Vitamin D supplements for good health

The use of vitamin D supplements is now promoted to the general population, because vitamin D deficiency is now common. For people living with Gorlin Syndrome, who need to minimise exposure to UV, vitamin D supplements are essential, unless your doctor has specifically instructed that you must not take vitamin D. This is a rare circumstance, but it can happen, in certain diseases.

General comments follow:

Everyone needs vitamin D. Recent scientific research indicated that this vitamin is vital for normal function of many body systems, and not only for maintaining our skeletons, by helping us to absorb calcium from our diets (or from calcium supplements). Vitamin D deficiency has been linked to a wide range of disease states including hypertension, depression, schizophrenia, autism, infections, cancers and autoimmune diseases such as multiple sclerosis and type 1 diabetes.

Over the years, I have found several useful sources of information about science and health, such as "Wikipedia" and the Australian ABC, which broadcasts TV shows such as “Catalyst” and radio shows such as “Health Report”, for which transcripts are available online. It is important to note the dates of these articles; this one was from 1999, and gives readers a useful introduction to the topic, but needs to be read in the context of later research:

http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s63610.htm

This discussion was about people with "normal" resistance to cancer, and not about how people with Gorlin Syndrome need to act, so they implicitly recommend more sun exposure than is advisable for people with Gorlin Syndrome.

Note especially that the expert said that our skin becomes less efficient at turning the precursor molecules into active vitamin D, as we age. No wonder that many Australians over the age of 60 are deficient in vitamin D, even though many of them would still get exposure to sunshine at a level that would suffice, if they were younger. Thus, our aging loved ones also need vitamin D supplements; see this article from ABC “Catalyst”:

http://www.abc.net.au/catalyst/stories/2514231.htm

"Vitamin D (12/03/2009)

Have we taken our fear of the sun too far? We’re told to keep out of the sun – so what are you to think when your doctor tells you that you’re not getting enough of it and as a result you now have a serious vitamin D deficiency? Dr Norman Swan soaks up some rays to find out what is really going on. …......."

Vitamin D is also vital for brain development and function, see:

http://www.abc.net.au/science/articles/2010/09/07/3005303.htm

“Low vitamin D linked to schizophrenia

Tuesday, 7 September 2010 Timothy McDonald”

See the section called “Related Stories”:

“Audio: Link between vitamin D deficiency and schizophrenia (The World Today)

Sun-shy mums may raise MS risk in babies, Science Online, 30 Apr 2010”

Note that vitamin D deficiency has also been implicated in risk of developing multiple sclerosis (MS). There has recently been a breakthrough in identification of genes that are also involved; there is an interaction between the person's genetic makeup and environmental factors including vitamin D levels. This genetic breakthrough was reported on Australian TV; see this article about it:

http://www.abc.net.au/worldtoday/content/2011/s3290760.htm

"New genes found in MS study

Liz Hobday reported this story on Thursday, August 11, 2011 12:46:00

ELEANOR HALL: One of the largest human genetic studies ever undertaken is yielding some promising results for Multiple Sclerosis sufferers.

Scientists say they've found almost 30 new genes linked to the disease and are hoping that this will lead to better treatments. ….......”

Vitamin D is also implicated in our risk of developing certain cancers; see this transcript from ABC “Catalyst”:

http://www.abc.net.au/catalyst/stories/s805444.htm

"Vitamin D and Cancer (27/03/2003)

Medical experts around the world are talking about a new epidemic, a health concern that may be dramatically increasing our risk of cancer, hypertension and even diabetes – it’s a lack of Vitamin D.

Some experts predict that up to 25 per cent of Australians could be Vitamin D deficient. The cause is something that’s been known for nearly a century, a lack of sunshine. There now seems to be a connection between breast, colon and prostate cancer and a lack of Vitamin D.

Even more amazing, one expert believes 25 per cent of breast cancer deaths could be avoided if the women had maintained adequate vitamin D levels throughout their life.

Catalyst’s Karina Kelly investigates research in Australia that appears to show that Vitamin D actually kills cancer cells while protecting healthy cells from sun damage.

Vitamin D can only be made by the body when sunlight falls on skin unprotected by sunscreen. This raises some big questions for Australians who have been living with the sun safe message for the last 20 years. … … "

“Quarterly Advocate” had this article on vitamin D:

http://www.bccns.org/news/2009Winter.pdf

"Multiple Health Concerns Surface as Winter Arrives

Source: Future Microbiology , Nov 23, 2009

CORVALLIS, Ore. – A string of recent discoveries about the multiple health benefits of vitamin D has renewed interest in this multi-purpose nutrient, increased awareness of the huge numbers of people who are deficient in it, spurred research and even led to an appreciation of it as "nature's antibiotic."

