by Ian Wishart
Once again, the over-riding message: boost your vitamin D levels before you actually need them in a crisis. It may be the difference between life and death.
[1] It’s also proven successful at doing the unthinkable – killing the herpes virus in topical application in lab tests. See Investigate magazine, Jun/Jul 2012 issue, http://www.investigatedaily.com
[2] “Epidemic influenza and vitamin D,” Aloia & Li-Ng, Epidemiol Infect 2007; 135:1095-1096
[3] “A randomized controlled trial of vitamin D3 supplementation for the prevention of symptomatic upper respiratory tract infections,” Li-Ng et al, Epidemiol. Infect. (2009), 137, 1396–1404.
[4] “Serum 25-Hydroxyvitamin D and the Incidence of Acute Viral Respiratory Tract Infections in Healthy Adults,” Sabetta et al, PLoS ONE 5(6): e11088. doi:10.1371/journal.pone.0011088
[5] “A randomized controlled trial of vitamin D3 supplementation for the prevention of symptomatic upper respiratory tract infections,” Li-Ng et al, Epidemiol. Infect. (2009), 137, 1396–1404 http://www.vitaminedelft.org/files/art/ling2009.pdf
[6] “Cutting edge: 1,25-dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression,” Wang TT, et al. Journal of Immunology 2004; 173: 2909–2912.
[7] “Defensins in innate antiviral immunity,” Klotman ME, Chang TL. Nature Reviews Immunology 2006; 6: 447–
456.
[8] “Carbohydrate-binding molecules inhibit viral fusion and entry by crosslinking membrane glycoproteins,” Leikina E, et al. Nature Immunology 2005; 6: 995–1001
[9] The panel also ruled that vitamin D’s impact on cardiovascular health had not been sufficiently proven, but at the time of the ruling they did not have the benefit of the recent studies I’ve included in this book in the cardio chapter. EFSA Journal 2010; 8(2):1468 [17 pp.]. doi:10.2903/j.efsa.2010.1468
[10] “Randomized trial of vitamin D supplementation to prevent seasonal Influenza A in schoolchildren,” Urashima et al, American Journal of Clinical Nutrition, 2010, May, 91(5):1255-60
[11] “Vitamin D’s potential to reduce the risk of hospital-acquired infections,” Youssef et al, Dermato-Endocrinology, Volume 4, Issue 2 April/May/June 2012, http://www.landesbioscience.com/journals/dermatoendocrinology/article/20789/?show_full_text=true&
[12] “Pandemic influenza A (H1N1): mandatory vitamin D supplementation?” Goldstein et al. Med Hypotheses 2010; 74:756; PMID: 20006449; DOI: 10.1016/j.mehy.2009.11.006
[13] “The seasonality of pandemic and non-pandemic influenzas: the roles of solar radiation and vitamin D,” Juzeniene et al, Int J Infect Dis 2010; 14:e1099-105; PMID: 21036090; DOI: 10.1016/j.ijid.2010.09.002.
[14]http://www.naturalnews.com/033989_vitamin_D_tuberculosis.html#ixzz217RYbqP7
[15] “Vitamin D Deficiency and Tuberculosis Progression,” Talat et al, Emerging Infectious Diseases, Volume 16, Number 5 – May 2010, http://wwwnc.cdc.gov/eid/article/16/5/09-1693.htm
[16] “Vitamin D, tuberculin skin test conversion, and latent tuberculosis in Mongolian school-age children: a randomized, double-blind, placebo-controlled feasibility trial,” Ganmaa et al, Am J Clin Nutr August 2012 ajcn.034967
[17] “Vitamin D Is Required for IFN-y–Mediated Antimicrobial Activity of Human Macrophages,” Fabri et al, Sci Transl Med 12 October 2011: Vol. 3, Issue 104, p. 104ra102
[18] “Vitamin D’s potential to reduce the risk of hospital-acquired infections,” Youssef et al, Dermato-Endocrinology, Volume 4, Issue 2 April/May/June 2012, http://www.landesbioscience.com/journals/dermatoendocrinology/article/20789/?show_full_text=true&
[19] [Studies on the antimicrobial effect of vitamin D (author’s transl)]. Feindt E, Ströder J. Klin Wochenschr 1977; 55:507-8; PMID: 195120; DOI: 10.1007/BF01489010
[20] “The role of vitamin D in regulating immune responses,” Toubi & Shoenfeld, Isr Med Assoc J 2010; 12:174-5; PMID: 20684184
[21] “Antimicrobial implications of vitamin D,” Youssef et al. Dermato-Endocrinol 2011; 3:1-10; PMID: 21519401; DOI: 10.4161/derm.3.4.15027
[22] “Healthcare costs of Staphylococcus aureus and Clostridium difficile infections in veterans: role of vitamin D deficiency,” Youssef et al. Epidemiol Infect 2010; 138:1322-7; PMID: 20056018; DOI: 10.1017/S0950268809991543.
