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Decreased need for warfarin after Vitamin D levels optimized – RCT May 2016

The Effect of Treatment of Vitamin D Deficiency on the Level of P-Selectin and hs-CRP in Patients With Thromboembolism: A Pilot Randomized Clinical Trial.

J Clin Pharmacol. 2016 May 26. doi: 10.1002/jcph.774. [Epub ahead of print]
Hejazi ME1, Modarresi-Ghazani F2, Hamishehkar H2, Mesgari-Abbasi M2, Dousti S2, Entezari-Maleki T2.
1Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
2Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

VitaminDWiki summary of small trial

600,000 IU in 3 months: 15 nanograms ==> 73 nanograms
Loading: 50,000 IU weekly for 2 months
Then 50,000 IU every 2 weeks for 1 month
Study does not appear to state how much reduction there was in warfarin usage
See also VitaminDWiki

Despite the known role of vitamin D deficiency in development of thrombosis, no studies have evaluated the impact of treating of vitamin D deficiency on the markers of thrombosis. A pilot randomized clinical trial was done on 40 vitamin D-deficient patients with deep vein thrombosis (DVT) or pulmonary embolism (PE). The intervention group received an oral dose of 50,000 IU vitamin D3 every week for 8 weeks, followed by 1 pearl every 2 weeks for 4 weeks (a total of 3 months), while the control group did not receive vitamin D. Then, P-selectin and hs-CRP were measured at baseline and 1 and 3 months after the intervention.

There was no significant decrease in hs-CRP in either group after 1 month (P = .955) or after 3 months (P = .525).
Likewise, there was no significant decrease in P-selectin between the 2 groups after 1 month (P = .921) or 3 months (P = .795).
The results indicated that treatment of vitamin D deficiency had no significant effect on hs-CRP or P-selectin after 3 months among DVT/PE patients.
However, treatment of vitamin D deficiency in these patients resulted in the control of the international normalized ratio (INR) with the lower doses of warfarin.

This observation is the first clinical report of enhancement of the anticoagulant effect of warfarin by the supplementing of vitamin D. Larger trials are needed to clearly show the effect of treating of vitamin D deficiency on thrombosis.

PMID: 27225617

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Study described by Vitamin D Council

  • “Thromboembolisms affect approximately 900,000 people and are responsible for up to 100,000 American deaths each year in the treatments for thromboembolisms involve anticoagulants (blood thinners), aspirin or vasodilators.”
  • “Research has found that vitamin D deficiency is extremely prevalent among patients with thrombosis. In fact, research suggests that vitamin D deficiency may be a risk factor for the development of cardiovascular disease.”