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In the news: Vitamin D and Statin Use; Low maternal vitamin E & Asthma

Vitamin D and Statin Use

Statins, prescribed to lower cholesterol and the risks of heart attacks and strokes, is one of the most widely used drugs in the U.S. For those who take statins, a series of studies suggests that maintaining sufficient levels of vitamin D is important.

Results of the most recent study indicate that people may need slightly more vitamin D to raise blood levels when they’re taking a statin (1). Researchers reviewed clinical trials in which supplemental vitamin D was given to people 60 and older who had low levels of this vitamin. They found that the response to vitamin D was about 21% lower in statin users versus non-users over a 12 month period.

Earlier research conducted in China reveals that statins work better when vitamin D levels are sufficient (2). In this 6-month placebo controlled trial, people with elevated cholesterol, and already being treated with a statin, saw a decrease in total and LDL cholesterol as well as triglycerides. Improvements in blood lipid levels were greatest in the nearly 75% of participants who were either vitamin D deficient (blood levels below 20 ng/mL) or marginally deficient (levels between 20 and 30 ng/mL).

Other investigations report that the chance of developing statin-related side effects may be lessened by maintaining better vitamin D levels. In one study of statin users (3), those without myalgia (muscle pain) had an average vitamin D level of about 35 ng/mL compared to an average level of 28 ng/mL in those experiencing myalgia, a potential side-effect of statins.

Another potential side effect of statins is that they can reduce the improvements in cardiorespiratory fitness that are normally gained with exercise, and they can disrupt energy-producing mitochondria in muscle cells. Adequate vitamin D may help offset these effects.

In one study (4), vitamin D deficient type 2 diabetics performed moderate aerobic exercise and were randomized to receive a statin, or a statin plus a high dose of vitamin D once weekly, or only vitamin D each week. Cardiorespiratory fitness decreased by 8.4%

after 12 weeks of statin therapy only, while the addition

of vitamin D blunted that decline in fitness to 0.6% and improved skeletal muscle mitochondrial content. vitamin D alone also increased cardiorespiratory fitness.

While it isn’t wise to take the very high amounts of vitamin D tested in the last study, it does make sense for those on statins to ensure that their vitamin D blood levels are sufficient based on the current evidence.

Vitamin E During Pregnancy & Asthma Risk

The February 2017 issue of Staying Healthy featured a study showing that pregnant women who received omega-3 fatty acids gave birth to children less likely to develop asthma. A new study (5) suggests that low vitamin E levels in mothers may also increase the risk for asthma in their children.

The investigators followed 652 children and their moms for the first two years of the children’s lives. The two main forms of vitamin E in the body, alpha and gamma vitamin E, were measured in the blood of the mothers post-pregnancy. Both vitamin forms had previously been shown to decrease lung inflammation in both animals and humans.  The results of the study show that children whose mothers had low blood levels of the alpha vitamin E form were more likely to suffer from wheeze and require asthma medications. Research is now needed to see whether improving maternal blood levels of alpha vitamin E can cut the risk of asthma in their children.

References

1. Bischoff-Ferrari HA, et al. Statin use and 25-hydroxyvitamin D blood level response to vitamin D treatment of older adults. J Am Geriatr Soc. Epub ahead of print, Feb. 2017.
2. Qin XF, et al. Effects of vitamin D on plasma lipid profiles in statin-treated patients with hypercholesterolemia: A randomized placebo-controlled trial. Clin Nutr. 34:201-6, 2015.
   3. Michalska-Kasiczak M, et al. Analysis of vitamin D levels in patients with and without statin-associated myalgia - a systematic review and meta-analysis of 7 studies with 2420 patients. Int J Cardiol. 178:111-16, 2015.
3. Singla M, et al. Vitamin D supplementation improves simvastatin-mediated decline in exercise performance : A randomized, double-blind, placebo-controlled study. J Diabetes. Accepted manuscript online: 24 February 2017.
4. Stone CA. American Academy of Allergy, Asthma & Immunology (AAAAI) 2017 Annual Meeting. Abstract 263. Presented March 4, 2017.