Vitamin D to Combat Affects of PBF?
It looks like Vitamin D is the real deal to help combat Bird Flu. Of special note, Vitamin D helps control the excessive cytokine production in the lungs.
If that is not enough for you to look into it, there appears to be a STONG relationship between a Vitamin D deficiency and breast and other cancers as well as other serious health problems. It would also appear that we need a LOT more Vitamin D than we think and most of us are not getting any where near enough.
Dual effects of vitamin D-induced alteration of TH1/TH2 cytokine expression: enhancing IgE production and decreasing airway eosinophilia in murine allergic airway disease. http://tinyurl.com/z9yvc
Relationship Between Serum 25-Hydroxyvitamin D and Pulmonary Function in the Third National Health and Nutrition Examination Survey http://tinyurl.com/hkdab
Association of subclinical vitamin D deficiency with severe acute lower respiratory infection in Indian children under 5 years (children with low vitamin D levels are eleven times more likely to get lung infections!) http://tinyurl.com/zx5zu
Why does flu break out as the nights draw in? Scientists have seen the light - we don’t get enough of it. http://tinyurl.com/zpn32
Here is a link that contains over 40 references, many of which are medical reports like the ones above, on Vitamin D: http://tinyurl.com/g9kwq
Is Vitamin D one pellet in the shotgun shell for shooting down H5N1 infected birds?
Ahhh, yes. So Northern Europe and North America, being temperate, and whose populations have less exposure to sunlight, have less AI than Indonesia, in the tropics, and among farming populations who spend a lot of time outdoors. Not.
Read the scientific literature before commenting. It will make your opinion more valid. Just maybe BF is simmering now but will explode in Indonesia in the winter.
I did read the scientific literature. The vitamin d thing has been around awhile, and while interesting, has not been shown to be pivotal in much except osteoporosis and rickets.
That is not what just the links posted above say. Considering there are many more, as referenced, that say a whole lot more about Vitamin D’s affects on a whole lot more than osteoporosis and rickets I doubt you even read them. Regardless, what else is proven to work against an H5N1 infection?
Here is the article in Epidemiology and Infection to which the The Indepdent’s news story referred:
Epidemic influenza and vitamin
D.Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, Garland CF, Giovannucci E.
ABSTRACT:
In 1981, R. Edgar Hope-Simpson proposed that a ‘seasonal stimulus’ intimately associated with solar radiation explained the remarkable seasonality of epidemic influenza. Solar radiation triggers robust seasonal vitamin D production in the skin; vitamin D deficiency is common in the winter, and activated vitamin D, 1,25(OH)2D, a steroid hormone, has profound effects on human immunity. 1,25(OH)2D acts as an immune system modulator, preventing excessive expression of inflammatory cytokines and increasing the ‘oxidative burst’ potential of macrophages. Perhaps most importantly, it dramatically stimulates the expression of potent anti-microbial peptides, which exist in neutrophils, monocytes, natural killer cells, and in epithelial cells lining the respiratory tract where they play a major role in protecting the lung from infection. Volunteers inoculated with live attenuated influenza virus are more likely to develop fever and serological evidence of an immune response in the winter. Vitamin D deficiency predisposes children to respiratory infections. Ultraviolet radiation (either from artificial sources or from sunlight) reduces the incidence of viral respiratory infections, as does cod liver oil (which contains vitamin D). An interventional study showed that vitamin D reduces the incidence of respiratory infections in children. We conclude that vitamin D, or lack of it, may be Hope-Simpson’s ‘seasonal stimulus’.
PMID: 16959053 [PubMed - as supplied by publisher]
Thanks. It is time to start packing the shotgun shells with something - anything that might work against H5N1 infected birds that will soon be winging thier way in - Canadian Geese in our case. Given the dirth of solutions, I’ll have a lot of Vitamin D (and C) around.
Which Vitamin D do I get and where can I order it online?
spok – at 18:15 wrote:
Which Vitamin D do I get and where can I order it online?
Go into any pharmacy and purchase Vitamin D cheaply, over-the-counter, it’s inexpensive and will prevent your immune system from going into overdrive. Good new for those with autoimmune disorders eg, asthma, MS, IBS, Colitus, etc.
The amount required on a dialy basis has been grossly underestimated. There is strong evidence to support this, but not from the conventional sources. Best not to get your Vitamin D from milk. I consider Vitamin part of my Viral Kevlar, especially for anyone under the age of 40.
Medical Update Memo January 16, 2004
Summary
“A new study in nurses suggests that those with higher vitamin D intake may have had a reduced risk of developing multiple sclerosis. The study included 187,563 women, including 173 with probable or definite MS, enrolled in the Nurses’ Health Study, which regularly surveys female registered nurses in the United States. Women whose intake of vitamin D was greater than or equal to about 400 IU/day from supplements and food, or from supplements alone, had a 40% lower risk of developing MS than women who did not take vitamin D supplements. This study adds new information to ongoing research focused on a possible role for vitamin D in reducing the risk of developing MS. There is no information in this study to determine whether vitamin D affects the course of MS once it has begun. Further research is necessary to clarify these findings. The normal requirement for vitamin D is 200 to 400 IU daily for adults and adolescents from both food and vitamin supplement sources. Excessive intake of supplemental vitamin D can have serious, toxic effects.
