dev_1

Have You Fed Your Pathogens Today?

 Comments Off on Have You Fed Your Pathogens Today?
Oct 222016
 

Download a PDF of this page

img_0584By Eugene L. Heyden, RN

When it comes to the Western diet, it seems that there are others besides you (and me) who love this diet.  There are teeming multitudes of others who love it, too.  They are the pathogens that reside within.  What you eat is what they eat.  And boy do they love the Western diet!

The Western diet is evil on so many levels.  You have probably heard of saturated fat and cholesterol, and you may be trembling and living in fear.  I would be trembling and living in fear of other things if I were you.  In reality, reasonable intakes of saturated fat and cholesterol are not all that bad.  Go to Africa and ask the Maasai.  Their native diet is composed of approximately 70% animal fats and proteins—blood, meat, and milk products—and they do just fine . . . until they move to the city and eat their first Twinkie.  Then it’s all downhill from there.  So I think a little saturated fat and cholesterol tucked into in a healthy diet will not destroy you.  However, Twinkie after Twinkie may destroy you.  Studies are underway.

With so much attention directed towards saturated fat and cholesterol, seldom is attention directed at what the Western diet does for the pathogens in our life.  Here’s a little secret: It feeds them and allows their numbers to increase.  And at the same time, it unbalances the composition of our normal bacterial flora, allowing some bacterial families to dominate and greatly outnumber other bacterial families, many of which would otherwise provide us with positive health benefits.  This unfortunate turn of events, called dysbiosis, greatly favors the occurrence of a wide variety of diseases including Crohn’s disease and ulcerative colitis, rheumatoid arthritis, cancer, even obesity.  (Antibiotics do this, too—by wiping out multitudes of friendly bacterial and giving disruptive bacteria an opportunity to succeed).

So what are these evils found in the Western diet that we should tremble and live in fear of?  In this article we will focus our attention on two evils associated with a diet most harmful, a diet most unfortunate.

Dietary omega-6 excess

“An increase in IBD [Crohn’s and ulcerative colitis] has been associated with increased dietary intake of omega-6 fatty acids in humans, while IBD patients remain in remission longer when dietary intake of omega-3 fatty acids increases.”  (Ghosh et al., 2013)

If you want to limit bacterial diversity while selecting and feeding the pathogens in your life—and do a very good job of it—why not rely on the omega-6 polyunsaturated fatty acids (PUFAs) in the Western diet to provide this service?  They are more than abundant in the Western diet, and so easy to find.  The omega-6 fatty acids literally “saturate” the Western diet and greatly outnumber the generally anti-inflammatory omega-3 fatty acids also found in this diet.  Our hunter–gatherer ancestors consumed comparatively little in the way of omega-6 fatty acids, whereas we modern folks consume perhaps 10 to 50 times more omega fatty acids than those who once roamed the earth single-mindedly looking for anything they could find to eat.  (Kiliannan et al., 2015)

The omega-6 fatty acids are necessary for good health, but not in the amounts found in the Western diet.  And there is a price to pay for this excess.  One study done in a Danish population, “. . . found that excessive consumption of omega-6 PUFA increases ulcerative colitis by 30%; whereas consumption of docosahexaenoic acid, an omega-3 fatty acid, reduced the disease burden by 77%.”  (Brown et al., 2012)

Surprisingly, one thing that an excess of dietary omega-6 fatty acids do is promote dysbiosis.  In other words, they allow bad bacteria to thrive.  In a sense, it feeds them.  We know this from laboratory studies in mice fed two commonly used oils high in the omega-6 fatty acids, namely corn oil and canola oil.

“Dietary corn oil increases the opportunistic pathogens . . . whereas fish oil supplementation reduces these species and increases beneficial bacterial (Lactobacillus) which corresponds to alter their gene expression against higher levels of oxidative status in the gut.  Canola oil alters the GI microbiota [bacterial flora] similar to the corn oil group.”  (Rajendiran, 2012, emphasis added)

I suppose I need to drive home the message that excessive omega-6 fatty acids create dysbiosis.  I believe I can do this most effectively by using the following two quotations:

“Diets rich in omega-6 PUFAs cause blooms of pathobionts [pathogenic bacteria] but isocaloric diets [diets containing a similar number of calories] supplemented with omega-3 PUFA can reverse microbial alterations in mice.”  (Chan et al., 2013)

“Overall, while omega-6 fatty acids induced the growth of microbes known to induce pro-inflammatory responses, omega-3 fatty acid supplementation reversed this and in parallel enriched beneficial bacteria.”  (Ghosh et al., 2013)

While the above two quotations reflect the findings of studies on mice, it is more than reasonable to conclude that this same sort of thing happens in humans, too.  It is almost impossible for something as negative and disease producing as dietary omega-6 excess not to create an imbalance in the bacterial composition in the gut.  Not surprisingly, both dysbiosis and omega-6 excess (and a relative omega-3 deficiency) are risk factors for Crohn’s and ulcerative colitis.  And when dysbiosis exists, you get to feed more pathogens.  It’s that simple.  In fact, with the omega 6s in excess, you make more pathogens!  Then you get to feed them, billions of them.  One study found that omega-6 excess alters the nature of tissues and cells, and this alteration creates a specific host response that favors dysbiosis and allows pathogenic bacteria to thrive.  (Kaliannan et al., 2015)

So, although you may not be feeding pathogens directly by consuming the omega-6 fatty acids in excess, by this means you are creating more pathogens to feed.  And I know exactly what you are feeding them.  You are feeding them iron.

Dietary iron excess—food for pathogens

“Accumulating evidence indicates that excess of unabsorbed iron that enters the colon lumen causes unwanted side effects at the intestinal host–microbiota interface.

