Vitamin D Deficiency Linked to Fatigue, Studies Show

In continuation of my update on Vitamin D

Prevalence and Link to Fatigue

Approximately 40% to 75% of the teen and adult population in the United States is deficient in vitamin D, according to Raymond Francis in “The Great American Health Hoax.” ^[1] Low energy and occasional fatigue are commonly reported among individuals with low vitamin D status, according to a report on the silent epidemic of nutrient deficiencies. ^[2] The scale of the problem is vast, with estimates suggesting that nearly half of all adults may have insufficient levels, the report stated.

Vitamin D deficiency is not confined to a single demographic. Factors such as limited sun exposure, darker skin pigmentation, and indoor lifestyles contribute to widespread insufficiency, researchers said. The link between low vitamin D and fatigue has been documented in multiple studies, though many individuals remain unaware of their own deficiency status.

Mechanism: Vitamin D and Cellular Energy

Vitamin D supports mitochondrial function, which is responsible for cellular energy production, according to research cited in an article on fatigue and mitochondria. ^[3] The mitochondria act as the powerhouses of the cell, generating adenosine triphosphate (ATP) from nutrients. A deficiency may disrupt mitochondrial efficiency, contributing to feelings of lethargy, experts said. ^[4]

The role of mitochondria in energy production is central to understanding why vitamin D insufficiency can lead to persistent tiredness. As noted in the book “Dissolving Illusions,” proper mitochondrial metabolism is essential for normal cellular function, and any disruption can manifest as weakness or apathy. ^[5] Although that text focuses on vitamin C, the principle applies broadly to nutrients that support mitochondrial health, including vitamin D.

Supporting Studies

Multiple studies have reported a connection between low vitamin D levels and fatigue. A 2016 study of 200 female nurses in Iran found that low vitamin D levels accounted for 13% to 18% of reported prolonged tiredness, according to a review of nutrient deficiencies. ^[2] A 2019 study published in Nutrients similarly found that older adults with occasional fatigue had a significantly worse vitamin D status than those without fatigue, the review added. ^[2]

Other research has reinforced these findings. In a broader analysis, researchers noted that individuals frequently reporting low energy were more likely to have suboptimal vitamin D levels compared to their peers, according to an article on fatigue and mitochondrial function. ^[4] The consistency of the association across different populations suggests a robust relationship, though causation requires further investigation, scientists said.

Other Health Impacts

Beyond fatigue, vitamin D deficiency has been linked to several other health issues. Vitamin D directly modulates the body’s innate and adaptive immune responses, according to a review of the critical role of vitamin D in immune function. ^[6] Immune cells require adequate vitamin D to respond efficiently to threats, the review stated. Low levels have also been associated with increased susceptibility to infections and longer recovery times.

Vitamin D also influences bone health and cellular aging. Raymond Francis wrote that vitamin D is essential for calcium metabolism, supports bone health, helps control blood sugar, and protects against cancer. ^[1] The nutrient significantly increases the production of telomerase, an enzyme that repairs telomeres and slows aging, according to the same source. ^[1] These wide-ranging effects underscore the importance of maintaining optimal levels.

Solutions: Increasing Vitamin D Levels

Optimal vitamin D levels are considered to be above 50 nanograms per milliliter, and supplementation with 5,000 IU daily is recommended by some nutritionists, according to an interview on health testing and supplementation. ^[7] At-home blood tests can help individuals assess their current levels, the interview stated. ^[7] Testing allows for personalized dosing rather than generic recommendations.

The safety of higher vitamin D doses has been affirmed by recent reassessments. A news report noted that a “schoolboy error” in earlier guidelines led to overly cautious upper limits, and the Academy of Medicine has since acknowledged that higher intakes are not toxic for most people. ^[8] Dietary sources such as fatty fish, egg yolks, and fortified foods can also contribute, though supplementation is often the most reliable way to correct a deficiency, experts said.

Conclusion

Individuals experiencing unexplained fatigue may consider testing their vitamin D levels, clinicians advised. ^[7] Supplementation and dietary changes can help restore levels to the optimal range, though consulting a healthcare provider is recommended before starting any regimen, according to the interview. ^[7]

The evidence linking vitamin D deficiency to fatigue is supported by prevalence data, mechanistic studies, and clinical observations. Given the high rates of insufficiency in the general population, testing and appropriate supplementation offer a straightforward strategy for addressing a common but often overlooked contributor to low energy, researchers concluded.

https://en.wikipedia.org/wiki/Vitamin_D

Vitamin D Deficiency Linked to Fatigue, Studies Show 

Scientists discover strange link between vitamin D and pain

In continuation of my update on Vitamin D 

Women with low vitamin D levels may face a more painful recovery after breast cancer surgery and could require significantly more opioid medication afterward, according to research published online in the journal Regional Anesthesia & Pain Medicine.

The findings suggest that breast cancer patients with vitamin D deficiency (below 30 nmol/L) might benefit from taking vitamin D supplements before undergoing a radical mastectomy.

Researchers say growing evidence points to vitamin D playing an important role in how the body senses and regulates pain. Scientists believe this may be connected to the vitamin's anti inflammatory properties and its effects on the immune system. Vitamin D deficiency is also frequently seen in people with breast cancer.

Study Examined Pain After Breast Cancer Surgery

To explore the connection, researchers carried out a prospective observational study at Fayoum University Hospital in Egypt between September 2024 and April 2025.

The study included 184 women with breast cancer who were preparing to have surgery to remove one breast. Half of the participants had vitamin D deficiency (below 30 nmol/L), while the other half had vitamin D levels above 30 nmol/L. The two groups were otherwise similar, with average ages of 44 and 42.