On issues ranging from the health of your immune system to prevention of heart disease and even vulnerability to influenza, vitamin D is now seen as one of the most critical nutrients for overall health. But it's also one of those most likely to be deficient – especially during winter when production of the "sunshine vitamin" almost grinds to a halt for millions of people in the USA, Europe and other northern temperate zones. Analogs of the vitamin are even being considered for use as new therapies against tuberculosis, AIDS, and other concerns. And federal experts are considering an increase in the recommended daily intake of the vitamin as more evidence of its value emerges, especially for the elderly.

"About 70% of the population of the USA has insufficient levels of vitamin D," said Adrian Gombart, principal investigator with the Linus Pauling Institute at Oregon State Univ. "This is a critical issue as we learn more about the many roles it may play in fighting infection, balancing your immune response, helping to address autoimmune problems, and even preventing heart disease." Those issues were just outlined in a new publication in Future Microbiology, a professional journal, on the latest findings on vitamin D research, at OSU and in many other programs around the world. ….........”

Note that food in Australia is not supplemented with vitamin D, as far as I know.

Immune function is important for handling infectious diseases, and also for protecting us from cancer. Our immune systems are thought to destroy most tumours, soon after they begin, leaving a minority that somehow avoid this process and grow big enough to trouble us.

__________

Among the “Educational articles” at the USA Gorlin Syndrome site was a reprint from the New England Journal of Medicine (NEJM), which is a reputable medical journal:

http://www.gorlinsyndrome.org/EduDocs/Dermatological/VitaminD/Vitamin%20D%20Deficiency.pdf

“N Engl J Med 2007;357:266-81.

Vitamin D Deficiency

Michael F. Holick, M.D., Ph.D.”

It is a very detailed review of the whole topic of vitamin D, with more information than most of us want to read, but see Table 2 on page 274 – 275, which gives examples of groups that are likely to suffer from deficiency and how to fix it. How can we swallow enough vitamin D? The richest natural sources include codliver oil or lots of "oily fish"; the same ones that are recommended as sources of "omega 3" oil or "fish oil", such as sardines or salmon. Tablets or capsules, each having 1,000 units of vitamin D3, can readily be bought at pharmacies in Australia; I now take 2 to 3 such tablets a day. Higher potency supplements require a doctor's prescription. I was reassured by the information on page 278 that explained that I was not going to “overdose” if I took up to 10,000 units / day, but that 50,000 units a day for 6 months was definitely too much vitamin D. I am obese, and obesity impairs vitamin D utilisation in the body, meaning obese people need twice as much vitamin D as most slim people. Therefore, I am taking around 3,000 units / day, taking into account the various supplements I consume. That intake is safe for me, according to the NEJM article.

Long ago, my doctor had recommended that I take a supplement of 1,000 units / day, and I did so, for a time. For some reason, I had ceased taking it, but I resumed taking vitamin D last year, at 2,000 to 3,000 IU/day, because of what I had read in NEJM. I soon felt healthier than I had felt in years!! (In those ill years, my vitamin D intake was probably 200 IU/ day, or less.) My doctor had also diagnosed me as suffering from “fibromyalgia”. I have read that chronic vitamin D deficiency is often misdiagnosed as “fibromyalgia”because its symptoms are so similar: muscle weakness, aches and pains. My “fibromyalgia”symptoms are much less troubling, now that I am not deficient in vitamin D. I have been able to resume moderate exercise at the gym. I no longer struggle to do basic daily tasks, such as walking, and my use of analgesics has decreased.

Cancer and mutations

People with Gorlin Syndrome have only 1 working copy of a gene involved in the “Sonic Hedgehog Signalling Pathway”; generally the gene called “patched – 1” (PTCH1), but sometimes another of the relevant genes. Most people have 2 working copies of each of these genes, but Gorlin Syndrome results when one copy of a relevant gene is mutated, from conception, in all our cells. You could say that all our cells are therefore just a single - mutation - away from having NO working copy of a vital gene; a gene that can be described as a “tumour suppressor” gene, because it acts to prevent our cells becoming malignant or forming tumours.

Genes occasionally mutate. This is directly relevant to cancer.

