January 19, 2011

Is Vitamin D Dangerous?

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January 20, 2011
Bottom Line's Daily Health News
In This Issue...
  • Marge Couldn't Remember Her Phone Number... But Now Her Brain Is 20 Years Younger...
  • Is Vitamin D Dangerous? -- New Research Warns Against Overzealous Use of Vitamin D
  • Drug-Free Diabetes Cure
  • Your Eyes and Your Health
  • 5 Little-Known Ways to Reduce Arthritis Pain

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Is Vitamin D Dangerous?

Slam on the brakes -- after several years of exuberance about vitamin D as the magic solution for everything from preventing cancer to curing depression, the Institute of Medicine has just issued cautionary advice about taking too much of the sunshine vitamin. I’m glad to see it -- I’ve come across reports from organizations such as the Vitamin D Council and Livestrong suggesting that consumers consider taking 5,000 international units (IU) or more of vitamin D per day -- and, as this report makes clear, that’s a potentially dangerous dose. I called Alan Gaby, MD, author of the just published book Nutritional Medicine (www.DoctorGaby.com) for some expert insights on the appropriate use of vitamin D for good health.

Where "D" Advice Went Wrong

How did this situation reach such extremes? As it happens, there were some very good reasons why scientists got concerned about plummeting levels of vitamin D among Americans. Changes in lifestyle, including the fact that people were spending more and more time indoors, plus slathering on sunscreen and practicing other sun-avoidance techniques, resulted in widespread deficiency of this important nutrient. That’s a problem, since vitamin D is vital to good health.

A refresher: Vitamin D is actually a type of "pre-hormone" that the body converts into a hormone that regulates as many as 1,000 different genes. Among its many protective functions, D helps eliminate precancerous cells... prevent cardiac disease, stroke and diabetes... maintain the immune system and thus protect against colds, flu and the like... protect joints against arthritis... and promote absorption of calcium and phosphate, making it vital for healthy bones and teeth. Some of the problems caused or exacerbated by low levels of vitamin D include muscle weakness, poor balance leading to recurrent falls, low back pain and osteoporosis. A lack of D also can make fibromyalgia worse, says Dr. Gaby. Given that long list, it’s no wonder that excitement about vitamin D became so intense.

How Much -- and Too Much

Until a few months ago, the standard recommendation from the Institute of Medicine for vitamin D intake for adults age 51 to 70 had been 400 IU/day... and for adults over age 70, it was 600 IU/day. That was definitely not enough, Dr. Gaby said -- evidence shows that people under age 70 need 600 IU/day and adults over age 70 need 800 IU/day to prevent falls and thinning bones, which is what the new Institute of Medicine report recommends.

Although some scientists and doctors believe that people should routinely take larger doses, Dr. Gaby said research doesn’t support this. "Given the weakness of the evidence regarding both safety and efficacy, I think that caution is in order," he said, adding that he personally does not recommend doses above 2,000 IU per day except in rare circumstances. "I am not anti-vitamin D, but it is premature and potentially dangerous to take large doses for the sole purpose of pushing blood levels to an arbitrary target level," he said.

Dr. Gaby said it is important to realize that too much D is toxic and can cause serious problems, including a buildup of calcium in the blood (hypercalcemia) that can result in nausea, vomiting, weakness, constipation, heart rhythm abnormalities and possibly kidney stones. Another serious concern is atherosclerosis (hardening of the arteries) -- one study showed that swine fed high doses of vitamin D-3 developed arterial changes akin to those seen in people who need coronary bypass surgery.

It’s Complicated

Vitamin D is a uniquely complex nutrient, Dr. Gaby noted -- maintaining the right levels to optimize health isn’t a simple matter of swallowing a supplement once or twice a day. Specifically, he cited the following challenges:
  • Our bodies manufacture Vitamin D in response to sunlight. The biochemical effects of sunlight exposure are not the same as what occurs with oral supplementation with D. So-called "sunshine D" has built-in protection against toxicity as it prevents the release of excessive amounts into circulation and also modulates how it is used in the body.
  • Testing for D is imprecise and not always reliable. The most common blood test to measure D levels is called the 25(OH)D, which shows levels based on intake and sun exposure over three weeks. However, genetic differences can intrude on this test’s accuracy, Dr. Gaby said.
  • It’s hard to get significant amounts of vitamin D from foods, even fortified ones.
What to Do About D

For those reasons, it’s good to get vitamin D the old-fashioned way -- spend 10 to 15 minutes in the sun most days during the hours from 10 am to 2 pm. Expose as much skin as possible and, do not wear any sunscreen during this time.

