The Vitamin D Newsletter June/July, 2006

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The Vitamin D Newsletter

 

June/July, 2006

 

This is a periodic newsletter from the Vitamin D Council, a non-profit

trying to end the epidemic of vitamin D deficiency. If you don't want

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Dr. Liu and colleagues at UCLA, publishing in this March's edition of

the prestigious journal Science, showed that vitamin D might be, in

effect, a potent antibiotic. Vitamin D increases the body's

production of naturally occurring antibiotics: antimicrobial peptides.

Antimicrobial peptides are produced in numerous cells in the human

body where they directly and rapidly destroy the cell walls of viruses

and bacteria, including tuberculosis. Furthermore, Liu showed that

adding vitamin D to African American serum (African Americans have

higher rates of TB) dramatically increased production of these

naturally occurring antibiotics.

 

Science. 2006 Mar 24;311(5768):1770-3.

 

 

 

Plenty of you have e-mailed me that high (pharmacological) doses of

vitamin D (1,000 to 2,000 units per kg per day for three days), taken

at the first sign of influenza, effectively reduces the severity of

symptoms. However, has anyone ever studied giving 100,000, 200,000,

or 300,000 units a day for several days to see if vitamin D induces

antimicrobial peptides to help fight other life-threatening

infections? (By the way, doses up to 600,000 units as a single dose

are routinely used in Europe as " Stoss " therapy to prevent vitamin D

deficiency and have repeatedly been shown to be safe for short-term

administration.) No, you say, studies of " Stoss " therapy in serious

infections have never been studied or reported in reputable journals.

Well, maybe such treatment has been studied - and reported in the

best journals - by way of the weirdest medical invention ever patented

in the USA.

 

 

 

Before I get into that, I want to compliment the English for their

sense of fair play. Last month I pointed out that the English

discovered activated vitamin D (calcitriol) before the Americans.

It's important because I suspect the Nobel Committee will get around

to awarding a Prize for vitamin D sometime in the next several

decades, especially if vitamin D turns out to function like an

antibiotic. Well, I got an email from an English scientist who

pointed out that it was an American who first discovered calcitriol -

but none of the ones I listed. He pointed out that Dr. Tony Norman

was actually the first to discover calcitriol - in a series of

experiments starting in 1968. Too often, we only think of Dr.

DeLuca's and Dr. Holick's lab when we think of vitamin D, while Dr.

Norman's lab at UC Riverside is overlooked. He has authored 486

papers about vitamin D beginning in 1963 when he was a student in Dr.

DeLuca's lab. (By the way, Dr. DeLuca also trained Dr. Holick as he

has many vitamin D researchers) When a Nobel Prize is awarded, how

will they choose? I don't know - perhaps they should all share it. I

do know that I love the English sense of fair play.

 

J Biol Chem. 1968 Aug 10;243(15):4055-64.

 

Proc Natl Acad Sci U S A. 1969 Jan;62(1):155-62.

 

J Biol Chem. 1970 Mar 10;245(5):1190-6.

 

 

 

Before I get into this, be warned that what follows is bizarre. It

might not make much sense in the beginning. However, if you'll bear

with me, you'll see where I'm going. Remember how Professor Reinhold

Vieth has written about the complete absence of studies using

pharmacological doses of vitamin D (100,000 to 300,000 units a day for

several days) in serious diseases. Are there frequently fatal

illnesses, such as peritonitis (generalized infection in the abdominal

cavity), septicemia (infection of the blood), pneumonia (the Captain

of the Men of Death), etc, in which pharmacological doses of vitamin D

may be clinically useful when added to conventional treatment?

 

 

 

We know that vitamin D has profound effects on human immunity. Quite

recently, three independent groups have reported that vitamin D

triggers the release of these powerful natural antibiotics called

antimicrobial peptides. If you gave someone large doses of vitamin D,

would their bodies make large amounts of antimicrobial peptides?

 

Cell Mol Biol (Noisy-le-grand). 2003 Mar;49(2):277-300.

 

J Immunol. 2004 Sep 1;173(5):2909-12.

 

FASEB J. 2005 Jul;19(9):1067-77.

 

Science. 2006 Mar 24;311(5768):1770-3.

 

My attempts to answer that question led me to some very strange

research. Did you know that when some people get an infection, they

go to an alternative health care provider and have their blood

irradiated? I'm not kidding. About 300 cc of their blood is removed,

irradiated with UVB and UVC, and then returned to their body. Today,

alternative health practitioners call it " Photoluminescence Therapy. "

When results appeared in the best American medical journals, it was

called the " Knott Technic. " By the way, I'm not talking about

" photopheresis, " Dr. Richard Edelson's irradiation of some blood

components to treat cutaneous T cell lymphoma, used today in 150

medical centers around the country. I'm talking about Knott's

irradiation of whole blood to treat life-threatening infections, used

in hospitals around the country in the 1930's, 40's and early 50's.