Doctors and nurses caring for the patients did not know their vitamin D status. All participants received the hospital's standard treatment before, during, and after surgery.

During the operation, patients were given fentanyl to control acute pain. After surgery, everyone received intravenous paracetamol every eight hours. Patients were also able to self administer tramadol, another opioid pain medication, by pressing a control button.

Patients With Low Vitamin D Needed More Opioids

Pain levels were recorded immediately after surgery and again at 6, 12, 18, and 24 hours later. Researchers also tracked nausea, vomiting, sedation levels, and length of hospital stay.

Patients with vitamin D deficiency were three times more likely to experience moderate to severe pain during the first 24 hours after surgery compared with patients who had adequate vitamin D levels.

Researchers noted that none of the patients in either group reported severe pain of 7 or higher on the standard 0 to 10 pain scale. The difference was entirely related to a higher number of patients experiencing moderate pain levels between 4 and 6.

The vitamin D deficient group also required more opioid medication. On average, these patients received 8 μg more fentanyl during surgery, which researchers described as a modest increase.

However, after surgery, the difference became much larger. Patients with low vitamin D used an average of 112mg more tramadol than those with sufficient vitamin D levels. The medication was patient controlled, with doses capped at 50mg per hour.

Vitamin D and Recovery Complications

Opioid medications can lead to side effects such as nausea, vomiting, drowsiness, and confusion. They also carry risks of dependence and addiction.

The study found postoperative nausea occurred more often among patients with vitamin D deficiency. Vomiting was only reported in the deficient group, although researchers said the difference was too small to be considered statistically significant.

The researchers acknowledged several limitations. Because the study was observational and conducted at a single medical center, it cannot prove that low vitamin D directly caused the increase in pain. The team also did not measure inflammatory markers that might explain how vitamin D influences pain. In addition, information about anxiety, depression, cancer stage, previous treatments, and sleep problems before surgery was not collected.

Even with those limitations, the researchers concluded, "Vitamin D deficiency is associated with a higher occurrence of moderate to severe postoperative pain and increased opioid consumption in patients undergoing unilateral modified radical mastectomy."

They added, "Preoperative vitamin D supplementation in breast cancer patients with vitamin D levels below 30 nmol/L may have a role in modulating postoperative pain.

https://rapm.bmj.com/content/early/2026/05/04/rapm-2025-107495

https://en.wikipedia.org/wiki/Vitamin_D

Scientists discover strange link between vitamin D and pain | ScienceDaily

Scientists discover strange link between vitamin D and pain

In continuation of my update on Vitamin D

Women with low vitamin D levels may face a more painful recovery after breast cancer surgery and could require significantly more opioid medication afterward, according to research published online in the journal Regional Anesthesia & Pain Medicine.

The findings suggest that breast cancer patients with vitamin D deficiency (below 30 nmol/L) might benefit from taking vitamin D supplements before undergoing a radical mastectomy.

Researchers say growing evidence points to vitamin D playing an important role in how the body senses and regulates pain. Scientists believe this may be connected to the vitamin's anti inflammatory properties and its effects on the immune system. Vitamin D deficiency is also frequently seen in people with breast cancer.

Study Examined Pain After Breast Cancer Surgery

To explore the connection, researchers carried out a prospective observational study at Fayoum University Hospital in Egypt between September 2024 and April 2025.

The study included 184 women with breast cancer who were preparing to have surgery to remove one breast. Half of the participants had vitamin D deficiency (below 30 nmol/L), while the other half had vitamin D levels above 30 nmol/L. The two groups were otherwise similar, with average ages of 44 and 42.

Doctors and nurses caring for the patients did not know their vitamin D status. All participants received the hospital's standard treatment before, during, and after surgery.

During the operation, patients were given fentanyl to control acute pain. After surgery, everyone received intravenous paracetamol every eight hours. Patients were also able to self administer tramadol, another opioid pain medication, by pressing a control button.

Patients With Low Vitamin D Needed More Opioids

Pain levels were recorded immediately after surgery and again at 6, 12, 18, and 24 hours later. Researchers also tracked nausea, vomiting, sedation levels, and length of hospital stay.

Patients with vitamin D deficiency were three times more likely to experience moderate to severe pain during the first 24 hours after surgery compared with patients who had adequate vitamin D levels.

Researchers noted that none of the patients in either group reported severe pain of 7 or higher on the standard 0 to 10 pain scale. The difference was entirely related to a higher number of patients experiencing moderate pain levels between 4 and 6.

The vitamin D deficient group also required more opioid medication. On average, these patients received 8 μg more fentanyl during surgery, which researchers described as a modest increase.

However, after surgery, the difference became much larger. Patients with low vitamin D used an average of 112mg more tramadol than those with sufficient vitamin D levels. The medication was patient controlled, with doses capped at 50mg per hour.

Vitamin D and Recovery Complications

Opioid medications can lead to side effects such as nausea, vomiting, drowsiness, and confusion. They also carry risks of dependence and addiction.

The study found postoperative nausea occurred more often among patients with vitamin D deficiency. Vomiting was only reported in the deficient group, although researchers said the difference was too small to be considered statistically significant.

The researchers acknowledged several limitations. Because the study was observational and conducted at a single medical center, it cannot prove that low vitamin D directly caused the increase in pain. The team also did not measure inflammatory markers that might explain how vitamin D influences pain. In addition, information about anxiety, depression, cancer stage, previous treatments, and sleep problems before surgery was not collected.

