Vitamin D

[Tom_K]

Study: Vitamin D Reduces Cancer Risk
By TIMBERLY ROSS and JEFF DONN (Associated Press Writers)
From Associated Press

June 07, 2007 11:15 PM EDT

OMAHA, Neb. - Building hope for one pill to prevent many cancers, vitamin D cut the risk of several types of cancer by 60 percent overall for older women in the most rigorous study yet.

The new research strengthens the case made by some specialists that vitamin D may be a powerful cancer preventive and most people should get more of it. Experts remain split, though, on how much to take.

"The findings ... are a breakthrough of great medical and public health importance," declared Cedric Garland, a prominent vitamin D researcher at the University of California-San Diego. "No other method to prevent cancer has been identified that has such a powerful impact."

While the most reliable yet, the study does have drawbacks. It was designed mainly to monitor how calcium and vitamin D improve bone health, and the number of cancer cases overall was small, showing up in just 50 patients.

"It's a very small study," said Dr. Edward Giovannucci, who researches nutrition and cancer at the Harvard School of Public Health. "I don't think it's the last word."

In either case, the study takes an important step in extending several decades of research that began with observations that cancer rates among similar groups of people were lower in southern latitudes than in northern ones. Scientists reasoned that had to do with more direct sunlight in southern regions.

The skin makes vitamin D when exposed to sunlight's ultraviolet rays. This study used that same form of the vitamin, known as D3 or cholecalciferol. Multivitamins usually carry a much weaker variant known as D2, but D3 is available in stand-alone dietary supplements.

Earlier research has shown that vitamin D helps regulate cell growth, a fundamental biological process that goes haywire in cancer. Most other supplements have tended to target specific types of disease in early testing, like selenium or vitamin E for prostate cancer.

This study, published Friday in the American Journal of Clinical Nutrition, is the first time that researchers significantly boosted - and measured - blood levels of vitamin D and then followed identical groups of patients from start to finish.

That's why, despite its modest size, the research was generating excitement. Nearly all other work has compared disparate groups of patients.

The researchers at Creighton University in Omaha focused on 1,179 seemingly healthy women with an average age of 67. The women were divided into three groups: 446 got calcium and vitamin D3 supplements, a similar number got calcium alone, and 288 took dummy pills.

The research team gave 1,000 daily international units of vitamin D, more than current guidelines calling for 200 to 600 units depending on a person's age.

The researchers intended to check mainly for the effects of calcium on bone health. Their interest in cancer risk was secondary.

But the lower cancer risk stood out. Only 13 women, or 3 percent, developed cancer over four years of calcium and vitamin D supplements. With calcium alone, 17 women, or 4 percent, got cancer. With dummy pills, cancer appeared in 20 women, or 7 percent.

That shows a 60 percent lower cancer risk over four years in the group taking both supplements, compared to patients taking placebos. And when the first-year cancers were excluded - the ones mostly likely present before the study began - the findings were stronger still: a 77 percent lower risk for the combo group.

While the calcium-only group lowered its four-year cancer risk by 47 percent compared to the untreated group, it did no better when early cancers were excluded. That suggests calcium alone may have done little in this experiment, the researchers said.

Experts reviewing the study focused on vitamin D as the powerful agent in the combo group, but it can't be ruled out that calcium might somehow amplify the effect of vitamin D.

While numbers were limited, these women developed a broad range of cancers, including disease of the breast, colon, lungs and blood. Dr. Michael Holick, of Boston University Medical Center, who sat on the professional panel that issued the 1997 guidelines for vitamin D, said this study shows that enough vitamin D "markedly reduces the risk of developing the most serious deadly cancers."

He supports raising the recommended amount of the vitamin and said 1,000 daily units of vitamin D3 would now be reasonable for most people.

On the other hand, Dr. Michael Thun of the American Cancer Society favors keeping the current recommendation of 200 to 600 IUs for now. And he cautioned that more than 2,000 units is viewed in the guidelines as potentially dangerous.

Joan Lappe, the study's lead researcher, said it "just adds to the great bunch of evidence that we need to have better vitamin D nutrition." Some foods carry the vitamin, like salmon, tuna and fortified milk, but diet accounts for little of the vitamin circulating in the body. Overexposure to the sun can cause skin cancer.

Still, people should consult their doctors before boosting their vitamin dosage, several experts also warned.

More study is needed to determine if the effects in this study hold true for large groups of people and men as well as women.

