Will maintaining the Vit D level at the optimal range, reverse the media calcium build up?

Thanks,

Marilyn

Our emerging experience in the Track Your Plaque program suggests that medial calcification may, in fact, be MORE amenable to regression/reversal.

Dr Davis:
I am 72.
I recently had a CTA scan with "no detectable paque"
I am also aware of recent research which shows evidence of menaquinone both preventing and reversing calcification.
Is scanning thought to be less sensitive to medial calcification (as opposed to intimal), and at risk of being 'missed'?

If so would preventive menaquinone be justified in a 'clean' case like mine?
Thanks, MikeV

Hi, Mike-
No, the scan quite reliably detects both intimal and medial calcification. Taking K2 is very optional. How about some traditional, fermented cheese? I do not believe that K2 supplementation would yield substantial heart benefits. However, if bone health is in question, that migyht be a reason.

Thanks, Doc:
My cheese score is already fairly high.
I forgot to mention that I have already been taking fish oil, coQ10,vitamin D3, magnesium etc for some years, so I *heartily* endorse your standard recommendations.
You perform a great community service.  

mike V

Interestingly, whether calcium is intimal as in atherosclerotic plaque, or medial, both are strongly associated with risk for heart attack. In other words, if calcium is confined to the intima, heart disease risk is present. If calcium is limited to the media, risk is still present.

The media is the tissue thin layer just below the main fact because is one of the lasted arteries, the most inner layer of arteries that we usually associate with atherosclerotic plaque and this'll be an important discussion at the universities. Absolutely. 23jj

Dr Davis,

I am not a doctor by profession but an engineer. I am really frustrated in trying to get to the bottom of things in the medical field. It is quite vexing when I cant decide if something is a safe practice or not. Would you please help me (and perhaps many other) understand how I can take oil-based Vitamin D without worrying about Vitamin A levels as well? Should I worry about taking Cod Liver Oil based preparations with questionable manufacturing practices which seems to include filtering to remove the Vitamin D and then adding synthetic form at the end?

If you could get into some details, it would be very helpful.

Regards,

Anonymous, you could take fish oil instead of cod liver oil for the omega-3 and take vitamin D as D3 in softgel form.

Vitamin A can be supplemented by providing its precursors like alpha-carotene, astaxanthin, beta-carotene, cryptoxanthin, lutein, lycopene, and zeaxanthin. Supplying precursors will let your body decide how much vitamin A to make out of it. Supplying preformed retinol bypasses the body's control systems.

Cannell et al recommended an D:A ratio of about 6:1 in IU terms ("Cod Liver Oil, Vitamin A Toxicity, Frequent Respiratory Infections, and the Vitamin D Deficiency Epidemic", a commentary piece in Annals of Otology, Rhinology & Laryngology 117(11):864-870, on page 866, third paragraph).

Maybe it's best to avoid retinol and make sure you get enough A precursors.

StephenB

The yam based forms of Estrogen have a much better safety profile than the others on the market. In fact,the worst reaction I've ever had to a hormone was to a supposedly "bioidentical" estrogens from a compounding pharmacy.

The problem with anabolic steroids apply to bioidentical testosterone supplements too. Too much testosterone is bad for your body.

Does this mean that Benecol is not good to use in lowering cholesterol?

The bit that I find most disturbing in this post is the bit on sterols. Many authorities advise us to use phytosterols or stanols to lower cholesterol. I did find one article on PubMed a while ago (but can't refind it now) suggesting that, since the structure of phytosterols is similar to cholesterol, using them to replace cholesterol shouldn't just be assumed to be a safe thing to do. Do you have any more data or links on this issue?

I came across this post by Dr Michael Holick whom I respect, and naturally all readers here respect your findings from the front line in Milwaukee. There appear to be some differences in interpretation.
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Vitamin D2 vs. D3
Vitamindhealth.org
Posted by mfholick on November 27, 2008 under Vitamin D |  
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Vitamin D2 and Vitamin D3 Are They Equally Potent?

