Monthly Archives: March 2010

AS CLEAR AND CRUCIAL AS DAY AND NIGHT: SUNDAY -MONDAY HORMONE PRIMACY

ndburman@gmail.com   

 PRIME SLEEP  FACTORS:   SOLTRIOL, MELATONIN,  AND VITAMIN B12.     

Given the cardinal role of both sleep and these three micronutrients in multisystem prevention, can we afford not  to take,  promote vigorous melatonin, vit D and B12  especially at night?

This column last reviewed vitamin D  (soltriol, calciferol) in depth in October 2009 (there are now 47800 vitamin D entries on Pubmed) ; and melatonin 6 weeks  ago (there are now 15400 Pubmed entries on it)..  

 Sundays validly celebrate the supreme Sun’s life day in that without the sun, planet earth would have been nothing but barren frozen rock – no life, no surface movement. other than orbiting.  And Mondays celebrate the supreme goddess of crucial night in that without dark and  the moon (and the tilt of the earth’s axis) there would be no tides, no seasons, no water, no life as we know it – and no melatonin, no healing, restorative sleep-awake cycle.

 By Roman- Christian tradition/ mythology, most in the world (except those who follow the older sabbath Saturday – for whom Sunday is the first working weekday) start if not celebrate the new week with the rest sun(day) (hormone equivalent soltriol), followed at midnight by the moon(day) (hormone equivalent melatonin) day 2 the first workday of the week.

Sleep’s melatonin may be the leader of our hormone orchestra/cascade, but without the sun’s soltriol from sunbathing our skin, we surely would not exist as an upright species. Would life have advanced further than subterranean/ deep-ocean organisms and worms without the sun and thus plenty of soltriol?

Now modern science has at last decoded  Greek mythology that sun and moon -Helios and Luna/Selene (aka later Artemis, Diana) – are also our  brother and sister for health; the two main complementary hormones driven by bright light and dark darkness:  the complex fat-soluble steroid soltriol C22H44O3 (vitamin D, calciferol) and the complex water-and fat-soluble indole melatonin C13H16N2O2.  The latter – from mela, black- was coined as recently as 1958 because its secretion in the pineal is inhibited by light- unlike its independent paracrine secretion in other tissues eg bone marrow and gut.  Dr Russ J  Reiter of UTexas San Antonio has published some 730 papers on melatonin since 1969.

 And Soltriol- from sol – sun, light- was coined perhaps 15 years later  by Dr Walter Stumpf  because its secretion (from the biggest endocrine gland – skin) is dependent on sunlight activating it there.  This surely correlates with humankinds divine evolution from amoeba to amphibian to mammal; and then leaving behind quadripeds, to evolving higher bipedal primates. But then, unlike the dark furry apes, some black humanoids lost their fur and melanin  as they migrated from the tropical eden of Africa to darker colder subarctic climes with longer nights especially in the last Ice Age.

 They emerged paler, more skilled and creative, intellectual – lapping up whatever sunlight they could find, topping up vitamin D from eating fish, Arctic sealife and cod liver oil, and making more melatonin and less melanin (than their brothers in the Southern hemisphere) from the longer and darker winter nights. Hence it may be postulated that this is why the paler farther northern ‘caucasian’ and yellow races earlier developed more skills and creativity (and greed, and cruelty) than their ancestors who stayed and evolved /migrated  languidly nearer the tropics.

But the penalty of western scientific technology and sales hype meant that in barely the past century, most of the world’s population adopted  clothing, and spending most of the time indoors in artificial light, jobs and nightlife. And average natural lifespan more than doubled ie the majority began to outlive their biological timeclocks set by their pineal glands eg the age of menopause- which age only a small better-off minority achieved a century ago…

Melatonin is apparently the only endogenous significant antioxidant that declines with aging, eg ‘nighttime melatonin peaks in youth may reach 30-40 times the daytime basal levels’. .    Hence we who survive well past the magical new midlife age of fifty, now suffer increasingly from decades of steadily increasing deficiencies of melatonin and the prime steroids- both gonadal, adrenal, heart and skin, let alone our other crucial diminishing biological essentials like our marine omega3 oils and eg chondroglucosamine, arginine, alphalipoic acid, ascorbic acid, ribose, carnitine, carnosine, 5HTP, GABA, acetylcysteine, xanthines and minerals.

Now at our southern autumn equinox- shortening colder wetter days and thus more disease eg infections, cancer, depression, hypertension, arthritis- the everlasting Dr Walter Stumpf out of the blue kindly and intuitively sends us new inspiration (see below) with which to convince disbelieving doctors and patients to take balanced light and dark, AND supplement especially vigorously their respective soltriol and melatonin- in abundance.

