Recent Summary of Vitamin D Literature to July 2008

Recent Summary of Vitamin D Literature to July 2008

Competency # 17: Vitamin D

Reference: Indicated below.

The news on Vitamin (Hormone) D continues to roll out.  I’m flooded with it.  I could write an email every week for those who are interested.  But to make it simple, here is a brief synopsis of recent articles.

Stroke Risk with low Vitamin D.  July 24th, 2008 Journal Stroke.  From Heidelberg Germany.  Following some 3315 folks referred for angioplasty, the authors found that low Vit D was an independent predictor for stroke, with all other factors accounted for.  They consider Vit D to be antithrombotic and neuroprotective and suggest that a minimum concentration of 30 ng should be a target for supplementation, particularly after a stroke.

Low Vit D Associated with Double All Cause Mortality:  Archives of Internal Medicine June 23rd, 2008 Dobnig et al.   The lowest quarter of folks had Vit D levels of 7.6-13 ngs.  Their mortality was DOUBLE the highest quartile whose level was 28.  They also found that low D levels correlated significantly with higher C-reactive protein, oxidative burden and cell adhesion.  I want a level of 50-70 for me (folks living in the tropics naturally have that level.)

Diabetes in Pregnancy has Lower D Levels:  Diabetes Metab Res Rev 2008; 24: 27–32.  Maghbooli et al from Tehran.  Dr. Maghbooli found that women who became diabetic in pregnancy had Vit D levels around 16 ng.  Normals were around 23.  Again, a minimum of 32 and a optimum level of 50 might have changed things.  This is just an association.  But the association is pretty strong.  Reduce diabetes in pregnancy!

You Need 6000 IU of Vit D in Pregnancy to have Adequate Blood Levels: JOURNAL OF BONE AND MINERAL RESEARCH Volume 22, Supplement 2, 2007  Hollis.  Dr. Hollis shows elegantly that 400 IU does not raise pregnant and lactating women’s blood level.  Adequate Vit D during pregnancy is critical to fetal health. Lots of details and measures.

Cardiomyopathy in Infants from Severe D Deficiency.   Heart May 2008 Vol 94 No 5  This May, looking at 16 infants from England with cardiomyopathy.  All were from mothers with pigmented skin (6 Indian, 10 African)  Most presented in late winter.  All were breast feeding.  None had D supplements.  3 infants died.  The others all recovered by 12 months after being supplemented with Vit D.  My read:  D affects your heart too.  Every growing cell needs to mature into its intended function.  Hormone D does just that – helps cells mature into what they were intended to be.

Enough already!  I get it.  It’s still a bit of summer left.  We’re talking sunshine here.

WWW:  What will work for me.  I have skin cancers on my head.  I’m older.  Protecting myself from sun is an issue.  These aren’t a lot of randomized controlled trials yet.  A few show very dramatic effects.  Getting my D level to what it would be if I were in sun more is my goal.  I want a blood level of at least 50.  So should you.  Good things happen when you get to 32.  It appears better things happen when you get to 60.  Supplementation is the only way around it.  My body gobbles up D.  I only got to a blood level of 35 on 5000 IU a day.  A Dr. Garland published the following graph at a recent conference.  Your blood level, without supplementation, is likely around 40 during the summer if you are young and Caucasian.  It will drop to 20 during the upcoming winter.  You can increase it by 10 points for every 1000 IU a day you take.  To get to 50 ng reliably, you need 3,000-4,000 IU a day.  That’s what works.  See your doctor and ask!  It’s my belief that your D level may turn out to be a more important predictor of risk than any other factor.

Brought to you by John E. Whitcomb, M.D.