Showing posts with label Vitamin D DOSING. Show all posts
Showing posts with label Vitamin D DOSING. Show all posts

Saturday, July 9, 2011

Apo ε4: Less UV-Triggered Vitamin D Required... Evolutionary Adaptation

** Hat tips to both Mr. Tyler Simmons of Evolutionary Health Systems Blog and a wise, flexible, strong mentor, Mr. Marc Simonson.


The 'Genetic Landscape': Apo E4 Gradient in Europe, China, India and Japan

Mr. Simonson's insights for the migration of pastoralists across Europe, originating from the fertile crescent first started my thinking (nutritional bricolage) for how the world populations have exhibited endless varieties of phenotypes and infinite genotypes (mtDNA, apo E, HFE, and thyroid/autoimmune disorders). He often says that no two people are alike unless they are IDENTICAL TWINS. Therefore, no two dietary prescriptions can be alike.

I'd strongly concur. The perfect human diet is perhaps the one suited to one's ancestral past, unique genomic profile, neolethal toxicity/damage status and metabolic goals.

The below quote comes from Lars Ulrik Gerdes work on Apo E4. He's a FANTASTIC APO*E freak! His thesis is mindblowing. I don't agree w/all of his thoughts but he has plucked through the data comprehensively and thoroughly. Regarding the ApoE4 gradient in Europe (which has also been observed in other countries and continents) 'there is a conspicuous south-to-north gradient of APOE*4 frequencies in Europe, with the proportion of APOE*4 carriers rising from only 10-15% in the south to 40-50% in the north. In contrast, the proportion of APOE*2 carriers is a little higher in Central Europe than in the south and the north. Many other genetic polymorphisms show similar south-to-north gradients in Europe, and this peculiarity of the 'genetic landscape' on our continent is presumably caused by the demic expansion of agriculture (i.e. migrations of farmers) from the Middle East that began about 10,000 years ago. The farmers first migrated westwards along the north coast of the Mediterranean sea, and later turned towards the north. Thus, the APOE*4 gradient could have arisen as an 'admixture gradient', if the apoE*4 frequency were low in the migrating populations of farmers but high in the original populations of hunters/gatherers in the north.'




Evolutionary Adaptation To Lower UV Radiation at Northern Latitudes?

Gerdes has hypothesized that apo E4 allele carriers have less of a need for UV radiation derived vitamin D due to internal adaptations to preserving vitamin blood levels and maximizing intestinal absorption from dietary sources. One of the earliest indications that this was the case was research from Willnow et al. With vitamin D binding protein and apo E protein binding sites being shared regions at the same receptor in the proximal tubule of the kidneys, Gerdes theorized that E4 may have escaped the normal urinary losses of vitamin D and its metabolites. E4 typically produce higher protein amounts of apolipoprotein E (high carb diets lower apo E protein concentrations). From Gerdes' thesis, I restated, see the below. Lard, other pastured animal fats, foraged grub, and organ meats contain substantial, rich sources of fat soluble vitamins including vitamin D. For the ancestral hunter-scavenger-forager 200,000 years ago, these fatty sources of vitamin D, K and A may have been crucial and critical for growth, maintenance and reproduction.

In migrating northward out of sun-drenched Africa, with smaller guts, less fruit/fiber/fish and subsequent lower fermentation of fiber that resulted in SCFA (short chain fatty acids like the potently anti-inflammatory butyrate), how in the world did ancestral HGs survive and have babies?

Upregulation of receptors in the gut for the fat soluble goodies from food and downregulation of the kidney's capacity to leak these fat soluble hormones, metabolites and low molecular weight proteins out...? SUPER HIGH FERTILITY, DIESEL BRAIN FUEL, AND LIPOPHILIC BULLETPROOF IMMUNITY...?

Apo E4, I believe, apparently have ALL of these amazing survivor traits.

Does APOE*4 protect against vitamin D deficiency? [p. 33 from Gerdes' thesis]

A putative association of APOE with bone metabolism has been ascribed to an impact of APOE polymorphism on the transport of vitamin K (see page 40), but it could also relate to vitamin D metabolism and embrace a very strong selection pressure. Hypovitaminosis D in childhood (rickets) causes bone deformations, which can reduce the probability of surviving to adulthood, and perhaps more importantly, can cause pelvic deformations in girls that later may cause their death during delivery under primitive conditions, and also the death of their offspring. Inadequate endogenous production of vitamin D3 can be due to insufficient dietary supplementation or reduced intestinal uptake of the vitamin, or to low exposure to sunlight (UVB-radiation). The latter can be a particular problem to people with dark skin, because melanin blocks for ultraviolet photons and thus limits the synthesis of previtamin D3 [Vogel and Motulsky, 1986].

Mourant and co-workers showed that the frequency of Gc-2-allele for the gene coding for vitamin-D-binding protein (DBP; previously known as the group-specific component, Gc, of the α2-globulins of human plasma) was high in populations living in areas with low levels of sunlight and vice versa (with some exceptions). They suggested that the distribution could be explained by means of natural selection if the encoded isoform were more efficient in binding vitamin, and so in protecting Gc-2 carriers from rickets [Mourant et al., 1976]. This may be true, although the concept has been weakened by an analysis including more detailed climatic data [Cavalli-Sforza et al., 1994].

Interestingly, a very consistent pattern appears if one correlates the frequency of APOE*4 in aboriginal peoples around the world to their skin pigmentation, while also considering the intensity of solar radiation in their habitats:

• The APOE*4 frequency is generally higher in dark-skinned humans than in humans with less melanin, and the frequency is particularly high (40-50%) for instance in Papuans, Pygmies and Khoisan, who are dark peoples and whose (recent) habitats are tropical forests where the intensity of sunlight is relatively low.

• High APOE*4 frequencies (20-30%) are also found in Saami and Inuit, who are moderately pigmented humans living in regions with low average solar radiation, and in peoples living in South American rain forests.

• Conversely, the lowest frequencies of APOE*4 (5-10%) is found among lightly or moderately pigmented humans living in areas of high insolation, i.e. around the Mediterranean Sea, in East Asia, in the southern parts of North America and in Central America.

• The APOE*4 gradient in Europe (and possible also in Japan) could be interpreted to indicate natural selection for this allele with decreasing solar radiation.

The putative advantage of APOE*4 could be related to better intestinal absorption of vitamin D (see page 30), but could also be related, somehow, to the fact that apoE and DBP both binds to megalin. This receptor plays a central
role in vitamin D metabolism, since it binds and internalizes DBP on the luminal surface in the renal proximal tubuli. The function prevents systemic loss of vitamin D through the urine and is also a step in the conversion of 25-hydroxy- vitamin D3 to the biologically active 1,25-dihydroxy-vitamin D3 [Willnow et al., 1999].





Study: Carriers of apo E4 have higher vitamin D (25OHD) blood levels compared to population controls

411 news flash...New research from last month in FASEB supports an earlier speculaton that carriers of the ApoE4 allele require less vitamin D. Willnow's research and Gerdes' theory have a line of evidence for confirmation. To prevent vitamin D deficiency and subsequent health risks (female pelvic dysplasia, fatal childbirths, growth, maturation, steroidogenesis, rickets, testosterone/progesterone production, etc), an evolutionary adaptation to recycling of vitamin D at the kidney level that raises serum vitamin D in apo E4 carriers may have occurred. The researchers state ' The novel link suggests ε4 as a modulator of vitamin D status.'

(Sorry didn't have time for tracking this PDF but if anyone can toss over would be horribly AWESOME *BIG WINK*)

FASEB J. 2011 Jun 9.
APOE {varepsilon}4 is associated with higher vitamin D levels in targeted replacement mice and humans.

Rimbach et al

Abstract
The allele ε4 of apolipoprotein E (APOE), which is a key regulator of lipid metabolism, represents a risk factor for cardiovascular diseases and Alzheimer's disease. Despite its adverse effects, the allele is common and shows a nonrandom global distribution that is thought to be the result of evolutionary adaptation. One hypothesis proposes that the APOE ε4 allele protects against vitamin D deficiency. Here we present, for the first time, experimental and epidemiological evidence that the APOE ε4 allele is indeed associated with higher serum vitamin D [25(OH)D] levels. In APOE4 targeted replacement mice, significantly higher 25(OH)D levels were found compared with those in APOE2 and APOE3 mice (70.9 vs. 41.8 and 27.8 nM, P<0.05). Furthermore, multivariate adjusted models show a positive association of the APOE ε4 allele with 25(OH)D levels in a small collective of human subjects (n=93; P=0.072) and a general population sample (n=699; P=0.003). The novel link suggests ε4 as a modulator of vitamin D status. Although this result agrees well with evolutionary aspects, it appears contradictory with regard to chronic diseases, especially cardiovascular disease. Large prospective cohort studies are now needed to investigate the potential implications of this finding for chronic disease risks.




Vitamin D Dosing Revisited

For those supplementing vitamin D exogenously, care and caution for adverse effects should be monitored. Sunlight derived vitamin D can be shut off -- we have enzymes and systems that control blood/cellular levels, however for supplementation just as taking a birth control or exogenous hormone medication, what goes in, stays in. Previously I listed contraindications for vitamin d supplementation ((a) hypomagnesemia -- get mag up before supplementation because vitamin D will lower serum Mag; (b) sarcoidosis or other condition associated with elevated 25OHD or 1,25OHD3). Now I would add those with E4 should like monitor closely and avoid supratherapeutic levels which probably need to be addressed on an individual basis. With E4 there may be suggestions that intracellular 1,25OHD3 may be higher and this would not necessarily be reflected in serum levels (just like Mag levels are not, intracellular $$$$$ tests are required to accurately assess). Supratherapeutic needs to be individually defined...

So, what's an optimal, ancestral, nutrigenomically perfect serum vitamin D 25OHD and 1,25OHD3 level? I dunno. Who really knows?


Relevant Citations:

LU Gerdes Thesis HERE

The common polymorphism of apolipoprotein E: geographical aspects and new pathophysiological relations.
Gerdes LU.
Clin Chem Lab Med. 2003 May;41(5):628-31.

APOE {varepsilon}4 is associated with higher vitamin D levels in targeted replacement mice and humans.
Huebbe P, Nebel A, Siegert S, Moehring J, Boesch-Saadatmandi C, Most E, Pallauf J, Egert S, Müller MJ, Schreiber S, Nöthlings U, Rimbach G.
FASEB J. 2011 Jun 9.

Essential role of megalin in renal proximal tubule for vitamin homeostasis. Free PDF.
Christensen EI, Willnow TE.
J Am Soc Nephrol. 1999 Oct;10(10):2224-36.

Lipoprotein receptors: new roles for ancient proteins.
Willnow TE, Nykjaer A, Herz J.
Nat Cell Biol. 1999 Oct;1(6):E157-62.

Expression profiling confirms the role of endocytic receptor megalin in renal vitamin D3 metabolism.
Hilpert J, Wogensen L, Thykjaer T, Wellner M, Schlichting U, Orntoft TF, Bachmann S, Nykjaer A, Willnow TE.
Kidney Int. 2002 Nov;62(5):1672-81.

An endocytic pathway essential for renal uptake and activation of the steroid 25-(OH) vitamin D3.
Nykjaer A, Dragun D, Walther D, Vorum H, Jacobsen C, Herz J, Melsen F, Christensen EI, Willnow TE.
Cell. 1999 Feb 19;96(4):507-15.

The uptake of lipoprotein-borne phylloquinone (vitamin K1) by osteoblasts and osteoblast-like cells: role of heparan sulfate proteoglycans and apolipoprotein E. Free PDF.
Newman P, Bonello F, Wierzbicki AS, Lumb P, Savidge GF, Shearer MJ.
J Bone Miner Res. 2002 Mar;17(3):426-33.

Wednesday, April 29, 2009

Raving/Raging More On Vitamin D: DOSING

Once people start on appropriate doses of vitamin D... And...I am not referring to LICKING A CAPSULE, they come up to me and tell me HOW GREAT THEY FEEL.

More energy, more vitality and feeling younger.

In only o n e w e e k. Wowo.


Vitamin D is certainly a steroid precursor which has benefits for everyone. Not just athletes.



Who Frequently Needs Higher Doses?

I've broken this down to a few subgroups from my experience:
--Leaky gut (these benefit highly from the protective/healing effects of probiotics+digestive enzymes combined)
--Morbidly obese (but not necessarily)
--Again, those with leaky gut -- those still consuming WHEAT (and/or casein if sensitive)
--Genetically those who may be fast-metabolizers. Who r u? I have no idea. Ck your blood levels and if it does not respond in 6-8wks, you may be one of them. Hx Rickets? Hx Grave's? Hx Hashimoto's??
--Drugs which increase metabolism, disposal, elimination of fat-soluble drugs, xenobiotics and VITAMINS ADEK omega-3s EPA DHA -- anti-seizure drugs Valproic acid, Depakote, Carbamazepine and others incl Calcium channel blockers
--Those taking stupid drugs like Xenical or ALLI which block fat absorption (or ?Zetia as well hypothetically)




Contraindications to Vitamin D Therapy

If your blood levels of 1,25 OHD (calcitriol, one of the active metabolites) or 25-OH-D (calcidiol, another active metabolite) are fine or elevated, then you don't need supplementation.
--Plenty of sunlight exposure (esp equatorial, esp midday, esp when "your shadow is shorter than you are" per Dr. Cannell)
--Frequent naked *winky*, clothes-less, makeup-less, sunscreen-less exposure
--Dialysis patients already taking Rx Calcitriol where blood levels are optimal which they hardly ever are. Current national DOQI guidelines are to include Vitamin D supplementation and to achieve 25OHD blood concentrations appropriately.


Who should absolutely not receive supplementation?
--Sarcoidosis (already high calcitriol from inappropriate secretion secondary to autoimmune proliferative changes)
--Some weird malignant cancer where the cells are overproducing either calcitriol or calcidiol



Dosing

No... 100 IU Vitamin D from a cup of casein-milk will not get anyone ANYWHERE.

Babies from Day One are advised now from the Academy of Pediatrics to receive orally 400 IU daily (this is DOUBLE from prior recommendations of 200 IU daily) either from supplementation drops, formula (1-2 cups daily? wtf), or Momma's milk (if Momma chooses to improve her baby's health to supplement herself since 99% of Momma's are ALL also deficient).

Clover Organic Farms Milk
(reduced fat, whole, or nonfat)
Vitamin D3 content = 100 IU (25% of RDA) in one cup = 8 oz




Why Milk Even Contains Vitamin D

For the treatment of rickets in the early 1900's, the U.S. mandated vitamin D 400 IU to be added to every quart of milk (4 cups).

Let's say my minimal requirement for vitamin D is 5000 IU, barring any UVB exposure where typically a human would receive 99% of vitamin D sources (food provides less than 30-100 IU per serving like dairy, fish, liver, caviar or otherwise).

I would have to drink 50 (eg, F I F T Y) cups of milk to provide what my growing (ghetto fab/PHAT/HAWT) body would need...


FIFTY.


Milk isn't even Paleo.

Milk... Don't do it.

BTW...Casein, one of the main proteins in dairy sources, has been linked to many autoimmune disorders in susceptible folks (eg, autism, ADD, MS, Hashimoto's, RA, Sjogren's, Migraines, Type 1 Diabetes, Uveitis, IBD, Cholangitis, NASH/Liver Cirrhosis, etc). ??? CAD probably too.
Range of neurologic disorders in patients with celiac disease.
Infections, toxic chemicals and dietary peptides binding to lymphocyte receptors and tissue enzymes are major instigators of autoimmunity in autism.
Intestinal lymphocyte populations in children with regressive autism: evidence for extensive mucosal immunopathology.
Collagen disease: the enemy within.
Possible immunological disorders in autism: concomitant autoimmunity and immune tolerance.
Enterococci in milk and milk products.(and migraines)
[Cerebral calcifications: a clue for a diagnostic process in a nonspecific clinical case] (migraine)
[Primary headaches and the influence of inflammatory diseases of the CNS and their respective immunmodulatory therapy]
The neurology of gluten sensitivity: separating the wheat from the chaff.
Antibodies to bovine beta-casein in diabetes and other autoimmune diseases.
Cell-mediated immune responses to GAD and beta-casein in type 1 diabetes mellitus in Thailand.
Autoimmune uveitis and antigenic mimicry of environmental antigens.
Serum antibodies to cow's milk folate-binding protein in patients with chronic inflammatory bowel disease.
Autoimmune cholangitis in the SJL/J mouse is antigen non-specific.
IgA antibodies to dietary antigens in liver cirrhosis.
Evolutionary distance from human homologs reflects allergenicity of animal food proteins.
Relationship between naturally occurring human antibodies to casein and autologous antiidiotypic antibodies: implications for the network theory.
Development of immune response to cow's milk proteins in infants receiving cow's milk or hydrolyzed formula.

Saturday, December 27, 2008

Vitamin D and Other TYP Basics

We use a lotta Vitamin D at Track Your Plaque. Everyone is deficient and everyone requires supplementation. Dr. Davis has found that Vitamin D revolutionized and accelerated coronary calcification reversal in addition to many other attributes:
--improved insulin resistance
--increase in HDL 20-30% (in 6-12mos)
--lowering of blood pressure
--energy
--increased testosterone (and I've noticed higher estrogen)
--protection from colds and infections


Vitamin D is a pro-hormone... powerful, potent, and paleo-to-the-core. Since pre-paleolithic times, Vitamin D has been produced in our skin from the UVB radiation of sunlight. The sun indeed powers nearly all life on earth. It is essential and signals reproduction, energy and longevity for not just humans but all land and marine plants, prokaryotes, and animals. The sun has been around the last ~4 Billion years and scientists estimated it will continue to burn another ~4 Billion years.

If you are taking vitamin D, then you are on 'bio-identical hormone replacement therapy' baby!

Typical Dose: 2000 to 10,000 IU daily (enough to achieve and maintain ideal blood ranges 60-70 ng/ml)

Typical Administration: Morning/Daytime

(many people report insomnia, including me, if taken in the evening *makes sense right?*)

Typical Lab Monitoring: Calcium, Magnesium, PTH, [25(OH)D] every 6 months once optimal levels are obtained

TYPical Goal: Blood [25(OH)D] = 60-70 ng/ml




Other TYP staples are:

--High to Ultra-high dose fish oil 6 to 10 g EPA + DHA daily (Depending on how much inflammation and Lp(a); low dose 3 g/day if no inflammation)

--Niacin, Vitamin B3 1-2 grams daily (we prefer Slo-Niacin which is EFFECTIVE and cheap $12.99 at Costco for #150 tabs)




Side benefits of all the above:
--diminished infections (and maybe incl HIV?)
--diminished immunosuppression
--diminished cancers, melanoma
--diminished wrinkles *twinkle*
--increases life span



Vitamin A (natural; not vitamin A precursors like beta-carotene)
Vitamin A helps all the above as well. I like Vitamin A esp because most rice-eating communities are deficient of vitamin A (Bamji MS Experientia Suppl. 1983;44:245-63.). On the Japanese diet, 20% of individuals were deficient in Vitamin A and Riboflavin B2. Going grain-free and eating Paleo easily ameliorates Vitamin A deficiency. In the mean time, supplementation provides a bridge until optimal health is achieved.

Read more about Vitamin A: HERE

Wednesday, December 17, 2008

Physiologic Actions and Benefits of Vitamin D: DOSING

Many practitioners may be 'shy' when initiating vitamin D therapy for replacement. They may have learned in school (20-40 yrs ago) about risks of hypercalcemia (high blood calcium), kidney stones and other horrific adverse effects associated with toxicity. We'll debunk this myth in the next post.

Goal Vitamin D [25(OH)D]: 60 - 80 ng/ml

Magnesium goal: upper end of normal about 2.2 to 2.3 mg/dl (range 1.7 mg/dl-2.3 mg/dl)
Calcium goal: lower end of normal about 8.5 to 9.5 mg/dl (range 8.5-10.3 mg/dl)
Parathyroid hormone (PTH) goal: lower end of normal 10 to 20 pg/ml (range 10-65 pg/ml)


OTC Vitamin D costs me about $2 per month (Carlson's Solar D Gems 4000 IU-capsules ~$30/360 or NOW brand 5000 IU-capsules ~$8/120. Roughly 7 to 8 cents per day.

