Review finds improved survival in clinical trials of vitamin D3 supplementation
A lengthy review published on July 5, 2011 in The Cochrane Library reveals that supplementing older individuals with vitamin D3 is associated with reduced mortality over a two year average period.
Goran Bjelakovic of the University of Nis in Serbia and his European associates selected 50 randomized trials involving vitamin D supplementation, which provided a total of 94,148 participants for their analysis. Most of the trials analyzed the effect of supplementation on bone mineral density, falls and fractures. The subjects' average age was 74, and 79 percent were female. The median length of supplementation with vitamin D was two years.
Dr Bjelakovic and his colleagues uncovered a significant benefit for supplementation with vitamin D3, but not for other forms of the vitamin, on improving survival over the course of the trials. "A Cochrane meta-analysis published only a couple of years ago found that there was some evidence for benefit, but it could not find an effect on mortality," commented Dr Bjelakovic, who is affiliated with the University of Nis' Department of Internal Medicine - Gastroenterology and Hepatology. "We were, however, aware that more trials had been published and wanted to assess the effects of vitamin D when you added all the data together."
"Our analyses suggest that vitamin D3 reduces mortality by about 6%," he concluded. "This means that you need to give about 200 people vitamin D3 for around two years to save one additional life."
Because there were fewer trials involving other forms of the vitamin included in the current analysis, the apparent absence of a survival benefit for these forms needs to be taken with caution. "We need to have more randomized trials that look specifically to see whether these forms of vitamin D do or don't have benefits," Dr Bjelakovic stated.
"Previous reviews of preventive trials of vitamin D have not included as much information and have not examined the separate influence of different forms of vitamin D on mortality," he added. "By taking data from a larger number of trials we have been able to shed much more light on this important issue."
Along with calcium, vitamin D is the nutrient that most people recognize as important for bone health (Holick 2007). But, even today, few people understand the powerful and complex ways that vitamin D acts to promote not only bone health, but the way the entire body handles calcium, both in healthy and in undesirable ways (Holick 2007). Vitamin D triggers absorption of calcium from the intestine and deposition of calcium in bone — and also removal of calcium from blood vessel walls. Conversely, insufficient vitamin D intake results in depletion of calcium from bones — and increased deposition of calcium in arterial walls, contributing to atherosclerosis (Celik 2010, Tremollieres 2010).
Vitamin D deficiency (or insufficiency) also causes muscle weakness and neurological deficits, increasing the risk of falling, which of course makes fractures still more likely (Bischoff-Ferrari 2009, Pfeifer 2009, Janssen 2010). The dose of vitamin D required to achieve the neuroprotective and other non-bone related effects are substantially higher than those required simply to achieve good calcium absorption (Bischoff-Ferrari 2007).
A validated measure of total body vitamin D status in blood is serum 25-hydroxy vitamin D (also known as 25(OH)D, or calcidiol). Note that this measure is reported in two different units, nmol/L and ng/dL, so it is vital to check which set of units a lab is using. Vitamin D deficiency is defined as a serum 25(OH)D level of less than 50 nmol/L, or less than 20 ng/dL. Experts recommend a higher level of 75 nmol/L, or 30 ng/dL (Bischoff-Ferrari 2007, 2009). To obtain the many health benefits of Vitamin D, current scientific evidence suggests a minimum target threshold for optimal health is over 50 ng/ mL or 125 nmol/L (Aloia 2008, Dawson-Hughes 2005, Heaney 2008).
The optimal dose of vitamin D has been hotly debated in recent years. More than 13,000 Life Extension® members have had their vitamin D level checked. The results from these tests provides important information about achieved vitamin D blood levels in a large group of dedicated, health-focused individuals. Vitamin D dosage as high as 5000 to 8000 IU per day may be required to achieve a minimum target level for optimal health in aging individuals (Life Extension Magazine January 2010).
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