According to PubMed.gov, in 2012 there were 3600 publications with vitamin D in the title or abstract — more than for any other vitamin. This brings the total number of publications on vitamin D listed by PubMed to 33,800. This total compares to 35,100 on vitamin C or ascorbic acid, 21,700 on vitamin E, 19,100 on vitamin A, 17,600 on folate, and 12,000 on vitamin B12.
Vitamin D thereby has become the most popular vitamin, even though strictly speaking it is not a vitamin. Technically, it is an essential hormone that can be made in the body via the action of ultraviolet B (UVB) light. It can also be obtained orally via diet or supplements.
THINGS TO KNOW ABOUT THIS SUPERSTAR NUTRIENT
• In a world of sun avoidance, sun blocks, working indoors, latitudinal effects, etc., nearly the entire population suffers in multiple ways from Vitamin D3 deficiency.
• Dermatological associations in the US and some other countries have a “zero” sun-exposure policy. This shows how far they lag behind current research. Although Vitamin D supplementation is ideal in winter, in other months, a certain amount of sunshine on skin allows the body to generate its own Vitamin D3 naturally!
• Inadequate Vitamin D3 is associated with osteoporosis, poor immunity, autoimmune diseases, diabetes, hypertension, cancers, susceptibility to flu, neurological problems, autism, depression, chronic pain, periodontal disease, muscle weakness, birth defects, and other conditions.
• Human beings optimally produce 10,000–20,000 IU of Vitamin D3 (cholecalciferol) when exposed to full sunlight on a significant portion of skin for about 30 minutes.
• The body starts to gain the full benefits of Vitamin D3 only after it produces (or intakes orally) about 5,000 IU Daily.
• Vitamin D3 is a prehormone with powerful effects and with few exceptions cannot be obtained in sufficient amounts from diet.
• Vitamin D3 can be described as a “superstar” because indirectly it comes from our solar system star…the sun!
VITAMIN D DEFICIENCY IS EPIDEMIC WORLDWIDE
Vitamin D deficiency currently is a worldwide epidemic with more than one billion people at risk for diseases associated with low Vitamin D status. Vitamin D is proven safe and effective for a wide range of health conditions (see above and below). There are various reasons for this epidemic, including a significant portion of the world’s population living in northerly latitudes (where sunlight is inadequate during many months of the year), sun avoidance, time spent indoors, etc.
WHAT IS VITAMIN D3 PLUS?
VITAMIN D3 PLUS is an advanced Vitamin D formula providing high-dose Vitamin D3. Vitamin D3 is the natural form of Vitamin D produced in the body from sunlight and is the form best used for therapeutic purposes.
One softgel capsule of Vitamin D3 Plus provides 5,000 IU of Vitamin D3 derived from highly purified and molecularly distilled fish liver oils. In addition, the product contains 1,000 IU of Vitamin A also derived from highly purified and molecularly distilled fish liver oils and 10 mcg of Vitamin K2 from menaquinone-7.
RECOMMENDATIONS FOR SUPPLEMENTING WITH VITAMIN D3 PLUS
Recent research on Vitamin D suggests that most people will benefit from 5,000 IU of Vitamin D3 daily (unless there is some constraining lifestyle factor or medical reason). Due to its long half-life (about 30 days) in the body, Vitamin D can be taken effectively in smaller doses if needed (e.g., 5,000 IU taken fewer times per week). For example, taking one capsule once per week would give a daily equivalent dose of about 714 IU (i.e., 5,000 IU divided by seven days).
Additional important nutrients you need to take with Vitamin D3 in order to achieve maximum benefits include magnesium, calcium, zinc, and boron. These additional nutrients are included in our foundational supplements (multivitamins, essential fats, Vitamin C formulas, and Rejuvenate!™ superfoods) and bone formulas (Bone Jour!™and Bone Guardian).
NUTRITIONAL FACTS REGARDING HPDI’S VITAMIN D3 PLUS
The liver and kidney help convert vitamin D to its active hormone form. The major biologic function of Vitamin D is maintaining normal blood levels of calcium and phosphorus. Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones. It promotes bone mineralization in conjunction with a number of other vitamins, minerals (especially magnesium), and hormones. While adequate sun exposure is an ideal means to obtain Vitamin D, most of the population cannot obtain sufficient sunlight during fall and winter months to maintain optimal Vitamin D levels. HPDI’s Vitamin D3 Plus offers a solution for keeping Vitamin D levels healthy…so you can be your healthiest!
