Vitamin D Supplements for Increasing Aging Muscle Strength

We have known for more than 400 years that muscle weakness is a common presenting symptom of vitamin D deficiency. Bones aren’t the only organs that respond to vitamin D—muscles do, too. However, as we age, our muscles lose vitamin D receptors, perhaps helping to explain the loss in muscle strength as we age. Indeed, vitamin D status does appear to predict the decline in physical performance as we get older, with lower vitamin D levels linked to poorer performance. As I discuss in my video in my video Should Vitamin D Supplements Be Taken to Prevent Falls in the Elderly?, maybe the low vitamin D doesn’t lead to weakness. Rather, maybe the weakness leads to low vitamin D. Vitamin D is the sunshine vitamin, so being too weak to run around outside could explain the correlation with lower levels. To see if it’s cause and effect, you have to put it to the test.

As you can see at 1:01 in my video, about a dozen randomized controlled trials have tested vitamin D supplements versus sugar pills. After putting them all together, we can see that older men and women taking vitamin D get significant protection from falls, especially among those who had started out with relatively low levels. This has led the conservative U.S. Preventive Services Task Force, the official prevention guideline setting body, and the American Geriatric Society to “recommend vitamin D supplementation for persons who are at high risk of falls.”

We’re not quite sure of the mechanism, though. Randomized controlled trials have found that vitamin D boosts global muscle strength, particularly in the quads, which are important for fall prevention, though vitamin D supplements have also been shown to improve balance. So, it may also be a neurological effect or even a cognitive effect. We’ve known for about 20 years that older men and women who stop walking when a conversation starts are at particularly high risk of falling. Over a six-month timeframe, few who could walk and talk at the same time would go on to fall, but 80 percent of those who stopped walking when a conversation was initiated ended up falling, as you can see at 2:14 in my video.

Other high-risk groups who should supplement with vitamin D include those who have already fallen once, are unsteady, or are on a variety of heart, brain, and blood pressure drugs that can increase fall risk. There’s also a test called “Get-Up-and-Go,” which anyone can do at home. Time how long it takes you “to get up from an armchair, walk 10 feet, turn around, walk back, and sit down.” If it takes you longer than ten seconds, you may be at high risk.

So, how much vitamin D should you take? As you can see at 3:00 in my video, it seems we should take at least 700 to 1,000 units a day. The American Geriatric Society (AGS) recommends a total of 4,000 IU a day, though, based on the rationale that this should get about 90 percent of people up to the target vitamin D blood level of 75 nanomoles per liter. Although 1,000 IU should be enough for the majority of people, 51 percent, the AGS recommends 4,000 IU to capture 92 percent of the population. That way, you don’t have to routinely test levels, since 4,000 IU will get most people up to the target level and “is considerably below the proposed upper tolerable intake of 10,000 IU/d.” The AGS does not recommend periodic mega-doses.

Despite the AGS’s recommendation, because it’s hard to get patients to comply with pills, why not just give people one megadose, like 500,000 units, once a year, perhaps when they come in for their flu shot? That way, every year, you can at least guarantee an annual spike in vitamin D levels that lasts a few months, as you can see at 4:00 in my video. It’s unnatural but certainly convenient, for the doctor at least. The problem is that it actually increases fall risk, a 30 percent increase in falls in those first three months of the spike. Similar results were found in other mega-dose trials. It may be a matter of too much of a good thing. See, “vitamin D may improve physical performance, reduce chronic pain, and improve mood” so much that people start moving around more and, thereby, increase fall risk. When you give people a whopping dose of vitamin D, they get a burst in physical, mental, and social functioning, and it may take time for their motor control to catch up to their improved muscle function. It would be like giving someone a sports car when they’ve been used to driving a beater. You’ve got to take it slow.

It’s possible, too, that such unnaturally high doses may actually damage the muscles. The evidence the researchers cite in support is a meat industry study showing you can improve the tenderness of steaks by feeding cattle a few million units of vitamin D. The concern is that such high doses may be over-tenderizing our own muscles, as well. Higher vitamin D levels are associated with a progressive drop in fracture risk, but too much vitamin D may be harmful, as you can see at 5:29 in my video.

The bottom line is that vitamin D supplementation appears to help, but the strongest and most consistent evidence for prevention of serious falls is exercise. If you compare the two, taking vitamin D may lower your fall risk compared to placebo, but strength and balance training with or without vitamin D may be even more powerful, as you can see at 5:41 in my video.


Other studies in which vitamin D supplements have been put to the test in randomized placebo-controlled studies, effectively proving—or disproving—their efficacy, are featured in videos such as:

That brings up a number of important questions, which I answer in these videos:

Unfortunately, most supplements are useless—or worse. Here are some additional videos on supplements I’ve produced that may be of interest to you:

For more on the benefits of exercise, see Longer Life Within Walking Distance and How Much Should You Exercise?

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

What to Take for Menstrual Cramps

In my video Ginger for Migraines, I described how ginger works as well as the leading “drug” in the treatment of migraines, “one of the most common causes of pain syndromes,” affecting as much as 12 percent of the population. Twelve percent is “common”?

How about menstrual cramps, which plague up to 90 percent of younger women? You can tell this study was written by a guy because he emphasizes the absenteeism and all the “lost productivity” for our nation. Menstrual cramps also just really hurt.

Can ginger help? As I discuss in my video Benefits of Ginger for Menstrual Cramps, women took a quarter teaspoon of ground ginger powder three times a day during the first three days of menstruation, and pain dropped from seven on a scale of one to ten down to a five, whereas there was no significant change in the placebo group, as you can see at 0:56 in my video. Most women in the placebo group said their symptoms stayed the same, whereas those unknowingly in the ginger group said they felt much better.