Details
A new study in nurses suggests that those with higher vitamin D intake may have had a reduced risk of developing multiple sclerosis. Kassandra Munger, MSc, and colleagues (Harvard School of Public Health, University of California at Irvine) reported their findings in the January 13, 2004 issue of Neurology.
The cause of multiple sclerosis, which involves immune attacks against the body’s own brain and spinal cord tissues, is unknown. Worldwide, MS occurs more frequently in countries that are further away from the equator, such as Canada. It is thought that there may be genetic, infectious, and environmental factors that increase or decrease an individual’s risk of developing MS. One of several possible “protective” factors which are being explored is the increased sunlight exposure in areas closer to the equator and the resulting increase in the body’s production of vitamin D. (excerpt)
http://www.mssociety.ca/en/research/medmmo-vitaminD-jan04.htm
The B vitamins and Vitamin C are water soluble. If you take even very large doses of them, they are filtered out by the kidneys. You simply have very expensive urine … but no harm done. The fat soluble vitamins (A, D, E, & K) have a reputation for accumulating in the body when taken in excess, and causing damage of various types. One must wonder what the “safe upper limit” for Vitamin D is, given the reported benefits. The current RDA (which I regard as a minimum, and certainly not a maximum) is 400 IU per day. I found the following abstract in PubMed:
Critique of the considerations for establishing the tolerable upper intake level for vitamin D
J Nutr. 2006 Apr;136(4):1117–22
The tolerable upper intake level (UL) for vitamin D is 50 mcg/d (2000 iu/d) in North America and in Europe. In the United Kingdom a guidance level exists for vitamin D, 25 mcg/d (1000 iu/d), defined as the dose “of vitamins and minerals that potentially susceptible individuals could take daily on a life-long basis, without medical supervision in reasonable safety.” Exposure of skin to sunshine can safely provide an adult with vitamin D in an amount equivalent to an oral dose of 250 mcg/d. The incremental consumption of 1 mcg/d of vitamin D3 raises serum 25-hydroxyvitamin D [25(OH)D ] by approximately 1 nmol/L (0.4 microg/L). Published reports suggest toxicity may occur with 25(OH)D concentrations beyond 500 nmol/L (200 microg/L). Older adults are advised to maintain serum 25(OH)D concentrations >75 nmol/L. The preceding numbers indicate that vitamin D3 intake at the UL raises 25(OH)D by approximately 50 nmol/L and that this may be more desirable than harmful. The past decade has produced separate North American, European, and U.K. reports that address UL or guidance-level values for vitamin D. Despite similar well-defined models for risk assessment, each report has failed to adapt its message to new evidence of no adverse effects at higher doses. Inappropriately low UL values, or guidance values, for vitamin D have hindered objective clinical research on vitamin D nutrition, they have hindered our understanding of its role in disease prevention, and restricted the amount of vitamin D in multivitamins and foods to doses too low to benefit public health.
PMID: 16549491 [PubMed - indexed for MEDLINE]
(sorry about the split post — mouse click error)
ALSO:
1: Am J Clin Nutr. 1999 May;69(5):842–56.
Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety.
Vieth R., Department of Laboratory Medicine and Pathobiology, University of Toronto, Mount Sinai Hospital, Ontario, Canada.
For adults, the 5-microg (200 IU) vitamin D recommended dietary allowance may prevent osteomalacia in the absence of sunlight, but more is needed to help prevent osteoporosis and secondary hyperparathyroidism. Other benefits of vitamin D supplementation are implicated epidemiologically: prevention of some cancers, osteoarthritis progression, multiple sclerosis, and hypertension. Total-body sun exposure easily provides the equivalent of 250 microg (10000 IU) vitamin D/d, suggesting that this is a physiologic limit. Sailors in US submarines are deprived of environmentally acquired vitamin D equivalent to 20–50 microg (800–2000 IU)/d. The assembled data from many vitamin D supplementation studies reveal a curve for vitamin D dose versus serum 25-hydroxyvitamin D [25(OH)D] response that is surprisingly flat up to 250 microg (10000 IU) vitamin D/d. To ensure that serum 25(OH)D concentrations exceed 100 nmol/L, a total vitamin D supply of 100 microg (4000 IU)/d is required. Except in those with conditions causing hypersensitivity, there is no evidence of adverse effects with serum 25(OH)D concentrations <140 nmol/L, which require a total vitamin D supply of 250 microg (10000 IU)/d to attain. Published cases of vitamin D toxicity with hypercalcemia, for which the 25(OH)D concentration and vitamin D dose are known, all involve intake of > or = 1000 microg (40000 IU)/d. Because vitamin D is potentially toxic, intake of >25 microg (1000 IU)/d has been avoided even though the weight of evidence shows that the currently accepted, no observed adverse effect limit of 50 microg (2000 IU)/d is too low by at least 5-fold.
PMID: 10232622 [PubMed - indexed for MEDLINE]
Based only on the above two studies, and without having seen any conflicting data, it appears to me that 1000–2000 IU per day is an acceptable dose, with toxicity documented at a dose of 10,000 IU per day.
