Ever wonder why Vitamin D helps some of us and why the incidence of RLS is much lower in the tropics and higher in cloudy England?

Medscape Medical News

Vitamin D Lowers Hepcidin Levels in CKD Patients

Jenny Powers

June 01, 2012

June 1, 2012 (Paris, France) — Vitamin D supplementation is safe and economic for patients with chronic kidney disease (CKD); it can also decrease the need for erythropoietin-stimulating agents and ward off anemia by decreasing hepcidin levels and increasing ferroportin levels.

A new study has confirmed the positive effects of vitamin D on hepcidin and ferroportin levels in the serum of patients with CKD and in healthy volunteers. Justine Bacchetta, MD, PhD, from the Centre de Référence des Maladies Rénales Rares, Service de Néphrologie et Rheumatologie Pédiatriques, Hôpital Femme Mère Enfant, Bron Cedex, France, presented the research here at the XLIX European Renal Association-European Dialysis and Transplant Association Congress.

The study by Dr. Bacchetta and colleagues was based on reports of improved hemoglobin levels and decreased erythropoietin-stimulating agents requirements after vitamin D repletion in patients with CKD. "The iron homeostasis factor hepcidin is emerging as a likely cause of resistance to erythropoietic-stimulating factor," she noted. Higher hepcidin levels are also seen in CKD patients with anemia.

In the trial, a single oral dose of ergocalciferol 100,000 IU was given to 7 healthy subjects (4 men and 3 women); mean age was 42 years (range, 27 to 63 years). Measurements of serum hepcidin were taken at baseline and at 24 and 72 hours.

There was a 50% decrease in the serum hepcidin of all the healthy donors 24 hours after a single oral dose of vitamin D 100,000 IU; this suppression persisted for 72 hours (P = .001).

Levels of the active metabolites of 25-hydroxy vitamin D and 1,25 dihydroxy vitamin D were also detected in the serum.

A decrease of hepcidin and ferritin mRNA in PBMCs after vitamin D administration was seen on rtPCR. Increased levels of ferroportin were detected in the PMBCs using immunohistochemistry staining.

Similar results were observed in the monocytes of CKD patients. After vitamin D administration, a 0.42-fold decrease in hepcidin transcription was seen in PBMCs and a 0.57-fold decrease was seen in monocytes taken from patients with CKD (P < .05 for both).

"This points to a direct effect of 1,25 dihydroxy vitamin D on hepcidin transcription," said Dr. Bacchetta.

Ferroportin was expressed, and membrane enhancement in HepG2 cells, the adherent population of the PBMCs, was seen on immunohistochemistry after treatment.

"For the first time, we have shown results, both in vitro and in vivo, indicating that vitamin D is a potent suppressor of hepcidin in humans. We propose that these findings provide a clinically relevant mechanism showing how vitamin D supplementation can improve anemia management in CKD patients," Dr. Bacchetta explained.

"Vitamin D therapy absolutely has a role in the treatment of patients with CKD," said Dr. Stenvinkel. "The majority of dialysis patients have vitamin D deficiency, even in countries like Portugal and Brazil with a lot of sunlight. We need to replenish those stores in patients. It is an important cornerstone of treatment."

"Even if we do not have data from intervention trials regarding its effect on mortality, we know from registry and observational studies that those who have vitamin D treatment do better. If administered at the right levels, vitamin D is a nonrisky treatment," Dr. Stenvinkel asserted

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Let me be the first to reply to my post. Have you noticed that in this article they don't concern themselves with any physical sensations the participants might be having as a result of exercise and rise in hepcidin and loss of iron availability? I bet those participants don't have rls. I believe that RLSers are so sensitive to ANY drop in iron that we wouldn't be able to sit down for a second after this type of aerobic exercise. And why Kelka has to go flying off her stationary bike to get relief from the RLS that rushes over her as hepcidin rises and iron availability drops.

Everyone's iron availability drops at night - everyones! But not everyone gets RLS? I think we RLSer have a genetic variable (not defect) that makes us ultra sensitive to these fluctuations in iron availability and hence the corresponding drop in dopamine.

