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“Tregs”, autoimmune disorders, and vitamin D

Posted on: June 7, 2012   by  John Cannell, MD

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A treg sounds like something out of the Hobbit but for the 55 million Americans, mostly women, suffering from one of the eighty or more autoimmune diseases, a treg should be something that fascinates you. A treg or T regulatory cells is a part of the immune system that suppress reactions of other immune cells. This self-stop is built into the immune system to prevent excessive untoward reactions, especially the ones that mistakenly think of your own tissues as a foreign invader.

Regulatory T cells come in many forms but are crucial to prevent autoimmune diseases, where the patient’s immune system is killing self. These diseases are often chronic, debilitating, and life threatening. They are among the ten leading causes of younger female deaths.

About two years ago, Dr. Barbara Prietl of the University of Graz, working under Dr. Thomas Pieber, wanted to see if vitamin D would increase the percentage of tregs. If so, this would give a mechanism by which vitamin D might be effective in treating a whole range of autoimmune disorders.

Prietl B, Pilz S, Wolf M, Tomaschitz A, Obermayer-Pietsch B, Graninger W, Pieber TR. Vitamin D supplementation and regulatory T cells in apparently healthy subjects: vitamin D treatment for autoimmune diseases? Isr Med Assoc J. 2010 Mar;12(3):136-9.

They gave 140,000 IU of vitamin D to 46 healthy subjects as a single dose and then repeated it at 4 weeks. They measured tregs percentage at baseline and at 4 and 8 weeks. Sure enough, vitamin D increased tregs percentage from 4.8 at baseline to 5.9 at four weeks and to 5.6 at eight weeks.

This was significant at the .001 level and enough to give hope to those with lupus, rheumatoid arthritis, autism (yes, I do believe autism is an autoimmune disorder), MS, and a host of other diseases that the correct amount of vitamin D might help treat the disease.

My advice, if you have a serious autoimmune disease, is to get your vitamin D level up to the high normal range. For adults, this usually takes 10,000 IU/day, sometimes more. This kind of practice is already being studied and used in some clinical practices for MS patients.

If I were a true scientist, I might tell you to wait until science knows more, but I’m no scientist, rather a physician. Physicians have always been bound to act on what science knows now, not what it may learn in the future, and, thanks to some good scientists, we now know that vitamin D increases tregs, the cells needed to fight autoimmune diseases.

The alternative is to wait for more science, with all the death and pain that entails. However, the risk/benefit analysis on using vitamin D, in my opinion, shows that is better to be taking vitamin D now, rather than wait. I find waiting unethical.

4 Responses to “Tregs”, autoimmune disorders, and vitamin D

  1. Ian

    A question regarding Treg (cd4+cd25++) in people with ME/CFS.
    The following study by Brenu et al showed increase over normals of FOXP3.
    http://www.translational-medicine.com/content/9/1/81
    Does this suggest that a person with ME/CFS may experience some worsening of symptoms if they take vitamin D (at higher doses, say 10,000IU)?
    In the above study:
    “Vitamin D supplementation was associated with significantly increased %Tregs in apparently healthy individuals. ”
    I am a little confused about this.

  2. Brant Cebulla

    Ian, good question. My understanding is that this topic gets complicated very quickly. There are many types of T cells. Vitamin D inhibits production of some, while promoting others. For example, vitamin D inhibits Th1 and Th17, but promotes Th2 and Tregs.

    There doesn’t appear to be much research on CFS and vitamin D, other than a few studies showing that CFS patients are low in vitamin D.

  3. jannz

    Is there standardized blood test — available to the public – to measure the various T-cells? It seems if “Tregs” are the measurable indicator of autoimmunity then it would be prudent to track it.

  4. Rita and Misty

    Thank goodness for brave physicians, Dr. Cannell. 🙂 I agree with you: waiting is unethical.

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