Vitamin D, Curcumin May Help Clear Amyloid Plaques Found In Alzheimer’s Disease

ScienceDaily (July 16, 2009) — UCLA scientists and colleagues from UC Riverside and the Human BioMolecular Research Institute have found that a form of vitamin D, together with a chemical found in turmeric spice called curcumin, may help stimulate the immune system to clear the brain of amyloid beta, which forms the plaques considered the hallmark of Alzheimer’s disease.

The early research findings, which appear in the July issue of the Journal of Alzheimer’s Disease, may lead to new approaches in preventing and treating Alzheimer’s by utilizing the property of vitamin D3 — a form of vitamin D — both alone and together with natural or synthetic curcumin to boost the immune system in protecting the brain against amyloid beta.

Vitamin D3 is an essential nutrient for bone and immune system health; its main source is sunshine, and it is synthesized through the skin. Deficiencies may occur during winter months or in those who spend a lot of time indoors, such as Alzheimer’s patients.

"We hope that vitamin D3 and curcumin, both naturally occurring nutrients, may offer new preventive and treatment possibilities for Alzheimer’s disease," said Dr. Milan Fiala, study author and a researcher at the David Geffen School of Medicine at UCLA and the Veterans Affairs Greater Los Angeles Healthcare System.

Using blood samples from nine Alzheimer’s patients, one patient with mild cognitive impairment and three healthy control subjects, scientists isolated monocyte cells, which transform into macrophages that act as the immune system’s clean-up crew, traveling through the brain and body and gobbling up waste products, including amyloid beta. Researchers incubated the macrophages with amyloid beta, vitamin D3 and natural or synthetic curcumin.

The synthetic curcuminoid compounds were developed in the laboratory of John Cashman at the Human BioMolecular Research Institute, a nonprofit institute dedicated to research on diseases of the human brain.Researchers found that naturally occurring curcumin was not readily absorbed, that it tended to break down quickly before it could be utilized and that its potency level was low, making it less effective than the new synthetic curcuminoids.

"We think some of the novel synthetic compounds will get around the shortcomings of curcumin and improve the therapeutic efficacy," Cashman said.

The team discovered that curcuminoids enhanced the surface binding of amyloid beta to macrophages and that vitamin D strongly stimulated the uptake and absorption of amyloid beta in macrophages in a majority of patients.

Previous research by the team demonstrated that the immune genes MGAT III and TLR-3 are associated with the immune system’s ability to better ingest amyloid beta. In this earlier work, Fiala noted, it was shown that there are two types of Alzheimer’s patients: Type 1 patients, who respond positively to curcuminoids, and Type II patients, who do not.

"Since vitamin D and curcumin work differently with the immune system, we may find that a combination of the two or each used alone may be more effective — depending on the individual patient," he said.

Fiala noted that this is early laboratory research and that no dosage of vitamin D or curcumin can be recommended at this point. Larger vitamin D and curcumin studies with more patients are planned.

The study was funded by the Human BioMolecular Research Institute, the Alzheimer’s Association and MP Biomedicals LLC, a global life sciences and diagnostics company dedicated to Alzheimer’s disease research. Fiala is a consultant for MP Biomedicals and also served in the company’s speakers bureau.

Additional study authors include Ava Masoumi, Ben Goldenson, Hripsime Avagyan, Justin Zaghi, Michelle Mahanian, Martin Hewison, Araceli Espinosa-Jeffrey and Phillip T. Liu, of the David Geffen School of Medicine at UCLA; Senait Ghirami, Ken Abel, Xuying Zheng and John Cashman, of the Human BioMolecular Research Institute; and Mathew Mizwicki, of the department of biochemistry at UC Riverside.


Adapted from materials provided by University of California – Los Angeles, via EurekAlert!, a service of AAAS.

Is vitamin D deficiency linked to Alzheimer’s disease and vascular dementia?

