Vitamin D Levels Low in People with Severe Lupus, Study Shows

Vitamin D Levels Low in People with Severe Lupus, Study Shows

Those with severe cases of systemic lupus erythematosus (SLE) have low levels of vitamin D, according to new research.

The study, “25-Hydroxivitamin D Serum Concentration, Not Free and Bioavailable Vitamin D, Is Associated with Disease Activity in Systemic Lupus Erythematosus Patients,” was published in the journal PLoS One.

Vitamin D deficiency is common in SLE patients. Because they are sensitive to light, they avoid exposure to the sun, which helps create vitamin D through the skin. The SLE medications glucocorticoids and hydroxychloroquine may also reduce vitamin D levels in blood.

Researchers evaluated the disease activity of 199 SLE patients using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). They also collected blood samples to determine the patients’ vitamin D levels.

The team measured the blood levels of 25-hidroxyvitamin D [25(OH)D], a circulating form of vitamin D, and of vitamin D binding protein (DBP). The protein binds to 25(OH)D, regulating its stability and delivery to tissues.

Results showed that 25(OH)D serum concentrations were significantly lower in SLE patients than in 150 healthy volunteers. In the patient cohort studied, 142 or 71.4% had 25(OH)D serum concentrations below 30 ng/mL. The researchers categorized vitamin D deficiency as a 25(OH)D level lower than 20 ng/mL, and vitamin D insufficiency as a 25(OH)D level lower than 30 ng/mL

When the team looked for associations between 25(OH)D serum concentrations and disease activity, they discovered the concentrations were lower in patients with severe activity — those with SLEDAI scores of 20 or more — but not in patients with milder cases of the disease — those with SLEDAI scores of 1–5. They found no correlation between DBP blood levels and disease activity.

Researchers said it is possible that vitamin D deficiency alters the immune system in ways that lead to SLE. The deficiency may be a consequence of the disease, they said.

The team wrote that it was unable to “establish a causal relationship between vitamin D serum concentration and disease activity in SLE patients.” Whether “low vitamin D serum concentrations are a causal co-factor in the immunological disturbances that characterize SLE, or if, on the contrary, the inflammatory disease process and low sun exposure causes reduction in vitamin D serum concentrations,” will require additional research, the authors added.

They called for a study that tracks vitamin D levels in SLE development over time.

5 comments

  1. Rick J. Wanner says:

    What if the destructive inflammatory and/or antibody actions that lead to sicca syndrome also affect the biochemistry in the production of vitamin D in the skin itself? The sweat and oil producing glands are affected, is it far fetched that vitamin D producing areas are also affected?

    • Sandra Despain says:

      Jay leave your full name and where you r located and we can connect on facebook regarding this I have mixed connective tissue disease

  2. Jay says:

    Anyone know what biological mechanism is used to regulate vitamin D? I have “skin” lupus, but have all other signs of SLE including reynauds phenomenon, IBS, joint, and nerve pain. I would like to posit that my body is convinced it has too much vitamin d thus triggering IBS and an immune response to skin surface areas that are generating vitamin d. My 25-vit d tests usually come back at around 29.

    • Sandra Despain says:

      Jay email me …. I have mixed connective tissue disease and can partner up with you on what works and what doesn’t Sandra despain
      Or facebook me I am in greenwood indiana… when you look me up there’s two email sdespain at live dot com

  3. Melissa says:

    I have had SLE for over 37 years, and when I was prescribed a Vitamin D replacement, my pharmacy gave me Vitamin D2 and not D3. I monitored my labs over the next 3 years, and noticed that it barely increased over time, and I was taking 50,000 Units everyday. I decided to buy a Vitamin D3 replacement out of pocket, since my doctor at the time did not believe that there would be a difference, and did not want to change it. I alerted her that I was changing to D3, and we would repeat labs in 3 months. I was not surprised when I went from 9 ng/ml to 30 ng/ml within that 3 month period. I was taking the same amount 50,000 units everyday, so what was the difference? There are several reasons, I know. I just wonder why some physicians are so resistant to learning from patients, or even listening to them for that matter. I now take D3 once a week, along with Vitamin K2, and my level stays around 60ng/dl.

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