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Vitamin D Complex ® with vitamins A, E, K1 and K2 THIS INFORMATION IS PROVIDED FOR THE USE OF PHYSICIANS AND OTHER LICENSED HEALTH CARE PRACTITIONERS ONLY. THIS INFORMATION IS INTENDED FOR PHYSICIANS AND OTHER LICENSED HEALTH CARE PROVIDERS TO USE AS A BASIS FOR DETERMINING WHETHER OR NOT TO RECOMMEND THESE PRODUCTS TO THEIR PATIENTS. THIS MEDICAL AND SCIENTIFIC INFORMATION IS NOT FOR USE BY CONSUMERS. THE DIETARY SUPPLEMENT PRODUCTS OFFERED BY DESIGNS FOR HEALTH ARE NOT INTENDED FOR USE BY CONSUMERS AS A MEANS TO CURE, TREAT, PREVENT, DIAGNOSE, OR MITIGATE ANY DISEASE OR OTHER MEDICAL CONDITION. Vitamin D Complex may be helpful for: • Avoiding imbalances between the four fat- soluable vitamins (A, D, E & K) when taking therapeutic doses of any of these on an individual basis • Immune support/ fighting infection in adults and children • Support for those with malabsorption issues, in conditions where it is difficult to absorb fat-soluble vitamins, such as cystic fibrosis, celiac disease, ulcerative colitis, pancreatic insufficiency • Cardiovascular disease/atherosclerosis • Hypothyroidism and any condition that negatively affects the ability to convert beta-carotene to vitamin A and where thyroid receptors need nutritional support • Osteoporosis support and prevention • Health and maintenance of skin, hair, nails Vitamin D Complex features 2000 IUs of vitamin D, along with efficacious amounts of the other fat-soluble vitamins, A, E (tocopherols and tocotrienols), and K (K1 and K2). While there are a myriad of beneficial health attributes associated with vitamin D, it should be recognized just how important it is to keep it in balance with these other vitamins. New research is emerging on the intricate interrelationships between them which should make one think twice about dosing any of these supraphysiologically without the others. Focusing on vitamin D without regard to the other fat-soluble vitamins can actually offset the delicate harmony needed for vitamin D to function optimally. Interestingly, what were once thought to be signs and symptoms of vitamin D toxicity are now understood to actually not be toxicities, but rather deficiency symptoms of one or more of vitamin D’s other fat-soluble counterparts. Simply stated, supplementing therapeutic amounts of vitamin D creates a greater need for vitamins A, E, and K. D+A It has been noted that vitamin D increases the need for vitamin A and that these two vitamins have a collaborative working relationship. For example, the active forms of both A and D are necessary for modulating gene expression. Vitamin D3 (25-hydroxyvitamin D) binds to nuclear receptors that then function as transcription factors to modulate gene expression. Nuclear receptors are intracellular receptor proteins that bind to hydrophobic signal molecules (such as steroid and thyroid hormones) or intracellular metabolites and are thus activated to bind to specific DNA sequences, affecting transcription. The vitamin D receptor forms a complex with the retinoid-X receptor (vitamin A metabolite receptor), and this complex is what binds to DNA to allow for gene expression (control genes by turning them on/off ). Research in osteoporosis shows that in the absence of adequate levels of vitamin D, vitamin A supplementation can contribute to adverse effects such as bone loss. Yet, when vitamin D is present at sufficient levels, this does not seem to occur, once again exemplifying the partnership of vitamins A and D. D, A & K Researchers have observed that when animals are given very high doses of vitamin D, they present near-identical symptoms as to those seen in a deficiency of vitamin K or vitamin K-dependent proteins. Vitamin A seems to have what is referred to as a” vitamin K-sparing effect,” lowering the expression of these vitamin K-dependent proteins in the absence of sufficient levels of vitamin K, which again can be caused by high intakes of vitamin D. In this model we see that vitamin D increases the expression of proteins whose activation depends on vitamin K-mediated carboxylation; as the demand for carboxylation increases, the pool of vitamin K becomes depleted. D+K The carboxylation previously mentioned is responsible for the intricate relationships vitamins D and K have on healthy bone metabolism. This is because vitamin K is needed for carboxylation of matrix Gla protein (MGP), which makes it active. MGP is necessary for allowing vitamin D to direct calcium into the bone, and expression of MGP is dependent on vitamin D. Therefore, high vitamin D intake in the absence of adequate levels of vitamin K can increase the risk of calcium deposition in the arteries and other tissues including the breast, rather than in the bone. In understanding the importance of adequate levels of vitamin K, it should be noted that high intakes of vitamin A can create a deficiency of vitamin K. For example, when rats were given high amounts of vitamin A, serum levels of vitamins E and D dropped; and when vitamin A levels were raised even more, serum levels of vitamin K also dropped. Some rats experienced hemorrhaging, clearly a vitamin K deficiency since K is needed for blood clotting. ZTEC VDC 11/10 A+E Several studies suggest that vitamin E increases the need for vitamin A. Some examples of the protective effects of vitamins A and E together include a research study where rats exposed to gasoline vapors experienced blood