[Tom_K]

Dearth of Vitamin D
June 14th, 2007 by Helen

Dearth of Vitamin D


Many of us are not getting enough vitamin D. The dearth of this wonder vitamin has transpired due to the consumption of depleted industrialized foods coupled with an overzealous adherence to the anti-cancer slip,slop and slap campaigns of the past twenty-five years. The consequences of this vitamin deficiency are proving to be considerable and of great human and social cost.


Last week, media reports alerted us to the fact that there exists a link between vitamin D and Multiple Sclerosis. MS is a disabling neurological condition affecting 20,000 Australians and growing at a rate of 8% per annum.The disease affects mostly young people with women in their twenties and thirties who are juggling careers and families being affected three times more often than men.


And it also appears that vitamin D has a huge role to play in cancer prevention. Joan Lappe, a professor of medicine has conducted a four year study in which she found that large doses of vitamin D may reduce the risk of cancer. Women who took calcium and a dose of vitamin D almost three times the US Government’s recommended daily intake for middle-aged adults saw a 60 per cent lower incidence of all cancers than women not taking the vitamin.


So what is Vitamin D?

Vitamin D is a fat-soluble vitamin that dissolves in and can be stored by fat deposits in the body and is commonly found in oysters, mackerel, sardines plus generous amounts of butter, egg yolk, butter and cod liver oil. Vitamin D is also synthesized by sunlight acting on the skin.


Then what is the problem? Don’t we have a plentiful supply of sunshine and loads of fish and dairy products. Yes we do, but once again we have listened to well- meaning, but detrimental health campaigns and neglected our dietary history.


Over the past few decades western diets have tended to ignore the lessons observed from history where traditional diets included lots of saturated fats supplying varying amounts of vitamin D. Primitive peoples instinctively chose vitamin-D-rich foods including the intestines, organ meats, skin and fat from certain land animals, as well as shellfish, oily fish and insects.

On the other hand our modern diets have tended towards the processed low-fat diets leading to vitamin D deficiency and other nutritional disorders.


Vitamin D can also be synthesized in the skin during sun exposure, but precise amounts of sun exposure are difficult to pinpoint since they depend on a person’s skin type and age, as well as on latitude, season, time of day, and amount of skin exposed. The ultraviolet wavelength that stimulates our bodies to produce vitamin D is UV-B. UV-B initiates beneficial responses, stimulating the production of vitamin D that the body uses in many important processes.Latitude and altitude determine the intensity of UV light. UV-B is stronger at higher altitudes. Latitudes higher than 30° (both north and south) have insufficient UV-B sunlight two to six months of the year, even at midday.


The skin cancer campaigns of the last 25 years have been over effective in that we have been far too vigilant in protecting our skin from the sun’s rays. Schoolchildren of today play with their faces and other parts of their bodies shielded from the sun, missing out on the UV-B rays and most adults work longer hours inside than ever before. So depending on sunlight for sufficient vitamin D production can be tricky.


Factors such as geography and skin color plus decades of adhering to messages of sun avoidance and wearing sun blockers combined with reduction in food sources due to changing dietary habits have contributed to escalating vitamin D deficiencies.


Vitamin D is very important for the health and wellbeing of us all. One of its vital roles is the regulation of levels of calcium in the blood. It also plays an important role in regulation of the immune system and may protect against both Type I and Type II diabetes. The latest research that large doses of vitamin D may reduce the risk of cancer is welcome in that the remedy is relatively simple. The role of Vitamin D in preventing cancer can be explained by its ability to inhibit cell growth and proliferation and thus it is likely that it can prevent cells becoming cancerous or slow down the rate of tumor growth or maybe both.


In the case of the autoimmune system disease, multiple sclerosis, it is known that active vitamin D interacts with cells of the immune system and very likely plays an anti-inflammatory role in the body.

The incidence of MS is nearly zero in equatorial regions and increases dramatically with latitude where inadequate sun exposure exists for vitamin D synthesis.


