Dr. Porter, what role does vitamin D play in Breast cancer?
This is an excellent question; due to recent research we are rethinking our definitions, views and recommendations concerning vitamin D. We are all familiar with the correlation between vitamin D and bone health. What you may not know is that these receptors have also been found in the brain, breast, prostate and on lymphocytes (an important part of our immune system). The implications here are far reaching because research indicates that higher levels of vitamin D in our system are protective from breast and colon cancer, osteoporosis, cardiovascular disease and depression, to mention a few. Recent research may be proving that Vitamin D is not a vitamin at all but a hormone. The definition of a vitamin is an organic substance other than a protein, carbohydrate, fat, or organic salt that is essential to our body for normal metabolism. Vitamins are not formed in the body but are obtained from an animal or plant source, with the bulk coming from plant sources. A hormone, on the other hand, is a substance originating in an organ gland, or body part that is conveyed through the blood to another body part, stimulating that part to increase or decrease a functional activity or hormone. It has been suggested that Vitamin D(3) is an effective chemopreventive and chemotherapeutic agent for breast cancer. In fact, the research is so promising that the National Caner Institute has stated there is general agreement among experts that vitamin D deficiency is associated with a higher prevalence of cancer and several other diseases. Recent research may have identified one of the pathways that vitamin D uses to effect breast cancer cells by causing cell death (apoptosis). This is not a typical action we would expect from a vitamin and is pretty exciting news. Another possible mechanism that has been studied is the fact that calcitriol (a metabolite of Vitamin D) sensitizes breast cancer cells to reactive oxygen species (ROS) dependant cell death. What this means is that breast cancer cells are easier to destroy by our own internal mechanisms when exposed to calcitriol. You may be wondering, what does this mean to me and how do I produce Vitamin D? Each morning we wake to greet the sun. When these rays come into contact with our skin, the process of creating Vitamin D begins. We start with cholecalciferol which journeys to the liver, interacts with 25-hydroxylase enzyme to become calcidiol, proceeds to the kidney, finds the 1OHase enzyme to become calcitriol, which is the most active form. Calcitriol, in turn is responsible for many of the beneficial actions produced in our
body. It is has been shown that 15 minutes of full body exposure to the sun on a clear day at equatorial latitudes can provide the equivalent of 4,000-20,000IU of vitamin D in a lightly pigmented person, while 30 minutes is the equivalent of 50,000IU. In order to determine if you are deficient in vitamin D, it is recommended that you speak with your physician and have your Serum 25-OH-D level checked. The current lab reference ranges are 10-40ng/ml. Due to multiple studies and possible overestimation of toxicity from vitamin D in the past, current research recommends changing the reference range to 40-65ng/ml. This would reflect current research and increase the normal range towards more optimal levels for health. The current RDA dose for vitamin D is 400IU, which may prove to be grossly underestimated based on more recent research. We must also consider our geographic location for actual skin exposure to the sun is lower for the majority of the year in Montana. The available forms of vitamin D for supplementation are D2 and D3. Vitamin D3 (cholecalciferol) is the form produced by the skin and consumed in the diet. D2 has been shown to be less efficient as a precursor to D3 and has some contamination possibilities during processing which may be a problem to chemically sensitive people; therefore D3 is the preferred form of supplementation. In conclusion, vitamin D is responsible for essential functions in the body including calcium metabolism, cell proliferation, cardiovascular, immune/inflammatory balance, neurological function and genetic expression. Vitamin D supplementation may be indicated in certain individuals who are being treated for breast cancer.
Stephany Porter, N.D.
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