Consultant Physician, medical researcher and author, Dr David Grimes conducted much original research on the essential to life Vitamin D. Buy his inexpensive latest book here. https://yorkbookshop.com/health-and-personal-development/307-vitamin-d-deficiency-and-covid-19-its-central-role-in-a-world-pandemic.html
2 minor corrections – 150nmol/L = 60ng/mL (not 80ng/mL as stated and at 2min 27secs)
57min 11 secs Calcifidiol appears in the BNF here:
https://bnf.nice.org.uk/drugs/calcifediol-monohydrate/
and medicinal form here
https://bnf.nice.org.uk/drugs/calcifediol-monohydrate/medicinal-forms/
Well a warm welcome to this talk and uh we’re delighted today to be invited to the home of uh Dr David Grimes uh so Dr Grimes thank you very much for inviting us and uh thank you for coming back on the it’s a video great pleasure to see
You again John thank you for coming to this house rather than me going to yours it’s a bit of a check up the motorway isn’t it yeah well and and the last video is on about 1.8 million views so I believe so clearly demand for this
Message yeah good now one of the things I wish I had a pound for every time someone had asked me how much vitamin D should I take because we know that vitamin D is essential for immunity that debate is finished we know it’s essential for numerous other aspects of
Health yeah reducing chances of cancer heart disease probably type one diabetes whole range of things that we’ve covered but how much should I take well it yes you’re quite right so many people ask this question it’s a bit like diabetes actually soone has diabetes you say well
How much insulin should I take and the answer is you take enough for you as a person depend on your body size Etc and also you’re wanting to achieve good blood levels of of glucose and hba1c you need as the dose is as much as you need to achieve a good Target you’re
P for a Target and that’s what you need and so that’s the same with vitamin D the question is what what are we trying to do well firstly we’re trying to prevent things like rickets that requires a tiny tiny amount of vitamin D but the other thing is
Immunity which requires a lot more vitamin D quite honestly probably a thousand times more so sometimes recommended we should take 400 units of vitamin D but 400 it might prevent a child from developing rickets but it’s not going to do anything for immunity for that would require at least 10 times as
Much well we’re trying to achieve a good blood level of vitamin D and the blood level we require is between 100 and 150 actually about 150 nanomoles per liter and that that is 150 is 80 nanograms per mil in the older terms that’s the objective and if we look at the experience from
Covid-19 we find out that people who’ve got over 100 nanograms per Mill blood level they don’t can do any harm from Co but the ones with low levels do come to a great deal of harm can get finish up an INT intensive care units or they can
Die but the blood level above a 100 makes us safe from covid and probably from other things as well so when people take vitamin D ideally they should have the blood level checked it’s like with diabetes you get your blood test it’s like with hypertension you get your
Blood pressure measured you’re trying to achieve a Target and that’s what we’re trying to do the amount of vitamin D an individual requires to achieve a Target level of over 100 nanom per liter that um varies from person to person quite honestly but a good starting point is to say
Well what is a unit of vitamin D now a unit of vitamin D is like unit of insulin you both discovered at about the same time 100 years ago it was not possible to weigh them to develop a mass measurement it was only possible to have a biological measurement and the biological
Measurement of vitamin D is that one unit is the daily requirement of a 10 G Mouse So when you say how much do we need let’s start off with the 10 G Mouse one unit now one unit of um perang gr means that for a a
Human with a body weight of 60 kg would require 6,000 units I think I’m slightly more than 60 kg but yeah yeah that’s right absolutely yeah yeah we we we choose 60 kg sort of s vague average but average weight does tend to go up over the
Years so that’s a good starting point anyway we say well 60 6,000 units sounds like a lot people say that’s a big number yes it is a big number but it relates to the 10 G Mouse what we should have perhaps is kilo units and so then
We we rather than 6,000 units we’d have six kilo units which you know like we do with calories yes indeed absolutely so um anyway we don’t do that and so we say okay if 6,000 un sounds about right for 60 kg let’s make it start on 3,000 units
Which is very conservative it is conservative the standing advisory committee on nutrition sack um was advising four 400 units but does admit that 4,000 units is perhaps the maximum that should be taken what evidence for that I don’t know it’s the fear of overdose of Vitamin D which we come back to shortly
But um let’s say we start on 3,000 units a day and then get your blood tested after 6 months say see what it is and if it’s not up to 100 you increase the dose like you do with insulin and diabetes like you do with the treatment of
Hypertension you judge the dose by the response it’s had it’s a titration isn’t it you just it is a titration start off on 3,000 yeah for most people I think it would be fair we probably need I’m sure I need about 8,000 a day personally for
My body weight well I think that’s right so you could argue that someone weighs 120 kg for an excessive your weight might need 12,000 units a day but again it’s a matter of um measuring it with body weight by the way the obese people do not um have good blood levels
Of vitamin D the vitamin D they produce in the skin tends to be soaked into the fat cells of the body and it doesn’t seem to come out again so if you take an obese PE person and a non-obese person exposing both to the same amount of sunlight or UV
Light the obese person will produce perhaps only half the amount of vitamin D in as measured in the blood than the non-obese person so obese people do require more vitamin D and that that’s factual but again it should be managed on the response now ideally with with um with
Immunity we say well what is the best measure of immunity how can we measure immunity well we can’t really we can measure antibodies in the blood but that’s only a small component of immunity there’s no easy measure of immunity in fact the blood level of vitamin D is a reasonable surrogate for
The for measuring immunity because we know if people have high levels of vitamin D in the blood good levels they don’t get infections like flu or covid and if they have low levels of vitamin D they do get a lot of covid flu and also a lot of other diseases as well so
