Is my chest pain due to vitamin D3 deficiency?

Hello doctor,

Four months ago, I consulted you on this platform for premature complexes which I was having without any other symptoms. Below is my query and your answer - I am a male of 48 years of age. I have a lean build and do regular exercise. Since childhood, I had a tendency for heart palpitations and premature beats. After a few tests, anxiety was found to be the main cause. You had said that most probably these premature complexes are originating from ventricles which are leading to the symptoms. These are usually benign and not life threatening. The only concern remains is that of coronary artery disease, which is also less likely as these are occurring from a long time and you are not having any other symptoms. Lack of sleep, stress, alcohol, smoking, caffeinated beverages are known triggering factors for these due to sympathetic overactivity. You should also get thyroid test done. I think, just be on a safer side, you should get one treadmill test done to rule out coronary artery disease and echo should be repeated. Afterwards, I met a cardiologist and got an ECG and echo tests done. The tests were normal. The cardiologist said that there is no need for TMT test since I do running and other exercises daily and there is no known risk factor for CAD. But the VPCs continued for a month. Then, I realized that I was taking a weight gainer supplement from the last one year which contained creatinine. Two months back, I was not doing any exercise due to a small fracture in my elbow but continued to take this supplement. The doctor advised me to stop the supplement immediately since this could be the cause of missed beats. Then I read in the internet and found out that there have been cases of irregular heart beats due to creatinine supplementation. I stopped taking the supplement although it was from a reputed firm and did not contain any steroids. The missed beats reduced after stopping the supplement and from the last two months, it has come to a normal level of one or two in a day. But somehow my mind started getting preoccupied with the thoughts of heart disease and I started reading about it from the internet and even textbooks. I have been thin and slim since my childhood, have been quite active physically, no family history of heart disease, no diabetes, no hypertension, non-smoker, rarely eat fried foods. My lipid profile is normal with HDL being about 55 whenever tested, CRP is around 0.5. But in spite of this, I was not able to free my mind from worries of CAD. A month back, I did quite a lot of pushups after a gap of four to five months. After three to four days, I started having pain in my chest here and there mostly at rest. After a week I got an ECG done which was normal. The pain subsided slowly but whenever I did some exercise which put a strain on the chest muscle I started having pain and with pain, more worries. Then I met a psychiatrist. He said that I have got into an obsessive loop, which is part of health anxiety disorder which is causing these psychosomatic symptoms of chest pain. He advised me to take some antidepressants for three months, do Yoga and meditation and take some sessions of cognitive behavior therapy. I am reluctant to take antidepressants but have already started doing some meditation and Yoga. He also prescribed Alprazolam .25 mg on SOS basis. Now the pain is subsiding slowly and obsessive thoughts are also reducing. I have stopped doing any exercise that would put a strain on the chest. I do not know how long it will take to resume it. In a recent blood test, two months back my vitamin D3 was at 28 ng/mL. Could it be the cause of the chest pain? Secondly, I stopped the supplement but continued some strenuous exercises without taking a proper diet. Could it be the cause of it? Please guide me. How to get rid of this unwanted health anxiety which I have got into?

Hello doctor,

Thanks for the reply. My psychiatrist strongly insisted that this pain is of a psychosomatic nature and recommended treatment with anti-depressants as the solution. However, I personally believed that the pain is connected to the sudden strenuous exercise I had performed. Additionally, excessive worry can worsen it due to the focus of attention, as I have read. I will be following your advice and starting medication as suggested by you, and I will provide you with an update soon.

Hello doctor,

Thank you for the prompt response. As per your advice, I took Naproxen for five days. The pain significantly reduced during that time, but unfortunately, I caught an infection causing a cough and cold, resulting in mild pain persisting for a few more days. However, the pain has now almost disappeared. I am still avoiding exercises that strain my chest muscles. I also want to inform you that last year, I underwent a lipid profile test which showed a total cholesterol level of 193 mg/dL, LDL level of 114 mg/dL, HDL level of 56 mg/dL, and triglyceride level of 111 mg/dL. Three months ago this year, I repeated the test, and the results indicated a total cholesterol level of 206 mg/dL, LDL level of 120 mg/dL, HDL level of 50 mg/dL, and triglyceride level of 157 mg/dL. During that time, I was taking a weight gainer supplement, which led to a slight increase in my weight, reaching around 163 pounds. However, I have stopped taking the supplement, and my weight has since reduced to 154 pounds. Yesterday, I decided to conduct the lipid profile test again to observe the effects of discontinuing the supplement. Unfortunately, the results did not meet my expectations. The values showed a total cholesterol level of 221 mg/dL, LDL level of 138 mg/dL, HDL level of 65 mg/dL, and triglyceride level of 114 mg/dL. Although there was an increase in HDL and a decrease in triglycerides, both LDL and total cholesterol levels have shown an upward trend. I must mention that I had a heavy meal with some extra ghee the night before the test, and I have been consuming butter or ghee daily for the past month. Additionally, I have been having one or two whole eggs in the morning. Could these factors have contributed to the results? But my daily intake of fruits and vegetables is quite high. I would appreciate your advice on how to reverse this process and achieve desirable levels of LDL and total cholesterol.

Kindly help.

Thank you doctor,

I do not smoke, but occasionally I consume beer. I already engage in regular exercise and incorporate daily walks into my routine. Although my mother had slightly elevated cholesterol levels, there is no history of cardiac disease in our family. Could you please suggest me the desirable levels of lipids for me? And also, please inform is it beneficial to have high HDL (high-density lipoprotein) levels?

Kindly help.

Hello doctor,

Feeling unconvinced by the previous test results, I decided to have the test done again, this time at a different laboratory. This morning, I provided a blood sample there. The only difference was my dinner last night, which consisted of only one chapatti without butter or ghee. Additionally, I did not drink milk before going to sleep, as I usually have one glass of full-fat milk in the morning and another in the evening. The new test results arrived in the evening and showed some variations compared to the previous results from the other laboratory. The current results are as follows: total cholesterol of 196 mg/dL, LDL of 125 mg/dL, HDL of 61 mg/dL, and triglycerides of 109 mg/dL. There is a difference of 25 points in total cholesterol compared to the previous result of 221 mg/dL, and a difference of 13 points in LDL compared to the previous result of 138 mg/dL. However, there are no significant differences in the values of triglycerides and HDL. Could these variations be due to differences in the pre-meal routine or the laboratories themselves? I think the new results are more reliable. In any case, I am following the diet plan suggested by you. And also I wanted to ask, should I switch to toned milk instead of full-fat buffalo milk?

Kindly suggest.