The Amazing Curative Powers of High-Dose Vitamin D in Aging and Autism

In a comment to my post “Vitamin D Dysregulation in Chronic Infectious Diseases,” Charles Colenaty, who is in his 80s, reports that high doses of vitamin D, assisted by curcumin, have cured his high blood pressure, age-related macular degeneration, bone and tooth decay, enlarged prostate, and graying hair:

Stumbled upon your site while searching for information abouit vitamin d dysreguiation and was so impressed that I had to tell you so. You gave me a much more comprehensive insight into some of vitamin D’s ecosystem that I had never imagined might be the case.

All of which prompts me to mention my vitamin D enigma that has my doctor stumped. When I retired 15 years ago as a consulting psychologist I moved from the San Francisco Bay area to the Seattle area to be close to my son. Then I got so caught up in using the computer to follow a range of interests that I seldom got out of doors — and the latitude here limits the D I could get from sunlight anyway — and I get virtually no vitamin D from my diet since I am allergic to seafood. The upshot was that as I moved into my 80’s I was confronted with a variety of physical changes that that I now think were due to severe vitamin D deficiency. Three or four teeth just crumbled over a period of a month or so, I developed adult scoliosis, and my blood pressure (always a bit high) went out of control, hitting the 190’s and low 200’s. I refused blood pressure pills since I had previously been damaged by them, and instead began taking increasing amounts of vitamin D. When I hit 15,000 a day it began to drop, and settled at the 150 to 175 range. Three months ago my vitamin D level was measured as part of a yearly physical exam, and when my doctor found that my NgL level was 92 he said that he had never seen one that high and asked me to cut my intake to 10,000 units for starters. I had tried to do that three times previously, and my blood pressure went back up the first two times and the third time my face began to swell. This fourth time didn’t work either, with my blood pressure going up after a few days of starting. I stuck it out for two weeks and then went back to the 15,000 IUs. But, as opposed to my three earlier tries, when blood pressure was back to my normal in a week, this time it took a six weeks before the blood pressure came down again. So the enigma that I have has to do with this weird relationship between my vitamin D “requirement” and my blood pressure.

Otherwise I feel better than fine. My Google research led me to a curcumin program a while back and that has brought back my original dark brown hair color, and recently I found that I now longer had to get up to go to the bathroom every night(as has been the case for years). And as of a week ago I found that my prostate is shrinking. More importantly, the AMD I have in both eyes is gradually reversing to the point where I no longer am a member of the enlarged print gang. So as far as I know everything is working fine and I don’t have a chronic anything!

These conditions rarely regress on conventional medical treatments, so to achieve this degree of success is a medical miracle.

Like Charles’s doctor, I was stumped by this at first, but then I thought to look up some other case reports of patients who benefited from super-normal 25OHD. Autism reports from Dr. John Cannell of the Vitamin D Council gave me an idea that might solve Charles’s enigma.

Background on Vitamin D

For most people, health is optimized by obtaining about 4,000 IU/day of vitamin D3 from sun or supplements, leading to a serum 25-hydroxyvitamin D (25OHD) level of 35 to 50 ng/ml in people of Eurasian ancestry or 30 to 40 ng/ml in people of African ancestry.

Not long ago I did a post on the characteristic pattern of vitamin D dysregulation in chronic infections. In chronic infectious diseases, low 25OHD is often found with elevated levels of the more active metabolite 1,25-dihydroxyvitamin D (1,25D). Possible mechanisms for this include:

  • Infections making cell membranes leaky to 1,25D, causing it to spill out of cells into the blood, thus reducing activation of the nuclear membrane’s vitamin D receptor (VDR).
  • Infections obstructing or downregulating the VDR, causing the body to attempt to upregulate VDR activation by increasing conversion of 25OHD to 1,25D. Both forms of vitamin D are active ligands for the VDR, but 1,25D is far more active, so converting 25OHD to 1,25D means more activation of the VDR.

Inventing ways to block the VDR or move 1,25D out of the cell would be fitness-enhancing mutations for bacteria or viruses, since activation of the VDR triggers production of antimicrobial peptides that are central to intracellular immunity. Since bacteria evolve a lot faster than humans, it should be no surprise that pathogens have been able to evolve these capabilities.

But Some Diseases Have The Opposite Pattern

But some people have diseases that produce the opposite pattern. In their diseases, “normal” 25OHD levels are associated with impaired health, while unnaturally high 25OHD levels normalize health.

Charles is a great example:

  • He is taking super-normal amounts of vitamin D: Sunshine alone will generally not produce sustained creation of more than 4,000 IU/day. (Yes, I know that 10,000 IU can be produced in half an hour in D-deprived individuals, but if that person went out in the sun every day vitamin D production would soon decrease.) So 15,000 IU/day is roughly four times the normal dose.
  • He is achieving super-normal levels of 25OHD that would probably be toxic for most adults. The maximum 25OHD levels achievable through sunshine vary among persons, but are generally between 48 and 80 ng/ml. [1] Moreover, human cells turn on the gene CYP24A1, which codes for the main vitamin D-degrading enzyme, at 25(OH)D levels below 100 ng/ml. [2] It seems that evolution has designed us to keep 25OHD levels around 50 ng/ml or lower – certainly below 80 ng/ml. So Charles’s 92 ng/ml is well above the levels achievable by natural methods.

Since both 25(OH)D production and degradation have been strongly selected for by evolution, we can be confident that in healthy people of reproductive age it’s not a good idea to supplement at 15,000 IU/day or drive serum 25(OH)D to 92 ng/ml.