As so often happens the cure is simple and inexpensive. Old fashioned cod liver oil contains more vitamin A and more vitamin D per unit weight than any other common food with just a tablespoon a day providing well over the recommended daily allowance for both nutrients.

www.informyourself.com.au

[jody13]

Very good report and very true. Our sun screen is not good for more than one reason. . The medical community will fight the D report  because cancert is a money making businessd, for the doctors and the drug compaies. Simple things kike sunlight, cod-liver oil and many more are much better than chemo and radiation. I have seen nieghbors die and are dieing because the doctors don't know any thing but chemo and radiation. Herbs will cure lots of problems as well.  A simlpe thing like Vit D could do wonders. Jody13

[Tom_K]

 Public release date: 6-Oct-2008
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Contact: Rosanne Riesenman
mediaonly@acg.gi.org
301-263-9000
American College of Gastroenterology

Vitamin D deficiency common in patients with IBD, chronic liver disease
Vitamin D replacement may be necessary to reverse deficiency-related bone loss
Orlando, FL, Oct 6, 2008 – New research presented at the 73rd Annual Scientific Meeting of the American College of Gastroenterology in Orlando found patients with inflammatory bowel disease or chronic liver disease were at increased risk of developing Vitamin D deficiencies. Two separate studies highlight the importance of regular Vitamin D checkups in the evaluation of patients with certain digestive diseases.

For IBD Patients, Vitamin D Deficiency Associated with Lower Quality of Life and Higher Disease Activity

Researchers at the Medical College of Wisconsin investigated whether Vitamin D deficiency in patients with IBD is associated with a lower quality of life or higher disease activity independent of other known risk factors and medication use.

Disease activity and quality of life were assessed using validated questionnaires, which were administered at every clinic visit. The researchers also looked at the prevalence and seasonality of Vitamin D deficiency in this inflammatory bowel disease population, as well as its association with IBD-related hospitalizations, surgeries and medication use.

This retrospective cohort study conducted by Dr. Alex Ulitsky and his colleagues analyzed vitamin D levels of 504 inflammatory bowel disease patients. They recorded the patients' lowest Vitamin D measurements and date when each low measurement was taken.

Dr. Ulitsky and his team found almost 50 percent of the patients were Vitamin D deficient at some point, with 11 percent being severely deficient. Vitamin D deficiency was not significantly associated with being hospitalized for IBD or having IBD-related surgeries. However, in both Crohn's disease (CD) and ulcerative colitis (UC) patients, vitamin D deficiency was independently associated with having increased disease activity scores compared to those with normal levels of Vitamin D. Vitamin D deficient CD patients, but not UC patients, had worse quality of life when compared to patients who were not Vitamin D deficient.

According to Dr. Ulitsky, "All IBD patients, irrespective of their disease, disease location or nature should have their Vitamin D levels checked regularly and corrected aggressively when insufficiency is found."

Vitamin D Deficiency Prevalent in Patients with Chronic Liver Disease

Researchers from the University of Tennessee in Memphis measured the vitamin D levels of 118 chronic liver disease patients. Researchers found 92.4 percent of chronic liver patients had some degree of vitamin D deficiency and at least one third were severely deficient. Severe vitamin D deficiency was more common among cirrhotics.

"Since deficiency is common among these patients, Vitamin D replacement may hopefully prevent osteoporosis and other bone complications related to end stage liver disease," said lead researcher Dr. Satheesh P. Nair.

The study included 43 hepatitis C patients with cirrhosis; 57 hepatitis C patients without cirrhosis; 18 cirrhosis patients without hepatitis C. The severity of vitamin D deficiency was divided into three groups: mild (between 20-32 ng/ml), moderate (between 7-20 ng/ml), and severe (less than 7 ng/ml).

Importance of Vitamin D and Bone Health

Vitamin D, a fat-soluble vitamin, helps the body absorb calcium and plays a crucial role in the growth and maintenance of strong, healthy bones. A lack of vitamin D causes calcium-depleted bone, which can weaken the bones and increase the risk of fractures resulting from osteoporosis.

A diet rich in vitamin D, such as fish, eggs, fortified milk, and cod liver oil, is essential to maintaining good bone health.


###
About the American College of Gastroenterology

Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of more than 10,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist through its emphasis on scholarly practice, teaching and research. The mission of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically sound, humanistic, ethical, and cost-effective health care to gastroenterology patients.

The ACG is committed to providing accurate, unbiased and up-to-date health information. Visit the ACG Web site www.acg.gi.org to access educational resources for patients and their families spanning the broad range of digestive diseases and conditions - both common and not-so-common. Organized by disease, state and organ system, these educational materials, developed by ACG physician experts, are offered for the information and benefit of patients and the public.