There are several risk factors for the development of Alzheimer’s disease and vascular dementia. Based on an increasing number of studies linking these risk factors with Vitamin D deficiency, an article in the current issue of the Journal of Alzheimer’s Disease (May 2009) by William B. Grant, PhD of the Sunlight, Nutrition, and Health Research Center (SUNARC) suggests that further investigation of possible direct or indirect linkages between Vitamin D and these dementias is needed.

Low serum levels of 25-hydroxyvitamin D [25(OH)D] have been associated with increased risk for cardiovascular diseases, diabetes mellitus, depression, dental caries, osteoporosis, and periodontal disease, all of which are either considered risk factors for dementia or have preceded incidence of dementia. In 2008, a number of studies reported that those with higher serum 25(OH)D levels had greatly reduced risk of incidence or death from cardiovascular diseases.

Several studies have correlated tooth loss with development of cognitive impairment and Alzheimer’s disease or vascular dementia. There are two primary ways that people lose teeth: dental caries and periodontal disease. Both conditions are linked to low vitamin D levels, with induction of human cathelicidin by 1,25-dihydroxyvitamin D being the mechanism.

There is also laboratory evidence for the role of vitamin D in neuroprotection and reducing inflammation, and ample biological evidence to suggest an important role for vitamin D in brain development and function.

Given these supportive lines of evidence, Dr. Grant suggests that studies of incidence of dementia with respect to prediagnostic serum 25(OH)D or vitamin D supplementation are warranted. In addition, since the elderly are generally vitamin D deficient and since vitamin D has so many health benefits, those over the age of 60 years should consider having their serum 25(OH)D tested, looking for a level of at least 30 ng/mL but preferably over 40 ng/mL, and supplementing with 1000-2000 IU/day of vitamin D3 or increased time in the sun spring, summer, and fall if below those values.

Writing in the article, Dr. Grant states, "There are established criteria for causality in a biological system. The important criteria include strength of association, consistency of findings, determination of the dose-response relation, an understanding of the mechanisms, and experimental verification. To date, the evidence includes observational studies supporting a beneficial role of vitamin D in reducing the risk of diseases linked to dementia such as vascular and metabolic diseases, as well as an understanding of the role of vitamin D in reducing the risk of several mechanisms that lead to dementia."

More information: The article is "Does Vitamin D Reduce the Risk of Dementia?" by William B. Grant, Ph.D. It is published in the Journal of Alzheimer’s Disease 17:1 (May 2009).

Source: IOS Press (news : web)

I wonder if this is related to Pam

This article intrigued me. Pam has chronic pain and needs to take a lot of meds for it. Some months ago I blogged about her having to be placed on vitamin D supplements due to low levels in her blood. Now that her vitamin D levels are normal, her pain has mildly lessened. I never would have made the connection. I’d post the link to the article but it is for physician members only. Don’t worry about the technical jargon.

 

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Medscape Medical News 2009. © 2009 Medscape

Chronic Pain Linked to Low Vitamin D by Allison Gandey

 

March 25, 2009 — Inadequate vitamin D may represent an under recognized source of nociperception and impaired neuromuscular functioning, say researchers.

"Physicians who care for patients with chronic, diffuse pain that seems musculoskeletal — and involves many areas of tenderness to palpation — should strongly consider checking vitamin-D level," Michael Turner, MD, from the Mayo Clinic in Rochester, Minnesota, said in a news release issued Friday.

"For example," he added, "many patients who have been labeled with fibromyalgia are, in fact, suffering from symptomatic vitamin-D inadequacy. Vigilance is especially required when risk factors are present, such as obesity, darker pigmented skin, or limited exposure to sunlight."

Dr. Turner was lead investigator of a study published in the journal Pain Medicine in November 2008. The work suggests a correlation between inadequate vitamin-D levels and the amount of narcotic medication taken by chronic pain patients.

Required Nearly Twice As Much Pain Medication

The researchers found that patients who had inadequate vitamin-D levels and required narcotic pain medication were taking much higher doses — nearly twice as much — as those with adequate levels. These patients also reported worse physical function and worse overall health perception.

