Risks: When Too Much Vitamin D Is Too Much
http://www.nytimes.com/2012/01/17/health/research/risks-when-too-much-vitamin-d-is-too-much.html
January 12, 2012
By NICHOLAS BAKALAR
Too much vitamin D may be just as bad as too little, a recent study suggests.
Vitamin D supplements reduce blood levels of C-reactive protein, or CRP, an indicator of inflammation that is linked to cardiovascular disease. But supplements help only up to a point.
In a study of more than 15,000 adults ages 18 to 85, researchers at Johns Hopkins University found that after blood levels exceeded 21 nanograms per milliliter — the lower end of what is usually considered normal — any additional vitamin D led to an increase in CRP.
The association held after the researchers accounted for the effects of factors like obesity, smoking, cholesterol and high blood pressure. There was also a dose-response relationship: Above 21 units, each 10-unit increase in vitamin D was accompanied by an increase of 0.06 milligrams per deciliter in CRP.
“Vitamin D is good to a certain level,” said the lead author, Dr. Muhammad Amer, an assistant professor of medicine at Johns Hopkins. “But don’t just keep on taking it. Have your blood drawn and your levels checked.”
Previous studies of vitamin D supplementation have produced inconsistent results, with some trials showing a decrease in inflammatory markers and others showing no effect. The finding that the benefit is apparent only at lower levels of vitamin D, the authors write, may help explain these conflicting findings.
The study was published online in The American Journal of Cardiology.
Amer M, Qayyum R. Relation Between Serum 25-Hydroxyvitamin D and C-Reactive Protein in Asymptomatic Adults (From the Continuous National Health and Nutrition Examination Survey 2001 to 2006). The American journal of cardiology 2012;109(2):226-30. Elsevier
The inverse relation between vitamin D supplementation and inflammatory biomarkers among asymptomatic adults is not settled. We hypothesized that the inverse relation is present only at lower levels and disappears at higher serum levels of vitamin D. We examined the relation between 25-hydroxyvitamin D [25(OH)D] and C-reactive protein (CRP) using the continuous National Health and Nutrition Examination Survey data from 2001 to 2006. Linear spline [single knot at median serum levels of 25(OH)D] regression models were used. The median serum 25(OH)D and CRP level was 21 ng/ml (interquartile range 15 to 27) and 0.21 mg/dl (interquartile range 0.08 to 0.5), respectively. On univariate linear regression analysis, CRP decreased [geometric mean CRP change 0.285 mg/dl for each 10-ng/ml change in 25(OH)D, 95% confidence interval [CI] ?0.33 to ?0.23] as 25(OH)D increased ?21 ng/ml. However, an increase in 25(OH)D to >21 ng/ml was not associated with any significant decrease [geometric mean CRP change 0.05 mg/dl for each 10-ng/ml change in 25(OH)D, 95% CI ?0.11 to 0.005) in CRP. The inverse relation between 25(OH)D below its median and CRP remained significant [geometric mean CRP change 0.11 mg/dl for each 10-ng/ml change in 25(OH)D, 95% CI 0.16 to ?0.04] on multivariate linear regression analysis. Additionally, we observed a positive relation between 25(OH)D above its median and CRP [geometric mean CRP change 0.06 mg/dl for each 10-ng/ml change in 25(OH)D, 95% CI 0.02 to 0.11) after adjusting for traditional cardiovascular risk factors. In conclusion, from this cohort of asymptomatic adults, independent of traditional cardiovascular risk factors, we observed a statistically significant inverse relation between 25(OH)D at levels <21 ng/ml and CRP. We found that 25(OH)D at a level ?21 ng/ml is associated with an increase in serum CRP. It is possible that the role of vitamin D supplementation to reduce inflammation is beneficial only among those with a lower serum 25(OH)D.