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Automated Vitamin D Metabolites Analysis
 Moderated by: Prof Trevor Marshall
 

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Prof Trevor Marshall
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 Posted: Mon Mar 9th, 2009 16:42

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During a discussion about how much we have learned about Vit D metabolite interpretation over the last year, JoshR suggested that we could automate the whole (new) process.

Less than two months later - here it is for you to play with, and to find any bugs, before we advertise it more widely in a day or three.

You can access the calculator on the new Knowledge Base at:

http://mpkb.mp-dev.com/doku.php/home:tests:vitdinterpretation


Thanks to Paul and Joyful for making it happen :)
 

Teresa Green
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 Posted: Mon Mar 9th, 2009 20:16

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Trevor,

I tested it and found the following:

1.) That the original units selected in the entry screen reverted back from nmol/L to ng/ml and pmol/L to pg/ml respectively, following submission of the results.

2.)  And the entries for question 1 and 2 also reverted back to the default settings following submission of the results.

Teresa

 

Nasseroo
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 Posted: Tue Mar 10th, 2009 14:21

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Trevor,

What a helpful development.  I suggest two minor grammatical changes to the introductory paragraph:

1)  change "microbiota    accumulates" to "microbiota accumulate" since microbiota is plural

2)  eliminate the comma and replace with a period  at "medical diagnosis.  The healthcare practitioner..."    Use a period instead of a comma to avoid what English teachers call a run-on sentence. 

Debbie Mostaghel, Nasseroo/Nassim's mother



____________________
Nov 2007 (no breaks) Benicar every 6 hrs;Raynauds 1985; Ocular Rosacea '06; drs guess autoimmune, somatoform, connective tissue diseases; Nystamgus, Myoclonus '14. Extreme photosensitivity 13 yrs; whirling eyes, jerking muscles. 25D=4 ng/mL 1/15
Prof Trevor Marshall
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 Posted: Tue Mar 10th, 2009 18:47

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Teresa,
I think the initialization issues are fixed. Sorry that the defaults are set up for those members living in the USA, it was a choice we had to make...

Debbie,
Hmm... 'microbiota' is plural, eh? Hmm.. I had better think about that... there is a lot of stuff I have written which will need to be revised... Maybe I had better start using Microbiome and Metabonome instead. Sigh...
 
You are correct about the comma, however that sentence was written for lawyers to read (it is a disclaimer) and we don't want to make it too hard for them to keep it all together in their minds :):)

Thanks for your thoughts, though. Hmm... 'microbiota'... interesting...
 

Julia
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 Posted: Wed Mar 11th, 2009 02:54

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Microbiota is surely a plural term used for a colony, just as 'gut flora' is.  It is commonly used as a singular. 

Debbie, I've changed the comma to a semi-colon for clarity :)

Prof Trevor Marshall
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 Posted: Wed Mar 11th, 2009 10:34

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I had an email which pointed out that we have forgotten to tell people with low 25-D levels that this is usually a sign of Th1 disease. Ooops... I will fix that ASAP...
 

Deedee
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 Posted: Wed Mar 11th, 2009 12:17

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Should there be something on there that makes it clear that you can start treatment before reaching therapeutic D levels?



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06/08 Sarc in lymph nodes. Chronic high lipids. 2010 heath cat scan-zero plaque. 11/12 D8, 12/12 Normal CXR except scarred lymph node, normal PFTs 8/12 Off all MP meds. Metabolic Syndrome
Prof Trevor Marshall
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 Posted: Wed Mar 11th, 2009 13:30

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The text for levels below 20ng/ml has been altered to add:
In countries where milk is supplemented with Vitamin D, it is unusual to see 25-D levels in this range unless Th1/Th17 inflammatory disease is present. Assessment of the degree of inflammation involves assessment of both sources of ingestion, and the measured 25-D level. If the individual has been carefully avoiding all exogenous sources of Vitamin D, this level might possibly be within normal limits, and a therapeutic probe is suggested to confirm the presence or absence of Th1/Th17 disease.
and below 14ng/ml to say:
The primary mechanism depressing 25-D levels below 14ng/ml is Th1/Th17 inflammation. The 25-D metabolism will be driven to even lower values as the inflammation becomes more widespread. Conversely, the presence of ingested Vitamin D from milk, food, and supplements will counteract this trend. Assessment of the degree of inflammation involves assessment of both the sources of ingestion and the measured 25-D level.
-----------------------------

DeeDee,
Any 25-D values over 41 will trigger a message:
The 25-D has built up to a level which is highly immunosuppressive. It will need to be weaned lower before test results can be meaningful, and before contemplating any therapy
I don't think we have any other messages relating to not starting therapy, do we?

I am mainly concerned to make sure we don't get any more patients with a 25-D of 50ng/ml being put into Phase 2. As their 25-D drops into the therapeutic region it is likely that their immunopathology would become unstable and even uncontrollable.
 

Deedee
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 Posted: Wed Mar 11th, 2009 13:37

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One more question.....
When I started I had been supplementing and my D was 54.  I believe I read that by taking the benicar, that would help reduce the D faster. Correct me if I am wrong.  After 3 months I was down to D24.  I starting having IP within the first week of Benicar (...now realizing many improvements, thank you.)

So is this saying no Benicar if the D is over 41?



____________________
06/08 Sarc in lymph nodes. Chronic high lipids. 2010 heath cat scan-zero plaque. 11/12 D8, 12/12 Normal CXR except scarred lymph node, normal PFTs 8/12 Off all MP meds. Metabolic Syndrome
Prof Trevor Marshall
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 Posted: Wed Mar 11th, 2009 13:53

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Yes, DeeDee, I don't want anybody to get into trouble by starting therapy with a 25-D which is too high. Arguably, levels between 30 and 40 are likely to be problematic, too, but also we have the problem that symptoms will get really bad as the D immunosuppression lifts. Benicar can help them wean through the 30-40 range...

