I'm wondering if anyone else tested at a low level for this vitamin?
In this thread some people do have a low Vit.D level :
http://www.lymeneteurope.org/forum/view ... 3607#p3607
On the Dutch Lyme forum are several people who test low for it.
I'm wondering if anyone else tested at a low level for this vitamin?
A new study led by researchers at the University of California, Berkeley, adds to the evidence that vitamin C supplements can lower concentrations of C-reactive protein (CRP), a central biomarker of inflammation that has been shown to be a powerful predictor of heart disease and diabetes. The same study found no benefit from daily doses of vitamin E, another antioxidant.
This study comes just days after a larger, eight-year clinical trial led by researchers at Boston's Brigham and Women's Hospital failed to show that vitamins C or E could cut the risk of heart attacks or strokes.
That trial does not necessarily close the books on the benefits of vitamin C for cardiovascular health, according to Gladys Block, UC Berkeley professor emeritus of epidemiology and public health nutrition and lead author of the study looking at vitamins C and E and their impact on CRP levels. She pointed out that the Brigham and Women's Hospital study did not screen study participants for elevations in CRP - defined by the American Heart Association as 1 milligram per liter or greater - which is an important distinction in determining who might benefit from taking vitamin C.
The study led by Block, currently online and scheduled to appear in the Jan. 1 issue of the journal Free Radical Biology and Medicine, shows that for healthy, non-smoking adults with an elevated level of CRP, a daily dose of vitamin C lowered levels of the inflammation biomarker after two months compared with those who took a placebo. However, participants who did not start out with elevated CRP levels saw no benefit from vitamin C supplementation.
"This is an important distinction; treatment with vitamin C is ineffective in persons whose levels of CRP are less than 1 milligram per liter, but very effective for those with higher levels," said Block. "Grouping people with elevated CRP levels with those who have lower levels can mask the effects of vitamin C. Common sense suggests, and our study confirms, that biomarkers are only likely to be reduced if they are not already low."
The researchers said that for people with elevated CRP levels, the amount of CRP reduction achieved by taking vitamin C supplements in this study is comparable to that in many other studies of cholesterol-lowering drugs called statins. They noted that several larger statin trials lowered CRP levels by about 0.2 milligrams per liter; in this latest study, vitamin C lowered CRP by 0.25 milligrams per liter.
"This finding of an effect of vitamin C is important because it shows in a carefully conducted randomized, controlled trial that for people with moderately elevated levels of inflammation, vitamin C may be able to reduce CRP as much as statins have done in other studies," said Block.
Evidence of the link between elevated CRP levels and a greater risk of heart disease has grown in recent years, but it had been unclear whether the beneficial effects of lowering CRP were independent of the effects of lowering cholesterol.
Newly released results from a multinational clinical trial help answer that question. Led by researchers at Harvard Medical School, the study, known as the Jupiter trial, found that statins reduced cardiovascular mortality and morbidity among people whose cholesterol levels were normal, but whose levels of CRP were greater than 2 milligrams per liter. The Jupiter trial found that among people who had such high levels of CRP at baseline, levels of CRP were 37 percent lower with statins compared with a placebo.
"One of the strengths of the Jupiter trial is that only persons with CRP levels greater than 2 milligrams per liter were enrolled," Block added. "Researchers found very important effects of lowering CRP in people who had high levels to begin with."
In the UC Berkeley study on vitamin C, participants who started out with CRP levels greater than 2 milligrams per liter had 34 percent lower levels of CRP with vitamin C compared with a placebo.
The UC Berkeley study also found a strong link between obesity and elevated levels of CRP. The researchers found that while 25 percent of normal-weight people had elevated levels of CRP, those levels were found in 50 percent of overweight and 75 percent of obese participants.
"The low-grade inflammation that characterizes obesity is believed to contribute to a number of disorders, including atherosclerosis and insulin resistance," said Nina Holland, adjunct professor at UC Berkeley's Division of Environmental Health Sciences and co-investigator on the study. Holland's biorepository at UC Berkeley processed and stored the thousands of blood samples involved in this study.
