While vitamin D supplementation may be important for arthritis patients, the ‘how’ of such supplementation remains a bit unclear. New work from the UK attempts to shed light on this topic.
New Study: Vitamin D for Arthritis Did Not Work
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The new study, “Decreased sensitivity to 1,25-dihydroxyvitamin D3 in T cells from the rheumatoid joint,” was published in October 21, 2017 edition of the Journal of Autoimmunity.
Martin Hewison, Ph.D., professor of molecular endocrinology and deputy director of the Institute of Metabolism & Systems Research at The University of Birmingham in the UK, told OTW, “We are interested in the health benefits of vitamin D, and in particular how vitamin D can act as an anti-inflammatory agent.”
“Vitamin D deficiency is common in patients with inflammatory diseases such as rheumatoid arthritis and Crohn’s disease, and we have proposed that low vitamin D may disrupt normal anti-inflammatory immunity in these patients. Conversely, vitamin D supplementation may promote beneficial anti-inflammatory effects.”
“The novel feature of our study was that we used immune cells from both the blood and inflamed joints of patients with rheumatoid arthritis. We were therefore able to contrast the effects of vitamin D in the circulation with its effects at the actual site of inflammation.”
“The key observation was that when we took immune cells from patients’ blood they responded very well to treatment with vitamin D. However, when we took the same immune cells from the patients’ inflamed joints they did not respond very well to vitamin D—even though they had all the machinery to respond to vitamin D.”
“In other words, the inflamed joint has insensitivity to vitamin D.”
“Simply supplementing arthritis patients with vitamin D is unlikely to work because their disease is preventing vitamin D from working. One option would be to increase the dose of vitamin D to overcome tissue insensitivity. The other option would be to identify new molecules that could overcome the inflammation insensitivity to vitamin D.”
“Vitamin D-deficiency is an important factor for inflammatory diseases such as rheumatoid arthritis.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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