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.

Loading
Vitamin D and programmed aging?

Vitamin D and programmed aging?

As we age, we lose the capacity to activate vitamin D in the skin.

Studies suggest that, between ages 20 and 70, there is a 75% reduction in the ability to activate vitamin D. The capacity of conversion from 25 (OH) vitamin D to 1,25 di(OH) vitamin D also diminishes.

Holick M. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease.



From Holick, M. 2006

This would explain why 70-year olds come to the office, just back from the Caribbean sporting dark brown tans, are still deficient, often severely, in blood levels of vitamin D (25(OH) vitamin D). A tan does not equal vitamin D.














Courtesy Ipanemic


A practical way of looking at it is that anyone 40 years old or older has lost the majority of ability for vitamin D activation.

This often makes me wonder if the loss of vitamin D activating potential is nature's way to get rid of us. After all, after 40, we've pretty much had our opportunity to recreate and make our contribution to the species (at least in a primitive world in which humans evolved): we've exhausted our reproductive usefulness to the species.

Is the programmed decline of vitamin D skin activation a way to ensure that we develop diseases of senescence (aging)? The list of potential consequences of vitamin D deficiency includes: osteoporosis, poor balance and coordination, falls and fractures; cancer of the breast, bladder, colon, prostate, and blood; reductions in HDL, increases in triglycerides; increased inflammation (C-reactive protein, CRP); declining memory and mentation; coronary heart disease.

Isn't that also pretty much a list that describes aging?

A fascinating argument in support of this idea came from study from St Thomas’ Hospital and the London School of Medicine:

Higher serum vitamin D concentrations are associated with longer leukocyte telomere length in women

Telomeres are the "tails" of DNA that were formerly thought to be mistakes, just coding for nonsense. But more recent thinking has proposed that telomeres may provide a counting mechanism that shortens with aging and accelerates with stress and illness. This study suggests that both vitamin D and inflammation (CRP) impact telomere length: the lower the vitamin D, the shorter the telomere length, particularly when inflammation is greater.
















Data supporting vitamin D's effects on preventing or treating cancer, osteoporosis, lipid abnormalities, inflammation, cardiovascular disease, etc., is developing rapidly.

Now the big question: If declining vitamin D is nature's way of ensuring our decline and death, does maintaining higher vitamin D also maintain youthfulness?

I don't have an answer, but it's a really intriguing idea.

Comments (8) -

  • donnyrosart

    7/9/2008 4:21:00 PM |

    With aging, comes thinning skin. Maybe that has something to do with it? I was reading somewhere that topical skin creams that contain steroids can cause thinning of the skin. I wonder if endogenous hormonal imbalance can have a similar result?

    In this study;


    http://www.ncbi.nlm.nih.gov/pubmed/6715110

    children treated with prednisone had lower levels of 1,25(OH)2D.

    and I've seen people on forums addressing asthma treatment with prednisone and the thinning of skin as a result.

  • ethyl d

    7/9/2008 4:23:00 PM |

    May we therefore assume that, although we lose the ability to activate vitamin D from sun exposure as we age, D absorbed from dietary sources (whether food or D3 gel capsules)is still fully available to the aging body?

  • Stephan

    7/9/2008 5:05:00 PM |

    Hi Dr Davis,

      Nice post.  What you would need to evaluate your question is a population that fulfills their vitamin D requirement through diet.  That population existed at one time, the Inuit.  Despite long winters with no sun, they maintained their D by eating large amounts of arctic mammals, fatty fish and their livers.  So you would expect their diet to take skin D synthesis efficiency out of the picture.

    Well it turns out that they had a long maximum lifespan (I got my hands on some lifespan data from a Russian mission in Alaska), with some people often approaching 100 years old.  They had a shorter average lifespan than us of course, due to accidents and disease, however they did not get chronic disease including cancer.  Of course, this is fairly consistent with other HG groups that didn't get so much dietary D, so it's hard to pin the effect on D.

    I've put up two posts about this on my blog, where I review the data:

    http://wholehealthsource.blogspot.com/2008/07/mortality-and-lifespan-of-inuit.html

    http://wholehealthsource.blogspot.com/2008/07/cancer-among-inuit.html

  • Anonymous

    7/9/2008 7:16:00 PM |

    Is there any difference in the elderly with the amount of vitamin D absorbed into the blood from supplements?

  • Jenny

    7/9/2008 10:40:00 PM |

    Many good points.  But fitness in the Darwinian sense may be influenced by more than one individual's history.  See this
    http://primatediaries.blogspot.com/2007/09/evolution-of-menopause.html
    for only one discussion among many of the "grandmother hypothesis", which posits that among humans, survival of descendants may be advantaged by the entrance of older females into menopause, an anomaly among primates.  It may seem like a stretch, but I think this may be related to your topic, in that vitamin D production and the production of many other hormones seem intimately related to cholesterol and the uses to which it is put in the body.   The cessation of participation in reproduction may not be the negative that it at first appears to be, at least from the standpoint of survival of descendants.  From the standpoint of the individual's personal health it may be less of an advantage--but could it be that if  certain parameters such as Vitamin D could be controlled and corrected to optimal levels in our later years, perhaps each of us could look forward to growing older and dying without ever losing our health, as paradoxical as that might sound.

  • Dr. B G

    7/10/2008 6:00:00 AM |

    Jenny,

    I think your observations are right on. There is a paper on skin and how vitamin D circles and transforms to estrogen. In postmenopausal women this is the sole source of estrogen which may theoretically provide continued heart protection if the source is consistent and high enough (and no grains to derange the enzymes which convert vitamin D or activate it).

    Neat link!
    -G

  • Anonymous

    7/10/2008 10:44:00 AM |

    If you look at diets of the populations studied by Dr. Weston Price, all of them ate large amounts of fat-soluble vitamins, including Vitamin D. This would ward off the aging skin effect.

  • buy jeans

    11/3/2010 6:19:52 PM |

    While many people might find this unpalatable and overwhelming from the starting gate of their program, I do believe it may be a strategy we should consider adopting for full and more immediate plaque control in the Track Your Plaque program. Something to chew on.

Loading