Notably, the American Heart Association and the U.S. Centers for Disease Control and Prevention recommends that clinicians measure CRP levels in patients who have a moderately elevated risk of cardiovascular problems, as determined by other established risk factors such as high cholesterol levels and smoking.
"Major studies have found that the level of CRP in the body predicts future risk of cardiovascular disease, including myocardial infarction, stroke and peripheral artery disease, as well as diabetes," said Block. "Some believe CRP to be as important a predictor of future heart problems as high levels of LDL and low levels of HDL cholesterol."
The UC Berkeley-led study looked at the separate effects of two antioxidants: vitamin C and vitamin E. The researchers randomly divided 396 healthy, non-smoking adults from the San Francisco Bay Area into groups taking daily doses of either 1,000 milligrams of vitamin C, 800 international units of vitamin E or a placebo. The recommended dietary allowance (RDA) for vitamin C is 90 milligrams per day for men and 75 milligrams per day for women. The researchers noted that the suggested upper limit for vitamin C is 2,000 milligrams per day, or twice the level used in the study.
They compared participants' baseline CRP levels with their levels two months later, at the end of the study. Fewer than half of the participants in the study started with elevated levels of CRP.
Participants who had baseline CRP levels less than 1 milligram per liter saw no significant effect on CRP levels after taking vitamin C supplements. However, those who started off with CRP levels of 1 milligram per liter or higher saw a 16.7 percent drop in levels after two months of treatment with vitamin C.
The researchers found no significant results for those taking vitamin E. They are uncertain as to why vitamin E did not show an effect even though it is also an antioxidant. Block noted that these vitamins have other functions independent of their antioxidant properties. Or, perhaps the difference relates to the fact that vitamin E is fat soluble and thus found in cell membranes while vitamin C is water soluble and found in intercellular fluid, the researchers said.
Although this study ended at two months, Block noted that there is no evidence to date of adverse effects for longer-term use of vitamin C at high levels. At the same time, researchers acknowledged the need to study whether vitamin C's beneficial impact on CRP levels continue past two months.
This is clearly a line of research worth pursuing," said Block. "It has recently been suggested by some researchers that people with elevated CRP should be put on statins as a preventive measure. For people who have elevated CRP but not elevated LDL cholesterol, our data suggest that vitamin C should be investigated as an alternative to statins, or as something to be used to delay the time when statin use becomes necessary
Dec. 1, 2008 -- Getting too little vitamin D may be an underappreciated heart disease risk factor that's actually easy to fix.
Researchers say a growing body of evidence suggests that vitamin D deficiency increases the risk of heart disease and is linked to other, well-known heart disease risk factors such as high blood pressure, obesity, and diabetes.
For example, several large studies have shown that people with low vitamin D levels were twice as likely to have a heart attack, stroke, or other heart-related event during follow-up, compared with those with higher vitamin D levels.
"Vitamin D deficiency is an unrecognized, emerging cardiovascular risk factor, which should be screened for and treated," says researcher James H. O'Keefe, MD, director of preventive cardiology at the Mid America Heart Institute in Kansas City, Mo., in a news release. "Vitamin D is easy to assess, and supplementation is simple, safe and inexpensive."
Most of the body's vitamin D requirements are met by the skin in response to sun exposure. Other less potent sources of vitamin D include foods such as salmon, sardines, cod liver oil, and vitamin D-fortified foods like milk and some cereals. Vitamin D can also be obtained through supplements
Vitamin D Deficiency on the Rise
Vitamin D deficiency is traditionally associated with bone and muscle weakness, but in recent years a number of studies have shown that low levels of the vitamin may predispose the body to high blood pressure, congestive heart failure, and chronic blood vessel inflammation (associated with hardening of the arteries). It also alters hormone levels to increase insulin resistance, which raises the risk of diabetes.
In a review article published in the Journal of the American College of Cardiology, researchers surveyed recent studies on the link between vitamin D deficiency and heart disease to come up with practical advice on screening and treatment.
