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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by garnet71 on March 23, 2009, at 11:39:14
Larry-This is the 2nd time I took prescription vitamin D.
I just took my 2nd weekly dose of 50,000 vitamin D-and I feel great again--only 20 minutes later.
The first time I took it, which was last week about the time I started Wellbutrin, I felt great. It lasted for two days. I thought it was the Wellbutrin kicking in, but since this happened 2 times in a row--I don't think the vitamin D effect is just a coincidence.
Wow-is that amazing that a vitamin can do that!
Posted by Garnet71 on March 23, 2009, at 11:47:53
In reply to Vitamin D! **Larry Hoover**, posted by garnet71 on March 23, 2009, at 11:39:14
That was wrong (geez I have no concept of time) - this was my 3rd weekly dose. When I took my first dose, I noticed no effect--and I wasn't taking Wellbutrin at the time. When I took the 2nd dose last week, I had started WB at the same time, and the Vitamin D gives me a mild euphoria-I can feel the endorphines flowing in my brain.
Wouldn't it be interesting if Vitamin D somehow augments Wellbutrin? Or maybe the first does didn't effect me and now it's building up in my system.
Posted by Phillipa on March 23, 2009, at 12:54:04
In reply to Re: Vitamin D! **Larry Hoover**, posted by Garnet71 on March 23, 2009, at 11:47:53
Garnet it has to be prescription not the supplements in stores? I'd like to add that as endo just said D was normal. I just have Vita D gel capsules at 1000 and 2000mg. Love Phillipa
Posted by DG77 on March 23, 2009, at 15:37:20
In reply to Vitamin D! **Larry Hoover**, posted by garnet71 on March 23, 2009, at 11:39:14
Hi Garnet,
I've been a big proponent of Vitamin D lately. It seems like all kinds of research is coming out that demonstrates how ridiculously low the RDA is.
There is one thing about it that does kinda scare me, though. I've seen numerous references that cite high doses of Vitamin D as a risk factor for kidney stones. What I don't know is how high a dose is required to have this effect. At any rate, I've cut back a little bit on my dosing until I have a chance to have my levels measured. I would continue to having your levels monitored as well just in case.
Here is one of the references I mentioned:
http://www.mayoclinic.com/health/kidney-stones/ds00282/dsection=causes
(see "Calcium stones" item)
Posted by garnet71 on March 23, 2009, at 15:56:53
In reply to Re: Vitamin D! **Larry Hoover** » garnet71, posted by DG77 on March 23, 2009, at 15:37:20
DG! Haven't heard from you in a while. Did you read Larry's Vitamin D essay above about the US RDA?
So what kind/brand of vitamin D do you take and how much a day?
Posted by garnet71 on March 23, 2009, at 15:57:46
In reply to Re: Vitamin D! **Larry Hoover** » Garnet71, posted by Phillipa on March 23, 2009, at 12:54:04
Phillipa, yes it was a prescription an endocronologist wrote for me.
Posted by Larry Hoover on March 23, 2009, at 19:06:17
In reply to Re: Vitamin D! **Larry Hoover** » garnet71, posted by DG77 on March 23, 2009, at 15:37:20
> Hi Garnet,
>
> I've been a big proponent of Vitamin D lately. It seems like all kinds of research is coming out that demonstrates how ridiculously low the RDA is.Quite correct. It is ridiculously low.
> There is one thing about it that does kinda scare me, though. I've seen numerous references that cite high doses of Vitamin D as a risk factor for kidney stones. What I don't know is how high a dose is required to have this effect. At any rate, I've cut back a little bit on my dosing until I have a chance to have my levels measured. I would continue to having your levels monitored as well just in case.
>
> Here is one of the references I mentioned:
> http://www.mayoclinic.com/health/kidney-stones/ds00282/dsection=causes
> (see "Calcium stones" item)This link between nephrolithiasis and vitamin D supplements is medical folklore. It is plausible, but it is not demonstrated in clinical trials. The only references I find that link vitamin D supps to calcium kidney stones are of the sort "known risk factors include vitamin D supps" blah blah. But if you search clinical trials of high dose vitamin D, there is no link demonstrated. Before there can be nephrolithiasis (stone formation) there must be hypercalciuria (high calcium in urine), but that is very rare. And before there is hypercalciuria, there must be hypercalcemia (high blood calcium), but that is only slightly less rare.
