Who knew a vitamin D supplement had so many arthritis benefits or that 80% of Americans may have insufficient levels of vitamin D in their blood? Recent research shows low vitamin D levels may contribute to osteoarthritis, rheumatoid arthritis, systemic lupus and a variety of other degenerative conditions, including osteoporosis, heart, cardiovascular disease, diabetes, multiple sclerosis, cognitive impairment and more.
As you may know from other pages on this website, my husband and I have arthritis. For many years we’ve controlled our pain symptoms with natural products. We’re no longer on pharmaceutical drugs of any kind.
Recently we’ve become aware that most Americans are vitamin D deficient and taking a simple ten cent vitamin D supplement daily may play a considerable treatment role in joint health. This one minute video outlines the problems and solution very well. In addition, my health website, includes additional information on vitamin D.
To increase our vitamin D blood levels, we’ve added 3000IU daily by taking a clinically studied Vitamin D supplement containing the preferred D3. We've experienced surprising results of diminished pain and knee stiffness.
Taking a vitamin D supplement may soon become a standard treatment method for arthritis sufferers in the future.
The jury of conclusive evidence is still out on this subject. Many researchers believe that the “sunshine vitamin” may one day play a key role in preventing the development and progression of arthritis and numerous clinical studies have been performed, containing mixed results. Much of this literature can be found on the Vitamin D Council website, where publications looking at the effect of vitamin D on rheumatoid arthritis and osteoarthritis are listed.
Vitamin D is a fat-soluble vitamin, essential for human health and regulates up to 1,000 different genes. It’s also an active steroid hormone that binds to receptors in a host of tissues including joints, and helps keep these tissues healthy.
Arthritis and vitamin D are connected by research. Low blood levels of vitamin D have been linked to chronic pain conditions, including various types of bone and joint pain, muscle pain, rheumatic diseases and osteoarthritis.
An evidence-based review of 22 clinical studies involving patients with chronic pain and fatigue by Stewart B. Leavitt, MA, PhD, published in Practical Pain Management (2008, July/August)[24-42], discovered that in almost all cases the patients had inadequate levels of vitamin D. Of even more interest, it was noted that when the patients were given sufficient vitamin D supplementation, their aches and pains improved dramatically or went away in some cases.
So, how much vitamin D supplement is “sufficient”? A related report by Dr. Leavitt was peer-reviewed by a panel of eight experts entitled Vitamin D—A Neglected ‘Analgesic’ for Chronic Musculoskeletal Pain. Found on PracticalPainManagement.com, the report suggests the current recommendation for vitamin D (600 IU daily currently) is outdated. According to the author, most adults and children need at least 1000 IU per day, but people who already experience chronic musculoskeletal pain could benefit from 2000 IU or more per day of cholecalciferol (vitamin D3 supplement).
The report alludes that vitamin D supplements have a highly favorable safety profile. They are well tolerated, easy to self-administer, interact with very few drugs or other agents. They are very economical (about 10 cents a day), and are usually not harmful unless extremely high doses such as 50,000 IU or more are taken daily for an extended period of time.
In conclusion, Leavitt stresses that vitamin D should not be viewed as a cure for all musculoskeletal pain and in all patients and further research is necessary. It is not necessarily a replacement for other pain treatments.
The new Recommended Dietary Allowances (RDA) for Vitamin D were announced Nov. 30, 2010 by the Food and Nutrition Board’s (FNB) Institute of Medicine (IOM); the health arm of the National Academy of Sciences. The guidelines call for:
Many leaders in the medical community expressed disappointment the increases were not greater. The majority of the world’s most prominent vitamin D scientists debate these guidelines. Here is what the experts suggest:
Once known only for its bone-building properties, medical journals are now overflowing with the research findings that suggest many vitamin D benefits to one's health.
How much vitamin D is in your blood? It may not be enough. Sub-optimal levels of vitamin D run rampant in America.
Vitamin D is not found naturally in the body. It must be obtained from three sources: the sun, certain foods, and by a vitamin D supplement. Vitamin D blood levels are affected by each individual’s source of the vitamin, as listed below:
It is difficult to quantify how much vitamin D each individual should take. The intake, uptake and utilization of vitamin D3 varies individual to individual by many factors, including age, diet, genes, latitude, lifestyle, obesity and more. Discuss getting a vitamin D blood test with your doctor so that an optimal vitamin D supplement dose can be recommended for you.
“I would recommend that every patient, every person in America get their vitamin D checked, because so many people are low and the ramifications of having low vitamin D are so severe.” ~ Dr. Richard Honaker, family practice physician.
