Ep 113 Vitamin D: The D stands for drama

Podcast Summary

• A person's unexplained weight loss, intense thirst, and craving for salt led to a debilitating illness with various symptoms.: Unexplained weight loss, intense thirst, and craving for salt can be early signs of a debilitating illness, causing significant emotional and physical exhaustion.

  The onset of this individual's illness in late December 2015 began with unexplained weight loss and intense thirst, leading to a constant need for water and an unusual craving for salt. As the condition progressed, the person experienced various symptoms including frequent bathroom trips, difficulty concentrating, head heaviness, insomnia, hypnic jerks, muscle weakness, and energy loss. The individual's daily life became a struggle, with simple tasks taking hours to complete and requiring frequent rests. The emotional toll was equally significant, as the person lived in constant fear of the unknown and the potential for drastic life changes due to the worsening condition. The individual's story highlights the debilitating impact of the illness and the profound emotional and physical exhaustion it caused.

• Vitamin D deficiency symptoms overlooked due to more pressing health concerns: Feeling sick for months with undetected vitamin D deficiency, potential impact on overall health, importance of addressing both severe and less severe conditions, maintaining adequate vitamin D levels around 30, benefits of sunlight exposure

  Vitamin D deficiency, which can lead to various health issues, may go unnoticed if other more life-threatening conditions are present. The speaker's experience involved feeling sick for three months, with low vitamin D and sodium levels on initial blood tests. The doctor focused on the low sodium due to potential life-threatening consequences, leading to a water restriction. However, the speaker eventually changed doctors, who noticed the low vitamin D levels and prescribed a supplement. The speaker's symptoms improved within a day of starting the vitamin D supplement. This experience highlights the importance of addressing both potentially life-threatening and less severe conditions, and the potential impact of vitamin D deficiency on overall health. Additionally, the speakers discuss the importance of maintaining adequate vitamin D levels, ideally around 30, and the potential benefits of sunlight exposure.

• The Role of Vitamin D in Maintaining Healthy Bones: Vitamin D is a vital hormone and vitamin for bone health, derived from steroids and found in food sources. It comes in two forms, D2 and D3, which need processing to become the active metabolite, calcitriol. Calcitriol plays a crucial role in calcium homeostasis, ensuring proper calcium and phosphorus absorption and bone renovation.

  Vitamin D is a crucial hormone and vitamin that our bodies need for maintaining healthy bones. Derived from steroids, vitamin D is both a hormone we produce ourselves and a vitamin found in various food sources. Before it can become hormonally active, vitamin D comes in two forms: D2 (ergocalciferol) from plants and D3 (cholecalciferol) from animal sources. Both forms need to be processed in the liver and kidney to become the active metabolite, calcitriol. Calcitriol plays a vital role in calcium homeostasis, ensuring that calcium and phosphorus levels in our blood are maintained for bone health. It promotes calcium and phosphorus absorption in the gut and increases their reabsorption in the kidneys, while also stimulating bone renovation by activating osteoclasts. Without sufficient vitamin D, our bodies cannot effectively absorb calcium and phosphorus, leading to potential deficiencies and health issues like osteomalacia or rickets.

• Vitamin D deficiency in children leads to rickets: Vitamin D deficiency can cause rickets, resulting in weak bones, growth issues, and severe cases may lead to hypocalcemia and life-threatening complications

  Vitamin D deficiency in children can lead to rickets, a condition where bones fail to mineralize properly. This results in widened growth plates, weak bones, slowed growth, bowing deformities, and delayed closure of skull bones. Severe cases can lead to hypocalcemia, causing muscle spasms, seizures, and even cardiac failure. Vitamin D is essential for calcium absorption, and the active form of vitamin D, calcitriol, has a short half-life, requiring continuous production. The liver form of vitamin D, 25 oh vitamin D, is what is typically measured to determine sufficiency or deficiency.

• Vitamin D and calcium are essential for bone health and have extra-skeletal effects: Deficiencies in Vitamin D and calcium can lead to bone pain, muscle weakness, and increased risk of fractures. Severe deficiencies can cause diseases like rickets and osteomalacia, while milder deficiencies or insufficiencies increase risks of various cancers, cardiovascular disease, and autoimmune diseases.