When there is insufficient Vitamin D in the body, bones can become thin, brittle, soft, or misshapen. Vitamin D prevents rickets (in children) and osteomalacia (softening of bones) (in adults). These skeletal diseases result in defects that can severely weaken bones. It is estimated that over 25 million adults in the United States either have developed osteoporosis or are at risk of developing it. Osteoporosis is a disease characterized by fragile bones. It results in increased risk of bone fractures. Vitamin D deficiency was recognized as the cause of rickets and osteomalacia 75 years ago. The prevention and cure of these diseases with fish liver oil was a triumph for nutritional science and since then the body’s requirement for Vitamin D has been linked to these conditions.
Vitamin D deficiency also has been associated with greater incidence of hip fractures. In older women, a higher Vitamin D intake from diet and supplements is associated with less bone loss. Vitamin D supplementation therefore may help prevent fractures resulting from osteoporosis and the loss of bone. Vitamin D supplements offer a significant means for strengthening bones and skeletal structures, and for preventing bone weakness or bone loss leading to osteomalacia, osteoporosis, and other conditions related to weak bones.
Vitamin D affects major aspects of human health beyond its classical role in mineral metabolism. It is well established that the active form of Vitamin D acts an effective regulator of cell growth and differentiation in a number of different cell types, including cancer cells. Laboratory, animal, and epidemiologic evidence strongly suggest that Vitamin D may be protective against some cancers. Clinical studies now show Vitamin D deficiency to be associated with four of the most common cancers: breast cancer, prostate cancer, colon cancer, and skin cancer. The active form of Vitamin D plays a critical role in supporting optimal health!
VITAMIN A AND VITAMIN K2 WORK TOGETHER WITH VITAMIN D
It is important to understand that Vitamin A works together with Vitamin D and Vitamin K2 to maintain healthy bones. Vitamin D has been shown to prevent Vitamin A toxicity. VITAMIN D3 PLUS includes Vitamin A because Vitamin A and Vitamin D work together to create excellent health!
Vitamin K2 in the form of MK-7 has been shown in numerous studies to extract calcium from the blood and arteries and deposit calcium into growing or aging bones. In addition, MK-7 appears to have the potential to prevent or even reverse some forms of heart disease and, at the same time, do the same for bone loss. It is believed that patients would be able to be treated with doses of vitamin D that possess greater therapeutic value than those currently being used while avoiding the risk of adverse effects by administering Vitamin D together with Vitamins A and K2. Vitamin D3 Plus includes Vitamin K2 (as MK-7) because MK-7 provides unique benefits for health that complement the benefits offered by Vitamin D…and because they act synergistically to provide other benefits beyond the benefits each provides by itself!
RECENT RESEARCH STUDIES ON VITAMIN D
Orthomolecular Medicine News Service recently released the top 16 Vitamin D papers of 2012. These are summarized below.
4,000 IU vitamin D3 was of great help during pregnancy
A topic that generated considerable interest this year was the role of vitamin D during pregnancy. In a pair of papers, researchers from the Medical University of South Carolina discussed the findings and implications of their randomized controlled trial of vitamin D supplementation during pregnancy [Hollis et al., 2012; Wagner et al., 2012]. Over 300 women were enrolled in the study. Women were assigned to take supplements containing 400, 2000, or 4000 IU/d vitamin D3 or a placebo. No adverse effects were found such as hypercalcemia or hypercalcuria. This study found that it took 4000 IU/d to raise serum 25-hydroxyvitamin D [25(OH)D] levels to about 40 ng/ml (To convert to nmol/l, multiple ng/ml by 2.5.), a nearly optimal level of 1,25-dihydroxyvitamin D. 1,25-dihydroxyvitamin D is the active or hormonal metabolite of vitamin D which among other things controls the expression of several hundred genes. (See Hossein-nezhad and Holick  for a summary of the effects of vitamin D on fetal development.) In the study, those taking the higher vitamin D doses had significantly reduced risk of primary Cesarean section delivery and pre-eclampsia. Other adverse pregnancy outcomes occur with vitamin D deficiency such as premature delivery and low birth weight, but too few women were enrolled in this study to find statistically significant results on these conditions.
Mounting evidence that vitamin D deficiency is an important risk factor for autism
A study from Saudi Arabia examined the relation between serum 25(OH)D level and anti-myelin-associated glycoprotein (anti-MAG) auto-antibodies in autistic children near the age of eight years [Mostafa and Al-Ayadhi, 2012]. There was a very strong inverse relation between the two levels (r = -0.86, p<0.001). The serum 25(OH)D levels in autistic children averaged 19 ng/ml, while that for healthy children averaged 33 ng/ml. Both autistic and healthy children had about six hours of sun exposure per week. The reason that MAG is relevant to autistic children is that MAG is a compound that promotes regeneration of young neurons. Anti-MAG auto-antibodies appear to play a role in some autoimmune disorders relating to neurons through attacking cells that maintain a healthy nervous system. Serum anti-MAG auto-antibodies are strongly related to autism measured with the Childhood Autism Rating Scale. This provides very strong evidence that vitamin D deficiency is associated in some way with autism. Whether increasing serum 25(OH)D levels for those with autism reduces the symptoms of autism remains to be determined.