[23] “Healthcare costs of methicillin resistant Staphylococcus aureus and Pseudomonas aeruginosa infections in veterans: role of vitamin D deficiency,” Youssef et al. Eur J Clin Microbiol Infect Dis 2012; 31:281-6; PMID: 21695580; DOI: 10.1007/s10096-011-1308-9
[24] “Relationship between vitamin D status and ICU outcomes in veterans,” McKinney et al. J Am Med Dir Assoc 2011; 12:208-11; PMID: 21333923; DOI: 10.1016/j.jamda.2010.04.004
[25] “Relationship of Vitamin D Deficiency to Clinical Outcomes in Critically Ill Patients,” Higgins et al, JPEN J Parenter Enteral Nutr 2012; ; PMID: 22523178; DOI: 10.1177/0148607112444449
[26] “Vitamin D deficiency is associated with poor outcomes and increased mortality in severely ill patients,” Arnson et al, QJM, (2012) doi: 10.1093/qjmed/hcs014
[27] “Vitamin D’s potential to reduce the risk of hospital-acquired infections,” Youssef et al, Dermato-Endocrinology, Volume 4, Issue 2 April/May/June 2012, http://www.landesbioscience.com/journals/dermatoendocrinology/article/20789/?show_full_text=true&
CHAPTER 9
CONCEPTION, PREGNANCY, CHILDHOOD:
WHY YOUR BABY NEEDS VITAMIN D
“Our statistics suggest that it could explain about 40 percent of all schizophrenias. That’s a much bigger effect than we’re used to seeing in schizophrenia research”
– John McGrath, Queensland Brain Institute, 2010
You’ve probably heard the radio ads for erectile dysfunction. For men, it’s a little like those ads from the sixties and seventies where the skinny weakling on the beach gets sand kicked in his face by a musclebound Adonis. The latter may have been pitching a body-building programme, but the psychology behind the advertising is the same.
The moral of erectile dysfunction, however, appears to be that if the skinny weakling had spent more time sunbathing he’d probably be fine in the sack. From our ‘not-that-as-well?’ file comes the news that the sunshine vitamin has been linked to sexual performance issues.
The logic behind it is laid out in a recent report in the medical journal Dermato-Endocrinology, which points out that half of ED cases are caused by vascular health issues. With vitamin D’s role in maintaining the cardiovascular system and keeping blood pumping to the extremities, researchers say getting a vitamin D check-up is probably a wise idea.
“The treatment of choice for ED has been the use of phosphodiesterase-5 inhibitors such as Viagra,” says study author Marc Sorenson.
“While effective in relieving the ED symptoms, these drugs do nothing for the underlying cause and may lose their effectiveness over time. They may also hide from users the possibility of cardiovascular disease…if proven in further research, vitamin D optimization has the potential to influence the cause of ED to prevent or mitigate the condition.”
It may sound like something to chortle over, but Sorenson says it’s actually deadly serious. When erectile dysfunction appears, it can sometimes be a harbinger of something much worse.
“Although nonvascular factors such as depression, fatigue, stress, Parkinson disease, multiple sclerosis (MS), and hypertensive medications may affect ED,[1] it is primarily a vasculogenic disease. Its most prevalent cause is the arterial occlusion of atherosclerosis, which also affects the coronary arteries and can lead to heart attack[2] or, in other parts of the body, vascular events such as stroke[3] and peripheral arterial disease (PAD).[4]”
For all the reasons that you would take vitamin D to help maintain heart and cardiovascular health, the benefits of doing so might actually help you dodge an appointment down the track with an erectile dysfunction specialist.
Apart from affecting your ability to sexually perform, vitamin D turns out to have other fundamental roles in conception: creating healthy sperm[5] and boostin
g the fertility[6] and sexual health of both men and women[7]. Vitamin D has been linked to higher testosterone and androgen levels in men,[8] and is heavily linked to women’s reproductive health.
