Vitamin D supplements may benefit lupus patients - Science Daily

I've posted a link to this article and paper in the UTI thread and feel that rather than hijack a thread about UTI treatment/prevention it would be better to blog on the topic in a separate article.

The article is based on research paper called

"Restoration of regulatory and effector T cell balance and B cell homeostasis in

systemic lupus erythematosus patients through vitamin D supplementation"

The full text of the research can be found here.

arthritis-research.com/cont...

and a plain English account of the research can be found at Science Daily

Vitamin D supplements may benefit lupus patients

sciencedaily.com/releases/2...

I come at this from many years of studying papers about vitamin D3 and following the vitamin D3 research. I do not have lupus or an autoimmune condition. I do have a chronic disablity condition (Late Effects of Polio) and while I'm sure there is much about Lupus that I can learn, the basics of human evolution and how the human body works are common to all of us.

I'd therefore like to talk about how the above study could have been improved. The study used 100 000 IU of cholecalciferol per week for 4 weeks, followed by 100 000 IU of cholecalciferol per month for 6 months.

100,000 each week is roughly equivalent to 14,000iu daily. Naturally if we lay naked on a tropical beach turning over regularly so we didn't get sunburnt the action of UVB on 7 dehydrocholesterol molecules near skin surface creates 10,000~20,000iu that MAY be absorbed into the body over the next 48hrs. So although this counts as a mega-dose it isn't wholly unreasonable.

100 000 IU of cholecalciferol per month = 3333 iu daily approximately.

Bear in mind this study took place in PARIS and that's latitude 48 and SOUTH of all of the UK (nearer the Equator means more/stronger sunlight and more potential for vit d production)

Raising Vitamin D levels rapidly obliges the body to readjust it's immune response which takes time, It would IMO have been better to use DAILY Vitamin D supplements and kept DAILY Vitamin D3 intake at 10,000 iu/daily for 40 days (instead of just 4 weeks ) would have more like the natural increase in vitamin D3 status at the start of a long sunny summer holiday. and would have allowed the body more time to adjust immune function to the more gradual change in 25(OH)D level.

The maintainance intake of 100 000 IU of cholecalciferol per month averages out to about 3333iu/daily and for people living in the UK that is typically NOT sufficient to maintain 25(OH)D at the level human DNA evolved to function best with or enable vitamin D3 to act most efficiently as an anti-inflammatory agent. While there is a huge range of response to every daily intake of around 100 ng/ml 250nmol/l difference between the highest/lowest responders, typically in the UK 1000iu/daily/D3 is required to attain/maintain 25(OH)D above 100nmol/l and around 125nmol/l (40~50ng/ml)

In my view (and I'm not a health professional or a researcher, just someone who has had to learn how to improve anti-inflammatory status to control pain and infection) it is justifiable to use a loading dose to raise vitamin D levels rapidly but having done so it seems pointless to allow 25(OH)D levels to drop below the level of natural Vit d equilibrium. I would prefer 25(OH)D levels to be monitored monthly (If you bulk buy tests from Birmingham NHS path lab (City Assays) they cost £20 each and while this is significant for a research project it would enable trial participants to know when to reduce intake and continued testing would enable more frequent adjustments to intake to maintain 25(OH)D at the 125nmol/l 50ng/ml level throughout the trial.

The ONE month loading period and SIX month maintainence is simply not adequate to properly assess the effects of vitamin d on autoimmune conditions. Where doctors have been using EFFECTIVE vitamin D3 intakes. See Topping up your vitamin D tank

blog.trackyourplaque.com/20...

We know it can take up to 3 years before the body indicates it can manage on a lower dose.

We know that EVERY CELL in the Human Body has a Vitamin D Receptor indicating it has a vitamin d requirement.

We need proper long term research, in which fully replete Vitamin D trial participants equal those vitamin D levels naturally attained/maintained by people currently living as human DNA evolved.

If we think about where and how early humans evolved we should be aware of factors OTHER than Vitamin D3 that also affect immune function and may also affect the way Vitamin D3 functions.

We know from DAWN to DUSK human DNA is set to create vitamin D3 and from DUSK to DAWN it creates MELATONIN. Both of these are natural anti-oxidants, antibiotics, anti-inflammatory, antinociceptive agents. We should therefore try to take our Vitamin D3 first thing every morning (ideally in a form with a carrier oil (it's a fat soluble vitamin) and with a breakfast including saturated FAT to improve absorption.

