T Nation

Vitamin D Decrease and Increase Inflammation?


#1

"Raising low levels of vitamin D may also reduce inflammation in the body. In a study of blood from thousands of adult Americans, levels of C-reactive protein (CRP), a marker of inflammation, decreased as vitamin D levels increased to just below 21 ng/mL28 However, the opposite occurred when vitamin D levels reached and exceeded 21 ng/mL -- CRP levels slowly but progressively increased, suggesting an slight inflammatory action of vitamin D at these higher levels. The results seem to reinforce the importance of maintaining a plasma vitamin D level of at least 20 ng/mL and suggest some potential downside of higher levels of vitamin D."

I don't have any more info than this, was just released from www.consumerlabs.com

anyone have more info about it?


#2

Here is the study:

American Journal of Cardiology
Volume 109, Issue 2 , Pages 226-230, 15 January 2012
Muhammad Amer, MD and Rehan Qayyum, MD, MHS
Relation Between Serum 25-Hydroxyvitamin D and C-Reactive Protein in Asymptomatic Adults (From the Continuous National Health and Nutrition Examination Survey 2001 to 2006)

http://www.ajconline.org/article/S0002-9149%2811%2902748-2/abstract

Abstract:

The inverse relation between vitamin D supplementation and inflammatory biomarkers among asymptomatic adults is not settled. We hypothesized that the inverse relation is present only at lower levels and disappears at higher serum levels of vitamin D. We examined the relation between 25-hydroxyvitamin D [25(OH)D] and C-reactive protein (CRP) using the continuous National Health and Nutrition Examination Survey data from 2001 to 2006.

Linear spline [single knot at median serum levels of 25(OH)D] regression models were used. The median serum 25(OH)D and CRP level was 21 ng/ml (interquartile range 15 to 27) and 0.21 mg/dl (interquartile range 0.08 to 0.5), respectively. On univariate linear regression analysis, CRP decreased [geometric mean CRP change 0.285 mg/dl for each 10-ng/ml change in 25(OH)D, 95% confidence interval [CI] −0.33 to −0.23] as 25(OH)D increased ≤21 ng/ml.

However, an increase in 25(OH)D to >21 ng/ml was not associated with any significant decrease [geometric mean CRP change 0.05 mg/dl for each 10-ng/ml change in 25(OH)D, 95% CI −0.11 to 0.005) in CRP. The inverse relation between 25(OH)D below its median and CRP remained significant [geometric mean CRP change 0.11 mg/dl for each 10-ng/ml change in 25(OH)D, 95% CI 0.16 to −0.04] on multivariate linear regression analysis.

Additionally, we observed a positive relation between 25(OH)D above its median and CRP [geometric mean CRP change 0.06 mg/dl for each 10-ng/ml change in 25(OH)D, 95% CI 0.02 to 0.11) after adjusting for traditional cardiovascular risk factors.

In conclusion, from this cohort of asymptomatic adults, independent of traditional cardiovascular risk factors, we observed a statistically significant inverse relation between 25(OH)D at levels <21 ng/ml and CRP. We found that 25(OH)D at a level ≥21 ng/ml is associated with an increase in serum CRP. It is possible that the role of vitamin D supplementation to reduce inflammation is beneficial only among those with a lower serum 25(OH)D.


I don't really know about the significance that I can draw from these figures, I will see if I can get a hold of the study.


#3

Okay... in layman's terms... what did we learn here?


#4

Take your damn vitamin D, just don't overdo it, as with everything else. lol


#5

If it were that simple.

Does higher blood levels of Vit D equal more inflammation or is there something else going on.

If there is more inflammation, is it enough to negate all the positives of getting your D levels around 60-80?


#6

If you mean 60-80 nmol/L, that equates to around 24-32 ng/mL, so I would have to say that such a small difference is negligible. CRP is not solely a measure of inflammation. Mild inflammation is 1-4 mg/dL CRP, well beyond the range expected by the study if one was to supplement 2000-4000 IU/d. Also the study was for asymptomatic people, so how this relates to disease is very unclear. Studies linking CRP to whatever are all over the map.

If anything CRP is more of a lagging indicator. When one looks at the variability of CRP levels in a group of test subjects in diseased and non-diseased states, it is quite large with great overlap between the two groups, thus the predictive nature of measuring one person's CRP level at a given time is unclear. One would need a series of measurements for that person over time to make any correlation to a given disease or heightened risk.

Vitamin D intake that results in levels of 60-80 nmol/L has shown decreased mortality from all causes (by all it is meant in aggregate, not in every possible case).

I guess that is the long way of saying that there is more going on here.


#7

Agree with what you said but I'm pretty sure jehova meant 60-80 ng/ml


#8

The benefits seem to be conferred in the 75-110 nmol/L range or around 30-45 ng/mL, optimal suggestions are for 50-55 ng/mL from some sources. They also recommend that individuals shooting for this keep levels below 60 ng/mL.

These levels are attainable through supplementation of 2000-4000 IU/d for the lower levels in winter a higher latitudes and around half that in the summer, the 50ish ng/mL range is attainable for most around 6000-10000 IU/d in absence of significant skin production. Above this should be considered medical treatment and context specific, and testing of levels should be ongoing.

