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Importance of vitamin d levels to help control HBV replication

Hepatology. 2013 May 22. doi: 10.1002/hep.26488. [Epub ahead of print]
Low vitamin D serum concentration is associated with high levels of hepatitis B virus (HBV) replication in chronically infected patients.
Farnik H, Bojunga J, Berger A, Allwinn R, Waidmann O, Kronenberger B, Keppler OT, Zeuzem S, Sarrazin C, Lange CM.
Source
Medizinische Klinik 1, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, Haus 11, 60590 Frankfurt, Germany.
Abstract
Vitamin D is an important immune modulator which plays an emerging role in inflammatory and metabolic liver diseases, including infection with hepatitis C virus (HCV). In contrast, the relationship between vitamin D metabolism and chronic hepatitis B is less well characterized. Therefore, we quantified 25-hydroxyvitamin D [25(OH)D3 ] serum levels in a cohort of 203 treatment-naïve patients with chronic hepatitis B virus (HBV) infection and tested for their association with clinical parameters of chronic hepatitis B. 69 (34%), 95 (47%), and 39 (19%) out of 203 patients had severe vitamin D deficiency [25(OH)D3 <10ng/mL], vitamin D insufficiency [25(OH)D3 ≥10ng/mL and <20ng/mL], or adequate vitamin D serum levels [25(OH)D3 ≥20ng/mL], respectively. In both uni- and multivariate analyses, HBV DNA viral load (log10 IU/mL) was a strong predictor of low 25(OH)D3 serum levels (p=0.0007 and p=0.000048, respectively), and vice versa. Mean 25(OH)D3 serum concentrations in patients with HBV DNA <2000 IU/mL vs. ≥2000 IU/mL were 17 vs. 11 ng/mL, respectively (p<0.00001). In addition, hepatitis B early antigen (HBeAg) positive patients had lower 25(OH)D3 serum levels than HBeAg negative patients (p=0.0013). Finally, 25(OH)D3 and HBV DNA serum levels showed inverse seasonal fluctuations. Conclusions: Low 25(OH)D3 serum levels are associated with high levels of HBV replication in patients with chronic hepatitis B. This represents a major difference to chronic hepatitis C, were numerous previous studies have shown a lacking correlation between HCV viral load vitamin D serum levels. Inverse seasonal fluctuations of 25(OH)D3 and HBV DNA serum levels are suggestive for a functional relationship between both variables. (HEPATOLOGY 2013.).
Copyright © 2013 American Association for the Study of Liver Diseases.
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Avatar universal
very good researh, me and my sister are using d3 10.000iu daily since 2010-11 to keep serum levels around 70ng/ml, do you think higher levels like 90-100ng/ml can be even better (if calcium remains normal)

in the flu and cancer prevention studies there has been improvment at the end of normal range like 80-100ng/ml and much less effect at lower levels, may this apply too to hbv
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There is no good answer to this question. It is possible that at the high end some negative effects become important. I don't think that an even stronger HBV suppressive effect will occur. Only carefully designed trials can answer these important issues.
Meanwhile staying in the 70 to 90 ng/ml range seems to be wise.
Regular testing is truly needed to determine a specific patients supplementary need to achieve this target range. It is a fact, that for many a daily dose of 10000 IU of d3 is needed to get to this level.

Sometimes you wonder how the Vikings could have been so healthy and strong and successful with their lousy vitamin d levels...
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Any suggestions on:
How quick do we accumulate Vit D in the body?
How much to take to get VitD level increased in the body?
If I take 10000IU a day shall I decrease the dose if I play tennis 1 hour under the sun?
I have read that 15 min of sun exposure equals 10000IU ....

Any comments would be welcomed.



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Avatar universal
Sorry one more question.
I was taking 5000IU vit D daily for two month and 25(OH)D3 went up from 28 to just  31. BUT Calcium and Phosphorus in the blood came up a bit above the reference range. Do you think I should keep on 5000 IU?
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I have read that 15 min of sun exposure equals 10000IU ....

not for people with chronic diseases, that s only for healthy uninfected people.cancer, autism, cfs, lyme and many many others all have very low vit d levels, like in the study posted there s probably inverse correlation between disregulated immune system in chronic diseases and d levels
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Avatar universal
i can say about myself- started from 12ng/ml in october 2012. started taking 10000 IU. tested again in april 2013. vit D level went up to 60ng/ml!!
my HBV DNA levels went down from 5000 to 270 in april(maybe vit D helped?!).i am not taking any medications.
you can use this site for more info:
http://www.grassrootshealth.net/
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Avatar universal
a study from ISRAEL:
A new study has found that administering vitamin D to hepatitis C patients dramatically reduces the presence of the virus in the blood.

The study, carried out at Rebecca Sieff Hospital in Safed and Hillel Yaffeh Medical Center in Hadera by Dr. Assy Nimer and Dr. Saif Abu-Mouch covered 90 hepatitis C patients.

