Vitamin D Improves Clinical Function in Congestive Heart Failure

August 01, 2022

Vitamin D Improves Clinical Function in Heart Failure

In 2004, a report of two cases from Great Britain of infants presenting in severe congestive heart failure was published. Literally, 6-week-old infants, were admitted to ICUs with huge, dilated hearts and all indications of severe congestive heart failure. There were found to be recent immigrants of African descent who had had no prenatal care. Their vitamin D levels were unmeasurably low. On being given Vitamin D, their congestive heart failure was completely cured. Cured.

In 2011, Great Britain with its national database reported more cases. Again, immigrant women of color (requiring much more sunlight to get sufficient Vitamin D,) with litte prenatal care had infants presenting with severe congestive heart failure. Again, unmeasurable Vitamin D. Again, cured completely with Vitamin D.

This author had just moved to the Aurora Sinai ER in Milwaukee and was struck by the number of young, African American men presenting to the ER in congestive heart failure. I measured Vitamin D in all of them and to a patient they were below 10. I gave all of them 100,000 IU three days in a row and made appointments with cardiologists, after printing out the above two papers to present to their cardiologists, trusting that the system would pick up on their deficiency.

This author went to the Department of Cardiology at St Luke's Medical Center with the above information in hand and suggested that Vitamin D should be added to the protocol for congestive heart failure, even if not on American Heart Association guidelines yet. I showed the 25 assembled cardiologists the publication from the Journal of the American College of Cardiology by Victor Soukoulis about Vitamin D, CoQ10, carnitine being inadequate. But we didn't have a randomized, placebo-controlled trial to prove its benefit. Nothing happened. I was informed that the cardiologists did procedures to reverse disease and were not in the business of nutritional supplements. I was discouraged. No, I was furious.

Now we have proof. With that background, this week's paper is huge. First of all, it was randomized, placebo-controlled, and multi-hospital in design. Seventy-three patients whose Vitamin D level was below 30 were given 4000 iu of Vitamin D for 6 months/or a placebo. The authors wanted to prove an improvement of "endothelial dysfunction" which is awful in congestive heart failure. That did not improve in 6 months. But the clients were able to walk further, had better blood pressure and fewer symptoms. Their Vitamin D levels rose from below 30 to about 50.

What is endothelial dysfunction? It is essentially the inability of the vessel walls to relax due to lack of nitric oxide. Simplified, it is high blood pressure that can't relax. It is the first step to developing coronary artery lesions because the high blood pressure proceeds to damage the walls of the artery. Ok, so one micronutrient, by itself didn't solve the whole picture. But Vitamin D improved all the other halo effects around the margins. All in just 6 months.

And was 4,000 enough for 6 months? No! If they had gotten weekly blood levels of D, they would have seen the levels climbing and very likely just got to 50 in the final week. They should have given a loading dose of 100,000 Iu to raise their blood level 14 ng. From 30, they would have been at 44 in one day and then, 6 months of 44 -50 would have showed even more benefit. And how about throwing in some CoQ10, carnitine, magnesium and ribose too! The study wasn't near long enough. Vitamin D turns on DNA and makes cells grow. That doesn't happen overnight. It takes weeks to get started. To get full effect, you likely need 1-2 years.

But don't complain. Instead, find any old person you know or are living with and make sure everyone you love and care for knows their Vitamin D, or at taking at least, at least, 4,000 IU a day. 5,000 is easier, One pill.

Folks over 70 make 20% of the Vitamin D of 20 year olds, given the same amount of sun. That's what our wrinkles are: the loss of cholesterol in our skin from which Vitamin D is made when UV radiation hits our skin. And our dermatologists yell at us for being out in the sun too much so we don't get sunlight anyway. And have you seen any folks over 70 in swimming suits lately....not many?

The paper's "Conclusion: A daily vitamin D dose of 4000 IU for chronic HF appears to be safe. This dosage did not improve endothelial function but did improve the 6-min walk distance, symptoms, and left atrial diameter at 6 months." This is enough. We have our randomized, placebo-controlled trial. I was not heeded 11 years ago. But I was right. And for that, I feel considerable satisfaction.

www.What will Work for me. I'm taking 30,000 IU of D every day and have a blood level of 140. I sleep better. My calcium is normal. I've written columns about that. For those of you with anyone in your circle with a "weak heart", please make sure they are on Vitamin D. It's proven. And I biked 20 miles yesterday.

References: Medicine, J Royal Society of Med,. Vasc Health Risk Man, Lancet, J Am College of Cardiology

Pop Quiz.

1. What does Vitamin D for elderly with congestive heart failure?                       Answer: Helps them function better, walking further, and feeling less short of breath.

2. How does Vitamin D do that?                             Answer: unfair question. We didn't cover that. But Vitamin D controls 10% of the human genome and fundamentally is the hormone that turns on stem cells and has them develop into mature cells. A heart has to replace its muscle cells every 30 days. You need enough D to do that.

3. When you take 4000 IU of D a day, you are likely to get an overdose of the D. T or F.                  Answer: This is not a joke. There has been so much brouhaha over raising the daily minimum from 400 to 600, both laughably inadequate, that the thought that someone had the audacity to give 4000 Iu a day, sufficient to get a blood level of 50 after 6 months is simply wonderful. They proved it's safe. So, let's get everyone on 4,000 IU a day.

4. When you start a new course of Vitamin D and want to get your blood level up quickly, you should do what? Answer: You need a loading dose. 100,000 IU is safe. Those babies in England were given 600,000 IU. And they simply got better. No toxicity.

5. Pregnant women should have how much Vitamin D to have infants born with healthy levels of 50? Answer: 6400 IU a day. And studies from Finland show that babies who get 2,000 IU a day end up with 80% less insulin-dependent diabetes.