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NEW Vitamin D-3 Drops and Vitamin D-3 Softgels

October 22, 2014 Leave a comment
Cooper Complete Vitamin D-3 Softgels

Cooper Complete Vitamin D-3 Softgels

This Fall Cooper Complete® Nutritional Supplements has given our Vitamin D consumers an extra dose of attention. Cooper Complete Vitamin D-3, our vitamin supplement, has changed forms from an orange colored tablet to a softgel. If you’ve been taking Vitamin D-3 in tablet form, the item number (and SKU) remain the same.

Why the change? The softgel allows us to provide the same 1,000 IU Vitamin D-3 in a form that has fewer “other ingredients” which provides a more pure supplement.

We’ve also added a new product, Cooper Complete Vitamin D-3 Drops. Why another Vitamin D from Cooper Complete? The team of physicians at Cooper Clinic made this recommendation. If you’ve been to Cooper Clinic any time since 2008, you know that vitamin D testing is part of the laboratory analysis. Because food forms of vitamin D are pretty limited and prescribing prolonged sun exposure can be problematic for most folks, individuals with vitamin D levels that are less than optimal (anything less than 30 ng/mL) get supplements.

Unlike a prescription Z-Pak (Zithromax) where one-size-fits-all, this is not the case for Vitamin D—the amount I need compared to what you need may be wildly different. For some, the 2,000 IU Vitamin D that’s in each of the Cooper Complete Multivitamin is plenty, for others, an extra 1,000 IU Vitamin D does the trick. And then there are the rest of us—who may need an additional, 2,000-5,000 or more per day! So, enter Vitamin D-3 Drops, a multi-size solution.

Cooper Complete Vitamin D-3 Drops

Cooper Complete Vitamin D-3 Drops

The Vitamin D-3 Drops bottle looks like an over-sized bottle of dry eye moisturizer. Unlike dye eye “tears” that are very runny, the D-3 Drops are a thick emulsion and it requires a bit of pressure and squeeze of the bottle to get a single drop dispensed. Each drop is 1,000 IU of Vitamin D-3, so depending upon how much vitamin D-3 your doctor has prescribed; you simply squeeze out the required number of drops. The bottle contains a whopping 750 droplets.

Vitamin D-3 Drops are perfect for:

  • Those who dislike or have difficulty swallowing pills
  • Those who need significant levels of vitamin D

This product is not ideal for:

  • Those who have manual dexterity or weak motor skills
  • Those who like to have their prescriptions and supplements organized in pill containers (as there is nowhere to put the bottle)

The official dosing instructions for Cooper Complete Vitamin D-3 Drops are to squeeze as many drops as needed directly onto the tongue. The drops are not completely flavorless, but the flavor is honestly not off-putting. Because vitamin D is fat-soluble, for optimal absorption, you should take this (and all multivitamin and mineral supplements) with a meal that contains some fat. If squeezing drops onto the tongue is difficult or off-putting, we offer these alternatives:

  • Dispense on top of a cracker or Saltine.
  • Dispense on top of a spoonful of yogurt, applesauce, or other cool or room temperature food
  • Do not add to water—vitamin D is fat-soluble and will sink to the bottom of the cup where it will stay.
  • Do not add to coffee or other hot beverages—vitamin D will dissolve and will also be lost in the process.

The shelf life of Vitamin D-3 Drops is one year and our existing supply is good through July, 2015.

Whether you choose to take Vitamin D-3 Softgels or Vitamin D-3 Drops, both forms are equally absorbed in the body. Visit coopercomplete.com to purchase or call 888.393.2221 today.

A Healthy Start to College

Taking the right nutritional supplement for you is an important element in living a Cooperized lifestyle.

By: Karen Perkins, Account Executive, Cooper Concepts Inc.

As your child prepares to leave the nest and head off to college, there is no doubt that they are preparing for a season in their life unlike any other. The flexible schedule, opportunities to learn and try new things, thriving campus life, and close proximity to peers creates the perfect platform on which countless memories will be made. With so many exciting elements of this transition on you and your student’s mind, we want to remind you to help set your child up for a healthy semester.

It can be hard for college students to stay healthy. Crowded dorms and classrooms, along with reduced sleep and added stress often leave their immune systems trying to play catch-up. Dr. Cooper recommends eight healthy steps that make up a well-rounded, healthy life. One of the healthy steps to Get Cooperized is taking vitamins and supplements. So while your child may have outgrown taking a chewable Flintstone vitamin with their Fruit Loops® in the morning, it might not be a bad idea to continue to ask, “Have you taken your vitamins today?”

