Re: MED: Vitamin D and chronic fatigue syndrome

[Guest guest]

Hi Rich,

Your Co-cure post was really helpful, and I hope it encourages people who

are considering the Benicar treatment (Marshall protocol) to do the

pre-testing that Trevor Marshall recommends.

I and probably many others would appreciate it if you would talk in more

detail about the following terms you used on Co-cure:

25-OH-D3

1,25-OH-vitamin D

25-OH-vitamin D

For example, why 25? Why 1,25? What do these numbers mean? What does OH

stand for? How does D relate to D3?

Sue ,

Upstate New York

[Guest guest]

Hi, Sue.

I hope that people will get tested first, too. I think that some of

the PWC population is deficient in vitamin D, and some may have the

genetic defect that Dr. Marshall has described, and might benefit

from decreasing their intake of vitamin D.

The story on vitamin D is pretty involved, but as that old TV

program used to say, " You asked for it! "

I'm going to give you some information that is mostly from the PDR

for Nutritional Supplements by Hendler and Rorvik and from the

Dietary Reference Intakes book that includes vitamin D, by the

Institute of Medicine of the National Academy of Sciences. Quite a

bit of this has already been covered by Rob Napier in his recent

post, but I will reiterate some of what he said so that what I write

hopefully will be a coherent story.

The term " vitamin D " refers to certain compounds of the class

called " secosterols. " Secosterols are compounds based on the

steroid structure (which has four rings of certain types joined

together in a certain way), but in the secosterols, one of the rings

has been cut or cleaved open.

Vitamin D includes vitamin D2 (ergocalciferol) and vitamin D3

(cholecalciferol) and their analogues and metabolites. Vitamin D2

originates from yeast and plant sterol, and it is the most common

type used for Vitamin D supplements. Vitamin D3 is produced in our

skin by the action of ultraviolet-B radiation from the sun on 7-

dehydrocholesterol, a precursor of cholesterol. Both D2 and D3

undergo the same reactions and are thought to perform the same

functions in the body. Their molecular structures are very similar,

with slight differences in the side chains of the molecules,

involving a carbon double bond and a methyl group in D2 which are

not found in D3.

To arrive at the form of vitamin D that is active as a hormone,

either D2 or D3 must undergo two reactions that involve adding

hydroxide (OH) radicals. The first step adds one of them, producing

25-OH-vitamin D, and the second adds another, producing 1,25-(OH)2-

vitamin D, the latter being the active form. The numbers 1 and 25

refer to the numbers assigned to the particular carbon atoms in the

molecule to which the OH groups are added to form these new

compounds.

D2 and D3 have fairly short lifetimes in the blood before they are

stored in fat or metabolized in the liver. The first hydroxylation

reaction occurs in the liver, and the product, 25-OH-Vitamin D (also

called calcidiol), returns to the blood and is the main form of

vitamin D circulating in the blood. The second hydroxylation

reaction occurs normally primarily in the kidneys, and this produces

1,25-(OH)2-vitamin D (also called calcitriol), which is returned to

the blood. This second reaction is normally carefully controlled,

because it is important that the proper amount of the active form of

vitamin D be present in the blood.

The best-known job performed by vitamin D is to maintain the levels

of calcium and phosphorus in their normal ranges in the blood serum,

by stimulating the small intestine to absorb them from the food. If

there is not enough calcium in the diet, vitamin D, together with

parathyroid hormone, promotes the development of osteoclasts, which

are cells that break down bone and release calcium and phosphorus

from it.

Vitamin D also plays other roles, some of them not well understood.

One important area is its action involving certain white cells of

the immune system, the monocytes, the macrophages, and the

lymphocytes. Dr. Trevor Marshall has theorized that in the disease

sarcoidosis, there is a genetic defect in the regulation of the

conversion of 25-OH-vitamin D to 1, 25-(OH)2-vitamin D, so that too

much of the latter is produced by some of these white cells when

they are trying to respond to a bacterial infection. He says that

this promotes the growth of granulomas, which make it difficult to

kill the bacteria, and also produces symptoms suggesting that there

is too much vitamin D.

I think this covers the questions you asked. There is, of course, a

whole lot more that could be said about vitamin D!

