April 05, 2018
I have been gathering information on different supplements for several of my friends who have PD. The list has grown to well over 50 supplements now so in order to make it manageable, I am trying to narrow the list down to either 5 or 10 supplements that seem to show the most evidence in the form of studies or lacking that, significant anecdotal evidence since these PD /supplement studies are fairly limited.
Vitamin D is easily in that top 5 list based mainly on human studies. I will post the study links along with a very brief description of each study below.
A quick thought on vitamin D and how it is measured in people. It requires a blood test that determines your 25 (OH) d serum level . The reference range for 25 (OH) d is 30 to 100 ng/ml. If you fall below 30 ng/ml, but above 20 ng/ml you are considered to be insufficient in your vitamin D level. If you fall below 20 ng/ml you are considered to be deficient. Many studies suggest it is better to be in the upper half of the reference range and some cancer studies suggest the 60 to 75 ng/ml range as optimal, however, other studies for other health issues suggest even closer to the top of the range (100) or above the top of the range. Generally speaking, if you are actively trying to treat a disease, the upper half of the range and beyond may be needed and of course with your doctors approval and supervision. More recent studies are showing that doses of vitamin D that were previously thought to be toxic are actually healthful, so 400 iu per day is no longer a realistic daily value. Because serum 25 OH d levels vary significantly from person to person and because the dose required to get your serum level into the reference range also varies significantly, blood testing is needed to know your serum level before and after supplementing in order to determine what dose will get you to where you want to be within that reference range. The test for vitamin d can be done at your doctor's office or it can be done by mail using one of the pin prick tests from several on line vendors for under a hundred dollars per test depending on which vendor you choose. Doctors should be aware that vitamin D can have a positive impact on PD, so they should be willing to run those tests at your regular visits.
The other way to increase your vitamin D besides supplementing is to go out in the sun and expose as much skin as possible for specific periods of time when the sun is highest in the sky or directly over head. This will help during a major portion of the year, but, as long as your shadow in the sun is longer than you are tall, your body will not be able to make enough vitamin D from the sun exposure. Another point that doctors don't mention is that as we get older, our bodies ability to convert the uv rays from the sun to vitamin D by reacting with cholesterol in the skin, declines steadily. Given that PD tends to affect senior citizens more than younger people, supplementing with vitamin D-3 is likely the best way to get your serum level into the upper half of the reference range (30~100 ng/ml).
This first study suggests that vitamin D may be helpful for some people with PD and draws a correlation between serum 25 OH d level and PD severity.
https://academic.oup.com/ajcn/article/97/5/1004/4577000
This next study suggests that vitamin D can have a positive effect on balance control in people with PD.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3812066/
This next study in Iranian patients with PD suggests that most have serum levels that are too low and the lower the serum level, the more increased certain symptoms are.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3829282/
This next study concludes that higher vitamin d levels are associated with better mood and cognition.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966187/
The following study suggests that lower vitamin D levels are inversely correlated with severity of PD symptoms.
https://www.ncbi.nlm.nih.gov/pubmed/24036688
The next study suggests that low vitamin d levels can have a negative impact on brain function.
https://www.ncbi.nlm.nih.gov/pubmed/24036688
This next important double blind, placebo controlled study suggests that daily vitamin D supplementation may slow disease progression of certain aspects of PD.
https://academic.oup.com/ajcn/article/97/5/907/4577164
Another important study showing that vitamin D level is reduced in people with PD and bone mineral density is correlated with serum level also.
https://www.ncbi.nlm.nih.gov/pubmed/23052606
This next study discusses how low serum levels of vitamin d may contribute to gastrointestinal issues in people with PD.
https://www.karger.com/Article/Abstract/441917
This next study suggests that low serum vitamin D can impact PD early on in the disease process.
https://www.ncbi.nlm.nih.gov/pubmed/26343034
This next study discusses the correlation between people who work outdoors and PD.