I have yet to read the paper, but I don't think it will lead any changes to current practices for healthy people, and the dosages commonly used are within reason. I also haven't seen any studies recommending 60-80 ng/mL as the optimal for preventative use, the benefits seem to come at around half that level.


#9

correct

For example Dr. Oz recommends 50 ng/ml . Mercola and other recommend 50/60-80 ng


#10

Yes, they do.

Regarding those suggestions, I propose that those doses need not be maintained indefinitely as I see a cyclical approach to be more "normal". In my estimation, levels need only meet a threshold of 35-40 in the winter time (2-4000IUs with a meal containing fat will get most there), and in sunshiny times, a lower dose, or no dose at all, of natural sun exposure to bring a person up to 50-80 (higher pending serious disease state). Following and testing D levels twice yearly will potentially reveal vit D issues, disease state, indicate malabsorption of certain minerals, &/or fluctuations may otherwise reveal unhealthy change in lifesstyle, diet, etc. including dietary changes including removing lectin containing foods from the diet, as people with first diagnosed celiac disease most often have deficient blood levels of vit D3. Supplemental zinc, magnesium, selenium, and boron (which is sometimes hard to find -- not at the grocery store usually) along with dairy calcium and exercise (to reduce excess body fat, which affects vit D storage) may help when supplemention alone does not change levels, or moderate doses do not have intended effect. Dairy calcium preferably from raw (organic) dairy from a trusted source.


#11

Received this e-mail newsletter from Dr. Cannel from the vitamin D council to the study ~

Response to CRP and vitamin D association finding
http://us2.campaign-archive1.com/?u=f545cba30e1f9697fddbe8acb&id=624e760af2&e=d37488c337

excerpt:

"...Dozens of studies now exist showing supplemental vitamin D3 reduces mortality rates, in part due to its cardiovascular protection. The majority of these studies show that improvement in mortality continues through 30 ng/ml and even up to 40 ng/ml. Not enough people have levels of 50 ng/ml for scientists to see if such levels offer further protection. However, cardiovascular disease is rare in native peoples around the equator where vitamin D levels of 50 ng/ml are not uncommon.

The takeaway message from this paper is that scientists will need to recalculate lots of different ?normals,? using vitamin D sufficient subjects. It?s not just that normal CRP may be a bit higher in vitamin D sufficient people, their red blood count and the protein albumin may be a bit lower, for example. The point is that pathologists and epidemiologists will need to redo much of their work. We don?t know the normal range of CRP in 65-year-old men; we know the range of CRP in 65-year-old vitamin D deficient men. Likewise, we don?t know the incidence of heart disease in 65-year-old men; we know the incidence of heart disease in vitamin D deficient 65 year-old men. We have lots of work to do."


#12

@Menthol:

I definitely agree with that assessment, I personally dose 10000 IU/d in winter and titrate my dose in fall and spring along with plenty of sunshine in summer. But when it comes to recommendations I give, recently more and more of the people I work with are 'normals' not your average T-Nation follower so I moderate my advice to what is currently clearly 'proven' and within Health Canada guidelines. Since I do not work with therapeutic or clinical cases, there is no need to step outside the guidelines in most cases.

Accepted ranges of lots of clinical measures likely need refining, both for intra and inter-individual variability. Sometimes we get too caught up on numbers or targets rather than what they are telling us as a whole or how they react over time to different interventions.

The comments about the raw data are what my suspicions were. In general I am very suspicious of statistical data when raw data correlations are obvious or nearly non-existent. Still going to try an get a free copy of this study, damn not being in school!


#13

A little bit more information I saw concerning vitamin D3 - this time on natural circulating D3 levels on two African hunter gather groups.

"New study: Vitamin D levels of the Maasai and Hadzabe of Africa"

http://us2.campaign-archive1.com/?u=f545cba30e1f9697fddbe8acb&id=a87d885548&e=d37488c337

excerpt:

"....The Maasai are no longer hunter-gatherers but live, along with their cattle, either a settled or a semi-nomadic lifestyle. They wear sparse clothes, which mainly cover their upper legs and upper body, and attempt to avoid the sun during the hottest part of the day. They eat mainly milk and meat from their cattle, although recently they began to add corn porridge to their diet. Their mean 25(OH) vitamin D level was 48 ng/ml (119 nmol/L) and ranged from 23 to 67 ng/ml.

The Hadzabe are traditional hunter-gatherers. Their diet consists of meat, occasional fish, honey, fruits, and tubers. They have no personal possessions. They wear fewer clothes than the Maasai in that the men often wear nothing above the waist. Like the Maasai, they avoid the sun during the hottest part of the day. Their mean 25(OH)D was 44 ng/ml and ranged from 28 to 68 ng/ml.

Many of us have been waiting years for this data. To me, it means that the Vitamin D Council?s recommendation of 50 ng/ml is just about right, although I cannot argue with someone who recommends a level of 55 ng/ml. Remember, when errors in measuring vitamin D are made, they usually are overestimates. Thus, if mean natural levels are around 45 ng/ml, keeping your level around 50-55 ng/ml keeps you within what both the Maasai and the Hadzabe are telling us."


#14

Good stuff Menthol. Thanks for that.