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Vitamin D supplements cut heart attack risk by 52%. Why?(empirical.health)
74 points by brandonb 2 hours ago | 35 comments
Aurornis 28 minutes ago | parent | next [-]

The headline is poorly worded. The 52% number was for people with Vitamin D levels within a certain range, whether or not they took supplements

EDIT: The study was also performed exclusively on patients who presented with acute coronary syndrome. Average age was over 60, nearly 80% were men, and half had already had at least one heart attack.

> Participants in the experiment arm who stayed within 40-80 ng/mL of vitamin D had a 52% lower risk of a repeat heart attack.

The study did use supplements to get people into that range if necessary, but the important thing is to keep your Vitamin D in that range, not specifically to just take supplements.

There’s a lot of claims online that everyone’s Vitamin D is too low and we should all be taking very high dose supplements, but it’s getting exaggerated. My doctor said she’s seeing a huge number of patients coming back with excessively high Vitamin D levels after taking supplement doses recommended by influencers. It happened to me, too, with what I though was a conservative dose of Vitamin D (5K IU, not even taken every day)

So you really have to check. Even though I work indoors and wear sunscreen a lot, apparently my diet and limited sun exposure alone are sufficient for staying in this range. Others will have different results. Don’t guess!

Also remember that Vitamin D levels change slowly. Supplementation can build up and accumulate in the body over time if you’re taking too much. You want to stabilize on a dose and then check in 3-6 months. Some people get a low Vitamin D result and start taking high doses every day, then a year or two later they’re into hypervitaminosis D and have no way to clear it other than waiting for it to be processed out.

detourdog 16 minutes ago | parent | next [-]

I don't doubt you but I also wonder what you base this information on.

In 2020 I test results for vitamin D was ridiculous low. I have been taking supplements

Jan 02, 2020 4:32 pm 25-Hydroxy Vitamin D Total 9 ng/mL 30-100 ng/mL

I took me five years just to get to something close to the lowest end of normal.

I was started on supplements in the in 2k IU and after poor progress boosted to 5k IU everyday to get to this level.

I have been spending the past year on a sailboat instead of server room and look forward to seeing my test results.

Aurornis 8 minutes ago | parent [-]

My own experience getting a too-high result from supplementing 5K IU several times a week. When it came up, my doctor said I wasn't alone and that she's seeing a lot of people come back too high.

> I took me five years just to get to something close to the lowest end of normal.

Five years of supplementing to get up to 30ng/mL? Something is wrong. Could your supplements have not actually contained any real amount of Vitamin D? Certain malabsorption disorders also reduce Vitamin D absorption, for example.

brandonb 12 minutes ago | parent | prev [-]

> My doctor said she’s seeing a huge number of patients coming back with excessively high Vitamin D levels after taking supplement doses recommended by influencers. It happened to me, too, with what I though was a conservative dose of Vitamin D (5K IU, not even taken every day)

IMO that’s part of what’s interesting about this study design — they tested vitamin D blood levels and adjusted the supplement dose based on that. This seems like a much better approach than taking a high dose blindly.

I think the headline is accurate. The 52% number is from the experiment arm (participants who received a vitamin D supplement, with the quantity guided by blood testing). While it’s technically possible for the supplement dosage to be calculated as zero, 85% of participants were deficient at baseline, so this isn’t the main effect.

Aurornis 3 minutes ago | parent [-]

> I think the headline is accurate. The 52% number is from the experiment arm (participants who received a vitamin D supplement, with the quantity guided by blood testing). While it’s technically possible for the supplement dosage to be calculated as zero, 85% of participants were deficient at baseline, so this isn’t the main effect.

Yes, but it's also important to note that the study wasn't on a representative sample of the general population. They recruited people who had acute coronary syndrome. The average age was over 60 years old, 80% were men, and half of them had already had at least one heart attack.

brandonb 2 hours ago | parent | prev | next [-]

This was a write-up of a new study (TARGET-D) that used vitamin D supplements -- with the supplement amount guided by blood testing -- to reduce heart attack risk.

I've been working in heart health in 10 years and I was surprised at the magnitude of the effect here.

I hope it holds up as they move toward the final publication. Vitamin D supplementation is cheap and this could have a huge benefit.

skribb an hour ago | parent | next [-]

I believe there's also a Finnish vit-d study which showed very good results in afib protection

brandonb an hour ago | parent [-]

Cool! Is this the one? https://pubmed.ncbi.nlm.nih.gov/37302737/

tehjoker an hour ago | parent | prev [-]

Would it change practice substantially? I thought that typically vitamin D levels are measured at least annually and treated if low.

classichasclass 20 minutes ago | parent | next [-]

No, not typically. Myself I would usually order one either on specific request, or to investigate things like osteoporosis or pathologic fractures, but not as screening. USPSTF does not currently recommend vitamin D screening either in asymptomatic, non-pregnant adults ( https://www.uspreventiveservicestaskforce.org/uspstf/recomme... ).

detourdog 14 minutes ago | parent [-]

I moved to a different doctor and it was part of their normal blood work.

SketchySeaBeast an hour ago | parent | prev | next [-]

I would be very surprised if most people get vitamin d levels measured annually.

Aurornis 24 minutes ago | parent | next [-]

I’ve had 5 different primary care doctors across multiple practices in different locations due to moving, changing jobs, and doctors retiring

Every single one of them included Vitamin D testing in the annual checkup.