Has anyone seen any recent evidence to conflict with that?
I’ve been taking 2–3,000 IU daily, (along with a few other things). I can’t remember when I last got sick. So far so good.
- -
Vieth R. Why the optimal requirement for Vitamin D3 is probably much higher than what is officially recommended for adults. J Steroid Biochem Mol Biol. 2004 May;89–90(1–5):575–9. Review. [PubMed - indexed for MEDLINE]
Barriers to Optimizing Vitamin D3 Intake for the Elderly1
Creighton University, Omaha, NE 68178
“Available data on metabolic utilization of vitamin D3 indicate a total daily requirement of 4000 international units (IU) (100 µg) or twice the current tolerable upper intake level (UL). In young individuals, most of this comes from the skin.
However, cutaneous vitamin D3 synthesis declines with age, creating a need for increasing oral intake to maintain optimal serum 25-hydroxyvitamin D [25(OH)D] concentrations. Estimates of the population distribution of serum 25(OH)D values, coupled with available dose-response data, indicate that it would require input of an additional 2600 IU/d (65 µg/d) of oral vitamin D3 to ensure that 97.5% of older women have 25(OH)D values at or above desirable levels. The age-related decline in cutaneous input, taken together with the UL, creates a substantial barrier to the deployment of public health strategies to optimize vitamin D status in the elderly.”
For those under 40-years of age, and or with pre-existing autioimmune disorders, I would examine the use of oral Vitamin D supplementation as one means of modulating excessive Cytokine production.
Today on MSNBC under health is an article on vit D and pancreatic cancer. No link easy to find. I don’t drink milk so according to my calculations I would be in deficit if I didn’t jog. My schedule has forced me into night at times. Guess i will have to look at vitamins for supplementation.
Dennis in Colorado at 19:52. A colleague recently sent me another article, “High Prevalence of Vitamin D Inadequacy and Implications for Health”, by Michael F. Holick. It’s a clearly written piece that covers the currently known conditions that could be helped by vitamin D supplementation, with 264 references. This is what it has to say about dosage:
“Because it has been suggested that amounts up to 1000 IU/d of vitamin D3 may be needed to maintain a healthy 25(OH)D level of more than 30 ng/mL (75 nmol/L), an intake of 400 IU/d may represent a minimum…Vitamin D toxicity has not been reported from long-term exposure to sunlight and has only been observed from dietary intake when daily doses exceed 10,000 IU. Doses of 4000 IU/d for 3 months and 50,000 IU/wk for 2 months have been administered without toxicity.” [reference numbers not included]
Also, “Vitamin D from cutaneous synthesis or dietary sources typically occurs only intermittently. Irregular uptake of vitamin D, irrespective of the source, can lead to chronic vitamin D inadequacy.”
…”Excessive solar UV-B irradiation will not cause vitamin D intoxication because excess vitamin D3 and previtamin D3 are photolyzed to biologically inactive photoproducts. Melanin skin pigmentation is an effective natural sunscreen, and increased skin pigment can greatly reduce UV-B-mediated cutaneous synthesis of vitamin D3 by as much as 99%, similar to applying a sunscreen with a sun protection factor of 15.”
Comment - thus people with some degree of dark skin living in the southeast Asia may indeed have low levels of vit D.
I have read elsewhere that it takes a period of time, about 3 months, to bring levels of vitamin D up to optimum level. So if anyone is considering using it as a preventative against influenza, you may want to start. Make sure it’s vitamin D3 (cholecalciferol)
This is not a plug for any one company, nor do I have association with this company. Carlson sells a 2000 IU dose jar of 120 soft gels for $8.80 at their website here. Other companies are probably similar. If you take one every day, that’s a 4-month supply for $8.80. Considering the emerging range of benefits of this vitamin, seems like a person can’t go wrong - cheap insurance for a number of conditions. There is not definitive evidence yet against H5N1 (or similar severe influenza viruses), but it might help tip the scales in our favor, and the article posted by Dennis at 16:42 does point in that direction.
What’s a good solution for kids who won’t swallow soft gels?
Remember that vitamin D occurs in foods, too (e.g. milk, eggs, fish, animal fats, etc.)
For supplemental vitamin D, I wouldn’t exceed 1200IU daily.
Most of the research suggests that vitamin D supplementation is of medical benefit only when a deficiency exists. In northern climates (like mine) we don’t get enough sunlight in the winter months, and so milk is fortified with D.
Excess vitamin D is associated with sever liver damage, and can occur with doses as low as 2000IU used over a prolonged period of time.
Short and to the point: go ahead and supplement, but with no more than 1200IU/day (1000IU capsules are available at a price of about $4/90)
One last note on this, for those with the background to be able to use the information:
From The Merck Manual:
Vitamin D 1000 µg (40,000 IU)/day produces toxicity within 1 to 4 mo in infants, and as little as 75 µg (3000 IU)/day can produce toxicity over years. Toxic effects have occurred in adults receiving 2500 µg (100,000 IU)/day for several months.
