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Excerpted from the Vitamin D Council's website...
The Vitamin D
Newsletter
March 2007
Peak Athletic Performance and Vitamin D
"No thanks doc, I'm fine."
"No way doc." I had just finished informing my vitamin D deficient patient about the benefits of vitamin D, telling him he needed to take 4,000 IU per day. I used all the techniques I have learned in 30 years of medical practice to convince someone when proper treatment is needed. However, he knew that the U.S. government said young people need only 200 IU/day, not 4,000. He also knew the official Upper Limit was 2,000 IU/day. "What are you trying to do doc, kill me?"
I told him his 25?OH vitamin D blood test was low, only 13 ng/mL. He had read about that too, in a medical textbook, where it said normal levels are between 10 and 40 ng/mL. "I'm fine doc;" adding "Are you in the vitamin business?" I explained I was not; that the government and textbooks used outdated values; that recent studies indicate ideal 25OHD levels are about 50 ng/mL and that recent studies indicated that he needed about 4,000 IU/day to get his level up to this amount. "No thanks doc, I'm fine."
So I tried a different tact—I brought copies of recent press articles and asked him to take a look at them. Science News called vitamin D the "Antibiotic Vitamin." The Independent in England says vitamin D explains why people die from influenza in the winter, and not the summer. U.S. News and World Report says almost everyone needs more. Newsweek says it prevents cancer and helps fight infection. United Press International says that it reduces falls in the elderly, reduces stress fractures, helps heal wounds, and that many pregnant women are deficient in the vitamin.
The Important Things
He glanced at the articles, showing a little interest in the one about stress fractures. Then he told me what he was really thinking. "Look doc, all this stuff may be important to old guys like you. I'm twenty?two. All I care about are girls and sports. When I get older, maybe I'll think about it. I'm too young to worry about it. I'm in great condition." I couldn't argue. He was in good health and a very good basketball player, playing several hours every day, though always on indoor courts.
What could I do to open his eyes? As an African American, his risk of early death from cardiovascular disease or cancer was high, although the risk for blacks doesn't start to dramatically increase until their '40s and '50s. Like all young people, he saw himself as forever young. The U.S. government was no help, relying on a ten?year?old report from the Institute of Medicine that is full of outdated studies and misinformation.
I tired to tell him that the 200 IU per day the U.S. government recommends for 20?year?olds is to prevent bone disease, not to treat low vitamin D levels like his. I pointed out the U.S. government's official current Upper Limit of 2,000 IU/day is the same for a 300?pound adult as it is for a 25?pound toddler. That is, the government says that it's safe for a one?year?old, 25?pound child to take 2,000 IU/day but not safe for a 30?year old, 300 pound adult to take 2,001 IU/day and that whoever thought up these Upper Limits must have left their thinking caps at home—nothing worked. My vitamin D?deficient patient was not interested in taking any vitamin D.
So i thought, "what are young men interested in?" I remembered what he told me: "Sex and sports." Two years ago, I researched the medical literature looking for any evidence that vitamin D enhanced sexual performance. Absolutely nothing. That would have been nice. Can you imagine the interest?
Improving Athletic Performance
Then I remembered that several readers had written to ask me if vitamin D could possibly improve their athletic performance. They told me that after taking 2,000–5,000 IU/day for several months they seemed somewhat faster, a little stronger, with maybe better balance and timing. A pianist had written to tell me she even played a better piano, her fingers moved over the keys more effortlessly! Was vitamin D responsible for these subtle changes or was it a placebo effect? That is, did readers just think their athletic performance improved because they knew vitamin D was a steroid hormone precursor?
The active form of vitamin D is a steroid (actually a secosteroid) in the same way that testosterone is a steroid. It is also a hormone (hormone: Greek, meaning "to set in motion") in the same way that growth hormone is a hormone. Steroid hormones are substances made from cholesterol that circulate in the body and work at distant sites by setting in motion genetic protein transcription. That is, both vitamin D and testosterone set in motion your genome, the stuff of life. While testosterone is a sex steroid hormone, vitamin D is a pleomorphic steroid hormone.
