Vitamin D increased my cholesterol

2. October 2009 William Davis (38)
A friend told me this story.

Her friend, Linda, had added vitamin D to her daily supplements. Because she'd had a vitamin D blood level of 22 ng/ml, she was taking 6000 units per day.

However, Linda also had a high cholesterol value with a total cholesterol of 231 mg/dl. After several months on the vitamin D, she had another cholesterol panel. Total cholesterol: 256 mg/dl.

"It must have been the vitamin D! So I stopped it right away."

Is this true? Does vitamin D raise the level of blood cholesterol? Yes, it does. But it's a good thing. Let me explain.

Followers of The Heart Scan Blog know that total cholesterol is really a mix of 3 other factors:

Total cholesterol = LDL cholesterol + HDL cholesterol + triglycerides/5

This is the Friedewald equation, still used today in over 95% of cholesterol panels. So, by the Friedewald equation, anything that increases LDL, HDL, or triglycerides will increase total cholesterol.

One of the spectacular changes that develops over a year of taking vitamin D is that HDL cholesterol skyrockets. While sensitivity to this effect varies (probably on a genetic basis), HDL increases of 10, 20, even 30 mg/dl are common. A starting HDL, for instance, of 45 mg/dl can jump up to 65 or 70 mg/dl, though the effect requires up to a year, sometimes longer.

Vitamin D can also reduce triglycerides, though the effect is relatively small, usually no more than 20 mg/dl or so. Likewise, the effect on LDL is minor, with a modest reduction in the small type of LDL.

So the dominant effect of vitamin D from a cholesterol standpoint is a substantial increase in HDL. Looking at the equation, you can see that an increase in HDL is accompanied by a commensurate increase in total cholesterol. If HDL goes up 25 mg/dl, total cholesterol goes up 25 mg/dl.

So Linda is absolutely correct: Vitamin D increases cholesterol--but it's a good thing that reduces risk for heart disease and is an important part of a coronary plaque-reversal program.

This is yet another reason why I advocate elimination of total cholesterol on lipid panels. There is no useful information in the total cholersterol value, only the potential for misinformation.
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Comments (38) -

  • Anonymous

    10/2/2009 12:48:55 AM |

    I know enough to not stress about lipid levels that send some docs for their prescription pads.  However, I was a bit shocked to see my recent numbers as follows:
    TC 465
    HDL 102.18
    Trig 48.95
    LDL 353.73
    Even doing a more accurate calculation, the LDl is high, although all the ratios seem to be in order.  I'm mid 50's, slim and with no family history of heart disease.  I also do not have any of the indicators for Lp (a).  Anything else that would cause this?

  • David

    10/2/2009 12:55:49 AM |

    Dr. Davis,

    I was wondering why my HDL went up with my latest Lipid Panel test results I received yesterday from my Endocrinologist (Type 2 diabetes). It was a pleasant present on my 60th birthday – HDL of 65!

    My Lipid Panel results: - Total Cholesterol -127,     HDL – 65,  Triglycerides – 51,  LDL - 52

    I have been taking 4,000 IU of D3 for the past six months after reading your blog. Actually, my HDL was in the mid fifties to sixty since for a few years I have been taking 500 mg of Slo-Niacin along with two Omega 3 fish oil capsules per day. Added to this is four days per week at the gym for the last three years. This helps too.

    My HDL has never been so high at 65 and I didn’t realize the positive affect of the Vitamin D3 until the current test results.

    I believe my LDL is so low because I am taking a 20 mg dosage of Simvastatin, although I am now taking it every other day. Along with the Simvastatin, I am taking Metformin and Diovan all prescribed by my Endocrinologist. After researching on the Internet I added the Omega 3, Niacin, and from your blog Vitamin D3. My doctor doesn’t have much to say about this, although I have mentioned it to him.

    Vitamin D3 really seems to work on the HDL!

    Now I really have to try to cut down on my wheat consumption to drop my A1c below 6.4.

    I appreciate your blog along with your book.

    Thanks for all your helpful information.

    David

  • Dr. William Davis

    10/2/2009 1:26:15 AM |

    Anon--

    You must--MUST--consider getting an NMR lipoprotein test to obtain the LDL particle number.

    Given the very high HDL , it is possible that the true LDL is far, far lower than the calculated LDL. It likely will be high, but not that high.

