Inflammation and vitamin D: the infection connection

Inflamm Res. 2014 Oct;63(10):803-19. doi: 10.1007/s00011-014-0755-z. Epub 2014 Jul 22.


Introduction: Inflammation is believed to be a contributing factor to many chronic diseases. The influence of vitamin D deficiency on inflammation is being explored but studies have not demonstrated a causative effect.

Methods: Low serum 25(OH)D is also found in healthy persons exposed to adequate sunlight. Despite increased vitamin D supplementation inflammatory diseases are increasing. The current method of determining vitamin D status may be at fault. The level of 25(OH)D does not always reflect the level of 1,25(OH)2D. Assessment of both metabolites often reveals elevated 1,25(OH)2D, indicating abnormal vitamin D endocrine function.

Findings: This article reviews vitamin D's influence on the immune system, examines the myths regarding vitamin D photosynthesis, discusses ways to accurately assess vitamin D status, describes the risks of supplementation, explains the effect of persistent infection on vitamin D metabolism and presents a novel immunotherapy which provides evidence of an infection connection to inflammation.

Conclusion: Some authorities now believe that low 25(OH)D is a consequence of chronic inflammation rather than the cause. Research points to a bacterial etiology pathogenesis for an inflammatory disease process which results in high 1,25(OH)2D and low 25(OH)D. Immunotherapy, directed at eradicating persistent intracellular pathogens, corrects dysregulated vitamin D metabolism and resolves inflammatory symptoms.

Publication types

  • Review

MeSH terms

  • Angiotensin II Type 1 Receptor Blockers / therapeutic use
  • Animals
  • Autoimmune Diseases / blood
  • Autoimmune Diseases / etiology
  • Autoimmune Diseases / immunology
  • Bacterial Infections* / blood
  • Bacterial Infections* / complications
  • Bacterial Infections* / drug therapy
  • Bacterial Infections* / immunology
  • Humans
  • Imidazoles / therapeutic use
  • Inflammation* / blood
  • Inflammation* / drug therapy
  • Inflammation* / immunology
  • Receptors, Calcitriol / immunology
  • Tetrazoles / therapeutic use
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / drug therapy
  • Vitamin D Deficiency / etiology
  • Vitamin D Deficiency / immunology
  • Vitamin D* / blood
  • Vitamin D* / immunology
  • Vitamin D* / metabolism


  • Angiotensin II Type 1 Receptor Blockers
  • Imidazoles
  • Receptors, Calcitriol
  • Tetrazoles
  • Vitamin D
  • olmesartan