[snip]
The first symptoms are anorexia, nausea, and vomiting, followed by polyuria, polydipsia, weakness, nervousness, and pruritus. Renal function is impaired, as evidenced by low sp gr urine, proteinuria, casts, and azotemia. Metastatic calcifications may occur, particularly in the kidneys.
[snip]
Treatment consists of discontinuing the vitamin, providing a low-calcium diet, keeping the urine acidic, and giving corticosteroids. Kidney damage or metastatic calcification, if present, may be irreversible. Diuretics and forced fluids are not helpful.
Incidentally, the 50,000IU once weekly “vitamin D” is ergocalciferol, which is about 1/2 as “potent” as D3, or cholecalciferol. This still provides an average of about 2400IU of vitamin D daily, and is considered a therapeutic product (hence is prescription only)
Most of the world’s population relies on exposure to sunlight to naturally maintain adequate vitamin D nutrition. The sun imposes no risk of toxicity. In fact, by 3 hours of sunlight, Vit D synthesis in heavily pigmented people reaches the same plateau as in fair skin in 30 minutes. In other words, our bodies have a “built-in defense mechanism” to guard against natural toxicity levels. Prolonged exposure to sunlight degrates the vitamin D precursor in the skin, preventing its converstion to the active vitamin.
Brief and casual exposure to sunlight is equal to about 200 IU of Vit D, and seems to be sufficient to last through even winter months.
Vitamin D is the most toxic of all the vitamins. Excessive levels enhance calcium absorption, produces high blood calcium, and promotes return of bone calcium into the blood. The results may be seen as kidney stones, & hardening of blood vessels (*this is especially dangerous in the major arteries of the heart and lungs… where it can cause death.)
Vitamin D comes in 3 forms:
1. CALCIFEROL- occurs naturally in fish oils and egg yolk; in the US, it’s added to margarines and milk. (Diet)
2. CHOLECALCIFEROL (D3)- is created when sunlight hits you skin and UV rays react with steroid chemicals in body fats just underneath the skin. (Therefore, it occurs naturally in animal fats.) (sunlight)
3. ERGOCALCIFEROL (D2)- is made in plants exposed to sunlight. (Sunlight)
D2 & D3 are called “provitamins” because they are “precurssors” of Vit D present in both animal and plant tissues. They require sunlight to convert the “precurssor” to the “provitamin” form. The provitamin form requires conversion in the kidney to the “metabolically” active form. The plant form is primarily a food additive.
The “animal form” is more appropriately called a “prohormone” because it doesn’t need to be supplied from a source outside of the body. The metabolically active forms are produced in the kidney and function as “hormones”, with the intestine and bone as target organs.
INGESTED vitamin D is absorbed in the intestine with lipids, with the aid of bile.
Vitamin D from the intestine or “SKIN” is transported to storage sites in the liver, skin, brain, bones, and probably other sites.
Vit D has roles in immunity, reproduction, insulin secretion, differentiation of keratocytes, absorption of calcium and absorption of potassium.
Critique of the considerations for establishing the tolerable upper intake level for vitamin D: critical need for revision upwards.
Vieth R.
Department of Nutritional Sciences, University of Toronto, Mount Sinai Hospital, Toronto, M5G 1L5, Canada. rvieth@mtsinai.on.ca
The tolerable upper intake level (UL) for vitamin D is 50 mcg/d (2000 iu/d) in North America and in Europe. In the United Kingdom a guidance level exists for vitamin D, 25 mcg/d (1000 iu/d), defined as the dose “of vitamins and minerals that potentially susceptible individuals could take daily on a life-long basis, without medical supervision in reasonable safety.” Exposure of skin to sunshine can safely provide an adult with vitamin D in an amount equivalent to an oral dose of 250 mcg/d. The incremental consumption of 1 mcg/d of vitamin D3 raises serum 25-hydroxyvitamin D [25(OH)D ] by approximately 1 nmol/L (0.4 microg/L). Published reports suggest toxicity may occur with 25(OH)D concentrations beyond 500 nmol/L (200 microg/L). Older adults are advised to maintain serum 25(OH)D concentrations >75 nmol/L. The preceding numbers indicate that vitamin D3 intake at the UL raises 25(OH)D by approximately 50 nmol/L and that this may be more desirable than harmful. The past decade has produced separate North American, European, and U.K. reports that address UL or guidance-level values for vitamin D. Despite similar well-defined models for risk assessment, each report has failed to adapt its message to new evidence of no adverse effects at higher doses. Inappropriately low UL values, or guidance values, for vitamin D have hindered objective clinical research on vitamin D nutrition, they have hindered our understanding of its role in disease prevention, and restricted the amount of vitamin D in multivitamins and foods to doses too low to benefit public health.
PMID: 16549491 [PubMed - indexed for MEDLINE]
Epidemic Influenza And Vitamin D Main Category: Flu / SARS News Article Date: 15 Sep 2006 - 0:00am (PDT)
Article Also Appears In
Public HealthImmune System / Vaccines
In early April of 2005, after a particularly rainy spring, an influenza epidemic (epi: upon, demic: people) exploded through the maximum-security hospital for the criminally insane where I have worked for the last ten years.
