Do serum levels of vitamin D correlate to reduced cancer risk or not?

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The American Journal of Epidemiology just released several studies on vitamin D and cancer that concluded vitamin D levels were not correlated to several cancers; that is, higher levels of vitamin D did not correlate to lowered cancer rates.[1] The key to understanding this finding is that in each case, the levels were measured prior to the diagnoses of cancer. Prediagnostic measurements occur at one point in time and do not measure changes that occur between the measurement and the onset of the disease. If, after the moment of vitamin D measurement, habits of sunlight exposure or diet change, vitamin D levels can fluctuate considerably. I believe that Vitamin D levels at the time of diagnosis are much more indicative of the affects of vitamin D on the risk of disease, and my opinion is that optimal higher vitamin D levels that are maintained for long periods are much more likely to reduce disease risk. Dr. William Grant, in an email today, told me he believed …”serum 25(OH)D levels measured several years ago aren't a good indication of either lifetime 25(OH)D or recent 25(OH)D." 25(OH)D is the measurement labs use to assess serum levels of vitamin D.

A randomized controlled trial (RCT) that maintains similar supplementation amounts for a period of years could give a good indication of whether consistently higher vitamin D levels have a protective affect on cancers. Let’s suppose, for instance, that one group of randomly chosen women received a vitamin D supplement for four years and another group received a placebo during that same time. All of the women would be free of cancer when the study began. Then, at the end of four years, the women would be assessed for the number of cancers in each group, and it could be determined if the supplemented group fared better than the placebo group. This is known as a randomized, placebo-controlled interventional study, and is considered the “gold standard” of research. Obviously, if the vitamin D group fared far better than the placebo group, we could confidently state that consistently higher vitamin D levels over four years correlated strongly with reduced risk of cancer. But wait—we already have such a study. Lappe and colleagues already conducted the study described above and found that the vitamin D group had 60-77% lesser risk of all cancers, compared to the placebo group, after four years.[2] None of the studies published by the American Journal of Epidemiology were RCT’s. This is strong indication that the use of prediagnostic levels of vitamin D may not be of much value.

Also interesting is the fact that the authors of these papers mention that research shows sunlight exposure correlates to a rather impressive risk reduction in most of the cancers studied. There are two outstanding papers, one very recent, which demonstrate that relationship.[3] [4]
Based on what we have just discussed, it is possible that (1) regular sunlight exposure maintains consistently higher levels of vitamin D and results in reductions of cancer similar to those demonstrated in the research conducted by Lappe and colleagues, or (2) sunlight has positive influences of cancer beyond the production of vitamin D. My opinion is that the answer lies in a combination of both. We are beginning to see more research showing that in both cancer and multiple sclerosis, sunlight exposure may have its own anti-cancer benefits. Sunshine is, of course, the most natural way to produce vitamin D. Just be very careful not to sunburn.



[1] http://aje.oxfordjournals.org/papbyrecent.dtl
[2] Lappe, J. et al. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr 2007;85:1586–91.
[3] Grant WB. Does solar ultraviolet irradiation affect cancer mortality rates in China? .Asian Pac J Cancer Prev 2007;8(2):236-42.
[4] Chen W, Clements M, Rahman B, Zhang S, Qiao Y, Armstrong BK. Relationship between cancer mortality/incidence and ambient ultraviolet B irradiance in China. Cancer Causes Control.2010 Jun 16. [Epub ahead of print]

Air pollution, sunlight, vitamin D and type-two diabetes

Does air pollution cause diabetes, or does pollution cause vitamin D deficiency, which then leads to diabetes?

New research from Germany showed that women who lived in heavily air-polluted areas were at greater risk for type-two diabetes than those who lived in less-polluted areas. Those who lived within 100 meters of busy roadways doubled the diabetes risk. http://www.newswise.com/articles/study-suggests-link-between-air-pollution-and-type-2-diabetes-in-women

The authors assumed that the inhalation of pollutants was responsible for the increased risk of diabetes among those living in heavily-polluted areas, but I suggest another possibility: It is well-known that air pollution filters out sunlight and correlates to profoundly lower vitamin D levels. [1] [2] [3]

But do vitamin D levels have an influence on type-two diabetes? Research shows that Vitamin D levels correlate closely to insulin sensitivity; the higher the vitamin D levels, the more receptive the body is to the action of insulin, which makes carbohydrates easier to metabolize.[4] This same study shows that the higher the vitamin D levels are, the lower are the blood sugar levels. Other research shows that men with the highest vitamin D levels had a 30% reduced risk of type-2 diabetes compared to those with low levels,[5] probably because the beta cells of the pancreas (the insulin producing cells) have vitamin D receptors[6] and function more efficiently when vitamin D levels are higher.[7]

It is highly likely that the reason for the increased risk for diabetes was not the inhalation of air pollutants, but rather the lack of sunlight and subsequent vitamin D deficiency. It is time to leave the pollution and return to the sun.



