Vitamin D

I am sure this has been written about before, but I am wondering if any of you with an AF diagnosis take Vitamin D capsules and whether there is any adverse interaction with AF related meds, i.e. Warfarin, Bisoprolol and Ramipril

Thanks,

John

[jeanjeannie50]

Hi John

I've used a vitamin D1000 oral spray, made by Better You for a few years. I take Warfarin and it makes no difference to my INR. In the winter when I have two sprays of it daily, I also take a spray of the same make vitamin K2, to ensure the D goes more to my bone maintenance. I prefer to take vitamins that don't have too many additives.

Jean

[Hidden in reply to jeanjeannie50]

Thank you Jean. Very interesting - an oral spray. I was locked into the capsule mind set. 😱

I'm looking at the bones and joints application. My Pharmacist (at my surgery ) and I had our review today and during the phone consultation she suggested this approach (using Vitamin D I mean) and it took me aback somewhat which is why I thought I'd ask around. I wonder what the effectiveness ( spray v capsule I mean) actually means.

Thanks again.

John

[jeanjeannie50 in reply to Hidden]

The spray I use is oral. I hate all the additives/fillers in pills and avoid them when I can.

[Hidden in reply to jeanjeannie50]

Jean ..... thinking about your comments .... do you only take these vitamins in winter or all year round, are they suitable to use as a pill in the pocket, or once started should my intake be constant/consistent ? and not switched on/off by season. Thanks.

John

[jeanjeannie50 in reply to Hidden]

All year round. I take one spray of 1000IU each day in the summer months and two sprays in the winter. We get vitamin D from sunshine. Don't forget the vitamin K2 to direct the D to your bones. I take 1 x 180ug spray daily. My daily dose of warfarin didn't alter and I still only take 3mg.

[jeanjeannie50 in reply to Hidden]

It's no big deal if you don't take it for a day or two.

[Singwell in reply to jeanjeannie50]

About to order!

[Hidden in reply to Singwell]

wow ! 😂😂

[Singwell in reply to Hidden]

Do you think commission is appropriate here?

[Bagrat]

I and my husband on Apixaban and warfarin respectively take vit D 3 25 micrograms (1,000 iu). OH takes a selection of BP and heart meds and I'm on flecainide. No interactions we've noted and none on drugs.com

[Hidden in reply to Bagrat]

Thanks for that Bagrat. Looks like a pathway to try given yours and Jeans comments.

John

[Mrsvemb]

I take 1000iu of vitamin D prescribed by my doctor. My other meds are Nebivolol, Felodipine and Dabigatran. No problems at all.

I was on Warfarin for a short time with no adverse interactions.

[mav7]

I take 2000IU Vitamin D daily with Metoprolol and Eliquis with no issues. Cardiologist and primary care doctor are aware.

It is best to have a blood test to determine your level of Vitamin D to determine proper dosage.

[sleeksheep]

I get a Vit D test yearly and its been around 124 nmol/L ( ref. 50-150 )

I take 5000IU soft gel and have had no issues with other medications ,also take

Vit. K2M7 100mcg soft gel with Vit.D

I try to stay away from any capsule that has calcium added as a filler as I have had kidney stones - thats why I prefer gels.

[localad]

i rub 4000iu into my forearm area most days, September to April. (Just two drops of vit d in olive oil)

[Ppiman]

Have you had a blood test to check for deficiency? Without question, being out in the sunshine, even the lovely autumn sunshine we had yesterday, replaces vitamin D more effectively than any supplement. My friend is evidence of this. He has permanent AF and is on warfarin.

If you do take it, the recommendation is to take a standard dose only. I foolishly took a hefty dose following advice from online but after a few months developed severe back pains which my GP said were likely kidney stones possibly caused by the supplement, so, if you go for high dose, take care. If the stones were caused by the high dose of vitamin D, it would have been due to the increased calcium this causes in the blood, and this can also cause arrhythmias.

That said, the evidence isn't clear as this study showed:

health.ucsd.edu/news/releas...

