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Vitamin D helps control lupus, says new randomized control trial

Posted on: December 29, 2012   by  Kate Saley

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A new randomized controlled trial out of Egypt reports that vitamin D can reduce the incidence of flare-ups in patients with SLE.

Dr Anna Abou-Raya, MD, PhD, and colleagues of the University of Alexandria in Egypt recently published results from a randomized controlled trial in which 267 SLE patients were randomized to receive 2,000 IU/day (n=178) vitamin D3 or a placebo (n=89) for 1 year. They also included a group of healthy control participants (n=175), to compare baseline characteristics between healthy patients and SLE patients.

Systemic lupus erythematosis (SLE) is a chronic inflammatory autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue. SLE occurs most often in women between the ages of 10 and 50. The disease often causes joint pain and swelling, with some experiencing arthritis, hair loss, mouth sores, sensitivity to sunlight, chronic fatigue, and chest pain. The course of the disease can be erratic, with periods of illness (flares) alternating with remissions.

To start, mean 25(OH)D status at baseline for all patients with SLE was 19.8 ng/ml compared to 28.7 ng/ml in healthy controls. After 12 months of therapy, the vitamin D group’s mean 25(OH)D level increased to 37.8 ng/ml, compared to no change in the placebo group.In this randomized controlled trial, vitamin D levels, SLE disease activity, and markers of inflammation were all measured before and after treatment. The researchers found:

  • Over the course of the year, only 10% of patients in the vitamin D group experienced a flare-up, compared to 24% experiencing flare-ups in the placebogroup over the course of the year (p<0.05).
  • The authors noticed a significant reduction in SLE-related antibodies (indicate inflammation) in the vitamin D group compared with the placebo group (p=0.05).

In further analysis, the authors found:

  • 25(OH)D levels were lowest among patients experiencing active SLE flares.
  • Significantly higher SLE disease activity was observed in participants with severe vitamin D deficiency (p=0.01).

Based on the results of the study, the authors suggest that higher vitamin D status seems to improve inflammatory markers associated with SLE and shows a tendency toward overall disease improvement. They call for larger trials to establish optimal vitamin D dosage for SLE patients.

The authors conclude,

“Vitamin D, a safe, inexpensive, and widely available agent, may be as effective as a disease-suppressing intervention for patients with SLE.”

With research like this, hopefully vitamin D will soon become a common addition to standard SLE treatment.

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 systemic lupus erythematosis: A randomized placebo-controlled trail. The Journal of Rheumatology. Dec 2012.

6 Responses to Vitamin D helps control lupus, says new randomized control trial

  1. hlahore@gmail.com

    Recall a previous study reported at vitamin D Council in which 3,000 IU of vitamin D resulted in not just a 42% reduction, but a 100% reduction in flareups (no flareups). http://www.vitamindcouncil.org/index.aspx?o=3948&newsitem=207. The previous study used a loading dose before settling into 3,000 IU average

  2. Mary Pittaway

    It will be so helpful when the converstation changes from “what dose produces what effect” to what blood level produces what effect. There are simply too many variables to consider when recommending a daily dose of vitamin D. I think we all need to pin the researches down with the question of what was each patients baseline blood level before they were admitted to the study. We do a disservice to the public by focusing on doses, not blood levels. And why in the world hasn’t some researcher developed a low cost “fingerstick” test for vitamin D?

  3. Brant Cebulla

    Agreed, Mary, we do need cheaper testing. I think there are some serious barriers currently, however, for reasons that are beyond my depth of knowledge.

    I think for at least the next 20-30 years however, doses will be recommended, not serum levels, and I think there is good reason for that. Blood testing is just not easy or accessible enough currently to make blood serum recommendations versus a simple dosage recommendation. Given such, I think researchers are just in administering doses and measuring levels rather than measuring levels and titrating doses. There’s just more public health relevance in the former approach.

    I think there is still some debate for whether vitamin D testing is an effective use of health care costs currently. Does someone hovering around the poverty line really need to spend $60-200 on a vitamin D test when they can just take a supplement and have a 97.5% chance blindly meeting a serum target level?

    I can see a world where we check our levels for a variety of things on a daily basis from the convenience of our smart phones or similar device. In thirty years? Fifty years?

  4. Rita and Misty

    @ Mary–

    You statement really hits home with me…..

    It really is all about blood levels, isn’t it?

    And to me it, seems dosage to achieve optimal blood levels really may be unique to each individual, with consideration to his or her particular set of health conditions.

    BTW–my 25(OH)D level as of January 1, 2013 is 104 ng/ml. This is after supplementing with 32,000 iu of D3 since October 1, 2012….During the summer, my level was around 75 ng/ml, with 16,000 iu of D3 daily and approx 2.5 hours of high sun per week (I live in CT).

    FYI–I take all co-factors beneficial to Vitamin D, and I do not supplement with calcium.

    I am comfortable with my current 25(OH)D level… I didn’t receive a flu shot this year, and I am confident I will be flu free due to my Vitamin D levels.

    BTW–I think a finger stick test for 25(OH)D levels will be marketed shortly (I seem to remember reading this over the summer).

    Best,

    Rita Umile

  5. SKaiser

    Thanks Kate for your interesting summary. Hi all. New here. Love the discussion. Rita, I’m interested to know why you “do not supplement with calcium”?… as you put it, if you don’t mind my asking, is it due to age, other diagnosis? As I recall, Dr. Cannell, mentioned in one of his articles that a good dose would be approximately 5,000 IU/d and that was a base dose shown to correlate with decreased rates of various cancers, correct?

  6. Rita and Misty

    Greetings @SKaiser, and Welcome! You’re joining an excellent community for Vitamin D knowledge!!!!! 🙂

    I will gladly share my story with you:

    I choose to keep my 25(OH)D levels at the high end of optimal (range being 30 ng/ml–100 ng/ml). I made this decision last year based on family history of diseases, such as diabetes II, FBD, PCOS, osteoporosis, irritable bowel syndrome, depression, insomnia, etc.

    My decision to keep my Vitamin D Serum levels higher than 55 ng/ml is a personal one, based on my own research and I think it is valid for me…. Your decision is best made with your own physician, based on your own particular set of health issues.

    To keep my 25(OH)D levels in the 75–100 ng/ml range my body requires a substantial amount of Vitamin D3, along with all the necessary co-factors. You may have read in my above posting that my 25(OH)D level as of January 1, 2013 is 104 ng/ml. This is after supplementing with 32,000 iu of D3 since October 1, 2012….During the summer, my level was around 75 ng/ml, with 16,000 iu of D3 daily and approx 2.5 hours of high sun per week (I live in CT).

    BTW, since achieving higher range D levels, my health has greatly improved–including effortlessly losing 30 lbs of excess weight.

    Again, I am comfortable maintaining such a level based on my own set of health conditions. I do not advocate that you take such high amounts of D3 without consultation with your physician and close blood monitoring….

    I choose not to supplement with calcium, as my research indicates that high Vitamin D blood levels greatly enhance absorption of calcium from food sources….I do eat a significant amount of calcium containing food sources….plant and dairy.

    In closing, I encourage you to remember Vitamin D co-factors such as magnesium (many of us are deficient in magnesium), boron, Vitamin K (I take a mixed supplement), and Zinc. To this mix, I also include Iodine, Chromium and Selenium.

    To Sunny Days (and good health for all),

    Rita Celone Umile 🙂

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