Here's the bottom line.....some people have a genetic defect in their vitamin D receptors, and they can naturally form stones at typical vitamin D intakes. Some people have primary or secondary hyperparathyroidism, and they're vulnerable for other reasons. And such like. If your doctor has not identified you as being at risk for nephrolithiasis, the only way vitamin D is going to cause it to happen is if you have an undiagnosed disorder that creates the vulnerability. And in all the clinical studies I checked, including ones with doses of megadoses of between 100,000 and 600,000 IU/mo, there were no cases.
I would be far more worried about not having enough, than in getting too much.
Lar
Posted by bleauberry on March 23, 2009, at 19:19:15
In reply to Re: Vitamin D! **Larry Hoover** » DG77, posted by Larry Hoover on March 23, 2009, at 19:06:17
Hi Larry,
Hey, any information on Vitamin and infectious disease? Here's why I ask...
In the Marshall Protocol, an experimental method of conquering many unknown intracellular bacterial infections, especially ones lacking cell walls, Vitamin D is a big no-no. Long story short, it gives more advantage to the bad guys than us.
My Lyme doc tested my Vit D metoblites and they were low. He said to take 800IU daily.
Do you know anything about the relation of Vitamin D to infectious organisms, such as Lyme? On one hand, some say it is bad, bad enough to even avoid as much exposure to bright light as possible. On the other hand, some claim it is good. But at the same time Vit D benefits the body and the immune system, it equally benefits the infectious organisms. I'm confused on it all. I'm not sure anyone really knows, but I figured good ole Larry would have a more wisdom filled answer than anyone else I know.
Posted by iforgotmypassword on March 23, 2009, at 19:58:59
In reply to Re: Vitamin D! **Larry Hoover** » Larry Hoover, posted by bleauberry on March 23, 2009, at 19:19:15
Other than possible added fatigue, i personally have never noted any effect from vitamin d supplementation, even though my latest results are quite wierd.
My latest levels were a bit of a paradox:
25-hydroxy vitamin D was 50 something.
1,25-dihydroxy vitamin D was 280 something.My psychiatrist gave the results to me over the phone, so I don't have a copy of my own yet, but he said the first one was listed as insufficiency, and the second as well above the upper limit. I was supplementing 5000 IU every day when I remembered for about a week or two, continuing from what I had been rx'd the last time I took vitamin d but was too lazy too refill and forgot about it. (Initially, I had no detectable levels of 25(OH)D.)
He doesn't know what to suggest from observing the results, but I guess I should go see my GP or naturopath? I have discontinued the vitamin d supplementation now. It still seems wierd since 5000 IU isn't necessarily that high a dose and seems quite common, and especially since I am still "insufficient" in 25(OH)D stores. Could there be something else causing this I should be worried about?
When the numbers are all perfectly normal, can I expect some benefit in terms of physical and mental energy and cognitive clarity?
Posted by desolationrower on March 24, 2009, at 1:21:11
In reply to Re: Vitamin D! **Larry Hoover** » Larry Hoover, posted by bleauberry on March 23, 2009, at 19:19:15
Philipa, the D3 in the herb shop works just as well (better actually) than the prescription form. Of course, taking a bolus dose once a week could theoretically make it more noticable, especially if you are deficient to start with and so don't have a store of it in your liver.
my recollection is Marshall is an engineer or something, hasn't published anything peer reviewed, and is in the sort of crankish camp that says everything is caused by bacteria. even teh marshall protocal includes an vitamin D receptor agonist, i think the idea is to starve the bacteria of D. but i filed it in my 'he doesn't know waht he's talking about and i'll be dumber the longer i listen' category. maybe larry knows some more.
-d/r
Posted by Larry Hoover on March 24, 2009, at 4:58:26
In reply to Re: Vitamin D! **Larry Hoover**, posted by Garnet71 on March 23, 2009, at 11:47:53
> Wouldn't it be interesting if Vitamin D somehow augments Wellbutrin? Or maybe the first does didn't effect me and now it's building up in my system.
Actually, I've heard that before. That the first dose doesn't really seem to do much, and then it kicks in later. Kind of like priming a pump before you get a good flow of water.
Lar
Posted by Larry Hoover on March 24, 2009, at 4:59:53
In reply to Re: Vitamin D! **Larry Hoover** » Larry Hoover, posted by bleauberry on March 23, 2009, at 19:19:15
I'm not going to be able to answer your question off the top of my head, so I'll have to get back to you. This one sounds complicated.
Lar
Posted by Larry Hoover on March 24, 2009, at 5:03:44
In reply to 25(OH)D insufficiency 1,25(OH)2D above upper limit, posted by iforgotmypassword on March 23, 2009, at 19:58:59
Yup, that's a paradox all right. I'd be wondering if a re-test wasn't in order. In the meantime, I'll try and find an explanation, but it's like looking for a needle in a haystack. It may be an idiosyncratic result (i.e. unexplained/unique to you/we don't know what the heck is causing it), or it may be a lab error.
Lar
Posted by Larry Hoover on March 24, 2009, at 5:05:43
In reply to Re: Vitamin D! **Larry Hoover**, posted by desolationrower on March 24, 2009, at 1:21:11
Thanks for that insight into Marshall, before I begin research. That's a good red flag warning. There are many plausible but crackpot theories and theorists around these days.
Lar
Posted by Larry Hoover on March 24, 2009, at 7:05:44
In reply to Re: Vitamin D! **Larry Hoover** » Larry Hoover, posted by bleauberry on March 23, 2009, at 19:19:15
> Hi Larry,
>
> Hey, any information on Vitamin and infectious disease? Here's why I ask...
>
> In the Marshall Protocol, an experimental method of conquering many unknown intracellular bacterial infections, especially ones lacking cell walls, Vitamin D is a big no-no. Long story short, it gives more advantage to the bad guys than us.
>
> My Lyme doc tested my Vit D metoblites and they were low. He said to take 800IU daily.
>
> Do you know anything about the relation of Vitamin D to infectious organisms, such as Lyme? On one hand, some say it is bad, bad enough to even avoid as much exposure to bright light as possible. On the other hand, some claim it is good. But at the same time Vit D benefits the body and the immune system, it equally benefits the infectious organisms. I'm confused on it all. I'm not sure anyone really knows, but I figured good ole Larry would have a more wisdom filled answer than anyone else I know.First off, I want to say I appreciate the faith you have in me. I will caution you, however, that you will receive my considered opinion. My opinion.
About Marshall, and his protocol. The man has a Ph.D. in electrical engineering. He's not a doctor. That doesn't mean he can't be right, but it raises a red flag.
I found a copy of his Phase 1 treatment plan, which had a series of numbered references embedded in the text. I made notes as I read, planning to go the primary references soon after. When I got to the end of the text, there was no reference list. Then, I found another presentation of Phase 1, and its references were somewhat different, but at least they were there. Every reference, save one, was to an earlier paper he'd written, or to links to the Marshall Plan website, but all of those links failed. And the lone exception had nothing to do with what he was talking about, in my opinion.
I then considered his published work, and I learned that his protocol has never been subjected to double-blind review. It's been offered to him, and he's refused. So, the only evidence for efficacy is open-label, and hopelessly confounded by expectancy effects.
Now, even with that all said, that doesn't mean that it doesn't work. So, I questioned the mechanisms by which his protocol is said to operate. Here's where he steps right outside of science. My overall impression is that he has cherry-picked certain concepts, taken them completely out of context, and then generalized them by absurd extrapolation. Still, that doesn't mean it doesn't work. It just doesn't work for the reasons he says. If a witch doctor gives you an herb so that you might merge with the spirit of the plant's goddess, I might be tempted to argue that any efficacy might be due to chemical compounds contained therein. But the witch doctor would still demonstrate efficacy.