And what limited clinical evidence we have supports that conclusion. Those tropical lifeguards who get their serum 25(OH)D levels up to 80 ng/ml? They have three times the rate of heart attacks of those with normal 25(OH)D. [3]

Aside:  Their high rate of heart disease may be due to vitamin K2 deficiency. Charles, please be sure to supplement vitamin K2, preferably a mix of MK-4 and MK-7 forms, along with your D.

Yet whereas healthy younger people would experience toxicity at Charles’s vitamin D dose or 25OHD level, Charles’s health improves.

Autism and Vitamin D

Let’s consider a few other cases where super-physiological 25OHD levels have cured diseases. Dr. John Cannell of the Vitamin D Council is the most prolific writer on the subject of vitamin D, and in his newsletter has collected a number of reports of diseases being cured by pharmacologic doses of vitamin D.

Here’s a sample case report of the recovery of an autistic child, from the January 2010 newsletter. My comments are italicized within brackets:

At age 2.5 years, between December 2007 and January 2008, my son experienced a fairly dramatic onset of symptoms that led to his diagnosis of autism….

Neither the DAN Doctor nor our pediatrician would write a prescription for a therapy light, so we purchased one on our own and found it made no discernible impact on his symptoms. [PJ: No matter how much sunlight or UV light the child is exposed to, it is not possible to raise 25OHD levels enough to impact the disease.]…

I … decided we would try a vitamin D supplement. Our pediatrician did not encourage any dose higher than 400 i.u. (that found in a typical multivitamin) but did write a script to have his 25-hydroxy level tested. In August his level was 37, so we started him on 5,000 iu daily [PJ: Since vitamin D needs scale by body weight and this is a young child, this is a very high dose – comparable to Charles’s 15,000 IU] and had his level retested on October 21st. By October his level was 96 ng/ml [PJ: A super-normal level, close to Charles’s 92 ng/ml] The pediatrician was concerned that this was too high and told us he should not have more than 400 iu per day.

Knowing that Nov–March are typically his worst months, we reduced the dosage down only to 3,000 iu from October through mid-December. At an appointment in December our son was doing wonderfully (none of his usual fall/winter symptoms yet evident) and the pediatrician told us 3,000 iu was too much and that we should be giving no more than 400 iu. In mid-December we reduced the dose to 1,500 iu. [PJ: This would still be a high dose for a normal 4 year old]  By the beginning of January we noted a marked loss of eye contact. [PJ:  But this “high” dose is insufficient] We also noted that our son was again interchanging his right hand for writing and eating (after using his left hand exclusively for 8+ months). We increased his vitamin D level to 4,000 iu daily in early January. On January 11 we had his 25-Hydroxy level checked on January 11 and found that it was 89. [PJ: Again, the disease is present at a “normal” 25OHD of 37 ng/ml but absent at a super-normal level around 90 ng/ml.] By the end of January, we and his grandparents noted improvement in his eye contact.

In January 2010 we attended his preschool conferences. The teacher had marked cards with the following code (1=age appropriate, 2=developing, 3=area of concern). Our son received 1s in all areas with the exception of hopping on one foot and balance beam where he received 2s. We were told that he is on par with or ahead of his peers in all areas (academic, fine motor, etc.), and that his teacher had noted no unusual symptoms or concerns.

So the child’s autism is essentially cured on super-normal doses of vitamin D that raise serum 25OHD to around 90 ng/ml.

Is it just a coincidence that Charles and the autistic child experienced a normalization of health at the same 25OHD level? And that in both cases, the normalization occurs after a few weeks of high-dose vitamin D supplementation?

Hypothesis:  Impaired Production of 1,25D from 25OHD

Let’s step back for a moment and think about what would cause health to normalize with super-normal 25OHD.

Suppose that for some reason, cells were unable to convert 25OHD to 1,25D. What would happen?

First, cells would have unusually low levels of 1,25D for any given level of 25OHD. Since 1,25D is more than a hundred-fold more active as a VDR ligand than 25OHD, this means that their level of VDR activation would be reduced. 

By how much?  In many cells, there seems to be a nearly equal balance between 25OHD and 1,25D activation of the VDR. As one paper notes:

the high serum concentration of 25(OH)D3 [500–1000 times higher than 1,25(OH)2D3] overcomes its low affinity for the receptor [500 times lower than 1,25(OH)2D3]. [4]

If the higher activity of 1,25D is almost precisely balanced by its lower abundance, then a cell’s loss of ability to make 1,25D will cut VDR activation in half.

So to restore VDR activation to normal levels, you would need to raise 25OHD to double normal levels: 70 to 100 ng/ml.

This would fit the cases of the autistic child and of Charles, both of whom reached normal health at around 90 ng/ml.

Genetic Defects: Pseudo-Vitamin D Deficiency Rickets

Mutations in the gene CYP27B1, which codes for the enzyme that turns 25(OH)D into 1,25D, create a disease called pseudo-vitamin D deficiency rickets (PDDR) or vitamin D-dependent rickets type I (VDDR I). [5]

PDDR is characterized by muscle weakness and rickets.

One nice thing about diseases caused by a single genetic defect is that they are easily reproduced in animals. PDDR can be reproduced in mice by knocking out the CYP27B1 gene.

CYP27B1 knockout mice are growth retarded, hypocalcemic, and have poor bone mineralization. The negative effects are all apparent at normal 25OHD levels of 36 ng/ml. But when the mice were given high doses of vitamin D, raising 25OHD levels to 144 ng/ml, their health was normalized. [4]

Other insights into inadequate 1,25D production have been obtained through mice deficient in vitamin D receptors. Their characteristics:

VDR mutant mice have growth retardation, osteoporosis, kyphosis, skin thickening and wrinkling, alopecia, ectopic calcification, progressive loss of hearing and balance as well as short lifespan. [6]

“Alopecia” is hair loss. “Kyphosis” is the familiar hunchback that many elderly develop. Osteoporosis is a familiar symptom of aging, as is loss of muscle, wrinkled skin, hardening of the arteries and stiffening of joints (“ectopic calcification”), loss of hearing and balance, and – approaching death.

