Vitamin D and octagenarians

Roger practically bounced in his chair vibrating with energy.

"It must be the vitamin D! I haven't felt like this in years. I can work around the yard all day and still have energy left over."

At age 84, Roger started out with pretty good health, despite a prosthetic valve and bypass surgery 5 years earlier. He looked 74, perhaps younger.

I've seen this effect now in about 20 octagenarians. A Track Your Plaque Member mentioned this same effect in his father-in-law in a discussion in our Forum. Most are taking around 6000-8000 units per day (gelcap, of course). The average dose of vitamin D tends to be higher in this age group, since by age 80, you've essentially lost the capacity to convert 7-hydrocholesterol to active vitamin D3 in the skin. Most octagenarians start with 25-OH-vitamin D3 levels of 10 ng/ml or less--profound deficiency.

I believe the effect is real, having now witnessed it multiple times. Unfortunately, my observations are too informal to qualify as a study. (I wouldn't even know how to quantify this. I suppose some sort of muscle and coordination testing might yield quantifiable measures.) However, there are some data emerging that show less fractures, falls, improved coordination, and perhaps improved memory and mentation with vitamin D supplementation, though doses often used in studies tend to be lower than what we are using in practice.

I haven't been so excited about the effects of a nutritional supplement in a long time. Vitamin D continues to yield surprises every day in its array of positive and powerful effects.

Could we say that vitamin D restores youthfulness?

Comments (28) -

  • Anonymous

    10/10/2007 9:26:00 PM |

    I was wondering if you could breifly but exactly tell me what vitamin D does for your heart as far as reducing plague. I just always hear "its good to reduce plague" but how or what does it do?

  • Dr. Davis

    10/10/2007 9:42:00 PM |

    There is a full special report posted on the www.trackyourplaque.com website.

    Also, see my article in Life Extension Magazine on vitamin D; it should be posted online within the next couple of months if you don't have a hard copy.

  • Anonymous

    10/11/2007 1:51:00 AM |

    Are all brands of cholecalciferol interchangeable?  How do you know how much D to take?

    I am female, age 52.  I started on 2,400 IU of cholecalciferol last March because my Vitamin D levels tested at 19.  Last time I tested in August, my D levels were up to 42 (presumably because of the supplementation since I don't spend much time in the sun).  I'm also taking fish oil.

    However, I wish I could tell you that I felt more sprightly like your patients.  However, I really don't feel any better on Vitamin D than off of it.  I'm either (1) a non-responder; (2) not taking the right brand of Vitamin D; or (3) not taking a high enough dose (although 2,400 seems like a lot).

  • Dr. Davis

    10/11/2007 1:58:00 AM |

    We aim for a blood level of 50-60 ng/ml.

    However, though I've been impressed with the energy-enhancing effects, it does not develop in everybody. Why? That's another lesson to learn. But restoring vitamin D still provides all its imperceptible benefits.

  • over&out

    10/11/2007 2:59:00 AM |

    Dr Davis, 10 days ago I told you of my Diabetic wifes wonderful response to an experimental dose of 1000IU oil base gel cap D's. Her #'s dropped 20-30 points. She called her Endo requesting a prescription for a blood draw to check D level. He was unresponsive and today his nurse called and said not to take anymore, he had never read anything about D affecting Glucose levels, and He would talk to her at the next appointment. Undeterred we called our GP and he said sure,just stop in. We did and now await the #'s hoping we understand them. I am considering Faxing the Pub Med study "The roll of Vitamin D and Calcium in type 2 Diabetics" to my wifes Endo. Do you think he would be offended? .....Thanks

  • over&out

    10/11/2007 2:59:00 AM |

    Dr Davis, 10 days ago I told you of my Diabetic wifes wonderful response to an experimental dose of 1000IU oil base gel cap D's. Her #'s dropped 20-30 points. She called her Endo requesting a prescription for a blood draw to check D level. He was unresponsive and today his nurse called and said not to take anymore, he had never read anything about D affecting Glucose levels, and He would talk to her at the next appointment. Undeterred we called our GP and he said sure,just stop in. We did and now await the #'s hoping we understand them. I am considering Faxing the Pub Med study "The roll of Vitamin D and Calcium in type 2 Diabetics" to my wifes Endo. Do you think he would be offended? .....Thanks

  • Dr. Davis

    10/11/2007 3:22:00 AM |

    Yes, by all means.

    If he is offended, it's time for a new endocrinologist. Part of being a responsible professional is a willingness to learn.

  • over&out

    10/12/2007 2:35:00 AM |

    Sorry to be a pest...My wife's D checked at 42 pg/ml...what ever pg stands for? She want to take another 1000IU gel cap for a couple weeks (total of 2000IU) to see if glucose goes down more. If it does then she will retest to see if that is a safe maintenance dose. Sound like a reasonable plan?
    From 180's down to 150's has been  encouraging. Many Thanks.

