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RCT shows curious relationship between D and cholesterol

Posted on: October 8, 2012   by  Brant Cebulla

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A new randomized controlled trial published in the journal Atherosclerosis, Thrombosis and Vascular Biology reports that vitamin D in the short term has no effect on cholesterol.

The researchers, led by Dr Manish P Ponda and colleagues from the Rockefeller University, studied the effect of vitamin D supplementation on LDL cholesterol. Blood cholesterol levels are predictors of cardiovascular risk. Elevated low-density lipoprotein (LDL) cholesterol and decreased high-density lipoprotein (HDL) cholesterol levels are independent risk factors for cardiovascular events.

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24 Responses to RCT shows curious relationship between D and cholesterol

  1. JBG

    Reading this post was of no value to me. I do not want to spend my time reading about studies without a clear outcome, of which there are a very large number. It is better to let a day or two go by without a post than to lard the blog with low/no-information posts.

  2. Umileritac@aol.com

    That’s a rather harsh statement JBG…. I enjoy all the posts placed here by the VDC.

  3. Brant Cebulla

    JBG, as always, thanks for the feedback.

    Randomized controlled trials are high quality research, and they do not come out often, so it is important to cover them when they do. It’s not up to the Council whether the study shows a favorable outcome or not. The important thing is that we keep a clear record for the public of what vitamin D is proven to do and what it is not. Here, vitamin D is not proven to have an effect on cholesterol.

    Also, there are quite a few readers who rely on the Council to keep them up to date on the latest studies on vitamin D, so we would be foolish not to blog on RCTs. If we didn’t, we’d become unreliable and irrelevant.

    Cheers,

    Brant

  4. pidkb@comcast.net

    I had a similar reaction like JBG but let me explain why. At the VDC website we have been informed that we need a blood level of Vitamin D of at least 50 ng/ml. No one in the above study reached that level. Dr. Cannell is always saying that if you already have a disease (health problem) that you may quite possible need an even higher blood level of Vitamin D than 50 ng/ml. I’m sure the people running the above study think the 50,000 iu vitamin D (I assumed “per week”) was a tremendous amount but what if they needed double or triple to have any affect. What if it also takes a much longer period of time (at a higher) Vitamin D amount to see a change. To bad all the studies from here on out did not at least start at 50 ng/ml. I also believe, like Dr. Cannell, that Vitamin D should be given on a daily basis and even that could make a huge difference in these studies but certainly not if they are not even going to use enough.

  5. Brant Cebulla

    Well, I think in a post-hoc analysis, they found no correlation between cholesterol levels and 25OHD, and some people did reach levels above 50 ng/ml. The mean level of 43 ng/ml was with a standard deviation of 12 ng/ml (43 +/- 12).

    Curiously in the post-hoc analysis, for those who supplemented with vitamin D, if their parathyoid level went down, their LDL went up. And also for those who supplemented with vitamin D, if their calcium went up, their LDL went up.

  6. roger.rolfe@sympatico.ca

    The definition of a good lipid profile or a bad lipid profile is far from settled. There is no consensus in the scientific community about this. Perhaps the authors in this study were doing the wrong tests and measuring the wrong things. Read Dr. Peter Attia’s 9 part blog on “The Straight Dope on Cholesterol” for a detailed summary of the current state of the science. It will open your mind. http://eatingacademy.com/category/cholesterol-2

  7. eelisabethpuur@gmail.com

    Yes, this fear of cholesterol is really interesting. Anybody read dr Uffe Ravnskovs books?

    If I have no cholesterol, how would I make any D3 from the sun? If I have no cholesterol, I would be without sexhormones. What would a brain look like without cholesterol.

    I´m, just asking.

  8. boston

    it is my experience that my vitamin D intake and levels do not affect my cholesterol levels in a positive way…

    my LDL levels are very, very bad, (as are most of the other levels and kinds of cholesterol), and i have the bad kind of LDLs–the small particles….and my levels of 25hydroxy vitamin d have been around 50 ng/ml for about 6 years now…..

    the D supplements have kept me away from viruses and bacterial infections however…i guess it can’t do everything.

  9. Matt Rhodes

    But if you spent more time in the sun, then the excess cholesterol would be used to make vitamin D3 (cholecalciferol). Oral supplementation won’t. My best cholesterol values appeared at the end of the summer after I made it a point to spend as much time in the sun as I could manage. I’d been vitamin D3 supplements for 2-3 years & regularly test in 80-100 ng/ml range, but that didn’t lower my cholesterol.

  10. Umileritac@aol.com

    It’s my personal experience that VDS levels of 80-100 ng/ml (where I consistently run) do not significantly change my cholesterol levels. Indeed my general cholesterol levels are so set, regardless of diet, etc., I often wonder of the genetic component….

