Vitamin D, the study of disease: 86 minute discussion
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Summary (with approximate timestamps)
- (00:02–00:38) Introduction to Dr. David Grimes
- Lifelong physician, consultant, medical researcher/teacher, and pioneer in vitamin D.
- Early recognition of widespread vitamin D deficiency and its link to multiple diseases.
- (01:16–03:15) Discovering Vitamin D Deficiency
- Worked in Blackburn, NW England, a region with high poverty and a large South Asian population.
- Began measuring vitamin D in ~5,000 patients in the 1980s, finding up to 85% of white patients and 95% of South Asian patients severely deficient.
- (03:51–05:28) Tuberculosis and Vitamin D
- TB risk soared in the South Asian community 6–8 years after arriving in the UK, likely triggered by lack of sunlight (vitamin D).
- Vitamin D supports T-cell function (cellular immunity), helping contain TB bacteria.
- (08:39–10:34) Historical Insights on Rickets and TB
- Historical data (Glasgow, early 1900s) showed rickets (vitamin D deficiency) and TB clustered in poor, indoor workers.
- A 1926 study in Bombay revealed wealthier families (who stayed indoors) suffered more rickets/TB, whereas poorer families working outdoors were healthier.
- (14:13–15:10) Maternal and Childhood Vitamin D
- Vitamin D deficiency in pregnancy can cause rickets and long-term health issues for children.
- Babies born in winter months (when mothers have less sun exposure) have higher risks of certain diseases (e.g., multiple sclerosis).
- (18:09–23:00) Broader Disease Links (Renal Disease, Diabetes, Heart Disease)
- Chronic kidney disease and autoimmune conditions may be worsened or triggered by low vitamin D.
- Cardiac disease (atherosclerosis, coronary artery disease) may involve chronic infection/inflammation, where vitamin D is crucial to immunity.
- Type 2 diabetes correlates with low vitamin D, possibly due to effects on insulin resistance.
- (27:30–31:52) Case Histories: Abdul and Frank
- Abdul: Arrived from Pakistan as a child; spent most life indoors in poor conditions. Developed kidney failure, TB, strokes, heart attacks, diabetes—all tied to poor immunity and vitamin D deficiency.
- Frank: Born in a deprived area, developed peptic ulcers, coronary artery disease, strokes, and peripheral vascular disease. Again, linked to chronic vitamin D deficiency and social deprivation.
- (40:48–46:32) Decline in Heart Disease & Role of Infection
- Heart attacks peaked around 1970, then declined—possibly related to shifts in infection patterns and immunity.
- Vitamin D deficiency undermines the body’s ability to fight chronic inflammatory/infective processes in arterial walls.
- (50:00–1:03:00) Public Health Implications
- Advocates routine vitamin D testing, especially in pregnancy: “No child should be born deficient.”
- Highlights the importance of vitamin D for immunity against all infections (rather than specific vaccines alone).
- Notes that individuals vary widely in how much vitamin D they need (body weight, skin color, sunlight exposure).
- (1:06:00–End) Conclusion and Next Steps
- Emphasizes vitamin D as “low-hanging fruit” for global health improvement.
- Dr. Grimes plans to reissue/update his book in PDF form for wider distribution.
- Encourages broader public health policies to ensure universal vitamin D adequacy and break cycles of preventable disease.
Raw transcript
(00:02) well welcome back and uh Dr David Grimes has kindly agreed to come back and talk to us yet another time despite yesterday thanks for that David great great for you to come back now um today we want to you you're basically been a lifelong physician you're a consultant physician uh you're a medical researcher you're you're a medical author and medical teacher this is this is uh this is what you've dedicated your life to and you're also a leading Pioneer in the issue of of vitamin D recognizing the widespread deficiency
(00:38) of vitamin D and and the multiple conditions that are predisposed to if people don't have adequate levels of vitamin D yeah um what is it got you in when and why did you first get interested in this topic much of what I've learned during my working life has been learning from patients people tell me their stories somehow all fits together and a number of people told me their life stories and the illnesses they'd had during the lives and so much of it revolved around vitamin D deficiency I didn't realize that at the time but had to put two and
(01:16) two together work out the common factors and the people in particular were in I was working in Blackburn which is a poor town in the northwest of England and uh the there's a lot of poverty in the town the poor people with the predominant patients in the hospital where it was working also the ethnic salvation population had a large degree of of illness great degree of illness and putting it together these were basically first generation immigrants in this time so we're talking about 1970s ' 80s 90s that's right yes yes indeed but it
(01:53) continued in the second generation as well that's the important thing and um so putting together the northwest of England the British Isles at a fairly Northern position in the on the globe uh the poor people the South Asian um ethnic people and the common factor was vitamin D there's a great shortage of vitamin D um and I then under took quite a lot of research into vitamin D levels looking at about 5,000 people and the vitamin D levels this is what this is a sort of 1980 is yeah that's right 1980s and it was staggering how much deficiency of
(02:38) vitamin D there was especially in the South Asian population you finding a difference in the levels between the the white population and the yeah the Asian well basically about 85% of the white population were vitamin D deficient wow and about 95% of the South Asian population were severely vitamin D deficient it's a staggering numbers isn't it absolutely terrible yeah and it can always be put right of course now social deprivation is not not an easy thing to correct and as a physician I was not in a position to to uh alter
(03:15) improve social deprivation how is there to reduce illness and some people would say well rather than producing ill reducing illness directly and treating people you should have put right there social deprivation well do so you can only do as a physician I could only do what I was capable of doing what I knew what to do and one of those things was of course correction of vitamin D deficiency identification and correction of it and that's what um led me for the next 30 Years research Etc and here we are today what was what was
(03:51) the attitude of your colleagues at the time did they say oh this is a good idea doctor let's research this or were you how was it received not in a particularly positive way but I was really working on my own I didn't have a department I didn't have a team of people working with me it was very I was just on my own doing this well you just you said you'd have your regist some Junior doctors well the the junior doctors were involved on the clinical side and they become aware of what I was doing but the actual work and on on the
(04:23) research side was purely myself it was um right just on my own really wow impressive so I don't think I influenc my colleagues very much at all but perhaps uh perhaps by now they might be realizing there's a bit of what hard to say the pennies dropping very very slowly that's right yeah indeed so so you you found this great great levels of vitamin D deficiency especially in in the ethnic Asian population yeah yeah what would happened then well it was really a matter then of preventative medicine and to prevent disease
(04:57) correcting vitamin D deficiency I couldn't do it I could only deal with the people who were sick I couldn't deal with the people who were not yet sick the people that came into your care yeah that's right that's right right yeah and it that would need a public health yeah um initiative yeah but I wasn't able to influence the public health side of things yeah I mean even at that early stage as a pioneering thinker in this were you starting to correlate the vitamin D deficiencies with specific pathologies and reasons for the patient
(05:28) admissions yeah yes I was um the first one was tuberculosis right which is well established as being due to deficiency of immunity so that happens with the South Asian population yeah so tuberculosis is basically a chronic bacterial yeah often lowish grade or yeah I mean it can rumble on for years tuberculos it can indeed ultimately killing but going on for a long time yeah slowly reducing levels of um of health and gradually leading chronic morbidity for years and then you die that's right yeah I'm afraid so that's right that's right
(06:10) it's sad yeah so what was happening actually with the South Asian population there's a colleague of mine Professor Peter rrod and he would took the lead in tuberculosis and he um and he and I talked together about this with the South Asian population and there other Publications that showed that people from who came to this country from South Asia they didn't have they didn't have tubic when they came but they developed it and this has been researched by other people theyel cubiculos about six to eight years after
(06:46) they arrived in this country I did I assume that it was fairly indogen in South asiia they just brought it with them that's not the case well they brought the bacterium with them I see but the disease was latent I see the disease was latent and they come to this country and after about 6 eight years suddenly they became ill with tuberculosis it's been activated it's been activated by no vitamin D no sun entirely different environment from where they came from so in Sunny environments they're making enough vitamin D to keep yeah while
