Vitamin D: where we are now?

Vitamin D deficiency is common but vitamin D supplementation is relatively safe and is not an expensive treatment or prevention option argues Martin Hewison, Professor of Molecular Endocrinology, University of Birmingham.

Autoimmune diseases are commonly treated with glucocorticoids such as prednisolone, prednisone and dexamethasone. Although these are successful in treating the inflammation of autoimmune disease, they also have side effects, including osteoporosis. “Vitamin D just acts in a very similar fashion and it doesn’t really have that downside when it comes to your bone function”, says Professor Hewison. It might be possible to combine vitamin D with glucocorticoids to treat autoimmune disease because they work well to raise the levels of regulatory T-cells. “These are areas of potential vitamin D function that we’re trying to explore here at Birmingham – new ways of potentially utilising vitamin D in combination with other treatments as a treatment rather than a preventative agent for autoimmune disease”, he adds.

Summarising the current position Professor Hewison makes the following points:

• Many people are vitamin D deficient and given the “strong link between low vitamin D levels and a wide range of human health issues” and “vitamin D is a relatively cheap and relatively safe agent, then there is at least a good rationale behind improving the vitamin D levels for individuals”.
• Further studies will clarify the causative role of vitamin D deficiency in some disorders but in the meantime “the message will be that [supplementation] probably has little benefit for those who already have plenty of vitamin D but it has potentially important benefits for people who are vitamin D deficient – and I think that would include quite a lot of people in the UK”.
• Food fortification will be an important way to combat vitamin D deficiency generally.
• Targeted supplementation will still be important for some groups. Frontline health care practitioners should identify people who are at risk of vitamin D deficiency (dark-skinned individuals, those who are housebound or who keep their skin covered at all times) and suggest vitamin D supplements

“Hopefully, 100 years after vitamin D was discovered [we will] finally cure rickets in the UK “, he concludes.

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