Cooper Complete® Health Body Pack
We recommend the Cooper Complete® Health Body Pack. Each canister contains 30 individually wrapped cellophane packets with a Basic One Iron-Free one-tablet-per-day multivitamin and the daily recommended amount of omega-3. Having the supplements individually packaged makes them perfect for the on-the-go lifestyle of your student. It’s easy to grab a packet and put it in a backpack, purse, or pocket to take with a meal. Plus the packets remove guesswork and thinking—simply take one packet-full per day with any meal. That’s easy to remember.

Why Basic One Iron-Free?
Most nutrition experts agree that a balanced, nutritious diet is the best way to obtain needed nutrients. The recommended amount of fruits and vegetables per day is five servings (nine is even better!), yet the average teenager only eats 1.6 servings! A recent report from the University College London stated that eating seven or more portions of fruits and vegetables a day reduces your risk of death at any point in time by 42 percent compared to eating less than one portion. Supplements are not intended to replace a healthy diet and lifestyle, but taking a multivitamin can provide a convenient way to “bridge the nutritional gap” and address micronutrient inadequacies that may well occur when your child is suddenly away from home. Also, while girls tend to stop growing sooner, it is possible that your son’s body is still growing and developing. This makes it even more important for them to obtain the proper nutrients. Here are a few of the vitamins included in Basic One Iron-Free.

Vitamin A promotes normal bone growth and tooth development, healthy skin and assists in night and color vision.

Vitamin C helps the body absorb iron, strengthens connective tissue, muscles and skin and increases resistance to infection.

Vitamin D promotes tooth and bone formation and aids in the absorption of minerals like calcium. While you can get vitamin D naturally from sunlight, a study by Weill Cornell Medical Center found one in seven adolescents were vitamin D deficient. Cooper Clinic suggests at least 2000 IU per day which is the amount in our daily multivitamin.

Why Advanced Omega-3?
Omega-3 has shown to help with brain health (reduce depression) and heart health. The American Heart Association recommends eating fatty-fish such as salmon at least two times per week. One study found that fish oil (in foods or supplements) cut the risk of death from cardiovascular disease by 32 percent. Buying fish can be expensive and is generally not conducive to the typical college lifestyle so taking an omega supplement is highly recommended.

When you’re preparing the next care package for your college student, sneak in a Cooper Complete Healthy Body Pack to keep them on track. For more information about Cooper Complete products, click here.

How Do Blood Tests Fit Into the Comprehensive Exam?

Cooper Clinic’s in-house lab provides same-day results for the patient to review with their physician.

We began a blog series to define the components of the standard-six comprehensive preventive exam at Cooper Clinic with, ‘What Does a Comprehensive Exam Entail?.’ In this post, we introduced the series and covered the first of six components, Medical Exam & Counseling. Our second component of six is Laboratory Analysis.

Component #2: Laboratory Analysis

Comprehensive lab testing includes cholesterol profile, blood sugar level, complete blood count, homocysteine, urinalysis, high sensitivity C-reactive protein, thyroid stimulating hormone, vitamin D, omega-3 and other important tests. Cooper Clinic’s in-house lab provides same-day results for our physicians to review with the patients. Depending if the patient is new or returning, we examine up to 70 blood tests.

There are a number of risk factors for the development of chronic disease that can only be identified by blood tests. You certainly would not want to find out that you have high cholesterol by having a heart attack!

Cholesterol
A complete cholesterol panel is an important test for prevention. Knowing the numbers in your cholesterol profile (total cholesterol, HDL (good) cholesterol, LDL (bad cholesterol) and triglycerides) helps define your risk for heart disease and stroke.

Almost 32 million adults have significantly high cholesterol levels (≥240 mg/dL). More than one of four adults has high triglyceride levels (risk factor for heart disease and stroke). An HDL cholesterol level <40 mg/dL in adult males and <50 mg/dL in adult females is considered low and is a risk factor for heart disease and stroke; about half of all adults have an HDL cholesterol < 52 mg/dL. What side of 52 mg/dL median level is your HDL? Given that in more than a third of patients, the very first sign of heart disease is death, this is definitely a chronic disease you want to prevent.