They concluded that vitamin D deficiency is much more common than previously thought, affecting up to half of adults and apparently healthy children in the U.S.
Researchers say higher rates of vitamin D deficiency may be due in part to people spending more time indoors and efforts to minimize sun exposure through the use of sunscreens. Sunscreen with a sun protection factor (SPF) of 15 blocks approximately 99% of vitamin D synthesis by the skin.
"We are outside less than we used to be, and older adults and people who are overweight or obese are less efficient at making vitamin D in response to sunlight," says O'Keefe. "A little bit of sunshine is a good thing, but the use of sunscreen to guard against skin cancer is important if you plan to be outside for more than 15 to 30 minutes of intense sunlight exposure
Testing for Vitamin D Deficiency
Vitamin D levels can be measured with a blood test that looks at a specific form of vitamin D called 25-hydroxy vitamin D (25(OH)D). Vitamin D deficiency is defined as a blood 25(OH)D level below 20 ng/dL. Normal levels are considered to be above 30 ng/dL.
Researchers recommend 25(OH)D screening for those with known risk factors for vitamin D deficiency including:
Darkly pigmented skin
Reduced sun exposure due to seasonal variation or living far from the equator
Kidney or liver disease
The U.S. government's current recommended daily allowance (RDA) for vitamin D is 200 international units (IU) per day for individuals under age 50. For those between 50 and 70, 400 IU per day is recommended, and for those over age 70, the RDA is 600 IU. Most experts believe these doses are too low, and that somewhere between 1,000 and 2,000 IU of vitamin D per day is necessary to maintain adequate vitamin D levels. The safe upper limit of vitamin D consumption is 10,000 IU per day.
Vitamin D supplements are available in two different forms: Vitamin D2 and Vitamin D3. Although both appear effective in raising vitamin D blood levels, Vitamin D3 supplements appear to result in a longer-lasting boost.
Although there are no current guidelines for restoring and maintaining healthy vitamin D levels in people at risk for heart disease, for those who are vitamin D deficient, the researchers recommend initial treatment with 50,000 IU of vitamin D2or D3 once a week for eight to 12 weeks, followed by maintenance with one of the following strategies:
[50,000 IU vitamin D2or D3 every 2 weeks
1,000 to 2,000 IU vitamin D3 daily
Sunlight exposure for 10 minutes for white patients (longer for people with increased skin pigmentation) between the hours of 10 a.m. and 3 p.m.
Once maintenance therapy has been initiated, rechecking 25(OH)D blood levels is recommended after three to six months of ongoing supplementation
"Restoring vitamin D levels to normal is important in maintaining good musculoskeletal health, and it may also improve heart health and prognosis," says O'Keefe. "We need large, randomized, controlled trials to determine whether or not vitamin D supplementation can actually reduce future heart disease and deaths."
SOURCES: Lee, J. Journal of the American College of Cardiology, Dec. 9, 2008; vol 52
Diets that are high in protein and cereal grains produce an excess of acid in the body which may increase calcium excretion and weaken bones, according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM). The study found that increasing the alkali content of the diet, with a pill or through a diet rich in fruits and vegetables has the opposite effect and strengthens skeletal health.
"Heredity, diet, and other lifestyle factors contribute to the problem of bone loss and fractures," said Bess Dawson-Hughes, M.D., of Tufts University in Boston, Mass. and lead author of the study. "When it comes to dietary concerns regarding bone health, calcium and vitamin D have received the most attention, but there is increasing evidence that the acid/base balance of the diet is also important."
Average older adults consume diets that, when metabolized, add acid to the body, said Dr. Dawson-Hughes. With aging, we become less able to excrete the acid. One way the body may counteract the acid from our diets is through bone resorption, a process by which bones are broken down to release minerals such as calcium, phosphates, and alkaline (basic) salts into the blood. Unfortunately, increased bone resorption leads to declines in bone mass and increases in fracture risk
"When fruits and vegetables are metabolized they add bicarbonate, an alkaline compound, to the body," said Dr. Dawson Hughes. "Our study found that bicarbonate had a favorable effect on bone resorption and calcium excretion. This suggests that increasing the alkali content of the diet may attenuate bone loss in healthy older adults."