Immunity is best measured actually by vitamin D anyway so we start off and we we we we measure the response and we get there and some how it’s going to be about 6,000 units a day that seems reasonable and it is perfectly safe so it’s quite
Possible that you could give you and me 6,000 units of vitamin D A Day each and for genetic reasons for microbiome reasons for maybe a thousand reasons we don’t understand I don’t understand certainly we could end up with really quite different levels that there’s a difference in response indeed now what I
Find really curious here is that the vitamin D levels that are advised were basically worked out to prevent rickets back in the 1920s yes that’s right and we’ve learned all these new functions and no one’s bothered no no indeed to to update the requirement it just seems absolutely utterly bizarre and I think
When we transpose those that so like um if we have 4,000 units of vitamin D that’s only actually 100 micrograms isn’t it it’s 100 micrograms and and that’s a tenth of a milligram is it yeah 100 micr 100 microG is a tenth of a milligram one one
Microgram is a thousandth of a milligram correct which is a thousandth of a gram so we’re dealing with actually tiny T tiny amounts well it’s now possible to measure the mass of uh vitamin D and one gram sorry one unit weighs 25 billionths of a gram now it’s not very much so what
You find out that when you get capsules of vitamin D no matter what the dose of vitamin D is they all look the same yeah and people can’t get their mind Dr obvious reason actually TI but 99% of the content of Vitamin D capsule is olive
Oil there’s a tiny bit of vitamin D by mass and by volume because it’s a it’s an oil yeah so why can’t we test immunity by doing a differential I’m sure you’ve ordered differential white cell cell counts about 10,000 times yes that’s right but that’s um looking at
The different types of white blood cell yeah that’s right it still doesn’t quite work out could there be a situation where you had the right number of white blood cells the right number of lymphocytes and the right number of neutrophils but because you haven’t got enough vitamin D they could be
Physically present yes but physiologically um suboptimal in their physiological activity that’s the problem it’s it’s the function not the structure the t- cell the T lymphocytes are critical and the T lymphocytes are very dependent on vitamin D for their activation but also very badly damaged in AIDS and AIDS of course leads to
Infections malignances because immunity is suppressed and it gives a very good example actually of how immunity is suppressed when it is suppressed it leads to a lot of a lot of illnesses strange infections malignant in AIDS heart disease in AIDS dementia in AIDS a lot of things came out in AIDS
Which told us the importance of immunity and in particular te- cell function now we’re seeing at the moment that um I was reading just in the newspaper this morning in the guardan this morning that there’s an increase no it wasn’t it was the British medical journal I was
Reading this morning there’s an increase there’s been a 10% increase in osis from 2022 to 2023 and previously uh there’s been an increase in in the past few years suggesting that our immunity is damaged at the moment which is why the tuberculosis is appearing and they also
Read there’s an increase in leprosy as well now tuberculosis is a key to immunity um and that is what happened in AIDS a big increase in tuberculosis with AIDS and that’s my feeling now is that with repeated vaccinations and infections we’ve been depleted in vitamin D because every time we respond
To an immunization the vaccination or to an infection we use up vitamin D because one molecule of vitamin D can only be used once then it’s inactivated irreversibly so I think that the problem at the moment why there’s been a lot of additional illness and there is a lot of
Illness no question about it the um the ambulances aren’t queuing up at the hospitals for no reason at all um it’s because our immunity is damaged and I think we need Vitamin D in a big way at the present time it’s a public health imperative really but it’s
Not happening and there’s a lot of people watching this video feel a bit run down you know a little bit tired you know it’s it’s it’s not spring yet we’re still at the end of winter yeah and you know most people like me uh have had one
Or two viral infections over the course of the winter um those viral infections are going to use up my vitamin D so i’ have much lower levels of vitamin D after a couple of viral infections and it can be really quite low yeah and that can give rise to sort of physical
Symptoms I mean if you are very low on vitamin do how might that make you feel I mean is the tightness the heaviness are they features of it I’m I’m not sure quite honestly I I I wouldn’t say so might be true but I’d really just go for the infections and
The specific diseases rather than how you feel right people say how can I recognize that I’m deficient of vitamin D and the answer is well you you have a blood test you know yeah yeah yeah how do I know what my blood pressure is that’s right you take it absolutely You’
Got to have the test done I think there’s an important point there because a lot of the diseases that are associated with vitamin D by the time you’ve got them it might be a bit tricky to treat them dementia for example yes indeed I mean there’s no question in my
Mind that chronic lack of vitamin D is an eological factor in dementia and potentially other neurological diseases have you got any thoughts about the connection between vitamin D and neurological diseases well I think it’s true to say um the strongest one is multiple sclerosis but that goes back to birth
Because a baby born in the spring would have an increased risk of developing multiple sclerosis in adult life than a baby born in the Autumn now the Autumn birth means the mother was pregnant during the summer and that she was there getting vitamin D to pass on to the baby in the
Uterus and so the baby born in the in the Autumn has a biological advantage in several different ways whereas the baby born in the spring the mother was pregnant um an advance in the last three or four months of pregnancy during the winter time with no vitamin
D now to my mind no baby should be born in this country or anywhere deficient in vitamin D because I think every mother every woman who goes to the antinal clinic should have a blood level of vitamin D check there and then but this isn’t done it’s not done no folic
Acid we well aware of the r yeah that’s right yeah there was this there’s been the sh start project which we had in Blackburn which I was part of and with that we gave mothers expected mothers vitamin D during pregnancy but the sure start project has been cancelled it’s a