[H4HC]

Part of our problem with vitamin D is that, as a fat soluble vitamin, fat is necessary in absorption of the vitamin. All food sources rich in vitamin D are also rich in fat, seafood, butter, etc. Our society has been afraid of fat for the last 50 years and, in running from fat we also run from vitamin D.

Vitamin D synthesized at the skin requires cholesterol. As we have attempted to lower our cholesterol through drugs, we also lower our ability to synthesize this form of Vitamin D. Turning cholesterol and saturated fats into villains has done more to contribute to vitamin deficiency than almost any other factor in the last 50 years.

[DougV]

Skin doesn't just require cholesterol to synthesis Vit. D, it also requires sunlight.  But yeah, we do require a certain amount of fat in a diet, but you know the reality if we require a ton of things in our diet, and with the economy I suspect you'll see more dietary issues as it seems the things most healthy for you are also the most perishable and expensive.

Doug

[Hank's mom]

That's the sad truth about the economy. Fresh produce is a killer, costs more, sometimes a lot more, and it does need to be used sooner. One thing I have found is that making something like a slaw is a good way to make fresh produce last longer - not forever,  but longer.

This is the healthy choice recipe I was given and it's really good: mixed slaw ingredients including other fresh things to shred, dried craisins, nuts and sunflower seeds are nice, sprouts would work, marinate it a mix of 1/2 cup cider vinegar, 1/2 cup water. 1/4 cup sugar, black pepper, celery seed or whatever you like flavorwise. Nuke mix for 1 minute, pour over ingredients.

Fruit salads are another good way to get the most out of fruit that might be about to turn. We have been making apple or apple/cranberry, or apple/pear sauce from past their prime apples and pears all winter. I leave the skins in and add sugar only for cranberries depending on how many of them I add, then when the sauce is done I can strain out the sauce, but have already gotten the extra vitamins and flavors out so it's only a matter of taste. A good food processor will blend the skins right in. (Mom can't deal with that much of the skins in her diet so I take them out.) The other nice thing is I can save on the day old stuff at the store.

I always prefer dietary changes over pills and powders. Hope those are helpful suggestions.

Susie

[Ella]

The current trends are proving you right H4HC.  The obssession with sunscreen and lowering cholesterol has probably contributed to many cases of colorectal cancer - and other types of cancer.  Someone in Australia has now cottoned on to that fact, and vitamin D supplementation is recommended, after they found that the majority of people tested over here have mild to moderate and sometimes severe Vitamin D deficiency.  It seems that drugs used to lower cholesterol also adversely affect the liver.

[Pancho and Lefty]

Interesting perspectives.

As far as the American public, I can't see much indication of fat reduction in 'typical' diets. The obesity epidemic isn't being fueled by eating carrots and green beans.

I believe people find it easier to take a pill to lower cholesterol than eat a balanced diet and exercise the organism. 

[DougV]

I don't need a pill for the balanced diet part, in fact try to balance the diet as to avoid the pills.

BUT, if they ever invent the exercise pill, now that I'm taking, 'cause that's the part I don't do so well. 

Doug

[willy]

There have been a few Vit D threads.  I think that I'll add to this thread or spice a few more to this thread in alternatives.

Here is a new article on Vitamin D; this continues to look like a valuable supplement for us heppers and it may particularly be worth getting checked or bolstering ones intake prior to TX.  I am wondering if the levels set by the FDA would apply where one has a virus like HCV.  This information also explains a little to me why I often don't feel as well in the winter and seem to be healthier in the summer when I am working all the time outside.  I know that it seems as though the connection would have been found out sooner, but many of us actually move inside when it is really sunny (and hot).  Further, many of us as we age may spend less time outside.  Finally, due to the fear of skin cancer some people have been covering up more and wearing more sun block, resulting in lower Vit D levels. - willy

http://www.hivandhepatitis.com/2010_conference/easl/docs/0518_2010_b.html



Vitamin D Increases Sustained Response to Interferon-based Therapy for Hepatitis C, May Improve Liver Fibrosis
                  
SUMMARY: Vitamin D supplementation increased the likelihood of sustained response to pegylated interferon plus ribavirin therapy for chronic hepatitis C, leading researchers to suggest that vitamin D deficiency may help explain well-known racial/ethnic disparities in treatment response, according to a presentation at the 45th Annual Meeting of the European Association for the Study of the Liver (EASL 2010) last month in Vienna. A recently published related study found that low vitamin D levels were associated with more severe liver fibrosis and poor treatment response.
      
