Vitamin D deficiency is often accompanied by symptoms and diseases that are casually dismissed as “old age.”
What sometimes appears to be rapid physical and cognitive deterioration associated with aging, vitamin D proponents argue could be avoided with supplementation. Vitamin D deficiency has been linked to osteoporosis, cardiovascular disease, cancer, diabetes, autoimmune diseases, and depression. A majority of the population worldwide is vitamin D deficient.
Unlike other conditions, vitamin D deficiency has no clear list of symptoms because it’s not a diagnosis in itself—but a root cause. That means its symptoms—like fatigue, weakness, brain fog, and anxiety accompany a plethora of diseases that coexist with vitamin D deficiency, which may even be lurking with no symptoms at all. By the time you experience bone pain, you’re likely severely deficient in vitamin D.
The only way to know for sure if your vitamin D level is low is to test, but the test isn’t always covered by insurance and Medicare rarely pays for them—assuming a doctor recommends a test in the first place. One test costs $30-$100. There’s also no universal lab value that offers meaningful guidance to those who want to protect themselves against the list of diseases associated with low vitamin D.
Research has shifted and swayed, confusing patients and even doctors who may suffer analysis paralysis. But there are specific findings applicable—especially to seniors—that indicate supplementing with vitamin D does make a difference.
Understanding Vitamin D Levels
The first step is to test, rather than guess, your vitamin D levels. The test is for your 25 (OH)D, which stands for calcidiol 25-hydroxycholecalciferol, shortened to the “25-hydroxy vitamin D test.” Vitamin D, which acts more like a hormone than a vitamin, helps control calcium and phosphate levels in the body.
A group of 48 vitamin D scientists in a D*action report recommends that all people of every age need to reach and maintain a 25 (OH) D serum level of between 40–60 nanograms/milliliter (ng/ml) for optimal health. A 2017 report in Nature Reviews Endocrinology said despite varying recommendations from medical organizations, all of them agree that anything under 10 ng/ml should be avoided at all ages.
The aging process is complicated by vitamin D deficiency, in part because it becomes more difficult to synthesize vitamin D from the sunlight as we get older. Intake of vitamin D from foods like salmon, tuna, milk, eggs, pork, and beef liver is also lower in senior years. We know most older adults are deficient, but what to do about it has become a medical stumbling block.
It’s an issue that’s been complicated to the point of controversy as research creates new, confusing headlines every few months. Even a quick glance through undated articles on Today’s Geriatric Medicine’s website doesn’t settle questions about the benefits of vitamin D, who should take it, and how much they should take.
On top of this, the number of stories on vitamin D dangers and toxicity seem disproportionate to the actual risk. There is a small group of people who don’t tolerate vitamin D supplementation, which is why levels should be monitored by lab testing and a physician.
How Much Is Enough?
The Institute of Medicine last set standards in 2019 for a tolerable upper limit dose of vitamin D at 4,000 International Units (IU) per day, while the Endocrine Society around the same time recommended 10,000 IU per day as the upper limit.
The National Institutes for Health recommendation is 600 IU daily for people 51 to 70 and 800 IU for those over 70 but not more than 4,000 IU each day. But whether that will allow a patient to reach a serum level of 25 ng/ml is a case-by-case basis. The Epoch Times recently reported on the trend of higher doses of vitamin D being used for incurable diseases, and research shows there are benefits to getting the level between 40-60 ng/ml.
Dosing is more of an art than a science, as a 2017 study in Dermato-Endocrinology noted. One goal of the study was to achieve an average serum level of 40 ng/ml among the 3,882 participants. Another goal was to closely study toxicity.
Participants at the beginning of the study were taking an average of 2,100 IU vitamin D daily with an average serum level of 35 ng/ml. The researchers found it required 6,000-7,000 IU (depending on weight) to achieve a vitamin D level of 40 ng/ml. At the end of the study, the average serum level for all participants was 51 ng/ml. Vitamin D intakes of up to 15,000 IU per day were found safe in the study.
Dr. Ellie Campbell, an integrative primary care specialist, told The Epoch Times that her level was under 20 ng/ml when she first checked in 2006, and it took her 1.6 million IUs of vitamin D to reach a level above 50 ng/ml. Since then, she has found that it takes 5,000 IUs daily to keep it at that level.
Many patients aren’t aware of their vitamin D levels, and it frustrates her that labs report levels of 25 ng/ml and 30 ng/ml as “normal.”
“Normal is determined by a scattergraph by the last 100 or so specimens,” Campbell said. “They’re not reporting optimal.”
There are at least four reasons elderly populations should consider vitamin D supplementation.
