If you read last week’s rather lengthy blog post about the link between #vitaminDdeficiency and #vitiligo you will remember that I left you dangling (because there was just too much to say on this subject in one post)! I referred to the fact that people with vitiligo, #psoriasis and #autoimmune diseases in general are known to be deficient in vitamin D and that at least one clinical study achieved good therapeutic results from giving subjects very high doses of vitamin D3. However, I did stress that rushing out to buy potent vitamin D supplements was not necessarily the best thing to do. So, this week I will explain my reasons for saying this.
My first reason is because vitamin D, of all the vitamins it seems to me, is very complex in the way that it works, so it would be risky to take the simplistic approach that more is necessarily better. As I mentioned last time, it plays a much more complicated and far-reaching nutritional role than was understood until relatively recently and medical science is still uncovering its secrets today. Not only does it act as a vitamin but it also performs hormone-like functions within the body. In addition, the way that it interacts with other nutrients means that finding and maintaining a healthy level of vitamin D is a rather tricky balancing act. Because of this, it is important to understand more about these interactions before going mad with the vitamin D pills. (And, ultimately, your healthcare provider is the person who will be best qualified to advise you on whether or not you should be taking extra vitamin D).
The Vitamin D Council website explains it this way:
The way that vitamins and minerals work in your body is interconnected. How well vitamin D works depends on the amount of other vitamins and minerals that are present in your body. The other vitamins and minerals needed to help vitamin D work well are called cofactors.
To get the most benefit from vitamin D, you must have other cofactors in your body. Vitamin D has a number of cofactors; the ones listed below are the most important.
I fell foul of this delicate balancing act myself when I tried a course of vitamin D tablets and found they made me horribly constipated! At the time I didn’t know that this can be a sign that you are deficient in magnesium (one of the cofactors of vitamin D) but now this piece of information makes sense and when I decided recently to take calcium and vitamin D tablets to help prevent osteoporosis I made sure they also contained magnesium.
Vitamin D promotes the absorption of calcium (which is why, along with its cofactors, it is often found in supplements for bone health). But it is possible to overdose and taking excessive amounts of vitamin D supplements can raise blood levels of calcium to levels which can lead to hardening of the arteries and kidney stones. This risk is presumably the reason why the researchers who carried out the high dosage vitamin D trials I referred to above with vitiligo and psoriasis patients insisted that they cut out calcium-rich foods.
My second reason for not recommending vitamin D as your main vitiligo treatment is because oral supplementation is only as effective as the digestive system. In other words, if your ability to absorb nutrients is compromised – which appears to be the case for many of us vitiligo sufferers - it is hard to know how much benefit you will get from a particular supplement and deciding on the appropriate dosage to compensate for this becomes a matter of guesswork. So, my instinct is that the safest way to avoid upsetting the balance of vitamin D and its cofactors is to “hedge your bets” by making sure your diet includes all of the cofactors as well as bypassing your digestive system by getting vitamin D naturally from regular, moderate sun exposure. If, in addition to this, you decide to add a vitamin D supplement to the equation it makes sense to stay within safe recommended limits.
My final and (for me, at least) most compelling reason is based on personal experience. In spite of my confirmed low levels of vitamin D, I achieved a dramatic and permanent recovery from my vitiligo without taking any potent D supplements. The Boost capsules I took for the duration of my repigmentation contained, per day, 100% of the European recommended daily intake of vitamin D (as well as 20% of its cofactor zinc) but that is not a particularly high dose so I am guessing that it is not the main reason this supplement helped my vitiligo. The The Five a Day+ green food formulation, which I continue to take each day probably doesn’t contain much, if any, vitamin D because it is made from green plant sources. However, it certainly contains plenty of the cofactors magnesium, vitamins K and A and zinc because these nutrients are all plentiful in green, leafy vegetables.
What I am saying is that I was able to recover from vitiligo without addressing my vitamin D deficiency directly through supplementation. On the other hand, supplementing the cofactors of vitamin D – as part of a whole green food containing many other vitamins, minerals and phytonutrients too – definitely was a factor in my repigmentation, as was vitamin D-producing sun exposure.
My conclusion then is that it was the other nutrients in Boost, rather than just the modest vitamin D content, that were mainly effective in stimulating new skin pigment. My moderate UV exposure was probably just enough to avoid being seriously deficient in vitamin D and I was able to get plenty of the cofactors of vitamin D from my green supplementation. What I don't know, of course, is whether taking higher doses of D3 might have produced even faster results but my concern about doing this would be that it might throw the delicate balance of nutrients in my system out of kilter, so I would not, personally, consider taking D supplements in doses any higher than generally recommended.
Sun exposure and supplementation as part of a wider nutritional programme is my advice
My name is Caroline.