Vitamin D Improves Symptoms of Systemic Lupus Erythematosus

by | Oct 31, 2018 | 2013, Autoimmune Disease, Lupus, Vitamin D - General, Vitamins

Written by Angeline A. De Leon, Staff Writer. Compared to the control group, twelve months of Vitamin D supplementation significantly improved inflammatory and hemostatic markers as well as disease activity in the treatment group of 158 participants with systemic lupus erythematosus.

Research over the last few years has drawn a connection between vitamin D deficiency and risk for autoimmune disease 1-3. Vitamin D is well known for its role in regulating the immune system 4, and epidemiological evidence suggests that low levels of serum vitamin D are a predictor of later development of autoimmune diseases such as multiple sclerosis and autoimmune rheumatoid arthritis and diabetes 5-7. In patients with systematic lupus erythematosus (SLE), a chronic inflammatory disease that affects the skin, joints, and multiple organs, vitamin D deficiency is highly prevalent 8. Deficiency in vitamin D is not only considered a risk factor for SLE 9, but appears to contribute to the progression of disease activity in SLE patients, with research linking lower levels of vitamin D to higher disease activity and increased vitamin D levels to reduced disease activity over time 10. In rodent models of SLE, dietary intake of vitamin D has been shown to improve inflammation 11 and has been linked to immunomodulatory effects 12. Increasingly, vitamin D supplementation is being considered a potential disease suppressing intervention for SLE patients 13. Thus, in a research study published in the Journal of Rheumatology, researchers sought to investigate the effects of vitamin D supplementation on inflammatory and hemostatic markers and disease activity in patients with SLE.

A total of 267 patients with SLE (mean age = 38.8 years, mean disease duration = 8.2 years) and 175 age-, sex-, and body mass index-matched healthy controls were enrolled in a randomized, double-blind, placebo-controlled trial. SLE patients were randomized 2:1 to ingest either oral vitamin D3 (2000 IU) or matching placebo daily for 12 months. At baseline and at the end of 12 months, blood samples were collected to determine serum levels of 25(OH)D3 (major circulating form of vitamin D representing body’s vitamin D supply) as well as proinflammatory cytokines and hemostatic markers. Disease activity was assessed using the SLE Disease Activity Index (SLEDAI), based on 25(OH)D3 levels. Vitamin D levels < 10 ng/ml were considered deficient and 10-30 ng/ml insufficient.

At baseline, mean 25(OH)D3 level was 19.8 ng/ml for SLE patients vs. 28.7 ng/ml in healthy controls. After 12 months of therapy, a significant reduction in mean levels of pro-inflammatory cytokines (Il-1, IL-6, IL-18, TNF-α) and hemostatic disease activity markers (ESR, anti-dsDNA, Anti-Sm, C4, Fibrinogen, vWF) was apparent for the vitamin D group, relative to placebo (p < 0.05 for all). Patients with vitamin D insufficiency and those with deficiency demonstrated significant improvement on disease activity (SLEDAI score) after 12 months of vitamin D supplementation (4.9 to 3.2, p < 0.01; 4.9 to 3.0, p < 0.05, respectively). Across subjects, levels of 25(OH)D3 were also found to be inversely correlated with SLE disease activity score (r = -0.583, p < 0.05).

Results of the study confirm the prophylactic effects of vitamin D supplementation on SLE. Daily intake of vitamin D over the course of one year was found to improve inflammatory and hemostatic markers and disease activity in SLE patients. It is suggested that as a safe, inexpensive, and readily available supplement, vitamin D should be considered as an adjunct to standard SLE therapy. One of the limitations noted by the study’s author is the lack of data to determine optimal vitamin D dosage (due to the fact that many SLE patients remained at suboptimal 25(OH)D3 levels even after intervention). Additional studies are needed to further investigate the dose-response relationship between vitamin D intake and disease activity in autoimmune disorders. 

Source: Abou-Raya A, Abou-Raya S, Helmii M. The effect of vitamin d supplementation on inflammatory and hemostatic markers and disease activity in patients with systematic lupus erythematosus: a randomized placebo-controlled trial. Journal of Rheumatology. 2013; 40: 265-272. DOI: 10.3899/jrheum.111594.

Copyright © The Journal of Rheumatology 2013. Personal non-commercial use only

Posted October 31, 2018.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

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