Dr. Gaby said that most people would do well to take 800 IU to 1,200 IU of D-3 each day, especially during the winter months and most especially for people who are seldom in midday sun and older adults, whose skin loses some of its ability to manufacture D from sunlight. But, said Dr. Gaby, people with osteoporosis and diseases that cause malabsorption (such as Crohn’s disease) should probably be tested to determine where they are in terms of D levels, since they may require supplementation in higher doses.

While vitamin D is not the magic bullet some experts have made it out to be, it is without question immensely important. Do make an effort to get regular doses from sunlight, food and supplements... but do not overdo your D!

Source(s):

Alan Gaby, MD, author of Nutritional Medicine (self-published, available at www.DoctorGaby.com). He is a past president of the American Holistic Medical Association, testified before the White House Commission on Complementary and Alternative Medicine, and is the contributing medical editor of the Townsend Letter. He is based in Concord, New Hampshire.

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Your Eyes and Your Health

Next time you look in the mirror, make it a point to gaze deeply into your own eyes and take careful note of what you see. Is there a ring around your irises? Is there variation from one eye to the other? Are the whites of your eyes bright white, cloudy or on the yellow side? The answers to these questions might provide some important insights into the state of your health. I consulted Richard S. Koplin, MD, a board-certified ophthalmologist and director of the Cataract Division of the New York Eye and Ear Infirmary in New York City, for his take on when these variations are worrisome.

Keep an Eye Out for Trouble

Most people don’t realize that many disorders, both eye-related and systemic, can be reflected in color changes in the eyes. Some alterations take place in the white of the eye (the sclera)... others in the conjunctiva, the clear layer of tissue that covers the sclera ... and yet others in the iris, the pigmented part of the eye surrounding the pupil. Dr. Koplin outlined a number of eye abnormalities and what they might mean for your health...
  • A sudden red spot in the white of the eye is generally what’s known as a subconjunctival hemorrhage, caused by a brief elevation in blood pressure above the neck. This only sounds ominous -- Dr. Koplin said it’s no cause for worry, and it should fade within 36 hours. It can happen as a result of sneezing... straining (such as to lift a heavy object)... trauma (particularly to the head)... or from taking aspirin or blood thinners. Caveat: If this happens for absolutely no reason and most especially if it recurs, check with your doctor.
  • Yellowish eyes. A yellowish tinge to the white part of your eyes can be a sign of liver or gallbladder disease, most especially if you feel abdominal bloating (particularly on the right side)... experience gassiness... or notice that your stools are unusually pale. Schedule a doctor’s visit.
  • Muddy eyes. African Americans, as well as some other darkly pigmented individuals, may notice that the whites of the eyes darken and grow cloudy with age. This is a normal change in pigmentation associated with age, Dr. Koplin said. No treatment is necessary.
  • A gray white ring around the iris (appearing on the iris but actually on the periphery of the cornea). Not particularly uncommon in middle-aged and older individuals, this is a type of fat deposit that can occur with age, called an arcus. It’s not a cause for concern.
  • Changes in iris pigmentation. Some people are born with eyes of different color (a condition called heterochromia), but if it develops later in life it can be related to chronic inflammation (iritis) and require treatment. A change in eye color can sometimes occur as a side effect of medications used in or near the eyes -- for example, glaucoma eye drops called prostaglandin analogues (such as Latisse, a drug for lengthening and thickening eyelashes) can darken the iris. If you detect any change in eye color, stop the medication and consult an ophthalmologist.
  • A whitish discoloration of the central pupil. This is a sign of a very mature cataract, Dr. Koplin said, adding that it is almost never seen here in the US, where people get treatment for vision problems.
  • A sudden spot of color or darkening of the iris. An inexplicable and sudden change in the color of one area of one of your irises requires a visit to an ophthalmologist -- it can be a sign of a tumor.
Don’t Make Your Brown Eyes Blue!

Beware of practitioners peddling surgical procedures to change eye color. Dr. Koplin told me that he has treated patients who traveled to South America for expensive implants of colored discs to change eye color (a procedure that is not approved in the US). The discs caused problems such as irritation, inflammation, glaucoma and cataracts and required emergency surgical removal. If you must have a change, look into colored contacts instead!

Source(s):

Richard S. Koplin, MD, clinical assistant professor, director, Cataract Division, New York Eye and Ear Infirmary, New York City.

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Be well,


Carole Jackson
Bottom Line's Daily Health News




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