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Well lostinamerica you've lost me! Lol

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I dont think you are alone with that thought p1pp1ns...

[Hidden in reply to Hidden]

Xox Elisse. Sleep well my friend

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My above reply belongs under my exercise post.

[nightdancer]

I live in New England, the northeastern part of the US. We get so much less sun here as compared to other parts of the country and the world, like England. The less sun there is the lower our Vitamin D levels in a lot of people. In sunnier, warmer part the world Vitamin D deficiency is rare. And, yes, RLS has a proven genetic component. That is for sure. for example, I have RLS and PLMD, my sisters have RLS and PLMD, both my nieces, and now my niece's kids at the ages of 6 and 9. Genes were discovered in 2004 and 2007 and are named. A google search will find it for you, LIA. FYI

[nightdancer in reply to nightdancer]

localhealth.com/article/vit... We will see if this link works. lol

[nightdancer in reply to nightdancer]

yes, it works. Would love to see more RLS info. This is a link on most causes of a deficiency. CKD is only one cause, and I would rather links to RLS info than all these links to pernicious anemia and Chronic kidney disease. People on dialysis do sometimes, not always, develop RLS, but other than that, there are many other possible causes, like LESS sun exposure and the rays of the sun are weaker as you get away from the equator. Other causes can be a vegan diet, and so on. I had to do the big dose of Vitamin D for 10 wks last year, and then we did another 10 weeks at 5,000 units once a week orally. My vitamin D is fine now, and has had no effect one way or the other on my RLS.

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I would have given anything for that vitamin D to have worked for you. And as you say, I wish it were that simple. There's stored vitamin d and there's serum/blood circulating vitamin d, much like iron. I have a VERY sick feeling that like iron, our serum vitamin d is low or non-existent, even though our stores are in the normal range. I wouldn't be surprised if in the very near future they find mega-dosing with vitamin d is useless and that we have to figure out how to get the vitamin d from our stores and into our bloodstream.

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Sometimes we engage with the wrong people and care too much. Thanks again Nightdancer for your encouragement.

[Brett85]

My doctor put me on 50,000mg of vitamin D for the past 3 months. I have yet to

see a difference. I drink about a half gallon of skim milk everyday on top of that.

I'm not putting down your idea, I'm saying that my doctor must have read that

article and is trying it out on me. I live in Chicago and have had no sun pretty much

from Nov to now.

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NONE of this is my idea, I just spit back what I read.

I think it's important to see that there might be a connection here.

The great thing about these articles is that it reinforces everything that everyone on this site has been doing and trying. Check your b12/folate levels to see where you're at. If you're low give it a shot. Check vitamin d levels, do the same. You tried it Brett, no harm, no foul. People tried iron infusions, if it didn't work there was no irreparable harm done. I still sneak my brain some iron at night despite what the article says. It's a survival technique, one day I won't need it.

Live as naturally as possible, and as close to the way our far distant ancestors did. No processed foods. Lots of raw greens, free range animal protein. Alternate your food, don't eat the same thing day in day out. If you're constipated, don't be. Get as much safe sun as possible. Drink as much pure clean water as you can - recommended is at least 64 ounces a day. I put a little sea salt in some of that water. It is the ONLY thing that has ever helped with IBS/motility. My water is body temperature and I sip it like it is holy water through out the day. Less is more. I don't think we need all that much food or all that much vitamins unless we truly cannot absorb certain ones ie pernicious anemia and b12.

They say that 90% of our cells are not human, they are bacterial in nature. We need those bacteria. Our gut microbiome have evolved over millions of years to help us. But we changed the playing field on them so now it seems the zoo animals are getting a little out of hand. I truly believe that this is at the root of many, if not most, of our modern day ills.

If you need drugs to sleep, so be it. A lot of those drugs, if not all, are derived from plants. I would hold that pill in my hand and say thank you to the plant and feel the sacredness in all things, even that pill or that pump. I'm thinking about going to Peru this summer and trying ayahuasca with a shaman. That's a drug/hallucinogenic, but the natives call it "La Madre." And they believe the plant has a spirit and can heal.

We too can heal.