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Vitamin D in preventive medicine: are we ignoring the evidence? Zittermann A. Br J Nutr. 2003 May;89(5):552-72. Review. PMID: 12720576 Vitamin D is metabolised by a hepatic 25-hydroxylase into 25-hydroxyvitamin D (25(OH)D) and by a renal 1alpha-hydroxylase into the vitamin D hormone calcitriol. Calcitriol receptors are present in more than thirty different tissues. Apart from the kidney, several tissues also possess the enzyme 1alpha-hydroxylase, which is able to use circulating 25(OH)D as a substrate. Serum levels of 25(OH)D are the best indicator to assess vitamin D deficiency, insufficiency, hypovitaminosis, adequacy, and toxicity. European children and young adults often have circulating 25(OH)D levels in the insufficiency range during wintertime. Elderly subjects have mean 25(OH)D levels in the insufficiency range throughout the year. In institutionalized subjects 25(OH)D levels are often in the deficiency range. There is now general agreement that a low vitamin D status is involved in the pathogenesis of osteoporosis. Moreover, vitamin D insufficiency can lead to a disturbed muscle function. Epidemiological data also indicate a low vitamin D status in tuberculosis, rheumatoid arthritis, multiple sclerosis, inflammatory bowel diseases, hypertension, and specific types of cancer. Some intervention trials have demonstrated that supplementation with vitamin D or its metabolites is able: (i) to reduce blood pressure in hypertensive patients; (ii) to improve blood glucose levels in diabetics; (iii) to improve symptoms of rheumatoid arthritis and multiple sclerosis. The oral dose necessary to achieve adequate serum 25(OH)D levels is probably much higher than the current recommendations of 5-15 microg/d.

Vitamin D intake is inversely associated with rheumatoid arthritis: results from the Iowa Women's Health Study. Merlino LA, Curtis J, Mikuls TR, Cerhan JR, Criswell LA, Saag KG; Iowa Women's Health Study. Arthritis Rheum. 2004 Jan;50(1):72-7. PMID: 14730601 DOI: 10.1002/art.11434 CONCLUSION: Greater intake of vitamin D may be associated with a lower risk of RA in older women, although this finding is hypothesis generating.

Clinical aspects of vitamin D in the management of rheumatoid arthritis.\nLeventis P, Patel S.\nRheumatology (Oxford). 2008 Nov;47(11):1617-21. Epub 2008 Aug 5. Review.\nPMID: 18682414 \ndoi:10.1093/rheumatology/ken296 \n

Now a new and controversial book by an American doctor suggests that taking even higher levels of the vitamin - 10 to 15 times the recommended amounts - can work wonders. Dr James Dowd, who works at the Arthritis Institute of Michigan, has been prescribing vitamin D to people suffering from chronic disorders such as arthritis, back pain and headaches and the result, he claims, is a huge improvement in their symptoms. In his book, The Vitamin D Cure, Dr Dowd describes a number of success stories using this approach. One of his patients, Barbara, for instance, was obese, and suffered from arthritis in one leg as well as high blood pressure. As Dowd explains: "In the past I would have given her anti-inflammatory drugs, pain medication, a pill to lose weight and drug treatment for hypertension."

Vitamin D and autoimmune rheumatic diseases. Cutolo M. Rheumatology (Oxford). 2009 Mar;48(3):210-2. Epub 2008 Oct 17. PMID: 18930963 doi:10.1093/rheumatology/ken394

Hypovitaminosis D among rheumatology outpatients in clinical practice.\nMouyis M, Ostor AJ, Crisp AJ, Ginawi A, Halsall DJ, Shenker N, Poole KE.\nRheumatology (Oxford). 2008 Sep;47(9):1348-51. Epub 2008 May 22.\nPMID: 18499714 \ndoi:10.1093/rheumatology/ken203

Zittermann A. Vitamin D in preventive medicine: are we ignoring the evidence? Br J Nutr. 2003 May;89(5):552-72. Review. PMID: 12720576 [PubMed - indexed for MEDLINE]

itamin D and autoimmunity: new aetiological and therapeutic considerations. Arnson Y, Amital H, Shoenfeld Y. Ann Rheum Dis. 2007 Sep;66(9):1137-42. Epub 2007 Jun 8. Review. PMID: 17557889 doi:10.1136/ard.2007.069831