Tuesday, July 21, 2009

7. Sepsis and Vitamin D

As we have already seen, sustained low LDL will lead to low levels of vitamin D, because LDL supplies the cholesterol to the skin that manufactures the vitamin D.

Inadequate vitamin D, in turn, is a major risk factor for sepsis. An article published in the Journal of translational Medicine [13] provides strong evidence that vitamin D deficiency is associated with increased risk of sepsis. A direct quote from this article states, "Patients with severe infections as in sepsis have a high prevalence of vitamin D deficiency and high mortality rates."

This quote from the web shows all kinds of epidemiological evidence that vitamin D is protective against sepsis, and also explains the role it might play:

"Dr. Grant points out that septicemia incidence is highest in the winter and lowest in the autumn, that rates are also generally highest in the Northeast and lowest in the Southwest, and that African Americans (who have lower levels of vitamin D) have 1.7 to 4.3 times higher incidence rates than do whites. There is also a rapid increase in risk with age, and several other chronic and infectious diseases are closely associated with that increase. All of these factors indicate vitamin D deficiency; therefore, such a deficiency could play a strong causal role in septicemia, especially since deficiency inhibits the production of cathelicidins, which not only break down the cell walls of noxious germs, but also help to reduce the endotoxins resulting from the breakdown." (Vitamin D and Sepsis) .

To summarize, doctors have argued recently that people with known heart disease should target a level of LDL that is below 70 mg/dl. People prescribed statins due to C-reactive protein will also likely achieve a similar low level of LDL, as statins are very effective at reducing cholesterol. However, such a low value for LDL is dangerous, because of the increased vulnerability you now have to infection and sepsis, due to both insufficient cholesterol and insufficient vitamin D.

No comments: