Vitamin D and dementia

well you're most welcome to today's talk Tuesday the 25th of July now I want to look at the ongoing problem with vitamin D deficiency particularly with Alzheimer's disease today there's just so much low hanging fruit to improve health that we're simply not picking in the western world and the vitamin D situation is certainly one of them we're going to get on to Alzheimer's disease in a minute this is a real biological organic disease so we see the healthy brain here with the gray matter on the outside and the white matter on the inside and here we see the totally shrunken shriveled up Alzheimer's brain which is responsible for the disorientation and the well Progressive irreversible impairment of intellectual function which is the definition of of dementia let's look first of all at how common the prevalence of vitamin D is so this study here now the data from the United States is a little out of date now um but let's look at what we've got vitamin D deficiency and insufficiency in the U.S adults now this is published in 2018 not a lot published since then really in terms of good quality surveys that I've found vitamin D deficiency and vitamin D insufficiency are increasing at a global level they say and this remains true um part of the problem is um people have been advised to keep out the sun to prevent melanoma which of course is correct we don't want Sunburn and melanoma But there again the vast majority of our vitamin D is made by exposure to the Sun so there's a balance there to be attained that we haven't yet attained I don't think um now that they uh they looked at so this this is the vitamin D in the blood serum 25 hydroxy vitamin D so that's the vitamin D in the blood there that we could test for and this is the way with the the blood test test for this one so this is this is kind of what we can look for 26 000 adults um now vitamin D deficiency the defined as less than 50 nanomoles per liter which is kind of the traditional European way and the traditional American way of describing it it's exactly the same figure as 20 nanograms per ml so 59 moles per liter is exactly the same blood level as 20 nanograms per ml it's exactly the same and vitamin D insufficiency a bit higher 20 25 nanograms per mil now the the results are really quite horrendous actually um this is based on data from uh I think 2001 to 2011 but published in 2018 and I don't think things are that much better now maybe a little bit but not a lot vitamin D deficiency 28.9 of the population vitamin D insufficiency 41 of the population this is this is this is such a uh an epidemic well a pandemic really as we'll see in a minute of course adults with darker colored skin less education poor uh obese physically inactive and infrequent milk consumers had lower levels now the natural milk will contain some vitamin D but not a lot um but in in the United States they add vitamin D to milk in a lot of places in the United Kingdom we don't um so while this would apply milk drinkers in the United States are going to get more Vitamin D from drinking milk in the UK that is much less true obese adults Three Times Higher prevalence of vitamin D deficiency the thing is with vitamin D of course it's a fat soluble vitamin so if you've got a lot of Adipose fatty tissue the vitamin D goes into the fatty tissue very much less left in the blood so patients with obesity need much more vitamin D to top them up um three times more likely um and this is going to add to the problems of obesity of course um and uh physically inactive adults twice as likely and the uh the vitamin D insufficiency was also present in both of these groups now um this is uh another study here um a bit that the data is actually slightly more up to date but again a bit out of date but um the levels of deficiency there are described as less but of course it depends on how you sort of Define your levels doesn't it obviously um persons with higher persons with higher vitamin D dietary intake or who use supplements had a lower prevalence of at-risk vitamin of that risk deficiency or inadequacy in other words um higher dietary intake or supplements obviously really are going to reduce the levels of insufficiency and deficiency and um the levels that being advised by our governments in my view are still very low now does this apply worldwide well vitamin D deficiency 2.0 an update on the current status of the World published in nature magazine and this is pretty up-to-date data now most studies did not meet the basic requirement of a nutritional Interventional study now this illustrates a big part of the problem um the these studies are largely on vitamin D largely observational or correlation studies summer prospective and many are retrospective but there are prospective studies as well but the point is there's no good quality studies that show well there's lots of studies that show yes there's correlations between various diseases like Alzheimer's disease heart disease diabetes meant many things with vitamin D deficiency but there's not the evidence that shows that if you supplement with vitamin D these go away or are prevented because of course pharmaceutical industry can't make any money out of these this is the problem so we have to assume that correcting the deficiency will improve the condition which is a very reasonable assumption but do we actually know this well from Interventional Studies by sort of proper randomized double blind control trial data the answer is no not really so this is why there's always a bit of a bit of um debate about this um but but to me to me the evidence is is simply overwhelming but do we have the Interventional studies no are we like to get the Interventional studies no because pharmaceutical industry organized most of these Interventional studies and they're not going to do it for someone they can't make any money out of uh this is the state of Healthcare in the world at the moment it's money related which is um unfortunate but uh this is uh most so most studies do not make that pity but but there we go but uh about 40 of Europeans are deficient in vitamin D so pretty comparable levels really to the United States 13 severely deficient really quite high amounts now this study here took vitamin D deficiency again as being less than 15 nanomoles per liter or uh so the vitamin D deficiency yeah they took it as less than 15 animals per liter which is 29 grams per mil and they say quite clearly associated with unfavorable skeletal outcomes including fractures and bone loss um I mean are we in a situation whereby giving vitamin D we could prevent some fractures excruciatingly painful condition associated with huge implications for health and well-being and Health Care provision you know it's so simple if we could just reduce that levels of less sorry levels of greater than so that one's greater than isn't it greater than 50 nanomoles or 20 nanograms is therefore the primary treatment goal and it wouldn't be hard to titrate the population up to that quite readily severe vitamin D deficiency below 30 less than 30. nanograms per liter or 12 nanograms per ml dramatically increase it and remember this is quite a large percentage of the population this is so the talking here about 13 of the