Why Should Rheumatologists Consider Vitamin D Supplementation for their Patients?

Increasing evidence suggests that common musculoskeletal diseases such as osteoporosis (OP), osteoarthritis (OA), and rheumatoid arthritis (RA) are increased in the presence of low vitamin D intake or low serum 25-hydroxyvitamin D (25(OH) D) levels. In addition, individuals with OP, OA, and RA carry an increased risk for falls and fractures, while anti-fall and anti-fracture efficacy of vitamin D has been demonstrated in the general older population. For patients with OA or RA, evidence suggests that maintenance of bone density could slow disease progression, while 25(OH) D and bone density are positively correlated among these individuals. Finally, anti-inflammatory effects of vitamin D have been proposed, which may contribute to decreased joint destruction among individuals with OA or RA. In addition, cardiovascular benefits by vitamin D may provide significant improvement to the care of patients with inflammatory rheumatologic diseases. Given the low cost of vitamin D, its excellent tolerability, combined musculoskeletal- and suggested anti-inflammatory/cardio-vascular benefits, vitamin D supplementation holds a significant public health potential. Thus, based on this review, a general supplementation with vitamin D in patients with OP, OA, and RA may be warranted, especially as a high prevalence of vitamin D deficiency has been documented among these individuals.