In the 1940's, at least one prestigious American hospital even had a

" Department of Blood Irradiation. "

 

Knott EK, Hancock VK. Irradiated blood transfusion in treatment of

infections. Northwest Med.1934; 33: 200-204.

It began in the 1920's. Seattle scientist Emmett Knott knew that

sunlight and UV light was being used to successfully treat infectious

diseases. The 1903 Nobel Prize in Medicine was awarded to Dr. Niels

Finsen for his discovery that artificial UV radiation of the skin

cured tuberculosis of the skin. If skin infections could be treated

by irradiating the skin, Dr. Knott thought blood infections might be

cured by irradiating the blood! Knott built an apparatus that would

remove about 5% of the blood volume, anti-coagulate it, expose it to

UVB and UVC radiation, and then pump the irradiated blood back into

the body. Depending on the patient's weight, about 300 cc of blood is

removed and circulated in thin glass tubing while being irradiated by

ultraviolet light. The blood is then returned to the patient and the

process is repeated a number of times, depending on the seriousness of

the condition being treated. Sounds crazy?

Knott EK. Development of ultraviolet blood irradiation. American

Journal of Surgery 1948; 76(2): 165-171.

 

 

However, a couple of things caught my eye. First, the " Knott Technic "

didn't really work on test animals until Knott began using ultra-thin

quartz glass tubing. (Regular glass blocks UV radiation but quartz

glass does not.) Second, Knott added a series of baffles to ensure

all the blood came in direct contact with the interior surface of the

quartz tube. (The heme molecule would absorb UV light if the blood

was not agitated). Third, according to a book by Dr. William Douglas,

the procedure rapidly cured both rickets and tetany. (Of course, a

common cause of rickets and tetany is vitamin D deficiency.) Fourth,

according to Douglas, Knott's early animal studies showed this

procedure could maintain serum calcium in animals whose parathyroid

glands were surgically removed. (We used to use pharmacological doses

of vitamin D in humans who have had their parathyroid glands removed

in order to maintain serum calcium.) Finally, when Knott experimented

on dogs, he found that irradiating 100% of their blood volume (10

sessions with 10% of the blood removed and irradiated each time) cured

experimentally induced infections, but all the dogs died 5 - 7 days

later with cardiac arrhythmia, low blood pressure, respiratory

depression, loss of reflexes, loss of muscle tone, followed by coma

and death. (This is the clinical course in fatal hypercalcemia - the

cause of death in severe vitamin D toxicity.) If the " Knott Technic "

cured rickets and tetany, maintained serum calcium in

parathyroidectomized animals, and caused hypercalcemia with

over-irradiation, it must have delivered pharmacological amounts of

vitamin D into the circulation. See where I'm heading?

 

Into the Light, Tomorrow's Medicine Today

 

Some of you may know that many substances develop vitamin D activity

when irradiated. Milk used to be irradiated to fortify it with

vitamin D, now the vitamin D is just added. The famous Harry

Steenbock of the University of Wisconsin, found many things develop

vitamin D activity when irradiated, including olive oil, cereal

products, orange juice, and egg yolk. (He patented the procedure of

irradiating things, including ergosterol to make ergocalciferol or

vitamin D2, and gave the proceeds - which were enormous - to the

University of Wisconsin.) However, I couldn't locate a study that

sought to discover if human blood makes vitamin D when it is

irradiated. To find out, I looked in what must be the first vitamin D

textbook ever published in English (Blunt and Cowan, 1930). I learned

two interesting things. One, wavelengths between 250 and 280 nm (UVC)

were more effective in curing rachitic rats than was the UVB range

(pp. 74). Two, recrystalized red blood cells made lots of vitamin D

when irradiated (pp. 135). However, to my knowledge, no one has ever

directly tested the theory that irradiating blood delivers vitamin D

to the circulation. The entire idea is so weird, who would ever do that?

 

Blunt K, Cowan R. Ultraviolet Light and Vitamin D Nutrition. 1930; The

University of Chicago Press, Chicago Illinois.