These are all symptoms of a syndrome that is commonly called “aging.”

Here is what VDR knockout mice look like [7] (click to enlarge):

Note what happens when you can’t activate the VDR: hair loss, wrinkled skin. You get old before your time. VDR knockout mice die at an age of 10.6 months, compared to 20.5 months in wild-type mice. [7]

Our Cases Resemble PDDR

In his essay “Vitamin D Theory of Autism,” (http://www.vitamindcouncil.org/health/autism/vit-D-connection.shtml) Dr. Cannell notes similarities between PDDR and autism:

While no one has assessed afflicted [with PDDR] children for signs of autism, these children clearly display autistic markers such as hypotonia (flabby muscles), decreased activity, developmental motor delay, listlessness, and failure to thrive.

It is quite possible that autism results, as Dr. Cannell argues, from insufficient activation of the VDR during developmental ages. [8]

Similarly, what about the conditions Charles suffered from?  Tooth loss, bone mineral deficiencies, and scoliosis are all classic manifestations of rickets, and vitamin D deficiency is a known risk factor for high blood pressure and for arterial hardening. Finally, his recovery of hair color might be a result of restored vitamin D function:  the VDR promotes hair cycling. [9]

What Mechanisms Might Produce a CYP27B1 Deficiency in the Elderly?

It’s a safe bet that Charles does not have a genetic defect in CYP27B1. If he has a CYP27B1 dysfunction, it must have been acquired in old age.

What could have created the problem?  I don’t know, but speculation is permitted at PerfectHealthDiet.com. Two possibilities are:

  • Infection with a pathogen that interferes with CYP27B1. Pathogens have evolved ways to interfere with other human proteins in order to suppress the immune response. Since CYP27B1 creates 1,25D which enhances immunity, it would not be a surprise if some pathogen had evolved a way to interfere with CYP27B1.
  • Mitochondrial dysfunction. The enzyme coded by CYP27B1 operates in the inner mitochondrial membrane. Only in mitochondria can 1,25D be created. The “mitochondrial theory of aging” holds that mitochondrial decay is the primary cause of aging. Perhaps in elderly people suffering from mitochondrial dysfunction, CYP27B1 does not operate properly.

Conclusion

Whatever the mechanism of CYP27B1 loss-of-function may be, it appears that doubling 25OHD levels remedies much of the loss-of-function within a few weeks.

It might not be amiss for elderly patients and autistic children with symptoms of vitamin D deficiency to experiment with raising 25OHD to twice normal levels. In those with a CYP27B1 defect, this may produce an amazing recovery.

Further recovery might be possible. If the cause is infectious, appropriate antibiotics could help. If the cause is mitochondrial decay, then mitochondrial supplements might help.

The centrality of vitamin D function to optimal aging raises another thought. What if the main cause of aging is not the decay of mitochondria in general, but a specific decay in their support for 1,25D formation in the mitochondrial inner membrane? What if this loss of intracellular 1,25D is widespread among the elderly?

In that case, following Charles’s protocol and raising 25OHD in the elderly might significantly extend lifespans. And improve hair and skin at the same time!

Related Posts

“Vitamin D Dysregulation in Chronic Infectious Diseases,” http://perfecthealthdiet.com/?p=421, August 21, 2010.

References

[1] Heaney RP. Vitamin D in health and disease. Clin J Am Soc Nephrol. 2008 Sep;3(5):1535-41. http://pmid.us/18525006.

[2] Lou YR et al. 25-Hydroxyvitamin D(3) is an agonistic vitamin D receptor ligand. J Steroid Biochem Mol Biol. 2010 Feb 15;118(3):162-70. http://pmid.us/19944755.

[3] Rajasree S et al. Serum 25-hydroxyvitamin D3 levels are elevated in South Indian patients with ischemic heart disease. Eur J Epidemiol. 2001;17(6):567-71. http://pmid.us/11949730.

[4] Rowling MJ et al. High dietary vitamin D prevents hypocalcemia and osteomalacia in CYP27B1 knockout mice. J Nutr. 2007 Dec;137(12):2608-15. http://pmid.us/18029472.

[5] Takeda E et al. Vitamin D-dependent rickets type I and type II. Acta Paediatr Jpn. 1997 Aug;39(4):508-13. http://pmid.us/9316302.

[6] Tuohimaa P. Vitamin D and aging. J Steroid Biochem Mol Biol. 2009 Mar;114(1-2):78-84. http://pmid.us/19444937.

[7] Keisala et al. Premature aging in vitamin D receptor mutant mice. J Steroid Biochem Mol Biol. 2009 Jul;115(3-5):91-7. http://pmid.us/19500727.

[8] Cannell JJ. On the aetiology of autism. Acta Paediatr. 2010 Aug;99(8):1128-30. http://pmid.us/20491697. Cannell JJ. Autism and vitamin D. Med Hypotheses. 2008;70(4):750-9. http://pmid.us/17920208.

[9] Haussler MR et al. The nuclear vitamin D receptor controls the expression of genes encoding factors which feed the “Fountain of Youth” to mediate healthful aging. J Steroid Biochem Mol Biol. 2010 Jul;121(1-2):88-97. http://pmid.us/20227497.

Leave a comment ?

45 Comments.

  1. As usual :) , really fascinating stuff, Paul!

    I have allways wondered what would be the outcome on my Hashimoto with a high dose of vitamin D, since this is another disease where people tend to have a low 25OHD and gene polymorphisms on Vitamin D receptor (Pubmed 16721822, 18279374 and 10905383).

