Conference Abstracts are in a combination of German and English in PDF file attached at bottom of this page

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The German Foundation for Health Information and Prevention (dsgip) was founded in 2009 as a charitable institution. Their name is their program. In the first step, it collects and sifts the latest research in medicine, natural sciences and the adjacent area in the sociological.

In the second step, the quintessence of the results will be made ??available to the public (internet, print media, lectures). In the third step from the synopsis of the data compiled for a viable prevention initiatives and implemented in conjunction with professional providers of preventive services.

For more details, see the description of the various initiatives and projects on the Internet: www.dsgip.de.

Foundation serves as the operational base of the Institute for Medical Information and Prevention: Institute for Medical Information and Prevention Professor Jörg Spitz Krauskopf Allee 27, Wiesbaden 56 388 T: 0612/95 02 99 86, F: 0612/95 02 99 85 E-Mail : info at mim-spitz.de; www.mip-spitz.de

German Foundation for Health Information and Prevention

Distinguished guests, ladies and gentlemen,

Welcome to the vitamin D-Update 2011th We have managed to put together with contributions from 20 renowned national and international speakers a high current overview of the importance of vitamin D in the extra-osseous area.

The subject matter ranges from the realization that vitamin D is actually a hormone produced by the detection of vitamin D receptors in almost all cells and the unexpectedly widespread shortage to the diverse effects on virtually all chronic diseases such as heart and circulatory problems , cancer, diabetes, multiple sclerosis and depression as well as modulation of the innate and acquired immune systems.

These findings were quite a few years by different research groups independently developed and published worldwide. The lack of comprehensive presentation of research results was planned to rise over the past year, this conference. They do sometimes incomplete and inaccurate statements about vitamin D, even by professional societies in the last few months, as this conference is right and important.

Thus the extensive material can be conveyed in a single day really well, it requires not only the commitment of the speakers but great discipline among all participants. We ask you to understand when the time is not enough for the presentations to answer all outstanding questions from the audience can.

In order to remedy this situation, is provided as soon as possible after the conference a scientific booklet with the same title and the contributions of all speakers to issue, in which the details can be found.

So vitamin D is not perceived as a new insulated silver bullet for prevention, to the lunchtime symposium show up in a great arc of the diet on the movement toward the singing, qualities which have been advanced prevention concepts. The point of "healthy eating" we will also practice together as we celebrate all the breaks in a little "LOGI Festival".

In this sense, we wish you all an interesting and successful day!

Berlin, 09 April 2011 Prof. Dr. Jörg Reichrath Prof. Dr. Jörg Spitz

1 The physiology of vitamin D

Bodo Lehmann, former University Hospital of Dresden Technical University, Department of Dermatology, Dresden

The endocrine vitamin D system not only regulates calcium homeostasis and bone mineral metabolism, but its hormonal effects extend to a variety of cells. Vitamin D is a prohormone, which is mostly produced by a photochemical reaction in the skin. About the food is relatively little vitamin D was added.

For the endogenous activation of vitamin D to hormone 1a25-dihydroxyvitamin D, two enzymatic hydroxylation in the liver (CYP2R1 and CYP27A1) and kidney (CYP27B1) is required. Normally, the final product consists almost entirely of renal 1a25-dihydroxyvitamin D3 (calcitriol) and only slightly from 1a25-dihydroxyvitamin D2. The hormonally active form of vitamin D (1a25 (OH) 2D) reach the blood circulation of their target organs, where they are genomically and / or non-genomic effect.

For the genomic effect of the nuclear vitamin D receptor (VDR) is an essential prerequisite. More than 36 species are VDR-positive cells. Recently it was recognized that the VDR in the absence of vitamin D-hormone on signal transduction and gene regulation is an autonomous capable. The expression of vitamin D 1a-hydroxylase (CYP27B1) in cells of prostate, breast, colon, immune cells, B cells and other tissues capable of this, hepatic formed 25-hydroxyvitamin D (25 (OH) D) in 1a, 25 ( OH) 2D transform. Epidermal keratinocytes can even vitamin D3 to 1a, 25 (OH) 2D3 metabolisers.

By intra-, auto-or paracrine effects of calcitriol in extrarenal cells mainly regulated growth and Differenzierungsprozessse, but also other cell functions, which are responsible for cell homeostasis and thus for the health significance.

