How does vitamin D affect rheumatoid arthritis?

What is rheumatoid arthritis?

There are several different types of arthritis that have different causes and symptoms. Osteoarthritis is the most common form and results from joint wear and tear over time from overuse. Rheumatoid arthritis (RA) is an autoimmune, inflammatory disease in which the body’s immune system mistakenly attacks healthy body cells, causing inflammation. In rheumatoid arthritis, this inflammation usually occurs in the joints and can cause joint and tissue damage. Because rheumatoid arthritis is not caused by overuse of a joint over time, it often develops at a younger age than osteoarthritis. Rheumatoid arthritis can develop at any age but usually appears between the ages of 30-50. Juvenile idiopathic arthritis, formerly known as juvenile rheumatoid arthritis, is the most common form of juvenile arthritis.

Although the cause of rheumatoid arthritis is unknown, there is evidence that infection, genetics, and hormonal changes may be linked. The initial symptoms are joint pain, stiffness, and loss of range of motion. Other symptoms can include sleep difficulties, chest pain, dry eyes and mouth, itching or burning in the eyes, and tingling or burning in the hands or feet. It has been calculated that approximately 1.5 million Americans have rheumatoid arthritis and it is 2.5 times more common among women. 

How does vitamin D affect rheumatoid arthritis?

Low levels of vitamin D have been linked to an increased risk and activity of a variety of autoimmune diseases including rheumatoid arthritis, multiple sclerosis, diabetes and inflammatory bowel disease. Research suggests that there may be an association between vitamin D deficiency and juvenile arthritis and inflammatory arthritis. Some studies have suggested that vitamin D can help manage inflammation associated with arthritis, due to the role vitamin D plays in regulating immune and inflammatory responses in the body. 

 Vitamin D acts as an immune system modifier by suppressing inflammation associated with both the innate and adaptive immune response. Studies have shown that vitamin D plays a role in activating immune cells to help the body fight infection, as well as in suppressing the immune response in cases of excessive inflammation. This excessive inflammation is what happens in the body in cases of rheumatoid arthritis. In response to foreign pathogens, the immune system releases small proteins called cytokines, which trigger an immune response to help fight infection. Sometimes this response goes too fast and excessive amounts of cytokines are released. This is known as a cytokine storm and can cause excessive inflammation. 

One study looking at the relationship between vitamin D and ROS found that people with rheumatoid arthritis had lower levels of vitamin D and higher levels of ROS and inflammatory cytokines than a control group.

Is Vitamin D Good for Arthritis?

Several scientific studies have identified a link between a low level of vitamin D and rheumatoid arthritis, and it is common for people with rheumatoid arthritis to have a vitamin D deficiency. Genetic investigation of the vitamin D receptor reveals an association with rheumatoid arthritis sensitivity and severity. 

Studies looking at vitamin D and rheumatoid arthritis have suggested that higher levels of vitamin D may help prevent the onset of rheumatoid arthritis. The development of rheumatoid arthritis.

 Research also shows that low serum vitamin D is associated with increased rheumatoid arthritis disease activity, pain, and functional deficits. One study of 1,191 patients with rheumatoid arthritis found that lower levels of vitamin D were associated with more severe disease activity and disability as measured by the Health Assessment Questionnaire’s disability index, disease activity score (DAS28), and daily living score mobility activities. . Another study comparing 50 rheumatoid arthritis patients and 50 controls found that 84% of rheumatoid arthritis patients were deficient in vitamin D versus only 34% of the control group. Additionally, in this study, vitamin D level was associated with disease severity, with patients with lower vitamin D levels having higher disease activity. 

A study in Canada found that among people with rheumatoid arthritis, having a low level of vitamin D was associated with more than 5 times higher disease activity compared to those with adequate levels of vitamin D. A study measuring C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), indicators of inflammation, in rheumatoid arthritis patients, found that lower levels of vitamin D were associated with higher disease activity scores (DAS28) and higher levels of inflammatory markers. 

Why is vitamin D important for arthritis?

Vitamin D is produced in the skin when the body is exposed to sunlight, especially light in the ultraviolet light spectrum. This spectrum of light also produces many other hormones and peptides that contribute to systemic health and wellness. Substances made from chemical reactions with sunlight are called photovoltaic products. While vitamin D is the most universally recognized health benefit that humans receive from exposure to sunlight, it is just one of many important photosynthesis products. 

In addition to vitamin D, other healthy photovoltaic products made in the same UV wavelength range include: peptide-binding gene calcitonin, neuropeptide P, adrenocorticotropic hormone, melanocyte stimulating hormone, calcitriol, and beta-endorphins. These photodynamic products have a broad spectrum effect on the body and are involved in regulating the immune system, promoting healthy blood flow, reducing inflammation, acting as natural pain relievers, and more.

The association between higher serum vitamin D levels and disease prevention in several epidemiological studies actually measures sun exposure and not supplemental vitamin D. Population studies have repeatedly demonstrated that exposure to sunlight contributes more to vitamin D concentrations than oral administration. Therefore, at a population level, vitamin D is actually a measure of sunlight exposure, and higher serum concentrations are an indicator of increased skin contact with sunlight. 

Assuming that the level of vitamin D in the body from an oral dietary supplement represents the same health benefits as light-derived vitamin D does not take into account the effect of sunlight on human health outside of vitamin D production. It is important to keep in mind that there are other bio-photonic products that contribute to the health of our system in addition to Vitamin D.  

Some studies are beginning to look not only at the level of vitamin D and supplements, but also at how much UVB exposure a person has and its effect on rheumatoid arthritis. A study that looked at the effect of seasonality on rheumatoid arthritis activity found that disease activity was higher in the spring and lower during the fall. This pattern is likely influenced by vitamin D levels that tend to peak in early fall after the sunny summer months and then reach a low level towards the end of winter. One study that looked at 106,368 women between the ages of 30 and 55 found that higher cumulative UV exposure was associated with a lower risk of developing rheumatoid arthritis, with a 21% lower risk of developing rheumatoid arthritis compared to those in the lowest group. 

Vitamin D as a potential treatment for osteoarthritis 

More research is needed to determine the potential of vitamin D as a treatment for rheumatoid arthritis, and the exact form and dose of vitamin D needed to improve arthritis. High doses of oral vitamin D supplements are likely to cause harm, and therefore it is important to consider a safe and appropriate dosage.  

The Institute of Medicine (IOM) recommends that the dietary allowance of vitamin D be 600 international units (IU) per day. This recommendation is based on what is needed to prevent rickets and osteoporosis. Many vitamin D researchers disagree with this recommendation and say the IOM recommended allowance is not enough to prevent deficiency or support bone health. In general, 4,000 IU or less per day is considered safe, as long as your blood values ​​are monitored. It is important to avoid excessive doses of oral vitamin D. If the intake of vitamin D is too high, it can cause high levels of calcium in the blood and potentially dangerous consequences.

Getting vitamin D from light allows your body to self-regulate vitamin D production and achieve what it needs to stay healthy, without the risk of overdose or toxicity. Unlike oral supplements, you cannot overdose on the vitamin D produced in your skin. If you have enough vitamin D, your body will produce less.