Central project it’s been canceled unfortunately by government so that doesn’t happen now but really we should be we should be checking the pregnant women protecting them there’s a lot of evidence of vitamin D deficiency is related to uh eclampsia what do they call it pet nowe preeclamptic toxemia pregnancy the high
Blood pressure the protein your the edema that’s all yeah yeah indeed so a more successful pregnancy requires vitamin D and the baby after it amazing really so we’ve got three things there the health of the mother perhaps optimizing fetal development and making sure the baby’s vitamin D level is
Topped up when it’s when it’s born so as soon as a baby’s born it’s going to be assaulted left right and center from the mure of viruses and bacteria that’s right we hear about rickets yeah in young children that should not happen it particularly occurs in the children of
Black African and South Asian ethnicity because they’re mothers we know very well are going to be deficient of vitamin D people with dark skins do not um produce enough vitamin D in the environment of the UK where we’re living closer to the North Pole than to the
Equator and of course the South Asian ethnic women tend to cover up with clothing it as well rather what might guaranteed isn’t it it is and it’s well known yeah so at least these poor women should um should be checked these these women should be checked the ethnic
Minority women should be targeted in particular but they’re not being I’m afraid to say but even I I’m I’m pretty white as you can see and and last summer I got quite a bit of Sun at the allotment so for about five or six months last summer I didn’t take any of it
And I actually managed to persuade my GP to check the levels yeah at the end of it would be about September the very end of summer and I was pretty confident it would be topped up cuz I had a lot of sun exposure and it was only about 75
Nom moles per liter yeah and um yeah so even me being white spending quite a lot of time in the sun still didn’t have anywhere near Optimum levels of vitamin D I was very disappointed and certainly gone back onto the supplements now I’m sure a lot of people say that well I’m
Out on my bike I’m out on my allotment I have plenty of vitamin D and it turns out the they often just don’t have you know we we’ve got a day today it might it might still be the end of the winter the sun’s still low in the Horizon but
It’s all great Scouts it’s all Cloud yeah you know we’ve got Cloud C we’re not any brilliant Sunshine no and it’s often the same in the summer so my my basic science is a bit challenged is is vitamin D um a vitamin or a hormone it’s a hormone
Without any Shadow of Doubt it’s a hormone that’s produced in the skin we produce an oil in the skin called 7 Hydro cholesterol and um DHC we call it 7 DHC and the sun converts that into Vitamin D which enters our body activated partially in the liver and then
Activated fully in the cell cells it is a hormone the point is that it’s not just humankind that produces Vitamin D from 78c it starts off with Plankton which evolved one and a half billion years ago and they produce 7hc the oil as a sunscreen and it absorbs sunlight energy
It’s converted into Vitamin D but the plank can have no use vitamin D first they don’t have a skeleton so they don’t need it for bone and they have a very primitive immune system which does not require vitamin D but they don’t get sunburned no they don’t get
Sunburned but no no that’s not that’s not a joke that’s that’s true isn’t it it’s true to protect from the Sun that’s one of the two mechanisms of of see Plankton live close to the surface of the sea so they are actually prone to UV damage but the 7 DHC absorbs the UV
Energy to a large extent and vitamin D is the waste product but Plankton also tend to sink during the daytime and rise to the surface during the nighttime it’s called Dial Dial vertical migration it’s called which again protects them now fish don’t produce vitamin D either because they have scales and they live
Deep in the sea but but fish eat plank on it’s a start of the food chain and we eat fish do do fish need Vitamin D for their physiology as well then certainly they yes they will do yeah yeah yeah certainly well the bony fish need it for
The bones but all fish will need it for the immunity of course bone fish have got bones obviously never thought of that no seriously of course so they need Vitamin D absolutely but land animals also produce vitamin D as a hormone in the skin and we eat land
Animals and we we take vitamin D from meat but our Vitamin D supplements come from sheep because sheep produce vitamin D in the skin and when this when the when the when the when the um fleece is taken off in the in the summer when it’s too hot for
Them the oil of the wool contains vitamin D and it’s extracted it when we have Vitamin D supplements it comes from the Sheep’s hormone we call it a vitamin then we’re not taking in a vitamin we’re taking a hormone from the Sheep it’s like if we short of thyroid
If we short of them we have an underactive thyroid we take thyroxin tablets well the thyroxin comes from animals the animals produce a thyroxin and we take the thyroxin from the the thyroid extract from the um animals it’s it’s it’s not as primitive as that these days but nevertheless the principle is
All the same so yes vitamin D is a hormone it’s called a vitamin because we do get it from the diet as well of course that’s how insulin started I mean I remember when when I when I was a young staff nurse giving Bine or porine insulin yeah before the
Before absolutely before before they came along yeah insulin is a hormone and if we don’t produce our own hormone we got it from the animals from the sheep and the pigs yeah and it’s not just the Sheep being kind to humans all wooly animals yeah I think dogs do this as
Well they produce this precursor the Sun hits their their hair yeah and then of course what do they do well they lick it they lick it that’s right they lick they lick themselves and and something and another one yeah that’s right that’s how it gets into the bodies one thing that
Concerns me slightly is that we tend to put sheep through sheep dips with Organo phosphates yeah so do you think the supplements we’re getting contain nasty things like Organo phosphates as well do we know about that I don’t think so I think that the Organo phosphates are
Water soluble well they are sheep dip it’s through water right whereas when the fleece is washed to get the oils out it’s an inorganic it’s an organic solvent I don’t know if it’s something like xylene or in I’m not sure exactly what it is but it comes out in the it is
A fat so it doesn’t come out in the water and of course the vitamin D is is fat soluble which is convenient absolutely yeah yeah there I don’t there’s a danger there at all no so interesting that so all animals are requiring vitamin D it’s ubiquitous and it’s