    Anyway, as I’m managing to reverse this disease with what I’m doing, I think I will keep my actual dose of vitamin D (5,000 UI).

  2. Hi Mario,

    Yes, that’s what I did with my disease and I recovered.

    We need more brave souls to be guinea pigs and teach us which diseases benefit from high-dose D!

    And then we need scientists to investigate why the D helps.

    If indeed there’s a pathogen that shuts down CYP27B1 expression, it would be great to know what it is. Some enterprising scientist should collect Charles’s blood and measure CYP27B1 expression.

    • Hi
      I have been taking 20,000 IU daily for more than 2 years. 8 years ago I had carcinoma in situ in the left breast and had 2 operations. I still had more pre-cancerous cells but is was decided to keep me on 6 monthly checks – mammograms and MRI scans. After I started on D3 the MRI images changed and a biopsy was undertaken to investigate. Conclusion: All well. My doctor who has been with me from the onset said the breast tissue was “very active” but could not explain why. On my last mammogram I was called back. They could not see anything at all as the breast tissue was now too dense. “Effectively”, my doctor said, “this would be normal if you were 21, but you are 47″. His conclusion was that high D3 doses has rejuvenated me. He is baffled. I am also rid of my psoriatic rheumatoid arthritis and am now coaching gymnastics.

      Best regards
      Hanne TP

  3. “health is optimized by obtaining about 4,000 IU/day of vitamin D3 from sun or supplements, leading to a serum 25-hydroxyvitamin D (25OHD) level of 35 to 50 ng/ml”

    If levels of 50 ng/mL.

    Does there appear to be harm in aiming for the middle of the reference range, which in most US labs is 65ish ng/mL?

  4. Hi cillikat,

    I’ve never seen a US lab that has 65 ng/ml as the middle of its reference range. Dr. Cannell does (50-80 ng/ml), but he’s alone so far as I know.

    Whether there’s harm in 65 ng/ml is a controversial subject. It’s clear that there’s a U-shaped response to vitamin D, and that 100 ng/ml is too high. But where the optimum is is unknown. I like going for the “knee” in the 25OHD vs vitamin D curve, which is around 40 ng/ml for whites and usually a little lower for Africans. You can find top vitamin D researchers who recommend above and below that level.

    The lack of people supplementing D at high doses until recently means we don’t have much clinical data. Ill effects, if they exist, may take decades to show up. We know from mouse studies that a primary effect of excess vitamin D is premature aging. You can guess how many decades it may take to observe premature aging in humans.

    Best, Paul

  5. “Did you know that vitamin D is quite cytotoxic to CLL cells?” http://clltopics.org/VitaminD3/EssentialforHealth.htm

    I was diagnosed with CLL going on 6 years ago and am still untreated. No oncologist has ever suggested I take Vitamin D however. In fact, no oncologist has ever suggested I get my Vitamin D levels checked.

    I did so on my own almost a year ago and found that I was a a meager 31ng. After 6 months of supplementing at 10,000 iu per day I was up to 55ng. Curious, I upped my dosage to 15,000 iu per day. Soon it will be time for another Vitamin D test. Will keep you posted.

    In the meantime, supplementing with Vitamin D and eating a Paleo diet my WBC is trending downward, a good sign.

  6. Hi Kayu – Be sure to supplement with vitamin K2 also. That helps against leukemias, and protects against D toxicity. Good luck!

  7. @Paul

    Thanks for that. In fact, I do supplement with Vitamin K and drink plenty of green tea.

  8. Hi Paul, there is some controversy on vitamin D supplementation:

    http://mpkb.org/home/pathogenesis/vitamind

    http://www.poisonfluoride.com/pfpc/html/vit_d___thyroid.html

    http://www.poisonfluoride.com/pfpc/html/vit_d.html

    “In children with skeletal fluorosis – as in hypothyroidism – elevated levels of 1,25-Dihydroxy-Vitamin D3 have been observed (Pettifor et al, 1989).

    Hypothyroid children have higher serum levels of both calcium and 1,25-dihydroxy-vitamin D3, while having lower levels of osteocalcin (Lauffer et al, 1993; Verrotti et al, 1998), while the opposite is reported in hyperthyroidism (Saggese et al, 1990). These levels normalize after thyroid status is corrected (Verrotti et al, 1998; Saggeese et al, 1990).”

    What do you think?
    May vitamin D deficience not be the cause of the disease but rather the effect?

    The positive effects seen may be due to its immunosoppressive activity but in the long term it can promote infections.

  9. Hi snaider,

    I’m familiar with the Marshall folks and don’t agree with most of their beliefs, only with the thesis that chronic infectious pathogens may interfere with vitamin D pathways.

    Thanks for the links about thyroid-D interactions. I didn’t know that fixing hypothyroidism can fix the D dysregulation. That would certainly provide a simple explanation!

    Best, Paul

    • Hi Paul,
      I was wondering if you might be willing to share more of your critique of the Marshall protocol, something a relative of mine is interested in but I’m a little wary of since it doesn’t fit an ancestral health paradigm and seems a little risky.

      My relative is 32 with chronic “fibromyalgia” pain, severe fatigue and insomnia, anxiety and depression, and many other symptoms. She has Hashimoto’s and a recent diagnosis of chronic Lyme.

      When last tested she had low vitamin 25 D (21 ng/mL) and highish 1,25 D (74 pg/mL). She has been supplementing high doses of D3 per a holistic doctor’s recommendation (at first 50,000 IU daily for two weeks, now at 10-20,000) and believes she is worse off from it; so she is compelled by the idea of the Marshall protocol. She’s also been using cat’s claw and various other supplements but noticing no improvements in her symptoms.

