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http://intermountainhealthcare.org/hosp ... ewsID=1018

Low vitamin D has been shown to cause heart related risks, however, levels above 250 seem to double the risk of heart issues.

Does this mean we should aim for the 200-250 range and be very careful not to be above?

Thanks, because I am slightly concerned here.
It's definitely a cause for concern. Sadly, the study isn't published in detail so we can't see all of their method etc, but it's a very big sample size and the same people have produced studies supporting vit D supplementation in the past so they don't seem biased. I think the key message here is that there's no such thing as a supplement that's always good for us, even in enormous doses - maybe because vit D supplements don't have the exact same biochemical results as getting vit D from sunshine. I think I aim for around 200.
I wish we had access to info about what proportion of people in the study had high levels due to supplementation, and ideally separate results for supplementers and people who get out in the sun a lot.
AFAIK 1 ng/mL 25-Hydroxyvitamin D = 2.496 nmol/L
Fib' reminds me of butter making.
Seems serious indeed, not to go OTT (250nmol/L is in the red zone) with D.
If only there was a home test.
Thanks Pascal.
Plus see in general the health/weight/diet profile of the people as they could have been overweight meat eaters and nothing to do with the vitamin D level. Perhaps being an American study this is very likely that they were poor eaters etc.
Here's a quick opinion:

1) We take levels for people with MS. You may be at an increased risk of Atrial Fibrillation, but you have to weight that against exacerbations.

2) We don't know all the ins and outs of the study. It looks pretty good since they looked back retrospectively and saw who had AF and then how much VitaminD.So it may be true. What we don't know is whether as lots of people do, they were supplementing Calcium and VitaminD.
Alex

Diagnosis: Jan 2010, OMS April 2010.
I wonder what mechanism is involved in vitamin D causing Atrial Fibrillation.
It would be perverse if in our efforts to improve our general health and blood quality, in part to improve blood flow through the CNS, we also increased our chances of stroke, dementia and Alzheimer’s.

But if the brain risk from AF is only through clotting, then presumably thrashed good quality (largely satfat free) blood may be far less likely to clot. If so, then re. veg's point, OMSers might be even less at risk regardless of trading exacerbation versus stroke risks.

Although the general public's awareness of stroke symptoms seems mostly concerned with massive blockages, I wonder if micro blockages are the more common issue. The symptoms being more difficult to notice and mostly put down as "natural aging", even just personality change. For those with MS (which might in part be attributable to poor brain blood flow) any force that contributes to micro clotting could be a significant threat. Be it direct forces like fats, general diet, cold, lack of exercise, low BP, air travel (DVT), ... or more indirect forces like overdoing D, or anything that increases clotting likelihood.

A general message that I get from the Prof is that well circulated quality blood is a general priority.
veg wrote: Plus see in general the health/weight/diet profile of the people as they could have been overweight meat eaters and nothing to do with the vitamin D level. Perhaps being an American study this is very likely that they were poor eaters etc.


That's the kind of artefact that can mess up results from small studies, but in a sample of 132,000 I would expect a range of weights and general healthiness in all the groups. Would like to know more about e distribution of the data, though.
I lean towards veg's direction. The masses in the US tend to the overweight (and the rest of the world catching up fast), and those having health issues that justify scans might be the weightier proportion of them (or might scans be more an indulgence of the worried-well). This compared with OMSers who, if many are on the trajectory that I am find myself on, tend to the opposite of overweight, and presumably blood glue (satfat) starved.

Great to see a large sample size. If the data is well structured, analysing for our perspective rather tempts me, but I assume it is confidential and inaccessible. Sounds like a neat postgrad project.
I can see why people would be a little concerned about these findings, but it's too early to know whether they are significant or not. Firstly, the research hasn't yet been peer reviewed. When the authors try to publish this, the peer review process will appraise the methodology and significance of the results. Then we will know more. Secondly, it is hard to imagine the numbers in the group who had high vitamin D levels (>250nmol/L) were very large, even though the overall study numbers were large. After all, in the middle of this vitamin D epidemic, how many Americans will have abnormally high levels? A small number clearly. If the numbers in that group are small, it may reduce the significance of the finding. And who would the people in this group be? Typically, those with illnesses trying to improve their condition by taking supplements (it would be very hard to get to that level without supplements). So the intercurrent illnesses suffered by this group (for instance cardiovascular disease) might be confounders that could explain the higher incidence of atrial fibrillation. Thirdly, as one of you has suggested, what mechanism could explain such a finding? Although we know vitamin D plays a role in cardiovascular disease, generally it is protective. So, all in all, we should await the detail in the published paper (assuming it gets through peer review) before coming to any conclusion. In the meantime, we have always suggested here that it is sensible if you have MS to aim for a level that is high normal, over 150nmol/L, but preferably not above the upper limit of the normal range (75-225nmol/L).

Be well

George
Thank you for your steadying hand George.
Not related to the veracity or relevance of the study, but my mind wandered to the lifestyle fashions that drive people to "health" extremes which include taking many supplements, seemingly the more the merrier/healthier. Some (these without MS) that I know have taken to heart the message that rickets oriented advice of old had much underestimated appropriate D levels, and there being no upper limit, they take 10k IU or more daily. Your sage advice elsewhere about moderation seems apposite for them. Having simple guidelines for those with MS (150 to 225nmol/L) makes things very clear. It's a pity it can be so difficult to measure blood levels.
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