Volume 3 - Issue 5
Clinical Pharmacist-CST, Kauvery Hospitals, India
The relationship between vitamin D and chronic disease-related clinical outcomes is controversial. In recent times, many benefits from the administration of vitamin D in various clinical settings have been claimed, starting with claims of miraculous recovery from severe and critical COVID-19 in early 2020. The recent reports of such claims were compiled and examined. Vitamin D deficiency is widespread and linked to a variety of disorders. Several studies have looked into the significance of vitamin D supplementation in many of these contexts. However, not all of them found it to be beneficial.
Keywords: Vitamin D; Covid 19; Cancer; Depression; Heart disease.
"Sunshine in a bottle", there have been long-standing claims that vitamin D brings a wide range of benefits. Vitamin D is a fat-soluble vitamin that belongs to the vitamin D family, which includes (vitamin D1), Ergocalciferol (vitamin D2), and Cholecalciferol (vitamin D3). Vitamin D plays a major role in our body - it promotes calcium absorption and phosphorus, and its deficiency leads to rickets in children and osteomalacia in adults.
In the United States, Vitamin D deficiency is defined as blood calcidiol (25 OH) levels less than 50 nmol/L. Low serum calcidiol levels have been associated with a greater risk for a number of disorders including renal, dermatological, cardiovascular, autoimmune disease, infections, and cancer.
Recently, emphasis has shifted to non-traditional effects of vitamin D reduction in the risk of autoimmune illnesses (including type 1 diabetes), multiple sclerosis (MS), and systemic lupus erythematosus) and immune-mediated diseases such as inflammatory bowel disease (IBD), autoimmune encephalomyelitis (EAM).
Evidence from clinical trials shows that vitamin D may potentially play a role in the following:
Reducing the risk of heart disease
A randomised controlled study revealed that taking 400 IU of vitamin D and calcium for 8 weeks dramatically decreased systolic blood pressure by 9%. The study revealed CVD risk declined significantly with rising doses until levelling out at roughly 50 nmol/L and also similar for blood pressure (BP). In contrast, many smaller trials done found no impact of vitamin D supplementation on blood pressure. In a European trial, people receiving 800 IU of vitamin D had no better cardiovascular survival than controls . Vitamin D deficiency has been connected to cardiovascular disease. However, it is questionable whether vitamin D deficiency leads to cardiovascular disease.
Vitamin D deficiency linked to fatty liver
The researchers assessed 25(OH)D they found severe vitamin D deficiency is positively associated with non-alcoholic fatty liver disease (NAFLD). When compared to men, women are at more risk.
Vitamin D in cirrhosis patients with spontaneous bacterial peritonitis
In one study, patients received a loading dose 300000 IU of Vitamin D3, followed by a maintenance 800 IU/d orally, with 1000 mg oral calcium; supplementation increased survival rate .
Vitamin D and type 2 diabetes
A meta-analysis observed that people with greater 25(OH)D levels had a 38% lower chance of having T2D. A trial evaluated the efficacy of ergocalciferol 50.000 IU/week and placebo: there were no changes in insulin secretion or insulin sensitivity .
Magnesium intake might affect serum vitamin D and T2DM risk
The researchers analysed data from the National Health and Nutrition Examination Survey (NHANES) 2007 to 2014; they found evidence of interaction between vitamin D levels and magnesium intake on decreasing the incidence of T2DM.
Vitamin D in COVID-19
Although studies are mixed, low vitamin D levels contribute to acute respiratory distress syndrome, with the substantial increase in the risk of death.
Vitamin D could potentially benefit migraine
A meta-analysis suggested benefits in treating migraine. The study indicated that vitamin D supplementation might reduce headache episodes per month, headache days per month.
Vitamin D fails to improve mental health in early psychosis: DFEND trial
One randomised controlled trial looked at vitamin D supplementation in adults with psychosis, and 14 000 IU weekly for 8 weeks showed no advantage in resistant schizophrenia. According to the findings of a new study, there was no correlation between vitamin D supplementation and mental health or metabolic outcomes .
Cancer and vitamin D supplementation studies
A meta-analysis indicated that vitamin D supplementation is linked with a considerably decreased risk of cancer death. The study shows that, weekly high-dose calcitriol and docetaxel (Rocaltrol (0.5 mcg/kg) on day 1 + docetaxel (36 mg/m2 ) on day 2, repeated weekly for 6 weeks was effective in 37 prostate cancer patients. Analogues like Seocalcitol, Inecalcit, Calcipotriol, and Paricalcitol were reported effective in managing different types of cancers .
Vitamin D deficiency
Vitamin D deficiency is widespread and linked to a variety of disorders. Several research studies have looked into the significance of vitamin D supplementation; however, not all of them found it to be beneficial. The treatment of vitamin D insufficiency in healthy people must be tailored, and dosages should be appropriate to maintain blood 25(OH)D levels between 40-70 ng/mL. We may soon have a better knowledge of their function in a variety of chronic diseases and many more claims are on the way.