1. Vitamin D Lowers the Risk of Dementia
A new study examining the vitamin D supplementation habits of 12,388 participants from the National Alzheimer’s Coordinating Center data found it significantly lowered dementia. Results were published this month in Alzheimer’s & Dementia: Diagnosis, Assessment and Disease Monitoring.
Among the nearly 3,000 who developed dementia over the decade-long study, 75 percent had no vitamin D and the other 25 percent had only baseline exposure. Overall, the study found vitamin D was associated with a 40 percent lower risk of dementia.
There are currently about 50 million people living with dementia worldwide, a number that’s expected to triple by 2050, according to the study.
Professor Zahinoor Ismail of the University of Calgary and the University of Exeter, who led the research, said in a news release:
“We know that vitamin D has some effects in the brain that could have implications for reducing dementia, however, so far, research has yielded conflicting results. Our findings give key insights into groups who might be specifically targeted for vitamin D supplementation. Overall, we found evidence to suggest that earlier supplementation might be particularly beneficial, before the onset of cognitive decline.”
2. Vitamin D Reduces Recurrent Vertigo
A study published in 2020 in Neurology found that those who took a minimum of 20 ng/mL of vitamin D, along with calcium, reduced their chances of recurrent episodes of benign paroxysmal positional vertigo, the most common type that happens when a change in head position causes a spinning sensation.
Conducted in Korea, the study compared a group of 445 people taking vitamin D to 512 people in an observation group that didn’t receive supplements or have their levels monitored. There was a 24 percent reduction in the annual recurrence rate for those who took vitamin D, according to a news release about the study.
Traditional treatment involves a physical movement performed by a doctor that shifts the particles in the ear that are causing the vertigo, which can contribute to falls, fractures, and head trauma.
“Our results are exciting because so far, going to the doctor to have them perform head movements has been the main way we treat benign paroxysmal positional vertigo,” said Dr. Ji-Soo Kim of Seoul National University College of Medicine in Korea. “Our study suggests an inexpensive, low-risk treatment like vitamin D and calcium tablets may be effective at preventing this common, and commonly recurring, disorder.”
3. Vitamin D Helps Prevent Cancer
When it comes to advanced cancer, vitamin D supplementation can extend life, according to a 2020 study published in the Journal of the American Medical Association. In a clinical trial of 25,871 patients, vitamin D reduced the risk of metastatic or fatal cancers in those with a normal body mass index.
The Vitamin D Council highly recommends women with breast cancer take 5,000 to 15,000 IU per day of vitamin D and check levels to ensure it stays above 70 ng/ml. For prevention, the level recommended is 60 ng/ml. Several studies show a benefit associated with reducing breast cancer.
Because of a family history of cancer, Campbell said she’s adamant about keeping her vitamin D levels high. Depending on dosing, vitamin D was shown to lower breast cancer risk from 30 percent to 83 percent at an American Association for Cancer Research Annual Meeting in 2008.
“There’s no drug on the market that can lower your breast cancer risk to that level,” she said. “Everyone should know about this.”
4. Vitamin D Reduces Falls and Fractures
Older studies show as much as a 72 percent reduction in falls among those with higher vitamin D levels in nursing homes. On the other hand, a recent and highly publicized study in The New England Journal of Medicine concluded no correlation between vitamin D and fractures in older adults.
Critics of that study, which had dosing inconsistencies, as well as a few other 2022 studies say there’s a distinct benefit for taking vitamin D. One of those studies in the Journal of Bone and Mineral Metabolism reviewed 28 studies of 61,744 cases and 9,767 hip fractures, and concluded that low serum vitamin D levels in the elderly are associated with an increase in the risk of hip fracture.
“What a difference we could make to the nursing home population because they fall less often,” Campbell said. “It’s one of the cheapest, easiest interventions. If we push those levels to where the science tells us it should be, our patients are recipients of the benefits.”
The New England Journal of Medicine study received plenty of publicity, but it’s drawn some criticism, too. Participants in the trial were given an initial high dose of vitamin D and then received a smaller daily dose of 2,000 IUs, while the placebo group was permitted to take up to 800 IUs per day. Grassroots Health was critical of this type of research for creating skepticism and preventing optimal dosing.
Additional research has found that not only does low vitamin D translate to more falls, but is also associated with muscle weakness and pain, and gait disorders. Meanwhile, data demonstrated that those with a level of 25 OHD and higher had better use of their lower extremities.
The Vitamin D Council keeps an updated list of conditions that may benefit from using this hormone, along with links to studies. Grassroots Health also has information about vitamin D, testing, levels, and transformation stories.