Vitamin D Deficiency and Thyroid Disease
Vitamin D is an important vitamin that not only regulates calcium, but also has many other beneficial actions. Not many endocrinologists realize this, but several articles published over 20 years ago showed that patients with hypothyroidism have low levels of vitamin D.
This may lead to some of the bone problems related to hypothyroidism. It was thought that one of two mechanisms may explain the low levels of vitamin D in patients with hypothyroidism, 1) the low levels of vitamin D may be due to poor absorption of vitamin D from the intestine or 2) the body may not activate vitamin D properly. Other articles have demonstrated that patients with Graves disease also have low levels of Vitamin D.
Importantly, both vitamin D and thyroid hormone bind to similar receptors called steroid hormone receptors. A different gene in the Vitamin D receptor was shown to predispose people to autoimmune thyroid disease including Graves’ disease and Hashimoto’s thyroiditis. For these reasons, it is important for patients with thyroid problems to understand how the vitamin D system works.
Sources of Vitamin D
Vitamin D is really two different compounds, ergocalciferol (vitamin D2), found mainly in plants and cholecalciferol (vitamin D3), found mainly in animals. Both of these hormones are collectively referred to as vitamin D, and they can either be obtained in two ways. One is by exposure of the skin to the ultraviolet (UV) rays of sunlight or also from dietary intake.
Vitamin D is found naturally in fish (such as salmon and sardines) and fish oils, eggs and cod liver oil. However most Vitamin D is obtained from foods fortified with Vitamin D, especially milk and orange juice. Interestingly, as breast feeding has become more popular, the incidence of Vitamin D deficiency has increased as less fortified milk is consumed.
Vitamin D deficiency may also occur in patients with malabsorption from their intestine, such as in the autoimmune disease called Celiac Disease, which occurs frequently in patients with thyroid problems. Multivitamins also contain Vitamin D, as does some calcium supplements like Oscal-D and Citracal plus D.
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Add a Comment7 Comments
Dear Dr Friedman,
Thank you for your article however there is one point which I disagree with.
Your inference that vitamin D could relate to increased breast feeding is I think and bad inference to make to mothers. There are so many benefits from breast feeding and so many negatives attached to formula that you just have to look at the third world (yes even if we have better water although that could be debated). What you will find is a bigger correlation between vitamin D deficiency and the use of sun block (particularly on children) and the common vitamin D deficiency past on from parent to child. Pre conception health of both parents is key.
March 28, 2009 - 8:01amThis Comment
I understand the concern that vitamin D deficiency in infants may increase with breast feeding may be misconstrued as advice against breast feeding babies. What I think the point here is that if a mother is breast feeding, she should also give her child a vitamin D supplement in addition to breast milk rather than forgo breast feeding the baby.
It amazes me that the importance of vitamin D has been so ignored. I have just been floored by the articles that have been coming out the last two years relating low vitamin D to everything from diabetes to MS to obesity to stroke to heart disease to back pain to cancer. Now thyroid disease too. How much money could we save on medical treatment and improve our quality of life just by taking a cheap vitamin D supplement? I started.
March 29, 2009 - 7:53amMothers that are breast feeding and are worried about the lose of D-3. Just get the baby out in the sun when possible.............Pete
March 29, 2009 - 9:01amI am a gastric bypass patient of 5 years. My vitamin D -25 hydroxy levels was a 5. My question is if I can not absorb the 50,0000 IU am i just taking pils? I am in alot of pain and aches with my joints and hand and leg pain and have family history of arthritis, and cushing syndrom and ankloysis.
April 18, 2009 - 3:34pmWhat do i do or what r my options? I have an appt with Endo in a month....thanks Ann
There is a mistake in your article.
Dr., You've mixed up your Vit. D types. In the article you say, " cholecalciferol (vitamin D2) and ergocalciferol (vitamin D3)." You have it reversed. Actually, Vit. D3 is cholecalciferol and Vit. D2 is ergocalciferol.
If you need extra proof, just check out the National Osteoporosis Foundation's website at http://www.nof.org/prevention/vitaminD.htm
June 25, 2009 - 7:33amWell, to make the long story short, my friend had thyroid problems. Later they found out he has some nodules in her thyroid too. After that he was diagnosed with Vitamin D Deficiency. She had never heard of such thing. It's always about checking her cholesteral and all that, but never anyone told her to check her vitamin d level.
June 15, 2010 - 7:13pmSO the lesson here is to have your levels checked by your doctor!
i never knew vitamin d deficiency could cause thyroid problems. what is the best way to treat this? Exposure to sunlight?
August 13, 2010 - 11:05am