[1] Mims FM., 3rd Significant reduction of UVB caused by smoke from biomass burning in Brazil. Photochem Photobiol. 1996 Nov;64(5):814–816.
[2] Agarwal, K et al. The impact of atmospheric pollution on vitamin D status of infants and toddlers in Delhi, India. Arch Dis Child 2002;87:111-113
[3] Holick MF. Environmental factors that influence the cutaneous production of vitamin D. Am J Clin Nutr 1995;61:(Suppl):638S-645S.
[4] Chiu K. et al. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 2004;79:820-25.
[5] Mattila, C. Serum 25-hydroxyvitamin D concentration and subsequent risk of type-2 diabetes. Diabetes Care 2007;30:2569-70.
[6] Brown, A. et al. Vitamin D. American J of Physiol 1999;277(2 Pt 2):F157-75.
[7] Norman, A. et al. Vitamin D deficiency inhibits pancreatic secretion of insulin. Science 1980;209:823-25.

Sunlight, vitamin D and asthma in children

A current study shows African-American children with asthma are significantly more likely to have low levels of vitamin D than healthy African-American children.[1] Vitamin D deficiency in children with asthma was twenty times more likely than in healthy children.

This research is simply one of the latest proofs that the profound increase in asthma in the last few decades has been caused to a great extent by our societal exodus from sunlight exposure, along with the increased use of sunscreen, which can inhibit up to 99% of vitamin D production by the skin.[2]

Drs Litonjua and Weiss, in a medical hypothesis presented in 2007, made a strong case for vitamin D deficiency as a major player in the increase in asthma incidence among both children and adults.[3] They stated the following:

1. “… as populations grow more prosperous, more time is spent indoors, and there is less exposure to sunlight, leading to decreased cutaneous vitamin D production.”
2. “Vitamin D has been linked to immune system and lung development in utero, and our epidemiologic studies show that higher vitamin D intake by pregnant mothers reduces asthma risk by as much as 40% in children 3 to 5 years old.”
3. "Vitamin D deficiency has been associated with obesity, African American race (particularly in urban, inner-city settings), and recent immigrants to westernized countries, thus reflecting the epidemiologic patterns observed in the asthma epidemic."

These researchers might have also said that the Powers of Darkness—those who have a vested interest in convincing the populace to avoid all sunlight exposure and to cover up with sunscreens—are to a great extent responsible for the asthma pandemic that is gripping the nation. Reasonable, non burning sunlight exposure sunlight is normal and natural for children and adults, and those who would deprive us of that critically important contributor to human health should have the guilt of their actions weighing heavily on their consciences.

[1] Freishtat RJ, Iqbal SF, Pillai DK, Klein CJ, Ryan LM, Benton AS, Teach SJ. High prevalence of vitamin D deficiency among inner-city African American youth with asthma in Washington, DC. J Pediatr 2010;156:948-52.
[2] Matsuoka, L. et al. sunscreens suppress cutaneous vitamin D3 synthesis. Journal Clini Endocrinol Metab 1987; 64:1165-68.
[3] Litonjua AA, Weiss ST. Is vitamin D deficiency to blame for the asthma epidemic? J Allergy Clin Immunol 2007;120:1031–1035.

Vitamin D deficiency and death from diarrhea—another reason to return to the sunlight

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WebMD just posted an article regarding research on vitamin D levels and a particular “superbug,” clostridium difficile or C. diff, which causes severe diarrhea and death. http://www.webmd.com/digestive-disorders/news/20100505/c-diff-may-be-worse-with-low-vitamin-d

C. Diff occurs primarily in people who have been taking broad-spectrum antibiotics that kill the friendly bacteria that would keep this superbug under control.

The author noted that 53% of the patients with “normal” levels of vitamin D were able to resolve the infection and then remain free of diarrhea after 30 days. In those with “low” vitamin D levels, only 26% resolved the infection and remained free of diarrhea after 30 days.

