Supplements and Your Heart

Many Americans suffer from deficiencies in common vitamins and minerals. For example, as we spend more time indoors, vitamin D deficiency has reached significant proportions. About 50% of Americans have a vitamin D insufficiency, and about 35% have a vitamin D deficiency. And as our diets have worsened, many find themselves lacking in other essential nutrients. Many studies have been designed to prove the link between vitamin supplementation and heart health. While some studies have shown a correlation, others do not, with some even showing an adverse effect of certain supplements on heart health. So, how do we cut through the marketing and decide which supplements are appropriate?

The most important consideration is that a supplementation regimen should only be undertaken with the supervision of your primary care physician, specialist, or cardiologist. While they may seem harmless, some supplements do interact with medications and can potentially cause serious health issues. Since supplements are not regulated by the FDA the way prescription drugs are, some can be impure, misleading, or downright dangerous and should be avoided altogether.

What You Need to Know

The key to proper vitamin supplementation is understanding your current levels. This can be achieved with a routine blood test requested by your primary care physician or cardiologist. At your next check-up, speak to them about including vitamin and mineral levels in your blood test. You can take appropriate action once you and your doctor understand the deficiency. For example, people commonly have a vitamin D3 deficiency due to lower exposure to the sun. Many also have vitamin B12 deficiencies. Other common deficiencies include iron and calcium.

Now, let’s delve into common vitamin supplements and understand how they affect heart health.

• Calcium supplementation has long been considered essential for heart health. Many patients were prescribed calcium after a diagnosis of heart disease. However, newer research is starting to show that calcium may have a detrimental effect on heart health. A study indicated that men who took 1000 mg of calcium every day over 12 years had a 20% greater chance of dying of heart disease than those who did not take supplements¹. Later research has shown that post-menopausal women taking calcium supplements may be at higher risk of aorta calcification². Interestingly, dietary calcium is positively correlated with heart health.
• Fish oil has been heavily marketed as good for the heart. It has been posited that omega-3 fatty acids protect against heart disease. Several well-executed studies have shown benefits, while others have demonstrated no appreciable difference over a placebo. For example, an Italian study in 2017 showed that omega-3s:
  • Improved blood flow through vasodilatation.
  • Has antioxidant and anti-inflammatory properties.
  • Promoted antithrombotic (anti-clot) actions.
  • Slowed the progress of arterial plaque and
  • Decreased arterial wall hardening.
• Antioxidant vitamin supplements are also commonly researched to see if they affect heart health. According to an American Heart Association science advisory bulletin, most clinical trials have not shown heart health benefits from antioxidant cocktails, including Vitamin C, Vitamin E, and Beta-Carotene.
• Fiber is a winner when it comes to heart health. Fiber binds to cholesterol compounds in your diet and reduces how much your body absorbs into the bloodstream. Fiber is also exceptionally beneficial to the gut microbiome and can help regulate insulin secretion. Lastly, proper fiber intake can help you lose weight if needed. Just remember to drink plenty of water with your fiber supplement and try to get your fiber naturally when possible.
• Magnesium is a critically important yet underappreciated nutrient. Not many people are severely deficient in this nutrient, but we look forward to updated guidance from the FDA on appropriate levels for general health. Magnesium is quite effective when introduced intravenously to stop an Afib episode alongside the standard of care treatment. While oral magnesium supplementation has not been proven to help Afib, its muscle relaxant properties can be helpful for blood flow and heart health.

There are many considerations when understanding the role of supplementation as it relates to heart health. Remember, the FDA typically does not oversee the claims made by supplement makers, and these products may vary in potency and purity. The overarching takeaway is that vitamin and mineral intake can be improved through diet and lifestyle changes, which is always preferable to supplementation. However, some, like Vitamin D, are very hard to get enough of from food alone and may need to be supplemented.

Ultimately, because of the potential risks associated with vitamins and supplements, we do not specifically recommend their use as a treatment for heart disease unless directed by your doctor. A balanced and healthy diet combined with exercise should yield the vitamins and nutrients you need with minimal supplementation. If you are deficient in any essential vitamins or nutrients, the next step is finding out and getting treated.

References:

1. Xiao Q, Murphy RA, Houston DK, Harris TB, Chow WH, Park Y. Dietary and Supplemental Calcium Intake and Cardiovascular Disease Mortality: The National Institutes of Health-AARP Diet and Health Study. JAMA Intern Med. 2013 Feb 4:1-8.
2. Morelli MB, Santulli G, Gambardella J. Calcium supplements: Good for the bone, bad for the heart? A systematic updated appraisal. Atherosclerosis. 2020 Mar;296:68-73. doi: 10.1016/j.atherosclerosis.2020.01.008. Epub 2020 Jan 29. PMID: 32033778; PMCID: PMC7276095.
3. Colussi G, Catena C, Novello M, Bertin N, Sechi LA. Impact of omega-3 polyunsaturated fatty acids on vascular function and blood pressure: Relevance for cardiovascular outcomes. Nutr Metab Cardiovasc Dis. 2017 Mar;27(3):191-200. doi: 10.1016/j.numecd.2016.07.011. Epub 2016 Jul 26. PMID: 27692558.