Vitamin D Supplementation to Treat Statin-Associated Muscle Symptoms: A Review

2019 ◽  
Vol 34 (4) ◽  
pp. 253-257
Author(s):  
Kimberly Lowe ◽  
Khadija Tul Kubra ◽  
Ze Yang He ◽  
Katherine Carey

For the past 15 years, cardiovascular disease (CVD) has been the leading cause of death for both men and women in the United States and worldwide. With an aging population, there has been increasing use of statin therapy to reduce the risk of CVD. However, statin-associated muscle symptoms (SAMS) remain an obstacle to this treatment, leading to discontinuation and nonadherence to statin therapy. Signs and symptoms of SAMS include muscle pain, tenderness, and increased serum creatine kinase. Despite the idiopathic pathophysiology of SAMS, some studies have shown an association between vitamin D deficiency and SAMS; the use of vitamin D supplements can lead to relief of these symptoms. The purpose of this review was to critique evidence for the association between low serum vitamin D and SAMS and the use of vitamin D supplementation for treatment.

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Jonathan D. Adachi ◽  
Jacques P. Brown ◽  
George Ioannidis

Though vitamin D is important for bone health, little is known about the monitoring and management of vitamin D levels in patients with osteoporosis in clinical practice—a deficit this chart review initiative aimed to remedy. A total of 52 physicians completed profiles for 983 patients being treated for osteoporosis between November 2008 and April 2009. Information collected included demographics; fracture risk factors; availability and level of serum vitamin D measurements; and information on osteoporosis medications and calcium and vitamin D supplementation. Physicians also evaluated patients’ current regimens and detailed proposed changes, if applicable. Nearly 85% of patients were prescribed calcium and vitamin D supplements. Serum 25-hydroxy vitamin D levels were available for 73% of patients. Of these patients, approximately 50% had levels less than 80 nmol/L, which contrasts with the 37% thought to have “unsatisfactory” vitamin D levels based on physician perceptions. Physicians felt 26% of patients would benefit from additional vitamin D supplementation. However, no changes to the osteoporosis regimen were suggested for 48% of patients perceived to have “unsatisfactory” vitamin D levels. The results underscore the importance of considering vitamin D status when looking to optimize bone health.


2016 ◽  
Vol 30 (5) ◽  
pp. 521-527 ◽  
Author(s):  
Jenny H. Kang ◽  
Quynh-Nhu Nguyen ◽  
Juleann Mutka ◽  
Quang A. Le

Background: Statins are the primary class of medications used to lower cholesterol and reduce risks for coronary heart disease. However, statin muscular adverse effects are one of the main reasons for statin nonadherence and a barrier to cardiovascular risk reduction. Objectives: The primary objective of our study was to examine the effect of replenishing vitamin D on statin-induced myopathy in veteran patients who failed to maintain statin therapy in a pharmacist-run ambulatory care setting. Secondary objectives were to examine changes in patients’ vitamin D levels, fasting lipid profiles, and achievement of lipid goals after reinitiation of statin therapy. Methods: This was a retrospective cohort study of veteran patients conducted at a pharmacist-managed cholesterol-optimization clinic. Patients with low-serum vitamin D, history of statin-induced myopathy, and who received vitamin D replenishment prior to rechallenging statin therapy between December 1, 2008, and April 1, 2015, were identified. The primary outcome was the percentage of patients who maintained their statin therapy at 12 months after statin reinitiation. Results: Twenty-seven patients met the study criteria. All patients were able to maintain their statin therapy without myalgia after vitamin D supplementation. Eleven patients (40.7%) tolerated their previously failed statins. The most frequently restarted statins were atorvastatin, pravastatin, and rosuvastatin. A 22% to 30% increase in the number of patients who achieved cholesterol goals based on the national lipid guidelines was observed at 12-month follow-up. Conclusion: Replenishing low vitamin D in patients with statin-induced myopathy appears to be an effective strategy in improving medication adherence and subsequently preventing cardiovascular and mortality events.


