Does vitamin D supplementation reduce risk of dementia, the right time for a GLP-1 medication, and take the challenge or regret not knowing.

Does Vitamin D supplementation decrease risk of dementia?

I came across a study that examined the association between vitamin D supplementation and incident dementia in 12,388 dementia-free adults from the National Alzheimer's Coordinating Center titled, Vitamin D supplementation and incident dementia: Effects of sex, APOE, and baseline cognitive status, published fairly recently, two years ago in March, 2023. 

Vitamin D is a nutrient that is essential for many bodily functions, including bone health, immune function, and cognitive function. In recent years, there has been growing interest in the potential role of vitamin D in dementia prevention, and this study aimed to see if there was a correlation between actual vitamin D supplementation and incidence of dementia. 

In short, the study found and stated that “vitamin D exposure was associated with significantly longer dementia-free survival and lower dementia incidence rate than no exposure”. 

SIGNIFICANTLY longer dementia-free survival and lower dementia incidence.

Here are some key highlights from the findings of this study:

• Vitamin D exposure was associated with 40% lower dementia incidence versus no exposure.

• Vitamin D effects were significantly greater in females versus males and in normal cognition versus mild cognitive impairment.

• Vitamin D effects were significantly greater in apolipoprotein E ε4 non-carriers versus carriers.

Let’s unpack these findings a bit more. 

Overall, the occurrence of vitamin D supplementation showed a 40% lower incidence of dementia, which I would definitely agree is quite significant, especially considering this is just a single, very inexpensive preventive intervention with a host of other researched potential benefits such as improved immune function, and reduced risk of other diseases. 

That said, the study found that women (who also comprise 65-70% of the total population afflicted with Alzheimer’s) were even more significantly affected by vitamin D supplementation.

It also found that those who exhibit no signs of dementia, and had normal cognitive function were also more significantly affected by vitamin D supplementation. Which means, prevention here with vitamin D supplementation (and natural sunlight exposure, which is the natural way to supplement with vitamin D3) is key, as supplementation BEFORE any signs of dementia actually shows a greater impact on helping to keep you free of dementia. 

Finally, non-carriers of APOE e4, a common genetic risk factor for Alzheimer’s, were found to also have a more significant impact on reducing incidence of dementia with vitamin D supplementation. If Alzheimer’s and/or other forms of dementia seem to run in the family, it’s probably worth testing for this. 

Final Thoughts

The study's findings are consistent with some previous research, which has suggested that vitamin D deficiency may be a risk factor for dementia. The difference with this study was that it was attempting to see if there was a correlation between actual vitamin D supplementation and incidence of dementia, which was found, and found to be significant at that. 

One limiting factor of the study was that it was observational and based on existing data sets, and was unable to determine a therapeutic, researched dose of vitamin D supplementation to reduce risk of incidence of dementia. 

Vitamin D supplementation needs can vary based on the individual, so it always helps to get your levels checked with some blood work. That said, there are some general rules I tend to follow that I think are pretty reliable. 

During the warmer spring and summer months, where sunlight is far more direct, (which we are just getting into with the beginning of spring) and thus, effective at helping the body to naturally produce vitamin D3 (as well as making it more enjoyable to be outside gaining that natural exposure) I try to get as much natural light exposure as possible, and then supplement with probably 10,000-15,000iu of vitamin D3 per week. 

During the colder, drearier winter months, where sunlight is also far less direct, and far less effective at helping to produce D3 naturally, I will supplement with upwards of 50,000iu per week. 

I also recommend supplementing with extra vitamin K2 either through a high quality multivitamin, or a separate vitamin K2 supplement, with a vitamin D3 supplement.  

Vitamin D3 when taken in higher, what would be known as “therapeutic doses”, helps with calcium absorption, which is great for your bones, however, it can also lead to calcium buildup in your bloodstream, which you don’t want, and vitamin K2 helps mitigate that, along with having its own therapeutic benefits. 

This is a relatively minor downside to vitamin D3 supplementation, which can easily be offset by supplementing with extra vitamin K2, and I would say the tremendous, multi-faceted health benefits of supplementing with vitamin D3 far outweigh this minor downside. 

Improving longevity is typically a combination of small actions and steps done with relative consistency over time, and supplementing with vitamin D3, an inexpensive addition if you currently are not, can go a long way in living a healthier, longer life, free of disease. 

