Dr Sunshine

Dr Sunshine, otherwise known as Michael Hollick, was interviewed by the New York Times Magazine this morning. I've been convinced by Dr Sunshine to increase my Vitamin D intake - now at 3,000 IUs a day, every day - but there are times when I think that I would not loan any money to Michael Hollick.

Read this interchange between Michael and the writer Deborah Solomon:

What bothers me about your research is the inflated claims you make for it. You say that one pill can prevent and treat everything from cancer to autism to depression. There has never been a medication that did all that.

I never said autism.

It’s on the cover of your book!


Read all of a punchy little interview.

Of course he was promoting his most recent book - out April 1, 2010. Probably worth reading.

Knee Cartilage and Vitamin D

I'm back to running 12 to 15 miles a week and I've been just a tad surprised that my knees have not been hurting non-stop but I've given all the thanks to my knee lubrication in 2008. However increasing my Vitamin D intake might well have been helping as well.

The research, in Tasmania, Australia, looked at men and women aged 51 to 79 years with an average of 61 years. This is right in my age range and hence the interest.

The paper has the title Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: The Tasmanian older adult cohort study

Dr. Changhai Ding is a long time researcher on cartilage, osteoarthritis and knees (look at his long list of research papers) said "Cartilage loss is the hallmark of osteoarthritis."

I've increased my Vitamin D intake up to 3,000 IU's a day and hopefully this has increased the level of serum 25-hydroxyvitamin D [25 OHD] . The research was carried out in Tasmania, Australia and maybe that was why the mean 25-hydroxyvitamin D [25 OHD] baseline was 52.6 nmol/L - the sunny climate gave high Vitamin D levels. In northern climates a Vitamin D level of 30 nmol/L and up is seen as normal.

The next thing to do is to get my Vitamin D level measured to find out if my less painful knees are related to much higher Vitamin D levels (bearing in mind my levels were around 30 nmol/L in April 2009).

Vitamin D

Are you getting enough Vitamin D ?

What exactly is "enough Vitamin D ?"

My favorite Nutrition textbook Nutrition Now by Judith Brown (University of Minnesota) - 4th edition from as far back as 2005 - gives the recommended daily dose of Vitamin D as 200 IU's (5 mcg) with 2,000 IU's as the Upper Level.

By way of contrast the April 2008 issue of Tufts University Health & Nutrition Health Letter talks about taking 1,000 IU's of Vitamin D daily.

Our skin makes Vitamin D3 at a great rate when exposed to the sun but do we get enough sun on our bodies ? Last month the Arizona Cancer Center published their study of Vitamin D status amongst residents of Arizona. Due to the states large number of sunshine days there was not expected to be a problem. But there is ! Most adults in the survey were Vitamin D deficient.

The big new piece of information concerning Vitamin D in the April 2008 Tufts Health & Nutrition Letter is that it helps strengthen muscles just as much as strengthening bones. These benefits only seem to come with the new higher levels of Vitamin D - at least 700 IU's and better still 800 IU's.

Vitamin D precursors come in 3 forms - D1, D2 and D3. It is the D3 form which is most effective. If you read nutrition labels look for D3. D2 is 25 % less effective and D1 is not worth much at all.

How high can you go with Vitamin D ? Dr Bruce Hollis of the Medical University of South Carolina maintains that much higher dosages are safe. He has provided nursing mothers with up to 6,000 IU's a day with no reported adverse affects.

However most doctors worry about possible side-affects with very high dosages e.g. calcium deposits in heart, kidney, liver; abnormal bone growth; young children mental retardation. The side-affects are definitely not trivial.

You can obtain Vitamin D from all kinds of dairy foods, eggs, fish, mushrooms. Milk and margarine are generally Vitamin D fortified. The easiest and best source is to allow your skin to make Vitamin D when exposed to sunlight.

The problem is that most people do not get enough sun-light on enough of their skin for long enough. If you are fairly light skinned and less than 55 years then 5 to 15 minutes exposure to the skin 3 times a week is enough to keep Vitamin D supplies high. Darker skin or older then you'll need to expose more skin and for longer.

Nexium and Osteoporosis

I take a Nexium capsule every morning so I'm interested in news about Nexium.

This month's issue of the Mayo Clinic Health Letter has a piece about the increased risk of osteoporosis from taking drugs like Nexium to stop acid reflux. The Mayo Clinic Health Letter come to be through the mail and I don't know whether there is an electronic version available - hence to way to let you click through to read the piece for yourself.

The issue is that to stop acid reflux you either take one of the proton pump inhibitors (like Nexium, Aciphex, Prevacid, Prilosec, Protonix, Zegerid) or take one of the H-2 receptor blockers (like Pepcid, Zantac) but they reduce proper absorbtion of calcium from food. As a result bones become weaker and down the line there is the possibility of a fractured hip.

Not taking Nexium or one of the others is not a good option because you get acid reflux back and left untreated you could eventually be dealing with a cancer in the throat.

The Mayo Clinic answer is to:

• keep taking the pill for acid reflux
• take your calcium supplement in the form of calcium citrate
  
• take the calcium supplement multiple times spread through the day
• increase calcium from food e.g. dairy if dairy is part of your diet, dark green veggies
• make sure you are getting enough Vitamin D (for most people that means supplementing with Vitamin D in Winter and even in Summer if you always go out with sunblock already applied.)

Nexium and Osteoporosis

I take a Nexium capsule every morning so I'm interested in news about Nexium.

This month's issue of the Mayo Clinic Health Letter has a piece about the increased risk of osteoporosis from taking drugs like Nexium to stop acid reflux. The Mayo Clinic Health Letter comes to me through the mail and I don't know whether there is an electronic version available - hence no way to let you click through to read the piece for yourself.

The issue is that to stop acid reflux you either take one of the proton pump inhibitors (like Nexium, Aciphex, Prevacid, Prilosec, Protonix, Zegerid) or take one of the H-2 receptor blockers (like Pepcid, Zantac) but they reduce proper absorption of calcium from food. As a result bones become weaker and down the line there is the possibility of a fractured hip.

Not taking Nexium, or one of the others, is not a good option because you get acid reflux back and untreated you could eventually be dealing with a cancer in the throat.

The Mayo Clinic answer is to:

• keep taking the pill for acid reflux
• take your calcium supplement in the form of calcium citrate
  
• take the calcium supplement multiple times spread through the day
• increase calcium from food e.g. dairy if dairy is part of your diet, dark green veggies
• make sure you are getting enough Vitamin D (for most people that means supplementing with Vitamin D in Winter and even in Summer if you always go out with sunblock already applied.)

Nothing these days is simple - even taking something as low tech as calcium.
If you might have kidney stones, parathyroid disease even taking specific antibiotics, then you'll need detailed medical advice.