Wednesday, June 26, 2013

Fluke or Trend? Vitamin D vs Heart Disease

The latest supplement being lobbed back & forth these days is vitamin D.  At the very least, we have plenty of cause & effects studies demonstrating that vitamin D is necessary for bone health.  Without enough vitamin D, we end up with rickets.  But what about health matters unrelated to bone?  Heart disease?  Diabetes?  Cancer?

It turns out that there are plenty of studies linking low vitamin D to greater risk of death from all-causes & from heart disease.  However, these observation studies don't demonstrate cause & effect.  But as the Rolling Stones say, you can't always get what you want.  So in this case, I'll settle for an observational study published this month in the American Journal of Medicine in which the authors concluded that 25OH vitamin D less than 21ng/mL was linked to an increase risk of all-cause & cardiovascular mortality.

In a fashion not unlike that of the National Security Administration, except with permission & proper supervision, the authors gathered data from 10,170 men & women avg 47yo participating in the National Health & Nutrition Examination Study and correlated this with the National Death Index for an average of just under 4yrs.  They noted that low levels of 25OH vitamin D, up to what's currently considered insufficiency at 21ng/mL, were associated with increase risk of death from both all-causes & heart disease.  This is consistent w/recent reviews concluding that "normal" values in 30-100ng/mL range do not improve upon outcomes.

Yet despite the fact that this study supports the trend of studies linking vitamin D to our health, there's still no conclusive proof of cause & effect.  So what are we to do in the meantime?  Well, the good news is that unless you exceed 100ng/mL, it's unlikely that you'll suffer from hypercalcemia & other maladies.  In other words, vitamin D supplementation appears to be safe, as far as we currently know.  Which then makes it easier to consider supplementation if we don't have time to wait around for a cause & effect trial.  Of course, this is something that should be discussed w/your family physician.  And don't forget to think like Goldilocks. You want your 25OH vitamin D level just right, not too high & clearly, not too low.



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