During the past several years, there have been two studies Trang et al, (Am J Clin Nutr 68:854-858, 1998); and Armas et al, (J Clin Endocrinol Metab 89:5387-91; 2004) that have raised questions about whether vitamin D2, which is found in some supplements, used in some fortified foods and is the pharmaceutical form of vitamin D that doctors prescribe for their patients, is as effective as vitamin D3 in maintaining a person’s vitamin D status, i.e., blood level of 25-hydroxyvitamin D.  Trang et al 1998 gave healthy adults 4,000 IU of vitamin D2 or 4,000 IU of vitamin D3 in alcohol for two weeks.   A comparison of the blood levels of 25-hydroxyvitamin D after two weeks revealed that there was approximately a 50% difference in the group receiving vitamin D3 (being approximately 50% higher) than the vitamin D2 group.  This implied that vitamin D3 was more effective than vitamin D2 in maintaining circulating blood levels of 25-hydroxyvitamin D.  Armas et al 2004 gave a single 50,000 IU dose of either vitamin D2 or 50,000 IU dose of vitamin D3 to healthy volunteers during the summer and observed that the group who received vitamin D2 had a more rapid drop in their circulating blood levels of 25-hydroxyvitamin D.  They also observed that the group that received vitamin D2 had a more rapid drop in their blood levels of 25-hydroxyvitamin D3 compared to the placebo group suggesting that vitamin D2 was not only less effective than vitamin D3 in maintaining circulating levels of 25-hydroxyvitamin D, but also that vitamin D2 increased the destruction of vitamin D3.

Based on these observations, physicians, health care professionals and patients have made an effort to find vitamin D supplements that contain vitamin D3.  However, in the United States, only vitamin D2 is available as a pharmaceutical preparation, and, thus, patients who are vitamin D deficient and treated by their physicians receive vitamin D2.  I treat vitamin D deficiency with 50,000 IU of vitamin D2 once a week for eight weeks.  To prevent vitamin D deficiency from recurring, I then put the patient on 50,000 IU of vitamin D2 every two weeks forever.  From my experience of over 100 patients on this regime for up to six years, their blood levels are sustained above 30 ng/ml which is considered to be the vitamin D sufficient range.  On average, the blood level was between 40-50 ng/ml.  Furthermore, an evaluation of their blood calcium, a measure of whether ingesting vitamin D2 at these levels, had caused any toxicity did not change.  Therefore, this regime was effective in maintaining my patients’ vitamin D status without causing any untoward toxicity.

To determine whether vitamin D2 was as effective as vitamin D3 in maintaining circulating blood levels of 25-hydroxyvitamin D, a study was conducted whereby healthy adults received either 1,000 IU of vitamin D2 or 1,000 IU of vitamin D3 in a capsule once a day in the winter for 11 weeks.  In addition, one group received a placebo capsule and one group received a capsule that contained 500 IU of vitamin D2 and 500 IU of vitamin D3 daily for 11 weeks.  Blood levels of both 25-hydroxyvitamin D2 and 25-hydroxyvitamin D3 were determined by state of the art method using liquid chromatography tandem mass spectroscopy.  Holick et al, (Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D, J Clin Endocrinol Metab  93:677-681, 2008;) reported that the blood levels of 25-hydroxvitamin D rose to the same degree in the healthy adults who took either 1,000 IU of vitamin D2 a day or 1,000 IU of vitamin D3 a day for 11 weeks.  The group that received vitamin D2 also had their blood level of 25-hydroxyvitamin D3 measured.  There was no significant drop in the blood level of 25-hydroxyvitamin D3.  To determine whether the mixture of vitamin D2 with vitamin D3 would alter the blood levels of 25-hydroxyvitamin D, the adults who received 500 units of vitamin D2 with 500 units of vitamin D3 also raised their total blood levels of 25-hydroxyvitamin D3 in an almost an identical manner as the adults who received 1,000 IU of vitamin D2 or 1,000 IU of vitamin D3 a day for 11 weeks.  The authors concluded that ingesting 1,000 IU of vitamin D2 or 1,000 IU of vitamin D3 a day during the winter (at a time when sun exposure had no influence on blood levels of 25-hydroxyvitamin D) that both vitamin D2 and vitamin D3 were equally effective in maintaining the blood levels of 25-hydroxyvitamin D.  Furthermore, vitamin D2 did not have a negative influence on serum levels of 25-hydroxyvitamin D3.  Adults who took 500 units of vitamin D2 with 500 units of vitamin D3 had similar increases in their blood levels of 25-hydroxyvitamin D suggesting that vitamin D2 taken with vitamin D3 does not have any negative influence on the metabolism of vitamin D3.  

The authors reviewed in their Conclusion several studies that had previously reported that vitamin D2 was as biologically effective as vitamin D3 in both pregnant women and in healthy adults.  This study confirms these observations and adds to the body of scientific literature demonstrating that at least when healthy adults take 1,000 IU of vitamin D2, they can be assured that it is as effective as taking 1,000 IU of vitamin D3
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Although this a little academic, since I have been perfectly happy with D3 for years, a resolution would be iteresting.
Any chance of an update, or a Holick interview here?
MikeV