Calcium and vitamin D supplements and prostate cancer; IOM and NIH reports

Use of calcium supplements has been already been associated with an increased risk of prostate cancer for men for many years in a National Institute of Health (NIH) an Institute of Medicine (IOM)report, (see page 6 and see excerpt later in this post)(and prostate cancer is also mentioned in a 1997 report on page 144, and from page 142 a summary statement about some groups of people who may be more at risk from excessive calcium intake:

Subpopulations known to be particularly susceptible to the toxic effects of calcium include individuals with renal failure, those using thiazide diuretics (Whiting and Wood, 1997), and those with low intakes of minerals that interact with calcium (for example, iron, magnesium, zinc).”)

from: Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, Jan 1, 1997 [http://iom.nationalacademies.org/Reports/1997/Dietary-Reference-Intakes-for-Calcium-Phosphorus-Magnesium-Vitamin-D-and-Fluoride.aspx]

If you are a person who is already seeing health professionals about prostate cancer risks and you haven’t been told that excess calcium has been associated with an increased risk of prostate cancer then maybe it’s time to ask why not? The following webpage does suggest men may be better to use calcium rich foods instead of supplements, however prostate cancer risk is not mentioned: MayoClinic.

While I was looking for the Institute of Medicine report I found a more recent National Institute of Health update on vitamin D levels and prostate cancer which shows on an apparent U-shaped trend for risk of prostate cancer and vitamin D levels.

Having low levels of vitamin D and having elevated levels of vitamin D was associated with risk of prostate cancer in men, however the trend was only apparent when patient’s data was grouped by quartiles rather than by the three currently accepted categories of vitamin D sufficiency. Quartiles divide the data into five groups. If the U-shaped trend was more apparent for the 20% of patients with the lowest levels of vitamin D and for the 20% with the most elevated levels of vitamin D then the lab values of those groups of patients must not have overlapped very closely with the range of lab values that are included in any of the three established categories of vitamin D sufficiency: “(concentrations less than 50 nmol/L being considered deficient, 50–75 nmol/L insufficient, and 75–125 nmol/L considered sufficient).” — which suggests to me that those currently accepted ranges of vitamin D sufficiency do not actually provide any information that is useful for assessing or counseling men about their risk of prostate cancer.

We would need to go to the original research study and see what the lab values were for the patients who fell in the lowest and highest quartiles — the 20% with the lowest values and the 20% with the highest lab values for vitamin D — in order to have some idea of how low or how elevated the lab values were for the men who had an increased risk of prostate cancer. The lowest 20% might have had values that were lower than 50 nmol/L (below 20-30 nmol/L is considered deficient) and the most elevated 20% may or may not have had values below or above 75 nmol/L — but we have no idea without going back to the original research article.

  • Excerpt from Vitamin D and Calcium: A Systematic Review of Health Outcomes (Update).:
  • Prostate Cancer

    “In the current report, four new nested case-control studies (two rated A, two rated B) and one new prospective cohort study (rated B) found no association between baseline serum 25(OH)D concentrations and risk for prostate cancer. Two new nested case-control studies (both rated B) observed a trend between higher serum vitamin D concentrations and increasing risk for prostate cancer. In one study this increase was seen only among men whose sera were sampled in summer or autumn; in the other study, this trend was observed only when participants were divided by quartiles of 25(OH)D concentration, but not when they were divided by categories of vitamin D sufficiency (concentrations less than 50 nmol/L being considered deficient, 50–75 nmol/L insufficient, and 75–125 nmol/L considered sufficient).”

    “In the original report, 12 nested case-control studies (3 rated B, 9 C) evaluated the association of baseline serum 25(OH)D concentrations and prostate cancer risk. No eligible RCTs were identified. Eight of the nested case-control studies found no statistically significant dose-response relationship between serum 25(OH)D concentrations and the risk of prostate cancer. One C-rated study found a significant association between lower baseline serum 25(OH)D concentrations (<30 compared with >55 nmol/L) and higher risk of prostate cancer. Another C-rated study suggested the possibility of a U-shaped association between baseline serum 25(OH)D concentrations and the risk of prostate cancer (i.e., lower and higher serum 25(OH)D concentrations were associated with an increased risk of prostate cancer compared with that of the in between reference level).”

