Vitamin D
Vitamin D supplementation is something often recommended to cancer patients, so I thought I would share this article, which warns that it may not be that simple: Vitamin D article
Comments
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It is certainly not simple, however it appears vitamin D does improve the odds when it comes to breast cancer: Vit D and Breast Cancer
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Muska, that study may be making the wrong inference. That is exactly what the article I posted talks about. The study you posted says that women who already had high vitamin D at DX had better survival and then it says that therefore women should maintain high D. The "therefore" may be misguided. It may be that low D is simply a marker of more serious/deadly disease. In other words, the process that lead to the more serious cancer may also have led to low D. So the answer is not necessarily to take a lot of vitamin D.
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Vitamin D supplementation is not simple. It has long been known that it can even be toxic, however, low vitamin D levels are not a good thing either. Being deficient of any vitamin is hardly ideal. For those of us whose vitamin D levels tank without supplementation, taking vitamin D everyday is, I believe, pretty danged important. A blood test is a relatively easy and inexpensive way to monitor one's vitamin D levels to determine if supplementation is necessary or desirable. There is really no reason to guess at this-my insurance even pays for this test without me having to jump up and down. LOL.
I take 5000 I.U. daily and have my levels checked twice per year. Prior to supplementation my levels were basically non-existent, with supplementation as ordered by my doctor, they remain in the normal/high range but far from being anywhere close to the toxic level. Whether or nor this helps to prevent a recurrence of BC is debatable I guess (the whole chicken/egg thing) but being deficient in vitamin D is not being touted as being healthy either.
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Labelle, yes, although some studies, according to the article that is, found negative correlations with vit D doses in the range of 40.000-60.000 I.U a month (i.e. doses that are less than half of what you and many other people routinely take).
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I saw that, but there was really no distinction made between those taking high doses of vitamin D that bring their individual levels up to very high (one would imagine) or to just up to something like normal. Perhaps it is less about how much vitamin D you take than it is about the end result-the levels of vitamin D in your system when all is said and done. I think most people taking this dosage would end up with very high levels of vitamin in their blood-for whatever reason I don't so I'll keep taking mine-the evidence that being low on vitamin D is not good for one's bones is I think still pretty convincing. BC prevention aside, osteoporosis is not one of the problems I want in my lifetime.
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I second what Labelle said above. I am taking Vit D3 only because my MO prescribed it from the start (my first measurement was 30.) I took 2,000 units a day for about 1.5 years and had Vit D3 at 46 -50. At my last checkup in October I was told to double the dose to 4,000, to my question about overdosing my MO responded there was no way I could overdose by taking 4,000 a day and she wanted it to be above 60. I think she is taking into account that I am on anastrazole. -
Just saw this article regarding low Vit D levels. (just to add to any confusion)
http://www.sciencedaily.com/releases/2016/01/16010...
http://www.sciencedaily.com/news/health_medicine/vitamin_d/
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I had my physical yesterday. My internist noticed I was prescribed 4,000 units of D3 daily, voiced some doubt about my needing it and ordered vit D blood test. I just checked my result - it's 70. I wonder what he and my oncologist will say about it.
If you are on an AI and are taking vit D, what level did your MO set as target?
Editing to add link to an interesting article about vit
Vitamin D and Cancer: A Uniform Dose Is Unlikely to Fit All Patients -
muska, in my opinion, 70 is great! I take D3 with K2 because supposedly they interact together. I asked my oncologist about toxicity and she said there isn't any real proof about toxic levels, and at the time I had gotten mine to 98. She was not worried. I did find some online data showing there is a sweet spot, too little or too much isn't good, but I recall somewhere between 50 and 100 is optimal. I can't find the link that talked about the optimal levels, sorry about that! I also found information saying keeping d levels in a good range is believed to help women stay on aromatase inhibitors more effectively because it helps reduce bone pain. I think it was a document put out by UCSD. I can't find that article, but I did find this one. I also take no calcium.
Hopefully the link works
http://www.womenshealth.northwestern.edu/blog/brea...
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These are three old posts. The key is RE: Dr Heaney. He is now retired from Creighton. He answered my questions within 6 hours.
Mar 25, 2015 02:09PM - edited Mar 25, 2015 02:40PM by sas-schatzi
I bumped into this. New area of study. Very early, but has promise. Sometimes when something this exciting comes along it spurs allot of research wide and far.