2019 ◽  
Vol 89 (1-2) ◽  
pp. 55-61 ◽  
Author(s):  
Sunkyung Lee ◽  
Euni Lee ◽  
Mary K. Maneno ◽  
Allan A. Johnson ◽  
Anthony K. Wutoh

Abstract. Optimal serum vitamin D levels are reported to be associated with many health benefits; however, few studies have determined predictive factors using national level data. An assessment of predictive factors for vitamin D inadequacy was conducted using National Health and Nutrition Examination Survey (NHANES) 2001–2006 data. Using the study sample including adults aged 40 years or more, data analysis was performed using the weighted multivariate logistic regression statistical procedure. The prevalence of vitamin D inadequacy (serum vitamin D <20 ng/ml) was 37.3%. Non-Hispanic Blacks were 6.4 times more likely to demonstrate vitamin D inadequacy compared to non-Hispanic Whites (ORadj=6.351; 95% CI 5.338, 7.555; p<0.0001). Also, female gender was a significant predictor of vitamin D inadequacy (ORadj=1.499; 95% CI 1.315, 1.708; p<0.0001) in multivariate models. Subjects who reported not taking vitamin D supplements in the past 30 days were more than twice as likely to be vitamin D inadequate compared with those who had taken dietary supplements containing vitamin D (ORadj=2.225; 95% CI 1.903, 2.601; p<0.0001). In conclusion, the strongest predictor of vitamin D inadequacy was non-Hispanic Black ethnicity. Other potential predictors included smoking, non-use of vitamin D supplements, abnormal BMI, collecting samples in winter, female gender, perception of own health condition as not excellent, lack of health care, and older age. More focused interventions targeting groups of United States residents with vitamin D inadequacy are needed.


2019 ◽  
Vol 9 (o3) ◽  
Author(s):  
Suaad Muhssen Ghazi ◽  
Fatin Shallal Farhan

Vitamin D deficiency is common in women with polycystic ovarian syndrome. Vitamin D plays an important physiologic role in reproductive functions of ovarian follicular development and luteinization through altering anti-müllerian hormone signaling, follicular stimulating hormone activity and progesterone production in human granulose cells. Vitamin D is precipitated in adipose fat tissues, making it notable to be used for the body as a result; obese people with high body mass index are already highly expected to have low levels of serum vitamin D.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhiyong Cui ◽  
Yun Tian

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has struck globally and is exerting a devastating toll on humans. The pandemic has led to calls for widespread vitamin D supplementation in public. However, evidence supporting the role of vitamin D in the COVID-19 pandemic remains controversial. Methods We performed a two-sample Mendelian randomization (MR) analysis to analyze the causal effect of the 25-hydroxyvitamin D [25(OH)D] concentration on COVID-19 susceptibility, severity and hospitalization traits by using summary-level GWAS data. The causal associations were estimated with inverse variance weighted (IVW) with fixed effects (IVW-fixed) and random effects (IVW-random), MR-Egger, weighted edian and MR Robust Adjusted Profile Score (MR.RAPS) methods. We further applied the MR Steiger filtering method, MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) global test and PhenoScanner tool to check and remove single nucleotide polymorphisms (SNPs) that were horizontally pleiotropic. Results We found no evidence to support the causal associations between the serum 25(OH)D concentration and the risk of COVID-19 susceptibility [IVW-fixed: odds ratio (OR) = 0.9049, 95% confidence interval (CI) 0.8197–0.9988, p = 0.0473], severity (IVW-fixed: OR = 1.0298, 95% CI 0.7699–1.3775, p = 0.8432) and hospitalized traits (IVW-fixed: OR = 1.0713, 95% CI 0.8819–1.3013, p = 0.4878) using outlier removed sets at a Bonferroni-corrected p threshold of 0.0167. Sensitivity analyses did not reveal any sign of horizontal pleiotropy. Conclusions Our MR analysis provided precise evidence that genetically lowered serum 25(OH)D concentrations were not causally associated with COVID-19 susceptibility, severity or hospitalized traits. Our study did not provide evidence assessing the role of vitamin D supplementation during the COVID-19 pandemic. High-quality randomized controlled trials are necessary to explore and define the role of vitamin D supplementation in the prevention and treatment of COVID-19.