The findings were presented in late November at a conference of the American Association for the Study of Liver Diseases.

For six months, in addition to the standard treatment, which included Interferon once a week and a daily dose of the antiviral drug Ribavirin, 30 patients were also treated with 1,000 units of vitamin D a day. A control group of 60 patients went without the vitamin.

In order to assess the impact of vitamin D on the treatment of the disease, before starting the study, all patients, including those from the control group and those who were found to have a vitamin D deficiency, were given supplements, so that all participants began the study from the same point.

A month after the start of treatment, the virus had disappeared from the blood in 44 percent of the group receiving vitamin D supplements, as opposed to just 18 percent among the control group.

After three months, the success rate for the group getting the supplement rose to 96 percent, compared to 48 percent in the control group.

Other findings from the study, which will be presented next month in Kfar **** at a conference of the Israeli Association for the Study of the Liver, indicate that this trend continues even after the end of drug treatment.

The initial results show that six months after the end of treatment, 90 percent of patients treated with drug therapy and vitamin D supplements had the virus disappear and completely recovered.

"The drug treatment for hepatitis C patients is usually administered for around a year, and occasionally the virus disappears from the blood, but remains in other places, for example, in the liver and lymph glands," explained Nimer, the director of the Liver Disease Unit at Rebecca Sieff Hospital. "At the end of the treatment, the virus may return to the blood, but we found that in patients who were also given the vitamin D supplement, the virus did not return, that is, it was excreted by the body."

How vitamin D helps improve the condition of hepatitis patients is not entirely clear. However, according to Nimer, "It has already been proven that vitamin D benefits the immune system by increasing the activity of T cells [white blood cells that help in the fight against pathogens], improves the body's reaction to the insulin hormone, and reduces the level of pro-inflammatory proteins that cause liver infections caused by viruses."

The findings have important ramifications, mainly in light of the difficulty in effectively treating all patients with hepatitis C, a disease that has become the leading cause of cirrhosis of the liver and the need for liver transplants, and thereby the number one cause of liver cancer.

It is the only form of hepatitis for which no vaccine has been developed yet.

"The proteins surrounding the virus change constantly and it is difficult to create a vaccine against it," Nimer said.

There are some 300 people believed to be living in Israel with hepatitis C and receiving drug therapy. World Health Organization data indicates that this is an infectious disease with global reach: in the United States, 2 million-4 million patients are diagnosed annually, 5 million-15 million patients in Europe, and 12 million patients in India. Most of them are unaware they have been infected and are not receiving drug therapy, which increases the risk of a worsening of liver function.

There is also an incidence of disease in Japan, where some 350,000 new cases are diagnosed annually, and in Egypt, where 20 percent of blood donors are rejected as carriers of hepatitis C.

The virus is spread primarily by coming into contact with tainted blood, either through blood donation or unsterilized syringes, mainly among narcotics users.

The risk of being infected during unprotected sex is low - around 2-3 percent.

In recent years medical literature has highlighted vitamin D as effective in reducing the risk of various diseases, including infectious diseases, diabetes and even breast cancer, prostate cancer and colon cancer. It also increases the effectiveness of treatment for cancer patients.

An article published in 2006 suggested the possibility that a vitamin D deficiency during the sunless days of winter is the cause of flu outbreaks and increases the risk of respiratory illness in children, even though articles published later countered those findings.

Let the sunshine in

Vitamin D is absorbed from the sun's rays, but according to recently conducted studies over the past few years, even in sunny Israel, a substantial part of the population suffers from a Vitamin D deficiency.

A survey conducted at Rambam Medical Center in Haifa found that there is a severe shortage of vitamin D in the ultra-Orthodox community due to their modest dress, which shields most of the body from the sun's rays.

A survey conducted a year and a half ago at the Kupat Holim Meuhedet health maintenance organization, which checked vitamin levels in the blood in children up to the age of 19, found an average level of 22 nanograms per milliliter of vitamin D. This amount is only two-thirds of the recommended level (32 units).

In the ultra-Orthodox Kiryat Sanz neighborhood in Netanya, an especially severe shortage was found, with an average of 18.5 units. However even in the Jerusalem neighborhood of Baka, which is partially secular, the average level measured was still only 29 units.

About two years ago, Prof. Sophia Ish-Shalom of Rambam found that young high-tech workers also have a vitamin D deficiency, due to the many hours spent working in offices during daylight hours.

Around 5-10 percent of vitamin D levels are obtained from foods, especially salmon, sardines, mackerel, cod, tuna and egg yolks. Vitamin D levels are measured in international units.

At the U.S. National Academy of Science's National Institute of Health, the recommended daily consumption is 200 units of vitamin D up until age 40, 500 units from age 51-70 and 600 units from age 71 on.

Many experts argue that the recommendations are too low, and the issue is under discussion in professional medical associations in the West.