  • Evidence Reports/Technology Assessments, No. 217.
    Newberry SJ, Chung M, Shekelle PG, et al.
    Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Sep. [http://www.ncbi.nlm.nih.gov/books/NBK253544/]
  • Dietary reference intakes for calcium and vitamin D / Committee to Review Dietary Reference Intakes for Vitamin D and Calcium, Food and Nutrition Board ; A. Catharine Ross … [et al.], editors. Copyright 2011 by the National Academy of Sciences — ISBN 978-0-309-16395-8 (pdf) [http://www.nap.edu/read/13050/chapter/2#5] Excerpt, Box S-3: Potential Indicators of Adverse Outcomes for Excess Intake of Calcium and Vitamin D (page 6):

BOX S-3: Potential Indicators of Adverse Outcomes for Excess Intake of Calcium and Vitamin D (page 6)

Calcium

Vitamin D

  • Intoxication and related hypercalcemia and hypercalciuria

  • Serum calcium

  • Measures in infants: retarded growth, hypercalcemia

  • Emerging evidence for all-cause mortality, cancer, cardiovascular risk, falls and fractures

So excess calcium and excess vitamin D are both officially associated with increased risk of prostate cancer or with “emerging evidence for cancer” in general.

From some old notes, [8]: 12. [ncbi.nlm.nih] Carcinogenesis. 2011 Jun;32(6):822-8. Epub 2011 Mar 10. Enhanced formation of 5-oxo-6,8,11,14-eicosatetraenoic acid by cancer cells in response to oxidative stress, docosahexaenoic acid and neutrophil-derived 5-hydroxy-6,8,11,14-eicosatetraenoic acid. Grant GE, Rubino S, Gravel S, Wang X, Patel P, Rokach J, Powell WS.

“Stimulation of neutrophils with arachidonic acid and calcium ionophore in the presence of PC3 cells led to a large and selective increase in 5-oxo-ETE synthesis compared with controls in which PC3 cell 5-oxo-ETE synthesis was selectively blocked by pretreatment with NEM. The ability of prostate tumor cells to synthesize 5-oxo-ETE may contribute to tumor cell proliferation as well as the influx of inflammatory cells, which may further induce cell proliferation through the release of cytokines. 5-Oxo-ETE may be an attractive target in cancer therapy.”

***Did anyone besides me notice that they stimulated those cancer cells with calcium? Might simply not over stimulating cancer with excess calcium be an attractive target for cancer therapy? and cheap? – less calcium intake – more health output? /speculation/

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. Information is not a substitute for individual health guidance. Please see a health professional for individual health care purposes./

Hypothyroid or Iodine Deficient ?

