Vitamin D for Peter, Paul, and Mary

27. March 2009 William Davis (15)
Why is it that vitamin D deficiency can manifest in so many different ways in different people? One big reason is something called vitamin D receptor (VDR) genotypes, the variation in the receptor for vitamin D.

It means that vitamin D deficiency sustained over many years in:

Peter yields prostate cancer

Paul yields coronary heart disease and diabetes

Mary yields osteoporosis and knee arthritis.


Same deficiency, different diseases.

VDR genotype-determined susceptibility to numerous conditions have been identified, including Graves' thyroiditis, osteoporosis and related bone demineralization diseases, prostate cancer (Fok1 ffI genotype), ovarian cancer, rheumatoid arthritis, breast cancer (Fok1 ff), birth weight of newborns, melanoma and non-melanoma skin cancers, insulin resistance and metabolic syndrome, susceptibility to type I diabetes, Crohn's disease, and neurological or musculoskeletal deterioration with aging that leads to falls, respiratory infections, kidney cancer, even periodontal disease.


Why is it that the dose of vitamin D necessary to reach a specific level differs so widely from one person to the next? VDR genotype, again. Variation in blood levels of 25-hydroxy vitamin D from a specific dose of vitamin D can vary three-fold, as shown by a University of Toronto study. In other words, a dose of 4000 units per day may yield a 25-hydroxy vitamin D blood level of 30 ng/ml in Mary, 60 ng/ml in Paul, and 90 ng/ml in Pete--same dose, different blood levels.

Should we all run out and get our VDR genotypes assessed? So far the data have not progressed far enough to tell us. If, for instance, you prove to have the high-risk Fok1 ff genotype, would you do anything different? Would vitamin D supplementation be conducted any differently? I don't believe so.

Virtually all of us should be supplementing vitamin D at a dose that generates healthy blood levels, regardless of VDR genotype. For those of us following the Track Your Plaque program for coronary plaque control and reversal, that means maintaining serum 25-hydroxy vitamin D levels between 60-70 ng/ml.

As the fascinating research behind VDR genotype susceptibility to disease unfolds, perhaps it will suggest that specific genotypes be somehow managed differently. Until then, take your vitamin D.
Tags :

Comments (15) -

  • Kiwi

    3/27/2009 8:48:00 PM |

    I've been taking vitamin D for about five months now after reading Dr. Davis' excellent blog.
    Was taking two Thompson's D 1000 caps/day. Latest test result for 25 hydroxy came back at 142 nmol/l so have cut back to one cap/day. So yes, dose depends on body type and sun level (summer here).

  • Kiwi

    3/27/2009 9:00:00 PM |

    I've just done the conversion to ng/mL. Is that by dividing by 2.5? Perhaps I should keep up the two caps/day?

  • Dr. William Davis

    3/27/2009 10:39:00 PM |

    Yes. 142 nmol/L = 56.8 mg/dl.

  • Monica

    3/28/2009 1:41:00 AM |

    Thanks for blogging on this, Dr. Davis.  I just got my test for the first time and was alarmed that I came in at only 30 ng/mL after supplementing with 1000 IU daily for about a year.  I had previously lived in Syracuse, NY, the cloudiest city just behind Seattle.  And on a grain-based crap diet, too.  No longer.  Here's my vitamin D story:  http://sparkasynapse.blogspot.com/2009/03/vitamin-d-results.html

    I've been wheat-free for 9 months now, but this makes me really curious about my lipid profile...  I still have a ways to go to reach optimum health.  I'm only 34 so hopefully plenty of time to correct this problem.  Unfortunately for my older relatives they were not so lucky.  Cancers, diabetes, heart disease abound.

  • Anonymous

    3/28/2009 5:58:00 AM |

    Have you any comment on this:
    http://www.cholesterol-and-health.com/Vitamin-D.html

  • Peter Silverman

    3/28/2009 10:28:00 AM |

    Article in yesterday NY Times regarding high doses of D3 protecting against fractures:
    http://www.nytimes.com/2009/03/31/health/research/31aging.html?ref=health
    Unfortunate that the title says pills not capsules.

