What is the optimum blood level of Vitamin D for maximum testosterone?

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Nelson Vergel

Nelson Vergel

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Serum vitamin D levels and hypogonadism in men.


 Osteoporosis_s22_vitamin_d.jpg
Sources of Vitamin D



Lerchbaum E, et al.
Andrology. 2014 Jul 16. doi: 10.1111/j.2047-2927.2014.00247.x. [Epub ahead of print]


Abstract

There is inconsistent evidence on a possible association of vitamin D and androgen levels in men. We therefore aim to investigate the association of 25-hydroxyvitamin D (25(OH)D) with androgen levels in a cohort of middle-aged men. This cross-sectional study included 225 men with a median (interquartile range) age of 35 (30-41) years. We measured 25(OH)D, total testosterone (TT) and SHBG concentrations. Hypogonadism was defined as TT <10.4 nmol/L. We found no significant correlation of 25(OH)D and androgen levels. Furthermore, androgen levels were not significantly different across 25(OH)D quintiles. The overall prevalence of hypogonadism was 21.5% and lowest in men within 25(OH)D quintile 4 (82-102 nmol/L).

We found a significantly increased risk of hypogonadism in men within the highest 25(OH)D quintile (>102 nmol/L) compared to men in quintile 4 (reference) in crude (OR 5.10, 1.51-17.24, p = 0.009) as well as in multivariate adjusted analysis (OR 9.21, 2.27-37.35, p = 0.002). We found a trend towards increased risk of hypogonadism in men within the lowest 25(OH)D quintile (&#8804;43.9 nmol/L).


In conclusion, our data suggest that men with very high 25(OH)D levels (>102 nmol/L) might be at an increased risk of hypogonadism. Furthermore, we observed a trend towards increased risk of hypogonadism in men with very low vitamin D levels indicating a U-shaped association of vitamin D levels and hypogonadism. With respect to risk of male hypogonadism, our results suggest optimal serum 25(OH)D concentrations of 82-102 nmol/L.

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Defy Medical TRT clinic doctor
Interesting study. Of course, folks need to understand that Vitamin D levels are not an independent determinant of testosterone levels. And, there are likely a variety of reasons not to shoot for supra-physiological levels of Vitamin D. Personally, I'm inclined toward finding the middle ground among the many so called "experts" on Vitamin D supplementation. So, I aim for keeping mine between 40-60 nmol/L. The safety of this level is relatively well-researched and can be accomplished naturally by small amounts of daily sun exposure or reasonable supplementation with Vitamin D3.

http://www.westonaprice.org/blogs/2...ople-pushing-their-vitamin-d-levels-too-high/

People supplementing with Vitamin D need to research the importance of obtaining adequate amounts of Vitamins A and K as well, either through their diet or through supplementation. This would be especially relevant for vegetarians and vegans, as these fat soluble vitamins are most prevalent in meat, fish, dairy and eggs. There may also be an argument for ensuring adequate Vitamin E intake also.

http://www.westonaprice.org/blogs/c...amins-a-and-k-testimonials-and-a-human-study/
 
If you're following the health news, you know that vitamin D currently is in the media spotlight, and rightly so. Will Brink just did a great podcast “Vitamin D3 &#8211; scam or panacea?“, giving an overview on the importance vitamin D. In this article I will expand upon some key points taken up in the podcast, and back up the case with a solid reference list of recent studies on the topic. I will also present some revealing prevalence stats on vitamin D insufficiency, in order to convince you to get your blood levels checked to find out your vitamin D status.

Vitamin D is interesting for several reasons:

Click Here
 
A Predictive Equation to Guide Vitamin D Replacement Dose in Patients
Gurmukh Singh, MD, PhD, MBA and Aaron J. Bonham, MS


From the Department of Pathology, Truman Medical Center (GS), and the Office for Health Services & Public Health Outcomes Research, Department of Biomedical and Health Informatics (AJB), University of Missouri-Kansas City School of Medicine, Kansas City, MO; and Heritage Laboratories International Inc., Olathe, KS (GS).
Corresponding author: Gurmukh Singh, MD, PhD, MBA, Georgia Regents University, 1120 15th St., Augusta, GA 30912

Abstract

Background: Vitamin D is essential for bone health and probably the health of most nonskeletal tissues. Vitamin D deficiency is widespread, and recommended doses are usually inadequate to maintain healthy levels. We conducted a retrospective observational study to determine whether the recommended doses of vitamin D are adequate to correct deficiency and maintain normal levels in a population seeking health care. We also sought to develop a predictive equation for replacement doses of vitamin D.

