With western diet and lower outdoor/ sunshine exposure, vitamin D supplement is turnng out to be the most important antiaging vitamin of all: starting at age 62yrs, the elderly with the lowest quartile of vitamin D level have double the all-cause mortality (ie about 4% pa) compared to those in the highest quartile (about 2% pa- Dobnig 2008; Pilz 2008). And this is in a Germanic population apparently with little vitamin D supplementation.
Overall, a multivite supplement has not been shown to have much influence on wellbeing in an overfed first-world population. This may be because multivites are formulated based on the adequate minimal daily allowance MDA of each to avoid frank deficiency disease eg scurvy, rickets, pellagra,
– rather than the pharmacological dose to significantly reduce chronic degenerative aging disease. – which doses may up to 100 fold higher for vitamin D, or >thousand times higher for vitamin C (MDA 10mg, therapeutic dose may be 100gm/day intravenously) or some vitamins B.
On the contrary, moderately high dose vitamins E (>800iu/day, vs MDA <20iu/day) and retinol appear to be adverse in highrisk populations.
But the 100fold therapeutic window for vitamin D appears to be more critical than other vitamins: the minimum daily requirement being about 400iu (10mcg) for humans, but the optimal dose in frail older persons perhaps ~10000iu/day- with all known cases of toxicity apparently occurring at above about 40 000iu/day (Wiki-“The Nutrition Desk Reference states “The threshold for toxicity is 500 to 600 micrograms [vitamin D] per kilogram body weight per day.” ie at least 100 000iu/day)..
The multisystemic importance of vitamin D3 is well set out in Wikipedia and by the Vitamin D Council: even in the average USA (ie well-fed outdoor-loving ) population’s vitamin D range, those with the lowest vitamin D blood level have 25% higher all-cause mortality than the 25% with the highest level. 25% reduction in all-cause mortality translates to a lot of extra years of lifespan let alone more importantly, healthspan.
The past year has seen an explosion of evidence for much higher vitamin D intake: just in the last 12 months, excluding osteoporosis, there have been over 300 studies published on vitamin D.
This week a Swiss cancer registry (Levi ea) shows that (Alpine) patients with skin cancer – usually associated with excess sun exposure- have no less internal cancers.
But this tells us nothing about cause and effect: excessive sunburn alone does not guarantee optimally high vitamin D levels, which are now believed to be up to 100 (- 200)nmol/L (still well below risky levels), requiring about 5000 to 10 000iu vitamin D a day, ie 10 to 20 times the traditional RDA of 400 iu/day provided by a multivite or a teaspoon of even cod liver oil.
As John Cannell and colleagues from a Californian psychiatric hospital (and the Vitamin D Council) point out, indoor work and play, skin-cancer phobia, dairy intolerance – lower sun and dairy product exposure.- and falling natural fish oil intake lower our vitamin D levels These falling levels in turn seem to relate strongly to many increasing diseases the past few decades, not least arthritis, asthma, autism, autoimmune, cancer, dementia, depression, diabetes types 1 and 2, frailty, growth, hypertension-vascular, infection, infertility, multiple sclerosis, obesity, osteoporosis fractures, psoriasis, schizophrenia, thyroid chronic pain and chronic fatigue. . Low vitamin D levels are thus a major risk factor for all major diseases.
Pilz ea from Germany & Austria have just reported that (compared to the highest vitamin D levels), low vitamin D level trebles the risk of heart failure and sudden death, and doubles all-cause mortality. .
D’Autio ea from London have just reported that severe periodontitis more than doubles the risk of metabolic syndrome. We know that low vitamin D intake promotes infections.
Tuohimaa ea 2007 from Scandanavia show that having low vitamin D in the presence of low HDLC and metabolic syndrome increases the risk of prostate cancer eightfold.
Pittas ea from Boston 2007 show consistent inverse relationship between vitamin D – calcium, and metabolic syndrome – diabetes (the precursors of hypertension and ischemic vascular disease).
As this column has pointed out, no modern designer drug for chronic long term use significantly reduces all-cause mortality and morbidity – unlike appropriate HRT, fish oil or metformin, which each reduce all-cause morbidity and mortality by about 1/3. But even cod liver oil provides only about 100iu vitamin D /gm- vit D 5000iu/d would require us to drink 50gm cod liver oil a day… .
Here is a single vitamin which, on it’s own in vigorous safe daily supplement of about 5000iu will at least halve all-cause morbidity and mortality at a retail cost of perhaps R3.50/month or US$5 a year … and probably even more so in a sensible preventative vitamin-mineral-biologial combination.
One cannot treat presumed hypertension without measurments. One should not treat thyroid or diabetes or hypogonadism cases without blood level measurements. But like obvious hypogonadism, for practical purposes – with rare clinical warning signs eg kidney stones – if need be, just clinical judgement is all that is essential to treat most patients with appropriate steroid hormones- sex hormones , vitamin D and even digoxin.
Who needs the Disease Industry for chronic modern designer prescription drugs, antimicrobials, cancer therapy or surgical procedures for the diseases of aging ? Now these costly designer interventions can be deferred for use in the ailing oldest old..
So vitamin D – even more than vitamin C and magnesium- becomes the key supplement that the public has been misled by officialese- zealous Regulators carefully guided by the new-drug pharmaceutical industry – into dangerously underusing.