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Vitamin supplementation for health benefits is widespread among patients in our clinical practices. Data emerging from randomized trials have indicated that vitamin supplementation may not be beneficial in some cases (e.g., vitamin E for stroke), and harmful in others (e.g. beta-carotene and vitamin A for lung cancer prevention in smokers). Vitamin D is the most recent darling of vitamin fever, and the evidence has reliably been pointing to a positive effect on health. The salutary effects of vitamin D on cardiovascular disease are likely related to its ability to decrease inflammation. But should all patients be taking vitamin D?
Evidence published recently in the American Journal of Cardiology (Am J Cardiol. 2011 Oct 12. Epub ahead of print) suggests that vitamin D may not turn out to be a panacea for everybody. In this study, investigators evaluated data from the National Health and Nutrition Examination Survey (NHANES), an ongoing sample assessing the nutritional status of U.S.-based adults. The NHANES collects surveys and serum samples, and the current study evaluated the relationship between vitamin D [25-hydroxyvitamin D = 25(OH)D] and C-reactive protein (an inflammatory marker) blood concentrations from 15,167 individuals. The median serum concentration of vitamin D was 21 ng/mL. Below this median serum level, an inverse relationship was observed between vitamin D and CRP levels. Above the median serum vitamin D level, a direct relationship was observed between vitamin D and CRP levels. The authors concluded that vitamin D levels above the population median might be pro-inflammatory.
More research needs to be conducted to quantify the risks incurred by supplementing vitamin D in patients with normal concentrations of vitamin D. At the very least, this study may warrant having discussions with our patients about taking what we would consider high doses of vitamin D. Obtaining serum concentrations of vitamin D is a common clinical practice and might be a good place to start these discussions. Among patients who, for example, have osteoporosis and cardiovascular disease, we may need to make tradeoffs between the risks and benefits of vitamin D supplementation. For now, we should balance these risks by encouraging our patients implement “everything in moderation.”
Vitamin supplementation for health benefits is widespread among patients in our clinical practices. Data emerging from randomized trials have indicated that vitamin supplementation may not be beneficial in some cases (e.g., vitamin E for stroke), and harmful in others (e.g. beta-carotene and vitamin A for lung cancer prevention in smokers). Vitamin D is the most recent darling of vitamin fever, and the evidence has reliably been pointing to a positive effect on health. The salutary effects of vitamin D on cardiovascular disease are likely related to its ability to decrease inflammation. But should all patients be taking vitamin D?
Evidence published recently in the American Journal of Cardiology (Am J Cardiol. 2011 Oct 12. Epub ahead of print) suggests that vitamin D may not turn out to be a panacea for everybody. In this study, investigators evaluated data from the National Health and Nutrition Examination Survey (NHANES), an ongoing sample assessing the nutritional status of U.S.-based adults. The NHANES collects surveys and serum samples, and the current study evaluated the relationship between vitamin D [25-hydroxyvitamin D = 25(OH)D] and C-reactive protein (an inflammatory marker) blood concentrations from 15,167 individuals. The median serum concentration of vitamin D was 21 ng/mL. Below this median serum level, an inverse relationship was observed between vitamin D and CRP levels. Above the median serum vitamin D level, a direct relationship was observed between vitamin D and CRP levels. The authors concluded that vitamin D levels above the population median might be pro-inflammatory.
More research needs to be conducted to quantify the risks incurred by supplementing vitamin D in patients with normal concentrations of vitamin D. At the very least, this study may warrant having discussions with our patients about taking what we would consider high doses of vitamin D. Obtaining serum concentrations of vitamin D is a common clinical practice and might be a good place to start these discussions. Among patients who, for example, have osteoporosis and cardiovascular disease, we may need to make tradeoffs between the risks and benefits of vitamin D supplementation. For now, we should balance these risks by encouraging our patients implement “everything in moderation.”
Vitamin supplementation for health benefits is widespread among patients in our clinical practices. Data emerging from randomized trials have indicated that vitamin supplementation may not be beneficial in some cases (e.g., vitamin E for stroke), and harmful in others (e.g. beta-carotene and vitamin A for lung cancer prevention in smokers). Vitamin D is the most recent darling of vitamin fever, and the evidence has reliably been pointing to a positive effect on health. The salutary effects of vitamin D on cardiovascular disease are likely related to its ability to decrease inflammation. But should all patients be taking vitamin D?
Evidence published recently in the American Journal of Cardiology (Am J Cardiol. 2011 Oct 12. Epub ahead of print) suggests that vitamin D may not turn out to be a panacea for everybody. In this study, investigators evaluated data from the National Health and Nutrition Examination Survey (NHANES), an ongoing sample assessing the nutritional status of U.S.-based adults. The NHANES collects surveys and serum samples, and the current study evaluated the relationship between vitamin D [25-hydroxyvitamin D = 25(OH)D] and C-reactive protein (an inflammatory marker) blood concentrations from 15,167 individuals. The median serum concentration of vitamin D was 21 ng/mL. Below this median serum level, an inverse relationship was observed between vitamin D and CRP levels. Above the median serum vitamin D level, a direct relationship was observed between vitamin D and CRP levels. The authors concluded that vitamin D levels above the population median might be pro-inflammatory.
More research needs to be conducted to quantify the risks incurred by supplementing vitamin D in patients with normal concentrations of vitamin D. At the very least, this study may warrant having discussions with our patients about taking what we would consider high doses of vitamin D. Obtaining serum concentrations of vitamin D is a common clinical practice and might be a good place to start these discussions. Among patients who, for example, have osteoporosis and cardiovascular disease, we may need to make tradeoffs between the risks and benefits of vitamin D supplementation. For now, we should balance these risks by encouraging our patients implement “everything in moderation.”