Just just a sort of philosophical Point really isn’t it amazing that something that algae should we say invented were given created as a sunscreen just happened to be essential for all higher physiology absolutely amazing it really is quite quite quite quite evolution is a difficult thing to understand but coming
Back to the creation of vitamin D difficult stroke impossible yeah that’s right coming back to the vitamin D in our skin yeah it’s okay we produce vitamin D we produce sorry we synthesize 70 hydroch cholesterol 70hc in the skin the sun converts into Vitamin D but the problem is when we get
Old we don’t produce the oil in the skin Oh that could be my problem last summer it could well be yeah it could well be but um or part of it anyway but very old people yeah are always deficient of vitamin D is inevitable because they’ve got dry
Skin the skin is not producing adequate amounts of of 70hc and therefore doesn’t matter how long they sit in the sun they’re not going to have adequate amounts of vitamin D when we give them a supplement they just need a normal supplement a normal dose that’s what it’s going to ask do
Old people obese people people from different races do we all need actually the same amount of physiological available vitamin D elderly people people with pigment Ed skins dark skins all require the same amount of vitamin D as a supplement but obese people require additional they require more but the amount required depends not
On age or skin color it depends on body weight effectively got it and of course it’s fat soluble so if people had a lot of adiposity a lot of fat cells yeah the the vitamin D would simply just diffuse into those cells that’s that’s simple physics isn’t it it is indeed would hide
Away and it’s not there to be used could you just go back to our discussion on units yeah as well now you’ll know that insulin is also given in units mhm and effectively the starting PO is would produce a normal person would produce about one unit an hour okay about 24
Units a day that was the the simple starting point interesting which measured in units now no one has been stupid enough to decide to alter the dose of insulin from units into micrograms it’s about 34 something is it something like that basically not to know is it better not
To know it’s about 34 micrograms of insulin per unit I think something but you can imagine the chaos that would result if someone decided teaching student units of in know that that’s that’s early 20th century measurement we’re now in the 21st century we’re much more scientific we’ll now use micrograms
Of um of of of insulin it would cause chaos and and multiple deaths through overdoses oh yeah indeed yeah overdo absolutely now there’s been no move for that that’s common sense but our sack standing Environ Committee of nutrition expresses vitamin D in micrograms now because they’re clever and modern and scientific that’s exactly
It but also very very stupid I’m afraid to say apart from that yeah yeah yeah now okay so that’s what sack says micrograms the average person has never heard of a microgram no I went along to our local pharmacy the other day and I was getting some vitamin D capsules for
A friend and there was one packet it had on it only micrograms it didn’t say what the units were at all you has about just said micrograms so I went to the girl at the county not the qualified pharmacist and I said to her what does this mean and it had
Mu micam I said what’s that says I don’t know said I’ve never heard of that I said well it means a microgram now people who do not work in the scientific environment do not know what micrograms are there’s no reason why they should milligrams people know of milligram that’s your your tablet you
But you get your tablets I take fleckin out 100 milligrams twice a day e easy to remember everyone’s accustomed to micrograms uh but not sorry every’s accustomed to milligrams to say 100 milligrams twice a day we know about milligrams but micrograms a thousandth of a milligram now if you’re told to take uh
400 micrograms I’m going to get myself lost in take 400 units as we are that would be 10 10 Micro mic that’s right to 100 micrograms to 4,000 units correct but if instead of that you take 100 milligrams you’re taking 4 million units a day yeah which wouldn’t be
Concertive and that’s where things can go horribly wrong yeah because people confuse micrograms and milligrams and I’ve seen this in the newspapers headlight take 100 milligrams a day well yeah a lot of medical journalists have got Bas in journalism yeah yeah and don’t know these things absolutely it’s
A real risk so so I agree let’s stick let my advantage keep to units forget all these micrograms keep to units because we all know what they are we’ve got 100 unit 100 years of experience of units let’s keep to it let’s do like the insulin people are doing yeah keep to it
I’m not going to mention the old days where we had insulin with 20 40 and 80 strength we we’ll ignore that it’s all now 100 strength so standardized yeah yeah it took me three years to memorize all that then they changed it all so they did
Abely but that’s okay so getting back to the vitamin D the vitamin D is going to be activated so it goes to the so whether it comes from your skin that’s the vitamin D3 what comes from a tablet that’s the D3 that goes to the liver yeah how long does that activation process
Take it takes several days should we say yeah um up to perhaps a month before the high blood levels are achieved before full conversion has taken place it’s a slow process there’s no reason for it to be fast yeah because ideally we’re producing vitamin D every day so it’s
Just a daily top up so you keep putting at one end of the pipeline keeps coming out the other yeah if if we take 3,000 4,000 units of insul of sorry I’m saying insulin now of vitamin D a day yeah 3 or 4,000 us of insulin a day so I say it
Again if we’re taking 3 or 4,000 units of vitamin D a day and the blood levels the same yeah that means we are consuming 3 or 4,000 units per day we require that to keep us fit and healthy now if we take a dose if we are
Very deficient in vitamin D and we take a s a single large dose of say 20,000 units which is generally speaking a week’s or a week’s Supply then we um it’ll take a week for the blood level to to come up to an ideal level and that takes us into the
Storage form yeah it does yeah the caly dial ABS absolutely storage form the storage and the storage is not in the fat cells the storage is actually in the blood itself so it just ready to go when we need yeah ready to go it’s circulating ready for action in contact
With all the cells of the body so when they’re triggered there’s an infection taking place they pick up more and more Vitamin D from the blood and then they um then they reprocess it and reactivate it for ready for action how long does it take the cells to get the vitamin D
