Vitamin D Supplement in Chronic Heart Failure

Vitamin D Supplement in Chronic Heart Failure
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The heart depends on calcium to function properly. Calcium's absorption in the intestine is facilitated by vitamin D. Vitamin D is synthesized in the skin under direct sunlight. Low blood calcium results when vitamin D is not adequately absorbed. Low blood calcium weakens the heart muscle and can cause it to fail.

Heart Failure

The heart pumps oxygen-rich blood from the lungs to the body; it also pumps oxygen-poor blood from the body to the lungs. To function efficiently, the heart muscle needs calcium. Very low calcium in the blood weakens the heart and has been associated with heart failure. When the heart fails, blood flow is affected, and oxygen-rich blood backs up to the lungs. Heart failure must be addressed and followed closely because it affects the oxygenation of blood.

Major Complications

Vitamin D deficiency is mainly a result of poor intestinal absorption or poor dietary intake of vitamin D. Inadequate sunlight exposure can also contribute to a deficiency of vitamin D. Low blood calcium is a direct complication of vitamin D deficiency. Other complications seen in vitamin D deficiency are a result of low blood calcium. An irregular pulse commonly occurs with low blood calcium, but reversible heart failure, which is rare, can occur when calcium is very low. The parathyroid gland is stimulated to produced parathyroid hormone when blood calcium is low. Excess of parathyroid hormone causes excessive bone breakdown for the sake of releasing calcium to the blood. Excess parathyroid hormone weakens bone and makes it more likely to fracture.

Symptoms

The heart muscle is weakened by very low blood calcium; it causes shortness of breath while lying down. Leg and belly swelling are seen also. Low blood calcium can lead to a condition of uncontrollable muscle contractions called tetany. Tetany may cause odd sensations over the tongue and lips and abnormal twitching of the facial muscles. Excess parathyroid hormone release makes an already weak bone worse. Individuals with excess parathyroid hormone in the blood often complain of bone and joint pain. Generalized weakness, abdominal pain, nausea and depression can also occur.

Assessment

Evaluation of vitamin D deficiency begins with the extraction of blood from a vein in the arm. The sample of blood is sent to the lab for analysis,where levels of vitamin D are measured. A normal level of active vitamin D should be above 30 nanograms per milliliter, or ng/mL; if less than 30 ng/mL, it's abnormal. An active vitamin(See Reference 3)

Management

When vitamin D is deficient, it should be treated by the supplementation of vitamin D as well as dietary modifications and increased sun exposure. Dietary modifications should include fish, eggs, vitamin D-fortified milk and cod liver oil; these are excellent sources of vitamin D. The U.S. Department of Health and Human Services recommends vitamin D at doses of 700 to 800 international units, or IUs, per day with 500 to 1,200 mg of calcium; this is effective in preventing a loss in bone density. Always consult your doctor before taking supplements to treat any condition.

References

Article reviewed by Holland Hammond Last updated on: Oct 29, 2010

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