We should also try to minimise the use of electric light after dusk and dim our monitors and other LED device displays to improve evening melatonin secretion and pay more attention to sleep hygiene to increase melatonin secretion throughout the night.

FREE DOWNLOAD

f.lux: software to make your life better

stereopsis.com/flux/

(also available for Mac, Linux , and iPhone/iPad)

All the food eaten by our Paleo ancestors and humans continuing to live Hunter Gatherer lives was/is free range organic produce. Because it grew without the use of modern fertilizers, pesticides or the benefit of modern breeding techniques it was produced more slowly and produced a more nutrient dense food that was higher in magnesium and had an omega 3 omega 6 ratio about 1<> 1 so the body was able to benefit from both omega 3 and omega 6. Modern Western Diets lead to higher omega 6 levels that overwhelm the ability of omega 3 to resolve inflammation, but that is a topic for a separate blog.

As far as this blog is concerned it's important to be aware that BOTH magnesium and the Omega 3 DHA improve the ability of the circulating form of Vitamin D3 (CALCIDIOL) switch to the active hormonal form (CALCITRIOL) we know also that the omega 3 DHA acts as a vitamin D receptor ligand that increases the production of CALCITRIOL.

If we want our car or computer to perform optimally according to the makers specifications we have to ensure we continue to maintain the original specifications..

If we want to see how the human body can optimally control the immune and inflammatory response we first have to ensure the natural levels of anti inflammatory agents vitamin D3, melatonin, omega 3 and magnesium are supplied according to our cells circadian rhythm.

While this study does produce interesting results it certainly isn't a perfect piece of research and I am absolutely certain we can and should do better. I'm very pleased to answer any questions that may arise and I'd like to be able to post further blogs on the role of vitamin D3 (and it's cofactors) in the prevention and management of autoimmune conditions.

17 Replies

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  • People, please use your common sense here.

    I have emailed Ted privately to ask him a number of questions about WHY he is on our site (and others!) posting about Vitamin D when he is also selling it (he claims, ‘at cost’). He has declined to answer my email, but has responded by publishing this blog.

    I do not propose to compete with the flood of words that Ted is posting – but am still urging people who actually have lupus to be VERY cautious before they jump on his bandwagon. We simply do not know enough yet, either about Lupus or about how Vitamin D works in the body, to start taking the huge amounts that Ted is suggesting need to be taken for the body to ‘adjust’.

    Inform yourselves: please Google “Vitamin D3 Toxicity” (or overdose). Vitamin D3 is a very safe supplement, but it is still possible to overdose and an overdose has very significant adverse consequences (including potentially hypercalcaemia, which may lead to renal failure).

    Additionally, if anyone would like to see the academic papers that I have relied on for information, please send me a private message and an email address, so that I can send you the PDf files (the links on their own, without a username and password for an academic library, won’t work). These include two very up-to-date studies in the journal Lupus, written by people with specialist qualifications, and published in 2011. These conclude 1. that more research is needed, and 2. that to date there is no consensus on whether SLE activity is influenced by Vitamin D status.

    I am now bowing out of this discussion in public, and leave it to your good sense to make a judgement for yourself. Please do contact me if you would like copies of the papers I have.

    Take care of yourselves,

    Maggie

  • please Maggie could you send PDF to sheilafrewin@hotmail.com thank you so much.

  • I understood non of what he said lol I am vitD deficient now and take big tabs for it free on the NHS :-)

  • "People, please use your common sense here. "

    Indeed that is precisely my view.

    We MUST use our common sense and understand what the HUMAN BODY does naturally and take our guidance from that.

    There is NO DOUBT at all that human DNA is set to produce 10,000iu Vitamin D3 if you are able to lay naked in the midday summer sun without burning.

    Common sense tells us that HUMAN DNA evolved for HUMAN SURVIVAL and not to exterminated humanity.

    Therefore the human body has a role for Vitamin D3 in the amounts the human body naturally produces which is why EVERY CELL in your body has VDR (vitamin d receptors)

    The human form of vitamin D3 cholecalciferol is biologically identical to that provided in Cholecalciferol capsules and once absorbed Vit D3 capsules are used in the same way as cholecalciferol produced in human skin.

