Use of Vitamin D in Clinical Practice

This recent review discusses the recent discovery—from a meta-analysis of 18 placebo controlled trials—that taking vitamin D helps people to live longer. This is not surprising as vitamin D is involved in over 200 functions in your body, and deficiency is often the rule rather than the exception. It also talks about how vitamin D produces cathelicidin, a naturally occurring broad-spectrum antibiotic which can help your body fight infections. When trees, plants and molds get an infection, they often make natural antibiotics. Maybe we can also make our own natural antibiotics and antivirals!

Altern Med Rev. 2008 Mar;13(1):6-20.
Cannell JJ, Hollis BW
Director, Vitamin D Council. Correspondence address: 9100 San Gregorio Road,Atascadero, CA 93422 Email: jjcannell@gmail.com.

The recent discovery—from a meta-analysis of 18 randomized controlled trials—that supplemental cholecalciferol (vitamin D) significantly reduces all-cause mortality emphasizes the medical, ethical, and legal implications of promptly diagnosing and adequately addressing vitamin D deficiency. Not only are such deficiencies common, and probably the rule, vitamin D deficiency is implicated in most of the diseases of civilization. Vitamin D's final metabolic product is a potent, pleiotropic, repair and maintenance, seco-steroid hormone that targets more than 200 human genes in a wide variety of tissues, meaning it has as many mechanisms of action as genes it targets. One of the most important genes vitamin D up-regulates is for cathelicidin, a naturally occurring broad-spectrum antibiotic. Natural vitamin D levels, those found in humans living in a sun-rich environment, are between 40-70 ng per ml, levels obtained by few modern humans.

Assessing serum 25-hydroxy-vitamin D (25 (OH) D) is the only way to make the diagnosis and to assure therapy is adequate and safe. Three therapy modalities exist for vitamin D deficiency: sunlight, artificial ultraviolet B (UVB) radiation, and vitamin D3 supplementation. Therapy of vitamin D deficiency in otherwise healthy patients with 2,000-7,000 IU vitamin D per day should be sufficient to maintain year-round 25 (OH) D levels between 40-70 ng per mL. In those with serious illnesses associated with vitamin D deficiency, such as cancer, heart disease, multiple sclerosis, diabetes, autism, and a host of other illnesses, doses should be sufficient to maintain year-round 25 (OH) D levels between 55-70 ng per mL. Vitamin D-deficient patients with serious illness should not only be supplemented more aggressively than the well, they should have more frequent monitoring of serum 25 (OH) D and serum calcium. Vitamin D should always be adjuvant therapy in patients with serious illnesses and never replace standard therapy. Theoretically, pharmacological doses of vitamin D (2,000 IU per kg per day for three days) may produce enough of the naturally occurring antibiotic cathelicidin to address common viral respiratory infections, such as influenza and the common cold, but such a theory awaits further science.