A must watch - Risk Breast cancer and vitamin D 50-80% risk reduction

[R.B.]

If short on time start at 8.30

http://www.uctv.tv/search-details.aspx?showID=15767

Then please watch this.

http://her2support.org/vbulletin/showthread.php?t=40694

And then bear in mind long chain Omega 3 have been linked with a 70% reduction in risk of lumps being invasive.

http://her2support.org/vbulletin/sho...ght=greek+diet


And "Vitamin D deficiency and insufficiency may contribute to musculoskeletal symptoms and bone loss observed in women taking aromatase inhibitors (AIs)."

http://vitamind3.blogspot.com/

[sarah]

great post. so how much vitamin D should someone take and what happens if you take too much?
thanks#
sarah

[R.B.]

so how much vitamin D should someone take and what happens if you take too much?

That is the big question that is debated by the medical profession.

It in part depends on how much midday sun you get where you live skin colour etc. You cannot overdose from sunshine. But sun bathing in a polluted environment northern latitude etc maybe a bit of a waste in vitamin D terms. But how much you need in part depends on how much you are getting from the sun.

400 iu some say, but given the amount a Caucasian can make in 20 mins of full body exposure 20-50,000 units that does not seem very much.

http://www.uctv.tv/search-details.aspx?showID=15771

If you listen to this from 38 mins it may help - this is about diabetes. They give recommendations at the end as to intakes.

Linus Pauling also recommend 2000 IU http://lpi.oregonstate.edu/infocente...mins/vitaminD/


At what level the negative effects start is not clear

http://www.solarien-verbaende.de/pdf/studien_2.pdf

Side effects are listed here but they cite a 1000iu upper limit, which is at odds with the above.

And then you have the discussions about the need to balance A and D.

http://enzyme-health.blogspot.com/20...-counters.html

But the question I have is what happens in nature where you are getting lots of vit D from sun, how would you be increasing your vit A intake.




Ultimately the best thing is to get tested and adjust your intake to achieve your desired level.

Please discuss dietary change with your doctor. I can only inform debate and cannot give advice.

[sarah]

thanks RB, I'll check out the links. you always have informative posts.
sarah

[Ted_Hutchinson]

To understand how much vitamin d someone needs to take you first have to know if they have a cancer diagnosis or are simply trying to reduce the risk of getting cancer. It is one thing to reduce risk is requires more to fight it successfully.

In the paper I discuss here
Effect of vitamin D supplementation on serum 25-hydroxy vitamin
D levels, joint pain, and fatigue in women starting adjuvant
letrozole treatment for breast cancer
They used 50,000 IU per week for 12 weeks and achieved a level between 60~70ng/mL. Which is in the region suggest byDr Cannell of the Vitamin D Council That's approximately 7000iu/daily/D3

For preventing BC a slightly lower level may be fine.
The chart here Showing Chronic Disease incidence prevention by 25(OH)D Level indicates the maximum risk reduction for cancer occurs around the 50~55ng level. and that equates with a daily D3 intake around 5000~6000iu/d.

As far as safety goes Vitamin D adverse events have only been recorded at intakes considerably above those levels. 40,000iu/daily would be needed to push 25(OH)D above `150ng/mL 375 nmol/l It would take some months to achieve that. In trials for MS using megadose amounts even these levels were exceeded without adverse events being recorded however as far as readers here are concerned. Evidence from clinical trials shows, with a wide margin of confidence, that a prolonged intake of 10,000 IU/d of vitamin D(3) poses no risk of adverse effects for adults, even if this is added to a rather high physiologic background level of vitamin D.

Ideally people will get their 25(OH)D tested so they will know how well they are responding to effective strength supplements. As the first trial I linked to shows it generally takes around 12 weeks to attain and reasonable vitamin d level when taking 50.000iu/week or 7000iu/daily.
This trial provides the cheapest 25(OH)d postal testing for vitamin d that I am aware of.

If anyone knows a cheaper source then do let me know.