Low vitamin D during pregnancy is associated with childhood language impairment
A study in Perth, Australia measured serum 25(OH)D levels at 18 weeks into pregnancy, and then measured language impairment of the offspring at 5 and 10 years of age. It found that women with serum 25(OH)D levels below 18 ng/ml had children with twice the risk of clinically significant language difficulties compared to those with 25(OH)D levels above 28 ng/ml. Exactly why is not currently known, but there are many possibilities. It is noted that in the United States in the early 2000s, white women of childbearing age had mean 25(OH)D level of 26 ng/ml while black women of childbearing age had mean 25(OH)D level of 14 ng/ml. Both of these levels are low by current standards. As explained below, skin color is directly relevant to serum vitamin D levels produced by exposure to sunlight.
Higher vitamin D is associated with lower all-cause mortality rates
A topic of interest at the other end of life was the relation of mortality rate to serum 25(OH)D levels. A meta-analysis of 11 observational studies and 60,000 individuals found a reduction in risk over about 10 years for highest vs. lowest category of 25(OH)D level of mortality of 29% [Zittermann et al., 2012]. Comparing graded levels of intake, the reduction in risk was 14% for an increase of 5 ng/ml, 23% for an increase of 10 ng/ml, and 39% for an increase of 20 ng/ml in plasma levels of 25(OH)D, starting from a median of ~11 ng/ml. The participants starting with the lowest levels of serum 25(OH)D received the greatest benefits. Those who started with higher serum levels, closer to optimal (30-40 ng/ml), received less benefit from additional vitamin D. This relation between starting serum 25(OH)D levels and health outcome is not surprising because it is similar to many other health studies. Since 25(OH)D levels likely changed over the duration of the studies, and some participants died of unrelated causes, the actual effect of serum 25(OH)D level on mortality rate is greater than these estimates.
And less cardiovascular disease
Cardiovascular disease is an important contributor to mortality rates. A study of 11,000 patients in Kansas was reported. The patients had a mean age of 58±15 years, a body mass index of 30±8 kg/m2, and a mean serum 25(OH)D level of 24±14 ng/ml [Vacek et al., 2012]. Serum 25(OH)D levels below 30 ng/ml was significantly associated with several cardiovascular-related diseases, including hypertension, coronary artery disease, cardiomyopathy, and diabetes. After a period of 5.5 years, those with serum 25(OH)D levels below 30 ng/ml had twice the mortality rate of those with higher 25(OH)D levels.
And less risk of diabetes mellitus type 2
In a 2.7-year study of 2000 prediabetics, participants with the highest third of 25(OH)D levels (median, 30.1 ng/ml) had a reduction in risk of 28% for developing diabetes mellitus type 2 compared with participants in the lowest third (median, 12.8 ng/ml) [Pittas, 2012].
. . . and less diabetes mellitus type 1 (T1DM)
An observational study on insulin-dependent diabetes mellitus (T1DM) was based on 1000 U.S. military service personnel who developed this disease between 2002 and 2011 [Gorham et al., 2012]. They had provided blood samples between one and ten years prior to developing T1DM. They were carefully matched with another thousand service personnel who did not develop T1DM. There was a reduction in risk of 78% for developing T1DM for those with serum 25(OH)D levels above 24 ng/ml compared to those with levels above 24 ng/ml. This finding is highly statistically significant and is one of the strongest studies of its type.
Fewer bacterial and viral infections
The effect of vitamin D in reducing risk of infections is a topic of increasing interest. Vitamin D reduces risk of infections primarily by strengthening the innate immune system, primarily by inducing production of cathelicidin, a polypeptide with antimicrobial and antiendotoxin properties. It also shifts production of cytokines, a type of cell signaling molecule, away from proinflammatory ones, and has a number of other actions on both the innate and adaptive immune system [Lang et al., 2012]. While the effects of vitamin D have been found mostly for bacterial infections, some have also been reported for viral infections such as influenza, HIV, and hepatitis C [Lang et al., 2012]. In a supplementation study in Sweden involving 140 patients with frequent respiratory tract infections (RTIs) using 4000 IU/d vitamin D3, those in the supplementation group increased their serum 25(OH)D level to 53 ng/ml while those in the placebo group had levels near 27 ng/ml [Bergman et al., 2012]. Those taking vitamin D3 had a 23% reduction in RTIs and a 50% reduction in the number of days using antibiotics.
