Vitamin D supplementation in psoriasis treatment
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Vitamin D Supplementation and Psoriasis Severity
Several recent studies have examined whether vitamin D supplementation can improve psoriasis symptoms. Most large, well-designed randomized controlled trials found that oral vitamin D supplementation does not significantly reduce psoriasis severity, as measured by the Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), or other clinical scores, compared to placebo 12356. These findings were consistent across different durations of supplementation and in various populations, including those with low baseline vitamin D levels 12356.
Subgroup Effects and Vitamin D Deficiency
Some subgroup analyses suggest that vitamin D supplementation may be more effective in certain populations. For example, supplementation with vitamin D2 or in Asian populations showed more promising results, with significant improvement in PASI scores in one study 1410. Additionally, maintaining serum vitamin D levels above 30 ng/mL may benefit patients with severe psoriasis, although this requires further investigation in larger trials . There is also a consistent finding that people with psoriasis tend to have lower serum vitamin D levels compared to healthy controls, but this does not necessarily mean that supplementation will improve psoriasis symptoms 610.
Relationship Between Vitamin D Levels and Psoriasis
While direct supplementation did not consistently improve clinical outcomes, some studies found an inverse relationship between serum vitamin D levels and psoriasis severity—higher vitamin D levels were associated with milder disease in some subgroups 2410. This suggests that vitamin D status may play a role in disease activity, but supplementation alone may not be sufficient to produce significant clinical improvement for most patients 2410.
Safety and Adverse Effects of Vitamin D Supplementation
Across multiple studies, vitamin D supplementation was generally safe, with no serious adverse effects reported. Minor side effects, such as nausea, were rare 1458. The optimal dose for treating psoriasis remains unclear, and most studies used doses within a relatively narrow and safe range .
Topical vs. Oral Vitamin D in Psoriasis Treatment
Topical vitamin D analogues are well-established as effective treatments for psoriasis, especially when used in combination with other therapies. In contrast, oral vitamin D supplementation has shown inconsistent results and is not currently recommended as a standalone treatment for psoriasis 789.
Future Directions and Research Needs
Current evidence does not support routine oral vitamin D supplementation as an effective treatment for psoriasis. However, more research is needed to determine if specific subgroups, such as those with severe disease or significant vitamin D deficiency, may benefit from higher doses or combination therapies. Future studies should also explore the optimal dosing and potential synergistic effects with other treatments 147810.
Conclusion
In summary, while people with psoriasis often have lower vitamin D levels, most clinical trials do not show a significant benefit of oral vitamin D supplementation for improving psoriasis severity. Supplementation is generally safe, but its use as a primary treatment for psoriasis is not supported by current evidence. Further research is needed to clarify its role in specific patient groups and in combination with other therapies.
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