It's part of a trial trying to be more precise about what actually is optimum vitamin d status as far as disease prevention is concerned. But the survey they are doing is very simple to complete and as you save about half the cost of the test it's time well spent.

[R.B.]

Thank you very much Ted for those excellent links and particularly the July !!!! 2009 paper from Mount Sinai.http://www.mshri.on.ca/ on intakes.


That was very well spotted 10/10.

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum

I have seen that sentiment expressed on a number of occasions but not in such direct terms or by such a well regarded institution.

I have copied it so people can see it for themselves and ask their medical advisers what they think.

Ann Epidemiol. 2009 Jul;19(7):441-5. Epub 2009 Apr 11.Click here to read Links
Vitamin D and cancer mini-symposium: the risk of additional vitamin D.
Vieth R.

Department of Nutritional Sciences, University of Toronto, and Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Canada. rvieth@mtsinai.on.ca

Any benefit of vitamin D needs to be balanced against the risk of toxicity, which is characterized by hypercalcemia. Daily brief, suberythemal exposure of a substantial area of the skin to ultraviolet light, climate allowing, provides adults with a safe, physiologic amount of vitamin D, equivalent to an oral intake of about 10,000 IU vitamin D(3) per day, with the plasma 25-hydroxyvitamin D (25(OH)D) concentration potentially reaching 220 nmol/L (88 ng/mL). The incremental consumption of 40 IU/d of vitamin D(3) raises plasma 25(OH)D by about 1 nmol/L (0.4 ng/mL). High doses of vitamin D may cause hypercalcemia once the 25(OH)D concentration is well above the top of the physiologic range. The physiological buffer for vitamin D safety is the capacity of plasma vitamin D-binding protein to bind the total of circulating 25(OH)D, vitamin D, and 1,25-dihydroxyvitamin D [1,25(OH)2D]. Hypercalcemia occurs when the free concentration is inappropriately high because vitamin D and its other metabolites have displaced 1,25(OH)2D from vitamin D-binding protein. Evidence from clinical trials shows, with a wide margin of confidence, that a prolonged intake of 10,000 IU/d of vitamin D(3) poses no risk of adverse effects for adults, even if this is added to a rather high physiologic background level of vitamin D.

[RobinP]

RB, thanks for reminding us about the value of vitamin D!

http://www.asco.org/ASCOv2/Meetings/...stractID=31397

A link about how important vit. D3 is for prevention of cancer and for cancer relapse. I take at least 2000 IU per day, as recommended by Dr. Norton from the Memorial Sloan-Kettering.

[Ted_Hutchinson]

I take about 2000 IU per day, as recommended by Dr. Norton from the Memorial Sloan-Kettering.

For a long time it was thought that 2000iu/daily was the safe upper limit, so doctors were reluctant to suggest amounts higher than the "official" safe upper limit, even though common sense should have informed them that as giving infants in their first year of life 2000iu/daily only resulted in an 80% reduction in Type 1 diabetes over the next 30yrs that if newborn babies can safely take 2000iu/d it is probable that adult sized bodies may safely consume more.

We now know that Vitamin D is a lot safer than previously thought.
In fact here is a report of
a 56-year-old woman who received supratherapeutic doses of ergocalciferol (150,000 IU orally daily) for 28 years without toxicity Given ergocalciferol is the form of vitamin D usually prescribed by health professionals and is (as that example shows) not utilized at all by many individuals, one cannot always rely on the accuracy of information about supplements from health professionals.
Dr Davis of the Heartscanblog discusses The case against vitamin D2 and questions the ethics prescribing the more expensive but least effective form of the vitamin. Dr Davis finds at Wisconsin his heart disease patients generally require 5000iu/daily females and 6000iu/daily males to attain what he considers the safest level for heart disease patients 60~70ng/mL.

Each individual responds differently to oral vitamin D3 supplementation in the same way each person will be respond differently to sun exposure. Some people will find 10~20 minutes full body midday sun exposure is sufficient while others will require 20~30 minutes daily.

The only way you can be sure your body has attained and is maintaining a safe 25(OH)D status is by having a regular 25(OH)D blood test.

