vitamin D makes muscles stronger in athletes (and you too)

A study published in the Oct 2012 issue of the Journal of Sports Sciences by the Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK. (read abstract here) showed that 62% of a group of 61 professional UK athletes in winter months who were not taking vitamin D supplements were vitamin D deficient (average blood level of 25-hydroxy vitamin D was 12 ng/ml), which is quite low indeed. The control group was a group of 30 age matched healthy non athletes, who were also not taking vitamin D supplements, and 73% of them were deficient. The athletes were supplemented with 5,000 units of vitamin D per day (despite regulatory councils in both the US and the EU stating that 4,000 IU is the “upper safe limit”), which brought their average blood levels up to 41 ng/ml. (the units were expressed in nmol/L, which must be divided by 2.5 to get the units in ng/ml). The control group received a look alike placebo, and their blood levels of 25-hydroxy vitamin D levels did not change. The researchers then tested muscular performance with the following results: “There was a significant increase in 10 m sprint times (P = 0.008) and vertical-jump (P = 0.008) in the vitamin D group whereas the placebo showed no change (P = 0.587 and P = 0.204 respectively). The current data supports previous findings that athletes living at Northerly latitudes (UK = 53° N) exhibit inadequate vitamin D concentrations (<50 nmol · l(-1)). Additionally the data suggests that inadequate vitamin D concentration is detrimental to musculoskeletal performance in athletes. Future studies using larger athletic groups are now warranted.”

P values of .008 in a group this small (91 people) means that this effect is HUGE. Many clinical trials require thousands of participants to obtain statistically significant results, with p values of only .05   — .008 is HIGHLY significant.  Of course, skeletal muscle in professional athletes and elderly people, who are prone to falls and hip fractures, is made of the same stuff. Studies from years ago have shown that vitamin D supplementation reduces falls in the elderly. Muscle is muscle. Muscle, indeed EVERY tissue in the human body functions better with blood levels of 25 hydroxy vitamin D above 40 ng/ml (I prefer 50 ng/ml, for optimum health, and in my cancer patients, I aim for 70-80 ng/ml). Any athlete, trainer, or owner of professional sports team who is not measuring blood vitamin D levels and supplementing vitamin D to be sure their blood levels are >40 ng/ml is missing a very significant competitive edge. And if you have elderly parents who are looking frail, ask their doctor to measure their blood levels as well, and see that they are corrected if low. This will not only reduce the risk of falls, but of many many negative health consequences. Vitamin D is not only a ‘vitamin’— it is the most potent steroid hormone in the human body. Before the industrial revolution when people started working inside, humans got it from the sun in the summer, and stored enough in body fat to make it through the winter. These days, most people require 4000 to 5000 IU per day for optimum function, during the winter months in temperate regions, and all the time for people who don’t get regular sun exposure without sunscreen in the summer months. An hour of sun exposure in mid summer produces 10 to 20 thousand IUs of vitamin D, which was discovered for the first time by Dr.  Michael Holick and his team in the late 1980s. Up till then everyone assumed that 400 IU of vitamin D (the amount in a teaspoon of cod liver oil, which has been known for 100 years to prevent rickets in a baby), was all that healthy adults needed. We were only off by a power of 10…….

standardized OPC extract of French Maritime Pinebark clinically useful in asthma management

A clinical trial done at the Chieti-Pescara University in Pescara Italy, published in the Sept 2011 issue of Panminerva Medica, showed that a surprisingly small amount of a standardized oliogmeric proanthocyanidin (OPC) extract of French Maritime Pinebark (Pycnogenol®, produced by Horphag Research), made a very significant difference to a group of chronic asthma sufferers, who were already being treated with inhaled corticosteroids. You can read the abstract here. One group received only 50 mg of the OPC concentrate twice daily, while continuing their inhaled corticosteroids, whereas the control group continued to receive only inhaled corticosteroids. It has previously been shown that OPCs decrease expression of an enzyme that produces highly inflammatory fatty acids called leukotrienes, which are known to mediate bronchial muscle inflammation in asthma. Over the 6 month period of the study, nearly 20% of the control group required an increase in the dose of inhaled steroids to keep their asthma under control, whereas none of the Pycnogenol group did. In fact, in the group taking the OPC supplement, 55% of them improved enough that they were able to lower their dose of inhaled steroids, vs only 6% of the control group that was able to lower their inhaled steroid dose.