“Notably, accumulating evidence suggests that unabsorbed iron can stimulate growth and virulence of bacterial pathogens in the intestinal environment.”  (Kortman et al., 2014)

In my book on Crohn’s, I spend a lot of time warning of the dangers of iron, and how its excess—so commonplace in our society—leads to disease.  No one else seems to be telling you this story, so I guess it’s up to me.  And why do I raise the alarm?  Because iron feeds and strengthens the pathogens in your gut.  It increases their numbers.  It makes them more aggressive and more likely to offend.

“In the colonic lumen, large amounts of iron are regularly present, mostly constituted by excess dietary iron not absorbed in the duodenum (the major site of iron absorption).  This is illustrated by the high concentration of iron found in feces of British adults on a standard Western diet and in weaning infants fed with complementary solid foods.

“Besides the effects or iron on the gut microbiota, which may cause a shift towards a more pathogenic profile and an increase in virulence of enteric pathogens, iron may also directly exert unfavorable effects on the gut epithelium most likely by the promotion of redox stress.”  (Kortman et al., 2014, emphasis added)

Here’s the deal:  The Western diet is saturated with iron.  It is in supplements.  It is in iron-fortified foods.  It is in meat.  It is in our water supply (Aamodt et al., 2008).  There is just too much of it around.  Silly society!  But our society is always screwing things up, so it is very easy to experience iron excess along with its harmful effects.

Let’s end our little discussion on iron with this string of quotations:

“In a laboratory study, the researchers found that human intestinal cells with excess iron were more susceptible to attack by bacteria that caused infection of the small intestine. The study suggests that enriching breakfast foods and other foods with high doses of iron—a nutritional strategy that has been widely adopted to eliminate iron deficiency—could be causing other health problems.

“The scientists found that cells containing high levels of iron were more easily invaded by the bacteria.

“’Instead of fortifying everyone’s diet with excess iron, we should diagnose iron deficiency and then provide supplemental iron only to those who need it.’” —Quoting Dr. Mark Failla (Ohio State Research News, 2001)

“Ultimately, iron use allows for greater microbial growth and an increased capacity of the bacteria to adhere and possibly disseminate to distal sites to cause infection.”  (Radek, 2010)

(One final quotation—read carefully!)

“Iron is an important factor for the growth of bacteria and their expression of virulence. When the level of iron increases, the balance between the quantities of different bacteria species in the gut is altered, depending on their ability to compete for iron. The interaction between bacteria and host tissue will also be altered when iron levels are enhanced, including the ability for the bacteria to express virulence.”  (Aamodt et al., 2008)

Closing remarks

You’ve heard of the Mediterranean diet, right?  And how it is good for you?  One of the reasons why the Mediterranean diet is good for you is because it is not fueled by the omega-6 fatty acids.  Instead, it is fueled by olive oil—a mix of fatty acids that includes some omega-6s and some omega-3s but is mostly composed of an anti-inflammatory omega-9 fatty acid called oleic acid.   And this is nice: The Mediterranean diet doesn’t mind letting you have a reasonable amount of saturated fat.  So, in order to lower your intake of the omega-6s, consider using olive oil and real butter in your food preparation instead of using seed oils and margarine.  In addition, avoid the use of vegetable oils and all-vegetable shortening in an effort to avoid saturated fat.  Their use will simply increase your consumption of the omega-6 fatty acids (a feed the pathogens within).  And in order to bring your omega-6/omega-3 ratio into a more healthful balance, consider adding more omega-3s to your diet.  You can do this by making wise dietary choices.  Word of warning:   Be cautious with the use of fish oils (high in the omega-3s).  Problems can occur.  The omega-3s are so effective at reducing inflammation, they could interfere with the body’s defense against bacteria should an infectious process be taking place (Ghosh et al., 2013).  Your doctor will advise.

As far as the iron excess issue discussed, weaning yourself off of factory prepared iron-fortified foods is a good call, as is limiting the consumption of meat.  See my post Crohn’s Disease: Finding a Way Out Japanese Style.  If you have Crohn’s or ulcerative colitis, you should definitely be monitored for anemia.  Anemia in this setting is usually not from low iron availability.  It is typically due to a block on the absorption of iron.

I really am going to bring this article to a close, but I have to say this: It is my strong belief that the continued consumption of excess omega-6 fatty acids, and the intake or iron in excess of one’s need, are big mistakes made by many individuals in their personal battle against Crohn’s or against ulcerative colitis.  But I guess you have figured this out by now.

 

Note: In the quotations used in this presentation, I took the liberty of changing the terminology used in order to provide consistency and to use terms you are more likely to be familiar with.  Hence, if an author used n-6 or v-6 to refer to the omega-6 fatty acids, I inserted omega-6 in its place.  I also dropped the clarifying acronym PUFA (polyunsaturated fatty acid) at times because I felt this abbreviation was unnecessary for our conversation.  You can thank me later.

References

Aamodt G, Bukholm G, Jahnsen J, Moum B, Vatn MH 2008 The Association Between Water Supply and Inflammatory Bowel Disease Based on a 1990–1993 Cohort Study in Southeastern Norway. Am J Epidemiol 168:1065–1072

Brown K, DeCoff, D, Molcan E, Gibson DL 2012. Diet-Induced Dysbiosis of the Intestinal Microbiota and the Effects on Immunity and Disease. Nutrients 4(8):1095–1119.

Chan YK, Estaki M, Gibson DL 2013. Clinical Consequences of Diet-Induced Dysbiosis. Annals of Nutrition and Metabolism 63(Suppl. 2):28–40.