  • Dr. William Davis

    10/2/2009 1:26:24 AM |

    Great work, David!

  • steve

    10/2/2009 2:38:01 AM |

    Dr. Davis:  How do you know the increased HDL is due to the D3 and not from the wheat elimination you recommend?

  • Lyn

    10/2/2009 2:40:24 AM |

    Raises TC?!!!  Wow, thanks!  Gonna print out and show to Primary, Endo, and Cardio who are talking statins (Primary said statins or niacin). Comments?

    Aug 08: D=15.2, TC=212, TRI=181, HDL=47, LDL=129, TSH=2.795(normal free T3 & T4), A1C=11...50K IU/wk of D2 for 8 wks, then 1K D3 daily. Very low carb diet, metformin ER, Januvia (terrible CNS side effects), Maxzide, Cozaar. BP=140s/65 <1800 mg sodium told to add a bit more.

    Dec 08: D=33, TC=205, TRI=119, HDL=57, LDL=124, TSH=4.289 (normal free T3 & T4), A1C=6.9, TSH=2.667(normal free T3 & T4)...2K D3 daily.  Very low carb diet, metformin ER, Maxzide, Cozaar (half dose). BP=130s/75

    Jun 09: D=36, TC=231, TRI=119, HDL=57, LDL=150, TSH=4.548(normal free T3 & T4), A1C=6.4...4K D3 daily.  Very low carb diet, metformin ER, Maxzide, Cozaar (1/4 dose) on days following apnea events that wake me up (on CPAP), aver BP=128/72

    Sep 09: D=41, TC=235, TRI=145, HDL=60, LDL=147, TSH=5.51 normal free T3 & T4), A1C=6.5 (tried new foods-meals & spiked)...4K D3 daily (thinking of upping to 5-6K).  Very low carb diet, metformin ER, Maxzide, Cozaar (1/4 dose) on days following apnea events that wake me up, aver BP=130/70, started generic Levothyroxine 25 mcg/day, just started Iodoral 12.5 mg a wk ago--body temp finally staying the 98s. Subbing a high-protein (lots of BCAAs) shake for breakfast and 1/2 shake for snack -- lost 4 pounds in 6 days (monitoring BGs frequently). ApoB=111 (<109 normal)...oops.

    So, are my rising cholesterol numbers the results of the following or ?
    - Very low carb (<40 gms) diet (guessing larger LDL particles)
    - Rising TSH levels(hypothyroidism increases cholesterol right?)
    - Increased amts of D3

    60 yo female. Lost 50+ pounds but still obese (takes time). 35-60 mins/day low intensity recumbent exercise bike. Laidoff--lots of angst & stress.  All other bloodwork results good (high RBC down to normal, guessing less apnea desats). Using topical progesterone, 3 wks on, 1 wk off a la Dr John Lee. No CVD in family, just Type 2 and hypothyroidism.  If niacin is good, which form?  Not sure I can handle flushing, have touchy skin, used to have rosacea.

  • Lynn M.

    10/2/2009 5:38:54 AM |

    Anonymous,

    Hypothyroidism will jack up cholesterol and LDL.  People can be hypothyroid even if they're slim.  Have you had your FT3 checked?

  • moblogs

    10/2/2009 9:27:36 AM |

    I actually found different. I've been on 10,000IU of D3 and found a general dip in my cholesterol levels (although a slight increase in HDL).

    Here's a scan of my results in '07 (when I was just 15nmol/L) and recently where I'm above 76nmol/L (I just say above as my most recent D reading is yet to arrive).
    http://bit.ly/3h9X4C

    Of course it may be co-incidence too, but both my brother and father have had no change at all in their cholesterol levels in the last few years. My brother's on D but only just enough as recommended by a doctor.

    My levels this year are now well below UK average (which is 5.7mmol/L and I'm now 4.95 from 5.62) and correspondingly I wasn't told to modify my diet or go on a statin, even though my cholesterol level was deemed as only marginally high before.

  • denparser

    10/2/2009 11:41:02 AM |

    wow.. how could it be? in fact, if that's gonna be true, not all vitamins are good for the body in the sense that it has a side effect inside the body.

  • Jim Purdy

    10/2/2009 12:00:27 PM |

    I read this and then immediately ordered some vitamin D.