Dr. Turner told Medscape Neurology & Neurosurgery his group was surprised by the finding. "We didn’t anticipate that the difference would be so high."

The investigators retrospectively studied 267 patients admitted to the Mayo Comprehensive Pain Rehabilitation Center. They compared serum 25-hydroxyvitamin-D levels at the time of admission with other parameters such as the amount and duration of narcotic pain medication used, self-reported levels of pain, emotional distress, physical functioning, health perception, and demographic information such as sex, age, diagnosis, and body-mass index.

Patients with vitamin-D levels below 20 ng/mL were considered to have inadequate amounts. The prevalence of low vitamin D was 26% (95% CI, 20.6% – 31.1%).

Among patients using opioids, the mean morphine-equivalent dose for the inadequate vitamin-D group was 133.5 mg/day compared with 70.0 mg/day for the adequate group (P = .001). The mean duration of opioid use for the inadequate and adequate groups was 71.1 months and 43.8 months, respectively (P = .023).

The researchers also observed a link between increasing body-mass index and decreasing levels of vitamin D.

Inadequate Vitamin D May Create or Sustain Pain

The preliminary results suggest that inadequate vitamin D may play a role in creating or sustaining chronic pain. During an interview, Dr. Turner suggested that patients with inadequate vitamin D may benefit from cholecalciferol 50,000 international units dosed according to the level of deficiency.

But he urged caution for patients with calcium- or phosphate-processing disorders. "Increasing vitamin-D levels could be problematic in patients with kidney failure or stones or primary hyperparathyroidism or sarcoidosis. This doesn’t preclude increasing levels, but it might warrant discussion with an endocrinologist," he said.

For patients with adequate vitamin D looking to maintain levels, he recommends10 to 15 minutes of sun exposure with no sunscreen on the trunk and arms and legs 3 times a week.

Sun Exposure or Diet and Supplements?

It is a recommendation often made by proponents of vitamin D but hotly contested by the American Academy of Dermatology. The academy recommends that vitamin D be obtained from a healthy diet and supplements and not from unprotected exposure to ultraviolet (UV) radiation.

"Unprotected UV exposure to the sun or indoor tanning devices is a known risk factor for the development of skin cancer," dermatologists write in the academy’s position statement.

Dr. Turner and his team conclude: "Prospective trials utilizing a repeated-measures design are warranted to assess the effects of vitamin-D repletion on pain outcomes and physiological measures of neuromuscular functioning among patients with chronic pain and comorbid vitamin-D inadequacy."

The researchers have disclosed no relevant financial relationships.

Pain Med. 2008;9:979-984. Abstract


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Warmly………David

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How much Vitamin D should you take?

Inge commented on the vitamin D blog yesterday:

This is a very interesting article. I knew about the B12 and have read about folic acid also helping but never vitamin D!

I wonder what the dementia rate is for people in the the northern U.S. is since they have dark winters also?

The article doesn’t say how much vitamin D to take so how do you know if you are getting enough?

There has been a lot of controversy over the last year or so about the minimal daily requirements for vitamin D. But the census seems to be that all along the recommended dose has been too low.

I did some research to see what the current thoughts are at this time. For people over 50, they recommend a minimum of 400-800 IU/day. For what they call “older people,” they recommend at least 600-800 IU/day. This certainly makes sense to me since many of us don’t get outdoors much. Those individuals who are home bound or in care facilities probably get very little sunlight which produces vitamin D in our system naturally.

I used to make sure I took at least 400 IU/day. Since the controversy, I’ve started to take around 800 IU/day. Occasionally I take an extra 400 IU/day on real dark cloudy days.

Who knows? Maybe it does help us more than we realize. Would my dementia be worse with less vitamin D? I don’t know but I don’t think I want to take a chance.