Kilian K, et al. 2015 A Host–Microbiome interaction Mediates the Opposing Effects of Omega-6 and Omega-3 fatty acids on Metabolic Exdotoxemia. Sci Rep 5, 11267: doi: 1038/srep112767

Kiliannan K, Wang B, Li XY, Kim KJ, Kang JX 2015. A Host-Microbiome Interaction Mediates the Opposing Effects of Omega-6 and Omega-3 Fatty Acids on Metabolic Endotoxemia. Scientific Reports 5.

Kortman G AM, Raffatellu M, Swinkels DW, Tjalsma H 2014 Nutritional Iron Turned Inside Out: Intestinal Stress from a Gut Microbial Perspective. FEMS Microbial Rev 38:1202–1234

Ohio State Research News 2001 Excess Iron Intake Increases Risk of Intestinal Infections, Study Suggests. http://researchnews.osu.edu/archive/iron.htm

Radek KA 2010 Antimicrobial Anxiety: The Impact of Stress on Antimicrobial Immunity. Journal of Leukocyte Biology; August; 88:1–15

Rajendiran E 2012 The Differential Effects of Omega-6 and Omega-3 Polyunsaturated Fatty Acids on Intestinal Microbial Ecology and Host Redox Responses. Master’s Degree Thesis; University of British Columbia.

 

Disclaimer: This article is presented solely for informational purposes. The information contained herein should be evaluated for accuracy and validity in the context of opposing data, new information, and the views and recommendations of a qualified health care professional, and is not to be substituted for professional judgment and guidance or to provide reason to neglect or delay appropriate medical care.  It is the reader and reader only who bears the responsibility for any actions that could be construed as being a response to the information contained herein.  The statements and opinions expressed by the author have not been reviewed or approved by the FDA or by any other authoritative body, nor is the author endorsing any product or specific therapy.  This article is offered to the reader to broaden his or her understanding of the issues discussed and to help identify options that may be suitable for the individual to pursue, on behalf of self or others, under approval and direction of a qualified physician.  The author and publisher offer no guarantees of the accuracy or validity of the quotations incorporated into this article or the accuracy or validity of the information presented by the resources that are herein recommended.

Copyright © 2016 Eugene L. Heyden, RN

All Rights Reserved.

 

Download a PDF of this page

 Posted by at 6:20 pm

War Stories: Adam

 Comments Off on War Stories: Adam
Sep 032016
 

Download PDF of this page

ADAMBy Eugene L. Heyden, RN

 

Adam was 18 years old when he received the diagnosis of Crohn’s.  He remembers the very day—December 23, 2004.  Today, Adam is 30 and counting, free of Crohn’s now for over 8 years (and counting).  This is his story:

Prior to his diagnosis, Adam had been ill, off and on, for approximately 10 months—with the occasional bloody stool and adnominal cramping that came and went.  And to the doctor he came and went, multiple times.  He saw several different physicians, until one came to the realization “we better get to the bottom of things.”  Of course, getting to the bottom of things meant a colonoscopy.  Suspicions gave way to evidence; the diagnosis of Crohn’s was now an easy one to make.

With faithful use of prednisone and Asacol (and whatever), Adam soon returned to “normal.”  Prednisone was tapered off, Asacol use continued, his health steadily improved . . . until it didn’t.  Later in the year, 2005, Adam had a major flare up that landed him in the hospital.  His Crohn’s had become complicated by abscess formation.  But thanks to the miracle of modern medicine, Adam gradually improved—so much so that his health was stable enough to follow through on his plan to study abroad.  He left for Mexico in August, 2005, at the age of 19.

Mexico is the land of abdominal cramping, and sure enough, while in Mexico, Adam’s symptoms again came and went.  Overall, during his four month stay in Mexico, he described his health as “rocky.”  Even though he faithfully continued his Asacol, Adam experienced two major “flares,” one of which landed him in the hospital.  Yes, it was a struggle, and thanks to a much-awaited visit from Mom, and the supply of Asacol she brought, Adam was still able to complete his study abroad.

After returning from Mexico, Adam’s health generally stabilized.  A year and a half after returning home, and a few flares later, he graduated from college with a degree in Business and a minor in Spanish.  At this point in time, Adam was 21 years old.  He was feeling pretty good about life and his health, and faithfully continued to take Asacol to control his symptoms . . . until six months after graduation.

In December, 2007, three years following his initial diagnosis, Adam found himself becoming rapidly ill over a period of two days.  On the evening of day two, he lost consciousness.  His mom rushed him to the hospital.  He was admitted and appropriately treated.

Three days later, after multiple I.V.’s to correct his dehydration, along with aggressive steroid therapy to control his GI inflammation, Adam was once again on his feet.  Feeling much better, he was well enough to be discharged from the hospital.  But when he left, he left a changed man—determined to fight his disease in a different way.

While in the hospital, it donned on Adam that the conventional route was not healing him, it was only buying time until the next time.  Somewhere along the line, either during or shortly after his hospitalization, Adam realized that help may have been within his reach for that past three years.  He remembered that soon after he received his Crohn’s diagnosis, his aunt (certain to be his favorite aunt) had given him a book.  It was The Maker’s Diet, by Jordan Rubin (we’ll meet him later).  He decided it was time to read the book and began reading.  The Maker’s Diet made sense to him, so a decision was made.  He was going to put it to the test.  Within a matter of weeks after starting the diet, he felt great, so much so that he began weaning himself off of Pentasa—a new medication given to him upon his recent discharge from the hospital.  For Adam, “feeling great” became a way of life.  His symptoms of Crohn’s have never returned.  He credits it primarily to The Maker’s Diet.  In addition to his diet makeover, Adam took dietary supplements and followed a healthy, physically active lifestyle.

