Orthopedic Surgery and Vitamin D

I am delighted to see that orthopedic surgeons are finally realizing the importance of having normal vitamin D levels in order to heal the bones that they operate on. I chose a photo of a child with a broken let for this article because 70% of American children have insufficient vitamin D.

Just this month in the prestigious Journal of Bone and Joint Surgery,Joseph Lane, MD, and colleagues published an article looking at over 700 patients they had operated on retrospectively between January 2007 and March 2008.

The results were that 43% of all patients had insufficient levels of vitamin D and 40% had completely deficient levels.

Of note the highest rates of vitamin D deficiency were seen in the trauma and sports services. In this subgroup 66% of the patients were vitamin D's insufficient and 52% were absolutely deficient.
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More on Asthma and Vitamin D

Another article looking at the importance of vitamin D in patients with asthma has just been published in Annals of Allergy, Asthma, and  Immunology.

The authors, MS Sandhu and TB Casele, point out that evidence suggests that vitamin D deficiency is associated with lung airway over-responsiveness, worse asthma control, and possibly resistance of asthma patients being able to respond to steroid treatment.

They point out that the cells in the lung show high amounts of the enzyme necessary to convert vitamin D to the activated vitamin D within the lung.

This activated vitamin D has been shown to inhibit the manufacture of certain molecules that promote inflammation in the lung. Therefore having sufficient vitamin D would contribute to less lung inflammation, which is the cause of asthma.

They also point out that vitamin D in the lung helps manufacture several natural anti-infective molecules that can help prevent infections, like bronchitis.
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Mental Health and Vitamin D

I was recently interviewed about the role of vitamin D in depression. When the article comes out I will post a link on my blog.

What I basically said is that the medical literature supports the possibility that vitamin D deficiency is connected with depression but more studies need to be done to prove the connection.

Now in the Journal of Photochemistry and Photobiology a new article has been published,entitled "Vitamin D, light, and mental health". The author is MB Humble.

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Vitamin D Now Found Useful in Certain Lymphomas

The standard message for patients with vitamin D deficiency is that everyone can take vitamin D unless they have a granulomatous condition (for example tuberculosis or sarcoidosis), or a lymphoma.

The exact details on the why and why not this vitamin D optimization of patients with these diseases is not discussed in detail in the medical literature.

Now a new study has come out that shows that vitamin D actually appears to HELP patients with two specific types of lymphoma.

In a significant paper published in the Journal of Clinical Oncology that was just published online, Matthew Drake, MD and his colleagues from the Mayo Clinic and 2 other schools  tested the theory that vitamin D levels might be predictive of "event free survival" (EFS), and "overall survival" (OS) in non-Hodgkin's lymphomas (NHL). An "event" would be getting so sick the patient would need intervention most likely in a hospital. Otherwise, these terms are self-explanatory.
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Vitamin D Related to Pre-Eclampsia

A new study shows a possible link between vitamin D deficiency and a pregnancy condition called preeclampsia.

Preeclampsia is a condition which usually occurs at the end of pregnancy that is characterized by high blood pressure as well as protein in urine. Without treatment it can become very serious and can affect the delivery of the baby.

Early onset preeclampsia is not very common. It occurs in only about 2 or 3% of pregnancies. Nevertheless it is responsible for about 15% of premature births yearly. The definition of "early onset" is when it occurs before the 34th week of pregnancy.
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Economic Burden and Premature Deaths in Canada Due to Vitamin D Deficiency

Studies by Garland and other medical researchers have shown the tremendous economic cost of vitamin D deficiency in America. For example, studies published in 2004 estimated that vitamin D deficiency costs the United States from $40-$56 billion annually. It is estimated that every year there are 60,000 premature deaths from cancer caused by insufficient vitamin D in the United States.

Now, for the first time, a study on the economic burden of vitamin D deficiency in Canada has been published. It is especially important for Canada to pay attention to their population's vitamin D levels because most of the Canadian population lives north of the 43rd parallel. Because of this, making vitamin D from sun UVB radiation is impossible for at least 4 to 5 months of the year. ("Vitamin D Winter")The Canadian diet provides about 200 IU of D from food every day, which is not enough to maintain normal blood levels. Therefore the people of Canada should all be taking supplementary Vitamin D for at least those winter months.

This article was written by William B. Grant and others. The authors carefully searched the medical literature for articles that showed the dose-response relationships for vitamin D and disease outcomes. For example they reviewed one study which I discussed in my book that showed increasing vitamin D levels could reduce the risk for death from cardiovascular disease by 25% or more. They looked at many other diseases including cancer, diabetes, influenza, falls and fractures, multiple sclerosis and even pregnancy outcomes.