Methods: We reviewed the response to vitamin D supplementation in 1327 patients and 3885 episodes of vitamin D replacement and attempted to discern factors affecting the response to vitamin D replacement by conducting multiple regression analyses.

Results: For the whole population, average daily dose resulting in any increase in serum 25-hydroxyvitamin D level was 4707 IU/day; corresponding values for ambulatory and nursing home patients were 4229 and 6103 IU/day, respectively. Significant factors affecting the change in serum concentrations of 25-hydroxyvitamin D, in addition to the dose administered, are (1) starting serum concentration of 25-hydroxyvitamin D, (2) body mass index (BMI), (3) age, and (f) serum albumin concentration. The following equation predicts the dose of vitamin D needed (in international units per day) to affect a given change in serum concentrations of 25-hydroxyvitamin D: Dose = [(8.52 − Desired change in serum 25-hydroxyvitamin D level) + (0.074 × Age) – (0.20 × BMI) + (1.74 × Albumin concentration) – (0.62 × Starting serum 25-hydroxyvitamin D concentration)]/(−0.002). Analysis of the dose responses among 3 racial groups—white, black, and others—did not reveal clinically meaningful differences between the races. The main limitation of the study is its retrospective observational nature; however, that is also its strength in that we assessed the circumstances seen in usual health care setting.

Conclusions: The recommended daily allowance for vitamin D is grossly inadequate for correcting low serum concentrations of 25-hydroxyvitamin D in many adult patients. About 5000 IU vitamin D3/day is usually needed to correct deficiency, and the maintenance dose should be ≥2000 IU/day. The required dose may be calculated from the predictive equations specific for ambulatory and nursing home patients.

Full Paper: http://www.jabfm.org/content/27/4/495.full
 
Vitamin D and mortality in older men and women


Authors: Pilz, Stefan1; Dobnig, Harald1; Nijpels, Giel; Heine, Robert J.; Stehouwer, Coen D. A.2; Snijder, Marieke B.; van Dam, Rob M.; Dekker, Jacqueline M.3

Source: Clinical Endocrinology, Volume 71, Number 5, November 2009, pp. 666-672


Abstract:

Summary Objective 

Vitamin D deficiency is common among the elderly and may contribute to cardiovascular disease. The aim of our study was to elucidate whether low serum levels of 25-hydroxyvitamin D [25(OH)D] are associated with an increased risk of all-cause and cardiovascular mortality. Design and patients 

The Hoorn Study is a prospective population-based study among older men and women. Measurements 

Fasting serum 25(OH)D was determined in 614 study participants at the follow-up visit in 2000–2001, the baseline for the present analysis. To account for sex differences and seasonal variations of 25(OH)D levels we formed sex-specific quartiles, which were calculated from the 25(OH)D values of each season. Results 

After a mean follow-up period of 6·2 years, 51 study participants died including 20 deaths due to cardiovascular causes. Unadjusted Cox proportional hazard ratios (HRs; with 95% confidence intervals) for all-cause and cardiovascular mortality in the first when compared with the upper three 25(OH)D quartiles were 2·24 (1·28–3·92; P = 0·005) and 4·78 (1·95–11·69; P = 0·001), respectively. After adjustment for age, sex, diabetes mellitus, smoking status, arterial hypertension, high-density lipoprotein-cholesterol, glomerular filtration rate and waist-to-hip ratio, the HRs remained significant for all-cause [1·97 (1·08–3·58; P = 0·027)] and for cardiovascular mortality [5·38 (2·02–14·34; P = 0·001)]. Conclusions 

Low 25(OH)D levels are associated with all-cause mortality and even more pronounced with cardiovascular mortality, but it remains unclear whether vitamin D deficiency is a cause or a consequence of a poor health status. Therefore, intervention studies are warranted to evaluate whether vitamin D supplementation reduces mortality and cardiovascular diseases.
 
Dr. James Dowd of the Vitamin D Cure posted his insightful comments regarding the Institute of Medicine's inane evaluation of vitamin D.