Both is the answer or kind-of is the answer to the question in the title. I realize I never answered it directly in the post or may not have explained it clearly. We may have the RDA, the Recommended Daily Allowance, of iodine in a supplement or fortified products each day — but if the environment and diet are also providing the chemically similar minerals bromide, perchlorate (chloride), and fluoride then the body may be making thyroid hormone with the atoms of bromide, chloride and fluoride instead of with atoms of iodine and a lab test might show the presence of thyroid hormone but that lab test wouldn’t be testing specifically for the presence of iodine.
     Thyroid hormone might be present that contained bromide, chloride, or fluoride, or a combination, but it wouldn’t actually function within the energy pathways in the body and symptoms of tiredness and other symptoms of hypothyroidism.  A very large dose of iodine taken for one month can help the body replace the wrong atoms in the thyroid hormone with atoms of iodine. The presence of bromide, chloride and fluoride may be involved in risk for autoimmune thyroid disease and cancer of the thyroid or other endocrine glands. More is included on these topics later in this post. It can also help resolve the pain of fibrocystic breast disease, that topic isn’t included in this post but I did find it helpful for resolving that condition for me, and it hasn’t returned. I had symptoms of it for years and the standard answer is along the lines of “we don’t know,” – well I know that for me my condition resolved after taking a large dose of iodine for one month and then a smaller but still larger than RDA dose for several years — but I didn’t know about or forgot the selenium and ran into hyperthyroid problems, more on that –>
*This updated post is not about being fat or thin, or “body-shaming,” inner beauty has nothing to do with size, however good health can have to do with size.  Mood and skill in social settings can also be affected by size.  Information about cancer is included in this post because a problem with iodine deficiency can increase risk for cancer.
     The commonly used treatment for hypothyroidism within the current medical community is simply replacement of the thyroid hormone which is not addressing iodine deficiency for the thyroid gland or for the rest of the endocrine glands and the rest of the body. The thyroid organ can preferentially take up iodine when there is a limited supply, so a diagnosis of hypothyroidism suggests the rest of the body has even less iodine than the thyroid gland. Other side effects of hypothyroidism include depression, extreme tiredness, feeling cold, a tendency towards gaining weight and for constipation – everything slows down in the body when there is inadequate thyroid hormone or when it is present but not functioning correctly.
     It is more comfortable to not weigh an excessive amount and it is more comfortable to have energy and not feel depressed and cold.
     Showing the two pictures below is again, not about “body-shaming,” but was to give some idea of my past. Overweight women are somewhat invisible to men and to other women who care a lot about image. I have the social skills of an overweight woman, not those of a woman used to fending off unwanted attention from strangers or old acquaintances. I’ve never been to a fancy “cocktail party” if such a thing still occurs outside an episode of Mad Men (aka/the 1950’s). Or – more accurately – I have the social skills of someone with child trauma issues who may not have tried much in life and never gained experience and learned better skills.
     It takes a while to learn what you don’t know and further, to learn how many layers of not-knowing-what-you-didn’t-know and that you’ll have to learn about and work through before you will really get to the core issue or issues.
     A core issue revealed in the first picture is hyperthyroidism – I look thinner than typical for me. In the second picture I’m heavier but that was the weight that stubbornly stuck no matter how hard I tried to diet and exercise it off – until I took the large dose iodine supplement. My problem turned out to be the selenium. I didn’t learn about that until later after having developed hyperthyroid symptoms. Autoimmune thyroid problems can fluctuate between hypothyroid – low activity, and hyperthyroid – elevated activity. The first picture is me with hyperthyroidism and the second picture is hypothyroid.
     We all do need iodine though. I have to limit how much I eat now because I still have an overactive autoimmune thyroid condition. I do eat some iodine foods but not much iodized products or any supplements and I do try to eat selenium rich foods regularly, which is about two Brazil nuts per day.
     There aren’t many foods naturally rich in selenium. Coastal ocean microbes transform it from the form found in the ocean water into a form that can be carried in water droplets in the atmosphere where it is rained onto Brazil nut trees in the Amazon rain forest – isn’t our planet amazing?
We all need iodine.
This is how I spent most of my years as an adult, before I took iodine supplements.

The rate of infants born with congenital hypothyroidism has been escalating, baffling many, unless you consider an older diagnostic term – cretinism or iodine deficiency. Cretinism is somewhat reversible if the infant receives adequate iodine after diagnosis, the thyroid gland would grow and begin to produce hormone naturally. If the infant is treated only with synthetic thyroid hormone, then organ development would continue to suffer and the baby will probably need the drug for the rest of its life. Weight gain, fatigue, apathy and depression are common symptoms in adults and children born hypothyroid typically are petite and can have reduced IQ. Women can’t grow babies out of synthetic hormone, but that is what they usually are given if diagnosed with hypothyroidism instead of iodine deficiency.

All of our glands need iodine not just the thyroid gland. The pineal gland, also known in more  ancient terms as our Inner Eye, [crystalinks], has the second largest uptake of iodine and it is crucial for melatonin and a good night’s sleep. [5, 6] The mammary and prostate glands need iodine as well. Prostate and breast cancer also may involve an underlying iodine deficiency [2, 3] and the substitution of bromide, perchlorate and/or fluoride.

Lab tests have become a primary diagnostic tool and if the science underlying their use was wrong then the diagnosis based on the tests may not be very reliable. Our bodies have learned how to fool the lab test’s expectations of goiter by producing thyroid hormone containing fluoride or bromide. The gland is functioning normally but the hormone it is producing won’t prevent the symptoms and malfunction of hypothyroidism.

I had all those symptoms, but my lab tests were normal and therefore I was normal, or so I was told. However, after attending a seminar by Dr. Brownstein, I started a high dose iodine supplement that is equivalent to the amount of iodine provided by the sea weed in the traditional Japanese diet. The supplement that I have taken daily for six years contains 83 times more iodine than our current RDA. Our national guideline for iodine has not been changed since it was created in the 1940’s. Salt doesn’t have that much added to it and we aren’t really using much iodized table salt anymore. Do we reach for the salt shaker when we think about any other vitamin

It is important to get adequate amounts of the trace mineral selenium when supplementing with iodine, especially when using a large dose of iodine. Selenium is essential for the enzyme that breaks down excessive amounts of the active thyroid hormone. Excessive thyroid hormone can cause hyperthyroidism which can be associated with extreme mood and physical symptoms. Selenium can be toxic when excessive amounts are consumed for months.