To quote detailed results from the study: “The levels of asthma control in the 6 interventional months as compared to the same period in the previous year were compared. In the Pycnogenol® group, night-awakenings were less frequent, the number of days with PEF<80% were decreased, days with asthma score >1 were lower, requirement for salbutamol and additional asthma medication less frequent, and consultation of general practitioner and specialist required less commonly. All these parameters were statistical significantly improved in Pycnogenol® + ICS (inhaled corticosteroid) group versus the ICS control group where no considerable changes were observed. Various common signs and symptoms were evaluated by visual analog scale, (dry) cough, severity of chest symptoms, wheezing, dyspnea and daytime symptoms. In the ICS-only group values did not improve while they did improve significantly in the ICS + Pycnogenol® group (P<0.05 vs. ICS only group). A decrease by 15.2% of the specific IgE titer was found in the Pycnogenol® + ICS group, whereas the titer increased by 13.4% in the ICS-only group.”

All that means that the group that received 50 mg of OPC from pine bark supplement twice daily for 6 months experienced very significant clinical improvement in their asthma symptoms, and were able to decrease dependence on medication. That fact that the results were statistically significant with only 76 patients in the whole study indicate that this was a very large effect. Many clinical trials require thousands of patients to demonstrate a statistically significant improvement.

Having grown up with pretty severe asthma myself (I recall one of my professors in medical school telling me that I could expect to develop chronic obstructive pulmonary disease (COPD, also known as emphysema), by the time I would be 60, which I am now well past)– I’ve learned that many nutritional factors can help to heal asthma. In addition to OPCs,  Fish oil (and keeping dietary intake of omega-6 fatty acids low), Evening Primrose oil (or other source of gamma-linolenic acid, an omega-6 fatty acid that is actually anti-inflammatory) vitamin D (5000 IU per day), lipid extract of New Zealand Green lipped mussel,  recognition of food sensitivities (and avoiding those foods) all have helped to the point, that, except for several weeks after the occasional viral upper respiratory infection, I can exercise, even in cold air, without wheezing, be around cats without the asthma attacks that only 25 years ago were predictable after exposure to cats, and generally live an active and for the most part asthma free life. So the only surprise to me about this study, was how little Pine Bark OPC it took to make a very significant clinical difference in this group of people with moderately severe asthma. Personally I have experienced and also seen similar effects in other people with asthma, from supplementation with grape seed derived OPC, and with combinations of grape seed and pine bark OPC concentrates. The important thing is that they be high quality, high purity concentrates, as is the case with Pycnogenol®.

I’m also glad that my medical school professor (who was a specialist in pulmonology, ie study of lung diseases) turned out to be quite wrong about me!

Glucosamine + fish oil omega-3’s has been shown to begin the process of reversing osteoarthritis

A recent study looks at the effect of glucosamine sulfate with or without omega-3 fatty acids in patients with osteoarthritis.

Glucosamine + fish oil omega-3’s has been shown to begin the process of reversing osteoarthritis, as published by Gruenwald et al in the Sept 2009 issue of the journal Advances in Therapy. (link) Though this is not a big surprise,  its nice to see as a new addition to the scientific literature. I’ve been recommending glucosamine/chondroitin + fish oil/vitamin D + green lipped mussel oil + MSM + proteolytic enzymes, for years, and now have added to the repertoire concentrated anthocyanins from all the major “super fruits”,  for all manner of inflammatory problems. With just 1500 mg of glucosamine, and 200 mg of EPA+DHA (a wimpy dose of omega-3) 44% of the group receiving both glucosamine and omega-3 showed at least an 80% reduction in pain over 26 weeks time, as compared with only 32% of those who received only glucosamine. Just think what they might find if they added vitamin D, green lipped mussel oil, MSM, proteolytic enzymes, and fruit anthocyanins…

Study linking Vitamin D levels and cancer prevention

A study in the Annals of Epidemiology linking vitamin D and Cancer Prevention.