In basic biology courses, genetic mutations are generally discussed in the context of inheritance, where the mutation may be passed to descendants. In humans and many other species, only the cells in specialised parts of the organism will pass their genes to descendants. In humans, the ovaries of women and the testes of men contain cells that produce “gametes”: ova from women, and spermatozoa from men. Mutations in ova or spermatozoa are called “germ-line” mutations, because they may be passed to descendants (“germ” is old scientific jargon related to seeds and reproduction). Cells in the rest of our body also accumulate genetic mutations over our lifetime, when the DNA in those cells is damaged, but those are genetic mutations which are not passed to descendants; they will affect only a part of that person's body. Such mutations are called “somatic mutations”, because “somatikos” is Greek for “of the body”. Wikipedia has a brief article about this scientific term.

http://en.wikipedia.org/wiki/Somatic

Many cancers are thought to result from somatic mutations. Therefore, I want to help people living with Gorlin Syndrome to understand what somatic mutations are, and know how they can minimise the rate of somatic mutations in their own bodies and minimise the rate at which tumours begin.

How can we minimise genetic mutations?

Some of the factors causing genetic mutations are not able to be controlled by us. We can (and should) choose to minimise our exposure to UV and to “ionising radiation” such as X-rays, but all of our bodies naturally contain some radioactive atoms and we are exposed to radiation from rocks, bricks and cement, and from outer space (“cosmic rays”), so we cannot avoid all radiation – induced genetic mutations.

In addition, the cellular mechanisms that copy DNA during cell division are not 100% perfect, so occasional mistakes are made in copying genes. There are repair mechanisms operating to fix these errors in DNA replication, but sometimes they fail to correct all the errors, and the alteration in DNA is then copied as the cell multiplies. The mutation is perpetuated in cells derived from the original altered cell.

Since every cell in people living with GS already carries a mutation in a relevant gene, our risk (or rate) of tumour formation is higher than in most people. It is important that we do what we can to avoid a mutation in our single copy of the relevant gene, because loss of that sole copy will cause severe damage to the cell involved, and will generally lead to initiation of a tumour as the cell multiplies.

I will explain what I think we can do about this. What we eat and drink is worth considering.

First, do NOT smoke. Smoke contains carcinogenic molecules; molecules that promote cancer formation. Many increase the rate of genetic mutations. Secondly, diet is worth considering. In my opinion, it is common sense to do what we can to stay well.

Public health experts recommend that everyone should eat certain foods, to minimise risk of cancers. People living with Gorlin Syndrome especially need to do this; I am convinced that it is important and worthwhile. Diet is known to influence rates of tumour formation, and I think this effect will probably be more – obvious in Gorlin Syndrome than in the absence of Gorlin Syndrome, because we are so sensitive to carcinogenic agents. Eating plenty of antioxidant – rich foods will help our bodies prevent or repair the inevitable DNA damage that occurs as we age, even in areas of our bodies that are not exposed to extra radiation.

Green tea is sometimes promoted as a source of antioxidants. It was investigated years ago in the UK as an agent to slow down the rate of BCC formation in people with GS. It seems that "black" tea (that is, Ceylon / Indian style tea) also help to prevent BCCs; I am glad about this, because I drink a lot of “black tea” (with milk).

See this article from "Quarterly Advocate":

http://www.bccns.org/news/2007Summer.pdf

"As Published in Journal of the American Academy of Dermatology, May 2007

Tea Drinkers May Have Lower Skin Cancer Risk

People who unwind with a cup of tea every night may have a lower risk of two common forms of skin cancer, new research suggests. In a study of nearly 2,200 adults, researchers found that tea drinkers had a lower risk of developing squamous cell or basal cell carcinoma, the two most common forms of skin cancer. Men and women who had ever been regular tea drinkers -- having one or more cups a day -- were 20 percent to 30 percent less likely to develop the cancers than those who didn't drink tea. … … …"

It is good to know that tea has many good effects on my body, as well as being a refreshing daytime drink.

Red wine is another source of dietary antioxidants, but there are plenty of non-alcoholic choices; apparently, fruits and vegetables that are naturally coloured red, orange, yellow, purple or green are good sources, too.

I will discuss vitamin D in another post. In brief: take vitamin D, in a supplement!

Australian Gorlin Syndrome Mutual Support Group website

The Australian Gorlin Syndrome Mutual Support Group (AGSMSG) now has its own website:

http://home.vicnet.net.au/~gorlinsyndromesupport/LightNEasy.php?page=Home

The home page features photos taken at some of the lunch meetings of the group, in Adelaide, South Australia.