Tag Archives: vitamin D

Low Vitamin D Linked to Obesity and High Triglycerides


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Understanding of the various ways vitamin D effects the body is growing rapidly. Originally this vitamin was thought to only effect calcium in the blood and bone but recent research shows it possesses important influences on the immune system and cancer development. A study just published in Journal of Endocrinology and Metabolism June 2012 now shows that this same vitamin can possibly influence metabolism. A common disorder of metabolism known as Syndrome X or the Metabolic Syndrome is characterized by high triglycerides and low good cholesterol (HDL), abdominal obesity, along with elevated blood pressure and blood sugar. The researchers discovered those with vitamin D levels between 16 and 20 were 75% more likely to develop the Metabolic Syndrome within 5 years than those with vitamin D levels above 34 (levels below 30 are considered low).

Whether low vitamin D is the cause of the Metabolic Syndrome is unclear. Vitamin D prevents fat cells from reproducing, helps the natural process of triglyceride breakdown and helps regulate blood sugar by making insulin work more efficiently. Without enough vitamin D the fat cells could multiply faster, triglyceride levels accumulate and blood sugar rise as is seen in Metabolic Syndrome.

As I have explained in previous posts at metabolism.com, vitamin D is also related to development of hardening of the arteries (atherosclerosis) and obesity in Type 2 Diabetes which could be considered a more advanced form of Metabolic Syndrome.

Doctors’ efforts to monitor vitamin D levels are being hindered by new regulations by Medicare and private insurance carriers to deny payment for vitamin D screening. Lately, a number of my patients’ vitamin D tests were denied by insurance carriers with patients being charged over $200 per test because it was not “indicated”.

Recommendations for vitamin D supplementation are debated. When skin is exposed to sunlight it manufactures vitamin D so there is thought that people who get sun exposure should not need vitamin D supplement but that is not borne out in reality. Previously the recommended daily allowance (RDA) was 400 units per day an amount which has been increased slightly for the elderly. Some experts recommend 1000 unit daily or more. In my practice I generally recommend starting at 1000 units and then rechecking 25 hydroxy vitamin D levels a few months later. Some individuals require 4000 unit or more daily to achieve vitamin D levels over 30. When purchasing vitamin D the D3 form appears to be converted in the body more rapidly than the D2 variety. High priced brands of vitamin D, in my opinion, are a waste of money.

Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com

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Low Vitamin D Linked to Obesity and Atherosclerosis in Diabetics


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Type 2 diabetics are more prone to heart attacks, peripheral vascular disease and stroke. All of these can be linked to hardening of the arteries (atherosclerosis). Known risk factors for atherosclerosis are high cholesterol levels, obesity and high blood pressure. A recent study now demonstrates that atherosclerosis and obesity are associated with low vitamin D 25 levels in African-American type 2 diabetics. This study published in the March issue of JCEM was conducted at Wake Forest University School of Medicine. The researchers found that low vitamin D levels in diabetics are more common with increasing obesity and also with greater degrees of atherosclerosis of the aorta and carotid arteries (which supply the brain with blood).

Whether low levels of vitamin D cause any of these diseases or are simply another abnormality found in people with these illnesses has yet to be determined. Future studies are being planned in which obese type 2 diabetics are treated with vitamin D to see if these diseases can be improved.

Gary Pepper, M.D. Editor-in-Chief, Metabolism.com

Good News About an Old Enemy….Cholesterol!…….. by Beth Ellen DiLuglio M.S., R.D., C.N.S.D., C.C.N., LD/N