Steve

[Auriculaire in reply to Ppiman]

Sorry Steve - you are wrong. The angle of the sun in the UK now is too low to produce enougb if any vit D . You will need to wait till mid April next year. As for hefty doses it has been the practice here to give loading doses of up to 400,000iu in an ampoule at the beginning of winter. Studies have shown that this is not an ideal way of dosing -daily or weekly is better- but the risk of kidney stones is rare. Possibly because calcium supplements are not as popular here - people have not been scared off dairy by so called "health" influencers. The standard dose of 400iu recommended in the UK is more or less useless as far as correcting any deficiency is concerned. Taking vit K2 will make sure that any excess calcium intake will be directed into the bones . I agree you should get tested first and again after 3 months of supplementation to see if the dose is effective.

[Ppiman in reply to Auriculaire]

You've studied it far more than I have, but I did read a study where sunlight produced as much as the supplements gave. You are right about our winter sun, I agree. There's no consensus on this vitamin, though, although, as you've said before, there seems to be possible potential for its use not as a supplement, but in hefty doses as a therapeutic agent. That's a very different thing from taking it in the kind of doses that would emulate sunshine - the normal means of the body making it.

Steve

[Auriculaire in reply to Ppiman]

You are right. Sunshine can actually produce far more vit D than supplements and is altogether a better way of getting vit D but this is dependent on several interdependant factors such as time of year ,time of day,latitude , skin type, age , and amount of skin exposed. Prof Holick has tables in his book "The Vitamin D Solution" which show how much time a person with a given skin type needs to spend in the sun depending on latitude, season and time of day. This is for exposing most of the body. Even so this will be approximate and there is no adjustment for decline in skin cholesterol with age or taking a statin! A young person with white skin can make between 10,000 and 20,000 iu with just 20 min of whole body exposure to midday sun in summer. Which of course is heavily frowned upon by the slip ,slap ,slop brigade. But most people in the UK are just not able to actively sunbathe ( even if they disregard the 3S brigade and don't use suncream ) for enough time to get high enough levels even in summer. Although what is built up in summer if one can do enough sun bathing is partially stored by the body this declines rapidly through autumn and winter and come Feb/March is rock bottom.

[Hidden in reply to Auriculaire]

Hiya Auriculaire,

Just following your discussion with Steve ...... so where does this leave me ? ..... a simple bus driver. Yes I'm an outdoor worker but not exposed to direct sunlight, because obviously for 5 hour stretches at a time on my shift I'm ensconced in my drivers cabin. In my off duty time I will potter in our courtyard trying to kill the least number of Mrs CarnEunys plants as possible.

Since my days living in Sydney and Melbourne when alot younger I learned a healthy respect for the sun, where mid summer can see a normal white skin burn in as little as 8 to 10 minutes of constant and direct exposure.

John

[Auriculaire in reply to Hidden]

You ought to get a test to see if you are deficient - or rather how deficient you are. Then supplement, and eat sardines and plenty eggs. In spring/ summer/ early autumn potter in shorts building up a gradual tan . We are lucky - it is hot enough here some years in Feb to start sunbathing on a sunny day with no wind and I start off with 5 mins each side and build up so that by summer I can do 30 mins each side without burning. I do not use sunscreen . In the hot sun of Australia a white skin could probably make enough vit D with 5 -10 min exposure. I too have a healthy respect for the sun as I have fair skin. Even here when working in full sun in the garden in summer, if it is very hot I have to wear a protector for my back that I have rigged up out of that silvery stuff you put on car windscreens. Otherwise I burn my back through the t shirt. I always wear a big hat as I cannot stand the sun on my head. And when I have done my allotted bathing time in the sun I move into the shade. Interestingly studies have shown that the more deficient in vit D you are - the more you burn! Not wanting go be gloomy but those who drive for a living are more prone to skin cancer on the arm or side of face/ neck that gets most exposure to sun even through the window. This is because UVA which is present all year round can cause skin cancer as well and it does get through glass unlike UVB. So a sunscreen with UVA block might be advisable when driving your bus.

[Hidden in reply to Auriculaire]

Once again, thanks to everyone for their comments which I’ve found very educational. So, although I’m addressing my reply to Auriculaire, I must also make mention of JeanJeanie, Singwell and CDreamer for their input to my question, and of course everyone else too numerous to mention whose comments have helped me in making a decision.