Dr Stumpf (studying and publishing medicine for over 60years now, papers on Pubmed from 1947) already in 1988 had written  the Endocrinology of Sunlight and Darkness,  and The first Eye; and the Second, Third and Fourth Eyes Relationships between Skin, Pineal, and Lateral Eyes.  that both melatonin and vitamin D synergistically promote health from the brain to pituitary to thyro/parathyroid, thymus, adrenals, gonads, reproductive organs, kidneys, intestine, bone, growth and blood.

Now we are at last applying the benefits of his pioneering work in an increasingly diseased aging 1st-world  population, by encouraging everyone to take vigorous supplements of soltriol calciferol eg 100iu/kg vitamin D and melatonin eg 1 to 100mcg/kg body mass/day (titrated slowly as required up to tolerance) – perhaps especially together in the evening to promote better sleep and night growth- bone and all tissue regeneration.. . .

Neurologist Dr Gominak ‘s letter to him of course highlights other vitamin deficiencies common as we age, even in the well-off who may thus live the longest; who may still be more prone (due to rich diet, alcohol, malabsorption, obesity, metformin etc) to more organ impairment, and deficiency of especially vitamins B12 and  D .

The Japanese (Owaka ea) have for at least 20 years done studies showing the importance of vitamin B12 repletion in sleep disorder. Hence the wisdom of if possible checking baseline blood values of especially B6, 9, 12,  and C,  and calmag and potassium, before adding especially these to at least an evening dose of vit D and melatonin. As Dr Gominak says, vitamin D has also been recognized as important for promoting sleep and wellbeing for at least twenty years.  But of course, in clinical practice, patients rather simply pay much less to take health-extending vitamins as injection (B12 load) and then cheaply orally together with the non-prescription hormones, than pay for the costly (and not necessarily helpful) laboratory tests. Proof depends on clinical response, not laboratory results.

 Its a couple of months since I persuaded my bright but miserable bed-and wheelchair-bound mother-in-law at 86years to start taking weekly vitamin D 50 000iu and nightly melatonin. The only time we have been able to coax her out into the sun for years was last christmas day. Her constant pain in her ever-infected knee replacement at last no longer requires handfuls of painpills daily.

SLEEP, BEHAVIOUR AND MEMORY -NEURODISORDER:     Normal sleep is crucial to optimal daytime function, but is damagingly disturbed in attention deficit hyperactivity disorder ADHD, autism spectrum disorder ASD, Alzheimers, muLtiple sclerosis MS and restless legs syndrome  RLS.

In RLS  (Whittom ea 2010 Univ Montreal ), exogenous melatonin aggravates whereas bright light improves symptoms and sleep .

In multiple sclerosis,   Reiter ea U Texas 2007   and Kaur ea Univ Singapore 2008   point out that melatonin is a potent antioxidant neuroprotective on many levels.        And in both mice (Olcese ea, 2009  Florida University )  and men (Wang, 2009 Harvard Univ )  melatonin has been shown to reduce diverse types of chronic neurodegenerative damage.

In ADHD   Bendz ea Duke University 2009 confirm that melatonin improves sleep and behaviour .

In  ASD  Miano ea Univ Rome, Italy  2010  show that melotonin improves sleep   

Nutritional balance   including of hormones and vitamins is essential for good sleep – but especially melatonin, GABA, 5HTP,  thyroid, cortisol, gonadal hormones, and vitamins B and  D .   And these are major all-health benefit- in contrast to dulling hypnotic addictive  prescription drugs. . 

VITAMIN D3  THE PANACEA ANABOLIC STEROID: Multiple new reports attest to the increasing evidence for the benefit of even >1000iu a day of vitamin D3 supplement- but especially doses which increase blood levels consistently to above 100nmol/L (Leventis ea 2009 – even 300 000iu orally perhaps 3 times a year under supervision – without toxicity)  against not just rickets, osteoporosis  frailty and fatigue but also against  cancer  (Garland, Holick ea 2009),  rheumatoid arthritis activity (Turhanoğlu ea 2010), hypertension and ischemic heart disease (Barnard ea 2010), diabetes (Kositsawat ea 2010) and psychiatric disease (Humble 2010). Considering that 300 000iu every 4 months (ie about 2500iu/day) costs less than US$0.50 a month retail, there are few panaceas that are as low cost for major benefit,  ease and safety- especially for administering to the aging, to keep them independent out of institutions. Vitamin D has finally been recognized as THE anabolic steroid for all.   

Who has not enjoyed a delicious nap in warm (not hot) sunshine – especially with a blindfold to shut out the light!  ie the best of dark (melatonin) and  sunshine (vit D) and  warmth…

Dr Stumpf writes recently:

Dear Neil, It is amazing how the perception of vitamin D has changed, is changing. The company in Japan, I was an in house-consultant for three year between 1992 and 1995, had a large committment to the development of vitamin D analogues for the ‘safe’ treatment of osteoporosis. Our discoveries of multiple receptors not related to calcium homeostasis barely impressed the management.

