Vitamin D and DHEA Help Men Avoid Frailty: Study – EndocrineWeb
With age, frailty—defined as a gradual loss of energy, strength and physical ability—leads to a loss of mobility, falls and even death, experts know.
Now, new research suggests that men with sufficient Vitamin D levels are more apt to avoid frailty. In older men, over 70, having enough male hormones may also help.
So vitamin D is not just good for bones, says Agnieszka Swiecicka, MD, a clinical research fellow at the University of Manchester in Manchester, U.K. She presented the findings Sunday, Apr. 2 at ENDO 2017, the annual meeting of the Endocrine Society, in Orlando.1
She evaluated more than 3,000 men, ages 40 to 79, over a four-year period. She assessed their hormone levels, vitamin D levels and their degree of frailty using standard measures. She looked at low muscle mass, exhaustion, how fast they walked and how much they exercised.
Vitamin D—Frailty Link
The men who had higher vitamin D levels at the study start were less likely to become frail later. With each unit increase in vitamin D levels, she says, the risk of frailty decreased. “Vitamin D [levels] were associated with a reduction of frailty in both frailty models [she used],” Dr. Swiecicka says.
“Vitamin D, besides maintaining bone health, regulates muscle function, and low vitamin D levels are linked to lower muscle mass and strength,” she says. In older men, over 70, those with higher levels of the male hormone DHEA-S, were also less frail, she says. For those 70-plus, higher DHEA levels reduced frailty by about 43%, she says. She speculates that DHEA-S may have a direct effect on the muscle. Recently, experts say it may also help the brain and the immune system.
Dr. Swiecicka found that those who became more frail over the follow up also had lower body mass indexes and were older, on average age 61. They were also more likely to have diabetes. While 5% of those who didn’t become more frail over the follow up had diabetes, 8% of those who deteriorated did.
Previous Vitamin D-Frailty Research
In a previous study, Australian researchers evaluated more than 4,000 older men, ages 70 to 88. They found that vitamin D status predicted independently who would become frail.
Those who had the lowest vitamin D levels, compared with those with the highest, were also about 20% more likely to die over a nine-year follow up. The risk of death was not solely dependent on frailty status, however. 2
A Dietitian Speaks
“Vitamin D intake is one that is challenge for most adults,” says Connie Diekman, RD, director of university nutrition at Washington University in St. Louis, who reviewed the findings. Yet, she says, ”the impact on bone health, immune function and other aspects of metabolism can be significant. As we age our ability to convert the inactive vitamin D in the skin declines, and often sun exposure decreases as well so that vitamin D deficiency in adults is common.”
“The current level of understanding about adequate vitamin D intake and the roles of vitamin D in health are evolving, but this study provides one more consideration for why we need to monitor vitamin D status to prevent some of the maladies of aging.”
How Much is Enough?
According to the Institute of Medicine, adults 51 to 70 should aim for 600 International Units (IUs) a day; those over 70, 800 IUs. (The upper tolerable limit is 4,000 IUs for children 9 years and above and adults.) However, your doctor may suggest a different amount.3
“Everyone is at risk of vitamin D deficiency, including older men,” says Michael Holick, MD, PhD, professor of medicine, physiology and biophysics at Boston University Medical Center, and a long-time vitamin D researcher. “I recommend to my older male patients the same as I recommend for all my patients. They should be on at least 3,000 IUs of vitamin D a day. I am on 4,000 IUs a day which is perfectly fine.” Your doctor can order a blood test to evaluate your levels, and base advice on the results.
Among the good sources of vitamin D from food is salmon, which has about 450 IUs per 3-oz serving, and swordfish, with more than 560 IUs in the same size serving. Many people rely on a vitamin D supplement to get enough.3
DHEA Past 70 and Frailty
Overall, having higher levels of DHEA, a hormone made in the adrenal gland and the brain, was linked with less frailty. However, after Dr. Swiecicka adjusted for age, she found that higher DHEA levels were linked with a lower risk of worsening frailty in men older than 70, but not in younger men.
In those over 70 years old, higher levels of DHEA reduced frailty risk by 43%.
More About DHEA
DHEA triggers the production of both androgens and estrogens, the male and female sex hormones. Levels of DHEA produced by the body begin to decline after age 30, experts know. 4 Due to potential risks of prostate, breast and ovarian cancers, DHEA supplement use is not suggested without guidance from your doctor. 4
Doses vary depending on the condition being treated, according to Mayo Clinic. For instance, doses of 50 to 200 milligrams of DHEA have been taken by mouth every day for up to two years to improve bone density. However, research is evolving. 4
It’s especially important that your doctor know if you are taking DHEA supplements because some diabetes drugs (including metformin) can increase DHEA levels. Your DHEA levels can be assessed with a blood test. 5