Vitamin D And Arthritis: The ‘Sunshine’ Vitamin May Offer A Ray of Hope!
blog detail banner

Arthritis

The ‘Sunshine’ Vitamin May Offer A Ray of Hope in Arthritis!

Feb 26, 2018

Many of us complain of joint stiffness and pain every few days well before we are in our 40’s. We blame our sedentary life and lack of exercise, adulterated foods and polluted air for this pain. But is there more to these joint pains? Similarly, for patients who have already been diagnosed with arthritis, is there more to simply popping painkillers all life long? Let’s understand the connection between vitamin D and arthritis, and tips to correct a vitamin D deficiency.

Vitamin D And Arthritis: What Is The Connection?

Many studies have shown that taking vitamin D supplements helps in easing joint pain. In conditions like osteoarthritis (OA), rheumatoid arthritis (RA), and fibromyalgia, it has been observed that lower the vitamin D levels, greater is the pain.

It is believed that vitamin D relieves pain by influencing our immune system and pain mechanisms. Also, patients with arthritis are commonly treated with oral steroids. It has been observed that patients taking steroids are at twice a higher risk of suffering from vitamin D deficiency.

Role Of Vitamin D In Osteoarthritis

The role of vitamin D in osteoarthritis is still not very clear. Some studies suggest that vitamin D deficiency may be helpful in the following ways in OA:

  • Vitamin D deficiency may worsen osteoarthritis
  • Moderate vitamin D deficiency can worsen knee pain over 5 years as well as hip pain over 2.4 years among the elderly

Thus, correcting vitamin D deficiency can benefit knee and hip pain in osteoarthritis significantly, helping you look beyond painkillers.

Role Of Vitamin D In Rheumatoid Arthritis

It has been observed that vitamin D levels can be significantly low in patients of rheumatoid arthritis. Lower vitamin D levels in rheumatoid arthritis are also known to cause the following:

  • Higher disease activity
  • Poorer response to treatment
  • Worsening of the disease

Therefore, vitamin D supplementation may be beneficial for patients of rheumatoid arthritis. This can help in slowing down the progression of the condition, paving the way for a better response to treatment, for pain relief, and for preventing osteoporosis.

Benefits Of Vitamin D For Our Body

The most important function of vitamin D in our body is to absorb calcium and phosphate from our intestines and deposit them into our bones. Apart from this function, vitamin D has also shown to have anti-inflammatory action, which means it can help in relieving the pain caused by many conditions, such as joint pain in arthritis.

What’s The Difference Between Vitamin D Insufficiency And Deficiency?

Our skin produces vitamin D when it is exposed to ultraviolet B rays present in sunlight. However, not all of us produce sufficient levels of vitamin D. A study has shown that almost 1 in 2 people suffers from a vitamin D insufficiency.

Whether you are suffering from an insufficiency or deficiency of Vitamin D can be easily determined by measuring the blood level of vitamin D through a test named 25(OH)D.

Vitamin D level Status
<20 ng/mL – Deficiency
21–29 ng/mL – Insufficiency
≥30 ng/mL – Sufficiency

It is considered healthy to have vitamin D levels in the range of 40–60 ng/mL.

Why Is Vitamin D Deficiency So Widespread?

The major cause of vitamin D deficiency is the lack of sun exposure. Secondly, there are very few foods that naturally contain vitamin D. Examples of foods rich in Vitamin D include oily fish like salmon, herring, and mackerel, sundried mushrooms, or those exposed to sunlight, and cod liver oil. Other causes of vitamin D deficiency include dark skin pigmentation, obesity, pregnancy, and ageing.

How To Correct Vitamin D Deficiency?

vitamin d and arthritis

How To Correct Vitamin D Deficiency

Exposure To Sunlight

According to the World Health Organization, sensible exposure to the sun has many health benefits that include vitamin D production. But how do we define sensible sun exposure? Sensible sun exposure is difficult to define because the production of vitamin D in our skin is dependent on many factors such as time of the day, season, latitude, altitude, and skin pigmentation. A free app called dminder.info offers a solution. This app provides its users information on how much vitamin D can be produced from sun exposure anywhere in the world for all skin types.