“In terms of getting more bang for your health care buck, Vitamin D testing and supplementation for the population is one solution which is guaranteed to improve overall health of the population at a ridiculously low cost.” ~ Jeffrey Dach, MD
To find out how much vitamin D is in your blood, ask your doctor to order a 25-hydroxyvitamin D, or 25(OH)D blood test. Serum concentration of 25(OH)D is the best indicator of vitamin D status. Whether it is made in the skin or ingested, vitamin D3 passes through the liver and becomes 25-hydroxycholecalciferol (abbreviated 25(OH)D).
Result of circulating vitamin D is reported in both nanomoles per liter (nmol/L) and nanograms per milliliter (ng/mL). 1 nmol/L = 0.4 ng/mL. U.S. labs express measurements in nanograms per milliliter. In Canada and internationally, nanomoles per liter is used.
We’ll use nanograms per milliliter (ng/mL), the American standard, for the remainder of this article.
According to a Dietary Supplement Fact Sheet on Vitamin D produced by the National Institutes of Health (NIH), “There is considerable discussion of the serum concentrations of 25(OH)D associated with deficiency (e.g., rickets), adequacy for bone health, and optimal overall health, and cut points have not been developed by a scientific consensus process.”
Based on its review of data of vitamin D needs, a committee of the Institute of Medicine concluded the following:
INSTITUTE OF MEDICINE (IOM) Serum 25-Hydroxyvitamin D [25(OH)D] Concentrations and Health
|<12||Associated with vitamin D deficiency, leading to rickets in infants and children and osteomalacia in adults|
|12-20||Generally considered inadequate for bone and overall health in healthy individuals|
|21-50||Generally considered adequate for bone and overall health in healthy individuals|
|>50||Emerging evidence links potential adverse effects to such high levels, particularly >60 ng/mL|
The new RDA immediately brought outcries that they’re too low. Numerous experts, researchers and doctors believe vitamin D blood levels should be set higher for optimal health. Critics are disturbed the FNB committee focused on bone health, ignoring thousands of studies over the last ten years that suggest lower levels of vitamin D linked to a host of health conditions.
The following table reflects a consensus among vitamin D researchers. Note that its cut points concerning adequacy and inadequacy are considerably higher than the RDA:
RESEARCHERS CONSENSUS Serum 25-Hydroxyvitamin D [25(OH)D] Concentrations and Health
|<10||Associated with vitamin D deficiency, leading to rickets in infants and children and osteomalacia in adults|
|10-29||Generally considered inadequate for bone and overall health in healthy individuals|
|30-49||Generally considered adequate for bone and overall health in healthy individuals|
|50-80||Generally considered optimal for bone and overall health|
|>100||Evidence suggests possible toxicity at this level|
The FNB committee cited research which found that intakes from a vitamin D supplement of 5,000IU/day achieved serum 25(OH)D concentrations between 40–60ng/mL, but no greater.
As we learn more about vitamin D, Dr. Haque anticipates that the optimal level will be pushed considerably higher, with an ideal range between 50 and 70ng/mL.
For additional information, please see this June 1, 2012 article Shining Light on Vitamin D Testing by Connie Mardis, MEd, CLPMAG.
Vitamin D experts speak out about new RDA
John Cannel, Executive Director of the Vitamin D Council, wrote on Nov. 30, 2010, “Today the FNB has failed millions of pregnant women whose as yet unborn babies will pay the price. They recommended that a three-pound premature infant take virtually the same amount of vitamin D as a 300 pound pregnant woman”
“My advice, especially for pregnant women: continue taking 5,000 IU/day until your 25(OH)D is between 50-80 ng/mL (the vitamin D blood levels obtained by humans who live and work in the sun and the mid-point of the current reference ranges at all American laboratories).”
He also said, “The FNB committee consulted with 14 vitamin D experts and - after reading these 14 different reports - the FNB decided to suppress their reports.”
Walter Willett at Harvard, who may be the single best-known nutritionist in the world, commenting on the IOM’s Nov. 30, 2010 vitamin D adequacy recommendations, wrote, “a threshold of 20 ng/m/L for its 25(OH)D blood level is not supported by the available data from double-blind randomized controlled trials (RCTs) of fracture risk.”
Willett pointed out that “in two 2009 meta-analyses of double-blind RCTs, a threshold of 20 ng/ml was insufficient for fracture or fall reduction” based on achieved blood levels in the treatment groups. He also cited that in the very large NHANES analysis, “bone density increased with higher 25(OH)D levels far beyond 20 ng/mL in younger and older adults suggesting that the IOM threshold recommendation is too low for optimal bone health in adults.”
