such as oat, rice, and soy milk were ex- cluded in order to prevent potential cal- ciotropic effects, or soft tissue calcifica- tions that could result from potential vita- min D toxicity. Studies indicate that vita- min D conforms to a biphase dose-re- sponse curve, whereby both deficient and excessive levels lead to vascular calcifica- tions, or deleterious deposition of calcium in blood vessels that can promote the atherosclerotic changes observed in heart disease.
At physiologically appropriate levels, “vitamin D actions include the inhibition of processes that are important for intimal and medial artery calcification such as pro-inflammatory cytokine release, adhe- sion molecule release, and proliferation and migration of vascular smooth muscle cells”. However, when vitamin D is either too high or low, it has the potential to promote atherogenic soft tissue calcifica- tions, so researchers restricted dietary calcium as a safeguard to prevent
this
possibility. After the study duration, significant increases in serum 25-hydroxy vitamin D3 levels were observed, to a mean level of 106.3 ng/mL and 132.5 ng/mL, in psoria- sis and vitiligo patients, respectively. Levels of parathyroid hormone, a hormone
important in bone remodeling that is se- creted in response to low blood calcium levels, which promotes release of calcium from bones, were significantly decreased. Vitamin D levels were inversely related to PTH levels. In fact, Finamor and col- leagues suggest reduction in serum PTH concentration may be the best surrogate marker for determining maximal thera- peutic dosing of vitamin D3 for autoim- munity.
As evidenced by the dramatic photos included in this publicly available study, there was significant improvement in le- sion severity in all psoriasis patients as indicated by the Psoriasis Area and Sever- ity Index (PASI) score compared to base- line. Further, in fourteen of sixteen vitiligo subjects, 25-75% re-pigmentation oc- curred. In addition, laboratory and clinical manifestations of vitamin D toxicity, such as hypercalciuria, hypercalcemia, and kidney dysfunction, were not observed in any subjects. The researchers conclude that, “High-dose vitamin D3 therapy may be effective and safe for vitiligo and pso- riasis patients”.
Looking Ahead: Vitamin D as an Adjunctive Therapy for Autoimmunity
This article should not be interpreted as medical advice or serve as license to take megadoses of vitamin D, as this strat- egy has not been studied for long-term adverse effects. Vitamin D supplementa- tion should be performed under the su- pervision of a licensed medical physician, dosed according to lab levels, and ideally balanced with other fat-soluble vitamins. Rather, it demonstrates the potential
of this immunomodulatory hormone to induce self-tolerance and arrest autoim- mune responses. It should also motivate further research to ascertain whether au- toimmune patients require 25-hydroxy vitamin D3 levels above the normal refer- ence range. This notion can be reconciled with findings demonstrating that serum 25-hydroxyvitamin D3 levels under 300 ng/mL are unlikely to pose toxicity risk). It is possible that this data could be
extrapolated to other autoimmune dis- eases, given the prominent role that vita- min D deficiency plays in the patho- physiology of autoimmunity. For instance, a prospective Finnish study following children from birth found that individuals who were administered vitamin D supple- ments during infancy had an almost 90% lower risk of developing type 1 diabetes. Another study highlighted a 62% lower risk of developing MS in individuals with the highest vitamin D concentrations compared to those with the lowest. Therefore, optimizing vitamin D lev-
els, preferably through evolutionarily appropriate means such as sun exposure, should be a clinical priority in autoim- mune patients. In addition, vitamin D optimization should be employed as a pre-emptive strategy in people with a fam- ily history that predisposes them to auto- immune disorders.
Written by Ali Le Vere, B.S., B.S. © Septem- ber, 2017 GreenMedInfo LLC. This work is reproduced and distributed with the per- mission of GreenMedInfo LLC. Want to learn more from GreenMedInfo? Sign up for the newsletter here
http://www.green-
medinfo.com/greenmed/newsletter.
GreenMedInfo.com began in 2008 with the vision of founder, Sayer Ji, to provide a resource where consumers and health care professionals could access evidence-based, clinical data without the complexity of searching and navigating multiple health institutions.
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