Vitamin D against HPV (human papilloma virus) and Cervical Intraepithelial Neoplasia (CIN)
Update to Antiviral Nutrition (download free sample) protocol by Dr Alex Vasquez posted 20 January 2018; also see previous publications on vitamin D
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Antiviral Nutrition Update #1 for 2018
Clinical Trial of Selenium against HVP/CIN1
Written and recorded by Dr Alex Vasquez
The video of this presentation is archived at ichnfm.org/hpv1, and the transcript in PDF format—which is considered the final and citable version—is archived at academia.edu/35808436; any corrections or updates will be made to the PDF file. Observe that this video presentation is truly an *update* subsequent to previous publications and that therefore not all sources are cited; for citations, see the video, and for complete citations regarding the protocol in its entirety, see the book Antiviral Strategies and Immune Nutrition or the ebook version titled Antiviral Nutrition.
“Hello everyone, Dr Alex Vasquez here with our next video which is going to discuss antiviral nutrition. This will be the first update for 2018.
If I'm providing an update, then obviously that information will be founded upon and predicated upon some previous information. So let's take a look at those sources right now. This series of updates builds upon previously published books, articles, videos and blogs. In 2014, I published a small book called Antiviral Strategies and Immune Nutrition; it's also available as an ebook through the Amazon Kindle platform, that was published under the name of Antiviral Nutrition. I also published kind of an editorial journal article called “Unified Antiviral Strategy” in 2014, you can get that online for free. And I also did a presentation in 2016 at the International Congress on Naturopathic Medicine in Barcelona, you can see that on the internet for free as well and I've provided you the website address. Also in 2014, I published a series of videos which you can find online for free if you're interested in looking at those.
Book: Antiviral Strategies and Immune Nutrition (2014)
eBook: Antiviral Nutrition (Kindle ebook, 2014)
Tutorials: AntiViral Strategies and Immune Nutrition: Antiviral Nutrition (video, 2014) https://vimeo.com/109318556
If you want an independent view of some of these topics, the best article that I could recommend for you would be this one from British Journal of Nutrition 2007, “Selected vitamins and trace elements support immune function by strengthening epithelial barriers and cellular and humoral immune responses.” So if you want kind of an independent view of some of the things we're going to talk about today, then you might look at that article, British Journal of Nutrition, 2007 October.
So when we talk about viral infections which is mostly what we're talking about, we're going to talk about viral infections—a particular viral infection called HPV: human papilloma virus—and its relationship to vitamin D status and response to vitamin D supplementation.
So again, kind of laying the foundation and putting all of this in a reasonable context, when we talk about the treatment of viral infections, we have to have a comprehensive way of looking at that, not just talking about virus here and virus there. As you can imagine, with the book, I've developed not simply an antiviral strategy but also a more cohesive and comprehensive way of looking at viral infections and their clinical complications.
So as I said, in 2014, I'll state it again here, if you don't have a structured understanding of a good, comprehensive antiviral strategy, then you really don't have either an understanding or a strategy. And I can say that, after having gone through three different doctoral programs: we never learned an antiviral strategy, we never learned how to understand viral infections in a comprehensive way that would really leverage the clinical tools that we have for optimal effectiveness. And when you look at my strategy, you get to see some ways that you can intervene and understand how these viral infections progress and how the body responds and that provides you some insight into ways that you could treat these virus-infection-related diseases, whether those are acute infections or persistent infections that go on to have other complications. So at the very least, let's touch upon these major four categories.
1. Antiviral: Starting with antiviral interventions, we can target the virus itself.
2. Antireplication: We can use antireplication intervention, so that is targeting the machinery of viral replication, we can attack that process as well.
3. Immunonutrition: We can use immunomodulation and immunonutrition because obviously, the immune system does usually a very competent job, protecting us from these viral infections. So let's optimize immune function and that usually means nutritional supplementation.
4. Cell and systemic support: We can also use cell and systemic support to mitigate some of the consequences of viral infections and of course, I'm talking about inflammation, oxidative stress and of course, mitochondrial dysfunction which accompanies many viral infections.
So when we start to deconstruct this phenomenon of viral infections and we look at each of these components, we can intervene at each of these levels/layers and provide better treatment, whether we're treating ourselves or whether we're treating our clients. So today, we're going to talk about vitamin D in the treatment of a very common type of viral infection and most of that work is going to put us here in this third category of immunonutrition, but also, you'll see some implications for this antireplication category as well. (See book and video for explanatory diagrams: http://www.ichnfm.org/hpv1)
So let us go ahead and start taking a look at this article that we're going to focus on today which is “Effects of Long-Term Vitamin D Supplementation on Regression and Metabolic Status…” associated with cervical intraepithelial neoplasia. This article comes from Hormones and Cancer, February of 2017. You've got the digital object identifier here as well. This is a randomized double-blind placebo-controlled trial with 58 women with cervical intraepithelial neoplasia grade one (CIN1). The intervention was 50,000 international units (IU) of vitamin D3 each two weeks, so that averages out to a bit over 3,500 IU per day for six months. And overall, I consider that intervention to be reasonable; the dose is reasonable but certainly not heroic, nor assertive.
