Vitamin D and Lupus
Vitamin D is much more than a vitamin, it’s an essential “steroid” hormone with an important role in mineral metabolism, skeletal health, and recently discovered role in cardiovascular and immune systems.
Vitamin D deficiency is very common, which directly contribute to increased chronic diseases, especially systemic Lupus Erythematosus (SLE).
Because we Lupies are told to avoid the sun due to photosensitivities, rashes, and potential disease flare, we especially NEED supplementation.
Vitamin D Deficiency
Vitamin D deficiency is a global health problem and it starts early. It’s being detected during pregnancy.To give you perspective, out of 100 infants born in South Carolina, 46% had under 11 ng/ml, which are levels associated with the development of rickets. [note] 4 In Michigan, 50% of mothers and 65% of their newborn infants were severely deficient with levels less than 12 ng/ml. (4)
Despite growing awareness of vitamin D deficiency, it remains a growing problem. According to the National Health and Nutrition Examination Survey finds nearly all (90%) African and Mexican Americans have vitamin D deficiency. (6)
Vitamin D Deficiency and Lupus
This is important because African Americans and Hispanics are at a disproportionately higher risk of developing SLE and having the most severe disease manifestations.
Multiple studies validate that most of us Lupus patients have Vitamin D deficiency even with vitamin D supplementation.
Risk Factors for Vitamin D Deficiency in Lupus patients
Our body makes vitamin D with sun exposure. With ultraviolet B (UVB) radiation, our body makes vitamin D, however, with clothes, sunscreen use, and pigmentation this conversion can fluctuate.
Those with darker skin pigmentation are especially prone to developing vitamin D deficiency, which explains the prevalence of this in the African American and the Hispanic population.
Corticosteroids- Obesity and Vitamin D Deficiency
With Lupus, more attention is given to medications such as corticosteroids which further add to this problem. For those of us who took or take steroids often require higher doses of vitamin D3 to maintain adequate levels.
What’s also interesting is that obesity is also linked to vitamin D deficiency. If you’ve been on corticosteroids, you know what I mean. We all know the moon face, edema, increased fat tissue, and the weight that creeps up on you that you can’t get rid of.
We begin to compound the situation by having secondary risks like obesity. Obesity is not just a cosmetic problem. Increased accumulation of body fat can worsen not only our Lupus but cause various health problems: insulin resistance, impaired glucose tolerance, Type II Diabetes, and increase the risk for cardiovascular disease.
This is because fat tissue plays an important role in keeping balance in our body by secreting several bioactive proteins known collectively as adipokines: adiponectin, leptin, resistin, visfatin, and apelin, which are all involved in regulation of food intake, glucose, insulin action, and fat metabolism.
There can also be nutritional deficiencies despite increased eating in overweight individuals. This all ties into Vitamin D’s role as a regulator for so many different pathways in our body.
Vitamin D in Fracture Prevention
With Lupus, we have a higher risk for osteoporosis and fractures and vitamin D deficiency is one of several osteoporosis risk factors common among patients with SLE including high disease activity, renal disease, corticosteroid use, and those who took cytotoxic medications, like cyclophosphamide. (14)
To add to this, bone mineral loss tends to run a rapid course, making vitamin D status even more important. Despite such strong evidence, a recent study found that our Lupus patients do not take calcium and vitamin D supplementation. (16)
Cardiovascular Disease Risk with Low Vitamin D
We also have a much higher risk of cardiovascular disease at a younger age. Vitamin D plays a protective role in protecting our heart.
Vitamin D status is important based on a new study showing decreased risk with vitamin D supplementation. (20)
Cancer and Vitamin D
Due to the medications that we take, we are at an increased risk here as well. They found that vitamin D deficiency increases the risk of dying from breast, colon, ovarian, and prostate cancer.(1) Supplementing Vitamin D over 4 years was shown to improve overall cancer risk. (21)
Vitamin D Deficiency and Immune System
Sinde the 1980s, researchers have been studying genes related to Vitamin D and its involvement in our immune system.
Maintaining a steady Vitamin D levels for Lupus patients helps to have a protective innate immune response while keeping abnormal immune response in check. (25-28)
Lupus Flares and Vitamin D Levels
Significant research evidence recently proved that there is a relationship between lower Vitamin D levels and Disease Flares. [note]26
They also found that Vitamin D supplementation improves fatigue [note]31 and foggy brain. [note] 32
What Do You Do?
Unlike other vitamins, Vitamin D doesn’t come from food. Because of this, it’s highly recommended that Autoimmune patients like Lupus supplement are necessary for ALL Lupus patients. Your Rheumatologist may test you from time to time and if it’s within the standard range of 30ng/ml-100ng/ml, they may not supplement.
However, I strongly advocate getting your Vitamin D levels to at least 65 ng/ml and if you’re deficient, to begin with, requires you to supplement at a very high dose. Please contact us at [email protected] to ensure you’re supplementing the right dose based on your levels.
It takes about 3-6 months to obtain steady levels once you begin supplementation.
Lupus patients must get Vitamin D levels checked for prevention of flares, osteoporosis, cardiovascular, cancer, and immune dysfunction.
I personally have seen a drastic improvement in myself as well as the patients, if you would like to be tested, your doctor should easily be able to test. They may not supplement optimal levels as it’s not a mainstream technique to do so, but from a Functional Medicine standpoint, we believe in supplementation as absolutely necessary to optimize your health in dealing with Lupus.
I believe in supplementation mostly because of my personal experience. But I believe we have to be meticulous about the quality and the type of supplements. This is why I’ve selected a handful of essential Lupus supplements that’s been effective for both myself and my patients. Please visit http://lupusfarmacy.com.
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