Vitamin D and Prostate Cancer | Helpline Questions

Hi, I’m Dr. Scholz. The subject of vitamin D comes up frequently
when talking about prostate cancer. Why isthat? Well, probably because men with prostate
cancer are often treated with hormonal therapywhich causes accelerated calcium loss from
the bones and that needs to be counteracted. Adequate vitamin D levels help improve the
absorption of calcium from the intestine intothe bloodstream. So everyone who is getting
hormonal therapy, typically, is advised totake some calcium at bedtime and some vitamin
D. The subject of vitamin D and metabolism and
treatment is fast and very controversial. Some people claim it improves your immune
system, it does all kinds of other magicalthings. I’ve seen this pattern over and over
with all kinds of supplements where discoveriesare made that they’re necessary and then the
public tends to go overboard and believe thatmassive amounts are going to be useful. The
problem with that thinking is that massiveamounts of anything are almost never useful,
and so the appropriate approach, at leastwith vitamin D is to test the levels in the
blood, and I don’t know why that’s not talkedabout more frequently. People talk about you
should take a thousand or 2,000 or 5,000,or 400, but it really is predicated on whether
or not your levels are low. And it turns outthat the general population that I see (men
in their 60s, 70s, and 80s) about 25% of menrun low vitamin D levels—that is, below
30—and low vitamin D is going to mess upcalcium metabolism and can have other deleterious
effects. So, testing once a year should bean appropriate part of everyone’s annual physical
exam. If vitamin D levels are low I would recommend
starting 1,000 to 2,000 units a day and thenretesting after about three or four months.
It takes a while for new levels to equilibrateonce the vitamin D has been started. You can’t
check it a week or two later. And then oncenormal levels are achieved periodic rechecks
are necessary to ensure that it is maintainedand also to make sure that the levels don’t
go too high. So, in summary, vitamin D isa very appropriate thing for men with prostate
cancer, especially those that are on hormonaltherapy. But it starts by checking blood levels,
not by picking some arbitrary amount of 1,000,2,000, 5,000 units a day because your levels
may already be adequate and getting too muchvitamin D is a potentially negative thing
that could lead to problems instead of becominga solution.

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