Flu/immunity Question For Dr. Hess

[littlecanoe]

The flu is going around here in KY. My family, 4 of the 7 of us have gotten it. I was talking with an older lady at a patients home today. She is into homeopathic treatment and prevention. We were discussing cold and flu type illnesses and she recommended taking Vit D3 from late October through May of the following year. She said that she and her husband have taken the "Sun Vitamin" in this manner for the last 4 years and no longer get those nagging winter sicknesses. When questioned about the years preceding this she stated that they were always sick then. What are your thoughts on this? Any evidence of effectiveness that you've run across?

 

thanks,

lc

[Jimro]

I did a quick search through Pubmed and found these abstracts.

 

In 1981, R. Edgar Hope-Simpson proposed that a 'seasonal stimulus' intimately associated with solar radiation explained the remarkable seasonality of epidemic influenza. Solar radiation triggers robust seasonal vitamin D production in the skin; vitamin D deficiency is common in the winter, and activated vitamin D, 1,25(OH)2D, a steroid hormone, has profound effects on human immunity. 1,25(OH)2D acts as an immune system modulator, preventing excessive expression of inflammatory cytokines and increasing the 'oxidative burst' potential of macrophages. Perhaps most importantly, it dramatically stimulates the expression of potent anti-microbial peptides, which exist in neutrophils, monocytes, natural killer cells, and in epithelial cells lining the respiratory tract where they play a major role in protecting the lung from infection. Volunteers inoculated with live attenuated influenza virus are more likely to develop fever and serological evidence of an immune response in the winter. Vitamin D deficiency predisposes children to respiratory infections. Ultraviolet radiation (either from artificial sources or from sunlight) reduces the incidence of viral respiratory infections, as does cod liver oil (which contains vitamin D). An interventional study showed that vitamin D reduces the incidence of respiratory infections in children. We conclude that vitamin D, or lack of it, may be Hope-Simpson's 'seasonal stimulus'.

 

And

 

Calcitriol, also known as 1,25-dihydroxy-vitamin D3, is a steroid hormone that has been shown to have effects on cytokine production and lymphocyte proliferation. Coadministration of calcitriol with trivalent influenza vaccine in mice enhanced both mucosal and systemic antibody responses. We studied the effects of calcitriol coadministered with a commercially available influenza vaccine in 175 human volunteers in this double-blind, placebo controlled clinical trial. Subjects that received calcitriol experienced more pain at the injection site compared with placebo recipients. No significant differences in hemagglutination inhibition titers against H1N1, H3N2, or influenza B antigens were detected at 1 or 3 months postvaccination. We conclude that coadministration of 1.0 microg of calcitriol at a site adjacent to influenza vaccination does not enhance humoral immunity in human volunteers.

 

So the available evidence is that Vitamin D gives an immunity benefits to mice and children. It isn't a huge stretch to assume that the same benefits would extend to adult humans as well. The caveat is that you can't take Vitamin D on the same day that you get sick and expect any benefit (as demonstrated by the calcitriol double blind study).

 

Jimro

[odies dad]

Vitamins D, C and if you can find it, Elderberry extract works well. Also Echinacia and Goldenseal help boost your immune system.

[Dr.Hess]

Well, you can probably find studies that will show anything you want, depending on who paid for it. If that works for her, great, keep it up. Would it hurt you to try it? No, probably not. Would C help? Maybe, maybe not. I read somewhere that Linus Pauling took like 2-3 grams of C a day. That's a lot of C, borderline too much, but that's what he did because that's what he believed helped him.

