Effect of Vitamin D3 Supplementation on Cardiac Autonomic Nerve Function in Male Epileptic Patients With Hypovitaminosis D

In epilepsy, there is a shifting of autonomic balance toward sympathetic dominance & heart rate variability (HRV) is reduced which can be detected by interictal heart rate variability (HRV) testing. Patients treated with anti-epileptic drugs (AEDs) are suffered from one of its major adverse effects of vitamin D3 deficiency or hypovitaminosis D due to enzyme inducing effect of AEDs. Vitamin D3 is a neuroprotective hormone that modulates autonomic balance and regulates sympathetic and parasympathetic nervous systems. Vitamin D3 deficiency is also associated with the risk of reduced HRV. Administration of vitamin D3 in vitamin D3 deficient epileptic patients may improve their cardiac autonomic nerve function that can be interpreted by HRV.

Inclusion criteria

• • Diagnosed male patients with Epilepsy by neurologist from the OPD of Department of Neurology by taking proper history of at least two unprovoked (or reflex) seizures occuring > 24 hours apart, from patients and eye witnesses.

• Having hypovitaminosis D (serum vitamin D3 level <30 ng/ml)
• Age: 20-40 years.

• Sex: Male
• BMI : 18.5-24.9 kg/m2
• Taking antiepileptic drug for 6 months to 2 years ( Enzyme inducer AEDs, e.g. Carbamazepine, Phenytoin, Phenobarbital)
• Without medication that affect central nervous system other than antiepileptic drugs (AEDs).

Exclusion criteria

• • Epileptic patients taking Sodium valproate, oxcarbazepine, Topiramate, Lamotrigine, Levetiracetam.

• Patient having absence seizure
• Alcoholic
• Smoker
• Patients taking following drugs will be excluded-

• Anti-diabetic drugs
• Antioxidant vitamin supplements
• Antihypertensive drug
• Anti-arrhythmic drug
• Lipid lowering medications
• Sedatives
• Patients having known hypersensitivity to vitamin D3
• All patients with the history of or currently suffering from following diseases & condition will be excluded-

• Cardiovascular disorders (Myocardial infarction, coronary heart disease, cardiac arrhythmia, CCF)
• Other neurological disorders (Migraine, stroke)
• Respiratory disorders (Bronchial asthma, COPD)
• Renal insufficiency (S. Creatinine > 1.5 mg/dl, Acute or chronic kidney disease)
• Endocrine disease (Diabetes mellitus, Thyroid disorders- hypothyroidism, hyperthyroidism)
• Arthritis (rheumatoid arthritis)
• Liver diseases
• Neoplastic disease
• Psychiatric disorder (schizophrenia, bipolar disorder)
• Current use of iron, zinc, calcium, magnesium and multivitamin supplementation
• Already performing yoga or breathing exercise
• Patients with hypercalcemia