 

About now, you may be wondering if I've lost my mind. Why would

anyone care if irradiating blood triggers vitamin D production when

vitamin D supplements will do the trick? The reason it's important is

that hundreds of studies have been published, many in the best

journals, describing clear-cut antibiotic-like actions following blood

irradiation. Remember when I said Dr. Reinhold Vieth has complained

that pharmacological doses of vitamin D have never been tested in

clinical trials. Well, maybe they have, and on lots of frequently

fatal infections - but no one knew blood irradiation was actually

delivering hundreds of thousands of units of vitamin D to desperately

ill patients. That is, no one knew it was pharmacological doses of

vitamin D actually being tested.

 

I'll concentrate on just a few of the published studies. In 1942,

Professor George Miley at Hahnemann Hospital in Philadelphia reported

using the " Knott Technic " on 103 patients with life-threatening

infections. Remember, all they had at the time was sulfa drugs so

most of these patients usually died. He classified the patients as

early, moderately advanced, and moribund (close to death). The

diagnosis included sepsis, septic abortion, peritonitis, pneumonia,

appendicle abscess, pelvic abscess, wound infection, septicemia, and

similar conditions. He treated all of them with ultraviolet blood

irradiation and reported that all 20 of the early patients, 46 of 47

of the moderately advanced patients, and 17 of 36 moribund patients

fully recovered - such results were unheard of at the time.

 

Miley GP. The Knott Technic of Ultraviolet Blood Irradiation in Acute

Pyogenic Infections. New York State Journal of Medicine. 1942;42(1):38-46.

 

 

 

Miley and Christensen went on to report what might be the largest case

series ever published by The American Journal of Surgery. They

reported treating 445 patients with a variety of life-threatening

infections over six years. All of the early, 98% of moderately

advanced, and 45% of moribund patients recovered after treatment with

Knott hemo-irradiation - results that would rival those obtained

today. The only side effect noted was a curious flushing of the skin

that occurred in most treated patients and lasted up to 30 days. They

also noted that treatment of staph aureus septicemia with sulfa drugs

reduced effectiveness of hemo-irradiation.

 

Miley GP, Christensen JA. Ultraviolet blood irradiation therapy:

further studies in acute infections. American Journal of Surgery 1947;

73: 486-493.

 

 

 

Miley and Rebbeck also reported on 40 patients with generalized

peritonitis (a usually fatal infection of the abdominal cavity). All

23 moderately advanced patients and 9 of 17 moribund patients

recovered after blood irradiation.

 

Miley GP, Rebbeck EW. The Knott Technic of Ultraviolet Blood

Irradiation as a Control of Infection in Peritonitis. Review of

Gastroenterology. 1943;10:1.

 

 

 

In 1948, Miley and Christensen reported the technique had near

miraculous results on viral pneumonia, including influenza. Within a

few days of one treatment, fever disappeared and symptoms abated. For

those of you who haven't tried it, 1,000 to 2,000 units per kg per day

of vitamin D early in the course of influenza or influenza-like

illnesses, has very similar effects.

 

Miley GP, Christensen JA. Ultraviolet blood irradiation therapy in

acute virus-like infections. Review of Gastroenterology 1948; 15; 271-277.

 

 

 

Dr. Rebbeck, from the " Department of Blood Irradiation, " at Shadyside

Hospital in Pittsburgh went on to independently confirm Miley's

reports of successful treatments in acute peritonitis, puerperal

(childbirth) sepsis, post-abortion sepsis - even 6 of 8 patients

survived E-coli septicemia, a routinely lethal infection. Of

interest, the two patients who died from E-coli septicemia had

autopsies: one had a sterile bloodstream and the other showed the

E-coli was gone but staph aureus was present.

 

Rebbeck EW. Ultraviolet Irradiation of Auto-transfused Blood in the

Treatment of Escherichia coli Septicemia. Archives of Physical

Therapy. 1943;24:158-67

 

Rebbeck EW. Ultraviolet Irradiation of Auto-transfused Blood in the

Treatment of Acute Peritonitis, General. The Hahnemannian Monthly,

April, 1941

 

Rebbeck EW. Ultraviolet Irradiation of Auto-transfused Blood in the

Treatment of Puerperal Sepsis. American Journal of Surgery. 1941;54:691

 

Rebbeck EW. Ultraviolet Irradiation of Auto-transfused Blood in the

Treatment of Postabortional Sepsis. American Journal of Surgery.

1942;55:476-86

 

Rebbeck EW. Further studies with ultraviolet blood irradiation therapy

(Knott technic) in septic abortions. Am J Surg. 1951 Dec;82(6):736-40.

 

Rebbeck EW. Use of ultraviolet blood irradiation (Knott technic) in

biliary tract surgery. Am J Surg. 1950 Jul;80(1):108-12.

 

 

 

In the late 40's and 50's, articles in the American Journal of Surgery

reported that the technique was useful in a variety of ailments.