“There is some evidence, that in addition to sex steroid hormones, the classic regulators of reproduction, vitamin D also modulates reproductive processes in women and men,” say the research team behind one recent analysis.[9]
Around 15% of couples report fertility problems, and 30-40% of those are related to male issues including sperm quality. Again, it’s no surprise to see fertility problems rising in the wake of two decades of slip, slop, slap sun avoidance messages.
In women, vitamin D – which is in reality a steroid hormone – lowers the dominance of estrogen, thereby helping improve fertility as well as lowering breast cancer risk.[10] On the other hand, low vitamin D levels appear to be strongly associated with infertility, as a team from Yale University discovered in 2008:
“Of note, not a single patient with either ovulatory disturbance or polycystic ovary syndrome demonstrated normal Vitamin D levels; 39 per cent of those with ovulatory disturbance and 38 per cent of those with PCOS had serum 25OHD levels consistent with deficiency,” Yale’s Dr Lubna Pal told journalists.[11]
“Given the pandemic of Vitamin D insufficiency, if indeed our observations are substantiated, aggressive repletion with Vitamin D may emerge as an alternative approach to facilitate ovulation resumption with minimal to no risk for ovarian hyperstimulation syndrome or multiple pregnancy.”
A staggering 93% of infertile women treated by the Yale team were either clinically deficient or insufficient in vitamin D.
Fertility forums on the internet are rife with women who haven’t been able to get pregnant and whose obstetricians are now prescribing megadoses of vitamin D (50,000IU a week for several weeks) to improve their blood levels and chances of healthy conception.
Low vitamin D levels may be linked to second trimester miscarriage.[12]
It is, however, in pregnancy itself that vitamin D is so crucial, and at levels far above those contained in pregnancy multivitamins: “During pregnancy, supplementation with the current standard amount of vitamin D in prenatal vitamins – 400 IU (10 μg) vitamin D/day – has minimal effect on circulating 25(OH)D concentrations in the mother and her infant.”[13]
“There is considerable evidence that low maternal levels of 25 hydroxyvitamin D are associated with adverse outcomes for both mother and fetus in pregnancy as well as the neonate and child.[14]
“Vitamin D deficiency during pregnancy has been linked with a number of maternal problems including infertility, preeclampsia, gestational diabetes and an increased rate of caesarean section.
“Likewise, for the child, there is an association with small size, impaired growth and skeletal problems in infancy, neonatal hypocalcaemia and seizures, and an increased risk of HIV transmission. Other childhood disease associations include type 1 diabetes and effects on immune tolerance.”
You can add childhood obesity to that list. Over the past thirty years, we’ve increasingly become fatter. Now a new study is blaming part of that on low vitamin D during pregnancy.
Researchers at the University of Southampton followed up the pregnancy blood samples of 977 women by comparing them to the health outcomes of their children by age 6. Low vitamin D levels in mothers were found to result in lower weight babies, but ironically fatter children by the age of six, even after controlling for lifestyle, physical activity, body mass index and other factors.[15]
It is too early to know how, but researchers believe there is something about vitamin D that helps lock in fat regulation mechanisms in the developing foetus. [16] Further possible evidence of this emerged in another recent study of seriously obese teenagers undergoing bariatric surgery. Fifty-four percent were either deficient or severely deficient in vitamin D, and although obese people are routinely low in vitamin D, in this case race played a huge part. Eighty-two percent of African-American teens in the study were deficient or worse, 59% of Hispanics and 37% of European-Americans.
“The US adolescent obesity rate has more than tripled in the past 30 years,” reported one medical journal on the study, “with 16% of children and adolescents now overweight, 4% obese and 4% morbidly obese.”[17]
As we discussed in the Asthma chapter, mothers with low vitamin D levels during pregnancy are more likely to have children with asthma and/or common allergies. Children with 25(OH)D levels lower than 15 ng/ml are a whopping 240% more likely to have a peanut allergy than children with 30 ng/ml vitamin D, for example.[18] Another case-control study in 2012 reported children with low vitamin D levels in their first year of life are almost four times more likely to develop food allergies.[19]
A comprehensive review of vitamin D in pregnancy published recently, and available to read in full on the internet,[20] shows just how widespread deficiency in pregnancy is:
“Reports of profound [severe] deficiency among pregnant women, those with 25(OH)D concentrations <10 ng/mL (25 nmol/L) are common throughout the world: 18% of pregnant women studied in the UK[21], 25% in the UAE ,[22] 80% in Iran,[23] 42% in northern India,[24] 61% in New Zealand ,[25] 89.5% in Japan,[26] and 60–84% of pregnant non-Western women in The Hague, Netherlands[27] had serum 25(OH)D concentrations <10 ng/mL (25 nmol/L).