Now, we go back to that question about the cost of a burger and cookie which I posted last week. If you haven’t tried it yet, go for it. Post your answer in the COMMENT section. I’ll give a special gift to those who get the correct answer. And NO cheating or having someone else help you!  icon_biggrin-copy Deadline for submission of your answers will be next Tuesday, January 27th, 2009. Good luck and enjoy playing around with it.

Warmly………David

Supplements of vitamin D could cut Alzheimer’s risk

I like this article:

Taking supplements of the “sunshine vitamin” D could help cut the risk of Alzheimer’s disease in later life, say researchers.

Seniors — Dementia — Seasonal Affective Disorder (SAD) and Treatment Options

 

 

The Only Light You Really Need is the One Inside You!

 

 

Several days ago, I wrote about seasonal affective disorder and will focus on some treatment options today. Recently my wife, Pam, had some blood work done which revealed low levels of vitamin D. Recently there has been much talk in the medical community about whether the recommended daily requirement for vitamin D is sufficient. Vitamin D production is produced from sunlight. (But, wait)! We are also told to put on sunscreen to protect us from skin cancer. The sunscreen also acts as a barrier to producing vitamin D through the skin. Do we have a double whammy or not? Ironically, Pam tends to be very sensitive to sun deprivation!

 

In 1979, Norman Rosenthal, MD and Dr. Al Lewy headed research at the National Institute of Mental Health (NIMH) investigating the connection between light and mood. During the 1980s, I was most fortunate to have been mentored by Dr. Rosenthal in the theories of light and mood as well as in the treatment options available for mood disorders associated with light and dark cycles. Sometime, I will have to write down some specific examples of some of my patients who had a mood disorder and light therapy. Two individuals would not be alive today had it not been for light treatment.

 

I am sharing part of that information today. I have no intent to prescribe treatment to anyone. This is information only. Any attempt to treat SAD should begin with your physician. In this blog, I mention the use of light boxes or sun boxes. Dr. Rosenthal used the sun boxes from the SunBox company. Subsequently, that is the company I have relied upon during my psychiatric career. I do not have any financial interest in this company. However, there are other companies which sell light boxes as well.

 

Winter-onset seasonal affective disorder (SAD) or the winter blues is most likely caused by your body’s reaction to light deprivation (the lack of sunlight). In the dark days of fall and winter, you may turn your face to the afternoon sun, seeking out what little light filters through fading gray skies. You may throw open the blinds, leave lights on throughout your home or even head south for a vacation — anything for a little more light. Or you may even be unable to crawl out of bed in the morning. This can be a long walk outside or arranging your home or office so that you are exposed to a window during the day. Even being outside during a cloudy day provides more light than being indoors. Did you know that most rooms in our homes have little lighting? Even with lights on, most people’s brains interpret this small amount to be the same as being in darkness.

 

You may feel better if you get some exercise most days of the week. Being active during the daytime, especially first thing in the morning, may help you have more energy and feel less depressed. Gentle exercise such as walking, riding a stationary bike, or swimming is a good way to get started.

 

There are senior citizens residing in assisted living facilities, nursing homes, retirement homes or other long term care facilities. These individuals do not always have the luxury of being exposed to bright light. They may ask to have their bed near a window and to spend as much time as possible in a room with as much bright light as possible. Many dayrooms have large windows allowing for this. Light therapy has been found to be helpful to these elderly patients as well as those suffering from Alzheimer’s Disease, Lewy Body Dementia and vascular dementia (multi-infarct dementia). It is known that melatonin levels decrease as we age and there is a syndrome common in the elderly that is called “sundowner’s syndrome.” In winter months and summertime alike, when the sun goes down those with Alzheimer’s or dementia can become sullen, depressed anxious or morose as darkness approaches. Research published in the Journal of Geriatric Psychiatry and Neurology in 1997 and the American Journal of Psychiatry in 1992 are only two of the studies showing that light therapy can ameliorate symptoms in the elderly. Check out this article. Dementia Slowed by Light Therapy

 

sad1Light therapy is one option for treating this type of SAD because increased sunlight can improve symptoms. Doctors often prescribe light therapy (phototherapy) to treat SAD.