2 Epidemiological evidence for health benefits from ultraviolet-B irradiance and vitamin D

William B. Grant, Sunlight, Nutrition, and Health Research Center (SUNARC), San Francisco, USA

The epidemiological evidence for a role of solar ultraviolet B (UVB) and vitamin D to maintain optimal health-ing and reducing the risk of many types of disease has expanded greatly in the past decade. The epidemiological approaches used are ecological (based on geographical or seasonal variations in disease outcome), observational (case-control and nested case-control), cross-sectional studies, and randomized controlled trials.

Each approach has strengths and weaknesses. There are about 100 types of disease Which for low serum 25-hydroxyvitamin D 25 (OH) D levels are a risk factor or consequence of the disease. The major types of diseases For Which strong evidence for beneficial effects include autoimmune diseases, bone diseases, cancers, cardiovascular disease, infectious (bacterial and viral) diseases, and neurological or brain diseases.

Preliminary serum 25 (OH) D level-disease outcome relationships exist for enough of the major types of disease that the effect of increasing population mean serum 25 (OH) D level from 60-70 nmol / l to 105 nmol / l on mortality rates and the economic burden of disease can be estimated for various countries and regions. Five papers have been published on this topic for European and North American countries with the general finding that the mortality rate can be reduced by 15-20% and the economic burden of disease by 10% or more.

It takes on extra GeneRally 2000-5000 IU / day of vitamin D3 from supplements and / or natural or artificial UVB irradiance to increase serum 25 (OH) D levels to 105 nmol / l. Testing of serum 25 (OH) D levels is recommended for adjusting serum levels as there is Considerable individual variability in serum vitamin D dose level.

3 The role of vitamin D in pulmonary diseases

Robert Bals, Internal Medicine V, University Hospital of Saarland, Homburg

The importance of vitamin D (VitD) on bone metabolism is well established. In recent years, it was recognized that additional VitD modulates a number of processes and regulatory systems, which include resistance to infection, inflammation, immune and repair processes. Patients with lung disease often have low levels of VitD.

Epidemiological data suggest that this situation is associated with impaired lung function, increased frequency of infection, increased over-reaction in the airways, infections and neoplastic diseases. Various lung diseases, all the inflammatory nature, may be associated with the effect of VitD together. These include asthma, COPD and cancer.

VitD is one of the factors that regulate the immune response of macrophages and epithelial cells. Decreased levels cause an increased susceptibility to tuberculosis and other respiratory diseases. Clinical studies have shown that the addition of VitD at least leads to a partial protection against these infections.

The exact mechanisms underlying the underlying are not yet known. VitD seems to have an influence on the function of various cell formations have, including lymphocytes, monocytes, and dendritic and epithelial cells. The current state of knowledge it is not allowed, VitD routinely use for the prevention or treatment of lung diseases. However, there are already several pre-clinical and clinical studies support this approach.

4 Effect of vitamin D in cardiovascular disease, diabetes and metabolic syndrome

Armin Zittermann, Heart and Diabetes Center NRW, Bad Oeynhausen

The active form of vitamin D, which unfolds 1,25 (OH) 2D, including its effects on the cardiovascular system: influence of Gefäßkalzifizierungen, cardiovascular risk markers such as pro-and anti-inflammatory cytokines and blood lipids as well as on components of blood pressure regulation. The presentation of scientific evidence for protective effects of vitamin D on various cardiovascular risk factors is presented.

It was found, a meta-analysis of randomized controlled trials that vitamin D in hypertension leads to a reduction in blood pressure. Such randomized, controlled trials are currently lacking in relation to the primary endpoint cardiovascular morbidity and mortality. Large prospective cohort studies suggest, however, that the multivariate-adjusted cardiovascular mortality is increased especially when the blood levels of 25-hydroxyvitamin D (25 OH D) below 25 nmol / l (10 ng / ml) lie.

Such low levels are measured both in the general population or in different patient populations are not uncommon. As part of the metabolic syndrome should be noted that an elevated body mass index a risk factor for low 25 (OH) D-Spie-gel, and run low 25 (OH) D levels in turn lead to increased triglyceride levels.

Both experimental data and studies in humans suggest that optimization reduces to suffer vitamin D intake, the risk of Type I diabetes. In impaired glucose tolerance in adulthood improved optimal vitamin D intake in previously deficient 25 (OH) D levels of insulin sensitivity.