(07:22) while they didn't eliminate the bacterium it was still still there but it was kept it was kept sub pathological levels it was kept down by our immunity and Immunity is so vitally important and the tuberculosis kept under control by immunity which depends upon vitamin D without vitamin D immunity doesn't work basically well there are other reasons why immunity doesn't work one of them is AIDS acquired immuno deficiency syndrome due to HIV the virus and that virus damages the tea cells now that's one way in which the tea cell cells the tea
(08:01) helper cells uh don't work properly but the other way is because tea cells require vitamin D to escalate the immunity without vitamin D the immunity cannot be escalated and the T cells don't work properly and disease occurs such as tubos yeah and this is cellular immunity not the um antibody immunity cellular immunity yes the so these immune cells will actually attack yeah the bacterium directly or attack an infected cell yeah cell imity as opposed to humoral immunity where the antibodies were floting around in the body tissues so
(08:39) this is the important thing in the South Asian population coming to England is they didn't catch tuulos when they came to England yeah but being in England or Scotland even Wales or Ireland um activated the disease right and so what's that all about it's because they're no longer getting vitamin from the Sun and especially if they are and it was it it was more common actually in some research in the Hindus who did not eat meat and um right let less fatty food perhaps they were not getting any Vitamin D from the diet that alone from
(09:21) the Sun interesting and it was it was very sad to see it happening ideally what should have happened is that well let me give you another example if we go into a the tropical area we find out if there are any diseases there that we don't want to catch such as malaria yep and if if it's a dangerous place well you don't go but on the other if you need to go there and there's malaria you take an antimalarial treatment fine that's that's an initiative that should have happened when people came from Asia South Asia to
(09:58) England yeah the question should have been put to them or statement should have been made to them when in England you're going to become vitamin D deficient you must take vitamin D when you're in England but no one tell them that I I remember I remember at that time in the early 80s y learning that there was a huge amount of tuberculosis in in the South Asian especially population and I didn't realize it was vitamin D deficieny but but why why didn't the respiratory Physicians around the country realize this well some of them
(10:34) did right no question some of them did they two and two together um this is particularly so in the um in the London Hospital in London there was there there's a great awareness of vitamin D deficiency going with tuberculosis now it was realized 100 years ago that there was a lot of tuberculosis in the poor people of Glasgow yes and there's a lot of rickets as well yes the rickets that due to deficiency of vitamin D and tuul tuberculosis went together among the poor people in Glasgow so rickets and tuberculosis both common in the in the
(11:16) SL yeah Association as you say is a clue to cause the two conditions are associated that is is such an important it's such an important point that Association is a clue to causality you know when whenever these days you say well there's an association here and there's always I get I wish I had a pound for every time someone and sent me a message saying John um correlation is not causality don't you realize this yeah I do realize this but yeah you know if there is a causal relationship there'll also be a correlation there
(11:51) will indeed absolutely so let's not let's stop poo pooing correlations and say ah correlation interesting yeah yeah so here we have it Association is a clue to C absolutely is a clue to ca now the point is of course if you're interested in your work and life in general you look out for Clues and a clue makes you stop and think it doesn't prove anything but it makes you stop and think and then you can take it to Stage sometimes you may just dismiss it in a few minutes but at least you should stop and think about it
(12:23) and not automatically he got to mean something yeah absolutely well pattern recognizing aren't we are exactly exactly recognizing patterns all important there's a Dr JS Hutchinson in Glasgow decided to investigate this further and he went to India yeah and he had this this is when this is 1926 oh wait well this is way back right okay so the the association between rickets and tuberculosis in Glasgow yeah it was in Glasgow let's have a look at India he had the opportunity to go to India as part of the the British Empire
(13:02) as it were yeah and we can learn so much from cross-cultural comparisons very much so anyway he's in Bombay and he was assisted by a a a a a man called I think he Mr sha whatever it was anyway yeah huton sha and they produced a wonderful monograph of this and what they found out is that tuberculosis or did they start with I'm not quite sure the started withi it or tuberculosis but anyway they found out that they coexisted and they coexisted in the wealthy people the poor people were much much healthier and the wealthy people in
(13:44) Bombay they were the ones who got tuberculosis and the children got rickets right so it was the opposite way around to Glasgow that's right yeah see the wealthy people yeah they were able to stay indoors yeah yeah away from the Sun yeah whereas in Glasgow poor people were working in the Mills and the M that's right Indo indoors and the wealthy people were out in the gardens in the suburbs whereas the poor people working out in the fields of India yeah they had they they they were the wealthy they were the healthy ones that's so
(14:13) simple isn't it so in Glasgow the wealthy got plenty of Sun yeah and in in Bombay the poor got plenty of Sun that's right yes indeed it was the other the other way around yeah this is a brilliant bit of research they did yeah I love reading the book that came out of it I've not read it recently and before we carry on with that story this you know to the people in Bombay and the people in Glasgow that would have been so obvious yeah we wouldn't have thought of it that's right the question in my mind is how many Clues to the causes of
(14:47) disease we have now yes yes are blatantly obvious yeah absolutely and and and including psychiatric disorders as well as physical disorders and we just don't see it because we live with it every day so often what you need is someone like this doctor coming from Glasgow to Bombay yes where everything's new and fresh and seeing it with fresh eyes and realizing that that's right anyway he he he sused this out did he and he did indeed and he get very careful records of the people who he interviewed and visited yeah in in in
(15:16) this area of Bombay it's very very thorough piece of research um I don't know how influential it was I know one thing it influenced me in a very big way I thought it was absolutely brilliant and I paid a lot of attention to it you realize vitamin D then no it was just the sun right so he knew it was the sun yeah they put the two together it was the Sun so was knowledge of I mean vitamin D was known about in in the 1920s was it yeah but in Glasgow in particular it was considered to be a dietary Factor right because when
(15:49) children with rickets um in Glasgow was sent home to the coastal Villages and given codly oil and eating fish yeah they improved so people have never seen Ricket just just tell us a little bit about it what is rickets well rickets is a disease of growing bone where the bone doesn't grow properly bone starts off as a sort of fibrous cartilagenous Matrix and then it becomes ossified by the addition of calcium yeah so it's quite flexible when you're a child isn't it absolutely and uh when when babies are um in the first year of Life the Rick is it
(16:33) becomes obvious with with the where the ribs join the sternum and also on the on the wrists as well the Ring of beads yeah yeah that's right and on the wrists so so so the joints between the cartilage and the bone in the chest is not is not joining up not joining up properly no no now once the bab once a little one-year-old starts to walk and becomes a toddler yeah then the weight of the body is on the legs yeah and so the legs deform and so we get the bow legs of rickets at that time yeah cuz the bone only when they're toddlers yeah this of
(17:10) course is why why children often get green sting green stick fractures yeah the fracture doesn't go all the way through because the bone bends whereas yours and minees are just snap like an old dry TG and the bad part of it when there are toddlers also and young children yeah is in girls yeah the femur the head of the femur the hip yeah would push into the pelvis yeah and the pelvis would deform and narrow yeah so when they came childbearing age they had a dreadful time with child birth yeah because the pelvis wasn't big enough for
(17:45) the baby to go through so women want a nice wide pelvis yeah to facilitate the fetal head going through that and if the pelvis is small we get a condition called keop pelvic disproportion that's right which is still a huge problem it can be certainly in Asia I visited I've visited fish hospitals in in Africa where uh the mother goes into labor she stays in labor for two or 3 days yeah yeah four days eventually the unconscionable in The Villages yeah uh eventually the the baby will die it massat that the baby's ejected yeah but
(18:23) they left with his uh the pressure effects and and you often get the fistulas yes between the bladder and the vagina and uh it's all caused by this keop pelvic disproportion could have been completely prevented Yeah by early life nutrition for the these poor young women absolutely Glasgow became a major Center for understanding this right and for the pregnant management of delivery and these poor women with this contract disproportioned yeah and I suppose a lot of them would in the Glasgow situation there'd be cesarian
