A month ago I wrote a blog describing some research which found that supplementing elderly individuals with vitamin D led to improvements in their muscular strength without any physical training. I made the point that this sort of effect is important because it means vitamin D may be able to prevent disability. I also mentioned that vitamin D appears to have the ability to improve reaction times and balance. In theory, therefore, I suggested that vitamin D might also be able to help falls, which can have dire consequences, particularly for the elderly.
Recently, the British Medical Journal published a study on-line which reviewed the evidence regarding vitamin D therapy and risk of falling in the elderly [1]. The review examined results from several separate studies.
This review revealed that supplementing individuals with vitamin D (at doses of 700-1000 IU per day) reduced the risk of falling by an average of 19 per cent. Low dose supplementation was not associated with a reduced risk of falling.
Higher vitamin D levels were associated with a reduced risk of falling. Levels of 60 nmol/l or more (24 ng/ml or more) were associated with a 23 per cent reduced risk of falling. Lower vitamin D levels were not associated with a reduced risk of falling.
This review shows that supplementation with vitamin D at a dose of at least 700 IU per day reduces the risk of falling. These results are promising, and give us yet another reason to think about optimising vitamin D levels in the elderly. The levels of supplementation used here were high compared to current recommended levels (400 IU), but low compared to what would be required to elevate blood levels to truly optimal levels (100 nmol/l or more).
It is possible that higher vitamin D dosages and blood levels may deliver more benefits in terms of fall risk reduction. More studies using higher vitamin D dosages would have to be performed to determine if greater benefits are to be had in this regard.
References:
1. Bischoff-Ferrari HA, et al. Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials BMJ 2009;339:b3692
If we look at this Chart showing Disease Incidence by Vitamin D level it puts the 60 nmol/l ~ 24 ng/ml or more suggestion from the above research into perspective.
Levels above 55ng/ml 135nmol/l are associated with least incidence of chronic illness.
This paper from Breastfeeding Medicine Does Vitamin D make the world go round has a section explaining vitamin D3 intakes around 6400iu/daily are needed if mothers want breast milk naturally vitamin d3 replete .
This paper says Peak athletic performance may occur when 25(OH)D levels approach those obtained by natural, full-body, summer sun exposure, which is at least 50 ng/ml
In my opinion natural bio markers of optimum vitamin D status are good health, vitamin D replete breast milk and peak muscle performance.
As we know up to 10,000iu/daily is safe those suggesting unnaturally low intakes around 1000iu/d are attempting to preserve the current levels of chronic illness by keeping people only just above the level at which rickets occurs.
Heaney explains in this You Tube Video “Whats a Vitamin D Deficiency?”</a.
Grassrootshealth.net is a group of University of California faculty who formed a non-profit organization with the purpose of conducting a 5 year international study of Vitamin D levels. Falls and health outcomes are part of the study, too.
Vitamin D ‘may cut premature birth risk and protect newborn babies has an interesting article on the importance of higher, natural intakes of vitamin D3 particularly for pregnant women and nursing mothers.
Vitamin D ‘may cut premature birth risk and protect newborn babies an interesting article on the importance of higher, natural intakes of vitamin D3 particularly for pregnant women and nursing mothers.
The idea that 60nmol/l may be a sufficient status or that a mere 1000iu/day a sufficient intake is rapidly becoming unsupportable.
It is amazing that such a small dose of vit D can make such a huge difference. That shows how difficient people really are. The research posted at vitamindcouncil.com suggests that most adults need 2000-5000 units daily for maintenence depending on their size and body fat content. Just think of the benefits these people would have had with more aggressive therapy. Here in the USA, we are seeing return of congenital rickets from D deficiency. Many times the parents are charged with child abuse because of the fractures that these children develop. I have seen one case of vit D toxicity. A collegue of mine was persuaded to take 50000 units daily for a year. It almost killed him. Go figure?
Dr. Trumbower,
Interesting that it took a YEAR on 50,000 iu/day to ALMOST kill him. Yet, many people freak out if you take more than 400 iu/day because that is the RDA and what is in a typical multi-vitamin.
The knowledge gap on vitamin D is very scary.