      Reading up on the Marshall protocol brought to mind your discussion of the role of intracellular pathogens in chronic disease and that there’s a time and place for selective use of antibiotics in recovery. So, I thought you would be a good resource for putting the Marshall protocol into perspective.

      I see from your advice that she might be better off lowering the D and adding K2 to her supplementation and that you’d recommend iodine; however she’s been instructed to avoid iodine due to the Hashimoto’s. I need to research your website more to see if you’ve already written on this subject, but if not I’m also curious to hear your thoughts on Hashimoto’s and iodine as well!

      Many thanks.

      • Hi Grace,

        First, that’s too much D for any one. An excess of D is dangerous. A normal level of D supplementation is 2,000 to 4,000 IU/day. Regular sun exposure at tropical latitudes generates 4,000 IU/day.

        So I’m not surprised your friend has gotten worse. Has she gotten her serum 25OHD levels tested on this protocol?

        My main objections to the Marshall protocol are (1) I believe the 25OHD levels they target are too low and suppress immunity, and (2) I don’t believe their computer model evidence that the drug Benicar is a better ligand for the Vitamin D receptor than natural 25OHD. I don’t think any one else except Marshall himself believes that either. If it were true, we should have evolved to make Benicar instead of 25OHD.

        You’re right, I would recommend supplementing K2. Supplementing iodine may also help.

  10. Paul:
    I am glad that you and Shou-Ching had a nice vacation. Thank you for sharing the pictures, although I must admit that wilderness areas with long grass are making me a little nervous at the moment.
    I was about to begin a total elimination diet with my daughter because of what I thought might be food sensitivities (salicylates and oxalates) when she developed a strep infection. 10 days of penicillin cleared up everything, including her bowel issues, migrating bone pain, motor tics, headache and fatigue. 3 days after finishing the Abx, everything came back with a vengeance, with the addition of night sweats, light sensitivity, sore soles of feet, continuation of low grade sore throat despite a negative strep swab.
    Our family physician suggested that because she is high functioning AS that anxiety might be the cause and suggested anti-anxiety and tic medication. The pediatric psychologist Dx PANDAS (autoimmune disorder) and suggested tic medication, the immunologist suggested an elimination diet, the pediatrician is investigating autoimmune bowel disorder. I decided to take things into my own hands and found a LLMD (we are Canadian, so have to travel to the US).
    Katie has tested positive for bartonella and indeterminate for lyme (IgG indeterminate bands 34, 39, 2+ band 41) through Igenex. Her 25-hydroxy D level is 205 nmol/L (reference levels 75-250) and her 1,25-Hydroxy D level is 176 pmol/L (reference levels 30-120). Her CRP is 98), her CD57 %lympho is 0.80 (normal >4.65). Her WBC is 5.2 (ref 4.5 – 13.5), RBC 4.42 (ref 4.00 – 5.20). She is now taking bactrim and biaxin, Interfase, Boluoke, Transfer Factor Multi-immune, CLO, magnesium, vit D3, MK-7, and several probiotics. We have also started eating fermented vegetables (my first try at sauerkraut was inspired by your Kimchi post, and further investigated at http://www.wildfermentation.com), and kefir .
    We have eliminated all processed sugar, oils and grains, except for some white rice, eat lots of pastured ghee and butter, vegetables, eggs (Katie gets only the yolk) and grassfed meat when I can get it.
    I had increased her D3 supplementation from 1000 IU to 3000 IU/day after all initial testing was finished, knowing that it might help her immune system. The LLMD now suggests stopping D3 supplementation because of the high 1,25 Hydoxy D. Could you give me your thoughts on the vit D supplementation? I am looking forward to your blogs on chronic disease, as I think these issues may be ongoing depending on the state of her immune system. Thank you for your help.

    Louise

  11. Sorry, something happened during the translation of the 4th paragraph:

    Katie has tested positive for bartonella and indeterminate for lyme (IgG indeterminate bands 34, 39, 2+ band 41) through Igenex. Her 25-hydroxy D level is 205 nmol/L (reference levels 75-250) and her 1,25-Hydroxy D level is 176 pmol/L (reference levels 30-120). Her CRP is 98), her CD57 %lympho is 0.80 (normal >4.65). Her WBC is 5.2 (ref 4.5 – 13.5), RBC 4.42 (ref 4.00 – 5.20). She is now taking bactrim and biaxin, Interfase, Boluoke, Transfer Factor Multi-immune, CLO, magnesium, vit D3, MK-7, and several probiotics. We have also started eating fermented vegetables (my first try at sauerkraut was inspired by your Kimchi post, and further investigated at http://www.wildfermentation.com), and kefir.

  12. One more time:

    Her 25-hydroxy D level is 205 nmol/L (reference levels 75-250) and her 1,25-Hydroxy D level is 176 pmol/L (reference levels 30-120). Her CRP is 98), her CD57 %lympho is 0.80 (normal >4.65). Her WBC is 5.2 (ref 4.5 – 13.5), RBC 4.42 (ref 4.00 – 5.20).

  13. Her CRP is 98),

    her CD57 %lympho is 0.80 (normal >4.65).

  14. Sorry Paul:

    Her CRP <1

    CD57 total is 18

  15. Hi Louise,

    I am glad you have a diagnosis. That is the single most important, and usually the most difficult, step. It was lucky that she had the antibiotics.

    I think most so-called “autoimmune” conditions are due to infections and antibiotics should be tested as a matter of course in AS. One shouldn’t have to wait for a supposed strep throat to do it.

    Re vitamin D, since both 25OHD and 1,25D are high, I would stop the supplementation. It is summertime, she should get midday sun exposure whenever she can and let it go at that.

    I would not take any anti-anxiety medication. Does tic medication refer to tick medication, ie antibiotics? Or to medicine to stop spasms, eg facial tics?

