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Update on Vitamin D

The hottest subject in medicine today is the amazing number of diseases associated with low vitamin D levels. People with low levels of vitamin D are at double the risk for blocked arteries in their legs, called peripheral artery disease (Arteriosclerosis, Thrombosis, and Vascular Biology, June 2008); markedly increased risk for heart attacks and strokes, angina, and heart failure (Circulation, January and April 2008; Archives of Internal Medicine, June 2008); increased rate of aging of their tissues (The American Journal of Clinical Nutrition, November 2007); cancers of the breast, lung and colon (American Journal of Clinical Nutrition, November 2007); diabetes (Epidemiology, May 20, 2008). Other recent articles show that Vitamin D helps pain control (Pain Medicine, April 2008); and vitamin D reduces the risk of falls (Archives of Internal Medicine, March 2008).

Next winter, ask your doctor to draw blood tests called vitamin D3 and D2. If your D3 level is below 40 ng/ml, you are at increased risk for a host of diseases. You can take pills containing D2 or D3. D2 is the plant pre-vitamin D that is so weak that it usually will not help raise your blood level. On the other hand, D3 is the animal pre-vitamin D that appears to be quite effective. Scientists do not agree on the optimum dose for people with blood levels of D3 below 40 ng/ml. It used to be 200 international units per day. Today, many doctors think that it should be at least 2000 international units. You can also meet your needs for vitamin D from sunlight by exposing a few inches of skin for 15 minutes every other day in the summer. However, during the winter in northern climates, the sun's rays come in at an angle and are therefore markedly reduced by the increased areas of atmosphere through which the sun's rays must pass. You can solve this problem with a tropical vacation.

I have found that tanning beds provide almost no vitamin D. Ultraviolet light is classified into UVA and UVB. UVB are the rays that cause skin cancer. They are also the rays that cause the skin to manufacture vitamin D. Since manufacturers of tanning bulbs are concerned about skin cancer, they reduce the percentage of UVB emitted from tanning lamps. This also markedly reduces the rays that provide vitamin D.

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Reports from drmirkin.com

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Dear Dr. Mirkin: When competing during very hot weather, is there a good way to recover between events?

Researchers at Edith Cowan University in Australia showed that you can recover faster and compete at a higher level by soaking your legs in cold water (14 degrees C) for five minutes during rest periods between events (British Journal of Sports Medicine, June 2008). The cooling session dropped body temperature a half degree centigrade and the athletes were able to cycle faster with greater power output.

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Dear Dr. Mirkin: Are heart attacks more common in summer or winter?

Breathing cold air turns on your immunity. Your immunity is supposed to attack and kill germs, but as soon as the invading germ is gone, your immunity is supposed to shut down until the next attack. If it remains active, it causes inflammation, a condition in which your immunity attacks your own body to damage your blood vessels, joints and other tissues. Researchers at the German Research Center for Environmental Health in Neuherberg showed that exposing men, who had previously had heart attacks, for five consecutive days to colder weather increased blood levels of three markers of inflammation: C-reactive protein, interleukin-6 and fibrinogen (Epidemiology, May 2008). This could explain why heart attacks occur more commonly in the winter. Cold temperatures also increase blood pressure.

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Recipe of the Week

Summer Vegetable Curry

You'll find lots of recipes and helpful tips in The Good Food Book - it's FREE

June 25th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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