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…….

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.

vitamin D supposedly doesn’t protect against breast cancer

A study of 36,000 women, half of whom took a gram of calcium and 400 IU of vitamin D for a period of 7 years was recently published in the Journal of the National Cancer Instutute

The main findings do not support a causal relationship between calcium and vitamin D supplement use and reduced breast cancer incidence, despite the association observed in some epidemiological studies

Commentary:  When I see studies like this, its hard to know whether the authors are just uninformed, or actually malicious. OF COURSE there was no difference in breast cancer incidence from taking a gram of calcium and 400 IU of vitamin D (the calcium is mostly irrelevant, its the vitamin D that is important in cancer prevention). There is a very rich scientific literature about vitamin D that has appeared over the past decade, which these authors apparently have not been reading.  Given that somewhere between 50 and 80% of adults in the US are vitamin D deficient or insufficient (levels below 30 ng/ml), and that during the wintertime, taking even 1000 IU of vitamin D a day will not raise the blood level of 25-hydroxy vitamin D above 30 ng/ml (recently published by Dr. Michael Holick), drawing conclusions from a study in which 18,000 women took 400 IU of vitamin D is ludicrous! Now if they had given these women 4,000 IU of vitamin D instead of 400, its very likely that they would have seen very different results. In fact, a study by Lappe et al reported that postmenopausal women who took 1100 IU of vitamin D3 a day for 4 years (along with calcium) showed a 60% reduced risk of developing all cancers compared to a group with similar cancer risk factors that took placebo. So just because a study is in the Journal of the National Cancer Institute, don’t assume that its authors know what they’re talking about!

those with low vitamin D levels twice as likely to die

A recent study suggests that vitamin D may be one of our most crucial nutrients to health and long life continues to mount:

CHICAGO – New research linking low vitamin D levels with deaths from heart disease and other causes bolsters mounting evidence about the “sunshine” vitamin’s role in good health.

Patients with the lowest blood levels of vitamin D were about two times more likely to die from any cause during the next eight years than those with the highest levels, the study found. The link with heart-related deaths was particularly strong in those with low vitamin D levels.

Science used to believe that vitamin D was simply needed to prevent rickets, a disease of soft bones, and that people needed only 200-400 international units (IUs) for this. In the past decade we’ve learned that vitamin D is crucial to the health of every cell in the body, and that heart health, brain health, immune system health, and cancer prevention all rely heavily on robust levels of this vitamin in our bodies. Not only that, we’re learning that nutrition scientists were off by a factor of 10 in how much is optimal. In other words, we need 2,000 to 4,000 (and in some cases 6,000) IU of vitamin D daily for optimal blood levels (above 50 ng/ml). What wasn’t known for a long time is that a healthy human exposed to summer (or tropical winter) sun for 30 to 60 minutes, depending on how dark or light skinned we are, will make between 10 and 10 THOUSAND IUs of vitamin D. When we started subtracting sun exposure (or using sunscreen) from our lives some 30 years ago, we shut off the tap of the “sunshine vitamin”, and our food “fortifications” and multivitamin pills had far too little vitamin D to make up for it. I recommend to everybody to take at least 2,000 IU daily, and after a few months, to ask their doctor to order a 25-hydroxy vitamin D level–this number may be more important to your health than knowing your cholesterol level or your blood pressure–and for optimal health, you want it to be between 50 and 100 ng/ml, even though 30 is considered “adequate”–and you wouldn’t believe how many millions of people are well below 30!

Example of partial responsibility of epidemic of vitamin D deficiency

Scaring ourselves out of the sun may be fueling epidemics of cancer and autoimmune disease. Here’s a classic example:

There is no such thing as a safe tan, U.S. and British researchers said on Thursday.

They said in their review of published studies that tans and skin cancer both begin with DNA damage caused by exposure to ultraviolet light but many people, especially the young, ignore or are unaware of this danger in a quest for a bronzed body.

Humans developed over many centuries working, playing, and living outside, under the sun. About 40 years ago, we went inside, put on sun screen and hats when we’re outside, because science told us we were killing ourselves with skin cancer. But guess what? We’re killing ourselves with all kinds of cancers, because hiding from the sun has created an unprecedented epidemic of vitamin D deficiency–so much so that Rickets has returned in the children of dark skinned mothers (who are also not out in the sun).

Our food supply doesn’t have nearly the sources of vitamin D to make up for what we are not getting from the sun. In an hour of sun exposure, most people (if they get just slightly pink) will make between 10 and 20 THOUSAND units of vitamin D-3. So when you read that you should increase your vitamin D intake from 400 IU per day (which dose nothing to correct D deficiency) to 1000 units a day (which dose just a little to start to correct deficiency), think about how much vitamin D our bodies are designed to make in the summer sun. We’re designed to live off the vitamin D stores in our body fat during the winter months, but most people run low–which many vitamin D experts believe is what’s behind “flu season”.

If you’re going to replace sun with vitamin D supplements, better be thinking more along the line of 4-6 thousand units a day (and 10 thousand if you’re overweight, since vitamin D gets lost in body fat stores). True, too much sun can spoil your fun, and eventually lead to skin cancer for some, but the kinds of cancer caused by cumulative sun exposure are basal cell and squamous cell cancers, which are more “nuisance” cancers–almost nobody dies from them. The deadly one is melanoma. Since the anti-sun campaign was started in Australia, melanoma rates have continued to soar–probably because robust levels of vitamin D in the body help to prevent melanoma, as well as most of the other common skin cancers.

There is some reasonable scientific evidence that antioxidants in diet and supplements, as well as omega-3 fatty acids can protect our skin’s DNA from sun damage, and reduce the risk of the “nuisance” skin cancers, as well as retard skin aging.