 

You have to understand what a vitamin is. A vitamin is a chemical that your body needs to survive but cannot produce itself. Humans need C, for instance. Animals can make their own. C is needed to make collagen. D is needed for bone growth and maintenance. If you are low on a vitamin, then taking a suppliment will help you. If you are not low on a vitamin, then taking the suppliment will do nothing for you. Fat soluable vitamens (A, D, E, K) will stay in you for months. That is, you have several months' supply onboard right now and you could go without eating any of them for months before a problem came up. Water soluable vitamins (B's, C, all the rest) don't hang around long and are washed out. Those you need to eat regularly. That's why the early sailors got scurvy. They didn't know you had to eat something with C in it, and after a couple month voyage, their teeth started falling out. The English discovered this and stocked up their vessels with limes, why they are called "Limey's" today, and thus had a large military advantage over other nations as their vessels could stay out at sea longer and their sailors would be in better battle condition than other nations.

 

So, to answer your question, there is no answer. If it makes you feel better, go for it.

 

I don't really believe in the vaccines either, at least for me. I will take a vaccine if it's free and somehow I'm there anyway, otherwise, I don't bother with them. They may help certain high-risk groups, but I have doubts about that too.

 

[littlecanoe]

Looks like I'm back where I started.

 

I may give it a try next year. Maybe I'll at least get some psychosomatic benefit...............

[AzRednek]

Well, you can probably find studies that will show anything you want, depending on who paid for it.

 

Myself being involved in a drug study. Pardon the colloquialism but ain't that the truth. Seems like all they want to hear about are the beneficial effects. They don't seem very interested in the undesirable side effects I'm still dealing with months later. I shouldn't complain though, if it hadn't been for an experimental drug stimulating my stem cell production I would have been toasted or pushing daisies by now. My life was on the line and a drug saved my life. I'm now a born again supporter of the drug manufactures.

 

 

 

 

 

 

 

 

[Jimro]

To build on what Dr. Hess has posted,

 

Vitamins function as co-enzymes. Vitamin C works by activating the prolylhydroxylase enzyme. That's a fancy way of saying that it modifies the collagen proteins so that your connective tissue functions as planned. All enzymes catalyze chemical reactions, that is all they do. (edit: cellular signaling pathways can be triggered by enzyme activity, but pretty much every molecule has some signaling cascade associated with it.)

 

Some vitamins also function as "anti-oxidants" which mean that they have a spare electron to donate to a another molecule that has been oxidized. However studies have shown that large doses of anti-oxidants provide no added benefit.

 

The bottom line is that taking your vitamins doesn't hurt and probably does you good.

 

Jimro

[littlecanoe]

My biggest concern would be doses. What amount would be advisable and what would be too much? Can excessive D3 cause toxicity or other undesirable effects?

[Jimro]

I wouldn't worry about overdosing from a multivitamin supplemented with a Vitamin D pill.

 

You would have to take hundreds of pills to hit the LD50 for Vitamin D. LD50 means a Lethal Dose for 50% of the test population (usually mice).

 

Jimro

[Dr.Hess]

Be careful with the vitamin D, though. Jim, I dunno if you can get to Medscape, but

http://www.medscape.com/viewarticle/588002_1

is a case study of vitamin D toxicity.

 

--------------

Subsequently, the patient reported that, when she had complained of generalized fatigue before her hospitalization, her relatives had recommended that she purchase an OTC prescription vitamin supplement, Soladek (Indo-Pharma, S.A., Dominican Republic) (Fig. 1). Five milliliters of Soladek contains 120,000 IU of vitamin A, 600,000 IU of vitamin D, and 5.0 mg of vitamin E. She had consumed 2 vials of 5 mL initially and 1 vial weekly for 10 more weeks until her hospital admission.

 

Our case involves a foreign prescription medication that is sold without a prescription in the United States. Soladek is sold as an OTC supplement, without dosing information, instructions for use, or any warning about potential toxicity. Our patient was able to purchase it in a New York grocery that caters to immigrants from the Dominican Republic. Ingestion of this product can result in severe hypercalcemia, as substantiated in our patient.

