Learning Center
I’ve decided to use this page to post what I think are the best audio and video presentations about vitamin D deficiency. I’ve also added some information about vitamin D testing and treatment at our clinic. You can also find these posted in various locations throughout the blog, but I figured it would be most helpful to have them all in one place and easily accessible.
1. This is the latest (and outstanding!) addition to the learning Center:
Expert Opinion Paper on Vitamin D Deficiency
Diagnosis and Treatment of Vitamin D Deficiency is a new paper by four vitamin D experts.
JJ Cannell†, BW Hollis, M Zasloff & RP Heaney
2. Here’s a very informative Vitamin D video - John Cannell MD is interviewed extensively. There’s quite a lot of information about vitamin D helping to fight the flu and cancer. “Much watch” stuff if you’re looking to learn more about this wide spread health problem.
3. Dr. Vieth is a leading vitamin D researcher. This is a video of a lecture he gave to a non-researcher (people like you and me) audience. Dr Vieth presents a lot of very interesting research, charts, and graphs to get his message across. One thing that was obvious to me was his frustration with the lack of publicity, funding, and research on this important topic.
4. Watch this excellent video presentation on vitamin D deficiency. (from oct 2007) The presenter is Louise Gagne MD, a medical doctor who has become intrigued with this epidemic problem.
This is a presentation worth watching, takes about an hour.
I loved that she recommends doctors consider adding vitamin D testing to annual screenings!!
Another thing I liked was her map of the U.S. I’ve had a hard time conceptualizing where exactly UVB exposure diminishes and therefore D deficiency increases. She had a horizontal line drawn from Los Angeles across to Atlanta and said that anyone south of that line had access to good UVB throughout the year; anyone north of that line was subject to more seasonal limitations of UVB. She also used shadows as a helpful tool in knowing if you’re getting UVB exposure. If your shadow is as long as you are (or longer) your not getting adequet UVB during those times.
She goes on to discuss diseases, research, and treatment of vitamin D deficiency.
Enjoy!
p.s. - I noticed that I couldn’t get the video to work in my firefox browser, but it worked fine when I used Internet Explorer.
5. Here’s a very informative radio interview with vitamin D expert Michael Holick MD, PhD. He hits all of the main topics including; history, doses, toxicity, disease prevention, etc.
A couple of the things I found interesting about this interview was his mentioning of there being only 2 dozen cases worldwide of vitamin D intoxication in the past 30 years!
Also interesting to me was his mentioning that he’s noticed vitamin D2 to be about half as effective as the vitamin D3 (his preference and the type we use at our clinic). This is what we’ve seen as well for a couple of patients who had been given D2 by different doctors, but since it was only a couple of patients it was not entire clear if it was the D2 or some other reason.
6. Vitamin D Testing & Treatment
At our clinic Dr. Elliott (my wife) always runs baseline vitamin D testing on her patients prior to starting any sort of vitamin D supplementation. The test is called Vitamin D, 25-Hydroxy. If someone tests low (about 95% do around here) they are given 10,000 IU’s of vitamin D (cholecalciferol D3) everyday for 30 days. Please note that this is a strong/therapeutic dose of vitamin D for people who are verified as being vitamin deficient. That being said (and as others have reported as well) we’ve not seen anyone experience vitamin D toxicity on this 4 week loading dose. The RDA (albeit many would argue is too low depending on where you live) for infants under 1 year are 400-800 i.u. daily, and for children and adolescents up to 20 years – 400 i.u. In the latter half of pregnancy and throughout lactating period, the dose should be 400-800 i.u.) Her preference is to see people get into the middle to upper middle end of the normal range. So if the normal range is 32-100 ng/mL she likes to get her patients into the 50 to 65 ng/mL part of that range.
After the 30 day “loading dose” they re-check their D blood test to see how they’ve responded to treatment. This is where it gets very interesting. We’ve seen a wide variety of responses to this initial loading dose. Some patients’ levels barely improve at all (and still stay below normal) with the initial dose. Others respond moderately well and reach the low end of normal on the first go-round, and still others respond well and get to that target zone with the initially treatment. Depending on how the patient responds, they’ll either lower the D to a maintenance dose between 3,000 - 5,000 IU’s everyday, or they’ll stay with the 10,000 IU daily dose again and repeat testing in another 4 weeks. Some need to increase to 15-20,000 IU daily and re-check the level 4 weeks later. A rare few have needed to go to tanning beds twice per week (more about tanning later) because of an apparent problem with absorbing the oral form of D in order to get their level into that mid-range target zone. So as you can see, the treatment is definitely not “one size fits all” and this process of running the lab test and adjusting the treatment continues until that person gets to that mid-range target.
In summary, for patients at our clinic, the baseline level and re-checking of the vitamin D blood test has become a key (and eye-opening) part of their treatments!
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