However, in the mean time, given the consequences of low vitamin d status are far worse than a slightly higher level than average, and taking into consideration the scientific evidence showing the average adult can safely consume up to 10,000iu/daily while also getting regular sun exposure, the safest option is to use a 5000iu/daily oil-based gel D3 capsule or one recommended from The Vitamin D Council website. It will then be a simple matter to reduce intake by 1000iu/daily for each 10ng/mL you have overshot the 70ng/mL level for people with a cancer diagnosis. or be in a better position to understand how your body requires more perhaps more like 2000iu to raise status by 10ng/mL to reach 55ng/mL ( the minimum safe level for good BC prognosis)
As a basic guide to the latest research in Vitamin D3 this video explains what vitamin D deficiency is.
What's a Vitamin d Deficiency?

there are more similar evidence based videos at Grassrootshealth.net

[R.B.]

Dr T a nephrologist (a link form Ted's site) says

http://nephropal.blogspot.com/search/label/vitamin%20d

Please discuss supplementation and dietary change with your doctor. I simply try to bring you what is being discussed.


Dr T says on his blog site

"Why an optimal level of 50-70 ng/ml? There are more than 30 organs in the body that contain Vitamin D receptors - not just the bone but heart, white blood cells, brain, breast tissue, parathyroid glands, etc. The Disease Incidence Prevention chart (click) by Grassroots Health says it all.

* Breast Cancer: At a level of 32 ng/ml, breast cancer risk is reduced by 30%. At a level of 50 ng/ml, risk decreases by 83%!

* Multiple Sclerosis: A level at 42 ng/ml - risk decreases by 33%. A level at 54 ng/ml, risk decreases by 54%

* Type I Diabetes: At level of 34 ng/ml, there is a 25% decreased risk. A level of 53 ng/ml, gives a 66% reduction.

. . .

If it is true that there is an 83% reduced risk of breast cancer at a level of 50 ng/ml, then at least 83% of women should not be getting breast cancer. Since this information is public, it is insane not to do anything about it.

The current RDA value for daily Vitamin D supplementation requirement is 400 IU. This recommendation is horribly low. Most of my patients in the office require 2000 IU to 6000 IU daily of Vitamin D3. Some are at 8000-10000 IU daily.

To read more about Vitamin D go to Vitamin D Council or Grassroots Health."

[RobinP]

Interesting links, RB, thanks. Just got in from a summer vacation in sunny, hot Baltimore, MD, and probably got a good dose of vitamin D while tanning. Was 110 degree there the last few days!

[tricia keegan]

Thanks for posting this RB and Ted, I'll check out the links.
A friend of mine who is a 22 year survivor of bc was found recently to be depletive of VIT D and started on 50,000 IU perday for six weeks but developed disturbing side effects which she attributed to the vit d. I think as mentioned it's a very personal decision as to where you live and how much sun you get as mentioned.

[Ted_Hutchinson]

A friend of mine who is a 22 year survivor of bc was found recently to be depletive of VIT D and started on 50,000 IU perday for six weeks but developed disturbing side effects which she attributed to the vit d.

Dr Davis The case against Vitamin D2 Ergocalciferol This blog post explains some of the reasons why the usually prescribed 50,000iu form is NOT the best option for most people.
Biotech are the cheapest source of D3 Cholecalciferol 50,000 I have absolutely no financial or other connection with this company. I offer the link as I think it's wrong to claim D2 has problems without providing a link to the cheaper and more effective more reliable alternative.

Vitamin D3 is an ENABLING substance, it is involved in signaling and control mechanisms. I can't begin to explain how complicated some of these control systems are but for those who Want to go into the detail Mark R. Haussler, Ph.D.makes a good attempt here in Session 1: Assessment of Vitamin D Status Monday, December 4, 2006 This is a presentation for a Vitamin d expert conference. You will see from the date that we now are better informed but it was the state of knowledge then. For those wanting an easier introduction than Haussler, Try the talks from Heaney, Hollis, Vieth Bess Dawson Hughes & Edward Giovannucci first.