OK so, here we go ............. no, I have had no blood tests to determine my Vit D levels, at least that I know of. I have recently had my normal annual range of blood tests carried out by my surgery. My Surgery have the attitude that unless you hear from your GP, forget it, all bloods will be normal. Hmmmmm ! Nothing like a ‘hands off approach’.

1 I have bought a HomeHealth UK VitD Home blood testing kit. Waiting for delivery. If anyone wants to know about it its the one priced at £7.25 on the website. I’ve chosen this at random with no particular logic but it looks so much like a CoVid LFT kit.

2 The only other ‘Vitamins’ I take are BioQ10.

3 My VitD of choice will be an oral spray VitD3 + Vitamin K2. Although the K2 may impact on my Warfarin INR I don’t think it’ll be any more dramatic than the BioQ10. In any event, as I’ve often said over the last (almost) 13 years I’ve made very few concessions to Warfarin and my INR is 95% on target. I just eat and drink whatever I like so long as a number of diet basics remain, i.e. no gluten, wheat or oats. Drink includes alcohol, beer, wine and spirits as well as tea and coffee.

Again my thanks to you all.

John

[Rubymurray25]

I'm on Rivaroxaban and use a D3 spray daily and also a B12 spray and have never had any issues.

[Hidden in reply to Rubymurray25]

Many thanks 🙂

[RG72]

I have chewable Vit D tablets and no issues with bisoprolol, very low dose. My doc commended my vitamin D levels on the last blood test. As mentioned above, getting it naturally is the goal, supplementation in winter or when there is less sun.

[ozziebob]

If you are interested in Vitamin D and AF, please try to find time to read Steven Carr's testimony at ...

carrafibdietinfo.com/

Highly recommended, even though his efforts are certainly beyond my abilities.

bob

[ILowe]

There is no need to take a Vitamin D test since most people in Britain are too low. It is cheap and safe with plenty of margin and the benefits are well established so most medics do not bother to test the level. The safety margin is now 4000IU even on the government page nhs.uk/conditions/vitamins-...

This means that you can probably quite safely go up to 4000IU without checking the level.

A cheap test will determine if you are below 30. A quality test with a number? The cheapest I could find was vitamindtest.org.uk

I like to be up at 60-80. For that I need 5000IU daily and an annual check to tweak it.

To answer the question: I do not know of any interference with medicines when taking such low amounts, but the usual caveats apply so do check with the medical services you deal with.

[Auriculaire in reply to ILowe]

I assume your 60-80 is in ng/mL . The UK measurements of nmol/l would be two and a half times higher. This can be confusing and a level of less than 75 nmol/l would be in the insufficient range. You are right about levels of deficiency in the UK.but I think a blood test is useful to perhaps shock people about how low their vit D might be! When my vit D deficiency was disgnosed in 2007 my level was 13ng/ mL. I was shocked. I live in a country with lots of sun , took 400iu with my calcium supplement (now abandoned) , and ate oily fish 4/5 times a week and sometimes took cod liver oil. I spent lots of time outdoors gardening but not nearly naked. I did not actively sunbathe. The idea that getting out in the sun and exposing only face and arms will cut it for vit D production is widespread but erroneous. For some people 4000iu a day will be sufficient but for others ( particularly the obese) a higher dose will be required which is why I think testing after a few months is a good idea.

[ILowe in reply to Auriculaire]

You are right. Thanks for the clarification. The minimum aimed at is 30 ng/mL (= 75 nmol/L) and I want 60-80 ng/mL (= 150-200 nmol/L).

[Auriculaire]

I take it you are not obese or even overweight. On 3000iu a day my husband ( slim and still well muscled) was able to achieve a respectable 49ng /mL . On the same dose I could not get past 24ng! My GP prescribed me Calcifediol drops which work like a charm . My level is around 70ng /mL with just 3 drops.

[Kingdaddy]

I found out my Vitamin D was low back in 2015 at 27. I am heterozygous for the VDRTaq genetic SNP which can result in lower D levels.

I take 10,000 D3 with K2, and my levels remain between 70-90, depending on how much sun I also get at any particular time of year.

Back in April I was on Multaq with it. No issues then. I also was on Eliquis for about 5 months. No issues there either.