(18:59) sections yeah yeah yeah but in Glasgow initially as I say because rickit could be healed by fish oils yes it was considered to be a dietary disease makes perfect sense yeah and in fact today um the organization in the UK the official organization which advises us on vitamin D is the standing advisory committee on nutrition yes interesting you know it's not really nutrition yeah it is not really a diety factor it was realized in the in Austria in particular in the Alps that um not in the Alps but in the industrial areas of Austria that
(19:43) children again were born and develop Ricket develop Ricket because their mothers were V vitamin D deficient so if the mother was vitamin D deficient that means the child would not be getting the vitamin D in the breast milk well it's before the B before birth development right yeah it's the it's the last three months of pregn right so it's almost like it's almost like prenatal rickets it is yeah yeah yeah in fact prenatal the main the main issue is brain development in the last three months of pregnancy and that requires
(20:18) vitamin D you know I I didn't know that really right yeah I mean yeah another interesting Factor right so so vitamin D maternal vitam Vin D is necessary for fetal third trimester neurological maturation absolutely yeah vitamin D is vital in pregnancy see no child should be born deficient in vitamin D absolutely not yeah it it a little baby is not going to be exposed to the sun no and it's going to be protected from the Sun so the baby requires enough vitamin D certainly to last it for six months right and then
(20:59) it'll develop its own so the ideal time for a baby to be born yeah is in about October November yes so the mother's been pregnant during the summer mom's had a bit of sun baby loads of vitamin D pass it on to the baby and the baby is born with adequate amount of vitamin to last through the winter and then when the baby is 6 months old in its pram the mother will put it out in the sun not to get sunburnt of course but it in Direction before was paranoia about melanoma that was that was the case yeah exactly but
(21:33) the um that's another interesting story but any going back to the babies the time to be born is is October November and you in other research has noticed the difference in children children's health depending on the time of year that they were born exactly yeah right the main one is the development of multiple sclerosis later in life wow it's childhood factors influencing their adult life right so the the risk of T of multiple sclerosis is highest in babies born in March April when the mother's been pregnant in the
(22:09) winter time and the risk of Tu multiple sclerosis is lowest in the baby's born in October November in a sense that's such a simple observation but I hadn't I mean I've talked tuberculosis for the last 30 or 40 years I've always taught that it's more you know tuberculosis is more common in the northern you know way up North way down south near you know near the Arctic circles but and less common near the equator but yeah that's why I didn't go became the tuberculosis capital of the world tuberculosis or multiple sclerosis tubos tuis yeah but
(22:44) also it's been the multiple sclerosis capital of the world is that Northwest Scotland especially in people that were born yeah in Spring yeah that's right and now of course now at long last vitamin D is being used in the treatment of people with with multiple sclerosis yes and I've certainly had I don't know a thousand emails and messages yeah of people that say they're multiple multiple sclerosis dramatically improved yeah yeah with fair I must say fairly high doses of Vitamin D it needs to be absolutely yeah yeah so people with
(23:23) multiple sclerosis if they're watching this video go to your doctor get your blood levels checked yes and get it bunked up yeah so we can't tell you to take 10,000 units a day but some doctors might tell you to take 10,000 units a day yeah yeah yeah whatever is necessary to achieve a goodev it yeah it's like with treating insulin treating diabetes with insulin you the dose de is dependent upon the the blood the blood test results basically you can't say diabetics need five units of in in a day that would be nonsense yeah it's going
(23:55) to be massively different depending on the blood test for Every indeed and the same with vitamin D it's achieving a good blood level yeah which is thought to be now about 100 um nanomoles per liter which is 40 nanog per mil yes yes that's what 40 n per M but it's a matter of achieving that blood Target level if you're eating we're treating hypertension we have a target blood pressure we raing up of course we do treating diabetes is EXA we're obsessed by hba1 C and youred and yet for vitamin D don't worry about
(24:35) that any doctors watching titrate your patients vitamin D levels we would suggest is that fair that's right yeah titrate them why not now in the industrial areas of Austria the children again I mentioned develop rickets because the mothers who are working in the factories didn't have enough vitamin D to provide them for when they were born and I suppose that supp the further away they are from the sea the less fish oily fish especially they're going to get absolutely wouldn't but what happened we know the Heidi Story the
(25:10) children were sent to the relatives in the Alps yeah away from the cities in the high areas of farming and they got better yeah and so it was realized it wasn't known why they just did but it realized in Austria the key was the sun y whereas in Scotland who where they didn't get much sun the key was the fish right and it was really that's why vitamin D was regarded as being a vitamin an essential thing that we can't produce ourselves I see whereas its proper name because it's vit it's vital in the diet yeah it's a
(25:47) hormone that's producing the skin so interesting so in Austria they realized that rickets was a sunlight deficiency disease yeah in Glasgow they realized it was a dietary deficiency disease yes that's right suppose if you're 10,000 ft up in the Alps you've got so much less atmosphere yeah yeah I would assume you'd make vitamin D more quickly you would at sea level would you is it is it there's much more ultraviolet light high altitude yes indeed it's just being in the fresh air and getting the sun Yeah so basically when people are short of
(26:17) vitamin D is not a nutritional issue it's a hormone deficiency and when we take vitamin D supplement when we take a vitamin D it's a form of hormone replacement therapy yes and so is it so is diabetes yes of course it is we give insulin it's hormone replacement therapy when someone has an underactive thyroid and we give thyroxin it's hormone replacement therapy as well as the estrogen deficiency that follows the menopause in women and so it is with um vitamin D yeah we're giving hormone replacement therapy we have to achieve or Addison's
(26:55) disease where you might want to give some steroids another one yeah indeed add is another one yeah yeah indeed so so interesting TI tying those things together it is it is indeed so you better show this book off David that you've got here what is this text here and and where can we buy one well this is the book that I wrote I think it was 1999 and I must say it's probably the most readable medical textbook I've ever read it is so the intelligent laier would have no difficulty with that at all it was written not for it was written for the
(27:30) general public that comes through yeah to understand yeah so the book can be a bit tedious a lot of medical knowledge no I I if you know lots and lots of stuff I suppose but no I don't even so I I don't think so it's we've got to think about what diseases Etc yeah yeah but I've started the book off I said I learned a lot from my patients and can I read the bit about Abdul please do I'll just read this to if you don't mind yeah no please can't remember it all so I'll just read it out of the book Abdul was born on 22nd of October
(28:05) 1961 in Pakistan in a village close to Rael pindy the family was poor his father worked on the land but his mother did not work outside staying in the house most of the time as far as he can remember his mother wore a headscarf but she not she did not cover her face Abdul did not go to school but he spend his T days playing outside with the other boys in 1971 the family came to live in England in search of a better life they settled in ozel twistle in Lancashire where his father obtained employment in a textile mill abda went to school in
(28:45) Ole twistle but he did not he did not play out very often they lived in the Terrace house without a garden the textile M which his father worked closed down but he was able to obtain work as a laborer in the C Factory and the family moved again living in a small Terrace house after leaving school with no qualifications Abdel worked in the factory as a battery filler in England two more children were born to the family but they were not as healthy as Abdul was in childhood one swed from learning difficulties and the
(29:19) other was congenitally deaf Abdul had always been of low weight small in sta but in 1993 at the age of 32 years his health deteriorated he visited his family doctor with symptoms of lethargy he was 52 kilogram in weight and initial blood test showed he was anemic further investigations showed that he had Advanced kidney failure he was clearly critically ill and his family doctor therefore arranged for him to be admitted to the hospital as a matter of urgency full assessment included the ultrasound scan which showed the kidney to be small and