Dr. Dowd hits a bullseye with this remark:

The IOM is focusing on deficiency when it should be focusing on optimal health values for vitamin D. The scientific community continues to argue about the lower limit of normal when we now have definitive pathologic data showing that an optimal vitamin D level is at or above 30 ng/mL. Moreover, if no credible toxicity has been reported for vitamin D levels below 200 ng/mL, why are we obsessing over whether our vitamin D level should be 20 ng/mL or 30 ng/mL?

Yes, indeed. Have no doubts: Vitamin D deficiency is among the greatest public health problems of our age; correction of vitamin D (using the human form of vitamin D, i.e., D3 or cholecalciferol, not the invertebrate or plant form, D2 or ergocalciferol) is among the most powerful health solutions.

I have seen everything from relief from winter "blues," to reversal of arthritis, to stopping the progression of aortic valve disease, to partial reversal of dementia by achieving 25-hydroxy vitamin D levels of 50 ng/ml or greater. (I aim for 60-70 ng/ml.)

The IOM's definition of vitamin D adequacy rests on what level of 25-hydroxy vitamin D reverses hyperparathyroidism (high PTH levels) and rickets. Surely there is more to health than that.

Dr. Dowd and vocal vitamin D advocate, Dr. John Cannell, continue to champion the vitamin D cause that, like many health issues, conradicts the "wisdom" of official organizations like the IOM.
 
 
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"For women, a level of 40 nmol/L was associated with the lowest myocardial infarction risk; for men, it was 75 nmol/L. "Most studies have not found any gender differences investigating the association between cardiovascular disease mortality and 25-hydroxyvitamin D levels by gender," noted the researchers.The Institute of Medicine has proposed a cutoff of 50 nmol/L as being the minimum amount to maintain bone health. But the researchers said that level might be lower for women.

"A gender specific association may exist and needs to be further investigated in other studies and for other health outcomes than bone health," wrote the researchers.
As limitations, the authors noted the observational nature of the study and the fact that information about body mass index, health status, education, smoking, and ethnicity was lacking.

"Several mechanisms may explain the link between vitamin D deficiency and cardiovascular diseases and mortality, including over-expression of renin and parathyroid hormone," said the authors.

"Less clear is the reason for higher levels of vitamin D to be associated with increased cardiovascular disease mortality."

Vitamin D Extremes Tied to Greater Cardiovascular Death Risk
 
Active vitamin D (1,25 dihydroxyvitamin D) is associated with chronic pain in older Australian men: the Concord Health and Ageing in Men Project.

Hirani V, et al. J Gerontol A Biol Sci Med Sci. 2015.

Abstract
BACKGROUND: Although there is a conflicting evidence for an association between low serum 25-hydroxyvitamin D (25D) levels and pain, the relationship between pain and the active vitamin D metabolite, 1,25-hydroxyvitamin D (1,25D), has not been investigated. The aim of this study was to examine the associations between serum vitamin D metabolites: 25D and 1,25D with intrusive or chronic pain in community-living men aged &#8805;70 years.

METHODS: Population-based, cross-sectional analysis of the baseline phase of the Concord Health and Ageing in Men Project, a large epidemiological study conducted in Sydney between January 2005 and May 2007. Participants included 1,659 community dwelling men aged &#8805;70 years, taking part in Concord Health and Ageing in Men Project. Main outcome measurements were symptoms of chronic or intrusive pain. Covariates included 25D and 1,25D, parathyroid hormone, estimated glomerular filtration rate as well as age, country of birth, season of blood collection, body mass index, health conditions, and medication, including nonsteroidal anti-inflammatory drugs and statins.

RESULTS: The prevalence of intrusive pain was 22.9% and of chronic pain was 29.7%. Low serum 25D concentrations were associated with intrusive and chronic pain in unadjusted analysis, but after adjustment, the associations were no longer significant. Low 1,25D levels (<62.0 pmol/L) remained independently associated with chronic pain (odds ratio: 1.53 [1.05, 2.21, p = .02]), even after adjustment for a wide range of potential confounders and covariates of clinical significance.

CONCLUSIONS: Low serum 1,25D concentrations are associated with chronic pain in older men. This raises the question whether vitamin D metabolites may influence pain states, mediated through different biological mechanisms and pathways.
 