Robert P. Heaney MD, Professor of Medicine, Creighton University, in response to the new vitamin D RDA, in his online blog Feb. 2, 2013, based on his and other studies, said that the requirement to ensure that 97.5% of the population would have a value of at least 20 ng/mL, was 8,895 IU per day. Recall that the IOM figure was less than 1/10 that, i.e. 600 IU per day up to age 70 (and 800 IU per day thereafter). My colleagues and I calculated a value closer to 7,000 IU per day, still a full order of magnitude higher than the estimate of the IOM." Previously, Dr. Heaney has said, “It is important to stress that there is no disagreement in the scientific community about the importance of vitamin D for total body health. Where there is disagreement it is about how much is needed to insure that the bulk of the American population achieves vitamin D’s full benefits. There is an impressive body of scientific evidence supporting levels higher than the IOM panel is currently recommending. “
Heaney added, “Even if the evidence for a higher intake were uncertain (and I don’t believe it is), intakes two to five times the IOM recommendations would carry a good chance for benefit at essentially no cost and no risk.” Dr. Heaney also said that serum 25(OH)D values for “adequacy” needed to be 40-60 ng/mL.
For additional information, click on GrassrootsHealth an online public health organization that assembled a science panel of 41 expert vitamin D researchers and medical practitioners.
Vitamin D toxicity does not occur from too much sun—the body regulates D produced from sun exposure. Food and fortified food do not contain large enough amounts of vitamin D. Toxicity is rare and usually results from taking an excessive amount of vitamin D supplement. Few people take anywhere near the upper limit of vitamin D.
A buildup of calcium in the blood (hypercalcemia) is the main consequence of vitamin D toxicity. It causes symptoms such as nausea, lack of appetite, constipation, weakness, confusion, heart rhythm abnormalities and kidney stones. Treatment may include stopping any vitamin D supplement. Hospital intervention rarely occurs.
“Toxicity is simply not a concern in doses below 10,000 units a day. Restoring physiological serum levels of 25(OH)D will help many more patients than it will hurt,” said John Jacob Cannell, MD, Executive Director, VitaminDCouncil.org.
Quoting the NIH Vitamin D Fact Sheet for all adults: “Symptoms of toxicity are unlikely at daily intakes below 10,000 IU/day. Most reports suggest a toxicity threshold for vitamin D of 10,000 to 40,000 IU per day and serum 25(OH)D levels of 200-240 ng/mL”.
The Fact Sheet applies the following toxicity thresholds for children: Infant to six months, 1000 IU/day, age 7 to 12 months 1500 IU/day, 1 to 3 years 2500 IU/day, 4 to 8 years 3000 IU/day, and 9 years to adulthood 4000 IU/day.
Americans are vitamin D deficient, period. According to author Jordan Lite in a March 23, 2009 article in Scientific American, titled "Three-quarters of U.S. teens and adults are deficient in vitamin D -- study says New research suggests that most Americans are lacking a crucial vitamin", the so-called "sunshine vitamin" whose deficits are increasingly blamed for everything from cancer and heart disease to diabetes.
Most experts now agree that the optimal level should be 30 ng/mL or higher.
Using a cutoff of 32 ng/ml, up to 80% by some estimates, have suboptimal blood levels of vitamin D. In part, that's because we spend less time outdoors and absorb less vitamin D from sunlight. However, it also may be because we don't get enough vitamin D from our diet.
Whatever the cutoff or whatever the percentage, no less a recognized authority than Dr. Michael F. Holick, MD, PhD, one of the world's most prominent vitamin D scientists, said “Vitamin D deficiency is now recognized as an epidemic in the United States” (The vitamin D epidemic and its health consequences, Journal of Nutrition, 2005, Nov; 135(11):2739S-48S). “We estimate that vitamin D deficiency is the most common medical condition in the world,” he cautioned.
Vitamin D is actually available in two forms, cholecalciferol and ergocalciferol, better known as vitamin D3 and vitamin D2.
When taking a vitamin D supplement, the recommendation of the Harvard School of Public Health and many other public health organizations is to supplement with vitamin D3 (cholecalciferol) rather than D2 (ergocalciferol).
In October, 2006, the American Journal of Clinical Nutrition published a study by Houghton, L and Vieth, R The case against ergocalciferol (vitamin D2) as a vitamin supplement in which the authors conclude “vitamin D2 should no longer be regarded as a nutrient appropriate for supplementation or fortification of foods.”
One online osteopathic physician, Dr. Joseph Mercola, D.O., advised: “Make sure, if you supplement, that you are using vitamin D3 and not the far inferior vitamin D2. As the latest research shows, D3 is approximately 87% more potent in raising and maintaining vitamin D concentrations and produces two to threefold greater storage of vitamin D than does D2.”
Once you’ve decided to supplement using vitamin D3, there are two primary questions to consider when deciding upon a vitamin D3 cholecalciferol supplement :
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Bottom line: always check with your doctor before beginning any method of self treatment and obtain his/her recommendation regarding adding a vitamin D supplement to your daily regimen.
Vitamin D Supplement Disclaimer: Health statements on this Vitamin D Supplement page have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.
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