Did most of us PC guys have low vit D before we were diagnosed and/or supplemented?

This is in response to a comment by Prato on another thread. I felt my comment should best be made in my own thread:

Pratoman said...
I always had low D. Since I’ve been on 500- is daily of D3, my D is smack in the middle of the normal range. Did it have to do with my PC? No clue.

I agree, no clue. But, you may remember a poll I did back about Feb of 2016. Nonscientific, just for kicks, to ask who had their levels checked before they ever supplemented, if they even did ever supplement. Of course my little nonscientific study was bound to be low N, because how many of us have had our levels checked before we even supplemented or diagnosed with PC?

Still, though not worth much, of course the results went exactly the way one would expect. Correlate perfectly with all of those studies we have seen showing an association of low D and PC, especially hi risk PC.

Of the guys with PC who responded, they overwhelmingly fell into one of 2 "not enough categories", i.e insufficient(21-29ng/ml) or the lower "worse" deficient(0-19ng/ml). Looking at the entire group of 20, without breaking down by risk category, 90% were either insufficient(60%) or deficient(30%). Only 10% were "sufficient".

Of 13 guys who were low to intermediate risk, 1(8%) was sufficient, 10(77%) were insufficient, and 2(15%) were deficient. So, 77% were insufficient. 90% were either either insufficient or deficient, but with the single largest group(10/77%) falling into the insufficient category.

But for the high risk guys(of course, lower #s of them, only 7), again only 1 was sufficient (or 14%), 2(28%) were deficient, and 4(57%) were deficient. So 85% were not enough, but with the largest group falling into the deficient(lowest) category.

Quite a coincidence, don't you think? By sheer chance, couldn't it have just as easily shown that every one was sufficient?

Of course, one flaw other than small #s: there is no one here to ask who did not also end up with PC. So it could just be that in the age of sunscreen and computer screens(all indoors) and big hats, that EVERYONE is too low, so if we asked 20 old enough guys who did not yet have PC, they might all fall into the same low vit D category. I doubt it, but possible. But, even if that is so, it does not account for the breakdown along risk categories, with lower levels being associate with higher risk, just as several real studies have found.

It also does not account for how how in several studies that associate lowest risk with highest levels, how these people got the high levels if every one is low. Especially in some studies with some people having over 40 ng/ml. It is rare for people to be >40 ng/ml unless they are supplementing or getting lots of sun. For example, Africans living a traditional outdoor life average 40-60ng. But the average American is no where near this, probably closer to 20 on average, unless supplementing. If supplementing, they are a stealth intervention group.

/www.healingwell.com/community/default.aspx?f=35&m=3581293

My D has always been high, I am outdoors more every day than most people are in a week. While this has given me some sun damage, it has kept my D optimal.The only time I have missed was 2 weeks starting with the day of my surgery. 2 weeks later the cath was out and so was I, 2 - 3 hours/day minimum outdoors.

Additionally, I supplement D and others.

PCa comes in many flavors and has many causes and triggers.

Yeah on the T.

Pratoman said...
BB, I do recall that poll if yours. And I remember it struck me as curious, at the time.

Of course it proves nothing, I was just curious how we might measure in that department. But I did think that the odds- based on sheer chance and assuming there is no relationship between D and PC whatsoever- were at least equal that the majority could have been in the higher or at least sufficient range based on the averages. I guess now we could add- if they participated in the poll- trailguy to the sufficient category and RobLee to the deficient(both in high risk group). Even though RobLee's was found after RP, it would then only be reasonable to assume he was the same before, unless specifically told otherwise.

I just saw this from 2012:
/www.cdc.gov/media/releases/2012/p0402_vitamins_nutrients.html

Somebody said...
The report also found that deficiency rates for vitamins and nutrients vary by age, gender, or race/ethnicity and can be as high as 31 percent for vitamin D deficiency in non-Hispanic blacks. ........According to the report, the vitamin D deficiency rate for Mexican-Americans was 12 percent and for non-Hispanic whites it was 3 percent. Vitamin D is essential for good bone health but it may also improve muscle strength and protect against cancer and type 2 diabetes. Researchers are investigating these potential benefits, as well as, the vitamin D requirements for various groups.