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Why is everyone picking on cholesterol !?  It is certainly one of the most misunderstood, demonized molecules that our bodies make!  It is so important as a precursor to many important molecules in our bodies and even acts as an antioxidant and anti-inflammatory!  We produce cholesterol on an ongoing basis, for an ongoing reason.  If we make too much or eat too much cholesterol, a feedback loop will kick in and slow down production for most people.  Cholesterol drugs called “statins” triger that feedback loop and inhibit cholesterol production.  Unfortunately they reduce production of squalene and Coenzyme Q10 (CoQ10) as well  so people on statin drugs often experience side effects such as muscle cramping and exhaustion.
You must be asking why would we produce cholesterol when drug companies are telling us it is bad for us, so let’s review “Cholesterol 101”.  We are able to convert cholesterol into “vitamin” D, bile acids, cortisol and other vital hormones including DHEA, progesterone, testosterone and estrogen. Cholesterol is incorporated into our cell membranes and is one of the primary lipids in brain tissue! Does that sound like a poison to you?  OF COURSE NOT! Cholesterol is clearly vital to our health.
I put “vitamin” D in quotes for emphasis and to get your attention. Vitamin D is actually a hormone, but that’s another lecture!  It is produced from cholesterol in the skin, in the presence of UV light from the sun.  We can make up to 10,000 units of vitamin D with 30 minutes or so in the sun.   Vitamin D has several target organs including the central nervous system, GI tract, immune system, pancreas and reproductive organs.  Vitamin D is thought to protect us from tuberculosis, multiple sclerosis and even some cancers!  Make sure you are making or taking plenty of the “sunshine vitamin”!
What about “bad” or “good” cholesterol?  People like to call LDL a “bad” cholesterol but that is actually misleading.
The liver produces cholesterol and sends it out for delivery on the “LDL bus.”  It can be delivered to the cells that need it at the time.  The “HDL taxi” will pick up left over cholesterol and return it to the liver for recycling or disposal.  Be aware that LDL and HDL can become elevated in response to toxins such as organic solvents, pesticides, heavy metals or even dry cleaning fluid!  Elevated blood lipids should be completely assessed before any drug therapy is initiated!
There is one “bad” cholesterol and that is OXIDIZED cholesterol.  This can lead to a cascade of events that build up plaque in our arteries.  So, how do we prevent OXIDATION?  ANTI-OXIDANTS of course!  Vitamin C and full spectrum natural Vitamin E are especially important.  No wonder why a deficiency of Vitamin C (master antioxidant) can lead to a type of heart disease known as  atherosclerosis (“hardening of the arteries).  Apparently heart disease and atherosclerosis are not “statin deficiency” diseases after all!
P.S., eat the yolk of your eggs.  Not only do they contain cholesterol that should kick in your feedback loop, but they contain important nutrients such as choline, B12, vitamin E and even vitamin D!
So there, I hope you’ve started to fall in love with cholesterol.  I just had to defend that vital, yet defenseless molecule! Stay tuned for more !  Clinical Nutritionist Beth Ellen DiLuglio, MS, RD, CNSD, CCN, LD/N.  Metabolism.com

What is the Correct Vitamin D Dosage?


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Annette posts a question to metabolism.com since she is on a high dosage of vitamin D due to intestinal surgery. Is the dosage too much for her, she wonders?

When the intestines fail to absorb fats due to surgery or due to disease, Vitamin D which is a fat soluble vitamin, can see its levels fall dramatically. Otherwise healthy people in the U.S., however, are being found to have unacceptably low Vitamin D levels. Is it due to inadequate diet or is it a result of wide spread sunlight phobia?

Here is Annette’s post followed by my response to her question. Answers to these questions are contained in this exchange.

Annette writes:

I had a Bilio Pancreatic Diversion surgery done in 1990. My Vitamin D level is low, at 15.
My Dr. has me on 50,000 iu of Vit D every other day, 4,000 iu on the other days.

May I ask you, what is your opinion on this amount of Vit. D. The 50,000 iu capsules are by prescription.

Thanks so Much,

AS
**************************************************

Metabolism.com responds:

Vitamin D deficiency is a serious problem and has been largely overlooked in the general population until recently. Vitamin D is not only important for bone health but we are learning it is important for the immune system and may help protect against certain cancers. In my medical practice in Florida I am finding an alarming number of my patients with very low and borderline low levels of Vitamin D that were totally unexpected. I assume it is because everyone knows that sunlight is bad because it causes wrinkles and skin cancer. The further north you live the weaker the sunlight so the incidence of vitamin D deficiency is higher.

Until recently the recommended daily Vitamin D allowance was 400 IU but recently this was increased to 800 IU and some authorities recommend higher amounts.
10,000 IU levels daily for the average normal person is thought to be an upper limit before toxicity can be seen. Vitamin D is a fat soluble vitamin so in people who have problems absorbing fat, such in your case after intestinal bypass surgery, higher amounts are needed. Vitamin D doses of 50,000 IU at a time are not unusual but are usually given only a few times weekly or monthly, depending on needs. A handy tip is that deficient Vitamin D causes serum calcium levels to be low, so many clinicians will monitor serum calcium levels to help adjust the prescription.

Although I can’t recommend medical therapy in this forum I have some thoughts I can share. Why not get another blood vitamin D level measured to see if the amount you are getting is okay? Calcium levels go up in vitamin D excess so a serum calcium level that is elevated can be an indication of too much vitamin D.