<snip> However, as the epidemic progressed, I noticed something unusual. First, the ward below mine was infected, and then the ward on my right, left, and across the hall - but no patients on my ward became ill. My patients had intermingled with patients from infected wards before the quarantines. The nurses on my unit cross-covered on infected wards. Surely, my patients were exposed to the influenza A virus. How did my patients escape infection from what some think is the most infectious of all the respiratory viruses?
<snip> All of the patients on my ward had been taking 2,000 units of vitamin D every day for several months or longer. Could that be the reason none of my patients caught the flu?
Long interesting article at this link http://tinyurl.com/qtsf5 (Medical News Today)
Wow! Thanks.
Even if high levels of synthetic vitamin d are considered to be toxic over the long term, would the collective concious here think that in the short term, while a pandemic is raging, we should all be making sure we have what access to the sun that we can and take vitamin at the 1000–2000 (if not higher) unit level during active waves in addition to additional vitamin C? Or will that be too little too late? Maybe just for half of the year we should take the extra vitamin D on top of what is found in our multivitamins and fortified foods?
I wonder if there is a liquid version of Vitamin D that could be given if someone starts to come down with the flu since swallowing a pill might not be that easy?
My multivitamin that I have taken for years and years has 400 iu of Vitamin D.
I also remember reading a few months back that ‘they’ were considering raising the RDA of Vitamin D because so many children in the northern latitudes were developing rickets since kids don’t play outside any more— I’ll try to find the link.
Another wow, and thanks AnnieB (at 3:22)! Here are a couple more relevant paragraphs (bold added by me).
“Hope-Simpson had no way of knowing that vitamin D has profound effects on human immunity, no way of knowing that it increases production of broad-spectrum antimicrobial peptides, peptides that quickly destroy the influenza virus. We have only recently learned how vitamin D increases production of antimicrobial peptides while simultaneously preventing the immune system from releasing too many inflammatory cells, called chemokines and cytokines, into infected lung tissue.
In 1918, when medical scientists did autopsies on some of the fifty million people who died during the 1918 flu pandemic, they were amazed to find destroyed respiratory tracts; sometimes these inflammatory cytokines had triggered the complete destruction of the normal epithelial cells lining the respiratory tract. It was as if the flu victims had been attacked and killed by their own immune systems. This is the severe inflammatory reaction that vitamin D has recently been found to prevent.
I subsequently did what physicians have done for centuries. I experimented, first on myself and then on my family, trying different doses of vitamin D to see if it has any effects on viral respiratory infections. After that, as the word spread, several of my medical colleagues experimented on themselves by taking three-day courses of pharmacological doses (2,000 units per kilogram per day) of vitamin D at the first sign of the flu. I also asked numerous colleagues and friends who were taking physiological doses of vitamin D (5,000 units per day in the winter and less, or none, in the summer) if they ever got colds or the flu, and, if so, how severe the infections were. I became convinced that physiological doses of vitamin D reduce the incidence of viral respiratory infections and that pharmacological doses significantly ameliorate the symptoms of some viral respiratory infections if taken early in the course of the illness. However, such observations are so personal, so likely to be biased, that they are worthless science.”
Comment - but nonetheless these are very valuable observations that will hopefully trigger more research! In the meantime, vit D goes on my list of remedies against H5N1. I have read enough journal literature to sense that 2000IU/day is safe for me and my family.
spok at 14:39:
What’s a good solution for kids who won’t swallow soft gels?
You could prick the softgel with a decent-sized pin, and squeeze the contents out onto food or into a drink.
J Steroid Biochem Mol Biol. 2005 Oct;97(1–2):13–9
The Vitamin D requirement in health and disease.
Heaney RP.
Creighton University, Omaha, NE
ABSTRACT:
Advances in Vitamin D nutritional physiology since publication of the DRIs in 1997 are briefly summarized. Available data indicate that (1) Vitamin D’s canonical function, optimizing intestinal calcium absorption, is fully expressed at serum 25-hydroxyvitamin D (25OHD) concentration of approximately 80nmol/L; (2) elevated parathyroid activity, typical of aging populations, is minimized at the same 25OHD value and (3) osteoporotic fractures are reduced when serum 25OHD is raised to near 80nmol/L. Depending upon starting value, achieving 25OHD concentrations of 80 or higher may require a daily oral intake of 2200IU (55microg) or more in addition to prevailing cutaneous inputs. The tolerable upper intake level (TUIL), currently set at 2000IU (50microg)/day, is too low to permit optimization of Vitamin D status in the general population. Actual toxicity is not seen below serum 25OHD values of 250nmol/L, a value that would be produced only at continuing oral intakes in excess of 10,000IU (250microg)/day.
PMID: 16026981
What can we conclude for a prophylactic measure much prior to PBF? 400–500 IUs/day? How about when we know BF has gone pandemic and is in our area? 2000IU/day? How about if we catch BF? Then 5000 - 10,000 IU/day?
Is it better to take all at one time or spread out throughout the day?
Given that the dosage creates the concentration and one probably wouldn’t want to be going beyond 250HD how do you scale down the dosage for children? What is the “standard weight” for an adult that the TUIL dosage is based on so that a proportionally smaller dosage can be computed?