They then obtained data from Health Canada, on mortality rates for 2005.

The authors then estimated the benefit in reducing disease based on increasing the average person's vitamin D level from 27 ng/ml to 42 ng/ml.
The results were astounding. It was estimated that the death rate in Canada would fall by 37,000 deaths per year, which represented over 16% of annual deaths and that the economic burden of disease could be reduced by 6.9% which is equal to over $14 billion per year.

Their conclusion was that they recommended that "Canadian health policy leaders consider measures to increase serum vitamin D levels for all Canadians". Of course I would certainly agree with this!

I would ask all of my readers who live in Canada or anyplace that far north to check their vitamin D levels at least once a year. My book has been translated into the Estonia language and I would remind my Estonia readers that the latitude of Estonia is 58 degrees. Even more north than Canada! And all of Scandinavia is north of Estonia ! They need vitamin D even more!

So if you have family or friends in these northern countries, call or email them to remind them to take their D at least during the winter.

Let me know what you think of all this information? Have you notified your friends even in the north of the United States about taking vitamin D?

REFERENCE

 

Vitamin D Deficiency Associated with Dementia

A new study has been published in the Archives of Internal Medicine looking at vitamin D levels and brain function. The study was led by David Llewellyn, Ph.D. of the University of Exeter in England. His group evaluated elderly patients' brain function 3 times over a six-year period.

The researchers tested overall cognition which includes thinking, learning, and memory. They also tested attention and executive function. Executive function is the ability to plan, organize and prioritize.

The results of the study showed that those patients who were deficient in vitamin D were 60% more likely to have a significant decline in overall cognition and 31% more likely to have declines in executive function, than those who had sufficient vitamin D levels. A significant aspect of this study is that none of the elderly patients had any signs of dementia at the beginning of the study.

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50% of Americans Don’t Have Enough Vitamin D!

In a new article in Endocrine Today, Anthony Norman, MD, distinguished professor of biochemistry and biomedical sciences at the University of California, Riverside has said that "it is now widely appreciated by vitamin D scientists that 50% of people in North America and Western Europe are vitamin D insufficient. As far as the rest of the world, He went on to say in another interview  that "Elsewhere, it is worse, given that two-thirds of the people are vitamin D-insufficient or deficient. It is clear that merely eating vitamin D-rich foods is not adequate to solve the problem for most adults."

He also stated that "There is the emerging view that the relative daily intake of vitamin D should be increased from the currently recommended 200 IU, 400 IU, 600 IU per day to a significantly higher level of 2000 IU to 4000 IU per day. He further stated "Already, several studies have reported substantial reductions in incidence of breast cancer, colon cancer and type 1 diabetes in association with adequate intake of vitamin D, the positive effect generally occurring within five years of initiation of adequate vitamin D intake."

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50% of Americans Don’t Have Enough Vitamin D!

In a new article in Endocrine Today, Anthony Norman, MD, distinguished professor of biochemistry and biomedical sciences at the University of California, Riverside has said that "it is now widely appreciated by vitamin D scientists that 50% of people in North America and Western Europe are vitamin D insufficient. As far as the rest of the world, He went on to say in another interview  that "Elsewhere, it is worse, given that two-thirds of the people are vitamin D-insufficient or deficient. It is clear that merely eating vitamin D-rich foods is not adequate to solve the problem for most adults."

He also stated that "There is the emerging view that the relative daily intake of vitamin D should be increased from the currently recommended 200 IU, 400 IU, 600 IU per day to a significantly higher level of 2000 IU to 4000 IU per day. He further stated "Already, several studies have reported substantial reductions in incidence of breast cancer, colon cancer and type 1 diabetes in association with adequate intake of vitamin D, the positive effect generally occurring within five years of initiation of adequate vitamin D intake."

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Happy Summer! More and More Vitamin D Studies!

The amount of information coming out about vitamin D is exploding! There are currently more than 1000 ongoing studies looking at the benefits of vitamin D listed on clinicaltrials.gov.

From 1995 to 1999 the average number of papers with the term "vitamin D" in the title or abstract was about 700 to 900 annually. In 2009 alone over 2400 papers were published on vitamin D.

Prominent vitamin D researcher Anthony W. Norman M.D., who is a distinguished professor of biochemistry and biomedical sciences at the University of California, Riverside was quoted as saying "There has literally been an explosion of new data on vitamin D".
In his Endocrine Today blog Michael Kleerekpoer, MD, estimated that there are over 30,000 blood tests drawn for vitamin D done by laboratories every month in America.

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