Jacob Schor, ND
November 7, 2006
This article appeared in the January 2007 issue of NDNR
A Seasonal Stimulus for Influenza
The recent paper by John Jacob Cannell linking epidemic influenza outbreaks with vitamin D deficiency may turn out to be the landmark paper of the year. It certainly is going to change the way I answer questions about flu shots or approach lower respiratory infections. If Cannell's hypothesis is correct, and there is little reason to think it isn't, taking a giant dose of vitamin D makes as much or more sense as bothering with the flu shots.
There was a time when philosophy dominated the practice of naturopathy. A hundred years ago, everyone ate organic, all agriculture was local, genes were mysterious and the idea of modifying them was pure fantasy. Many of the health battles we wage in our practices today weren't even worries back then. Most ‘medicines' of the day would be considered natural in contrast to the pharmaceuticals of today.
Cannell's paper awakens the old debate of germ theory versus fertile field. He starts the paper by going back a quarter century to the work of the British epidemiologist, Edgar Hope-Simpson. Hope-Simpson spent his later years studying influenza. He was convinced that a link existed between the seasonal outbreaks of influenza and the seasonal variations in ultraviolet light levels. He just didn't know what the link was.
Influenza all but disappears during the summer months when ultraviolet exposure is at its maximum. If we were trying to explain this using germ theory, we would conclude that the ultraviolet light weakened the virus, making it less virulent. Indeed, as Cannell points out, people exposed to the flu virus during the summer are less likely to fall ill. People injected with attenuated flu virus in the winter are 8 times more likely to develop a fever than if the experiment is conducted in the summer.
It's not the germ that is stronger in the winter but the immune system which is weaker. Vitamin D, we now understand, is essential for the immune system to fight infection. When D status is low, people are more susceptible to infection. Ultraviolet light triggers vitamin D production in the skin. During the winter months when ultraviolet light levels decline, vitamin D production decreases to the degree that a high percentage of the population will at least temporarily become deficient. Those at highest risk for deficiency, the elderly, the obese and those with dark skin are all at higher risk for viral infection. Black children develop pneumonia twice as often as white children. Deficiency makes them more susceptible to infection.
There's an interesting story behind how Cannell came to write this paper. The man has always been a bit of a troublemaker. Born with a heightened sense of moral outrage, his career has been marked by constant attempts to rectify injustice. He has spent his life justifiably angry about social iniquities and campaigning for social redress.
He was an antiwar activist in the 1960's, helping organize the "March on Washington ", and was there for 1968 Chicago Democratic Convention. He practiced medicine among the coal mines of Appalachia and fought for miners with black lung to get fair disability payment. In the 1980's he took on the nation's school boards who were using a bogus standardized test that all but guaranteed that all the districts were “above average.” He became a psychiatrist and took on the lost memory recovery movement.
Cannell moved to Atascadero , California in the late 1990's and has worked there since as a psychiatrist at Atascadero State Hospital , the largest hospital for the criminally insane in America . While there, he became fascinated with vitamin D and soon had all the patients on his ward taking large daily doses.
In April 2005, a flu epidemic broke out at Atascadero . The illness spread through the hospital, but none of Cannell's patients became ill. This convinced Cannell that vitamin D protected his patients. He contacted the most prominent vitamin D researchers and with their assistance produced this current paper, published in the same journal that published Hope-Simpson's earlier work on influenza and ultraviolet light.
How much D.
Cannell is currently suggests daily winter doses of 5,000 IU per day to prevent flu. At the first onset of symptoms, he is advocating much higher doses in what Europeans have called Stoss Therapy. By high doses, he means 2,000 IU per kilogram body weight for three days. This is very different from the 400 IU per day I learned in school.
If this hypothesis holds up over time, we could be in for some interesting changes. In a 1990 Russian study, athletes treated with ultraviolet radiation twice a year for three years. Compared to a matched control group, the treated athletes recovered faster from infection, had higher levels of salivary immunoglobulin, but most importantly developed half the number of respiratory infections. I find myself viewing these numbers and thinking in terms of germ theory. Would lowering flu cases by half, lower germ transmission and take the momentum out of an epidemic so it doesn't spread? Could we add flu to that list of things like typewriters, record players and dial phones, that were once a big part of life, but which are now only vague memories?
Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, Garland CF, Giovannucci E. Epidemic influenza and vitamin D.
Epidemiol Infect. 2006 Dec;134(6):1129-40.
Epub 2006 Sep 7.
PMID: 16959053 [PubMed - in process]