Approximately two Brazil nuts provide the recommended daily goal of 200 micrograms of selenium. A one-a-day or prenatal vitamin would likely include 200 mcg of selenium. “Selenium” [ods.od.nih.gov/factsheets/selenium/]

A peer reviewed article with seaweed nutrient content information suggests that there is a wide range in iodine levels between different types of seaweed and between different samples of the same type of seaweed. [10]

The case study does not mention selenium. Hyperthyroid problems induced by abrupt increased intake of iodine may be mitigated by increasing selenium intake at the same time.

Kelp supplements can contain an unreliable amount of iodine. Out of 17 supplements tested the iodine content ranged from 45 micrograms to 57,000 micrograms. [1]

The kelp supplements content as tested is unreliable and potentially dangerous due to the unknown amount that might be contained. Seaweed also may contains goiterogens that interfere with thyroid function and occasionally toxins or other contaminants can be present due to the variability in ocean waters. [healthlibrary.epnet.com/GetContent.aspx?token=af362d97-4f80-4453-a175-02cc6220a387&chunkiid=21786 ]

Excessive iodine chronically can lead to toxicity side effects that include acne, a metallic taste in the mouth, a persistent mild cough and nasal discharge. The metallic taste can be a short term side effect due to bromide stores being exchanged for iodine. The RDA has been 150 micrograms. The Iodoral supplement that I have been using for six years contains 1250 micrograms of iodine/iodide which is a mega dose but is consistent and known, breaking the tablets and using a portion for a smaller daily dose is possible.

Those at increased risk of developing hypothyroidism include: Postpartum women, Women with family history of autoimmune thyroid disorders (AITD), Those with previous head, neck, or thyroid surgery or irradiation, Those with other autoimmune endocrine disorders (e.g., type 1 diabetes mellitus, adrenal insufficiency, or ovarian failure), Those with nonendocrine autoimmune disorders (e.g., vitiligo, multiple sclerosis), Patients with primary pulmonary hypertension, Those with Down’s or Turner’s syndromes. 

The following biological activities are particularly impaired by hypothyroidism: Calorigenic modification, Oxygen consumption throughout most tissues, Protein, fat, and carbohydrate metabolism, Augmentation of calcium ATPase activity in cardiac muscle, Mitochondrial ATP production, G-protein-coupled membrane receptor activity, Organ-specific effects. 

The clinical manifestations of hypothyroidism (see Symptoms) are the result of effects occurring at the molecular level because of the impact of thyroid hormone insufficiency.” Read more: [medicinalplants.us/hypothyroidism ]

December 15, 2011 addition:

  • “Asian countries, such as Japan, have low rates of breast cancer, while Western countries have cancer rates that are many times higher. 25,26 However, when Japanese girls are raised on westernized diets, their rate of breast cancer increases dramatically.”  [cancerproject.org/survival/cancer_facts/breast.php]
  • Some statistics about prostate and breast cancer rates compared to iodine levels. [drdavidbrownstein.blogspot.com/2009/05/rapid-increase-in-thyroid-cancer.html]
  • www.faostat.fao.org – world food supply statistics. ***The world three year average consumption of Aquatic Plants ( aka seaweed) for 2007-2005 is zero if you remove the three out-lying values out of the 154 countries with data. The countries with Aquatic Plant consumption are China – 20.39 grams/capita/day, Japan- 4.02 gr/cap/day, and the Republic of Korea – 35.28 gr/capita/day. [faostat.fao.org/site/610/DesktopDefault.aspx?PageID=610#ancor]
  • The Japanese intake of 4.02 grams Aquatic Plants may provide a safe amount of iodine without an excess of goiterogens that may be provided in the Chinese 20.39 average intake or the Republic of Korea’s 35.28 grams/capita/day of Aquatic Plants.
  • The World’s Healthiest Foods website,”Sea Vegetables, What’s New and Beneficial about Sea Vegetables?” – recipes and health information for a variety of sea vegetables. [whfoods.com/genpage.php?tname=foodspice&dbid=135 ]
  • Nutrient information for Kelp lists iodine content as 415 micrograms per 20 gram serving. The U.S. Nutrient Data Base # 11445, Seaweed, Kelp Raw did not have a line for Iodine content. Based on the wide range in content found by the research team in citation #1 it would be hard to estimate how much iodine the Japanese, Chinese, and Republic of Korea citizens might be consuming on average – but it is clearly an excellent source. [whfoods.com/genpage.php?tname=nutrientprofile&dbid=51]

