Vitamin D - Remarkable Paper in British Medical Journal

[Guest guest]

" So it is not just autistic children that are being harmed by

vitamin A. Avoid cod liver oil like the poison it is and check your

multivitamins. Life Extension Foundation just reformulated their

multivitamin to contain only 500 IU of preformed retinol. And, I am happy

to report that Purity Products, which markets my vitamin D, has no

preformed retinol at all in any of their multivitamins, only beta

carotene. Purity has also stopped selling cod liver oil. Now, if only

Carlson, Solgar, Nature's Way, and other companies would stop selling cod

liver oil and stop selling their concentrated vitamin A supplements to a

country whose problem is widespread sub-clinical vitamin A toxicity, I'd

be a happier agitator. "

and

" However, the elderly of many countries, not just Nordic countries,

were raised on cod liver oil and I suspect that a sizable number of

Americans continue to take cod liver oil as they age. While cod liver oil

from the 1980s and 90s had higher amounts of vitamin D than does modern

cod liver oil, it still had toxic amounts of A. I suspect if authors of

the above ten studies had controlled for cod liver oil intake, they would

have found that high retinol intake was blocking the cancer-preventing

effects of vitamin D. "

http://thenaturaladvocate.blogspot.com/2010/02/remarkable-paper-in-british-medical.html

Sunday, February 28, 2010

Remarkable Paper in British Medical Journal - vitamin D

The Vitamin D Newsletter

February 28, 2010

This is a periodic newsletter from the Vitamin D Council, a non-profit

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A few weeks ago, the British Medical Journal published a remarkable

paper, remarkable that it studied more than 500,000 subjects, remarkable

that it had 56 (fifty-six) authors, remarkable that it confirmed low

vitamin D levels obtained in the past are a risk factor for developing

colon cancer in the future. However, the most remarkable part of the

paper is that the 46 scientists minimized the true significance of their

own research. They found that vitamin A, even in relatively low amounts,

appears to thwart vitamin D's association with reduced rates of colon

cancer.

Jenab

M et al. Association between pre-diagnostic circulating vitamin D

concentration and risk of colorectal cancer in European populations: a

nested case-control study. BMJ 2010;340:b5500

This is a prospective nested case-controlled study, which means it uses

subject's vitamin D blood samples obtained and frozen in the past and

then reviews their medical records into the future to see who gets colon

cancer, comparing the study subjects to similar members of the group that

did not get the illness. Dr. Mazda Jenab and his 45 colleagues from the

International Agency for Research on Cancer confirmed that low vitamin D

levels are a risk for colon cancer in a dose response manner; those with

the highest levels were about twice as less likely to develop colon

cancer compared to those with the highest levels.

However, hidden on page eight is one sentence and a small table, which

shows that the benefits of vitamin D are almost entirely negated in those

with the highest vitamin A intake. And the retinol intake did not have to

be that high in these older adults to begin to negate vitamin D's

effects, about 3,000 IU/day. Remember, young autistic children often take

3,500 IU of retinol a day in their powdered multivitamins, which doesn't

count any additional vitamin A given in high single doses.

This is the largest study to date showing vitamin A blocks vitamin D's

effect and explains some of the anomalies in other papers on vitamin D

and cancer. For example, Dr. Stolzenberg- of the NIH

conducted two similar studies on pancreatic cancer, with startling

different results. Her first paper showed high vitamin D levels tripled

the subsequent risk of pancreatic cancer, her second paper showed no

effect. The difference, the first was conducted in a cod liver oil

country, Finland, the second in the USA.

Stolzenberg- RZ et al. A prospective nested case-control study of

vitamin D status and pancreatic cancer risk in male smokers. Cancer Res.

2006 Oct 15;66(20):10213-9.

Stolzenberg- RZ, et al. Serum vitamin D and risk of pancreatic

cancer in the prostate, lung, colorectal, and ovarian screening trial.

Cancer Res. 2009 Feb 15;69(4):1439-47.

Prostate cancer is another good example; ten similar studies have been

conducted on vitamin D blood levels and the risk of subsequent prostate

cancer. Dr. Lu Yin of the German Cancer Research Center reviewed them in

detail. Eight of the studies found no relationship but two studies found

a U shaped curve, that is, an increased risk of prostate cancer at both

lower and higher vitamin D levels. You guessed it; both of these studies

were from Nordic countries where cod liver oil consumption is

rampant.

Yin L

et al. Meta-analysis of longitudinal studies: Serum vitamin D and

prostate cancer risk. Cancer Epidemiol. 2009

Dec;33(6):435-45.

So why is there no relationship between vitamin D levels and the future

risk of prostate cancer? All the subjects had their vitamin D levels

checked in the late 1980s or 1990s, well into the sun-scare but before

the vitamin D revolution. So how did these older people get high levels

of vitamin D back then? Multivitamins? No, they only contained a

meaningless 400 IU. Vitamin D supplements? No, they were not widely

available back then and only contained a meaningless 200 to 400 IU of

vitamin D if available. Sunshine? Maybe, but I doubt it. Studies have

shown that the elderly were the first to abide by sun-avoidance advice;

anyway, the elderly lose the ability to make vitamin D from sunshine; it

takes the elderly up to ten times more time in the sun that the young to

make an equivalent amount of vitamin D.

