5 November 2013

Vitamin D and Your Immune System

Coughs and sneezes spread diseases but vitamin D might help protect you this winter.
Beckie Port | Tuesday 5 November 2013

It is well known that vitamin D plays an important role in keeping your bones strong and health but did you know it may also be essential for maintaining your immune system? Scientists have discovered that deficiency is associated with autoimmune diseases and can make you more vulnerable to infections. And research has even shown that the number of cases of influenza rise in the winter when vitamin D levels are at their lowest 1. So, could more vitamin D help prevent a runny nose this season?

Vitamin D has been described as a "prohormone" and is unique as it can be both ingested, from foods such as oily fish and eggs, and synthesised by our body. Our recent blog post (The UK's Vitamin D 'Epidemic')  talked about vitamin D2 synthesis when the skin is exposed to sunlight, and the lifestyle changes that have lead to the UK, as a nation, becoming vitamin D deficient. However, as winter closes in - and the warm coats make their annual decent from boxes hidden in attics and appear from the back of wardrobes - the chance to synthesise vitamin D this year, in the UK at least, has passed. Between the months of October and March the sun's rays are too weak at our latitude to allow the skin to produce this vitamin and we must rely on the vitamin D that occurs naturally in foods, that is added to fortified milk, cheese and yoghurt or that comes in the form of supplements to maintain sufficient levels. But how exactly might vitamin D help you fight off those winter sniffles?  We investigate why this vitamin is important for our immune system and look at what you can do to help keep your levels up until the sun comes back next year.

Research has suggested that Vitamin D plays an important role in our immune system. The vitamin D receptor molecule - that captures and binds to vitamin D - is found on a number of immune cells including B-cells and T-cells 2. These specialised immune cells are are found in your blood and help fight foreign and invading organisms in our bodies. Studies looking at how this vitamin helps regulate the immune system have discovered that T-cells may use vitamin D to communicate with "phagocytes" - the cells which engulf and destroy harmful particles and bacterial 3. This prohormone also helps maintain parts of the immune system that, when left unchecked cause autoimmune disease - where the body starts attacking healthy cells by mistaking them as harmful foreign invaders 4

The research all suggests that having adequate levels of vitamin D is important to keep you fit and healthy this winter, and whilst using vitamins to fight infection may sound a little "new age" vitamin D has been used to treat infections since before antibiotics were invented - a report from 1849 described the use of cod liver oil, which is a good source of this vitamin, to treat patients with tuberculosis 5. So this winter when you wrap up to protect your self from the cold outside, consider taking vitamin D supplements to help boost your immune system and help it protect you form the inside.

1. Cannell JJ, 2004
2. Aranow C, 2011
3. Chandra G, 2004
4. Adorini L, 2005
5. Williams C, 1849


At StratifiedHealth we want to help you work towards the best health possible, by treating people as individuals and helping them to analyse, understand and manage their health we are working towards a healthier nation. We are busy getting our website up an running were we will be helping you to assess and take control of aspects of your health. If you would like to know more, or be the first to know when the website is live, follow @StratHealth or sign up to our newsletter...

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1 November 2013

Heathcare Efficiency through Technology

At StratifiedHealth we aim to 'bring healthcare into the digital age' but what does that actually mean? And, more importantly, what does the future of healthcare in the UK look like? Last month we went to the Healthcare Efficiency through Technology Expo in London to talk to the experts and find out how the government aims to use technology to save the NHS £3 billion by 2015.
Beckie Port | Friday 1 November 2013

The UK has definitely entered the digital era 86% of us use the internet and 36 million of us access the internet every day. In relation to our health, nearly 50% of people in the UK go online in search of medical information, double that in 2007. But here's the question, if you have searched for health information online do you remember what the source of that information was? Maybe it was is a reliable site such as NHS health or perhaps it was somewhere less reliable. One of the challenges in this digital era is making sure that the health information we are all searching for is available, understandable and accurate. 

The UK healthcare system is in the midst of a digital challenge that will see a £1 billion investment in technology to deliver the governments commitment of allowing everyone to book GP appointments and order repeat prescriptions online, and access their GP record by March 2015. At the expo we had the chance to talk to the companies behind a paperless NHS, learn about how our medical records are becoming electronic and question the experts about how these changes will impact on the future of healthcare. We had the chance to see the latest in home health monitoring - telecare and telehealth - systems, and were shown a future where doctors will be consulting a computer tablet instead of a clipboard on their ward rounds. 

Information is driving advances in medicine and healthcare, which are developing at an unprecedented pace, and we now have the opportunity to understand, prevent and control many diseases. One of the ways
 the government is helping us understand disease is to make this information, or 'big data', available through data.gov.uk in the form of Health Surveys. These surveys monitor the nations health and help track progress towards targets that will make the country healthier. The surveys also help evaluate and shape health policy, estimate the proportion of people with specific health conditions and give us information about risk factors that contribute to disease. All the information is available to the public and could be used to help inform your health choices. The challenge is to make the most out of this data, something that the government is keen  to encourage. That's where StratifiedHealth comes in, we want to help you understand more about your health by providing you with the information that is relevant to you, in a way you use to take control of your future.

