Name: Vitamin D, Vitamin D3, cholecalciferol
Number of scientific references: 55
Level of Evidence: Level II What is this?
Note: Normal vitamin D levels support better brain health and cognition. No definite evidence confirms that Vit D deficiency increases the risk of PD, but certain genetic variants of Vitamin D receptor gene have been associated with Parkinson’s disease. If a PD patient is diagnosed with Vit D deficiency/insufficiency, please consult the doctor about supplementation as Vitamin D can protect bone health and possibly cognition.
Vitamin D is a neuroprotective agent and benefits the nervous system. It inhibits the production of free radicals that can damage brain cells. It stimulates the production of enzymes that are vital for the production of the important antioxidants in our body that also protect brain health.
It also stimulates brain cells to produce growth factors like nerve growth factor and glial cell-line derived neurotrophic factor which protects and supports the development of brain cells.
A recent study published in Journal of Parkinson’s Disease, 2016 has explored the link between vitamin D and Parkinson’s disease. This study revealed that Parkinson’s disease patients have significantly lower levels of the sunshine vitamin than healthy individuals.
This deficiency may not be linked to low Vit D intake but may be associated be genetic mutations in Vitamin D receptor (VDR) gene. Its supplementation is found to protect from worsening of symptoms in Parkinson’s disease patients with mutations in VDR gene.
Links of four genetic polymorphisms or mutations in Vitamin D receptor gene have been actively researched in Parkinson’s disease:
- TaqI (rs731236)
- ApaI (rs7975232)
- BsmI (rs1544410)
- FokI (rs10735810)
In a genome-wide association study, Butler et al. observed that VDR gene mutations may not be significantly associated with risk of Parkinson’s disease but can influence the age of onset of Parkinson’s disease. This is indicative of a possible preventive role of vitamin D in Parkinson’s.
Some studies have found no link between the presence of genetic variants in VDR gene and Parkinson’s disease while some have found an increased risk of PD with BsmI and FokI variants specifically in the Asian population.
Researchers from Loma Linda University and UCLA have observed that the presence of genetic variants in VDR gene can influence the risk of developing Parkinson’s disease in a population (mainly non-Hispanic Caucasian individuals) that is highly exposed to UV rays throughout their lifetime.
Maintaining optimum Vit D levels is essential for better brain health. No definitive evidence confirms that deficiency of the sunshine vitamin can increase PD risk. However, in case of deficiency or genetic defect, Vitamin D supplementation can help in Parkinson’s by strengthening bone health, preventing the risk of fractures and possibly protecting cognition.
Suggested Vitamin D Supplements For Parkinson’s
Please consult a health practitioner before taking any health supplements.
Vitamin D supplementation is helpful only in case of deficiency.Vit D supplements should not be taken over a long period, unless prescribed by a health practitioner, as it may cause toxicity.
It is essential to maintain calcium and magnesium levels while supplementing with vitamin D for best resolution of symptoms.
The vitamin is fat soluble and it is advisable to take it after a meal containing dietary fats.
Dosage: Please read the detailed dosage section below and try working with a health practitioner to identify a dose that suits you.
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5 Potential Benefits Of Vitamin D For Parkinson’s Disease
Let’s go over the research conducted to date on the role of the sunshine vitamin in Parkinson’s.
1.It can help rectify the deficiency and may protect from Parkinson’s
Table of Contents
- 1 Suggested Vitamin D Supplements For Parkinson’s
- 2 5 Potential Benefits Of Vitamin D For Parkinson’s Disease
- 3 Dosage of Vitamin D For Parkinson’s Disease
- 4 Precautions with Vitamin D Use
- 5 Conclusion
According to the Harvard Biomarker Study, there is an association between 25-hydroxyvitamin D3 (a metabolically active form of Vit D) and PD and thousands of patients with Parkinson’s in North America alone are vitamin D deficient.
Patients with Vit D insufficiency are at increased risk of developing PD while those with a deficiency have a two-fold increased risk of developing PD. A recent meta-analysis published in Nutrients, 2015 suggested that vitamin D supplementation, as well as outdoor work, reduces the risk of PD.
Wang and colleagues state that this link between Vit D deficiency and PD is not simply explained by reduced sunlight exposure due to immobility in patients. It could also be attributed to gastric dysfunction, reduced absorption of vitamin D2 and reduced intake of foods rich in vitamin D.
Given such contrasting evidence, what we could conclude is that lowered vitamin D levels may not be a direct causative factor of PD but could contribute to its symptoms.
Also, healthy vitamin D levels protect brain health and cognition, and this protective action could indirectly contribute to the prevention of brain disorders.
Quick Gist: Vitamin D deficiency is observed in PD patients, but the exact cause of this deficiency is not determined.
