Health and Nutrition

April 27, 2010

Vitamin D Replacement Is all the Craze These Days

Filed under: Uncategorized — Doc Joe @ 3:35 pm

Jazeela Fayyaz, DO, Pulmonary Medicine, 11:34PM Apr 14, 2010

It seems like everyone is on Vitamin D replacement lately. A study published in the American Journal of Respiratory and Critical Care Medicine this winter looked at the effects of Vitamin D levels on steriod response in asthmatics. Adult, nonsmoking asthmatics were enrolled and the relantionship between serum 25 hydroxyvitamin D concentration and lung function, airway hyperresponsiveness and glucocorticoid response was evaluated. Higher vitamin D levels were associated with greater lung function, and patients with vitamin D levels <30ng/mL had increased airway hyperresponsiveness. Steriod response increased with increasing levels of Vitamin D. Checking vitamin D levels and supplementing in asthmatics may help improve their symptoms and the treatment response to steriods. http://ajrccm.atsjournals.org/cgi/reprint/181/7/699

April 1, 2010

Higher Vitamin D Levels Linked to Lower Risk for Female Pelvic Floor

Filed under: Nutrition,Vitamin D — Doc Joe @ 11:29 pm

From Medscape Medical News:
Higher Vitamin D Levels Linked to Lower Risk for Female Pelvic Floor
Disorders

Laurie Barclay, MD
April 1, 2010 – Higher vitamin D levels are linked to a lower risk for
female pelvic floor disorders, according to the results from the National
Health and Nutrition Examination Survey (NHANES) reported in the April issue
of Obstetrics & Gynecology.
“Because vitamin D receptors are present in human muscle tissue, a direct
effect of vitamin D on muscle physiology is biologically plausible,”
write
Samuel S. Badalian, MD, PhD, and Paula F. Rosenbaum, PhD, from SUNY Upstate
Medical University and St. Joseph’s Hospital Health Center in Syracuse, New
York. “Thus, it is not surprising that vitamin D deficiency has long been
clinically associated with impaired muscle strength and loss of muscle mass.
Given that vitamin D insufficiency or deficiency is epidemic among adults,
it is plausible that low vitamin D status contributes to the development of
poor muscle strength and can lead to different pelvic floor disorders such
as urinary/fecal incontinence and POP [pelvic organ prolapse].”
The goal of the study was to determine the rate of vitamin D deficiency in
women with pelvic floor disorders and to examine possible relationships
between vitamin D levels and pelvic floor disorders. This cross-sectional
analysis of 2005-2006 NHANES data included 1881 nonpregnant women older than
20 years in whom data on pelvic floor disorders as well as vitamin D
measurements were available. Insufficient vitamin D levels were defined as
those lower than 30 ng/mL. Data were analyzed regarding demographic factors,
pelvic floor disorders, and vitamin D levels, accounting for the multistage
sampling design. After controlling for known risk factors, the investigators
calculated odds ratios (ORs) and 95% confidence intervals (CIs) to determine
associations between vitamin D levels and pelvic floor disorders.
Nearly one quarter (23%) of women reported 1 or more pelvic floor disorders.
Regardless of age, women reporting at least 1 pelvic floor disorder and
those with urinary incontinence had significantly lower mean vitamin D
levels.
With increasing vitamin D levels, risks for 1 or more pelvic floor disorders
were significantly decreased in all women at least 20 years old (OR, 0.94;
95% CI, 0.88 – 0.99) and in the subset of women 50 years and older (OR,
0.92; 95% CI, 0.85 – 0.99), based on adjusted logistic regression models. In
women at least 50 years old with vitamin D levels of 30 ng/mL or higher (OR,
0.55; 95% CI, 0.34 – 0.91), the likelihood of urinary incontinence was
significantly reduced.
“Higher vitamin D levels are associated with a decreased risk of pelvic
floor disorders in women,” the study authors write. “The vitamin D
association was strongest among older women reporting urinary incontinence
in the NHANES survey. The pattern was similar for fecal incontinence
although not significant.”
Limitations of this study include drifts in the assay performance of vitamin
D levels with time, limited power regarding subtype analyses, and lack of
gynecologic examination to assess the severity of pelvic organ prolapse.
Contrary to expectation, vaginal bulge was reported more frequently among
those with higher vitamin D levels.
“Given the increase in the number of patients with pelvic floor disorders,
further evaluation of the role of vitamin D is warranted, particularly
future research to assess the relationship between vitamin D levels and
pelvic muscle strength in women of all ages and racial/ethnic groups,” the
study authors conclude. “Our findings suggest that treatment of vitamin D
insufficiency and deficiency in both premenopausal and postmenopausal women
could improve pelvic muscle strength, with a possible reduction in the
prevalence of pelvic floor disorders including urinary incontinence.”
The study authors have disclosed no relevant financial relationships.
Obstet Gynecol. 2010;115:795-803. Abstract

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