New research identifies promising drug therapy target for breast cancer
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I also bumped into this re: Vitamin D. I posted it on Insomniacs too. We had a discussion re: dose. This satisfies my need to know what are the current recommendations. I was having difficulty finding Evidence Based Research on Google. Love it when research falls into my lap.
"YAY Hootie Hoo- I was researching something else and happened upon an article that referenced research that says current recommendations re: Vita D was WRONG by a factor of ten. This is the statement made by the lead researchers
"Researchers at UC San Diego and Creighton University have challenged the intake of vitamin D recommended by the National Academy of Sciences (NAS) Institute of Medicine (IOM), stating that their Recommended Dietary Allowance (RDA) for vitamin D underestimates the need by a factor of ten."
"Both these studies suggest that the IOM underestimated the requirement substantially," said Garland. "The error has broad implications for public health regarding disease prevention and achieving the stated goal of ensuring that the whole population has enough vitamin D to maintain bone health."
'Robert Heaney, M.D., of Creighton University wrote: "We call for the NAS-IOM and all public health authorities concerned with transmitting accurate nutritional information to the public to designate, as the RDA, a value of approximately 7,000 IU/day from all sources."
Full article http://www.news-medical.net/news/20150318/Recommended-intake-of-vitamin-D-miscalculated-by-IOM-experts-say.aspx
Mar 27, 2015 04:36PM sas-schatzi wrote:
Mar 25, 2015 04:08PM , edited Mar 25, 2015 04:21PM by sas-schatzi
Okey dokey, I emailed Dr. Haney at Creighton University. This is what I wrote to him.
"Dr. Haney, Thank you for your work on osteoporosis and Vitamin D3. I'm s/p breast cancer(BC) 6 years. Also, one year s/p papillary thyroid cancer with a follicular variant. Still very active in the breastcancer.org(BCO) discussion community.
I just posted the article "Recommended intake of vitamin D miscalculated by IOM, experts say" from March 18th, 2015 from new-medical.net. It has raised questions re: breast cancer survivors. BCO members come from all over the world. As a consequence, we are all being told different ways to manage post breast cancer life. It ranges from "do not take vitamin D supplements to take 5000 units a day. The article referencing your research and The research in California(forgot his name)will help the BCO member's that see my post.
I was delighted to find your article. I researched dose, but was having trouble finding EBR. Looking for something else, and the article fell into my sight. YAY.
The questions? Is there a contraindication to Vitamin D3 supplementation by breast cancer survivors? What amount of Vitamin D3 should a breast cancer patient/survivor take? What amount of Vitamin D3 should a Breast cancer patient/survivor that has been previously diagnosed as deficient? ( pre BC-I was originally < 4 not detectable) Do cancer patients differ in the amount of Vitamin D3 needed versus the rest of the population? What is D2's role with cancer patients? Is there a link between Vitamin D deficiency and BC? Vitamin D3 deficiency and Thyroid cancer? Recommendation on dose of Vitamin D3 for Metastatic Breast Cancer (MBC), specifically but not limited too, bone mets?
Forgive me, I got carried away with the questions. The thought of getting answers from someone so knowledgeable about Vitamin D, has my head in the clouds.
I realize osteoporosis is your schtick, but trying to get decent recommendations for cancer patients regarding supplements is not good. Most docs don't keep up on it. The research is not being done across the gamut of supplements. NCCAM isn't much help. This causes too many cancer survivors, being subject to bad information.
My volunteer role as a retired nurse in the BCO discussion group has been to seek out the most current EBR on information that impacts our care.
Thank you in advance for any insight you can give us,
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Sent second email
"Dr. Haney, Sorry about the big oops in directing all my statements on Vitamin D as Vitamin D3. But it does raise the questions Re; what we should be taking as a supplement i.e. D, D3, D2. Thanks, "
Mar 27, 2015 04:37PM sas-schatzi wrote:
6 hours ago , edited 6 hours ago by sas-schatziWOW Dr. Heaney answered my email the same day, I didn't open email till today. LOL Now I wish asked lot's more questions.
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Is there a contraindication to Vitamin D3 supplementation by breast cancer survivors? No
What amount of Vitamin D3 should a breast cancer patient/survivor take? Whatever it takes to get serum 25(OH)D above 40 ng/mL – typically 4000–6000 IU/d from all sources.
What amount of Vitamin D3 should a Breast cancer patient/survivor that has been previously diagnosed as deficient? ( pre BC-I was originally < 4 not detectable) Same as everyone else. See answer above.