5 Effect of vitamin D on muscle and fitness

Harald Dobnig, Institute Univ. Prof. Dr. H. Dobnig and Medical University of Graz, Division of Endocrinology and Metabolism, Graz

Vitamin D deficiency results in older people demonstrated in impaired muscular function and it is likely that at levels of from about 15 ng / ml increased the percentage of those who benefit in this regard by a vitamin D supplementation. Whether there are (significantly) higher values ??also have an advantage, studies must show first.

Largely it is unclear what causes vitamin D deficiency in our youth and how adequate vitamin D supplementation during childhood and adolescence in terms of sustainable development of optimal musculoskeletal apparatus necessary.

It appears definitely to develop essential strategies that have an implementation of the new from the "Institute of Medicine" formulated daily vitamin D requirements for children and adults to the goal. One can assume that (with the exception of certain high risk groups) with the are recommended if average daily vitamin D intake of 600 IU vitamin D3/Tag (1st-70th year) and 800 IU for people 70 +, good conditions for an optimal functioning of our muscular system.

6 Vitamin D and kidney

Rolf Dieter Krause, KFH Kidney Center Berlin-Moabit and Department of Clinical Natural Medicine Charite, Berlin

The kidney is the organ in which the hormonally active metabolite calcitriol, vitamin D, 1,25-Dihydroxyvi is formed. A normal kidney function is therefore a prerequisite for the homeostasis of calcitriol from calcidiol and well (25-hydroxyvitamin D). In the course of chronic kidney disease (CKD) of calcidiol status by the decrease in GFR and the consequent loss of megalin is reduced. This is then offset by adequate substitution with Ergo (D2) or cholecalciferol (D3).

In CKD "supraphysiological" blood levels of calcidiol is needed - is recommended in the current KDIGO guidelines, fix a vitamin D deficiency as well as in the general population,. It is also made ??to an orientation to the parathyroid hormone levels are also currently available reports. a positive influence on the survival of dialysis patients when they received active vitamin D supplements.

For Germany, we were able to demonstrate on a representative cohort of patients with ESRD that there is more than 80% of these patients sometimes severe vitamin D deficiency, although in the past 15 years, the median of 9 ng / ml to 26 ng / risen ml. The mortality was 25 (OH) D blood levels <20 ng / ml increased by 1.5-to twofold, with a peak in the winter months.

In addition, positive correlations were found for the initiation of dialysis between vitamin D deficiency and the underlying cause of today's leading incident diabetes mellitus and hypertension. This could be a normal vitamin D status a prevention to delay ESRD.

7 Effect of vitamin D on nerve and brain

Dirk Lemke, Median Clinic Berlin-Kladow (specialist clinic for neurological and orthopedic rehabilitation), Berlin

For many decades, the limited knowledge about vitamin D to its active classical areas such as bone calcium balance and equilibrium. New research findings point to a much broader spectrum of action of vitamin D or its active form, calcitriol. Among the so-called "nichtkalzämischen" functions are also found within some of our most complex organ: the brain.

With the discovery of the vitamin D receptor in neurons or glial cells in key regions such as the prefrontal cortex, the cerebellum, thalamus and hippocampus and the detection of enzymes within the brain, which the CNS are the local synthesis of calcitriol enable the physiological Pre-requirements for a Influence of vitamin D on our central nervous system demonstrated.

Neuroprotective or immunomodulatory effects and regulatory effects on type differentiation, proliferation and apoptotic activity of cells within the central and peripheral nervous system are now recognized as much as possible. But what role these effects play in diseases of the human brain? What is the role of vitamin D in the pathology of major neurological / psychiatric disorders?

To answer this question is shown on the basis of epidemiological and experimental data suggest that vitamin D could in the prevention of diseases such as multiple sclerosis, depression, dementia, Parkinson's disease or stroke, play a key role. Furthermore, there is substantial evidence justifying the therapeutic use of at least among disease-associated complications and allow for further future clinical trials appear to be useful therapeutic options.

8 Vitamin D during Pregnancy and Lactation Requirement

Bruce W. Hollis, Medical University of South Carolina, Department of Pediatrics, Charleston, USA

The current IOM recommended dietary requirement for vitamin D intake (600 IU / d) during pregnancy and lactation is based on little, if any, scientific evidence, and as a result is Clini-cally irrelevant with respect to nutritional vitamin D status during Maintaining these ing demand humane conditions.

