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Vitiligo and Vitamin D deficiency – What’s the connection?

Vitiligo and Vitamin D deficiency

Many sources can be listed to confirm that Vitamin D (known as a pleiotropic hormone) enhances absorption of dietary calcium and phosphorus; however, its physiological functions extend well-beyond mineral assimilation and balance. The receptors for vitamin D are found in many organ systems, including the muscles, intestines, pancreas, and nervous system, which only illustrate its far-reaching effects.

Over the years many research studies have been administered that associate vitiligo to vitamin D status. Reason? There have been past evidences that support strong links between vitamin D deficiency and autoimmune conditions like systemic lupus erythematosus, rheumatoid arthritis, and multiple sclerosis. Researchers have already talked about how low levels of vitamin D negatively impact an individual’s immune system. After all, it plays a crucial role in fighting infection and controlling inflammation, something essential for proper recovery from skin disorders. Keeping such a hypothesis in mind, many researchers across the globe, every now and then, attept to evaluate the role of vitamin D status on vitiligo as well.

Signs of vitamin deficiency in people with vitiligo

Challenging common disbelief, vitamin D insufficiency is becoming common globally. As per an estimate, it affects nearly one billion people worldwide. You might have a vitamin D deficiency if:

  • You get sick often.
  • You constantly feel tired.
  • You experience a backache and pain in bones.
  • You have problems with excess weight.
  • Your wounds healed too slowly.
  • You have hair loss.
  • You get depressed very easily.
  • You suffer from muscle pains.

Does vitamin D deficiency cause vitiligo?

Vitamin D, an essential hormone, is synthesized in the skin. It protects the epidermal melanin unit and restores melanocyte by controlling the activation, proliferation, migration of melanocytes. This leads to the recognition of the fact that vitamin D could be a potent immunomodulator and could be a very useful finding in the treatment of vitiligo if approached correctly. The mentioned studies also provide evidence that vitamin D can prevent the death of melanocytes, thus preventing the loss of pigment in the chronic skin disorder.

In a pilot study, vitamin D3 was given to 16 vitamin D-deficient participants with vitiligo on a daily basis in concert with a calcium-restricted diet and ample hydration. After the study duration, noteworthy increases in serum 25-hydroxy vitamin D3 levels were observed in participants with vitiligo. In 14 of 16 vitiligo patients, 25-75% re-pigmentation occurred. This hinted that high-dose vitamin D3 therapy may play an effective and safe role in prevention and treatment of vitiligo.

In addition to this, during a research study by the Department of Dermatology, King Saud University, Riyadh (Saudi Arabia), low levels of vitamin D have been observed in participants with vitiligo. In many other clinical trials, many participants with vitiligo have even been found as vitamin D resistance. This establishes a possible link between vitamin D deficiency and chronic skin disorder.

Looking Ahead: The usage of Vitamin D as an Adjunctive Therapy for Vitiligo

A recent study investigated the influence of low-dose narrowband Ultraviolet B (UVB) phototherapy on serum levels of vitamin D. The results of the study revealed that UVB phototherapy increased vitamin D levels in participants, which indicates that the beneficial effect of UVB depends, at least partially, on the induction of vitamin D.

Although the relationship between vitamin D and pigmentation has been established in numerous autoimmune diseases, the association between vitiligo and vitamin D levels still needs to be investigated more thoroughly. So far, studies that establish a link between two have been limited by their sample size and cross-sectional design. Hence, further studies are needed to determine the pathological nature of vitamin D status in people in vitiligo.

Treatment of vitamin D deficiency in people with vitiligo

If vitamin D deficiency causes vitiligo, then its supplementation could help control its spread. Given the fact that many research around vitamin D deficiency and vitiligo are underway, it’s recommended to go for Vitamin D supplementation only under the supervision of a licensed medical physician. It should be dosed according to lab levels, and ideally balanced with other fat-soluble vitamins.

Since vitiliginous skin is sensitive to the sun, exposure to sunlight as natural vitamin D intake can cause a few complications. Alternatively, a vitamin D rich diet can be considered. The two main forms of vitamin D (cholecalciferol and ergocalciferol) can be obtained by nutritional intake. Ergocalciferol (vitamin D 2 ) is present in fungi/yeast while cholecalciferol (vitamin D 3 ) is found in foods of animal origin (fatty fish). Other vitamin D sources are eggs, milk, cheese, and cereals.

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