Tag Archives: Vitamin D

Dr. C's Journal, In The Lab, Medicine, Reviews

Vitamin D: Importance Of Knowing Blood Levels

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Vitamin D Blood levels are seldom ordered by doctors, or demanded by patients, in spite of the fact that it is the “vitamin of the decade”.

Vitamin D is the sunshine vitamin, since the UVB light normally converts skin cholesterol into vitamin D. The white skin of peoples who migrated into temperate zones such as Europe was very likely a survival factor due to the low amount of sunlight in northern climates  compared to the African tropics, and white skin permits increased vitamin D production.

Vitamin D is most famous as the factor that prevents the childhood bone disease “rickets”. The industrial revolution resulted in kids being in factories, getting insufficient sun exposure, and having an epidemic of rickets.

The Covid pandemic resulted in orders of magnitude more deaths among the elderly, especially those in sunless retirement homes. Eventually, vitamin D became implicated in immune deficiency, and the ability to survive Covid.

Vitamin D Is suspected as a factor in multiple sclerosis, tuberculosis, and even seasonal affective disorder, where there is a great increase in depression during the dark months of winter in extreme northern climates.

The NFL, ever striving to keep their players in top physical condition and accelerate recovery from injury, now supplements their players, and, I hear, requires blood levels of 60 ng./ml and above, more when they are injured. Vitamin D thought to improve muscle strength, and the rate of repair in muscle injury.

A lot of studies have failed to show the benefits claimed for vitamin D, but  a recent large study from Harvard showed that the beneficial effects of vitamin D occur only among thinner individuals with a BMI of less than 25, which is a shrinking percentage of our population. It seems that already healthy people who are not overweight are the only recipients that can benefit from vitamin D, a fat soluble vitamin, which may be tightly held by the excess fat of overweight people.

Although I am waiting for more and better studies, I obtain yearly vitamin D blood levels. in fact, I was rather worried recently that my 5000 i.u./day supplementation might be excessive. Not so; it came back as 51 ng/mL The normal level is now considered to be above 30 ng/mL. This was determined in part by finding that the parathyroid hormone blood level was elevated with lower levels of vitamin D, and reached normal only at 30 ng.

How much is too much? It has been documented that most lifeguards in the summer have levels above 100.ng/ mL and there has never been Vitamin D toxicity based on with sun exposure as the sole source of elevation in vitamin D level. “

Getting your vitamin D by sun exposure can lead to skin cancers in later life, however, and my opinion is that VITAMIN D BY ORAL SUPPLEMENTATION IS SAFER.

Checking  your blood vitamin D level should be done at least twice. Once to check the baseline, and, since most people in our mostly inside, sunscreen-using population will not have an adequate level, a second test to be sure that you are adequately and not excessively, supplemented.

My recent results:

Result Value: 51 ng/mL (Vitamin D, 25 Hydroxy)

Reference Range: 30-100 ng/mL (1 ng/mL =  0.83 IU/mL)

Deficiency is  < 20  ng/mL.                 

Insufficiency     20-29  ng/mL

Sufficiency         30-100 ng/mL

—Dr. C.

Aging, Medicine, Studies

Vitamin D: Lower Levels Increase Dementia Risks

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Low vitamin D levels were linked with an increased risk of both dementia and stroke over the following 11 years. Based on this observational study, people with low vitamin D levels were found to have a 54% greater chance of developing dementia compared with people whose levels were normal.

A study published online April 22, 2022, by The American Journal of Clinical Nutrition suggests vitamin D deficiency may raise risk for dementia and stroke.

The study analyzed more than 294,000 people (most of them women over 60) living in the United Kingdom. Using blood tests on all participants and neuroimaging tools on about 34,000, researchers looked for associations between vitamin D levels and risks of dementia and stroke. A normal blood vitamin D level was defined as at least 50 nanomoles per liter (nmol/L); a deficiency was defined as less than 25 nmol/L.

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Diet Health, NUTRITION, Resources, Reviews

Reports: Tufts Health & Nutrition, November 2022

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Cover Image

Inside the Tufts Health & Nutrition Letter – November 2022:

  • Give Thanks for Good Health
  • Newsbites: Vitamin D; red meat and CVD risk; psyllium and constipation
  • Grain Products: Don’t be Fooled by Healthy-Sounding Labels!
  • Special Report: Top 3 Reasons to Avoid “Top Foods” Lists
  • Diet and Hemorrhoids
  • Featured Recipe: Fresh Cranberry Orange Relish
  • Ask Tufts Experts: Processed foods; calcium intake
Dr. C "Comments", Men's Health, Prevention, Resources, Studies, Women's Health

HARVARD STUDY: VITAMIN D LOWERS THE RISK OF YOUNG-ONSET COLORECTAL CANCER

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COMMENTARY:

Vitamin D has many beneficial effects, but my comments will be restricted to the effect of vitamin D on cancer.