We hear a lot about the problems behind the current model of medical care; it is based around  hospitals and health centres not at your home where you want it, care is focused on managing problems after they arise rather than preventing them, and it is not made personal for you. Here at StratifiedHealth we are tackling some of those problems today by helping you analyse various aspects of your health, see what the best levels would be, and take steps to correct it with personalised supplements and advice all from the comfort of your own home. 

We are busy getting our website up an running so we can help you work towards the best health possible. Working together we can help you reduce your risk of disease and help you live a longer, healthier life. If you would like to be the first to know when the website is live follow @StratHealth or sign up to our newsletter...

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29 October 2013

The D2d Trial: Can Vitamin D Prevent Diabetes?

Scientists in America are undertaking a national clinical trial to investigate if Vitamin D can help to delay, or even prevent, type 2 diabetes.
Beckie Port | Tuesday 29 October 2013

Over the last few years evidence has come to light that Vitamin D supplements may prevent the development of type 2 diabetes. In the UK, there are 2.9 million people affected by diabetes and 90% of them have type 2 diabetes; this type of diabetes is caused when the body produces insufficient insulin to reduce blood sugar levels, or when cells no longer respond to the insulin being produced. Furthermore, by 2025 it is predicted that five millions people will have diabetes as our population continues to put on weight; making this disease one of the biggest health challenges in the UK today. If the vitamin D and type 2 diabetes (D2d) clinical trial demonstrates that this supplement can help control this disease it would significantly impact on millions of lives worldwide and help save money on medical treatment 1.

The study is being lead by Professor Philip Raskin at the University of Texas Southwestern Medical Centre, and will take 4 years as it follows the progress 2,500 clinical trial participants with prediabetes. Prediabetics have higher than normal blood glucose levels, and are at risk of developing diabetes in the future. This will be the first trial of its kind and builds on findings that suggest low vitamin D levels are correlated with higher risk of type 2 diabetes. Studies have demonstrated that vitamin D levels decrease with age, obesity and in Black and South Asian populations; groups which are at risk of developing type 2 diabetes. Type 1 diabetes may also be linked to vitamin D as risk of type 1 diabetes is higher at increasing latitudes where there is less sunlight and greater chance of vitamin D deficiency.


A high dose to see effects

Researchers in Texas speculate that vitamin D supplements may act to decrease the risk of developing diabetes by 25%, one of the ways it may do so is by improving insulin sensitivity 2-3. The D2d trial will involve giving half the trial participants a daily dose of 4,000 IU of Vitamin D3 (cholecalciferon) - for more information on the different types of Vitamin D see our infographic 4. This is much higher than the recommended daily dose of vitamin D in the US which stands at 600-800 IU (15-20 micrograms) but is still reported as within safe limits.

Currently the UK Department of Health recommends that: 
  • all pregnant and breastfeeding women should take a daily supplement containing 10 micrograms (0.01mg or 400IU) of vitamin D to ensure the mother's requirements for vitamin D are met and to build adequate foetal stores for early infancy
  • all babies and young children aged six months to five years should take a daily supplement containing vitamin D in the form of vitamin drops to help them meet the requirement set for this age group of 7-8.5 micrograms (0.007-0.0085mg or 280-340IU) of vitamin D a day 
  • babies fed infant formula will not need vitamin drops until they are receiving less than 500ml (about a pint) of infant formula a day, as these products are fortified with vitamin D 
  • breastfed infants may need to receive drops containing vitamin D from one month of age if their mother has not taken vitamin D supplements throughout pregnancy
  • people aged 65 years and over and people not exposed to much sun should also take a daily supplement containing 10 micrograms (0.01mg or 400IU) of vitamin D 5

Vitamin D supplements in other diseases

A recent analysis of all the research into the role of vitamin D on bone density reported that vitamin D had no significant effect when taking 800 IU or less per day 6. But, whilst we are still advised not to exceed 1000 IU/ 25 micrograms a day, it has been suggested that supplementation with <800 IU may be insufficient to see the full beneficial effect of vitamin D on bone health. Furthermore, the recommended supplement level in the UK of 400 IU/day has been criticised by experts at the Barts and The London research centre who suggest a supplement of up to 5000 IU a day may be required to prevent rickets 7 and there is evidence that a short course of high dose vitamin D may be required to correct vitamin D deficiency 8

Whilst the media was quick to pick up on the negative finding of this analysis, suggesting vitamin D supplements "do not help bone health" 9, the results could suggest that a combination of calcium and vitamin D supplementation is required to increase bone density in health adults, alternatively vitamin D supplementation may only improve the bone health of those with osteoporosis or over the age of 65. However, as highlighted in the last blog post, we do know that chronic vitamin D deficiency can significantly affect our bone health and only time will tell if vitamin D might also help to prevent diabetes.


Final remarks

As vitamin D can be toxic at high doses, particularly when taken over a long period of time, it is important that we don't exceed recommended doses. The current discussion around what levels of vitamin D supplementation should be recommended suggests that we still have much to learn about vitamin D's role in our health. It also highlights the need for personalised medicine and advice to ensure that every individual is being treated for their circumstances. 