  • over&out

    10/12/2007 2:35:00 AM |

    Sorry to be a pest...My wife's D checked at 42 pg/ml...what ever pg stands for? She want to take another 1000IU gel cap for a couple weeks (total of 2000IU) to see if glucose goes down more. If it does then she will retest to see if that is a safe maintenance dose. Sound like a reasonable plan?
    From 180's down to 150's has been  encouraging. Many Thanks.

  • Dr. Davis

    10/12/2007 11:44:00 AM |

    I'm puzzled.

    I've never seen vitamin D expressed in those units. It also doesn't make sense. There are 1000 pg in one ng; thus, a value of 42 pg/ml would equal .042 ng/ml, a value less than 1 ng/ml, meaning virtually zero vitamin D in the blood.

    Something is wrong. You might go back and verify the value.

  • Anonymous

    10/12/2007 4:27:00 PM |

    Oct. 12, 2007

    Dr. Davis:
    Re: Over & out:

    There are two Vitamin D test.
    One is Vitamin D,1, 25-Hydroxy (Calcitriol). This test is reported in pg/ml.
    The other Vitamin, D test is Vitamin D, 2-Hydroxy (Calcidiol).
    This reported as ng/ml.
    I think this should be the Vitamin D test to be ordered.
    I made the same mistake, before.

    So, I think Over & Out should have her test redone, on Vitamin D2-Hydroxy (Calcidiol).
    I have mine done thru, Directlabs.com., blood drawn at Labcorp.

    Thanks,

  • over&out

    10/12/2007 6:32:00 PM |

    Your a genius! We attached your text (minus your name so they wouldn't T.P. your house)and went to Paul Oliver Hosp. In Traverse City, MI. "Whats up with this" we asked. "Oh, we ran the wrong test" this is for a 1,25 OH Vitamin D test.
    So now its the weekend and we will have to wait till Mon-Tues for the real results. What a miatake we could have made without your generous help. Many Thanks ...big time.

  • over&out

    10/12/2007 6:32:00 PM |

    Your a genius! We attached your text (minus your name so they wouldn't T.P. your house)and went to Paul Oliver Hosp. In Traverse City, MI. "Whats up with this" we asked. "Oh, we ran the wrong test" this is for a 1,25 OH Vitamin D test.
    So now its the weekend and we will have to wait till Mon-Tues for the real results. What a miatake we could have made without your generous help. Many Thanks ...big time.

  • Dr. Davis

    10/13/2007 1:46:00 AM |

    Ah, that makes sense. Thanks.  

    However, it's the 25-OH-vitamin D3 that we measure, the effective form, not D2.

  • G

    10/17/2007 5:48:00 AM |

    You are actually shooting for 60-60-60-60 (LDL TG HDL, vit D-25-OH)! I can't wait to see an RCT on the results of your interventions. do you think your results will beat Vit B3 (ie niacin) + zocor 40mg/d from the HATS trial with a better than 90% reduction in secondary CAD?  I would wager the results will trump. i hope the doubts are put to rest.
    I've recently test my own vit d and am so confounded they are so low (21 ng/ml) for living in sunny Cali, taking my kids to swimming for hours in the summer 2-4 days/wk, running 3-4 half-marathons and a mini-triathlon every year...  is it really all the sunscreen causing this silent pandemic of deficiency?  is there a point in screening. it seems everyone is deficient, even if the dark toned individuals who spend hours in the sun daily. i'm only 30-something, not obese (bmi 18.5). i've even checked my glucose (i'm an educator) and surprised to find it > 160 after a rare sugary drink. also i never use my asthma inhaler in the summer but found i needed it without being sick... i may need to go sun myself and get D3 3000-4000 IU/d to get the level up to 60. i'm so bummed. but glad to not be in the dark (pun intended)  thank you again for your excellent insights.

  • G

    10/17/2007 7:32:00 AM |

    Lipitor is 'doing the D'!
    you've probably seen this (the post-1yr leves are still very low << 80 nmol/L)...  


    Effects of Atorvastatin on vitamin D levels in patients with acute ischemic heart disease.

