Annouschka Laenen5, Lieve Verlinden3, Carsten Kriebitzsch3, Anne-Sophie Dieudonné4, Robert Paridaens4, Patrick Neven4, Marie-Rose Christiaens4, Roger Bouillon3 and Hans Wildiers1
1 Catholic University Leuven and University Hospitals, Laboratory of Experimental Oncology and Department of General Medical Oncology, Leuven, Belgium
2 Catholic University of Leuven, Vesalius Research Center, Leuven, Belgium
3 Catholic University of Leuven, Laboratory of Experimental Medicine and Endocrinology, Leuven, Belgium
4 University Hospitals Leuven, Multidisciplinary Breast Center, Leuven, Belgium
5 Catholic University of Leuven, Interuniversity Centre for Biostatistics and Statistical Bioinformatics, Leuven, Belgium
*Corresponding author Sigrid Hatse Contact email: email@example.com Catholic University Leuven and University Hospitals, Laboratory of Experimental Oncology and Department of General Medical Oncology, Leuven, Belgium
Introduction: We correlated serum 25-hydroxyvitamin D3 (25OHD) levels with tumor characteristics and clinical disease outcome in breast cancer patients and assessed the impact of genetic determinants of vitamin D insufficiency.
Methods: We collected serum from 1800 early breast cancer patients at diagnosis, measured 25OHD by radioimmunoassay and determined genetic variants in vitamin D-related genes by Sequenom. Multivariable regression models were used to correlate 25OHD levels with tumor characteristics. Cox proportional hazard models were used to assess overall survival (OS), disease-specific survival (DSS) and disease-free interval (DFI).
Results: Lower 25OHD serum levels significantly correlated with larger tumor size at diagnosis (p=0.0063) but not with lymph node invasion, receptor status, or tumor grade. Genetic variants in 25-hydroxylase (CYP2R1) and vitamin D-binding protein significantly determined serum 25OHD levels but did not affect the observed association between serum 25OHD and tumor size.
High serum 25OHD (>30 ng/mL) at diagnosis significantly correlated with improved OS (p=0.0101) and DSS (p=0.0192) and additionally had a modest effect on DFI, which only became apparent after at least 3 years of follow-up.
When considering menopausal status, serum 25OHD had a strong impact on breast cancer-specific outcome in postmenopausal patients (hazards ratios for 25OHD >30 ng/mL versus ?30 ng/mL were 0.15 [p=0.0097] and 0.43 [p=0.0172] for DSS and DFI, respectively), whereas no association could be demonstrated in premenopausal patients.
Conclusion: High vitamin D levels at early breast cancer diagnosis correlate with lower tumor size and better OS, and improve breast cancer-specific outcome, especially in postmenopausal patients.
More breast vitamin D and breast cancer related trials on Vitamin D wiki
A vitamin D centric video looking at vitamin D intake and breast cancer.
There are clearly lots of other potential factors and mechanisms that are not examined here, such as low iodine and omega 3:6 imbalances, genetic differences etc. but it contains some interesting material, and I cannot disagree with the conclusion :).
A great :) highly informative chapter on the photo biology of vitamin D by Holick in this book, most of which can be viewed.
It includes the pathways by which vitamin D itself can act as an antioxidant in the skin.
The book itself is in the medical text book price league, and too new for second hand copies
08-24-2014, 02:42 AM
Roz, my doctor has me on 5,000 iu daily.
If anybody is in the UK and interested I am speaking at a Royal Society of Medicine food section conference on hidden nutritional deficiencies in my new role as recently appointed Chair of the McCarrison Society, which is a venerable society with its own widely recognized Journal 'Nutrition and Health'.
The Society has a long illustrious history, but is in need of a bit of revamping including a new web site.
I will be looking in whistle-stop fashion at deficiencies in nutrients particularly Iodine, Vitamin D, minerals, and imbalances in Omega 3 and 6 set within the context of the shoreline diet which arguably provided the conditions for out existence.
I am hoping to make the McCarrison Society a forum to bring together the Food Agricultural and Health sectors to the same table, which they never are, to try and bring focus on deficiencies such as Vitamin D, Iodine and secure the implementation of strategies to address them.
This is the link to the conference.
^ Very many thanks to anybody who attended. I understand the RSM copies of presentations to attendees, and I have given them permission to give out my slides. I hope at some point to do a longer presentation with a couple of additional slides that I hope to get put up on the web.
Why researchers keep using small amounts of vitamin D viz 400iu in expensive trials with the expectation of a significant change in outcome (except in groups that are seriously deficient) is somewhat of a puzzle to me.
What I then find most sad is a doctor saying to me (which happened yesterday) for example that they had seen a paper that looked at vitamin d in pregnancy and no effect was seen; I understand the amount trialled was 400iu,which is not in the scale of things going to produce a very significant change in vitamin D levels.
The conversation was fortuitous in so far as it fired me up and I found the papers below which contain very useful data which should be more widely available
This may be of interest to those thinking about supplementing with Vitamin D and wanting information to share with their doctors. Breast cancer is specifically referred to in the discussion part of which I copy below. I also copy some data in healthy populations as to intake and outcome.