Do cancer patients differ in the amount of Vitamin D3 needed versus the rest of the population? No
What is D2 a role with cancer patients? None. D3 does it all – better and cheaper than D2
Is there a link between Vitamin D deficiency and BC? Probably. Adequate vitamin D status helps our bodies recognize and throw off cancers in their earliest stages. Probably works better for some cancers than for others. We don't know for sure which are protected and which are not.
Vitamin D3 deficiency and Thyroid cancer? See above. The link is clearter for breast cancer than for thyroid cancer
Recommendation on dose of Vitamin D3 for Metastatic Breast Cancer (MBC), specifically but not limited to, bone mets? Same as above. But no harm in pushing to a higher level, such as 60–80 ng/mL. (But don't go above 200 ng/mL.)
Robert P. Heaney, M.D.
John A. Creighton University Professor Emeritus
Creighton University
2500 California Plaza
Omaha, NE 68178
Tel: 402 280 4029
Blog: <http://blogs.creighton.edu/heaney/>-------------------------------------------------------------------
About Dr. Heaney
Robert P. Heaney, BS'47, MD'51, is a clinical endocrinologist specializing in nutrition. Until 2014 He held the John A. Creighton University Professorship. He is world-renowned for providing nearly 50 years of advancements in our understanding of bone biology, osteoporosis, and human calcium and vitamin D physiology
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Thank you for researching Vit D links and contacting Dr. Heaney. This confirmation is wonderful news and I will continue to use this supplement along with a few others. I can't recall my initial Vit D when dx but it may have been in 15 - 20 ng/ml range. Now I attempt to maintain with the 50-70 ng/ml range with supplements.
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Thank you!!!
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include K2 with the vitamin D. They work synergistically together. Had oncologist appointment after final Herceptin, and she said we monitor d level long term, just keep it high. Said it is super important, along with exercise. And she is strictly by the book. Told me keeping bones strong, avoiding osteoporosis is key to preventing bone mets. If bones are strong and dense enough, cancer has a harder time growing there
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ItalyChick your oncologist's reasoning makes a lot of sense about keeping bones strong. I've been taking ~2000IU vitamin D for a while now, and I added 100mcg K2 about a month ago. My last vitamin D test was a couple years ago and it was 29 I think. I have osteoporosis in my spine and osteopenia in my hip, so I need to strengthen my bones as much as I can. My PCP doesn't want to put me on bone strengtheners because he thinks their side effects are not worth their benefits, plus it could make my bones brittle even though they are denser. I'd rather do it naturally and we'll see where it leads.
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Look into strontium, a product called Bone Up (http://www.amazon.com/gp/product/B0045X82OE?keywor...) and Biosil to take for approximately two months. Strontium should not be taken close to calcium. I had an upper tooth implant and before the implant my husband put me on that regimen and the dentist said I grew bone there that was denser than the rest of my jaw bone. But not for long term use, just for the short term. Do exactly what the products prescribe if you try it, don't overdo it.
I got my Vitamin D level to between 70 and 90 during chemo using a product called Bio-D-Mulsion Forte made by Biotics Research. It's a liquid where I put drops under my tongue.
I found articles by a UCSD doctor and others that said getting D levels high also helps women stay on AIs longer because it can help reduce bone pain.
All the foregoing is an n=1 (me), so no guarantees that what worked for me will work for anybody else. Got get a disclaimer in, lol.
Consulting with a naturopath might help since they might do something similar for bone issues.
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Calcium is no longer recommended as an oral supplement. Associated with heart risk.
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yes I agree, I take no calcium supplements
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Interestingly, I have been told take calcium supplements by my MO. I will ask again in May when I see her.
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My onc also wanted to me to take 1200mg of calcium. I've been doing it, because I am not eating dairy anymore.
And ItalyChick, I'm also in San Diego!
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When I was getting Zometa infusions and now Prolia injections - the nurse reminded me to take my Vit D and Calcium supplements.
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Just like Italychick said, don't forget the Vitamin K2 to make sure that calcium gets into your bones, otherwise you may be wasting your time if you are on Vitamin D3 without the Vitamin K2.
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Italychick - Did your MO approve the strontium? Prior to diagnosis I was taking a whole food calcium supplement formula that contains strontium, and continued until recently. Then I ran across the following study and it scared me into changing to a different supplement without the strontium. I also have to take some calcium to supplement my dairy-free diet, but I track everything I eat and only take it as needed, with vitamin D, K2 and magnesium. I get a lot of vitamin K in my diet as well.