Fasting Blood Sugar
A fasting blood sugar measurement and a hemoglobin A1C measurement (which estimates your average blood sugar over the last three months) are important tests for prevention. An estimated 20 million American adults have been diagnosed with diabetes (fasting glucose ≥ 126 mg/dL). Another eight million adults have full blown diabetes, but don’t know it. More than 87 million adults (38 percent of the population) have prediabetes (fasting blood glucose 100-125 mg/dL). If you have prediabetes, you can take active steps in improving lifestyle to significantly lower your risk of developing full blown diabetes. Given that the presence of diabetes can result in vision loss, kidney dysfunction, heart attacks, strokes, poor circulation and amputations, this is definitely a chronic disease you want to prevent.

Kidney disease is another chronic condition that is detected by changes in blood work long before symptoms occur. More than 26 million adults (13 percent of the population) have chronic kidney disease and many do not even know it. Another 20 million are at risk for developing kidney disease because they have risk factors for kidney disease like diabetes or high blood pressure. Chronic kidney disease is a risk factor of heart disease and stroke.

The sooner you know if your kidney blood tests are abnormal, the sooner you can take proactive steps to protect your kidneys from further damage. Given that chronic kidney disease may require treatment with dialysis or kidney transplantation, this is another chronic disease you can prevent.

Vitamin D
Vitamin D is a fat-soluble vitamin that has helps keep calcium and phosphate levels in the blood normal which is important for healthy bones. Although more research is needed in these areas, preliminary studies have demonstrated that vitamin D deficiency is associated with increased risk of death from all causes, cardiovascular events including sudden cardiac death and stroke, diabetes, hypertension and impaired function of the immune and musculoskeletal system.

If you visit clinicaltrials.gov, where all on-going clinical trials are listed, and search vitamin D, you will see that vitamin D deficiency and vitamin D supplementation is being studied in countless conditions including  preventing diabetes, improving periodontal (gum disease), reducing hot flashes and improving fatigue! It is clearly the “it” vitamin of this decade.

Vitamin D is made in the skin in the presence of sun exposure. We can also get vitamin D from natural sources like fatty fish (less commonly) and more commonly from fortified foods (milk, breads and cereals). Despite the fact that sun exposure is not hard to come by and that fortified foods are generally available, vitamin D deficiency is shockingly common. A recent national survey of American adults (NHANES survey) identified that 42 percent of adults were vitamin D deficient.

Identifying vitamin D deficiency is simple (with a single blood test) and improving vitamin D levels is  easy too once you know you need to do it! Given the myriad of on-going clinical trials  involving vitamin D, who knows how many chronic diseases vitamin D levels may influence.

To learn more about a preventive exam at Cooper Clinic, click here or call 866.906.2667 (COOP). Stay tuned for the third component within the exam, cardiovascular screening.

Dr. Cooper’s Response to Recent Vitamin Studies

December 17, 2013 9 comments

Dr. Cooper continues to provide insight as an inspiring authority in preventive medicine.

In a new editorial in Annals of Internal Medicine (Dec. 16, 2013), physicians warn that “most supplements do not prevent chronic disease or death, their use is not justified and they should be avoided.”

We spoke to our own Kenneth H. Cooper, MD, MPH, on this topic and here are his thoughts:

I’m a strong believer in objective scientific research. In 1984 it was said that exercise did nothing but make you feel good. In the 1970s I began my work to prove that exercise is medicine. Today with our over 600 research articles published on the subject [at The Cooper Institute] we can say for certain that exercise is medicine and has health benefits. On exercise we have bridged the gap between faddism and scientific legitimacy.

I feel that we are in the same place today on the subject of vitamin supplementation as we were 25 to 30 years ago on exercise. It’s my opinion that we should try to prove or disprove the use of vitamin supplementation with objective research.

Recent studies, including those in the Annals of Internal Medicine article are not objective science. The reason is that in nearly all these studies researchers do not measure the blood level of vitamins to determine whether a person needs a vitamin or not. Researchers arbitrarily put study participants on a supplement and compare them to those on a placebo.

In our studies on vitamins B12, D and omega-3 (conducted over the last eight years) we have looked at blood levels and show that they vary tremendously. Some people taking no supplements have a very high level of certain vitamins and some people taking supplements have a very low blood level of vitamins. At Cooper Clinic we treat vitamins like any drug we prescribe. We measure the blood level and recommend vitamin dosages to get blood levels up to satisfactory levels. In my opinion that’s how a vitamin has to be prescribed. In addition, we are studying the long-term benefits of these vitamins in our practice of preventive medicine.