Interest in this association was started by the observation that certain cancers are less common near the equator, where there is more sunlight exposure, and therefore more natural vitamin D generation in your skin.
The most information on cancer in humans Is available on colorectal, breast, prostate, and pancreatic cancer. Colorectal cancer, highlighted DWW our posting, is the only cancer that apparently is affected by vitamin D.

Several studies have suggested that vitamin D can decrease cancer cell growth, stimulate cell death, and reduce cancer blood vessel formation. Increasing cell death, or apoptosis, is what interests me the most, since this is one of the factors which increases inflammation in aging.

The infographics stated that only 300 international units of vitamin D is necessary to produce a 50 Percent reduction in cancer, and that a healthy diet generally supplies this.

I personally take 5000 international units vitamin D. This produces a blood level of about 60 ng/mL, and what the NFL recommends to keep their players healthy, and well within the maximum recommended level of 120 ng/milliliter.

Excessive vitamin D can produce an elevated calcium blood level, and mine is within normal limits. I take the higher dose because of vitamin D’s other effects, such is benefiting the immune system in a time of Conid-19.

I suggest that you get a vitamin D blood level, and also a calcium blood level if you elect to take more of this useful vitamin.

–Dr. C

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Medicine, Men's Health, Resources, Videos, Women's Health

RESEARCH: ‘THE SCIENCE OF HEALTHY AGING’ (SCRIPPS)

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Although growing older comes with a number of major life changes, science can help inform the things we do in the here in and now to forestall the most serious features of the aging self, promoting healthspan and not just lifespan.

Summer 2021
  • Build Muscle – Muscle mass is one the best predictors of health and longevity. Muscle tissue is known to release its own chemicals called myokines, which can have benefits that span cognition, immunity and anti-cancer activity. By performing regular, resistance-based exercise that prioritizes strength, we can delay the loss of bone density and risk of physical injuries.
  • Vitamin D – Commonly known as the sunshine vitamin, vitamin D is in fact a critical hormone that helps maintain healthy bones, boost our immune system and improve our cardiovascular function. With age, the production of vitamin D in the skin can become less efficient, so if we don’t spend enough time outdoors, our risk of vitamin D deficiency may increase.
  • Neurodegenerative Diseases – One of the most unsettling aspects of aging is the potential for neurodegenerative disease. These conditions are increasingly prevalent in those with diabetes, suggesting that the brain’s blood flow and energy supply may be compromised. Research indicates that regular physical exercise, a healthy whole foods diet and staying intellectually active could at least slow the rate of decline.
  • Mindfulness – As we get older, major arteries can become thicker and less flexible, leading to increased blood pressure and undue strain on the heart. A regular mindfulness practice such as yoga or meditation has been shown to stem the release of stress hormones like cortisol and adrenaline. By freeing us from this “fight-or-flight” state, this habit can improve blood flow and reduce the risk of heart attack and stroke.
  • Stay Social – As social animals, maintaining a strong sense of community and close personal relationships into old age are underestimated contributors to longevity. While social isolation in seniors can result in significant physical and mental decline, research suggests that close loved ones offer important emotional support and behavioral modifications that can overcome periods of high stress.
  • Metabolism – “My metabolism is slowing down!” That’s what we often hear, as the aging body becomes less effective at using energy, placing us at risk of obesity and type 2 diabetes. By maintaining our muscle mass and reducing sugar consumption, we can support hormonal health, preserve our metabolism and keep our vitality into those advanced years. As scientists continue to find ways to extend our lives, paying attention to these keys to healthy aging can help increase the quality of those extra years.

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Dr. C's Journal, Men's Health, Opinion, Resources, Women's Health

DR. C’S JOURNAL: BENEFITS OF PARATHYROID HORMONE

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Hormones, Vitamins, and minerals all have extensive interactions in the give-and-take of the bodies’ ballet of homeostasis. No where is this more clear-cut than the interplay of parathyroid hormone, vitamin D, and calcium.