[MarkS]

Hi John, as you know I'm on warfarin and I take 1000 IU of Vit D p.d. in tablet form from the end of Sep to April. From April onwards I'm in shorts and I reckon I get enough Vit D naturally. Cheers, Mark

[Hidden in reply to MarkS]

G'day Mark, thanks for that. I have pretty much gone through all comments now and there is still one mystery in my mind .......... "exposure to ... ". This has come up time and time again in replies. People like Auriculaire, CDreamer and I think Singwell and others have all commented about the best form of vitamin D is sunshine. So, where my confusion creeps in is ..... what would be the difference between Daylight and Sunlight. I am an outdoor worker (bus driver nicely tucked away in the cab of my double decker bus and therefore sheltered from the direct sun) so, in theory, I do not receive full benefits from Sun because obviously I'm protected by my drivers cab, even though I'm driving in Daylight. So on a nice Cornish cloudy day or cloudy wet day does this mean I am not getting any Vitamin D at all.

I never had this issue in my home town, Sydney, driving buses because in summer time the sun was so intense that my right arm turned positively brown as it was inside the drivers side window. In fact I recall a constant stream of health warnings via the Sydney print and visual media telling people the burn time this morning or at midday or whenever was gonna be 8 or 12 minutes.

Cheers,

John

[MarkS in reply to Hidden]

Hi John, I'm not sure anyone has a definitive answer to the exposure question. From the limited research I've done, it seems that you need to get a light tan to get the right amount of UV. There is very little UV on cloudy or wet days. Having said that, I have come back with some colour after cloudy days when I've been out all the time. I think that most UV is absorbed by the car/bus windows so I'm not sure you'll get much that way. If I'm driving I'll open my side window on a sunny day and leave my arm exposed (unless I'm on the motorway!). But living near the south coast and wearing shorts and T-shirts all summer long, I reckon I get enough exposure naturally whilst dog walking or playing on the water.

I also understand that those who got sunburnt as children at least twice, live longer than those who didn't, despite the increased risk of melanomas. Hardly a year went by without my getting burnt at least once. I assume this is down to getting sufficient UV and a lifetime habit of exercising outdoors. Cheers, Mark

[dunestar]

I take Vitamin D daily, just bog standard stuff from Boots. I was found to be seriously deficient some years ago and had to take loading doses prescribed by the GP. I accept sun is a good source but as my poor exposed body would scare the horses I'm happy to opt for the supplement approach. No interaction with my heart meds - isosorbide mononitrate, ramipril and atorvastatin.

[MvTries]

Just had my bloodwork done. 54ng/ml. That is on 5000 IU per day and living in shorts 9 months per year. Flecainide, apixaban, metropolol. No interaction noted.

My GP is obsessive about keeping my vitamin D levels up .

[Tomred]

I take vit d 5000iu on mon wed and fri, just passed kidney stone yesterday 5mm it give me lots of pain, passed 1 also 10 years ago when i was taking maybe 25iu daily .

[Kingst]

I am completely baffled about the vitamin D issue. If you Google vitamin D and heart palpitations there are numerous articles about how it can cause heart palpitations!

[Cookie24]

I always check drug and vitamin interactions on drugs.com

[frazeej]

I've been taking D3, 5,000 IU's, gelcap for several years. I have no adverse effects, to the best of my knowledge/feeling, and I have not been warned off this dose by the myriad of doctors I visit. I also take the standard afib drugs-beta blocker, antiarythmic and anticoagulant. All seems well with everything. P.S. I don't like sunbathing, and in fact try to avoid the sun (not a vampire, to the best of my knowledge!)

[JOY2THEWORLD49]

Hi

Best tested for Vit D and Calcium.

I was OK on both.

I sit out in sun early before SV cream.

Pop your mushrooms outside in sun or sun sill as they absorb Vit D.

A friend taking Vit D for depression showed an overdose. Capillaries on his nose burst.

If you have the normal range do not take Vit D.

Some vitamin overdoses do not excrete but 'grow' into toxicity.

'Cheri JOY. 73. (NZ)

I have a sunny deck which faces East, North and West. Lucky me.

[Georgie8]

I take vit D as I have osteoporosis, I take Edoxaban changed from Rivaoxaban with no side affects