For more on hypothyroidism and pickle’s value as a side dish, see my post:  [Vitiligo, hypothyroidism and melanin]

Plastics, pesticides, herbicides and other chemicals may be a major cause of the feminizing of our young men [13] but the lack of iodine is also at fault. The prostate and testicles need iodine in addition to the thyroid, mammary and pineal glands. Switch to stainless steel drinking bottles and filtered water if you are worried about chemicals that disrupt the endocrine system; avoid soda (metal cans are lined with plastic) it is so acidic that it is leaching magnesium from you anyway; and take a high dose iodine or tested seaweed supplement. Boys will only continue to be boys if we provide their pregnant mothers and their growing bodies with nutritious building blocks. We still can’t build a functioning body out of pharmaceuticals or synthetic hormones.

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./
_____________________________________________________________________

  1. Norman JA, Pickford CJ, Sanders TW, et al. Human intake of arsenic and iodine from seaweed-based food supplements and health foods available in the UK. Food Addit Contam. 1988;5:103-109. www.drbrownstein.com/homePage.php
    [drdavidbrownstein.blogspot.com/2009/05/rapid-increase-in-thyroid-cancer.html]
  2. Most Asian Men Have Better Prostate Cancer Survival Rates, Finding could help to govern treatment approaches, study suggests. By Steven Reinberg, HealthDay Reporter,  [abcnews.go.com/Health/Healthday/story?id=4508275&page=1]
  3. Race Plays A Key Role In Prostate Cancer Survival Rates, sciencedaily.com,  [sciencedaily.com/releases/2006/06/060613072943.htm]
  4. Watanabe R, Hanmori K, Kadoya H, Nishimuta M, Miyazaki H, Nutritional Intakes in community-swelling older Japanese adults: high intakes of energy and protein based on high consumption of fish, vegetable and fruits provide sufficient micronutrients, J Nutri Sci Vitaminol (Tokyo). 204 Jun: 50(3): 184-95, [ncbi.nlm.nih.gov/pubmed/15386931]
  5. On Pineal calcification and its relation to subjective sleep perception: a hypothesis-driven pilot study, Volume 82, Issue 3, Pages 187-191 (30 June 1998)  [psyn-journal.com/article/S0925-4927%2898%2900013-4/abstract]
  6. Richard Mahlberg, Thorsten Kienast, Degree of pineal calcification (DOC) is associated with polysomnographic sleep measures in primary insomnia patients, [sleep-journal.com/article/S1389-9457%2808%2900154-8/abstract
  7.  “Selenium” [ods.od.nih.gov/factsheets/selenium/]
  8. [ncbi.nlm.nih.gov/pmc/articles/PMC1924637/table/tbl3/]
  9. [ncbi.nlm.nih.gov/pmc/articles/PMC1924637/]
  10. Müssig, K., Thamer, C., Bares, R., Lipp, HP., Häring, HU., Gallwitz, B., Iodine-Induced Thyrotoxicosis After Ingestion of Kelp-Containing Tea, J Gen Intern Med. 2006 June; 21(6): C11–C14. doi: 10.1111/j.1525-1497.2006.00416.x. PMCID: PMC1924637
  11. Leung, A.M., Pearce, E.N., Braverman, L.E., Iodine Content of Prenatal Multivitamins in the United States, N Engl J Med 2009; 360:939-940, [nejm.org/doi/full/10.1056/NEJMc0807851]
  12. Jian-Ying Zhan, Yu-Feng Qin and Zheng-Yan Zhao, Neonatal screening for congenital hypothyroidism and phenylketonuria in China, World Journal of Pediatrics Vol. 5, Number 2, 136-139,  [springerlink.com/content/w7054w4550233404/]
  13. Why so many teen-age boys are wimpy, irresponsible, unmotivated and bored: one of the reasons, gatesofhorn.com,  [gatesofhorn.com/blog/why_so_many_teen_age_boys_are_wimpy_irresponsible_unmotivated_and_bored_one_of_the_reasons]

I need to talk about iodine a bit before I get to the vitamin D and calcium story. I don’t think I would have kicked my migraine and autoimmune problems if I hadn’t conquered my undiagnosed hypothyroidism first. The body can’t do anything without energy and the thyroid hormone is our energizer. Hypothyroid bodies become super efficient at not wasting energy and people can gain weight on 600 calories a day – you can’t live on that. Extreme fatigue, depression, apathy, hair loss, infertility and miscarriages are also common symptoms.