Deficiency in Vitamin D leads to Aggressive Prostate Cancer – new study

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Deficiency in Vitamin D leads to Aggressive Prostate Cancer – new study

VitD

 

Doggy Bag Message First

New study suggest that vitamin D deficiency is associated with aggressive prostate cancer in European-American men and even more so in African American men.
Vitamin D3 supplementation should be considered for all men, especially those from African American descent starting at 2000units a day.

Details of the Study
•    275 European-American men and 273 African-American men were studied between 2009 and 2013.
•    The men were aged between 40 and 79 years and were undergoing an initial prostate biopsy after abnormal prostate-specific antigen (PSA) or digital rectal examination (DRE).
•    168 men were diagnosed with prostate cancer from each group.
•    Researchers measured levels of 25-hydroxyvitamin D (25-OH D) in their blood [normal is 30 to 80 nanograms per milliliter (ng/ml)] •    Results: Those with lower vitamin D levels acquired aggressive prostate cancer

More on this study

25-OH D levels of 16.7 ng/ml in the African-American men group were much lower than that of European-American men at 19.3 ng/ml.

The researchers then divided the men into groups dependent on their 25-OH D levels. They were:
•    Less than 12 ng/ml
•    Less than 16 ng/ml
•    Less than 20 ng/ml
•    Less than 30 ng/ml
They found that the lower a man’s vitamin D levels, the higher their risk of prostate cancer.
With 25-OH D levels lower than 12 ng/ml, European-American men were over 3 ½ times more likely to develop aggressive prostate cancer (Gleason grade 4+4 or higher), while African-American men were more than 4 ½  times more likely to develop an aggressive form of the disease.

 

My Take On This

This should not be completely new to you. Not that long ago we posted the benefits of vitamin D against heart disease, cancer and decrease in all-cause mortality.  There is some evidence that vitamin D plays a role in prostate cancer progression. Different genetic material in the vitamin D receptor are associated with Gleason score(Chen et al. 2010) and with risk of recurrence or progression and prostate cancer-specific mortality. (Holt et al. 2010)

Another study of prostate cancer mortality looking at two large prospective groups found that prostate cancer patients with the lowest levels of pre-diagnostic 25(OH)D had a significantly greater risk of prostate cancer-specific mortality. (Fang et al. 2011) Low pre-diagnostic vitamin D levels were significantly associated with both stage and grade in this study.
Interestingly I took another browse through PUBMED, the master database on medical and scientific research and found another excellent recent study published by the Cochran Review.

They found evidence suggesting that vitamin D3 may significantly improve survival of elderly participants living in institutional care who were likely to be vitamin D deficient with significant risk of falls and fractures. Vitamin D2, another type sometimes found in supplements, was NOT found to decrease mortality.
In fact, vitamin D2 may increase mortality some clinical trials.  The researchers concluded that vitamin D3 might improve mortality. (Bjelakovic et al. 2014)

Caveat: Vitamin D3 combined with calcium significantly increased kidney stones.(Bjelakovic et al. 2014)

The tolerable upper limit is 2,000 mg according to the Institute of Medicine (IOM 2011)

 

What should you do?

Take at least 2000 units of vitamin D3 a day with food. This is a minimal dose. Often people need much more based on their blood test. Also, the bigger the person, the more they need.
The good news is that vitamin D3 supplementation is highly inexpensive and there are typically no manufacturing issues with making this vitamin. I use myself and recommend to patients Omega Avail Ultra with D3, K1 and K2 – 2 softgels two times a day with food. (Disclosure).

I like this formula because it “ kills 3 birds with one stone” if you will, with Omega-3’s, Vitamin D3 and Vitamin K – especially K2. Often, however, patients need more Vitamin D especially in the winter and if they are big.
Patients with Kidney failure and Hyperparathyroidism should NOT take vitamin D without supervision.

In fact, I recommend every to visit a nutritionally oriented physician like a naturopathic doctor or an integrative MD.

Go get some sun this weekend. It’s been a tough, very low vitamin D winter for most.

Reference:

Chen L, Davey Smith G, Evans DM, Cox A, Lawlor DA et al. Genetic variants in the vitamin d receptor are associated with advanced prostate cancer at diagnosis: findings from the prostate testing for cancer and treatment study and a systematic review. Cancer Epidemiol Biomarkers Prev 2009; 18: 2874–81.

Holt SK, Kwon EM, Koopmeiners JS, Lin DW, Feng Z et al. Vitamin D pathway gene variants and prostate cancer prognosis. Prostate 2010; 70: 144860.

Fang F, Kasperzyk JL, Shui I, Hendrickson W, Hollis BW et al. Prediagnostic plasma vitamin D metabolites and mortality among patients with prostate cancer. PLoS ONE 2011; 6: e18625.

Bjelakovic G1, Gluud LL, Nikolova D, Whitfield K, Wetterslev J, Simonetti RG, Bjelakovic M, Gluud C.Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev. 2014 Jan 10;1:CD007470.

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by Dr. Geo

4 comments… add one
  • Susan 05/02/2014, 9:10 AM

    Yeah thank you thank you, so glad you wrote this. We spoke about it over a year ago when I starting reading studies, so clear yet so hidden, from the 80s! My husband,s level was 11 when Dx, gleason 9 now close to 50. Few Drs. except you of course thought there was a connection! Thanks again for all your good work. Susan

    Reply
  • margaret ellis 05/03/2014, 2:21 PM

    I have some patients on 2000 units d3 daily – I believe they are faithful to take this – and they are still deficient – some are even deficient on 4000 units daily. Are there brands that are better absorbed? Or are there reasons why some people don’t absorb d3 and others do? Thanks for all your insight.

    Reply
    • Dr. Geo 05/13/2014, 11:54 PM

      Lack of absorption of Vitamin D3 typically has very little to do with the brand and all to do with low dosing or the patient not taking with food – particularly fat in the food. Sometimes, patients need to start at 5000 units or higher. I hope this helps.

      Reply
  • margaret ellis 05/15/2014, 10:02 PM

    thanks so much – I will watch this and recommend that patients take d3with a meal!

    Reply

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