All of a sudden, it didn't seem so silly. Certainly steroids can improve athletic performance—although they can be quite dangerous. In addition, few people are deficient in growth hormone or testosterone, so athletes who take sex steroids or growth hormone are cheating, or doping. The case with vitamin D is quite different because natural vitamin D levels are about 50 ng/mL and since almost no one has such levels, extra vitamin D is not doping, it's just good treatment. I decided to exhaustively research the medical literature on vitamin D and athletic performance. It took me over a year.
To my surprise, I discovered that there are five totally independent bodies of research that all converge on an inescapable conclusion: vitamin D will improve athletic performance in vitamin D deficient people (and that includes most people). Even more interesting is who published the most direct literature, and when. Are you old enough to remember when the Germans and Russians won every Olympics in the '60s and '70s? Well, it turns out that the most convincing evidence that vitamin D improves athletic performance was published in old German and Russian medical literature.
With the help of my wife and mother?in?law, both of whom are Russian, and with the help of Marc Sorenson (whose book Solar Power for Optimal Health is a must?read) I was able to look at translations of the old Russian and German literature. Combining that old literature with the abundant, modern, English?language literature on vitamin D and neuromuscular performance, the conclusion was inescapable: the readers who wrote me were right!
If you are vitamin D deficient, the medical literature indicates that the right amount of vitamin D will make you faster, stronger, improve your balance and timing, etc. How much it will improve your athletic ability depends on how deficient you are to begin with. How good an athlete you will be depends on your innate ability, training, and dedication.
However, peak athletic performance also depends upon the neuromuscular cells in your body and brain having unfettered access to the steroid hormone, activated vitamin D. How much activated vitamin D is available to your brain, muscle, and nerves depends on the amount of 25?hydroxyvitamin D in your blood. In turn, how much 25?hydroxyvitamin D is in your blood depends on how much vitamin D you put in your mouth or how often you expose your skin to UVB light.
One might ask why I would write about such a frivolous topic like peak athletic performance when cancer patients all across this land are dying vitamin D deficient. The reason is that, like many vitamin D advocates, I have been disappointed with the medical profession's and the public's lack of enthusiasm over vitamin D. Maybe people like my young basketball player will take an interest in vitamin D if they know of its potential benefit to their athletic performance? Let's see…. Hey jocks! Want to improve your game? Take vitamin D. Listen up—I'm talking speed, balance, choice reaction time, muscle mass, muscle strength, squats, reps—important stuff!
Want to learn more? Here's the first?ever Sports Edition Vitamin D Quiz:
1 German and Russian Olympic athletes used UVB radiation to strengthen their performance.
FalseTrue
2 Athletic performance peaks in the winter and is lowest in the summer.
FalseTrue
3 Vitamin D has direct, muscle?building (anabolic) effects.
FalseTrue
4 The higher your vitamin D level, the better your neuromuscular performance.
FalseTrue
5 Numerous studies have found that vitamin D improves physical performance.
FalseTrue
In Summary
Five converging—but totally separate—lines of scientific evidence leave little doubt that vitamin D improves athletic performance. There is actually a sixth line of evidence that i left out due to its complexity: the two studies I found on muscle strength and vitamin D receptor polymorphisms (genetic variations), both were positive. Anyway, the scientific evidence that UVB radiation, either from the sun or a sunbed, will improve athletic performance is overwhelming and the mechanism is almost certainly vitamin D production. Peak athletic performance will probably occur with 25OHD levels of about 50 ng/mL, a level that can be obtained through the use of supplements as well.
