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Dr Orrange received her BA in Biology at the University of California San Diego and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health She received her MD from the USC Keck School of…
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Vitamin D(ude): Vitamin D Deficiency in Older Men
Vitamin D is necessary for a wide variety of biological functions such as bone and mineral metabolism, muscle function, and immunity. As many of you know even in sunny climates, vitamin D insufficiency has been noted to be present in a variety of populations. In my previous blog (http://www.dailystrength.org/blog/32-vitamin-d-and-me) I addressed how to define deficiency and gave specifics on Vitamin D supplementation and a new study has reinforced the importance of this.
Why should we care? Vitamin D is implicated in the causation of common disorders including osteoporosis and fractures, falls, cancer, psoriasis, among others. Vitamin D deficiency is of particular interest because it is easily, safely, and inexpensively corrected with adequate supplementation. Although findings have been somewhat inconsistent, trials of the effects of vitamin D supplementation suggest beneficial effects on important clinical outcomes. As a result, increased attention has been directed at improving vitamin D nutrition,including recent recommendations to increase the routine intake of Vitamin D.
What is the extent of Vitamin D deficiency in men and how do we identify those at risk? In the April 2009 Journal of Clinical Endocrinology and Metabolism looked at 1600 men 65 or older in the United States to find the prevalence of vitamin D deficiency and the risk factors for its occurrence.
What did they find? Vitamin D deficiency and insufficiency were common. Approximately one fourth had a 25(OH) D level below that commonly considered to represent deficiency (less than 20 ng/ml), and the majority had levels considered insufficient (less than 30 ng/ml). Deficiency was particularly common during the winter and spring months (especially in the Northern communities) and in the oldest and more obese subjects. In fact, 86% of the men with multiple risk factors were deficient.
What did we learn from this study? This study showed that there are independent predictors of Vitamin D deficiency (obesity, older age) and that during the winter season there was a high proportion of men classified as deficient.
What could we do differently? In addition to screening men over 65 for vitamin D deficiency, it appears that older men may particularly benefit from vitamin D supplementation, especially in the winter and spring months.
What can you take? As I mentioned in the previous blog, 400-600 IU a day of Vitamin D (and more if you are deficient) is currently recommended. Many calcium supplements now contain Vitamin D and I recommend these to my patients: Caltrate, ColonHealth, Chew-Cal, Liqua-Cal, Os-Cal; and for Vitamin D alone, Calcitriol or Rocaltrol are popular options.
Dr O.
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Displaying comments 12-1 of 12
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Here are what a few other doctors I have read about in the last week that seem to agree with my point.
http://drhotzeblog.netymology.com/...
Also, the “normal laboratory range” of thyroid hormones is an arbitrary value, defined statistically as plus or minus two standard deviations from the mean. This so-called normal range is as wide as the Grand Canyon. In practice, it means that approximately
90–95 percent of the population will always fall within the normal range. However, I assure you that 90–95 percent of the population does not feel healthy, well, and full of energy.
Not only that, but the arbitrarily defined “normal” value has actually changed over time. Between 1991 and 2002, the normal laboratory range for the free thyroxine (free T4) blood test was lowered by 15 percent, from 0.90–2.00 ng/dl to 0.76–1.70 ng/dl.
What this means is that an individual in 1991 who had a free T4 value of 0.80 ng/dl would have been classified by a conventional doctor as hypothyroid, but an individual with an identical T4 value in 2002 would be told that her thyroid function was in the normal range and would be denied treatment. Yet these two patients, separated in time by eleven years, likely would have had numerous symptoms in common—symptoms that are highly responsive to thyroid hormone replacement therapy.
(me) BTW the book "Breakthrough: 8 steps to Wellness" that interviews many different doctors say the same thing. ie page 26 as well as other pages by different docs.
My issue with vitamin D testing is the same issue I emailed you about months ago with "normal range" not always being healthy. You need to be in the higher range of 75-100 approx to reduce your risks for diseases like MS and RA (see below study). Normal range differs depending on where you are in US and in IL it is 32-100. My hubby came back at 33.7 and GP thought this is fine. It may be normal but it is NOT healthy because at this level you are at HUGE% risk for disease like MS/RA/breast and colorectal cancer + others. (see studies at http://www.ramswebsite.net/Vitamin... ).