It is projected that raising the minimum year- round serum 25(OH)D level to 40 to 60 ng/mL (100–150 nmol/L) would prevent approximately 58,000 new cases of breast cancer and 49,000 new cases of colorectal cancer each year, and three fourths of deaths from these diseases in the United States and Canada, based on observational studies combined with a randomized trial. Such intakes also are expected to reduce case-fatality rates of patients who have breast, colorectal, or prostate cancer by half. There are no unreasonable risks from intake of 2000 IU per day of vitamin D3, or from a population serum 25(OH)D level of 40 to 60 ng/mL. The time has arrived for nationally coordinated action to substantially increaseintake of vitamin D and calcium.

Insufficient levels of vitamin D increase risk of dying from heart disease

Its not just cholesterol any more….  New study connects vitamin D levels to risk of dying from heart disease (link). And if you think the 400-600 IU of vitamin D in your multiple vitamin is going to give you optimum levels of vitamin D in your blood, think again! Government health agencies are now admitting that the recommended levels of vitamin D intake for all ages are woefully inadequate, but they still recommend levels (such as 1,000 IU) that are far too low. Start at 2,000 IU per day, unless you’re a sun worshipper and you live in the land of eternal summer. After 3-4 months, ask your doctor for a 25-hydroxy vitamin D level test—it’s probably a more important number to know than your cholesterol level. If that number is less than 50 ng/ml (be sure its ng/ml and not nmol/L units—if the latter, you have to divide it by 2.5 to get ng/ml). Many people require 4,000 to 6,000 IU of vitamin D—especially older, heavier, or more dark skinned people—some may need even more. The blood level will tell you if you’re getting enough—don’t wait for government regulations to do so—they’re 10 years behind the science.

Insufficient levels of vitamin D puts elderly at increased risk of dying from heart disease

A new study by researchers at the University of Colorado Denver and Massachusetts General Hospital (MGH) shows vitamin D plays a vital role in reducing the risk of death associated with older age. The research, just published in the Journal of the American Geriatrics Society, evaluated the association between vitamin D levels in the blood and the death rates of those 65 and older. The study found that older adults with insufficient levels of vitamin D die from heart disease at greater rates that those with adequate levels of the vitamin.

Read more about the University of Colorado study at ScienceDaily.com.

Vitamin D may be the MOST important vitamin

Evidence that vitamin D may be the MOST important vitamin continues to mount. Although epidemiological studies such as this one (link) don’t prove cause and effect, the sheer number of such associations are suggesting that one of the most important things you can do for your health is make sure that you have a 25-hydroxy vitamin D level in the neighborhood of 50 ng/ml.

A new study in the Journal of Nutrition research showed:

Higher vitamin D levels associated with increased survival among older women over a 6 year period

Vitamin D deficiency is associated with osteoporosis, poor muscle strength, falls, and fractures. The relationship between serum vitamin D concentrations and mortality in older community-dwelling women has not been well characterized. We hypothesized that women with lower 25-hydroxyvitamin D (25[OH]D) concentrations were at higher risk of mortality. We examined the association between serum 25[OH]D concentrations and all-cause mortality in a prospective, population-based study of 714 community-dwelling women, aged 70 to 79 years, the Women’s Health and Aging Studies I and II in Baltimore, Md. The studies were originally designed to evaluate the causes and course of physical disability in older women living in the community. Vital status was determined through follow-up interviews and matching with the National Death Index. During a median of 72 months of follow-up, 100 (14%) of 714 women died. Women in the lowest quartile of 25(OH)D (<15.3 ng/mL or 38.2 nmol/L) were at higher risk of death (hazards ratio, 2.45; 95% confidence interval, 1.12-5.36; P = .02) compared to women in the highest quartile (>27.0 ng/mL or 67.4 nmol/L) of 25(OH)D in a multivariate Cox proportional hazards model adjusting for demographics, season, and conventional risk factors. Older community-dwelling women with low 25(OH)D levels are at an increased risk of death.

DHEA May Increase Bone Density In Older Women

You probably don’t hear much from your doctor about DHEA. Since it’s a naturally occurring hormone and not patentable, its become a nutritional supplement in the US (though a drug in the EU). And doctors don’t get educated about nutritional supplements, at least not much (not yet). But I’ve been paying attention to DHEA for about 15 years, and have often included it in programs for people who need to build back lost bone. The only people who shouldn’t use it are those who have or have had hormone related cancers such as estrogen receptor positive breast cancer, or prostate cancer. In this study, reported on at Science Daily, they gave both men and women between the ages of 65 and 75, 50 mg of DHEA.