1. ClinicalTrials.gov number NCT01942694
2. Belechia, AM 2013 - clinicaltrials.gov as NCT00994396
3. Talaei, A 2013 The effect of vitamin D on insulin resistance in patients with type 2 diabetes
4. http://media.wix.com/ugd/d4b59e_4616e44d06ce5ef19e2ebcf9da2a3d47.pdf
6. Reed, IR 2013 Effect of vitamin D supplements on bone mineral density: a systematic review and meta-analysis.
7. http://blizard.qmul.ac.uk/images/Hull_Sally.pdf
8. Vincent, P 2011 An effective high dose supplelemt protocol for hypovitaminosis D


At StratifiedHealth we want to help you work towards the best health possible, by treating people as individuals and helping them to analyse, understand and manage their health we are working towards a healthier nation. We are busy getting our website up an running were we will be helping you to assess and take control of aspects of your health. If you would like to know more, or be the first to know when the website is live, follow @StratHealth or sign up to our newsletter...

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24 October 2013

The UK's Vitamin D 'Epidemic'

How is your lifestyle and diet affecting you health? This week is national vitamin D awareness weeks and news today reports that the UK appears to be in the middle of an 'epidemic' that has left up to 90% of the population deficient for Vitamin D and at risk of bone disease.
Beckie Port | Friday 24 October 2013

The discovery of the extent of our nations vitamin deficiency follows a five-fold increase in the number of case of rickets in the last 15 years. Rickets, a bone deforming disease that is caused by vitamin D deficiency, was common in the Victorian era had been nearly eradicated by the addition of vitamin D to foods such as milk, margarine and cereal. However, it would appear that poor diet and lack of sunshine have lead to a nation that is vitamin D deficient and a return of 'Victorian health standards' 1.

Our nations Vitamin D levels

Studies have found up to 9 out of 10 adults have inadequate levels of vitamin D - 1 in 6 having severe deficiency - and estimate that 40% of children could have lower than recommended levels 2,3. These findings have encouraged NICE to examine whether all children ages 6 months to 5 years should be given vitamin supplements that are currently only available to children of low income families but may now be necessary as a preventative measure and ensure our children grow up with healthy bones 4-6.

Side effects of Vitamin D deficiency

Many people with vitamin D deficiency do not show symptoms or simple feel fatigued or have more aches and pains. Severe or long term deficiency can lead to brittle or painful bones, and muscle weakness and has also been linked to other conditions including heart problems and autoimmune disease 7-9.

What can I do?

Deficiency is easy to correct as most of our vitamin D comes from the sun - during the summer just 10 minutes of sunshine each day allows our skin to make sufficient amounts of vitamin D3. As suncream blocks 99% of possible vitamin D production the advice is to spend frequently, short periods of time in the sun without suncream but to avoid burning, which can increase your rick of skin cancer. The increase use of suncream, which is now present in many face moisturisers, is another factor that may be contributing to this current epidemic

However from the months of October to March the sun is not strong enough - and does not have the required UVB rays - to allow the skin to produce vitamin D. Instead we must get our vitamin D from foods such as oily fish and eggs; which are high in vitamin D2, fortified milk, yogurt and cheese or from supplements.

I'm thinking of taking supplements, how much should I take?

The Department of Health in UK recommends that:-
  • all pregnant and breastfeeding women should take a daily supplement containing 10 micrograms (0.01mg or 400IU) of vitamin D to ensure the mother's requirements for vitamin D are met and to build adequate foetal stores for early infancy
  • all babies and young children aged six months to five years should take a daily supplement containing vitamin D in the form of vitamin drops to help them meet the requirement set for this age group of 7-8.5 micrograms (0.007-0.0085mg or 280-340IU) of vitamin D a day 
  • babies fed infant formula will not need vitamin drops until they are receiving less than 500ml (about a pint) of infant formula a day, as these products are fortified with vitamin D 
  • breastfed infants may need to receive drops containing vitamin D from one month of age if their mother has not taken vitamin D supplements throughout pregnancy
  • people aged 65 years and over and people not exposed to much sun should also take a daily supplement containing 10 micrograms (0.01mg or 400IU) of vitamin D 10.

1. Harries, C 2012
2. Morton, JP 2012
3. Madden, K 2012
4. http://www.nice.org.uk/nicemedia/live/13795/63153/63153.pdf
5. http://guidance.nice.org.uk/PHG/71
6. Marchisio, P 2013
7. Baeke, F 2010
8. Pearce, SH 2010
9. http://www.nos.org.uk/document.doc?id=1352
10. http://www.nhs.uk/Conditions/vitamins-minerals/Pages/Vitamin-D.aspx


At StratifiedHealth we want to help you work towards the best health possible, by treating people as individuals and helping them to analyse, understand and manage their health we are working towards a healthier nation. We are busy getting our website up an running were we will be helping you to assess and take control of aspects of your health. If you would like to know more, or be the first to know when the website is live, follow @StratHealth or sign up to our newsletter...

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