We are closing out what’s turned into a 4 week segment on GLP-1 by discussing some use cases where a prescribed GLP-1 receptor agonist, or “GLP-1” like Ozempic™️ or Mounjaro™️ could be the best answer and life saving. 

In the weeks prior, I wrote about the actual hormone called GLP-1 your produces endogenously, and all of the healthspan and longevity inducing benefits of it, and all the reasons why I have been paying attention to this hormone for years, and do what I can to maximize my own body’s production of this very beneficial hormone. 

If you haven’t caught any of these segments in the previous weeks, I highly recommend getting up to speed now, or after reading this.

In the first week, I began with a primer on GLP-1 and discussed its role in the body and how it is naturally produced. 

Next I wrote about the aforementioned healthspan and longevity inducing long term benefits increased GLP-1 can have beyond weight loss. 

Finally, last week I wrote about how you can harness the power of GLP-1 naturally to achieve those healthspan and longevity inducing benefits.

What is a GLP-1 receptor agonist?

The weight loss medications you keep hearing about called “GLP-1s”, and some of you may be taking are technically a GLP-1 receptor agonist. A GLP-1 receptor agonist (Glucagon-Like Peptide-1 receptor agonist) is a type of medication that mimics the action of the natural GLP-1 hormone, which we’ve now discussed in length in the previous weeks. 

Since a “GLP-1” mimics the natural hormone GLP-1 in the body, they provide the same results just accelerated, Here’s how a GLP-1 medication works at the receptor level: 

• These drugs are designed to activate GLP-1 receptors, which are found in key areas like the pancreas, brain, stomach, and intestines.

• Once activated, the receptors trigger the same effects as natural GLP-1, such as increasing insulin secretion, reducing glucagon release, slowing gastric emptying, and promoting satiety.

• However, unlike natural GLP-1 (which is broken down quickly by an enzyme called DPP-4), GLP-1 receptor agonists are engineered to last longer in the body, providing more sustained effects.This is key, and why they provide accelerated results. 

So, you’re telling me that GLP-1 receptor agonists simply mimic the GLP-1 hormone, which we naturally produce in the body?

Yes.

Why not just focus on doing the things you’ve outlined in previous weeks to help your body produce more of this beneficial hormone instead of taking a synthetic medication that mimics something your body produces naturally?

I agree, most of the time. 

When a GLP-1 Could Be Life Saving

First, I want to begin with the instances where I don’t think a GLP-1 receptor agonist medication should be used.

With children. Even if they are obese and struggle with their food intake, ultimately, this is a synthetic medication that mimics a natural process in the body, and you do not want to mess with hormones in a developing child in this way. 

Now, I also stress that this is just my opinion. 

Secondly, if you are looking for a small amount of weight loss. In instances like this, you can definitely achieve this kind of weight loss by naturally harnessing the power of your own endogenous GLP-1. It may take a little longer than using a “GLP-1” medication, but you’re also not synthetically messing with your endogenous hormone production. 

But again, just my opinion. 

If you or anyone considering a GLP-1 for that matter, would be classified as a “metabolic emergency”, meaning the individual in question has such poor cellular metabolism that they are gaining lots of excessive weight and/or have type II diabetes that they are not controlling naturally, a “GLP-1” could be part of getting on the right path, and ultimately could be key to saving someone’s life. 

Plenty of natural and functional health focused individuals, most of whom make their money off positioning themselves as an expert, may say that a GLP-1 medication has no place under any circumstances due to the potential side effects. 

I tend to disagree. 

A GLP-1 medication like an Ozempic™️ or Mounjaro™️ will work, and work quickly for most individuals, which again, I think could be life saving, making any potential side effects relatively arbitrary to the potential upside. 

If an individual is at a point in their life where their health is deteriorating fast, and they are not getting it under control on their own, a once weekly shot of a GLP-1 receptor agonist will most definitely cut their appetite and cut it quickly. 

This significant and immediate reduction in appetite will lead to less calories consumed as well as giving your body time to re-regulate its ability to process blood sugar, and from there, a whole host of symptoms related to poor metabolic health will begin to right themselves. 

I’ve also seen firsthand that this can then be the “lightbulb” moment that is needed for those who were unable to control their weight prior. 

In these instances, when an individual’s health is a metabolic emergency, meaning their cellular metabolism is so poor that they are at a much greater risk for all the lifestyle oriented diseases related to poor metabolic health: cancer, Alzheimer’s, diabetes, and heart disease, then yes, this kind of an intervention could be life saving, and thus, worth the potential side effects in my opinion. 

Let’s Discuss the Side Effects 

✔️ Gut & Intestinal Distress and Discomfort. 

The most common side effect seems to be gut and intestinal distress and irritability that could cause some extreme discomfort and more trips to the bathroom than most would like. 

Now, if you are in the category of “metabolic emergency”, this is relatively minor if it means it saves or significantly extends your life. 

However, this also seems to be a result of increasing and higher doses than needed. 

The typical dosing protocol for these GLP-1 medications is to basically keep increasing the dosage (which lets be honest, may be to drive up the price you’re paying) to a point where you can no longer tolerate. 

If the main benefits come from the blood sugar regulation and the significant decrease in appetite, and the rest kind of takes care of itself with time, maybe don’t keep increasing the dosage, and just find a lower dose that seems to have a positive impact on reducing your appetite and staying there, which will make it less likely to result in these side effects. 

More isn’t always more; sometimes less is more. 

✔️ Muscle & Bone Loss

A very common side effect reported from GLP1 receptor agonists is what seems to be a significant loss of bone and muscle mass, two very important things for maintaining healthspan and longevity. 

No doubt this is definitely noteworthy, as I’ve written extensively on the importance of muscle for longevity, however, I don’t think this is a direct example of correlation equals causation. 

If an individual is taking a GLP-1 receptor agonist medication, most likely their diet isn’t very good, and thus, devoid of a lot of high quality protein. 

In a caloric surplus as these individuals typically run, they may get enough protein for basic muscle and bone maintenance kind of by default from simply eating too many calories, but typically, it’s not coming from eating adequate amounts of high quality protein. 

Now, give these individuals a medication that significantly reduces their appetite, and you now have individuals with poor eating habits, eating less, many times, a lot less, and now in a massive caloric deficit, and are probably getting nowhere near the amount of quality protein they need for muscle and bone maintenance. 

I would highly, highly recommend individuals taking a GLP-1 receptor agonist supplement with extra protein, amino acids, and ensure the limited calories they do consume, are comprised of high quality protein. 

And again, if an individual is considered a”metabolic emergency”, getting the weight off them quickly, and getting blood sugar stabilized, as well as systemic inflammation reduced, is more critical, and the muscle and bone loss can be addressed later, after they’ve extended their life. 

✔️ Rebound Effect
 
If you don't use it, you lose it. If you go off of a GLP-1 1 medication, there does seem to be a fairly significant “rebound” effect, which can lead to sudden weight gain. 

This makes sense if you think about how these medications work. 

They mimic, and for much, much longer (which yes, does accelerate their benefits) the natural GLP-1 your body produces. 

So, if you’re getting all these benefits from a synthetic GLP-1 mimicker you are injecting into your body, it would make sense that your body might down regulate its own production of GLP-1 over time. 

Now imagine you stop taking a GLP-1 medication AND your body is no longer producing GLP-1 naturally, or significantly less than it was prior to you taking the “GLP-1”, you can see how that might cause what they call a “rebound” effect where you then gain weight back more quickly. 

I wouldn’t recommend taking a GLP-1 forever for this reason, or for super long periods of time without cycling off at minimum. 

I would also recommend supplementing with a natural GLP-1 stack that will help your body produce it naturally and help it secrete more GLP-1 when you do stop taking a GLP-1 to try to mitigate most of or avoid the “rebound” effect. 

Take the challenge or you will regret not knowing.

Is there something in your life you want to do, but are stalling, holding off on, or ignoring for fear of the outcome?

What’s the worst that could happen?

For some of you, it could be existential, and something you truly do need to consider with lots of care and concern. 

However, I’d bet for many of us the worst case would be failure, or things not turning out as you’d hoped. 

Nothing existential. 

You’re still alive and well, and here to fight another day. 

Even amidst the failures, there are learning moments you simply cannot achieve without going after it. 

Life is more fun when you go after it. 

Even if “it” doesn’t work out, you are now gifted with hindsight and an opportunity to learn, grow, and evolve. 

And what you don’t have is the regret of not knowing.