The latest IOM recommendations are based on the premise of ridiculously low levels of circulating 25 (OH) D and as a result a minimal dietary intake of vitamin D is required to attain this low circulating 25 (OH) D level.

We believe this requirement to be an absurd method by Which to define the dietary vitamin D. Current research has shown the actual dietary requirement during pregnancy and lactation to be as high as 6.000 IU / d. These intake levels likely will contribute to improving pregnancy outcomes such as decreased incidence of preeclampsia and complications of pregnancy.

Current data on the new recommendation Which should have been based will be presented.

9 Higher intake of vitamin D needed to reduce Cancer Risk

Carole A. Baggerly, Grassroots Health Organization, Encinitas, United States

Studies Indicate that intake of vitamin D in the range from 1.100 to 4.000 IU / d and a serum 25-hydroxyvitamin D concentration 25 (OH) D from 60-80 ng / ml may be needed to reduce cancer risk.

Few community-based studies allow estimation of the dose-response relationship between oral intake of vitamin D and corresponding serum 25 (OH) D in the range above 1.000 IU / d.

Materials and Methods: A descriptive study of serum 25 (OH) D concentration and self-reported vitamin D intake in a community-based cohort (n = 3.667 mean, age 51.3ffl13.4 y).

Results: Serum 25 (OH) D rose as a function of self-reported vitamin D supplement ingestion in a curvilinear fashion, with no intakes of 10,000 IU / d or lower producing 25 (OH) D values ??above the lower-bound of the zone of potential toxicity (200 ng / ml). Unsupplemented all-source in-put was estimated at 3.300 IU / d.

The supplemental dose Ensuring that 97.5% of this population Achieved a serum 25 (OH) D of at least 40 ng / ml was 9.600 IU / d. Conclusion: Universal intake of up to 4,000 IU vitamin D per day is unlikely to result in vitamin D toxicity.

10 Extent of the shortage -Why you can not eat this vitamin

Nicolai Worm, German Institute for Prevention and Health Management, Saarbrücken

About 5% of the vitamin D come from the food store, the rest of the body's own synthesis. The German Society for Nutrition (DGE) recommends a daily intake of 200 IU of vitamin D for adults and 400 IU for children and seniors. The richest source of vitamin D is fatty fish. In 100 grams of tuna contains about 200 IU. A comparable supply could be achieved with 1.5 kg of cream yogurt, 4 liters of milk or 2 kg of liver. On average, in Germany recorded only about 100 IU per day for food and 82% of German men and 91% of women did not reach the recommendation of the DGE.

100 IU taken orally to increase the blood levels but only at 1ng/ml. Thus, adults should take 2,000 IU daily to a blood level of 20 ng / ml or 3000 IU to achieve a suffiency value of> 30 ng / ml. As in Germany in the winter months but the need for vitamin D synthesis UVB radiation intensity is not dominant, the supply situation particularly critical. And it is exacerbated when weather conditions or even prevent lifestyle during the summer months a sufficient UVB irradiation.

The results: 57% of men and 58% of women reach an annual average does not raise blood levels of 20 ng / ml. During the winter months there are almost 70% in children and adolescents and even about 80%.

To what extent food fortification and supplements can correct the lack of supply is discussed.

11 Possibilities, limitations and side effects of Sonnensc Conservation-Measures

Jürgen Lademann, Skin Physiology Research Group, Department of Dermatology, Venereology and Allergy, Charité-Universitätsmedizin, Berlin

In the first part of the lecture will be presented new findings that will influence the demands of modern sunscreens in the future much. VIEWING recent studies that produced half of the free radicals that are generated by the sun in the skin, in visible and near infrared region.

While for the UV filter substances are effective range, the radical formation in the visible and infrared ranges can only be a kind of "second Line of defense "in the form are influenced by antioxidants. Currently, there are sunscreens on the market that advertise and even with an infrared protection.

The role that antioxidants play in this and especially the vitamin D is shown in the lecture.

At the boundaries of sunscreen has drawn attention to the restriction that filter-absorbing materials can not be used in the visible range in order not to cause discoloration of the skin.

Regarding the side effects of sunscreens are discussed possible allergic reactions.

