Vitamin D and Rehabilitation after Stroke: Status of Art
Appl. Sci. 2020, 10(6), 1973; https://doi.org/10.3390/app10061973
by Mariacristina Siotto,Massimo Santoro *OrcID andIrene Aprile
IRCCS, Fondazione Don Carlo Gnocchi, 20121 Milan, Italy
- Overview Stroke and vitamin D
- Stroke outcome at 3 months was 3X worse if bad stroke and low vitamin D – Jan 2020
- Stroke risks increased if low Vitamin D: Death 3.6 X, recurrence 5.5 X – Meta-analysis Nov 2019
- Stroke incidence not associated with low Vitamin D (but stroke outcome is) – Aug 2019
- Death after Ischemic Stroke 2.5 X more likely if less than 10 ng of Vitamin D – May 2019
- Ischemic stroke and low vitamin D – 3X higher risk of poor outcome, 6 X higher risk of a second stroke, Oct 2017
- Stroke outcome 6.9 X worse if black and overweight (all three related via low vitamin D) – March 2018
- Depression following a stroke is 2.7 X more likely if low vitamin D – Sept 2018
- Stroke mortality 3X worse among seniors with less than 26 ng of vitamin D – June 2014
Genetics category listing contains the following
see also
- Vitamin D Receptor has
530 items - Vitamin D Binding Protein = GC has
178 items - CYP27B1 has
63 items - CYP24A1 in title of 34+ items
- CYP2R1 25+ items
- Calcidiol has
48 items - Calcitriol has
62 items - Topical Vitamin D
- Nanoemulsion Vitamin D may be a substantially better form
- 1289 genes changed with higher doses of Vitamin D - RCT Dec 2019
- CYP3A4 (7 as of Dec 2022)
- Getting Vitamin D into your body
Vitamin D blood test misses a lot
- Vitamin D from coming from tissues (vs blood) was speculated to be 50% in 2014, and by 2017 was speculated to be 90%
- Note: Good blood test results (> 40 ng) does not mean that a good amount of Vitamin D actually gets to cells
- A Vitamin D test in cells rather than blood was feasible (2017 personal communication) Commercially available 2019
- However, test results would vary in each tissue due to multiple genes
- Good clues that Vitamin D is being restricted from getting to the cells
1) A vitamin D-related health problem runs in the family
especially if it is one of 51+ diseases related to Vitamin D Receptor
2) Slightly increasing Vitamin D shows benefits (even if conventional Vitamin D test shows an increase)
3) DNA and VDR tests - 120 to 200 dollars $100 to $250
4) PTH bottoms out ( shows that parathyroid cells are getting Vitamin d)
Genes are good, have enough Magnesium, etc.
5) Back Pain
probably want at least 2 clues before taking adding vitamin D, Omega-3, Magnesium, Resveratrol, etc- The founder of VitaminDWiki took action with clues #3&5
Vitamin D Receptor activation can be increased by any of: Resveratrol, Omega-3, Magnesium, Zinc, Quercetin, non-daily Vit D, Curcumin, intense exercise, Ginger, Essential oils, etc Note: The founder of VitaminDWiki uses 10 of the 12 known VDR activatorsDownload the PDF from VitaminDWiki
Stroke is the first cause of disability in the population and post-stroke patients admitted to rehabilitation units often present a malnutrition status which can influence nutritional indices and then vitamin levels. Vitamin D deficiency seems implicated beyond stroke severity and stroke risk, and also affects post-stroke recovery. Some studies on vitamin D levels and outcome in stroke patients are available but very few data on vitamin D levels and outcome after rehabilitation treatment are reported. This literature review shows the possible relationship between vitamin D deficiency and recovery in post-stroke patients undergoing rehabilitation treatment. Moreover, because several studies have reported that single nucleotide polymorphisms and promoter methylation in genes are involved in vitamin D metabolism and might affect circulating vitamin D levels, these aspects are evaluated in the current paper. From the studies evaluated in this review, it emerges that vitamin D deficiency could not only have an important role in the recovery of patients undergoing rehabilitation after a stroke, but that genetic and epigenetic factors related to vitamin D levels could have a crucial role on the rehabilitation outcome of patients after stroke. Therefore, further studies are necessary on stroke patients undergoing rehabilitation treatment, including: (a) the measurement of the 25(OH) vitamin D serum concentrations at admission and post rehabilitation treatment; (b) the identification of the presence/absence of CYP2R1, CYP27B1, CYP24A1 and VDR polymorphisms, and (c) analysis of the methylation levels of these genes pre- and post-rehabilitation treatment.
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