Published on November 16, 2024
Today we will provide several more answers to questions submitted during the Clearing Confusion Around Vitamin D virtual forum
Key Points
- A post criticizing the findings of a study by two GrassrootsHealth scientist panel members attacks the use of vitamin D during pregnancy and lactation, but leaves a major key point out of the review and discussion
- There is much evidence to show that vitamin D is associated with the risk of many inflammation-based diseases, with higher levels of vitamin D in the blood associated with lower levels of inflammatory markers and lower disease risk
- The measurement of calcitriol is very rarely indicated, and is NOT a better measure of vitamin D status; serum 25(OH)D concentration is the only test a healthcare provider should request to establish the vitamin D status and correlate with diseases
Many participants submitted questions during and prior to our recent Virtual Vitamin D Forum, Clearing Confusion Around Vitamin D. In case you missed it, the recorded forum and additional presentations, papers, questions & answers, and more can be viewed on the ongoing virtual forum page here.
Below we address several questions submitted by one of our participants, including a question referring to a post written by Jim Stephenson Jr. on the Root Cause Protocol website about vitamin D, pregnancy, and breastfeeding. Several individuals asked about this same topic and post, so we figured we would share this one with all of our followers in today’s newsletter.
If you have additional questions, please feel free to submit them!
Submit Questions Here
The Question of the Hour
Here is the question submitted by one of our participants:
“So much confusion out there based on what is going on re Jim Stephenson Jr’s information he’s sharing in sub stacks / fb. So, any help clearing all this up is appreciated! How much vitamin D3 should be taken by a pregnant / breastfeeding mother? Jim Stephenson and his followers say 0 while Dr Hollis says 6500 IUs.”
Responses to “Vitamin D in Breastmilk – Jim Stephenson Jr”
Below, we break the Root Cause Protocol (RCP) post in question down into segments, providing responses from GrassrootsHealth as they come up. Let’s go through the post that the participant is questioning, from: https://therootcauseprotocol.com/vit-d-faq/#breastmilk
RCP post:
“This is the study that gets cited as support for fixing “lame” breastmilk.
For context, think “human breast milk is the perfect human food”. Women are told to take calcium during pregnancy so as to not deplete their own. It’s not the same advice with hormone D.”
GrassrootsHealth Response re: “hormone D”
First off, vitamin D should never be referred to as just a hormone – in fact, its hormonal function of calcium regulation is only one of the many functions of vitamin D. Vitamin D (as vitamin D3, 25(OH)D and 1,25D) is a nutrient and a signaling molecule with actions directly within the cells and tissues that are unrelated to its hormonal function.
Also, it is important to note that during pregnancy, conversion of 25(OH)D to the hormonal form, 1,25(OH)2D, increases so that by 12 weeks, levels in the blood are triple that of normal, non-pregnant female and normal male subjects. In a non-pregnant person, these levels would alter calcium concentrations in the blood and result in toxicity and potential death, but these are perfectly normal levels during pregnancy. Furthermore, the rise in 1,25(OH)2D is independent of the calcium system, nor is it controlled by parathyroid hormone, which is the only time in the lifecycle that this un-coupling occurs. Further observation has revealed that the direct influence of 25(OH)D (up to ~40 ng/ml) on 1,25(OH)2D levels is also unique to pregnant women. This leaves much more to discover about the unique roles of vitamin D during pregnancy. Learn more here.
RCP post:
“They say women are deficient in D so when they are pregnant, they need to really load up on it so their breast milk won’t be deficient as well. Let me repeat that. The breast milk will be deficient according to the current Vitamin D push if a woman isn’t at least at the unscientific minimum currently proposed.”
GrassrootsHealth Response re: “when they are pregnant they need to really load up on (vitamin D) so their breast milk won’t be deficient as well.”
To put it simply, vitamin D taken during pregnancy will NOT ensure adequate vitamin D levels in the breastmilk, however, supplementing to maintain a vitamin D level of at least 40 ng/ml during pregnancy will decrease the risk of several complications for the mother and baby, including preterm birth, preeclampsia, infections, etc.. Interestingly, women who receive plentiful UVB rays for supplementing their own vitamin D levels naturally achieve a vitamin D level of 40-60 ng/ml or higher during pregnancy, indicating this is the ‘natural’ physiological level necessary to support prenatal and overall health.
For the breastmilk to have sufficient vitamin D for the baby, a daily intake/input of vitamin D3 is needed, as it is the D3 that crosses into the breastmilk, not the 25(OH)D or 1,25D. Since vitamin D3 has a very short half-life (about 24 hours), if it is not taken regularly after pregnancy, the supply quickly diminishes and will not cross into the breastmilk.
RCP post:
“In this study they had one group of women taking 400 iu, the current recommendation of the IOM New York Academy of Sciences, and another group taking 6,400 iu. The 6,400 was based upon calculations to maintain the unscientific level.”
GrassrootsHealth Response Re: “one group of women taking 400 iu…”
A very KEY fact that is missed or not shared here about this study is that the infants in the group of women taking only 400 IU of vitamin D per day were ALSO given 400 IU of vitamin D per day. The point of the study was to determine the effectiveness of vitamin D supplementation of 6400 IU per day to the breastfeeding mother for generating 400 IU of vitamin D in the breastmilk compared to the newborn directly receiving 400 IU of a vitamin D supplement. (In other words, did giving mom 6400 IU vitamin D have the same effects for the infant as giving the infant 400 IU supplement vitamin D directly.)
RCP post:
“What happened???
“Well the women’s 25D went up and stayed up in the women and breastfeeding children, in both groups. And what happened to the babies level after “helping out” our bodies making inferior breast milk? The ones with mothers taking 400 iu (*Note from GrassrootsHealth: these babies were being given 400 IU vitamin D supplement per day too) went from 13 to 43 in their 25D. The ones with mothers taking 6,400 went from 14 to 48 in their 25D.”
Response from GrassrootsHealth:
KEY POINT: There was a similar increase in the infant’s vitamin D level whether they were receiving 400 IU vitamin D supplementation directly (an important fact that the post fails to mention) compared to if their mother was supplementing with 6400 IU per day (therefore providing an adequate amount of vitamin D to her baby through her breastmilk, around 400 IU per day). Keep in mind, the mothers who were receiving extra vitamin D were also benefiting from adequate vitamin D levels and the resulting health benefits, such as decreased risk of postpartum depression.
RCP post:
“A difference of 5 in the end for SIXTEEN times the dose! Looks like breast milk is the perfect food after all.”
GrassrootsHealth Responds Re: “Looks like breast milk is the perfect food after all.”
One cannot claim that breast milk is the perfect food if the babies had to be given 400 IU of vitamin D per day via supplementation in addition to being fed breastmilk. The key issue in this post is the failure to mention that as part of the study design.
RCP post:
“(The breast milk analysis itself left me scratching my head, FYI. Very old science used in that).”
GrassrootsHealth Response:
GrassrootsHealth is scratching our head, wondering how he could have missed such an important piece of the study design!
Here is a link to the study in question:
Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial
Submit your questions to GrassrootsHealth and our vitamin D scientists and experts.
Additional Questions from the Forum
Question: Is there any link between the amount of inflammation in the body and low 25OH?
Answer:
Yes, there is a link between low vitamin D levels and higher rates of inflammation. Vitamin D is known to be associated with the risk of many inflammation-based diseases, with higher levels of vitamin D associated with lower levels of inflammatory markers and lower disease risk. It acts to suppress the production of inflammatory cytokines (such as IL-1, IL-6 and IFN which are predominant in the cytokine storm characteristic of severe COVID-19), and plays a very important role in preventing the activation of an inappropriate hyper-inflammatory immune response, therefore preventing the now infamous cytokine storm.
A meta-analysis by Jamilian et al. reviewed the research available on inflammation, mental health, and vitamin D in patients diagnosed with psychiatric disorders. The review found a significant reduction in depression, improved quality of sleep, and a significant reduction in CRP following vitamin D supplementation. Evidence-based research points to a minimum 25(OH)D level of 40 ng/ml (100 nmol/L) to fully optimize these demonstrated anti-inflammatory and immune regulating properties of vitamin D. Remember that vitamin D does not work alone – magnesium and omega-3 fatty acids are also important for keeping inflammation in check. Here is a blog about how vitamin D and omega-3s, for example, work together to regulate inflammation.
Question: Since 1,25OH is usually not tested by doctors, is this a better measure? Is 25OH converted to 1,25OH when the body requires it and that means 25OH needs to be constantly “restocked”?
Answer:
Dr. Sunil Wimalawansa discusses this topic in his presentation on Key Fundamentals of Vitamin D. Peripheral target cells for vitamin D contain both 1α-hydroxylase and 25-hydroxylase enzymes capable of converting vitamin D into 25(OH)D and then to 1,25(OH)2D to initiate a host of physiological functions. This “intracellular” generation of calcitriol in target cells like immune cells is critical for autocrine and paracrine functions of vitamin D and its DNA interactions (i.e., Genomic actions) that regulate over 1,200 essential genes. These cells access vitamin D and 25(OH)D from the bloodstream; in such instances, the converted 1,25(OH)2D is not ever released into the blood, and therefore, cannot be measured.
The measurement of calcitriol is very rarely indicated, and is used primarily to diagnose “functional disorders” of the parathyroid glands, such as hyperparathyroidism, hypoparathyroidism, and pseudohypoparathyroidism. It is also measured in hypercalcemic conditions, renal osteodystrophy, and vitamin D-resistant rickets. Calcitriol levels are useful for differential diagnosis of hypercalcemia, to exclude squamous cell carcinoma from the head and neck region, and to exclude parathyroid disease, especially when the PTH-related peptide (PTHrp) measurements are unavailable.
It is NOT a better measure of vitamin D status; serum 25(OH)D concentration is the only test a healthcare provider should request to establish the vitamin D status and correlate with diseases. The body should have a consistent supply of vitamin D3 with daily dosing preferable; this will help maintain a steady level of 25(OH)D in the blood, which is important for the autocrine and paracrine functions mentioned above.
How Are Your Levels of Vitamin D and Other Important Nutrients?
Check your vitamin D, omega-3, HbA1c and magnesium levels today as part of the vitamin D*action project, and add the Ratios for more about how to balance your Omega-3s and 6s for better inflammation control.
Measure your:
- Vitamin D
- Magnesium PLUS Elements
- Omega-3 Fatty Acids
- hsCRP (for Inflammation)
- HbA1c (for Blood Sugar)
- and more
Did you know that each of the above can be measured at home using a simple blood spot test? As part of our ongoing research project, you can order your home blood spot test kit to get your levels, followed by education and steps to take to help you reach your optimal target levels. Start by enrolling and ordering your kit to measure each of the above important markers, and make sure you are getting enough of each to support better mood and wellbeing!
Build your custom kit here – be sure to include your Omega-3 Index along with your vitamin D.
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