The point of mentioning this control mechanism here is that one of the main enabiling roles Vit d does is to enable a higher uptake of calcium. ONLY when our 25(OH)D is above 32ng/mL or 80nmol/l can most people be sure they are getting sufficient calcium from diet/supplements.
Calcium is important for muscle, bone, brain function but the actions of calcium need to be balanced by an appropriate amount of magnesium.
For muscle fibres calcium contracts and magnesium relaxes the fibre
For brain neurons calcium excites and magnesium calms.
In the bone calcium is needed for structure but magnesium and vitamin K2 are involved in ensuring the calcium goes and stays where it is required.

So what happens when you raise calcium intake quickly (by raising 25(OH)D fast with 50,000iu) but there is insufficient magnesium in the diet?

You may get adverse side effects, muscle cramps, feeling tense but it is NOT the vitamin D that is the cause of the problem, really it is the magnesium deficiency that is exposed by the newly increased availability of much needed calcium but without the presence of sufficient counterbalancing magnesium.

Krispin here has some sensible thoughts on magnesium supplementation Dr Davis Heartscanblog on Magnesium Stephan Whole Health Source explains some of how magnesium deficiency has come about. But the obvious reason is the modern grain varieties simply don't have as much as older slower growing varieties.

The take home message is that it's worth Checking your magnesium food sources and taking some magnesium with your vitamin d. You will see from The vitamin d council source of vitamin d3 that Dr Cannell is now supporting the use of a formulation containing a SMALL amount of vitamin A, 5000iu/D3, 100mcg K2, 100mg magnesium, zinc 5mg and boron&genisten.
While I haven't used the Vitamin D Council formulation myself I understand the reasons behind the inclusion of those minerals. I personally take separate magnesium and vitamin K2 supplements. I suspect that buying them individually may work out cheaper but I haven't done the sums yet.

[Ted_Hutchinson]

I think as mentioned it's a very personal decision as to where you live and how much sun you get as mentioned.

Indeed that is why this decision needs to be taken in the light of the evidence.

Only when you have had a 25(OH)D test will you know how far from ideal your current vitamin d level is.

I can show you the chart of average UK adult vitamin D status.

Remember this chart is in nmol/l and the Grassrootshealth D Action result comes in ng/mL to convert take the ng/mL number and multiply by 2.5 so 40ng/mL mulitplied by 2.5 = 100nmol/l
or take the nmol/l number 75nmol/l (I will be surprised if many UK adults reach that this year) and DIVIDE by 2.5 so 75nmol/l divided by 2.5=30ng/mL

I can show you evidence that Vitamin D deficiency is much the same in Ireland as the UK.

But the only way you will know if this also applies to you is if you get yourself tested. and then use either 1000~2000iu/daily for each 10ng/mL you need to raise to reach the level you decide is your target. 55ng/mL ~ 66ng/mL
or if you live somewhere where sun exposure is viable you may like to use this online calculator to be more confident you are getting sufficient though you have to remember vitamin d synthesis is a HEAT driven process and if your skin is freezing cold you it won't be synthesizing vitamin d3 whatever the calculator may say is theoretically possible.

Bear in mind that you are trying to mimic the NATURAL vitamin D level that would have occurred if you lived wearing the clothes you were born with and which it now appears our DNA works best with.

This new paper from Vieth
How to optimize vitamin D supplementation to prevent cancer, based on cellular adaptation and hydroxylase enzymology.
Explain a question that has bothered me for some time and needs to be understood by everyone who likes to rely on winter sun holidays to top up their vitamin d status in the winter.

The paper explains why higher 25(OH)D concentrations are not good if they fluctuate and that desirable 25(OH)D concentrations are ones that are both high and stable.

It's bothered me for some time that people from the UK who take short breaks to the tropics midwinter to try to boost their vitamin D status appear more vulnerable to picking up bugs from the recycled air in aircraft cabin on the flight home. We know that people who generally have higher levels of 25(OH)D are generally more resistant to upper respiratory tract infections so one might expect people who have just spent 5~7 days sunbathing would be less vulnerable to infection.