 

Popular lore, as reflected in a computer search using Google, is that Soladek controls pain, prevents colds and viruses, and enhances general conditioning and muscle strength. Apparently, it has also been used by professional athletes as a performance-enhancing drug.[2]

 

The use of herbal alternative supplements in the United States has been on the rise since the 1990s.[3] The risk of taking such OTC supplements is well documented. Studies have shown that most patients do not report the use of alternative treatments to their physicians, even if concomitant conventional medications are used.[4,5] Our patient denied the use of OTC supplements during her initial interview, but she subsequently admitted to taking Soladek after she was found to have a substantially increased blood level of 25-hydroxyvitamin D. The daily requirement of vitamin D for adults is now believed to be 1,000 to 2,000 IU (personal observation). In contrast, however, our patient ingested 600,000 IU with each vial of Soladek.

 

As osteoporosis prevention awareness increases in the general population, more vitamin D and calcium supplements are use, with or without physician supervision. Vitamin D intoxication with OTC supplements has been described in both the adult and the pediatric population.[6-11]

 

Vitamin D intoxication is characterized by elevated blood levels of 25-hydroxyvitamin D, suppressed PTH levels, and the presence of hypercalcemia, hypercalciuria, and hyperphosphatemia. Vitamin D is stored in adipose tissue and is cleared rather slowly, as reflected in Figure 2.

--------------

 

So here was a woman that was taking 1 over the counter suppliment a week called Soladek and she went toxic. I dunno how many IU (International Units) are in a typical Vitamin D suppliment, but be watch out. One a day won't hurt you, and a couple a day most likely won't either, especially for a week, but a hundred might be a bad thing. Also, if you're on Retin-A, you can go toxic from rather low doses of Vitamin D supliments.

 

[littlecanoe]

Gentlemen, Thanks for the feedback and discussion on this topic.

[Jimro]

Dr. Hess,

 

That is an insane amount of vitamin D.

 

Animal data indicates signs of toxicity can occur with ingestion of 0.5 mg/kg (20,000 IU/kg ), while the oral LD50 for cholecalciferol in dogs is about 88 mg/kg, or 3,520,000 IU/kg.

 

That means she was taking 15mg of Vitamin D per dose, with an initial dose of 30 mg. That means the very first dose if the patients mass was under 60kg (132 lbs) she hit the agreed upon threshold for Vitamin D toxicity. Since Vitamin D is a fat soluble vitamin it clears from the body slowly.

 

A normal multi-vitamin isn't going to have more than a few hundred IU's of Vitamin D, and a vitamin D pill normally runs in the 1,000 to 2,000 IU range. Say a daily total dose of 1,400 IU's.

 

To equate those levels of Vitamin D to what that lady took on her initial dose, you would have to take 857 multivitamin pills, and 857 1,000 IU Vitamin D pills. Normal people don't swallow 1714 pills in a session.

 

In the words of Paracellus, "The dose makes the poison". After all, even good old water is lethal in sufficient doses.

 

Jimro

[AzRednek]

Gentlemen, Thanks for the feedback and discussion on this topic.

 

Without sounding like a complete numb-skull I always thought, at least here in central Arizona, we got sufficient Vitamin D via sunlight and dairy products. When I was hospitalized I was given massive doses of vitamins. When I complained to the chemo RN about the vitamin stench in my urine. She said the unique thing about vitamins is one's body rejects excess vitamins and only keeps what is needed. She assured me I wasn't being over dosed and it was perfectly normal to piss away the excess my body can't use or store.

[Jimro]

Vitamin D needs solar radiation to break a strong carbon ring structure, and if you spend plenty of time outdoors you probably have more than enough. Most people don't need vitamin supplementation, but it falls into the realm of "doesn't hurt, probably helpful".

 

Jimro

 

 

[littlecanoe]

It sounds as though consistent use of a good multivitamin is about all you need to worry about.

 

How do the people in the extreme north fare when they have near darkness for 24 hrs a day? Is there a greater problem for them with synthesis and uptake?

[Jimro]

Vitamin D is plentiful in fish like salmon and cod and red meat from ruminants, so even in northern climes you can get your daily dose by eating tasty animals.

 

In fact a healthy diet including fish and lean red meat with lots of vegetables and whole grains is probably better for you than eating crap and taking a multivitamin....

 

Jimro