(29:56) shrunken the results are progressive inflammation over a period of perhaps 10 years usually driven by an immune process the disease was not reversible ABD was started on life-saving dialysis and put on a maintenance program in 1996 he received a kidney transplant on further investigation he was shown to have low serum calcium level in the blood and the serum para thyroid hormone concentration was high the combination of the two indicated by chemical features of osteomalacia the the adult form of rickets the result of basically isn't it
(30:37) soft bones yeah he was given vitamin D supplement that was necessary however the D the supplement had to be stopped quite early because his blood calcium level Rose above the normal range he developed what's called tertiary hyperparathyroidism a rare but well recognized complication of advanced chronic renal failure in 199 5 abdol sustained a fracture of the scapula an unusual fracture there was almost certainly a manifestation of continuing osteum malaa the next development was 1997 when he developed en large lymph
(31:11) Dan in the neck cical lymph had an opathy chest x-ray showed enlarged lymph glands in the chest and biopsy of the neck glands confirmed the clinical suspicion of tuberculosis and he was given a a six-month course of treat treat with rampin aizin and pomide in 1998 Abdul developed sudden onset weakness of his left arm this was because of a cerebral infarction a stroke in 2001 he was admitted to hospital as an emergency because of a sudden onset of chest pain ECG showed features of mardal infarction heart attack on that admission he was found to
(31:52) have high blood glucose levels and a diagnosis of diabetes was made he later went on to receive treat M with oral hypoglycemic agents in 2002 his kidney function deteriorated and it appeared that the immunological inflammatory process Glo arthritis that had damaged his natural kidneys was now damaging his transplanted kidney in October 2004 he was admitted as an emergency because of sudden onset of weakness of the right leg he had sustained a further cereal inunction a stroke blood test showed deteriorating real function despite the
(32:30) huge burden of illness during the past 10 years abdor remained cheerful and optimistic this was the last time I saw Abdul in December 2004 he developed a stfloral septicemia despite full intensive care support his kidney function deteriorated rapidly and he died his age was 43 years the good life that abdel's parents expected for their children had failed to materialize poor guy I mean I mean dear me yeah R renal failure which is horrible yeah tuberculosis Strokes myocardial infarctions diabetes yeah it's a life of
(33:09) chronic ill health yeah it is absolutely but what's the let's maybe the relationship between renal failure and vitamin D what's the thinking there well OST maltia yeah that's basically soft so he didn't have rickets cuz when he was playing outside Pakistan so he was healthy when he came to the UK he was he was healthy when he came to the UK then because he didn't have enough bones he wasn't mineralizing his bones and they went soft yeah you got osto Malaysia what we know about kidney failure yeah it's far more common
(33:45) in the South Asian population and the and the black African population in this country yes in the UK yeah I knew that yeah yeah yeah and it's thought to be because of it's one of these immunological things where vitamin D deficiency is a major factor so glamelia nephritis as I understand it is an inflammatory disease of the kidney stimulated by infection with autoimmune processes after that so it's all it's all related to initial infection and ongoing autoimmune factors and we know that vitamin D is massively important in
(34:17) the initial infection yeah and is is vitamin D important in modulating autoimmune pathologies autoimmune diseases it it certainly seems to be Associated yeah no question about that with the kidney when people get kidney failure they can get vitamin D deficiency as a result of the kidney failure as well as it probably causing the kidney failure in the first place because the kidney is activating the compated story the kidney is activating some forms of vitamin D as yeah yeah but we can see that AB all these diseases that you developed were
(34:54) all linked to vitamin D deficiency so it's quite possible if if he' been vitamin D replete all his life he might never have developed that yeah that's tuberculosis we've already discussed clearly that's right bacterial infection vitamin D is a huge Factor yeah um I'm I'm not so sure about the vascular disease so he he he had a myidal infarction he had a cerebrovascular accident what's what's the kind of linking there well heart attacks are very closely linked to vitamin D deficiency yeah no question about that
(35:24) do do we know why that that that's certainly true do we know why it is well this is another story let's have it why do people get heart attacks what is the nature of the disease that leads to what we call mical INF right so what i t what I taught for a couple of generations was it's due to uh fatty accumulation atherosclerosis yeah in the arteries clogging up the arteries meaning the blood supply to the tissues is juice and making blood clots more likely yeah yeah well that's that's basically true oh that's good because I found out so many
(36:07) things I've taught all my life and of course that leads on to cholesterol yes it's all due to cholesterol that's what we were taught yeah and so Keys you know yeah it personally don't believe it is due to cholesterol I think that the disease is due to infection in the arterial wall and chronic inflam yeah and chronic inflammation and as as we know we need Vitamin D to control subdue infection yes keep it under control if we short a vitamin D then the the inflam the infection the inflammation takes over and becomes more
(36:46) severe well people say well how on Earth can a disease of the coronary arteries the arist to the heart arist to the my why it be due to infection well what else is it due to people say it's you to diet well what about what do you mean diet and but there've been loads of ideas about how diets can be bad for us especially high cholesterol diets high fat diets and this has been the story for for for nearly a century well for my for my working life yeah absolutely you know since the mid '70s up until the you know
(37:21) I only learned yeah the the more modern thinking perhaps in the last 10 15 years yeah but Dad manipulation there not been a benefit I'm afraid to say so people say well it's due to cholesterol well cholesterol is an important part of the body yeah we make cholesterol why on Earth should cholesterol be um should we make cholesterol if it's going to be poisonous to us and so it doesn't make a lot of sense now the fat in the arteries is this LDL cholesterol which is part of the body defense mechanisms so you might
(37:56) say um why are there a lot of firemen at the scene of a fire yes are the pyromaniacs you know are they setting fire to the places but they're not they're there as Defenders why are there a lot of policemen at this the sign of crime all these policeman criminals no they're not why is a lot of cholesterol in the tissues of of the heart is there it's a protective mechanism secondary mechanism interesting that's the first line of defense really I mean I I remember I worked on carare in the late 80s and the the people used to come in with
(38:35) huge myidal infarctions yeah yeah yeah almost like boils inside the arteries that would just burst that's exactly what it is like a boil inside the artery yeah and they add huge amounts of damage to the heart yeah yeah don't see it now you see it less if well those severe mical inunctions with ECG changes don't see at all yeah we we used to call it we used to say you know not in front of the patients I open up but you know we call it Tombstone ECGs because the St elevation would be like like a tombstone I've not said that expression but
(39:11) massive change just massive St elevation you know the thing about it about the um deaths from mardal infarction deaths from heart attacks it started the disease started about 1926 interesting and it's been very very clearly recorded in this country from England Wales in particular statistics the onset of the disease in about 1926 and it Rose and Rose into the night into the time of the second world war but then people weren't interested in disease then they were interested in survival from a war yeah and it reached
(39:49) its peak in 1970 now in 1970 I was the resident medical officer of the Manchester oil infirmary and we every every day we saw people brought in absolutely clapped out dreadfully pale sh why is pouring with sweat sweaty pain shocked excruciating pain terrified that's right horrible and the chance of death was very high very high now before then we didn't have coronary care units but we had to have coronary care units then because we were suddenly dealing with something this hadn't happened before yeah it was the it was the peak
(40:24) of an epidemic it was a pandemic really and all over Europe North America in particular and um and then it declined and it declined almost completely in the first decade of the 21st century interesting it didn't decline be God of statins because 80% reduction had taken place before statins were invented yeah in the trend was well and truly down yeah yeah yeah the another interesting thing about statins is that they were developed as an antibiotic were they yeah they know out 1972 in Japan and they found to have a serious side effect
(41:09) reducing the cholesterol level of the blood right so they couldn't get approval with the side effect like that as an antibiotic yeah far too dangerous now an antibiotic you take for a week and that's it yeah anyway they they put they put it on the Shelf as it were and then later on it became clear that what was required pharmacologically was a cholesterol lowering agent said ah what about that Statin thing that we that we discovered from a mold in 1972 let's take it off the shelf reformulate it remarket it as a