1/3 of Americans are diabetic and about another 1/ 3 are PREdiabetic. 66% of Americans are not in a healthy place with this disease. If this is normal this is NOT where I want to be. I think the medical community needs to take another look at what is a "healthy target range" is for vitamin/meneral/hormone/fatty acid tests. Another example is testosterone, many studies say if you are around 150 you are at a HUGE increase of all kinds of disease in lower life expectancy. In IL the "normal range" is 140-827. So it is normal and ACCEPTABLE to be 140-150 even thought there are huge increase risks of death here or anywhere near here!!!! Who could I contact to change this dangerous and detrimental way of viewing test scores?
Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyvitamin D levels and risk of multiple sclerosis. JAMA. 2006;296(23):2832-2838. (PubMed)
Vitamin D deficiency has also been implicated in MS. A recent case-control study in U.S. military personnel, including 257 cases of diagnosed MS, found that white subjects in the highest quintile of serum 25(OH)D (>99.1 nmol/L) had a 62% lower risk of developing MS .
Wondering if at this point he should bother w/ the sunscreen as it would mean he'd absorb more D vitamin, which I have read, can mean fewer general aches in pains overall.
He's on chemo off and on -- two weeks on, two weeks off. He's doing well under these trying circumstances. He's in his late 70s and they recently removed some tumors that spread to his lungs. He can still outrun me at the track. Amazing man.
Vit D deficiency is very common in older people, it doesn't discriminate. I am also D deficient and was told to take a toxic amount (50,000 IUs) of prescription D. I chose to take 400 IUs of D3 4 times a day and was able to get back into the normal range. I also have osteopenia, and since I have had skin cancer, I limit my time in the sun (an excellent source of D). I make sure to take the proper ratio of calcium, magnesium and D, plus a little extra D for good measure.
Thank you for positively addressing a male health issue. I was starting to get worried that you were being dismissive of men and male health issues, so I appreciate the fact that you published this article. Now that Representative Murphy has introduced H.R. 2115, the Men and Families Health Act of 2009, we may finally see funding for male-specific health issues on a level comparable to that presently accorded female-specific health issues. Your effort here is certainly a good start. Thank you again.
Reduces risk of heart disease, diabetes AND
Osteoporosis
* 26% reduction in hip fracture
Rheumatoid Arthritis (RA)
* Reduce their risk of developing RA by as much as 42%
Multiple Sclerosis (MS)
* 41% decrease in the incidences of MS in white males & females
Breast Cancer
* reduction by 50% in incidence of breast cancer
Colorectal Cancer
* 50% lower incidence of colorectal cancer
Prostate Cancer
* D3 acts as a chemopreventive agent against several malignancies including cancers of the prostate and colon
* may lead to its use in the treatment or prevention of prostate cancer.
If you want to see the NIH research studies that state the above then go to http://www.ramswebsite.net/Vitamin... and click the URL links to the specific research you are interested in.
also i have read that ~paraphrasing~ sun exposure through glass actually will deplete vitamin d stores because vitamin d is made by exposure to UVB rays.which is blocked by glass, UVA can pass through windows.
"UVA can cause cancerous mutations, and can also break down the vitamin D formed in your skin after outdoor UVB exposure. And vitamin D is a potent defense against melanoma -- melanoma cells convert it to calcitriol, which causes growth inhibition and apoptotic cell death in vitro and in vivo. New research shows that increased UVA exposures and inadequately maintained cutaneous levels of vitamin D promote melanoma."
on that artical it also states " What Does Showering Have to Do With Your Vitamin D Levels?
First, it’s important to understand that vitamin D3 is an oil soluble steroid hormone. It’s formed when your skin is exposed to ultraviolet B (UVB) radiation from the sun (or a safe tanning bed). When UVB strikes the surface of your skin, your skin converts a cholesterol derivative in your skin into vitamin D3.
However, the vitamin D3 that is formed is on the surface of your skin does not immediately penetrate into your bloodstream. It actually needs to be absorbed from the surface of your skin into your bloodstream.
The critical question then is: how long does it take the vitamin D3 to penetrate your skin and reach your bloodstream?
If you’re thinking about an hour or two, like I did until recently, you’re wrong. Because new evidence shows it takes up to 48 hours before you absorb the majority of the vitamin D that was generated by exposing your skin to the sun!
Therefore, if you shower with soap, you will simply wash away much of the vitamin D3 your skin generated, and decrease the benefits of your sun exposure. So to optimize your vitamin D level, you need to delay washing your body with soap for about two full days after sun exposure.
Now not many people are not going to bathe for two full days.
However you really only need to use soap underneath your arms and your groin area. , so this is not a major hygiene issue. You’ll just want to avoid soaping up the larger areas of your body that were exposed to the sun. "
http://articles.mercola.com/sites/...