Vitamin D3 dosed at 4,000 IU per day is considered to be the minimum for replacing vitamin D in patients who are deficient. We might use higher doses closer to 10,000 IU; I think that would have been a bit more robust and not necessarily heroic; six months of duration is certainly the minimum. We wouldn't want to see a study for example for two months or three months or four months but six months is acceptable, and the dose is acceptable. So we can evaluate this study, thinking that this might actually be a reasonable representation of competent clinical practice.
And that's an important place for us to start because a lot of these studies using vitamin D have used inadequate dosing and inadequate duration and they reached the false conclusion that vitamin D is inefficacious for whatever it is that they're investigating. And really, vitamin D is not at fault. The fault lies with the researchers for poorly designing their studies. I have published guidelines on the use of vitamin D in clinical practice as well as guidelines for designing clinical trials in Alternative Therapies in Health and Medicine, British Medical Journal, and International Journal of Human Nutrition and Functional Medicine. You can download those articles from the internet for free at http://www.ichnfm.org/d. Results of the study show the following:
1. After six months of vitamin D administration, a greater percentage of women in the vitamin D group had regressed their cervical intraepithelial neoplasia grade one, 84% success versus 33% in the placebo group.
2. They had improved vitamin D status, that's another thing that we always want to look for in studies; they always need to actually measure vitamin D levels, not simply give people vitamin D and assume it was a properly manufactured supplement with good absorption, et cetera. We actually have to measure vitamin D response by looking at 25 hydroxyvitamin D in the serum.
3. These patients also benefited from showing reduced serum insulin levels and improved insulin sensitivity.
4. They had improved antioxidant defenses, they had elevated glutathione levels, relative to the placebo group and they had reduced oxidative stress as well.
5. Excellent safety.
6. The authors barely mentioned modulation of the vaginal microbiome, and I think that this beneficial microbiome-specific effect is likely of major importance. This is probably where a lot of the power of this intervention is coming from against HPV/CIN1. Not necessarily the systemic administration of vitamin D but the effect that that vitamin D has on systemic inflammation but also immune function and the modification of the vaginal microbiome via improved immune function, via vitamin D supplementation. I think that's probably where the action is here in terms of mechanisms of effect of this intervention.
Let's look at some more details and how we might understand this study a bit more; here I will review several of the Biological effects of vitamin D3: When we're talking about optimizing serum levels and therefore body reserves. Vitamin D improves gut absorption of calcium—we are quite sure about that, magnesium probably and also we see some new data showing that vitamin D might also improve selenium absorption. If vitamin D3 indeed increases selenium absorption, this would greatly explain the reported benefits in antioxidant status, reductions in mortality and the antiviral benefits that are apparently being reported here. So selenium has antiviral effects, number one, by blocking viral replication and number two, by blocking viral mutagenesis; those are very important when the body is trying to combat these persisting viral infections. Reductions in physiologic elevations of parathyroid hormone which reduces intracellular calcium—this is referred to as the “calcium paradox.” I've also published an article detailing “intracellular hypercalcinosis” (reprinted online http://www.ichnfm.org/ichc), and it's also republished in my book Inflammation Mastery, 4th Edition as well as in Textbook of Clinical Nutrition and Functional Medicine, Volume 1. This reduction of parathyroid hormone reduces intracellular calcium which promotes a reduction in excess inflammation and cell proliferation. Inhibiting excess cellular proliferation is one of the physiologic and clinical benefits of vitamin D. Also, inducing differentiation and apoptosis—obviously effects have anticancer benefits. Vitamin D also reduces systemic inflammation, this has been very well documented. One very nice study back in December of 2002 published in the Quarterly Journal of Medicine showed this very conclusively. Vitamin D metabolites inhibit the NFkB pathway. This is very important because the NFkB pathway drives viral replication. So anything that's going to block that NFkB pathway, whether it's vitamin D, selenium, zinc, et cetera, is going to probably provide some antiviral benefit by reducing viral replication. Vitamin D also improves immune efficiency, increased resistance to infections and dysbiosis with improved immunotolerance. People commonly have a simplistic “bipolar” view of the immune system, whether it's “overactive”—resulting in allergies and autoimmunity, or “underactive”—resulting in an increased susceptibility to infections. But what we see with vitamin D is actually improved resistance against infections and dysbiosis and also improved tolerance at the same time. The expected result would be a reduction in allergy and autoimmunity; certainly a reduction in autoimmunity has been documented and also some increased resistance to infections. Now in this context, when we're talking about cervical intraepithelial neoplasia (CIN), we have to talk about not simply the HPV virus, the human papillomavirus but also the bacterial microbiome within the vagina which obviously affects the cervix. So what I suspect is happening in this study is that the administration of vitamin D is improving immune function, modulating the bacterial microbiome within the vagina—obviously that's directly adjacent to the cervix. When the immune system of the vaginal mucosa is improved, that favorably modulates the bacterial microbiome within the vagina to reduce inflammation and the reduced inflammation leads to a reduction in viral mutagenesis and viral replication. I suspect that this is the mechanism of action here. As I mentioned before, these patients also showed improved glucose insulin sensitivity; that same result has been shown in several other studies, so I think we can believe quite strongly in that. Several studies have shown reductions in elevated blood pressure as well. We consistently see with vitamin D supplementation improved mood, reduced neuroinflammation and reduced pain and—well documented by William Grant's work—reductions in all-cause mortality and disease-specific mortality.