It is time to start packing the shotgun shells with things that work in preparation for PBF. Vitamin D appears to be one of them.
pfwag – at 12:15
It is tough to calculate the dose for children without emperical studies on children. In so many cases, their absorbtion & metabolism of medicines and supplements is “more different” than would be expected just based on their body size. One tenet of pediatric practice is that “they aren’t just little adults.”
RPh, are you still checking this thread?
Low Vitamin D Tied to Poorer Lung Function in Teens http://tinyurl.com/k4ddl
Research on Vitamin D http://tinyurl.com/f5973
NIH Fact Sheet on Vitamin D http://tinyurl.com/g8oqt
A Vitamin D calculator http://tinyurl.com/kml7y
Vitamin D Lowers Inflammation http://tinyurl.com/howm8
Vitamin D: its role and uses in immunology http://tinyurl.com/jvusr
Vitamin D is a steroid hormone http://tinyurl.com/ks3os
Evidence that vitamin D3 reverses age-related inflammatory changes in the rat hippocampus http://tinyurl.com/zdsrh
- The hippocampus is like the brains answering machine, it decides which memories to store
for the long-term. Or that’s the way I remembered it. :-)
anonymous – at 15:23 13 September
Ahhh, yes. So Northern Europe and North America, being temperate, and whose populations have less exposure to sunlight, have less AI than Indonesia, in the tropics, and among farming populations who spend a lot of time outdoors. Not.
Indonesia is worried about the monsoon season. People stay indoors when it rains just like when it is cold.
I have a colleague involved with vitamin D research… and unfortunately cannot reveal that person’s name. I asked this person for feedback on the dosing issue, and this is the reply I got back, reposted with permission.
The old safety guidelines are largely based on studies that had poor quality control in their vitamins. If I remember correctly, this resulted in people who were supposedly receiving 2k IU/day getting many many times that dose, and experiencing toxicity. It has been demonstrated time and time again in the last decade that a dose of 2000 IU/day over an extended period of time is safe, where safety is measured by the urinary calcium/creatinine ratio. At least two studies have shown that even 10,000 IU daily can be taken for up to 5 months with no indication of toxicity (Heaney and Vieth, independent studies).
Regarding what the proper dose is: we know that 400 IU/day (the current guideline) will result in a decrease of 25(OH)D over winter months. It is not sufficient to maintain stores. In lactating women, who lose around 20% of their vitamin D to their infant, it is even more insufficient. The argument that milk is fortified is to be laughed at: 8 oz of milk provides 100 IU of vitamin D. Big whoop. How many gallons should I be drinking?
1000 IU per day in third trimester pregnant women results in a small increase (5–6 ng/mL) in serum 25(OH)D levels (Mallet). We knew this in 1986! This dose level is clearly insufficient to bring individuals to the currently recommended 25(OH)D levels, which are …
It is currently thought that an optimal level of vitamin D intake will be that which maintains a proper level of parathyroid hormone (PTH), keeping the calcium and bone mineralization processes in balance. This is a serum 25(OH)D level of approximately 30 ng/mL, perhaps slightly higher. We are still working to figure out what level of supplementation is needed to produce this. In many people, 2000 IU will bring them close. If they are lactating, in northern latitudes, work indoors, wear sunscreen, shield the body from the sun with clothing, or are darkly pigmented, then a higher dose may be necessary. As we continue to learn about the many roles that vitamin D plays in the body, including immunity and regulation of cell proliferation, it is likely that an optimal intake will be based on multiple considerations. Regardless of this current uncertainty, it is well-known that, for the vast majority of the populace, 400 IU and even 1000 IU will not maintain a healthy 25(OH)D level.
My professional opinion as someone who works with some of the best established vitamin D researchers in the world: anyone that is posting with claims of toxicity and recommendations for dosing at 1500 IU/day or less needs to meet their professional responsibilities by pulling the current research off of PubMed and digging up a few references. It is their responsibility to the public that they serve to keep up to date on current research and practice, and they are clearly not managing to do so, to the potential detriment of a large segment of the public.
Thanks, beehiver.
FluWikians —
You people are really quite wonderful. I thank you, and my family thanks you.
Remember - there only needs to be a process to reduce the transmission factor below 1. This can do it.
pfwag at 12:15, this is what my colleague had to say about children…it parallels Dennis’ reply but with a bit of expansion.
I am not sure that as much work has been done in children - it is more difficult to do pediatric studies. We do know that
a) cod liver oil was a traditional source of significant amounts of vitamin D
b) from Holick - “Children who regularly took the recommended supplemental dose of 2000 IU/d of vitamin D during their first year of life had a rate ratio of 0.22 (range, 0.02–0.89) for type I diabetes mellitus compared with those who regularly received less than 2000 IU/d.” - reference for that is Hypponen 2001 (The Lancet). So 2000 IU was not felt to be a risk to the child, and believe me, if there was any hint of a risk, the study wouldn’t have happened at that dose. IRBs (institutional review boards) are extremely touchy about putting children at risk.
c) Children of breastfeeding mothers who are vitamin D deficient will be vitamin D deficient. We are working to find out the level of oral supplementation of the breastfeeding mother that is necessary to optimize 25(OH)D in both the mother and breastfed infant.