2017 ◽  
Vol 256 ◽  
pp. 125-127 ◽  
Author(s):  
Charles J. Glueck ◽  
Kevin Lee ◽  
Marloe Prince ◽  
Alexander Milgrom ◽  
Frini Makadia ◽  
...  

Author(s):  
Cora M Best ◽  
Leila R Zelnick ◽  
Kenneth E Thummel ◽  
Simon Hsu ◽  
Christine Limonte ◽  
...  

Abstract Context The effect of daily vitamin D supplementation on the serum concentration of vitamin D (the parent compound) may offer insight into vitamin D disposition. Objective To assess the total serum vitamin D response to vitamin D3 supplementation and whether it varies according to participant characteristics. To compare results with corresponding results for total serum 25-hydroxyvitamin D (25(OH)D), which is used clinically and measured in supplementation trials. Design Exploratory study within a randomized trial. Intervention 2,000 International Units of vitamin D3 per day (or matching placebo). Setting Community-based. Participants 161 adults (mean ± SD age 70 ± 6 years; 66% males) with type 2 diabetes. Main Outcome Measures Changes in total serum vitamin D and total serum 25(OH)D concentrations from baseline to year 2. Results At baseline, there was a positive, nonlinear relation between total serum vitamin D and total serum 25(OH)D concentrations. Adjusted effects of supplementation were a 29.2 (95% CI: 24.3, 34.1) nmol/L increase in serum vitamin D and a 33.4 (95% CI: 27.7, 39.2) nmol/L increase in serum 25(OH)D. Among those with baseline 25(OH)D &lt; 50 compared with ≥ 50 nmol/L, the serum vitamin D response to supplementation was attenuated (15.7 vs 31.2 nmol/L; interaction p-value = 0.02), whereas the serum 25(OH)D response was augmented (47.9 vs 30.7 nmol/L; interaction p-value = 0.05). Conclusions Vitamin D3 supplementation increases total serum vitamin D and 25(OH)D concentrations with variation according to baseline 25(OH)D, which suggests that 25-hydroxylation of vitamin D3 is more efficient when serum 25(OH)D concentration is low.


2020 ◽  
Author(s):  
Elahe Allahyari ◽  
Parichehr Hanachi ◽  
Seyed Jamal Mirmoosavi ◽  
Gordon A. Ferns ◽  
Afsane Bahrami ◽  
...  

Abstract BackgroundAccumulating data have highlighted the prominence of supplementation as an effective approach for vitamin D deficiency. But individuals vary in their response to vitamin D supplementation. In this study, the effect of cardiometabolic risk factors were evaluate on magnitude of response to vitamin D supplementation by using novel statistical analysis, artificial neural networks(ANNs).Methods608 participants aged between 12 to 19 years old were assed in this prospective interventional study. Nine vitamin D capsules containing 50000IU vitamin D/weekly were given to all participants over the 9 week period. The change in serum 25(OH)D level was calculated as the difference between post-supplementation and basal levels. Suitable ANNs model were selected between different algorithms in the hidden and output layers and different numbers of neurons in the hidden layer. Then, the major determinants in predicting response to vitamin D supplementations were identified (Trial registration: IRCT201509047117N7; 2015-11-25; Retrospectively registered)ResultsSigmoid in both hidden and output layers with 4 hidden neurons had acceptable sensitivity, specificity and accuracy area under the ROC curve in our study. Baseline serum vitamin D (30.4%), waist to hip ratio (10.5%), BMI (10.5%), systolic blood pressure (8%), heart rate (6.4%), and waist circumference (6.1%) were the greatest importance in predicting the response in serum vitamin D levels. ConclusionWe provide the first attempt to relate anthropometric specific recommendations to attain serum vitamin D targets. With the exception of cardiometabolic risk factor, the relative importance of other factors and the mechanisms by which these factors may affect the response requires further analysis in future studies.