Working from taking it from from the blood it’s more or less in instantaneous right so it’s it’s a week or so to get the vitamin D through the liver once it’s in the blood It’s banging it’s there yeah it is indeed right now what we require the problem is when we take
Vitamin D in it’s raw form or we produce it in the blood and we produ in the skin in it raw form it has to be circulated and taken up if we if we take it by mouth as a supplement yeah and and from the skin
It’s got to go through the liver and that’s the slow process takes time yeah and if we’re very deficient but seriously ill it’s going to be a week or so before we get the vitamin D that we need into the immunity cells we just get this all
The time every shift on A&E you’ll get several patients in with sepsis respiratory sepsis urinary sepsis or of not sepsis severe infections yeah so there’s no point giving them high doses of Vitamin D as soon as they come in no the high Dose side doesn’t work the high dose doesn’t get act
Action any quicker it’s got to go through the liver that’s the hold up but we can bypass the liver what the liver does it it it adds an O group hydroxy group to vitamin D to put it into the blood this is the caly DI that’s right
Store form yeah absolutely but we can give that form by mouth well why on Earth don’t we do that every time someone gets an infection yeah because the activate that part activated form the gidal that is absorbed into the blood within about 2 hours whereas it will take up to two
Weeks for the raw form of vitamin D to become activated or pod activated the CID it takes two hours so we have an immune Optimizer yeah that works goes into the blood within two hours and that is working one heck of a lot quicker than antibiotics which are going to take
Yeah even IV are they going to take four or eight hours to work and that’s going to work and then the cells can use that straight away the white blood cells could use that essentially instant instantaneously yeah so we could be getting the immune system really roaring
Into gear yeah in my septic patients within 2 or 3 hours yeah absolutely and yet for some so what we have in in emergency departments we have something called the sepsis six yeah so we get them in and you’ve got to tick them all off and it’s got to be done within an
Hour rightly so first one is oxygen yeah the next one is IV antibiotics yeah the next one is checking lactate I might be out of order checking lactate and hemoglobin yeah uh intervenous fluid resuscitation uh checking the urine output and uh one other one I’ve forgotten um but really we should change
That from the sepsis 6 to the sepsis 7 then we should be giving yeah calid I’m sure because all of those things that we’re doing apart from giving the antibiotics um not really affecting the infection it’s just monitoring the body’s response to the infection yeah yeah antibiotics won’t work with with if
If the immunity is no good we’ve got to have immunity antibiotics are are very useful obviously very very important but the immunity system the natural immunity in the body is of vital importance and we’ve got to we’ve got to make sure it’s optimal that you’re working properly and the thing
That keeps it from working properly is vitamin D deficiency now we could come on to you mentioned coming to a hospital seriously ill and the other thing is one thing that makes you seriously ill is having an operation quite honestly a major operation means you’re temporally
Seriously ill Y and you’ve got to get over that operation and that requires defensive immunity as well and it’s been well worked out that postoperative complications are more common in people who are vitamin D deficient so pre-operatively pre-operative check when you go to a hospital pre-up check should include a
Vitamin D level of the blood but it doesn’t for major operation I mean this is why is it yeah it’s so obvious it is it is indeed yeah yeah well why the health authorities work this out it’s I mean it’s it just seems inexplicable that you wouldn’t want to optimize that’s right this
Wonderful natural immune system that we have it is absolutely see you and I believe in nature the Crea we’ve got to believe in nature we’ve got to optimize our natural immunity and we know we’re all vitamin D deficient we know we work indoors not in
The fields we know we have a lot of clothes cover we know we’ve got a lot of cloud cover we know that half our year is we don’t produce vegamin got it’s winter we know all these things let’s let’s put it all into action there was there’s a photograph in the newspaper
Last week it was a a little um afro afro afro Caribbean black African ethnic child and it said he was to illustrate a finding that come from the pediatricians that ethnic minority children have a much higher complication rate after they’ve had her appendix removed they’re slow to recover more complications why is
This is it is it something to do with racism well it’s glaringly obvious it’s glar when know very well that these children from ethnic minority backgrounds are born deficient in vitamin D we know that probably deficient when there were fetus yeah absolutely yeah we know very well that
Vitamin D is essential for optimizing immunity and we know that postoperative complications are more common in people with effective in people with defective immunity and also in people who are vitamin D deficient let me see if I can work this one out it’s just it’s just so obvious it is
Indeed but in this article in the guardian I think it must have been this article which is based on Research done by I think pediatric groups was um never mentioned the possibility of vitamin D deficiency and it can be put right immediately yeah with calid literally immediately yeah absolutely absolutely yeah yeah
Within two hours yeah yeah yeah absolutely there’s two other lines of evidence that the first line of evidence that convince me about the accuracy of of what you’re saying and I think we should say that you are one of the pioneering researchers and Publishers on
This you did the early work on this way back in the yeah 80s and 90s um so one one of the lines of argument is is why are we white because presumably our ancestors would be yeah if you know if the Out of Africa theory is correct they would have been dark
Skinned yes and the evolutionary advantage in turning white as we migrated North yeah yeah is really the only reason okay we might produce a bit more nitric oxide and yeah but um we I mean I I I was working with some colleagues in Africa recently and um I
Was I was going out in the morning and putting sunscreen on the stopping putting sunscreen on and they they said John what are you doing I said what if I don’t put this on I’ll burn they said and these were doctors and things said oh really you burn in the
