From the Guidelines
For patients with a history of myocardial infarction (MI), taking vitamin D3 at 5000 IU daily is generally considered safe with minimal risks, as there is no strong evidence to suggest it increases the risk of cardiovascular events, and some studies suggest vitamin D may have cardiovascular benefits 1.
Key Considerations
- The dose of 5000 IU/day is above the recommended daily allowance but below the upper limit of 4000-10000 IU/day established by various health organizations.
- There are no specific contraindications for vitamin D supplementation in post-MI patients.
- Some research suggests vitamin D may have cardiovascular benefits, as deficiency has been associated with increased cardiovascular risk, with observational studies indicating that 25(OH)D levels less than 15 ng/mL are associated with excess risk of cardiovascular events 1.
- Patients should be aware that very high doses of vitamin D over extended periods could potentially lead to hypercalcemia, which might affect cardiac function.
- Patients taking certain medications like digoxin or calcium channel blockers should exercise additional caution.
Monitoring and Precautions
- It's advisable to periodically monitor vitamin D blood levels and calcium levels when taking this dose long-term.
- Patients should inform their cardiologist about this supplementation to ensure it doesn't interfere with their post-MI medication regimen.
Evidence Summary
- A meta-analysis of 8 RCTs in patients with a mean baseline blood pressure above 140/90 mmHg concluded that vitamin D reduces blood pressure modestly but significantly in hypertensive patients 1.
- The Ludwigshafen Risk and Cardiovascular health (LURIC) study demonstrated a strong association between vitamin D status and several cardiovascular outcomes, such as cardiovascular mortality, with the lowest risk among those with the highest 25(OH)D level 1.
From the Research
Risks for Patients with History of MI Taking Vitamin D3 5000IU per Day
- There is no direct evidence to suggest that taking vitamin D3 5000IU per day poses specific risks for patients with a history of myocardial infarction (MI) 2, 3, 4.
- However, it is essential to note that vitamin D deficiency has been linked to an increased risk of cardiovascular disease, including MI 2, 4.
- Studies have shown that vitamin D supplementation may have cardioprotective effects, but the evidence is not conclusive, and more research is needed to fully understand its impact on cardiovascular health 2, 4.
- One study found that long-term supplementation with vitamin D3 in doses ranging from 5000 to 50,000 IUs/day appears to be safe, with no cases of vitamin D3-induced hypercalcemia or adverse events attributable to vitamin D3 supplementation 3.
- Another study suggested that vitamin D supplementation in doses of 800-5000 IU/day may improve musculoskeletal health, but the evidence for its benefits in preventing cardiovascular disease is limited 5.
- A randomized controlled trial found that early administration of high-dose enteral vitamin D3 did not provide an advantage over placebo with respect to 90-day mortality or other nonfatal outcomes among critically ill, vitamin D-deficient patients 6.