Dennis in Colorado - If it was for the common cold I would be conservative, but with BF I believe we need to be more aggressive. Other than taking Tamiflu for 6 weeks prior to being exposed to H5N1, Vitamin D is one of the few things I have found with any real data behind it that offers any potential hope of making it through PBF and an H5N1 infection and not being one of the 60% that currently die. Since I am older (57) the present BF mortality data indicates that I have a better chance of surviving but the 60% would include my kids and grandkids. If 30% of my nuclear family catch H5N1 and 60% of those die, that is three people. Take that to extended family and that is 11 people. Which ones will it be? It is bad enough if my parents, both in thier 80s die, but another if my children, ages 28 - 33, or grandchildren, ages 4 - 9, die. It is time to start making the potential of PBF personal.
Given the fact that there are NO viable medical solutions, and even if available they wouldn’t be available to the vast majority of the infected during a PBF epidemic any way, the choice is to do something that MAY help or work or most likely just futiley watch your kids or grandkids die. Besides, exactly what is the pediatrician going to do except probably pooh-pooh Vitamin D, tell you it is poisonous, and, with an air of authority, tell you not to take more than the RDA?
When it comes down to the nitty-gritty, doctors and medicine often don’t have a clue what to do but will go through all the motions of standard treatment protocols knowing it will do little or no good. Often the major tenet is do something or anything so they don’t get sued. Maybe putting an H5N1 infected person on a ventilator will save them and maybe it won’t. There is no data. In any case you can be sure that the Mayor and his family will get one of the few ventilators available before most of us and our families get it. Medical rationing will need to be employed big time for PBF (especially if the death rate holds at 60% and not the “worst case” 2% being planned for) and most of the infected will die untreated and mostly alone in whatever place they have room to stick all the dying.
We all mostly agree that PBF is basically just a mutation or two or three away and could be brought in any day on the next 747 arriving from the Far East. It is time to stop being theroretically and start making our best guesses on what to do for treatment so we can be as prepared as we can be. Many people went out and procured the standard course of Tamiflu when newer data now indicates that it is no where near enough. It is better to have too much Tamiflu or Vitamin D and not need it then be caught without enough and desperately need it.
For too many people on these forums, these postings seem to be an intellectual discussion, theoretical excercise, or a “I’m more prepared than you” trip. We are talking about a potential plague of Biblical proportions and it is time for everybody, ESPECIALLY the anonymous doctors and medical researchers, to start saying WHAT WOULD YOU DO if you, your wife, your kids, or your grandkids catch H5N1. And the treatment needs to exclude everything available in a hospital because even you might not have access or availability.
The case is closed on Vitamin D for me. I will get a LOT of it (which brings up shelf life issues). Now I just need some best or at least educated GUESSES for a treatment should my grandkids come down with BF. Is too much Vitamin D for a week or two better or worse than having any H5N1 for a week or two?
Dennis in Colorado, I glean from your posts that you seem to know a lot more about medical issues than most of us. For me personally the potential of PBF has caused me to learn more about all sorts of things than I ever wanted to and there is still so much more to learn. And time is running out. So, what are YOU going to specifically do when you or someone in your family catches H5N1? If you are choosing not to use Vitamin D, what is your best guess for those of us who will? And I already know the answer is not in the Merck Manual.
beehiver - given the data, ask your colleague what he would do for children with an H5N1 infection and compare the results of the risks of too much Vitamin D for a week or two with the potential results of having H5N1 for a week or two.
At this point, I’ll take your and an anonymous Vitamin D expert rather than try to make my own decisions in vacuum, however:
while my 4 year old grandchild is as big as most 6 year olds, how do they define a child? There would seem to be a rather large difference in dosage between a 160lb adult, an 80lb child, and a 40lb child. Then what about a 20lb baby/toddler? That is an 8:1 range and I would GUESS that the anount of vitamin D to achieve similar concentrations in the blood should be roughly proportional.
And with the results of BF, what would be considered the upper limit for a therapeutic dose? Where is the point where too much won’t do any more good? That should consider the side affects of too much Vitamin D for a week or two versus any H5N1 for a week or two.
Being specific, should I/we plan on having enough Vitamin D for taking ????IUs for say 60 days prior to being infected and 10,000IUs for two weeks if infected?
What is your colleague going to spedicially do?
pfwag – at 13:45
I already take Vitamin D 1200 IU per day, and have been for several years (I’m not sure why you thought that I might not use it). Based on the info we’ve found here, I will probably increase that to 2000 IU/day. My post quoting The Merck Manual was intended to provide information to others about what the signs/symptoms/treatment for hypervitaminosis D might be, for those who choose to push the envelope of high doses and might cross over to toxicity.
I have no agenda here other than to seek (and present) the truth. For me, much of that can be found in peer-reviewed medical literature. When I educate myself about an issue such as this, I take in ALL information; that which supports my original theory and that which does not. When I have gathered as much information as I can, then I make a decision on how to act. That is part of the scientific method. I am fortunate enough to have the ability to assimilate very large amounts of information and make decisions based on that information.