Sun you know to them this was a novel concept strange is so so that that that’s one thing that we we became White our ancestors um cheda cheddar man I think I think around about 8,000 years ago found in the cheddar Gorge he had blue eyes uh dark hair and dark skin
Yeah but he was British he was in Britain so we’ve evolved so that’s completely convincing yeah I think we actually I think we got our white skin from the undertales I was I was and the other interesting thing is that that the major ape gorillas are wh skinned really they’re wh skinned but
They could with hair and I think the Neanderthals were um neanderthals were wh- skinned but they were hairy to protect them but uh certainly we have an advantage in this climate you know as I say close to the North Pole into the equator because we become vitamin D
Deficient but not as deficient as the people with dark skins who live in this climate yeah and of course the under thows were a nor largely a northern nor northern European yeah African surprising they were white another thing about the the the uh in Africa and the doctors not understanding
About the skin getting burnt they should have done because in Africa there’s a huge problem with children or adults who develop Vitiligo where the skin loses its pigmentation and the patchy white skin and it burns terribly yeah it really does and also the genetic condition of albinos albinism does occur in Africa
And a child who’s born as an albino with white skin is is is a terrible condition to have there they are terribly burned yeah yeah and the other line of evidence that was convincing apart from me being white was if we take traditional cattle herders like the
Massi other groups in Africa caram Jong um that that live in their kind of natural environment um they’ve got very very dark skin but they’re outside all day every day Under The Tropical Sun and their levels of vitamin D in that what you could say is a completely natural
Human environment is well over the 100 nanog per uh Nan per liter well over the 100 sort of the 150 yeah 160 kind of range yeah which suggests to me that that presumably they’ve optimized that over over tens of thousands of years and that seems to the optimal level around
About 150 nanom per liter but it doesn’t go higher and people do not get uh vitamin D excess from the Sun and it’s considered that any excess vitamin D in the blood is inactivated by the sun the sun has a controlling effect both on the production of vitamin D and
On the blood level of vitamin D so that means if I took a lot of vitamin D supplement but was out in the sun yeah my levels probably wouldn’t go too high but if I took a lot of vitamin D supplement and lived indoors yeah there is the potential yeah for overdose
Now how you’ve been a doctor for a long long long long time um have you ever seen a case of vitamin D hypervitaminosis no neither have I it is stuggling the rare yeah and is always due to either stupidity yeah or mixing up the dose micrograms milligrams but
Okay which a thousand time different suppose you were in a really bad mood and you wanted to give me too much vitamin D yeah so it caused high blood calcium High B calcemia how much would you have to give me probably in terms of probability probably over 100,000 units
A day for yeah and also with calcium for for for days and weeks with calcium you if you’re taking vitamin D you shouldn’t be taking calcium if you’re taking a higher dose of vitamin D don’t take calcium because that that can lead to problems we don’t need calcium we’re not
Short of calcium there’s plenty of calcium in the diet but we need Vitamin D to absorb calcium from our food M if you’re taking a good dose of vitamin D you don’t need calcium where are you on the K2 bit I’m not quite honestly right I’m not so I mean k k if
You take K1 the bacteria in our colons are going to yeah produce vitamin K2 for us yeah yeah but there again we don’t eat much fermented foods in this country but no no indeed um it it’s a new thing which I I I don’t know an awful lot
About to be quite honest the idea is that the the the K2 prevents the calcium being deposited in the tissues well calcium is deposited in the tissues where there is chronic inflammation and it’s not very common actually either you know you in we see occasional drain pipe
Arteries don’t we where see the calcium in there that’s because the AR disease is due to chronic inflammation and the chronic inflammation is there because they people with vitamin D deficient you know you don’t get the chronic inflammations when you when when you’ve got plenty of
Vitamin D on board vitamin D is an inflammatory modulator it’s absolutely it does see when we get an an an acute infection we had a body response which orchestrated by um something called tnf Alpha tum necrosis Factor Alpha and that’s that’s that’s that’s orchestrating this acute response pro-inflammatory absolutely
Yeah but that has to be switched off remember the cyto kind storm yeah in covid that was tnf Alpha produced modulated too much of it and what it has to be done it has to be switched off and trans it’s called the macro Fage balance hypothesis the macrofagos white cells in
The tissues in particular are producing tnf Alpha and it has to be switched off to produce something called TGF beta transforming growth factor beta which is a damper down a it’s a yeah it’s a healing one it damps it down it’s part of the it’s it’s part of the specific
Targeted immun defensive immunity then so we’re going from TG tnf Alpha to TGF beta and that transformation is modulated by vitamin D so vitamin D is going to switch off the acute response and come into a healing right specific defensive response so inflammation is good during an acute illness ABS or an
Acute illness soal if I if I twist my ankle I’m going to get heat pain redness swelling loss of function yeah which which is Tau that a few times which is part of the necessary healing response the blood vessels will dilate the nutrients will come out or very and we know this is
Essential because if we give people um high doses of hydrocone or Dex methasone and we switch this inflammatory response off yeah yeah then the W the ankles won’t get better and worse than that they’ll probably get pneumonia and die yeah yeah because we need this inflammatory response but but then once
We’ve had it from we need to go from the inflammatory phase D and Dusty thank you very much got rid of the bugs then we need to go on the healing regenerative phase yeah absolutely that’s and to do that switch if we haven’t got the vitamin D to switch off the
Pro-inflammatory stage then the inflammation can kill us yes what’s often called autoimmune disease is inflammation that’s not being switched off chronic inflammation low grade inflammation it’s not being switched off and you often find vitamin D deficiency is the basis of that and of course then you get tumors tumors have been called wounds