Even with those limitations, the researchers concluded, "Vitamin D deficiency is associated with a higher occurrence of moderate to severe postoperative pain and increased opioid consumption in patients undergoing unilateral modified radical mastectomy."

They added, "Preoperative vitamin D supplementation in breast cancer patients with vitamin D levels below 30 nmol/L may have a role in modulating postoperative pain."

https://rapm.bmj.com/content/early/2026/05/04/rapm-2025-107495

Scientists discover strange link between vitamin D and pain 

High vitamin D levels may help prevent cancer

In continuation of my update on Vitamin D, 

The study reinforces the existing theory that vitamin D helps defend against certain cancers. Exposure to sunlight stimulates the production of vitamin D by our skin. Vitamin D contributes to calcium level maintenance in our bodies, which in turn helps teeth, muscles and bones remain healthy. Aside from established benefits of vitamin D on bone diseases, evidence continues to emerge that vitamin D could be effective for other cancers and chronic diseases.   

Yet more comprehensive research needs to be conducted, as to date, the majority of studies have been conducted throughout American and European populations, and more studies focusing on Asian populations are necessary.
It is vital to determine whether the effects are the same in non-Caucasian populations, since Vitamin D metabolism and concentrations differ dependant on ethnicity.
The study published by the BMJ was carried out to determine if vitamin D was linked to site specific and total cancer.

Data spanning nine public health centres across Japan was analysed, from 33,736 female and male participants between the ages of 40 and 69 years old.
Participants were required to disclose a comprehensive overview of their lifestyle, diet and medical history and have blood samples taken to assess their vitamin D levels. Factors such as seasons affected vitamin D levels; summer and autumn typically produced higher levels compared to spring or winter. Samples were then assigned to one of four groups, based on levels.

Researchers then monitored the study participants for a mean period of 16 years, during which 3,301 new cancer cases were registered.
Once multiple known cancer risk factors had been accounted for, including weight (BMI), physical activity, age, dietary factors, smoking and alcohol intake, researchers discovered that high levels of vitamin D  reduced the overall risk of cancer by 20% in both women and men.

Higher levels were linked to a 30-50% lower relative risk of liver cancer, and more so in men than women. No cancers exhibited a higher risk connected to high vitamin D levels, and there was no evidence of a link to prostate or lung cancer.
Adjustments were made for dietary and other factors to confirm the strength of the findings, but this did little to affect the results. One limitation of the study was an insufficient number of organ specific cancers. In addition, even with the risk factor adjustments, there is no absolute certainty that the results were skewed by unidentified factors.  For this reason, no concrete conclusions about cause and effect can be asserted.

The large sample size for overall cancer, large number of blood samples tested and the extensive follow up period were vital strengths of the study. The result reinforce the theory that vitamin D has a role in defending against the risk of cancer, but the authors emphasize that vitamin D may carry additional health benefits too, that were not measured in this study.  

Further studies are needed to clarify the optimal concentrations (of vitamin D) for cancer prevention."

Further studies are needed to clarify the optimal concentrations (of vitamin D) for cancer prevention."

Ref : https://www.eurekalert.org/pub_releases/2018-03/b-hvd030618.php

High vitamin D levels may help prevent cancer

Mycobacterium tuberculosis is extraordinarily sensitive to killing by a vitamin C-induced Fenton reaction : Nature Communications : Nature Publishing Group

In a striking, unexpected discovery, researchers at Albert Einstein College of Medicine of Yeshiva University have determined that vitamin C kills drug-resistant tuberculosis (TB) bacteria in laboratory culture. The finding suggests that vitamin C added to existing TB drugs could shorten TB therapy, and it highlights a new area for drug design.

Dr. Jacobs and his colleagues observed that isoniazid-resistant TB bacteria were deficient in a molecule called mycothiol. "We hypothesized that TB bacteria that can't make mycothiol might contain more cysteine, an amino acid," said Dr. Jacobs. 

"So, we predicted that if we added isoniazid and cysteine to isoniazid-sensitive M. tuberculosis in culture, the bacteria would develop resistance. Instead, we ended up killing off the culture  something totally unexpected."

The Einstein team suspected that cysteine was helping to kill TB bacteria by acting as a "reducing agent" that triggers the production of reactive oxygen species (sometimes called free radicals), which can damage DNA.

"To test this hypothesis, we repeated the experiment using isoniazid and a different reducing agent vitamin C," said Dr. Jacobs. "The combination of isoniazid and vitamin C sterilized the M. tuberculosis culture. We were then amazed to discover that vitamin C by itself not only sterilized the drug-susceptible TB, but also sterilized MDR-TB and XDR-TB strains."

To justify testing vitamin C in a clinical trial, Dr. Jacobs needed to find the molecular mechanism by which vitamin C exerted its lethal effect. More research produced the answer: Vitamin C induced what is known as a Fenton reaction, causing iron to react with other molecules to create reactive oxygen species that kill the TB bacteria.

"We don't know whether vitamin C will work in humans, but we now have a rational basis for doing a clinical trial," said Dr. Jacobs. "It also helps that we know vitamin C is inexpensive, widely available and very safe to use. At the very least, this work shows us a new mechanism that we can exploit to attack TB.".....

Ref : http://www.einstein.yu.edu/news/releases/907/study-finds-vitamin-c-can-kill-drug-resistant-tb/


Mycobacterium tuberculosis is extraordinarily sensitive to killing by a vitamin C-induced Fenton reaction : Nature Communications : Nature Publishing Group

Vitamin C may reduce cancer-linked digestive chemical reactions

In continuation of my update on Vitamin C

A new study from the University of Waterloo uses mathematical modeling to examine how Vitamin C affects chemical reactions in the digestive system that are linked to cancer development. 