The evidence regarding the concept of whether vitamin D deficiency increases PD risk is rather conflicting. But it is safe to conclude that maintaining healthy Vit D levels protects the brain and this indirectly protects from neurological conditions.
2.Vitamin D may reduce symptom severity in Parkinson’s
A study published in Neurological Sciences, 2014 reveals that blood Vit D levels may predict the severity of the symptoms of Parkinson’s disease.
Sleeman and colleagues have investigated the role of Vitamin D levels in disease progression in early Parkinson’s (Journal of Parkinson’s Disease, 2017). 145 newly diagnosed PD patients were enrolled in the study, and their 25(OH)D levels were assessed at the baseline and after 18 and 36 months.
PD patients had significantly lower 25(OH)D levels than healthy individuals at the baseline. A small but significant association between vitamin D levels and severity of motor symptoms was observed at 36 months.
The low Vit D levels could impact bone health in PD patients and increase the risk of developing osteoporosis, osteopenia and a greater risk of having fractures in case of falls.
Other studies have highlighted that low levels of the sunshine vitamin could influence other symptoms of PD such as orthostatic hypotension (a dizzy feeling when you stand up which occurs as a result of sudden drop in blood pressure), balance control, endothelial dysfunction ( dysfunction of blood vessels impacting heart health) and delayed gastric emptying.
Thus, it can be hypothesised that supplementing with Vit D and rectifying the deficiency can help reduce such non-motor symptoms of PD.
There has been one double-blind, placebo-controlled clinical trial that has explored the effect of vitamin D3 supplementation in Parkinson’s disease.
114 patients with PD received either 1200 IU of vitamin D3 supplements per day or placebo for 12 months. The researchers observed what percentage of individuals experienced worsening of symptoms.
Compared to placebo, vitamin D3 supplementation helped prevent worsening of symptoms in PD patients. As we observed in the earlier section, Fok1 mutations in VDR gene is associated with Parkinson’s disease risk.
In this study, it was observed that vitamin D3 supplementation significantly protected those with Fok1 gene variant in Vitamin D receptor gene than those with normal CC genotype.
Researchers concluded that vitamin D3 supplementation might help stabilise symptoms in PD patients for a short period without causing elevated calcium levels.
However the researchers have stated that there are several limitations to the study and further research is required to ascertain whether ‘this effect is specific to PD’.
Quick Gist: Low levels of the sunshine vitamin may be correlated with motor symptom severity in PD. It is also associated with non-motor symptoms such as delayed gastric emptying, bone health, balance control and postural hypotension.
One clinical trial has demonstrated that vitamin D3 supplementation prevents worsening of symptoms in PD patients especially in those with FokI gene variant in VDR gene. Further research is required to confirm these findings.
3.It can improve cognition and reduce depressive symptoms
Vit D is referred to as a ‘neurosteroid’ since it has multiple biological actions that impact brain and nervous system health.
Vitamin D receptors are present in the brain, and they mediate a neuroprotective effect, support growth and development of brain cells, affect brain chemistry and brain’s plasticity. Low Vit D levels during adulthood may worsen underlying brain disorders and may reduce the ability to recover from stress.
Researchers from the University of Queensland, Australia have speculated that low Vit D levels may worsen brain dysfunction in various brain disorders including PD.
The sunshine vitamin can protect cognition in PD; in fact, high levels of this vitamin is associated with better cognition and mood in PD patients without dementia.
In the Parkinson Environment Gene Study, 190 PD patients were assessed for genetic variants in Vitamin D receptor gene and it is was observed that occurrence of FokI variant in VDR gene is associated with cognitive decline in PD.
These findings suggest that vitamin D can protect cognition in PD and clinical trials must evaluate this aspect.
Reduced mobility, high levels of inflammation in the brain and reduced quality of life cause depression in PD patients. Several meta-analysis studies have revealed that vitamin D supplementation can reduce depressive symptoms and its effect may even be comparable to antidepressants.
Quick Gist: Vitamin D plays an important role in supporting brain function and maintaining optimal brain chemistry. Low Vit D levels are associated with cognitive decline, depression and memory issues in elderly individuals.
Therefore, supplementation with the sunshine vitamin can protect cognition and mood in PD patients; further research is required to confirm this.
4.It protects brain health
Dopaminergic neurons (brain cells that predominantly use neurotransmitter dopamine) present in the substantia nigra (a part of the brain) are of importance when it comes to Parkinson’s disease treatment. Degeneration of these brain cells contributes to Parkinson’s symptoms especially motor symptoms.
Vitamin D may be an essential nutrient for development and survival of dopaminergic neurons. Recent research studies suggest that the sunshine vitamin can protect midbrain dopaminergic neurons and may prevent neurodegeneration in PD.
Pre-treatment with Vit D3 protects motor neurons (brain cells dealing with our movement) from Parkinson’s like toxicity, reduces hypokinesia (absence of movement) and prevents cell death.