12 What else can the sun: Photobiology and Prevention

Alexander Wunsch, Medical Light Consulting, Heidelberg

The human skin is a masterpiece of evolution. The adequate response of the whole organism to environmental stimuli is probably the most important life-sustaining role of autonomic nervous and endocrine systems. With both systems, the skin is a boundary organ closely. Nervous system and skin are common descendants of the outer germ layer, and the relations between the two are intimately and particularly with regard to their nerve supply to the skin takes on the organs of the body a privileged position.

Sunlight is a key stimulus to the skin, but not individual spectral regions are targeted, but characterized the optical radiation in their entirety, but depending on geographical and seasonal variation shear, responsible for the large number of specific adaptive responses. Light reactions take place locally in the skin and systemically throughout the body from where the eye-brain system between acts as a mediator and coordinator.

It is useful to consider the role of vitamin D in the context of autonomic and endocrine regulation processes. It is for both systems to regulatory networks, impress in the ideal case (with = health) by the rhythmic interplay of antagonistic effect sizes.

By incorporating chronobiological aspects broadened the understanding of the role of vitamin D and the importance of a proper circadian and seasonal timing of pharmacological measures such as physical substitution is clear.

13 Effect of vitamin D in cancer

Stefan Pilz, Medical University Hospital, Department of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria

There is increasing evidence that vitamin D plays a role in carcinogenesis and prognosis of cancer patients. 70 years ago for the first time an inverse association between sun exposure and cancer mortality was found. Meanwhile, there is an established knowledge that exposure to ultraviolet-B radiation from the sun is inversely associated with various cancers.

Epidemiological studies showed that low serum levels of 25-hydroxyvitamin D with an increased risk of cancer incidence and cancer mortality are linked. This seems to be a causal relationship, given that vitamin D metabolites have various anti-carcinogenic effects: inhibition of tumor cell proliferation and angiogenesis-mediated tumor growth, induction of cell differentiation and apoptosis, and anti-inflammatory effects.

Intervention studies on the effects of vitamin D supplementation on cancer incidence and cancer mortality, however, are scarce and inconsistent, but a randomized controlled trial in postmenopausal women has been shown that vitamin D supplementation is associated with a significantly reduced incidence of cancer.

However, whether vitamin D supplementation really effective for the prevention and treatment of cancer remains to be further evaluated in large-scale studies, but the promising data location of vitamin D on cancer and various aspects of health underpins the usefulness of prevention and treatment of vitamin D deficiency.

14 The skin as endocrine organ -How much sun do we need?

Jörg Reichrath, Department of Dermatology, Venereology and Allergology, University Hospital of Saarland, Homburg / Saar

Numerous studies show that the less intense, chronic exposure to sunlight (as opposed to short-term intense exposure to sunlight) no risk factor for the development of malignant melanoma is. Excessive UV exposure is a major risk factor for the development of epithelial skin cancer (basal cell carcinoma, squamous cell carcinoma of the skin).

Therefore, measures to provide sun protection is an important component of many programs for the prevention of skin cancer dar. However, we now know that insufficient UV exposure of skin to serious health risks associated with it. It needs to be about 90% of the human body needs vitamin D in the skin under UV-B exposure formed - a serious problem because a vitamin D deficiency, contrary to the earlier view not only for the calcium and bone metabolism of importance .

Besides numerous other positive effects (eg on the muscles and cardiovascular system, protective effect against autoimmune diseases, increase resistance to infection) of the ku-tans vitamin D synthesis is now being attributed to a krebsprotektive effect.

In this paper, the tension between positive and negative effects of UV radiation is discussed in light of new research results. Summarized can be expected that the present scientific knowledge of it that outweigh a moderate, not intense sunlight, the protective against the mutagenic effects.

15 D-Lightful Sunlight for Health

MF Holick, University Medical Center, Boston, USA

Vitamin D is the sunshine vitamin. During exposure to sunlight 7-dehydrocholesterol Absorbs ultraviolet B radiation resulting in the cutaneous production of previtamin D3. Once formed previtamin D3 undergoes an internal isomerization resulting in the production of vitamin D3.

During prolonged exposure to sunlight pre-vitamin D3 and vitamin D3 absorb UVB radiation resulting in their conversion to a variety of biologically inert (on calcium metabolism) for products. A variety of factors markedly influence the production of vitamin D in the skin including skin pigmentation, sunscreen use, time of day, season of the year, latitude and aging.