    Successful antibiotic treatment will usually normalize the CD57 lymphocyte percentage, eg http://www.ncbi.nlm.nih.gov/pubmed/11222912.

    Another thing I would recommend are “detox” supplements for clearing lipopolysaccharides and other fat-soluble toxins generated by bacterial die-off. I found cholestyramine extremely effective, but charcoal, bentonite clay, or chlorella can also be used. These bind bile and cause fat-soluble toxins to be excreted with bile in the feces. But don’t overdo these, because suppression of LDL/HDL is bad for immunity. Find the lowest dose that minimizes symptoms.

    With it, dietary cholesterol (eg egg yolks, shellfish), vitamin C, taurine, and gelatin / beef broth soups can help increase bile production and improve toxin clearance.

    Intermittent fasting and a modest amount of coconut oil (2 tbsp per day during the fast) may also help.

    I am assuming those are good antibiotics for bartonella, I haven’t looked into which drugs are best.

    Don’t let her be taken off antibiotics too quickly, it takes a long time to clear these infections.

    Congratulations on finding your way. She should be optimistic that she will be fully cured.

    Best, Paul

  16. Hi Paul,

    I am a young female who has suffered from chronic insomnia since early child hood. I do not get any sun due to lupus. I had exhausted all options for restoring sleep patterns. Everything failed until I read a paper on vitamin D and insomnia. I had originally been taking 1000 IU of vitamin D3 at night. I immediately upped my dosage to between 7,000 and 10,000 IU daily, taken upon rising. Within 3 days my sleep patterns were restored. After reading your post – I wanted to check with you to see if what I am doing is OK.
    I follow the diet that you have outlined but I am yet to begin supplementing with K2. Because I am having trouble obtaining it. All the other supplements I take. Until I am able to ship a supplement in I am relying on fermented foods – in particular kefir, grunkohl and sauerkraut.
    Thank you.

    • Hi Christiane,

      7,000 to 10,000 IU is OK for a few weeks to restore vitamin D from deficient conditions, but for routine supplementation you should cut it back to under 4,000 IU. For most people 2500 IU per day will be sufficient through the winter.

      It’s good to supplement with K2 also, or at least eat K2-rich foods like fermented foods eg aged cheese and liver and egg yolks, plus the fermented vegetables and dairy you’re eating.

  17. Hi Paul,

    Thank you so much for taking the time to reply. I really appreciate it. I will take your advice and cut back on the vitamin D.

    • Hi Paul,

      Last week I got a full physical examination along with a blood test. One of the tests I requested was my vitamin D levels. As per your advice I dropped my vitamin D intake from 10,000 IU down to under 4,000 IU. I did this slowly – but as soon as I went under 7,000 IU per day my insomnia immediately returned. My tests came back with the results 286 nmol/L. Last years test in November 2011 my levels were 126 nmol/L. I have begun taking all the basic supplements at the doses specified by you, I also still follow the diet guidelines from your book. My GP was not concerned at all by my vitamin D results and said that I was in the healthy normal range. What are your thoughts on this?

      • Hi Christiane,

        I’m surprised your doctor is not concerned. Normal range is about 100-125 nmol/L. So your Nov 2011 levels were what would normally be regarded as optimal, and the new results as very high. (Standard ref ranges for 25OHD and 1,25D can be found at http://www.rcpamanual.edu.au/index.php?option=com_pttests&task=show_test&id=649&Itemid=27 and http://www.rcpamanual.edu.au/index.php?option=com_pttests&task=show_test&id=648&Itemid=27)

        As this post discussed, people with certain diseases, and your lupus may be one of them, sometimes do well with higher serum vitamin D levels, usually around twice normal, 200-250 nmol/l.

        I would do three things:
        - First, any time you supplement high doses of vitamin D, be sure to supplement vitamin K2 with it and to get adequate vitamin A (eg, eat 3+ egg yolks a day plus some liver).
        - Second, for your insomnia I would try melatonin before bed and see if that allows you to reduce vitamin D intake and still keep the insomnia away.
        - Third, support circadian rhythms with daytime exposure to sunlight, exercise daily, bright lights indoors in daytime and dim lights at night, etc.

        I think it’s great that you’ve found a way to relieve insomnia. It is probably a clue to your larger disease. However, we don’t really know how to interpret it. The need for extra D could be due to genetic mutations in the vitamin D creation or degradation enzymes, or could be due to interference by an infectious pathogen in those processes.

        So I would definitely find a combination of these that relieves insomnia and makes you feel better, but try to do it in the safest possible way, using K2, A, and melatonin along with D to make an optimal combination.

        Best, Paul

        • Hi Paul,

          Thank you again for your help.
          The GP I saw seemed to have a blase attitude toward everything. I am going back to the medical centre this weekend to collect my leptin test. I also forgot to mention that I have secondary amenorrhea (over 3 years) despite all tests coming back normal. The gynecologist wants to start me on oestrogen tablets to see if that will help get my cycle back. That is the only hormone I am slightly low on, apparently. I am a little aprehensive about this, I will try and resist taking it if at all possible. He says that the lack of menses is not at all dangerous or likely to effect my health or fertility.
          As for your suggestions, I have started taking 2100 mcg of K2 with the D3 in the morning. I eat between 2 and 3 egg yolks daily depending on my activity levels and I also consume about an 1 oz. of liver 5-7 days per week.(rotating varieties)Other stuff I include when possible is fish eggs, oysters, shellfish and a variety of organ meats etc. I think I get K2 also in the form of fermented dairy and vegetables. I will definately try the melatonin and see what happens. I have ordered the doses based on the supplements recommendations. To get D3 serum levels back to a safer range, would it be best to avoid supplementation for a short time or simply lower the dose to what you originally specified?
          Thank you for taking the time to answer my questions I truly appreciate everything that you have done for me. The work of Shou-Ching and yourself has aided me greatly. I have a long list of health problems that your lifestyle and diet advice has wiped out. Should you ever require a testimonial I would be happy to oblige.