  • Anonymous

    10/2/2009 4:02:13 PM |

    Anonymous,

    Has your LDLs always been this high or have you never had your cholesterol tested before? If so, then perhaps you have Familial Hypercholesterolemia like I do. If your LDLs have been tested before and were never that high, then it must be something else.

    Since your Trig. are so low and your TC is over 250, the standard Friedewald equation isn't the most accurate for you. Here is a better calculator for people like you:

    http://homepages.slingshot.co.nz/~geoff36/LDL_mg.htm

    Regardless, that still is a high LDL. Have you recently started taking new supplements?

    The reason I ask is because I was once was advised to take a several difference supplements in the hopes of raising my Testosterone and they all had some zinc in them and my LDLs skyrocketed (even for me)! I later learned that too much zinc can do this. I was taking around 100 or 110mg of zinc daily if my memory serves me correctly. I believe taking too much zinc can adversely affect copper levels which in turn can raise cholesterol. Now I try to stay around 100% to 200% of the RDA (15mg - 30mg) and I don't have that problem.

    Are you taking sterols? Maybe you're absorbing the sterols...just a thought.

    Maybe it was a just lab fluke. I would recommend a retest (preferably using a NMR or a VAP test).

    Good luck!

    John M.

  • trinkwasser

    10/2/2009 4:25:01 PM |

    Put your numbers through this

    http://homepages.slingshot.co.nz/~geoff36/LDL_mg.htm

    it brings your LDL down to 286, still a bit high, I'd suggest there's something else occurring, could be thyroid?

    One "authoritative" site for calculating cardiovascular risk won't even permit HDL levels over 100 to be entered, so you've aced that, and the trigs

  • Anonymous

    10/2/2009 5:48:46 PM |

    http://www.elements4health.com/cholesterol-buildup-in-diabetes-patients-deficient-in-vitamin-d.html

    interesting...have you read or posted on this yet?

  • Helena

    10/2/2009 7:50:31 PM |

    Total Cholesterol is by far a wrong way to measure the risk of heart disease. In this case, if the doctor she was going to was one among many she would have been prescribed statin drugs without further investigation. Higher Cholesterol must be bad right - let's make a buck and sell her some lipitor or Simvastatin! People in general are too uneducated and trust doctors more than anything else. This makes me scared! A low carb high fat (LCHF) diet will gett people more healthy all over! Better cholesterol quota, less over weight, less risk of developing type 2 diabetes, less risk of inflammation, and better energy! You can't go wrong! Thanks for this very important post!

  • Anonymous

    10/3/2009 2:34:28 AM |

    Dr. Davis,
    Thanks so much for your response.  Would it make a difference to know that I have eaten low carb for several years, and seldom eat grains?  Also, apparently my lipids were 'normal' when last checked 10 years ago.
    My GP claims ignorance of the difference between calculated and direct measure of LDL, or of different particle size.  He just knows the numbers the lab sends.  I believe I would need to see a specialist to get tested further.  Worth the trouble?

  • Dr. William Davis

    10/3/2009 12:33:08 PM |

    Hi, Steve--

    You are absolutely correct: Given sufficient time, wheat elimination increases HDL also. However, vitamin D can also increase it independently. I've seen many people add vit D to an already established no-wheat diet and still send HDL through the roof.

    Lyn--

    As you can see, it's probably a combination of all the good things you've done.

  • Lieta

    10/4/2009 2:40:15 AM |

    I've been supplementing with 6,000 mg of D3 each day for a month and following a low carb but not wheat-free diet for 2 months. I was surprised to see my HDL come back so low and my LDL so high on a recent test:

    HDL: 34
    LDL: 203
    VLDL: 9
    Trig: 47

    I will add Niacin to my supplement regimen to help bring down the LDL, and eliminate wheat. I am about 40 lbs overweight, with no other health issues (that I know of!). My A1C and fasting insulin numbers are good (A1C 4.7, Ins 4.3). I wonder if I need to pursue a more agressive approach to bring down my LDL, or just give the Vitamin D/Niacin supplementation time to work (and give up wheat)?

  • World Vitamins Online

    10/4/2009 9:25:55 PM |

    Very good information. Many people do not understand how to decipher the information when they get the results of a cholesterol test. This should help out some.

