A pilot study assessing the effect of prolonged administration of high daily doses of vitamin D on the clinical course of vitiligo and psoriasis.
Level 4 - case-series / case-control
Uncontrolled prospective interventional pilot study (case series)
PubMed 24494059 · doi:10.4161/derm.24808
What was done
Nine patients with psoriasis and 16 patients with vitiligo, all presenting with baseline 25(OH)D3 ≤ 30 ng/mL, received 35,000 IU of oral vitamin D3 once daily for six months. The regimen was combined with a strict low-calcium diet (avoiding dairy and calcium-fortified milks) and fluid intake of at least 2.5 L daily. Clinical severity was evaluated using the Psoriasis Area and Severity Index (PASI) for psoriasis and a quartile grading scale for vitiligo. Serum 25(OH)D3, parathyroid hormone (PTH), renal function, and calcium levels (serum total/ionized and urinary excretion) were monitored.
What was found
Serum 25(OH)D3 increased from 14.9 ± 7.4 to 106.3 ± 31.9 ng/mL in psoriasis patients and from 18.4 ± 8.9 to 132.5 ± 37.0 ng/mL in vitiligo patients. PTH decreased from 57.8 ± 16.7 to 28.9 ± 8.2 pg/mL in psoriasis and from 55.3 ± 25.0 to 25.4 ± 10.7 pg/mL in vitiligo. PASI scores significantly improved across all 9 psoriasis patients (specific numerical PASI values were not reported in the abstract). Fourteen of 16 vitiligo patients achieved 25–75% repigmentation. Serum calcium, urea, and creatinine did not change, while urinary calcium excretion increased within normal limits.
Why it matters
This pilot provides preliminary proof-of-concept that high-dose vitamin D supplementation with dietary calcium restriction may alter the course of autoimmune dermatological conditions, though findings require rigorous confirmation in randomized trials.
Limits
The sample size is very small (n=25 total) with no control or placebo group, preventing attribution of clinical improvements solely to vitamin D. The abstract does not provide exact baseline and post-treatment PASI scores or follow-up durability after treatment cessation. High-dose regimens carry significant risks of toxicity and hypercalcemia that mandate strict dietary restrictions and biochemical monitoring.
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