Tag Archives: Vitamin D

Insane Medicine – A few points on cardiovascular health and interventions

Here’s some general cardiovascular stuff that is useful:

  • There is now a trend to treat your hypertension and cholesterol based on risk factors rather than just specific targets. Looking at the overall cardiovascular risk is more important tan focusing on just one factor.  The decision to treat cholesterol issues should be based on not just the absolute LDL – cholesterol number but also the coexisting problems, such as obesity or hypertension. It is important to modify other lifestyle issues including losing weight, maintaining regular exercise, eating a low-salt diet, and taking your prescribed medications. Look at the overall picture and not just a single parameter.
  • Be certain to stay active. Check with your doctor about the safety of exercise for you before you start on a program. Engage in aerobic activity such as walking or jogging at least four to five times a week and be certain to mix this with muscle-strengthening exercise at least twice a week. Get moving!30-60 minutes a day, and be certain to use good form, standing upright and keeping your back straight, walking on even surfaces so you don’t fall, with good heel-strike and arm swing to maintain balance. Wear comfortable, well-fitted shoes. Stretch after a brief walk and be careful to do the stretching appropriately without any bouncing so you don’t damage your muscles. As winter approaches, you may need to exercise indoors due to the cold. Consider working out a variety of muscle groups to spice it up and keep you interested. This stimulates other muscle groups to maintain overall fitness. You thereby avoid burnout and keep motivated! Consider indoor sports that you can add to your regimen such as swimming, indoor rowing, stair-climbing machines, ellipticals, aerobics, yoga, and racquetball. Keep social. Get a training partner to keep things fun.
  • Be certain to stay on the best diet, rich in fruits, vegetables, whole grains, and lean proteins with low saturated and trans-fats as well as low cholesterol and sodium. Avoid processed foods and added sugar. Keep your Vitamin D intake at the appropriate levels, with 600 IU a day being recommended for ages 51-70 and 800 IU a day for ages over 70. The goal is a blood level of more than 30 nanograms per milliliter. Sources of foods wit Vitamin D include salmon, swordfish, tuna, canned sardines, milk, eggs, yogurt, orange juice, and cereals fortified with it. Vitamin D provides cardiovascular, neurological, and immune system health. People with high levels of vitamin D have had lower in-hospital death and morbidity rates.
  • Try to get 8 hours of sleep a night.

Insane Medicine – Don’t ignore Potassium, Calcium, Vitamin D, and fiber in your diet.

Per the National Health and Nutrition Examination Survey, there are several “shortfall nutrients” that may be deficient in your diet. Here they are:

  1. Potassium: If you have normal kidneys, potassium promotes blood pressure control by countering the role of excess sodium. The recommended amount is 4700 mg a day, which most people do not get. Fruits, vegetables, and beans are sources of potassium. Bananas, citrus, avocado, kiwi, and melon are excellent for potassium supplementation. Dark leafy vegetables, like spinach, kale, and turnip greens also provide potassium as well.
  2. Vitamin D is recommended currently to be taken at 600 IU a day for the average adult, but 800 IU a day if you are older than 70. Not only does it protect your bones but also there may be some protection from cancer and chronic disease. Sources include fish such as sardines, mackerel, rainbow trout, and tuna (all have a lot of omega-3 fatty acid as well). Fortified yogurt and fortified milk are also excellent sources.
  3. Fiber: plays a lot of roles in the body, but higher intake lowers your colon cancer risk. The target is 25 grams a day for women age 19-50 and 38 gm for men in that same age range. For men over 50, 30 gm a day is enough and 21 gm a day for women over 50 is sufficient. Sources include whole grains, cereal, pasta, rice, and bread. Substitute dried beans for meat in your dish to increase fiber without destroying taste.
  4. Calcium: 1000 mg a day is the daily value needed. Calcium fortified milk and yogurt are helpful sources. Dark green leafy vegetables are good sources, with kale, Bok choy, and broccoli being choices as they have less oxalates that can bind calcium in the gut and preventing absorption of calcium.

http://www.cdc.gov/nchs/nhanes.htm < CDC national health survey

Insane Medicine – Low Vitamin D is linked to a greater increased risk of Dementia!