    (UVB exposure produces more than just cholecalciferol so the benefits of sun exposure are greater than just the impact of more vit d3 but that's a reason for not relying exclusively on supplements)

    "I have emailed Ted privately to ask him a number of questions about WHY he is on our site (and others!) posting about Vitamin D when he is also selling it (he claims, ‘at cost’). He has declined to answer my email, but has responded by publishing this blog "

    I'm sorry I missed the email last night I have now seen it and replied. If Maggie wishes to post my reply to her then she is welcome to do so but I'd prefer it if she did so on her own blog or start a thread if she wants rather than hijack this blog.

    Like MAGGIE I have access to a university library so am able to obtain the full text of many of the papers on the topic and am also very willing to share those if requested.

    Whenever we read any science paper we have to consider the source of funding for that research.

    Perhaps one of the reasons we have chronic health conditions is that people can make a lot of money on providing medications to treat those conditions and the research is dedicated profiting from treatments rather than preventing the condition or delaying or slowing the progression of that condition.

    I think it does us all good to have our views challenged by a logical examination of recent research.

    Perhaps watching

    Ben Goldacre: What doctors don't know about the drugs they - Ted

    ted.com/talks/ben_goldacre_...

    Will help you understand why whatever science you read you have to keep your COMMON SENSE functioning so you don't get misled.

  • It may help base this discussion on a firmer footing if before we start we make an effort to learn the basics of

    "Vitamin D and Autoimmune Disease"

    So I think it may help if we read this full text paper so we understand a bit better what we are talking about.

    bit.ly/T48kYo

    While of course it's true that different presentations of autoimmune disease have their own special features there are some common underpinning factors that apply to most of them. Which is why some of the approaches that delay progression, reduce flares in MS may have some relevance to Lupus.

    Similarly some of the factors that MAY prevent diabetes incidence may also makes us more resistant to developing lupus.

    If you've nothing better to do today have a look at these

    1.usa.gov/T48Vt2 herpes diabetes

    1.usa.gov/T49bID herpes lupus

    1.usa.gov/T49e79 herpes MS

    1.usa.gov/T49i6I herpes Alzheimer's.

    Now is the common denominator the cause or is low vitamin D status allowing Herpes infections that progress to these and similar conditions?

  • Maggie

    Would be glad of PDF send to gilliancook64@hotmail.com Many thanks.

  • The Toxicity of Vitamin D - extract from Wikipedia

    In healthy adults, sustained intake of more than 1250 micrograms/day (50,000 IU) can produce overt toxicity after several months; those with certain medical conditions such as primary hyperparathyroidism are far more sensitive to vitamin D and develop hypercalcemia in response to any increase in vitamin D nutrition, while maternal hypercalcemia during pregnancy may increase fetal sensitivity to effects of vitamin D and lead to a syndrome of mental retardation and facial deformities. Pregnant or breastfeeding women should consult a doctor before taking a vitamin D supplement. For infants (birth to 12 months), the tolerable upper limit (maximum amount that can be tolerated without harm) is set at 25 micrograms/day (1000 IU). One thousand micrograms (40,000 IU) per day in infants has produced toxicity within one month. After being commissioned by the Canadian and American governments, the Institute of Medicine (IOM) as of 30 November 2010, has increased the tolerable upper limit (UL) to 2500 IU per day for ages 1–3 years, 3000 IU per day for ages 4–8 years and 4000 IU per day for ages 9–71+ years (including pregnant or lactating women). Vitamin D overdose causes hypercalcemia, and the main symptoms of vitamin D overdose are those of hypercalcemia: anorexia, nausea, and vomiting can occur, frequently followed by polyuria, polydipsia, weakness, insomnia, nervousness, pruritus, and, ultimately, renal failure. Proteinuria, urinary casts, azotemia, and metastatic calcification (especially in the kidneys) may develop. Vitamin D toxicity is treated by discontinuing vitamin D supplementation and restricting calcium intake. Kidney damage may be irreversible. Exposure to sunlight for extended periods of time does not normally cause vitamin D toxicity. Within about 20 minutes of ultraviolet exposure in light-skinned individuals (3–6 times longer for pigmented skin), the concentrations of vitamin D precursors produced in the skin reach an equilibrium, and any further vitamin D that is produced is degraded.

