Vitamin D: Explosive new player in heart health
Let me provide a little history first. I've always been interested in reversal of coronary heart disease. Ten years ago, I began using CT heart scans to track heart disease, since heart scans yield an easy-to-track "score." These tests could conceivably yield a useful tool to track both plaque growth, "progression," as well as plaque reversal, "regression." Back then, we had some rewarding successes and a few failures.
About two years ago, I was exploring the idea of adding vitamin D to the reversal approach we were using. To my surprise, patients showed extraordinary degrees of vitamin D deficiency. Person after person showed shockingly low blood levels of 25-OH-vitamin D3. Levels near zero weren't uncommon.
We learned several important lessons along the way. We learned that only oil-based gelcaps yielded substantial rises in blood levels; powder-based tablets yielded virtually no consistent effects. (This means that the multivitamin you take, or the calcium tablet with D, cannot be counted on to yield substantial rises in blood vitamin D levels.) We also learned that the oral dose required to raise blood levels is far more than previously thought. In women, we find that the average dose is 4000 units per day; 5000-6000 units per day in males (in our northern U.S. latitude).
We also learned that many people were severely deficient even in summer. In fact, it is not at all uncommon to diagnose severe vitamin D deficiency in someone with a dark tan.
We also learned of the unexpected reduction in the capacity to convert inactive vitamin D to its active form in the skin as we age. In fact, over age 50 or so, virtually nobody in our northern Midwest population shows a normal blood vitamin D level. We also witnessed how little a month in Florida or other tropical or semi-tropical climate can improve levels.
Now, we aim to replenish blood vitamin D levels to 50 ng/ml.
Next thing you know, people are dropping their heart scan scores like crazy, often by enormous margins. A 40-year-old school principal, for instance, dropped his heart scan score from a worrisome 339 to 161-a 52% drop in just over a year.
Why exactly would vitamin D have such an effect? We're sailing into some uncharted waters here. But there are indeed scientific data that document several phenomena that develop when vitamin D is supplemented:
- Insulin response is enhanced and blood sugar is reduced.
- Inflammatory measures like C-reactive protein are reduced.
- Blood pressure is reduced.
- Triglycerides are reduced. (Triglycerides are a crucial yet seriously neglected aspect of heart health. More about that in future.)
In our heart disease reversal experience, vitamin D supplementation also has consistently raised good HDL cholesterol and reduced undesirable and dangerous small LDL particles. Do these healthy effects fully explain why we are witnessing such extraordinary results in reducing CT heart scan scores?
I'm unsure, though we are embarking on a series of research studies to explore these questions.
In the meantime, supplementing vitamin D to restore normal blood levels (we aim for a blood level of 50 ng/ml) has become a crucial step in our heart disease reversal program. (Please note that, since it's such a new idea, your doctor may give you a puzzled look if you ask to have your vitamin D level checked. You might have to specify to him/her that you'd like a "25-OH-vitamin D3 level." Because most doctors are unfamiliar with this measure, they will often order the similar-sounding "1,25-diOH vitamin D3," a different measure that reflects kidney function but is useless to gauge vitamin D status.)
As powerful as it is, vitamin D should not relied on as a sole strategy in a program of heart disease prevention. Vitamin D supplementation can be a powerful addition to a broader program of heart disease prevention and reversal.
Beyond heart disease, vitamin D supplementation is showing other benefits including reduction of cancer of the colon, prostate, breast, and bladder; reversal of osteoporosis and, to a modest degree, arthritis; relief of winter "blues"; vitamin D may even provide benefits in multiple sclerosis.
I am endlessly excited about all the emerging possibilities for this previously neglected and under-utilized nutrient. Every day that goes by, I learn something new about the numerous health benefits of vitamin D.
I get my vitamin D from the Vitamin Shoppe, who sells both their own brand and Carlson's, both of which have yielded consistent and effective rises in blood vitamin D. (I have no relationship with either company.)