“Interestingly, in a recent study involving 144 pregnant women in the greater Copenhagen area evaluated at 18, 32 and 39 weeks of gestation, 1.4–4.3% had this degree of deficiency;[28] this lower rate may correlate with increased dietary intakes of fish. For those areas of the world with higher rates of deficiency, it appears that a long-standing unawareness of how vitamin D is made and of the short and long-term health consequences of vitamin D insufficiency has led to widespread insufficiencies in most populations.”
New Zealand is one of the countries that has taken the sunsmart, slip, slop, slap message utterly to heart, and its 61% severe deficiency levels in pregnancy may be a direct result of educated New Zealand women avoiding the sun. Those levels would also explain the rise in rickets, autism, asthma, attention deficit disorder and some of the other conditions we’re about to see.
Good levels of vitamin D are needed during pregnancy for proper development of your baby’s skeleton, tooth enamel and growth and wellbeing. Women take folic acid to prevent neural tube defects in their babies like spina bifida, but with mothers hiding from the sun they’re leaving their unborn children vulnerable to a range of other nasties.
Otherwise-healthy newborns, but with low vitamin D levels, are six times more likely to fall victim to RSV, a virus responsible for the most serious lower respiratory tract bronchiolitis infections in infants.[29]
If a woman’s vitamin D deficiency is severe whilst she is pregnant, she runs a heightened – albeit rare – risk that her baby may have hypocalcaemic seizures in the womb.
As we’ve already seen, a lack of vitamin D in pregnancy may lead to autism, and new research has added schizophrenia to that list. A 2010 study of 424 Danish schizophrenia sufferers matched them for both gender and birthdate with a control group of 424 people without the condition.
Using blood samples taken at birth and stored, researchers were able to look at the vitamin D levels of all the babies at birth. They discovered those babies with low levels of the vitamin were twice as likely to develop schizophrenia later in life.[30]
“Our statistics suggest that it could explain about 40 percent of all schizophrenias. That’s a much bigger effect than we’re used to seeing in schizophrenia research,” lead researcher John McGrath, of the Queensland Brain Institute in Australia, told reporters.[31]
There are other factors at play in schizophrenia, mainly genetic[32] and environmental,[33] but just as with autism it appears low vitamin D levels leave your child’s body more vulnerable to whatever flicks the switch and brings those other factors into play.
There was a strange twist in the tail of this particular study, similar to the one discovered with that other Scan
dinavian study – the Finnish smokers. Just like that, the schizophrenia research team found that those with the absolute highest levels of vitamin D appeared to begin raising the risk again for schizophrenia. In statistical analysis, this is known as a “U-shaped curve”, inasmuch if you follow the U, the risk goes down, then goes back up at some point.
The researchers on the Danish data haven’t been able to find out why it happened, but they suspect it may be a genetic variation in the Scandinavian sample, where a certain number of people can have high circulating vitamin D in their blood, but a mutation prevents them from converting the vitamin in the blood to the biologically-active form of vitamin D actually used by the organs. In other words, their vitamin D processing system is not working properly – they have a lot of vitamin in the tank but the outflow pipe is blocked. They would appear in the sample with high levels of the vitamin, but wouldn’t be getting the benefit of it, which could explain the apparent rising risk.[34]
It is a cautionary development, however, and all the more reason to get your vitamin D levels regularly checked by your doctor during pregnancy to ensure you are neither low nor excessively high. Because baby’s skeleton is formed by stripping back minerals from a mother’s bones, a lot of the vitamin D taken by a pregnant woman will be used to help replenish and rebuild, in addition to supplementing your child’s brain development.
The schizophrenia study, like autism studies before it, found babies born to dark-skinned mothers are far more likely to develop the mental illness, and researchers believe this discovery of a sunlight factor could have huge implications for our society, as lead author McGrath notes:
“For example, in dark-skinned ethnic groups living in cold countries, there is a substantially increased risk of schizophrenia.[35] Kirkbride and Jones[36] have estimated that if the yet-to-be-identified risk factors underlying the increased risk of schizophrenia in black minority ethnic groups living in England could be identified and prevented, it may be feasible to reduce the incidence of schizophrenia in this group by a staggering 87%.[37] While there is much more work to be done, if future studies confirm the association between developmental vitamin D deficiency and risk of schizophrenia, it raises the tantalizing prospect of the primary prevention of this disabling group of brain disorders in a manner comparable with folate supplementation and the prevention of spina bifida.”