Major Breakthrough in Vitamin D3 (March 2014) and Improving Your Survival:
Halve Your Mortality!
Many studies [1-5] have demonstrated a positive association between Vitamin D3 levels, measured as 25(OH)D and survival from breast cancer. Now a new just published (March, 2014) meta-analysis  of five studies of the relationship between 25(OH)D and survival of patients from breast cancer has added still stronger results confirmative of a survival benefit accruable from maintaining optimal Vitamin D3 levels.
The meta-analysis found that higher serum concentrations of 25(OH)D were associated with lower case-fatality rates after diagnosis of breast cancer, with patients in the highest quintile of 25(OH)D having an amazing approximately HALF the mortality rate from breast cancer as those in the lowest. This, in conjunction with other human clinical studies [1-5] established that the survival value of maintaining consistently high serum 25(OH)D levels. The study authors conclude, based on the aggregate meta-analyzed data, that all patients with breast cancer:
(1) have their serum 25(OH)D measured; and
(2) the serum 25(OH)D levels in all breast cancer patients should be restored to optimal concentrations in the range of 30-80 ng/ml, along with appropriate monitoring.
What's an Optimal Vitamin D3 Level?
Also I draw your attention to my discussions and reviews of option Vitamin D3 supplementation elsewhere (especially on No Surrender) where I noted that as to optimal dosing, this is not based on any magical amount of D3 supplementation: every one is different; rather it is based on whatever supplemental amount, for you, consistently raises your 25(OH)D levels to at least 66 ng/ml if on antiestrogen (especially aromatase inhibitor) therapy, and no less than 44 - 50 ng/ml otherwise [Heany et al, Am J Clin Nutr, 2008; Hollis et al, J Steroid Biochem Mol Biol, 2007)], up to 80 ng/ml), when it is tested by the D3 (25(OH)D) assay. For person X, 4000 IUs daily may be sufficient to achieve that target, for person Y (myself) 8000 IUs daily was required to reach the same target. In addition, a pooled meta-analysis from Cedric Garland and colleagues (Garland et al., J Steroid Biochem Mol Biol, 2007) estimated that 25(OH)D levels of 52 ng/ml are needed to effect a 50% reduction in the risk of breast cancer, while Carol Fabian's University of Kansas team (Breast Cancer Res Treat, 2009) found 66 ng/ml for bone health related arthralgia relief.
Therefore, the weight of the clinical data to date suggests 25(OH)D optimality for both bone health or anticancer benefit of 66 - 80 ng/ml, on the best evidence, and above 66 ng/ml for bone health and anticancer benefit.
Also remember as I observed, that sun exposure is not a reliable means of optimizing D3 levels: there are large proportions of Vitamin D deficient populations in sun-drenched Sicily, Hawaii, and Queensland, Australia, as I have documented extensively.
How to Figure Out Your Vitamin D3 Supplementation Needs
To take an example of how to determine what supplementation is required to achieve an optimal level, first understand that you must get a simple 25(OH)D (Vitamin D3) assay or laboratory test, also known as a cholecalciferol assay / test, but by most laboratories as the "25-Hydroxy Vitamin D" test or assay). Second, to take some "live" numbers: say that the assay shows your 25(OH)D levels at 36 ng/ml and you are already taking a supplement of 1000 IUs of Vitamin D3. Well, the key insight here is that we know that roughly each 1000 IUs of Vitamin D elevates serum 25(OH)D levels approximately 10 ng/ml above base. This patient therefore would probably need an additional 2000 IUs added to the 1000 IU she is already taking, for a total of 3000 IUs daily, in order to top 52+ ng/ml.
But better still would be that after the patient takes the 3000 IU dose for approximately a couple of weeks, she should be retested to assure that she is indeed 50+ ng/ml. And as I noted, for patients on antiestrogen therapy with an known potential compromise of bone density, a more optimal target would be at least 66 ng/ml. Since she is already at 36 just by taking 1000 IUs of a Vitamin D3 supplement, then she needs to raise her levels by 30 points (66 minus 36), and since it takes about 1000 IUs to move up 10 points, then she would need to add 3000 IUs to her supplementation, for a total of 4000 IUs daily. But again, everyone is different, so everyone should ask for a simple 25(OH)D "Vitamin D" test in order to be able to determine how much to supplement. Then you should be retested in 3 to 6 months to make sure (1) that you are really achieving the optimal target, and (2) you are staying at that level.
1. Goodwin PJ, Ennis M, Pritchard KI, Koo J, Hood N. Prognostic effects of 25-hydroxyvitamin D levels in early breast cancer. J Clin Oncol 27: 3757-3763, 2009.
2. Villasenor A, Ballard-Barbash R, Ambs A, Bernstein L, Baumgartner K, Baumgartner R, Ulrich CM, Hollis BW, McTiernan A, Neuhouser ML. Associations of serum 25-hydroxyvitamin D with overall and breast cancer-specific mortality in a multiethnic cohort of breast cancer survivors. Cancer Causes Control 24: 759-67, 2012.
3. Hatse S, Lambrechts D, Verstuyf A, et al. Vitamin D status at breast cancer diagnosis: correlation with tumor characteristics, disease outcome, and genetic determinants of vitamin D insufficiency. Carcinogenesis 33: 1319-26, 2012.
4. Vrieling A, Hein R, Abbas S, Schneeweiss A, Flesch-Janys D, Chang-Claude J. Serum 25-hydroxyvitamin D and postmenopausal breast cancer survival: a prospective patient cohort study: Breast cancer research 13: 74, 2012.
5. Tretli S, Schwartz GG, Torjesen PA, Robsahm TE. Serum levels of 25-hydroxyvitamin D and survival in Norwegian patients with cancer of breast, colon, lung, and lymphoma: a population-based study. Cancer Causes Control 23: 363-370, 2012.
6. Mohr SB, Gorham ED, Kim J, Hofflich H, Garland CF. Meta-analysis of Vitamin D Sufficiency for Improving Survival of Patients with Breast Cancer. Anticancer Res 2014; 34(3):1163-6.
Breast Cancer Watch/Evidencewatch