Over the last several decades, North American diets have seen a steady increase in exposure to nitrates and nitrites: compounds found in cured meats as well as fruits and vegetables grown using polluted soil and water. While nitrates and nitrites play important roles in neurological and heart health, in the stomach, they can undergo a chemical reaction known as "nitrosation" and form chemicals that many scientists suspect increase cancer risk. 

Since at least the 90s, researchers have been studying the link between cancer and these compounds, with conflicting results. Our work suggests that the presence of dietary Vitamin C may help explain these inconsistencies." 

Dr. Gordon McNicol, post-doctoral researcher in applied mathematics and first author of the study

The team built a mathematical model of the salivary glands, stomach, small intestine and plasma, and simulated how nitrites and nitrates move through the body and change over time. Their model demonstrated that when Vitamin C is also present in food, such as leafy greens like spinach, which contain both Vitamin C and nitrate, it could decrease cancer risk. 

The study also suggested that taking Vitamin C supplements after each meal could have a moderate positive effect in reducing the formation of nitrosation products associated with cancer risk from dietary nitrites and nitrates, such as those found in foods like bacon and salami. 

The researchers hope these findings will support future nutrition research. 

"This work provides a mechanistic roadmap for future clinical and laboratory studies by identifying the key interacting drivers of these potentially harmful chemical reactions, including nitrite exposure, antioxidant intake, meal timing, gastric conditions and oral microbiome activity," said Dr. Anita Layton, professor of applied mathematics and Canada 150 researcher chair. "This model can help researchers design more targeted experiments and interventions, focusing on when and in whom nitrosation is most likely to occur." 

The research, "Vitamin C as a nitrosation inhibitor: A modelling study across dietary patterns and water quality," appears in the Journal of Theoretical Biology.

https://www.sciencedirect.com/science/article/pii/S002251932600069X?via%3Dihub

Vitamin C may reduce cancer-linked digestive chemical reactions

Taking vitamin D with quetiapine can help avoid new-onset diabetes risk

In continuation of my update on quetiapine

Atypical antipsychotics, though effective for treating disorders like schizophrenia, bipolar disorder, and depression, gives patients a heightened risk of developing new-onset diabetes. A new data mining study, however, has found a way to relieve this side effect. The study, published in Scientific Reports, shows that taking vitamin D ameliorates the risk of developing new-onset diabetes from atypical antipsychotics like quetiapine.

 quetiapine.

The consequences of developing diabetes from taking antipsychotics are dire, as they occasionally cause life-threatening conditions and sometimes even death.

Members of Shuji Kaneko's lab at Kyoto University looked for potential antidotes on the US FDA's Adverse Event Reporting (FAERS) system, which is the largest database of self-reported adverse side effects. "We found that patients who had coincidentally been prescribed vitamin D with quetiapine were less likely to have hyperglycaemia," says Kaneko. "It's unusual for vitamin D to be prescribed with quetiapine because it is typically prescribed to treat osteoporosis; in fact, there were only 1232 cases in the world where vitamin D was prescribed with quetiapine. Data mining proved helpful in locating these cases."

The team confirmed this finding with further tests on mice; the group of mice that was fed vitamin D along with quetiapine had significantly lower levels of blood sugar than those that took only quetiapine.

"Interestingly, vitamin D on its own doesn't lower diabetes risk, but it certainly defends against the insulin-lowering effects of quetiapine," elaborates lead author Takuya Nagashima. "We clarified the molecular mechanisms of how quetiapine causes hyperglycaemia using datasets in a genomics data repository. Through this we found that quetiapine reduces the amount of a key enzyme called PI3K that gets produced. Vitamin D stops quetiapine from lowering PI3K production."

"Databases like FAERS aren't just for making drug regulations; they have so much potential for side-effect relief using pre-existing drugs," says Kaneko. "There's a lot we can hope for from reverse translational research like this. "

Ref : http://www.kyoto-u.ac.jp/en/research/research_results/2016/160523_2.html

Does Vitamin E Prevent or Promote Cancer?

In continuation of my update on Vitamin-E

The cancer preventive activity of vitamin E has been suggested by many epidemiologic studies. However, several recent large-scale human trials with α-tocopherol, the most commonly recognized and used form of vitamin E, failed to show a cancer preventive effect. The recently finished follow-up of the Selenium and Vitamin E Cancer Prevention Trial (SELECT) even showed higher prostate cancer incidence in subjects who took α-tocopherol supplementation. The scientific community and the general public are faced with a question: “Does vitamin E prevent or promote cancer?” Researchers lead by Dr. Chung S. Yang, Director of the center did experiments in animal models and tried to conclude about  the cancer preventive activity of γ- and δ-tocopherols as well as a naturally occurring mixture of tocopherols, and the lack of cancer preventive activity by α-tocopherol. 

On the basis of these results as well as information from the literature, we suggest that vitamin E, as ingested in the diet or in supplements that are rich in γ- and δ-tocopherols, is cancer preventive; whereas supplementation with high doses of α-tocopherol is not.

Ref : http://cancerpreventionresearch.aacrjournals.org/content/early/2012/04/14/1940-6207.CAPR-12-0045.abstract?sid=5d446d6b-8eb0-426f-b86a-378f60ad7d15

Vitamin B12 as an effective 'Canker Sore Therapy' ..

I used to wonder why, the medical practitioners recommend Vitamin B12 for canker sores, now thanks to the research group lead by Dr. Ilia Volkov, have confirmed the fact that a nightly dose of vitamin B12 is a simple, effective and low risk therapy to prevent Recurrent Aphthous Stomatitis (RAS), better known as "canker sores." In India vitamin B12, is available as OTC.

