Rheumatoid arthritis (RA), and the debilitating symptoms it induces, has been documented for centuries.
At its core, RA causes the immune system to mistakenly attack the body. Specifically, the lining of your joints, called the synovium, is most often the first place RA strikes.
Rheumatoid Arthritis tends to be chronic and progressive, meaning that the disease worsens over time. Researchers have worked diligently to pinpoint causes, management strategies, and potential cures for RA.
Vitamin D’s connection to RA has been at the forefront of their research since the late 1930s. However, proper medical research takes a long time.
Over the decades, conflicting reports have been published on the topic. Excitingly, just recently in 2016, long-reviewed studies have concluded that there is a strong correlation between low vitamin D levels and evidence of rheumatoid arthritis.
The Connection Between Vitamin D and Rheumatoid Arthritis
Vitamin D (a secosteroid hormone), or vitamin sunshine, has a miraculous ability to promote health in our body.
Strong bones, cancer prevention, healthy blood pressure, and a strong immune system are all positively correlated to adequate vitamin D levels.
In fact, the medical community, as a whole, touts vitamin D as a foundational building block to good health.
Vitamin D can help regulate the immune system, ward off sickness and disease and if you’re taking medication that lowers immune system defenses it can help you from getting sick as often. -Karen Langston, spokesperson for the National Association of Nutrition Professionals
Rheumatoid arthritis is no exception.
It appears that vitamin D deficiency is highly prevalent in patients with RA, and that vitamin D deficiency may be linked to disease severity in RA.
As vitamin D deficiency has been linked to diffuse musculoskeletal pain, these results have therapeutic implications.
Vitamin D supplementation may be needed both for the prevention of osteoporosis as well as for pain relief in patients with RA. –U.S. National Library of Medicine, National Institutes of Health
Physicians and rheumatologists cannot say that healthy vitamin D levels will prevent or cure RA. Rheumatoid arthritis is far too complex with a multitude of variables.
Yet, there is enough evidence for doctors, scientists, and researchers to prescribe vitamin D to RA patients and those at risk for RA.
Vitamin D Levels
According to the National Institutes of Health, the general screening guidelines for vitamin D levels are as follows:
- Normal: 250HD level higher than 30 ng/mL (75 nmol/L)
- Normal levels of vitamin D are associated with healthy immune function, reduction of inflammation, healthy bone density, and normals absorption of calcium.
- Insufficient: 250HD level between 20 and 30 ng/mL (50-75 nmol/L)
- Insufficient levels of vitamin D are considered inadequate for bone health and is associated with poorer immune function and overall health.
- Deficiency: 250HD level less than 20 ng/mL (50 nmol/L)
- Deficient levels of vitamin D are connected to rickets in children and osteomalacia (softening of the bones) in adults.
- Toxic: 250HD level greater than 150 ng/mL (375 nmol/L)
- Toxic levels of vitamin D are rare. Supplementation is usually the only way levels can become toxic. Toxicity is correlated with hypercalcemia (build-up of calcium in your blood), and possible hardening of your arteries.
The test for vitamin D levels is simple and straightforward. The technical name is a 25(OH)D blood test. Your rheumatologist can easily order the test. Or, there are resources for at-home testing kits.
Sources Of Vitamin D
Vitamin D comes from three different sources.
1. Sunlight: Nature’s gift of vitamin D. Sun exposure’s safety is somewhat controversial and the risk of sun damage is very real.
However, many would argue it’s the best source of vitamin D, as long as you’re not at risk for sun damage and you’re receiving a safe exposure amount.
The right dose differentiates a poison from a remedy. –Paracelsus, German-Swiss Physician (1493-1541)
Generally, about 10 minutes of daily sun exposure is adequate to boost and maintain your vitamin D to healthy levels. Depending on your skin tone, a little less (fair skin) or more (darker skin) may be needed.
2. Food: Few foods naturally contain vitamin D. Cod liver oil (remember Nana, the dog, trying to give the kids a dose in Peter Pan?) and fatty fish are considered some of the best sources.
- Cod liver oil
- Fatty fish (i.e. salmon, tuna)
- Fortified milk
- Fortified orange juice
- Fortified yogurt
- Sardines, packed in oil
- Fortified cereals
3. Supplementation: There are two main forms of vitamin D supplements: vitamin D2 and vitamin D3.
While the two forms have scientifically been regarded as equivalent in their ability to treat vitamin D deficient conditions, such as rickets, vitamin D3 is recommended more often.
Vitamin D3 is the type that most experts believe should be utilized in clinical practice…
There is a plethora of logical reasons for advocating the use of vitamin D3 over vitamin D2 dietary supplements including: UVB light from the sun strikes the skin, and humans synthesize vitamin D3, so it is the most “natural” form.
Human beings do not make vitamin D2, and most healthy fish contain vitamin D3. –Mark A. Moyad, MD, MPH, Medscape
Studies have shown that insufficient levels of vitamin D are associated with increased rates of rheumatoid arthritis symptoms.
When vitamin D levels are raised to normal ranges, researchers find that symptoms of RA are reduced.
Controversy still remains over what medical experts believe are appropriate levels of vitamin D. However, it is agreed upon that high-risk populations, like RA patients, should have their vitamin D levels monitored.
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