Vitamin D Supplements

Vitamin D can be supplemented for deficiency in either of these ways:

  • 50,000 IU of vitamin D2/D3 given once a week for 8 weeks
  • 5000 IU of vitamin D2/D3 daily for 2 months followed by a maintenance dose of 2000–3000 IU of vitamin D2/D3 daily

Preventing Recurrence Of Deficiency

Once you’ve corrected a deficiency of vitamin D, you need to ensure adequate levels of this vitamin are maintained. For this, supplementing with 50,000 IU vitamin D2/D3 once every 2 weeks is effective and safe to be taken for at least 6 years.

In obese adults (body mass index >30 kg/m), the requirement of vitamin D is 2-3 times more in order to treat as well as prevent deficiency.

Final Thoughts

To sum it up, vitamin D deficiency is fairly common today globally. Vitamin D plays a role in the smooth functioning of our immune system and pain mechanisms of the body. It has a promising role in the treatment of arthritis, especially RA.

Keeping this in mind, if you are suffering from arthritis of any kind, you should determine your vitamin D levels. If there’s a deficiency, appropriate measures should be taken to maintain your vitamin D levels in the preferred range of 40-60 ng/mL.

Remember that a little bit of sunlight will do no harm… it may just be the ray of good health that you need!

 Dr. Rachita Narsaria
Dr. Rachita is a practising doctor with a passion for prose. With over 6 years of medical writing experience for patients and doctors alike, this doctor-cum-entrepreneur loves learning and sharing knowledge.

References:

  1. de Oliveira DL, Hirotsu C, Tufik S, Andersen ML. The interfaces between vitamin D, sleep and pain. J Endocrinol. 2017 Jul;234(1):R23-36.
  2. CDC – Arthritis types [Internet] [Updated Apr 12, 2017]. Available at: https://www.cdc.gov/arthritis/basics/types.html. Accessed on Jul 20, 2017.
  3. Nair R, Maseeh A. Vitamin D: The “sunshine” vitamin. J Pharmacol Pharmacother. 2012 Apr;3(2):118-26.
  4. Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord. 2017 Jun;18(2):153-65.
  5. Gheita TA, Sayed S, Gheita HA, Kenawy SA. Vitamin D status in rheumatoid arthritis patients: Relation to clinical manifestations, disease activity, quality of life and fibromyalgia syndrome. Int J Rheum Dis. 2016 Mar;19(3):294-9.
  6. Skversky AL, Kumar J, Abramowitz MK, Kaskel FJ, Melamed ML. Association of glucocorticoid use and low 25-hydroxyvitamin D levels: Results from the National Health and Nutrition Examination Survey (NHANES): 2001-2006. J Clin Endocrinol Metab. 2011 Dec;96(12):3838-45.
  7. Zhang FF, Driban JB, Lo GH, Price LL, Booth S, Eaton CB, et al. Vitamin D deficiency is associated with progression of knee osteoarthritis. J Nutr. 2014 Dec;144(12):2002-8.
  8. Laslett LL, Quinn S, Burgess JR, Parameswaran V, Winzenberg TM, Jones G, Ding Moderate vitamin D deficiency is associated with changes in knee and hip pain  in older adults: a 5-year longitudinal study. Ann Rheum Dis. 2014 Apr;73(4):697-703.
  9. Sanghi D, Mishra A, Sharma AC, Singh A, Natu SM, Agarwal S, et al. Does vitamin D improve osteoarthritis of the knee: A randomized controlled pilot Clin Orthop Relat Res. 2013 Nov;471(11):3556-62.
  • Lee YH, Bae SC. Vitamin D level in rheumatoid arthritis and its correlation with the disease activity: A meta-analysis. Clin Exp Rheumatol. 2016 Sep-Oct;34(5):827-33.
  • Jeffery LE, Raza K, Hewison M. Vitamin D in rheumatoid arthritis-towards clinical application. Nat Rev Rheumatol. 2016 Apr;12(4):201-10.
  • Kostoglou-Athanassiou I, Athanassiou P, Lyraki A, Raftakis I, Antoniadis C. Vitamin D and rheumatoid arthritis. Ther Adv Endocrinol Metab. 2012 Dec;3(6):181-7.