All that is missing is a big time professional or college team identifying, and then treating, their elite athletes who are vitamin D deficient. Can you imagine what such performance?enhancing effects would do for basketball players, the majority of which are black and practice and play indoors all winter? Or gymnasts? Weight lifters? Can you imagine what it might do for those chronic neuromuscular injuries which are so common in sports medicine?
A word of caution, though. The above studies suggest that taking too much vitamin D (more than 5,000 IU/day) may actually worsen athletic performance. So take the right amount, not all you can swallow. Take enough to keep your 25?hydroxyvitamin D levels around 50 ng/mL, year?round. Easier yet, regularly use the sun in the summer and a sunbed (once a week should be about right) in the winter—with care not to burn.
When you think about it, none of this should surprise anyone. Every bodybuilder knows that steroid hormones can improve athletic performance and they certainly increase muscle mass. Barry Bonds knows they increase timing and power. Activated vitamin D is as potent a steroid hormone as exists in the human body. However, unlike other steroids, levels of activated vitamin D in muscle and nerve tissue are primarily regulated by sun exposure. That's right, the rate?limiting step for the autocrine function of activated vitamin D is under your control and depends on how much daily vitamin D you receive. It's ironic that many athletes now avoid the sun. Organized baseball is even promoting sun avoidance and sunblocks.
The ancient Greeks knew better; they had their elite athletes train on the beach and in the nude.
So the level of vitamin D (50 ng/mL) associated with peak athletic performance is the very same level that recent studies show also helps to prevent cancer, diabetes, hypertension, influenza, multiple sclerosis, major depression, cognitive decline, etc. But who cares about all that disease stuff old people get! We're talking about important stuff here: speed, balance, reaction time, muscle mass and strength, squats, reps. As for my young basketball player, guess who's now taking 4,000 IU vitamin D a day? That's right! And his 25?hydroxyvitamin D level is now 54 ng/mL. Has this improved his game? Well…he said to me that he feels his timing is better and that he can jump a little higher, run faster and…oh yeah! and that the ball feels "sweeter"—whatever that means.
John Jacob Cannell MD
Executive Director
The Vitamin D
Newsletter
March 2007
Peak Athletic Performance and Vitamin D
"No thanks doc, I'm fine."
"No way doc." I had just finished informing my vitamin D deficient patient about the benefits of vitamin D, telling him he needed to take 4,000 IU per day. I used all the techniques I have learned in 30 years of medical practice to convince someone when proper treatment is needed. However, he knew that the U.S. government said young people need only 200 IU/day, not 4,000. He also knew the official Upper Limit was 2,000 IU/day. "What are you trying to do doc, kill me?"
I told him his 25?OH vitamin D blood test was low, only 13 ng/mL. He had read about that too, in a medical textbook, where it said normal levels are between 10 and 40 ng/mL. "I'm fine doc;" adding "Are you in the vitamin business?" I explained I was not; that the government and textbooks used outdated values; that recent studies indicate ideal 25OHD levels are about 50 ng/mL and that recent studies indicated that he needed about 4,000 IU/day to get his level up to this amount. "No thanks doc, I'm fine."
So I tried a different tact—I brought copies of recent press articles and asked him to take a look at them. Science News called vitamin D the "Antibiotic Vitamin." The Independent in England says vitamin D explains why people die from influenza in the winter, and not the summer. U.S. News and World Report says almost everyone needs more. Newsweek says it prevents cancer and helps fight infection. United Press International says that it reduces falls in the elderly, reduces stress fractures, helps heal wounds, and that many pregnant women are deficient in the vitamin.
The Important Things
He glanced at the articles, showing a little interest in the one about stress fractures. Then he told me what he was really thinking. "Look doc, all this stuff may be important to old guys like you. I'm twenty?two. All I care about are girls and sports. When I get older, maybe I'll think about it. I'm too young to worry about it. I'm in great condition." I couldn't argue. He was in good health and a very good basketball player, playing several hours every day, though always on indoor courts.
