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Newsletter: Vitamin D, muscles, and the governator

Posted on: August 20, 2004   by  John Cannell, MD

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Today, Dr. Bischoff-Ferrari and colleagues at Harvard Medical School published a very important study. As it concerns a substance which can not be patented (vitamin D), it may not interest the medical industry but the study may be read intently in one high official’s office in Sacramento, California.

Dr. Bischoff-Ferrari showed that muscle strength is linked to vitamin D blood levels. She found that lower extremity muscle function in persons over the age of sixty improved as serum vitamin D levels improved.

Bischoff-Ferrari HA, et al. Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged ≥60. Am J Clin Nutr. 2004.

Most of the improvement occurred as serum vitamin D levels rose above 20 ng/ml (50 nmol/L) but further improvement was seen at higher levels. Maximum improvement was evident at about 50 ng/ml (125 nmol/L). As more than 80 percent of the total U.S. population has vitamin D blood levels lower than 50 ng/ml, Dr. Bischoff-Ferraris’ findings raise the possibility that muscles of most Americans, even the muscles of Governors, may be improved by supplemental vitamin D (a point Dr Bischoff-Ferrari did not speculate about).

Dr. Bischoff-Ferrari points out that if you take 1,000 units of vitamin D a day you will have about a 50 % chance of having an adequate vitamin D blood level (1,000 units a day will result in a mean of about 40 ng/ml (100 nmol/L). The daily amount needed for nearly all Americans to be repleted (the RDA) is still unknown but Dr. Reinhold Vieth recently studied the issue when he showed that vitamin D improves depressive symptoms. He found that 4,000 units a day helped depressive symptoms the most, but also resulted in nearly everyone achieving levels greater than 40 ng/ml.

Vieth R, et al. Randomized comparison of the effects of the vitamin D3 adequate intake versus 100 mcg (4000 IU) per day on biochemical responses and the wellbeing of patients. Nutr J. 2004.

The vitamin D Council estimates that 2000 units a day will probably get about 75 to 80 % of white Americans vitamin D sufficient if they take it every day, while Blacks will need more due to melanin pigment decreasing skin production. Two thousand units a day has the added benefit of not needing any blood testing as the U.S. government (Institute of Medicine) says no one will get toxic on 2,000 units a day (2,000 units a day is the NOAEL or no observed adverse effects level).

Dr. Bischoff-Ferrari also recently published a meta-analysis in JAMA showing that vitamin D prevents falls in the elderly, concluding more than 20% of falls in the elderly could be prevented by simple vitamin D supplementation. Such falls cause significant mortality and enormous morbidity, mainly through fractured hips, and cost the health care system billions of dollars annually. Vitamin D costs pennies a year.

Bischoff-Ferrari HA, et al. Effect of Vitamin D on falls: a meta-analysis. JAMA. 2004.

In fact the savings may be significantly more than 20 percent. In a study published last year, Dr. Bischoff-Ferrari showed that even modest doses of vitamin D (800 units of Vitamin D3) reduced falls by a whooping 49%.

Bischoff-Ferrari HA, et al. Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res. 2003.

Other authors found vitamin D cuts falls in the elderly by 100%, that is, from an average of one fall every two years (0.54 falls per year) before vitamin D to an average of one fall every four years (0.24 falls per year) after taking 800 units a day.

Pfeifer M, et al. Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res. 2000.

Unfortunately, the press and the medical establishment generally ignore such findings, in spite of their enormous implications for the health of seniors and for our health care dollar. It seems no one will really care about vitamin D until it is proven that vitamin D improves sexual functioning, decreases weight or increases muscle mass.

The first two will have to wait for a subsequent newsletter, but does vitamin D improve muscle mass? Well, ask the ancient Greeks. They used to train in the sun as they noticed improved performance in athletes that trained outdoors. Only interested in science? Ok, vitamin D has been shown to reduce sarcopenia (muscle wasting), which should surprise no one as the most active form of vitamin D, calcitriol, works by turning your RNA on to make proteins, lots of different kinds of proteins, including the proteins that make up muscle tissue. To my knowledge, vitamin D has only been shown to be associated with improved muscle mass in the elderly but vitamin D’s mechanism of action (turning on the genes that make muscle proteins) is present in all humans.

Visser M, et al. Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. J Clin Endocrinol Metab. 2003.

As I work for the terminator, I may want to let Governor Schwarzenegger know about the connection between muscles and vitamin D right away.

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