Vitamin D and Rheumatoid Arthritis: A HealthCentral Explainer
Based on its presence in the news, it seems as if vitamin D is a cure-all for almost anything, including hangnails and a bad hair day. But what about rheumatoid arthritis (RA)?
What is vitamin D?
Vitamin D promotes calcium absorption, facilitates bone growth, regulates the immune system and assists in cell-to-cell communication, in addition to a number of other important functions to help keep you going. If you are taking an immunosuppressant medication, it also can help reduce your risk of getting sick.
Can vitamin D help someone with RA?
People with RA may experience vitamin D deficiency for a number of reasons. RA itself is associated with a deficiency in this vitamin, making up to 90 percent of people living with the condition experience low levels.
Lower levels of vitamin D may also affect how severe your RA is, as well as the level of inflammation in your body and bone loss, therefore contributing to how much pain you experience. An additional fact pointing to a connection is an indication in research that vitamin D supplementation can play a role in preventing RA from developing. “Maintaining an adequate serum vitamin D level is important for optimizing bone health and managing disease progression,” according to Erin Enns, doctor of naturopathy.
Research into whether vitamin D supplementation helps pain shows conflicting results. This may be because pain is a very complex condition that requires a variety of treatments for improvement. That said, if your pain is caused by a combination of RA and fibromyalgia, it may be improved by taking vitamin D. Studies show it can be especially useful as part of fibromyalgia treatment.
Testing for Vitamin D deficiency
Symptoms of vitamin D deficiency include low energy and fatigue, muscle pain, depression, and sleep problems. These overlap significantly with RA symptoms, so it can be difficult to separate what is caused by what.
To find out if vitamin D deficiency is causing your symptoms, talk to your doctor or naturopath about getting the vitamin D blood test. It measures your level of 25-hydroxy-vitamin D and in the United States, it is measured in nanograms. Most sources consider a level of 40-50 ng to indicate a healthy level of vitamin D. However, there is some debate about how low your levels should be before being labelled deficient. Generally, if your levels are 10-20 ng, you are considered deficient and less than 10 ng is considered severely deficient. Your doctor or naturopath will be able to help you interpret the results.
Medications and vitamin D
If you take oral corticosteroids for RA, you are twice as likely to be deficient in vitamin D. Steroids can be a valuable tool in treating RA, so if your rheumatologist has prescribed this, it’s important to check your vitamin D levels on a regular basis.
“There does not appear to be any direct contraindications when taking vitamin D (and RA medications),” said Dr. Enns. However, she emphasized the importance of checking with your doctor whenever you add a new medication or natural health product to your regimen.
How much vitamin D should you get?
Vitamin D supplements, when combined with calcium, also can protect your bones. The U.S. Institute of Medicine recommends 600 IU of vitamin D daily, but some studies indicate that this may not be enough, instead suggesting up to 5,000 IU for people with vitamin D levels of lower than 25 ng.
“Vitamin D is a fat-soluble vitamin,” explained Dr. Enns. “To optimize absorption, it is best taken alongside a meal in either a soft gel capsule or as a liquid.”
Getting too much vitamin D is possible and can cause too much calcium to be created in your blood. If you are on high supplemental doses, you and your doctor should monitor your levels.
How to increase your vitamin D
Vitamin D is also called the “sunshine vitamin” because sunlight activates the production of vitamin D in your body. Just 10 to 15 minutes of exposure a day — even on just your hands — is enough to give you the daily recommended dose. It is important, though, to balance getting more vitamin D with the need to protect your skin from the harmful rays of the sun.
Vitamin, D is not naturally available in food, with the exception of egg yolks, and some oily fish (salmon, mackerel). Many foods, such as soy, milk and cereal, are fortified with vitamin D. You may also want to try cod liver oil, now available in citrus and other flavours.
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