http://www.mdpi.com/2072-6643/7/6/4817/htm
The following abstract briefly discusses how vitamin d can affect cell signaling in multiple diseases including PD.
https://www.ncbi.nlm.nih.gov/pubmed/26009175
This next study draws a correlation between low vitamin D and PD.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4390412/
This next study is a pilot study that used ultra high doses of vitamin D, that were previously believed to be toxic, but not in this study that treated psoriasis and vitiligo patients to good effect.
https://www.tandfonline.com/doi/full/10.4161/derm.24808
This next one is an interesting anecdote as opposed to a study as reported to Dr. Cannell at the Vitamin D Council.
Dear Dr. Cannell,
About four years ago, I was diagnosed with Parkinson's disease (PD). Looking back, I could see that my illness had been slowly developing over the course of at least twenty years. By the time I was diagnosed, my symptoms began to worsen quickly. I was experiencing extreme imbalance issues that impaired my ability to walk as well as painful muscle cramping known as dystonia.
I also began to drool during the day and at night while sleeping. Coincidentally, I started taking vitamin D 50,000 IU/day, because I thought it might help treat the flu. I was greatly surprised within several hours after taking vitamin D that these major PD symptoms began to clear up. It has been two years since I accidentally discovered the miracle of vitamin D, and I now take 10,000 IU/day and keep my vitamin D level around 80.
I'm still amazed. I still have Parkinson's, but my symptoms are less severe.
Paul, California
Dear Paul:
A number of readers have written me that they had a very rapid response to vitamin D. In the standard genomic model of vitamin D's metabolism, it makes no sense. However, Professor Bruce Hollis recently alerted me to an important paper.
Gibson CC, Davis CT, Zhu W, Bowman-Kirigin JA, Walker AE, Tai Z, Thomas KR, Donato AJ, Lesniewski LA, Li DY. Dietary Vitamin D and Its Metabolites Non-Genomically Stabilize the Endothelium. PLoS One. 2015 Oct 15;10(10):e0140370.
This paper basically shows that the parent compound, vitamin D, has a very rapid effect on endothelial cells. Endothelial cells are a thin lining of cells that make up the innermost lining of vessel walls.
The newly discovered effect occurs so rapidly that it could not be via genetic function. The vitamin D signaling pathway teaches us that vitamin D is converted to 25(OH)D in the liver and that 25(OH)D is circulated around the body and absorbed into cells where the cells transform 25(OH)D into a steroid hormone, calcitriol, which helps regulate gene transcription. This paper does not dispute this pathway, but adds to it, finding cholecalciferol by itself may plug up holes in the lining of blood and lymph tissues.
As the authors state, vitamin D acts very quickly to “stabilize barrier structure and function, thereby reducing vascular leak into the surrounding tissues. This new observation may explain, in part, the broad associations between vitamin D and many diseases."
Professors Bruce Hollis and Carol Wagner were, to the best of my knowledge, the first to recognize that the parent compound has important effects, independent of the liver's transformation into 25(OH)D.
Hollis BW, Wagner CL. Clinical review: The role of the parent compound vitamin D with respect to metabolism and function: Why clinical dose intervals can affect clinical outcomes. J Clin Endocrinol Metab. 2013 Dec;98(12):4619-28. doi: 10.1210/jc.2013-2653. Epub 2013 Oct 8. Review.
If they are right, it serves as an explanation as to why some people seem to notice vitamin D works very quickly. It also explains why vitamin D should be taken daily, not weekly or monthly.
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Based on the above abstracts, studies and anecdotes, it certainly seems like a good idea to make sure you are vitamin D replete and especially if you have PD . Vitamin D is easy to get and has a very good safety profile while being inexpensive. Many people are insufficient or deficient when it comes to vitamin D. Regular testing is the best way to determine how much vitamin D you will need to take in order to get into the upper half of the reference range and your doctor should be willing to help you do this!
Art