The researchers defined low vitamin D levels as 21 ng/ml, which is very low indeed, since a level of 32 is considered the lowest level for good health, and most scientists now recommend levels of about 60 ng/ml as optimal. I’m assuming that “normal” levels were considered to be anything over 21 ng/ml.

Vitamin D has been known for some time to be a potent antibiotic which breaks down the cell walls of both bacteria and viruses. However, it is not a “broad-spectrum” antibiotic—an antibiotic that kills not only the disease-causing pathogens—but also the friendly bacteria in the intestine that work to keep such pathogens at bay. Vitamin D recognizes only the foreign invader (pathogen) that can damage the body. Unfortunately, many pathogens develop resistance to antibiotic drugs, and the drugs cannot then kill the pathogen, which has a heyday because it is unopposed by the friendly bacteria that would normally thwart its action; hence, we have the term “superbug.”

Vitamin D works by stimulating the immune system’s army of cells such as T cells[1] and macrophages[2] to attack and destroy pathogens. There is no research I am aware of indicating that any pathogen develops a resistance to vitamin D. As antibiotics become less and less effective in fighting pathogens, optimal levels of vitamin D may become our last line of defense.

The WebMD article also points out that “Overall, 40% of the patients died during the month." A total of 67% of patients with low vitamin D levels died compared with 44% of those with normal vitamin D levels…” This indicates that the levels considered normal were not normal at all, and probably came nowhere near the optimal levels of 60 ng/ml.

And who is responsible for this loss of life? It is obviously the Powers of Darkness, those organizations that profit from teaching us that we should “protect” ourselves from any contact with sunlight or other sources of natural vitamin D production such as sun lamps. It behooves us to return to the habit of regular, non-burning sunlight exposure, such as sunbathing, preferably around midday. That certainly seems like a terrific alternative to death by diarrhea. Would you agree?

[1] von Essen MR, Kongsbak M, Schjerling P, Olgaard K, Odum N, Geisler C.. Vitamin D controls T cell antigen receptor signaling and activation of human T cells. Nat Immunol. 2010;11:344-49 .
[2] Kamen DL, Tangpricha V. Vitamin D and molecular actions on the immune system: modulation of innate and autoimmunity. J Mol Med 2010 May;88(5):441-50.

Rheumatoid arthritis, sunlight deprivation and vitamin D—so what’s new?

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An interesting study on rheumatoid arthritis (RA) and latitude appeared recently in the online journal, Environmental Health Perspectives.[1] The researchers found that the disease was considerably more prevalent among those living at higher latitudes than at lower latitudes. They had expected to find a relationship between air pollution and RA, but such a relationship did not exist. They concluded that the correlation of high latitudes to RA was probably due to less vitamin-D producing sunlight exposure and consequent vitamin D deficiency. My response is, “This is news?”

There should have been so expression of surprise about the results. RA is one of many autoimmune diseases, and it has long been known that vitamin D has a profound, positive influence on those diseases.[2] These are diseases in which the immune system attacks the body’s own healthy tissue, mistaking that tissue for a foreign invader. When this happens, a specialized immune-system cell (called a T cell) assaults and kills some of the tissue of a targeted organ. Autoimmune diseases, then, are caused by T cells gone awry. In the case of rheumatoid arthritis the immune system attacks the collagen-producing cells of the joints. T cells in a person with an autoimmune disease lack the “intelligence” to recognize that they are attacking the wrong tissue. That intelligence, in part, comes from vitamin D, the receptors of which are found in large quantities in mature T cells and even larger concentrations in immature T cells produced in the thymus gland. Without vitamin D stimulation of the receptor sites, these cells will not function properly. When vitamin D is present however, they have the ability to discern between foreign invaders and the body’s own tissue. Animal experiments show that vitamin D acts as a “selective immunosuppressant” (see footnote 2), meaning that it gives T cells the ability to distinguish between “good and evil.” It is this ability to reduce the autoimmune response, as well as its anti-inflammatory properties that are likely responsible for the lessened risk of RA in sun-deprived areas, and this is further corroborated by the fact that RA is also more severe in winter,[3] a time of less sunshine, and a time when sunlight exposure in northern latitudes does not produce vitamin D.

In another report from researchers in Ireland (a northern country with little sunlight exposure), it was shown that 70% of patients had low vitamin D levels and that 26% were severely deficient.[4] However, in that report, 21 ng/ml was considered as the deficiency level and 10 ng/ml as the severe deficiency level. In reality, a level of 21 is dangerously deficient. It is likely that all of these patients had levels under 32 ng/ml, now considered the lowest level for good health. My opinion is that levels of 50 to 60 are optimal.

