Vitamin D Does Not Improve Thyroid Autoimmunity

We’ve discussed two studies that have shown that vitamin D supplementation can lower thyroid antibodies, but a recent study found that vitamin D did not lower antibodies.  What does this mean and how to we interpret these finding?  Let’s discuss.

Dr. R’s Fast Facts

Recent Study

Effect of Vitamin D deficiency treatment on thyroid function and autoimmunity markers in Hashimoto’s thyroiditis: A double-blind randomized placebo-controlled clinical trial.

  • Fifty-six patients with Hashimoto’s thyroiditis and Vitamin D deficiency (25-hydroxyvitamin D level ≤20 ng/mL) were randomly allocated into two groups to receive Vitamin D (50, 000 IU/week, orally) or placebo for 12 weeks, as Vitamin D-treated (n = 30) and control (n = 26) groups, respectively.
    Vitamin D Does Not Improve Thyroid Autoimmunity - vitamind

Findings

  • There’s no appreciable effect of Vitamin D supplementation on thyroid autoimmunity
  • Vitamin D levels increased, but thyroid autoimmunity did not change

What does this mean?

  • It is important to share data about what works and what does NOT work
  • Vitamin D may help with thyroid AI, but it’s not a guarantee
  • Remember, vitamin D supplementation is not a replacement for sun exposure

How much sun exposure should we be getting?

  • Weekly sun exposure is an important part of health
  • 15-30 minutes per day
  • Between the hours of 11:00 AM and 2:00 PM

Subscribe on:
itunes-button stitcher button
Download Episode (Right click on link and ‘Save As’)

Vitamin D Does Not Improve Thyroid Autoimmunity

Dr. Michael Ruscio: Hi, this is Dr. Ruscio, and let’s discuss when vitamin D supplementation does not help with thyroid autoimmunity. We’ve discussed a number of studies in the past—two specifically—that have shown supplementation with vitamin D can help to decrease thyroid antibodies. So that’s great. That’s good news.

But let’s talk about a study that was recently published that showed that vitamin D supplementation did not help and had no effect on thyroid autoimmunity. I’ll put the abstract of the study up here on the screen, entitled “Effect of Vitamin D Deficiency Treatment on Thyroid Function and Autoimmunity Markers in Hashimoto’s Thyroiditis: A Double-Blind, Randomized, Placebo-Controlled Clinical Trial Trusted SourcePubMedGo to source.”

And let’s go into just a couple of the details here. Fifty-six patients with Hashimoto’s thyroid autoimmunity and vitamin D deficiency. And they defined vitamin D deficiency as below 20 nanograms. And essentially half of these patients were put on vitamin D; the other half were given a placebo, and they were followed.

Now, when you look at this chart, you see something very interesting. And they were followed for 12 weeks, so it’s an adequate amount of time. If you look at the top of the table, you see vitamin D levels, and you see the vitamin D levels between the baseline and three months. And you also see it broken out by the vitamin D treatment group and by the placebo group.

You see, in the group receiving vitamin D, of course, their vitamin D blood levels increased, and the placebo group did not see an increase in their blood levels. Makes complete sense. Move down to where it says TPO-abs, your thyroid peroxidase antibodies. Probably the most clinically relevant marker to assess thyroid autoimmunity.

And when you look at the vitamin D treatment group from baseline to three months, the level of antibodies is essentially the same. You go from 820 to 734. That change is not significant. And when you look at the placebo group, you see 838 to 750. So what you’re seeing here is no appreciable effect of vitamin D supplementation on thyroid autoimmunity in this study. Their vitamin D levels increased, but the thyroid autoimmunity did not improve.

So what does this mean? Well, I think it illustrates a very important concept, which is oftentimes in complementary and alternative medicine and natural medicine, we oftentimes want to share what works, what works, what works, what works. But we don’t take as much time to share the evidence showing that something does not work.

And why that’s important is because if you only share the information, the data, that supports something working, this can lead to a false confidence that a treatment is going to be successful or a treatment must be done all the time. And so, vitamin D may be one of those. There may be some doctors or patients out there who strongly, strongly feel that you must take vitamin D if you have thyroid autoimmunity. And if your thyroid autoimmunity does not improve, you must take higher doses or take it for a longer period of time. And that’s really misguided.