 

There are two types of light therapy:

 

 

  1. Bright light treatment. For this treatment, you sit in front of a “light box” or  “sunbox” for half an hour or longer, usually in the morning. The light box is a special fluorescent lamp.  
  2. Dawn or sunshine simulation. For this treatment, a dim light goes on in the morning while you sleep, and it gets brighter over time, like a sunrise.

Light therapy works well for most people with SAD, and it is easy to use. You may start to feel better within 3-5 days or so after you start light therapy. But you need to stick with it and use it every day until the season changes. If you don’t, your depression could come back. Once you stop using the sunlight therapy or sunbox, the depression can return in 3-5 days as well. I think of so many individuals who go to Florida or to another sunny location in the winter for 1-2 weeks of vacation. Upon leaving their homes, they would suffer from anxiety, depression and arthritic aches and pains. They would tell me, “Wow. All that salt water from the ocean really helped me feel better. It even helped my arthritis go away.” Well, it wasn’t the salt water. It was the sunlight which traveled through the eyes to the brain which caused a marked elevation in their mood! Depression always tends to make aches and pains worse.

 

Other treatments that may help include:  

 

—    Antidepressants. These medicines can improve the balance of brain chemicals that affect mood.

—    Counseling. Some types of counseling, such as cognitive-behavioral therapy, can help you learn

          more about SAD and how to manage your symptoms.

 

If your doctor prescribes antidepressants, be sure you take them the way you are told to. Do not stop taking them just because you feel better. This could cause side effects or make your depression worse. When you are ready to stop, your doctor can help you slowly reduce the dose to prevent problems.

 

If you feel you are suffering from SAD, it is important to seek the help of a trained medical professional. SAD can be misdiagnosed as hypothyroidism, hypoglycemia, infectious mononucleosis, and other viral infections, so proper evaluation is necessary. For some people, SAD may be confused with a more serious condition like severe depression or bipolar disorder.

 

However, if you feel the depression is severe or if you are experiencing suicidal thoughts, consult a doctor immediately regarding treatment options or seek help at the closest emergency room.

 

Tanning beds should not be used to treat SAD. The light sources in tanning beds are high in ultraviolet (UV) rays, which harm both your eyes and your skin.

 

Melatonin, a sleep-related hormone, also has been associated to SAD. This hormone, which has been linked to depression, is produced at increased levels in the dark. When the days are shorter and darker, more melatonin is produced.

 

Researchers have proved that bright light makes a difference to the brain chemistry, although the exact means by which sufferers are affected is not yet known. Some evidence suggests that the farther someone lives from the equator, the more likely they are to develop SAD. For example, approximately 25 percent of the population at the middle-to-northern latitudes of the U.S. experience winter doldrums, a sub-clinical level of SAD. These people notice the return of SAD-like symptoms each winter, but remain fully functional.

 

Drs. Rosenthal and Lewy eventually focused on the hormone melatonin. Melatonin is produced in the pineal gland, located in the midbrain. When research the early 1980’s pointed to melatonin’s role in promoting sound and restful sleep, as an anti-aging supplement and showing success in fighting cancer, the public started gobbling tons of the hormone, easily available in health food stores. Melatonin showed virtually no danger of side-effects. In fact, government researchers who set out to determine the “LD 50”, — the amount necessary to kill fifty percent of the animals tested — couldn’t produce a concentration strong enough to kill one mouse.

 

Other research found that taking melatonin helps airline employees deal with jet lag affecting their sleep. Melatonin in as small an amount as 5 milligrams helped them adjust.

 

Melatonin controls the function of many glands and Rosenthal and Lewy found that melatonin production is affected by exposure to light in excess of 2500 lux. (Lux is a measure of luminosity.) The link between sunlight and hormonal and mood function was made.sad7

 

Dr. Rosenthal and others demonstrated in research later published in the Archives of General Psychiatry in 1998 that the mechanism of melatonin affecting SAD may have to do with internal core temperature as well. Melatonin and serotonin are two hormones that regulate temperature while we sleep. The relative temperatures associated with sleep and waking may be part of the mood equation.

