Friday,
September 15, 2006
Influenza (from Italian
-Medieval Latin Influentia) Season around the Corner
The
ANNOTICO Report
The
word influenza comes from Italian (Medieval Latin Influentia)
or influence, because of the belief that the sudden and abrupt epidemics were
due to the influence of some extraterrestrial force. One seventeenth century
observer described it well when he wrote, "suddenly a
Distemper arose, as if sent by some blast from the stars, which laid
hold on very many together: that in some towns, in the space of a week, above a
thousand people fell sick together."
It's
only a question of when a pandemic will come, not if it will come. Influenza A
pandemics come every 30 years or so, severe ones every hundred years or so. The
last pandemic, the
Young
healthy adults, in the prime of their lives in the morning, drowning in their
own inflammation by noon, grossly discolored by sunset, were dead at midnight.
Their body's own broad-spectrum natural antibiotics,
called antimicrobial peptides, seemed nowhere to be found. An overwhelming
immune response to the influenza virus - white blood cells releasing large
amounts of inflammatory agents called cytokines and chemokines
into the lungs of the doomed - resulted in millions of deaths in 1918.
Dr.
Cannell suggests that 2,000 daily units of Vitamin D can help you avoid the Flu.
BUT Do
I
am very Anti fad, am the the epitome of a cynic, and
skeptic. I shy away from Prescription Drugs, and for my enlarged Prostate,
I take natural Saw Palmetto, which has NONE of the side effects.
I'm
Really Rather Healthy, and my only medical symptom is Peripheral Neuropathy . It is a numbness that starts in the feet and worked
it's way up to my hips. The Neurologists took
ALL kinds of tests,,,, and pronounced they could do
NOTHING. Fortunate for me it was "sensory" (feeling) rather than
"motor" (muscular). I researched, and found that low levels of Folic
acid can be responsible. I started taking Folic Acid Tablets and the Numbness
has receded ALL the way down to my Toes!!!!!!! I'm a believer!!!!
We
are what we Eat! Modern Urban dwellers don't get the Vits and Mins they Need. Supplements are the way to go.
I
find that at 76, when I don't take my Multi Vits,
plus Vit C, & E , I
don't have my usual Energy level.
Dr
Connell's rather lengthy article boils down to this. Vitamin D is unique in the
vitamin world by virtue of three facts.
First, it's the only known
precursor of a potent steroid hormone, calcitriol, or
activated vitamin D. Most other vitamins are antioxidants or co-factors in
enzyme reactions. Activated vitamin D - like all steroid hormones - damasks the
genome, turning protein production on and off, as your body requires.
Second,
vitamin D does not exist in appreciable quantities in normal human diets.
Americans depend on Milk for their vitamin D that has
only with a paltry 100 units per eight-ounce glass.
The Third way
vitamin D is different from other vitamins is the dramatic difference between
natural vitamin D Nutrition and the modern one.
Formerly, Vitamin
D steroid hormone system has always had its origins Naturally through
the Skin from the Sun, not in the Mouth. Until recently, when
dermatologists began warning us about the dangers of sunlight. We
just cannot get adequate amounts of vitamin D from our diet, and if we don't
expose ourselves to ultraviolet light, we must get vitamin D from dietary
supplements.
Today,
most humans only make about a thousand units of vitamin D a day from sun
exposure; many people, such as the elderly or African Americans, make much less
than that. A single, twenty-minute, full body exposure to summer sun will
trigger the delivery of 20,000
units of vitamin D into the circulation of most people within
48 hours. Twenty thousand
units, that's the single most important fact about vitamin D.
Compare that to the 100 units you get from a glass of milk, or the several
hundred daily units the
Of Additional concern. It has only recently
been learned how vitamin D increases production of antimicrobial peptides while
simultaneously preventing the immune system from releasing too many
inflammatory cells, called chemokines and cytokines,
into infected lung tissue.
Because in 1918, when medical scientists did autopsies on some of the fifty
million people who died d! uring
the 1918 flu pandemic, they were amazed to find destroyed respiratory tracts;
sometimes these inflammatory cytokines had triggered the complete destruction
of the normal epithelial cells lining the respiratory tract. It was as if the
flu victims had been attacked and killed by their own immune systems. This is
the severe inflammatory reaction that vitamin D has recently been found to
prevent.
