Does Vitamin D help hair growth in Alopecia Areata?
Does Vitamin D help hair growth in Alopecia Areata? In this post, I look at the importance of Vitamin D not only for overall health but also for improving the outcome of Alopecia treatment.
As Vitamin D Receptors (VDR) are strongly expressed in hair follicles, several studies have investigated the link between vitamin D levels and severity, duration, and the number of patches in Alopecia. I also look into daily vitamin D requirements for children and adults, and how to get enough daily intake of vitamin D.
How important is Vitamin D?
Vitamin D is not just a single nutrient. Instead, vitamin D is a group of fat-soluble secosteroids “with an endocrine mechanism of action which is sequentially synthesized in humans in the skin, liver and kidneys”.
Vitamin D has many important functions in the human body, including the regulation of immune functions, absorption and metabolism of other minerals in the body, such as calcium metabolism, bone mineralisation, phosphate and magnesium metabolism.
In a growing fetus, sufficient vitamin D is necessary for “fetal growth, development of the nervous system, lung maturation, and fetal immune system function”, according to this source.
Given its important role in supporting our overall immune system and metabolism of vital minerals, deficiency in vitamin D can lead to adverse risks and effects on our overall health, including growth-related concerns in children, as well as infection, bone density and autoimmune related concerns in children and adults alike.
Vitamin D is even more so important because it is not easy to get vitamin D from foods. There aren’t many food sources that contain good amounts of vitamin D, making diet a rather insignificant source of this nutrient. In other words, even if you eat a healthy and well-balanced diet, you will still need to pay extra attention to ensure you are not vitamin D deficient.
How much Vitamin D do we need?
The topic of how much vitamin D we really need has always been somewhat of a tricky question. It is still a field that is being studied to say the least, with new recommendations and updates being released as more are known from ongoing clinical trials.
1. Health Canada, as of 2011, recommends 400 IU daily intake of vitamin D for infants, 600 IU for children aged 1 to adults aged 70, and 800 IU for adults aged over 70, with no more than 4000 IU daily in order to stay within safe limits.
2. Osteoporosis Canada recommends 400 to 1000 IU for healthy adults between the age of 19 and 50, and 800 to 2000 IU for younger adults at high risk, as well as adults over 50.
3. The Institute of Medicine, on the other hand, recommends 700mg for children aged 1 to 3, 1000mg for children aged 4 to 8, 1300mg for children aged 9 to 18, 1000mg for adults aged 19 to 50, 1200mg for women aged 51 to 70, 1000mg for men aged 51 to 70, and 1200mg for adults aged 71 and over.
This recommended daily amount includes sources from sunlight exposure as well as diet and supplementation.
Can you get too much Vitamin D?
As vitamin D is fat soluble, it is difficult for our body to get rid of it if we take too much.
It is recommended that we don’t exceed the daily limits of 1000 to 2000 IU for infants, 2000 IU for 25lbs of body weight for children and no more than 4000 IU daily, and no more than 4000 to 10000 IU for adults.
Again, these are just recommended general guidelines and different organisations set different limits, so exercise caution based on your own circumstance.
How and where can you get vitamin D?
The main source of vitamin D is photosynthesis in the skin. There are only several food sources that naturally contain vitamin D, which is why many food manufacturers fortify their food products with vitamin D. This also means that we cannot get sufficient vitamin D through food alone.
#1 source of Vitamin D: Sunlight
The most prescribed way to get adequate vitamin D is by exposing our bare skin to sunlight. Our body naturally ‘makes’ large amounts of vitamin D through photosynthesis in the skin, in other words, when it is exposed to the UVB rays of sunlight. A few things to bear in mind about sunlight as a source of vitamin D are:
– Being exposed to the sun for prolonged period of time may bring harmful risks such as getting burned or worse still, skin cancer. You need to be mindful of the length of time and time of day/year that you are exposed to sunlight. Generally, 15 minutes of exposure if you have fair skin and slightly longer if you have darker skin is a good rule of thumb although this too depends on where you are at which time of the year.
– You need to expose larger amount of skin to produce more vitamin D, and sunscreen blocks a lot of vitamin D production.
– UVB doesn’t travel through glass, so if you are behind glass doors of windows, you don’t get the UVB needed for vitamin D production.
– The time of year, altitude, time of day, distance from the equator, and your skin type can all affect the level of vitamin D you can make through sun exposure.