During my interview with Adam, I learned several things that are clearly relevant to the story.  I learned that Adam first started having GI symptoms at about age twelve, but nothing was persistent enough or severe enough to warrant medical attention—“they sorta just came and went.”  This was probably the beginnings of what would develop into full-blown Crohn’s.  I also learned that, at the time of diagnosis, he only weighed 108 pounds.  For someone who was five foot ten, he was sooooo underweight.  But after his Crohn’s was diagnosed and treatment began, Adam gained 25 pounds within a period of six months.  During my interview with Adam I learned one more thing worth sharing: The Makers Diet was, in his own words, “difficult to follow,” and he ate a lot of chicken (that was two things).  But he persevered.  And the rest is history.

Adam is so proud of his accomplishment; so glad to be Crohn’s free.  Today, Adam eats what he wants, but generally practices a “natural diet.”

 

Adam Dunlap tells his story on his website www.adamdunlap.com.  Click on the image below and you can listen to Adam tell the story of Adam.

ADAM website

http://www.adamdunlap.com/how-i-beat-crohns-disease-the-adam-dunlap-show-ep-6/

 

If you would like your story told in a forthcoming book entitled Crohn’s Disease Has Met its Match:  Stories of Remission in the Battle against Crohn’s, contact the author at: info@impactofvitamind.com.

 

 

 

Excerpt from More to Consider in the Battle Against Crohn’s

Copyright © 2016 Eugene L. Heyden, RN

All Rights Reserved.

Download PDF of this page

 

 Posted by at 6:56 pm

WHAT IS THIS?

 Comments Off on WHAT IS THIS?
Sep 032016
 

Download PDF of this page

whatisthis

By Eugene L. Heyden, RN

Vitamin D has work to do.  It’s primary job is to interact with our DNA to allow genetic events to occur.  Somehow, a molecule of vitamin D finds its way within the nucleus of a cell, a molecular binding occurs between vitamin D and a specific, pre-positioned protein called the vitamin D receptor (VDR), and the magic happens.  How it all works is truly amazing.  It will take a great little video to give us a glimpse of just how amazing the whole thing is.  And do I have a video for you!

In the image above, taken from the accompanying video, what you see is a large molecular machine (looks like an alien brain with a blue frontal lobe).  That green thing, seemingly attached to and extending away from the alien brain-like thing is the VDR.  There is a yellowness near the top of the DVR—that’s a molecule of vitamin D.  The ropey structure at the bottom of the image is a segment of DNA destined to respond to vitamin D.  Not much goes on with this DNA segment until the conditions are just right.  Once a molecule of vitamin D binds the VDR, a chain reaction is triggered.  The alian brain-like thing changes shape and releases a protein that unzipps the segment of DNA in order to expose a portion of it to allow the creation of a string of instructions.  The instructions are subsequently used by the cell to create things that are useful, such as proteins that maintain health and defend against disease. To see how this all occurs, and transpires at such an incredable rate of speed, watch this incredible video:

Impressed, arn’t you?  (I’m blown away!)  But there is a problem, a big problem.

Most of us are vitamin D deficienct.  Therefore, most of us will not be using our alian brain-like things at full capacity.  Potection against disease is compromised.  Many fall victum.  Lives are lost.  Don’t believe me?  Listen up!

A more recent analysis estimated that currently between 50.000–63,000 Americans and 19,000–25,000 individuals living in the United Kindom annually die prematurely from cancer due to vitamin D deficiency.  (Spina et al., 2006, emphasis added)

Chronic vitamin D deficiency may have serious adverse consequences, including increased risk of hypertension, multiple sclerosis, cancers of the colon, prostate, breast, and ovary, and type 1 diabetes.  (Holick, 2003)

So it would seem that becoming vitamin D sufficient is not just something else to do.  It is a matter of life and death.  Does your physician regard all this as a matter of life and death?  I’ll let you be the judge.

As mentioned earlier, health professionals need to ‘broaden their horizon’ and think of vitamin D in more global health terms that incorporate vitamin D’s true role as a hormone.  The vitamin D endocrine system is the only steroid endocrine system in the body that is almost always limited by substrate [stuff to work with] availability because of latitude, life-style, race/skin pigmentation, sunlight exposure, and other factors.  (Wagner et al., 2008, emphasis added)

Vitamin D deficiency and its consequences are extremely subtle, but have enormous implications for human health and disease.  It is for this reason that vitamin D deficiency continues to go unrecognized by a majority of health professionals.  (Holick, 2003, emphasis added)

References

Holick MF 2003a Vitamin D: A Millenium Perspective. Journal of Cellular Biochemistry 88:296–307

Spina CS, Tangpricha V, Uskokovic M, Adorinic L, Maehr H, Holick MF 2006

Vitamin D and Cancer. Anticancer Research 26:2515–2524

Wagner CL, Taylor SN, Hollis BW 2008 Does Vitamin D Make the World Go

“Round”? Breastfeeding Medicine 3(4):239–250

Disclaimer: This article is presented solely for informational purposes. The information contained herein should be evaluated for accuracy and validity in the context of opposing data, new information, and the views and recommendations of a qualified health care professional, and not to be substituted for professional judgment and guidance or to provide reason to neglect or delay appropriate medical care.  It is the reader and reader only who bears the responsibility for any actions that could be construed as being a response to the information contained herein.  The statements and opinions expressed by the author have not been reviewed or approved by the FDA or by any other authoritative body, nor is the author endorsing any product or specific therapy.  This article is offered to the reader to broaden his or her understanding of the issues discussed and to help identify options that may be suitable for the individual to pursue, on behalf of self or others, under approval and direction of a qualified physician.  The author and publisher offer no guarantees of the accuracy or validity of the quotations incorporated into this article or the accuracy or validity of the information presented by the resources that are herein recommended.

