Vitamin D levels and the risk of ... PCa mortality

[pjoshea13]

New Danish study below [1].

"All men who underwent prostatic biopsy in the Danish PCa Registry (DaPCaR) and who had a serum vitamin D measurement during the period 2004 to 2010 (n = 4,065) were identified.

Men were categorized by clinical cut-offs based on seasonally adjusted serum vitamin D levels in <25 (deficient), 25-50 (insufficient), 50-75 (sufficient) and >75 nmol/L (high) serum vitamin D."

Conversion of nmol/L to ng/mL"

25 ---> 10

50 ---> 20

75 ---> 30

"Overall survival was lowest for serum vitamin D deficiency and a significantly higher PCa specific mortality (HR: 2.37 ...) and other cause mortality (HR: 2.08 ...) was found for PCa patients with serum vitamin D deficiency compared to serum vitamin D sufficiency."

-Patrick

[1] pubmed.ncbi.nlm.nih.gov/331...

Acta Oncol

. 2020 Oct 24;1-7. doi: 10.1080/0284186X.2020.1837391. Online ahead of print.

Vitamin D levels and the risk of prostate cancer and prostate cancer mortality

Hein Vincent Stroomberg 1 , Fie Juhl Vojdeman 2 , Christian Medom Madsen 2 , John Thomas Helgstrand 1 , Peter Schwarz 3 , Anne-Marie Heegaard 4 , Anja Olsen 5 6 , Anne Tjønneland 5 7 , Bent Struer Lind 8 , Klaus Brasso 1 , Henrik Løvendahl Jørgensen 8 , Martin Andreas Røder 1

Affiliations collapse

Affiliations

1 Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital, Rigshospitalet, Denmark.

2 Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen, Denmark.

3 Department of Endocrinology, Copenhagen University Hospital, Rigshospitalet, Denmark.

4 Deptartment of Drug Design and Pharmacology, Copenhagen University, Copenhagen, Denmark.

5 Danish Cancer Society Research Center, Copenhagen, Denmark.

6 Institute of Public Health, Aarhus University, Aarhus, Denmark.

7 Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.

8 Deptartment of Clinical Biochemistry, Copenhagen University Hospital Hvidovre Hospital, Hvidovre, Denmark.

PMID: 33103532 DOI: 10.1080/0284186X.2020.1837391

Abstract

Background: Vitamin D has a role in bone turnover and potentially bone-metastatic spread of prostate cancer (PCa). The aim of this observational study was to address the association between levels of serum vitamin D, diagnosis of PCa and subsequent mortality in men who underwent a biopsy of the prostate.

Methods: All men who underwent prostatic biopsy in the Danish PCa Registry (DaPCaR) and who had a serum vitamin D measurement during the period 2004 to 2010 (n = 4,065) were identified. Men were categorized by clinical cut-offs based on seasonally adjusted serum vitamin D levels in <25 (deficient), 25-50 (insufficient), 50-75 (sufficient) and >75 nmol/L (high) serum vitamin D. Logistic regression model for association between vitamin D and risk of PCa diagnosis and multivariate survival analyses were applied.

Results: No association between serum vitamin D and risk of PCa was found. Overall survival was lowest for serum vitamin D deficiency and a significantly higher PCa specific mortality (HR: 2.37, 95%CI: 1.45-3.90, p < .001) and other cause mortality (HR: 2.08, 95%CI: 1.33-3.24, p = .001) was found for PCa patients with serum vitamin D deficiency compared to serum vitamin D sufficiency.

Conclusion: No association was found between serum vitamin D categories and risk of PCa in men who underwent biopsy of the prostate. Men with PCa and serum vitamin D deficiency had a higher overall and PCa specific mortality compared to men with a sufficient level of serum vitamin D.

Keywords: Prostatic neoplasms; Vitamin D; epidemiology; mortality; risk.

[LearnAll]

Thanks Patrick for these valuable facts and data. Not only in Prostate Cancer , Vit D levels play a huge role in mortality from Covid19.

Similar large retrospective study done showed only a month or so ago that people who had Vit D level above 40 had a much lower rate of ICU admission and death due to Covid19 compared to ones who had VitD levels less than 40. (My vit D level was 58 a week ago.)

[Ralph1966]

My last test for Vitamin D3 level was 90 nmol/L

When I was diagnosed with PCa 3 years ago it was 29 nmol/L

I am taking 30,000 IU daily lately based on the advice of one of the posts here.

I will decrease my daily intake to 5,000-10,000 nmol/L

May I ask how much your daily intake of Vitamin D supplement dear Patrick?

[pjoshea13 in reply to Ralph1966]

I find that I need 70 IU daily.

I had blood drawn for a full male panel yesterday. It has been 2 years since my last D test. Will let you know when my results come in.

-Patrick

[cigafred in reply to pjoshea13]

70, or 7000 IU??

