Controlling Chronic Diseases and Acute Infections with Vitamin D Sufficiency

Abstract

Apart from developmental disabilities, the prevalence of chronic diseases increases with age especially in those with co-morbidities: vitamin D deficiency plays a major role in it. Whether vitamin D deficiency initiates and/or aggravates chronic diseases or vice versa is unclear. It adversely affects all body systems but can be eliminated using proper doses of vitamin D supplementation and/or safe daily sun exposure. Maintaining the population serum 25(OH)D concentration above 40 ng/mL (i.e., sufficiency) ensures a sound immune system, minimizing symptomatic diseases and reducing infections and the prevalence of chronic diseases. This is the most cost-effective way to keep a population healthy and reduce healthcare costs. Vitamin D facilitates physiological functions, overcoming pathologies such as chronic inflammation and oxidative stress and maintaining broader immune functions. These are vital to overcoming chronic diseases and infections. Therefore, in addition to following essential public health and nutritional guidance, maintaining vitamin D sufficiency should be an integral part of better health, preventing acute and chronic diseases and minimize their complications. Those with severe vitamin D deficiency have the highest burdens of co-morbidities and are more vulnerable to developing complications and untimely deaths. Vitamin D adequacy improves innate and adaptive immune systems. It controls excessive inflammation and oxidative stress, generates antimicrobial peptides, and neutralizes antibodies via immune cells. Consequently, vitamin D sufficiency reduces infections and associated complications and deaths. Maintaining vitamin D sufficiency reduces chronic disease burden, illnesses, hospitalizations, and all-cause mortality. Vulnerable communities, such as ethnic minorities living in temperate countries, older people, those with co-morbidities, routine night workers, and institutionalized persons, have the highest prevalence of vitamin D deficiency—they would significantly benefit from vitamin D and targeted micronutrient supplementation. At least now, health departments, authorities, and health insurance companies should start assessing, prioritizing, and encouraging this economical, non-prescription, safe micronutrient to prevent and treat acute and chronic diseases. This approach will significantly reduce morbidity, mortality, and healthcare costs and ensure healthy aging.

Physiology of Vitamin D—Focusing on Disease Prevention

“…Figure 2 illustrates fundamental differences between the hormonal and non-hormonal forms of calcitriol and the related generation of calcitriol. demonstrates key functional differences between the circulatory hormonal form of calcitriol (the hormonal form) that is generated in renal tubular cells vs. the intracellularly generated calcitriol in peripheral target cells, such as immune cells (modified from Wimalawansa, SJ., 2023 [7]).…”

“…Elevated PTH levels resulting from low dietary calcium or, more commonly, vitamin D deficiency contribute to heightened bone turnover and gradual loss of bone mineral demonstrates key functional differences between the circulatory hormonal form of calcitriol (the hormonal form) that is generated in renal tubular cells vs. the intracellularly generated calcitriol in peripheral target cells, such as immune cells (modified from Wimalawansa, SJ., 2023 [7]).…”

“…Vitamin D deficiency increases the susceptibility to certain infections, especially tuberculosis [ 4 ] and respiratory tract infections [ 5 ]. Maintaining sufficient levels of 25(OH)D leads to reduced risks of infectious diseases and downregulating inflammatory responses [ 6 , 7 ]. Vitamin D has also been implicated in preventing chronic diseases such as cardiovascular disease [ 8 ], diabetes [ 9 ], cancer [ 10 ], and autoimmune disorders [ 3 , 11 , 12 ].…”

Impact of vitamin D on ultraviolet-induced photoaging and skin diseases

“…However, ultraviolet (UV) radiation-activated cutaneous synthesis is considered the main source of vitamin D. Cutaneously generated pre-vitamin D gets converted to vitamin D 3 via thermal isomerization and enters the blood circulation bound to vitamin D binding protein [2,3]. Once in the circulation, vitamin D is hydroxylated into 25hydroxyvitamin D [25(OH)D; calcidiol] in the liver, and then in the kidney to 1,25-dihydroxyvitamin D [1,25(OH) 2 D; calcitriol], the physiologically active form of vitamin D [4]. Calcitriol can also be generated within peripheral target cells, functioning as a localized cytokine and a signaling molecule.…”

Circulating vitamin levels mediate the causal relationship between gut microbiota and cholecystitis: a two-step bidirectional Mendelian randomization study

“…Interestingly, an observational study indicated that circulating vitamin C levels have a protective effect against cholesterol gallstones ( 18 ). Notably, vitamin D exerts potent regulatory effects on both innate and adaptive immunity ( 19 ), with research suggesting that maintaining serum 25(OH)D concentrations above 40 ng/mL can significantly reduce symptomatic diseases and decrease the prevalence of infections and chronic conditions ( 20 ).…”