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home:pathogenesis:vitamind [02.13.2019] – [Learn more] sallieq | home:pathogenesis:vitamind [08.06.2023] (current) – [Failing to control for biases inherent to observational studies] ron | ||
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A number of studies have suggested that patients with chronic inflammatory diseases are deficient in 25-hydroxyvitamin D (25-D) and that consuming greater quantities of vitamin D, which further elevates 25-D levels, alleviates disease symptoms. | A number of studies have suggested that patients with chronic inflammatory diseases are deficient in 25-hydroxyvitamin D (25-D) and that consuming greater quantities of vitamin D, which further elevates 25-D levels, alleviates disease symptoms. | ||
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+ | <note important> | ||
+ | "The idea that widespread vitamin D deficiency exists in the world has never had any credibility, | ||
+ | |||
+ | " | ||
+ | |||
+ | "The mis-labeling of this compound as a vitamin is regrettable, | ||
Some years ago, molecular biology identified 25-D as a secosteroid. Secosteroids would typically be expected to depress inflammation, | Some years ago, molecular biology identified 25-D as a secosteroid. Secosteroids would typically be expected to depress inflammation, | ||
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< | < | ||
- | // | + | // |
</ | </ | ||
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==== Supplemental vitamin D show no consistent effects on infection ==== | ==== Supplemental vitamin D show no consistent effects on infection ==== | ||
- | In studies on acute respiratory tract infection(({{pubmed> | + | In studies on acute respiratory tract infection(({{pmid> |
| | ||
- | A complete evaluation of the above mentioned studies, and the differences between them that can help explain the different results, is not suited for this article. However, on a general basis, one of the reasons for differing effects may be that vitamin D works differently in relatively healthy people as compared to sick people. Thus, vitamin D supplementation //may// give a marginal benefit in preventing infections in healthy people (see section below), but not in sick people. As of today (Dec 2012) we are not aware of any studies that have shown an actual reduction in infections in sick people (for instance tuberculosis or COPD) by vitamin D supplementation, | + | A complete evaluation of the above mentioned studies, and the differences between them that can help explain the different results, is not suited for this article. However, on a general basis, one of the reasons for differing effects may be that vitamin D works differently in relatively healthy people as compared to sick people. Thus, vitamin D supplementation //may// give a marginal benefit in preventing infections in healthy people (see section below), but not in sick people. As of today (Dec 2012) we are not aware of any studies that have shown an actual reduction in infections in sick people (for instance tuberculosis or COPD) by vitamin D supplementation, |
- | It is however not certain, in spite of some reported benefits in a few studies, that //any// level of supplementation is beneficial in terms of reducing infection. The studies are still too few to draw firm conclusions, | + | It is however not certain, in spite of some reported benefits in a few studies, that //any// level of supplementation is beneficial in terms of reducing infection. The studies are still too few to draw firm conclusions, |
In sick people vitamin D supplementation increases infectious burden, and suppresses the immune system: | In sick people vitamin D supplementation increases infectious burden, and suppresses the immune system: | ||
- | * **monocytes** – According to a 2011 interventional study in which patients with multiple sclerosis were given high doses of vitamin , peripheral blood mononuclear cells (monocytes) lose " | + | * **monocytes** – According to a 2011 interventional study in which patients with multiple sclerosis were given high doses of vitamin , peripheral blood mononuclear cells (monocytes) lose " |
- | * **Epstein Barr virus** – In a 2010 study of pregnancy-associated breast cancer, higher levels of 25-D were positively correlated with serum antibodies to Epstein Barr Virus, suggesting that EBV is able to better proliferate in patients who take vitamin D.(({{pubmed> | + | * **Epstein Barr virus** – In a 2010 study of pregnancy-associated breast cancer, higher levels of 25-D were positively correlated with serum antibodies to Epstein Barr Virus, suggesting that EBV is able to better proliferate in patients who take vitamin D.(({{pmid> |
- | * **toll-like receptors** – As discussed [[home: | + | * **toll-like receptors** – As discussed [[home: |
- | * **reduction in levels of inflammation** – A 2011 study showed that in colorectal adenoma patients, the vitamin D supplementation group, TNF-alpha decreased 13%, IL-6 32%, IL-1 beta 50%, and IL-8 15% relative to placebo.(({{pubmed> | + | * **reduction in levels of inflammation** – A 2011 study showed that in colorectal adenoma patients, the vitamin D supplementation group, TNF-alpha decreased 13%, IL-6 32%, IL-1 beta 50%, and IL-8 15% relative to placebo.(({{pmid> |