Copyright © 2016 Eugene L. Heyden, RN

All Rights Reserved

Download PDF of this page

 

 Posted by at 6:32 pm

Vitamin D: A natural history

 Comments Off on Vitamin D: A natural history
Sep 032016
 

Download a PDF of this page

historyvitDBy Eugene L. Heyden, RN

In terms of human history, humans were not confronted with Vitamin D deficiency until the industrial revolution began.     ~Holick, 2003

Despite evidence of its profound importance to human health, vitamin D inadequacy is not widely recognized as a problem by physicians and patients.     ~Holick, 2006

Calling Vitamin D a “vitamin” is something of a misnomer.  Although the name is still used for historical reasons, vitamin D is more properly classified as a secosteroid [steroid hormone] because it consists of a cholesterol backbone and exerts steroid-like effects throughout the body, directly affecting the expression of over 1000 genes through the nuclear vitamin D receptor.     ~Cekic et al., 2011

 

Vitamin D has been around for a very long time; it was perhaps the first true hormone in continuous use on planet earth.  And it was free, freely derived from the sun.  The single-celled creature created it for personal use in many of its metabolic activities.  Then along came a hungry multi-celled creature that ate the single-celled creature.  And  in this manner, driven by the need of some creatures to eat other creatures in order to survive, vitamin D became a hormone that could be passed along from creature to creature within the food chain, a hormone useful to the metabolic processes of the one who had not yet been eaten.

Somewhere along the way, along came the hungry human.  And, as luck would have it, the human saw a fish.  And so the human ate the fish that ate other little fishes that ate the multi-celled creatures that ate the single-celled creatures, and in this manner the human was able to obtain an important ingredient, a hormone, if you will, that somehow became necessary to sustain life.  But the food chain was just one way to get this hormone.  Nudity was another.  So like many other creatures both big and small (and naked), humans were able to obtain vitamin D in abundance by exposure to the sun.  Eventually, nudity gave way to clothing (thank god!), and still mankind was able to get plenty of vitamin D, both by diet and by sunlight exposure.

And so, for what seems like forever, the human race obtained plenty of vitamin D to meet its needs.  Then came the industrial revolution, and boy did we get into trouble.  And then came the dermatologists with truckloads of sunscreen, and boy did we get into even more trouble.

In this context of reduced exposure to sunlight and alterations in diet, humanity is now faced with a host of diseases that are related, in part, to a lack of vitamin D; related, in part, to an immune system that is compromised; related, in part, to a medical profession that just can’t seem to wrap its mind around this simple truth:  Vitamin D must be in adequate supply or people will show up in droves to get drugs to treat diseases that are related, in part, to vitamin D deficiency.  Multitudes will suffer.  Many will die.  All of this is so very true.  This is why I wrote a certain little book on vitamin D.

How vitamin D became so essential to our musculoskeletal system, to our nervous system, to our immune system, even to the hair we grow on our head, is indeed somewhat of a mystery.  Many a physician is still waiting for all the details to be worked out before venturing forth and paying very close attention to this vitamin, this hormone, the one we call vitamin D.  Fortunately, things are beginning to change.  But, be aware, your physician may not be all that into vitamin D, in addition to all the other things he or she is not all that into.  I am speaking in generalities, of course.  Let’s hope that your physician is very knowledgeable in the issues that surround vitamin D and its relationship to the diseases that he or she sees each and every day.  But you are clueless, probably, so I will need to get you up to speed.

Let’s start with the skin.  The skin is really dead.  It is the under-the-skin skin that is important to our discussion.  Here we find a living tissue containing all sorts of things, including cholesterol.  As with so many other hormones, cholesterol is the backbone of the vitamin D molecule.  Sunlight, specifically the UVB wavelength, has the capacity to displace an electron from the cholesterol molecule, and the beginning of a hormone is born.  This altered cholesterol molecule no longer “fits in” with its neighbors (it must look kinda different) so it is forcibly evicted to eventually find its way to the liver where it is stored, processed, and sent forth as a prohormone to the kidney or to many other organs, tissues, and cells where it is converted by an enzyme called 1-alpha-hydroxylase into its active form.  While in its active form, called calcitriol or 1,25(OH)2D3, vitamin D joins up with a nuclear receptor called the vitamin D receptor (VDR) and the magic happens.  Up to 1000 genes or more can respond, orchestrating genetic events that promote health and resistance to disease.

So now you know the natural history of vitamin D.  Please keep in mind that you, too, have a natural history, one that is currently in progress.  This vitamin, this hormone, many help make the story of you a lengthy one and a relatively smooth ride.

 

References:

 

Cekic M, Cutler SM, VanLandingham JW, Stein DG 2011 Vitamin D Deficiency Reduces the Benefits of Progesterone Treatment after Brain Injury in Aged Rats. Neurobiology of Aging 32:864–874

 

Holick MF 2003 Vitamin D: A Millenium Perspective. Journal of Cellular Biochemistry 88:296–307

 

Holick MF 2006 High Prevalence of Vitamin D Inadequacy and Implications for Health. Mayo Clin Proc; March; 81(3):353–373        

 

Disclaimer: This article is presented solely for informational purposes. The information contained herein should be evaluated for accuracy and validity in the context of opposing data, new information, and the views and recommendations of a qualified health care professional, and not to be substituted for professional judgment and guidance or to provide reason to neglect or delay appropriate medical care.  It is the reader and reader only who bears the responsibility for any actions that could be construed as being a response to the information contained herein.  The statements and opinions expressed by the author have not been reviewed or approved by the FDA or by any other authoritative body, nor is the author endorsing any product or specific therapy.  This article is offered to the reader to broaden his or her understanding of the issues discussed and to help identify options that may be suitable for the individual to pursue, on behalf of self or others, under approval and direction of a qualified physician.  The author and publisher offer no guarantees of the accuracy or validity of the quotations incorporated into this article or the accuracy or validity of the information presented by the resources that are herein recommended.