Olney reported that viral hepatitis responded.

 

MILEY GP, DUNNING PM. Ultraviolet blood irradiation therapy (Knott

technic) in thrombophlebitis. Am J Surg. 1949 Dec;78(6):892.

 

NEFF FE, ANDERSON CM. Use of ultraviolet blood irradiation in the

treatment of bursitis and tendinitis calcarea. Am J Surg. 1951

Jun;81(6):622-8.

 

SCHULTZ IT. Use of the Knott technic of blood irradiation therapy in

cases of threatened and inevitable abortion. Am J Surg. 1954

Sep;88(3):421-4.

 

OLNEY RC. Treatment of viral hepatitis with the Knott technic of blood

irradiation. Am J Surg. 1955 Sep;90(3):402-9.

 

 

 

Let me say again, I'm not advocating blood irradiation. I'm only

interested in the research because it may mean pharmacological doses

of vitamin D acts as a broad-spectrum antibiotic by ramping up

production of the body's own antimicrobial peptides. If the " Knott

Technic " creates pharmacological amounts of vitamin D, then maybe

that's its mechanism of action. If so, thousands of desperately ill

patients with life-threatening infections in ICU's all over the world

might be saved if short pharmacological courses of vitamin D were

added to standard treatment with conventional antibiotics.

 

 

 

So what ended research on ultraviolet blood irradiation in the United

States? First, more antibiotics became available, with much improved

results (that was before many bacteria developed resistance to

antibiotics). Second, Knott's proposed mechanism of action - directly

killing bacteria in the irradiated blood or sterilization of the blood

- was proven wrong. When you think about Knott's reasoning, it never

made any sense. Only a small portion of the blood volume is irradiated

so bacteria in the un-irradiated blood would be free to reproduce

inside the body. No, direct sterilization of the blood was never a

reasonable mechanism of action. However, without a viable mechanism

of action, the procedure was doomed, at least in America.

 

J Bacteriol. 1944 Jan;47(1):85-96.

Archives of Physical Medicine 1948;19:358-65

 

Another critical study was funded in part by the American Medical

Association and appeared in its journal. Again, they found that blood

irradiation didn't sterilize the blood. They also administered Knott

hemo-irradiation to 68 patients with a wide range of diseases and

found it safe, but ineffective, although none of the treated patients

died. Although the JAMA article was its death knell in the USA, the

authors concluded with the sentence, " A longer and more extensive

program of study is warranted before in vivo ultraviolet irradiation

of blood can be finally either accepted or rejected. "

J Am Med Assoc. 1952 Jul 26;149(13):1180-3.

 

After its death in the USA, the Germans revived it, then the Russians.

One of the German studies was exceptionally well controlled, finding

ultraviolet blood irradiation compared favorably to infrared and sham

ultraviolet blood irradiation as well as whole-body skin irradiation -

which will produce physiological amounts of vitamin D. Therefore, if

it works by a vitamin D mechanism, it is producing pharmacological

amounts of vitamin D. To this day, it remains a treatment modality in

Russia where it is often added to standard treatment of severe

infections. Russian scientists have reported it helps improve

standard treatment of numerous infections including tuberculosis, just

what the UCLA group recently suggested about vitamin D. I've only

included the few Russian studies with abstracts; hundreds more have

been published without abstracts, so many my wife refuses to read

anymore of them to me.

Kariakin AM, Kucher VV, Susla PA, Kofman BL. [Hemosorption and

ultraviolet irradiation of the blood in the treatment of acute

septicemia] Vestn Khir Im I I Grek. 1983 Apr;130(4):109-12.

Petukhov VA, Perekokin NN, Gorelenko AG, Koloda AS. [ultraviolet

irradiation of the blood] Vestn Khir Im I I Grek. 1987 Jan;138(1):66-7.

Butylin LP, Volobuev NN, Tikhonov KS, Sinani MB. [ultraviolet

irradiation of the blood in the complex treatment of

suppurative-inflammatory diseases] Klin Khir. 1989;(1):27-9.

Scherf HP, Baumler H, Meffert H, Turowski A, Schmidt HH, et al.

[serial infrared and ultraviolet whole body irradiation and placebo

and ultraviolet irradiation of autologous venous blood in peripheral

arterial occlusive disease. 1. Treadmill ergometry, metabolic,

rheologic and hemodynamic parameters] Z Gesamte Inn Med. 1989 Apr

1;44(7):201-7.

Riabtsev VG, Gorbovitskii EB, Myslovatyi BS, Masiukevich AV, Ronami

VG. [Hemosorption and ultraviolet irradiation of the blood in the

complex treatment of peritonitis] Vestn Khir Im I I Grek. 1989

Apr;142(4):84-7.

