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Vitamin D fails to help patients with chronic heart failure

Posted on: May 24, 2017   by  John Cannell, MD

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Dr. Zittermann is one of the preeminent vitamin D experts in the world. He and his colleagues must be disappointed. His 3-year trial of 4,000 IU/day in 400 patients with chronic heart failure (CHF) failed to find any benefit from vitamin D. Their primary end-point was to prevent death from all causes. In fact, the vitamin D group had an insignificantly higher death rate than the placebo group (vitamin D (19.6%; n = 39) and placebo (17.9%; n = 36).

Also, the need for a mechanical implant was actually greater in patients assigned to vitamin D (15.4%, n = 28) vs. placebo [9.0%, n = 15). The left ventricle is the large, muscular chamber of the heart that pumps blood out to the body. A left ventricular mechanical implant is a battery-operated, mechanical pump-type device that’s surgically implanted. It helps maintain the pumping ability of a heart that can’t effectively work on its own.

The study was well designed in that they fulfilled most of “Heaney’s Criteria.” They used a placebo group who had a 25(OH)D < 16 ng/ml throughout the study while the treatment group achieved 40 ng/ml in about 3 months and maintained it. The study used a physiological dose of vitamin D, measured 25(OH)D before and after the trial, included a vitamin D deficient placebo group, had a long treatment period (3 years), assessed a specific disease being treated and used uniform measurements of outcome. The only criterion left out, as always, is the administration of co-nutrients.

What are the co-nutrients vitamin D needs? No one knows for sure. However, when I designed D3Plus for Bio Tech Pharmacal. I added magnesium, because so many people are deficient in magnesium, and it is required in a number of vitamin D’s enzymes. I added zinc, because the vitamin D receptor is like a hand, with a zinc molecule at the base of each finger, and more than 40% of people have inadequate zinc intakes. I also added boron, since it is used in the non-genomic actions of vitamin D as well as a myriad of other functions, and many people receive less than 3 mg/day of boron. I also added vitamin K2, as that helps vitamin D strengthen bone.

I know of no mechanism by which vitamin D, in physiological doses, could harm the heart. And, there are dozens of studies showing high 25(OH)D is associated with less heart disease. But, remember 25(OH)D is a marker for vitamin D status but also a marker for sun exposure. This study makes me want to get out in the sunshine.

Citation

John Cannell, MD. Vitamin D fails to help patients with chronic heart failure (CHF). The Vitamin D Council Blog & Newsletter, 5/2017.

Source

Zittermann A, Ernst JB, Prokop S, Fuchs U, Dreier J, Kuhn J, Knabbe C, Birschmann I, Schulz U, Berthold HK, Pilz S, Gouni-Berthold I, Gummert JF, Dittrich M, Börgermann J. Effect of vitamin D on all-cause mortality in heart failure (EVITA): a 3-year randomized clinical trial with 4000 IU vitamin D daily. Eur Heart J. 2017 May 12. doi: 10.1093/eurheartj/ehx235. 

3 Responses to Vitamin D fails to help patients with chronic heart failure

  1. hlahore@gmail.com

    See VitaminDWiki for 5 possible reasons that Vitamin D did not help this RCT
    Heart Failure not helped by Vitamin D (several strange things about the trial) – RCT May 2017
    https://vitamindwiki.com/tiki-index.php?page_id=8464

  2. David

    Along with the comments of VitaminDWiki, since these people had pre-existing heart disease they would be likely to have high calcium loads in their arteries and soft tissues. A high calcium load in the arteries is currently the best predictor of heart disease. While Vitamin D3 is a partial solution to this, the calcium scavenging proteins of the body, MGP and others, require MK4 vitamin K2 for potentiation of the calcium scavenging. Vitamin D3 does help by boosting MGP levels but these will be ineffective if MK4 vitamin K2 levels remain low. That was likely since these patients had existing heart disease. So this test was short of the required cofactors for reversing heart disease.
    Those wishing to review MK4 and MK7 Vitamin K2 research can start here:
    http://www.nbihealth.com/t-mk7-hip-fractures.aspx

    • maskay

      What you call “high calcium loads” are not really an excess of calcium, but a deficiency of the different forms of calcium that causes a shift in body chemistry. It is this shift in body chemistry that causes deposits in all parts of the body.

      Look at kidney stones, for example, people with a urine pH either too high or too low are at greater risk for kidney stones. This is not excess calcium, this is a shift in the pH that causes minerals to precipitate out of solution where they will form stones.

      It is a deficiency of calcium that causes a shift in body chemistry because, for one thing, calcium is the body’s main pH buffer.

      A calcium deficiency can also cause a vitamin D deficiency since a dietary calcium deficiency causes secretion of PTH that activates vitamin D. A chronic calcium deficiency depletes vitamin D.

      What people don’t understand about calcium is that there are thousands of different forms of calcium and each one has a different effect on the body chemistry. We need them all

      In the body calcium is needed by weight and volume more than any other mineral, by far.

      The big fad of the last few years has been that magnesium is the most deficient mineral because there isn’t as much in food anymore.

      The studies that I have seen show a much more significant decline in calcium than magnesium in foods. So why is it that somehow, even though the amount of calcium the body needs is much more than calcium, and calcium is more deficient if the foods, that somehow we are getting too much calcium, and too little magnesium?

      So this study is no surprise.

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