population in in Europe with the very low levels dramatically increases the risk of excess mortality that means you're more likely to die simple as that infections more likely to get infections such as covid influenza and and many other diseases and should be avoided wherever possible obviously given its rare side effects and it's relatively wide safety margin it may be a it may be an important inexpensive and safe adjuvant therapy for many diseases but then they go on to say to cover themselves future larger and well-designed studies should evaluate this further but of course they're not going to that is simply not going to happen unless governments take that on um so I've gone on a bit longer than a mentor there um I think we might do no we'll carry on we'll carry on and do the dementia I think we can always split it afterwards um vitamin D deficiency vitamin D supplementation and uh incidence of dementia now um cognitive status vitamin D exposure in this study here I've always put the links check it out for yourself vitamin D exposure was associated with 40 lower dementia increase versus no exposure so people with vitamin D got 40 percent less dementia if they had vitamin D additional vitamin D and we did look at this before so I'm not going to do this one in detail but it was a good study the other study I want to look at today low vitamin D serum levels um as a risk factor of Alzheimer's disease then this is a review in meta-analysis so did this show the same thing uh serum vitamin D levels related to cognitive dysfunctions brain thinking not working properly for example Alzheimer's disease now they did say past studies vary in their resource that's why they wanted to do a meta-analysis and this is up-to-date data up to December 2022. now Alzheimer's disease accounts for 75 percent of dementia so dementia is a progressive irreversible impairment of intellectual function once you've lost the intellectual function you can never get it back never ever ever get it back by definition that is dementia now of course sometimes intellectual function is diminished for a period of time you correct the underlying condition and then you get the you go back to normal function that's called delirium that's a separate condition so delirium is reversible Dementia by definition is irreversible but going on to this study this meta-analysis uh Six studies 10 884 individuals vitamin D receptors are present throughout the brain so it makes sense that this would work because there's lots of vitamin D receptors patient vitamin D serum levels less than 25 nanograms per ml had an increased risk of developing Alzheimer's disease it's really quite simple compared to those with higher levels and the hazard ratio was 1.59 in in other words patients with high levels of vitamin D were 59 less likely to get dementia um the fact that this is not being acted on really is quite uh really is quite incredible and um I've just put this in parenthesis because it's from a different study um but severe severe deficiency having the strongest Association so it does make sense doesn't it compared to moderate deficiency so the lower the vitamin D the greater the risk of dementia it's what the studies are showing very very simple the lower the levels of vitamin D the greater the risk of dementia like me I can't imagine there's any others out any of you have been unaffected by dementia of close friends family um at work I'm sure we've all had relatives with levels of dementia like me I'm sure you have very few people will be unaffected by dementia back to the original study vitamin D probably May promote the clearing of amyloid plaques now this amyloid is an abnormal protein so in the brain we get so if you're out we have lots of nerve cells here in the brain with all their interconnections this this amyloid um is abnormal protein which is laid down in clumps in the brain so this abnormal amyloid protein so um vitamin D May promote the clearing of amyloid plaques so it may actually promote the clearing of the blacks now the nerve cells which have been damaged aren't going to recover uh significantly but um good news if we can get rid of that vitamin D may also prevent cognitive dysfunction via neuroprotection protecting the nerves neurotrophy that is nutrition of the nerves neurotransmission that is the transmission across the synapses between the nerves and neuroplasticity is the formation of new uh potentially new nerve cells but certainly new connections between them um potential to prevent neural inflammation and also we know it inhibits pro-inflammatory cytokines and yet Department of Health and Social care in the UK current guidelines check this out uh just last night um still advising my new doses of supplementation in the UK just during winter in Autumn everyone is advice to take supplement containing 10 micrograms for 100 international units of vitamin D a day now I can't tell you what to take but um I take at least 10 times that a day personally take 100 micrograms of vitamin D a day with 100 micrograms of vitamin K2 and many people think magnesium supplement is a good idea with the vitamin D but I'm personally taking 100 micrograms of vitamin D that's 4 000 international units and 100 micrograms of vitamin K2 with that if you're eating fermented foods you don't need the K2 supplement but most of us don't eat that many fermented foods so laughably low recommendations in the United Kingdom but we have huge amounts of Dementia in the state it's not a lot better adult dose recommendation in the states is 600 international units and again I often take 10 times that um and uh it I think it does go up to 800 over the age of 70 but strange that governments are admitting the problem but not really advising any solution ideally everyone would have their vitamin D levels checked and titrated by their doctoral healthcare provider to say that doesn't happen very often unfortunately so there we go dementia big problem vitamin D I am totally convinced is a big factor and yet uh National guidelines are simply not reflecting this and clinical trials are simply not reflecting this um it's almost as if there's vested interest in policy making I'm actually not being sarcastic I'm not saying there is but why don't they get their act together and why doesn't the government organize or sponsor a university to do a trial on this they could do this the ability is there because the pharmaceutical industry aren't going to but these government guidelines to me are um out of date we'll leave it there um thank you for watching and um it's a bit overcast here today but if you can get some sun this time of year without sunburning um so basically if you're out in the sun and you've got fairly good body exposure uh if you're out suppose it took like two hours to get sunburned if you're out for about an hour well below the time it takes to get sunburned you're going to make about 20 000 units of vitamin D a day and yet the government guidelines in the UK is 400 units a day can you see the sort of mismatch here leave it there um thank you for watching

Channel: Dr. John Campbell

Views: 623,696

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: fmU7ivk2GMk

Length: 16min 24sec (984 seconds)

Published: Tue Jul 25 2023