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Therapy Tip
   
Patients with elevated 1,25(OH)2D often need to block the production of vitamin D in the skin to avoid symptoms caused by natural light exposure. This is best done by staying indoors during daylight hours and covering up with dark clothing when daylight outings are unavoidable. Sunscreens may block some of the cutaneous production of vitamin D3, 25(OH)D and 1,25(OH)2D that occurs when light falls on the skin and might be helpful to some patients.
 
 
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Issue: 78
May 2016

Greetings!

It seems scientists have received an answer to their calls for funding to study the microbiome with this week's launch of the National Microbiome Initiative. This project will support research of the microorganisms that live in or on the human body, plants and other ecosystems to help us better understand their role in human and environmental health.

The National Microbiome Initiative is to build on existing microbiome research efforts, like the National Institute of Health's Human Microbiome Project. The plan is for the U.S. government to invest $121 million dollars in the initiative for 2016 and 2017.

We expect a lot of things will develop from this. The initiative is supposed to foster collaboration between universities and research projects. It should also result in additional genomic mapping of at least a few specific microbes and better understanding of how communities of microbes function and react. We can hope that new tools and resources will also be developed.

We look forward to seeing how the results from these projects will change our understanding of human inter-connection to other living things, especially microorganisms, and how we can influence those relationships for the good of all. 
 
Warm Regards,
 
  signatureBelinda
About Inflammation Therapy
 
Vitamin D Basics
 
Vitamin D was misnamed when it was discovered in 1922. It's not a true vitamin because an ongoing nutrient source is not required to sustain normal levels in the body. Vitamin D is properly classified as a secosteroid hormone precursor. A hormone is a chemical substance produced by one organ and then transported in the bloodstream to a target organ, where it causes a specific biological action.
 
Vitamin D has several natural forms. For practical purposes, this explanation is limited to three of those forms: vitamin D3, 25(OH)D and 1,25(OH)2D.
 
Vitamin D3 is formed in the skin in response to exposure to sunlight. Vitamin D3 may also be obtained from naturally occurring dietary sources (e.g., fish, fish oils, liver, eggs, etc.), processed foods that are supplemented with vitamin D3 (e.g., dairy products, cereals, etc.) and vitamin D3 supplements. Vitamin D3 is transported to the liver where it's converted to 25(OH)D (also known as calcidiol or calciferol).
 
25(OH)D is not very active biologically. 25(OH)D is the major circulating form of vitamin D and the form that is usually measured to assess vitamin D status. It's main purpose is conversion to 1,25(OH)2D, the biologically active form of vitamin D.

1,25(OH)2D (also known as calcitriol) is, primarily, formed in the kidneys but it's also generated locally by many other body tissues. 1,25(OH)2D is a potent secosteroid paracrine (cell to cell) mediator and it affects almost all cellular activity.

There's no Recommended Daily Allowance (RDA) for vitamin D, because it's produced by humans by a few minutes of sunlight exposure. The alternative Recommended Dietary Intake (RDI) for nutritional vitamin D is based on the absence of adequate sunlight. Most humans, who have access to minimal sunlight several months of the year, will not become deficient in vitamin D.
 
Normally, production of 1,25(OH)2D is tightly controlled by the kidneys in response to a complex system of hormonal regulation. However, if nucleated cells are infected with bacterial pathogens, the immune system response may cause over-production of 1,25(OH)2D in extra-renal tissues because they lack a controlling feedback mechanism. This causes the level of 1,25(OH)2D to exceed the upper limit normally controlled by the kidneys. It also results in a depletion of the precursor 25(OH)D which often leads to a misdiagnosis of vitamin D deficiency.
 
Healthy people who are obtaining vitamin D naturally, often have a level of 25(OH)D that is erroneously considered low by some current standards. Patients with a chronic inflammatory disease (who have not been supplementing with vitamin D3) often have a low level of 25(OH)D while the level of 1,25(OH)2D is quite high. When systemic inflammation is suspected, it's essential to measure both 25(OH)D and 1,25(OH)2D to assess vitamin D status because the level of the precursor doesn't always accurately reflect the level of the active metabolite. If 1,25(OH)2D is measured as normal, there is no vitamin D deficiency, even if 25(OH)D is considered low.
 
In the chronically ill, the key result is the level of 1,25(OH)2D because it's the active metabolite. Testing only 25(OH)D, may result in a false diagnosis of vitamin D deficiency.

New Scientific Articles
 
This study found that vitamin D supplementation, compared with placebo, did not slow disease progression or structural change in knee osteoarthritis.
Jin X et. al, Effect of Vitamin D Supplementation on Tibial Cartilage Volume and Knee Pain Among Patients With Symptomatic Knee Osteoarthritis: A Randomized Clinical Trial, JAMA, 2016 Mar 8;315(10):1005-13.
 
This study, although higher monthly doses of vitamin D were effective in reaching a threshold of at least 30 ng/mL of 25-hydroxyvitamin D, they had no benefit on lower extremity function and were associated with increased risk of falls compared with 24,000iu.
Bischoff-Ferrari, HA et.al, Monthly High-Dose Vitamin D Treatment for the Prevention of Functional Decline: A Randomized Clinical Trial, JAMA Intern Med. 2016;176(2).
 
   
About the CIR patient counseling program 
 
To enroll in the Chronic Illness Recovery counseling program, a patient sends us an email and asks for an Enrollment Form. We then send their physician a letter of explanation about the CIR counseling program and the two professional forms to sign - Authorization to Counsel and Standing Orders for Inflammation Therapy Medications. When we've received all the necessary documents, any applicable fee and reviewed the enrollment form, the patient is notified of acceptance and registered at the Website/Forum where they post progress reports and ask questions.

Recovery Reports 
 
We are contacted daily by people with chronic illnesses who are looking for an effective treatment. Many ask us to provide evidence of efficacy in the form of statistics or stories. If you have recovered your health or had significant symptom improvement with Inflammation Therapy, please help us 'pay it forward' by telling your story. We will post it in the public section of our website to encourage others. Any report, short or long, with or without objective data (e.g., lab results, imaging reports) would be helpful. Please email your story here. Thank you!
Please see Recovery Reports here

Quotes 
 
Benicar works...I got through the stress of losing my husband last May. In August my adrenal function test show my adrenals were functioning normally again. Last month my doctor cut my thyroid medicine in half. I am functioning normally again - normal enough to square dance at least two nights a week and keep up with all daily living. ~Jeanne
 
The help and advice of CIR advisors have guided me through some very tough times and dreadful health issues in my life and I will be forever grateful. ~Safeharbour