The researchers tested the effect of vitamin B12 on 58 randomly selected RAS patients who received either a dose of 1,000 mcg of B12 by mouth at bedtime or a placebo, and were tested monthly for six months. Approximately three quarters (74 percent) of the patients of the treated group and only a third (32 percent) of the control group achieved remission at the end of the study.

The results are of important by the fact that the average outbreak duration and the average number of ulcers per month decreased in both groups during the first four months of the trial. However, the duration of outbreaks, the number of ulcers, and the level of pain were reduced significantly at five and six months of treatment with vitamin B12, regardless of initial vitamin B12 levels in the blood. During the last month of treatment a significant number of participants in the intervention group reached 'no aphthous ulcers status' (74.1% vs 32.0%; P < .01) and not only becoz., of the statistical significance and also this treatment is simple and inexpensive and has no known significant toxic effects. More....

FDA Approves Rayaldee (calcifediol) to Treat Secondary Hyperparathyroidism in Patients with Chronic Kidney Disease

OPKO Health, Inc. announced that the U.S. Food and Drug Administration (FDA) has approved Rayaldee (calcifediol) extended release capsules for the treatment of secondary hyperparathyroidism (SHPT) in adults with stage 3 or 4 chronic kidney disease (CKD) and serum total 25-hydroxyvitamin D levels less than 30 ng/mL. Rayaldee is a patented extended release product containing 30 mcg of a prohormone called calcifediol (25-hydroxyvitamin D3).

 calcifediol

"FDA's approval of Rayaldee represents an important milestone for OPKO," noted Dr. Phillip Frost, CEO and Chairman of OPKO. "Rayaldee is the first product to receive FDA approval for this important indication and is one of OPKO's many pharmaceutical products being developed for significant medical problems which will benefit from new treatment options."

Results from two 26 week placebo controlled, double blind phase 3 trials demonstrated that a larger proportion of stage 3 or 4 CKD patients with SHPT and vitamin D insufficiency achieved ≥30% reductions in plasma intact parathyroid hormone (iPTH) when treated with Rayaldee than with placebo. Vitamin D insufficiency was corrected in more than 80% of the patients receiving Rayaldee compared with less than 7% of subjects receiving placebo. Mean serum calcium and phosphorus levels increased by 0.1 mg/dL during Rayaldee treatment compared to placebo treatment, but these changes were deemed clinically irrelevant. No differences in Rayaldee's efficacy or safety were observed between patients with stage 3 CKD or stage 4 CKD.

"Rayaldee fills a large void in the current treatment options for SHPT in predialysis patients," commented Dr. Charles W. Bishop, CEO of OPKO's Renal Division. "The current standard of care is high dose vitamin D supplementation, an approach for treating SHPT that is neither FDA approved nor demonstrated to be safe and effective in this population. SHPT is a progressive disease that becomes increasingly debilitating and difficult to treat, necessitating timely and effective treatment."

"Rayaldee is an important new option for treating SHPT in patients with stage 3 or 4 CKD and vitamin D insufficiency," stated Kevin J. Martin, Director of Research, Division of Nephrology at Saint Louis University School of Medicine. "The great majority of SHPT cases in this patient population are associated with vitamin D insufficiency, a problem that Rayaldee can correct."

About Rayaldee

Rayaldee (calcifediol) extended release capsules are approved by the U.S. Food and Drug Administration (FDA) for the treatment of SHPT in adult patients with stage 3 or 4 CKD and serum total 25-hydroxyvitamin D levels less than 30 ng/mL. Rayaldee has a patented formulation designed to raise serum total 25-hydroxyvitamin D (prohormone) concentrations to targeted levels (at least 30 ng/mL) and to reduce elevated iPTH. OPKO expects to launch Rayaldee in the U.S. through its dedicated renal sales force in the second half of 2016. Rayaldee is not indicated in patients with stage 5 chronic kidney disease or end-stage renal disease on dialysis. The full prescribing information for Rayaldee will be available at www.opkorenal.com.

Potential side effects of Rayaldee include hypercalcemia (elevated serum calcium), which can also lead to digitalis toxicity, and adynamic bone disease with subsequent increased risk of fractures if intact PTH levels are suppressed by Rayaldee to abnormally low levels. Severe hypercalcemia may require emergency attention; symptoms of hypercalcemia may include feeling tired, difficulty thinking clearly, loss of appetite, nausea, vomiting, constipation, increased thirst, increased urination, and weight loss. Digitalis toxicity can be potentiated by hypercalcemia of any cause. Excessive administration of Rayaldee can cause hypercalciuria, hypercalcemia, hyperphosphatemia, or oversuppression of intact PTH. Common symptoms of vitamin D overdosage may include constipation, decreased appetite, dehydration, fatigue, irritability, muscle weakness, or vomiting. Patients concomitantly taking cytochrome P450 inhibitors, thiazides, cholestyramine, phenobarbital or other anticonvulsants may require dose adjustments and more frequent monitoring.

The most common adverse reactions in clinical trials (≥3% and more frequent than placebo) were anemia, nasopharyngitis, increased blood creatinine, dyspnea, cough, congestive heart failure and constipation.

Sorafenib and vitamin K combo as anticancer drug against pancreas cancer....

We know that Sorafenib, is a drug approved for the treatment of primary kidney cancer (advanced renal cell carcinoma) and advanced primary liver cancer (heptacellular carcinoma).

