Dr. Schwalfenberg MD has written a wonderful review about the wide range implications of vitamin D insufficiency and the potential adverse impact on Canadian citizens. The above figure delineates how vitamin D affects all organ systems in humans. He however failed to list (1) the benefits for vascular atherosclerotic plaque remodeling which Dr. Davis has deep experience with, (2) Thyroid (he does discuss Parathyroid -- which the 2 are intimately related), and (3) modulation of the cholesterol/steroid/testosterone/estrogen reserves. Otherwise, I believe this is one the best comprehensive reviews done on the studies so far generated regarding vitamin D. Dr. Schwalfenberg has even included a brief mention about how medical residents were deficient due to long hours working indoors (Haney EM, Stadler D, Bliziotes MM. Vitamin D insufficiency in internal medicine residents. Calcif Tissue Int 2005;76(1):11-6.20). I liked that one.
Who is Vitamin D deficient?
He implies that nearly EVERYONE (greater than 50%) in Canada is either insufficient or deficient in Vitamin D due to the northern location of Canada relative to the equator. In Table 1, he cites a succint list (2 pages long) of the clinical trials and epidemiological studies on various subpopulations (including the medical residents). Below is Table 5 which lists Risk Factors for Low Serum Vitamin D levels.
The definition of 'insufficient' however begs a little argument. Less than 25 nmol/L (U.S.: 10 ng/ml) is considered clinically deficient at this time and less than 80 nmol/L (32 ng/ml) is clinically insufficient. Fortunately, the tides are changing and the awareness of the populace is increasingly demanding for this sunlight hormone. Costco warehouse carries the 1000 IU tablets and Long's and CVS pharmacies carry it as well; Oprah recently discussed vitamin D in reference to her recent-onset Hypothyroidism -- Oprah, honey, are you still consuming W-H-E-A-T ?? Oprah's magazine has a piece HERE about how various Maternal/fetal Vitamin D Deficiencies may determine our astrological zodiac behavior, characteristics and traits. Interesting, huh?? Science meets popular wisdom *hee* and it lights up Oprah's community board HERE.
At Track Your Plaque (and other expert communities), the optimal target goal for Vitamin D blood levels is 25(OH)D = 70 ng/ml (translates to: 70 * 2.5 = 175 nmol/L).
Cardiovascular Actions and Benefits of Vitamin D
With the addition of Vitamin D to the arteriosclerosis reversal program, Dr. Davis witnessed countless cases of regression of CAC/plaque (coronary artery calcium score) and improved benefits of many organ systems. For the LEF mag, he wrote a fantastic, complete review about the basics of Vitamin D and its role in cardiovascular health. HERE is the PDF for September 2007 Vitamin D’s Crucial Role in Cardiovascular Protection.
He writes about Vitamin D so frequently on HEARTSCANBLOG, it's a topic that certainly becomes hard to ignore, right? Assessing serum Vitamin D was actually my first introduction to the TrackYourPlaque program and why it is so effective in initiating and maintaining longevity and optimal health. Is the medical science and the establishment still millenium behind us? Or...suddenly are they starting to play catch up with Dr. Davis -- our favorite interventionalist and humble icon? The latest title from JACC: Holick MF. STATE-OF-THE-ART PAPER: Vitamin D Deficiency -- An Important, Common, and Easily Treatable Cardiovascular Risk Factor? J Am Coll Cardiol, 2008; 52:1949-1956. Wow, he finally got into JACC.
Let's review what the medical science so far says:
- Low Vitamin D = Predicts All-Cause and Coronary Mortality (Maerz W. Arch Intern Med. 2008 Jun 23;168(12):1340-9.)
- Low Vitamin D = Predicts Strokes (Maerz W Stroke. 2008 Sep;39(9):2611-3.)
- Solar Radiation (not the Mediterranean diet) = Lower Coronary Heart Disease Mortality Rates in Europe (Wong A Eur J Epidemiol. 2008;23(9):609-14.)