Two of my jobs in the past few years have had wellness programs that offered free Vitamin D testing along with a couple other things (A1c, lipids)

It’s very common in the United States at least. I know this goes against the “US healthcare bad” narrative but one of the difficulties with our costs is that we get more testing and procedures. Cutting those costs is going to be hard because people like the freedom to have their doctor order common tests

tocs3 43 minutes ago | parent | prev | next [-]

At least for the past few years it has been part of my annual physical. I had no idea it was part of the blood test until it came out as being low.

bookofjoe an hour ago | parent | prev [-]

I would be very surprised if anyone got vitamin d levels measured who didn't specifically request it.

Aurornis 22 minutes ago | parent | next [-]

All of my doctors (due to moves, retirements, etc) have done this for years in the US.

When the topic came up recently at a get together everyone could recall their relative Vitamin D levels (too low, normal) from recent checkups.

It’s common, at least in the US areas where I’ve lived.

Supermancho an hour ago | parent | prev | next [-]

The 25-hydroxy vitamin D test (aka: 25(OH)D test) is not part of a lipid panel, comprehensive (nor standard) metabolic panel, or any number of tests I have regularly. Without a specific request, it's unlikely anyone gets tested for this unless maybe you're a psychiatric patient. When I had severe depression in my 20s, a doctor did have this test done.

fjordofnorway an hour ago | parent | prev | next [-]

People in particular groups with higher risk of deficiency will be tested every year by many doctors. That practice obviously can't amount to testing every year being the average though.

tehjoker an hour ago | parent | prev [-]

It's surprising because so many people are deficient and the treatment is extremely cheap. It's bizarre, it's like if a problem is a big enough problem, medicine says well most people are living with it and washes its hands.

amanaplanacanal 27 minutes ago | parent | prev [-]

I'm nearly 70, and I have never had my vitamin D levels tested. (This is in the US).

shevy-java an hour ago | parent | prev | next [-]

> Vitamin D also stabilizes plaques in arteries by reducing macrophage activation.

Well, that is strange though. Because if you have such an effect, should you not include this? If macrophages are less active, perhaps infection rates go up, which can contribute to death. Perhaps not to the amount of the 52% gains mentioned here, but the website does not mention this at all whatsoever; the word "macrophages" occurs only twice on total.

rubyfan 12 minutes ago | parent | prev | next [-]

Looks like this is a freebie article in a permission marketing campaign designed to build engagement and then get you to use their services.

themafia an hour ago | parent | prev | next [-]

Isn't it a possibility that our lifestyles have changed in ways that have reduced the amount of Vitamin D we have historically received? Are we incidentally measuring the sum result of our social choices?

crazygringo an hour ago | parent | next [-]

Of course, we get less sun from being outdoors less and wearing more sunscreen. This isn't just a possibility, this is generally understood.

Sharlin an hour ago | parent | prev | next [-]

Well, most of us certainly spend much less time outside than common folks in preindustrial societies.

fjordofnorway 37 minutes ago | parent | prev [-]

Probably yet I don't see much direct connection. People were not having less heart attacks or heart attacks later in life. I suppose testing a vitamin D theory to significance may not have been easy before ~1980 because of many other causes of heart attack having higher frequency.

ziml77 an hour ago | parent | prev | next [-]

Is this actually real? I don't see any link to a study. The use of AI has me suspect, as does visiting the main page of the site and seeing: "A 365º view of your heart health" I guess that could be intentional but it comes off as someone mistaking days in a year with degrees in a circle.

canucker2016 an hour ago | parent | next [-]

FTA under "TARGET-D study Caveats"

  There are two main caveats to the TARGET-D study. First, this was presented at the American Heart Association scientific sessions, but the full manuscript isn’t out yet. It’s possible the results will end up not being statistically significant, having a methodological flaw, and so on. In the presented results, the reduction in heart attack risk was statistically significant but the change in overall death and stroke risk had a p value > 0.05. Second, while Vitamin D seems to be an effective intervention to reduce heart attack risk, we don’t yet know whether Vitamin D is an independent marker of heart disease risk or whether it’s reflecting known mechanisms such as inflammation and calcification.
shevy-java an hour ago | parent [-]

> but the full manuscript isn’t out yet.

Aww that's bad.

I remember years ago they claimed that a bacterium was using arsenic instead of phosphorus - turns out the data they produced was all made up:

https://www.science.org/doi/10.1126/science.1197258

This was here in this article most likely not the case, I assume, but still it is bad to talk about the data without having published the article already.

suprjami an hour ago | parent | prev | next [-]

One web search away. It was apparently a conference presentation but is well reported in medical media:

https://newsroom.heart.org/news/heart-attack-risk-halved-in-...

https://www.hcplive.com/view/target-d-optimized-vitamin-d-do...

brandonb an hour ago | parent | prev [-]

The 365º view of your heart health was supposed to be a joke. Although not necessarily a good one. :)

The study was presented at the AHA scientific sessions; full manuscript isn't out yet. It's in the caveats section in the article.

leetrout an hour ago | parent | prev [-]

This is interesting to me because I was put on prescription 50000IU D2 and it gave me heart palpitations.

LooseMarmoset 24 minutes ago | parent | next [-]

I was put on 5000IU D2 and I got kidney stones, twice. The doctor wouldn't believe that the D2 was the cause, but I stopped taking it and the stones have not recurred.

I would like to bring my D levels up, but not at the expense of kidney stones.

Aurornis 21 minutes ago | parent | prev | next [-]

50K IU in a single dose is probably a bad idea. You’d also want D3 generally.

hu3 an hour ago | parent | prev [-]

is that daily?

I'm taking same dose, 50000UI but bi-weekly and it's D3, not D2.