(41:46) cholesterol lowering medication and so you know the rest of the say is history it all happened and it's amazing without the benefit of cholesterol lowering is very minimal yeah but it could be due to its antibiotic effect that's the point the benefits could be due to an antibiotic effect the best the most effective time to take a Statin is when you're actually having a heart attack at the time where that boil is bursting yeah in the arteries yeah you require an anti an antimicrobial agent the other thing about infection is there
(42:32) are two well there are three major um precedents of infection causing damage to the heart yeah one of them is syphilis yes um and syphilitic heart disease very serious damages aort aortic aneurism rupture damages the Artic valve in particular and causes death cardiac death half fa basically yeah the next one is rheumatic fever yeah um which was common at the the beginning of the 20th century and we they had rheumatic heart disease an infection causing damage to the valves which would cause death and then of course coronary uh open heart
(43:19) surgery came in to solve that with with the valve replacement surgery and the other one is infective endocarditis which gets inside the heart sticks in the heart and causes serious damage and death there destroying the valves also so there are precedence to infection causing heart disease there are no precedence to diet causing heart disease apart from deficiency of vitamin B1 which causes berry berry yes yes but that's the deficiency yes a dietary deficiency not a dietary Surplus but when people say well the
(43:57) heart disease is due to a dietary excess of something or other there are no precedents for that at all it doesn't really work and then they say oh well it's it's all the fast food now if you look at the graph of um of deaths from coronary heart disease increasing from about 1926 up to up to 1970 and then declining equally rapidly since 1970 we've had fast food there's not much fast food before I mean we recommend strongly against Ultra processed food for many reasons but for this specific pathology the amount of ultra processed food that
(44:36) we've been eating is increased since 1970 yeah but heart coronary coronary arterial atherosclerosis yes yes all the atherosclerosis the fatty aoma in the cereal arteries has been has been reducing yeah so is is is cereal are Strokes less common than they used to be less cereal vascular it's been well recorded the decline of Strokes the decline of coronary heart disease it's been well recorded in the United States and in the and in this country as well very very well record both the rise and the fall has been very
(45:11) well recorded but we're still so so this idea that the there's potential rumbling infection inside the blood vessels yeah you can see that vitamin D is going to be essential for combating that infection yes but we've had a decline of cardiovascular disease since 1970 yeah but we haven't had a a corresponding increase in vitamin D levels particularly have we no we haven't but basic if it is an infection yeah see there's a background of arterial inflammation all the bacteria circulating in our blood and the is controlled and it
(45:54) doesn't cause a serious problem but it causes is lowgrade artherosclerosis that's okay but superimposed upon this we get this boils this really severe form yeah which I think was due to a new a new bacterium and the research has been far from complete but um cidian pneumonia is the most likely candidate but there we are you know and that could spread from the respiratory passages absolutely and if it's a new one if it's a new bacterium with no immunity against it yeah like with covid-19 we had no immunity against it
(46:32) so it caused an awful lot of trouble awful lot of deaths yeah so but but it's gone away because we' become naturally immune to it and the immunity is passed from generation to generation now yeah yeah not a problem really anymore hardly so things you epidemics always sort of reduce so much we can learn from the the historical pattern dis and the geographical patterns of disease it's we can learn we can learn four today by looking after looking it yesterday Yeah question and the diabetes that abdor had presumably was type
(47:10) two yes it was it was type two diabetes yes indeed what basically is the difference between type 1 and type two diabetes Well type 1 diabetes is basically a deficiency of a primary deficiency of insulin yeah so people need insulin the body produces approximately one unit of insulin an hour yeah on average 24 units a day that's that's the basic level but when it goes down when you stop producing insulin that's when you get type 1 diabetes so it's the disease of the pancreas if yes basically yes that's right now type two
(47:47) diabetes is what happens is the body becomes resistant to the effects of insulin so insulin stops working yeah yeah stops working as well so the blood sugar Rises and you get diabetes yes now the insulin resistance factors are far from Clear even today but insulin resistance is is the big problem I'm afraid vitamin D comes into this as well well that's what I was thinking abdol was quite thin yeah we normally associate type two diabetes with obesity we do so what's the kind of how do we round that square round that
(48:25) Circle um well we I'm not quite sure I can answer that question I'm afraid to say there's so much going on in poor Abdul's life yeah but nevertheless he he was insulin resistant and that see he was diagnosed the diabetes was diagnosed when he was admitted on account of a heart attack yeah and that's been the case ever since for with a lot of people that's when the diabet type 2 diabetes is usually not people are not aware of it it doesn't create the dangerous illness of Keto acidosis in the type one diabetes it's it's in
(49:04) it's in it's Insidious is stealthy yeah it's just there it's a piss and it's it's discovered on routine testing you might say what's the commonest cause of diabetes um answer is going to see your doctor absolutely you you're going thinking you're perfectly normal and he does some tests and he found out you've got diabetes and that's type two diabetes and he's quite right to to find it and he's quite right to treat it because it can lead to oh yeah absolutely very very serious damage yeah so so vitamin D is very involved in type
(49:37) two diabetes vitamin D deficiency is just tell us a bit more about that what's what's the thinking there I'm not sure there is any thinking about it to be quite we've no an association between low vitamin D levels and type two diabetes that's right yeah indeed yeah yeah so it looks like so it's ludicrous to say in Abdul's case the type two diabetes could have been associated with his long lifelong vitamin D deficiency no I'm sure that was correct we just don't necessarily understand all the mechanisms I mentioned early on about
(50:09) disease being more common in the poor and what have you there's some very interesting research done in Liverpool about 20 years ago I can't remember exactly when and they br Liverpool down into its its Wards its local government groupings around Liverpool yeah and it it was it was done by Professor Peter towns and research actually and um the they broke down each according to levels of socioeconomic deprivation and it was no question the areas of low of high socio economic deprivation the poor areas yeah had a
(50:50) high incidence of diabetes and those with the high with the affluent group had low interest in a lower risk of diabetes yeah yeah big social gr gradient there Which towns I was very interested in I mean what I would have said normally is the the quality of diet that could be afforded by the poorer people so they're more likely to eat biscuits rather than fruit and things like that yeah could be multiple factors potentially yeah the thing is once we go into di factors he doesn't really stack up yeah in general
(51:24) terms yeah you know so many people from eating biscuits well yeah I think that's B optimistic yeah is there another example in the book that you mentioned another patient that you learned from there was Frank yeah Frank yeah that was it you hear about Frank yeah I'd love to hear about Frank yeah okay he about Frank Frank was born in Arrington in 1943 in a household of significant social socioeconomic deprivation his father had been born in 1910 but had a great deal of illness he spent a lot of his time as a young man in the
(52:02) sanatorium being treated for tuberculosis this meant that he was never able to establish regular employment and at the time Frank was born he was working as a part-time caraker Frank's mother did some work as a part-time cleaner Frank passed through school without education making but should impact on him yeah yeah this is a sad thing real indictment on the system the childhood at the school come out of it with no particular benefit from it total indictment on on on the educational system you and education is so
(52:37) incredibly important to to health as an adult yeah yeah anyway so he left school at the age of 15 without any qualifications he had a succession of jobs in unskilled work usually as a storeman he married at the age of 24 and had two children the cycle of socioeconomic deprivation continued as it so often does and there was never much money in the family they lived in a small house close to the center of Arrington in his early 20s Frank developed dyspepsia in digestion yeah and after Barum x-ray he was found to
(53:11) have a Judy Lula yeah at the age of 31 years because of worsening symptoms surgical treatment they got to in pyloroplasty was undertaken in 1974 shortly before the effective medical treatment became available that is that is the ppis lon oao the meao he became unemployed in in 1980 at the age of 37 and did not work afterwards by that time ill health had developed mainly in the form of low-grade bronchitis he had smoked 20 cigarettes a day during his adult life but did not drink very much alcohol at the age of 40 Frank was admitted the