The benefits of vitamin D in reducing risk of cancer
One of the important and well-documented effects of vitamin D is reduced risk of cancer and increased survival after cancer diagnosis. There were 400 publications on vitamin D and cancer in 2012 according to PubMed.gov. Evidence from ecological, observational and laboratory studies have identified over 15 types of cancer for which higher solar UVB light and/or serum 25(OH)D levels are associated with reduced risk. Two of the papers are especially noteworthy. One, a study from Norway involving 658 patients with either breast, colon, lung, or lymphoma with serum 25(OH)D levels determined within 90 days of cancer diagnosis were followed for up to nine years [Tretli et al., 2012]. Compared to those with levels <18 ng/ml, those who originally had levels >32 ng/ml had a reduction in risk for dying from cancer of 66%. To a cancer patient, this would be a lifeline.
Another cancer paper reported the results of supplementation with 4000 IU/d vitamin D3 of those with low-grade biopsy-assayed prostate cancer [Marshall et al., 2012]. Forty four patients successfully completed the one-year study. Twenty four of the subjects (55%) showed a decrease in the amount of cancer; five subjects (11%) showed no change; 15 subjects (34%) showed an increase. In comparison, with a historical group of 19 patients, only 4 (21%) had reductions in the amount of cancer, 3 (16%) showed no changes, and 12 (63%) showed an increase in cancer. Thus optimal vitamin D supplementation appears to be useful for treating those with cancer.
Falls and fractures
The classical role of vitamin D is to regulate calcium and phosphate absorption and metabolism, leading to strong bones. A pooled analysis of 31,000 persons (mean age, 76 years; 91% women) participating in randomized controlled trials of vitamin D supplementation who developed ~1000 incident hip fractures and ~3800 nonvertebral fractures found that those with the highest intake (median 800 IU/d; range 792-2000) had a 30% reduction in risk of hip fracture and a 14% reduced risk of nonvertebral fracture [Bischoff-Ferrari et al., 2012]. The role of vitamin D in neuromuscular control also plays an important role in reducing risk of falls and fractures.
Skin pigment adapts slowly to changed ultraviolet environment
Jablonski and Chaplin have published a series of papers on human skin pigmentation and its relation to solar ultraviolet radiation (UVR) [Jablonski and Chaplin, 2012]. Their primary thesis is that human skin pigmentation has adapted to UVR conditions where a group of people live for 50 generations, or about a thousand years. UVR from mid-day sunlight produces vitamin D, which provides important protection against many diseases, but sunlight also causes skin cancer and destruction of folate. Dark skin protects against free radical production, damage to DNA, cancer, and loss of folate. Thus, dark skin is best in the tropical planes regions while pale skin is best at high latitude regions. Those with skin adapted to UVB between 23° and 46° have the ability to tan, which is an adaptation to seasonal changes in solar UVB doses. However, in recent times, people have moved or traveled to regions where their skin pigmentation is not suited to the local UVR conditions. They discuss three examples: nutritional rickets, multiple sclerosis and melanoma. Their abstract concludes with this observation: “Low UVB levels and vitamin D deficiencies produced by changes in location and lifestyle pose some of the most serious disease risks of the twenty-first century.”
Vitamin D levels for traditionally living Africans
A study on traditionally living Africans near the equator provides information on “normal” 25(OH)D levels. A paper was published on serum 25(OH)D levels of the Masai and the Hadzabe living near 4° S in Tanzania [Luxwolda et al., 2012]. They have skin type VI (very dark), wear a moderate amount of clothing, spend the major part of the day outdoors, but avoid direct exposure to sunlight when possible. The mean serum 25(OH)D levels of Maasai and Hadzabe were 48 (range 23-67) ng/ml and 44 (range 28-68) ng/ml, respectively. This finding suggests that serum 25(OH)D levels in the range of 40-50 ng/ml may be optimal for human health, which is generally consistent with observational studies for a number of health outcomes.
Vitamin D is made by exposure to sunlight to a significant degree only when the sun is 45 degrees or more above the horizon. At the latitudes of North America and Europe, this is summer midday sunlight between the hours of 11 a.m. and 3 p.m. In the early morning or late afternoon, light-skinned individuals may tan but they hardly get any vitamin D from sunlight. And in the winter, nobody gets much vitamin D from the sun. This explains the health benefits of taking supplements of vitamin D.