The benefits of vitamins are well documented in scientific literature. For example:

  1. Vitamin D supplementation reduces fractures from falls in the elderly (as shown in most studies).
  2. Vitamin D deficiencies can be a factor in osteopenia and osteoporosis and supplementation can be used to treat it.
  3. Vitamin D deficiency may be related to Multiple Sclerosis and in some clinics, high doses of vitamin D are being used to treat it.
  4. Vitamin B6 in some cases has been effective in treating carpal tunnel syndrome.
  5. Omega-3 supplementation has been approved by the FDA to lower blood triglyceride levels.
  6. Niacin (vitamin B3) is used to lower total cholesterol and to increase HDL (good) cholesterol.
  7. Folic acid deficiencies in women have been known to result in spinal bifida and neural tube defects in the newborn.
  8. Vitamin B12 is used as a treatment to correct pernicious anemia and is a factor in cognitive dysfunction in the elderly.
  9. Folic acid, B6 and B12 have been shown to lower Homocysteine levels, hopefully a beneficial effect on reducing the frequency of heart attacks and stroke.
  10. Niacin (vitamin B3) has been used to reduce the frequency of some cancers.

I believe that in order to practice responsible medicine we cannot make a broad based statement about vitamins. If every American ate between five to nine servings of fruit and vegetables a day we would not need additional vitamin supplementation. However, because the average American adult eats 3.1 servings of fruits and vegetables and the average teenager gets 1.6 servings, levels of vitamins in the blood can be low and supplementation becomes necessary.

While we can never replace a good diet, I continue to recommend vitamins as insurance for people who don’t follow the recommended daily serving of fruit and vegetables.

To learn more about Dr. Cooper’s work in preventive medicine as the ‘father of aerobics’, click here.

Prevent Fractures From Falls With Vitamin D Supplementation

October 23, 2013 1 comment

Sunshine vitamin DNews reports have picked up the story about a recent meta-analysis on vitamin D, and headlines have read: “Vitamin D doesn’t aid the prevention of Osteoporosis.” A meta-analysis (Effects of vitamin D supplements on bone mineral density: a systematic review and meta-analysis) conducted by researchers at the University of Auckland in New Zealand and published in The Lancet earlier this month looked at 23 vitamin D studies. The studies totaled 4,082 generally healthy people (92 percent female) with an average age of 59 years. Bone mineral/density was studied at one to five sites in each study, with the sites being lumbar spine, femoral neck, total hip, femur, total body or forearm. Participants took 500-800 International Units (IUs) of vitamin D per day. Results of the meta-analysis showed a small benefit at the femoral neck in bone density, but no other areas. The lead author of the study, Dr. Ian R. Reid, said “for healthy people focused on osteoporosis prevention, vitamin D does not make a positive contribution.”

While this meta-analysis didn’t find vitamin D to be helpful in managing osteoporosis, the study doesn’t review vitamin D levels and the potential for falls. In May, 2012, the U.S. Preventive Services Task Force (USPSTF) recommended exercise or physical therapy and vitamin D supplementation to prevent falls in community dwelling adults 65 years or older who are at increased risk for falls.

Falls are the leading cause of injury in community dwelling adults 65 years or older, and 30-40 percent of adults 65 years or older fall at least once per year! Fractured bones are the result of approximately 5 percent of these falls, and two meta-analyses have found that vitamin D prevents fractures. Low vitamin D levels increases fracture risk. It has been estimated that as many as half of the older adults with hip fractures could have vitamin D levels below 30 ng/mL. (Optimal vitamin D is 30-100 ng/mL; suboptimal is 20-29 ng/mL and lower than 20 ng/mL is insufficient. Dr. Cooper likes to see levels 40-60 ng/mL in patients.)

Adult Cooper Complete multivitamins contain 2,000 IU vitamin D, and a standalone 1,000 IU Vitamin D tablet for individuals who need higher supplementation to get to an appropriate level.

Since falling is such a risk for older adults, it makes sense to stay aware of vitamin D levels through an annual blood test and to supplement as appropriate to get levels where they need to be. In addition, as Dr. Cooper has long advocated, it makes sense to commit, at every stage of life, to move and exercise like your life depends on it.

