Feb. 23rd 09: Vitamin D - The alternative hypothesis

Many patients with autoimmune or other chronic inflammatory disease are being told by their doctors that they are vitamin D deficient. Typically after measuring their secosteroid hydroxyvitamin-D (25-D) levels. The patients are then often prescribed supplementation of Vitamin D (D3).

However, scientists from Universities in the U.S and Australia have been investigating and researching this hypothesis now for many years, and has, based on molecular modeling, scientific reviews and study trials conducted over the Internet including several hundreds of patients reporting their vitamin D status, presented an alternative hypothesis, soon to be published in the journal Autoimmunity Reviews.

They claim that today’s understanding of the vitamin D metabolism is a failure, dividing the perceptions into two categories; the “deficiency/disease model”, and their own “the alternate model”. The first model is based on the understanding that the low levels of 25D found in many chronically ill patients somehow contributes to their disease, and that supplementation will somehow improve the patients health by correcting their 25D levels, although no studies has yet to prove that there is a connection between supplementation and better health or decreased risk of disease in the long term. “The alternate model” argues that the low 25D levels, and high 1,25D (the active metabolite) levels often found in patients with chronic inflammatory disease is a result of the disease process itself, and that there are no long term benefits of supplementing these patients with vitamin D. Further they argue that since 25D is found to be a secosteroid hormone, suppressing the immune system, hence leading to a short term feeling of wellness as the immune system shuts down, actually increases risks for disease in the long term. This is also indicated by the long term studies that are done on the effect of Vitamin D supplementation. (1,2 )

“The alternate model” coincides a lot with my own personal experience with Vitamin D. I have always been less symptomatic when travelling to southern places like Asia or the Middle East, and many Norwegian Rheumatoid Arthritis patients travel to Spain for symptom relief on a regularly basis, supporting the theory that increased vitamin D followed by sun exposure, reduces symptoms by decreasing the immune system’s activity. So, this is all well then? We can just substitute steroids with Vitamin D? Unfortunately that is not a right conclusion. First off all too much Vitamin D can lead to calcium being resolved from your bones and teeth, leading to kidney stones and hypercalcemia, second, growing evidence shows that autoimmune disease, and other diseases, like Mycordial infarction, has a pathological etiology. (Caused by bacteria or other microorganisms) These pathogens are proliferating in your body by shutting down your immune system’s ability to produce important antimicrobial peptides and fight off disease, hence the immunosuppressant of any steroid, be it medications or vitamin D, will let these bacteria grow even more, causing more disease. This can explain why so many autoimmune patients collect multiple diagnoses during their lifetime, as the microbial infections accumulate during life.

My advice would be to be very careful with supplementing of “Vitamin” D without testing once blood levels first. And it is very important than one tests both for 25D and the active metabolite 1,25D which is the hormone the body use to activate the Vitamin D Receptor (VDR) in your body.

The paper can be downloaded from this site:

Albert PJ, Proal AD, Marshall TG, Vitamin D – The alternative hypothesis

Trevor Marshall (ph.d) coauthoring the paper is also the founding director of Autoimmunity Research Foundation.

References:

1) Does vitamin d intake during infancy promote the development of atopic allergy? PMID: 19197538

2) Infant vitamin d supplementation and allergic conditions in adulthood: northern Finland birth cohort 1966. PMID: 15699498