  • Anonymous

    10/4/2009 11:30:46 PM |

    I started taking 500mg niacin daily
    (for 40 days now) and increased my HDL to 49 from 35
    but my TC went from 189 to 251!
    (my trig is 62)
    Can niacin increase TC also?

  • Dr. William Davis

    10/6/2009 2:08:45 AM |

    Lieta--

    When it comes to vitamin D and wheat elimination, it generally requires about 6 months for full effect to be reflected in your blood work.

    So patience pays!

  • Dr. William Davis

    10/6/2009 2:09:27 AM |

    Anon--

    Niacin or any other agent that increases HDL will likewise increase total cholesterol. It's all good!

  • Anonymous

    10/6/2009 2:28:53 PM |

    Do you have a recommended brand of Vit D3?  Does it have to be taken with Vit A (as I've read in some other places)?

    Thanks

  • Alex

    10/8/2009 2:22:51 PM |

    Does the lack of useful information in total cholesterol value extend all the way down to 150 and below, which is the level Joel Fuhrman and others say people should strive for?

  • Brian

    10/31/2009 2:07:32 PM |

    This reminds me of a story that the renowned physicist Richard Feynman told about the poor quality of textbooks he had reviewed, which gave students totally useless problems with no practical purpose.

    His example was a problem that listed the temperature of 3 random stars, and asked the student to calculate the total temperature, a totally meaningless and pointless number that tells you absolutely nothing about anything.

  • Calculating cholesterol

    12/14/2009 2:07:28 AM |

    I have looked at many sites on this subject and not come across a site such as yours which tells everyone everything that they need to know. I have bookmarked your site. Can anyone else suggest any other related topics that I can look for to find out further information?

  • Kerri Knox

    4/20/2010 2:09:57 PM |

    Dr. Davis,

    Do you have any studies to support that vitamin d increases HDL? I've searched it and could find nothing but neutral studies on it or studies in combination with omega's and niacin.

    This study that was ONLY with vitamin d saw no effect.

    http://www.ncbi.nlm.nih.gov/pubmed/19352377?dopt=Abstract

    and this study showed that atorvastatin needed adequate vitamin d levels in order to work.

    http://www.hindawi.com/journals/ije/2010/320721.html

    but I couldn't find anything saying that vitamin d raised HDL. Any references that you can refer me to or is this just your observations?

  • Anonymous

    9/27/2010 1:21:55 PM |

    Vitamin D doesn't raise cholesterol - cholesterol uses sunlight to synthesize or create Vitamin D.  If you are taking a cholesterol lowering medication, your body can't process the cholesterol to make Vitamin D.

  • Anonymous

    10/5/2010 11:22:57 PM |

    In May 2008 I had a D3 level of 25. Now it's near 80, after 1+ years on 5000 IU of D3 per day. My LDL cholesterol has gone up (it's in the 170s) and my HDL is still low (40-50). HDL has actually changed very little while LDL has increased over time since the first time it was tested in 2002.

    Despite the info presented here, I'm not convinced that there's such a clear relationship between LDL and Vitamin D.

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    11/3/2010 6:41:09 PM |

    So the dominant effect of vitamin D from a cholesterol standpoint is a substantial increase in HDL. Looking at the equation, you can see that an increase in HDL is accompanied by a commensurate increase in total cholesterol. If HDL goes up 25 mg/dl, total cholesterol goes up 25 mg/dl.

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    4/28/2011 8:25:17 AM |

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  • Brian

    12/4/2013 8:36:08 PM |

    Vitamin D3 supplements will absolutely increase both your LDL and HDL cholesterol.  The impact on each can be quite large.  I know people want to believe that supplements can do nothing negative, but it is what it is.  All you have to do is buy a Cardiocheck PA meter or the like and test your cholesterol at home.  Take 5000 IU per day of vitamin D3 for 2 weeks and recheck -- your LDL will go up dramatically, and your HDL will rise as well (and so your total will increase a fair amount).  The exact same thing will happen if you get massive amounts of sun without sunscreen over a number of weeks.  Who know whether this effect is a good or bad thing -- your guess is as good as mine.  But I'm always amazed at all the $30 million dollar studies that have to be done to find out what any person can see with a single affordable at-home monitor...

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