2020 ◽  
Vol 52 (05) ◽  
pp. 305-315
Author(s):  
Nasim Säidifard ◽  
Hadith Tangestani ◽  
Kurosh Djafarian ◽  
Sakineh Shab-Bidar

AbstractIt is reported that vitamin D deficiency is associated with carotid intima-media thickness (CIMT). In addition, several randomized clinical trials (RCTs) have studied the influence of vitamin D supplement on CIMT. However, results are inconclusive. This review aimed to systematically explore the potential link of the serum vitamin D level with CIMT pooling together observational studies and RCTs. PubMed and Scopus were searched for studies published until February 13, 2018. The Fisher’s z (SE) correlation coefficient, odds ratio (OR), and mean (SD) of changes in CIMT from baseline were used to perform meta-analysis in observational studies and RCTs, respectively. To pool data, both a fixed-effects model and a random-effects model (in case of heterogeneity) were used. Heterogeneity was assessed using Cochran’s Q and I2 tests. Nineteen observational studies and 3 RCTs met inclusion criteria. The pooled correlation coefficients of 17 observational studies showed [(Fisher’s z=− 0.41, 95% CI: –0.63 to –0.19, p<0.001), I2=96.9%, p < 0.001] a significant inverse association between serum vitamin D and risk of CIMT. Pooling three risk estimates of three studies [(OR = 1.69, 95% CI: 0.74 to 3.86, p=0.209); I2=085.1%, p<0.001)] indicated no significant association between serum vitamin D status and risk of CIMT. Combining data of RCTs showed vitamin D supplementation significantly reduced CIMT [(MD: –0.034, 95% CI: –0.62 to –0.05, p=0.012), I2=16.6%, p = 0.301]. Our findings show that serum vitamin D is inversely associated with CIMT and vitamin D supplementation may reduce CMIT.


2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 35-36
Author(s):  
R A MacMillan ◽  
T Ponich

Abstract Background Vitamin D is a critical factor in bone remodelling, calcium absorption and may promote anti-inflammatory cytokines in the gut. Inflammatory bowel disease (IBD) is associated with a reduction in serum Vitamin D levels and a chronic inflammatory state, both of which are strong risk factors for bone density loss affecting IBD patients. Despite European and North American IBD maintenance guidelines for Vitamin D monitoring and bone density scans, there are limited North American investigations into factors influencing serum Vitamin D levels in the IBD patient population specifically. Aims We investigated whether patient demographics, disease severity indexes and/or inflammatory markers were linked to low serum Vitamin D levels in our IBD patients. We also established the extent of Vitamin D serum deficiencies and supplementation rates in our IBD patients. Methods A retrospective chart review of a single clinician’s practice at London Health Science Centre, Victoria Hospital, over the past 20 months, was performed to: 1) assess the frequency of low serum 25-OH Vitamin D (25-OH D) in the IBD patient population and 2) determine whether patient disease severity was linked to lower 25-OH D levels. A multivariate regression analysis was performed assessing Crohn’s Disease (CD) or Ulcerative Colitis (UC) patient factors: age, sex, disease duration, seasonality, current pharmacologic treatments, past surgeries, CD Activity Index, UC Mayo score, C-reactive protein, and fecal calprotectin (Fcal) level. Results 175 IBD patients had at least one 25-OH D measurement with 71 patients actively on Vitamin D therapy. Of UC and CD patients who were not on Vitamin D therapy, 63% (17/27) and 79% (61/77) were 25-OH D deficient, respectively. 25-OH D levels in the CD population was associated with Vitamin D supplementation (regression coefficient [RC] 23.99, 95% confidence interval [CI] 14.54 to 33.45), summer season ([RC] 9.90, [CI] 0.56 to 19.24), and past bowel resection ([RC] -10.61, [CI] -20.48 to -0.76). 25-OH D levels in the UC population was associated with Vitamin D supplementation (regression coefficient [RC] 47.23, 95% confidence interval [CI] 27.62 to 66.83), and Mayo severity scores ([RC] -23.01, [CI] -41.82 to -4.20). Fcal (78 patients) was inversely associated with 25-OH D levels but the trend was not significant. Conclusions Overall, 25-OH D levels were lower in both the UC and CD patient populations relative to the already deficient Canadian population. However, IBD patients are responsive to Vitamin D supplementation. Tools with more objective evidence of disease severity such as UC Mayo score and fcal should be prioritized for identifying the IBD population requiring supplementation. Funding Agencies None


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