In this study, 171 men and women aged 50 and older were randomized to receive placebo or doses of either: potassium bicarbonate, sodium bicarbonate, or potassium chloride for three months. Researchers found that subjects taking bicarbonate had significant reductions in calcium excretion, signaling a decrease in bone resorption.
"In this study, we demonstrated that adding alkali in pill form reduced bone resorption and reduced the losses of calcium in the urine over a three month period," said Dr. Dawson-Hughes. "This intervention warrants further investigation as a safe and well tolerated supplement to reduce bone loss and fracture risk in older men and women."
During the past decade, major advances have been made in
vitamin D research that transcend the simple concept that vitamin
D is important for the prevention of rickets in children and has
little physiologic relevance for adults. Inadequate vitamin D, in
addition to causing rickets, prevents children from attaining their
genetically programmed peak bone mass, contributes to and
exacerbates osteoporosis in adults, and causes the often painful
bone disease osteomalacia. Adequate vitamin D is also important
for proper muscle functioning, and controversial evidence suggests
it may help prevent type 1 diabetes mellitus, hypertension,
and many common cancers. Vitamin D inadequacy has been
reported in approximately 36% of otherwise healthy young adults
and up to 57% of general medicine inpatients in the United States
and in even higher percentages in Europe. Recent epidemiological
data document the high prevalence of vitamin D inadequacy
among elderly patients and especially among patients with osteoporosis.
Factors such as low sunlight exposure, age-related
decreases in cutaneous synthesis, and diets low in vitamin D
contribute to the high prevalence of vitamin D inadequacy. Vitamin
D production from cutaneous synthesis or intake from the few
vitamin D–rich or enriched foods typically occurs only intermittently.
Supplemental doses of vitamin D and sensible sun exposure
could prevent deficiency in most of the general population.
The purposes of this article are to examine the prevalence of
vitamin D inadequacy and to review the potential implications for
skeletal and extraskeletal health.
Researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) found that pregnant women who are vitamin D deficient are also at an increased risk for delivering a baby by caesarean section as compared to pregnant women who are not vitamin D deficient. These findings currently appear on-line in the Journal of Clinical Endocrinology & Metabolism.
At the turn of the 20th century, women commonly died in childbirth due to "rachitic pelvis" rickets of the pelvis. While rickets virtually disappeared with the discovery of vitamin D, recent reports suggest that vitamin D deficiency is widespread in industrialized nations.
Over a two-year period, the researchers analyzed the relationship between maternal serum 25-hydroxyvitamin D [25(OH)D] and the prevalence of primary caesarean section. In total, 253 women were enrolled in this study, of whom 43 (17 percent) had a caesarean section. The researchers found that 28 percent of women with serum 25(OH)D less than 37.5 nmol/L had a caesarean section, compared to only 14 percent of women with 25(OH)D greater than 37.5 nmol/L.
In our analysis, pregnant women who were vitamin D deficient at the time of delivery had almost four times the odds of caesarean birth than women who were not deficient," said senior author Michael Holick, MD, PhD, director of the General Clinical Research Center and professor of medicine, physiology and biophysics at BUSM and Anne Merewood assistant professor of pediatrics at BUSM and lead author of the study.
According to Holick, one explanation for the findings is that vitamin D deficiency has been associated with proximal muscle weakness as well as suboptimal muscle performance and strength.
This study was funded by the US Department of Health and Human Services, Bureau of Maternal Child Health: R40MC03620-02-00, and by the US Department of Agriculture Cooperative State Research, Education, and Extension Service, Award.