I am surprised that it is only 31% at most and almost none for whites. Maybe different definitions of what equals deficiency or maybe a lot of the population are already supplementing before being tested? They also noted the the lowest group- blacks(also highest PC risk?) also had higher bone density. Genetics, or does lower D give you stronger bones? But if accurate regarding % deficient, then it appears we PC types have a much higher % (than even that lowest group) that who are low.

This even earlier article(2009) does not agree on % deficient. Is that because by 2012 many were already starting to supplement? Who knows, not me.
/www.scientificamerican.com/article/vitamin-d-deficiency-united-states/

Somebody said...
Vitamin D deficiency soars in the U.S., study says
The trend marks a dramatic increase in the amount of vitamin D deficiency in the U.S., according to findings set to be published tomorrow in the Archives of Internal Medicine. Between 1988 and 1994, 45 percent of 18,883 people (who were examined as part of the federal government's National Health and Nutrition Examination Survey) had 30 nanograms per milliliter or more of vitamin D, the blood level a growing number of doctors consider sufficient for overall health; a decade later, just 23 percent of 13,369 of those surveyed had at least that amount.

The slide was particularly striking among African Americans: just 3 percent of 3,149 blacks sampled in 2004 were found to have the recommended levels compared with 12 percent of 5,362 sampled two decades ago. ..............."We were anticipating that there would be some decline in overall vitamin D levels, but the magnitude of the decline in a relatively short time period was surprising," says study co-author Adit Ginde, an assistant professor at the University of Colorado Denver School of Medicine. Lack of vitamin D is linked to rickets (soft, weak bones) in children and thinning bones in the elderly, but scientists also believe it may play a role in heart disease, diabetes and cancer.

"We're just starting to scratch the surface of what the health effects of vitamin D are," Ginde tells ScientificAmerican.com. "There's reason to pay attention for sure.".....................
But Mary France Picciano, a senior nutrition scientist in the National Institutes of Health's Office of Dietary Supplements, is skeptical that the dip is as deep or widespread as suggested, noting that there's disagreement on how much vitamin D is needed. She notes that the Institute of Medicine (IOM) defines insufficiency as less than11 nanograms per milliliter. Using that as a threshold, some 10 percent of U.S. adults are vitamin D deficient, according to a study published in November in the American Journal of Clinical Nutrition....................

My doc started testing my D level about 12-15 years ago and finally got me to start supplementing. As a runner I am outside quite a bit although in our Montana winters I am covered up when I do so. (No, I NEVER run inside on a dreaded treadmill.)

Anyway, I take 5,000 iu daily and by numbers are normal.

What are the dangers...if any...to excessive vitamin d3 and oh what is the difference between vit d and d3...if any?

Yeh...that's the ticket

logoslidat said...
What are the dangers...if any...to excessive vitamin d3 and oh what is the difference between vit d and d3...if any?

Yes, there are differences in D3 and other Ds, like D2(ergocalciferol) and D3(cholecalciferol).
/www.medscape.com/viewarticle/746941#vp_2

Somebody said...
Traditionally, oral formulations of vitamin D2 and D3 have long been regarded as equivalent in their clinical activity. However, studies indicate that ergocalciferol (vitamin D2) is much less potent and has a shorter duration of action than cholecalciferol.[9,10,11]

Historically, ergocalciferol has been used instead of cholecalciferol for severe vitamin D deficiency. This is out of convention, or perhaps because high-dose ergocalciferol is more widely available in doses of up to 50,000 IU per softgel capsule from multiple manufacturers.

IOW, historically, D2 is more likely to be used by Docs to treat deficiency or perhaps in older studies. But d3 seems to be the preferred and what we get from sunshine.

As for too much: since sun exposure can generate 10K(unless using sunscreen), then much above that might be risky requiring close monitoring of blood levels. I don't think it is possible to get too much via sunshine, but you can obviously over do it on the supplements. Especially since people vary widely as to how high of a blood level they generate from supplements. I get a blood level of a whopping 80 from 10K per day, 30 from 2K per day. But there are people here taking 10-15K per day and only maintaining a level a lot lower than 80ng/ml. So, if supplementing with more than the "recommended" 600, the occasional monitoring is a good idea.