Considering this information, it should have come as no surprise that RA was more common at higher latitudes. It is time to return to the sun in the summer and to find ways of maintaining optimal vitamin D levels in the winter through the use of sun lamps.

[1] http://ehp03.niehs.nih.gov/article/info%3Adoi%2F10.1289%2Fehp.0901861
[2] http://www.fasebj.org/cgi/content/full/15/14/2579
[3] http://www.ncbi.nlm.nih.gov/pubmed/17967727
[4] http://fatlies.wordpress.com/2008/06/

Will vitamin D stop the new killer strain of drug-resistant tuberculosis, or is sunlight the cure?

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It appears that the first case of drug-resistant TB has arrived in the US from Peru.[1] It is nearly 100% resistant to antibiotics, and does not bode well for the country, since it could cause an immense killer epidemic. There seems to be no answer to the “superbug” that causes it. Or is there an answer? Could sunlight and its skin-produced hormone, vitamin D, provide answers to this latest health threat?

Sunlight has a long history of treatment for tuberculosis. Much of the following discussion of TB comes from Dr. Fielder’s history of heliotherapy.[2]

As early as 1857 Madame Duhamel of France exposed children with TB to sunshine because it hastened their recovery. Many doctors of that same era used heliotherapy (sunlight treatments) with great success, and as Dr. Fielder states, “As a general rule, the experience of all the Hygienists in their use of sunbathing was so successful that all question of doubt as to its place in the Hygienic System was ensured.”

Madame Duhamel was correct about sunbathing healing tuberculosis (TB). Later on, a disillusioned physician, Dr. Rollier, gave up a promising surgical practice and moved to the mountains of the Swiss countryside to practice medicine there. However, he discovered that the people needed little help, as they were seldom sick. People were always telling him, “Where the sun is, the doctor ain’t [sic].” In fact, Dr. Rollier’s fiancée had TB and would have died without intervention. He brought her to the Alpine area, exposed her regularly to sunshine, and she completely recovered.

Dr. Rollier opened a sanatorium in 1903 that was really just an extremely large solarium (sunbathing facility) with patient living quarters. There were 2,167 patients under Dr. Rollier’s care for TB following World War One. Of these, 1,746 completely recovered their health. Only those in the most advanced stages of the disease failed to recover.

In 1895, Dr. Niels Finsen made use of the first artificial UV light in treating patients with a particularly virulent form of TB known as lupus vulgaris (a skin disease). Though the disease was considered incurable, 41 of every 100 patients under his care recovered. Finsen’s work earned the Nobel Prize in medicine in 1903.

These researchers and physicians were not alone in their observations of the therapeutic power of sunlight. In 1877 two scientists, Arthur Downes and Thomas Blunt, discovered that sunlight was bactericidal. In 1890, the German microbiologist Robert Koch (who had isolated and described the tuberculosis bacterium in 1882), showed that sunlight killed TB bacteria.[3]

Recently, the interest in Vitamin D to thwart TB is being revisited.[4] [5] [6] and it has been shown that Black immigrants to Australia have much lower vitamin D levels than the general population and a much higher risk of TB.[7] Moreover, the effectiveness of vitamin D was demonstrated against the TB bacteria in an experiment in which a single dose of vitamin D (100,000 IU) significantly increased immunity to the TB bacterium.[8] The effectiveness of vitamin D against TB is determined by the production of cathelicidin,[9] an antibacterial peptide, which we could call the “body’s natural antibiotic.”

Further corroborating vitamin D’s essential role is that people who lack vitamin D receptors (VDR) are three times more likely to contract TB as those with normal VDR.[10] Vitamin D also inhibits the body’s inflammatory response to TB infection in the lungs.[11] [12] Considering the efficacy of sunlight therapy and vitamin D in inhibiting or even curing tuberculosis, doesn’t it seem that it’s time to return to the sun? Remember that you should never burn yourself in the sunlight.

