Vitamin D - Good or Bad?

[neo]

I know it has been very popular to take Vitamin D supplements, especially if tested low during a routine office visit's blood work. Low Vitamin D has been tied to everything from osteoporosis to depression to poor sleep. Apparently, we don't often get as much sun as we need which can lead to low Vitamin D.

I was recently tested as being low in Vitamin D, and it was suggested that I take 1,000 iu's of Vitamin D daily, over the counter. After doing some research, however, I found that Vitamin D may have a harmful effect on the lifespan of bovine (bioprosthetic) tissue valves. I had some suspicions when I read that Vitamin D improves calcium absorption. I wondered if that calcium absorption could be increased in tissue valve leaflets, which would be bad due to more rapid calcification. Then I found the article below...

Looks like this article was recently published. I would appreciate any thoughts on the matter!

http://www.cardiothoracicsurgery.org/content/pdf/1749-8090-8-11.pdf

 

[Paleowoman]

Hi Neo,

I read that paper with interest since I take a high dose of vitamin D3. Several things stand out in the paper:

1) The patient was taking alfacalcidol which is an analogue of vitamin D and not the same as vitamin D3.

2) Nowhere did the authors of the study state the serum level of D, the 25(OH)D level, of the patient. That is something they should not have excluded because we don't know if she was getting too high a level !

3) The authors state: "We could not find any reports of early prosthetic valve calcification in patients taking vitamin D supplementation, whereas it has been reported that administration of vitamin D caused the development of aortic stenosis in rabbits" Neither you nor I are rabbits but we are people (patients) !

4) The authors further state: "Serum calcium concentration in the present case was 9.1 ± 0.7 mg/dl, within the normal range of 8.0 to 10.2 mg/dl, although the pa- tient had been taking 1 μg/day of alfacalcidol for 3 years".

5) Authors further state "High calcium concentration did not seem to be directly related to early calcification in the present case."

But, as I said, they did not state the levels of serum D and the patient was taking alfacalcidol which is not vitamin D !

PS - keying in vitamin D and coronary calcification, it would seem that being vitamin D deficient leads to greater coronary calcification, how this ties in with calcification on heart valves I don't know, but a 71 year old with osteoporosis, as in that study, is likely to be vitamin D deficient...and maybe that's why she was prescribed that analogue of D - though goodness knows why she was prescribed that rather than vitamin D3 which is the form of D we humans get from the sun. As I wrote above, since the study authors did not say what the woman's level of serum D was we can only assume she was deficient and maybe that's why her valve deteriorated. Here's just three studies about the correlation of low serum vitamin D levels and calcification:

http://www.vitamindcouncil.org/vita...-calcification-in-african-americans-with-hiv/

http://www.renalandurologynews.com/...inked-to-vitamin-d-deficiency/article/141373/

http://www.easy-immune-health.com/vit-d-and-calcification-of-the-arteries-heart-disease.html

 

[neo]

Paleogirl,

Those are good points, we don't have an exact tie to VitD. However, the analog is intended to have a similar mechanism as vitD, increase absorption of calcium and direct it to certain places in the body. It seems likely, that especially with a higher level of VitD, that we could hypothesize that VitD would lead to a faster rate of calcification in artificial valves. Specific VitD calcification is seen currently only in rabbits, not humans I realize. This is still very concerning especially if there's no real need to supplement VitD.

Hi Neo,

I read that paper with interest since I take a high dose of vitamin D3. Several things stand out in the paper:

1) The patient was taking alfacalcidol which is an analogue of vitamin D and not the same as vitamin D3.

2) Nowhere did the authors of the study state the serum level of D, the 25(OH)D level, of the patient. That is something they should not have excluded because we don't know if she was getting too high a level !

3) The authors state: "We could not find any reports of early prosthetic valve calcification in patients taking vitamin D supplementation, whereas it has been reported that administration of vitamin D caused the development of aortic stenosis in rabbits" Neither you nor I are rabbits but we are people (patients) !