The Japanese company has since been swallowed by Roche (50.1 percent of the capital) and abandoned fully vitamin D R and D; now all is anticancer therapies. I presume, the reason for the change is the Roche realization that there is no money in vitamin D analogues (related to calcium) and that vitamin D3 is a food supplement, available over the counter, also that the danger of hypercalcemia has been overstated by the calcium vitamin D experts for too long.

The market drives the development. For the public, the development in the vitamin D-soltriol field is favorable. Attached is a letter of a California Neurologist who is interested in sleep problems and who found vitamin D beneficial in a number of cases. I alerted her to melatonin and sent her your article.  Again, we do not know enough about the targets of melatonin, a very important hormone, probably the yang for the yin, while in certain physiological events acting as the yin. I am attaching also an earlier article related to that..

With best regards, Walter Walter E Stumpf 2612 Damascus Church Rd Chapel Hill, NC 27516 Tel/Fax: 919 942 8646 http://www.walterstumpf.com                                   3 attachments;  

 and he attaches a letter from neurologist Dr Stasha Gominak:

Dear Dr. Stumpf: 

 I have spent the last month reading everything I can about vitamin D and I have several comments:   The first is that you got it completely right back in the 1980’s and it has to have been terribly frustrating to have the rest of us blockheads not understanding (for years on end) what is so completely obvious to you. I just finished Holick’s review in NEJM and I realized that I had already read it but that his treatment of the subject is so incredibly boring and “calcium focused” that the good stuff at the end comes across as accidental observation instead of the organized bio- logic  that you provide, which is why it didn’t integrate with what I’ve been thinking about.  

 The second is that it appears to me that just in the last year your vitamin D viewpoint appears to have reached critical mass. Every other patient or physician I talk to about your ideas has just heard something about vitamin D and several of the local physicians here have apparently just come back from a lecture that opened their eyes to….. etc, sort of a religious conversion, “vitamin d is not just about calcium”. One of my patients who just started vitamin D said her friend called her from california and told her that her own doctor had just called and apologized to her for thinking she was crazy. I’ve made several of those calls recently though with most of them i knew there was something goofing up their sleep I just didn’t know what it was that was doing it.   In October I’ll be going to lecture about your ideas, as well as my findings in sleep to the “Pain Experts” (and what a misnomer that is) in Austin. Last lecture was about the fact that all of their patients had a sleep disorder that was the primary cause of their pain.

This year it will be that the sleep disorders are caused by either B12 or D deficiency in the great majority of the patients, and that ( fortunately  for our patients) in about five years all  pain experts will be out of a job because the rest of medicine will realize that this is an easily treatable condition.   I would expect that your original articles, which are now being referenced by all the primary clinical researchers in vitamin D treatment and deficiency, will become more and more known, finally.   I would really like to talk to you about my observations about sleep disorders as it adds some of the final aspects to your hypotheses. Most of what is written about sleep in the journals is still very primative for complex political reasons having to do with falling between medical subspecialties.  Although I have a very good sense of how B12 affects brain stem pacemaker cells, I don’t have any good ideas about the cell biology of how low D is goofing everything up.

Most of the D deficient patients have a pattern of REM related apnea with multiple awakenings to light sleep and some important leg movements. I think the reason why the original rickets kids had predominent leg pain despite osteomalacia everywhere was the leg movements in sleep. That’s a consistent complaint in the patients with periodic leg movements during sleep regardless of the cause. When a part of the body does not get appropriately paralyzed in sleep it doesn’t get repaired.  

In my view your ideas are every bit Nobel Prize material. Your science is rigorous and careful and your conclusions are clearly every bit correct. It is so odd that medicine is so incredibly inflexible that when given an obviously correct idea that is not the “party line” everyone in that field is particularly blind to its truth because it challenges the assumptions they build their thoughts on. It has always been so, but this is “vitamin D blindness” is particularly tragic because every day in the hospital I see people’s lives ruined by this one small thing, a vitamin deficiency. The implications of not accepting your ideas back in the 1980’s is hundreds of thousands of people who have lived painful, tortured lives or have died unnecessarily. Over the last 20 years I have seen thousands of patients who would have benefited from your views, I could have really helped them and I didn’t.    I will be writing up the sleep study results of the B12 deficient patients and the D deficient patients and would benefit from your thoughts about cellular effects. There have to be many things about vitamin D that you have figured out but have not published as they weren’t part of the actual experiments.  

Thank you for your attention. Stasha Gominak,   Texas