    Published cases of toxicity involving hypercalcemia in which the vitamin D dose and the 25-hydroxy-vitamin D levels are known all involve an intake of =40,000 IU (1000 µg) per day. Recommending supplementation, when those supposedly in need of it are labeled healthy, has proved contentious, and doubt exists concerning long term effects of attaining and maintaining high serum 25(OH)D by supplementation.

  • Vitamin D and Its Role During Pregnancy in Attaining Optimal Health of Mother and Fetus

    1.usa.gov/Ret9SV

    It's clear Wiki isn't up to date with the latest research

  • "Vitamin D overdose causes hypercalcemia,"

    What actually happens in practice with the amounts of vitamin D3 typically used to restore 25(OH)D to the levels that are required to attain and maintain 25(OH)D levels around the 125nmol/l (50ng/ml) mark, equivalent to those humans evolved with.

    The answer is at Medpage Today

    "No Risk of Calcium Overload with Mega Vitamin D"

    bit.ly/ResXDn

  • bit.ly/Retfdf The Risk of Additional Vitamin D Reinhold Vieth

  • "In healthy adults, sustained intake of more than 1250 micrograms/day (50,000 IU) can produce overt toxicity after several months;"

    So what?

    Has anyone ever suggested that 50,000iu daily was a sensible amount to take ever?

    I've several times made the point that it is more sensible to restrict daily intake to no more than human skin naturally produces.

  • those with certain medical conditions such as primary hyperparathyroidism are far more sensitive to vitamin D and develop hypercalcemia in response to any increase in vitamin D nutrition, while maternal hypercalcemia during pregnancy may increase fetal sensitivity to effects of vitamin D

    hypercalcemia What does it mean if not TOO MUCH CALCIUM

    VITAMIN D only ENABLES calcium absorption it doesn't magically PUT CALCIUM into the body if it isn't in the diet.

    We all have sufficient common sense to work out that if doubling our vitamin D status doubles our calcium absorption capacity we will only require HALF the amount of supplments. If we treble vitamin D status will may triple our calcium absoption capacity so will only require a third of the supplemental calcium previously required..

    The problem with HYPERCALCEMIA is TOO MUCH CALCIUM.

    It's not vitamin d forcing calcium supplements down your throat.

    We all have sufficient common sense to use an online calculator and work out how much calcium is in our diet. We can all ring our water authority to confirm how much calcium is in each litre of our drinking water. It's simple basic arithmetic to make sure your diet + your supplements do not provide more than the current RDA for calcium.

    It's not that much of a problem to get your vitamin d levels checked so you stay around the levels humans evolved to function best at.

    The answer to too much calcium is to stop consuming excessive amounts of calcium supplements.

    It is not sensible to deprive every cell in your body short of an essential nutrient.to keep yourself safe from obsessive calcium overconsumption.

  • It was my understanding that those of us who post on this site either have or may have an autoimmune condition and we join in the discussions to be supportive and share our experiences of Lupus and other similar diseases. I have not found this information either useful or supportive. Therefore I will 'vote with my feet' and will not take any further part in this. I'm sure I won't be the only member who has concerns about this blog.

  • I agree with you grannyjogger. Ted himself admits that he is does not have Lupus or any autoimmune condition's so in my opinion should not be offering any opinions re this subject because he cannot speak from first hand experience. I on the other hand have 8 autoimmune conditions including SLE and will be leaving my treatment to my professional medical team who have studied my own particular conditions very carefully, and for more than 25 years. Therefore, I will not make any further comments, this post doesn't warrant it.

  • Lupus and fibromyalgia are two common rheumatic conditions

    What helps for one condition may also apply to the other.

    So what happens when Fibromyalgia women raise 25(OH)D levels to 125nmol/l?

    You cn read it here.

    The relation between vitamin D deficiency and fibromyalgia syndrome in women.

    ncbi.nlm.nih.gov/pubmed/218...

    Among the 100 fibromyalgia women, there were 61 women with 25(OH) D deficiency; with vitamin D supplementation, only 42 women showed a significant improvement when their blood level of 25(OH) D became>or=30 ng/mL, this improvement became more significant when their blood level of 25(OH) D exceeded 50 ng/ mL.

    30ng/ml=75nmol/l

    50ng/ml=125nmol/l

    Those people who want to see significant improvement will notice a difference when their 25(OH) D blood level rises above or equal to 30 ng/mL= 75nmol/l.and it's likely this improvement will more significant when 25(OH) D level equals or exceeds 125nmol/l.