Rich

Hi Rich,

Your Co-cure post was really helpful, and I hope it encourages

people who

are considering the Benicar treatment (Marshall protocol) to do the

pre-testing that Trevor Marshall recommends.

I and probably many others would appreciate it if you would talk in

more

detail about the following terms you used on Co-cure:

25-OH-D3

1,25-OH-vitamin D

25-OH-vitamin D

For example, why 25? Why 1,25? What do these numbers mean? What does

OH

stand for? How does D relate to D3?

Sue ,

Upstate New York

[Guest guest]

Thanks a lot Rich. Although I was reading on Marshall's protocol, I

was not very clear as to how the increase in D levels correlate with

the levels of inflammation. Was too foggy to put the pieces

together.

Thanks for your very clear explanation.

Gayathri.

>

> Vitamin D also plays other roles, some of them not well

understood.

> One important area is its action involving certain white cells of

> the immune system, the monocytes, the macrophages, and the

> lymphocytes. Dr. Trevor Marshall has theorized that in the disease

> sarcoidosis, there is a genetic defect in the regulation of the

> conversion of 25-OH-vitamin D to 1, 25-(OH)2-vitamin D, so that too

> much of the latter is produced by some of these white cells when

> they are trying to respond to a bacterial infection. He says that

> this promotes the growth of granulomas, which make it difficult to

> kill the bacteria, and also produces symptoms suggesting that there

> is too much vitamin D.

>

>

> Rich

>

[Guest guest]

I think I am still confused. So if someone tests very low normal,

and their physician advised to take vitamin D, should they?

thank you

best,

lea

>

>

>

> >

> > Vitamin D also plays other roles, some of them not well

> understood.

> > One important area is its action involving certain white cells

of

> > the immune system, the monocytes, the macrophages, and the

> > lymphocytes. Dr. Trevor Marshall has theorized that in the

disease

> > sarcoidosis, there is a genetic defect in the regulation of the

> > conversion of 25-OH-vitamin D to 1, 25-(OH)2-vitamin D, so that

too

> > much of the latter is produced by some of these white cells when

> > they are trying to respond to a bacterial infection. He says

that

> > this promotes the growth of granulomas, which make it difficult

to

> > kill the bacteria, and also produces symptoms suggesting that

there

> > is too much vitamin D.

> >

> >

> > Rich

> >

[Guest guest]

Hi, Lea.

If a person tests low in 25-OH-vitamin D, they may indeed be low in

vitamin D, but it is also possible that they have the genetic defect

that Dr. Marshall has found, which causes their 25-OH-vitamin D to

be converted to 1,25-(OH)2-vitamin D too rapidly.

The best thing to do is to have both these substances measured, and

to calculate the ratio between them. If the ratio of the 1,25 form

to the 25 form is significantly higher than normal, this suggests

that the person has the genetic defect, and in that case it would be

better to decrease the intake of vitamin D.

If it isn't possible for a person to get this test, one approach

would be to take some supplementary vitamin D and see if it makes

the person feel better or worse. Another way would be to get some

sunshine. If either the sunshine or the supplementary vitamin D

makes the person feel better, then it is likely that they really did

have a vitamin D deficiency. Vitamin D deficiency is more likely in

people who don't eat vitamin D fortified foods, such as milk

products, and who don't get much sunshine.

Rich

> >

> > >

> > > Vitamin D also plays other roles, some of them not well

> > understood.

> > > One important area is its action involving certain white cells

> of

> > > the immune system, the monocytes, the macrophages, and the

> > > lymphocytes. Dr. Trevor Marshall has theorized that in the

> disease

> > > sarcoidosis, there is a genetic defect in the regulation of

the

> > > conversion of 25-OH-vitamin D to 1, 25-(OH)2-vitamin D, so

that

> too

> > > much of the latter is produced by some of these white cells

when

> > > they are trying to respond to a bacterial infection. He says

> that

> > > this promotes the growth of granulomas, which make it

difficult

> to

> > > kill the bacteria, and also produces symptoms suggesting that

> there

> > > is too much vitamin D.

> > >

> > >

> > > Rich

> > >