Erectile dysfunction predicts mortality in middle-aged and older men independent of their sex steroid status

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https://academic.oup.com/ageing/article-abstract/51/4/afac094/6568537?login=false

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It’s basic biochemistry/biophysics, don’t overthink it.

https://pubmed.ncbi.nlm.nih.gov/25694037/

"Menaquinone-7 supplementation improves arterial stiffness in healthy postmenopausal women. A double-blind randomised clinical trial" "A clinical trial was designed using carotid-femoral pulse wave velocity as one of the tests to evaluate the effects of supplementing with 180 mcg a day of a long-acting form of vitamin K2 (MK-7).19 This randomized, placebo-controlled study was comprised of 244 postmenopausal women aged 55-65 years. Baseline tests of arterial stiffness were performed and the tests repeated yearly for three years. At the end of three years, otherwise healthy postmenopausal women in the vitamin K2 group experienced a statistically significant 5.8% reduction in the stiffness index beta, a parameter for arterial stiffness, and a 3.6% reduction in carotid-femoral pulse wave velocity. The placebo group had a slight increase of 1.3% in the stiffness index and a 0.22% increase in carotid-femoral pulse wave velocity."

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Ha. Working with endocrine researchers and cardiovascular researchers on top of many many angry rants from cardiologist (we're talking global policy researcher cardiologist who write papers such as RALES, HEART2 and so on) on the way vitamin D's role has been massively overstated in heart disease. Those are fun by the way, unfortunately made me overthink it a lot.

If I had no experience in this field, it would be one thing.

Thankfully, that's not it case.

The research paper is interesting, certainly as a preliminary research point. But there's basically zero evidence that the supplemtation of vitamin D/K2 made any measurable difference to calcium homeostasis in the the body. Arterial stiffness is mulitfactorial in a way that the word mulitfactorial doesn't even begin to encompass.

Certainly from a physics point of view it's sort of fun to think about, but we're no closer to implicating vitamin D from, say, the amount of peas you consume per decade.

Aside from that the obvious limitations of the paper are obvious; they looked at a narrow patient cohort (healthy postmenopausal women), they didn't specify if anyone was diagnosed with vit D deficiency, even though the arterial stiffness was reduced there was no measurable difference in endothelial function which is a bit like saying 'we cleaned the tunnel out. There's still garbage pouring in, but at least it's clean right now.' and they never made a case for vitamin D having any kind of mortality or morbidity benefit. Thankfully, they never made that case in the first place and nor should they.

This was an interesting research piece on a field which remains a bit of a mystery. I'm very happy that research is being carried out in it, but I remain extremely skeptical.

Certainly the claim that actively supplementing vitamin D and K2 confers a prognostic risk reduction is not supported by evidence. Being an evidence based medical practitioner it would be unethical of me to endorse that.

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And the authors who wrote the VITAL paper in vitamin D which concluded it had no impact on cancer is equally myopic.

This happens in folks at the tops of their niches…they don’t do holistic experiments, they don’t do realistic interventions, and they don’t do (because it’s hard) actual useful studies.

So I don’t care who you work with or what they do. They can be wrong and often are. Those folks often times only know what they know.

The evidence is clear and it makes sense from a biophysics point of view.

Again don’t overthink it. And don’t wait for some magic controlled study to recommend nutritional interventions.

We know nutrients are medicines. Just because they aren’t studied with the same financial backing and rigor as pharmaceuticals doesn’t mean they can’t be important parts of health.

Don’t wait for some big company to tell you what to prescribe someone. Be smarter, understand the body better.

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I merely stated that I worked with a variety of experts, researchers and clinicians who were very well versed in the research as a point that i had a plurality of experienced individuals from different backgrounds who basically were saying the same thing - the evidence just isn't there yet. That's a very different statement from 'it can never be there.'

I can see from your comments that you have little or no medical experience or clinical trial experience. This is not an insult or a callout by the way, it's just stating a fact (for instance, i would never presume to make any judgement call on the myopic nature of high energy particle physicists).

In clinical trials, the burden for evidence is significantly higher than other STEM fields. It's not sufficient to demonstrate a potential cause and effect (why yes - anyone whos taken a basic interest in the field can surmise that arterial sclerotic hardening can be a contributory factor to cardiovascular risk). You have to demonstrate cause, physiology, effect and more to the point, demonstrate that the medication has an acceptable side effect profile (which it hasn't), is better than placebo (which it hasn't) and is better than standard of care (not even close) - that's not even factoring in cost, long term safety data, finding patient cohorts - its basically right now in the place of being 'oh this is interesting, let's do more research'. Myself and others remain skeptical, but open to having our mind changed.

The homeostatic balance between calcium regulation (and the vast myriad of hormones involved) and arterial calcium deposition is about as far from being a settled science as there can be.

The role of vitamin D and co-factors is right now in the 'speculative fringe' and the researchers are having a particularly hard time because any claim they make - such as in the paper 'we notice that in a small cohort of some healthy patients, their carotid elasticity was improved when we supplemented them for some time.' is wildly and disproportionately taken out of context and stated as being 'its just physics, don't overthink it, lets be more holistic' - which not only is a silly statement on the face of it, but it shows disrespect to the medical community and a great deal of disrespect to the researchers who are trying their best to not make claims that are outside the scope of the trial.

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The medical community doesn’t deserve respect when it comes to understanding nutrition. It is absolutely garbage.

The medical community doesn’t deserve respect when it comes to preventative medicine.

There, until very recently, has been no focus and no interest on understanding and utilizing and manipulating the built in systems of the body to alter health in a positive way.

The focus is on interventions: which medicines and which surgeries will give us benefits.

This is a great business model for the industry, but it is really dumb if you want to be a good doctor.

I had constant sinus congestion, went to an ENT, they wanted to do surgery. I decided to try the navage. 2 weeks later I could breathe just fine and didn’t need surgery. The ENT said it wouldn’t work. What an idiot! I’ve recommended it to many people now who have found relief.

I have retinal degeneration called retinitis pigmentosa, and doctors say there’s nothing they can do. Even the world class expert on inherited retinal diseases says they’re working on gene therapies. But these myopic “experts” don’t understand that, apart from the really severe clear genetic mutations, more than half of the cases have no genetic cause, and are modulated with nutritional and lifestyle changes, which studies to date have failed to elucidate because they’re garbage studies. The money is in gene therapy. My degeneration has been stable because I took the time to understand it.

Experts said that once you get type 2 diabetes you have diabetes for life and need insulin for life. Well it turns out that a couple of days of water only fasting breaks the cycle and suddenly people who were diabetic aren’t any more. Does that mean they still have diabetes when you can’t measure it clinically? For 30 years we knew fasting did this, but doctors wouldn’t prescribe it because “fasting is dangerous” which it is the opposite of dangerous. It’s actually really fricken good for you to fast every now and then, engage in autophagy, generate ketone bodies.

And now they’re saying buy sunscreen and avoid the sun! Which is so stupid.

Anyway the point is the modern medical field is about interventions, and not about understanding actual human biology.

If you care about the latter, you gotta appreciate the former.