Vitamin
D in 400 I.U form in a 250 tablet bottle for $10.
Take 5 a day. and that's a 50 day supply, or 20
cents a day.
I saw an ad on the Web. A Special. Puritan's
Pride. Buy one bottle get 2 Free. (Shipping is
$3.95 on any order).
I'd
call 20 cents a day a good investment, NOT possibly harmful, and if a waste of
money, a pittance.
Let
me know your thoughts or experiences.
Medical
News Today
Dr.
John Cannell
15
Sep 2006
In
early April of 2005, after a particularly rainy spring, an influenza
epidemic (epi: upon, demic:
people) exploded through the maximum-security hospital for the criminally
insane where I have worked for the last ten years. It was not the pandemic
(pan: all, demic: people) we all fear, just an
epidemic. The world is waiting and governments are preparing for the next
pandemic. A severe influenza pandemic will kill many more Americans than died
in the World Trade Centers, the
It's only a question of when a pandemic will come, not if it will come.
Influenza A pandemics come every 30 years or so, severe ones every hundred
years or so. The last pandemic, the
As I am now a psychiatrist, and no longer a general practitioner, I was not
directly involved in fighting the influenza epidemic in our hospital. However,
our internal medicine specialists worked overtime as they diagnosed and treated
a rapidly increasing number of stricken patients. Our Chief Medical Officer
quarantined one ward after ano! ther as more and more patients were gripped with the
chills, fever, cough, and severe body aches that typifies the clinical
presentation of influenza A.
Epidemic influenza kills a million people in the world every year by causing
pneumonia, "the captain of the men of death" These epidemics are
often explosive; the word influenza comes from Italian (Medieval Latin Influentia) or influence, because of the belief that the
sudden and abrupt epidemics were due to the influence of some extraterrestrial
force. One seventeenth century observer described it well when he wrote,
"suddenly a Distemper arose, as if sent by some
blast from the stars, which laid hold on very many together: that in some
towns, in the space of a week, above a thousand people fell sick
together."
I guess our hospital was under luckier stars as only about 12% of our patients
were infected and no one died. However, as the epidemic progressed, I noticed
something unusual. First, the ward below mine ! was infected, and then the ward on my right, left, and
across the hall - but no patients on my ward became ill. My patients had
intermingled with patients from infected wards before the quarantines. The
nurses on my unit cross-covered on infected wards. Surely, my patients were
exposed to the influenza A virus. How did my patients
escape infection from what some think is the most infectious of all the
respiratory viruses?
My patients were no younger, no healthier, and in no obvious way different from
patients on other wards. Like other wards, my patients are mostly African
Americans who came from the same prisons and jails as patients on the infected
wards. They were prescribed a similar assortment of powerful psychotropic
medications we use throughout the hospital to reduce the symptoms of psychosis,
depression, and violent mood swings and to try to prevent patients from killing
themselves or attacking other patients and the nursing staff. If my patients
were similar t! o the patients on all the adjoining wards,
why didn't even one of my patients catch the flu?
A short while later, a group of scientists from UCLA published a remarkable
paper in the prestigious journal, Nature. The UCLA group confirmed two other
recent studies, showing that a naturally occurring steroid hormone - a hormone
most of us take for granted - was, in effect, a potent antibiotic. Instead of
directly killing bacteria and viruses, the steroid hormone under question
increases the body's production of a remarkable class of proteins, called
antimicrobial peptides. The 200 known antimicrobial peptides directly and
rapidly destroy the cell walls of bacteria, fungi, and viruses, including the
influenza virus, and play a key role in keeping the lungs free of infection.
The steroid hormone that showed these remarkable antibiotic properties was
plain old vitamin D.
All of the patients on my ward had been taking 2,000 units of vitamin D every
day for several month! s or
longer. Could that be the reason none of my patients caught the flu? I then contacted
Professors Reinhold Vieth and Ed Giovannucci
and told them of my observations. They immediately advised me to collect data
from all the patients in the hospital on 2,000 units of vitamin D, not just the
ones on my ward, to see if the results were statistically significant. It turns
out that the observations on my ward alone were of borderline statistical
significance and could have been due to chance alone. Administrators at our
hospital agreed, and are still attempting to collect data from all the patients
in the hospital on 2,000 or more units of vitamin D at the time of the
epidemic.
Four years ago, I became convinced that vitamin D was unique in the vitamin
world by virtue of three facts. First, it's the only known precursor of a
potent steroid hormone, calcitriol, or activated
vitamin D. Most other vitamins are antioxidants or co-factors in enzyme
reactions. Activated vitamin! D - like all steroid
hormones - damasks the genome, turning protein production on and off, as your
body requires. That is, vitamin D regulates genetic expression in hundreds of
tissues throughout your body. This means it has as many potential mechanisms of
action as genes it damasks.
Second, vitamin D does not exist in appreciable quantities in normal human
diets. True, you can get several thousand units in a day if you feast on
sardines for breakfast, herring for lunch and salmon for dinner. The only
people who ever regularly consumed that much fish are peoples, like the Inuit,
who live at the extremes of latitude. The milk Americans depend on for their
vitamin D contains no naturally occurring vitamin D; instead, the
The vitamin D steroid hormone system has always had its origins in the skin,
not in the mout! h. Until quite recently, when
dermatologists and governments began warning us about the dangers of sunlight,
humans made enormous quantities of vitamin D where humans have always made it,
where naked skin meets the ultraviolet B radiation of sunlight. We just cannot
get adequate amounts of vitamin D from our diet. If we don't expose ourselves
to ultraviolet light, we must get vitamin D from dietary supplements.
The third way vitamin D is different from other vitamins is the dramatic
difference between natural vitamin D nutrition and the modern one. Today, most
humans only make about a thousand units of vitamin D a day from sun exposure;
many people, such as the elderly or African Americans, make much less than
that. How much did humans normally make? A single, twenty-minute, full body
exposure to summer sun will trigger the delivery of 20,000 units of vitamin D
into the circulation of most people within 48 hours. Twenty thousand units,
that's the single most important ! fact about vitamin
D. Compare that to the 100 units you get from a glass of milk, or the several
hundred daily units the U.S. government recommend as ?Adequate Intake.? It's
what we call an ?order of magnitude? difference.
Humans evolved naked in sub-equatorial Africa, where the sun shines directly
overhead much of the year and where our species must have obtained tens of
thousands of units of vitamin D every day, in spite of our skin developing heavy
melanin concentrations (racial pigmentation) for protecting the deeper layers
of the skin. Even after humans migrated to temperate latitudes, where our skin
rapidly lightened to allow for more rapid vitamin D production, humans worked
outdoors. However, in the last three hundred years, we began to work indoors;
in the last one hundred years, we began to travel inside cars; in the last
several decades, we began to lather on sunblock and
consciously avoid sunlight. All of these things lower vitamin D blood levels.
The inesca! pable
conclusion is that vitamin D levels in modern humans are not just low - they
are aberrantly low.
About three years ago, after studying all I could about vitamin D, I began
testing my patient's vitamin D blood levels and giving them literature on
vitamin D deficiency. All their blood levels were low, which is not surprising
as vitamin D deficiency is practically universal among dark-skinned people who
live at temperate latitudes. Furthermore, my patients come directly from prison
or jail, where they get little opportunity for sun exposure. After finding out
that all my patients had low levels, many profoundly low, I started educating
them and offering to prescribe them 2,000 units of vitamin D a day, the U.S.
government's ?Upper Limit.?
Could vitamin D be the reason none of my patients got the flu? In the last
several years, dozens of medical studies have called attention to worldwide
vitamin D deficiency, especially among African Americans and the elderly! , the two groups most likely to die from influenza. Cancer,
heart disease, stroke, autoimmune disease, depression, chronic pain,
depression, gum disease, diabetes, hypertension, and a number of other diseases
have recently been associated with vitamin D deficiency. Was it possible that
influenza was as well?
Then I thought of three mysteries that I first learned in medical school at the
University of North Carolina: (1) although the influenza virus exists in the
population year-round, influenza is a wintertime illnesses; (2) children with
vitamin D deficient rickets are much more likely to suffer from respiratory
infections; (3) the elderly in most countries are much more likely to die in
the winter than the summer (excess wintertime mortality), and most of that
excess mortality, although listed as cardiac, is, in fact, due to influenza.