The reason why it’s misguided is because vitamin D may help with thyroid autoimmunity. Some evidence certainly supports that, but it’s not to say that vitamin D treatment is a panacea for thyroid autoimmunity. Now, certainly, it’s not hard to make a case for supplementing with the vitamin D. There have been some health benefits shown, of course, for supplementing vitamin D especially when you’re deficient.

However, there’s something else very important to keep in mind here, and that is that there are benefits that one acquires from sun exposure that you cannot obtain from vitamin D supplementation. And this is very important to keep in mind. Some of the best review evidence, namely coming out of Michael Holick’s group, has shown that while we do see a vitamin D deficiency associated to a number of conditions, there does not seem to be the data to support that supplementing with vitamin D will rectify those disease associations.

Meaning, if someone with depression takes vitamin D—so someone with depression shows low vitamin D. We then give that person vitamin D. Does that vitamin D help with the depression? No. There are some trials that do show benefit with vitamin D supplementation, so it is justifiable. But the bigger point to keep in mind here is when you look at these trials more broadly, you see a trend emerge, which is there are a number of health conditions or biomarkers that will improve from sun exposure that will not improve from vitamin D supplementation.

What this simply tells you is that you cannot just take vitamin D in place of a lifestyle deficiency of not obtaining sun exposure. And the more contemporary thinking on sun exposure is showing that chronic sun exposure, meaning weekly sun exposure, is an important part of health. This does not mean spending hours at a time. Maybe 15-30 minutes a few days a week may be sufficient for most people.

So this does not mean you’re going to go to the extreme of crazy doses of sun exposure, hours at a time. However, at least a few days a week, getting 15-30 minutes in the sun between the hours of usually 11:00 and 2:00 in the sunny months is a very important health practice. And this may help with obtaining health benefits that you cannot obtain from vitamin D supplementation alone.

But back to the issue at hand regarding vitamin D supplementation and thyroid autoimmunity, it can help, but it’s not a guarantee. Certainly, something to add into your therapeutic repertoire for thyroid autoimmunity, but it’s not the only piece and all of the data does not show benefit. So just keep that in mind when supplementing with vitamin D to try and aid and improve your thyroid autoimmunity. And also, remember, do not look at vitamin D supplementation as a way to avoid a very important lifestyle practice of obtaining routine exposure to the sun and time outside.

Ok. This is Dr. Ruscio, and I hope this information helps you get healthy and get back to your life. Thanks.

What do you think? I would like to hear your thoughts or experience with this.

Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.

Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!

26 thoughts on “Vitamin D Does Not Improve Thyroid Autoimmunity

  1. I am curious if the amount of people 56 is enough for a “study”; it seems a little low. Great place to start but in my world not a true study.
    Also; were the people eating foods the same; same amt. of sunshine all the same?

    1. Good points Laurie. Also, remember that vitamin D might simply not lower antibodies in everyone all the time and that is OK. It is extremely rare for something to work 100 percent of the time.

  2. Does this mean Vitamin D doesn’t help with hypothyroidism and TSH levels? The result shows an increase at the 3 month time?

  3. Hello Dr. Ruscio,

    I am wondering if you are familiar with a brazilian scientist that prescribes high doses of Vitamin D – his name is Dr. Cícero Coimbra. I am a practicioner, doing a PhD as well and been following volunteer Hashimoto’s patients for quite some time. I compare different treatments prescribed by many practioners. The best results I have seen on antibodies reductions are with the High dose of Vitamin D protocol – however I have seen in many patients that it takes about 1 year for the antibodies to decrease, therefore, analyzing this paper I don’t believe either the dose, nor the follow-up time was adequate to observe changes in TPO levels.

    1. Hi Carolina,
      I have not. I think you make some great points here. I tend to think its more likely that vitamin D will not reduce AI in all subjects and this study happened to be a sample that showed that. 50,000 IU/week is a fair dose. 3 months is a fair time window. However, 56 patients is a small group. Selenium studies in AI show most of the benefit at 3 months, with a moderate dose of Se (200mcg) for example.
      In any case, thanks for making your points 🙂

    2. Dear Carolina,

      My apologies for contacting you in this way. I am very interested in your research and I was wondering if I could contact you to get some more information about the Coimbra protocol for thyroid autoimmune diseases.