  • Anonymous

    3/28/2009 5:17:00 PM |

    I was also very shocked with my vitamin d test results. After 5 months @ 6000iu daily my level was only 34 ng/mL. It is winter but I work outside and seldom use suncreen.

  • Anonymous

    3/28/2009 9:34:00 PM |

    The Toronto study suggests there are polymorphisms of the D-binding protein. Isn't this a separate entity than VDR, which is present on cellular surface in many tissues? Maybe I am misunderstanding something ....Thomas

  • Ricardo

    3/28/2009 10:46:00 PM |

    Dr. Davis, should runner's use some suncreen? I was reading this article and decided to ask here: http://dailyviews.runnersworld.com/2009/03/i-will-never-ev.html

  • Kismet

    3/29/2009 11:12:00 AM |

    As the evidence currently stands everyone should wear sunscreen *and* supplement vitamin D. (benefits of red & blue light can be had without dangerous UVR)

  • rabagley

    3/29/2009 9:56:00 PM |

    Basically, we should all be getting full-spectrum sunlight in moderate amounts.  Moderate means that you have browning or slight reddening of the skin (if you're still red the next day, that was too much).  This does increase your risk of carcinomas (a low risk type of cancer), but minimizes your risk of melanomas (an extraordinarily high risk type of cancer).  Repeated sunburns increases your risk of melanoma and should be avoided if at all possible.

    As a runner, it's often difficult to control the length of time you spend in the sun to moderate your exposure.  The length of time you spend running will usually have more to do with your exercise goals than your sun-exposure goals.  This means that you will most likely not be able to maintain moderation and would put yourself at increased risk of dangerous cancers.

    So starting from a completely different set of assumptions, I reach the same conclusion as Kismet, that you should probably be wearing sunscreen and supplementing with Vitamin D3 gelcaps.

  • TedHutchinson

    3/30/2009 11:22:00 AM |

    Ricardo

    Skin Cancer/Sunscreen - the Dilemma

    and everyone else will benefit from  watching the Edward Gorham's video or if time is short at least look at the slides used in his presentation
    Skin Cancer/Sunscreen -- the Dilemma slides PDF
    No one should ever allow skin to burn. Prolonged UVB exposure   processes any vitamin d near the skin surface into suprasterols that are not usable, so alternating short sun sessions with time for the skin to cool down and Vitamin D to be absorbed will optimize the process.

  • Rick

    4/2/2009 7:11:00 AM |

    This lecture is entertaining and informative:
    Vitamin D

  • Anonymous

    4/6/2009 10:34:00 PM |

    I have always purchased Vitamin D3 from fish oil but discovered while shopping this weekend that there is also a Vitamin D3 obtained from 'wool' or 'lanolin'.  I had never seen this before.  Which is preferable? from fish oil or from lanolin?

    thanks,
    nancy

  • Anonymous

    4/10/2009 6:24:00 PM |

    Can someone list the effects of overdosing on D3?

Add comment

Loading
An epidemic of heart disease reversal

An epidemic of heart disease reversal

10. January 2007 William Davis (3)
Heart disease reversal is nothing new in my office. However, I have to admit that it's not something that generally happens each and every day.

As our approach is refined, we are witnessing an unprecedented frequency of plaque reversal. Since Monday (today is Tuesday), I've seen four people who have regressed their coronary plaque and dropped their heart scan score.

Pat was the most recent addition to this list. At age 53, I was honestly surprised at the ease of dropping her heart scan score from 128 to 42 in the space of a year. I was surprised because among her lipoprotein patterns was the dreaded combination of lipoprotein(a) and small LDL, probably the most aggressive risk for heart disease I know of and also among the most difficult to gain control over. She also suffered a deep personal tragedy in her family, an emotional convulsion that can sometimes wipe out any hope of plaque reversal.

