This is a continuation of yesterday’s post. Well, knock me down with a cat’s whisker! I am really pleased with what I found on PubMed: quite a few studies on multiple myeloma and vitamin D levels. Almost 100, in fact! I don’t have time to go through ALL of them (hah)…I have looked only at some of the studies listed on page 1, and I don’t have the full studies with one exception (see below), but the abstracts contain enough information—for now, at least.
For instance, this July 2009 Mayo Clinic study concludes that vitamin D deficiency may portend poorer outcomes in subjects with MM (see: http://tinyurl.com/yz67bxn). Of the 148 newly diagnosed multiple myeloma patients scrutinized at the Mayo Clinic over a period of four years, the ones with vitamin D deficiency had higher levels of C-reactive protein (CRP) and creatinine AND lower serum albumin compared to patients with normal vitamin D levels. Eh that’s not good at all! Furthermore, the D-deficiency increased in parallel with the International Staging System…that is, patients in Stage III were more vitamin-D deficient compared to those in Stage II.
A more recently-published study, http://tinyurl.com/yzxt288, simply mentions myeloma: A vitamin D deficiency has also been documented in patients with prostate cancer, ovarian cancer, as well as multiple myeloma. Larger randomized clinical trials should be undertaken in humans to establish the role of vitamin D supplementation in the prevention of these cancers. I couldn’t agree more.
Truth be told, I am very busy today, so I have time only to post about one more study, titled “Prevalence and significance of vitamin D deficiency in multiple myeloma patients,” published in the British Journal of Haematology in May 2008. The full text is available for free online: http://tinyurl.com/yf8fahx It’s only three pages long, so please go have a look. Good stuff!
This study was conducted on 100 myeloma patients seen at the University of Maryland between September 2006 and October 2006. Of these, 40% turned out to be vitamin D-deficient. FORTY PERCENT…makes you pause for thought, eh? And have a look at this percentage: only 25% had adequate vitamin D levels, defined as more than 75 nmol/l. Eh.
Important: There were no significant correlations between vitamin D status and MM activity (remission, relapsed or newly diagnosed), presence or absence of lytic bone disease and/or fractures or history of osteonecrosis of the jaw (ONJ). So vitamin D didn’t do any harm, which is an important bit of news for us. I was concerned about increased serum calcium and whatnot when I began supplementing with vitamin D last spring. No worries now…
The following excerpt confirms what my endocrinologist told me, that is, that my highish parathyroid hormone, or PTH, levels (for info on PTH, see http://tinyurl.com/ch8za) are connected to my low vitamin D levels: Patients in the vitamin D deficient and insufficient groups had higher serum PTH levels than those in the sufficient group. Interestingly, PTH levels were also higher in patients with renal insufficiency. And in patients with bone pain. Gee whiz. If you have high PTH levels, read this part carefully…
Then on page 2 we are given actual vitamin D supplementation numbers, which is very helpful. The vitamin D-deficient patients were given a huge amount of vitamin D (you will find the exact numbers in the study) until they reached the optimal level of 75 nmol/l, at which point they received maintenance therapy consisting of 1000 IU (international units) of vitamin D3 per day.
Wait. Pause for a moment…a question just popped into my head: on the recommendation of my endocrinologist, I am taking vitamin D3, cholecalciferol, but the folks in the study were given vitamin D2, ergocalciferol. Any comments on this? What form of vitamin D are you taking?
Let’s read on: Responses were favourable in most patients, with increases in 25(OH)D and decreases in PTH levels, even in patients with renal insufficiency. Many symptoms of vitamin D deficiency resolved after supplementation, including muscle weakness (n = 7), fatigue (n = 7) and chronic bone pain (n = 10). Well, this is very good to know. Unfortunately, many of these patients relapsed after one year, but this had nothing to do with their vitamin D levels.
A final excerpt: The present study found a high incidence of vitamin D deficiency in MM patients. Vitamin D deficiency was independent of age, sex and disease status; the lack of sun exposure because of limited activity may play a role. A recent update of the American Society of Clinical Oncology recommendations for bisphosphonates use in MM did not mention the role of Ca and vitamin D supplementation (Kyle et al, 2007); this emphasizes the need for education about the role of vitamin D in maintaining bone health (Guise, 2006). In conclusion, the recommended daily 400 IU of vitamin D is inadequate for healthy adults and a higher daily supplementation (1000 IU) should be standard maintenance, after correction of the deficit, guided by vitamin D serum level. The current study found no correlation between vitamin D status and MM activity.
Okay, in my opinion, the message is clear: get your vitamin D levels tested immediately and, if need be, discuss vitamin D supplementation with your MM specialist. Don’t put it off!
Interesting….keeping up the research and keep posting. I go to Mayo, am in remission, and they have me taking vitamin D and Cal.
I take Vitamin D3 – about 7,000 units daily. I believe D3 is the most active form.
This is interesting information, Margaret, like all the others. Today I heard that my blood results were good. I’m still stable! I’ve also talked with the doctor about Turmeric and given here one article (found via your blog). The next time I will ask about vitamin D (sorry for bad English)…
I take D3 also: 2,000 iu daily.
My naturopathic doctor, who specializes in oncology, is a strong believer in Vitamin D3. I’m taking 5000 IU per day.
Also important for some of us myelomiacs is Vitamin K2. Taken together with Vitamin D3, it can help us rebuild bones. Here’s an old PubMed link, and there are more. I recall seeing a Japanese study where that combination compared well with Fosamax. My naturopath has me taking 30 mg (six 5-mg caps) per day.
I take vit. D3. Vit. D2 water de solve vitamin is synthetic and interferes with vit. D3 metabolism. During last spring and summer I spend much more time on sun. Despite that my blood level was low normal (above 40). The dose depends on sun expose and diet. I increase supplemental oil de solve D3 to about 6000 Units a day. I eat a lots of raw greens, and self made green juices so I do not supplement vit. K.
I’ve taken 2,000 IU of Vitamin D3, 3 times a day since I first read about it on your blog some time ago. I probably should have my Vitamin D levels checked.
One statement I read about Vitamin D said this, “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.” If it’s safe to get that much Vitamin D from the sun in 20 minutes, it seems feasible that my paltry 6,000 IU daily should be safe. Better check to be on the safe side!
Another statement I read that really fascinated me! It said the body will “sluff off” any Vitamin D received from the sun that was not needed! Isn’t that amazing! Wish it would do the same for supplements too but I don’t think it does. As always, I appreciate your research! Donna
PS-I think Hans does a great job with his English! : )
So do I!
I have to find out what percentage of the general population is vitamin D deficient. I’ve recently been given a 50,000 IU/week rx for vitamin D. Um, I forgot to take it this week though!
There are some diseases (such as type 1 diabetes) that are more common the further north you go. Surely if cancer/MM was simply the result of a vit D deficiency you would expect that the incidence of disease could easily be shown to increase with latitude. I’m not sure that is the case and it is possible that it is MM that is causing the vit D deficiency – not the other way round. Also, there might be other factors at work. I seem to remember reading that Afro-Americans have a higher risk of MM so genetics could play a part.
From my own experience I have not noticed any great benefit from low vit D3 supplementation although I feel great when I can get out in the sun and experience the real thing. Maybe, as Donna says, the sun is much more powerful. Unfortunately the opportunity for “20 minutes full body exposure” doesn’t happen too often here in the UK.
If I would have myeloma (or any other cancer) I would ask my GP (or physician) to take twice a year a blood test for vitamin D (and calcium at the first few times). Occasionally lymphoma patients have a dysregulation of the vitamin D metabolism and sometimes too much of the active D-hormone floats about causing the body to absorb too much calcium. That’s why it is sensible to check the calcium level once or twice at the beginning of nay supplementation and if it’s elevated, then not to take any more vitamin D. I would aim to have vitamin D (25(OH)D) at a level above 130 nmol/l (= 37.5 ng/ml) and below 200 nmol/l (= 80 ng/ml). (doesn’t have to be exact). – And if I couldn’t find a Dr. to take the bood level, I understand that Carole Baggerly provides test kits to do it yourself, so I would order one from her. I might need between 3 -6000 IU daily to maintain this level. (depends on body-weight and skin colour). Depending on how low the level is to begin with I would want to take 10,000 IU a day for 10 days or more. 10 days of such a dose would make a blood level of vitamin D (25(OH)D) probably rise by 40 – 60 nmol/l (= 17.5 – 22.5 ng/ml). And, yes, it probably is the case, that malignant cells “use up” more vitamin D, causing a deficiency.
Hope this advise is not considered patronising, but I work in primary care and have become a little knowledgeable in vitamin D in the past few years.
i’m new of course to your site and have just been diognosed with mm and in smoldering stage. a friend from my website posted your link and i’m gratefull for the information. i thank you and all the posters kindly for the information shared here. jm