[1] http://www.sphere.com/nation/article/first-case-of-highly-drug-resistant-tuberculosis-in-us/19294836?icid=mainhtmlws-main-ndl1link3http%3A%2F%2Fwww.sphere.com%2Fnation%2Farticle%2Ffirst-case-of-highly-drug-resistant-tuberculosis-in-us%2F19294836
[2] Fielder, J. Heliotherapy: the principles & practice of sunbathing. Soil and Health Library (online) http://www.soilandhealth.org/index.html.
[3] Hobday, R. The Healing sun. Findhorn Press 1999:132
[4] Martineau, A. Effect of vitamin D supplementation on anti-mycobacterial immunity: a double-blind randomized placebo-controlled trial in London tuberculosis contacts. Int J Tuberculosis Lung Dis 2005;9:S173.
[5] Martineau, A. et al. Vitamin D status of tuberculosis patients and healthy blood donors in Samara City, Russia. Int J Tuberculosis Lung Dis 2005;9:S225.
[6] Nnoaham, K. et al. Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int J Epidemiol 2008;37:113-19.
[7]Gibney, K. et al. vitamin D deficiency is associated with tuberculosis and latent tuberculosis infection in immigrants from sub-Saharan Africa. Clin Infect Dis 2008’46:443-46.
[8]Martineau, A et al. A single dose of vitamin D enhances immunity of mycobacteria. A J Respir Crit Care Med 2007;176:208-13.
[9]Liu, P. et al. vitamin D mediated human antimicrobial activity against mycobacterium tuberculosis is dependent on the induction of cathelicidin. J Immunol 2007;179:2060-63.
[10]Liu, W. et al. A case-control study on the vitamin D receptor gene polymorphisms and susceptibility to pulmonary tuberculosis. Zhonghua Liu Xing Bing Xue Za Zhi 2003;24:389-92.
[11] Selvaraj, P et al. Regulatory role of promoter and 3’ UTR variants of vitamin D receptor gene on cytokine response in pulmonary tuberculosis. J Clin Immunol 2008; January 30. Epub ahead of print.
[12]Vidyarani, M. et al. 1, 25 Hydroxyvitamin D3 modulated cytokine response in pulmonary tuberculosis. Cytokine 2007;40:128-34.

Do 250,000 North American babies die each year due to vitamin D deficiency?

Recent evidence has shown that pregnant mothers who were given 4,000 IU (ten times the usual dose) of vitamin D daily had only half the risk of giving birth to premature babies as those who were not supplemented. [1] That amount can also be produced by about 20 minutes of full- body exposure to non-burning sunlight at midday.

The importance of this information is shown in the fact that annually, half of all premature babies die in the first month after birth, according to the March of Dimes.[2] In North America, about 500,000 premature births occur annually.[2] If vitamin D supplementation could prevent half of these deaths, that would save the lives of 250,000 babies per year. Worldwide, the lives saved might be as many as 7 million, since approximately 13 million babies are born prematurely each year. We also know that the average cost for each premature baby in the first year of life is about $49,000. http://www.marchofdimes.com/aboutus/22684_55250.asp

Premature babies, of course, are also low-birth-weight babies in most cases, which present an additional problem. Here is one more reason for mothers to get back in the sunlight: the potential for low birth weight in their babies.

Low birth weight is associated with poor mood, anxiety, depression, high blood pressure and other problems during childhood and afterward. Recent research shows that low birth weight is related to exposure by pregnant women to winter temperatures during a critical developmental time for the fetus.[3] [4] This could indicate vitamin D deficiency of the pregnant mother during “vitamin D winter,” the time of year in northern latitudes when the sun is too low in the sky to produce vitamin D. The answer, of course, is to use a tanning bed or take vitamin D3 supplements (3,000-5,000 IU) during the winter. Remember never to burn!

Those who make a living frightening people out of the sunlight are responsible for much of the vitamin D deficiency in the population of North America. Don’t expect them to change. Non-burning sunlight is a wonderful gift for health, and we must stop the insanity that is causing vitamin D deficiency. The child needs every possible advantage prior to birth, and one of the advantages is a mom with high vitamin D levels. The only source of vitamin D for the fetus is the mother’s body, and the only natural way to obtain vitamin D is exposure to sunlight.

[1] Hollis, B. and Wagner C. Report from an international conference on vitamin D in Bruges, Belgium.
[2] March of Dimes statement Oct 4, 2009, based on World Health Organization (WHO) statistics.
[3] [1] Elter K, et al. Exposure to low outdoor temperature in the midtrimester is associated with low birth weight. Aust N Z J Obstet Gynecol 2004;44:553-7.
[4] Murray, L. et al. Links of Season and outdoor ambient temperature: effects on birth weight. Obstet Gynecol. 2000 Nov;96(5 Pt 1):689-95.