Sorafenib is a small molecular inhibitor of several protein kinases. (Protein kinases are overactive in many of the molecular pathways that cause cells to become cancerous. These pathways include Raf kinase, PDGF (platelet-derived growth factor), VEGF receptor and kinases and c Kit the receptor for Stem cell factor. A growing number of drugs target most of these pathways). Sorafenib is unique in targeting the Raf/Mek/Erk pathway. After the FDA (US), approval in 2005 & European Commission in 2006, the drug was used to treat both forms of cancers. Now something interesting has been achieved by Dr. Brian Carr (a professor of Medical Oncology at the Jefferson Medical College of Thomas Jefferson University). Vitamin K1 or vitamin K2, plus sorafenib (Nexavar) each have shown activity against the growth of human cancer cells by inhibiting the extracellular signal-regulated kinase (ERK) pathway. The basis for the research lies in the fact that, sorafenib has demonstrated success at extending survival in patients with hepatocellular carcinoma (HCC, or primary liver cancer), hand-foot syndrome is a common adverse effect that affects approximately 20 percent of patients who receive the drug. It typically manifests as painful sores on the soles of patients' feet that can prevent the patients from walking, Dr. Carr said. Profound tiredness and weight loss is also seen in at least 30 percent of patients.

The research is of great significance because of the fact that in the pancreas cancer study, Dr. Carr and his colleagues tested each K vitamin in combination with sorafenib in pancreatic cell lines. Each combination inhibited cell growth, induced cell death and decreased the expression of ERK. They found that when combining vitamin K and sorafenib, the sorafenib dose required for inhibiting cancer cell growth decreased by more than 50 percent. The conclusions are really great 1. The dose required is reduced to half; 2. reduced side effects and 3. vitamin an established drug, no need of toxicological studies.... Congrats, Dr. Dr. Brian Carr and group..

The Secret of Lowering Cholesterol Through Diet...

I am really happy to share an interesting and important article  'the secret of lowering cholesterol through diet' by  Deborah Land, who has written this article exclusively for the readers of  my blog.......

The Secret of Lowering Cholesterol Through Diet

a. The Myth of Cholesterol - the Bad and the Good:

Most people think that cholesterol is always bad, but there are actually two types of cholesterol. LDL is  considered the "bad" cholesterol, and HDL is considered the "good" cholesterol. If there is too much LDL in our bloodstream, it will form plaque on our arteries. Over time, this narrows our arteries and can eventually block blood flow completely. Dietary cholesterol actually isn't the primary reason for high cholesterol in the blood; it is high amounts of saturated fat and trans fat. To keep cholesterol low, you should eat unsaturated fats, eat fibrous foods, and exercise more.

b. Number Relevance in Cholesterol :
Every adult should have their cholesterol checked at least every 5 years. When you get a cholesterol test, you'll usually get back four different results. Here are the 4 categories and the healthy range you want to be in.

Total Cholesterol - less than 200 mg/dL (5.2 mmol/L);
LDL Cholesterol - less than 100 mg/dL (2.6 mmol/L);
HDL Cholesterol - greater than 40 mg/dL (1.0 mmol/L) &
Triglycerides - less than 150 mg/dL (1.7 mmol/L).

If you are over or under the desired level on any category, it is usually indicative that a diet or exercise change is needed.

c. Heart Protection and Vitamin E:
Vitamin E, an important vitamin, is sourced in vegetable oils, nuts and leafy vegetables. Vitamin E can decrease your heart disease risk, but it will not prevent a heart attack.

d. Lowering Cholesterol with these Five Foods :
1. Oatmeal and Oat Bran: These contain a high amount of soluble fiber, which can lower LDL.
2. Fish: Fish is a great source of omega 3 fatty acids, which lowers LDL and raises HDL.
3. Nuts: Not only are nuts high in fiber, but they contain the healthy fats you need to keep LDL in check.
4. Plant Sterols: This is found in foods like margarine, salad dressing, orange juice, and functional cookies. 2  grams per day will lower your LDL by 10-15%.
5. Soy: This popular meat replacement can lower LDL by up to 3%.

e. Plant Sterols and Benefits to Health :
Foods such as VitaTops Muffin Tops, Benecol Spread, granola bars and fat free milk are rich sources of plant sterols. You can easily help your heart when you start eating foods packed with plant sterols and avoid eating foods that contain saturated fats. A saturated fat-filled diet is not canceled out by this. Exercising often as well as eating healthy food will keep your cholesterol in check.

About the Author - Deborah Land writes for Cholesterol Lowering Diet Blog  ,  her personal hobby blog focused on tips to eat healthy to prevent high cholesterol. I find the blog very informative, do visit for more details...

Can Brightly Colored Fruits, Veggies Protect Against ALS? - Drugs.com MedNews

Researchers from Harvard School of Public Health have,  found that increasing consumption of carotenoids, particularly beta-carotene and lutein, might reduce the risk for this progressive neurological disease, which attacks nerve cells in the brain and spinal cord.

Carrots, yams and mangoes are rich in beta-carotenes, and spinach, collard greens and egg yolks are good sources of lutein. The study found, however, that diets rich in the antioxidants lycopene, beta-cryptoxanthin and vitamin C do not apparently reduce the risk for ALS, which causes the muscles to waste away and eventually results in paralysis.

"ALS is a devastating degenerative disease that generally develops between the ages of 40 and 70, and affects more men than women," senior study author Dr. Alberto Ascherio, a professor of epidemiology and nutrition at Harvard School of Public Health, said in a journal news release. "Understanding the impact of food consumption on ALS development is important."

Analyzing information on more than 1 million people, the researchers identified nearly 1,100 cases of ALS. The researchers found that increased overall carotenoid intake -- especially among those who ate diets rich in beta-carotene and lutein -- seemed to be linked to a lower risk for the devastating condition. 