Once formed vitamin D undergoes sequential hydroxylations in the liver and kidneys (and other organs) to form 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] respectively. 1,25(OH)2D plays an important role in maintaining calcium homeostasis and max-imizing bone health.

There is mounting evidence that increasing blood levels of 25(OH)D reduces risk of many chronic illnesses including autoimmune diseases, cancer, heart disease and type II diabetes. There is also evidence for reducing risk of infectious diseases, preeclampsia and requiring a primary Cesarean section. Improving vitamin D status has also been associated with improve-ment in neurocognitive function and in muscle strength.

Serum 25(OH)D> 30 ng/ml can be achieved in most children by ingesting 1000 IU of vitamin D a day and for teenagers and adults 2000 IU of vitamin D a day.

16 Correction of vitamin D deficiency through supplementation

Reinhold. Vieth, University of Toronto, Canada

The terminology about how to define vitamin D adequacy differs, depending on who is defin-ing it. Among the most conservative estimates is the Institutes of Medicine (IOM), which re-cently tripled the recommended dietary allowance for vitamin D for Americans. They advise an average daily intake of 15 mcg for adults up to age 70 years, and for older adults, 20 mcg (800 IU).

These doses are for the bone-health-protecting 25(OH)D minimum of 50 nmol/l (20 ng/ml). If the serum 25(OH)D level is known, a useful estimate of the requirement toward a target blood level is that for every additional 1 mcg/day (40 IU) of vitamin D3, the serum 25(OH)D will go up by 1 nmol/l — after 8 months of use. (Equivalent to 100 IU/day increases 25(OH)D by 1 ng/ml).

There is no difference whether the same total dose is given at daily, weekly, or monthly dose intervals. "Non-calcemic" doses are considered "safe" by conventional criteria, and for vitamin D, the IOM concludes a safe long-term intake can be up to 100 mcg/day . To be sure that everyone in a group of sun-deprived adults has 25(OH)D levels higher than 75 nmol/l will require an average daily vitamin D3 intake of 100 mcg/day.

17 Vitamin D as a drug

Uwe Grober, Academy of micronutrient medicine, food
Many drugs interfere with vitamin D levels. A drug-induced vitamin D deficiency may manifest as sec. Hyperparathyroidism, impaired bone mineralization up to express osteoporosis (eg antiepileptikainduzierte osteopathy). The medi-cation-oriented use of vitamin D not only reduces the risk of adverse drug reactions, but also extends the metabolic and pharmacological activity profile of a drug.
Examples: Vitamin D improves the lipidmodulierende effect of statins reduced the risk of statin-induced myalgia, optimizes the osseous effects of bisphosphonates and reduce musculoskeletal pain and the risk of hypo bisphosphonatinduzierten calcämie. Drug-induced disorders of vitamin D budget should be given more attention in practice.
The offer of adequate vitamin D supplements is limited in Germany. In a daily dose> 1000 I.E. 400-1000 or I.E. subject of vitamin D supplements or prescription pharmacies. Cause among other things, the restrictive attitude of leading professional societies (eg, DGE, BfR), ignore what the current scientific evidence.
The DACH-reference values ??for adults are considered with 200-400 IU / d as well as in the U.S. recently published recommendations of the IOM with 600-800 IU / d not extraos sar-effects of vitamin D.

18 Vitamin D deficiency and sec. Hyperparathyroidism in the Ruhr: rule and not the exception

Jörg Mahlstedt, practice f. Nuclear Medicine / Association of German nuclear medicine, food
Preliminary results (download at www.profmahlstedt.de / vitamin D) were carried out over three years to study the seasonal dependence of 6500 Pat thyroid practice and reflecting on age, sex, body weight and family origin (Locals = residents or immigrants = immigrants) with the results:
25 (OH)-vitamin D (Diasorin-Liaison): median of 34.6 pts nmol / l (normal 75-150), within the normal range 10% of the residents and 6% of the immigrants.
35% of all thyroid patient practice, VD-values ??<25 nmol / l, at the beginning of even 50%. The low values ??relate mainly to immigrants who are overweight and the elderly. The so-called "headscarf women" find themselves liable regular values ??below the lower limit of the As-says <10 nmol / l. The minimal increase in summer / winter from 26.4 to 41.2 at age> 61 years and at a maximum of 21, 9 to 54.0 at age <45 years <66 kg.
PTH (Diasorin-Laison): median of 62.9 pts pg / l (normal 10-65), in the normal range 55% of residents and 52% of immigrants
The waste summer / winter average maximum of 68.7 to 56.5 for women and minimally from 64.4 to 56.8 for men.
Knowledge of the seasonal variations according to gender, age, weight and family of origin allows the assessment of individual values ??regarding the independent assessment of seasonal shortage.
This established the concept of latent hypothyroidism in Thyreologie elevated TSH Spie-gel can be similarly applied to the function of the parathyroid gland. This means that more than half of the patient to vitamin D deficiency, sec. Hyperparathyroidism leads with consecutive substitution requirement.

