Stephen J. Genuis

An estimate of the economic burden and premature deaths due to vitamin D deficiency in Canada

The objective of this work is to estimate the economic burden and premature death rate in Canada attributable to low serum 25-hydroxyvitamin D (25(OH)D) levels. Vitamin D deficiency has been linked to many diseases and conditions in addition to bone diseases, including many types of cancer, several bacterial and viral infections, autoimmune diseases, cardiovascular diseases, and adverse pregnancy outcomes. Canadians have mean serum 25(OH)D levels averaging 67 nmol/L. The journal literature was searched for papers reporting dose-response relationships for vitamin D indices and disease outcomes. The types of studies useful in this regard include randomized controlled trials, observational, cross-sectional, and ecological studies, and meta-analyses. The mortality rates for 2005 were obtained from Statistics Canada. The economic burden data were obtained from Health Canada. The estimated benefits in disease reduction were based on increasing the mean serum 25(OH)D level to 105 nmol/L. It is estimated that the death rate could fall by 37,000 deaths (22,300-52,300 deaths), representing 16.1% (9.7-22.7%) of annuals deaths and the economic burden by 6.9% (3.8-10.0%) or

Human Excretion of Bisphenol A: Blood, Urine, and Sweat (BUS) Study

14.4 billion (

Sensitivity-related illness: the escalating pandemic of allergy, food intolerance and chemical sensitivity.

8.0 billion-

Blood, Urine, and Sweat (BUS) Study: Monitoring and Elimination of Bioaccumulated Toxic Elements

20.1 billion) less the cost of the program. It is recommended that Canadian health policy leaders consider measures to increase serum 25(OH)D levels for all Canadians.

Vitamin D Status of Clinical Practice Populations at Higher Latitudes: Analysis and Applications

Background. Bisphenol A (BPA) is an ubiquitous chemical contaminant that has recently been associated with adverse effects on human health. There is incomplete understanding of BPA toxicokinetics, and there are no established interventions to eliminate this compound from the human body. Using 20 study participants, this study was designed to assess the relative concentration of BPA in three body fluids—blood, urine, and sweat—and to determine whether induced sweating may be a therapeutic intervention with potential to facilitate elimination of this compound. Methods. Blood, urine, and sweat were collected from 20 individuals (10 healthy participants and 10 participants with assorted health problems) and analyzed for various environmental toxicants including BPA. Results. BPA was found to differing degrees in each of blood, urine, and sweat. In 16 of 20 participants, BPA was identified in sweat, even in some individuals with no BPA detected in their serum or urine samples. Conclusions. Biomonitoring of BPA through blood and/or urine testing may underestimate the total body burden of this potential toxicant. Sweat analysis should be considered as an additional method for monitoring bioaccumulation of BPA in humans. Induced sweating appears to be a potential method for elimination of BPA.

Toxic Element Contamination of Natural Health Products and Pharmaceutical Preparations

The prevalence of allergic-related diseases, food intolerance, and chemical sensitivities in both the pediatric and adult population has increased dramatically over the last two decades, with escalating rates of associated morbidity. Conditions of acquired allergy, food intolerance and chemical hypersensitivity are frequently the direct sequelae of a toxicant induced loss of tolerance (TILT) in response to a significant initiating toxic exposure. Following the primary toxicant insult, the individuals become sensitive to low levels of diverse and unrelated triggers in their environment such as commonly encountered chemical, inhalant or food antigens. Among sensitized individuals, exposure to assorted inciting stimuli may precipitate diverse clinical and/or immune sequelae as may be evidenced by clinical symptoms as well as varied lymphocyte, antibody, or cytokine responses in some cases. Recently recognized as a mechanism of disease development, TILT and resultant sensitivity-related illness (SRI) may involve various organ systems and evoke wide-ranging physical or neuropsychological manifestations. With escalating rates of toxicant exposure and bioaccumulation in the population-at-large, an increasing proportion of contemporary illness is the direct result of TILT and ensuing SRI. Avoidance of triggers will preclude symptoms, and desensitization immunotherapy or immune suppression may ameliorate symptomatology in some cases. Resolution of SRI generally occurs on a gradual basis following the elimination of bioaccumulated toxicity and avoidance of further initiating adverse environmental exposures. As has usually been the case throughout medical history whenever new evidence regarding disease mechanisms emerges, resistance to the translation of knowledge abounds.