What could I do to open his eyes? As an African American, his risk of early death from cardiovascular disease or cancer was high, although the risk for blacks doesn't start to dramatically increase until their '40s and '50s. Like all young people, he saw himself as forever young. The U.S. government was no help, relying on a ten?year?old report from the Institute of Medicine that is full of outdated studies and misinformation.
I tired to tell him that the 200 IU per day the U.S. government recommends for 20?year?olds is to prevent bone disease, not to treat low vitamin D levels like his. I pointed out the U.S. government's official current Upper Limit of 2,000 IU/day is the same for a 300?pound adult as it is for a 25?pound toddler. That is, the government says that it's safe for a one?year?old, 25?pound child to take 2,000 IU/day but not safe for a 30?year old, 300 pound adult to take 2,001 IU/day and that whoever thought up these Upper Limits must have left their thinking caps at home—nothing worked. My vitamin D?deficient patient was not interested in taking any vitamin D.
So i thought, "what are young men interested in?" I remembered what he told me: "Sex and sports." Two years ago, I researched the medical literature looking for any evidence that vitamin D enhanced sexual performance. Absolutely nothing. That would have been nice. Can you imagine the interest?
Improving Athletic Performance
Then I remembered that several readers had written to ask me if vitamin D could possibly improve their athletic performance. They told me that after taking 2,000–5,000 IU/day for several months they seemed somewhat faster, a little stronger, with maybe better balance and timing. A pianist had written to tell me she even played a better piano, her fingers moved over the keys more effortlessly! Was vitamin D responsible for these subtle changes or was it a placebo effect? That is, did readers just think their athletic performance improved because they knew vitamin D was a steroid hormone precursor?
The active form of vitamin D is a steroid (actually a secosteroid) in the same way that testosterone is a steroid. It is also a hormone (hormone: Greek, meaning "to set in motion") in the same way that growth hormone is a hormone. Steroid hormones are substances made from cholesterol that circulate in the body and work at distant sites by setting in motion genetic protein transcription. That is, both vitamin D and testosterone set in motion your genome, the stuff of life. While testosterone is a sex steroid hormone, vitamin D is a pleomorphic steroid hormone.
All of a sudden, it didn't seem so silly. Certainly steroids can improve athletic performance—although they can be quite dangerous. In addition, few people are deficient in growth hormone or testosterone, so athletes who take sex steroids or growth hormone are cheating, or doping. The case with vitamin D is quite different because natural vitamin D levels are about 50 ng/mL and since almost no one has such levels, extra vitamin D is not doping, it's just good treatment. I decided to exhaustively research the medical literature on vitamin D and athletic performance. It took me over a year.
To my surprise, I discovered that there are five totally independent bodies of research that all converge on an inescapable conclusion: vitamin D will improve athletic performance in vitamin D deficient people (and that includes most people). Even more interesting is who published the most direct literature, and when. Are you old enough to remember when the Germans and Russians won every Olympics in the '60s and '70s? Well, it turns out that the most convincing evidence that vitamin D improves athletic performance was published in old German and Russian medical literature.
With the help of my wife and mother?in?law, both of whom are Russian, and with the help of Marc Sorenson (whose book Solar Power for Optimal Health is a must?read) I was able to look at translations of the old Russian and German literature. Combining that old literature with the abundant, modern, English?language literature on vitamin D and neuromuscular performance, the conclusion was inescapable: the readers who wrote me were right!
If you are vitamin D deficient, the medical literature indicates that the right amount of vitamin D will make you faster, stronger, improve your balance and timing, etc. How much it will improve your athletic ability depends on how deficient you are to begin with. How good an athlete you will be depends on your innate ability, training, and dedication.
However, peak athletic performance also depends upon the neuromuscular cells in your body and brain having unfettered access to the steroid hormone, activated vitamin D. How much activated vitamin D is available to your brain, muscle, and nerves depends on the amount of 25?hydroxyvitamin D in your blood. In turn, how much 25?hydroxyvitamin D is in your blood depends on how much vitamin D you put in your mouth or how often you expose your skin to UVB light.
