Vitamin D Deficiency Linked to Metabolic Changes in People With Lupus

A new international study published in the journal Rheumatology has shown that vitamin D deficiency may be linked to metabolic syndrome in lupus. Vitamin D is an important hormone for the heart, immune system, and bones. But most people with lupus have low levels of vitamin D. This may be because people with lupus avoid sunlight to reduce the risk of a flare.^1,2

Studies have shown that people with lupus and low vitamin D levels are more likely to have:^3,4

• Higher blood pressure
• Higher total cholesterol
• Higher blood triglyceride levels
• Insulin resistance
• Low levels of good cholesterol

The study also found a link between vitamin D deficiency and corticosteroid exposure. Corticosteroids increase the risk for vitamin D deficiency because they speed up vitamin D degradation.³

Metabolic syndrome and cardiovascular disease in lupus

Many of the symptoms of lupus and low vitamin D levels are symptoms of metabolic syndrome. Metabolic syndrome is a group of conditions that increase your risk of cardiovascular disease. Vitamin D levels seem to be linked to metabolic syndrome no matter the age, ethnicity, or body weight.³

People with lupus are more likely to have metabolic syndrome. People with metabolic syndrome have at least 3 of the following:^5,6

• High blood pressure
• High blood sugar
• High body fat around the waist
• Low levels of good cholesterol
• High levels of triglycerides, a type of fat

Metabolic syndrome is very common in the US. Almost 1 in 3 U.S. adults have it. It is closely related to obesity and insulin resistance. Normally, your pancreas makes insulin to help cells remove sugar from the blood. In people with insulin resistance, cells respond poorly to insulin. This causes blood sugar levels to rise as your body produces more and more insulin.⁶

Certain features of lupus may increase the risk of metabolic syndrome. Complications such as kidney problems may contribute to the risk. Immunosuppressive drugs like corticosteroids may also play a role.⁵

Lupus recommendations

Experts recommend that people with lupus be tested for vitamin D deficiency. Doctors will test for a type of vitamin D called 25-hydroxyvitamin D.^7,8

Unlike other vitamins, vitamin D is not common in your food. Many experts recommend that foods should be fortified with vitamin D. But for now, people with lupus should take vitamin D supplements. This is especially true if they are taking corticosteroids. Vitamin D is usually safe, cheap, and widely available. Experts usually recommend taking vitamin D3 instead of vitamin D2.⁷

We do not yet know if vitamin D supplements will help prevent metabolic syndrome. It is also hard to predict what dose is needed to reach appropriate levels. Doctors may monitor your vitamin D levels after 3 months of vitamin D supplementation.⁷

Lifestyle changes are also helpful to prevent metabolic syndrome. This includes:⁶

• Exercising regularly
• Maintaining a healthy diet
• Avoiding smoking
• Reducing stress

If lifestyle changes and vitamin D supplements are not working, other medicines may be necessary. Certain drugs may help control blood pressure, cholesterol, and blood sugar.⁶

Lupus doctors can help

Most of the conditions associated with metabolic syndrome do not have obvious signs or symptoms. But if you have 1 part of metabolic syndrome, ask your doctor about getting tested for the other parts. You can also ask for diet and exercise tips to prevent cardiovascular disease.⁶

Talk to your doctor ahead of time about symptoms of cardiovascular disease. Many symptoms are similar to symptoms of lupus. These include:⁶

• Chest pain
• Fatigue and weakness
• Shortness of breath
• Fainting or lightheadedness
• Pain or numbness in legs
• Uneven heartbeat
• Difficulty speaking

If any of these symptoms get worse or appear suddenly, talk to a doctor as soon as possible.