A 70 year-old male presented with acute renal failure and mental obtundation. On examination, he was found to have hypercalcemia and on further questioning, it was found that it was secondary to injections of a slow-release vitamin D preparation. Although total body exposure is sufficient for vitamin D synthesis, increased vitamin D deficiency secondary to poor exposure to sunlight is observed in some parts of the world. We report here a case of vitamin D intoxication from the Kashmir valley where vitamin D deficiency is 100% in the general population that is confined indoors
Vitamin D toxicity is a known cause of hypercalcemia and renal failure. The daily requirement of vitamin D is about 200-600 IU and the skin can only produce around 10,000 IU of vitamin D after total body exposure to UV light.  Although vitamin D has a wide therapeutic index, its toxicity is well known and cases of accidental ingestion, self medication, and malpractice have been reported. We report here a case of malpractice-related vitamin D intoxication in an elderly male who presented with hypercalcemia, acute renal failure, and mental obtundation.
Our patient was a 70 year-old male hypertensive who had been undergoing treatment (enalapril, 5 mg) for the last three years and was nondiabetic. He presented with lethargy, loss of appetite, constipation, confusion, and pain in the abdomen. Examination revealed a pulse of 76/min, blood pressure of 130/80 mm Hg, and no systemic abnormalities. Routine chemistry revealed; Hb 12 g/dL, TLC 6.1 × 10 9 /L, DLC: N 64 %, L 24%, platelet 123 ×10 9 /L, ESR 12/1 st h, urea 87 mg/dL, creatinine 3.8 mg/dL (0-1.5 mg/dL), glucose 98 mg/dL, serum calcium 13.5 mg/dL (9.5-11.5 mg/dL), serum phosphorus 8.6 mg/dL (3.5-5.5 mg/dL), uric acid 6.6 mg/dL, LDH 292 U/L, total protein 7.0 g/dL, albumin 4.0 g/dL, bil 0.75 mg/dL, OT 35 U/L, PT 40 U/L, ALP 210 U/L. Urine: normal, 24 h urinary proteins 0.15 g/day, the 24 h urinary calcium 200 mg/dL, chest X-ray: normal, electrocardiography normal, the ultrasound was normal.
The patient was managed by continuous saline infusion, diuretics, hydrocortisone, and bisphosphonates. The level of serum calcium on the 10 th day of treatment was 10.28 mg/dL, that of phosphorus was 3.94 mg/dL, and the creatinine level stabilized at 1.5 mg/dL.
The patient reported that he had been taking injection vitamin D, 6,00,000 IU (OSTA D3) every two weeks for the last two years for arthralgias and generalized body aches. He had received 35 injections of vitamin D to date, with a cumulative dose of 2, 10, 00,000 IU.
The PTH level was 15 ng/L (10-60 ng/L) and the 25-hydroxy vitamin D level was 302 nM (47-144 nM). The PSA was normal and the myeloma profile was negative. The serum calcium and renal functions remain normal on follow up.
Vitamin D intoxication can be accidental  or due to self medication,  after the topical application of vitamin D ointment,  induced by dietary or OTC supplements, , or iatrogenic in some unusual cases.  The clinical manifestations of this intoxication are kidney disorders (65.0%), renal insufficiency (51.0%), gastrointestinal tract disorders (23.0%), and arterial hypertension (52.0%). 
The overzealous use of vitamin D in European countries due to the fear of rickets can lead to vitamin D intoxication;  although some cases have also been reported from India.  The season, the geographic latitude, the time of day, cloud cover, smog, and sunscreen affect UV exposure and vitamin D synthesis.  For example, sunlight exposure from November through February in Boston is insufficient to produce significant vitamin D synthesis in the skin. However, in a country like India, sunlight exposure is sufficient for vitamin D synthesis except for the northern part of India.
In the Kashmir valley, the prevalence of vitamin D deficiency is quite high, 69.6% in individuals exposed to the outdoors, to 100% in those confined indoors, reflecting the lower mean weekly exposure to sunlight. 
Our patient had received a slow-release preparation of vitamin D after every 15 days for the last two years, leading to a cumulative dose of 2, 10, 00,000 IU. This emphasizes the need to regularly assess the levels of vitamin D in patients suspected of its deficiency and who are put on vitamin D replacement therapy