Gemlin said...
Some say there is a U-shaped association, with elevated disease risks at both high and low D!

It is not surprising that few men on HW was "sufficient". It has been estimated that over one billion people in the world are vitamin D deficient or insufficient with the levels used in BB's survey. The sale of vitamin D has also become a billion $$ industry, as we can easily understand.
I think it would be a very unusual biological phenomenon if the majority of the population would need the addition of high doses of a prohormone to be healthy.
I have never checked my levels and have never supplemented despite the the long Swedish winter with very little sunshine. Strange that I am so healthy, except the PC.

Some have indeed pointed to a U shaped curve, but I did not see any increase(or decrease) in PC rates in the recently posted RCT where they gave a whopping 200K(100-200 times a usual daily dose by many who supplement with 1000 - 2000Us per day) and then got another 100K once a month. If you accept the premise that this works out to an average of 6,666 units per day the 1st month, and 1/2 of that for the following 4 years(I do not know if that is an accurate assumption), then it appears no U shaped curve was observed with those doses. Not even when hitting the body with a staggering dose once a month.

Also, though obviously not done with PC, in the RCT I have recently posted looking at breast cancer as well as all cancers except PC(all participants were female), giving between 1100 and 2000 per day(pus participants were allowed to take additional on their own, and apparently some did), when going by the blood levels attained, there was the opposite of a U shaped curve for all cancers. Or at the very least, if there was a U shaped curve, the increased risk part was still always way below the lowest and 2nd lowest vitamin D levels. Always an improvement comparing the highest levels to the lowest blood levels, which were measured multiple times throughout the study. And looking only at breast cancer(rather than all cancers) there was no curve at all, only lower risk with higher levels, with the biggest drop in risk seen with levels above 60ng/ml, a very high level.

But alas, that tells us nothing about PC, only about all other cancers in post menopausal women. It may well be worthless for PC, but at least according to that RCT Allen posted, it was not harmful.

I would also "think it would be a very unusual biological phenomenon if the majority of the population would need the addition of high doses of a prohormone to be healthy." if we did not originate from the tropics, and if much of man's history was not spent with a lot more time outdoors than most people get these days. Hunting, fishing, farming, etc, for much of the human population for much of human history. And in the not too distant past, recreational sun bathing without sunscreen! (pretty much frowned on today!)

Gemlin, I sure would love to see your vitamin D levels, just out of curiosity!

Post Edited (BillyBob@388) : 7/31/2018 11:14:28 AM (GMT-6)

I don't but can you tell me if fasting is necessary for an accurate vitamin D level? I did a halfass fast which may have also skewed my cholesterol level so I am currently dieting and will retest in another month.

F8 said...
I don't but can you tell me if fasting is necessary for an accurate vitamin D level? I did a halfass fast which may have also skewed my cholesterol level so I am currently dieting and will retest in another month.

As far as I know, fasting is not required for vitamin D testing.

Gemlin said...
From Worldwide status of vitamin D nutrition it seems that the difference is more complicated than northern and southern climate.

Vitamin D deficiency (serum 25(OH)D<25 nmol/l) is highly prevalent in India and China while vitamin D status is better in Japan and South-East Asia. Vitamin D deficiency is very common in the Middle-East and there is a relationship with skin covering clothes and staying outside of the sun. A poor to moderate vitamin D status is also common in Africa, probably caused by the dark skin types and cultural habits of staying outside of the sunshine. Vitamin D status is much better in North America where vitamin D deficiency is uncommon but vitamin D insufficiency (serum 25(OH)D between 25 and 50 nmol/l) is still common. In the United States and Canada milk is usually supplemented with vitamin D and the use of vitamin supplements is relatively common. Vitamin D status in Latin America usually is reasonable but there are exceptions and vitamin D insufficiency still occurs quite often. In Australia and New Zealand a poor vitamin D status was seen in the elderly who were often vitamin D deficient and also in immigrants from Asia. Vitamin D deficiency also occurred in children when the mother was vitamin D deficient. Within Europe, vitamin D status usually is better in the Nordic countries than around the Mediterranean. This may be due to a lighter skin and sun seeking behaviour and a high consumption of cod liver oil in the Northern countries while in Southern Europe people stay out of the sunshine and have a somewhat darker skin.