That do not heal chronic inflammation leads to cancers the inflammation is not being switched off then you get a transformation into cancer and you find chronic inflammation in the skin in the uterus cervix in the in the esophagus in the pancreas in the gallbladder in the colon
In the breast I’m sure I’ve not gone through them all all these areas of chronic inflammation that lead into cancer so it’s quite reasonable to say that optimizing vitamin D levels could well reduce the chances of pretty well all forms of cancer yeah perhaps not all
But most most yeah certainly I mean the first research I read was colon you were a gastroenterologist of course so the first research I read was colon cancer yes when did you first learn about that the link between vitamin D deficiency and colon cancer do you think which when I first learned about
Vitamin D basically right so so about late 1990 yeah yeah yeah or late 80s yes so that’s 30 35 years ago 34 years ago 37 years ago and still Yes it hasn’t been implemented yeah that’s right how long does it take for science to transpose into these bodies getting
Their act together and updating their their guidelines it really just beggers credulity how how long that how long that you mentioned about the um you mentioned about the calcification in the arteries well it took a long time I’m not sure it’s even appreciated now that the arterial atherosclerosis is an inflammatory
Condition it was first noted by vof in the late 19th century famous pathologist he described T Tams Tams tumor Associated macrofagos he was a clever guy wasn’t he brilliant and everyone forgot about that and everybody thought it was all about cholesterol yeah well it’s not you know cholesterol cholesterol is there
Cholesterol is part of the defensive mechanism for in inflammation we don’t it’s in the muscle cells of the arteries that the disease occurs we don’t get arteriosclerosis in veins there’s no muscle layer we’re doing arteries fundamental difference and it’s it’s chronic inflammation within the arteries that’s causing the
Damage and uh we can switch that off with vitamin D yeah in a good dose and we’ve got to get that good dose no giving people a silly little dose of vitamin D we’ve got to achieve Target level Des the could that partly explain why I mean we’ve known for a long long
Time that that smokers were more prone to heart attacks atherosclerosis so so again products from the smoke could be part of this chronic inflammatory process is that yeah indeed absolutely yes when you smoke you get things go into the lungs nicotine and lots of other components from the cigarette goes into the lungs
Circulates around the body yeah causes chronic inflammation yeah absolutely and Al and with smoking we get recurrent bronchitis recurrent infections in the lungs and it’s these it’s these infections in the lungs the lungs is the main way in which microorganisms got into the body yeah the GI tract as well
But the lungs in particular MH so is there any advantage to taking what do I I Trend to take about 8,000 units most days when I remember I probably remember about 5 days a week is there any advantage to taking it daily weekly monthly well as we we get back that slow
Process of pro of of processing of it in the liver before it goes into the blood properly say when we measure the blood level vitamin D we’re not measuring vitamin D in its raw form we measure it it in its liver process form uh 25d or c of a
Dial we can take it easily once a week I take it once a week I take 40,000 units once a week if I forget on the on the Sunday when I usually take it on the Sunday if I forget on the Sunday I take it on the
Monday or the Tuesday if I miss it one week I’ll take double the dose the next week I won’t come to any harm by missing a weekly dose quite honestly at all yeah because it’s it’s chronically constantly top up yeah it it’s convenient to take
It once a week I’m very happy with that mhm some people say take it just once a month 100,000 or 200,000 years once a month can probably get away with that but I think once a week is probably a sensible way to do it just occur to me
Would it be easier to overdose on the if we don’t do it in this country I know they do it in Italy when you get an active infection you actually take the activated form the calid dial would it be easier to overdose on that than it
Would be on the raw vitamin D do you think probably yeah in fact the activated calid is measured in micrograms on the on the container and it’s the equal it’s the kind of equivalent unit isn’t it so it is yeah you would take the equivalent do so if
You got acute infection and you took 10,000 units or 20,000 but it’s only when you it’s only when you’re very ill you need to take that when you need it straight away yeah but as a routine it’s not necessary it’s best not not to it’s
Best not to take it in in it just take the raw form absolutely and then when you are really you’re topped up yeah that’s right for the thousands of patients that come into our care who aren’t topped up yeah yeah we give them antibiotics but we don’t give them the
Activated cidal I mean I you know I think what I know now from your teaching and David Anderson’s teaching I think not to give that is now unethical yeah see every Intensive Care Unit should have a big stop stock of calal but in this country we’re only allowed to give it to farm
Animals it’s not available for humans in this country it’s not in the British national formulary it’s not absolutely unbelievable it is it’s available in Italy available in Spain it might be available in Australia actually now and possibly in Germany but it’s not aailable in this country it it’s
Criminal so so you as a consultant physician in a hospital in this country are completely unable to prescribe a life-saving CID dial preparation yeah yeah yeah it is it’s quite remarkable I mean we’re sniggering because of the ludicrousness of it but people die because of this yeah my daughter has a
Friend who lives in Spain or visits Spain frequently and she asked this daughter she asked his friend to bring back some the Cal dial which she did yeah and she and I had it but my daughter kept some as well and a friend of his was um who was
Indian ethnicity he was taken into Hospital very very ill with um with covid-19 Co and I said to Caroline I said make sure he takes two of these when he goes into hospital or as he’s going as soon as possible I said yeah two as soon as possible and then one at weekly
Intervals while he’s in hospital anyway he did that he took two and he took the cap he took the packet into hospital with him gave them to the nurse said I’ve got to take one of these every day every every week sorry while I’m in hospital now I think this regime was two
