a) serum 25 hydroxyvitamin D [25-D ... calcidiol]. This is the commonly measured vitamin D reservoir.
b) serum 1,25 dihydroxyvitamin D [1,25-D ... calcitriol]. Hormonal (active) vitamin D. Reflects kidney conversion from 25-D in response to a drop in circulating calcium. Levels vary throughout the day.
"In this cross-sectional analysis of 119 men undergoing radical prostatectomy, serum from whole blood and expressed prostatic fluid was collected on the day of surgery."
"Serum and prostatic levels of 25 hydroxyvitamin D were correlated with each other ..."
"... there was also a correlation between serum 25 hydroxyvitamin D and 1,25 dihydroxyvitamin D"
"Serum 1,25 dihydroxyvitamin D was inversely correlated with Ki67 staining in tumor cells"
Ki67 is a protein that is a good marker of tumor proliferation [2]. A high level of 1,25-D was associated with low Ki67 levels.
"Serum and prostatic 25 hydroxyvitamin D levels were not correlated with Ki67"
... which is a reminder that a good 25-D reservoir does not guarantee good 1,25-D levels. Calcium & phosphorus/phosphates can keep it low; fructose can help keep it high.
Also worth considering, for those interested in the systems-wide, complex "vitamin D" HORMONAL functions is this intro. article, with its useful refs list:
fearlessparent.org/suppleme... - should we be supplementing this, precursor (cholecalciferol) to the prohormone (calcidiol) ? ? ? Certainly NOT base solely on the result of the calcidiol (25-D) test alone ( - at least in some cases). BEWARE: these are metabolites in a HORMONAL system, where cholecalciferol seems to have been MISNAMED a "vitamin" in 1928, . . . . . . . . an error which in social & legal terms ( - if not in strict biochemical terms) has YET to be more widely appreciated & CORRECTED !
Best wishes to all readers,
Sid ;~)
10 Feb 2019
PS: Let's START talking ( - & writing) about the "vitamin D" hormonal system, comprising the prohormone, calcidiol & active hormone calcitriol - rather than simply vitamin D, to begin ADDRESSING the major confusion that persists over this in mainstream medicine and in society at LARGE: PLEASE, . . . . . let's ALL start doing that from TODAY ! ! !
"Ki67 is a protein that is a good marker of tumor proliferation [2]. A high level of 1,25-D was associated with low Ki67 levels." . . . .
. . . . it MAY be that HIGHER calcitriol (1,25D) levels ( - as reported in chronic, inflammation-causing conditions, as Mangin & others report) COULD be protective for prostrate cancer ? ? ?
Just a thought - although living with such inflammation-causing conditions is NO picnic either, on the whole !
- that calcitriol [1,25-D] in the PCa cells is essential to control proliferation.
- that having a good calcidiol [25-D] level does not automatically lead to the above.
The way I have been handling that is:
- aiming for a good 25-D reservoir. I follow the Vitamin D Council, which says that we need to be at 50 or over. I try for 70 & I need to take 7,000 IUs for that, but not everyone will need that much, & some will need more. Dr. Myers once said that 25-D up to 100 was OK, but later reduced the target upper limit to 70. 25-D at 100 has been shown to be safe, but I doubt that there is value in keeping a full reservoir. The important thing, apparently, is to maintain constant daily amounts. Massive monthly doses are not a good idea.
- I do not supplement with calcium, although some supplements have calcium in them.
- I do not eat processed meat that might contain phosphates
- I do not use soft drink which might contain phosphates.
- I do not eat big portions of meat, partly because of the phosphorus content.
- I use fructose in my coffee. That can raise 1,25- for several hours. Fructose from fruit is OK too. But fruit comes with other sugars too.
I can't measure my 1,25-D throughout the day. Would be nice to have 24 hourly readings. & I certainy can't measure the 1,25-D in my prostate cells - nor can I measure Ki67 levels, but I have done all one can reasonably do, IMO.
Good info Patrick. I follow similar practices that you mentioned. I take 4-6k of D3 daily. My readings have been and 42 last time. The one thing I don't do is add fructose. I thought knitting sugar was preferred. What form does the fructose come in? I eat oak with nuts, seeds and fruits while I have coffee. Sometimes I add manuka honey to my coffee.
I'm sitting in a hotel now waiting for my PSA readings etc with my mom tomorrow at Duke. I caught done infection while getting cardiology and back appointments at Duke on Friday. I hope getting infections doesn't weaken the immune system and give opportunity for the cancer to grow. Have you ever read anything about that?
Do you live in NC? I'm in Asheville. Nalakrats is nearby, mostly.
Some years ago someone on a PCa site said the "Everything from corn is evil." I know what he meant, but fructose is fructose regardless of the source. Not that fructose from fruit is healthy.
Fructose has a glycemic index of 19. So, safe for diabetics. Will not cause a glucose spike.