Finally, to the specific concerns about vitamin D, Marshall is flat out wrong. For those with low vitamin D status, high white blood cell counts are common. The immune system has become dysregulated, and is churning out high numbers of white blood cells, but they have poor capacity to discriminate host cells from threat cells. Autoimmune disorders are associated with low vitamin D, for example, because this host of immune cells has dysfunctional guidance systems. It's like they have low IQ. Improving vitamin D status leads to fewer white blood cells that are much more selective. They have their guidance system functioning much better, so fewer intelligent cells do a better job than many stupid ones. Marshall has confabulated cell count as a measure of immune function, and has created an hypothesis that low vitamin D status is an effect of the disease. A simple correlation doesn't discriminate between whether A leads to B, or instead, B leads to A. But we already have a huge body of evidence that low vitamin D status leads to infection, not the other way around. We've known that ever since tuberculosis patients were found to improve when they were put outside in the sun, over a hundred years ago.
If I was in your shoes, I'd be taking more than 800 IU/day.
Marshall is a quack. His Plan still might work, but if it does, it works despite his erroneous vitamin D avoidance rule.
Here's a full-text link to a nice summary by a medical researcher who is dedicated to studying the immune effects of vitamin D, with an excerpt from that paper.
Lar
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=18505808
"While the potential protective effects against TB infection have attracted the most attention, data are accumulating from several sources that vitamin D may also be beneficial in combating a range of other bacterial or viral infectious agents. One small but intriguing study worthy of follow up found that elderly women undergoing long-term treatment with vitamin D as an antiosteoporosis agent had a significantly lower rate of Helicobacter pylori infections than women in an untreated control group (44). There have also been a number of studies examining the potential role of vitamin D in protection against upper and lower respiratory tract infections, which can be caused by a variety of etiological agents, many of which are viral (14, 57, 102). Subclinical vitamin D deficiency was associated with severe lower respiratory tract infection in an Indian study (97), and clinical vitamin D deficiency was associated with a 13-fold-increased risk of pneumonia in Ethiopian children (58). A Finnish study found that there was an association between serum 25D concentrations of less than 40 nM (16 ng/ml) and a range of acute respiratory infections (sinusitis, tonsillitis, otitis, bronchitis, pneumonia, pharyngitis, and laryngitis) in young army recruits (46). In addition, Cannell and several colleagues have persuasively argued, based on a range of epidemiological data, that cutaneous vitamin D production provides the seasonal stimulus associated with solar radiation that underlies the seasonality of epidemic influenza (16, 17). Finally, clinical and genetic evidence is accumulating that vitamin D may play a role in modulating human immunodeficiency virus (HIV) infection, although more work needs to be done to clarify the relationship between vitamin D physiology and HIV infection. A positive correlation was established between vitamin D supplementation and CD4-positive T-cell counts in seropositive individuals (94). A correlation between mortality from HIV infection and vitamin D deficiency has not been clearly established. However, interpretation of the vitamin D status of HIV-positive individuals is complicated by the potential confounding effects of antiretroviral therapy on vitamin D metabolism (94). This is an area that merits further clarification, because, as detailed below, a potential role for 1,25D signaling in modulating HIV infection is supported by genetic studies on vitamin D receptor (VDR) gene polymorphisms."
Posted by Larry Hoover on March 24, 2009, at 7:20:42
In reply to 25(OH)D insufficiency 1,25(OH)2D above upper limit, posted by iforgotmypassword on March 23, 2009, at 19:58:59
> Other than possible added fatigue, i personally have never noted any effect from vitamin d supplementation, even though my latest results are quite wierd.
5000 IU for maybe a week or two may not produce effects which enter into consciousness, but I can assure you that your body is "conscious" of the difference.
> My latest levels were a bit of a paradox:
>
> 25-hydroxy vitamin D was 50 something.
> 1,25-dihydroxy vitamin D was 280 something.
>
> My psychiatrist gave the results to me over the phone, so I don't have a copy of my own yet, but he said the first one was listed as insufficiency, and the second as well above the upper limit. I was supplementing 5000 IU every day when I remembered for about a week or two, continuing from what I had been rx'd the last time I took vitamin d but was too lazy too refill and forgot about it. (Initially, I had no detectable levels of 25(OH)D.)
>
> He doesn't know what to suggest from observing the results, but I guess I should go see my GP or naturopath? I have discontinued the vitamin d supplementation now. It still seems wierd since 5000 IU isn't necessarily that high a dose and seems quite common, and especially since I am still "insufficient" in 25(OH)D stores. Could there be something else causing this I should be worried about?Probably not. Once I looked, the answer really wasn't hard to find at all.
