Supplement or Sunshine? How Best to Get the Vitamin D You Need

Over the past decade or so, there’s been a real avalanche of research on vitamin D.

Just last week, word came of two new studies – one suggesting the nutrient could play a role in pain management; the other, that supplementation could help improve fertility in both men and women. A little earlier this year, research in JAMA suggested that higher D levels may lower risk for some cancers.

Combine findings like these with the fact that most Americans have suboptimal D levels, and you get a loud choir of practitioners insisting that their patients supplement.

The usual recommendation is that you take D3. D3 is the form we get mainly from the sun, as well as a few animal foods, and it’s the form most beneficial to human health. Many rightly recommend that it be taken along with vitamin K2, since your body can’t really use the D without it.

But some naturopathic physicians are starting to question the conventional holistic wisdom.

In a recent article for the Natural Medicine Journal, naturopathic oncologist Dr. Jacob Schor notes that several major, recent reviews of the literature have found the evidence for supplemental D to be lacking – at least for the conditions studied (fractures; skeletal, vascular, and cancer outcomes; fall prevention).

Maybe, he said, it’s not the vitamin D itself that’s crucial but the way we get it in nature: exposure to sunlight.

Sunlight has a range of actions on the human body, only some of which we understand. Besides triggering vitamin D production it also triggers production of p53,4 the enzyme that regulates apoptosis (cell suicide) and destroys cancer cells, or at least is supposed to. Increasing p53 activity is the primary goal of both conventional and naturopathic oncologists. This may be why sun exposure is associated with decreased cancer risk.

Sunlight also triggers nitric oxide (NO) production, which in turn causes vasodilation, lowering blood pressure. NO may be why sunlight lowers risk of heart disease and strokes.

Perhaps it’s not the D but the sun that is protective. As high blood pressure is the leading cause of death in the world, even small improvements in blood pressure might have widespread consequences. This NO discovery explains a long-time mystery, why blood pressures are higher during the winter. It also explains why blood pressures increase with latitude.

A December 2016 article in the journal Medical Hypotheses, suggests several other possible explanations for the benefits of sunlight including immunomodulation, melatonin, serotonin, and the effect on circadian clocks, which are also involved in triggering the health benefits of sunlight. A paper published in late January 2017 reported that sun exposure stimulates lymphocyte motility and gets those white blood cells to chase down invading microbes in the body. Perhaps this is why sun exposure reduces rates of infection?

It’s a compelling possibility, to be sure.

Regardless, we can say that just as the ideal way to get the nutrients you need is through real, whole food, so, too, the ideal is to get your D the way nature intended: from sunlight.

Most of us need just 10 to 15 minutes of daily sun exposure to maintain adequate D levels – though this can vary depending on where you live and your skin pigmentation. There’s a handy online tool that will factor in all the variables you enter and calculate the amount of sun time you, specifically, need.

One thing to keep in mind, though, is that it’s the ultraviolet radiation in sunlight that helps your body synthesize D. Sunblock can defeat the purpose. Fortunately, the exposure time you need is quite short. If you’ll be out in the sun for prolonged periods, however, you do want to protect your skin. (Check out EWG’s guide to sunscreens, as well as their sun safety tips.)

If you’re very fair skinned and must use sunblock, look first to eating more D-rich foods – you’ll find a list of them here – and then supplementing as needed.

D3 image by Sbrools, via Wikimedia Commons

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For Chronic Knee Pain, Think Prolozone Therapy

Arthroscopic surgery is big business. How big, you ask? Each year, we spend more than $3 billion dollars for knee surgery alone.

And according to guidelines just published in the BMJ, much of that may be a waste. As NPR reported,

The guidelines…reviewed 13 studies involving nearly 1,700 patients and found the surgery did not provide lasting pain relief or improve function for most of them. Those studies compared the surgery with a variety of options, including physical therapy, exercise and even placebo surgery.

Fewer than 15 percent of patients felt an improvement in pain and function three months after the procedure, and that those effects disappeared after one year, the review found. In addition, the surgery exposed patients to “rare but important harms,” such as infection.

Fortunately, arthroscopic surgery is hardly the only option, whether the pain comes from injury or the long-term effects of arthritis.

We’ve talked before about prolozone therapy, an effective way to bring about long-term pain relief and support the healing of wounded tissues. Research supports this.

For instance, one randomized clinical trial in Anesthesiology and Pain Medicine found that prolozone therapy reduced pain and improves knee function, on par with one of the treatments it was originally developed from, prolotherapy.

In prolotherapy, the doctor injects the pain site with a sugar solution, lidocaine, and vitamin B12. The idea is to trigger an inflammatory response and the healing it generates.

With prolozone therapy, we add ozone, homeopathics, and vitamins to the mix. (Prolozone also uses procaine instead of lidocaine.)

The ozone is key. That super-charged oxygen stimulates cellular growth factors and the regeneration of new, healthy tissue. In the words of ozone expert Dr. Robert Rowen, without oxygen, “cells simply cannot repair.”