A subsequent study found that even just an eighth of a teaspoon three times a day appeared to work just as well, dropping pain from an eight to a six and, in the second month, down to a three. The “alleviation of menstrual pain was more remarkable during the second month of the intervention,” and study participants had only been taking the ginger for four days, not the whole month, suggesting it might work even better if women use ginger every period. 

What about the duration of pain? As you can see at 1:52 in my video, a quarter teaspoon of ground ginger powder three times a day not only dropped the severity of pain from about a seven down to a five but also decreased the duration of total hours in pain from 19 hours down to about 15 hours, indicating that three quarters of a teaspoon of ginger powder a day for three days is a safe and effective way to produce pain relief in college students with painful menstrual cramps, compared to placebo, capsules filled instead with powdered toast. But women don’t take breadcrumbs for their cramps. How does ginger compare with ibuprofen? An eighth of a teaspoon of ginger powder four times a day for three days versus 400 milligrams of Motrin were put to the test, and the ginger worked just as well as the drug of choice, as you can see at 2:40 in my video.

If you do take the drug, though, I was surprised to learn that it may be better to take drugs like ibuprofen and naproxen on an empty stomach because that may speed up the pain relief and help keep people from taking higher doses.


I’ve touched on this effect before in Ginger for Nausea, Menstrual Cramps, and Irritable Bowel Syndrome. What else can this amazing plant do? See, for example:

What else can really help with cramps, PMS, and cyclical breast pain? Check out:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

How to Treat Endometriosis with Diet

“Endometriosis is a major cause of disability and compromised quality of life in women and teenage girls.” It “is a chronic disease which is under-diagnosed, under-reported, and under-researched…[and for patients, it] can be a nightmare of misinformation, myths, taboos, lack of diagnosis, and problematic hit-and-miss treatments overlaid by a painful, chronic, stubborn disease.”

Pain is what best characterizes the disease: pain, painful intercourse, heavy irregular periods, and infertility. About one in a dozen young women suffer from endometriosis, and it accounts for about half the cases of pelvic pain and infertility. It’s caused by what’s called “retrograde menstruation”—blood, instead of going down, goes up into the abdominal cavity, where tissue of the uterine lining can implant onto other organs. The lesions can be removed surgically, but the recurrence rate within five years is as high as 50 percent.

Endometriosis is an estrogen-dependent disease, so might the anti-estrogenic effects of the phytoestrogens in flaxseeds and soy foods help, as they appear to do in breast cancer? I couldn’t find studies on flax and endometriosis, but soy food consumption may indeed reduce the risk of that disease. What about treating endometriosis with soy? While I couldn’t find any studies on that, there is another food associated with decreased breast cancer risk: seaweed.

Seaweeds have special types of fiber and phytonutrients not found in land plants, so in order to get these unique components, we would need to incorporate sea vegetables into our diet. Seaweeds, may have anti-cancer properties, including anti-estrogen effects. Japanese women have among the lowest rates of breast, endometrial, and ovarian cancers, as well as longer menstrual cycles and lower estrogen levels circulating in their blood, which may help account for their low risk of estrogen-dependent cancers. We assumed this was due to their soy-rich diets, but their high intake of seaweed might also be helping.

When seaweed broth was dripped on human ovary cells that make estrogen, estrogen levels dropped. Why? It either inhibits production or facilitates breakdown of estrogen. It may even block estrogen receptors, lowering the activity of the estrogen that is produced. This is in a petri dish, though. Does it happen in women, too? Yes.

Researchers estimated that an effective estrogen-lowering dose of seaweed for an average American woman might be around five grams a day, but, apparently, no one has tried testing it on cancer patients yet. However, it has been tried on endometriosis, as I discuss in my video How to Treat Endometriosis with Seaweed.

Three women with abnormal menstrual cycles, including two with endometriosis, volunteered to add a tiny amount of dried, powdered bladderwrack, a common seaweed, to their daily diet. This effectively lengthened their cycles and reduced the duration of their periods—and not just by a little. As you can see at 3:14 in my video, subject 1 had a 30-year history of irregular periods, averaging every 16 days. Taking just a quarter-teaspoon of this seaweed powder a day added 10 days onto her cycle, up to 26 days, and adding a daily half-teaspoon increased her cycle to 31 days, nearly doubling its length. Furthermore, as you can see at 3:38 in my video, all three women experienced marked reductions in blood flow and a decreased duration of menstruation. For 30 years, subject 1 had been having her period every 16 days, and it typically lasted 9 days. Can you imagine? Then, by just taking a daily half-teaspoon of seaweed, her period came just once a month and only lasted about four days. Most importantly, in the two women suffering from endometriosis, they reported “substantial alleviation” of their pain. How is that possible? There was a 75 percent drop in estrogen levels after just a quarter-teaspoon of seaweed powder a day and an 85 percent drop after a half-teaspoon. 

Of course, with just a few women and no control group in that study, we need bigger, better studies. But, that study was published more than a decade ago and not a single such study has been published since. Millions of women are suffering with these conditions. Does the research world just not care about women? The more pointed question is: who’s going to fund the work? Less than a teaspoon of seaweed costs less than five cents, so a larger study may never be done. But, without any downsides, I suggest endometriosis sufferers give it a try.


For more on endometriosis, see my video What Diet Best Lowers Phthalate Exposure?, and, to learn about the anti-estrogenic effects of the phytoestrogens in flaxseeds on breast cancer, see Flaxseeds and Breast Cancer Survival: Clinical Evidence.

Interested in more on sea vegetables? See:

I recommend staying away from kelp and hijiki, though. Why? See Too Much Iodine Can Be as Bad as Too Little.

Learn more about other natural remedies for menstrual problems:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: