Vitamin D (actually, a hormone) appears to play a wide variety of roles in health and disease. Back in 2007 I reported on a study which found that higher levels of vitamin D were associated with better physical functioning in the elderly over time. This may not come as too much of a surprise when we consider the evidence that vitamin D has the ability to preserve muscle, and enhance balance and reaction times.
The role vitamin D has here may have particular relevance to the elderly. As we age, we can be at increased risk of frailty and falls. It is possible, therefore, that maintaining higher levels of vitamin D might help preserve functioning and prevent falls in later life.
The study I reported on back in 2007 has validity, I think, but we’re limited in what we can learn from it due to it being ‘epidemiological’ in nature. Because of this, all it can tell us is that vitamin D is associated with improved function. We can’t tell if there’s a causal relationship here from this study. Even if there is, perhaps vitamin D does not cause improved function, but the other way round (improved function might lead to enhanced sunlight exposure and higher vitamin D levels).
I was therefore interested to read a recent study in which vitamin D therapy was tested in group of elderly individuals (average age 70). The study participants were divided into four groups:
Group 1 received 300,000 IU of vitamin D into the muscle
Group 2 received a placebo injection into the muscle
Group 3 received 300,000 IU of vitamin D as an oral supplement
Group 4 received an oral placebo
The group underwent a range of assessments at the start of the study and one month later.
Here are the changes seen after a month in each of the four groups:
Group 1. Reduced pain, improved functional mobility, improved quality of life, improved general health, improved mental health, improved social functioning.
Group 2. Reduced pain, improved physical functioning.
Group 3. Reduced pain, improved physical functioning.
Group 4. Reduced pain.
Overall, compared to placebo, just one big dose of vitamin D had significant benefits for this population, particularly when given directly into the muscle.
We have some evidence here, that vitamin D can directly enhance functioning in the elderly. It makes me think that many elderly individuals can get quite easily get caught in a cycle of impaired functioning, restricted movement, reduced sunlight exposure and then suboptimal vitamin D leading to impaired functioning and so on and so forth. ‘Institutionalised’ individuals in nursing and care homes may be at particular risk, as may any individuals who are long-stay patients in hospital.
It’s impossible to know what sort of disease and disability burden is caused by suboptimal levels of vitamin D, though my suspicion is that it’s sizeable. On the plus side, it’s a problem that is easily tested for and treatable. Growing awareness of this issue may see many more individuals getting the management they require in later life to keep them alive and well.
References:
1. Sakall H, et al. The effect of oral and parenteral vitamin D supplementation in the elderly: a prospective, double-blinded, randomized, placebo-controlled study. Rheumatol Int. 2011 May 10. [Epub ahead of print]
The problem here is that vitamin D3 is a natural substance, that cannot be patented. So no profit motive.
Whereas the patented form of vitamin D, D2 is much less effective, and sunshine lotion is very profitable.
There is little financial incentive for GP’s to monitor and treat vitamin D levels and there is no concensus on what is an optimal level of vitamin D, as opposed to outright deficiency.
In this country vitamin D is still essentially looked at from the perspective of ricketts.
As vitamin D is fat soluable, the situation ios probably exasperated by the prevailing advice to follow a low fat diet – avoiding butter and fatty meats and fish, for example, and factory farming.
Nevertheless, the tide does seem to9 be slowly turning.
Maybe the attitude of your GP depends on what’s being treated by him/her and your own age. My GP and my osteoporosis consultant are both very keen for me to make sure I get plenty of D3, while advising me to check that I’m not taking too much calcium in tablet form. I was asked to keep a food diary and to adjust intake of both accordingly, rather than simply downing two Calcichew D3 Forte tablets per day as I had done for several years. I was also told to get out into the sun for 20 minutes in the middle of the day when possible and not to wear cosmetics or creams in the UK with SPF in. So some members of the medical profession are taking note of developments, regardless of Big Pharma’s blandishments to prescribe a pill for everything.
I read recently that Vit D3 was recommended for snorers and realised that my son who has been taking Vit D3 for over a year now does not snore nearly as much. My pal who I take holidays with said recently that I’m not sawing logs either. I’m over 70 and I do have more energy than I have had for years, the amount of gardening I have done this year is amazing to everyone even myself. I try to remember to take 15000 iu daily but guess its more like 5-7 times a week. Its taken me a long time to get my reading up to 65 and I’m hoping that my next blood test will show another increase no matter how slow. Any aches and pains from the gardening and I rub magnesium oil in and that seems almost as good as Arnica.
Some report within the last month said that a patented Vit D 3 is being researched which accounted for the very low recommendations for the amount of Vit D3 that needed to be taken.
An interesting study, but yet another one that administers 60 days-worth of Vitamin D3 in one go. This is not the optimum way to do things, as serum 25(OH)D starts off high but is always falling. See Vitamin D and UV fluctuations.
This article interested me and brought to mind something I have been thinking about recently. My elderly father (96) fell and broke his hip last autumn. He came through an operation for a partial hip replacement and rehab of only 2 weeks and seemed well. Since then he has deteriorated quickly. This may well be normal as I imagine this is quite a trauma at this age. However, before his fall he used to go out regularly sitting for hours in the local gardens in good weather. I am wondering if any of this deterioration could be due to lack of vitamin D? Also he used to take supplements but has stopped this.