Taking a DHEA supplement combined with vitamin D and calcium can significantly improve spinal bone density in older women, according to a new study from a Saint Louis University scientist and his colleagues at Washington University.

In my experience that dose is a bit high for women, about right for most men, though some need up to 100 mg to normalize their blood level. Its really best to ask your doctor to test your blood levels of both “free” (unbound) DHEA, and DHEA sulfate (its storage form). If either one is low, you’re a good candidate for supplementing this “supplement”. Your body can turn DHEA into any adrenal or sex hormone that it decides it needs—DHEA is a so-called “precursor” hormone.

They also went a little bit light on the vitamin D in this study (700 IU). Most adults who work indoors need 1000 IU of vitamin D for every 30 pounds of body weight, and 50% more than that if they are dark skinned, overweight, or obese. Again, after you’ve supplemented vitamin D for 3 or 4 months, it’s a good idea to ask your doctor to measure your blood level of 25 hydroxy vitamin D. You want it to be between 50 and 100 ng/ml (be sure its in ng/ml units, not nmoles/L units, or it needs to be between 80 and 140).

These, along with good weight bearing exercise and resistance exercise, are BASIC things that should be done in everyone before considering drugs like Fosamax, Actonel, or Boniva. You can build a lot of your bone back, no matter what the reason that you lost it in the first place. And be sure your kids and grandkids are getting enough vitamin D, calcium, magnesium and trace minerals—they’re building the bone they’ll live off for a lifetime during their teens and early 20s.

More about Vitamin D and the Flu

Finally, SOMEBODY is talking about the vitamin D—influenza connection.   Researchers see link between vitamin D, flu immunity:

–In February, researchers reported a link between vitamin D levels in the blood and upper respiratory infections in a group of nearly 19,000 people ages 12 and older.
–A 2006 review article in the journal Epidemiology of Infection laid out a detailed case for vitamin D and its protective effect against the flu.

Best thing you can do for you and your families to protect them from the flu, swine, avian, or otherwise, is to take 1,000 IU vitamin D per 30 pounds body weight (if you’re not getting summer sun exposure without sunscreen—if you are, start supplementing when the time of year comes that your shadow is taller than you are—a rule of thumb for whether or not the sun is strong enough to produce vitamin D in your skin. I predict that once studies are done, they will show that having a 25-OH vitamin D level between 50 and 100 ng/ml is better at preventing flu than any vaccine—not to mention reducing the risk of many common and deadly forms of cancer.

Vitamin D and Flu

With all the media coverage of the “swine flu” (H1N1) non-epidemic, I haven’t heard a single expert mention what could well be the most effective public health measure in preventing a pandemic—the recommendation for everyone to take enough vitamin D3 (or get enough un-blocked summer sun exposure) to get their 25-hydroxy vitamin D blood level above 50 ng/ml (but not more than 100 ng/ml). A good rule of thumb for supplementation is 1,000 IU for every 30 pounds of body weight. If your health insurance won’t cover the cost of a vitamin D test, the least expensive way ($65) to check your level is a home test kit available through the vitamin D council’s website, unless you live in NY, in which case you’ll have to get your doctor to order a blood test for you.

To read the abstract of the study about vitamin D levels and influenza visit PubMed.

Low vitamin D levels while taking statins can lead to sore muscles

OK, so this study published on Sciencedirect.com is in the language of medicine.

We speculate that symptomatic myalgia in statin-treated patients with concurrent vitamin D deficiency may reflect a reversible interaction between vitamin D deficiency and statins on skeletal muscle

What it says is that people with low vitamin D levels who take statins can get really sore muscles. We used to think that this was due to the fact that statins prevent the body from making co-q-10 (which they do), so I’ve always advised people taking statins to take co-q-10 supplements as well. But some of them STILL got sore muscles.

Of course, I advise EVERYONE who is not getting at least 30 min of full body summer sun exposure (or its equivalent) to supplement with 1000 IU of vitamin D3 for every 15 kg (33 lb) of body weight, twice that if they are also obese, and to measure their blood level of 25-hydroxy vitamin D at least twice yearly (this may be more important to your overall health  than checking your cholesterol).

So if you’re on a statin, you should not only take co-q-10 supplements (50-100 mg if enough for most people), but also ask your doctor to check your 25-hydroxy vitamin D level. You want that number to be between 50 and 100 ng/ml.