Can vitamin D help treat symptoms related to arthritis? There's a lot of excitement surrounding supplements and alternative forms of medicine and vitamin D is already recognized for its critical role in bone and joint health. But here's the burning question: Can vitamin D go beyond its known benefits and potentially improve osteoarthritis symptoms, decrease inflammation in the body, and even slow down the progression of arthritis?
We’re going to explore the role of vitamin D on how it can decrease symptoms related to arthritis, examine clinical trial evidence to see if it actually works, and talk about different ways to increase your vitamin D levels.
Osteoarthritis is the most common form of arthritis worldwide. It occurs when the protective cartilage that cushions the ends of bones deteriorates over time. As a result, the bones rub against each other, causing pain, inflammation, and a decrease in joint mobility.
Recently there has been considerable interest in supplements and alternative forms of medicine for the treatment of arthritis. Among them, vitamin D emerges as a notable contender. Vitamin D is already acknowledged for its crucial contribution to bone and joint health. It plays an important role in the absorption of calcium and phosphorus, which are essential minerals for strong bones.
Recent research has shed light on some additional benefits of vitamin D beyond bone health. Some studies have suggested a potential association between vitamin D deficiency and an increased risk or severity of osteoarthritis. This has sparked interest in investigating whether vitamin D supplementation could play a role in managing osteoarthritis symptoms.
Researchers have proposed several mechanisms through which vitamin D might impact osteoarthritis. One proposed mechanism is its potential anti-inflammatory effects. Vitamin D can regulate the production of pro-inflammatory cytokines like IL-1 beta and TNF alpha. It can also inhibit the activation of immune cells involved in the inflammatory response, such as macrophages. By modulating inflammation, vitamin D may help alleviate symptoms associated with arthritis, such as pain, swelling, and joint stiffness.
Additionally, vitamin D receptors are found in chondrocytes, the cells responsible for cartilage maintenance. Activation of these receptors by vitamin D may influence gene expression, potentially affecting the production of cartilage components and enzymes involved in cartilage remodeling. Vitamin D may regulate the synthesis of type II collagen, which is a major component of healthy cartilage. More importantly, it can inhibit the expression of matrix metalloproteinases that contribute to cartilage degradation.
Furthermore, we know people with osteoarthritis have significant muscle weakness and impaired muscle function. Strong muscles are important in stabilizing the joint, whereas weak muscles negatively affect joint stability and results in more irritation, more inflammation, and worsening arthritis.
Similarly, vitamin D deficiency has been associated with muscle weakness. By supplementing and improving vitamin D levels, we may be able to restore some muscle strength and function. This could potentially alleviate symptoms and improve outcomes in those with osteoarthritis.
So that’s the theory behind why vitamin D supplementation may help treat symptoms related to arthritis, but what do clinical trials show?
This study was a systematic review and meta-analysis that wanted to examine the effects of vitamin D supplementation on knee osteoarthritis. Six clinical trials for a total of almost 1600 patients were included in the analysis. The results demonstrated that supplementation of vitamin D resulted in statistically significant improvements to WOMAC pain scores, WOMAC functional scores, and WOMAC stiffness scores.
Another systematic review and meta-analysis found similar results. They reported that a daily supplement of at least 2000 international units of vitamin D resulted in significant improvements to WOMAC pain and functional scores. Doses less than 2000 international units daily did not result in benefits.
So it seems like vitamin D can help reduce pain and improve function, but can it also change the progression of arthritis and reduce inflammation? That’s what this study tried to determine. They wanted to assess whether vitamin D supplementation affects inflammatory and metabolic biomarkers in patients with knee osteoarthritis.
Unfortunately, the results showed that vitamin D supplementation had no significant effect on inflammatory marker levels such as C-reactive protein, IL-6, IL-8, and IL-10. Other metabolic markers such as leptin and adiponectin also were no different after vitamin D supplementation. The authors conclude that because vitamin D supplementation did not alter serum inflammatory or metabolic biomarkers, vitamin D likely does not affect systemic inflammation.
Interestingly, both of the systematic reviews and meta-analyses that we reviewed earlier also concluded that vitamin D did not change knee cartilage volume nor did it slow down the progression of arthritis.
And what about muscle health? Can vitamin D improve muscle health thereby improving strength and stability of the joint? This study looked to answer that question. They analyzed data from 54 randomized controlled trials for almost 9000 patients. The authors conclude that vitamin D supplementation did NOT differ from placebo in improving muscle health.
Ok so to quickly summarize, available evidence suggests that while vitamin D may help reduce pain and symptoms related to arthritis, it does NOT have any effect on inflammation, slowing down arthritis, or improving muscle health.
So the question we have to ask ourselves is how does vitamin D compare to other common treatments for arthritis? Let’s first start with direct comparisons and look at other supplements, specifically with glucosamine chondroitin, turmeric and curcumin, and boswellia serrata. All three of these supplements have been shown in multiple randomized controlled trials as well as systematic review and meta-analyses to help treat and reduce symptoms related to arthritis.
It seems like all three of these, again that’s glucosamine chondroitin, turmeric and curcumin, and boswellia serrata all have larger effect sizes than vitamin D. Moreover, turmeric and curcumin as well as boswellia serrata have been shown to have very large effect sizes comparable to common medications such as ibuprofen and naproxen, without any of the side effects of these medications.
So while vitamin D has been shown to help with symptoms, I would recommend trying some of the other supplements first as you probably will get a better bang for your buck in terms of outcomes for the treatment of arthritis. You can check out my playlist on supplements and alternative medicine which I will link here to learn more about those options.
Ok so with all that said, many people still want to take every supplement available that can potentially help reduce symptoms. So if you are interested in increasing your body’s vitamin D levels, there are a few ways to do that. The primary source of vitamin D is sunlight exposure. Spending time outdoors, particularly between the times of 10 am and 4 pm can stimulate vitamin D production in the skin. However, factors such as geographical location, time of year, skin pigmentation, and sun protection practices can affect the amount of vitamin D produced.
Most adults need about 15 minutes of sun exposure on their face, arms, and legs 2 to 3 times a week to produce adequate amounts of vitamin D. People with darker skin tones may require longer exposure to sunlight to produce the same amount of vitamin D.
In addition, it’s important to point out that the use of sunscreen will block the production of vitamin D. You’ll want to get 15 minutes of sun exposure before applying sunscreen to exposed skin.
The other way to increase vitamin D levels in the body is through diet. Dietary sources of vitamin D include fatty fish (such as salmon, mackerel, and trout), fortified dairy products, eggs, and certain mushrooms.
However, it can be challenging to obtain sufficient vitamin D from sunlight and dietary sources alone, especially for individuals with limited sun exposure or specific dietary restrictions. In such cases, vitamin D supplementation may be considered.
According to our clinical studies, you want to aim for at least 2000 IU daily to get benefits from vitamin D supplementation. Of course, exact dosages can vary depending on factors such as age, overall health, sun exposure, and existing vitamin D levels.
It's crucial to remember that vitamin D supplementation is just one component of a comprehensive approach to managing osteoarthritis. Lifestyle modifications, including regular exercise, weight management, and pain management strategies, play key roles in optimizing joint health.