As we understand more about the science underlying the therapy, we can start to put in safeguards to make sure that people don't get too many surprises. A month (or so) of waiting while the D drops to 40 is better (IMO) than risking the transition from extreme immunosuppression to immune activation in just a few days...
 

Deedee
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 Posted: Wed Mar 11th, 2009 13:54

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Thanks for that clarification.

Mostly, thank you and the team for providing hope and a path for restored health. 



____________________
06/08 Sarc in lymph nodes. Chronic high lipids. 2010 heath cat scan-zero plaque. 11/12 D8, 12/12 Normal CXR except scarred lymph node, normal PFTs 8/12 Off all MP meds. Metabolic Syndrome
Prof Trevor Marshall
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 Posted: Wed Mar 11th, 2009 15:30

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++++++++ IF NOBODY HAS ANY MORE ISSUES +++++++++
 
+++++++ WE CAN START LETTING THE NEWBIES +++++++
 
+++++++++ KNOW ABOUT THE CALCULATOR ++++++++++

 
 
 
 
http://mpkb.mp-dev.com/doku.php/home:tests:vitdinterpretation
 

expate
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 Posted: Wed Mar 11th, 2009 15:46

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Microbiota is a plural, not a collective noun.  Commonly, people do say, "The data is convincing," but properly it should be "data are".

I expect this is analogous to that:   you have a single datum that when grouped with others becomes data.  I don't talk science, so I don't know - does anybody ever refer to a single microbiotum?  Hmmmm, that sounds a little, uh funny as in, "Wow, you've lost weight.  You sure do have a micro biotum."  [heavy Southern accent needed for that one!]

:cool:dette



____________________
Hypervitaminosis D 1,25D 52 pg/ml (3/08), 49 pg/ml (2/11), 25D 38 (3/08), 25D 34 (8/08), 25D 29 (10/08), 25D 14 (3/09), 25D 15: D3=15, D2<4 (6/09) 25D=9 (1/27/10), 25D=9, D3 9, D2<4 (2/20/11): all ng/ml, started Ph1 7/17/08, Ph2 11/4/08, Ph3 2/18/09
Prof Trevor Marshall
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 Posted: Wed Mar 11th, 2009 16:07

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I knew Wikipedia wouldn't let us down:

http://en.wikipedia.org/wiki/Microbiota
 

Julia
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 Posted: Wed Mar 11th, 2009 16:31

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Good old Wikipedia! :D:D

I think you might be right, Odette, but a quick google-hunt produces many scientific papers using the term as singular and many as plural.  And Wiktionary actually gives the plural "microbiotas".

Cold Feet
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 Posted: Wed Mar 11th, 2009 17:14

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I like the simplicity of this test – please keep it that way if you can. My test result shows “less than 7" for 25-D, so I chose “6.” Does this matter? What’s the cut-off?! Here’s my result cut & pasted:

Feedback on vitamin D results

25-D:  6 ng/ml

1,25-D:  25 pg/ml

Steroids/TNF drugs:  No

Olmesartan:   Yes


Interpretations of 1,25-D are not useful after therapy with olmesartan has commenced – or if corticosteroids, anti-fungals, or TNF-alpha drugs have recently been taken. Please post on the
Physicians Forum on the study site. 

The primary mechanism depressing 25-D levels below 14ng/ml is Th1/Th17 inflammation. The 25-D metabolism will be driven to even lower values as the inflammation becomes more widespread. Conversely, the presence of ingested Vitamin D from milk, food, and supplements will counteract this trend. Assessment of the degree of inflammation involves assessment of both the sources of ingestion and the measured 25-D level. 

This level of 25-D is in the therapeutic range. This is a good place from which to initiate therapy concomitant with continued avoidance of ingested Vitamin D.

Last edited on Wed Mar 11th, 2009 17:16 by Cold Feet



____________________
Lyme & Mycoplasma Pneumonia 2004 -Age 44| 6 Wks Doxy & 25 mG Atenolol STOPPED| 1,25D–42 25D-37| Phase 1 Oct. 06| Avoiding all D & Sun | NOIRs Everywhere | March 2007: 1,25D–30 | 25D-11
expate
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 Posted: Wed Mar 11th, 2009 17:57

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Well, is this what you meant about Wikipedia not letting us down?  "Microbiota (as a plural noun) also refers to microflora and microfauna as a group; especially to the various bacteria that live in the gut of normal, healthy humans and other animals."  [http://en.wikipedia.org/wiki/Microbiota_(disambiguation)]  Or were you being sarcastic about the main definition being a genus of conifer in Siberia?

Anyhow, datum, bacterium, microbiotum (I can't type that without laughing :P ) are singular and data, bacteria, and microbiota are plural.  But, as I said, common usage pretty much allows a person to say, "The bacteria left from cutting raw chicken on a cutting board is dangerous and should be washed off before using the same board for cutting vegetables for raw comsumption."  [I know, that sentence has a couple of other grammatical errors, but you get my point...]

And then there's genus/genera.  Unfortunately, I did not study Latin, but I suspect that's the culprit here.

I honestly don't care one way or the other.  There are times I feel people who say "data are" sound pretentious.

:?dette



____________________
Hypervitaminosis D 1,25D 52 pg/ml (3/08), 49 pg/ml (2/11), 25D 38 (3/08), 25D 34 (8/08), 25D 29 (10/08), 25D 14 (3/09), 25D 15: D3=15, D2<4 (6/09) 25D=9 (1/27/10), 25D=9, D3 9, D2<4 (2/20/11): all ng/ml, started Ph1 7/17/08, Ph2 11/4/08, Ph3 2/18/09

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