I was invited as the outside expert for a Clinical Pathology Conference for the Harvard Medical School and New England Journal of Medicine about a child presenting with seizures who had severe vitamin D deficiency rickets. I also edited a book on bone health in children entitled Perinatal Calcium and Phosphorus Metabolism and served on the editorial board for the Journal of Pediatrics. I have done and continue to do both basic and clinical genetics research and was the author for the chapter Genetics of Vitamin D Disorders for the textbook Genetic Diagnosis of Endocrine Disorders. I wrote the review on Vitamin D Deficiency for the New England Journal of Medicine1 and alerted health care professionals worldwide about the unrecognized vitamin D deficiency and rickets epidemic in the review Resurrection of Vitamin D Deficiency Rickets in the Journal of Clinical Investigation 2006.2
I have published over 600 manuscripts in well-respected peer-reviewed journals and more than 200 reviews and book chapters. There have been more than 150,000 citations for my work in the field of calcium, vitamin D and bone metabolism on Google scholar. I served as the Chair for the Endocrine Society’s Clinical Practice Guidelines Committee for Vitamin D that published recommendations for how to treat and prevent vitamin D deficiency in children and adults.3 I have been considered by Castle Connolly as one of America’s Top Doctors for the past 19 years. Thompson Reuters in 2014 considered me to be one of the World’s Most Influential Scientific Minds, Clinical Medicine. In 2019 I was elected as a Fellow in the American Society for Clinical Nutrition and was elected into the Orthomolecular Medicine Hall of Fame. In 2019, the journal Current Opinion in Pediatrics invited be to write an up-to-date review on bone fragility for pediatricians. The review, Diagnosis and management of pediatric metabolic bone diseases associated with skeletal fragility was published in Current Opinion in Pediatrics 32;560-573: August 2020.4
Vitamin D Intoxication
Recently a patient presented at Boston Medical Center with vitamin D intoxication. We have identified that the patient was taking this product called ‘Bone Health’. Its states on the label that the product contains in each capsule 25 mg of vitamin D3. Users are instructed take two capsules a day. We analysed the capsule and found that it does contain 25 mg which is equivalent 1 million IUs vitamin D3. The company likely made a mistake of thinking that they were adding 25mcg (micrograms) which is 1000 IUs vitamin D3. This amount of vitamin D can cause severe vitamin D intoxication. I recommend that patients taking this product should stop taking it immediately.
Genomic or Non-Genomic? A Question about the Pleiotropic Roles of Vitamin D in Infammatory-Based Diseases
A recent large study reported that increasing vitamin D intake can reduce risk of autoimmune disorders including psoriasis. rheumatoid arthritis among other autoimmune disorders. This review provides an up to date review on the role of vitamin D on immune function and it’s anti-inflammatory activities.
‘Genomic or Non-Genomic? A Question about the Pleiotropic Roles of Vitamin D in InFammatory-Based Diseases’
Vitamin D Articles on Bottom Line Personal
100th anniversary of the discovery of vitamin D
Last year was the 100th anniversary of the discovery of vitamin D. I was given the opportunity to provide a historical record of its discovery and my personal experiences in identify the major circulating of vitamin D and active form of vitamin D when I was graduate student of the University of Wisconsin.
The One- Hundred-Year Anniversary of the Discovery of the Sunshine Vitamin, D3: Historical, Personal Experience and Evidence-Based Perspectives. Nutrients 2023, 15, 593. https:// doi.org/10.3390/nu15030593
Vitamin D Supplementation Linked to Fewer Suicide Attempts
Vitamin D Supplementation Linked to Fewer Suicide Attempts
This is a very large study of veterans evaluating vitamin D2 and vitamin D3 supplementation on suicide rates.
Those veterans who took vitamin D2 supplementation had a 48,8% reduced risk in suicide/self-harm and those on vitamin D3 supplementation had a 44,8% reduction in suicide attempt-self-harm risk.
For black veterans who took vitamin D2 supplementation they had a 57,9% reduction in suicide attempt and self harm risk compare to 46,3% lower risk for white veterans.
The same observation was made for black and white veterans for vitamin D3. 63,8% and 48,7% lower risk for black and white veterans respectively.
https://doi.org/10.1371/journal.pone.0279166
https://www.medscape.com/viewarticle/987738_print
Podcast Conversation: Sunlight, Skin and Vitamin D Synthesis
Vitamin D supplements may help decrease the risk of chronic inflammatory diseases
Older people with a vitamin D deficiency have higher levels of inflammation, a new study has found. Image credit: Guille Faingold/Stocksy.
Inflammation is the mechanism by which the body responds to and fights infection.
