Vitamin D and Prostate Cancer | Helpline Questions
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Vitamin D and Prostate Cancer | Helpline Questions

December 16, 2019

Hi, I’m Dr. Scholz. The subject of vitamin D comes up frequently
when talking about prostate cancer. Why is that? Well, probably because men with prostate
cancer are often treated with hormonal therapy which 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 into the bloodstream. So everyone who is getting
hormonal therapy, typically, is advised to take 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 magical things. I’ve seen this pattern over and over
with all kinds of supplements where discoveries are made that they’re necessary and then the
public tends to go overboard and believe that massive amounts are going to be useful. The
problem with that thinking is that massive amounts of anything are almost never useful,
and so the appropriate approach, at least with vitamin D is to test the levels in the
blood, and I don’t know why that’s not talked about 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 out that the general population that I see (men
in their 60s, 70s, and 80s) about 25% of men run low vitamin D levels—that is, below
30—and low vitamin D is going to mess up calcium metabolism and can have other deleterious
effects. So, testing once a year should be an 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 then retesting after about three or four months.
It takes a while for new levels to equilibrate once the vitamin D has been started. You can’t
check it a week or two later. And then once normal levels are achieved periodic rechecks
are necessary to ensure that it is maintained and also to make sure that the levels don’t
go too high. So, in summary, vitamin D is a very appropriate thing for men with prostate
cancer, especially those that are on hormonal therapy. 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 much vitamin D is a potentially negative thing
that could lead to problems instead of becoming a solution.

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