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Here is a sad confession: I often think about topics on which I blog when a news article appears or, even more often, when one of the many medical websites that fill my email box each day with targeted posts (and ads) sends something new. For a really hilarious read on the email scene, if you are a subscriber to the New Yorker, click here for an outstanding Shouts and Murmers article regarding “walk-in bathtubs” by Calvin Trillin. But I digress…
With thanks to the good folks at Medscape, two articles worth knowing about suggest that in spite of my general anti-supplement stance, you really SHOULD consider vitamin D supplementation, or at the least know your levels and think about it. Vitamin D (cholecalciferol, D3) is actually a member of the steroid superfamily. (called secosteroids) Thus, there can be interactions between various forms of Vitamin D and other steroid receptors in all likelihood if certain mutations occur. This could be good or bad, but provides a plausible explanation for why Vitamin D (and other non-androgen types of molecules) might play a role in prostate cancer.
In one article, Chinese investigators did a review of 25 studies that evaluated the Vitamin D levels in over 17,000 patients with various cancers and found that those patients with the highest levels lived significantly longer than those with the lowest levels. A similar study appeared in the British Medical Journal last month, evaluating >800,000 patients from 73 studies and reached a similar conclusion: “Evidence from observational studies indicates inverse associations of circulating 25-hydroxyvitamin D with risks of death due to cardiovascular disease, cancer, and other causes. Supplementation with vitamin D3 significantly reduces overall mortality among older adults; however, before any widespread supplementation, further investigations will be required to establish the optimal dose and duration and whether vitamin D3 and D2 have different effects on mortality risk.”
In the other article highlighted by Medscape, baseline 25-OH Vitamin D levels were evaluated in men undergoing prostate biopsies. Among both African American and European American men, severe deficiency (<12 ng/ml) was associated with higher Gleason scores and more advanced stage disease. In the AA population, <20 ng/ml had a significant association with a positive biopsy.
The problem, of course, is that when experts review these and similar articles, they really cannot come to a strong consensus on what to do for the general population, let alone for the cancer population. In this review, the authors point out all of the pitfalls in taking publications like the two Medscape articles as “gospel”. Quoting their abstract, “…vitamin D use and cancer may not have correctly addressed the question, and that new randomized trials should be organized. The reasons are due to several unsolved issues including selection of the effective dose, varying baseline levels of subjects before randomization, compliance with the intervention, contamination of the placebo group (i.e., intake of vitamin D supplements by subjects allocated to the placebo group) and unknown effective lag time between start of the intervention and disease onset.”
“So what would you do, doctor?” Ah, the piercing question… What I did was measure my 25-OH Vitamin D level and found that it was very low. I’m now taking 2-4000 U/day of D3, and I plan to remeasure my level in a couple of months. So there! (BUT – I’m still slathering on the sunscreen that probably got me deficient in the first place)