Q&A: optimal vitamin D levels; reducing risk for cholesterol plaque; preventing UTIs; & should I take hormones

Happy New Year! 🎉

ICYMI 👉

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In this week’s reader-submitted Q&A, we’re tackling these questions:

• What is the optimal vitamin D level?

• How do I stave off cholesterol plaque buildup?

• How can I prevent UTIs?

• Am I missing out by not taking HRT?

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Disclaimer: The views expressed here are entirely my own. They are not a substitute for advice from your personal physician.

Photo by Michele Blackwell on Unsplash

The following subscriber questions have been lightly edited for length and clarity.

QUESTION #1: OPTIMAL VITAMIN D LEVELS

I have osteoporosis and my latest Vitamin D level was 30. My endocrinologist wants it increased to 40 and has recommended that I increase my dosage of daily Vitamin D from 1000 IUs to 2000 IUs. Seems high and I know that there is a difference of opinion with respect to Vitamin D levels. What are your thoughts? Also, is there any reason to take D other than bone health?

-Jill

Dear Jill,

Vitamin D supplementation had its heyday about 10 years ago when it was hypothesized to help with everything from breast cancer prevention and cardiovascular disease to depression and weight loss. However, a systematic review of data from nearly 250 studies published between 2009 and 2013 concluded that no relationship could be firmly established between vitamin D and health outcomes other than bone health.

Vitamin D helps the body absorb calcium, which is essential for maintaining strong bones and teeth. A deficiency can lead to conditions like rickets in children and osteoporosis in adults. (My piece about bone health is here.)

Vitamin D levels are measured in ng/ML and here are some goalposts:

• Vitamin D deficiency = Less than 20 ng/mL

• Insufficient vitamin D: 20–29 ng/mL

• Optimal vitamin D: 30–50 ng/mL

• Possible Upper Limit: 50–100 ng/mL (generally safe but avoid going above 100 ng/mL)

For anyone with osteopenia or osteoporosis, it’s best to aim for the higher end of the optimal range (30–50 ng/mL) to support bone health, but 30–40 ng/mL is often sufficient for most people.

Vitamin D may also play a role in supporting the immune system, helping the body fend off infections and diseases. Some studies suggest that vitamin D may help improve mood and reduce the risk of depression. It supports muscle strength and function, which is particularly important as we age. There is ongoing research into vitamin D's role in reducing the risk of certain chronic diseases, including heart disease and some cancers. But for now, think of vitamin D as a bone vitamin above all else.

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QUESTION #2: PREVENTING CHOLESTEROL PLAQUE

What's the best way to prevent cholesterol plaque buildup? and can it be reversed? or do lifestyle changes/meds just help prevent further buildup?

-Jennifer

Dear Jennifer,