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Calcium and Vitamin D Pills Questioned

The prestigious Institute of Medicine issued a report recommending that adult North Americans need only 1,000 milligrams of calcium and 600 IU of vitamin D per day, and that most people do not need supplements. Taking too much calcium can cause kidney stones, and taking calcium without also taking vitamin D may increase risk for heart disease. Very large amounts of vitamin D may increase risk for fractures. The authors believe that adolescent girls may be the only group that is getting too little dietary calcium (Report from the Institute of Medicine of the National Academies, November 30, 2010).

Those of you who have read my newsletters for the past few years know that I am very concerned about vitamin D deficiency. However, I do not recommend taking vitamin D pills unless your blood level of vitamin D is less than 75 nmol/L (30 ng/L). How have scientists decided that your blood level of vitamin D should be above 75 nmol/L? A major function of vitamin D is help your body absorb calcium. When you lack vitamin D, ionized blood calcium levels drop. This causes your parathyroid gland to become overactive and produce too much parathyroid hormone. Too much parathyroid hormone forces calcium out of bones to weaken them. The lowest level of vitamin D that keeps parathyroid hormone at normal levels is 75 nmol/L. If your blood level of vitamin D3 is less than 75 nmol/L, you need extra sunlight or to take at least 2000 IU of vitamin D3/day until you reach a normal level.

Hundreds of studies show that people with low blood levels of vitamin D are more likely to suffer many different cancers, heart attacks, strokes, diabetes, osteoporosis, bone fractures, autoimmune diseases, decreased immunity, and so forth. However, except for weakened bones, these are associations, not cause-and-effect. To prove causation, we need studies showing that giving pills to raise blood levels of vitamin D prevents or cures cancers, diabetes, heart disease and other conditions. So far this has been done only for bone diseases, fractures and prevention of influenza. It may be that vitamin D deficiency is only a marker for other factors, such as lack of outdoor exercise, that contribute to all of these diseases. If this is true, then taking vitamin D pills would not correct the underlying problem.

Researchers at Emory University studied vitamin D status in twins living in different North American locations. They concluded that vitamin D deficiency runs in families and is mostly genetic (American Journal of Clinical Nutrition, December 2010).

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Dear Dr. Mirkin: What's the best kind of exercise for a diabetic?

Diabetes is controlled better by a combined program of lifting weights and walking on a treadmill than if people just lift weights or just walk (Journal of the American Medical Association, November 24, 2010). This is very exciting news because the authors used a blood test called HBA1C that measures the amount of sugar stuck on cells. They showed that combining strength and aerobic training lowered HBA1C far more than either one alone. When blood sugar levels rise too high, sugar sticks to the surface of cell membranes. The sugar can never get off and is eventually converted to sorbitol, which damages and kills cells to cause all of the known side effects of diabetes (heart attacks, strokes, cancers, blindness and so forth).

Resting muscles are inactive and can draw sugar from the bloodstream only by having insulin drive sugar into their cells. On the other hand, contracting muscles draw sugar from the bloodstream and don't even need insulin to do this. This effect lasts maximally only during exercise and for up to an hour after you finish. The study subjects exercised for only 140 minutes per week, which is certainly not enough to control their blood sugar levels.

The combination of lifting weights and aerobic exercise helps to prevent and control diabetes because: *It enlarges muscles. The more muscle you have, the greater your ability to clear sugar from your bloodstream. *It gets rid of fat. Full fat cells release hormones of inflammation that turn on your immunity and destroy the cells in your body.

One of three North Americans now become diabetic because they exercise too little and eat too much. Diabetes can be both prevented and treated by *exercising aerobically, *lifting weights to enlarge muscles, *getting rid of fat, *restricting red meat and refined carbohydrates such as sugar water and foods made from flour, and *getting blood levels of vitamin D3 above 75 nmol/L.

Everyone should have a program of aerobic exercise and lifting weights. You should exercise every day, even if you have limited time. Try to run or cycle or move continuously for at least half an hour every day. Go fast and hard on one day, go slowly on the next few days until the muscle soreness goes away, and then go faster again. Arrange for access to strength machines and try to do two or three sets of ten repetitions on the machines at least three times a week. Caution: exercise can cause heart attacks in people who have blocked arteries; check with your doctor.

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Reports from drmirkin.com

Diet for heart health
Restless legs
Corns and calluses

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Dear Dr. Mirkin: How could finger length predict prostate cancer risk?

Men with long ring fingers may be more likely to develop prostate cancer, according to a study in the British Journal of Cancer (December 2010). Researchers compared the hands of 1,500 prostate cancer patients and 3,000 healthy men and found that those whose index finger was longer than their ring finger were 33 percent less likely to develop prostate cancer. Finger length is set before birth. A longer index finger is the result of exposure to lower levels of testosterone in the uterus, which may protect against cancer later in life.

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Recipe of the Week:

Hot and Sour Fish Soup

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June 21st, 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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