Vitamin D & all-cause mortality. - Advanced Prostate...

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Vitamin D & all-cause mortality.

pjoshea13 profile image
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New study below.

I am posting this because of some negative PCa studies conducted on populations that are largely vitamin D deficient for much of the year. Inexplicably, sufficiency (>32 ng/mL) has been associated with increased risk. Essentially, the risk was U-shaped, with the lowest point somewhere in the insufficiency range (20-32 ng/mL).

The new study population (11,022) was from Olmsted County, Minnesota - where it is difficult to attain D-sufficiency during the winter except through supplementation.

25-D readings were adjusted for month of measurement. I'm not sure what that means - was the adjustment intended to obtain an average for the year or a high summer equivalent?

In an earlier study [2], the team had been concerned about the risk of toxicity with 25-D levels above 50 ng/mL. "The age- and sex-adjusted incidence of 25(OH)D values >50 ng/mL increased from 9 to 233 per 100,000 person-years from 2002 to 2011 .., respectively, and was greatest in persons of age ≥65 years ... and in females". Presumably indicative of the greater awareness of the importance of D, & the increased availability of high-dose supplements.

"Serum 25(OH)D values were not significantly related with serum calcium values or with the risk of hypercalcemia. Medical record review identified four cases (0.2%) where 25(OH)D values >50 ng/mL were associated temporally with hypercalcemia, but only one had clinical toxicity associated with the highest observed 25(OH)D value of 364 ng/mL."

Hypervitaminosis D is inferred from 25-D & hypercalcemia. The remedy? Vitamin K! Without K for calcium transport to bone, excess calcium in the blood must be dumped by the kidneys. (K deficiency is associated with calcification of the arteries.)

Back to the new study:

"Unadjusted all-cause mortality hazard ratios (HRs) ... for 25(OH)D values of less than 12, 12 to 19, and more than 50 ng/mL were 2.6 .., 1.3 .., and 1.0 .., respectively, compared with the reference value of 20 to 50 ng/mL."

"In white patients, adjusted HRs for 25(OH)D values of less than 12, 12 to 19, 20 to 50, and greater than 50 ng/mL were 2.5 .., 1.4 .., 1.0 (referent), and 1.0 .., respectively."

"In patients of other race/ethnicity, adjusted HRs were 1.9 .., 1.7 .., 1.5 .., and 2.1 ...

"White patients with 25(OH)D values of less than 20 ng/mL had greater all-cause mortality than those with values of 20 to 50 ng/mL, and white patients had greater mortality associated with low 25(OH)D values than patients of other race/ethnicity."

"Values of 25(OH)D greater than 50 ng/mL were not associated with all-cause mortality."

Cause-specific mortality is covered in the full text, so I don't know for sure that 25-D > 50 ng/mL is not associated with greater PCa mortality in this study. But, as I have mentioned elsewhere, supplementation at high levels can be due to a perceived risk for PCa & such cases need to be excluded.

-Patrick

[1] mayoclinicproceedings.org/a...

[2] ncbi.nlm.nih.gov/pmc/articl...

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cesanon profile image
cesanon

Patrick

So if I understand this correctly, it is dangerous with respect to increasing the incidence of prostate cancer, if you have too much or too little vitamin D?

And if you take vitamin D it may be a good idea to supplement with vitamin K.

pjoshea13 profile image
pjoshea13 in reply to cesanon

The studies that found a U-shaped curve did not have men with high levels, which is as might be expected in Nordic studies.

The new study concludes:

"Values of 25(OH)D greater than 50 ng/mL were not associated with all-cause mortality." Thus contradicting studies from the north.

No extra risk, but no extra protection - in terms of all-cause mortality..

The puzzling finding:

"In patients of other race/ethnicity, adjusted HRs were 1.9 .., 1.7 .., 1.5 .., and 2.1 ...

i.e. suggestion of a U-shaped curve.

But not for white men.

To get calcium back into bone, vitamin D & vitamin K are both required.

(For calcium & D without K, if one's kidneys can't handle excess blood calcium levels that the D facilitate, hypercalcemia is possible I suppose.)

cesanon profile image
cesanon in reply to pjoshea13

Interesting. Myers had me on Vitamin D.

Any reason or contraindications not to take vitamin K?

pjoshea13 profile image
pjoshea13 in reply to cesanon

The only one I know of is Warfarin use.

Incidentally, my wife had a calcium scan after using LEF's K2 supplement for several years. There was zero arterial cacification. Highly unusual for a 65 year old.

Some time later, a paper appeared claiming that K could actually reverse calcification.

-Patrick

cesanon profile image
cesanon in reply to pjoshea13

Any idea what the half-life of vitamin K in the bloodstream is?

pjoshea13 profile image
pjoshea13 in reply to cesanon

As it happens, thanks to LEF, I do.

Vitamin K1 (phylloquinone) disappears fairly quickly.

Vitamin K2 consists of a group of menaquinones, with MK-4 & MK-7 the most common in supplements.

"The MK-4 form is the most rapidly absorbed type of vitamin K. However, it only lasts in the bloodstream for a few hours. In contrast, the MK-7 form is available to the body for a full 24-hour period at much higher levels."

lifeextension.com/Vitamins-...

A human study found PCa protection from menaquinones:

"We observed a nonsignificant inverse association between total prostate cancer and total menaquinone intake [multivariate relative risk (highest compared with lowest quartile): 0.65 ...]. The association was stronger for advanced prostate cancer (0.37 ...)"

ncbi.nlm.nih.gov/pubmed/184...

"Menaquinones from dairy products had a stronger inverse association with advanced prostate cancer than did menaquinones from meat."

"Menaquinone-4 is synthesized by animal tissues and is found in meat, eggs, and dairy products."

"Menaquinone-7 is synthesized by bacteria during fermentation and is found in fermented soybeans (nattō), and in most fermented cheeses"

en.wikipedia.org/wiki/Vitam...

-Patrick

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