Elimination of persistent toxicants from the human body

There is limited understanding of the toxicokinetics of bioaccumulated toxic elements and their methods of excretion from the human body. This study was designed to assess the concentration of various toxic elements in three body fluids: blood, urine and sweat. Blood, urine, and sweat were collected from 20 individuals (10 healthy participants and 10 participants with various health problems) and analyzed for approximately 120 various compounds, including toxic elements. Toxic elements were found to differing degrees in each of blood, urine, and sweat. Serum levels for most metals and metalloids were comparable with those found in other studies in the scientific literature. Many toxic elements appeared to be preferentially excreted through sweat. Presumably stored in tissues, some toxic elements readily identified in the perspiration of some participants were not found in their serum. Induced sweating appears to be a potential method for elimination of many toxic elements from the human body. Biomonitoring for toxic elements through blood and/or urine testing may underestimate the total body burden of such toxicants. Sweat analysis should be considered as an additional method for monitoring bioaccumulation of toxic elements in humans.

Exceptionally High Serum Concentrations of Perfluorohexanesulfonate in a Canadian Family are Linked to Home Carpet Treatment Applications

Background: Inadequate levels of vitamin D (VTD) throughout the life cycle from the fetal stage to adulthood have been correlated with elevated risk for assorted health afflictions. The purpose of this study was to ascertain VTD status and associated determinants in three clinical practice populations living in Edmonton, Alberta, Canada - a locale with latitude of 53°30’N, where sun exposure from October through March is often inadequate to generate sufficient vitamin D. Methods: To determine VTD status, 1,433 patients from three independent medical offices in Edmonton had levels drawn for 25(OH)D as part of their medical assessment between Jun 2001 and Mar 2007. The relationship between demographic data and lifestyle parameters with VTD status was explored. 25(OH)D levels were categorized as follows: (1) Deficient: <40 nmol/L; (2) Insufficient (moderate to mild): 40 to <80 nmol/L; and (3) Adequate: 80–250 nmol/L. Any cases <25 nmol/L were subcategorized as severely deficient for purposes of further analysis. Results: 240 (16.75% of the total sample) of 1,433 patients were found to be VTD ‘deficient’ of which 48 (3.35% of the overall sample) had levels consistent with severe deficiency. 738 (51.5% of the overall sample) had ‘insufficiency’ (moderate to mild) while only 31.75% had ‘adequate’ 25(OH)D levels. The overall mean for 25(OH) D was 68.3 with SD=28.95. VTD status was significantly linked with demographic and lifestyle parameters including skin tone, fish consumption, milk intake, sun exposure, tanning bed use and nutritional supplementation. Conclusion: A high prevalence of hypovitaminosis-D was found in three clinical practice populations living in Edmonton. In view of the potential health sequelae associated with widespread VTD inadequacy, strategies to facilitate translation of emerging epidemiological information into clinical intervention need to be considered in order to address this public health issue. A suggested VTD supplemental intake level is presented for consideration.

Electromagnetic hypersensitivity: Fact or fiction?

Background Concern has recently emerged regarding the safety of natural health products (NHPs)–therapies that are increasingly recommended by various health providers, including conventional physicians. Recognizing that most individuals in the Western world now consume vitamins and many take herbal agents, this study endeavored to determine levels of toxic element contamination within a range of NHPs. Methods Toxic element testing was performed on 121 NHPs (including Ayurvedic, traditional Chinese, and various marine-source products) as well as 49 routinely prescribed pharmaceutical preparations. Testing was also performed on several batches of one prenatal supplement, with multiple samples tested within each batch. Results were compared to existing toxicant regulatory limits. Results Toxic element contamination was found in many supplements and pharmaceuticals; levels exceeding established limits were only found in a small percentage of the NHPs tested and none of the drugs tested. Some NHPs demonstrated contamination levels above preferred daily endpoints for mercury, cadmium, lead, arsenic or aluminum. NHPs manufactured in China generally had higher levels of mercury and aluminum. Conclusions Exposure to toxic elements is occurring regularly as a result of some contaminated NHPs. Best practices for quality control–developed and implemented by the NHP industry with government oversight–is recommended to guard the safety of unsuspecting consumers.

Addressing vitamin D deficiency in Canada: A public health innovation whose time has come

There is compelling evidence that various chemical agents are important determinants of myriad health afflictions — several xenobiotics have the potential to disrupt reproductive, developmental, and neurological processes and some agents in common use have carcinogenic, epigenetic, endocrine-disrupting, and immune-altering action. Some toxicants appear to have biological effect at miniscule levels and certain chemical compounds are persistent and bioaccumulative within the human body. Despite escalating public health measures to preclude further exposures, many people throughout the world have already accrued a significant body burden of toxicants, placing them at potential health risk. As a result, increasing discussion is underway about possible interventions to facilitate elimination of persistent toxicants from the human organism in order to obviate health affliction and to potentially ameliorate chronic degenerative illness. An overview of the clinical aspects of detoxification is presented with discussion of established and emerging interventions for the elimination of persistent xenobiotics. Potential therapies to circumvent enterohepatic recirculation and a case report highlighting a clinical outcome associated with detoxification are also presented for consideration.