More Vitamin D and HDL

I’m seeing more and more of it and I am convinced that there is a relationship: significant boosts in HDL cholesterol from vitamin D supplementation.

To my knowledge this remains an undescribed and uncharacterized phenomenon. There have been several observers over the last two decades who have noticed that total cholesterol shows a seasonal fluctuation: cholesterol goes up in fall and winter, down in spring and summer; year in, year out. This phenomenon was unexplained but makes perfect sense if you factor in vitamin D fluctuations from sun exposure.

I have come across no other substantiating evidence about fluctuations of HDL. But I am convinced that I am seeing it. Replace vitamin D to a blood level of 50 ng/ml, and HDL goes up if it is low to begin with. If HDL is high to begin with, say, 63 mg/dl, it doesn’t seem to change.

But, say, starting HDL is 36 mg/dl. You take niacin, 1000 mg; reduce high-glycemic index foods like breakfast cereals, breads, cookies, bagels, and other processed carbohydrate foods; exercise four days a week; add a glass of red wine a day; even add 2 oz of dark chocolate. You shed 15 lbs towards your ideal weight. After 6 months, HDL: 46 mg/dl. Better but hardly great.

Add vitamin D at a dose of, say, 4000-6000 units per day (oil-based gelcap, of course!), and re-check HDL two or three months later: 65 mg/dl.

I’ve seen it happen over and over. It doens't occur in everybody but occurs with such frequency that it’s hard to ignore or attribute to something else. What I’m not clear about is whether this effect only occurs in the presence of the other strategies we use to raise HDL, a “facilitating” effect, or whether this is an independent benefit of HDL that would occur regardless of whatever else you do. Time will help clarify.

We are tracking our experience to see if it holds up, how, and to what degree on a more formal basis. Until then, a rising HDL is yet another reason—-among many!-—to be absolutely certain your 25-OH-vitamin D3 level is at 50 ng/ml or greater.

How high is an ideal vitamin D blood level? If 50 ng is good, is 60 or 70 ng even better? Probably not, but there are no data. We have to wait and see. Unlike a drug that enjoys plentiful “dose-response” data, there are no such observations for vitamin D into this higher, though still “physiologic,” range.

Comments (8) -

  • Anonymous

    4/2/2007 1:25:00 PM |

    Dr. Davis,
    As cholesterol in the skin is a precurser to Vitamin D, it makes sense that there'd be a seasonal fluctuation in circulating cholesterol.  In summer months, with skin exposure, the cholesterol in the skin is being converted and "used" and more has to come from the rest of the body to take it's place. Couldn't that naturally draw down the serum choesterol levels?

  • Zer

    4/2/2007 3:44:00 PM |

    Zuleika's Vitamin D Experiment shows data from http://www.anaboliclabs.com/company_main/PDFS/Vit%20D%20telecon%20-%20Jan%202007.pdf

    January 2007

    Deficiency <50 nmol/L
    Insufficiency 50-80 nmol/L
    Optimal 80-250 nmol/L
    Excess/Tox: >250 nmol/L

  • Dr. Davis

    4/2/2007 3:57:00 PM |

    Great thought. It would make sense.

    I'm uncertain if the quantity of cholesterol taken for conversion of inactive to active vitamin D in the skin is sufficient impact on blood levels. It will be interesting to see how this argument unfolds as the vitamin D experience grows worldwide.

  • Anonymous

    4/3/2007 12:59:00 AM |

    Perhaps vitamin D raises HDL by improving glucose metabolism. There are vitamin D receptors in pancreatic beta cells, and vitamin D deficiency has been shown to impair insulin synthesis and secretion in humans and in animal models [1]. Vitamin D supplementation in women with type 2 diabetes increased first phase insulin secretion, and also reduced insulin resistance, though not significantly [2].

    1. Mathieu C, Gysemans C, Giulietti A, Bouillon R. Vitamin D and diabetes. Diabetologia. 2005 Jul;48(7):1247-57. Epub 2005 Jun 22.

    2. Borissova AM, Tankova T, Kirilov G, Dakovska L, Kovacheva R. The effect of vitamin D3 on insulin secretion and peripheral insulin sensitivity in type 2 diabetic patients. Int J Clin Pract. 2003 May;57(4):258-61.

  • Cindy

    4/3/2007 1:30:00 AM |

    I'm going to a new doc soon and want to have my vit d levels checked. I've been taking supplements and want to find out my level.

    What test do I ask for? Is it just a blood level? or is there more to it?

    I also am going to ask for CRP, hemocystine and ferritin in addition to all the normal labs for a 53 yr old woman.

    I'm also concerned about the cholesterol testing. My levels are high, and I reacted badly to statins. What's the best thing to ask for with the cholesterol tests. I'm in the Duke system, so I'm sure almost everything is available, but can't afford anything that insurance won't cover.

  • Dr. Davis

    4/3/2007 1:44:00 AM |

    Cindy--
    Ask for a 25-OH-vitamin D3 level. Be certain it is NOT a 1,25-diOH-vitamin D3. They sound and look the same but are very different. The second is a measure of kidney function. Only the 25-OH form serves as a measure of vitamin D.

    We suggest an NMR lipoprotein profile with lipoprotein(a), C-reactive protein, glucose, insulin, homocysteine (though you'll get some resistance on this one).

    Dr. Davis

  • Anonymous

    3/5/2008 7:04:00 PM |

    What about the seasonal differences of diet and physical activity on total cholesterol? Our winter and fall diets are heavier with foods that raise cholesterol whereas in the warmer spring and summer we tend to eat lighter and maybe more salads and fruits.  And the warmer weather of spring and summer also makes us more active, going outdoors for walks, working on our yards, going to the beach, etc.

  • buy jeans

    11/3/2010 6:58:40 PM |

    I’ve seen it happen over and over. It doens't occur in everybody but occurs with such frequency that it’s hard to ignore or attribute to something else. What I’m not clear about is whether this effect only occurs in the presence of the other strategies we use to raise HDL, a “facilitating” effect, or whether this is an independent benefit of HDL that would occur regardless of whatever else you do. Time will help clarify.

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