Although it has many other actions in the body, calcium is best known as the prime component of our bones. It is essential for making them healthy and strong. The bones act as a storehouse or vault for the bodies calcium. The parathyroid hormone is the key that unlocks the vault to release the calcium so it can perform its many other roles in the body. An elevation of the calcium in the blood stream shuts down the parathyroid Glands.

Parathyroid hormone also acts to instruct the body to absorb more vitamin D, just as the vitamin D causes the intestinal tract to absorb more calcium. The parathyroid glands are in the upper poles of the thyroid which as we mentioned before sits astride the windpipe.
Sometimes the parathyroid gland develops an adenoma which causes too much secretion of parathyroid hormone.

This results in an excess of calcium in the body and a variety of symptoms, such as joint pain muscle weakness, fatigue, nausea and vomiting. One of the technicians in my medical practice developed hyperparathyroidism. It was detected by a metabolic panel, which showed an elevation of serum calcium.

This discovery, early in my practice, made me a big fan of metabolic panels when patients have general symptoms. Her condition, a parathyroid adenoma, was cured by surgery. Conversely, surgery for an overactive thyroid can sometimes accidentally remove the parathyroid glands if the surgeon isn’t careful. The parathyroid glands are tiny, but they perform a huge function.

—Dr. C.

Men's Health, Opinion, Prevention, Women's Health

THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #18: ACTINIC KERATOSES

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Red hair and freckles are associated with MCR-1 gene variants, and large areas of skin with lowered melanin protection against the adverse effects of the sun. I have red hair and freckles, for which I was teased. My response was that I had a lot of Iron in my blood, and that the freckles were Rust. This is ironic (no pun intended).

Since becoming an Octogenarian, I have had trouble keeping my Iron levels normal. I live in a beach area, where all the young ladies are sunning themselves to promote the socially desirable “bronze goddess” effect, and all of the older ladies hide their leathery skin and wear broad-brimmed hats.

The sun has a good reputation as a health-giver. Being outside does correlate with a lot of beneficial effects, such as enhancing production of Vitamin D. My recommendation, however biased, is to get your Vitamin D in capsule form, and reduce sun exposure.

SUNSHINE, however salutary, is accompanied by invisible, high energy photons capable of breaking DNA strands, and ultimately causing SKIN CANCER. Not accidentally,Visible light has insufficient energy to break bonds, although the rhodopsin in rods and cones do release electrons if stimulated by light.

Actinic Keratoses are the roughened plaques of skin, often on the face, which have a small but definite risk of turning into Cancer. I have a dermatology check every 6 months for precancerous areas to be frozen and destroyed by CO2 spray.

PREVENTION of UV Skin damage is advisable. I wear a broad brimmed hat and UV-blocking sunglasses (UV can promote cataracts and retinal damage as well) when outside in the sun. When swimming I wear a “rashguard” shirt with UV protection in the fabric.

Also, I try to limit my exposure to the Evening and Morning sun, because the light is warmer, and contains less UV. Even with these precautions, I use Sunscreen creams and lotions. I always wondered how a transparent lotion can block UV light.

The explanation lies in the chemicals contained. Such chemicals as Avobenzone and Homosalicylate actually absorb the energy of UV light. Protect yourself now for later health.

–Dr. C.

Men's Health, Opinion, Prevention, Women's Health

FALLS AMONG THE ELDERLY: CONDITIONS & PREVENTION

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Falling down is common on both ends of the Human lifespan. Little kids are always falling down, but there isn’t much energy to dissipate, since their mass is small and they don’t have far to fall. Moreover, their bones are pliable.

The Elderly also fall, increasingly, as they age. They have a lot further to fall, and their bones are often brittle and osteoporotic. Injury is quite common, they often break a hip, and may slide into a peogressive deterioration leading to their demise..

Ordinary walking, a “normal gait”, is a very complex activity and requires a lot of information and coordination by the nervous system.

VISION is critical, as you are often navigating through a minefield of stairs, rug edges, slippery objects, lamp cords, tubes and pets. Cataracts may be a problem to be corrected. Multifocal glasses can be a factor.

HEARING can warn of certain hazards or warnings and is important. A FINE SENSE OF TOUCH is required to give you cues as you are walking. Peripheral neuropathy can make walking difficult.

