This Vitamin D Council newsletter was interesting, concerning vitamin A and cod 
liver oil.   
http://www.vitamindcouncil.org/newsletter/vitamin-d-vitamin-a-and-cancer.shtml  
I'll try to copy and paste, but it might be too long.


The Vitamin D NewsletterFebruary 2010

Vitamin D, Vitamin A, and Cancer
A Remarkable Paper
A few weeks ago, the British Medical Journal published a 
remarkable paper, remarkable that it studied more than 500,000 subjects, 
remarkable that it had 56 (fifty-six) authors, remarkable that it 
confirmed low vitamin D levels obtained in the past are a risk 
factor for developing colon cancer in the future. However, the most 
remarkable part of the paper is that the 46 scientists minimized the 
true significance of their own research. They found that vitamin A, even in 
relatively low amounts, appears 
to thwart vitamin D's association with reduced rates of colon cancer. Jenab M, 
et al. Association 
between pre-diagnostic circulating vitamin D concentration and risk of 
colorectal cancer in European populations:a nested case-control study. BMJ 
2010;340:b5500.
This is a prospective nested case-controlled study, which means it 
uses subject's vitamin D blood samples obtained and frozen in the past 
and then reviews their medical records into the future to see who gets 
colon cancer, comparing the study subjects to similar members of the 
group that did not get the illness. Dr. Mazda Jenab and his 45 
colleagues from the International Agency for Research on Cancer 
confirmed that low vitamin D levels are a risk for colon cancer in a 
dose response manner; those with the highest levels were about twice as 
less likely to develop colon cancer compared to those with the lowest 
levels.
Vitamin A and the U-shaped Curve
However, hidden on page eight is one sentence and a small table, 
which shows that the benefits of vitamin D are almost entirely negated 
in those with the highest vitamin A intake. And the retinol intake did not have 
to be that high in these older adults to begin to negate vitamin D's effects, 
about 3,000 IU/day. Remember, young autistic 
children often take 3,500 IU of retinol a day in their powdered multivitamins, 
which doesn't count any additional vitamin A given in high, single doses.
Pancreatic Cancer
This is the largest study to date showing vitamin A blocks vitamin 
D's effect and explains some of the anomalies in other papers on vitamin D and 
cancer. For example, Dr. Rachael 
Stolzenberg-Solomon of the NIH conducted two similar studies on pancreatic 
cancer, with startling 
different results. Her first paper showed high vitamin D levels tripled 
the subsequent risk of pancreatic cancer, her second paper showed no 
effect. The difference, the first was conducted in a cod liver oil 
country, Finland, the second in the United States. Stolzenberg-Solomon RZ, et 
al. A prospective nested case-control study of vitamin D status and pancreatic 
cancer risk in male smokers. Cancer Res. 2006 Oct 
15;66(20):10213–9. Stolzenberg-Solomon RZ, et al. Serum vitamin D and risk of 
pancreatic cancer in the prostate, 
lung, colorectal, and ovarian screening trial. Cancer Res. 2009 Feb 
15;69(4):1439–47.
Prostate Cancer
Prostate cancer is another 
good example. Ten similar studies have been conducted on vitamin D blood levels 
and the risk of subsequent prostate cancer. Dr. Lu Yin of the 
German Cancer Research Center reviewed them in detail. Eight of the 
studies found no relationship but two studies found a U shaped curve, 
that is, an increased risk of prostate cancer at both lower and higher 
vitamin D levels. You guessed it; both of these studies were from Nordic 
countries where cod liver oil consumption is rampant. Yin L, Raum E, Haug U, 
Arndt V, 
Brenner H. Meta-analysis of longitudinal studies: Serum vitamin D and prostate 
cancer risk. Cancer Epidemiol. 2009 
Dec;33(6):435–45.
So why is there no relationship between vitamin D levels and the 
future risk of prostate cancer? All the subjects had their vitamin D 
levels checked in the late 1980s or 1990s, well into the sun-scare but 
before the vitamin D revolution.
So how did these older people get high levels of vitamin D back then? 
Multivitamins? No, they only contained a meaningless 400 IU. Vitamin D 
supplements? No, they were not widely available back then and only 
contained a meaningless 200 to 400 IU of vitamin D if available. 
Sunshine? Maybe, but I doubt it. Studies have shown that the elderly 
were the first to abide by sun-avoidance advice; anyway, the elderly 
lose the ability to make vitamin D from sunshine; it takes the elderly 
up to ten times more time in the sun than the young to make an 
equivalent amount of vitamin D.
Cod Liver Oil and Retinol
However, the elderly of many countries, not just Nordic countries, 
were raised on cod liver oil and I suspect that a sizable number of 
Americans continue to take cod liver oil as they age. While cod liver 
oil from the 1980s and 90s had higher amounts of vitamin D than does 
modern cod liver oil, it still had toxic amounts of vitamin A. I suspect if 
authors of the above ten studies had controlled for cod liver oil 