19 The impact of approximately 300,000 IU of vitamin D3 on the symptoms of vegetative dystonia

Raymond of heroes, Institut.VitaminDelta.de, Lennestadt background:
Vegetative symptoms such as fatigue and circulatory problems are widespread. In view of the equally widespread lack of vitamin D raises the question whether the administration of vitamin D is beneficial.
Patients:
137 patients aged 13-87 had a 25-OH vitamin D levels below 30 ng / ml and therefore received vitamin D3.
Method:
With a formula for increasing the dose of vitamin D levels was determined. This VITAMIN D-SETUP therapy (VDS) took into account the individual vitamin D levels and body weight and was fractionated in daily doses of 100,000 IU. Then a weekly maintenance dose was given at least 20,000 units. Patients were asked to document their observations on a questionnaire at 25 symptoms. In addition, the individual overall impression was requested on a scale of 0 to 5 stars.
Results:
Even within 7 days after the VDS resulted in 75.5% of patients positive reviews and high ratings with 5 or 4 stars at 39.6%. In the subsequent period of up to 90 days resulted in 80.6% positive reviews and high ratings with 5 or 4 stars at 45.6%.
Conclusions:
This observational study showed that many complaints can be better in outpatient medicine with the vitamin D-up within 7 days. Given the high prevalence of vitamin D deficiency and the vegetative dystonia may be a high practical value of the VITAMIN-D-SETUP are expected.

20 Substitution of vitamin D in patients with asthma and COPD

Hermann Teutemacher, Aeroprax, location Heart Center, Wuppertal
Background: The number and severity of Infektexazerbationen play in patients with asthma and COPD on quality of life, the need for medication and the prognosis of a crucial role. The initial experience with this group of patients with a systematic substitution of vitamin D are presented.
Procedure: From a cohort of approximately 1,700 patients from three outpatient clinics pneumology (except the speakers nor A. Deimling, Schleswig, and H. Trötschler, Freiburg) was at 927 patients (including 600 pts with obstructive airway disease) of 25-OH Vitamin D levels determined. Then, a substitution after the set-up scheme by Dr. of heroes and was continued by. Interviews during the course of normal controls (every 3-12 months).
Results:
1) The initial values ??for 25-OH vitamin D were on average 16.1 ng / ml.
2) The saturation was> 90% of the patients easily tolerated. Most common side effects were transient muscle cramps. Discontinuations were rare.
3) The substitution resulted in the majority of these cases (80-90%) of patients experienced an impressive improvement of the infection problem.
4) The study of vitamin D is for doctor and patient is an opportunity for a more prevention-oriented health and way of thinking and working, as they inevitably implemented aspects of evolutionary medicine into everyday practice.
Conclusions: The substitution of vitamin D in patients with asthma or COPD is our experience shows that a highly effective, simple, well tolerated and cost-effective measure to reduce the number and severity of Infektexacerbationen dar.

21 Vitamin D deficiency and oral vitamin D replacement in patients with diseases of the pancreas

Rainer Klapdor, internist, Hamburg
Chronic pancreatitis, pancreatic cancer and surgery on the upper gastrointestinal tract and pancreas, leading many patients to an absolute or even relative excretory pancreatic insufficiency with maldigestion of dietary fat and especially fat-soluble vitamins.
In our own patients was the serum vitamin D in more than 90% of patients <30ng/ml in 30% <10ng/ml and 55% between 10-20ng/ml (p. Klapdor et al. Proc. Germ. Nutr . Soc., 15,
2011, p.99).
In our own studies showed the generally recommended in Administration of ADEK prepara-th (10,000 IU every 14-28 days) had no significant effect. By contrast, it was possible in all patients, the vitamin D levels in serum by oral administration of vitamin D supplements permanently raise over values ??of 30ng/ml, both during the winter and the summer time.
The dose required could be very different (eg, 1000 IU daily, 20,000 IU every 4 weeks, or weekly or every 2-3 days up to 20,000 IU daily). The dose was adapted individually based on the serum vitamin D controls.
Additionally performed in all patients dietary advice and appropriate treatment with pancreatic enzyme supplements.