      Thank you in advance,

      Anne

  4. I am curious if the amount of people 56 is enough for a “study”; it seems a little low. Great place to start but in my world not a true study.
    Also; were the people eating foods the same; same amt. of sunshine all the same?

    1. Good points Laurie. Also, remember that vitamin D might simply not lower antibodies in everyone all the time and that is OK. It is extremely rare for something to work 100 percent of the time.

  5. Does this mean Vitamin D doesn’t help with hypothyroidism and TSH levels? The result shows an increase at the 3 month time?

  6. Hello Dr. Ruscio,

    I am wondering if you are familiar with a brazilian scientist that prescribes high doses of Vitamin D – his name is Dr. Cícero Coimbra. I am a practicioner, doing a PhD as well and been following volunteer Hashimoto’s patients for quite some time. I compare different treatments prescribed by many practioners. The best results I have seen on antibodies reductions are with the High dose of Vitamin D protocol – however I have seen in many patients that it takes about 1 year for the antibodies to decrease, therefore, analyzing this paper I don’t believe either the dose, nor the follow-up time was adequate to observe changes in TPO levels.

    1. Hi Carolina,
      I have not. I think you make some great points here. I tend to think its more likely that vitamin D will not reduce AI in all subjects and this study happened to be a sample that showed that. 50,000 IU/week is a fair dose. 3 months is a fair time window. However, 56 patients is a small group. Selenium studies in AI show most of the benefit at 3 months, with a moderate dose of Se (200mcg) for example.
      In any case, thanks for making your points 🙂

    2. Dear Carolina,

      My apologies for contacting you in this way. I am very interested in your research and I was wondering if I could contact you to get some more information about the Coimbra protocol for thyroid autoimmune diseases.

      Thank you in advance,

      Anne

  7. I have recently been supplementing with Vitamin D and my level has gone from 30 to 55. Haven’t had antibodies checked as I need more time for the levels to increase. The Vitamin D Council feels that most people are not getting enough D and that the normal ranges are too low. Another issue is that without adequate D, the conversion from T4 to T3 cannot take place effectively. My free T-3 was in the lower end of normal but thyroid experts feel it should be in the upper range for optimum results. I am curious to see what my free T-3 levels will be after supplementing for a few months more.. I’m feeling better but still not optimum. Once again, it’s only after my own research and requesting this test, that I was determined to be low in D. We have to be our own advocates.

  8. I have recently been supplementing with Vitamin D and my level has gone from 30 to 55. Haven’t had antibodies checked as I need more time for the levels to increase. The Vitamin D Council feels that most people are not getting enough D and that the normal ranges are too low. Another issue is that without adequate D, the conversion from T4 to T3 cannot take place effectively. My free T-3 was in the lower end of normal but thyroid experts feel it should be in the upper range for optimum results. I am curious to see what my free T-3 levels will be after supplementing for a few months more.. I’m feeling better but still not optimum. Once again, it’s only after my own research and requesting this test, that I was determined to be low in D. We have to be our own advocates.

  9. Interesting. Thank-you. In looking at the full text of the study, I do not see anywhere where it states they used D3 (unless I missed it). It may be D3, but commonly 50,000 IU per dose is D2. They do state the supplement was made by a company in Iran, so they may have used either form. Wish they had stated. Disturbing that they omitted to state.

  10. Interesting. Thank-you. In looking at the full text of the study, I do not see anywhere where it states they used D3 (unless I missed it). It may be D3, but commonly 50,000 IU per dose is D2. They do state the supplement was made by a company in Iran, so they may have used either form. Wish they had stated. Disturbing that they omitted to state.

  11. 50000iu is not that much. I take 10000 per day and have done for many years. What was the blood serum level after the three months?? I have read a lot about the Coimbra protocol so very interested to know more. Vit d is best taken daily Imo. Dr Coimbra has also said it takes time to heal.

  12. 50000iu is not that much. I take 10000 per day and have done for many years. What was the blood serum level after the three months?? I have read a lot about the Coimbra protocol so very interested to know more. Vit d is best taken daily Imo. Dr Coimbra has also said it takes time to heal.

Leave a Reply

Your email address will not be published. Required fields are marked *