For our latest recommendations subscribe to our free e-newsletter The Cooperized here.

Vitamin D and Calcium Researcher, Robert Heaney, MD, is Interviewed

March 15, 2013 Leave a comment
Robert Heaney, MDDepartment of Medicine at Creighton University | Vitamin D & Calcium Researcher

Robert Heaney, MD
Department of Medicine at Creighton University | Vitamin D & Calcium Researcher

Below is a transcript from Todd Whitthorne’s interview with Dr. Robert Heaney, professor in the Department of Medicine at Creighton University in Omaha.  Dr. Heaney has spent over 50 years in the study of osteoporosis, vitamin D, and calcium physiology; he’s authored three books and has published over 400 scientific papers, so when it comes to the world of vitamin D, and calcium in particular, Dr. Heaney is one of the leading gurus, literally, in the world!  Click here to listen to the interview, or continue reading for the transcript.

Todd Whitthorne

This is Todd Whitthorne and I’m very pleased today to be joined once again by Dr. Robert Heaney, who is a professor in the Department of Medicine at Creighton University in Omaha.  Dr. Heaney has spent over 50 years in the study of osteoporosis, vitamin D, and calcium physiology; he’s authored three books and has published over 400 scientific papers, so when it comes to the world of vitamin D, and calcium in particular, Dr. Heaney is one of the leading gurus, literally, in the world!  So Dr. Heaney thanks again for joining us.

Robert Heaney, MD

My Pleasure.

Todd Whitthorne

It’s certainly a pet peeve of mine, and I know it is one of yours as well, and that’s primarily the media – how they love to focus on harm, or potential harm, as opposed to the overwhelming benefits of certain topics, and what I’m primarily referencing is the of the recent headlines from the US Preventive Services Task Force saying that postmenopausal women should avoid taking low daily doses of vitamin D   and calcium to ward off bone fractures. They say that those amounts have no benefit for the primary prevention of fractures, but there is evidence that taking them could increase the likelihood of kidney stones. I know they released this last summer, and then it suddenly got another whole round of headlines, and I’m getting calls and e-mails with all sorts of questions about it and it drives me a little bit nuts! What about you?

Robert Heaney, MD

Well, yes, it was originally published in draft form in June of last year and that elicited a lot of media reaction because as you correctly point out the media love controversy, and if this seems to contradict the accepted wisdom then that’s considered newsworthy. However, it tends to get exaggerated. The current recommendations, which are essentially the same as the draft form nine months ago. The current recommendations are really quite confusing because they do recommend taking calcium and vitamin D for the prevention of falls in the elderly, but they don’t recommend it for the prevention of fractures.  Well, so what’s a person to do?  Well obviously what the person should do is continue to take calcium and vitamin D supplements.

What they mean when they say they don’t recommend is not saying you shouldn’t do this,  it’s saying we don’t have the evidence to permit us to recommend this to you, and the kind of hidden subtext is “well it could be helpful, but we just don’t know.” Now in fact a lot of experts in the field feel they do know as a matter of fact…

Todd Whitthorne

I was going to say! What they know is not what you know, is it?

Robert Heaney, MD

Exactly, or right! And it’s worth pointing out  that the Preventive Services Task Force consists of public health people, not one of whom, to my knowledge, and I recall I checked his last June, not one of them has ever published a scientific paper on calcium or vitamin D.  I mean, they’re given a task, and the task is apply a certain set of rules to a set of published papers, and see if that constitutes evidence to make a formal recommendation, and if it doesn’t meet the standards of those rules, then they say “well, we can’t recommend.” But it’s very important that they’re not recommending against something, they’re simply saying they can’t recommend “for” it and there’s a big difference.

Todd Whitthorne

I understand. From a controversy standpoint, going back looking at PSA (Prostate-Specific Antigen Test) or mammograms, it’s not the first time that the US Preventive Services Task Force seems to be in conflict with a lot of the research world. But let me ask you in general, can calcium and vitamin D supplements increase the risk of kidney stones? What are your thoughts?