However this immune system vulnerable "lag time" created by a sudden change in vitamin d status could be avoided by supplementing BEFORE going for your winter break and on your return from the tropics so the rise before is more gradual and the decline after the holiday is reduced.

[Ted_Hutchinson]

I'd like to draw attention to this new paper
Fish oil enhances the antiproliferative effect of 1alpha,25-dihydroxyvitamin D3 on liver cancer cells. partly to dismiss any idea that because I tend to go on about vitamin D3 that I must therefore think this is the answer to everything.
In a way it's true deficiency of Vitamin d does underlie many chronic conditions but so does an imbalance in the ratio of omega 3<>omega 6 and also a deficiency in magnesium will disrupt the proper functioning of over 300different enzymes.

So there are just 3 fundamental anti-inflammatory agents which many readers here will probably have a low or deficient status, and it's no good anyone saying I take the "official" RDA of all three and therefore cannot be deficient. I'm afraid just the "official" RDA for vitamin D is so low it inevitably leads to deficiency status.

I'm sure everyone here is aware that the main dietary source of vitamin d is oily fish and also that oily fish is the main dietary source of omega 3 and this research, albeit on liver cancer, shows that when omega 3 intake is higher the anti proliverative effect of calcitriol 1.25 (the active hormone derived from vitamin d3) is much more pronounced and lower amounts can be used with lower risk of adverse events.

It isn't a case of do I use omega 3 or vitamin d or magnesium?
We know these substances work synergistally>
So rather than put all your eggs in one basket it makes sense to attack on all fronts where possible.

[Mary Jo]

As of stated before in other threads. My 2008 Vit. D levels were at 32.....(or 31 - don't remember exactly right now) I increased my Vit. D3 amount to 4000 i.u.'s - not to mention what, if any, is in my Omega 3 (fish oil that I take) and this years level was at 62.

[Laurel]

I just read this thread through, having watched the lst post's videos a few days ago. Man, what an interesting dialog! Absolutely fascinating! Many thanks to all who have shared their knowledge. Ted, hope to hear more from you in the future.

[Ted_Hutchinson]

Well if you really don't mind perhaps I could comment on Mary Jo's post

2008 Vit. D levels were 32. she took 4000 i.u.' reached 62 and lives in Sheboygan,

This is a fairly typical response and 62 is a reasonable level for someone with a chronic condition or a previous BC diagnosis to aim for.

Sheboygan, is around latitude 43 and will have a vitamin D3 low winter so while 4000iu is fine for summer maybe Mary Jo could think about raising intake to 6000iu from Oct through to the end of Feb.

I mentioned Vieth's new paper a couple of posts back and he raises the idea that fluctuations in Vitamin D status may allow periods for an imbalance to occur
When 25(OH)D declines, the ratio of 1-hydroxylase/24-hydroxylase [CYP24] must increase to maintain tissue 1,25(OH)2D at its set-point level. The mechanisms that regulate this paracrine metabolism are poorly understood. I propose that delay in cellular adaptation, or lag time, in response to fluctuating 25(OH)D concentrations can explain why higher 25(OH)D in regions at high latitude or with low environmental ultraviolet light can be associated with the greater risks reported for prostate and pancreatic cancers.

What happens in prostate cancer also often occurs in BC and We see here Vitamin D-24-hydroxylase[CYP24] in benign and malignant breast tissue and cell lines.

Nothing is ever simple and there that other factors are also concerned in the regulation of CYP24 Human CYP24 catalyzing the inactivation of calcitriol is post-transcriptionally regulated by miR-125b.

So bear in mind this is very recent information, Vieth's work is only at the HYPOTHESIS stage, but most here don't have the luxury of waiting xx years for it to be confirmed.