Read the comments to this last article. One comment suggested that higher levels of Vitamin D promotes higher levels of calcium deposits in the arteries

when you have proper levels of vitamin D3, you become hyperabsorber of calcium, so do not take any calcium supplements and have your calcium levels checked.
 
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croaker24 said:
Read the comments to this last article. One comment suggested that higher levels of Vitamin D promotes higher levels of calcium deposits in the arteries

when you have proper levels of vitamin D3, you become hyperabsorber of calcium, so do not take any calcium supplements and have your calcium levels checked.
Click to expand...

croaker sorry I didn't mean to add it to your post:eek:
 
[h=2]Higher serum 25-hydroxyvitamin D concentrations are related to a reduced risk of depression.[/b][h=3]Jääskeläinen T, et al. Br J Nutr. 2015.


Abstract[/b]Vitamin D has been suggested to protect against depression, but epidemiological evidence is scarce. The present study investigated the relationship of serum 25-hydroxyvitamin D (25(OH)D) with the prevalence of depressive and anxiety disorders. The study population consisted of a representative sample of Finnish men and women aged 30-79 years from the Health 2000 Survey. The sample included 5371 individuals, of which 354 were diagnosed with depressive disorder and 222 with anxiety disorder. Serum 25(OH)D concentration was determined from frozen samples. In a cross-sectional study, a total of four indicators of depression and one indicator of anxiety were used as dependent variables. Serum 25(OH)D was the risk factor of interest, and logistic models used further included sociodemographic and lifestyle variables as well as indicators of metabolic health as confounding and/or effect-modifying factors. The population attributable fraction (PAF) was estimated. Individuals with higher serum 25(OH)D concentrations showed a reduced risk of depression. The relative odds between the highest and lowest quartiles was 0·65 (95 % CI 0·46, 0·93; P for trend = 0·006) after adjustment for sociodemographic, lifestyle and metabolic factors. Higher serum 25(OH)D concentrations were associated with a lower prevalence of depressive disorder especially among men, younger, divorced and those who had an unhealthy lifestyle or suffered from the metabolic syndrome. The PAF was estimated to be 19 % for depression when serum 25(OH)D concentration was at least 50 nmol/l. These results support the hypothesis that higher serum 25(OH)D concentrations protect against depression even after adjustment for a large number of sociodemographic, lifestyle and metabolic factors. Large-scale prospective studies are needed to confirm this finding.
 
BioMed Research International
Volume 2015 (2015), Article ID 953241, 11 pages
http://dx.doi.org/10.1155/2015/953241

Review Article


Vitamin D: A Review on Its Effects on Muscle Strength, the Risk of Fall, and Frailty

Abstract

Vitamin D is the main hormone of bone metabolism. However, the ubiquitary nature of vitamin D receptor (VDR) suggests potential for widespread effects, which has led to new research exploring the effects of vitamin D on a variety of tissues, especially in the skeletal muscle. In vitro studies have shown that the active form of vitamin D, calcitriol, acts in myocytes through genomic effects involving VDR activation in the cell nucleus to drive cellular differentiation and proliferation. A putative transmembrane receptor may be responsible for nongenomic effects leading to rapid influx of calcium within muscle cells. Hypovitaminosis D is consistently associated with decrease in muscle function and performance and increase in disability. On the contrary, vitamin D supplementation has been shown to improve muscle strength and gait in different settings, especially in elderly patients. Despite some controversies in the interpretation of meta-analysis, a reduced risk of falls has been attributed to vitamin D supplementation due to direct effects on muscle cells. Finally, a low vitamin D status is consistently associated with the frail phenotype. This is why many authorities recommend vitamin D supplementation in the frail patient.
 
J Clin Endocrinol Metab. 2015 Jun;100(6):2480-8. doi: 10.1210/jc.2015-1353. Epub 2015 Apr 9.

Thresholds for Serum 25(OH)D Concentrations With Respect to Different Outcomes.

Sohl E1, de Jongh RT1, Heymans MW1, van Schoor NM1, Lips P1.



Abstract
CONTEXT:
Vitamin D is essential for bone health. In addition, vitamin D has recently been proposed to play a role in the pathophysiology of many chronic diseases. Despite the large number of studies published on vitamin D, the threshold for a sufficient serum 25-hydroxyvitamin D [25(OH)D] concentration is still debated and may differ according to outcomes and subgroups.