Robert Heaney, MD

No. No. No. I’m glad you asked that question. The truth is exactly the opposite. It’s been shown in good experimental studies, that increasing calcium intake decreases the risk of kidney stones. Now, I’m sure many people find it counterintuitive because kidney stones are made from calcium, and I must have too much calcium in my body and so I should cut down my calcium intake. Well, it’s been shown that if you do this you’ll double your risk of getting a recurrence of the kidney stone.  There was a wonderful study from Italy published eight to ten years ago now published in the New England Journal of Medicine describing the results of precisely such a study, and they had a set of male kidney stone formers and half of them were put on a low calcium diet, and the other half were asked to increase their intake of calcium, cheese and stuff you know, and those who increased their intake had half the recurrences of those who restricted their intake, and that fits the biology. The reason for that, as we may have discussed previously Todd, is that one of the principal risk factors for kidney stones is a chemical compound called oxalic acid or oxalate, the salt form of oxalic acid, and some of that comes into us into our body through our diet, through food. Well, oxalate is a very potent stone former, it’s a more important stone former than calcium, and if you have a high calcium intake by mouth, much of that calcium stays in your intestinal tract and combines with oxalate in food and prevents the oxalate from being absorbed into your body, and therefore doesn’t have to be excreted to the kidney…, and therefore it’s not in the urine to predispose to kidney stone formation.

Todd Whitthorne

I see.

Robert Heaney, MD

There’s very  good biology behind this, and lots of experimental data, and it does seem kind of counterintuitive, and many doctors don’t know what to tell you to do if you have kidney stones, so they say well you better cut out your milk or dairy or calcium supplements, or whatever the source may be.  But that’s actually bad advice, and we have to try to counter that, so no, it does not cause kidney stones.

The reference there is a single paper that came out of the Women’s Health Initiative in which in the group receiving calcium and vitamin D supplements there was a seventeen percent increase in risk of kidney stones. Seventeen percent – not very big.  But in fact if you look at the other segments of the Women’s Health Initiative Study, they had exactly the same kidney stone risk as this group that got the calcium and vitamin D supplements. So there really is no strong evidence there, and all the other evidence is in the other direction. It’s also worth noting that the vitamin D dose prescribed in the Women’s Health Initiative was only 400 IU (international units ) per day, and it’s worth noting that the compliance with the medication in the Women’s Health Initiative is only fifty percent.

Todd Whitthorne

Goodness.

Robert Heaney, MD

So that means on average, these people were getting only 200 IU (international units) of vitamin D –  that’s not capable of doing anything, good or bad! That’s such a tiny dose, that it couldn’t possibly make any difference. But that’s the only evidence they had to go on.  The point is that it was a big government study, and the US Public Services Task Force has these strong government connections so one talks to the other and they kind of feed off of one another. But the data points in exactly the opposite direction.

Todd Whitthorne

Well that’s very helpful, and you’re very clear in allowing us to understand exactly how that happens. One other headline Dr. Heaney, that I want to mention, and I’m sure many people have asked you about is the risk of calcium supplementation in terms of increasing the risk of heart attacks. What are your thoughts on that?

Robert Heaney, MD

Well, thank goodness that you don’t have to rely on my thoughts – that’s been clearly refuted in papers and major scientific journals in the last six months to twelve months, but mostly since last fall, and there’s always lag time because when those things came out, this was a group of New Zealand investigators who had seemingly found this kind of an effect in the study they did, and they’ve gone around the world with kind of an evangelistic  fervor to tell people to be careful this could be making them worse by giving them heart attack.  Well is a total re-analysis of big studies like the Women’s Health Initiative in this case, again, shows that this simply wasn’t true. It’s not just that it wasn’t found in the Women’s Health Initiative, but the New Zealand investigators had gone into the NIH database and had kind of cherry picked or preferentially selected some of the cases from the Women’s Health Initiative and used that to support their thesis. So, it was very important, therefore, that the people who had access to, and in a sense control of, the entirety of the data of the Women’s Health Initiative, repeat their analysis and they did, and they published that last fall and the answer is there’s nothing there.

Todd Whitthorne

That’s great news.

Robert Heaney, MD

So, the problem is that if you eat if you stopped taking calcium because of fear of a heart attack then the chances are you’ve increased your risk of a hip factor, and so more harm has been done. And I think it’s very important to say we all need more calcium and we all need more vitamin D and there are some ways to get that, but you mustn’t worry about an increased risk of heart attack because the evidence shows it’s not there. It’s not just that there isn’t any evidence to show it is there, it’s actually the opposite, it’s not there at all – there is no reason to believe that.