Vitamin D
Vitamin D and its effects in the body.
  • The nervous system does not function normally without Vitamin D. It is involved in the synthesis of neurotransmitters such as dopamine, serotonin, and acetylcholine. Vitamin D protects against inflammation in the brain, particularly in the hippocampus, which is important in memory.
  • Vitamin D injections lessen age-related inflammation and also improve age-related memory impairments. In particular, it augments the removal of beta-amyloid plaques found in Alzheimer’s disease.
  • There is a strong association between vitamin D level and the risk of Alzheimer’s disease. In particular, people deficient in Vitamin D (levels less than 20ng/ml) have a 53% increase risk of becoming demented, and a 69% increase risk of getting Alzheimer’s disease. In severe Vitamin D deficiency (levels less than 10 ng/ml), the chance of Alzheimer’s is 122%!
  • Recommended intake of Vitamin D per the Institute of Medicine is 600 IU/day of Vitamin D for age under 70, and 800 IU/day for age over 70.
  • There is evidence that you can safely take up to 4000 IU/day of Vitamin D.
Vitamin D sources and effects with depletion
Vitamin D sources and effects with depletion

Insane Medicine – Bone health depends on a lot of nutrients mixed together!

Insane Medicine - Bones need a lot of nutrients
Insane Medicine – Bones need a lot of nutrients

What is your osteoporosis risk? See the calculator in this link: http://cals.arizona.edu/maricopa/fcs/bb/OstQuiz.htm

Bones need more than just calcium. They need Magnesium, Vitamin C, Vitamin D, and Vitamin K. There are medical factors as well that come into play with respect to bone health. For example, there are medications that can wash out your bones, such as prednisone, and diseases, such as parathyroid disorders, that can result in early osteoporosis.  Get checked for these types of issues. From the nutrition point of view, there are measures you can take to help prevent osteoporosis.

  • Calcium: You need 1000-1200 mg a day. This is the backbone of your bones, literally!
  • Magnesium: The RDA is 310-420 mcg (micrograms) a day. Magnesium is tied in with bone health, in that a lower magnesium intake is associated with lower bone mineral density. Supplementation to near the RDA suppresses bone loss in postmenopausal women. Around half of your magnesium stores are in the bones. Food sources high in magnesium include: Almonds, spinach, black beans, kidney beans, avocado, peanut butter, edamame, and whole-wheat bread.
  • Vitamin C:  This is important for the immune system and also linked to less bone loss. the RDA is 75-90 mg a day. Good sources include: oranges, strawberries, red and green bell peppers, kiwi, mango, and others.
  • Vitamin B12: The RDA is 2.4 mcg a day.  Low B12 levels affect the nervous system as well as bone mineral density and osteoporosis. Sources include clams, salmon, haddock, canned tuna, milk, yogurt, egg, cottage cheese, breakfast cereals that are fortified.
  • Vitamin D: The RDA is 600-800 IU a day. It is essential to Calcium absorption in the gut. Supplementing at 800 IU a day decreases the risks of hip and non-vertebral fractures. Sources include: Cod liver oil, swordfish, canned tuna, fortified orange juice, eggs, and sockeye salmon.
  • Vitamin K: The RDA is 90-120 mcg a day. There appears to be a link between vitamin K intake and decreased risk of fractures. Sources of Vitamin K include: spinach, brocolli, green leaf lettuce,kale, swiss chard, collard greens, and brussel sprouts. If you take blood thinners, be careful of interactions with vitamin K. Ask your doctor.
  • Remember to quit smoking and exercise!
  • Fast facts on osteoporosis: http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/osteoporosis_ff.asp

Insane Medicine – Parkinsons disease symptoms can be improved by Vitamin D supplementation

Insane medicine - old man walking
Insane medicine – old man walking – note the wide based walking pattern and hunched over – this may be a presentation of Parkinson’s Disease, even if there is no tremor.


  • There is an apparent link between Parkinson’s disease (PD) severity and lack of vitamin D! Increased serum levels of vitamin D (25-OH-D) are associated with less Parkinson’s symptoms!
  • Studies in which patients with PD were supplemented with vitamin D to raise their serum vitamin D levels had improved outcomes and less need for PD medications relative to those who did not take Vitamin D supplementation.
  • Apparently there is a genetic component in the response to vitamin D supplementation for PD patients. Those PD patients with the VDR Fokl TT or VDR Fokl CT gene types responded better to supplementation.
  • How much vitamin D? 1200 Units a day – not that much at all!
  • Why does this work? The VDR gene is expressed in the substantia nigra of the brain, an area involved with movement, and is depleted in PD patients. Dopamine is what allows an individual to move normally, and this is depleted in PD patients. Vitamin 1, 25-Hydroxy D ( a metabolite of the Vitamin D we take over the counter), when increased by supplementation, increases the rate limiting enzyme Tyrosine hydroxylase in the brain, which produces more dopamine to allow better movement.
  • Levels of serum vitamin-D that we want is greater than 30 ng/ml.
  • Of note, there are benefits shown from other studies, that in patients with knee osteoarthritis and low vitamin- D the use of  oral vitamin D3 (Cholecalciferol) results in less knee pain after a year relative to untreated individuals! These people received 60,000 IU Vitman D3 once a month.