Re: immunosuppressive, not in dispute...

Hello John,

That patent seems to be currently outdated, at least outdated according to the current standard of care for kidney transplants.

It appears that this discussion is suffering from the same confusion that the researchers and medical professionals are suffering from - Terminology.

The patent calls for supplementing with 1.25 D. I don't think anyone is suggesting that is the form of D to supplement with. 25 D is what is formed when your skin is exposed to sunlight, and 25 D is what is recommended for supplementation and is known as D3. Your body converts 25 D to 1.25 D as needed to maintain serum calcium levels, and stores the left over 25 D in cells.

Transplant procedures used 1.25 D directly to guard against bone loss, but the current standard of care has changed to supplementing with ergocalciferol (vitamin D2) which is available as a prescription. Since D3 is not available as a prescription, D2 is ordered.

The amount of D2 the transplant patient has to take is determined by measuring the blood levels of 25 D.

This information comes from a kidney transplant patient who had the transplant some 12 years ago and has followed the vitamin D information with keen interest. With a transplanted kidney 150000 - 200000 IU a week are necessary to maintain proper 25 D levels and to maintain bone mass. As I understand it, the prime concern has to do with loss of bone mass. The efforts made using 1.25 D resulted in wide variations in blood levels that were extremely difficult to control.

I guess the main problem I have with Marshall and his work is that he is building models based upon mathematical possibilities. You say that he may be correct in is definition of the problem, but you totally disagree with his treatment outline. The fact is that the same model is being used for both.

On the other hand, evidence based medicine is showing very positive results when 25 D levels are in a therapeutic range.

If Marshall's group is every successful in verifying the various aspects of his model that may open up additional areas of study, but for now the choice looks like it is between a theoretical model and actual results. I believe Marshall is planning on doing a clinical trial in China. It will be interesting to see how well his model performs in that trial.

Computers allow you to explore all of the various possibilities but they don't tell you which one, or which set, is correct. I have been involved in many situations where the computer model stated that everything was good to go, and then the structure failed when it was put into service. While everything looked good on paper, the proof was in the actual use. The body is much more complex than a structure, and the proof manifests itself in the actual quality of life primarily, followed by the actual length of life.

I trust the computer to alert me to the various possibilities, but I live by what gives me a high quality of life.

Tom Tweet