Dr. Geo Espinosa: Vitamin D for Longevity and Reducing Lower Urinary Tract Symptoms

Dr. Geo Espinosa

This recent study, published in the British Journal of Urologyshows low vitamin D levels are associated with lower urinary tract symptoms (LUTS) in men, especially during the winter. The following is an excerpt of a blog on the subject by contributor, Geo Espinosa, ND.

STUDY DETAILS

  • 457 patients participated in a prospective study;
  • Evaluation included medical history acquisition, physical examination and the completion of validated questionnaires, such as the IPSS, the Overactive Bladder Symptom Score (OABSS), and the International Physical Activity Questionnaire (I‐PAQ);
  • Laboratory test data, including serum anti‐inflammatory markers, serum PSA testosterone and glycated hemoglobin (HbA1c) levels, urine analysis, uroflowmetry, with post‐void residual urine volume (PVR) and prostate volume measurement using TRUS, and Serum 25‐OH vitamin D level was assessed;
  • Low Vitamin D levels aggravated overactive bladder (OAB) symptoms in men with LUTS all year, but particularly in winter. [Source]

My Take on Vitamin D in Men to Promote Longevity

First of all, vitamin D is not a “vitamin,” it’s a hormone. But, for simplicity, let’s keep calling it vitamin D.

I digress. As you know, vitamin D has two primary jobs: 1. It increases absorption of calcium (calcemic effect) in the body primarily to maintain bone health and; 2. It has its numerous actions on the body independent of calcium metabolism (non-calcemic effect), i.e., boost immunity, anti-inflammatory, maybe even anti-cancer, etc.

The most recent study associating vitamin D with LUTS is just one of a plethora of research suggesting its protective qualities. And, just so we are on the same page, vitamin D insufficiency is defined in most studies as below ≤ 30 ng/mL, and deficiency ranges from < 20 ng/mL to 10 ng/mL. As you will see, for my patients, I prefer a higher range.

A previous research study demonstrated that men with the lowest vitamin D levels developed aggressive prostate cancer. This scientific paper showed that those with 25-OH D blood levels lower than 12 ng/ml, over 3 ½ times more likely to develop aggressive prostate cancer (Gleason grade 4+4 or higher), while African-American (AA) men were more than 4 ½ times more likely to develop an aggressive form of the disease. AA typically have even lower D levels than non-AA men.

Another study looked at overall mortality associated with low vitamin D levels. In a 9-year follow-up study looking at over 13,000 adults 20 years or older, there was an increased rate of death in those with low Vitamin D levels (25[OH]D levels <17.8 ng/mL).

The sweet spot, that is, where most participants died the least, was with D levels around 40 to 45ng/ml.

The same group of men were studied for 15-years, increase mortality became apparent in those with D levels steep below 40 nmol/L (16ng/ml) and higher than >120 nmol/L (48 ng/ml). Decrease death rates were noticed in those with D levels between 32 and 40ng/ml.

Based on my clinical experience and analyzing hundreds of Vitamin D scientific papers, I have my patients at an optimal range of 40 to 50ng/ml.

Other studies have reported benefits from Vitamin D intake on prostate size and urinary problems. In a previous study, serum vitamin D concentration was reported to be lower in men with LUTS than in men without LUTS. In another review study, I published with a few other researchers we indicate a moderate decrease in prostate size amongst men with adequate blood vitamin D levels

Dr. Geo’s Clinical Takeaway on Vitamin D, Urinary and Prostate Health, and Longevity

  • The primary source and most natural form of vitamin D is sun exposure.
  • During the winter months it is virtually impossible to get enough vitamin D from sun exposure; thus supplementation should be considered. (it is difficult to get optimal D levels in the summer months, as well as most people, spend most of their time indoors these days)
  • The highlighted study above on vitamin D and LUTS showed that men did better with higher vitamin D levels intake all year, but they suffered more from LUTS in the winter and did better after D levels increased with external use.
  • Determining how much vitamin D supplementation one should take depends on a blood test, 25-Hydroxy Vitamin Dnot 1,25 Hydroxy Vitamin D. Also in the winter time, more is required. Some of my patients take up to 10,000 units a day only during the winter season.
  • Blood levels of D should be between 40 and 50ng/ml. More is not better and can have diminishing returns. I emphasize the range between 40 – 50ng/ml because some holistic docs recommend higher levels – higher levels than 50ng/ml of vitamin D may be counterproductive based on this study.
  • Keeping optimal levels of vitamin D (40 – 50ng/ml) has many health benefits, including relieving urinary symptoms, lowering the risk of aggressive prostate cancer and improving longevity.
  • Vitamin D is fat soluble; it should be consumed with a meal that contains fat or combined with fish oil (a source of fat).
  • I use and recommend this fish oil supplement that contains 500mg of vitamin D per pill. I recommend and take 2 of these pills two times a day – which yields 2000 units of absorbable vitamin D3. In the winter, I take another 5000 units to keep me in an optimal range (some time ago I did a Q&A on Omega Avail Ultra, a fish oil that contains vitamin D3 along with vitamin K1 and K2, you may want to check it out.).
Geo Espinosa, N.D., L.Ac, C.N.S., RH (AHG) is a renowned naturopathic doctor recognized as an authority in integrative and functional urology. He is the founder and director of the Integrative and Functional Urology Center at New York University Langone Medical Center (NYULMC) and lectures internationally on the application of integrative medicine in clinical settings. He is the author of Thrive – Don’t Survive: Dr. Geo’s guide to living your best life Before & After Prostate Cancer. He has published in numerous peer-reviewed scientific journals related to integrative management of prostate conditions and urological disorders. Dr. Geo has been a medical contributor to Men’s Journal magazine, WebMD and in medical textbooks. Dr. Geo has been acknowledged as one of the top 10 Health Makers for Men’s Health by sharecare.com created by Dr. Mehmet Oz and WebMD. He is a formulator of dietary supplements for prostate, bladder and sexual health and co-founder of XY Wellness, LLC. On his time off from work, Dr. Geo enjoys writing on his popular blog, DrGeo.com and having fun in outdoor activities with his wife and 3 kids.