(53:51) hospital as an emergency because of severe chest pain which is found to be caused by a Mard inunction heart attack appropriate medical treatment was given and he made a good recovery but subsequently developed angina by the age of 48 he was experiencing pain in his calf muscles and walking and peripheral artherosclerotic vascular disease was diagnosed this was progressively worsened causing quite severe restriction of Mobility he continued to smoke despite being despite advice to stop although he was thin as a child and
(54:25) young adult his waging increased when he sto work and this also affected mobility in 1996 at the age of 53 years he had a stroke a cereal infarction causing right right sided weakness and severe speech disturbance he spent two months in hospital and Recovery was only partial in 200 in 2012 he was admitted to the hospital because of severe chest pain the is result to further myod inunction he survived his further development he was left sely disabled I was unable to go outside he was not able to manage stairs and slept
(55:01) downstairs in 2004 he had a second stroke which is fatal his age was 61 years now Frank chronical Health yeah Frank was my age he was born in 1943 as I was born in 1943 and our paths through life could not have been different yeah I didn't come from a a poor family I came from I didn't come from a wealthy family by any means but not the the the the the low level of Soo economic deprivation of Frank experience but it just shows how that level of socioeconomic deprivation leads to a catalog of illnesses like with Abdul and I put all
(55:41) this down to vitamin D deficiency which is known vitamin D deficiency is much more common in the poor so you lived in a ter little Terrace House yeah now I lived in a semi detached house as a child and we we had a garden and was able to play out and and and and we play in the with my friends and we and going to the Garden Etc and now as an adult we live in at quite a big house now with a a big Garden we can spend time outside when people are living in a small Terrace House in the center of Arrington there's not much to do they bented life
(56:23) is spent mainly indoors yeah and the yards used to be small it wasn't really suitable for kids playing out on and of course the atmosphere was much um worse yeah you know I live in the Ribble Valley near in Lango near to Clyo and the standardized mortality ratio uh if if you take 100 to the average National the standardized mortality ratio where I live is about 90 which is below the national average so it's better health the lower the number the better yeah whereas Arrington only 6 miles away Frank would have lived 6
(57:01) miles from where I live and so would Abdul only 6 miles away the um standardized mortality ratio is 134 you know 34% above above the national average six six miles that's all it makes a huge difference but we don't we live in a rural area of Ribble Valley not in the industrial areas and Frank probably had vitamin D malnutrition as a fetus yeah yeah absolutely meaning his brain probably never reached its genetic potential which of course is a complete tragedy correct yes yes I mean I I think this is probably a global problem I
(57:42) suspect there's a global deficiency subclinical deficiency of iodine which is necessary for normal brain development yeah um but I hadn't realized until this conversation how important vitamin D is yes indeed for normal fetal brain development yeah so if if M was deficient in vitamin D during pregnancy uh instead of being a senior executive or a brain surgeon or a brilliant Barrister yeah you know which Frank potentially could have been yes yes yeah um and the fact that education failed him yeah but very often teachers
(58:18) would think you know if if this child is not showing a bit of flare I won't bother with them so it becomes a self sort of fulfilling prophecy indeed he does but you know if his if his intellect so it's quite reasonable to surmise that if Frank was born vitamin D deficient that would have lowered his his IQ basically would have been less intelligent as a result of that and so the social economic deprivation just goes on generation to generation for biological reasons as well as sociological reasons the key to it really to my mind a key to
(58:51) it as to say I can't alter social economic deprivation no but I can perhaps help the results of it minimize the effects of it and so it would be nice if when a woman is pregnant yeah she goes to the booking department at the at the antinal clinic booking in that's the first attendance and at that time she has a blood test done for the blood level of Vitamin D yep and she's given vitamin D to throughout pregnancy to make to maintain blood level of vitamin D it's not asking a lot quite and basic I mean we actually we actually
(59:29) do that with some success with folic acid already don't we yeah we do because we've recognized that spab bifido was more likely in mothers that were folic acid deficient we we give we we we test the the women for iron and we test them for diabetes and we test them for blood pressure y well let's do a vitamin D test as well why not we don't test for folic acid we just give it give it 5 milligrams a day easy the idea iDine and vitamin D could be treated in much the same way potentially indeed yeah yeah indeed but the woman
(1:00:06) should go through pregnancy with adequate vitamin D levels and I said before no child should be born vitamin D deficient And if every child is born with adequate vitamin D development we might see a change for the better in society it's almost like breaking a generational curse isn't it this goes on from one generation to the next and absolutely right in this case a medical intervention could could eliminate the biological component of that yeah but this should this is a public health issue this isn't for me
(1:00:41) you know I'm a retired 8-y old doctor you I'm yesterday's story but there ought to be Public Health people coming up with this yeah and saying we've got to do something here's something we can do we've been trying for years to to do something about social deprivation now it's something we can do about it about the effects of it if not about the cause of it all you know absolutely the other thing that's never been clear in my mind is why are people more likely to get colds in Winter well people the more like get colds in Winter the more likely
(1:01:20) to die in the winter the more likely to have heart attacks in the winter the more likely to have strokes in the winter winter you're more likely to be diagnosed with cancer in the winter why well well could it be to do with vitamin D it's an obvious Association isn't it there's some interesting work done um on on um lung cancer the outcome of lung cancer survive you know the five years survived from lung cancer it's not good no no it's still terrible but it's best in the survival is best in the people who take Vitamin D supplements and when
(1:01:59) the diagnosis and treatment are given in the summer yeah this is a very very nice study very nice study indeed you've got a better chance of survival from lung cancer if you take a vitamin D supplement and if you're diagnosed and treated it in the summer interesting I think that might be something to do with vitamin D you know absolutely and and just an anecdotal account from me I mean I started taking vitamin D probably about 10 years years ago and maybe know just to people I know maybe about 10 or 20 of them have started taking vitamin D
(1:02:34) yeah yeah and consistently they report more energy and better mood in Winter yeah yeah less sad seasonal affective disorder yes yes and I'm sure I'm sure I looking back I used to get that I think I was pretty down in the dumps in winter time and uh yeah I'm sure the vitamin D is is has been a factor in that when it comes to mental health this is some interesting work um the diagnosis of schizophrenia yes is more likely to be in the winter time in Australia it's more likely to be in the winter time as well but their
(1:03:12) winter of course is our summer and vice versa yeah so there's a seasonal V variation so so you're more like to get schizophrenia in the winter in the UK yeah and in the winter in and in their winter in Australia in other words you're more likely to get schizophrenia December January in England yeah or in May June July in Australia a absolutely yeah looking I'm a clear way of looking at it so there's this seasonal variation but when we go to Australia we sometimes stop off in Singapore I don't know if you've ever
(1:03:46) stopped off in Singapore you probably haven't yeah well you may know Singapore is on the equator yes and the research has been done there as well and there's no se seasonal variation in the diagnosis of schizophrenia in Singapore the weather's the same all year around yeah that's right no season of variation but the seasonal variation is there in Australia and in and and in the United Kingdom so we we've got all these ideas some some some are hard evidence yeah other others as you and me yeah chitchatting really yeah
(1:04:22) um but what we need to do is make the whole country or ideally the whole world have an Optimum level of nutrition I mean that statement is impossible to argue with the whole world should be have Optimum Nutrition that that that that that's an axium isn't it and that would include making everyone vitamin D replete yeah indeed yes now if everyone was vitamin D replete we suspect would' see great reductions in all these diseases absolutely and many types of cancer yeah yeah yeah yeah and is there any is there any reason not to make the population to