  Vitamin D and calcium are essential for bone health, and deficiencies in either can lead to conditions like rickets in children and osteomalacia in adults. These conditions can cause bone pain and muscle weakness, increasing the risk of fractures. Vitamin D also has extra-skeletal effects, influencing over 200 genes and being involved in various processes such as immune response and cellular proliferation. Severe deficiencies can lead to diseases like rickets and osteomalacia, but even milder deficiencies or insufficiencies have been linked to increased risks of various cancers, cardiovascular disease, autoimmune diseases, and other health issues. Vitamin D and calcium levels are tightly controlled by the body through complex hormonal loops, including parathyroid hormone and calcium levels. Milk fortified with vitamin D does not necessarily help in absorbing that calcium in the same glass, and nutritional deficiencies are the most common causes of these conditions.

• Vitamin D's role in health and disease is not fully understood: Despite a link between health conditions and vitamin D deficiency, the causality and mechanisms are unclear. Optimal vitamin D levels and their relationship to health are still debated.

  While there is a link between various health conditions and vitamin D deficiency, the causality and mechanisms behind these relationships are still unclear. Vitamin D is important, but its role in the broader context of health and disease is not yet fully understood. The definitions of sufficient, insufficient, deficient, and severe deficiency in vitamin D levels vary, making it challenging to draw definitive conclusions based on lab results alone. The half-life of vitamin D in the body makes it difficult to determine how long a measured level has been present. The categories for good and bad levels of vitamin D were established based on the risk of rickets and osteomalacia, but beyond that, there is ongoing debate about the optimal levels. And yes, there is such a thing as having too much vitamin D, which is known as toxicity or hypervitaminosis D.

• Vitamin D: Balancing Deficiency and Toxicity: Maintain a healthy vitamin D level by understanding personal risk factors and consulting healthcare professionals to avoid both deficiency and toxicity, essential for bone health and immune function.

  Vitamin D toxicity is rare but can lead to serious health issues like hypercalcemia and kidney problems. On the other hand, vitamin D deficiency, which is more common, can be caused by lack of sun exposure, diet, certain medical conditions, and higher body fat mass. Despite the varied recommended daily allowances, it's clear that both deficiency and toxicity should be avoided. Vitamin D is essential for bone health and immune function, but excessive intake can be harmful. It's important to understand your personal risk factors and consult with a healthcare professional to ensure you're maintaining a healthy vitamin D level.

• The ancient origins and diverse functions of Vitamin D: Vitamin D, essential for calcium absorption and bone health, has a long history of protecting DNA and proteins from UV damage. Discovered in water-dwelling species' adaptation to land, its diverse functions add to its intrigue.

  Vitamin D, which has been produced or utilized by plants and animals since life began, is not just important for calcium absorption and bone health, but also has a long history of protecting DNA and proteins from damage due to UV radiation. Its evolutionary role expanded around 385 million years ago when water-dwelling species moved onto land and needed to adapt to gravity, leading to its role in calcium absorption. The discovery of vitamin D's ancient origins and diverse functions adds to the excitement and intrigue surrounding this essential nutrient.

• The complex relationship between vitamin D, skin pigmentation, and human health: The vitamin D hypothesis suggests darker skin protects from UV radiation in tropical latitudes, but the evidence is not conclusive. Multiple factors contribute to health disparities, including structural inequalities and institutionalized racism.

  While vitamin D has played a crucial role in the evolution of various organisms, including humans, its impact on skin pigmentation and human health is a complex issue. The vitamin D hypothesis suggests that darker skin pigmentation evolved to protect from UV radiation in tropical latitudes, while lighter skin emerged as humans shifted to higher latitudes and relied more on agriculture. However, the evidence supporting this hypothesis is not conclusive, and it's essential to consider other factors, such as structural inequalities and institutionalized racism, when examining health disparities. Vitamin D's role in various health outcomes, including COVID-19, should not be oversimplified or used as a sole explanation for racial disparities. Instead, a more nuanced approach that considers multiple factors is necessary.

