1. Recommended Dietary Allowance (RDA) for Vitamin D: 400 IU/day To prevent rickets in children and osteomalacia in adults Vitamin D Vitamin D

2. Vitamin D Deficiency Rickets, Osteomalacia Influenza, Tuberculosis MS, RA, SLE, Type I diabetes Hypertension, CAD, PVD, CHF Syndrome X, Type 2 Diabetes Chronic Fatigue, SAD, Depression Cataracts, Infertility Osteoporosis Cancer

3. Vitamin D 25(OH)D 1,25(OH)D 26 + cells throughout the body 7-dehydrocholesterol UVB photons

4. Nuclear Receptors

5. System and Tissue Distribution of Nuclear Vitamin D Receptors (VDR) System Tissue Immune Thymus, bone marrow, macrophages, B cells, T cells Gastrointestinal Esophagus, stomach, small intestine, colon, rectum Cardiovascular Endothelial cells, smooth muscle cells, myocytes Respiratory Lung alveolar cells Hepatic Liver parenchyma cells Renal Proximal and distal tubules, collecting duct Endocrine Parathyroid, thyroid, pancreatic beta cells Exocrine Parotid gland, sebaceous gland CNS Brain neurons, astrocytes, microglia Epidermis/appendage Skin, breast, hair follicles Musculoskeletal Osteoblasts, osteocytes, chondrocytes, striated muscle Connective Tissue Fibroblasts, stroma Reproductive Testis, ovary, placenta, uterus, endometrium, yolk sac

6. Nutrigenomics Vitamin D Wood RJ, Tchack L, Angelo G, etal. DNA Microarray Analysis of Vitamin D- induced Gene Expression in a Human Colon Carcinoma Cell Line. Physiological Genomics 2004;17:122-129. Confirmatory PCR for 1,25-dihydroxyvitamin D-regulated genes found by Affymetrix GeneChip transcriptional profiling

7. Human Migration Out of Africa 35° N 35° S Lamson Rl, etal. SLC24A5, a putative cation exchanger, affects pigmentation in zebrafish and humans. Science 2005;310:1782-1786.

9. Indigenous Human Skin Color by Latitude 35° S 35° N Jablonski NG, Chaplin G. The evolution of human skin coloration. J Hum Evol 2000;39:57-106

10. Seasonal Variation in 25-hydroxyvitamin D Levels in People at Latitude 48° N Cannell JJ, etal. Epidemic influenza and vitamin D. Epidemiol Infect 2006;134:1129-1140.

11. Cannell JJ, etal. Epidemic influenza and vitamin D. Epidemiol Infect 2006;134:1129-1140

12. Noncalcemic Functions of 1,25-dihydroxyvitamin D Cytokines Adaptive Innate Immune modulation

13. Tuberculosis Treated with Sunshine

14. Immunomodulatory Effects of 1,25-dihydroxyvitamin D

15. Multiple Sclerosis in World War II Veterans by Latitude and State of Residence Wallin MT, etal. Multiple sclerosis in US veterans… Ann Neurol 2004;55:65-71

16. Breast Cancer Mortality Rates and Contours of Annual Mean Daily Solar Irradiance Lappe JM, etal. Vitamin D and calcium supplementation reduces cancer risk: Results of a randomized trial. Am J Clin Nutr 2007;85:1586-1591.

17. 25-hydroxyvitamin D3 Blood Levels Severely deficient < 8 ng/ml Deficient 8-19 ng/ml Insufficient 20-29 ng/ml Sufficient 30-49 ng/ml Optimal 50-99 ng/ml Excessive 100-150 ng/ml Toxic >150 ng/ml Calcium Absorption PTH Levels 32 ng/ml (1 ng/ml = 2.5 nmol/L, 1 nmol/L = O.4 ng/ml)

18. Preop Vitamin D3 levels in 73 Veterans Undergoing Heart Surgery at the Seattle VA Hospital No. of Patients History of Cancer 25-hydroxyvitamin D 3 Level (ng/ml) 7 (9.6 %) 1 (colon) < 8 (severely deficient) 41 (56.2%) 6* 8-19.9 (deficient) 9 (12.3%) 0 20-29.9 (insufficient) 13 (17.8%) 0 30-49.9 (sufficient) 3 (4.1%) 0 50-100 (optimal) * Prostrate cancer – 3; Colon cancer – 1; Tonsillar cancer – 1; Melanoma -- 1 Surgery performed December 2006 – July 2007

19. Sources of Vitamin D Cholecalciferol (D 3 ) and Ergocalciferol (D 2 ) Dietary Natural Salmon (wild, 3.5 oz) 800 IU D 3 Salmon (farmed, 3.5 oz) 150 IU D 2 or D 3 Cod liver oil (1 tsp) 400-1100 IU D 3 Tuna (canned, 3.6 oz) 230 IU D 3 Egg yolk 20 IU D 2 or D 3 Fortified Foods Milk (8 oz) 100 IU D 3 Orange juice (8 oz) 100 IU D 3 Infant formula (8 oz) 100 IU D 3 Butter (3.5 oz) 50 IU D 3 Breakfast cereals/serving 100 IU D 3 Supplements Prescription Ergocalciferol (D 2 ) 50,000 IU/capsule Over the Counter Multivitamins 400 IU D 2 or D 3 Cholecalciferol (D 3 ) 400, 800, 1000, 2000, 5000 and 50,000 IU/tablet Skin synthesizes 20,000 IU D 3 in 20 minutes when exposed to sunlight 5,000 IU D 3 50,000 IU D 3 5,000 IU D 3 50,000 IU D 3 OTC at vitalady.com, lifespannutrition.com

20. Serum 25-hydroxyvitamin D3 Levels on 0, 1000, 5000, and 10,000 IU of Vitamin D 3 a Day Heany RP, etal. Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 2003;77:204-210. (80 ng/ml) (80 ng/ml) (60 ng/ml) (30 ng/ml) 80 ng/ml 60 ng/ml 30 ng/ml 10,000 IU qd 10,000 IU qd 5000 IU qd 5000 IU qd 1000 IU qd 1000 IU qd 0

21. Benefits of Vitamin D Skeletal-muscularSkeletal-muscular –Strong muscles and bones InfectionsInfections –Prevent influenza, treat tuberculosis CancerCancer –Prevent breast, colon, and prostate cancer –? Suppress metastasizes Autoimmune DiseasesAutoimmune Diseases –Prevent multiple sclerosis and type 1 diabetes Cardiovascular DiseaseCardiovascular Disease –Slow progression of atherosclerosis –Treat hypertension and congestive heart failure Neuropsychiatric DisordersNeuropsychiatric Disorders –Prevent schizophrenia and relieve depression