intake, they would have found that high retinol intake was blocking the 
cancer-preventing effects of vitamin D.
I say this because one author has controlled for retinol intake and 
the pre-cancerous condition, colon adenomas. Dr. Kyungwon Oh, of the 
Korea Centers for Disease Control and Prevention, working with Harvard 
epidemiologists, found that high retinol intake 
completely thwarted the beneficial effects of vitamin D, stating, "a 
higher retinol intake, approximately > 4,800 IU/day, appears to counter the 
beneficial effect of vitamin D . . ."  In other words, exactly what the British 
Medical Journal paper found with colon cancer. Oh K, Willett WC, Wu K, Fuchs 
CS, 
Giovannucci EL. Calcium and vitamin D intakes in relation to 
risk of distal colorectal adenoma in women. Am J Epidemiol. 
2007 May 15;165(10):1178–86.
Breast Cancer
Let's look at Dr. Pamela Goodwin's study from the University of 
Toronto that studied breast cancer survival. This a very different 
study as it looked at vitamin D levels obtained after the diagnosis of 
breast cancer and subsequent survival in 535 Toronto women between 1989 
and 1996. Vitamin D levels ranged from 3 ng/mL to 70 ng/mL. The women with the 
lowest levels were 
about twice as likely to die and to suffer distant cancer recurrence 
compared those with the highest levels. Ten year survival was 85% for 
those in the upper one-third of vitamin D levels compared to 74% in the 
lower one-third. However, the data suggested a U shaped curve for the 
women with levels above 40 ng/mL, that is, a higher risk of dying, but it was 
not statistically significant. Goodwin PJ, Ennis M, Pritchard KI, 
Koo J, Hood N. Prognostic effects of 25-hydroxyvitamin D levels 
in early breast cancer. J Clin Oncol. 2009 Aug 
10;27(23):3757–63.
Again, let's ask where women would get levels above 40 ng/mL in 
Toronto between 1989 and 1996? Sunshine? We know the answer is no as the 
authors found no seasonal variation in 25(OH)D levels in the 535 women, even in 
the women with the highest levels. So where did blood levels of 40–70 ng/mL 
come from in the early 1990s?
Vitamin D supplements were not widely available in the early 1990s, 
and only contained meaningless doses when available. As sunshine was 
ruled out, they could only have gotten it from cod liver oil. I have 
emailed Dr. Pamela Goodwin, lead author, asking how hard it would be to 
see if cod liver oil use was asked about in the dietary questionnaire 
and if she could control for cod liver oil intake. She did find retinol 
intake was associated with higher vitamin D levels but I am particularly 
interested in cod liver oil intake in women with vitamin D levels above 40 
ng/mL.
It's not just in breast cancer that vitamin D levels appear to have a treatment 
effect; it's in lung, prostate and colon cancer as well. 
Again, these are studies of people diagnosed with cancer to see if high 
vitamin D levels at the time of diagnosis are associated with improved 
survival; that is, do high vitamin D levels have a treatment effect?
Those With Highest Vitamin D Levels Live Longer
On average, those with the highest vitamin D levels at time of 
diagnosis lived 2 or 3 times longer. One has to ask how high vitamin D 
levels are associated with greatly improved survival once you get cancer but a 
higher risk of getting cancer in the first place. That requires 
some gymnastic thinking and acrobatic basic science. Zhou W, et al. Circulating 
25-hydroxyvitamin D levels predict survival in early-stage 
non-small-cell lung cancer patients. J Clin Oncol. 2007 Feb 
10;25(5):479–85. Ng K, et al. Circulating 25-hydroxyvitamin d levels and 
survival in patients with colorectal 
cancer. J Clin Oncol. 2008 Jun 20;26(18):2984–91. Tretli S, Hernes E, Berg JP, 
Hestvik UE, Robsahm TE. Association between serum 25(OH)D and death 
from prostate cancer. Br J Cancer. 2009 Feb 10;100(3):450–4.
Remember, studies of vitamin D levels and subsequent risk of cancer 
are only one type of epidemiological study. Studies of latitude and 
cancer are quite clear, the less sunshine the higher the cancer risk. 
Studies of dietary vitamin D intake and cancer are also mostly 
supportive but such studies are limited by the tiny doses people get in 
their diets.
Avoid Retinol and Cod Liver Oil
So it is not just autistic children that are being harmed by vitamin A. Avoid 
cod liver oil like the poison it is and check your 
multivitamins. Life Extension Foundation just reformulated their 
multivitamin to contain only 500 IU of preformed retinol. And, I am 
happy to report that Purity Products, which markets my vitamin D, has no 
preformed retinol at all in any of their multivitamins, only beta-carotene. 
Purity has also stopped selling cod 
liver oil. Now, if only Carlson, Solgar, Nature's Way, and other 
companies would stop selling cod liver oil and stop selling their 
concentrated vitamin A supplements to a country whose problem is 
widespread sub-clinical vitamin A toxicity, I'd be a happier 
agitator.
John Jacob Cannell MD Executive Director






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