I don't need a doctor's prescription (so convenient for me).

For optimal multi-organ functioning and longevity, hey!, 7-8 cents/day is a fraction of the cost of the triple-shot-latte from Peet's coffee (~$5 + gas) I frequently indulge in (though much much less now BTW).

Of course Dr. Davis has already talked about the non-toxicity of Vitamin D in his practice (consisting of thousands of patients). Personally, I have never witnessed an elevated blood calcium (unless the patient had a parathyroid tumor and/or had very low Magnesium (less than 1.6-1.8 mg/dl) and/or low Free T4 T3).

Another expert on Vitamin D dosing is Dr. Cannell of the non-profit Vitamin D Council in California. Several years ago, he co-authored a fabulous CME (continuing medical education) piece for health care providers. Physicians (like RNs and PharmDs and RDs) need to collect educational units called CMEs annually to keep up with medical advances and treatments.

Great reference for Vitamin D:
THE CLINICAL IMPORTANCE OF VITAMIN D (CHOLECALCIFEROL): A PARADIGM SHIFT WITH IMPLICATIONS FOR ALL HEALTHCARE PROVIDERS (CME)
By Alex Vasquez, DC, ND, Gilbert Manso, MD, John Cannell, MD


Here, Dr. Cannell reviews some basics about dosing and the studies that support using Vitamin D doses that are 10-fold higher than current recommendations (only 400 IU/day). He writes...

"Based on the research reviewed in this article, the current authors believe that assessment of vitamin D status and treatment of vitamin D deficiency with oral vitamin D supplements should be come routine component of clinical practice and preventive medicine. Vitamin D supplementation with doses of 4,000 IU/day for adults is clinically safe and physiologically reasonable since such doses are consistent with physiologic requirements. Higher doses up to 10,000 IU/day appear safe and produce blood levels of vitamin D that are common in sun-exposed equatorial populations. Periodic assessment of serum 25-OH-vitamin D [25(OH)D] and serum calcium (and I'd add M-A-G-N-E-S-I-U-M *wink*) will help to ensure that vitamin D levels are sufficient and safe for health maintenance and disease prevention."




If you live at the equator and stay outdoors the great majority of the time, then there is a slim chance you are NOT deficient. Even Hawaiians (who did not wear sunscreen for 30min daily) were found to be deficient.

Low vitamin D status despite abundant sun exposure.
Binkley N, Novotny R, Krueger D, Kawahara T, Daida YG, Lensmeyer G, Hollis BW, Drezner MK.
J Clin Endocrinol Metab. 2007 Jun;92(6):2130-5.
PMID: 17426097


Severe vitamin D deficiency in Hawai'i: a case report.
Bornemann M.
Hawaii Med J. 2006 Jan;65(1):16-17, 20.
PMID: 16602611


Serum vitamin D metabolite levels and the subsequent development of prostate cancer (Hawaii, United States)
Nomura AM, Stemmermann GN, Lee J, Kolonel LN, Chen TC, Turner A, Holick MF.
Cancer Causes Control. 1998 Aug;9(4):425-32.
PMID: 9794175


A prospective investigation of serum 25-hydroxyvitamin D and risk of lymphoid cancers.
Lim U, Freedman DM, Hollis BW, Horst RL, Purdue MP, Chatterjee N, Weinstein SJ, Morton LM, Schatzkin A, Virtamo J, Linet MS, Hartge P, Albanes D.
Int J Cancer. 2008 Sep 9;124(4):979-986. [Epub ahead of print]
PMID: 19035445



Contraindications to Vitamin D Supplementation
Certain conditions may exist where vitamin D is contraindicated. Dr. Cannell talks about Sarcoidosis, a granulomatous condition where the certain cells over produce activated vitamin D metabolites (1,25-OHD), which can lead to hypercalcification of soft-tissues.

Another condition would be where blood testing cannot be readily done. It is important to follow up and have blood level 'tracking' to not only make sure the levels are adequate but also to avoid excessive over-supplementation.



