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Vitamin D Deficiency May Be Related to Bone Marrow Health

By Greg Arnold, DC, CSCS, December 14, 2010, abstracted from “Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia (CLL)” in the November 4, 2010 issue of Blood

An emerging health concern among patients with chronic pain (1), pregnancy complications (2) and cardiovascular disease (3) is vitamin D deficiency. The average U.S. adult consumes about 230 IU vitamin D per day (4). Current recommendations by the National Institutes of Health are 200 IU daily for individuals younger than 50 years, 400 IU daily for individuals between age 50 and 70 years, and 600 IU for those older than age 70 years (5). However, because of the prevalence of vitamin D deficiency and admission by the FDA that up to 10,000 IU per day is considered safe (6), the need to increase vitamin D intake recommendations seems prudent.

Although no universal levels have been established, most define vitamin D deficiency as blood levels below 20 nanograms per milliliter, vitamin D insufficiency between 21 and 29 ng/ml, and optimal concentration at least 30 ng/ml (7). Research has found that vitamin D insufficiency is present in 25-50% of patients seen in doctors’ offices and it is estimated that up to 1 billion people worldwide have vitamin D insufficiency. A study out of Canada has suggested that insuring vitamin D sufficiency could save $14.4 billion per year (8).

Now a new study (9) has suggested that vitamin D deficiency may play a role in chronic lymphocytic leukemia, a cancer of bone marrow. In addition to causing an estimated 4,390 deaths in 2010, it is estimated that 8,870 men and 6,120 women will be diagnosed with the disease (10), with $125 million in hospital costs each year (no indirect costs of chronic lymphocytic leukemia have been calculated) (11).

In the study, researchers measured vitamin D levels in 390 patients diagnosed with Chronic Lymphocytic Leukemia. At the time of diagnosis, the average vitamin D levels were 30.6 ng/mL, and 30.5% (119 patients) were vitamin D insufficient. The researchers then measured the risk of patients progressing to chemotherapy and overall risk of death over the next 3 years. They found that vitamin D insufficient patients were 66 percent more likely to eventually receive chemotherapy while also having a doubling of their risk of death.

The researchers confirmed these findings with other research showing a 77% reduced risk of cancer in women who increased their daily vitamin D intake by 1100 IU (12). They concluded that “Vitamin D insufficiency was associated with [an increased risk of needing chemotherapy]…as well as a 2-fold increased risk of death” but admit that “Whether normalizing vitamin D levels in deficient CLL patients would improve outcome merits clinical testing.”

Greg Arnold is a Chiropractic Physician practicing in Danville, CA. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com

Reference:

1. Hooten WM. Prevalence and Clinical Correlates of Vitamin D Inadequancy among Patients with Chronic Pain. Abstracft A1380. Presented October 15, 2007 www.asaabstracts.com/strands/asaabstracts/abstract.htm;jsessionid=322B71A1205E5A48DE86C59DD815D36A?year=2007&index=3&absnum=1501
2. Bodnar LM. Maternal Vitamin D Deficiency Is Associated with Bacterial Vaginosis in the First Trimester of Pregnancy. J. Nutr. 2009 139: 1157-1161. First published online June 1, 2009; doi:10.3945/jn.108.103168
3. Lee JH. Vitamin D deficiency an important, common, and easily treatable cardiovascular risk factor? J Am Coll Cardiol. 2008 Dec 9;52(24):1949-56
4. Moore C, Murphy MM, Keast DR, Holick MF. Vitamin D intake in the United States. J Am Diet Assoc 2004;104:980 –3
5. Dietary Supplement Fact Sheet: Vitamin D. Office of Dietary Supplements, NIH Clinical Center, National Institutes of Health. 2007. Available at: http://dietary-supplements.info.nih.gov/factsheets/vitamind.asp
6. Hathcock JN, Shao A, Vieth R, Heaney R. Risk assessment for vitamin D. Am J Clin Nutr 2007;85:6 –18
7. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 2006;84:18 –28.
8. Grant WB. An estimate of the economic burden and premature deaths due to vitamin D deficiency in Canada. Mol. Nutr. Food Res. 2010, 54 , 1 –10
9. Shanafelt TD. Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia (CLL) Blood, Nov 2010; doi:10.1182/blood-2010-07-295683
10. “SEER Stat Fact Sheets: Chronic Lymphocytic Leukemia”
11. Stephens JM. Chronic Lymphocytic Leukemia: Economic Burden and Quality of Life: Literature Review. American Journal of Therapeutics 2005; 12(5): 460-466
12. Lappe JM. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007;85(6):1586-1591