          Christiane.

          • I would normally say stop vitamin D for 3-4 weeks then start at a more normal level of supplementation, say 2500 IU/day.

            We’re always happy to receive testimonials! The Reader Results page is the place to leave them. Also, if you feel so inclined, you could leave an Amazon review of our book. Thank you!

  18. No problem, will do. Thank you Paul.

  19. Hello
    I wonder if you would comment on my 15 year-old daughter’s situation – she has been diagnosed with “quite severe depression” and anxiety.

    Her psychiatrist prescribed 4 x 20,000u Dekristol capsules over two days then one each week, plus iron. This was alongside other supplements and SSRI anti-depressants.

    Soon her hair began to fall out (all over, not clumps). We researched causes ourselves and decided it might have been an overload of vitamin D. Her hair also changed colour from blonde to brown.

    We now see a nutritionist who has prescribed 1200 iu as an emulsion, daily. Her hair loss seems to be decreasing but she still has the depression and all sorts of other health issues such as headaches, fatigue.

    She also has other supplements from the nutritionist but Vitamin D seems to be in the spotlight currently.

    Many thanks
    Suzanne

    • Hi Suzanne,

      Have you been testing her serum 25OHD and 1,25D levels through this?

      It is difficult to know what is appropriate to supplement without blood tests to know status. If the 160,000 IU she took created an excess, she might need to avoid vitamin D supplementation for up to 2 months to clear the D.

      I would also check thyroid status, as hair falling out often indicates hypothyroidism. It’s also possible that vitamin A was depleted, A partners with both vitamin D and with thyroid hormone so an excess of D might deprive thyroid hormone of vitamin A.

      As Chris Masterjohn has discussed, vitamin A and vitamin K2 are antidotes to D toxicity, so it would be good to supplement K2 and get extra A (feed her lots of chicken liver).

      I think she should try to normalize these nutrients, get on a healthy diet, treat any hypothyroidism, do healthy lifestyle steps like the circadian rhythm strategies discussed in our book, and then revisit the depression and anxiety.

      My personal preference is normally to avoid the pharmaceutical drugs like SSRIs until healthy dietary and lifestyle steps have been fully implemented. But, you will have to use your judgment, with advice from your doctors, to decide how to proceed in regard to drugs from here.

  20. Thank you very much. I will try what you suggest.

  21. Hi Paul,

    I’ve just read your book (thoroughly enjoyed it btw thanks). Anyway I just had a couple of questions. I’m a 27 Male and since adolescence I have had prominent red cheeks. I cant make out if its rosacea or not, but I dont think it is because its not on my nose or anything and you cant really see individual capillaries, but they flare up when drinking or exercising and occasionaly they feel hot. On adopting a Paleo diet they’ve faded a bit but not all the time and I just wondered if you think it could be dietary. I struggle with digestion – passing stools is slow, takes me 10 – 15 minutes and my lower gut always seems to feel a little tender, like I’m always aware that there’s tension or something in my intestines and when I lay down I can feel tender areas when I press on my lower abdomen. Cutting out gluten and the like has helped but not completely. Anyway, I just wondered if you had any advice and if you think the two things might be linked. Thanks again. PS Is it acceptable to add bones to stews, curries etc if you dont have time to make bone broth? thanks

    • Hi Tim,

      It does sound like rosacea.

      I think a major factor in that is the thyroid hormone – vitamin A pathway which is also modulated by vitamin D and circadian rhythms. So eat liver (1/4 lb beef or lamb liver, 1/4 lb duck/goose/chicken liver per week), normalize thyroid and vitamin D, tend to circadian rhythms.

      Your gut symptoms indicate a mild hypothyroidism and/or gut dysbiosis/infection. Try yoga breathing exercises to help stimulate gut healing.

      Then fix up your gut flora. Fermented vegetables, joint broth soups, etc.

      Yes, bones in stews and curries are a partial substitute.

      Rosacea will clear as your gut/thyroid/nutritional status improves.

      Best, Paul

      • Paul,

        You have been mentioning yoga breathing a lot recently. There are a number of yoga breathing exercises. Are there any in particular you think are best?

        • Hi Ellen,

          Yes, I’m experimenting with it. I’m planning to do a blog post on this at some point, I’m thinking it may promote gut health and a beneficial gut flora. But I don’t feel able to say that one type is better than another. Probably, as with other forms of exercise, it’s good to vary what you do and increase intensity as you get more fit.

      • I’ll try those things. Thanks Paul, much appreciated.

  22. Paul,

    Sorry for writing so generally but alas, i’m at my wit’s ends. I’ve been sick for a while: persistent insomnia, migraines, cognitive decline. And I’ve taken your advice. I’ve done the diet, faithfully. And I’ve done my course of doxycycline. I have a friend who works with the folks who promote the Marshall protocol. I’m not a scientist, but it seems to me that what they say makes sense, at least at fundamental level. I honestly believe that after all that I’ve done to help myself, it may after all be a deep rooted infection which is causing problems. I’ve read the posts above, and I know that you’re not in favor of the marshall protocol, but what in particular are you against. For the person who is choosing that path, what would you counsel against. Your book is wonderful. I have bought and given away countless copies. But I wish you would talk more on the topic on infections and what to do. I understand that many of your readers are not in the camp that I am, but given so few resources and your past troubles, I would love to hear your opinion on more of the particulars of how you have dealt/would deal with infections in general.

    with the utmost respect and gratitude,

    James

  23. Paul,

    My daughter ,7, diagnosed on autism spectrum , has vitamin d deficiency . Reading John c’s blogs , tempting to start high dose of supplemnt of d3 . Please advice.

