Vitamin D Deficiency and Thyroid Disease

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There's increasing evidence to suggest that low levels of vitamin D may play a role in thyroid disorders. For instance, research has suggested a possible link between vitamin D deficiency and autoimmune thyroid disorders, namely Hashimoto's thyroiditis, the most common cause of hypothyroidism (underactive thyroid), and Grave's disease, characterized by an overactive thyroid.

In one study, 72 percent of subjects with autoimmune thyroid disease were deficient in vitamin D, while just under 31 percent of healthy subjects had low levels of D. Similarly, a study of people in Greece with Hashimoto's thyroiditis revealed that more than 85 percent of them had low levels of vitamin D, as well as high levels of anti-thyroid antibodies.

Vitamin D supplementation also has shown promise as a way to help treat thyroid disease. In the Greek study, for example, the Hashimoto thyroiditis patients who were deficient in vitamin D took 1,200 to 4,000 international units (IU) of vitamin D every day for four months, after which time they had significantly lower levels of anti-thyroid antibodies. (The Recommended Daily Allowance, or RDA, for vitamin D is 600 IU; see below for more specifics.)

In yet another study, people with hypothyroidism who took extra vitamin D supplements for 12 weeks had improvements in blood levels of thyroid stimulating hormone (although the extra D did not affect levels of the actual thyroid hormones triiodothyronine, T3, and thyroxine, T4).

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Defining Vitamin D Deficiency

According to some reports, 40% of adults have insufficient levels of vitamin D, although estimates vary. Certain risk factors are associated with lower levels, including race (African American and Hispanic populations have higher rates of vitamin D deficiency), obesity, lack of college education, and lack of daily milk consumption.

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Sources of Vitamin D

The main source of vitamin D is sun exposure—when skin soaks up ultraviolet rays it triggers the production of D. Concerns about skin cancer and the increasing use of sunscreen may be one of the reasons for the hike in low vitamin D levels.

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Choosing Vitamin D Supplements

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There are two forms of vitamin D supplements: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). While some experts prefer D3 supplements, there is no strong evidence to believe that one is better than the other when consumed in nutritional doses. At high doses, D2 may be less potent.

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Most vitamin D supplements provide 400 IU per dose, which is several hundred IU shy of the RDA. But most individuals get some vitamin D naturally from sun exposure and by consuming fortified foods.

It is also important to make sure you're not getting too much vitamin D. The upper limit for children over age 9 and adults is 4,000 IU per day. Too much vitamin D can be harmful. Signs of toxicity include nausea, vomiting, poor appetite, constipation, weakness, and weight loss.

Excess vitamin D also can cause damage to kidneys and increase the levels of calcium in blood—a condition called hypercalcemia that can cause confusion, disorientation, and problems with heart rhythm.

Note, too, that vitamin D supplements can interact with a number of medications, among them steroids, certain cholesterol-lowering drugs, and medications for preventing epileptic seizures.

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