Those who ate more carotenoids daily also were more likely to exercise, have an advanced degree, have increased vitamin C intake and take vitamin C and E supplements.

The researchers pointed out, however, that long-term vitamin C supplements did not lower people's risk for this degenerative disease.

"Our findings suggest that consuming carotenoid-rich foods may help prevent or delay the onset of ALS," Ascherio concluded. "Further food-based analyses are needed to examine the impact of dietary nutrients on ALS."

 Ref : http://onlinelibrary.wiley.com/doi/10.1002/ana.23820/abstract

Can Brightly Colored Fruits, Veggies Protect Against ALS? - Drugs.com MedNews

S-methylmethionine (Vitamin U) as antiulcer agent .......

About S-methylthionine :

S-Methylmethionine, or S-methyl-L-methionine, is a derivative of methionine In plants, it is produced from methionine by the enzyme methionine S-methyltransferase. S-Methyl- methionine is sometimes called vitamin U in naturopathic medicine, but it is not recognized as a vitamin by mainstream nutrition science. Methionine in itself has not been demonstrated as effective for treating peptic and duodenal ulcers. Its proponents claim that sources of methionine are limited, or claim it can be found only in raw cabbage; however, these claims are incorrect. Methionine is a common amino acid found in a wide variety of fruits, vegetables, and legumes.

More interesting results by the researchers from the Stanford University, have further substantiated the claim that it can be used to treat peptic and duodenal ulcers.

Acetaminophen is a pain reliever present in many over-the-counter cold and flu medicines. It is broken down, or metabolized, in the body into byproducts , one of which can be very toxic to the liver. At normal, therapeutic levels, this byproduct is easily deactivated when it binds to a naturally occurring, protective molecule called glutathione. But the body's glutathione stores are finite, and are quickly depleted when the recommended doses of acetaminophen are exceeded. Acetaminophen overdose is the most common cause of liver transplantation and the only effective antidote is an unpalatable compound called NAC that can induce nausea and vomiting, and must be administered as soon as possible after the overdose.

As per the claim by the authors, an enzyme called Bhmt2 helped to generate more glutathione. Bhmt2 works by converting the diet-derived molecule S-methylmethionine, or SMM, into methionine, which is subsequently converted in a series of steps into glutathione. The researchers confirmed the importance of the pathway by showing that SMM conferred protection against acetaminophen-induced liver toxicity only in strains of mice in which the Bhmt2 pathway was functional.

By administering SMM, which is found in every flowering plant and vegetable, we were able to prevent a lot of the drug’s toxic effect,” said Peltz. He and his colleagues are now working to set up clinical trials at Stanford to see whether it will have a similar effect in humans. In the meantime, though, he cautions against assuming that dosing oneself with SMM will protect against acetaminophen overdose....

Source : http://med.stanford.edu/ism/2009/november/peltz.html

Blueberries, Red Grapes May Boost Body's Immune Function

Researchers found that both fruits contain compounds called stilbenoids, which work with vitamin D to increase expression of the human cathelicidin antimicrobial peptide (CAMP) gene, which is involved in immune function.

The stilbenoid compounds included resveratrol in red grapes and pterostilbene in blueberries.

"Out of a study of hundreds of compounds, just these two popped right out," Adrian Gombart, a principal investigator at the Linus Pauling Institute at Oregon State University, said in a university news release.

"Their synergy with vitamin D to increase CAMP gene expression was significant and intriguing," said Gombart, an associate professor in the university's college of science. "It's a pretty interesting interaction."

Gombart and colleagues noted, however, that these findings were made in laboratory cell cultures and do not prove that eating blueberries and red grapes would boost a person's immune function.

The study was published Sept. 17 in the journal Molecular Nutrition and Food Research.

The CAMP gene has been shown to play a key role in the innate immune system -- the body's first line of defense that gives it the ability to fight bacterial infection. The response is especially crucial as many antibiotics become less effective.

Previous research has found a strong association between adequate vitamin D levels and the function of the CAMP gene. This new study suggests that certain other compounds may play a role as well.

Blueberries, Red Grapes May Boost Body's Immune Function - Drugs.com MedNews

Vitamin A Compound Might Aid in Colon Cancer Fight

In continuation of my update on Retinoic acid

Retinoic acid, a compound derived in the body from vitamin A, might have a role in suppressing colon cancer, new animal research suggests.

"Retinoic acid has been known for years to be involved in suppressing inflammation in the intestine," said study senior author Dr. Edgar Engleman, professor of pathology and medicine at Stanford University School of Medicine in Palo Alto, Calif.

Meanwhile, the development of colon cancer has been linked to inflammation. For example, inflammatory bowel disease, such as ulcerative colitis, has been associated with colon cancer, he said in a university news release.

"We wanted to connect the dots and learn whether and how retinoic acid levels directly affect cancer development," Engleman added.

When the researchers looked at mice with colon cancer, they saw lower levels of retinoic acid in the intestines of the mice.

The researchers also found that boosting levels of retinoic acid in the intestines of mice with colon cancer slowed progression of the disease.

In humans, colon cancer patients who had high levels of a protein that degrades retinoic acid in their intestinal tissue tended to have worse outcomes than other patients, the study authors noted.

The findings suggest new ways to prevent or treat colon cancer. However, it's important to note that animal research doesn't always produce the same results in humans.

"The intestine is constantly bombarded by foreign organisms. As a result, its immune system is very complex," Engleman said.

"We found that bacteria, or molecules produced by bacteria, can cause a massive inflammatory reaction in the gut that directly affects retinoic acid metabolism," he said.