Todd Whitthorne

One more question Dr. Heaney. I know you’ve spent a great deal of your life studying these topics. The recommendations now seem to be at least 2000 IU of vitamin D per day is a pretty good starting point for most people. I know you have commented and lectured frequently about the dosage of 2600 IU reduce risk of falls and fractures, as well as other medical issues, but still, there is a huge variability between a three and six fold variance in terms of how we as individuals react to vitamin D.  So what are your recommendations for both vitamin D and calcium for men and women?

Robert Heaney, MD

Well, I tend to swim against the stream a little bit here, and in this connection I should alert you to the fact that the US Preventive Services Task Force is once again looking at this vitamin D issue and raising the question of whether we should screen for vitamin D deficiency, and I’m quite sure that they’re going to come up with a “No, we shouldn’t.”  I know the American Society of Clinical Pathologist, in trying to be good citizens, but I think bending over backwards, have identified five tests that physicians should think twice about ordering because, they, in their judgment, are probably not very helpful, and one of them is measuring vitamin D status…, and I think that’s wrong. But that’s all kind of preamble to the answer to your question. The only way to tell whether you’re getting enough vitamin D is by measuring. You have to measure what’s in the blood, because as you pointed out, the response to a given dose varies over six-fold range. We think that that’s because  we think that that’s because different people have different capacities of the enzyme, probably mostly in their livers, that is responsible for converting vitamin D into the form that we measure in the blood stream, that is 25-hydroxyvitamin D. Some people are what I call very slow hydroxylaters, and others are every fast hydroxylaters, which means they have a lot of the enzyme necessary to do it, and in the other case means they don’t have much of the enzyme, so they don’t get as much for their vitamin D dose as somebody else does, and that means they need twice as much, or three times as much, or maybe even six times as much as the other person. We can’t tell that from looking at their forehead – there isn’t any UV or invisible ink on the backs of their hand you can scan with a UV lamp and see whether this person will need more or less.  A good place to start, as you say, is at 2000 IU (international unit) per day, and once you’ve done that we like to measure them three to six months later. If they’re up in a good range, we stick with 2000 (IU); if they’re not then we double it until we get them where we want them. But you can’t tell that without measuring, so I’m strongly in favor measuring.

Todd Whitthorne

Okay. How about (recommendations) for calcium?  Is there a difference between men and women? I know calcium is more challenging because there’s not a blood test for calcium like there is for vitamin D.

Robert Heaney, MD

There’s no way to assess calcium by a simple test. Vitamin D is really a wonderful nutrient in that regard as it permits measurement the status, and of the compound that the body is actually looking at and needs and uses. But we don’t have that for calcium as you correctly point out. Actually, this is a bit of a digression, but in all of these nutrient controversial areas, I take as my benchmark ancestral intake; that is, what did humans take before the agricultural revolution, surely before the Industrial Revolution, but before the agricultural revolution which was a giant change in the kinds of foods we ate. The natural vitamin D level under ancestral conditions would’ve been between 40 and 60 ng/ml. We know that because it is been measured in East African tribes that are following ancestral lifestyle, so I take as my benchmark, well I’m back in my blood level up to where it would have been had I been living under the more primitive circumstances.

Todd Whitthorne

Sure.

Robert Heaney, MD

And the reason for that is that our physiology has been fine tuned to what the environment provided during the millions of years in which the human body was developing, and human physiology was evolving. Different animals have different requirements everything. For example, rats and mice are primarily nocturnal animals and therefore don’t get vitamin D from the sun in usual way. They have very low requirements and they metabolize vitamin D very differently. But we grew up in equatorial East Africa that’s how we developed, so we were getting sun every day of the year, and of course we didn’t wear clothing and didn’t have a lot of fur, so we got a lot of vitamin D. Now when it comes to calcium, the best guess is that we probably were getting from 1500 to 2500 mg of calcium per day, and again, I’d like to take that as my benchmark. Now that doesn’t have to come in, in the form of supplements, it’s probably better if it’s taken in as food, but the important thing is to get it in.  The reason that it’s better as food is that with the decreased physical activity of the modern urbanized human,  we can’t consume as much food as we did before, and many of the foods available to us are calcium poor, and micronutrient poor, and if we provide just the calcium in the form of the supplements then we’re not taking care of the other micronutrients that are probably deficient in the same individuals. So, I’m a strong advocate of natural food sources of calcium, but there’s definitely a role for supplements and that’s to be what their name says they are – supplements. But there’s a lot of sense to people take nutrients in and in the sense of taking medicine for a specific endpoint all nutrients are necessary for all body tissues, and it’s a mistake to think of a single end point because what with both calcium and vitamin D, I can name dozens of systems that are adversely affected by inadequate intake of either or both nutrients, so the goal is our bodies need these things, all of our organs, and all of our tissues need these things, and we should be focusing on this as nutrition, and not as medication.