(1:05:05) have adequate levels of vitamin D is it is there any side effects or dangers to people having Optimum levels of vitamin D no side effects at all no problems at all but it's like when you treating somebody with diabetes with insulin you don't give them too much insulin they got become unconscious yeah so you same with people treated for high blood pressure you don't give them too much treatment but you monitor the treatment yeah and I think with vitamin D also people are going to need a supplement yeah but they're going to need a supplement
(1:05:43) it's difficult to get adequate Vitamin D from the Sun yeah in this country and especially the older you get yeah yeah Sun beds can give you excellent vitamin D levels can they right yeah I remember very vividly a couple of patients who was just checking people for vitamin D and this particular man was he wasn't ill I don't think in any particular way but he had an excellent vitamin D level and he told me he visits a sunbed once a week actually I did know that because in the 1920s in Sweden they treated rickets
(1:06:15) with with yeah basically sunbeds yeah cotherapy treat by the sun yeah and tuberculosis as well no no this was artificial right that they used in Scandinavia sure yeah yeah yeah but yeah we used to put patients out in the sun yeah yeah we used to have Bal I I worked in an old unit once and uh there was uh Great Big Wide Doors and a huge balcony and it was built so he could wheel the patients beds out yes yes yes and leave them on the balcony when it was when it was nice nice sunny day I mentioned another couple of patients you know I
(1:06:48) just learned so much from listening to people yeah it's the way medicine should be absolutely yeah and um there's one man um he had got a few aches and pains it's from Bangladesh first generation immigrant and I thought I bet he's got vitamin D deficiency ulation being enthusiastic to find it you know if we are well well your index of Suspicion was raised that's right so I checked his blood level of vitamin D expected to be low and he came back really high thought oh this is very strange anyway he was coming back to see
(1:07:21) me a couple of weeks later yeah so I said to him I thought you going to be short of vitamin D he said do you take vitamin D tablets capsules never heard of it he said what's vitamin D I said well do you eat a lot of fish and he's he says yeah I love fish I atat fish three times a day what sort of fish do you eat he says I've eat Bangladeshi fish right I said where'd you get it from said I get it from teso in Arrington right so I go along to Tes AC there it is frozen Bangladeshi fish small white fish sea fish or fresh water fish one uh
(1:08:04) I think they' be sea fish I'm not quite sure yeah so so it does show that you can get adequate Vitamin D from fish we got to eat an awful lot of it yeah now there was another patient came to see me uh the mobility wasn't very good and he was a man with quite severe learning disabilities and he was brought in uh by his carer and I thought well he can't walk very well he doesn't go outside because had asked this question I bet he's got vitamin D deficiency so it checked his blood level and of course he didn't have
(1:08:39) so he came back and said he's got very good vitamin D level does he take any vitamin D tablets no he doesn't go outside no he never goes outside and he doesn't take vitamin D said does eat fish eats prawns he said PRS the only fish the only food he eats eats prawns three times a day all he eat and there he was and pl prawns of course feed on Plankton and it's the Plankton that produce the vitamin D it's not the fish that produce the vitamin D they're no more capable of producing vitamin D we are but they eat the Plankton yeah yeah
(1:09:14) that produces the vitam when you think if if we're fully clothed we don't produce vitamin D well fish have covered in Scales they can't produce vitamin D and they're fairly deep in the ocean as well from the plankton eat it from the Plankton the food chain that get that gets the sun without the Plankton which evolved one and a half billion years ago no probably more two and a half probably I think it was two and great oxygenation event would be I think it was yeah yeah two and a half billion years ago you're right that's when the
(1:09:43) oxygen in the atmosphere well that's when we started getting oxygen in the atmosphere before that was but the the Plankton have no use of vitamin D they produce the oil 70 hydroch cholesterol which is their sunscreen and so that molecule absorbs the energy from the Sun producing vitamin D for which the plank can have no function no use for it because they don't have that level of immunity and it was a billion years before until the Cambrian explosion of complex life that vitamin D was necessary for the complex life yeah
(1:10:15) for the immunity to develop and also for fish to develop a Boney skeleton that's right that's right yeah before that there was no no bony skeleton no no meton no, years ago the camb explosion about started about 530 million years ago yeah that's right yeah yeah we were talking about this last night that the just the we were when we start thinking about how complex ecosystems are yeah just totally mindblowing yeah says all these things that have to be in the right place at the right time vitamin D's become an essential part of that for
(1:10:52) for for all advanced life yeah indeed yeah so what what what what what should we do if you were chief medical officer if if Bobby kenned is coming in in the United States um what advice would you give him i' start off with women who are pregnant let's start with pregnant women the first starter is that no child should be born deficient of vitamin D absolutely or deficient in anything yes absolutely that is simple simple Public Health Initiative dead yeah and then we can expand it from there yeah and we can advise people to
(1:11:30) take vitamin D supplement in a sensible dose realistic dose but we've got to get the blood levels checked yeah so we know if they're achieving a target blood level or not yeah so we need a cheap Mass screening tool ideally don't we well I mentioned to you that I arranged about 5,000 vitamin D tests when I was doing my research yeah and it didn't cost very much basically it was a matter of buying the kit and we bought the kit out of my small research fund for a few thousands and then we could do the testing with the cost of reagents only
(1:12:09) you still got it Che I I don't know if it's still there in the hospital oh I just see sensing a business opportunity here yeah so so so basically you bought some fairly expensive equipment yeah then you needed to put some chemicals in it that were quite cheap yeah and and you did 5,000 vitamin D tests for for to produce all the wonderful graphs and things in that book yeah yeah and and it was actually quite cheap once you bought the re agents that's right once you bought the kit so there's no reason why this shouldn't be done I think the kits
(1:12:37) cheaper now you can look it up on the internet and find it's it's there so all all we need is the political will to do that really yeah yeah and then and then ideally because this is one of the frustrating things we we well we don't give medical advice anyway on this channel but we can't say well okay well most people probably need 4,000 units a day but some people are going to need more some people are going to need less yeah always the way and and the only way we can know that well it's like alcohol isn't it you know if you go into a pub
(1:13:08) one guy you know you're going to get there's always some Troublemaker who's completely blitzed after two points yes yes where his mates next door will be a bit tipsy after eight points you know that's right that's right it's the predisposition is is going to vary massively depending on lots of factors so the main one is body weight yeah you see mentioned before that one unit of vitamin D is the need the daily need of a 10 gr Mouse yes that's the definition that this was developed before we could add theigh we couldn't weigh it you know
(1:13:45) one unit of vitamin D May weighs 20 billionths of a gram you can't see it yeah yeah you can't even see it let long weigh it and until recently that wasn't known so it was by a biological assay how much vitamin D is necessary to maintain a 10 G Mouse in what you might call good health yeah good sceletal health that is in fact yeah so 10 one one unit for a 10 G Mouse and that works up for someone who weighs weighs um 60 kg it works out at 6,000 units a day right yes now that sounds a lot so let's just have it should we let's be
(1:14:28) on the safe side and just have it and say 3,000 units a day so I mean I mean it's likely that 2 or 3,000 units a day is going to be safe for the vast majority of the population yeah but if someone weighs 120 kilg yeah they need they need 12,000 units a day and as well as that the vitamin D that they take will be sequestered into the fatty tissues it goes there yeah absolutely and won't be available to the rest of the body until the fatty tissues are already Yes vitamin D's and oil the fat cells of the body mop it up yeah yeah
(1:15:03) yeah yeah so frustrating we can't do that but but so simple to test this and and this is a potential to revolutionize yeah people like Abdul and and Frank who who suffered appallingly yeah they did throughout their lives with something which is so readily correctable yeah you know it's it's low hanging fruit why let's pick the low hanging fruit yeah indeed stuff that's cheap yeah yeah yeah you know so there's so many nutritional things so many lifestyle things that can be corrected and yet so much money is spent on research for Hightech what I
(1:15:38) call clever clogs treatment yeah yeah you know sophisticated specific treatments and the the other thing about about I mean if we can compare vitamin D with with vaccination for example I mean vaccination I don't like the covid vaccines but other are necessary we could talk we could specific at least I could I don't have the background knowledge but but what what what back what all vaccines do is they are highly specific they are specific to a particular antigen producing a particular type of immune response yeah