 

You can buy a light therapy box over-the-counter, without a doctor’s prescription. Internet retailers, drugstores and even some hardware stores offer a wide variety of light therapy boxes and other light devices for seasonal affective disorder treatment.

 

But take caution before buying. Not all light therapy boxes being sold have been tested to make sure they’re safe and effective. And different light boxes work in different ways, using different parts of the light spectrum and offering different illumination intensities. That’s why it’s especially important to understand what you’re buying and what features to consider. It’s also important to check with your health professional before buying a light therapy box.

 

Here are some features to understand and consider when buying a light therapy box for seasonal affective disorder treatment:

 

1. SAD-specific. Make sure the light therapy box is specifically designed to treat seasonal affective disorder. If it’s not, it may not be as effective in treating SAD.

 

2. Intensity. Look for a light therapy box that provides the right intensity of light when you’re a comfortable distance away. Some light boxes offer the preferred 10,000 lux only when you’re within a few inches of the box, while others can reach a distance of nearly two feet.

 

3. Minimal UV exposure. Many, but not all, light therapy boxes now filter out harmful ultraviolet (UV) light. UV light can cause eye and skin damage. Look for a light box that produces as little UV light as possible at high intensity or that carefully shields the UV rays it produces. If you’re not sure about the UV light exposure, ask the manufacturer for safety information.

 

4. LEDs. Traditionally, light therapy boxes have used fluorescent or incandescent lights. Some manufacturers are now selling light therapy boxes with light-emitting diodes (LEDs). LEDs can produce light in a narrower, more targeted wavelength. LEDs are also more efficient and lighter weight than standard lights.

 

5. Blue light. White light is the standard type of light used in light therapy boxes. But some newer light therapy boxes give off narrow-spectrum blue light. This blue light has a shorter wavelength, which some research shows is more effective at reducing seasonal affective disorder symptoms. On the other hand, blue light poses a greater risk than does white light of damaging your eye’s retina because your retina is more sensitive to the shorter blue wavelengths. To help reduce this risk, don’t look directly at the light source in any light therapy box. Check with the manufacturer if you have concerns about a light box’s safety.

 

6. Light direction. Light from a light therapy box should come from above your line of sight, not directly at it or below it. Make sure the light box you want can be positioned appropriately.

 

7. Dawn simulation. Some light therapy boxes simulate dawn — they turn on in the morning while you’re asleep and gradually get brighter until you wake up.

 

8. Cost. Prices vary greatly, from about $200 to $500, and more. Health insurance plans don’t always cover the cost of light therapy boxes. Check with your insurance company to see if your benefits will cover the cost.

 

9. Style. Some light boxes look like upright lamps, while others are small and rectangular. You can even buy a light therapy device attached to a visor, which enables you to receive light therapy while remaining active. However, keep in mind that scientific evidence about the effectiveness of light visors is lacking.

 

10. Convenience. Some light boxes are bigger than others, which can make them less portable. Find one that you can move easily and that fits the desired location in your home or office. Some light therapy boxes offer a variety of other features, such as programmable timers, clocks, carrying cases, stands, wall-mount options and extended batteries, among other features. Decide which features are important to you. Before plunking down any hard-earned cash, talk to your doctor, mental health provider or pharmacist about the light therapy box you’re thinking about buying. He or she may offer additional guidance or tips to make sure that seasonal affective disorder treatment with a light therapy box is both safe and effective for you.

 

Cautions

 

Light therapy may trigger episodes of mania in people with bipolar disorder. In addition, although rare, some people, particularly those with severe forms of depression, have reported thoughts of suicide after treatment with light therapy. Light therapy alone may not be fully effective. You still may need treatment with medications or psychotherapy.

 

David

                                                                     sadlady1

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