- Statins = Vitamin D Increases (Grimes Lancet 2006)
- Statins = Improved Bone Mineral Density if 25(OH)D greater than 12 ng/ml (=30 nmol/L) (Duenas A Eur Rev Med Pharmacol Sci 2008)
- Statins = (Increased HDL 5-9% and) LDL-reduction less than 120 mg/dl are related to Regressive Coronary Volume Scores (CVS) assessed by EBT (electron beam tomography) (Russo DJ NEJM 1998 -- see below Figure)
- Calcium Begets Calcium = Kaiser Hawaii study: the higher the CAC, the faster the progression and obstruction (Golden JG Radiology 2002)
- Deteriorated Bone Mineral Density = Aortic Calcifications over 25 year Framingham study (Wilson PW Calcif Tissue Int 2001)
- High CAC = High Coronary Mortality and hard events (Raggi P JACC 2002: 39(2) 225-30.)
- Vitamin D = Regression of Coronary Plaque and Atherosclerosis assessed by EBT. The single human prospective (non-randomized) trial by Dr. Davis presented at the April San Diego FASEB meeting (Progression and Regression of Coronary Calcium Score FASEB J. 2008 22:1092.15.)
My Personal Experience with the Physiologic Actions and Benefits of Vitamin D
I never would've suspected that I had Vitamin D Deficiency -- I'm a tan Asian female who spends significant time in the sun esp in the summer Cali season when my children swam nearly everyday. I'm into skin cancer prevention so naturally in the past I lathered our bodies up with sunscreen (though as a kid my parents NEVER did b/c sunscreen did not exist, but then again we didn't wear seatbelts either). I didn't have an autoimmune disease I thought (although later I found out my asthma has autoimmune components -- oops -- I didn't learn that in school during the Pathophysiology of Diseases classes). After diligently reading the blog, PubMed (which confirmed what Dr. Davis and other experts like Holick, Heaney, Vieth, Cannell and others try to publicize), and some internet sources (ie, WAPF) for several weeks, I decided to get my 25(OH)D vitamin D blood level evaluated. In October 2007 my 25(OH)D was only ~20 ng/ml. The TYP recommendation at the time was 50-60 ng/ml. The current target by Dr. Davis is now 60-70 ng/ml. I started on 2000 IU daily for 4 weeks however my level didn't reach 50 and I didn't notice any benefits. I finally upped the level to 4000 IU daily in the AM (outside of the recommendation of the Endocrinologist that I -- against better judgement -- consulted individually with) and achieved > 60 ng/ml by December 2007.
The benefits I noticed were myriad and echo the things Dr. Davis talks about on his blog and other writings:
--better energy, mood, endurance
--more muscle growth
--resistance to colds and infections
--MY ASTHMA COMPLETELY WENT AWAY and I stopped having bronchitis every year (coughing for 4-8 wks at a time where antiobiotics and inhalers were useless and futile)
--my children's asthma resolved (no more inhalers for us) with supplementation 1000 IU daily in the AM (in addition to cod liver oil (CLO) + fish oil)
--20% increase in HDL (from 70 to 84 mg/dl)
--40% drop in TGs (from 50s to 30s)
--improvement in mild insulin resistance
--calmer and more regular heart rhythms
--improvement in my estrogen (despite the contraceptive suppressing most of it)
--resolution of SAD (seasonal affective disorder, 'winter blues')
--resolution of Reynaudy-type symptoms (cold extremities, poor circulation)
--reversal of periodontal gum disease
--reversal of the other plaque hopefully *fingers crossed*
--improvement in thyroid (my TSH has always been 1.3-1.9 and finally in Dec 07 TSH=1.0 perfect)
--faster growth of hair, skin, nails (I'm constantly clipping my nails in winter -- whereas before they essentially stopped growing during these months)
--more mental acuity and communication skills (*shock* I'm bloggin?)
--more IQ points *ha haa* (the fish oil also plays an adjunctive role as my brain's 'high speed internet' connection!!)
--better sense of smell (less allergies)
--better sense of balance (I trip around and fall far less now)
--better hearing...NOT... according to the hubby
--better vision...NOT (d/t occupational + extracurricular hazards)
--better in bed *chortle* (I mean I sleep better)