* **short-term symptom resolution** – Further evidence for vitamin D’s activity as an immunosuppressant comes in the range of reports of short-term symptom resolution in autoimmune patients taking vitamin D. Online forums are full of such reports. | * **short-term symptom resolution** – Further evidence for vitamin D’s activity as an immunosuppressant comes in the range of reports of short-term symptom resolution in autoimmune patients taking vitamin D. Online forums are full of such reports. | ||
===== Role in select diseases and conditions ===== | ===== Role in select diseases and conditions ===== | ||
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< | < | ||
- | According to a 2010 paper by Swales and Wang, " | + | According to a 2010 paper by Swales and Wang, " |
- | A recent cross-sectional study involving 340 African Americans with type 2 diabetes found that serum 25-hydroxyvitamin D levels were positively associated with increased calcified atherosclerotic plaque in the aorta and carotid arteries.(({{pubmed> | + | A recent cross-sectional study involving 340 African Americans with type 2 diabetes found that serum 25-hydroxyvitamin D levels were positively associated with increased calcified atherosclerotic plaque in the aorta and carotid arteries.(({{pmid> |
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==== Bioavailability ==== | ==== Bioavailability ==== | ||
- | Impact of 25-hydroxyvitamin D, free and bioavailable fractions of vitamin D, and vitamin D binding protein levels on metabolic syndrome components | + | Impact of 25-hydroxyvitamin D, free and bioavailable fractions of vitamin D, and vitamin D binding protein levels on metabolic syndrome components |
==== Pregnancy ==== | ==== Pregnancy ==== | ||
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==== Failing to control for biases inherent to observational studies ==== | ==== Failing to control for biases inherent to observational studies ==== | ||
- | <mainrelatedarticles> [[.: | + | <mainarticle> [[.: |
{{section>: | {{section>: | ||
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- | According to Professor Roger Bouillon of the University of Leuven, "over one billion" | + | According to Professor Roger Bouillon of the University of Leuven, "over one billion" |
Yet, observational studies show that populations which avoid vitamin D consumption have naturally low levels of 25-D and remain healthy with such levels. | Yet, observational studies show that populations which avoid vitamin D consumption have naturally low levels of 25-D and remain healthy with such levels. | ||
- | * **healthy Chilean women** – A study which tested the level of 25-D in 90 “healthy, ambulatory Chilean women” showed that 27% of the premenopausal and 60% of the postmenopausal women had 25-D levels under 20 ng/ml.(({{pubmed> | + | * **healthy Chilean women** – A study which tested the level of 25-D in 90 “healthy, ambulatory Chilean women” showed that 27% of the premenopausal and 60% of the postmenopausal women had 25-D levels under 20 ng/ml.(({{pmid> |
* **healthy Saudi medical students** – A 2012 study collected data from 95 male and 103 female students with an average age of 19.5 years old. In 100% of the students, the vitamin D level was considered low. The mean 25-D level was 26.83 nmol/L in males and 16.03 nmol/L in females. | * **healthy Saudi medical students** – A 2012 study collected data from 95 male and 103 female students with an average age of 19.5 years old. In 100% of the students, the vitamin D level was considered low. The mean 25-D level was 26.83 nmol/L in males and 16.03 nmol/L in females. | ||
- | * **healthy Bangladeshi women** – A study on healthy Bangladeshi women found that approximately 80% of the women had a level of 25-D under 16 ng/ml.(({{pubmed> | + | * **healthy Bangladeshi women** – A study on healthy Bangladeshi women found that approximately 80% of the women had a level of 25-D under 16 ng/ml.(({{pmid> |
- | * **healthy Chinese infants** – In a 1992 study, healthy full-term infants from China had serum concentrations of 25-D ranging from an average of 5 ng/ml to 14 ng/ml.(({{pubmed> | + | * **healthy Chinese infants** – In a 1992 study, healthy full-term infants from China had serum concentrations of 25-D ranging from an average of 5 ng/ml to 14 ng/ml.(({{pmid> |
- | * **healthy Omani women** – A 2011 study of 41 apparently healthy women (ages 18-45 years) working at the Royal Hospital, Muscat, Oman found that all study subjects had 25-D levels below 50 nmol/L.(({{pubmed> | + | * **healthy Omani women** – A 2011 study of 41 apparently healthy women (ages 18-45 years) working at the Royal Hospital, Muscat, Oman found that all study subjects had 25-D levels below 50 nmol/L.(({{pmid> |
- | * **young healthy adults in western India** – Among young healthy adults from the western part of India, the average serum level of 25-D indicated vitamin D " | + | * **young healthy adults in western India** – Among young healthy adults from the western part of India, the average serum level of 25-D indicated vitamin D " |
- | * **healthy Saudi Arabians** – Severe hypovitaminosis D is widespread and more common in non-diabetics than diabetics in Saudi adults.(({{pubmed> | + | * **healthy Saudi Arabians** – Severe hypovitaminosis D is widespread and more common in non-diabetics than diabetics in Saudi adults.(({{pmid> |