BB - maybe I will measure my D (out of curiosity) and inform you. As you see above maybe my light skin and the high cod liver oil consumption here maintains it on a normal and healthy level?

Gemlin, I suspect you are correct, it is more complicated than any one factor and your post makes some good points. In fact, it can be quite complicated.

Do you consume- or have taken frequently- cod liver oil? If so, that is a form of supplementation, I'm sure you know. I hope you do measure your D level and let us know. Although, if you have been taking CLO, that means you have been supplementing which should raise your level.

There are some(Mercola) that argue that the vitamin A in CLO defeats the benefits of vitamin D. Though he is supposed to be a member of their group, there are other people(Weston Price Foundation) that argue he has it backwards, and the vitamin A in SOME CLO(it is remove from much CLO these days) is a big help(and more natural), and that vitamin D by itself DEPLETES vitamin A. And they ask Mercola why he has to give so much Vitamin D- thousands of units per day- to get an adequate blood level of Vitamin D, when they can do it with the much lower vitamin D levels seen in CLO?

I have no clue as to who is correct. Risk of excessive (like above 80 or 90) blood levels of vitamin D are mentioned in this article by these pro vitamin D and Cod Liver Oil folks, as well as the need for vitamin A and K2 with the higher levels of Vitamin D, which they claim prevents most of the problems that might arise with massive supplements of vitamin D by itself. /www.westonaprice.org/health-topics/abcs-of-nutrition/update-on-vitamins-a-and-d/

BTW, I have long taken Vitamin K2 with my Vitamin D, and try to eat vitamin A rich foods and sometimes supplement with it, or sometimes take CLO, even though Mercola says I shouldn't. In fact, I have a concoction of high vitamin D/high vitamin A that I have taken for developing colds and lung infections that seems to have performed near miracles in recent years. Having had a couple of battles with pneumonia in years past, I can tell when it is approaching, and this has defeated it early(within hours) several times now. ( I am not recommending that for anyone, it might kill you so DON'T do it!)

This is lengthy and complicated, I will just provide a short quote:
/www.westonaprice.org/health-topics/cod-liver-oil/a-response-to-dr-joe-mercola-on-cod-liver-oil/

Weston A Price said...
..........In order for vitamin D to activate the expression of its target genes, it must bind to the vitamin D receptor (VDR) and then combine with the retinoid X receptor (RXR), which is activated by a particular form of vitamin A called 9-cis retinoic acid. Researchers from Spain recently showed that vitamin D can only effectively activate target genes when its partner receptor is activated by vitamin A.

Mercola Statement: The Weston Price Foundation, of which I am an advisory [honorary] member, holds a contradictory view. They believe vitamin D can only effectively target genes when its “partner receptor” is activated by vitamin A. If vitamin A is absent, certain molecules called co-repressors bind to the receptors and prevent vitamin D from functioning. It is their position that cod liver oil is still a highly recommended supplement.

WAPF Response: Dr. Mercola is no longer a member of the Weston A. Price Foundation honorary board. Research does indeed indicate that vitamin D can only effectively target genes when its partner receptor is activated by vitamin A.

Mercola Statement: After reviewing the evidence, I am personally convinced that there is sufficient vitamin A in the current American diet to facilitate sufficient vitamin D activation. This does not appear to be the case in third world countries, where cod liver oil, or some other preformed retinol supplement, would still be useful.

WAPF Response: Please supply us with this evidence. Where does the average American get vitamin A in the modern diet? If vitamin A in the American diet is adequate for vitamin D activation, why are Cannell and Mercola obliged to recommend such high levels of vitamin D—levels much higher than those found in traditional diets—in order to bring serum vitamin D levels into the normal range?................

Post Edited (BillyBob@388) : 7/31/2018 1:50:34 PM (GMT-6)

My PCP did a vit-d blood test after my first high PSA and it was low. Her words at that time (six years ago) were something like, "Want to make sure your bones stay healthy and there is some suggestion that low vit-d might be associated with PC."

My two brothers, who also had PC, got tested and neither had low vit-d.

So there's my statical study on the matter.

Andrew