    It's not that difficult to ask your health professionals for a 25(OH)D test or spend £20/25 for your own test from CityAssays (Birmingham NHS path lab)

    The BEST most effective Vitamin D3 form is available over the counter for less than £5 for a years supply.

    The products available to your health professionals can be seen in this guidance document here

    Products in UK that enable adherence to CMO advice on Vitamin D supplementation

    bit.ly/TAAP0i

    The aim is to get 25(OH)D to equal the level humans naturally attain and maintain when living as humans evolved.

    We can see from the graph at GRASSROOTS HEALTH how much vitamin d is generally required

    grassrootshealth.net/

    And why the products supplied by your health professionals will be little better than placebo.

  • I've been told by 2 unrelated nutritional therapists that taking Vit D can help with auto-immune diseases. I take a VIT D supplement called "BetterYou Dlux" 3000 every day and it is available inexpensively from my health food store. It's in the form of an oral spray, and I take 2 squirts each time. I've been told that taking between 3-10,000IU per day is optimal.

    It's good to have the information Ted Hutchinson, but I feel that the way you have presented this is coming across as rather 'pushy' and aggressive on this site which is primarily to provide mutual support for Lupus patients.

  • I think the best way of supporting people with inflammatory, painful conditions is to explain the most recent science about the level of 25(OH)D vitamin D3 associated with the most effective resolution of inflammation, in as straightforward a way as possible,

    I'm sorry if people find my manner pushy or aggressive, it's not meant to be,

    Whatever forum I'm on I write in the same style, as honestly and directly as I can.

    I'm afraid I'm too old and set in my ways to change.

    Providing links to the supporting science enables people to take those papers to their health professionals and discuss any issues arising.

    I don't want to appear to argue with what you have said BUT what matters with Vitamin D3 is NOT the amount taken daily (because individual response to any specific daily intake ranges over 100ng/ml = 250nmol/l between the lowest and highest responders.

    There is absolutely no way any individual, be they health professional or patient can predict what their response will be.

    Hence the need for individual 25(OH)D testing after supplementing at what has been shown to be a reasonably EFFECTIVE level for 3~6 months.to give that initial dosing regime time to reach equilibrium.

    The half life of 25(OH)D is 3~4 weeks so 15~20 weeks need to pass before anyone can know if that initial dose is adequate or not.

    Only then can you make an informed decision to raise or lower the daily intake depending on whether or not the 50ng/ml =125nmol/l target has been met.

    At that point increasing daily intake for each 25nmol/l (10ng/ml) below 125nmol/l~50ng/ml is sensible and reducing daily intake by the same amount if more than 25nmol/l over target.makes sense.

    Personally I don't think providing information that is neither up to date or evidence based is helpful or supportive.

    I've wasted enough of my life in chronic pain and with repeat infections and have learn't how to control pain and infections without the use of pharmaceutical drugs.

    If anyone doesn't want to benefit from my experience then I don't understand why they read my posts.

    There is a good set of resources looking at the role of Vitamin D and Autoimmune conditions at WIKI here bit.ly/OUqrE2

    and reading the whole of the WKI section on Vitamin D toxicity, rather than just cherry picked excerpts puts the matter into a more realistic perspective.

    bit.ly/OUqOOK

    The Better You 3000 iu spray sound very good and is reasonably priced. but It provides only 100 doses and costs £6.40 (Amazon UK free post).

    whereas the Healthy Origins 5000iu drops I suggest provide more than 3 times the number of doses (at £8 including shipping from Iherb USA ~2 packs would work out a better buy as it would make shipping per pack less expensive) and at a strength (5000iu) more likely to achieve the target associated with the most effective resolution of inflammation.

    If VITAMIN D3 supplementation is going to be an effective strategy it has to be regarded as a LONG TERM project.

    Every Cell in the human body has a Vitamin D receptor and so a vitamin D requirement. VDR is like a cell phone that calls for vit d.

    We have 10 TRILLION cells that may require Vit D.

    10,000,000,000,000,000,000 potential calls on your vit d reserves.

    It's no wonder that doctors using EFFECTIVE amounts (up to 10,000iu/daily) of Vitamin D3 find, even then, it MAY take 3 years to replete their patients.

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