Environ Res. 2012 Jan;112:212-7. doi: 10.1016/j.envres.2011.11.005. Epub 2011 Dec 15.
Urinary strontium and the risk of breast cancer: a case-control study in Guangzhou, China.
Chen LJ1, Tang LY, He JR, Su Y, Cen YL, Yu DD, Wu BH, Lin Y, Chen WQ, Song EW, Ren ZF.
Author information
Abstract
Strontium has been widely used in industries like electronic and pharmacy. It has a carcinogenic potential, however, and no study has been conducted to evaluate its effects on cancer risk. The aim of this study was to explore the possible association between strontium and breast cancer risk in a case-control study including 240 incident invasive breast cancer patients and 246 age-matched controls. We measured the urinary concentrations of strontium by inductively coupled plasma mass spectrometry, and conducted face-to-face interviews to obtain information on potential breast cancer risk factors. Multivariable analysis was used to estimate the association. Creatinine-adjusted levels [median (25th, 75th) μg/g] of strontium were 155.59 (99.05, 230.70) in the breast cancer patients and 119.62 (81.97, 163.76) in the controls. Women in the highest tertile of strontium showed 124% increased risk of breast cancer, when compared with those in the lowest tertile after adjustment for the potential risk factors [OR (95% CI): 2.24 (1.42-3.81)]. This association was particularly strong for HER2 positive breast cancer [OR (95% CI): 10.92 (3.53-33.77)], and only occurred among premenopausal women. These results suggest a potential role of strontium in the development of breast cancer and urge further studies on the environmental contamination and the physiological and pathological mechanisms of strontium.
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solfeo I get my DEXA scan Friday, so I don't know if I need to do any bone strengthening yet. I did it short term for a dental implant, and I actually have denser bone around my implant than in the rest of my mouth.
Now I am wondering if doing the strontium for my implant impacted me somehow, agh!
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but wait a minute, strontium with sufficient k2 and d3 is a different deal. And I only do it for a short period. Long term use of strontium is more problematic.
Why can't doctors inform us about stuff? I do know my oncologist is avid about d3 levels being high and measures mine all the time. Says exercise, d3 and baby aspirin best things I can do post treatment, and she is a very traditional Doctor, doesn't believe in anything alternative
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My MO is next to useless when it comes to supplements, but she is not against alternatives and encourages me to see my naturopath. The ND on the other hand is always telling me to take something that could interfere with tamoxifen, because that isn't his area of familiarity, so I can't trust either one of them. And they are the cream of the crop where I live. I have to do all of my own research and with my science challenged brain that can take awhile. I can't believe I missed the thing about the strontium all this time but with all the double and triple checking I do of everything that goes in my mouth, it just didn't dawn on me that a bone health formula could have anything bad for me in it. We really do have to check out every ingredient, ladies!
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I just found this thread - very interesting.
sas-schatzi - could you tell me more about your statement that, "Calcium is no longer recommended as an oral supplement. Associated with heart risk."
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I've had the same experience where my physicians have none to minimal background with supplement recommendations. I've had to do my own research but finally found a nutritionist who has experience with cancer patients. At least she can guide me to reputable supplements with tested and approved ingredients. In the past, she had mentioned a strontium supplement but I could not accept the fact that it was not a natural component of bones. So instead she recommended OsAplex MK-7 by Xymogen which contains Vit D & K plus calcium. So I am satisfied that it contains natural ingredients. I believe you may need a script to order or can get from an NP.
I just wanted to add that my doctors have mentioned they simply do not have the time to research and read on latest news and studies. So I guess it falls back onto the patient.....
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http://www.oncologynurseadvisor.com/breast-cancer/...
Vitamin D Deficiency Increases Risk of Tumor Growth and Metastasis in Breast Cancer
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is there a difference in getting supplemental vit d then getting it from the sun?
I live in tropical Australia and get plenty of sun, but just glanced over my last lot of blood tests and it appears I have never had vit d tested.
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BlueKoala- I live in California(stones throw from the beach). I'm outdoors a lot. Just not happy indoors. Prior to BC, my Vit D level was checked in February(winter here). It was 25, which I was told was low(the scale seems to have changed). This is higher than anyone else I knows. I'm just not sure it's possible to get your Vit D level up by sunshine. I've had squamous cell skin cancer once & basal cell skin cancer many times. My dermatologist thinks I get too much sun. I take 2000 Vit D most days & I hover above 40 at all times of the year.
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