– If it’s cloudy or the air where you are is polluted, you get less UVB and hence make less vitamin D.
– The older you are, the harder it is for your skin to synthesise and produce vitamin D.
– If you live further away from the equator, you won’t get much vitamin D during the winter months.
#2 source of Vitamin D: Foods with naturally occurring vitamin D
Foods that contain (small amounts of) vitamin D include oily fish such as salmon, snapper and mackerel, cod liver oil, liver, and egg yolk. Mushrooms are a plant based source of vitamin D.
As a guideline by Dietitians of Canada, salmon contains between 200 to 450 IU of vitamin D for every 75 grams (the amount varies between species), snapper has almost 400 IU in 75 grams, and egg yolk provides 30 to 44 IU in each.
#3 source of Vitamin D: Foods with fortified vitamin D
Some foods are fortified with vitamin D (usually vitamin D2), such as dairy products, orange juice, and cereals.
#4 source of Vitamin D: Supplementation
Supplementation is a good option in the absence of better natural ways to get sun exposure needed for vitamin D production, for example during the winter months, or you are worried about harmful risks of sun exposure.
When taking vitamin D supplementation, Vitamin D Council recommends that you take vitamin D3 as it is the type of vitamin D that our body produces in response to sunlight exposure, and it is understood to be a more active form compared to D2.
Consult with your doctor before taking supplementation to make sure it is the right option for you.
Does Vitamin D help hair growth and the autoimmune actions in Alopecia Areata?
Vitamin D receptors (VDR) are shown to be strongly expressed in key structures of hair follicles, and any disturbance in the hair follicle cycle may lead to Alopecia.
Although many cases of Alopecia Areata are not directly caused by deficiency in Vitamin D, a number of studies such as this study and this study revealed decreased serum levels of Vitamin D in subjects with Alopecia Areata when compared to healthy subjects.
In another study focusing on pediatric subjects, no significant difference was found in serum Vitamin D levels between subjects with and without Alopecia.
However, all the studies quoted above did reveal significant and negative correlation between levels of Vitamin D concentration and severity of Alopecia measured by its SALT score. In other words, the lower the levels of serum vitamin D, the higher the severity and duration of Alopecia.
Given these study results, it is suggested that Vitamin D, due to its immunomodulatory effect, may play a role in the pathogenesis of Alopecia Areata and therefore vitamin D supplementation is worth looking into for supporting the management of Alopecia when it is not possible to get sufficient Vitamin D levels from natural sources.
As micronutrients play a key role in normal hair follicle development, adequate serum levels of such micronutrients are thought to influence risk factors associated with the development of Alopecia Areata.
Vitamin D is one of such micronutrients that is rather widely studied for its role in Alopecia, because VDR expression in the epidermal keratinocyte compartment of the hair follicle is required to prevent the development of Alopecia.
Studies reveal that some cases of Alopecia Areata are correlated to lower levels of serum vitamin D levels while some are not. Many cases of Alopecia Areata show correlation between levels of vitamin D concentration and disease severity and duration.
Current available treatments for Alopecia only rely on steroid application, injections, or immunomodulating agents that are associated with harmful side effects while offering relatively low long-term success rates, making them unsuitable for children and unappealing to many adults who have Alopecia. Given limited options available today, supplementation of vitamin D is worth a try.
As with all supplementation, be mindful about what products you choose, and do your research on the content and ingredients of anything that you plan on consuming.
Vitamin D alone will not be sufficient in completely resolving autoimmune disease, however. It requires more complex solution than that. For more insights on how to get the best chances of recovery from autoimmune Alopecia, check out my other posts on Foods for hair growth for children with Alopecia and How to resolve autoimmune disease with immune modulation.
- Vitamin D: the secosteroid hormone and human reproduction
- The Role of Vitamin D in Non-Scarring Alopecia
- Food Sources of Vitamin D
- How do I get the vitamin D my body needs?
- Vitamin D receptor gene polymorphisms are not associated with alopecia areata
- The Role of Vitamin D in Non-Scarring Alopecia
- Serum vitamin D level is related to disease severity in pediatric alopecia areata
- Correlation of vitamin D and vitamin D receptor expression in patients with alopecia areata: a clinical paradigm
- The Role of Micronutrients in Alopecia Areata: A Review
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