 

Copyright © 2016 Eugene L. Heyden, RN

All Rights Reserved.

Download a PDF of this page

 Posted by at 6:01 pm

Aches and Pains in the Elderly

 Comments Off on Aches and Pains in the Elderly
Sep 012016
 

Download PDF of this page

AchesPainsElderly_small

By Eugene L. Heyden, RN 

Aches and pains are so very common, particularly in the elderly.  We should prevent them.   A lot of suffering is associated with aches and pains in this segment of our population.  Perhaps surprisingly, vitamin D deficiency could be behind many cases yet to be diagnosed—do you think that guy up there is getting enough vitamin D to keep him out of trouble?  (I think not.)  In this article we will review three case reports that shed a little sunlight on the issue of vitamin D deficiency and back pain.  But back pain isn’t the only thing we will discuss.  A variety of aches and pains in the elderly have been linked to vitamin D deficiency.  Read and share.  I know you have nothing better to do.

Important!  As you read the following case reports, keep in mind that a vitamin D level of less than 20­–30 ng/ml is probably too low, a vitamin D level below 15–20 ng/ml is way too low, and a vitamin D level below 15 ng/ml is bad news, very bad news.  Someone could get hurt.

Case #1: Back pain, age 78, long-term, initial vitamin D level of 2.2 ng/ml, complete resolution occurred within 4 weeks after vitamin D status normalized to 52 ng/ml.  (Ghose, 2004a)

Case #2: Back pain, age 86, of three months duration and associated with a history of lumbar compression fractures.  Vitamin D level was increased from <5 ng/ml to 36 ng/ml with pain resolution occurring following 3 weeks of treatment.  (Ghose, 2004b)

Case #3: Back pain, age 63 (not exactly elderly, but close), with a history of 4 back operations.  He received the diagnosis “failed back surgery” and his self-esteem plummeted (well, it probably did).  He was on long-term disability and attended a pain management clinic.  He was a total mess!  “His symptoms completely resolved after six weeks on 4,000 IU of vitamin D [per day] after years of having pain.”  His initial vitamin D level was 8 ng/ml.  After treatment, his level rose to 34.8 ng/ml.  (Schwalfenberg, 2009)  

Who would have guessed, it was vitamin D deficiency behind all the misery?  But if it’s not back pain, you know it will be something else.  Next we’ll focus on other aches and pains commonly found in the elderly.  I have more case reports to share.

Case #4: Age 71, history of severe leg pain, muscle weakness, and difficulty walking.  Included in his diagnosis was diabetic neuropathy.  After treatment that brought his vitamin D level from 11.2 ng/ml to 74.8 ng/ml, “his weakness and bone pains resolved within 6 weeks.  He currently walks 2 to 3 blocks on his own without support.”  (Prabhala et al., 2000)  He tells everyone around him, “Please, I beg of you, do not slap sunscreen on the youngins!” 

Case #5: Age 77, confined to a wheelchair, with a vitamin D level of 4.8 ng/ml.  “She was given oral ergocalciferol [D2] (50,000 IU/wk), with a dramatic improvement in her aches and pains.  There was improved mobility, decreased weakness, and ability to forsake the wheelchair in 6 weeks.”  (Prabhala et al., 2000)

Case #6: Age 67 (pre-elderly), with “severe, painful proximal myopathy at the hip girdle.”  This unfortunate lady has a life complicated by metastatic cancer.  After being treated with 50,000 IU/wk of D2, her vitamin D level went from 4.8 ng/ml to 16.8 ng/ml.  “Her pain and weakness improved significantly in 8 weeks.”  (Prabhala et al., 2000)

Now, if that’s not enough suffering to endure in one day, continue reading.

Case #7: Age 86, weak and malnourished.  She was admitted to a nursing home with severe lower extremity pain.  Her vitamin D level was 5 ng/ml.  Twenty some days later, and following restorative nutrition along with vitamin D replacement of 700 IU/day, her “pain had subsided completely.”  Following treatment, her vitamin D level rose to 35 ng/ml.  (Gloth et al., 1991)

Case #8: Age 85 and counting.  She was admitted to the nursing home following a 3 month stay in the hospital to undergo treatment for a lung infection.  She suffered “intense” pain in both legs and feet.   Each leg was tender to the touch.  She did not like her feet anymore, for they were not happy feet.  Her vitamin D level was 4.1 ng/ml.  Following a 50,000 IU dose of oral vitamin D, she reported    noticeable improvement in her level of pain.  (Gloth et al., 1991)

Case #9: Age 68 (elderly enough).  This gentleman was confined at home a number of years to a “dark and dingy bedroom” and was too weak to walk.  He would cry out in pain from time to time and  avoided all physical activity.  Pain limited his mobility and even occurred with a light touch to the skin.  His vitamin D level was found to be at 12.8 ng/ml.  After one week following an initial

50,000 IU of vitamin D and 400 IU/day, “his pain vanished.”  (Gloth et al., 1991)

Case #10: Age 94.  This lady had recently suffered a broken hip and was admitted to a nursing home for continuing care.  One complaint was severe lower leg pain.  Her vitamin D level was a mere 3.2 ng/ml (extremely low).  She received both vitamin D and calcium supplementation and, within 5 days, reported improvement, even with only a minor increase of her vitamin D level to 4.4 ng/ml.  Her need of pain medication was greatly reduced.  (Gloth et al., 1991)