Contrastingly a study published in PloS One, 2012 demonstrated that vitamin D depletion does not worsen the damage to brain cells in Parkinson’s disease.
Beyond protecting dopaminergic neurons, the sunshine vitamin may also protect the brain from inflammation in PD.
In an animal model of PD, Calvello et al. have demonstrated that Vit D protects dopaminergic cell loss, reduces levels of pro-inflammatory agents and increases the level of anti-inflammatory agents in the brain.
Quick Gist: Pre-clinical studies have demonstrated that vitamin D exerts neuroprotection in Parkinson’s diseases by protecting brain cells, preventing neurodegeneration and reducing inflammation in the brain.
These findings still need to be examined in clinical studies.
5.Vitamin D protects bone health in Parkinson’s
Compared to general population, bone loss is more common in PD patients. Various factors are responsible for it such as immobility, decreased muscle strength, malnutrition, low BMI, use of medications and vitamin D levels.
Deficiency of the sunshine vitamins may lead to reduced calcium absorption, and as compensation, this may stimulate the parathyroid glands to over-function. This may cause stooped posture, vertebral fractures and hip fractures.
Sunlight exposure may reduce the risk of hip fractures in PD patients by 77%.
Risedronate is a medication used to strengthen bone health and to treat osteoporosis. Treatment with risedronate and vitamin D2 supplementation improves bone mineral density and reduces the risk of hip fractures in elderly patients with PD.
Quick Gist: Improving vitamin D levels in PD patients can help improve bone mineral density and reduce the risk of fractures.
Dosage of Vitamin D For Parkinson’s Disease
There is no specific dosage of vitamin D prescribed for Parkinson’s disease. The dose may be dependant on your serum Vit D or calcidiol levels.
One clinical study has used a dose of 1200 IU vitamin D3 or cholecalciferol per day and demonstrated the stability of symptoms in PD.
A dose of 1000-2000 IU per day works for most individuals, but in case of severe deficiency, your health practitioner may suggest higher weekly dosages.
Opt for vitamin D3 (cholecalciferol) and not D2 (ergocalciferol) supplements.
Sun exposure is a simple way of getting necessary vitamin D for Parkinson’s prevention, but the high incidence of skin cancer and rising global warming makes it difficult to give specific advice on the duration of sun exposure.
For example, an individual with moderately fair skin residing in Northern Australia can produce 1000 IU vitamin D in 6-7 minutes ( in summer) and 9-12 minutes (in winter), if exposed to the sun between 10, am to 2 pm. But if that individual is in Tasmania, he may need 7-9 minutes (in summer) and 40-47 minutes (in winter) for equivalent levels.
Please consider working with a health practitioner to identify the dose that would suit your health.
Precautions with Vitamin D Use
High levels of vitamin D may cause toxicity. It can increase calcium absorption, and high calcium levels (hypercalcemia) contribute to the toxicity.
Toxicity symptoms include nausea, vomiting, diarrhoea, anorexia, constipation at early stages etc. Other symptoms include kidney stones, bone pain, frequent urination, drowsiness, headaches irregular heartbeat, weakness, nervousness, itching etc.
Therefore, it is necessary to work with a health practitioner to identify a dose of vitamin D that would suit you and to decide the duration of therapy as well.
A case study published in The Journal of Neurosciences In Rural Practice, 2017 reported a case of reversible Parkinsonism after treating vitamin D toxicity.
The patient was taking 60,000 IU vitamin D3 sachets per week for past four years as an over the counter vitamin supplement and the resulting toxicity caused Parkinson’s like symptoms. Treatment of the toxicity led to complete resolution of the symptoms.
Certain medications that affect calcium levels in the body may have drug interactions with the sunshine vitamin. These include corticosteroids, phenobarbital, phenytoin. Also, drugs that interfere with fat metabolism such as orlistat and cholestyramine can reduce the vitamin absorption.
Please consult a health practitioner before taking Vit D supplements.
Vitamin D is an essential nutrient for optimum brain health. It can influence mood, cognition, protect from brain disorders and strengthen the brain’s ability to recover from stress.
Parkinson’s disease patients have lower Vit D levels than healthy individuals. PD patients may also present with genetic mutations in Vitamin D receptor gene, and these mutations may be associated with symptom severity in the disease.
Maintaining adequate sunshine vitamin levels may protect bone health, cognition and mood in PD and reduce non-motor symptoms. These findings need to be investigated in clinical studies.
There is no clear consensus whether low vitamin D levels increase the risk of developing PD, but research has confirmed the importance of vitamin D in appropriate brain and nervous system function.
If diagnosed with low Vit D levels in PD, please discuss the potential of vitamin D supplementation with your doctor for better protection of bone health.