Need a reason to celebrate something? How about, me?
Seriously.
I’d normally add what I’m going to write on this post as a never ending addenda to my most popular post of all time (ego, sorry), but this deserves its own little fresh page as it’s virtually a end point (however, not the end point) – once I graft on my latest vitamin D results this year.
First things first. I’m going to share a little medical evidence. [Download .jpg here] I’ve censored out personal details – just kept. Mr. Mo.. so you know it’s me – and unrelated results.
You don’t need to be familiar with the cholesterol saga to analyse my figures. Basic maths will reveal to you a general decrease from 2007-2009.
There is a reason for excluding 2008; simply due to the fact my cholesterol was wrongly measured un-fasted then, and only my total cholesterol was given. However, my value was 5.4mmol/L, which was still slightly lower than my total fasted cholesterol in 2007 (5.62).
My vitamin D level in 2007 was between 10-21nmol/L – I can’t remember off hand if I started my initial 400IU D2 supplementation before or after my initial cholesterol profile.
Last year my vitamin D level reached 76nmol/L on 5,000IU D3. Since then I’ve been taking 10,000IU (as one 50,000IU capsule per 5 days) and by the end of this month my vitamin D level will be taken again. I forecast it to be in the safer early hundreds.
Whether or not cholesterol itself is a cause of cardiovascular disease, we do know that statins – even with their side effects – have made some data dent in heart disease statistics. But mechanisms for these drugs have never been made clear. Some have hypothesised that statins are an analogue of vitamin D and there are studies showing statins increasing vitamin D levels by up to threefold, as well as showing lipid changes. And of course you know cholesterol is a precursor of D, right?
When I received my results in 2007 I was given a warning about my slightly high profile and told to change my diet (I am slim, fairly active and a non-smoker, so wasn’t given advice on increasing activity). I also got a British Heart Foundation pamphlet to read. Though I was healthy, and still am, I felt that visit to be like visiting a mystic who shook their head at reading my palm. I was dismayed moreso as I think my diet is very balanced.
So I ignored their advice as something about family history of illness and my brother’s then recent vitamin D deficiency led me down this path.
This year, only part of my profile is high and only by a rather paltry 0.7. In any case I still have some dispute with cholesterol ranges, but my cumulative results also yielded a printout which wasted ink for the one line (which I won’t bother to scan but will send to anyone who wants it): Serum lipids [(GP initials)]-Normal, no action.
I am also now below UK total cholesterol averages at 4.95mmol/L (“In the UK, the average total cholesterol level is 5.7mmol/l.”) Most profiles remain unchanged even with diet/exercise changes, as has my father’s for years.
Does this mean I’m immune to heart disease (and other diseases)? Who knows. All it means is maintaining my current profile will prevent my GP from generating a repeat prescription for a drug that at best could be substituted by a gift from nature.
I must stress I still need to post my vitamin D level up, but it cannot be less than 76nmol/L, that’s for sure. I’m just hoping 10,000IU didn’t take me too high, but I haven’t had any ill effects on it and approached it responsibly. I will add my vitamin D (25-D) level here as soon as possible.
Update 1 of 2 (18/09/09): I had vitamin D and calcium blood tests today along with a DEXA scan (recommended to me to every 5yrs since 2004 due to a maternal history of bone disorders). While I wait for the former, the latter has revealed to me an increase in bone density as measured at the hip and spine since my previous, first scan. I had normal T-scores and Z-scores (scroll link for definitions) but they have been been bettered since then, most noticeably in my spine (T from -0.1 to 0.6). This is not unexpected as my last parathyroid hormone (PTH) level dipped as my 25D rose. PTH dipping means less calcium is stolen from my bones as my sufficient 25D handles the job of maintaining blood calcium with whatever I glean from my diet. Although bone health isn’t what I’m focusing on in this topic, it has been shown that brittle bones link to heart disease (at least more strongly for women who don’t have the extra protective effects of male level testosterone) So it did shed valid extra light. And of course we’ve long known about vitamin D’s skeletal effects.
If you’re interested, here’s a portion of my scans. The right graphs show you a significant rise in my spinal reading from 2004 (aged 24)-2009 (aged 29), while on the hip it’s virtually the same (although up a number by data given to me).
Update 2 of 2 (22nd Sep, unfinished): This evening I got my calcium result which is 2.7mmol/L. Now according to my doctor and various online sources that is ungravely high (as in probably not good), although not high enough to typically cause symptoms (which I don’t have and that would typically start at 3+) and not too high out of range (2.2-2.6). My doctor (who gave me these results on the phone; vitamin D is still being processed) seemed unconcerned about this as he believes my albumin (forgive my reliance on WikiPedia tonight) is likely normal (they would contact again if not). The two are used in tandem to indicate a calcium problem. However they can rule out bone leech since my bone mineral density showed a 6% increase since 5yrs ago (a positive outcome here) along with dropping PTH. But while the level could be benign in accordance with my lack of symptoms I may have “increased intestinal calcium absorption (is that all good?), or decreased renal calcium excretion (clearly not good…)” according to WikiPedia’s Hypercalcemia definition. This is not to say vitamin D has done me wrong (not with my bone density increase and a cholesterol profile that rules me off statins) but I may be on a dose that’s slightly too high than necessary personally. I’ll only know when I get my results. It is also quite possible 2.7 is actually as normal as 2.6 - one document appears to think so - (not that I have the expertise to hedge) due to the fact that ranges are defined by the norm – and the norm is vitamin D deficiency.
One other curious fact though to add is that when I was severely vitamin D deficient my calcium was 2.59. This is virtually upper-end normal according to online sources but both my GP and hospital regard 2.55 (2.15 to 2.55 on our UK health service) as the upper limit, but even then this slightly higher level, perhaps insignificant, didn’t concern them due to not being accompanied with symptoms and perhaps being the norm. But I’m only guessing now. My albumin was also normal (a stock level of 50 g/L).
It would make things simple if the only cause of this is consuming a bit more D than I need. If it’s not, it could imply nothing wrong or possibly being a bit risky. I will have to address this when my level comes within a week or two, but don’t worry (if anyone is!) I’m alright and this is fairly simple to address.
12 November 2009: I’m really sorry the result isn’t up yet. My hospital neither sent the result to me or my GP so I’ll have to chase it up. One interesting note however, my unfasted total cholesterol result might be as valid as my fasted ones, read this.
Update 2.5 of…2.5 (finished!): 141 nmol/L (56.4 ng/ml) is the magic value which I received today.
I had predicted that I would probably reach 132 nmol/L at my upped dosage of 10k per day, so I was just off by 9 nmol/L, showing that for every 5000IU I go up roughly by 65 nmol/L.
Given that revised (if not yet universally accepted) optimal values are between 125-200 nmol/L, I have likely found my personal correct dose.
Of course at 141 nmol/L I exceeded the 128 nmol/L limit defined by my local health authority (who also still insist that from 25 nmol/L upwards is ‘normal’) so I may need to to drop down to 50k every 7 days (just above 7000IU per day) rather than 5 just in the season before my next blood test to keep them sweet.
No further comment was made on my blood calcium level because other markers weren’t pointed out as being risky. So I think my personal dose will remain at 10k per day since I wouldn’t attain any extra benefits by going right up to 200 nmol/L or more, and I also don’t want to risk it.
The only future updates to this and perhaps the previous blog post will be just of future result scores to form a long-term result sheet. Any further writing on the topic will be on a dedicated blog. Guaranteed.