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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 to get the newsletter, please, please, please, hit reply and let me know.
This newsletter
is not copyrighted. Please reproduce it and post it on Internet sites. Not yet signed up for the free newsletter? Click on Vitamin D Newsletter and follow the directions. I will
post this newsletter on the website.
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."
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.
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, EuphotonŽ 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.
This newsletter
is not copyrighted. Please reproduce it and post it on Internet sites.
Not signed
up for the newsletter yet: Vitamin D Newsletter sign-up page
Remember, we are a non-profit and rely on donations to publish our newsletter and maintain our
website. Send your tax-deductible contributions to:
The Vitamin D Council
9100 San Gregorio Road
Atascadero, CA 93422
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