PROPRIOCEPTION, the positional sense of where your extremities are located in space, is a sense we take for granted, but which may deteriorate in time. Proprioception is very important for a normal Gait. The inner ear, with it’s semicircular canals and vestibular apparatus is necessary for proper BALANCE.

Balance can be PRACTICED in a number of ways, like standing on one leg, or merely WALKING a lot. These MULTIPLE SENSES must be COORDINATED by the Thalamus, Corpus Striatum, medulla, Cerebellum, and Cerebral Cortex and instructions sent to the muscles of your Legs, Arms, back and abdomen.

It is mandatory to keep these muscles, your Heart and your body, STRONG and FIT. Factors that make you more likely to have a fall are mostly the reverse of the above, and are called RISK FACTORS.

  • –Previous Falls are the best predictor. More than 2 or 3 in a year is worrisome.
  • –Balance Impairment is best treated by practice.
  • –Decreased Muscle strength. –Visual impairment.
  • –Polypharmacy (more than 4 prescription Meds), or a Psychoactive drug (look up)
  • –Gait impairment, Walking difficulty.
  • –Depression, which is often treated by antidepressants or sleeping pills- Psychoactive drugs.
  • –Dizziness or orthostatic hypotension, which causes a drop in blood pressure on standing. and a number of other problems, often a function of age.

PREVENTION of falls is of course better than treatment of the resulting INJURY. Working on your HEALTH will help the INTRINSIC causes of falls, and that is what we have been discussing.

Preventing the EXTRINSIC causes of falls means working on: –Improving the household safety by putting in railings, getting rid of throw rugs, clutter, and maybe pets( a good friend went into a downward spiral after tripping over his Dog.

Adjusting or eliminating psychoactive drugs and antihypertensive drugs (which often include the beta blockers which worsen orthostatic hypotension.

Interestingly, VITAMIN D supplements were mentioned in 2 references I saw. Apparently Vitamin D reduces falls by increasing MUSCLE STRENGTH.

Please refer to the following Canadian article for a more complete discussion.

–Dr. C.

Medicine, Men's Health, Prevention, Women's Health

DR. C’S MEDICINE CABINET: “FOLIC ACID” SUPPLEMENTS

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Folic acid has a secure place in my medicine cabinet, and is there for one of the best reasons. In screening for possible causes for heart disease, my doctor ordered a HOMOCYSTEINE LEVEL. The Laboratory value came back elevated.

The treatment given was folic acid. Some background is necessary. Homocysteine is a rather toxic amino acid that can cause heart disease and neurological problems, among other things. If you do not get enough folic acid in your diet with green vegetables, legumes, nuts, eggs and the like (it is hard to be deficient with a good diet), your Homocysteine may become elevated.

You need folic acid to convert Homocysteine to the essential amino acid, Methionine. 10-15% of the population, and up to 30% of older people have elevated Homocysteine levels. Stiffness, slow gait, and heart disease can be related to these elevated levels.

Since I have a good diet, I assume that I have a weak form of an enzyme called Tetrahydrofolate Reductase, which is the rate limiting enzyme in converting Homocysteine to Methionine. A weak enzyme needs more folic acid to do its job. The MDR of Folic acid is 0.4 mg./day. I started supplementing with 1 mg. Daily, without effect on the Homocysteine level. I doubled the dose to 2 mg., and my blood level was still above the upper limits of normal, 15 micromoles/L.. I doubled it again to 4 mg., 2 mg. Twice daily.

Finally my level became normal at 10, This was a decade ago. Recently, I have been doing some research on Alzheimer’s Disease, because a Friend is losing her short term memory. I talked to a neurologist to see if a medical evaluation was mandatory, and found that he has recently BEEN GIVING FOLIC ACID supplements to his AD Patients.

Folic acid deficiency is now being suspected as being a factor in AD! This story is similar to the Vitamin D conundrum. Should I take Vitamin D or not? Am I a “believer” or not. The resolution is easy. You get a Vitamin D blood level.

The lab test will report “normal” if your level is above 20 ng,/ml. I prefer 50, which I achieve with 4000 i.u. Daily supplement. The NFL likes their players to be above 50 to be in best shape. The point is, take a measurement, and then decide.

If you chose to take a Folic acid supplement, I would suggest checking both your Folic acid blood level, and Homocysteine blood level as a reference.

Also, if you take folic (B9) supplements, you should also take extra B12, and B6, since they are involved in the same metabolic pathways. Balance is necessary in metabolism.

–Dr. C