Kibirev AB, Kochulanov AN, Strelets BM, Grebenkina LA. [The

ultraviolet irradiation of autologous blood and endolymphatic

antibiotic therapy in treating pneumonia in patients with

craniocerebral trauma] Zh Vopr Neirokhir Im N N Burdenko. 1990

May-Jun;(3):11-4.

Zalesnyi SA, Khankoev IM, Grechishkin AI, Krasnopol'skii IS, Sitnik

SD. [Hemosorption and ultraviolet irradiation of blood in the complex

treatment of suppurative and septic diseases in children] Vestn Khir

Im I I Grek. 1990 Jun;144(6):79-81.

Piksin IN, Atiasov NI, Kiseleva RE, Romanov MD, Dorofeeva LS, et al.

[ultraviolet irradiation of blood in surgery] Khirurgiia (Mosk). 1990

Nov;(11):100-4.

Paleev NR, Cherniakov VL, Vetchinnikova ON. [ultraviolet irradiation

of the blood in the treatment of pyo-inflammatory complications in

patients with terminal renal failure] Vestn Akad Med Nauk SSSR.

1991;(3):15-20.

Sukhodub LF, Tertyshnyi NG, Duzhyi ID, Pliskachev VM. [ultraviolet

irradiation of blood in patients with pulmonary tuberculosis] Probl

Tuberk. 1991;(7):65-8.

Kalinkin VN, Mezentsev GD, Kashuba EA, Konovalova LA, Shatilovich LN.

[Autotransfusion of ultraviolet-irradiated blood in destructive

pneumonia of young children] Khirurgiia (Mosk). 1991 Aug;(8):14-20.

Sychev MD, Manucharov NK, Tomaev KB, Litvin AA. [Extracorporeal

methods for detoxification in the combined treatment of gunshot

peritonitis] Voen Med Zh. 1992 Jan;(1):44-5.

Potashov LV, Reshetov AV, Tone RV, Vismont VG. [The efficacy of the

ultraviolet irradiation of the blood in the combined treatment of

erysipelatous inflammation] Vestn Khir Im I I Grek. 1992

Jul-Aug;149(7-8):84-8.

Zhadnov VZ, Mishanov RF, Kuznetsov AA, Shprykov AS, Ryzhakova TM.

[Effectiveness of chemotherapy in combination with electrophoresis and

ultraviolet irradiation of blood in newly diagnosed patients with

destructive pulmonary tuberculosis] Probl Tuberk. 1995;(3):20-2.

Kuvshinchikova VN, Shmelev EI, Mishin VIu. [Effectiveness of

extracorporeal ultraviolet blood irradiation in treatment of chronic

obstructive bronchitis in pulmonary tuberculosis] Probl Tuberk.

1998;(3):48-50.

Kravets VP, Kravets AV. [Extracorporeal ultraviolet irradiation of

blood in combined treatment of patients with peritonitis] Klin Khir.

2002 Jul;(7):19-20.

 

 

Perhaps I've lost my mind and need to see one of my psychiatric

colleagues. Another possibility is that pharmacological doses of

vitamin D (via hemo-irradiation) have been tested in life-threatening

infections and found to be safe and remarkably effective, first in the

USA, then in Germany and finally in Russia. We will never know until

the Food and Nutrition Board starts living in the 21st Century. Their

Upper Limit of 2,000 units a day effectively prevents vitamin D

researchers from testing pharmacological doses of vitamin D, while

drug manufacturers test pharmacological doses of vitamin D analogs all

the time.

 

 

 

What we really need are some intrepid volunteers, some readers

interested in donating their body to science. The study would be

simple. Just contact one of the alternative health care providers on

the website listed below this paragraph and see if they use the German

made, Euphoton® EN 600 NT hemo-irradiator. If so, arrange for a

course of ultraviolet blood irradiation. But have your 25(OH)D levels

checked the day before you begin treatment and again about a week

after the course of treatment is finished. Then we will know if Dr.

Knott was - and Dr. Cannell is - out of their minds. Actually, if I

had a serious infection, I wouldn't hesitate taking 200,000 units of

vitamin D a day for three days, but I wouldn't have my blood

irradiated on a bet.

 

Photoluminescence Therapy

 

John Cannell, MD

 

The Vitamin D Council

 

9100 San Gregorio Road

 

Atascadero, CA 93422

 

This is a periodic newsletter from the Vitamin D Council, a non-profit

trying to end the epidemic of vitamin D deficiency. If you don't want

to get the newsletter, please hit reply and let us know.

 

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