OBJECTIVE:
The objective of the study was to estimate the thresholds for serum 25(OH)D concentration with respect to the different outcomes and for different subgroups.

DESIGN, SETTING, AND PARTICIPANTS:
Observational data from the Longitudinal Aging Study Amsterdam, an ongoing population-based Dutch cohort study [n = 1164, mean (SD) age 75.2 (6.5) y], were used.

MAIN OUTCOME MEASURES:
Falling, fractures, hypertension, cardiovascular disease, blood pressure, PTH, grip strength, physical performance, functional limitations, body mass index (BMI), and mortality were measured. To determine thresholds, spline curves were used. Visual inspection and the statistical best fit of the spline regression models were used together to estimate the best estimate of the thresholds.

RESULTS:
Thresholds for serum 25(OH)D concentrations in the whole sample ranged from 46 nmol/L (PTH) to 68 nmol/L (hypertension). On average, women, the oldest old (&#8805; 75 y), and individuals with a high BMI (>25 kg/m(2)) had lower thresholds compared with men, the youngest old (65-75 y), and individuals with a low to normal BMI (<25 kg/m(2)).

CONCLUSION:
The results indicate that thresholds for serum 25(OH)D may vary according to different outcomes and subgroups. This study does not support the high thresholds (>75 nmol/L) as advised by some experts, and the higher requirements in women, older persons, and those with high BMI.
 
J Clin Endocrinol Metab. 2015 Jun;100(6):2339-46. doi: 10.1210/jc.2014-4551. Epub 2015 Feb 24.

A Reverse J-Shaped Association Between Serum 25-Hydroxyvitamin D and Cardiovascular Disease Mortality: The CopD Study.

Durup D1, Jørgensen HL1, Christensen J1, Tjønneland A1, Olsen A1, Halkjær J1, Lind B1, Heegaard AM1, Schwarz P1.


Abstract

CONTEXT:
Cardiovascular disease is the major cause of death in the Western world, but the association between 25-hydroxyvitamin D [25(OH)D] levels and the risk of cardiovascular disease mortality remains unclear.

OBJECTIVE:
The objective of the study was to determine the association between cardiovascular, stroke, and acute myocardial infarct mortality and serum levels of 25(OH)D.

DESIGN:
This was an observational cohort study, the Copenhagen vitamin D study, data from a single laboratory center in Copenhagen, Denmark. Follow-up was from 2004 to 2011.

SETTING:
Serum 25(OH)D was analyzed from 247 574 subjects from the Copenhagen general practice sector.

PARTICIPANTS:
Examination of the association 25(OH)D levels and mortality from cardiovascular disease, stroke, and acute myocardial infarct was performed among 161 428 women and 86 146 men.

MAIN OUTCOME MEASURES:
A multivariate Cox regression analysis was used to compute hazard ratios for cardiovascular, stroke, and acute myocardial infarct mortality.

RESULTS:
Of 247 574 subjects, a total of 16 645 subjects died in the ensuing 0-7 years. A total of 5454 died from cardiovascular disease including 1574 from stroke and 702 from acute myocardial infarct. The 25(OH)D level of 70 nmol/L was associated with the lowest cardiovascular disease mortality risk. Compared with that level, the hazard ratio for cardiovascular disease mortality was 2.0 [95% confidence interval (CI) 1.8-2.1] at the lower extreme (∼ 12.5 nmol/L) with a higher risk for men [2.5 (95% CI 2.2-2.9)] than for women [1.7 (95% CI 1.5-1.9)]. At the higher extreme (∼ 125 nmol/L), the hazard ratio of cardiovascular disease mortality was 1.3 (95% CI 1.2-1.4), with a similar risk among men and women. Results were similar for stroke and acute myocardial subgroups.

CONCLUSIONS:
In this large observational study, low and high levels of 25(OH)D were associated with cardiovascular disease, stroke, and acute myocardial mortality in a nonlinear, reverse J-shaped manner, with the highest risk at lower levels. Whether this was a causal or associational finding cannot be determined from our data. There is a need for randomized clinical trials that include information on the effects of 25(OH)D levels greater than 100 nmol/L.
 
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