VITAMIN D AND YOU- what you may not know

One of my patients had 1,25 vitamin D ordered by one of our respected specialists whom I both like and respect. Let me make use of this opportunity to share with you what I know about vitamin D.

There is no place to order vitamin D -1,25 level. The test to order no matter what you are looking for high or low is--- 25 OH vitamin D. WHY?

What is not commonly known is even in renal failure we should not order 1,25 OH Vitamin D level, WHY NOT ?

In vitamin D deficiency -blood 1, 25 D level could be normal, high or low (Dr.Holick,) Why in the world is it high?? Vitamin D deficiency increases PTH level which stimulates 1-25 conversion and the lab report may look normal while the patient is still vitamin D deficient.)

TRIVIA

What is vitamin D 2-? What is vitaminD3- ? for most of us this is all a blurrrrrr..
Vitamin D 2 is from plant source-
Vitamin D 3 is from animal source like fish oils etc.

MORE TRIVIA ABOUT VITAMIN D

Did you know natural milk, mother’s milk or cows milk does not contain vitamin D, even if the mother is not vitamin D deficient !!!!!!!
Therefore the vitamin D is actually added to cows' milk. If babies live on mothers milk alone for too long then.....you fill in the gap yourself.

MORE

Think about nursing home patients or your parents, grand parents exposed to less sunlight than you are. .


When you go to the beach think about this or think about your grand mother sitting in the sun .

Sunscreen shut off UV B (not UV A.) It is UV-B which converts vitamin D on the skin,( UV A does not help with vitamin D synthesis ) MAYO CLINIC PROCEEDINGS p.364 March 2006.

So people using sunscreens on the beach shutting off UV-B may also get less vitamin D conversion in the skin .
Did you know blacks need more vitamin D than fair skinned people in cold climates. Even 50 times more- Melanin is a great sunscreen shutting off UV -B - Makes sense.

DID you know in patients who had gastric surgery or has achlorhydria, TUMS ( Ca CO3) is not a good Calcium source? WHY NOT ?

CACO3 needs gastric HCL for absorption. So in perhaps in old people or people with gastric resection you should use Calcium citrate not CA CO3 for osteoporosis. Is your grand mother on TUMS for osteoporosis, then use this information for her sake.
WHAT IS THE RELATIONSHIP BETWEEN CANCER AND VITAMIN D.?

FACTS- Women living in warmer climates like Atlanta and San Antonio have fewer cancer of the breast than women in northern climates.
People living in warm climates have fewer cancer of the colon.
Dr.William Grant of NASA reported that people who live in sunny climates have lower death rates (once you have cancer) in cancer of breast, colon, prostate ovary, bladder, uterus, esophagus rectum and stomach- New York Times June 17, 2003 section D7
A Scandinavian study linked low levels of Vitamin D with an increased risk of developing cancer of prostate. I do not have this reference in my PDA. In the prostate, Vitamin D hormone is known to be a powerful inhibitor of abnormal cell growth.

These are the facts . Will you extrapolate and say all cancer patients should be getting extra doses of vitamin D ? You decide yourself.
Will you tell patients to get extra sun light without sun screen ?( see what NASA says above) You decide.

SHOULD THEY ALL MOVE TO FLORIDA ????

HOW MUCH VITAMIN D FOR YOU AND YOUR FAMILY AND PATIENTS ?
Michael Hollick in NEJM May 25,2006 p.2287 says " it is generally agreed that 1000 units of vitamin D3 a day is needed....to increase intestinal absorption of calcium and prevention of CANCER" CAN you believe that? Do people know that ? Do MDs know that.
This is different from previous recommendations that stated 800 units a day is enough.

I hope you can use this information to help your family members and patients and those you with prostate cancer and other cancers.