I will conclude with a brief summary and clinical contextualization. This study—“Effects of Long-Term Vitamin D Supplementation on Regression and Metabolic Status of Cervical Intraepithelial Neoplasia” published in February of 2017 in the journal Hormones and Cancer—is a small trial but it is placebo-controlled and does provide encouraging data consistent with known benefits of vitamin D supplementation, whether that's provided systemically (for an endocrine effect) or directly vaginally (for endocrine [systemic absorption], and local paracrine and autocrine effects)—specifically the effects that that vitamin D has on the vaginal microbiome via its antiinflammatory and eubiosis-promoting effects.
Enhancement of self-resolution I think is one of the major keys here. Given the well-established fact that most people clear various human papillomavirus infections without consequence, research (such as this) should be emphasizing those natural and endogenous factors that promote viral clearance.
Medical interventions related to HPV disease include PAP smears and these should be continued every one to three years. The controversial anti-HPV vaccination is expensive and has produced many biologically-proven adverse effects, including autoimmunity (e.g., acute disseminated encephalomyelitis), neuroinflammation, infertility, and death. And of course, that vaccine provides zero collateral benefits.
In contrast, nutritional interventions such as vitamin D and methylfolate or calcium folinate safely provide numerous disease specific and general collateral benefits. What we need in the future are well-performed clinical trials using a complete antiviral nutrition protocol such as the one that I published back in 2014.
So thank you for your attention during this short video. What we're going to talk about in one of the upcoming videos is again, the role of vitamin D in modulating the vaginal microbiome, reducing inflammation and reducing the clinical consequences of various diseases.
Citation: Vasquez A. Antiviral Nutrition Update #1 for 2018. Video presentation (ichnfm.org/hpv1) and official transcript (academia.edu/35808436/) 2018 January
Primary reference: Antiviral Strategies and Immune Nutrition amazon.com/dp/1502894890/ also published in digital ebook format as Antiviral Nutrition
(Kindle ebook) amazon.com/dp/B00OPDQG4W. Also published in Inflammation Mastery, 4th Edition amazon.com/dp/B01KMZZLAQ/ and
Textbook of Clinical Nutrition and Functional Medicine, vol. 1: Essential Knowledge for Safe Action and Effective Treatment amazon.com/dp/B01JDIOHR6/
 Vasquez A. How to Understand, Refute, and Plan Studies Using Vitamin D. International Journal of Human Nutrition and Functional Medicine 2017 http://www.ichnfm.org/d
 Vasquez et al. The clinical importance of vitamin D (cholecalciferol): a paradigm shift with implications for all healthcare providers. Altern Ther Health Med. 2004
 Vasquez et al. Calcium and vitamin D in preventing fractures: Data are not sufficient to show inefficacy. BMJ: British Medical Journal 2005
 Vasquez A. Intracellular Hypercalcinosis. Naturopathy Digest 2006 September. See reprint online: http://www.ichnfm.org/ichc
 Sekiguchi et al. Two Cases of Acute Disseminated Encephalomyelitis Following Vaccination against Human Papilloma Virus. Intern Med. 2016;55(21):3181-3184
 Takahashi et al. Immunological studies of cerebrospinal fluid from patients with CNS symptoms after human papillomavirus vaccination. J Neuroimmunol. 2016 Sep 15;71-8
 Martínez-Lavín M, Amezcua-Guerra L. Serious adverse events after HPV vaccination: a critical review of randomized trials and post-marketing case series. Clin Rheumatol. 2017 Oct;36(10):2169-2178
 "The adverse reaction reports detail 26 new deaths reported between September 1, 2010 and September 15, 2011 as well as incidents of seizures, paralysis, blindness, pancreatitis, speech problems, short term memory loss and Guillain-Barré Syndrome. The documents come from the FDA’s Vaccine Adverse Event Reporting System (VAERS) which is used by the FDA to monitor the safety of vaccines." Lind P. U.S. court pays $6 million to Gardasil victims. The Washington Times December 31, 2014 https://www.washingtontimes.com/news/2014/dec/31/us-court-pays-6-million-gardasil-victims/