[pjoshea13 in reply to cigafred]

oops - 7,000! Thanks, -Patrick

[pjoshea13 in reply to pjoshea13]

As of Tuesday, 25-D was 52.6 ng/mL. & that's while taking 7,000 IU daily. -Patrick

[2b-lucky]

Some previous studies showed that for prostate cancer, Vitamin D is a Goldilocks substance. Too little and too much were both associated with poor outcomes. The men who fared best were those with adequate but not excessive levels of Vitamin D. This Danish study seems to contradict the idea that excessively high levels of Vitamin D are associated with poor prognosis for prostate cancer patients. Is this Danish study definitive? What is your takeaway, Patrick?

[Ralph1966 in reply to 2b-lucky]

Too little and too much? So what is the best range of Vitamin D3 level?

[pjoshea13 in reply to Ralph1966]

The Scandinavian studies are tricky, since most who do not supplement will be deficicient going into the new year. i.e. they will not average out to "high" for the year.

Who are the men who take supplements at a high enough dose to be considered "high". My contention is that they include men who know that they have a high risk of PCa. Perhaps familial risk or due to elevated PSA.

So we have the potential for a reverse association between high intake & diagnosis. The anti-supplement guys are happy to look at a U-shaped risk curve & take it at face value. One of them has said that if D does noy protect from incidence, it cannot protect from progression. & yet, a Swedish study that reported a U-shaped incidence, went on to report that the men with high levels had better survival.

& survival is all that matters, surely, at this point.

For survival, the benefit seems to be dose-related. i.e. no U-shape.

But Scandinavia is not a good place to study high levels. Those Nordic scientists should descend on Crete for a year.

But then you have the problem that the PCa rate is low in Crete.

I wonder why? lol

-Patrick

[2b-lucky in reply to pjoshea13]

Best range for D3? Short answer -- I don't know. Long answer:

Some members like Patrick, Nalakrats and Tall Allen have the extensive knowledge and real insights needed to put studies in context. I have none of that knowledge.

It’s my impression that the associations between prostate cancer and Vitamin D are suggestive, not conclusive.

I subscribe to Consumer Lab, which originally wrote:

A large study in the U.S. found both low and high vitamin D concentrations in the blood to be associated with increased risk of prostate cancer. The middle “sweet spot” associated with the lowest risk (about half the risk of the higher or lower levels) was between 23 ng/mL and 29 ng/mL, leading researchers to write that the optimum range for prostate cancer prevention “may be narrow.”

Later on, Consumer Lab wrote:

“A closer look at the study found that this correlation (high D3 linked to high PCa incidence) was true only for men with very high calcium intake. For all others, Vit D3 was not linked to increased incidence of PCa.”

And of course, calcium supplementation is linked to PCa. The 2014 study referred to can be seen here:

cebp.aacrjournals.org/conte...

cebp.aacrjournals.org/conte...

It’s unclear to me whether that there is widespread consensus on this issue. Years ago, my oncologist told me to take 6000 IU a day (about 10 times the average recommended dosage for the general population.) Since then, I’ve been taking 5000 IU (125mcg) a day, with no apparent problem. I rarely test my D3 levels, but when I have done so, they have always fallen within “normal” range.

Two different scales are used to measure Vitamin D, which can cause confusion. When receiving test results, knowing which unit of measurement was used is important.

In the USA, Vit D is most often measure in ng/ML:

ng/ML is nanograms per millimeter

In Europe and most other countries, Vit D is often measured in nmol/L

:

nmol/L = Nanomoles per liter (nmol/L)

Even though, there still seems to be debate about how much we actually need, most experts agree that below 25 nmol/L (or 10 ng/ml) is considered deficient. In the age of Covid, we surely need WAY more than that.

[Ralph1966]

Thank you, Patrick.

My Vitamin D3 level is at a higher limit as the accepted range is 30-90 nmol/L right?

So keeping the level may be at no less than 40 and no more than 70 may help...

[pjoshea13 in reply to Ralph1966]

Ralph, for those used to ng/mL, 30-90 nmol/L = 12-36 ng/mL.

The U.S. Vitamin D Council defines deficiency as <20 ng/mL (<50 nmol/L); insufficiency as <32 ng/mL (<80 nmol/L); from memory.) & recommends everyone to get above 50 ng/mL (125 nmol/L).

But different countries & different groups have different guidelines.

& if taking D with calcium, as many do, vitamin K (K2-7) should be used to ensure calcium gets transported to bone (& not arteries).

-Patrick

[JPnSD]

So if I want to live longer with my Stage 4 APC...all I need is a D3, a mini aspirin and 20-30 my of melatonin/day. If it were only that simple

[Magnus1964]

Thank for sharing. For years I have telling the Pca brothers to keep their vitamin D level up. Hope this drives home the point.

[j-o-h-n]

D for 2 and 2 for D

Just D for you and D for me.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 10/29/2020 7:30 PM DST

[SPEEDYX in reply to j-o-h-n]

D2 is company and D3 is a crowd!!!