Research presented at the 2015 Annual Meeting of the American College of Rheumatology found ozone alone maybbe helpful in treating of knee osteoarthritis. For the study, 98 seniors were randomly split into two groups. One got weekly injections of ozone gas over 8 weeks; the other got sham injections.

At baseline, age, sex, pain joint stiffness, physical activity, functional activity, and emotional aspects were similar in the ozone and control groups.

At 16 weeks, pain, function, overall health, and quality of life were significantly better in the ozone group than in the control group.

* * *

Differences emerged in the first week for some tests and by the fourth week for most tests.

Other studies – such as this, published last fall in the Middle East Journal of Rehabilitation and Health – have had similar results. As one paper summed up,

There is a long time evidence (four decades of clinical use) of the use of Ozone on many diseases and especially on treating musculoskeletal disorders such as knee OA. Ozone is able to inhibit inflammatory cytokines, MMP (mineral metalloproteinases), NO (nitric oxide), PGs and to stimulate anti-inflammatory cytokines, growing factors, chondrocytes and stem cells. Ozone diminishes inflammation and favours the trophism, vascularisation and repair of articular cartilage and subchondral bone. The action of Ozone over different targets on knee OA postulates it as a promising and wonderful therapeutic weapon capable to diminish pain, articular destruction and recover function and quality of life.

And what can you expect as a patient? Dr. Frank Shallenberger, who developed the therapy, describes it well in an overview published in the Journal of Prolotherapy:

The first thing that most patients notice after a Prolozone treatment is an almost immediate 50-80% decrease in pain. This is in part due to the effect of the procaine. But ozone itself has a significant ability to directly relieve pain. A 2009 article published in the European Journal of Pharmacology demonstrated that a single subcutaneous injection of ozone prevents allodynia and decreases the over-expression of pro-inflammatory caspases in the orbito-frontal cortex of neuropathic mice, immediately eliminating any signs of pain. Lamberto Re, a medical doctor and soccer team physician in Verona, Italy routinely injects the acutely injured areas of his players with ozone alone. He does not use procaine. And he reports a marked decrease in pain as well as an improved rate of healing.

Be sure to check out his article for some eye-opening case histories that further illustrate the power of this therapy.

Knee pain image by Esther Max, via Flickr

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Is It the Fat or Is the Actually the Sugar?

Recently, old research records were found, which cast even further doubt on “the dogma that eating vegetable fats instead of animal fats is good for the heart.”

Meanwhile, a new commentary in the British Journal of Sports Medicine pounded home the point we’ve mentioned before: Saturated fat is not the bad guy. As its authors bluntly put it, “Despite popular belief among doctors and the public, the conceptual model of dietary saturated fat clogging a pipe is just plain wrong.”

What does improve heart health? The authors point to the research supporting a Mediterranean-style diet, along with physical activity, and stress reduction.

It is time to shift the public health message in the prevention and treatment of coronary artery disease away from measuring serum lipids and reducing dietary saturated fat. Coronary artery disease is a chronic inflammatory disease and it can be reduced effectively by walking 22 min a day and eating real food. There is no business model or market to help spread this simple yet powerful intervention.

That’s not the case with unreal food – engineered products that offer little in the way of sound nutrition and plenty that your body just doesn’t need nor was even designed to eat. Products, of course, can be marketed like crazy, including low-fat versions of high-fat favorites.

And what replaces the fat? Sugar and other refined carbohydrates.

Remember when SnackWells were introduced back in the 1990s? These fat-free cookies were treated like a miracle. Yet folks who ate them gained all kinds of weight. Then, the theory was that consumers were just eating too many. The health halo of “fat-free” was a green light to indulge.

Yet the composition of those cookies made a difference, too, as new research in Physiology & Behavior reminds.

The study observed three groups of rats over four weeks. One group had a low-fat, high-sugar diet; one, a high-fat, high-sugar diet; the last, a balanced diet. Researchers monitored body weight, caloric intake, body composition, and fecal samples.

Both high-sugar groups gained not just more body fat but liver fat – a step on the road to non-alcoholic fatty liver disease. Both high-sugar groups also showed chronic inflammation in the intestinal tract and brain.

Former studies in rats conducted by [lead author Krzysztof} Czaja have shown that brain inflammation alters gut-brain communication by damaging the vagus nerve, which controls sensory signals, including the brain’s ability to determine when one is full.

“The brain changes resulting from these unbalanced diets seem to be long term, and it is still not known if they are reversible by balanced diets,” Czaja said.

And here’s the kicker:

“What’s really troubling in our findings is that the rats consuming high-sugar, low-fat diets didn’t consume significantly more calories than the rats fed a balanced diet,” Czaja said. “Our research shows that in rats fed a low-fat, high-sugar diet, the efficiency of generating body fat is more than twice as high — in other words, rats consuming low-fat high-sugar diets need less than half the number of calories to generate the same amount of body fat.”

Sugar: It does a body no good.

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