The role of vitamin D supplementation in patients with rheumatic diseases

Nat Rev Rheumatol. 2013 Jul;9(7):411-22. doi: 10.1038/nrrheum.2013.71. Epub 2013 May 14.


Vitamin D is a dietary vitamin that can also be synthesized in adequate amounts from cholesterol in most mammals exposed to sunlight. Vitamin D has classical roles in calcium and phosphate metabolism, and thus the skeleton; however, this molecule also has nonclassical effects that might influence the function of the immune, cardiovascular and endocrine systems. Vitamin D deficiency, due to insufficient sunlight exposure, dietary uptake and/or abnormalities in its metabolism, has been associated with rheumatic diseases, and both the classical and nonclassical effects of vitamin D might be of relevance to patients with rheumatic disease. However, conclusive data from intervention trials demonstrating the relationship between vitamin D levels and pathogenetic processes separate from classical effects of this molecule are lacking. Furthermore, the majority of studies linking vitamin D to health outcomes, harmful or beneficial, are observational in nature, linking clinical events to vitamin D exposure or serum levels of vitamin D metabolites. Evidence from high quality, prospective, double-blind, placebo-controlled, randomized trials should be obtained before vitamin D supplementation is recommended in the treatment of the many rheumatic conditions in which deficiency of this compound has been implicated. Herein, we review the evidence for vitamin D supplementation in the management of patients with rheumatic diseases.

Publication types

  • Review

MeSH terms

  • Dietary Supplements*
  • Disease Management
  • Dose-Response Relationship, Drug
  • Humans
  • Rheumatic Diseases / drug therapy*
  • Rheumatic Diseases / physiopathology
  • Vitamin D / administration & dosage
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / physiopathology


  • Vitamin D