            

By Liz Highleyman

In the EASL study, S. Abu Mouch and colleagues from Israel assessed whether adding a vitamin D supplement to standard hepatitis C therapy using pegylated interferon plus ribavirin could improve rates of sustained virological response (SVR), or continued undetectable HCV viral load 24 weeks after completion of treatment.

Vitamin D is a potent immune modulator that has a direct effect on T-cells and antigen-presenting immune cells, and can directly or indirectly influence the differentiation and activity of CD4 T-cells, the researchers noted as background. They hypothesized that vitamin D has an important role in innate immune response against HCV. In addition, some studies have shown that vitamin D improves insulin sensitivity (a predictor of better treatment response) and inhibits HCV replication.

The investigators first measured vitamin D levels in a group of 157 chronic hepatitis C patients treated at their liver clinic in Israel, and found that fully 84% had low levels, and one-third had "severe deficiency."

They then performed a randomized study of 67 patients. About half were men, the average age was 48 years, and most were of Russian origin, with only a few being of Israeli or Arabic origin.

Participants were randomly assigned to receive 1.5 mcg/kg pegylated interferon alfa-2b (PegIntron) plus 1000-1200 mg/daily weight-adjusted ribavirin for 48 weeks, with or without 1000-400 IU/day vitamin D3, enough to bring serum levels up to 32 ng/mL. By chance, patients in the vitamin D group were more difficult to treat than those in the control group, having a higher body mass index and larger percentages with high baseline viral load and advanced liver fibrosis.

Results
   44% of participants receiving vitamin D achieved rapid virological response (undetectable HCV at week 4), compared with 18% in the control group (P < 0.0001).
   94% of participants in the vitamin D group achieved complete early virological response (undetectable HCV at week 12), compared with 48% in the control group (P < 0.0001).
   85% of patients in the vitamin D group achieved SVR, compared with 43% in the control group (P < 0.001).
   Adverse events were mostly mild and were typical of those associated with pegylated interferon/ribavirin (mainly flu-like symptoms).
   No serious adverse events were reported.

These findings led the investigators to conclude that adding vitamin D supplements to pegylated interferon/ribavirin therapy for treatment-naive genotype 1 patients with chronic HCV infection significantly improves SVR rates.

They further suggested that vitamin D deficiency may contribute to the strong racial/ethnic disparity observed in responses to antiviral therapy for HCV. People of African descent -- and to a lesser extent Latinos -- do not respond as well as whites and Asians to interferon-based therapy.

People with darker skin produce less vitamin D when exposed to the sun, and are therefore more likely have low levels. The 2000-2004 National Health and Nutritional Examination Survey (NHANES), for example, found that U.S. non-Hispanic whites had average vitamin D levels nearly 10 nmol/L higher than those of Mexican-Americans, who in turn had average levels more than 10 nmol/L higher than non-Hispanic blacks.

Treatment Response and Fibrosis

In the second study, published in the April 2010 issue of Hepatology, S. Petta and colleagues from Italy looked at the association between vitamin D levels and histological and virological response to interferon-based therapy.

Adding to the mechanisms described by Abu Mouch's group, the study authors noted that vitamin D also can potentially interfere with inflammatory responses and fibrogenesis (formation of fibrous scar tissue).

This study included 197 patients with genotype 1 chronic hepatitis C and 49 healthy HCV negative control subjects matched according to age and sex. Most of the hepatitis C patients (167) were treatment with pegylated interferon plus ribavirin.

Levels of 25-hydroxyvitamin D were measured using high-pressure liquid chromatography. Tissue expression of cytochrome P450 25-hydroxylating liver enzymes (CYP27A1 and CYP2R1) were assessed in 34 hepatitis patients and 8 control subjects.

Results
   Serum 25-hydroxyvitamin D levels were significantly lower on average in chronic hepatitis C patients compared with healthy control subjects (25.07 vs 43.06 mcg/L; P < 0.001).
   Lower vitamin D levels were independently associated with female sex and liver necro-inflammation.
   Levels of CYP27A1, but not CYP2R1, were directly related to vitamin D levels and inversely correlated with necro-inflammation.
   Independent predictors of severe liver fibrosis or cirrhosis (stage F3-F4) included:
     
   Liver necro-inflammation (OR 2.235);
   Older age (OR 1.043);
   High ferritin (a protein that stores iron) (OR 1.003);
   Low cholesterol (OR 0.981);
   Low 25-hydroxyvitamin D (odds ratio [OR] 0.942).
   Overall, 70 patients (41%) achieved SVR.
   In a multivariate analysis, factors independently associated with poor response, or failure to achieve SVR, included;
     
   Lower 25-hydroxyvitamin D (OR 1.039);
   Lower cholesterol (OR 1.009);
   Liver steatosis (fatty liver) (OR, 0.971).