Low vitamin D status leads to high levels of white blood cells. One type of those cells, the macrophage, has the capacity to convert 25-(OH)D to 1,25-(OH)2D. The simplest explanation is almost always correct.....this is a temporary situation arising because your vitamin D levels were so low before treatment. In effect, your body is so ramped up seeking any scrap of vitamin D that it is briefly going to over-react, until it can settle down into a new stable state.
Just to be thorough, there may be a possibility that you have an underlying granulomatous disorder. Again, this is mediated by macrophages.
I strongly recommend that you resume vitamin D supplementation. Your 25-(OH)D is still way low. The other will normalize soon. If, after three months of steady supplementation, your 1,25-(OH)2D levels are still elevated, then it may be time to investigate further.
> When the numbers are all perfectly normal, can I expect some benefit in terms of physical and mental energy and cognitive clarity?Those would be reasonable expectations....depending on general improvement in diet. I don't suspect that vitamin D deficiency has occurred in a vacuum. And getting your vitamin D levels stabilized should be accompanied with enhanced calcium and magnesium intakes, at the very least. Vitamin D isn't going to fix everything.
Lar
Posted by DG77 on March 24, 2009, at 15:34:09
In reply to Re: Vitamin D! **Larry Hoover** » DG77, posted by garnet71 on March 23, 2009, at 15:56:53
Hi yourself. :) I read Larry's posts in another Vitamin D thread, but I'm not sure if I caught the one you're referring to.
I use the NOW brand, 1,000 IU caps, anywhere from one to three caps a day. That's in addition to 400 IU in a multivitamin (Nature's Way Daily Two Without Iron). I also have a couple of protein shakes a day with milk, so that bumps up my daily intake even further.
After reading Larry's response to my post, it sounds like there's no reason for me to take less than three of the 1,000 IU caps a day, even with the additional Vitamin D I'm getting on top of that.
Posted by DG77 on March 24, 2009, at 15:39:48
In reply to Re: Vitamin D! **Larry Hoover** » DG77, posted by Larry Hoover on March 23, 2009, at 19:06:17
I had a feeling you'd be able to clear that up, Lar. :) Some potential side effects are scarier than others, and "kidney stones" is closer to the top of the list than the bottom...lol. Sounds like there's little actual reason to be wary, though.
Posted by bleauberry on March 24, 2009, at 17:03:56
In reply to Re: Vitamin D! **Larry Hoover** » bleauberry, posted by Larry Hoover on March 24, 2009, at 7:05:44
Thanks for the time it took to look into the Marshall Protocol, Larry. I happen to agree with all your opinions on the matter.
Sure, it will work for someone. Why or how, who knows. I doubt any success has much to do with what he does with VitD. The bedrock of his protocol is a strategy of pulsing antibiotics that have intracellular penetration. I am in the camp that believes a fair amount of Fibro, CFS, MS, and psychiatric patients are actually under the invasion of a hidden undiagnosable bacteria which cause immune dysfunctions, inflammation, disruption of normal cellular activities, and systemic poisoning by excreted toxins, the bacteria hidden within cells or undetectable due to being cellwall-less. So obviously, in the context of this theory, antibiotics are going to help people. Regardless of whether they avoid VitD or not.
I am also in the camp that believes many more people have Lyme disease than has been diagnosed. So obviously taking some antibiotics is going to lead to some unexplained Herx reactions and improvements. Again, regardless of avoiding VitD.
I saw a web page written by Marshall for a magazine where he states Vit D, contrary to popular acceptance, is actually immunosuppressive. But, no evidence or references. Instead, he says people have been taking VitD supplements for years but chronic diseases continue to escalate. As if there was some way to link those two issues.
Some people have been healed of horrible afflictions by his protocol. But like I said, if an infection is indeed the hidden enemy, then of course some longterm pulsed antibiotics are going to help. On the other hand, there is a growing body of patients who have not been helped by his protocol because it was so torturous and rough that they could not persist with the treatment.
I'll personally stick with what my LLMD and Larry Hoover have to say. Both seem smart and scientific a few notches above the norm.
This is the end of the thread.
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