Speakers:

Baggerly, Carole A.
Director grassroots health, Encinitas, CA 92023-4208, USA E-mail: carole at grassrootshealth.org Bals, Robert, Prof. Dr. Dr. rer. nat.:
Director of the Department of Internal Medicine V-Pulmonology, Allergy, Respiratory Medicine, University Hospital of Saarland, 66421 Homburg / Saar, E-mail: @ robert.bals uks.eu
Blank, Thomas:
Faculty of Sociology, University of Bielefeld, 33501 Bielefeld, E-mail: @ gmail.com thomas.blank
Dobnig, Harald, Prof. Dr. med:
Institute Professor Dobnig GmbH, 8010 Graz, Austria, E-mail: @ harald.dobnig medunigraz.at Grant, William B., PhD:
Sunlight, Nutrition and Health Research Center, (SUNARC), San Francisco, CA, USA, E-mail: wbgrant at infionline.net
Grober, Uwe:
Academy of micronutrient Medicine, 45130 Essen, E-mail: uwegroeber at gmx.net Holick, Michael, PhD, MD:
University Medical Center, Boston, USA, E-mail: lorrie at bu.edu Hollis, Bruce, PhD:
Department of Pediatrics, Medical University, South Carolina, USA, E-mail: hollisb at musc.edu of heroes, Raymond, MD:
GP, 57368 Lennestadt, E-mail: Raimund.vonHelden @ t-online.de
Klapdor, Rainer, Prof. Dr. med:
Internist, 20148 Hamburg
Krause, Rolf Dieter, MD:
KfH Kidney Center, 10559 Berlin, e-mail: @ Rolfdieter.Krause kfh-dialyse.de Lademann Jürgen, Prof. Dr. rer. nat. Dr. Ing:
Department of Dermatology, Venereology and Allergy, Charité-Universitätsmedizin, 10117 Berlin, e-mail: sabine.grenz @ charite.de
Lehmann, Bodo, MD:
Former University Dermatological Clinic, 01307 Dresden, E-mail: Gabo.Lehmann @ t-online.de
Lemke, Dirk:
Median hospital (University Hospital for neurological and orthopedic rehabilitation) 14089 Berlin, e-mail: lemke1000 at googlemail.com
Mahlstedt, Jörg, Prof. Dr. med:
Practice for Nuclear Medicine / Association of German nuclear medicine, 45136 Essen, E-mail: pm at profmahlstedt.de
Pilz, Stefan, Priv. Doz Dr med:
Medical University Hospital, Department of Endocrinology and Metabolism, Medical University, 8010 Graz, Austria, E-mail: @ stefan.pilz medunigraz.at
Reichrath, Jörg, Prof. Dr. med:
Department of Dermatology, Venereology and Allergology, University Hospital of Saarland, 66421 Homburg / Saar, E-mail: @ joerg.reichrath uks.eu
Spitz, Jörg, Prof. Dr. med:
Institute of Medical Information and Prevention, 65388 Schlangenbad / Wiesbaden, E-mail: info at mip-spitz.de
Teutemacher, Hermann, MD:
Aeroprax, Heart Center location, 42117 Wuppertal, email: @ web.de hermann.te Vieth, Reinhold, PhD:
Department of Nutritional Sciences, Laboratory Medicine and Pathobiology, University of Toronto, Toronto, USA, E-mail: rvieth at mtsinai.on.ca
Worm, Nicolai: Prof. Dr. oec. troph.:
German Institute for Prevention and Health Management, 66123 Saarbrücken, E-mail: nicolai.worm @ t-online.de
Request, Alexander, physician:
Medical Light Consulting, 69115 Heidelberg, e-mail: wunschart at googlemail.com Zittermann, Armin, Prof. Dr.:
Heart and Diabetes Center NRW, 32545 Bad Oeynhausen, E-mail: azittermann at hdz-nrw.de