However, the elderly of many countries, not just Nordic countries, were

raised on cod liver oil and I suspect that a sizable number of Americans

continue to take cod liver oil as they age. While cod liver oil from the

1980s and 90s had higher amounts of vitamin D than does modern cod liver

oil, it still had toxic amounts of A. I suspect if authors of the above

ten studies had controlled for cod liver oil intake, they would have

found that high retinol intake was blocking the cancer-preventing effects

of vitamin D.

I say this because one author has controlled for retinol intake and the

pre-cancerous condition, colon adenomas. Dr. Kyungwon Oh, of the Korea

Centers for Disease Control and Prevention, working with Harvard

epidemiologists, found that high retinol intake completely thwarted the

beneficial effects of vitamin D, stating, " a higher retinol intake,

approximately > 4,800 IU/day, appears to counter the beneficial effect

of vitamin D . . . " In other words, exactly what the British Medical

Journal paper found with colon cancer.

Oh K

et al. Calcium and vitamin D intakes in relation to risk of distal

colorectal adenoma in women. Am J Epidemiol. 2007 May

15;165(10):1178-86.

Let " s look at Dr. Pamela Goodwin " s study from the University of

Toronto that studied breast cancer survival. This a very different study

as it looked at vitamin D levels obtained after the diagnosis of breast

cancer and subsequent survival in 535 Toronto women between 1989 and

1996. Vitamin D levels ranged from 3 ng/ml to 70 ng/ml. The women with

the lowest levels were about twice as likely to die and to suffer distant

cancer recurrence compared those with the highest levels. Ten year

survival was 85% for those in the upper one-third of vitamin D levels

compared to 74% in the lower one-third. However, the data suggested a U

shaped curve for the women with levels above 40 ng/ml, that is, a higher

risk of dying, but it was not statistically significant.

Goodwin PJ et al. Prognostic effects of 25-hydroxyvitamin D levels in

early breast cancer. J Clin Oncol. 2009 Aug

10;27(23):3757-63.

Again, let " s ask where women would get levels above 40 ng/ml in

Toronto between 1989 and 1996? Sunshine? We know the answer is no as the

authors found no seasonal variation in 25(OH)D levels in the 535 women,

even in the women with the highest levels. So where did blood levels of

40-70 ng/ml come from in the early 1990s? Vitamin D supplements were not

widely available in the early 1990s, and only contained meaningless doses

when available. As sunshine was ruled out, they could only have gotten it

from cod liver oil. I have emailed Dr. Pamela Goodwin, lead author,

asking how hard it would be to see if cod liver oil use was asked about

in the dietary questionnaire and if she could control for cod liver oil

intake. She did find retinol intake was associated with higher vitamin D

levels but I am particularly interested in cod liver oil intake in women

with vitamin D levels above 40 ng/ml.

It's not just in breast cancer that vitamin D levels appear to have a

treatment effect; it's in lung, prostate and colon cancer as well. Again,

these are studies of people diagnosed with cancer to see if high vitamin

D levels at the time of diagnosis are associated with improved survival.;

that is, do high vitamin D levels have a treatment effect? On average,

those with the highest vitamin D levels at time of diagnosis lived 2 or 3

times longer. One has to ask how high vitamin D levels are associated

with greatly improved survival once you get cancer but a higher risk of

getting cancer in the first place. That requires some gymnastic thinking

and acrobatic basic science.

Zhou

W et al. Circulating 25-hydroxyvitamin D levels predict survival in

early-stage non-small-cell lung cancer patients. J Clin Oncol. 2007 Feb

10;25(5):479-85.

Ng K

et al. Clin Oncol. 2008 Jun 20;26(18):2984-91. Circulating

25-hydroxyvitamin D levels and survival in patients with colorectal

cancer. J Clin Oncol. 2008 Jun 20;26(18):2984-91.

Tretli S et al. Association between serum 25(OH)D and death from prostate

cancer. Br J Cancer. 2009 Feb 10;100(3):450-4.

Remember, studies of vitamin D levels and subsequent risk of cancer are

only one type of epidemiological study. Studies of latitude and cancer

are quite clear, the less sunshine the higher the cancer risk. Studies of

dietary vitamin D intake and cancer are also mostly supportive but such

studies are limited by the tiny doses people get in their diets.

So it is not just autistic children that are being harmed by vitamin A.

Avoid cod liver oil like the poison it is and check your multivitamins.

Life Extension Foundation just reformulated their multivitamin to contain

only 500 IU of preformed retinol. And, I am happy to report that Purity

Products, which markets my vitamin D, has no preformed retinol at all in

any of their multivitamins, only beta carotene. Purity has also stopped

selling cod liver oil. Now, if only Carlson, Solgar, Nature's Way, and

other companies would stop selling cod liver oil and stop selling their

concentrated vitamin A supplements to a country whose problem is

widespread sub-clinical vitamin A toxicity, I'd be a happier

agitator.

Cannell, MD

Executive Director

Vitamin D Council

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