• Understanding the complexities of vitamin D and health disparities: While studying vitamin D's role in health and its link to COVID severity, it's crucial to consider the larger context and societal structures contributing to health disparities.

  While studies linking COVID severity and heart disease to factors like vitamin D deficiency, skin color, and diet can provide valuable insights, they often oversimplify complex issues and ignore systemic health disparities in medicine. It's crucial to approach these findings with a thoughtful perspective, recognizing the importance of vitamin D and other factors while considering the larger context. The history of recognizing vitamin D's significance dates back to ancient Greece and China, with early descriptions of rickets and its symptoms. The condition, which can result from vitamin D deficiency, remained largely unaddressed in medical texts for centuries, despite evidence from archaeological findings. The term "rickets" first emerged in the 17th century, as the condition became more prevalent during the industrial revolution. While it's essential to continue studying vitamin D and its role in health, it's equally important to consider the reasons behind deficiencies and the societal structures that contribute to health disparities. By taking a more nuanced approach, we can better understand the complexities of these issues and work towards more equitable solutions.

• The Cause of Rickets: A Mystery Solved: The industrial revolution led to the prevalence of rickets due to diet changes, reduced sunlight exposure, and longer work hours. The cause was later discovered to be vitamin D deficiency.

  The first clear descriptions of rickets, a disease characterized by weakened bones, are attributed to Daniel Whistler and Francis Glisson in the 1600s. Their descriptions included signs and symptoms, and suggested simple treatments like suspension for infants. Rickets became increasingly prevalent due to the industrial revolution, which led to a change in diet, reduced exposure to sunlight, and longer hours spent indoors. Despite its high prevalence, the cause of rickets remained a mystery until the late 1800s when researchers began investigating the importance of micronutrients in food. These experiments revealed that even with sufficient calories, animals were still dying or failing to thrive due to the lack of certain essential nutrients. This discovery eventually led to the identification of vitamin D as the missing piece of the puzzle, explaining the cause of rickets and the widespread vitamin D deficiency during the industrial revolution.

• Discovering the Role of Vitamins in Human Diseases: In the early 1900s, researchers discovered that certain diseases could be cured by specific foods, leading to the identification of essential micronutrients like vitamins. Rickets, a disease caused by a deficiency in vitamin D, was one of the first to be identified and treated with foods rich in fat-soluble vitamins A and D.

  The discovery of vitamins and their connection to human diseases began in the late 1800s and early 1900s. Researchers found that certain diseases could be cured by specific foods, leading them to believe that these foods contained essential micronutrients. One such disease, rickets, was found to be caused by a dietary deficiency, specifically a lack of vitamin D. Sir Edward Mellon B's experiments with puppies in 1918 demonstrated this, leading to the conclusion that rickets could be treated with foods rich in fat-soluble vitamins A and D. However, it was still unclear how these vitamins differed and the role of ultraviolet light in their absorption. The idea to use cod liver oil to treat rickets likely came from its success in treating vitamin A deficiency, as well as its long history as a folk remedy.

• The Discovery of Vitamin D and its Role in Treating Rickets: Vitamin D was discovered in cod liver oil by destroying Vitamin A, and researchers later found that UV radiation and sunlight could also treat rickets. Experiments on rats further solidified the connection between sunlight, Vitamin D, and bone growth.

  The discovery of Vitamin D and its role in treating rickets involved a combination of scientific research and historical practices. Hippocrates may have written about the use of dolphin liver oil for medicinal purposes, but it was not until the early 1900s that scientists like Elmer McCollum and Harriet Chick made significant strides in understanding Vitamin D. McCollum discovered Vitamin D in cod liver oil by destroying Vitamin A and observing its effects on rickets. At the same time, researchers like Harriet Chick and Holchinsky were exploring the use of UV radiation from lamps and sunlight as a treatment for rickets. The development of x-rays also played a crucial role in diagnosing and understanding the extent of Vitamin D deficiencies. Researchers like Harry Goldblatt, Catherine Soames, and Harry Steenbach carried out experiments on rats to further understand the connection between sunlight, Vitamin D, and rickets. These experiments involved irradiating rats and their food, as well as feeding irradiated rat skin to rats with rickets. The discovery of Vitamin D and its role in bone growth and prevention of rickets was a significant milestone in nutritional science, and the use of both cod liver oil and sunlight as treatments continued to evolve over time.

