Vitamin D3

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These pages hold in-progress web pages for the benefit of Rosacea Support Group members. Information provided herein is intended for informational purposes only and is not intended to replace medical advice offered by a physician or qualified healthcare provider. Feedback welcome to wiki-feedback@rosacea-research.org



Vitamin D3 (cholecalciferol)

Vitamin D3 In Immunity:

Recent studies suggest the importance of Vitamin D3 (Vit D3) in immunity. Vit D3 has been shown to promote the production of the human antimicrobial peptides, cathelicidins (LL-37), and cathelicidins have been found to have broad spectrum antimicrobial activity. Studies also suggest that it is unusual for bacteria to develop resistance to cathelicidins as they might from standard antibiotics:

Cutting Edge: 1,25-Dihydroxyvitamin D3 Is a Direct Inducer of Antimicrobial Peptide Gene Expression
Cathelicidins and innate defense against invasive bacterial infection
Cathelicidin Peptides Inhibit Multiply Antibiotic-Resistant Pathogens from Patients with Cystic Fibrosis


Some microbes cathelicidins have been shown to have activity against include:

C. albicans
Image: C. albicans treated with LL-37
C. trachomatis (Genitourinary tract infections0
Bacillus species (Several members)
B. burgdorferi (Lyme Disease)
E. coli
Image: E. coli treated with LL-37 (Figure 10, Page 10)
H. pylori
M. tuberculosis
M. furfur & Dermatophyes (Seborrheic dermatitis and tinea infections)
P. aeruginosa, S. aureus, S. epidermidis, Herpes simplex virus type 1, and Adenovirus
Streptococcus species (Group A)


Vitamin D3 also seems to have important immunomodulating effects, both reducing levels of pro-inflammatory cytokines and increasing levels of anti-inflammatory cytokines:

Immunomodulating effect of vitamin D3 derivatives on type-1 cellular immunity
Vitamin D3 Affects Differentiation, Maturation, and Function of Human Monocyte-Derived Dendritic Cells

Moreover, Vitamin D3 has been shown to contribute "to the regulation of development and function of mast cells, which play a critical role in several inflammatory disorders":

VDR-dependent regulation of mast cell maturation mediated by 1,25-dihydroxyvitamin D3




Vitamin D3 in Inflammatory / Autoimmune Disease and Cancers:

Vitamin D3 has been implicated as playing an important role in various inflammatory / autoimmune diseases, including diabetes, multiple sclerosis, rheumatoid arthritis, hypertension, cardiovascular heart disease, and many common deadly cancers.

The Vitamin D Epidemic and its Health Consequences
Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis
CBS News: Study: Vitamin D May Prevent Some Cancers- Sun-Related Vitamin Might Prevent Many Cases Of Colon And Breast Cancer

A recent study suggests Vit D3 supplementation may promote up to a 77% reduction of cancer incidence:

Creighton University News Center: Creighton Study Shows Vitamin D Reduces Cancer Risk
Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial



Vitamin D3 and Skin Disease:

Studies suggest that Vit D3 plays an important role in skin wounds. Clinical trials of oral and topical Vitamin D3 in atopic dermatitis and acne are now underway:

Vitamin D3 Provides Skin Protection From Harmful Microbes
D-Day for skin maladies

Studies also suggest that Vit D3 may play an important role in proper sebaceous function and may help reduce sebum production:

Epidermal growth factor and 1alpha,25-dihydroxyvitamin D3 suppress lipogenesis in hamster sebaceous gland cells in vitro
Vitamin D and the skin: an ancient friend, revisited

In an old study (from 1937) of Vit D in acne, 75% of subjects were reported to be much better or healed at 3 months:

Vitamin D in Acne

However, the following article seems to suggest that Dr Gallo - who remember previously found elevated kallikrein activated cathelicidins in rosacea patients - may not believe Vit D3 supplementation would help with rosacea.

Innate immunity: Role in rosacea

It is to be hoped that this won't hold up studies of Vit D3 in rosacea, given the potential of Vit D3 to help with this condition. As the studies listed above indicate, it has potent immunomodulating effects. Additionally, the following studies suggest that Vit D3 intake may even control levels of some matrix metalloproteinases (MMPs), some of which have been found to be elevated in rosacea:

Circulating MMP9, vitamin D and variation in the TIMP-1 response with VDR genotype: mechanisms for inflammatory damage in chronic disorders?
Suppressive activity of vitamin D3 on matrix metalloproteinase production from cholesteatoma keratinocytes in vitro



Vitamin D3 and Ocular Disease:

Studies suggest that the cathelicidins induced by Vitamin D3 also play an important role in antimicrobial protection of the ocular surface and surround:

Human Cathelicidin (LL-37), a Multifunctional Peptide, is Expressed by Ocular Surface Epithelia and has Potent Antibacterial and Antiviral Activity
Multifunctional Roles of Human Cathelicidin (LL-37) at the Ocular Surface
Defensins and Other Antimicrobial Peptides at the Ocular Surface



Vitamin D3 Supplementation & Safety:

Studies suggest Vitamin D3 (cholecalciferol) is more effective than Vitamin D2 so supplements should be clearly labeled as Vitamin D3 or "Vitamin D as cholecalciferol" or some combination of both in order to be certain that the supplement is not the more common Vitamin D2:

Vitamin D2 Is Much Less Effective than Vitamin D3 in Humans

Also, the liquid or gel form Vitamin D3 supplements often contain added oils, and it has been suggested that many may find that these added oils may cause additional allergies, so dry form Vitamin D3 supplements MAY be a better option.

There is much controversy surrounding the optimum levels of Vit D3 supplementation, and while the currently established safe upper limit for Vit D3 is listed as 2000 IU per day for adults and children over the age of 12 months, many are now questioning this level and calling for the upper limit to be increased to levels as high as 10,000 IU:

National Institutes of Health Office of Dietary Supplements: Dietary Supplement Fact Sheet: Vitamin D
Risk assessment for vitamin D
Council for Respnsible Nutrition: Scientific Experts Call for Increased Vitamin D UL

Some suggest, however, that the safest way to get high levels of Vit D3 is through approximately 15-20 minutes of near full body exposure to the sun at peak sun times during the summer. In this amount of time at peak sun / peak sun months, skin produces approximately 10,000 IU of Vit D3. No additional Vit D3 is produced in longer exposure, and 10,000 IU is produced prior to any sunburn pinkness. Still, even 15-20 minutes of peak sun exposure may be difficult to obtain on a daily basis, and we will want to avoid any risk of making rosacea symptoms worse, so supplementation may make sense.

Supplementation may be contraindicated in certain diseases including sarcoidosis, so please talk to your doctor before taking high level supplements of Vit D3.



Miscellaneous:

Below are some great video presentations that discuss many of the important aspects of Vit D3:

The Vitamin D Pandemic and its Health Consequences, Presented by Michael Holick, PhD, MD, Professor of medicine, physiology and biophysics and director of the General Clinical Research Center at Boston University Medical Center
Dr. Reinhold Vieth: Prospects for Vitamin D Nutrition
Contemporary Diagnosis and Treatment of Vitamin D-Related Disorders: Session 4: Vitamin D and Population Health (Particularly the section: Vitamin D Toxicity, Policy and Science by Reinhold Vieth, Ph.D (slides: 61-83, mins: 00:45:05-1:08:03)
Contemporary Diagnosis and Treatment of Vitamin D-Related Disorders: Session 5: Non-Traditional Roles of Vitamin D

And below is an excellent website, with links to many additional published studies supporting the benefits of Vit D3:

Vitamin D Council