One might ask why I would write about such a frivolous topic like peak athletic performance when cancer patients all across this land are dying vitamin D deficient. The reason is that, like many vitamin D advocates, I have been disappointed with the medical profession's and the public's lack of enthusiasm over vitamin D. Maybe people like my young basketball player will take an interest in vitamin D if they know of its potential benefit to their athletic performance? Let's see…. Hey jocks! Want to improve your game? Take vitamin D. Listen up—I'm talking speed, balance, choice reaction time, muscle mass, muscle strength, squats, reps—important stuff!
Want to learn more? Here's the first?ever Sports Edition Vitamin D Quiz:
1 German and Russian Olympic athletes used UVB radiation to strengthen their performance.
FalseTrue
2 Athletic performance peaks in the winter and is lowest in the summer.
FalseTrue
3 Vitamin D has direct, muscle?building (anabolic) effects.
FalseTrue
4 The higher your vitamin D level, the better your neuromuscular performance.
FalseTrue
5 Numerous studies have found that vitamin D improves physical performance.
FalseTrue
In Summary
Five converging—but totally separate—lines of scientific evidence leave little doubt that vitamin D improves athletic performance. There is actually a sixth line of evidence that i left out due to its complexity: the two studies I found on muscle strength and vitamin D receptor polymorphisms (genetic variations), both were positive. Anyway, the scientific evidence that UVB radiation, either from the sun or a sunbed, will improve athletic performance is overwhelming and the mechanism is almost certainly vitamin D production. Peak athletic performance will probably occur with 25OHD levels of about 50 ng/mL, a level that can be obtained through the use of supplements as well.
All that is missing is a big time professional or college team identifying, and then treating, their elite athletes who are vitamin D deficient. Can you imagine what such performance?enhancing effects would do for basketball players, the majority of which are black and practice and play indoors all winter? Or gymnasts? Weight lifters? Can you imagine what it might do for those chronic neuromuscular injuries which are so common in sports medicine?
A word of caution, though. The above studies suggest that taking too much vitamin D (more than 5,000 IU/day) may actually worsen athletic performance. So take the right amount, not all you can swallow. Take enough to keep your 25?hydroxyvitamin D levels around 50 ng/mL, year?round. Easier yet, regularly use the sun in the summer and a sunbed (once a week should be about right) in the winter—with care not to burn.
When you think about it, none of this should surprise anyone. Every bodybuilder knows that steroid hormones can improve athletic performance and they certainly increase muscle mass. Barry Bonds knows they increase timing and power. Activated vitamin D is as potent a steroid hormone as exists in the human body. However, unlike other steroids, levels of activated vitamin D in muscle and nerve tissue are primarily regulated by sun exposure. That's right, the rate?limiting step for the autocrine function of activated vitamin D is under your control and depends on how much daily vitamin D you receive. It's ironic that many athletes now avoid the sun. Organized baseball is even promoting sun avoidance and sunblocks.
The ancient Greeks knew better; they had their elite athletes train on the beach and in the nude.
So the level of vitamin D (50 ng/mL) associated with peak athletic performance is the very same level that recent studies show also helps to prevent cancer, diabetes, hypertension, influenza, multiple sclerosis, major depression, cognitive decline, etc. But who cares about all that disease stuff old people get! We're talking about important stuff here: speed, balance, reaction time, muscle mass and strength, squats, reps. As for my young basketball player, guess who's now taking 4,000 IU vitamin D a day? That's right! And his 25?hydroxyvitamin D level is now 54 ng/mL. Has this improved his game? Well…he said to me that he feels his timing is better and that he can jump a little higher, run faster and…oh yeah! and that the ball feels "sweeter"—whatever that means.
John Jacob Cannell MD
Executive Director