If Vieth is right that falling levels of 25(OH)D can lead to a temporary excess of CYP24 the simple answer is to keep 25(OH)D levels high and stable. There isn't a great deal of cost involved nor is there any risk as we know 10,000iu/daily is safe even where ample sun exposure is also present.
However Dr Davis working in Wisconsin find his female patients generally require 5000iu/daily to stay around the 60ng level so if Mary Jo took 4000iu summer and 6000iu winter she would average 5000iu/d over the year and has a greater chance of preventing the winter 25(OH)D dip which you see is typical for UK adults.

This new information should encourage people to take moderate (equivalent to daily full body sun exposure) amounts of Vitamin D DAILY rather than larger amounts monthly or even larger amounts 2/3 monthly.
The graph Dr Davis reproduces here shows using Vitamin D2 produces a greater swing in 25(OH)D (deeper falls in level) so to achieve a steady state ONLY CHOLECALCIFEROL Vitamin D3 should ever be used, even if you can get D2 prescribed from your doctor it's not worth using it.

Rembering that to prevent an excess of CYP24 the aim is to prevent sudden changes in 25(OH)d those booking a winter holiday in the tropics may want to to plan ahead. Consider possibly increasing vitamin D3 (+2000iu) intake over a couple of the weeks prior to departure, NOT taking D3 while you are in the tropics sunbathing on the beach, BUT restarting D3 supplementation before the flight home and also using an effective amount (5000~8000iu) in the weeks after your winter break.

Fish oil was mentioned earlier and although fish oil works synergisticly with D3 it's only cod liver oil that comes with SOME (usually just 200~400iu) vitamin d3. Cod liver oil also contains vitamin A and a little NATURAL vitamin A works in conjunction with D3 but too much synthetic vitamin A is antagonistic to the action of D3 so you have to be certain that the Vit A in your CLO hasn't been standardised.

UK readers may need reminding we live 600miles further North than Mary Jo. Our UK/EU milk is NOT vitamin d fortified, Most of our breakfast cereals are NOT vit d fortified. So because we don't have the same background level from UVB or even from diet our daily intakes need to be higher to achieve the same response that Mary Jo has achieved also the additional amount required to prevent levels dipping overwinter will need to be started September and go through to March rather than Oct~Feb.

Only regular 25(OH)D testing though will provide the certainty that you have got your 25(OH)D around 60ng 150nmol/l and understand what your summer/winter intakes need to be to keep steady around that level.

[AlaskaAngel]

One of the effects of chemotherapy is a reduction in testosterone level in both sexes. The loss happens with aging, even without cancer and cancer treatment. So the need for vitamin D is all the greater for those who have been through treatment, because we have even lower testosterone levels than those who never had cancer and chemotherapy.

Testosterone supplementation may be important for more than just beneficial effects on libido, but my point is primarily just to explain why it is that our need for additional vitamin D is so important.

http://www.pubmedcentral.nih.gov/art...?artid=2680613

AlaskaAngel

P.S. I do use a low-dose testosterone supplement .

Is it possible that one may not absorb vit. D? I live in South Florida, worked many years outside without sunscreen and still diagnosed w/breast cancer. My grandfather was a farmer, exposed to sunshine out in the fields most of his life, he dies of brian cancer, my mom, spent most of her days at the beach without sunscreen and diagnosed w/breast cancer at age 51. My family and myself, exposed to plenty of sunshine in South Florida without sunscreens and yet so much cancer! I was Brac-1 negative. Her-2 very positive and at time of diagnosis was declared deficiant in vitiman d levels. My Conclusion: Vitamin D levels meant nothing to me in terms of getting cancer, unless, there is a proven reason why I didn't absorb it, however, I'm now supplementing just to insure a reaccurance doesn't manifest itself but, we can speculate and support facts all we want, there's still nothing solid about vitamin d and cancer prevention.

[R.B.]

Unregistered, I am sorry to hear of your family history and cancer.

Please do watch the videos and check the links. The liver specialist who blogged on vitamin D is based in Florida and finds many of his patients are vitamin D deficient.

There are biological reason why Vit D could pay a part in protecting against cancer and the evidence it has a role in a number of diseases is growing.