• Discovering the role of skin in vitamin D production: Skin plays a crucial role in vitamin D production, but deficiency remains a concern, especially for populations with limited sun exposure or diets low in vitamin D. Sunlight exposure is a key source, but inconsistent definitions of deficiency and insufficiency make population-level estimates unreliable.

  The importance of skin in vitamin D production was discovered through an unusual experiment involving irradiated and non-irradiated skin. This finding led to a better understanding of vitamin D as an essential nutrient and paved the way for research on its chemical structure and sources. However, despite this knowledge, vitamin D deficiency remains a concern, especially for populations with limited sun exposure or diets low in vitamin D. Milk, which was used historically to treat rickets, is fortified with vitamin D but human breast milk has poor transfer of vitamin D. Sunlight exposure is a key source of vit D, with estimates suggesting that 5-30 minutes of exposure twice a week can prevent deficiency. However, the definition of deficiency and insufficiency varies, leading to inconsistent population-level estimates. Despite efforts to address vitamin D deficiency through food fortification and supplementation, it remains a significant public health issue.

• 1 billion people suffer from vitamin D deficiency: Despite efforts to address vitamin D deficiency, it remains prevalent and supplementation without first checking for deficiency doesn't lead to improved health outcomes.

  Despite efforts to address vitamin D deficiency through fortification and supplementation programs, the global prevalence of deficiency or insufficiency remains high, estimated to be around 1 billion people. While severe deficiency leading to conditions like rickets is less common than it once was, the risk of various health issues associated with vitamin D deficiency, such as cancers, cardiovascular disease, and falls, is still a concern. However, recent studies have shown that widespread supplementation without first checking for deficiency does not lead to improved outcomes in terms of fracture risk, low bone mass, cardiovascular disease prevention, or all-cause mortality. Therefore, it's important for individuals to focus on getting adequate vitamin D through their diets and, if necessary, consulting a healthcare professional for supplementation.

• Vitamin D's Role in Health and Disease: The relationship between vitamin D deficiency and diseases is complex, with ongoing research exploring its potential roles in severe illnesses like COVID-19 and infection in general.

  While there is a lot of research suggesting an association between vitamin D deficiency and various diseases or outcomes, the causality of these relationships is not yet clear. The debate around vitamin D supplementation is complex, with strong opinions on both sides. Some argue for widespread testing and supplementation due to the potential underestimation of deficiency, while others caution against it due to limited evidence of benefits and potential costs. The truth likely lies somewhere in the middle, as vitamin D is an essential nutrient with important functions in human health, and many people may not be getting enough. Ongoing research is exploring the potential roles of vitamin D in severe illnesses like COVID-19, sepsis, and infection in general. For more information, check out the sources mentioned in this episode on our website, thispodcastwillkillyou.com.

• Exploring the Complex Role of Vitamin D as a Hormone: Vitamin D is essential for bone health, immune function, and mood regulation. Sources include sunlight, fortified foods, and supplements. Optimal levels remain debated, and supplementation can be controversial.

  The complexity and importance of Vitamin D. We learned that it's not just a vitamin, but also a hormone that plays a crucial role in our bodies. We explored its various sources, functions, and health benefits, as well as the challenges of getting enough of it. The discussion also touched upon the controversies and debates surrounding optimal Vitamin D levels and supplementation. A special thanks to our guests, Liana Squilace, Bloodmobile, Exactly Right network, and our listeners for joining us on this deep dive into Vitamin D. And a heartfelt appreciation to our patrons for their continued support. Remember, stay informed, stay curious, and stay healthy! Wash your hands and stay tuned for our next episode.