- | * **healthy lactating mothers** – Even when lactating mothers take all but exceedingly high levels of vitamin D – 6,000 IU which is 15 times the United States' | + | * **healthy lactating mothers** – Even when lactating mothers take all but exceedingly high levels of vitamin D – 6,000 IU which is 15 times the United States' |
The Vitamin D Council, an organization that advocates vitamin D supplementation, | The Vitamin D Council, an organization that advocates vitamin D supplementation, | ||
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< | < | ||
- | //**Armando Sallitto**// | + | //**Armando Sallitto**// |
===== Ramifications of a simplistic understanding of vitamin D metabolism ===== | ===== Ramifications of a simplistic understanding of vitamin D metabolism ===== | ||
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Numerous studies have identified patient populations that are " | Numerous studies have identified patient populations that are " | ||
- | Although it is not unheard of, few seem to explore the possibility that a low 25-D is the result of disease. Perhaps it is because researchers conceptualize vitamin D as they might a resource which gets used up and needs to be replenished – not unlike gasoline when a car runs low. This metaphor is not at all apt, because vitamin D is regulated like the steroid it is.(({{pubmed> | + | Although it is not unheard of, few seem to explore the possibility that a low 25-D is the result of disease. Perhaps it is because researchers conceptualize vitamin D as they might a resource which gets used up and needs to be replenished – not unlike gasoline when a car runs low. This metaphor is not at all apt, because vitamin D is regulated like the steroid it is.(({{pmid> |
- | Large segments of the population are consuming vitamin D at historic levels. Like the first-line treatment for many autoimmune diagnoses, the corticosteroid Prednisone, vitamin D temporarily reduces symptoms of disease, but long-term use dramatically increases the odds of disease relapse.(({{pubmed> | + | Large segments of the population are consuming vitamin D at historic levels. Like the first-line treatment for many autoimmune diagnoses, the corticosteroid Prednisone, vitamin D temporarily reduces symptoms of disease, but long-term use dramatically increases the odds of disease relapse.(({{pmid> |
In practice, widespread and systematic supplementation of vitamin D may serve to drive a kind of self-fulfilling prophesy. When whole populations are given large amounts of vitamin D, the only members of that population who remain " | In practice, widespread and systematic supplementation of vitamin D may serve to drive a kind of self-fulfilling prophesy. When whole populations are given large amounts of vitamin D, the only members of that population who remain " | ||
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===== Supplemental vitamin D given to healthy people ===== | ===== Supplemental vitamin D given to healthy people ===== | ||
- | According to the Marshall Pathogenesis, | + | According to the Marshall Pathogenesis, |
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===== Learn more ===== | ===== Learn more ===== | ||
- | * [[http:// | + | * [[https:// |
* | * | ||
- | * [[http:// | + | * [[https:// |
* | * | ||
- | * [[http:// | + | * [[https:// |
* [[https:// | * [[https:// | ||
{{tag> | {{tag> | ||
+ | < | ||
===== Notes and comments ===== | ===== Notes and comments ===== | ||
- | * [[http:// | + | //broken link// |
+ | [[https:// | ||
+ | |||
+ | * [[https:// | ||
No longer a working link :-( | No longer a working link :-( | ||
- | http:// | + | https:// |
found for Ref.#18 in Cardiovascular disease, one with results expected 2016/ | found for Ref.#18 in Cardiovascular disease, one with results expected 2016/ | ||
- | This challenges the entire concept of vitamin D “deficiency” and helps explain why many patients with inflammatory disease present with low levels of 25-D even when they are consuming large amounts of the secosteroid or are exposed to abundant sunlight.(({{pubmed> | + | This challenges the entire concept of vitamin D “deficiency” and helps explain why many patients with inflammatory disease present with low levels of 25-D even when they are consuming large amounts of the secosteroid or are exposed to abundant sunlight.(({{pmid> |
- | < | + | < |
Allergy Asthma Clin Immunol. 2009 Nov 19;5(1):8. | Allergy Asthma Clin Immunol. 2009 Nov 19;5(1):8. | ||
- | Introduction of oral vitamin D supplementation and the rise of the allergy pandemic.(({{pubmed> | + | Introduction of oral vitamin D supplementation and the rise of the allergy pandemic.(({{pmid> |
Wjst M. | Wjst M. | ||
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Some good studies here? | Some good studies here? | ||
- | * http:// | + | * https:// |
- | * http:// | + | * https:// |
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From: Bane | From: Bane | ||
Date: 2011-11-01 16:27:18 | Date: 2011-11-01 16:27:18 | ||
- | Reply: | + | Reply: |
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- | http:// | + | https:// |
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</ | </ | ||
- | ===== References ===== | + | ===== References =====</ |