He said that retinoic acid levels are normally regulated very tightly.

"Now that we've shown a role for retinoic acid deficiency in colorectal cancer, we'd like to identify the specific microorganisms that initiate these changes in humans. Ultimately we hope to determine whether our findings could be useful for the prevention or treatment of colorectal cancer," he concluded.

The study was published online Aug. 30 in the journal Immunity.

Could guava juice help prevent anemia?

A systematic review from Indonesia, published in the journal BMJ Nutrition, Prevention & Health, indicates that adding guava juice to the diet could boost hemoglobin levels in adolescent girls and pregnant women. This could potentially offer a low-cost dietary complement to iron supplementation, given the high prevalence of iron-deficiency anemia among females, especially in low- and middle-income countries (LMICs).

Iron deficiency anemia among young women

In 2021, anemia was estimated to affect about 45 % of pregnant women and 39.5 % of non-pregnant women worldwide. Indonesia had similar figures: 48.9 % among pregnant women and 32 % among adolescent girls. Women with severe anemia are twice as likely to die during pregnancy and postpartum, compared to those with mild anemia.

Iron deficiency is the primary cause of anemia, especially in LMICs. The reasons include poor dietary intake, high prevalence of infection, heavy bleeding during periods, frequent pregnancies, and low healthcare access.

Iron deficiency anemia is conventionally treated with iron supplementation, but oral iron can cause symptoms such as diarrhea or constipation, other gut symptoms, an unpleasant taste, and may be inaccessible to some women. Pregnancy can further complicate treatment, as physiological changes may decrease iron absorption during this period.

This has resulted in persistently low use of iron supplements, even with national nutritional programs like the Gerakan Nasional Aksi Bergizi or iron supplementation programs targeting pregnant women and adolescent girls.

Nutritional benefits of guava

Guava is a locally cultivated and inexpensive fruit. Its juice is rich in vitamin C, folate, antioxidants, flavonoids, and polyphenols, and other micronutrients. The current study aimed to examine the potential of guava juice as a natural adjunct to iron therapy.

Guava juice and iron supplements

This systematic review and meta-analysis included 17 Indonesian studies published between 2019 and 2024, with a total of 726 participants. Most studies were quasi-experimental, while two were randomized controlled trials (RCTs). The participants were pregnant women or adolescent girls, with numbers ranging from 15 to 230.

While the findings were encouraging, most of the evidence came from relatively small quasi-experimental studies rather than randomized trials

Most studies evaluated guava juice alongside iron supplementation, while a few used it alone or in combination with carrot or red spinach juice. Intervention periods ranged from five days to three months.

Eight studies compared guava juice plus iron supplementation with iron supplementation alone, although only five of these provided extractable data for the direct comparative meta-analysis. One study used papaya juice and another dragon fruit juice as comparators. The remaining seven studies had no control group.

The meta-analysis was limited to 12 studies because the others lacked usable data. The results were promising, consistently indicating a significant average increase of 1.7 g/dL in hemoglobin among pooled participants who consumed guava juice.

When stratified by participant type, adolescents had a mean improvement in hemoglobin levels of 1.5 g/dL, versus 1.8 g/dL among pregnant women.

Across five studies that directly compared guava juice interventions with iron-only controls, hemoglobin levels increased by an additional 1.3 g/dL on average in the guava juice groups. This was confirmed to be robust by sensitivity analyses, with little evidence of publication bias.

Possible physiological pathways

The degree of improvement in hemoglobin observed by the researchers is substantial enough to potentially move some individuals with mild or moderate anemia into non-anemic categories. Other experimental studies involving male athletes, anemic schoolchildren, and postpartum women have shown similar positive effects from both guava juice and guava fruit consumption.

This suggests the beneficial impact of guava’s high vitamin C and polyphenol content, irrespective of the form of consumption. Vitamin C improves the absorption of iron from non-heme sources, including iron supplements, by converting ferric iron into its more absorbable ferrous form.

Guava also contains folate, antioxidants, flavonoids, and polyphenols that may support red blood cell survival by reducing oxidative stress. The researchers suggest that juice preparation may improve compliance and could enhance nutrient availability, while promoting more consistent intake.

Study limitations

Despite the promising results, the review also noted limitations. All studies were conducted in Indonesia, limiting generalizability to other populations. Many studies had a moderate risk of bias, sample sizes were relatively small, and most were non-randomized designs. Missing data also reduced the size of the meta-analysis. The studies showed high heterogeneity due to differences in guava dosage, preparation, and duration.

Future follow-up research should include larger, well-designed RCTs across multiple countries with standardized reporting, including regimens and outcomes. These should include not only hemoglobin but also parameters such as transferrin and ferritin that reflect broader health impacts and long-term effectiveness. This would help identify the optimal dosage, dosing frequency, and duration of use.

Implementation research is also required to understand how far such an intervention could be embedded into existing programs, supporting its real-world relevance.

Conclusion

Overall, the study concludes that guava juice significantly improves hemoglobin levels in women and adolescent girls. The authors highlight the potential of guava juice as an affordable, culturally acceptable, and locally available dietary adjunct to iron supplementation and anemia prevention programs in resource-limited settings.

It is particularly relevant in tropical countries with high guava production, such as India and Indonesia. The authors suggest integrating guava juice into school nutrition programs, antenatal care packages, and community health initiatives.

This could be a sustainable, complementary strategy to prevent and treat mild-to-moderate anemia, aligning with the United Nations’ Decade of Action on Nutrition (2016–2025) and its dietary emphasis on local foods.

Could guava juice help prevent anemia?