Vitamin D: Research at MUSC

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Vitamin D: Research at MUSC




Guest:  Dr. Carol Wagner - Pediatrics

Host:  Dr. Linda Austin – Psychiatry


Dr. Linda Austin:  I’m Dr. Linda Austin.  I’m talking, today, with Dr. Carol Wagner who is Professor of Pediatrics at the Medial University of South Carolina.  Dr. Wagner, you’re engaged in some very interesting research in the area of vitamin D and babies’ nutrition.  Tell us about the clinical trials that you have ongoing in that area.


Dr. Carol Wagner:  Sure.  I work with Dr. Bruce Hollis who’s a renowned vitamin D scientist.  And, about, now, eight years ago, we had discussions about the needs of vitamin D in pregnant and lactating women, and we began those studies here.  It is a very exciting area of research.  And, in the last four years, we’ve seen, truly, an explosion in the number of studies that have been performed throughout the world.  We are on the forefront of this research.  We are conducting a total of three studies specifically with vitamin D, two involving pregnant women and one involving lactating women. 


We’re very excited to have these studies.  Two are sponsored by the National Institutes of Health (NIH) and one from the Thrasher Research Fund (TRF).  It allows us to determine what the vitamin D requirements are of pregnant women and lactating women.  The premise is that the prenatal vitamin that’s given to pregnant women is not enough.  And, in fact, what we find is, baseline levels of vitamin D, women who’ve been on prenatal vitamins and their entry into the study at 12 weeks gestation, so that’s the first trimester of pregnancy, the vast majority of them, particularly if they’re African-American, are vitamin D insufficient.  And, at least 60 percent of African-American women in our study are vitamin D deficient.  That’s a significant number. 


Even in lighter pigmented individuals, we find a significant number who are vitamin D insufficient or deficient.  That means their fetus is developing in an environment of vitamin D deficiency, and we’re just beginning to find out what the long-term health implications are of that.  We know that vitamin D deficiency is linked with many diseases that occur later on in adulthood.  That’s probably why it’s taken decades of research to identify vitamin D as the culprit.


Dr. Linda Austin:  What are those diseases that it may be linked to?


Dr. Carol Wagner:  It’s associated through the innate immune system, which is a very important part of our immune system, with cancer, such as breast cancer, colon cancer, prostate cancer, inflammatory diseases like coronary artery disease.  There was a study that just came out two weeks ago that showed people who are vitamin D deficient have an independent risk factor for heart disease.  We also know that it’s linked with autoimmune diseases, such as lupus, rheumatoid arthritis, multiple sclerosis.  That doesn’t mean that if you have a good level of vitamin D you won’t get these diseases, but we’re talking about risks of these diseases. 


For our study that’s involving breastfeeding women and their infant, it’s been long known that milk from women from various parts of the United States have lower levels of vitamin D.  No one ever asked why that was.  And, in fact, if a woman is vitamin D deficient, her milk is going to be deficient and, therefore, her baby is deficient.  Women who are of darker pigmentation are at higher risk of that deficiency.  So, what we see is, those babies, who are breastfed, are at higher risk for rickets.  But, rickets, as Dr. Michael Holick at Boston University says, is the tip of the vitamin D iceberg, and it really is. 


So, our study here, we’re studying lactating women and supplementing them with higher doses of vitamin D; their babies are not supplemented.  We’re blinded to that, so we have, of course, a control group.  We have done pilot studies and shown very exciting results.  In women who are replete in vitamin D, their milk shows excellent levels of vitamin D and, therefore, their babies have levels that are equivalent to those who actually got the supplement.  And we’re now doing a much larger trial that’s taking place here and at the University of Rochester, in Rochester, NY.  We will enroll 389 mothers and their babies over the next, we’ve been doing it for a year, four years, and we expect exciting results.


Dr. Linda Austin:  I can’t resist asking this question.  As a psychiatrist, are there any conjectures about vitamin D deficiency and behavioral problems?  I’m just thinking, behavioral problems and attention deficit disorder (ADD) are so common, such common disorders, you just wonder what might be behind that.


Dr. Carol Wagner:  I think that there are genetic studies that they’re doing in Europe, looking for schizophrenia for the same family linkages, where they’ve had those family members who’ve been in the Caribbean versus those who’ve been in the United Kingdom, and seen some hints of that.  There has been some literature to suggest that autism is linked with vitamin D deficiency.  And seasonal affective disorder (SAD), of course, the light box, which was created in Rochester, NY, looks at it.  Those individuals have a much higher risk of vitamin D deficiency.  If you look at multiple sclerosis, which is a CNS disease, central nervous system disease, those individuals are at risk, geographically, who’ve been in the northern latitudes of North America. 


I think that we’re just beginning to understand vitamin D and I expect that, within the next five years, we’re going to have some startling results about that.  And I think that it’s going to take psychiatrists and psychologists and people who are studying brain function to really look at it carefully.  I can tell you that vitamin D insufficiency and deficiency is not going to help your brain because there are receptors in the brain.  We look at, in rat models, for example, the relevance of the rat to the human.  What we see is that there are morphologic changes.  If the rat mother is deficient in vitamin D, we can see changes in the rat and in the behavior of the offspring, in terms of locomotion and being able to go through a maze.  How that extrapolates, how that extends to the human, is unknown.  But I expect that we’re going to see some really startling results.


Dr. Linda Austin:  Dr. Wagner, thanks so much for talking with us today.


Dr. Carol Wagner:  Thank you.


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