    Am J Cardiol. 2007 Apr 1;99(7):903-5

    Authors: Pérez-Castrillón JL, Vega G, Abad L, Sanz A, Chaves J, Hernandez G, Dueñas A

    Vitamin D deficiency is a risk factor for osteoporosis and other chronic diseases, including type 1 diabetes, hypertension, metabolic syndrome, and ischemic heart disease. Cholesterol and vitamin D share the 7-dehydrocholesterol metabolic pathway. This study evaluated the possible effect of atorvastatin on vitamin D levels in patients with acute ischemic heart disease. Eighty-three patients (52 men and 31 women) with an acute coronary syndrome (75 with acute myocardial infarction and 8 with unstable angina) were included. After diagnosis, patients received atorvastatin as secondary prevention. Serum vitamin D was measured by high-performance liquid chromatography at baseline and at 12 months. Atorvastatin treatment produced a statistically significant decrease in cholesterol and triglyceride levels and an increase in vitamin D levels (41+/-19 vs 47+/-19 nmol/L, p=0.003). Vitamin D deficiency was decreased by 75% to 57% at 12 months. In conclusion, atorvastatin increases vitamin D levels. This increase could explain some of the beneficial effects of atorvastatin at the cardiovascular level that are unrelated to cholesterol levels.

    PMID: 17398180 [PubMed - indexed for MEDLINE]

  • Dr. Davis

    10/17/2007 12:27:00 PM |

    Isn't that interesting? I saw that, too, but was impressed with how little discussion it seemed to generate. Perhaps we're all becoming oversaturated with the statins do this, statins do that reports. But  I thought this one also merited special attention.

  • Dr. Davis

    10/17/2007 12:33:00 PM |

    That is impressive. Factors that contribute to vitamin D deficiency would include:

    1) season--even in LA, the sun is increasingly indirect.

    2)Lifestyles--with more time spent indoors and in cars; you probably wear clothes most of the time!

    3) Sunscreen, as you point out, is very effective to block vit D conversion.

    4) Genetic factors

    5) Skin color--The darker you are, the longer it takes to obtain D.

    I believe that our results will like be superior to a HATS-like experience, though they are two different populations, ours being lower risk. Event data will come eventually. We are currently focusing on surrogate measures of atherosclerosis first.

  • G

    10/18/2007 9:08:00 PM |

    You are awesome -- thank you for  your thoughts!!  yes, usually i'm clothed!  but wore the requisite suit at the poolside and perhaps increased the natural SPF in the skin as a consequence?  The more tan, perhaps the less skin activation of D3?  I'm a tan asian american (I was 'black' as a kid playing in the 'hood, but, now no longer to avoid you know wrinkles)

    As a rph, I read the life extension article and really appreciated the list of potential adverse effects with Vitamin D.  Do you routinely ck urine for calciuria?  When do you see this happen?  Do recommend checking annually?

    somehow you remind me of Tony Soprano but instead of knocking people off, you're HELPING PEOPLE STAY ALIVE...  Keep up your strong work.

  • Dr. Davis

    10/19/2007 2:39:00 PM |

    Thanks, much, G.

    No, I don't routinely check calcium in the urine nor in the blood. It is rare in an otherwise healthy person to see any adverse disruptions of calcium. In fact, most people who are deficient in vit D (nearly everybody!) show a modest drop in serum calcium, reflecting less mobilization of bone stores, a healthy effect.

  • Anonymous

    10/22/2007 9:18:00 PM |

    I would just like to say that your blog has really helped me.  My father just turned eighty and neither his primary doctor (who handles his heart disease) nor his Alzheimer's doctor has ever tested his vit.D levels.  When I inquired about him possibly adding fish oil and vit.D a year ago, both doctors looked at me like I was an an insane person. They dismissed me and I thought, hey, they are the ones with M.D.'s after their names.  Well, after recently educating myself with your blog, I insisted on a vit.D test and sure enough, the nurse said it was very low although she declined to tell me the actual level.  She said my father's primary doctor would follow up with us.  With the fish oil, the doctor said it is much better to get it from food and I said we don't eat an Eskimo diet!!  She said taking the fish oil wouldn't hurt.  But again, no guidance as to amounts.  Could you recommend amounts of both the vit.D gelcaps and fish oil for my 80 year old dad and myself (37 year old female)?

  • Dr. Davis

    10/22/2007 10:28:00 PM |

    Thanks for your kind comments. Unfortunately, I cannot dispense individual advice.

    However, an average dose in my patient 80 years and over is 6000 units for a male; 35-40 year old females usually require 2000-4000 units per day. Of course, needs vary depending on body size, region of the country, sun exposure, race, etc. These are ballpark figures.

    Always keep in mind that Vit D works far better when in gelcap form.

  • G

    10/28/2007 2:12:00 AM |

    I take it back!  you're not that Tony-esque... you're more akin to Emeril Largesse... spreading the LOVE (heart)!! and keeping the ticker ticking!  continue the strong work!  

    How detrimental is caffeine (ie, 2-3 shots espresso or green tea daily)?   1 glass red wine daily?  UV B tanning booth? (I'm considering the last vice since I'm tiring of taking pills)
    In Wisconsin, do you ever lay out or hit the tanning salon?