poisoning, inhibited growth and weight loss. Administration of vitamins A and E together produced a significant recovery in all three of these side effects, cultivating greater results than when these vitamins were given independently. A separate study showed increased intake of vitamin A and vitamin E among current and former smokers was associated with better lung function. E+Tocotrienols Supplement Facts Serving Size 1 capsule Servings Per Container 60 Amount Per Serving % Daily Value Vitamin A (as Palmitate) 5000 IU 100% Vitamin D3 (as Cholecalciferol) 2000 IU 500% Vitamin E (Total Natural Tocopherols) 50 mg * as d-gamma * 35 mg as d-alpha 4 mg/6 IU 20% as d-beta * 2 mg as delta * 9 mg Vitamin K 525 mcg 625% (as Vitamin K1 Phytonadione 500 mcg; Vitamin K2 Menaquinone-7 25 mcg) Tocotrienols are important members of the vitamin E family. They are antioxidants with their own distinctive characteristics, and work to combat such conditions as oxidative stress and chronic inflammation. For example, tocotrienols and vitamin E have been shown to protect against glutamate-induced neurodegeneration of the brain. They Tocotrienols (delta, gamma)† 10 mg also may be considered anti-aging antioxidants as they both prevent increases in advanced glycation end products (AGEs), which are substances formed when sugars *Daily Value not established. react with the amino groups of protein. This is a common complication of diabetes. Other Ingredients: Microcrystalline cellulose, vegetable Studies have shown that AGEs play a significant role in the formation and progression stearate, silicon dioxide. of atherosclerotic lesions and lead to retinal damage contributing to retinopathy. In addition, vitamin E in the form of gamma tocopherol given with tocotrienols has been demonstrated to improve fatty liver in rats. In conclusion, it becomes clear that the importance lies in the critical balance necessary for these fat-soluble vitamins to work in harmony and support each other. Health problems can easily occur when one or more of these vitamins are not provided in sufficient amounts. Thus, prescribing therapeutic doses of vitamin D without assuring supportive levels of vitamins A, E, & K can result in deficiency symptoms of one or more of these fat-soluble vitamins. Recommended Dose of Vitamin D Complex: Short term: up to 5 capsules per day; Long term: 1 – 2 capsules per day If a patient’s blood levels of vitamin D are not rising as expected while on their current vitamin D regimen, consider either adding Vitamin D Complex to their protocol or switching to this product for more optimal results. Vitamin K may adversely interact with anticoagulation drugs known as blood thinners. Patients on these medications should be medically supervised while taking Vitamin D Complex. It is not ideal for these individuals to take high dose vitamin D alone as it may contribute to arterial stiffening (loss of elasticity) since vitamin K is being restricted. Fat-soluble vitamin testing (Fat-Soluble Vitamins Profile) is available through Metametrix Laboratory - www.metametrix.com References 1. Antioxidants and Pulmonary Function Among Police Officers. Charles, LE, Burchfiel CM, Mnatsakanova A, Fekedulegn D, Tinney-Zara C, Joseph PN, Schunemann HJ, Violanti JM, Andrew ME, Ochs-Balcom HM. J Occup Environ Med. 2010 Nov;52(11):1124-1131. 2. The interaction of dietary vitamin A and vitamin D related to skeletal development in the turkey poult. Metz AL, Walser MM, Olson WG. J Nutr. 1985;115:929-35. 3. Vitamin A antagonizes calcium response to vitamin D in man. Johansson S, Melhus H. J Bone Miner Res. 2001 Oct;16(10):1899-905. 4. Assessment of the relationship of vitamin D with serum antioxidant vitamins E and A and their deficiencies in Iranian pregnant women. Asemi Z, Taghizadeh M, Sarahroodi S, Jazayeri S, Tabasi Z, Seyyedi F. Saudi Med J. 2010 Oct;31(10):1119-23. 5. Serum concentration of vitamins A and E and lipid in a rural population of north Cameroon. Gouado I, Ejoh RA, Kenne M, Ndifor F, Mbiapo FT. Ann Nutr Metab.2005 Jan-Feb;49(1):26-32. Epub 2005 Feb 25. 6. Vitamins A and E reverse gasoline vapors-induced hematotoxicity and weight loss in female rats. Uboh FE, Eteng MU, Ebong PE, Umoh IB. Toxicol Ind Health. 2010 Oct;26(9):559-66. Epub 2010 Jun 10. 7. Effect of gamma-tocotrienol on blood pressure, lipid peroxidation and total antioxidant status in spontaneously hypertensive rats (SHR). Newaz MA, Nawal NN. Clin Exp Hypertens. 1999 Nov;21(8):1297-313. 8. Vitamin D toxicity redefined: vitamin K and the molecular mechanism. Masterjohn C. Med Hypotheses. 2007;68(5):1026-34. Epub 2006 Dec 4. 9. Vitamin E supplementation and mammalian lifespan. Banks R, Speakman JR, Selman C. Mol Nutr Food Res. 2010 May;54(5):719-25. 10. Role of vitamin E-coated membrane in reducing advanced glycation end products in hemodialysis patients: a pilot study. Baragetti I, Furiani S, Vettoretti S, Raselli S, Maggi FM, Galli F, Catapano AL, Buccianti G. Blood Purif. 2006;24(4):369-76. Epub 2006 Jun 1. 11. Relationship between aging and vitamin E. Takasaki M, Yanagawa K, Shinozaki K, Fujii H, Shibuya T, Takeda H, Matsumiya T, Egashira T. 2002 Sep;39(5):494-500. 12. Protective Effects of Vitamin E Analogs against Carbon Tetrachloride-Induced Fatty Liver in Rats. Yachi R, Igarashi O, Kiyose C. J Clin Biochem Nutr. 2010 Sep;47(2):148-54. Epub 2010 Aug 6. To contact Designs for Health, please call us at (800) 847-8302, or visit us on the web at www.designsforhealth.com.