The paper is free and in full at the link below:
Impact of oral vitamin D supplementation on serum 25-hydroxyvitamin D levels in oncology
Pankaj G Vashi, Kristen Trukova, Carolyn A Lammersfeld, Donald P Braun and Digant Gupta*
Serum 25-hydroxyvitamin D [25(OH)D] is the major circulating form of vitamin D and a standard indicator of vitamin D status. Emerging evidence in the literature suggests a high prevalence of suboptimal vitamin D (as defined by serum 25(OH)D levels of <32 ng/ml) as well as an association between lower serum levels and higher mortality in cancer. We investigated the effect of oral vitamin D supplementation as a means for restoring suboptimal levels to optimal levels in cancer. "
"In order to put our study in context, we review here 3 studies in breast cancer that have evaluated the impact of vitamin D supplementation on serum 25(OH)D levels. Crew et al. examined the effects of standard-dose vitamin D supplementation on serum 25(OH)D levels in breast cancer patients. They observed that cholecalciferol 400 IU daily for 1 year raised serum 25(OH)D levels only modestly, by less than 3 ng/mL in only a small percentage of premenopausal women (< 15%). Although the RDA of vitamin D in premenopausal women is only 200 IU daily, their study suggested that a dose of 400 IU daily was inadequate in breast cancer patients, even to maintain skeletal health, and was probably too low for meaningful anticancer effects . "
"When comparing it with the vitamin D dose response in healthy individuals, the literature yielded the following results. Talwar et al. showed that supplementation with 800 IU/d vitamin D3 in postmenopausal African American women raised the mean serum 25(OH)D concentration from a baseline of 18.7+/-8.2 ng/mL to 28.5+/-8.6 ng/mL at a 3 month interval . In another study, Barger-Lux et al. showed that in a relatively replete group of white subjects, 1000 IU vitamin D3/d resulted in an increase of 5.2 ng/mL from a mean of 26.8 to 32 ng/mL . Likewise Heaney et al reported a dose response of 0.28 ng/mL per 1 μg/40IU oral vitamin D3 supplemented . Furthermore, Aloia et al. undertook a dose-finding study in African American and white men and women with the objective of investigating an algorithm for raising 25(OH)D concentrations to between 32 and 56 ng/mL. They suggested a dose of 3800 IU for those above a 25(OH)D threshold of 22 ng/mL and a dose of 5000 IU for those below that threshold . "
To convert nmol/l to ng/ml - divide by 2.5 (approx)
or 2.5nmol/l = 1ng/ml
Here is a link where they do it for you.
This is a highly thought provoking and unusually data rich and so exceptional paper looking at the issue of vitamin D.
The second link; a table looking at vitamin D falls in submariners is highly thought provoking, as are all of the tables.
A definite recommend for a quick scan or more if you have the time for the data it presents.
Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety1,2
Many arguments favoring higher intakes of calcium and other nutrients have been based on evidence about the diets of prehistoric humans (1). Likewise, the circulating 25-hydroxyvitamin D [25(OH)D; calcidiol] concentrations of early humans were surely far higher than what is now regarded as normal. Humans evolved as naked apes in tropical Africa. The full body surface of our ancestors was exposed to the sun almost daily. In contrast, we modern humans usually cover all except about 5% of our skin surface and it is rare for us to spend time in unshielded sunlight. Our evolution has effectively designed us to live in the presence of far more vitamin D (calciferol) than what most of us get now, yet there is no consensus about what vitamin D intakes are optimal or safe.
See corresponding editorial on page 825.
Unlike anything else used in the fortification of foods, the purpose of vitamin D is to correct for what is an environmental deficit (less ultraviolet exposure) and not to correct for lack due to classical nutritional reasons. With a few exceptions reviewed by Takeuchi et al (2), there is little or no vitamin D in the kind of foods that humans normally eat. Therefore, conclusions about the efficacy and safety of vitamin D must be in the context of the role of environmental factors.
Before 1997, the recommended dietary allowance of vitamin D (RDA; 3) for infants and children was 10 μg (400 IU). In essence, the scientific basis for this dose was that it approximated what was in a teaspoon (5 mL) of cod-liver oil and had long been considered safe and effective in preventing rickets (4). The basis for adult vitamin D recommendations has been even more arbitrary. Thirty-six years ago, an expert committee on vitamin D could provide only anecdotal support for what it referred to as “the hypothesis of a small requirement” for vitamin D in adults and it recommended one-half the infant dose, just to ensure that adults obtain some from the diet (5). In England, an adult requirement of only 2.5 μg (100 IU)/d was substantiated on the basis of 7 adult women with severe nutritional osteomalacia whose bones showed a response when given this amount (6). The adult RDA of 5 μg (200 IU)/d was described as a “generous allowance” in the 1989 version of American recommended intakes (3)—but why was this “generous” and in relation to what? It is remarkable that despite the widespread intake of 5 μg (200 IU) vitamin D/d, there is still no published data showing that this dose has any effect on the serum 25(OH)D concentration in adults.
Decline in 25-hydroxyvitamin D [25(OH)D] concentrations under acutely sun-deprived living conditions
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