Could vitamin D explain these three mysteries, mysteries that account for
hundreds of thousands of deaths every year? Studies! have
found the influenza virus is present in the population year-around; why is it a
wintertime illness? Even the common cold got its name because it is common in
cold weather and rare in the summer. Vitamin D blood levels are at their
highest in the summer but reach their lowest levels during the flu and cold
season. Could such a simple explanation explain these mysteries?
The British researcher, Dr. R. Edgar Hope-Simpson, was the first to document
the most mysterious feature of epidemic influenza, its wintertime surfeit and
summertime scarcity. He theorized that an unknown ?seasonal
factor? was at work, a factor that might be affecting
innate human immunity. Hope-Simpson was a general practitioner who became
famous in the late 1960's after he discovered the cause of shingles. British
authorities bestowed every prize they had on him, not only because of the
importance of his discovery, but because he made the discovery own his own,
without the benefit of a university! appointment, and
without any formal training in epidemiology (the detective branch of medicine
that methodically searches for clues about the cause of disease).
After his work on shingles, Hope-Simpson spent the rest of his working life
studying influenza. He concluded a ?seasonal factor? was at work, something that was regularly and predictably
impairing human immunity in the winter and restoring it in the summer. He
discovered that communities widely separated by longitude, but which shared
similar latitude, would simultaneously develop influenza. He discovered that
influenza epidemics in
Hope-Simpson had no way of knowing that vitamin D has profound effects on human
immunity, no way of knowing that it increases production of broad-spectrum
antimicrobial peptides, peptides that quickly destroy the influenza virus. We
have only recently learned how vitamin D increases production of antimicrobial
peptides while simultaneously preventing the immune system from releasing too
many inflammatory cells, called chemokines and
cytokines, into infected lung tissue.
In 1918, when medical scientists did autopsies on some of the fifty million
people who died during the 1918 flu pandemic, they were amazed to find
destroyed respiratory tracts; sometimes these inflammatory cytokines had
triggered the complete destruction of the normal epithelial cells lining the
respiratory tract. It was ! as
if the flu victims had been attacked and killed by their own immune systems.
This is the severe inflammatory reaction that vitamin D has recently been found
to prevent.
I subsequently did what physicians have done for centuries. I experimented,
first on myself and then on my family, trying different doses of vitamin D to
see if it has any effects on viral respiratory infections. After that, as the
word spread, several of my medical colleagues experimented on themselves by
taking three-day courses of pharmacological doses (2,000 units per kilogram per
day) of vitamin D at the first sign of the flu. I also asked numerous
colleagues and friends who were taking physiological doses of vitamin D (5,000
units per day in the winter and less, or none, in the summer) if they ever got
colds or the flu, and, if so, how severe the infections were. I became
convinced that physiological doses of vitamin D reduce the incidence of viral
respiratory infections and that pharmacological! doses
significantly ameliorate the symptoms of some viral respiratory infections if
taken early in the course of the illness. However, such observations are so
personal, so likely to be biased, that they are worthless science.
As I waited for the hospital to finish collecting data from all the patients
taking vitamin D at the time of the outbreak - to see if it really reduced the
incidence of influenza - I decided to research the literature thoroughly,
finding all the clues in the world's medical literature that indicated if
vitamin D played any role in preventing influenza or other viral respiratory
infections. I worked on the paper for over a year, writing it with Professor
Edward Giovannucci of Harvard, Professor Reinhold Vieth of the University of Toronto, Professor Michael Holick of Boston University, Professor Cedric Garland of
U.C., San Diego, as well as Dr. John Umhau of the
National Institute of Health, Sasha Madronich of the
National Center for Atmospheric Re! search, and Dr.
Bill Grant at the Sunlight, Nutrition and
Epidemiology and Infection, known as The Journal of Hygiene in
Hope-Simpson's day, recently published our paper. The editor, Professor Norman Noah, knew Dr.
Hope-Simpson and helped tremendously with the paper. In the paper, we detailed
our theory that vitamin D is Hope-Simpson's long forgotten ?seasonal
stimulus.? We proposed that annual fluctuations in vitamin D levels explain the
seasonality of influenza. The periodic seasonal fluctuations in
25-hydroxy-vitamin D levels, which cause recurrent and predictable wintertime
vitamin D deficiency, predispose human populations to! influenza
epidemics. We raised the possibility that influenza is a symptom of vitamin D
deficiency in the same way that an unusual form of pneumonia (pneumocystis carinii) is a
symptom of AIDS. That is, we theorized that George Bernard Shaw was right when
he said, ?the characteristic microbe of a disease
might be a symptom instead of a cause.?
