Benefits in Healthy
Adults Wear Off at Higher Doses, Research Suggests
In
recent years, healthy people have been bombarded by stories in the media and on
health websites warning about the dangers of too-low vitamin D levels, and
urging high doses of supplements to protect against everything from
hypertension to hardening of the arteries to diabetes.
But
new research from Johns Hopkins finds that blood levels of the so-called
"sunshine vitamin" that are higher than the top of the range
suggested by the Institute of Medicine confer no additional benefit. This
finding, combined with results of a previous study by the same group noting
potential harm from higher vitamin D levels in healthy people, has urged
investigators to prescribe caution.
"Healthy people have been popping these pills, but they should not continue taking vitamin D supplements unchecked," says study leader Muhammad Amer, M.D., M.H.S., an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine. "At a certain point, more vitamin D no longer confers any survival benefit, so taking these expensive supplements is at best a waste of money."
Amer
stresses that there are some groups of people -- elderly, postmenopausal women,
and people with kidney disease -- who do benefit from higher blood levels of a
vitamin vital to bone health. Such groups may need to take supplements.
In
an article published online in The American Journal of Medicine,
Amer and Rehan Qayyum, M.D., M.H.S., also of Johns Hopkins, describe their
review of data from more than 10,000 participants in the National Health and Nutrition
Examination Survey (NHANES) from 2001 to 2004. They matched those data with
mortality data from the National Death Index through Dec. 2006.
When
they looked at deaths from all causes and cardiovascular disease specifically,
those with blood levels of 21 nanograms per milliliter of 25-Hydroxyvitamin D
-- at the top of the range that the IOM considers "adequate" and at
the low end of "normal" -- cut their risk of death in half. Above 21
nanograms per milliliters, the data suggest that the protective effect appears
to wear off.
The
primary source of vitamin D is the sun, and although it is found naturally in
very few foods, commercially sold milk is usually fortified with it. Amer says
as people spend more and more time indoors and slather their bodies with
sunscreen when outdoors, concern is rising that many are vitamin D-deficient.
But he says there is no set amount of supplementation that can bring someone up
to 21 nanograms per milliliter because the way people process vitamins varies.
In
research published in January 2012 in the American Journal of Cardiology, Amer
and Qayyum found that increasing levels of vitamin D in the blood are linked
with lower levels of a popular marker for cardiovascular inflammation --
c-reactive protein (also known as CRP).
Beyond blood levels of 21 nanograms per milliliter, any additional increase in vitamin D was associated with an increase in CRP, a factor linked to stiffening of the blood vessels and an increased risk of cardiovascular problems. The team's unpublished research also suggests a link between excess vitamin D and elevated homocysteine levels, another danger sign for cardiovascular disease.
Beyond blood levels of 21 nanograms per milliliter, any additional increase in vitamin D was associated with an increase in CRP, a factor linked to stiffening of the blood vessels and an increased risk of cardiovascular problems. The team's unpublished research also suggests a link between excess vitamin D and elevated homocysteine levels, another danger sign for cardiovascular disease.
People
should consult with their doctors, Amer says, before starting vitamin D
supplements and should have their blood levels checked. Still, he says,
"most healthy people are unlikely to find that supplementation prevents
cardiovascular diseases or extends their lives," and there is no consensus
among doctors on what is the right level of vitamin D in the blood for healthy
people.
"There
are a lot of myths out there and not enough data," he concludes.
Story Source:
The
above story is reprinted from materials provided byJohns Hopkins Medicine, via Newswise.
Note: Materials may be edited for content and length. For further
information, please contact the source cited above.
Journal Reference:
1. Muhammad Amer, Rehan Qayyum. Relationship
between 25-Hydroxyvitamin D and All-cause and Cardiovascular Disease Mortality. The
American Journal of Medicine, 2013; DOI: 10.1016/j.amjmed.2012.11.021
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Johns Hopkins Medicine (2013, May 1). Vitamin D: More may not be
better; Benefits in healthy adults wear off at higher doses, research
suggests. ScienceDaily. Retrieved May 3, 2013, from
http://www.sciencedaily.com/releases/2013/05/130501192929.htm