4) The authors further state: "Serum calcium concentration in the present case was 9.1 ± 0.7 mg/dl, within the normal range of 8.0 to 10.2 mg/dl, although the pa- tient had been taking 1 μg/day of alfacalcidol for 3 years".

5) Authors further state "High calcium concentration did not seem to be directly related to early calcification in the present case."

But, as I said, they did not state the levels of serum D and the patient was taking alfacalcidol which is not vitamin D !

 

[Paleowoman]

Hi Neo,

I was adding to my post above just as you were replying ! here I'll add it here instead:

Keying in vitamin D and coronary calcification, it would seem that being vitamin D deficient leads to greater coronary calcification, how this ties in with calcification on heart valves I don't know, but a 71 year old with osteoporosis, as in that study, is likely to be vitamin D deficient...and maybe that's why she was prescribed that analogue of D - though goodness knows why she was prescribed that rather than vitamin D3 which is the form of D we humans get from the sun. As I wrote above, since the study authors did not say what the woman's level of serum D was we can only assume she was deficient and maybe that's why her valve deteriorated. Here's just three studies about the correlation of low serum vitamin D levels and calcification:

http://www.vitamindcouncil.org/vita...-calcification-in-african-americans-with-hiv/

http://www.renalandurologynews.com/...inked-to-vitamin-d-deficiency/article/141373/

http://www.easy-immune-health.com/vit-d-and-calcification-of-the-arteries-heart-disease.html[/QUOTE]

 

[Paleowoman]

Those are good points, we don't have an exact tie to VitD. However, the analog is intended to have a similar mechanism as vitD, increase absorption of calcium and direct it to certain places in the body. It seems likely, that especially with a higher level of VitD, that we could hypothesize that VitD would lead to a faster rate of calcification in artificial valves. Specific VitD calcification is seen currently only in rabbits, not humans I realize.

As the study authors said: "Serum calcium concentration in the present case was 9.1 ± 0.7 mg/dl, within the normal range of 8.0 to 10.2 mg/dl, although the pa- tient had been taking 1 μg/day of alfacalcidol for 3 years".

Authors further state "High calcium concentration did not seem to be directly related to early calcification in the present case."

So the woman did not have increased calcium levels.

This is still very concerning especially if there's no real need to supplement VitD.

There is a real need to supplement with Vitamin D if a person is deficient in it. What constitues deficiency appears to be still debated by the medical profession. You say you were tested and found to be low in D and advised to supplement so yes, it is necessary to supplement. A 71 year old with osteoporosis is likley to be deficient in D - it's very, very common.

 

[Paleowoman]

I think this might better answer your question Neo, it is a study with much greater numbers of people (than one and some rabbits) with calcific aortic stenosis: Calcific Aortic Stenosis is Independently Associated With Increased Parathormone and Decreased Vitamin D Levels in Coronary Artery Disease Patients.

http://circ.ahajournals.org/cgi/content/meeting_abstract/116/16_MeetingAbstracts/II_679-c

 

[neo]

Yes, it appears that low VitD can contribute to calcification in regular aortas. I am talking specifically about non-human, bioprosthetic valves like we have. I would think it a big assumption to think our bodies recognize a bioprosthetic valve the same way it does native tissue. VitD sends calcium to bone. What if our bodies see bioprosthetic valves as bone? One could hypothesize that, though not yet proven. The article I posted was the only study I've seen so far relevant to calcification, bioprosthetic valves, and VitD.

I think this might better answer your question Neo, it is a study with much greater numbers of people (than one and some rabbits) with calcific aortic stenosis: Calcific Aortic Stenosis is Independently Associated With Increased Parathormone and Decreased Vitamin D Levels in Coronary Artery Disease Patients.

http://circ.ahajournals.org/cgi/content/meeting_abstract/116/16_MeetingAbstracts/II_679-c