June 23rd, 2015

Vitamin D3 is Important in Autoimmune Disorders

Vitamin D3 BenefitsIntroduction

Vitamin D has a well-established role in calcium metabolism and bone health, but recently there has been a great deal of research looking at the effect of vitamin D on other body tissues, especially immune cells. It is now known that there are vitamin D receptors (VDRs) located in the nuclei of all immune cells, including antigen-presenting cells, natural killer cells, and B and T lymphocytes. There is also a considerable amount of research showing that vitamin D deficiency has been associated with several autoimmune diseases including multiple sclerosis, rheumatoid arthritis, type 1 diabetes mellitus, and systemic lupus erythematosus (SLE).

A new study conducted at Monash University in Australia has now shown that low vitamin D3 status in SLE was associated with higher disease activity while an increase in serum vitamin D3 levels reduced SLE activity. This study provides hope that many patients with SLE and other autoimmune disorders may benefit from vitamin D3 supplementation.

Background Data:

Patients with SLE are prone to vitamin D deficiency. Several factors contribute to this situation including avoidance of sunshine due to photosensitivity, the use of sun-screen, and the use of medications such as prednisone and antimalarial drugs that enhance the clearance of vitamin D. Several recent studies have identified a possible association of low vitamin D3 levels and disease activity in SLE.

SLE is a chronic multisystem inflammatory autoimmune disease that is characterized by abnormalities in the functioning of several types of white blood cells that ultimately result in the production of antibodies that attack the body’s own tissues. There is increasing evidence that vitamin D can prevent or reduce many of these events.

There have been a few studies looking at the impact of vitamin D3 supplementation in SLE. In one study, patients given 2,000 IU/day showed significant reduction in the levels of pro-inflammatory markers and disease activity scores compared with the placebo group.

New Data:

The objectives of the study were (1) to determine the prevalence of vitamin D deficiency in patients of the Monash Medical Centre Lupus Clinic in Melbourne, Australia; (2) to determine the relationship between disease activity and vitamin D deficiency in these patients; and (3) to determine whether vitamin D3 supplementation is associated with increases in vitamin D3 and whether this in turn is associated with reduced disease activity.

During 2007-2013, data was collected on 119 consecutive patients. Vitamin D3 deficiency (<40 nmol/L) was detected in 27.7% of patients at baseline while 44.5% of patients were taking a vitamin D3 supplement. Patients were also assessed at baseline for inflammatory markers such as ESR, C-reactive protein (CRP), anti-double-stranded DNA antibodies, as well as renal function and complement levels to establish their SLE disease activity (SLEDAI-2K). Detailed analysis showed a significant inverse correlation of with baseline vitamin D3 level and with vitamin D3 supplementation.

Over a 12-month period of observation, among the 119 patients, there were 464 serial vitamin D3 measurements with corresponding SLEDAI-2K, representing 266 time intervals. The results showed that low vitamin D3 was not only associated with a higher disease activity, but that an increase in serum vitamin D3 levels was associated with reduced disease activity over time.

Commentary:

A large proportion of the patients were receiving vitamin D supplementation, but the dosage level was not mentioned in the study. Instead, the focus was on blood levels of D3 and the effect on SLE disease activity. From the data it appears that increasing the level to above 60 nmol/L is critical. But, unfortunately the study did not provide guidelines on what might be an optimal range for serum levels of D3. Based upon existing data, my recommendation is to hit a target range of 150 to 200 nmol/L (60-80 ng/ml). Certainly, the minimum daily dosage for someone with SLE is 2,000 IU D3 daily, but likely higher dosages (e.g., 5,000 IU daily) are likely required to hit the target range. Periodic blood measurements of D3 will allow for proper dosage recommendations.

Reference:

Yap KS, Northcott M, Hoi AB, Morand EF, Nikpour M. Association of low vitamin D with high disease activity in an Australian systemic lupus erythematosus cohort. Lupus Sci Med. 2015 Apr 8;2(1):e000064.

Dr. Michael Murray
6/23/15

June 19th, 2015

Sweet Relief for Migraines

Does ginger work as well as prescription drugs for migraines? New research shows that it does.

ginger-690Migraines are estimated to affect more than 28 million Americans. These headaches are caused by excessive dilation of blood vessels in the head and are characterized by a throbbing or pounding sharp pain.

There are a number of dietary and supplement strategies that have been shown to be effective alternative treatments for migraines, with success rates often superior to standard therapy. One of the most promising is ginger, which has traditionally been used to ease nausea, relax and soothe the intestinal tract, and help to eliminate intestinal gas. Several double-blind studies have shown that ginger is effective in addressing a range of gastrointestinal issues, particularly nausea and vomiting.
Ginger also has a long history of use as a natural treatment for pain and inflammation. Some clinical studies have supported this use with positive results in people with arthritis, chronic low back pain, painful menstruation, and muscle pain.

Ginger has also been shown to exert a number of anti-inflammatory effects in experimental studies. Early studies in the treatment of migraine headaches were promising, but most were conducted with a combination product containing ginger extract and the herb feverfew.

The Latest Research

One new study compared ginger powder head-to-head with sumatriptan, the generic form of the migraine drug Imitrex. Ginger proved to be equally effective as the prescription medication, but it had a better safety profile than the drug. Minor side effects of Imitrex include nausea, dizziness, drowsiness, and muscle weakness. But it can also cause more serious side effects, including coronary artery spasms, heart attacks, stroke, abnormal heartbeats, and seizures.

A team of neurologists in Iran compared ginger and sumatriptan in 100 men and women who had suffered migraines for an average of seven years. Participants were randomly assigned to either the ginger (250 mg caplet of dried ginger powder) or the sumatriptan (50 mg) group, and neither the participants nor the observers knew which caplets the patient was taking until the study was completed. Patients were instructed to take a caplet as soon as a migraine started.

For each headache that occurred during that month, participants recorded the time the headache began, headache severity before taking the medication, and degree of pain relief at 30, 60, 90, and 120 minutes, as well as 24 hours later. Results showed that ginger was equally as effective as sumatriptan, achieving 90 percent relief within two hours of ingestion. While a very small percentage (4 percent) of the ginger group experienced minor digestive upset, 20 percent of patients taking sumatriptan reported dizziness, drowsiness, or heartburn.

For Fast Relief

The dosage of ginger used in this study was very low (250 mg dried ginger root). Higher dosages more than likely would have produced even better results. Most clinical studies have used a dosage of 1g powdered ginger daily.

Fresh ginger contains active enzymes and higher levels of other active constituents; therefore, it’s possible that fresh ginger may be more powerful than supplements for relieving migraines. The equivalent dosage to supplements would be 10 grams (about one-third of an ounce) of fresh ginger, which is roughly a quarter-inch slice.

The best method to take advantage of fresh ginger is to juice it. Ginger is a great addition to virtually every fresh fruit and vegetable juice. You can also juice or grate fresh ginger and add it to sparkling mineral water to make a delicious homemade ginger ale.

Fresh ginger is a phenomenal and widely available natural medicine.  When buying fresh ginger, the bronze root should be fresh looking, with no signs of decay (such as soft spots, mildew, or dry, wrinkled skin). Store fresh ginger in the refrigerator.