In recent months, the Health Ministry has begun promoting a plan to increase vitamin D levels among Israelis, by enriching milk drinks, approving the import of nutritional supplements that contain vitamin D in higher doses and increasing awareness of the importance of the vitamin among pregnant women and among children, among other tactics.

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Avatar universal
Thank you for the info!

Did you test calcium and Phosphorus?
Do you keep taking 10000 iu or you decreased the dose?
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Do you know your hbsag level? Hbe negative?
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Did you test calcium and Phosphorus?
NO

Do you keep taking 10000 iu or you decreased the dose?
reduced it to 4000 iu


Do you know your hbsag level?
no, unfortunetly the test is not performed in ISRAEL. i even tried to offer paying for the test in some of the best labs but no one agreed.

Hbe negative?
HBE Antigen - negative
ANTI HBE- positive

did make a lot of changes in my diet- no dairy! less meet/fish, started taking recently on a daily basis:
dandelion
artichoke
Glycyrrhiza glabra

thinking about adding - chanca piedra...

I definetly feel better
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Any antiviral treatment? Or just supplements and lifestyle changes.

Just bought some chanca piedra from Ebay in USA.
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no antiviral treatment!
just supplements and lifestyle changes.
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Avatar universal
Thanks for sharing your experience.

I would add some protein say whey protein to your diet, because you seem to be low  in proteins  but we do need to be slightly protein positive.

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Well guys amen to this. We are already doing clinical studies here. I too feel better after taking 10000 units of vit d3 daily. But I have only reached 50ng/ml on it. I am thinking going to 20k daily. But my calcium is yes at upper limits. I was told to take Vitamin K and more magnesium to lower calcium levels.

But from reading these articles. Here is the point again. Immune system is key. But big pharma is nit addressing this. They give us nucs that damage it over the long term of taking - years i mean that is.
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Vitamin D causes the serum creatinine to go up probably by competitive excretion.  So if you guys are taking big doses, better to stop the VitaminD for two weeks or one month before measuring serum creatinine.  Otherwise you may get a shock.  It is not causing damage but just an effect of the drug.  That is while sunshine is better.  Sunshine does not cause this side effect.  


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To those that take 10,000 iu Vit D3 daily, any sides?

Also, veteranB, is your HBV DNA UND? HBEAG + or -?
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Another thing, is it not high vitamin D dose bad for the liver? Thx.
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RESEARCHERS FIND LINK BETWEEN LOW VITAMIN D, HEPATITIS B
1 hour ago

http://www.foodproductdesign.com/news/2013/06/researchers-find-link-between-low-vitamin-d-hepat.aspx


Vitamin D Deficiency May Help Spread Of Hepatitis B Throughout Liver
June 6, 2013

http://www.redorbit.com/news/health/1112866582/vitamin-d-deficiency-may-help-spread-of-hepatitis-b-throughout-liver/
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Avatar universal
definitely no effect on creatinine whatsoever, was it a real human study with a lot of patients peer reviwed or the usual drug makers spam over vit d use?
because there are tones of spam article on vit d use and sun exposure......

1hr sun makes 20.000iu of d3, a big dose is 100.000 to 600.000iu and it is given by injection twice a year to make normal vit levels and creatinine stays the same also on these doses

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the thousands of human studies on thousands of people done on vitamin d are on this website:

http://www.vitamindwiki.com/VitaminDWiki
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Avatar universal
http://www.vitamindwiki.com/Many+hints+that+vitamin+D+megadoses+cure+some+diseases

Many hints that vitamin D megadoses cure some diseases
toxic dose 1.000.000 iu
There have been several indications that getting lots of vitamin D (> 20,000 IU daily) can cure some diseases
Appears that Vitamin D can induce remission in recent Multiple Sclerosis 1,000 patients 20,000 IU to 140,000 IU daily
Dr. Cannell on Autism – Spring 2013 3 moms accidentally gave 60,000 IU daily - rapid recovery from Autism
ovarian cancer had metastasized, give only months to live, internal bleeding 50,000 IU daily for 3 months
Totally cured, then dropped back to 50,000 IU weekly.
Traumatic Brain Injury reduced 2X by about 20,000 IU of vitamin D daily for 5 days
with progestrone. Similar to a loading dose
Lots of Vitamin D3 might repair spinal cord – rat experiment, June 2013 35,000 IU for average weight adult

damn we need a human study on the effect of vitd megadoses like for this causal reports in that page i linked:
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keeping high vit a (betacarotene is the safe type of vit a) and vit k may avoid sides from the super high vit d megadoses at 50.000-100.000 iu daily but i dont see human studies on this with results just animal studies
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http://www.vitamindwiki.com/Vitamin+D+can+inhibit+enveloped+virus+%E2%80%93+March+2011

Vitamin D can inhibit enveloped virus – March 2011

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Avatar universal
thanks rome,
I do make sure to eat enough protein - beens(all kinds encluding soy), nuts(Almonds!!), eggs...
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