In This Issue

• What's New at CHAC
  
• Acupuncture for the Winter Blues
  
• Acupuncture for Hot Flashes
  
• Vitamin D: Sunshine in a Bottle?

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Community Health Acupuncture Center's E-Newsletter

Posted: January 15, 2010

Acupuncture for the Winter Blues

Around here, winter means plenty of short, dreary, gray days, which can diminish energy levels and promote depression. Research shows that acupuncture can reduce symptoms of depression¹ by increasing production of serotonin and endorphins (the body's natural opiods).² Acupuncture is also know to promote relaxation and reduce sensitivity to pain and stress as well as to deactivate the 'analytical' brain, which is responsible for anxiety and worry. In addition, acupuncture is relatively side-effect free, and can be combined with conventional drug treatment for depression as well as help reduce some of the side effects of drug therapy. Treating physical ailments with acupuncture, such as chronic pain, may also improve depression, as these conditions often contribute to depression in the first place.

Vitamin D: A Bottle of Sunshine?

Vitamin D has been in the news a lot lately not only because of its long known ability to help the body absorb calcium for strong bones but also because of recent research showing that it is useful to heal many other conditions. Vitamin D comprises a group of fat-soluble substances and metabolites. The two major forms are vitamin D₂ (or ergocalciferol) and vitamin D₃ (or cholecalciferol), according to the National Institutes of Health.³ Calcitriol (1,25-Dihydroxycholecalciferol) is the active form of vitamin D that functions as a hormone to increase absorption of calcium from the intestines as well as to enhance mobilization of calcium from bone into the bloodstream.

Vitamin D₂ is produced by plants and invertebrate animals in response to UV irradiation. Vitamin D₃ is made in the skin of vertebrate animals when skin is exposed to UVB ultraviolet light at UV index greater than 3. The UV index is a rating scale of 1 to 11 used by the National Weather Service to forecast the intensity of ultraviolet radiation at solar noon in different parts of the country. In southeastern Michigan, the UV index is quite low in wintertime, averaging from 0-1 in December and January and peaking to between 6 and 7 in June and July, significantly lower than, for example, Florida, which has a UV index average of 8-9 in July. At a UV index greater than 3, adequate amounts of vitamin D₃ can be made in the skin after only ten to fifteen minutes of sun exposure at least two times per week to the face, arms, hands, or back without sunscreen. Most Michiganders are probably getting insufficient amounts of sunshine to produce the adequate amounts of vitamin D in winter.

Diseases treated
Vitamin D is known for helping the body absorb calcium which helps maintain optimal bone density to prevent osteoporosis, but new research suggests it is helpful in treating autism, cancer, chronic pain, depression, type 1 diabetes, heart disease, high blood pressure, flu, neuromuscular diseases, rheumatoid arthritis, multiple sclerosis, and other autoimmune diseases.

Vitamin D is known to play a key role in preventing autoimmune encephalomyelitis, which is a mouse version of multiple sclerosis that is widely accepted as virtually identical to human MS. Because of this evidence, researchers think vitamin D₃ may be able to downregulate an overactive immune system thus keeping autoimmune diseases such as rheumatoid arthritis in check.

Vit D may also be useful in treating congestive heart failure (CHF) because of its ability to regulate calcium metabolism (by increasing blood levels). Scleroderma and psoriasis have also been successfully treated with oral and topical vitamin D supplements.

Tanning beds
Yes, you can stimulate your body's production of vitamin D with tanning bed use. Unfortunately, too much UV radiation puts you at higher risk for skin cancer and photoaging, so oral supplements are preffered and are more efficient.

Who is Deficient

• People who don't get enough sun. Exposure to 10-15 minutes of direct sunlight at UV index > 3, 2-3 times per week is recommended.
• People who take drugs that deplete Vitamin D or impede its absorption:
• Phenytoin (Dilantin) and primidone (Mysoline) for siezures
• phenobarbital (a sedative)
• corticosteroids
• cimetidine (Tagamet) for ulcers
• heparin
• isoniazid and rifampin for tuberculosis
• cyclosporin (an antibiotic) and
• carbamazepene, an anticonvulsant
• African Americans are at an even higher risk for deficiency because heavily pigmented skin blocks up to 95% of UV radiation to the deeper skin layers.
• Everybody, because of air pollution which interferes with vitamin D syunthesis, and the depleted ozone, which causes people to minimize sun exposure and to overuse sunblock and sunscreen.
• Fair skinned people need more because it is difficult for them to get enough vitamin D without over-exposure to sun and sunburn, which causes skin cancer.
• Obese people need more because they are less able to utilize vitamin D because more of it is stored in excess fat cells than in lean people.

Caution
Some people need to be careful with vitamin D supplementation, including people with hyperparathyroidism (though this can be treated with vitamin D), lymphoma, lupus erythematosus, tuberculosis, sarcoidosis, and kidney disease. In addition, people who take calcium channel blockers or thiazide diuretics should consult a physician before taking extra vitamin D, and periodic testing for blood levels of vitamin D is advisable.

What's the best form of Vitamin D
Sunshine is best source of vitamin D because it's free, and your body will produce as much as it needs if you can get 10-15 minutes of direct sun 2-3 times per week. With longer exposure to sun, an equilibrium is achieved in the skin, and excess vitamin D simply degrades as fast as it is generated, so it is virtually impossible to overdose if you get your vitamin D from sun exposure.² Vitamin D₂ and D₃ are are both available over the counter, but experts agree that D₃ is superior for human supplementation because it has a significantly higher bioavailability. D₃ is manufactured from the fat of lambs wool, however, so for strict vegans, vitamin D₂ may be preferrable because it comes from plant sources. D₂ is still useful as a supplement, despite lower absorption rates.

A pharmaceutical form of vitamin D called calcitriol is actually a hormone that stimulates the cells of the intestine to promote the absorption of calcium from food and stimulates bone to mobilize calcium from the bone to the blood. Calcitriol is said to be extremely valuable as a cancer treatment because it reduces the unregulated growth of cancer cells by promoting normal cell death (apoptosis); and by promoting normal cell differentiation thus preventing new cells from becoming cancerous.

Unfortunately for the pharmaceutical industry, plain old vitamin D cannot be patented and therefore cannot make lots of money as a new cancer drug. That's why the pharmaceutical industry has sponsored so much research on vitamin D (calcitriol) analogs for use in cancer treatments. The research shows negligible results for the analogs with the basic unpatentable form performing the best.

How Much Do I Need
Rheinhold Vieth, a well known vitamin D researcher, points out that the body easily produces the equivalent of 10,000 IU of vitamin D with 10-15 minutes of sun exposure; others put that figure at 20,000 IU, which suggests that the body has a very high optimal physioloigical limit and that far more Vitamin D can and should be supplemented in at-risk individuals than the USRDA's current paltry recommendation of 200 IU per day. Vieth recommends supplementing with 4000 IU of Vitamin D3 per day in people who don't get adequate sun exposure. The Vitamin D council, a "group of concerned citizens" with backing from manufacturers of vitamin D supplements recommends 5000 IU per day.

The Vitamin D council and Andrew Saul, a medical homesteading expert, say that threat of vitamin D toxicity is overstated in the medical profession. Saul speculates that toxicity hype helps the pharmaceutical industry to market doctor-supervised administration of vitamin D-like drugs.

References