(1:16:13) yeah and so to to and yet out in this within half a mile of us there'll be 10 to the 22 types of viruses yes never mind all the bacteria and everything so you know the human immune system when I was learning immunity uh the the were told it it could recognize nine billion different foreign antigens which amazing isn't it sounds sounds kind of reasonable so you got to have something that works on all of them yeah not one exactly yeah so so why not bunk up your immunity for everything yeah absolutely and kill 10,000 birds with one stone
(1:16:48) very much so rather than taking 10,000 different way to look at it yeah indeed PR preparations and um the thing about vaccination also to remember as he said a vaccination produces an immune response yes that gobbles up and utilizes vitamin D interesting and the vitamin D molecule in the cells 125 ohd in the C can only be used once yeah and then it's inactivated so once we have vaccinations they're going to knock down our vitamin D levels a bit and if they were low to begin with yeah and then if we have another vaccination and another
(1:17:24) vaccination or vitamin D levels are going to go down so it's quite conceivable as as some data shows that giving a particular vaccination May well protect you against that particular disease yeah but predispose you to many other infections could be by knocking down by the mechanism of of lowering so so when you give a vaccination basically it's you are obliging the body becomes an obligate yeah yeah vitamin D user and the vaccination itself one requires vitamin D if he going to if it's going to produce an immune response it's got
(1:18:02) to use Vitamin D it needs vitamin D yeah and without vitamin D the vaccination might not work very well no no so the VAC so if you're low in vitamin D to begin with the vaccine won't generate a proper immune response because you're low in vitamin D but it in trying to generate an immune response it will lower your vitamin D levels further predisposing to range of other infections corre yeah absolutely so so why the heck don't we give vitamin D with vaccines absolutely that's right should be done I just worked that out
(1:18:35) just now you know in a shed in the shed in in the garden you know if I can work it out so great you know why aren't people why don't people realize this yeah see you on your interview with angal gich a little while ago he mentioned that the K with the treatment of cancer doesn't work properly unless someone's got vitamin D in The Bod exactly good levels of vitamin D is a pancreatic cancer in particular was he was talking about yeah he was talking about particular pancreatic cancer with a particular chemotherapeutic regime and
(1:19:06) for years they'd known there was two groups people that respond to the chemotherapy and those that don't yeah and they didn't know why yeah and then he found out that it was simple the ones that responded were vitamin D replete yeah the ones that didn't respond with vitamin D deficient yeah when he increased the vitamin D everyone responded yeah it's simple the vitamin D story it's not rocket science it's very I I can understand it a simple physician in Blackburn you're can understand it you know it's easy to understand yeah
(1:19:39) and again that makes perfect sense because there's a huge immunological component yeah to cancer yeah because there is absolutely know I probably caught cancer between breakfast time and now yeah God willing I won't get it because my immune system will keep it suppressed yeah you know there's so many can't remember it was it 70 trillion cells or something in the body yeah one's bound to go wrong few times a dayed but hopefully the immune system keeps that down and the vitamin D isn't just so important for everything yeah
(1:20:10) this is the important thing of course having good immunity yeah is vital for good health yeah without good immunity you do not have good health simple and if you want optimal immunity you've got to have plenty of vitamin D on board you got to have a good blood level of vitamin D yeah brilliant about 100 Nares per liter y 40 n 40 n per mil yeah so let's get doctors to titrate people up to that yeah um now I've been inundated with the request for your book David what are we going to do about this well this book is no longer available
(1:20:41) completely unacceptable sold sold AF we didn't we didn't Afra the population the population is demanding this book it's it's quite as simple it's got loads and loads of pictures you you've got plans to make it available in I'm to do though it needs to be brought up to date so I'm going to bring it up to date and I hope to have it very shortly available and I'll have it available as a PDF probably not as a printed book yeah that's what I've done with my books now yeah when I change from hard copy to PDF I think in hard copy I probably sold
(1:21:16) about 10,000 and in PDF so Val probably getting on for a million downloads now is that right the money is not where I'd like it to be but that's okay people people are reading the book but in the meantime the article that you've written on caly dial we are going to make available okay fine put that if you're happy to to do that we can there is an economic cost as well because to get we only put printed about the th000 copies of this book we we all went and um it cost me about £10,000 yeah yeah now by the time we' sent the
(1:21:50) books out to all your M and paid postage you you gave me one thank you right yeah and I think I got an income of about £3,000 an expenditure of £10,000 so it's just not economic because the cost of sending one of these to the United States for examp is is silly and in this country as well in fact postage costs are very high so the PDF is how it's going to be PDF now as as soon as that's finished can you send us the link yeah and we'll publicize that and we'll get people to to download the PDF and might just there might just be a link there to
(1:22:23) make a donation as well people want cover cost I might it's written in 10 parts is this book yeah and I might send the is out as a we could seriz we could serialize it on substack or something like that yeah might do it that way because there's so much valuable stuff there that the world really needs to to go hold of it but the first bit of it the prologue is the case stories of Abdul and Frank both both infuriating to listen to yeah so correctable that's right there are load of abduls in this country exactly
(1:23:01) there are load of Franks as well exactly and all over the world yeah in this country in particular where there's there's no vitamin D for them yeah it's very sad and it's still the same in Asia I mean um you know yeah huge SES of the population in Asia like to be light colored yes they do you know I was really surprised by this I worked with nurses and doctors in Cambodia yeah yeah and they wore long sleeves yeah you know were there were this lovely light brown color yeah that's right and uh the they always wanted to be paler by why why on
(1:23:35) Earth would want to be paler I don't know but I said I said if you're out the sun all the time you're going to be short of vitamin D and even the doctors and nurses there hadn't realized this no indeed no what is put to me by um an Indian doctor I knew or I know was that being pale is a sign of being upper class yes and dark skin darker skin is a sign of being poor could of course the the wealthy people are indoors all the time as we mentioned earlier on and the people who work Outdoors they're the dark skin the poor ones and people don't
(1:24:10) like to regard guarded as poor they ought to be regarded as more affluent where whereas in this country if you got Sun suntan it means you can afford to go abroad for your holiday does yes that's right yeah oppos completely reversed again both ludicrous and Preposterous I must say yeah yeah that's right all all skin colors are equally beautiful yeah absolutely but we just have to compensate for the fact that dark skin makes vitamin D way more slowly it does indeed yeah yeah this is an inconvenience you know I go
(1:24:41) out I was I was in Africa last year and uh my friend my friend there um uh uh he's uh he works out in he works out in the sun all day with Fafa and I said in the morning I had to put Sun cream on and he said what you putting Sun cream what are you doing I said well if I don't put this on I get burnt he said do you he had no idea he had no idea I says look I get burnt in the Sun but I make vitamin D quick you don't get burnt in the Sun but you make vitamin D slowly slowly yes indeed but this idea of putting on sun cream to protect yourself
(1:25:16) from the Sun just wasn't in the in the a medical officer but it just wasn't in his Consciousness because he doesn't get sunburned but uh but vitamin D so since then we' we've been aware of that and uh we are hoping to do vitamin D tests yes on the local population cu the the the the the banto area there the skin color is very very dark yes it is indeed or or be the uh the sun is very very bright yeah yeah so I I think I think it's the same as here if people are working Outdoors all the time they'll have enough but I'm sure all the doctors and
(1:25:49) nurses for example and the call center people I'm sure they're all deficient in vitamin D yeah absolutely yeah yeah we won't know till we look but it's just an interesting cultural difference yeah it is indeed fascinating Dr grams as always we are very grateful um if you've made it to the end of this interview uh how could you not make it to the end of this interview it's just been fascinating all the way through so but thank thank you for watching and thank you and uh thank you to Mrs Grimes who patiently yeah sat through this
(1:26:21) interview which you may have heard before but U okay yeah we appre thanks for making the effort to thank you John for inviting us thank you very much yeah"
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