  • g

    10/28/2007 2:21:00 AM |

    BTW, I have lived your low carb, moderate fat diet -- totally works! lost 45 lbs over 4 yrs after my children were born (coupled with strength training and yoga).
    I've convinced some of my diabetes pts -- but it's very hard for people to give up the pasta and rice.
    What are your thoughts on Fibrates (very good data from the DAIS and VA-HIT)?
    How about Plant Sterols (which is sold at Trader Joes -- LOVE THAT PLACE  -- they carry the oat bran, raw nuts and flaxseed you endorse -- I love their LOW GLYCEMIC FLOURLESS Ezekiel bread!)? it apparently is being added to EVERYTHING including milk and OJ soon... it's already mixed with margarine (yeck)

  • Dr. Davis

    10/28/2007 2:27:00 AM |

    Those are all great ideas. Tanning beds can indeed activate vitamin D, similar to sun exposure.

  • Dr. Davis

    10/28/2007 2:30:00 AM |

    I love Trader Joe's, too. We just got our first in Wisconsin about one year ago. It saves me a lot of driving back and forth to Chicago.

    Fibrates--I use them only occasionally, as a second choice to niacin, since niacin is much more powerful in effect.

    Please see our newsletter archive at www.trackyourplaque.com for a full discussion of the potential DANGERS of sterol esters. Stanol esters like those in Benecol are safe. But sterol esters can potentially be absorbed into the blood.

  • G

    11/9/2007 8:03:00 PM |

    Thanks for the plant sterol FYI!

    Should D3 be renamed...  it seems to be implicated in so many other functions (cardiac, CKD/PTH, reproductive, autoimmune, TSH, dyslipidemia, Type 1 and Type 2 DM, hypertension, cancers, osteoporosis, the list goes on)... something like DVH which would stand for 'D3 VITAL hormone'

    What are your thoughts on DHEA (and Testost replacement)? Do you titrate the dose to patient's tolerance, to symptom resolution or a physiologic levels?  For testost our lab normals are female T > 20 ng/dL; male  T > 260 pg/mL)...  Thank you for any input!

    I'm so grateful for you sharing your compelling observations on the effects on HDL and CAD reversal!  here's another interesting article... D3 (and calcium -- i think it's D3 dependent effect) on HDLs!

    Am J Clin Nutr. 2007 Jan;85(1):54-9.
    Supplementation with calcium + vitamin D enhances the beneficial effect of weight loss on plasma lipid and lipoprotein concentrations.Major GC, Alarie F, Doré J, Phouttama S, Tremblay A.
    Division of Kinesiology, Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Ste-Foy, Canada.

    BACKGROUND: Adequate calcium intake can have a favorable effect on some metabolic variables. OBJECTIVE: The objective of the study was to determine the effects of daily calcium intake and of supplementation with calcium and vitamin D (calcium+D) during a weight-loss intervention on blood pressures, plasma lipid and lipoprotein concentrations, and glucose and insulin concentrations in low calcium consumers. DESIGN: Healthy, overweight or obese women (n = 63) with a daily calcium intake of < 800 mg/d were randomly assigned in a double-blind manner to 1 of 2 groups: the group consuming 2 tablets/d of a calcium + vitamin D supplement (600 mg elemental calcium and 200 IU vitamin D/tablet) or the group consuming placebo; both groups observed a 700 kcal/d energy restriction. These 63 women then completed a 15-wk weight-loss intervention. RESULTS: Initial daily calcium intake was significantly correlated with plasma HDL cholesterol (r = 0.41, P < 0.001) and with 2-h postload glycemia (r = -0.29, P < 0.05) during an oral-glucose-tolerance test, independent of fat mass and waist circumference. After the 15-wk intervention, significantly greater decreases in total:LDL and LDL:HDL (P < 0.01 for both) and of LDL cholesterol (P < 0.05) were observed in the calcium+D group than in the placebo group. The differences in total:HDL and LDL:HDL were independent of changes in fat mass and in waist circumference. A tendency for more beneficial changes in HDL cholesterol, triacylglycerol, and total cholesterol was also observed in the calcium+D group (P = 0.08). CONCLUSION: Consumption of calcium+D during a weight-loss intervention enhanced the beneficial effect of body weight loss on the lipid and lipoprotein profile in overweight or obese women with usual low daily calcium intake.

    PMID: 17209177 [PubMed - indexed for MEDLINE]

  • Dr. Davis

    11/10/2007 12:53:00 AM |

    Hi, G--

    I use both DHEA and testosterone for specific lipid/lipoprotein treatment, e.g., DHEA in men and women to (modestly) reduce Lp(a), testosterone to reduce Lp(a) in men.

    Both can also be used to increase physical stamina, erectile capacity, and mood. I'd invite you to read our full length Special Reports on each of these topics on the www.trackyourplaque.com website.

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