Todd Whitthorne

Very Good. Well Dr. Heaney, I want to thank you for your time.  I want to point out to our listeners that Dr. Heaney has several wonderful scientific presentations available on YouTube (http://www.youtube.com/).  If you like to really dig deep and hear about some of Dr. Heaney’s research, and the things he’s been involvement there are three or four really good presentations available on YouTube. Continued success, and as always, I appreciate your time very much.

Robert Heaney, MD

Thank you very much.

Todd Whitthorne

Dr. Robert Heaney our guest today on our healthy living podcast.  As always you can get more information at www.CooperAerobics.com

Are you Getting Enough Vitamin D?

February 12, 2013 Leave a comment

By Todd Whitthorne,  Vitamin Expert

Today’s Healthy Living Section of the Dallas Morning News featured a story on healthy ways to make your face more beautiful, which included protecting your skin from the sun’s UV rays. As a guy that works at Cooper and oversees our vitamin and nutritional supplement line, I spend a great deal of time following the literature on this topic.

I obviously agree that the sun can do tremendous damage (aging and increased risk of skin cancer). But I also I think it’s always important to remind folks that when it comes to sun screen you should be careful “not to throw the baby out with the bath water.” That same UVB light that accelerates aging and increases cancer risk is also the same light that generates vitamin D.

We have a vitamin D deficiency epidemic in this country. An article published in the 2009 Archives of Internal Medicine found that 77 percent of U.S. adults and adolescents were insufficient in vitamin D (90 percent of Mexican-Americans and 97 percent of all non-Hispanic blacks). At Cooper Clinic we have been measuring vitamin D levels in our patients since 2006, and we find approximately 80 percent of our first time patients have levels lower than we like to see (<40 ng/ml).

Dr. Ed Giovannucci, a highly respected researcher from Harvard, wrote in the Journal of the National Cancer Institute in 2006 that “sunlight might prevent 30 deaths for each one caused by skin cancer. I would challenge anyone to find an area or nutrient or any factor that has such consistent anti-cancer benefits as vitamin D. The data are really quite remarkable.”

Of course, then the question comes up of whether physicians prefer that their patients get vitamin D through supplementation, as opposed to directly from the sun. That really depends on whom, and what type of doctor, you ask. Most of the research indicates that there is really very little difference between the two.

Most physicians feel supplements are the most logical choice because of ease, cost, accuracy of dosing, etc. Dermatologists clearly like to steer folks away from the sun. However a few, including Dr. John Cannell, Founder of the Vitamin D Council, feel that the sun is the preferred method since that’s the way we were “designed” to get vitamin D (listen to a podcast with Dr. Cannell).

Obviously no one, including Dr. Cannell, recommends getting a sun burn, but for most folks 10-15 minutes of unprotected sun exposure seems to be a logical, and safe, dose. The problem is how often do most people go out in a bathing suit, or shorts and a tank top, between 10 a.m. and 2 p.m. when the UVB light is most available? Clearly if the weather is gloomy and overcast that wouldn’t be practical.

Something else to keep in mind is that there is a huge variability in how much vitamin D we synthesize from the sun, or absorb from supplements. There clearly is no such thing as “one size fits all.” Cooper Clinic physicians recommend starting with 2000 international units (IU) of vitamin D-3 per day and go up in dose as needed. The ideal method to determine how much vitamin D you need is to get a blood test. But from a practical standpoint, most people aren’t going to take the time or spend the money to do that. 2000 IU per day may not get them to an “optimal” blood level, but for most individuals it will at least help them avoid “deficiency” (less than 20 ng/ml).

Even though I run and ride my bike outside quite a bit, I have found that I need to take 5000 IU of Vitamin D-3 per day for me to maintain a blood level of 60 ng/ml (my ideal target). But remember, everyone is different. The main takeaway is to make sure to get your vitamin D. Whether it’s from the sun or supplements….just get it.