Hope that helps. Keep us posted.

The metabolism.com website disclaimer applies to this and all my posts.

G. Pepper

Calcium and Vitamin D supplements reduce fractures


Categories: nutrition, osteoporosis
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Doctor Holding MedicineRecent information published in the British medical journal Lancet, supports using calcium and vitamin D supplementation to prevent fractures and bone loss in older people. A 12% reduction in bone fractures linked to osteoporosis was seen in people aged 50 and older who used calcium and Vitamin D supplements. Osteoporotic fractures are common with one in six people over the age of 50 experiencing this type of fracture in their lifetime. In people over 70, the occurence of a bone fracture, particularly of the hip is associated with a very high risk of mortality. One study showed a one year mortality of about 33% in elderly people after hip fracture. To achieve the bone benefits from supplements the researchers recommend a daily dose of 1,200 mg of calcium and 800 IU of vitamin D for people over 50.

The staff of metabolism.com wants to add a warning to people shopping for calcium and vitamin D supplementation. When shopping for these items be aware that there is a great variation in price among the various brands of supplements. The higher price brands often claim to be significantly better than cheaper competitors in terms of absorption and results. Be aware that many of these claims are false or exaggerated. Why spend $12 for 50 coral calcium pills when 100 Tums (calcium carbonate) can be gotten for half the price? If coral calcium is actually 20% better absorbed then calcium carbonate then an extra Tums per day will more than balance off any difference.

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The Vitamin D Story. An Old Dog with Some New Tricks.


Categories: diet, nutrition
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Mention Vitamin D to most people and they will try not to yawn. One of the less glamorous vitamins it is known as the sunshine vitamin because our skin, when exposed to the ultraviolet rays in sunlight, manufactures vitamin D. Not unexpectedly sunscreen on the skin blocks this production. The remainder of our body’s supply of this vital vitamin comes from a limited number of foods. The main role of vitamin D is thought to promote intestinal absorption of calcium. Calcium is crucial for bone development. Children without enough vitamin D suffer from a disorder of abnormally soft bones known as rickets resulting in extreme bowing of the legs and dental problems. Adults with vitamin D deficiency can develop low blood calcium levels, osteoporosis, as well as softening of the bone known as osteomalacia.

Recent studies however, have shown that Vitamin D may serve many other important functions in the body. Several investigators found that low Vitamin D plays a role in “seasonal affective disorder” which is a form of depression occurring during the winter when little sunlight is available. Low levels of Vitamin D can be found in Alzheimer’s patients, and some researchers believe low levels of this vitamin may contribute to loss of muscle tone and frequent falling in the elderly. Recent studies link low Vitamin D levels in pregnant women to the development of preeclampsia (toxemia of pregnancy). Vitamin D was also shown to help lung function and to delay a common but serious eye disorder known as macular degeneration.

Studies also show that Vitamin D may help benefit the immune system and help reduce the incidence of certain cancers. Recent studies suggest vitamin D may help prevent or delay colon, breast and ovarian cancer. One study showed that 1000 IU of vitamin daily could cut the risk of colon cancer by 50% while another study found a similar risk reduction for pancreatic cancer in those who took vitamin D supplementation. Results of these studies are still inconclusive and require verification but point to an important role of vitamin D in cancer protection.

Until recently the recommended daily allowance of Vitamin D was 400 IU. Some researchers now state that this amount is too low and advocate a daily intake of 1000 IU. Vitamin D can be found in Vitamin D supplemented milk, many multivitamins and calcium supplements. Yoghurt, margarine, cooking oils, breakfast cereal and bread may also be fortified with vitamin D. Oily types of fish such as salmon, tuna, and sardines are excellent sources of vitamin D. In particular the fish liver stores much of the vitamin, hence “cod liver oil” is an excellent vitamin D source.

The vitamin D we ingest in pills and food is an inactive form of the vitamin which then must be activated in the kidney. For this reason those with kidney disease frequently must receive medication with activated vitamin D to prevent bone disease or other conditions related to low calcium levels in the blood.

A note of caution about vitamin D is sounded by some experts. While there is still plenty of debate about the amount of vitamin D which could be toxic, most authorities believe that up to 2000IU daily should be safe.

Only you and your doctor can decide on what medical treatments are best for you. The articles on metabolism.com such as this one are meant for educational purposes only and should not be used to guide you in your medical care. Speak to your health professional before undertaking to change or initiate medical treatment plans.

Gary Pepper M.D.
Editor-in-Chief
Metabolism.com