I have not yet seen good evidence that a high-dose ‘blast’ of Vitamin D taken after the onset of infection will improve the outcome, but I am open to such evidence if it exists. At this time, my plan for treating an infection would center on Tamiflu, Sambucol, and prednisolone, along with aggressive pulmonary toilet.
My comments about dosing Vitamin D for children were simply an acknowledgement that we cannot take the dose for a 150-pound adult and divide by three to get the proper dose for a 50-pound child. There are too many other variables. My hope is that someone here (be it RPh, one of the other pharmacists, or one of the physicians with pediatric experience) can help determine a protocol for children’s doses. I will take their recommendations, combine them with other knowledge, and reach a conclusion regarding what I will do if I have to help make a decision about a child with H5N1 influenza.
pfwag
“So, what are YOU going to specifically do when you or someone in your family catches H5N1?”
Thank you.
I would like to see a thread started that asks everyone this exact same question or maybe:
If a pandemic starts, what supplements will you be taking prior and during an H5N1 infection? In what ammounts? What exactly does everyone have planned at this point based on what we know right now?
Dennis in Colorado – at 14:20
“At this time, my plan for treating an infection would center on Tamiflu, Sambucol, and prednisolone, along with aggressive pulmonary toilet.”
Thank you too.
I’ve read much and have an idea of how much Tamiflu and Prednisolone to take and when but it is still nice to here what dosages you have planned. I haven’t studied Sambucol yet so what are you plans with that? And hate to ask but what is an aggressive pulmonary toilet?
pfwag at 14:02,
My colleague would not be comfortable making any recommendation what to do when an H5N1 infection hits. I can tell you though, that this person already takes 2000 IU/day, as do I. If it seemed that this virus was starting to go more easily H2H, I personally will increase my dosage to 4000 IU/day, maybe more. However it’s my understanding that it takes time for the circulating levels in the blood to “ramp up”…a sudden increase in dosage at time of infection may not help like we would want or expect from pharmaceutical drugs.
I looked at the abstract for the Hypponen 2001 Lancet study (found at PubMed # 11705562) at this link, but don’t have personal full-text access. The abstract indicates they were looking at 1 year old infants and supplementing with 2000 IU/day in the study…but I would need to read the full text to be sure. I can obtain full text, given some time. Maybe someone else here has faster access.
13 September 2006 pfwag – at 15:19 wrote:
Is Vitamin D one pellet in the shotgun shell for shooting down H5N1 infected birds?
Yup.
- If you are stocking your armamentarium also investigate, Omega-3, Sambucol (Elderberry).
spok – at 14:36
I have Sambucol lozenges, and the manufacturer’s recommended dose for those is 2 lozenges four times per day during an infection; 1 lozenge twice daily as a preventative.
My initial plan for the prednisolone is ‘blast and taper,’ with daily doses of 80, 60, 40, 20, 20, 10, 10 (mg). I am still researching that and refining my plan.
We have only two courses of Tamiflu in stock and I would use it per the manufacturer’s recommended dose — 1 capsule twice daily for 5 days. I would like to double that length of time, but don’t have the stock for it at this time. Also, I have a suspicion that the Tamiflu blankets that are being used overseas could well result in a Tamiflu-resistant virus. I’ll be looking for documentation of that (yes or no) once H5N1 goes to easily-transmissible.
RE: aggressive pulmonary toilet: Sorry, I meant that in the medical sense of cleansing or hygiene. For us at home, that will include the use of an incentive spirometer, postural drainage & percussion when appropriate, and suctioning if appropriate. I do not have the expertise or equipment to intubate anyone or maintain them on a ventilator, but we do have a spare CPAP machine that might be of some help in certain circumstances.
These statements have not been evaluated by the FDA and they are not meant to constitute advice or treatment for any illness or medical condition. Please keep your hands and arms inside the ride at all times, and remain seated until the ride comes to a complete stop. Close cover before striking.
Now we are getting somewhere. Time is geting short and preps need to be in ordered and in place.
BTW: data from the field suggests the the MFR’s recommendations on Tamiflu are wrong. The links are somewhere in http://www.arielco.us/page8.html
and do not use a lawn mower as a hedge trimmer.
Hey, if it helps, I’ll send my kids outside in their skivies in the middle of winter to get some sun.
I will check their multivitamins and ours to see how much is in their currently, plus what they get from milk, etc. Like much else, I’ll risk a little over-dosage in the short term for a long-term benefit (survival). Same with things like Gatorade - if my kids are sick and dehydrated but the’ll drink that sugra concerns go out the window.
Dennis in Colorado – at 16:13
Thank you again.
Have you looked into Red Rice Yeast as a Statin?
And you didn’t mention the antibiotics that you have and when you’ll start using them.
The only other item that caught my eye, after all this time on fluwiki, was lemons and lemon water from the 1918 thread. It changes the ph in your body and there’s stories of it working in 1918.
In this chart it lists lemons in the “Extremely Alkaline” catagory:
Long thread closed and continued here
Last relevant post copied to new thread