Facts About Vitamin D and Rheumatoid Arthritis

Lene Andersen | Aug 15, 2013

Reviewed by Diane M. Horowitz, MD

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Vitamin D deficiency and autoimmune disorders

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A study has linked vitamin D deficiency with an increased risk for cancer and autoimmune diseases, such as rheumatoid arthritis MS, and lupus. Researchers found, through mapping vitamin D receptors binding throughout the human genome, that vitamin D deficiency is an environmental factor in increasing the risk of developing these disorders.

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1 billion people don't get enough vitamin D

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It’s been estimated that 70 percent of children and adults in the U.S. are vitamin D deficient. The cause of deficiency is a combination of not getting enough exposure to the sun and not having enough vitamin D in their diets.

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Medications can affect vitamin D absorption

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Hydroxychloroquine, or Plaquenil, and corticosteroids, which both can be prescribed for the treatment of rheumatoid arthritis, are among these. If you are taking one of these drugs, your doctor can adjust your vitamin D dose to correct any malabsorption.

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A blood test can determine your vitamin D level

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You can ask your doctor to give you a simple blood test called 25-hydroxy vitamin D test. It can tell you how deficient you might be in vitamin D.

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You can add vitamin D by changing your diet

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To increase your level of vitamin D through food, you should include more oily fish, such as salmon, mackerel, and tuna. Egg yolks and mushrooms also provide vitamin D. You also could also choose a cereal and milk fortified with vitamin D.

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15 minutes of sun exposure can make a difference

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Just 15 minutes of exposure to the sun gives you 20,000 IUs of vitamin D. However, this is without sunblock in the summer. Be aware that you need to be careful not to expose your skin to the sun without sunblock for long stretches of time. This can cause skin damage and increase your risk of skin cancer.

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Vitamin D can lift moods and strengthen bones

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Not only does vitamin D play a crucial role in the absorption of calcium, but it can stave off osteoporosis, which can be a risk for people with RA. It also protects those susceptible to seasonal affective disorder from becoming depressed.

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Vitamin D and chronic pain

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A lack of vitamin D may play a role in chronic pain caused by a variety of conditions. Research has indicated vitamin D deficiency may be implicated in musculoskeletal conditions, such as rheumatoid arthritis, neuropathy, migraine, and inflammation.

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Vitamin D can help you manage chronic pain

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It’s common for people who live with chronic pain to have a vitamin D deficiency. Many doctors routinely check their patients for their levels of vitamin D and often recommend vitamin D supplements as part of a treatment plan. Getting more vitamin D may help you to gradually get partial pain relief and improved mood.

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How Vitamin D is absorbed

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Unlike some vitamins that begin working in the body immediately after being consumed, vitamin D must be processed by the liver and kidneys into a form (calcitriol) that can attach to vitamin D receptors in most of the body’s cells. Your body stores one form of previtamin D, called dehydrocholesterol, in the skin.  When your skin absorbs sunlight, it is transformed into previtamin D3 (cholecalciferol).

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Vitamin D and heart disease

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Studies have linked low vitamin D levels with heart disease and heart attacks. The systemic inflammation of RA affects internal organs and increases the risk of heart attack and stroke. Managing this risk includes seeing a preventative cardiologist, eating a balanced diet and maintaining a healthy weight, quitting smoking. It may also include getting enough vitamin D.

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Access to vitamin D blood test

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Getting your vitamin D levels tested may be a challenge. In the last 10 years, demand for the blood test has jumped 4000 percent. Some insurance plans don’t cover it, and Medicare has restricted rebates for vitamin D testing to high-risk individuals, such as those with osteoporosis, deeply pigmented skin, or chronic lack of exposure to the sun.

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How much vitamin D do you need?

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The Institute of Health has set the recommended dietary allowance to be 600 units a day. If you have a vitamin D deficiency, you may need more than that. Some people may benefit from adding 1-2,000 IU of vitamin D per day. People who have been diagnosed with a severe deficiency or have certain medical conditions may take up to 5-10,000 IU per day.

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Can you get too much vitamin D?

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Too much vitamin D can cause toxicity, which can lead to abnormal heart rhythms, kidney stones, muscle weakness, and confusion. You would have to take very high levels of vitamin D over an extended period for it to get toxic. It’s important to talk to your doctor before taking high doses of vitamin D.

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New research

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A recent review of studies showed that the impact of vitamin D on rheumatoid arthritis may not be as effective as previously thought. More research is needed. However, vitamin D has been shown to have a positive impact on fall and fracture prevention, which are at a higher risk when you have RA. Your best option is to discuss this with your doctor.