However, chronic, or long-term, inflammation is associated with many diseases, including diabetes, cardiovascular disease, arthritis, and dementia.
Age, obesity, poor diet, and smoking increase the risk of chronic inflammation.
A new study has added to growing evidence of a link between supplements may help reduce the risk of many inflammatory diseases.
Acute inflammation occurs in response to tissue damage, infection, or allergens, and is a necessary part of the body’s defenses. It occurs rapidly and generally lasts up to a few days.
Chronic inflammation, however, can last for months or even years. It can be caused by triggers including :
- infection that the body fails to clear
- long-term exposure to an irritant or foreign material
- an autoimmune disorder, such as rheumatoid arthritis or systemic lupus erythematosus
- an autoinflammatory disease, such as Familial Mediterranean Fever
- recurrent episodes of acute inflammation.
- Inflammation is linked to lifestyle factors, including obesity , a diet high in
Inflammation is linked to lifestyle factors, including obesity, a diet high in fried, processed, and sugary foods, and smoking tobacco.
It also increases with age, so much so that the process has been termed “inflammaging.” Inflammaging has been linked to cardiovascular disease, chronic kidney disease, diabetes, cancer, depression, and dementia.
Several studies have suggested a link between vitamin D deficiency and inflammation.
Now, a large-scale community study in Ireland has found that older adults with vitamin D deficiency have higher levels of inflammation markers than those with sufficient levels of the vitamin.
The authors suggest that vitamin D supplementation could decrease the risk of diseases linked to chronic inflammation.
Vitamin D deficiency tied to inflammation
Dr. Michael Holick, a professor of medicine at the Boston University School of Medicine, not involved in this study, explained why vitamin D deficiency is such a widely studied phenomenon.
He told us: “Vitamin D deficiency is probably the most common medical issue worldwide. It’s estimated that a billion people, maybe even half the world’s population, [are] vitamin D deficient or insufficient. And the reason is simple. Our major source of vitamin D is sunlight, and we are no longer out in the sun. We avoid the sun because of worries about skin cancer.”
In this study, 13% of participants were deficient in vitamin D. Most of those with deficiency were in the oldest group, had lower education, poorer socio-economic status, or were smokers.
The researchers found high CRP levels in those aged 75 years or over, with lower education, and higher rates of obesity. Those who were less physically active, or had three or more chronic conditions also had higher CRP.
After controlling for other risk factors for inflammation, Vitamin D deficiency was strongly associated with higher CRP, indicating higher levels of inflammation.
How might a lack of vitamin D lead to inflammation?
“There’s a lot of evidence that vitamin D plays a very important role in immunity,” Dr. Holick told MNT.
“We know that your immune cells, called T-cells, have vitamin D receptors, and that the macrophages release active vitamin D,“ he noted.
“They make vitamin D, and then they send that off to the T-lymphocytes that increase production of cytokines that help to preserve health and reduce cytokines that cause cytokine storm like [it] was seen in COVID,” Dr. Horlick explained.
Dr. Holick’s new JAMA Commentary
Article: The Death D-Fying Vitamin D3 for Digestive Tract Cancers—The p53 Antibody Connection
Publication Date: 08-22-2023
JAMA oncology is publishing an article by Kanno et al. (Effect of vitamin D supplements on relapse or death in a p53-immunoreactive subgroup with digestive tract cancer: post hoc analysis of the AMATERASU randomized clinical trial. JAMA Netw Open. 2023;6(8):e2328886. doi:10.1001/jamanetworkopen.2023.28886) along with my commentary. The importance of this observation cannot be over stated. What they have found is that if a patient with a digestive cancer, like colorectal cancer, has mobilized their immune system to fight the cancer 2000 IUs vitamin D3 taken daily for 5 years improved cancer remission by more than 150%. These investigators reported that 80.9% of patients whose immune systems were fighting a mutant p53 protein that was being produced by the cancer and who took 2000 IUs vitamin D3 daily were in remission (relapse-free survival). Only 30.6% of the patients who had the same immune fighting system and were in the placebo group, thereby taking no vitamin D3, supplementation were in remission. Those patients whose immune system was unable to fight the mutant p53 protein did not benefit from vitamin D3 supplementation. Approximately 50% of human cancers produce mutant p53 proteins to help the cancer grow. Therefore, if the body is able mount an immune response to the mutant protein then the cancer patient may have a better survival outcome if they also take 2000 IUs vitamin D3 supplementation. Some cancer patients with lymphoma who are more sensitive to vitamin D would need to consult their oncologist before consider taking this amount of vitamin D. Otherwise this amount of vitamin D is considered to be safe.
1 Holick, M.F. Vitamin D Deficiency. New Engl. J. Med. 2007. 357:266-81