    • Hi Mita,

      I certainly support sun and supplements to eliminate a vitamin D deficiency. Aim for serum levels of 40 ng/ml. But you have to be careful not to overdo supplementation either. 1,000 to 2,000 IU per day is typically sufficient for a 7 year old, even if she doesn’t get much sun, although you could do more in the first week or two to make up for the deficiency.

  24. I have taken 20,000 IU of D3 daily for years. In addition I also apply the oily capsules directly on my skin. It has cured me of arthritis, psoriasis and rejuvenated breast tissue (still undergoing 6 monthly scans after breast cancer 9 years ago) My doctor is baffled. I now have breast tissue of a 20 year old (am 48). He has never seen MRI scans like it. I also don’t get sunburned anymore. My dad (68) also takes the same amount of D3. He started applying on his head as he had dry skin. His hair has started to grow back (not seen for the last 40 years). He also sprouts black hairs on his arms. We now take photos of his head and measure the shrinking bald patch. We have not experienced any bad side effects, rather it has been life changing for me. It takes three weeks for the D3 dose to be halved in the body. If you feel unwell simply stop taking them.

  25. I think danger of d toxicity has been greatly exaggerated. I think this is on purpose by the pharma/medical complex. It is interesting to read the woman’s comments above who has been taking 20,000 units a day for years with nothing but good effects as well as her father having the same experience. I just read Jeff Bowles kindle book The Miraculous Results of High Vitamin D Therapy My Experiment With Huge Doses. Jeff cured bone and joint problems, toe nail fungus and more taking generally between 20,000 iu and 50,000 iu daily. He gives the history of vitamin d supplement production. In the twenties when it first came out 20 mg was the standard dosage which is the equivalent of 800,000 iu. People were taking these daily for years and there was no problems, quite the contarary there were many amazing cure stories. The pharma companies which control modern medicine and hate nutritional cures that are their competition, went after vitamin d to keep people from having access to it over the counter. They changed the unit of measurement to iu from mg to make the dosages seem huge, when in reality 20,000 iu is only a fraction of a mg
    There was a public outcry when vitamin d was banned so the Streck report was commitioned. It studied high d dosages in hundreds of people over 9 years and found no toxicity except in a few rare instances with certain diseases, but symptoms were obvious and upon dropping the d quickly went away leaving no lasting repercussions.

    If you doubt the governments and big pharmas capability to be so evil as to cause harm for gain read about the Tuskegee experiment. You won’t doubt it anymore.

    Since I have been taking high dose d, between 10,000 and 20,000 iu for the past month I have been able to quit taking 60 mg of desiccated thyroid and have lost a few pounds. I took 2000. to 4000 iu daily depending on time of year. I still tested deficient. Paul you should read the life extention foundations article on the survey they did of their clients vitamin d tests. These are people all on high dose d between 2000-7000 iu. Only 15% were at or above 50 and no one was in the high normal range or out of range.

    This means that d toxicity is being grossly exaggerated.

  26. I forgot to mention that u should take k2 and all the fat soluble vitamins with d3. You can learn dosages in Jeff’s book.

  27. Hello, I have Asperger’s syndrome and was considering supplementing with d3 in hopes of curing it. Your article mentions children with autism have had success in curing it. Can an adult cure there autism as well? Also, how much k2 should I take along with the d3?

    • Hi Anon,

      I don’t know if vitamin D3 will help in any one case. It’s something you have to experiment with. I doubt it is a cure, but it may improve symptoms.

      I think one should take a minimum of 100 mcg/day MK-7 with any D3 supplementation. Also, I would eat 1/4 lb liver per week and try supplementing about 3000 IU of vitamin A per day. 10,000 IU vitamin A supplements (A derived from cod liver oil) are readily available and can be taken 2x per week. Alternatively, you can get cod liver oil with the A still in it, it typically has 5,000 IU per teaspoon, so you could take up to a teaspoon per day of natural cod liver oil.

      I would also combine this with eating a complete PHD diet for good nutrition, and follow our lifestyle advice including circadian rhythm entrainment, see Chapter 42 of our book.

      Good luck and let me know how your experiments go!

      Best, Paul

    • Anon – in addition to Paul’s suggestions, you might want to look at http://www.vitamindcouncil.org where there is quite a bit of discussion of vitamin D and autism. Search for ‘autism newsletter’ since most of the material is in Dr Cannell’s newsletters where some readers are reporting their experience with vitamin D and autism. A separate search for ‘asperger’s’ turns up 3 hits, as well. Good luck

  28. All,

    I have been supplementing with Vitamin D3 at 13000 IU/day for 2 years. I have Psoriatic Arthritis. I have been through Plaquenil, Methotrexate, Remicaide, Enbrel. Am now on Stelara. They work for awhile and then quit working. However, the high-dose vitamin D is what keeps the autoimmune consistently under control. One problem: my last check, I was at 183 on my level. I *do* take vitamin k and magnesium glycinate. Every time I try to dial back say to 10000 IU/day, the autoimmune comes roaring back. Are there other dietary supplements or foods that could promote absorption of vitamin D so I don’t need so much. I follow Dr. Furhman’s diet.


    Regards,
    Sandra Carney

    • Hi Sandra

      I have cured myself of psoriatic arthritis (see my comment from last year). If you worry about taking such high doses i recommend you do what I have done and take it topically instead. By smearing it on the skin it will be absorbed just as well but without any risk of getting toxic. It is also more efficient for joints and skin. I use about 5-6 capsules of 10,000 IU each day. Check out the latest research on PubMed:
      http://www.ncbi.nlm.nih.gov/pubmed/24711745

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