I think 10 case reports is enough—you get the point!  Vitamin D deficiency, prolongued and unidentified, could be a common cause of chronic aches and pains in the elderly, back pain inculded.  It certainly looks so.  Let’s end with this:

“Older adults are at particular risk for vitamin D deficiency due to reduced sun exposure and decreased dietary intake and absorption.  In addition, an increase in body fat leads to a larger distribution volume for the fat-soluble 25(OH) D3, which decreases bioavailability.  Multiple studies have suggested a correlation between vitamin D deficiency and pain, particularly back and musculoskeletal pain.”  (Kessenich, 2010)

“Vitamin D insufficiency is common; repletion of vitamin D to normal levels in patients who have chronic low back pain or have had failed back surgery may improve quality of life or, in some cases, result in complete resolution of symptoms.”  (Schwalfenberg, 2009, emphasis added)

Note: In the above case reports, I took the liberty to converting the nmol/L value used, where needed, to the ng/ml equivalent.  Since ng/ml is the value that you will most likely see on a laboratory report, this conversion should help you better relate to the above case reports.

 

References

Ghose R 2004a Osteomalacia: Recovery of Bone Density. Journal of the New Zealand Medical Association; June 18; 117(1196)

Ghose R 2004b Sub-clinical Osteomalacia. Journal of the New Zealand Medical Association; August 20; 117(1200)

Gloth III FM, Lindsay JM, Zelesnick LB, Greenough III WB 1991 Can Vitamin D Produce an Unusual Pain Syndrome? Arch Intern Med; August; 151:1662–1664

Kessenich CR 2010 Vitamin D Deficiency and Leg Pain in the Elderly.  The Nurse Practitioner 35(3):12–13

Prabhala A, Garg R, Dandona P 2000 Severe Myopathy Associated with D Deficiency in Western New York. Arch Intern Med; April 24; 160:1199–1203

Schwalfenberg G 2009 Improvement of Chronic Back Pain of Failed Back Surgery with Vitamin D Repletion: A Case Series. J Am Board Fam Med 22:69– 74

 

Disclaimer: This article is presented solely for informational purposes. The information contained herein should be evaluated for accuracy and validity in the context of opposing data, new information, and the views and recommendations of a qualified health care professional, and not to be substituted for professional judgment and guidance or to provide reason to neglect or delay appropriate medical care.  It is the reader and reader only who bears the responsibility for any actions that could be construed as being a response to the information contained herein.  The statements and opinions expressed by the author have not been reviewed or approved by the FDA or by any other authoritative body, nor is the author endorsing any product or specific therapy.  This article is offered to the reader to broaden his or her understanding of the issues discussed and to help identify options that may be suitable for the individual to pursue, on behalf of self or others, under approval and direction of a qualified physician.  The author and publisher offer no guarantees of the accuracy or validity of the quotations incorporated into this article or the accuracy or validity of the information presented by the resources that are herein recommended.

 

Copyright © 2016 Eugene L. Heyden, RN

All Rights Reserved.

www.impactofvitamind.com

Download PDF of this page

 

 Posted by at 6:04 pm

What I Want My Mommy to Know About Vitamin D

 Comments Off on What I Want My Mommy to Know About Vitamin D
Sep 012016
 

Download PDF of this page

post3

By Eugene L. Heyden, RN

I guess, the first thing I want Mommy to know is that vitamin D is necessary for my proper growth, for my neurological development, and for defense against disease . . . and it must be in adequate supply or you can just go ahead and place me in that box filled with other vitamin D deficient babies who will struggle as they stumble through this life.  It is a very big box.

The next thing I want my Mommy to know is that she will have to do things a little differently from now on if she plans on making me vitamin D sufficient and better able to deal with what life has to throw at me.  It takes thousands of International Units (IU) of vitamin D, taken or created per day, for adequate amounts to appear in her breast milk.  I’m relying on her for this.  She is my best and only real hope.  But, I’m afraid she is listening to the voices of others.

The current recommendations for vitamin D supplementation for nursing mothers are clearly not up to the task.  Only 400, perhaps 600 IU per day!  Are you kidding me?!!  Without any significant amount of sunlight exposure—the way mommies and babies have been making vitamin D throughout the ages—I am sure to stay inside the great big box of struggling babies who are vitamin D deficient.  Some of them will die, traceable to vitamin D deficiency.  (With respect to my vitamin D status, I would probably be better off living the life of a third-world baby—basically naked, playing in the dirt, but creating generous amounts of vitamin D.  But don’t tell Mom I said this.)  Have you noticed how much time I spend indoors?  And Mommy, she is just too busy to get outdoors during the time of day when she would generate enough vitamin D to make us both vitamin D sufficient.  I doubt if she knows that she can only make relative amounts of vitamin D between the hours of 10:00 AM and 3:00 PM, and only during the days between mid-Spring and early Fall—I don’t even know this!

Please tell Mommy (before it is too late) that if she can’t make it, I’ll have to take it.  Do you think she knows how much vitamin D I’ll need to protect me from type I diabetes, multiple sclerosis, Crohn’s disease, schizophrenia, and unbelievable amounts of snot and an ear ache or two?  I think not.  Let’s give her an idea of what it will take.

Some 50 years ago, an experiment was conducted.  Lots of cute little babies (like me) were given 2,000 IU vitamin D per day during their first year of life.  They were followed for 30 years.  Surprisingly, this group of babies, turned into adults, had an 80% less chance of contracting type I diabetes.  And the boys had a 77% less chance of developing schizophrenia.