I'm hopeful that this virtual epidemic of heart disease reversal continues. And I hope that you participate in it.
Tags :

Comments (3) -

  • Bill, the songwriter

    1/30/2008 12:58:00 AM |

    Dr. Davis, I have been reading your site off and on for months. I guess only a doc can answer this.

    I am confused about the options a "reasonable person" would have upon learning that he has coronary heart disease (CHD). By that, I mean blockage in a major artery.

    Take me for example. (First, I'm doing fine now.) Two years ago, I had the "felt like a band tightening around my chest." 911 ambulance ride to the hospital. Bummer. My family history is terrible, all the men died of heart disease. I'm 54 now. I was disappointed and a bit apprehensive, although not "scared." I just figured they'd fix it. It usually works out that you don't die. (Although I lost a good friend on the bypass table who was seemingly healthy as could be the day before... routine physical and a stress test and they recommended bypass right away. He died on the table from the surgery!)

    Back to me... over the next few days, CHD confirmed. LAD had 99% blockage and a branch had 90%.

    I assume that my options at that time were...

    1. Get angioplasty and that's it
    2. Get angioplasty and a stent(s)
    3. Get bypass surgery
    4. Treat the heart disease with aggressive therapy. Which if you buy into the mainstream medicine way, it's drugs, low-fat diet, exercise, stress reduction. If you buy into alternative methods, it can include low-carb diet and powerful supplements.

    Confusion revolves around #4. My question is...

    >>>
    Do you think #4 is apropos for a person in this situation? (99% blockage in LAD)
    >>>

    I am confused because I'm thinking, okay, confirmed blockage. But it was the first sign I had ever had that I had heart problems.

    I realize that the percentage is a guess on the cardiologist's part, they don't measure it. But if it's 99% I tend to think... what is the risk of walking away to treat it without #1, 2 or 3? A blood clot that occurs for whatever reason hits that blockage and I could die. Could happen at any moment. Hours, days, weeks, months, years later.

    I also realize that there is risk in angioplasty, stents and bypass. Even discounting risk (of complication or dying on the table), restenosis is a common problem. And of course, you can have other blockages manifest themselves.

    But you could take the aggressive alternative therapy route and hope to stop the growth of plaque. At that time, I was not convinced that the blockages could be "reversed." Now, it appears that this can occur.

    I'll assume that you can reverse the situation and actually clean up your arteries. Is it a reasonable risk to opt for #4 or is this only for people who have less severe blockage? You're risking that you DON'T have a blood clot hit a blockage and kill you before you can achieve the artery-cleaning effect by your therapy, whatever it is.

    Seems I have read that stats are showing that #1, 2 or 3 do not necessarily beat #4 ... that #4 does just as well (lifespan) after the diagnosis.

    If quality of life was an issue, such as a person who has angina so severe or such difficulty breathing that a normal life was not possible, maybe that person is a definite candidate for #1, #2 or #3. But I wasn't there. I felt fine before AND after the event.

    As mentioned, I'm doing fine now. I love my low-carb diet, my lipids are great, I've lost weight, I exercise. This is just something that I would like to clear up for my own education. And who knows, a friend might ask me about this if s/he is diagnosed.

  • Dr. Davis

    1/30/2008 1:12:00 AM |

    You've made great changes in your lifestyle that will likely translate into much reduced risk for more struggles with heart disease. However, it is highly unlikely that you've put a stop to it, let alone reversing it.

    I would refer you to the website that this blog accompanies, www.trackyourplaque.com. Please keep in mind that I nor any other responsible physician can diagnose or offer individualized medical information over the net.

  • Bill, the songwriter

    1/30/2008 2:03:00 PM |

    Thanks for answering. I didn't mean to infer I am asking about me in particular for a present situation, I just used me as an example because that's what I know. I was asking about a hypothetical person.

    I've read much on your site but I'll go back again.

    IMO, 99% (at least) of all people who get a recommendation from a cardiologist to undergo an invasive procedure... they do it. And I'm curious about one taking another approach.

    Oh well, thanks again, Doc.

Add comment

Loading