  11. Matt Rhodes

    I managed to bring my total cholesterol level down from the 260-270 using supplements (niacin, pantethine), but they were stuck in the 220’s for 10+ years. My vitamin D was 16 ng/ml before I started taking D3. At one point I overshot had a level of 150, so I back off the D3 to get back below 100. My total cholesterol was still around 225 with LDL of ~180. Time in the sun brought my LDL down to around 120 & total down to about 180. Oral supplementation doesn’t use up the circulating cholesterol, but time in the sun does. I view high cholesterol as symptomatic of a vitamin D deficiency. The body is revving up the cholesterol levels to eke out more D3 from time in the sun. Maybe long term oral supplementation will lead to lowered cholesterol levels, but then again maybe not. In my experience 1-2 years of supplementation isn’t long term enough to have an effect, so I tend to think oral supplementation never will. A day at the beach just works better.

  12. littieelise@msn.com

    I’ve been on D3 consistently since 2007. I maintain a rate of 85 ng/ml. My internist calls me The Poster Child for D3 and I’m happy to be so. HERE’S WHAT THE REPORT IS NOT SAYING: Some years ago, I had an HDL (yeah, the good cholesterol number in the cholesterol trifecta of HDL, LDL and Triglycerides) level of below 50. For the past two years, I’ve measure 94-95 in the HDL range. Here’s what I’ve told my doctor, who gets very concerned that my hereditarily high LDL (presently 130 and sometimes I get it to 113) will cause me to have premature heart attack, is don’t worry. MY HDL LEVEL IS THAT OF A WEEKLY MARATHONER and my Triglycerides are fine. If you can up the HDL this much from D3, then everyone needs to get into the 50+ ng/ml range. When I saw from my lab work (at least twice a year) that my HDL was climbing in this positive direction, I looked for the research on this connection, found it and gave it to my internist, advising that he get all his patients on D3 ASAP!

    While it’s not clear, anecdotally speaking, that the D3 is having any positive effect on my LDL, it has certainly increased my HDL.

  13. Umileritac@aol.com

    I suffer from a strange problem. My cholesterol is ALWAYS extremely low. I could eat a pound of butter a day, and my cholesterol would be low. This is only a tiny bit of a stretch….I think genetics are heavily involved in cholesterol….My cholesterol is within normal range now that my D level is 85 ng/ml. Also, several years back, my doc had me supplement with topical testosterone, and my cholesterol was also in normal range then….:) I know, I know….I really don’t have a problem. 🙂

  14. JBG

    (Re-)read the last part of the original post, from “Confused yet?” to the end. The post provides zero guidance re whether, how, or how much to supplement or sun. Maybe vitamin D doesn’t help the lipid profile? Who cares? Especially since maybe it does. Studies, even RCTs, that provide no information are not worth bringing to our attention.

    I did not mean to land quite so hard in my original comment, but this is not the first post in the last month or two that I felt wasted my time, and this after quite a long period when I felt *every* post was worthwhile, even if it didn’t apply to my own circumstances.

  15. Brant Cebulla

    @JBG, Very rarely does a study or journal paper actually offer clear guidance on how much to supplement, how much sun to get, what your blood level should be, etc… Even when the most complete and comprehensive study on vitamin D gets released around 2017-2020 (VITAL), their findings (is 2,000 IU better than placebo) will leave people and researchers wanting more. If the criteria is to only brief the public on studies that offer clear and absolute guidance, then there really isn’t anything to blog about.

    Your concerns may prompt us to run some usability testing on this blog, but my guess is that this blog is more useful than you may think. People actually do want to know — can vitamin D improve LDL scores? This includes patients, health care providers and researchers. This study says no and allows patients and health care providers to move a step forward in their search to improve their LDL.

    Now if someone wanted to take vitamin D independent of its known effect on LDL, I think the Vitamin D Council website provides ample pages and posts that support various other reasons why you need vitamin D. Every study isn’t going to be a slam dunk. Again, the important thing is to keep a clear record for the public on what vitamin D is known to do and known not to do.

    Cheers,

    Brant

  16. Ron Carmichael

    Brant – please tell me that the VITAL study is doing more than simply evaluating 2000iu/day of D3 as an appropriate dose? (forehead hits keyboard)

    If human physiology permits the generation of approximately 5,000iu minimum in a day of sun exposure (yes, some studies show 20,000 in lifeguards) then what in the world causes a researcher to pick “2,000” as an appropriate dosage for such a large study. Is this the study being run/funded by the NIH?

    As for any study being a waste of time – much as I dislike poorly designed (from my perspective) studies, I don’t view reading for a moment or two of any study up here as a “waste of my time”, but I guess I don’t place such a high value on my two minutes, or perhaps I place a greater value on learning anything possible about this particular issue. It also helps to be a speed reader, I guess. I feel that *no* study is perfect, and only through considering as many as possible while identifying their strengths and weaknesses can we feel gingerly through the fog towards the central truths.

    Nutritional decisions affect HDL, LDL, Triglycerides, and Cholesterol more than anything else. Being as healthy as your age, rearing, geneology, and lifestyle permit requires making the right decisions, especially about what you eat. Saying that vitamin D is “good” for your cholesterol is like saying “testosterone” or “estrogen” is good for your cholesterol. It may in some poorly understood way AFFECT your cholesterol, but as a hormone its functions effect change on every tissue, every organ system, in the body and by so doing, change the values of some markers we use to guesstimate health. Get your D naturally if you can, by capsule if you can’t, get your 9 to 12 helpings of fruits, veggies, and berries every day, and try to eat “bad things” like fast food in moderation if you must, to give your body a fighting chance to be healthy.