Dosing
Individual variations, sunlight exposure, stress (mental, physical) and illnesses affect vitamin D levels. Individual genetic variations play a great role as well. Vitamin D is a hormone and the dosing appears to me widely variable when hormone imbalances exist (obesity, high cortisol, high wheat intake, disruption of omega-3 to omega-6 balance, high estrogen in men, high testosterone in women, etc). Optimal dosing depends on the initial blood vitamin D concentration (eg, [25(OH)D]) and then a repeat test in 8-12 weeks. The 1,25-OHD blood test is incorrect. This is a very short-lived metabolite and typically does not correspond to vitamin D blood levels (it may however be elevated in Sarcoidosis).


Blood Testing
How do you know you are vitamin D deficient (eg, blood level less than 60 ng/ml)? You don't. Testing is paramount. LEF offers a blood test which is sometimes on sale for $20. Otherwise most insurance companies cover this test now if the doctor orders it.
http://www.lef.org/Vitamins-Supplements/ItemLC081950/Vitamin-D-25-Hydroxy-Blood-Test.html


Magnesium Supplementation
As bones mineralize and become stronger, crosslinked and denser, minerals from our blood are drawn out to fortify the skeleton. A notably co-factor for about 375 different enzymatic reactions is Magnesium. Do you remember Mg++ ATPase from biology? (Mg is the elemental abbreviation) Magnesium it turns out acts like a STATIN -- yes indeedy -- it raises HDL cholesterol (the 'good' stuff), lowers sdLDL cholesterol and TG by affecting the rate-limiting step in cholesterol synthesis and desaturases (Seelig MS et al J Am Coll Nutr. 2004 Oct;23(5):501S-505S.). At this time in fact, Dr. Davis is debunking statins: Statin Drug Revolt. Do we all have a 'Statin-Deficiency'? No, but perhaps a Magnesium one! Magnesium also relaxes muscles including the light/thin muscle sheaths lining our arteries, which subsequently lead to lowering and modulation of the blood pressures. Magnesium is also important in other muscles like a major one, the heart which beats 100,000+ per day. A recent study showed that Magnesium supplementation alone prevented more mortality than conventional heart failure treatment (MACH study Int J Cardiol. 2008 Feb 15.). We deplete Mag in various ways: breathing, living, urinating, sweating to name a few. Magnesium is rapidly depleted via use of 'water pills' or diuretics (including...uuuummm.. caffeine...alcohol...uummm, haven't had any of these lately no000OOsirrreeee *ha*)

Signs of Magnesium depletion or insufficiency may include: headaches, migraines, restless leg syndrome, muscle cramping, Charley horses, irregular heart rates, chronic constipation, etc.

At TYP, various salt forms of Magnesium are used (orotate, oxide, amino acid chelate $$$, malate, citrate, et cetera). My sister likes CALM for its citrusy taste. Yes, MOM (milk of magnesia) and Citrate of Magnesia are laxatives -- so if you take too much, you'll be warming the loo/WC!

Remember to check your calcium and magnesium levels along with vitamin D later and periodically.



Financial Incentives For Health Insurance
There are financial incentives for health insurance companies to NOT ignore vitamin D Deficiency -- costs for treating 'expensive' conditions like cancer, autoimmune diseases and diabetes are estimated to be reduced by many experts, epidemiologists and scientists.


Avoidance of Prescription SYNTHETIC Vitamin D2 (Ergocalciferol)
All synthetic hormones and vitamins should be suspect. They are not identified, metabolized, activated or eliminated in the human/mammalian body as well as the naturally-occurring structures. In a few anecdotal references, Vitamin D2 (synthetic, fake) has been reported to not only less therapeutic in correcting and ameliorating secondary hyperparathyroidism (elevated PTH due to low vitamin D), but also in producing higher blood glucoses in individuals with a certain vitamin D polymorphism. Toxicity (when it does occur) is also reported significantly more with synthetic vitamin D2 compared with natural D3.
Vieth 1998 Am J Clin Nut Vitamin D3 1.7x more potent than D2 (but reported potency outdated)
Vieth R The Case Against Ergocalciferol (eg, Vitamin D2 fake/synthetic stuff)



Disclaimer: I have no financial ties to NOW, Carlson's, or LEF.