To start with which he took yeah one after 3 days one after s days one after 14 days that was the regime so he got to hospital he tell the nurse this she D the tablets off him he never saw them again but he’d taken the two capsules of
C vial and he he he he he he was fine it’s probably what saved his life could well have saved his life knowing how people of Asian ethnicity fared at this start of Co and it’s really quite moving in in in the back of your uh in the back
Of your book here um this is the book you co wrote with uh yeah um David Anderson in this one we have pictures of the people that left us most mostly with dark skins in Co these were not sadistics these were real people there are the names and photographs there
There were 26 yeah do practicing doctors died in the first between uh March and March April and the beginning of May 2020 and the 26 who died 25 were of sou Asian or black African ethnicity that and that has been neglected forgotten about ignored I’ll tell you what happened also what happened
Then that um I’d identified that this was happening David Anderson being in Italy had access to uh C vial and vitamin D which just vitamin D at the time actually and our friend um parag in in um who’s professor of Endocrinology in Western supermare par singal he he was chairman
Of what’s called Papio the British Association of Physicians of Indian origin and he sent an email to all the members saying that it’s essential that you take vitamin D and if you’re short of it David we can supply davidon David Anderson will supply it he sent it the same email to the pre
Secretaries of the other like the British Association of Nigerian doctors etc etc etc and that went all around and the deaths of of ethnic minority doctors stopped in the middle of May there was one the last one who was a GP in Rams bottom I think it was close to where we are
Now and he died I think on the 3rd of May might have been the 10th third or 10th of May 2020 2020 the next one to to I saw reports of dying was in September so it was 25 ethnic marriage and doctors dying M mark April and the beginning of May and
Then after your advice that went down to nothing yeah yeah so you you’ve saved the lives of well pot well possibly hundreds of doctors parag Hussein parag singal sorry parag singal who who did it all he was um he saved so many lives he did what the Depart of Health should have been
Doing what the British Medical Association should have been doing what the RO colleges of Physicians General practicians Etc should have been doing but out to the whole population not just the doctors me saving the doctor’s lives is wonderful yeah but you know we could have said and of course the vaccines
Didn’t come until we’re not going to debate the VES but but yeah year later until 2021 yeah yeah the horse had builted by then quite honestly it terrible absolutely but the word is got around and I have a few neighbors who are doctors General Practitioners not all no um of Southern
Agan ethnicity and they tell me that their patients the general practitioner tell me they’re recommending vitamin D for the patients and the vitamin D is being taken but not in a very well supervised way I must say bit haphazard yeah it is haphazard but they are doing
It but they’re not checking the blood levels because excuse me they’re not checking blood loves they’re just scage from doing so the tell not to check blood levels it took me about 2 years to get my GP to check my vitamin D levels it’s amazing isn’t it and why on Earth with
Such a basic test you know they’re quite happy to check your PSA which is good absolutely or your blood pressure which is good or your blood sugar levels which is good but why on Earth not another the the other thing that I found really unhelpful at the start of the pandemic
2020 was the increased death rate and there was an increased death rate in people of ethnic minorities in the UK for example was because of social inequalities well these Consultants these doctors yeah weren’t in lower socioeconomic groups they weren’t they were mostly Consultants there was no socioeconomic deprivation among doctors
Of any ethnicity but you can take a doctor a young doctor from who Origins would say Sudan yeah who was at risk of V covid-19 death in this country his risk of death was about a thousand times greater than that of his brother in Uganda on the equator loads of vitamin D
Whereas he living in London going to be vitamin D defici in a big way and you’re dealing with people there from the same background so they probably have the same yeah immunological exposure to different bugs when they were children in the same FAL I doubt very much if the you Ugandan
Doctor living in London was socially deprived compared to his brother living in Uganda honestly yeah I think most doctors earn about3 or $400 a month in Uganda and uh slightly more yeah indeed slight slightly absolutely in in in in the UK now um vaccination we’re not going to argue about vaccination and
Side effects but giving covid vaccinations for example generates an immunological response would that use up vitamin D in the same way that act of infection would use up vitamin D I think so we we we the the experimentation to my knowledge has not been done but if vaccinations are
Stimulating an immune response they’re going to use up vitamin D in exactly the same way that an infection will stimulate an immunity response resulting so giving people repeated infe injections of vac ation repeated if they get these repeated infections repeated immunizations they’re going to become deplete of vitamin D and I think that’s
What probably what’s happening in our society at the moment in fact David Anderson goes further Professor Anderson goes further he says that no vacine should be given unless someone’s vitamin D status is first ascertained and checked to be adequate that’s because sensible it’s going to deplete the
Vitamin D and you’re not going to get an optimal yeah ime response yes indeed that seems a sensible approach you know the importance of vitamin D is is overwhelming yeah but it’s just neglected yeah and I can’t understand why why that’s the case so everyone needs to optimize the vitamin D levels
And sick people who are low on vitamin D in our view should be given the active form of calid to work within a couple hours and the fact that that’s not being done I consider to be unethical yeah yeah I agree given what we know now
Yeah yeah Dr Grimes thank you so much for that absolutely fascinating but yet still somehow just just common sense well thank you for the opportunity to speak to you John Common Sense isn’t that common trying to get the information out the importance of vitamin D let’s hope
This is a small contribution to that okay thank you very much thank you John