Based on these findings, the study authors concluded, "Genotype 1 chronic hepatitis C patients had low [25-hydroxyvitamin D] serum levels, possibly because of reduced CYP27A1 expression."

"Low vitamin D is linked to severe fibrosis and low SVR on interferon-based therapy," they added.

Investigator affiliations:

    Abu Mouch study: Hepatology Unit and Internal Medicine B, Hillel Yaffe Medical Center, Hadera, Israel; Faculty of Medicine, Technion, Haifa, Israel; Gastroenterology, Hillel Yaffe Medical Center, Hadera, Israel; Liver Unit, Ziv Medical Center, Safed, Israel.

    Petta study: Cattedra ed Unità Operativa di Gastroenterologia, DiBiMIS, University of Palermo, Italy; Dipartimento di Biopatologia e Metodologie Biomediche, University of Palermo, Italy; IBIM Consiglio Nazionale delle Ricerche, Palermo, Italy; Dipartimento di Biotecnologie Mediche e Medicina Legale Sezione Chimica e Biochimica Medica, University of Palermo, Italy; Cattedra di Anatomia Patologica, University of Palermo, Italy; Dipartimento di Medicina e Gastroenterologia, "Alma Mater Studiorum," University of Bologna, Italy.

5/18/10

References
S Abu Mouch, Z Fireman, J Jarchovsky, and N Assy. Vitamin D supplement improve SVR in chronic hepatitis C (genotype 1) naive patients treated with peg interferon and ribavirin. 45th Annual Meeting of the European Association for the Study of the Liver (EASL 2010). Vienna, Austria. April 14-18, 2010. (Abstract).

S Petta, C Camma, C Scazzone, and others. Low vitamin D serum level is related to severe fibrosis and low responsiveness to interferon-based therapy in genotype 1 chronic hepatitis C. Hepatology 51(4): 1158-1167 (Abstract). April 2010.

[Hank's mom]

Hi All-

Wow, it's been along time or felt that way since the last time I posted in this thread. I recently was put on vitD liguigels once a month. Had to write on the vial to remember that - 2nd of every month for 4 months. We gave a whirl at some intense liquid that will never pass these lips again, easy to take that one step further, tossed that real quick. But now that spring/summer is here, I'm in the sun as much as possible. Everyone thinks I was a good long vaca. (Nice way to cover my winter hermit status.) It's just that the Northeast has short days and a lot of bad weather fall/winter, so we have to make up for it. Thing about D is that it is only fat soluble so it takes that much more time to be in your body safely with a bad liver. I try to get it from foods as much as possible. The balance can get thrown off, but there are ways to take care of the problem dietarily. Of course as a liver decompenstates, things can change daily and there is not much you can do but trust and adjust thru meds, or whatever. Having had adjustments because of changes in my body stinks - you find out afterward, when you already are miserable, mean or worse.

That's all I've got.

Susie

[robin]

Hmmmm...this article was timely in that during treatment, they discovered I was in chronic renal insufficiency (stage 3 on a 5 stage scale)and have moderately severe hypoparathyroidism. Now I am taking zemplar (for the hypoparpathyroid) and Vit. D in prescription strength (extremely expensive) through my renal doctor.

Mine is a double edge sword because I have been a vegetarian for about 40 years and with the renal insufficiency, it is difficult to determine why I would be deficient in Vit. D. Normal per my lab is 30-80 and mine was 12.

Thanks for your research and keep your spirits high...robin

[glory]

Robin is your renal issue related to your anti-rejection meds?  I know sometimes this can happen.  Praying it all resloves.

[robin]

Not sure if renal problems are because of anti-rejection meds or due to my having been a vegetarian most of my life...at least the last 35 years of it. Probably a combination of both. I know Vit. D is very expensive in the form I take and for some reason, can't just use over the counter and there isn't a generic form. Kidneys are doing pretty good, most of the time. Thank you for asking.
Keep your spirits high...robin