Fructose at high levels is very stressful to the liver - fruitarians watch out! I don't understand the experts who say we should get x portions of fruit & vegetables daily. They are not interchangeable. The sugars in most fruits outweigh the benefits of the small amounts of nutrients they contain.
Fructose, unlike sugar, does not induce satiety, so people can drink countless super-sized soft drinks in a day. The drink companies love it.
But a small amount of fructose can induce the body to produce the hormonal form of vitamin D for several hours.
My attitude to food & basic vitamins & minerals is to ditch preconceptions & rely on PCa studies. If there is an association with PCa, as with calcium, I don't use it. I don't wait for the clinical trial. LOL. At the same time, if a "bad" food, such as fructose, is associated with protection, I will incorporate it. Again pre-clinical trial.
How good is the evidence that fructose raises 1,25D levels, please . . . . & for several hours ? My understanding is/has been, in the 'healthy' population, blood levels of 1,25D are remarkably stable.
Further, is there much evidence of increasing 1,25D levels for a few hours has any significant effects ? How often does one/you get these tested, . . . . & at what cost ?
Its a sensitive, fast degrading, unstable metabolite, from what I know - which therefore has to be measured very soon after withdrawing the blood sample, or frozen for later measurement.
"Calcium and Fructose Intake in Relation to Risk of Prostate Cancer" (1998)
"Another potentially important dietary factor is phosphorus, because
reductions in circulating phosphate increase 1,25(OH)2D levels appreciably ( 16, 17). Because phosphorus is generally abundant in most diets and is well absorbed intestinally. dietary-induced hypophos
phatemia is rare. Moreover, phosphate may bind calcium, reducing its bioavailability. and low phosphate stimulates parathyroid hormone; these properties tend to decrease circulating 1,25(OH)2D, making the overall impact of dietary phosphorus on circulating phosphate or 1,25(OH)2D levels unclear. Dietary fructose can reduce plasma phosphate levels by 30 to 50% for more than 3 h due to the rapid shift of phosphate from the extracellular to intracellular compartment (18,
19). This hypophosphatemia occurs because fructose is very rapidly phosphorylated in the liver, catalyzed by fructokinase (20), which by-passes the phosphofructokinase regulatory step in glycolysis (21)."
what about K2, do you supplement? With high vit D intake wouldn't we be at danger to have calcium going to arteries? What is the K2: Vit d3 intake ratio?
I know of a man with PCa who stopped taking K2. He developed a calcium problem. The odd thing was that his 25-D blood levels were in the low 30's.
In my view, hypervitaminosis D (which is rare) can be avoided by simply having enough K for normal transport of calcium into bone. 25-D blood levels are irrelevant IMO.
-Patrick
in reply to
Being vegan and already eating lots of greens, would it be better to find a supplement with just K2 and no K1? Any ideas of an equivalent to LEF?
LEF K2-7 dose is 100 mcg. Swanson has 50 mcg & 100 mcg products of K2-7 alone. I would take the higher dose, but that's is only because my wife & I have been on that dose for years.
The D3 dose depends on your target 25-D level & the dose needed to achieve it. Varies by individual.
When your wife had good results with K2 was she on statins? My point is I don't like the fact that statins interfere with K2 and don't know how to solve this problem, since my husband takes statins because of PCa.
I was on Simvastatin for some years before starting on Life Extension's K2 product. My heart calcium scan was a few years before hers. Two of four arteries had zero calcification, while the other two had minor calcification. My CVD risk was calculated as being low. I attribute this to the LEF product.
I have been meaning to repeat the test to see if all four are now clear.
I think it's prudent for statin users to supplement with K2.
There isn't much written on the subject. Here is a new mouse study [1].
"In male mice, atorvastatin reduced endogenous MK4 formation in the kidney, but not other organs. These observations are consistent with our hypothesis that cholesterol metabolism is involved in the generation of MK4. Further research is needed to understand potential regulatory mechanisms and the unique functions of MK4 in the kidney."
I should explain that I would not be on a statin if I did not have PCa. The fact that a majority of American men of my age are, means that the statistics supporting the association with better PCa survival are compelling in my view. & there are two plausible reasons why this might be so: (i) solid tumors accumulate cholesterol & higher accumulations are associated with poorer survival, & (ii) cholesterol is the starting point for steroidogenesis & allows PCa cells to make androgens.
My annual medical is in June & I will get a prescription for another calcium scan. If I am totally clear - as I expect to be - the LEF product is sufficient for anyone on a statin. IMO
{I had the original Coronary Artery Calcium scan in Oct, 2009. It cost $125 back then. Calcification is a signal to take vitamin K2 IMO. & lack of calcification, which means that a future cardiovascular event is unlikely, is a sign to stop using statins, IMO - unless one has PCa.}
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