In the paper, we propose that vitamin D explains the following 14
observations:
1. Why the flu predictably occurs in the months following the winter solstice,
when vitamin D levels are at their lowest,
2. Why it disappears in the months following the summer solstice,
3. Why influenza is more common in the tropics during the rainy season,
4. Why the cold and rainy weather associated with El Nino Southern Oscillation
(ENSO), which drives people indoors and lowers vitamin D blood levels, is
associated with influenza,
5. Why the incidence of influenza is inversely correlated with outdoor tem! peratures,
6. Why children exposed to sunlight are less likely to get colds,
7. Why cod liver oil (which contains vitamin D) reduces the incidence of viral
respiratory infections,
8. Why Russian scientists found that vitamin D-producing UVB lamps reduced
colds and flu in schoolchildren and factory workers,
9. Why Russian scientists found that volunteers, deliberately infected with a
weakened flu virus - first in the summer and then again in the winter - show
significantly different clinical courses in the different seasons,
10. Why the elderly who live in countries with high vitamin D consumption, like
11. Why children with vitamin D deficiency and rickets suffer from frequent
respiratory infections,
12. Why an observant physician (Rehman), who gave
high doses of vitamin D to children who were constantly sick from colds and the
flu, found the treated children were suddenly free from! infection,
13. Why the elderly are so much more likely to die from heart attacks in the
winter rather than in the summer,
14. Why African Americans, with their low vitamin D blood levels, are more
likely to die from influenza and pneumonia than Whites are.
Although our paper discusses the possibility that physiological doses of
vitamin D (5,000 units a day) may prevent colds and the flu, and that
physicians might find pharmacological doses of vitamin D (2,000 units per
kilogram of body weight per day for three days) useful in treating some of the
one million people who die in the world every year from influenza, we remind
readers that it is only a theory. Like all theories, our theory must withstand
attempts to be disproved with dispassionately conducted and well-controlled
scientific experiments.
However, as vitamin D deficiency has repeatedly been associated with many of
the diseases of civilization, we point out that it is not too early for phy! sicians
to aggressively diagnose and adequately treat vitamin D deficiency. We
recommend that enough vitamin D be taken daily to maintain 25-hydroxy vitamin D
levels at levels normally achieved through summertime sun exposure (50 ng/ml). For many persons, such
as African Americans and the elderly, this will require up to 5,000 units daily
in the winter and less, or none, in the summer, depending on summertime sun
exposure.
By: J. J. Cannell
Acknowldegement: We wish to thank Professor Norman
Noah of the London School of Hygiene and Tropical Medicine, Professor Robert Scragg of the University of Auckland and Professor Robert
Heaney of Creighton University for reviewing the manuscript and making many
useful suggestions.
-- Dr. John Cannell, Atascadero State Hospital, 10333
El Camino Real, Atascadero, CA 93422, USA, 805 468-2061, jcannell@dmhash.state.ca.us
-- Professor Reinhold Vieth, Mount Sinai Hospital,
Pathology and Laboratory Medicine, Departm! ent of Medicine, Toronto, Ontario, Canada
-- Dr. John Umhau, Laboratory of Clinical and
Translational Studies, National Institute on Alcohol Abuse and Alcoholism,
National Institutes of Health, Bethesda, MD
-- Professor Michael Holick, Departments of Medicine
and Physiology, Boston University School of Medicine, Boston, MA, USA
-- Dr. Bill Grant, SUNARC, San Francisco, CA
-- Dr. Sasha Madronich, Atmospheric Chemistry
Division, National Center for Atmospheric Research, Boulder, CO, USA
-- Professor Cedric Garland, Department of Family and Preventive Medicine,
University of California San Diego, La Jolla, CA
-- Professor Edward Giovannucci, Departments of
Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA
http://www.vitamindcouncil.com
Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, Garland CF, and Giovanucci
E. Epidemic Influenza and Vit! amin D. Epidemiol Infect.
2006 Sep 7;:1-12 (Epub ahead
of print)
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