Multiple sclerosis is another disease I need to be protected from.  Mommy is not concerned; she just can’t imagine I would come down with this dreadful disease!  But I can—particularly so if I live the vitamin D deficient life.  Until very recently, multiple sclerosis is practically nonexistent in populations who near the equator, a place where generous amounts of sunshine create generous amounts of vitamin D.  Perhaps not surprisingly, the chance of contracting multiple sclerosis progressively increased the further one lives from the equator.  Clearly, vitamin D deficiency makes one more vulnerable to this dreadful disease.  Of course, things are changing.  With the increased availability of air conditions worldwide, people living near the equator stay indoors a lot more than they used to, generate less vitamin D as a result, and are more at risk of contracting multiple sclerosis.

Speaking of dreadful diseases, Crohn’s disease is no picnic.  My risk of contracting this disease is greatly elevated if I remain vitamin D deficient.  Do I look like I need this disease?  Of course not.  Please tell Mom I don’t need this disease.  She loves me.  I know she will do her best to protect me from this one.

I certainly want my Mommy to know that she will probably need at least 6,000 IU of vitamin D, taken daily in addition to what can be found in her multivitamin, for her breast milk to satisfy my need for vitamin D.  Alternatively, I’m thinkin’ (and so are the scientists) I will need at least 1,000 IU, perhaps 2,000 IU per day, of vitamin D to meet my needs—but I’ll be glad to take the 400 IU of supplemental vitamin D currently recommended for nursing infants, this is certain to help.   Of course, she’ll need to run any level of vitamin D supplementation by my wellness doctor to make sure there are no contradictions.

Finally, tell Mommy I love her.  I don’t want the bad things in life to happen to her.  The bad things in life, such as diabetes, multiple sclerosis, Crohn’s disease autoimmune thyroid disease, breast cancer, and so on, happen much more frequently in those who are vitamin D deficient.  (Tell her before it is too late.)

 

References

Holick MF 2002 Vitamin D: The Unappreciated D-Lightful Hormone that is Important for Skeletal and Cellular Health. Current Opinion in Endocrinology & Diabetes 9:87–98

Holick MF 2006 Resurrection of Vitamin D Deficiency and Rickets. The Journal of Clinical Investigation 116(16):2062–2072

Hollis BW, Wagner CL, Howard CR, Ebeling M, Shary JR, Smith PG, Taylor SN, Morella K, Lawrence RA, Hulsey TC 2015 Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial. Pediatrics. Oct 1;136(4):625–34

McGrath J, Saari K, Hakko H, Jokelainen J, Jones P, Järvelin M-R, Chant D, Isohanni M 2004 Vitamin D Supplementation During the First Year of Life and Risk of Schizophrenia: A Finnish Birth Cohort Study. Schizophrenia Research 67:3237–324

Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A 2006 Serum 25Hydroxyvitamin D Levels and Risk of Multiple Sclerosis. JAMA; December 20; 296(23):2832–283

Zittermann A, Schleithoff SS, Tenderich G, Berthold HK, Körfer R, Stehle P 2003 Low Vitamin D Status: A Contributing Factor in the Pathogenesis of Congestive Heart Failure? J Am Coll Cardiol 41:105–112

 

Acknowledgement

Henry Lahore, administrator of  www.vitamindwiki.com, offered suggestions that were incorporated into this article.

 

Disclaimer: This article is presented solely for informational purposes. The information contained herein should be evaluated for accuracy and validity in the context of opposing data, new information, and the views and recommendations of a qualified health care professional, and not to be substituted for professional judgment and guidance or to provide reason to neglect or delay appropriate medical care.  It is the reader and reader only who bears the responsibility for any actions that could be construed as being a response to the information contained herein.  The statements and opinions expressed by the author have not been reviewed or approved by the FDA or by any other authoritative body, nor is the author endorsing any product or specific therapy.  This article is offered to the reader to broaden his or her understanding of the issues discussed and to help identify options that may be suitable for the individual to pursue, on behalf of self or others, under approval and direction of a qualified physician.  The author and publisher offer no guarantees of the accuracy or validity of the quotations incorporated into this article or the accuracy or validity of the information presented by the resources that are herein recommended.

 Posted by at 5:50 pm

Case Report #1 Problems after gastric bypass

 Comments Off on Case Report #1 Problems after gastric bypass
Jan 092015
 

Download PDF of this page

Gastric_smallLet’s hope you never find yourself in this kind of trouble. This is the story of a most unfortunate lady, age 64. She had undergone gastric bypass at age 58 and had lost 100 pounds yet remained severely obese. She presented with diffuse muscle and bone pain, pain she had experienced for several years and varied in intensity from day to day. The pain was especially pronounced in her rib cage. All of this was very concerning because she had breast cancer one year after her gastric bypass and soon thereafter underwent a modified radical mastectomy. The worry now was that her pain was from metastatic cancer to the bone. “A bone scan, obtained because of concern about metastatic malignancy, revealed areas of increased activity in the right hip, the right inferior pubic ramus, and multiple left ribs, interpreted as consistent with metastases.” Continue reading »

 Posted by at 7:20 pm

Fibromyalgia Story

 Comments Off on Fibromyalgia Story
Jan 092015
 

Download PDF of this page

FM_smallI have spent well over a decade of my life attempting to solve the mystery of fibromyalgia, what it is, and how it selects its victims. What’s my motivation? My sweet wife has it and has suffered greatly over the years from this disorder. And you think I am going to sit still and not go after this disease with all I’ve got?!! (You have to be joking.) After years of study, here is my conclusion: Fibromyalgia is whatever occurs that negatively affects muscles and nerves, producing, as a result, chronic widespread pain, pain that persists . . . unresolved. Well, that was pretty vague. Let’s look a little deeper.

Continue reading »

 Posted by at 12:12 pm