    And it is important to know of studies that temper what I have said above, in either direction, and as such, for me and any other person wishing to make informed decisions about health, cannot be a waste of time. Please don’t harsh my voyage of discovery!

  17. Umileritac@aol.com

    Ron, certainly you have a great deal of scientific background. I enjoy reading your posts, and I always learn something from what you write.

    Clinicians have repeatedly told me that my very low cholesterol levels (at times as low as 106) have not helped my hormonal issues (estrogen, testosterone). And, I have had plenty of hormonal issues.

    Since I have raised my Vitamin D levels to 84 ng/ml, my cholesterol levels have corrected to 156…my estrogen and testosterone levels are now right smack in the middle of healthy range….I feel great. At almost 48 years of age, I’m not on any supplemental hormones (other than DHEA), and I tick clock a Swiss watch. 🙂

    I’m certain that you are correct in stating that Vitamin D affects cholesterol in some poorly understood way….

    I’m just glad it appears to have helped me.

    🙂

  18. JBG

    Brant, you are so busy being defensive that you clearly have not processed what I’ve tried to convey. From its beginning, most posts to this blog have been useful (not specifically useful to me, but useful to someone). I have been repeatedly impressed with just how useful. In recent months, in my perception, things have begun trending downhill. This particular post hit my trigger because both the underlying study and the post itself proclaimed how little it had to say (for anyone but researchers in a couple sub-specialties). I will leave off commenting further here, but I will note any future posts that seem indicative of further decline in the quality of posts here.

    • Brant Cebulla

      JBG, please email me what blogs you feel are poor. As to this blog, we will almost always blog on RCTs, no matter the findings, because it is the highest standard of evidence-based medicine, which is what the public wants: evidence-based medicine.

      Cheers,
      Brant

  19. dew@richardshunter.com

    As a couple of the above posts have touched upon, Cholesterol is the essential precurser, or building block FOR Vitamin D. Sunlight hits your skin, and turns cholesterol into Vit. D. It appears from the essence of the question they were researching, that these researchers didn’t quite get it! Of course it doesn’t make any difference to supplement, because you’re not using up any of the cholesterol then – you’re just ingesting Vit. D3!

    The prior research that shows a helpful correlation between Vit. D and cholesterol, likely was testing and correlating blood levels, the higher instances of which were likely mostly caused by SUN EXPOSURE (!), not supplementation. The people got SUNLIGHT, which affected their cholesterol levels. There is potentially a huge health difference between sunlight and supplementation, and the fact that cholesterol is used up by sunlight converting it to Vit. D, would seem to be the obvious starting point for such research.

    Why wouldn’t this be obvious to presumably knowledgeable scientists? What am I missing here?!

  20. Umileritac@aol.com

    Visit the following link: http://www.ncbi.nlm.nih.gov/books/NBK22339/

    Specifically, the below section:

    26.4.7 Vitamin D Is Derived from Cholesterol by the Ring-Splitting Activity of Light

    Cholesterol is also the precursor of vitamin D, which plays an essential role in the control of calcium and phosphorus metabolism. 7-Dehydrocholesterol (provitamin D3) is photolyzed by the ultraviolet light of sunlight to previtamin D3, which spontaneously isomerizes to vitamin D3 (Figure 26.29). Vitamin D3 (cholecalciferol) is converted into calcitriol (1,25-dihydroxycholecalciferol), the active hormone, by hydroxylation reactions in the liver and kidneys. Although not a steroid, vitamin D acts in an analogous fashion. It binds to a receptor, structurally similar to the steroid receptors, to form a complex that functions as a transcription factor, regulating gene expression.

    May all your days be SUNNY!

    Rita C. Umile

  21. Brant Cebulla

    I think there is some interest in the research community that maybe sun exposure and the process of converting 7-Dehydrocholesterol to previtamin D has some kind of effect on total cholesterol, but that’s never really been studied and is a bit more complicated than it sounds, from my understanding. If there was something to report in that realm, I’m sure researchers would readily publish something on the matter, as sun exposure, vitamin D and cholesterol are hot topics.

  22. Umileritac@aol.com

    This link is also interesting: http://www.cholesterol-and-health.com/Vitamin-D.html

    Best,

    RCU

  23. showmeaschematic

    Is it possible that any effects due to Vitamin D were swamped by the negative effects of too much fructose in the patients’ diets ? Please refer to the work of Dr Robert Lustig at UCSD, who points out that fructose has toxic effects, including producing LDL …..

    I see that the participants were specifically selected as already suffering from Metabolic Syndrome ( my assumption, but very likely valid ) and, if you watch some of Dr Lustig’s lectures it will be very clear to you that fructose over comsumption… sugar and high fructose corn syrup … is in epidemic proportions, and is a major cause of cardio vascular problems.

    I would like to see this study on a group of people who didn’t over consume fructose, and then I think the effect of Vitamin D will truly be revealed, without the swamping mask of fructose toxicicy.

    Nigel Thornley

    Hantsport, NS

    Canada

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