Harvard Study Finds That Vitamin D Supplements Decreased Risk Of Autoimmune Diseases. Might Also Be Useful For Long COVID

Supplements: A new study by researchers from Harvard T.H. Chan School of Public Health, Brigham and Women’s Hospital, and Harvard Medical School have found that vitamin D supplements with or without Omega fatty acids decreased risk of autoimmune diseases.

Thailand Medical News further adds that as a result of many emerging studies showing that autoantibodies generated as a result of SARS-CoV-2 infections causes a variety autoimmune issues culminating in certain Long COVID conditions, vitamin D supplements might also be useful in Long COVID treatment protocols.
 
The study involved a nationwide American randomized Vitamin D and omega 3 trial (VITAL), double blind, placebo-controlled trial with a two-by-two factorial design. The trial involved a total of 25 871 participants, consisting of 12 786 men ≥50 years and 13 085 women ≥55 years at enrollment. The participants were followed for a median of 5.3 years. 18 046 self-identified as non-Hispanic white, 5106 as black, and 2152 as other racial and ethnic groups. The mean age was 67.1 years. https://clinicaltrials.gov/ct2/show/NCT01351805
 
https://clinicaltrials.gov/ct2/show/NCT01169259
 
Interventions tested were Vitamin D (2000 IU/day) or matched placebo, and omega 3 fatty acids (1000 mg/day) or matched placebo. Participants self-reported all incident autoimmune diseases from baseline to a median of 5.3 years of follow-up; these diseases were confirmed by extensive medical record review. Cox proportional hazard models were used to test the effects of vitamin D and omega 3 fatty acids on autoimmune disease incidence.
 
The primary endpoint was all incident autoimmune diseases confirmed by medical record review: rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease, psoriasis, and all others.
 
The study findings showed that for the vitamin D arm, 123 participants in the treatment group and 155 in the placebo group had a confirmed autoimmune disease (hazard ratio 0.78, 95% confidence interval 0.61 to 0.99, P=0.05). In the omega 3 fatty acids arm, 130 participants in the treatment group and 148 in the placebo group had a confirmed autoimmune disease (0.85, 0.67 to 1.08, P=0.19). Compared with the reference arm (vitamin D placebo and omega 3 fatty acid placebo; 88 with confirmed autoimmune disease), 63 participants who received vitamin D and omega 3 fatty acids (0.69, 0.49 to 0.96), 60 who received only vitamin D (0.68, 0.48 to 0.94), and 67 who received only omega 3 fatty acids (0.74, 0.54 to 1.03) had confirmed autoimmune disease.
 
The study findings showed that vitamin D supplementation for five years, with or without omega 3 fatty acids, reduced autoimmune disease by 22%, while omega 3 fatty acid supplementation with or without vitamin D reduced the autoimmune disease rate by 15% (not statistically significant). Both treatment arms showed larger effects than the reference arm (vitamin D placebo and omega 3 fatty acid placebo).
 
The study findings were published in the peer reviewed British Medical Journal. &l t;a href="https://www.bmj.com/content/376/bmj-2021-066452">https://www.bmj.com/content/376/bmj-2021-066452
 
Currently autoimmune diseases (AD) such as rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease and psoriasis, are a leading cause of morbidity and mortality as people age. Few effective treatments are available for autoimmune diseases, but some preclinical studies have hinted that supplements, including vitamin D and omega-3 (or n-3) fatty acids, may have beneficial effects.
 
The Supplements study team evaluated whether taking vitamin D and/or omega fatty acid supplements could affect rates of autoimmune disease. The team tested this in the large-scale vitamin D and Omega-3 Trial (VITAL), a randomized study which followed participants for approximately five years. Investigators found the individuals who took vitamin D, or vitamin D and omega-3 fatty acids had a significantly lower rate of autoimmune diseases than people who took a placebo.
 
Senior author Dr Karen Costenbader, MD, MPH, of the Brigham's Division of Rheumatology, Inflammation and Immunity told Thailand Medical News, "It is exciting to have these new and positive results for non-toxic vitamins and supplements preventing potentially highly morbid diseases. This is the first direct evidence we have that daily supplementation may reduce autoimmune disease incidence, and what looks like more pronounced effect after two years of supplementation for vitamin D. We look forward to honing and expanding our findings and encourage professional societies to consider these results and emerging data when developing future guidelines for the prevention of autoimmune diseases in midlife and older adults."
 
Dr Costenbader added, "Now, when my patients, colleagues, or friends ask me which vitamins or supplements I'd recommend they take to reduce risk of autoimmune disease, I have new evidence-based recommendations for women age 55 years and older and men 50 years and older. I suggest vitamin D 2000 IU a day and marine omega-3 fatty acids (fish oil), 1000 mg a day ie the doses used in VITAL."
 
The VITAL trial is a randomized, double-blind, placebo-controlled research study of 25,871 men (age 50 and older) and women (age 55 and older) across the United States, conducted to investigate whether taking daily dietary supplements of vitamin D3 (2000 IU) or omega-3 fatty acids (Omacor fish oil, 1 gram) could reduce the risk for developing cancer, heart disease and stroke in people who do not have a prior history of these illnesses. Participants were randomized to receive either vitamin D with an omega-3 fatty acid supplement; vitamin D with a placebo; omega-3 fatty acid with a placebo; or placebo only.
 
Prior to the launch of VITAL, the study team determined that they would also look at rates of autoimmune disease among participants, as part of an ancillary study.
 
Dr JoAnn Manson, MD, DrPH, co-author and director of the parent VITAL trial at the Brigham said, "Given the benefits of vitamin D and omega-3s for reducing inflammation, we were particularly interested in whether they could protect against autoimmune diseases."
 
All study participants answered questionnaires about new diagnoses of diseases, including rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease, psoriasis and inflammatory bowel disease, with space to write in all other new onset autoimmune diseases. Trained physicians reviewed patients' medical records to confirm reported diagnoses.
 
First author, Dr Jill Hahn, ScD, post-doctoral fellow at the Brigham added, "Autoimmune diseases are common in older adults and negatively affect health and life expectancy. Until now, we have had no proven way of preventing them, and now, for the first time, we do. It would be exciting if we could go on to verify the same preventive effects in younger individuals."
 
It was found that among patients who were randomized to receive vitamin D, 123 participants in the treatment group and 155 in the placebo group were diagnosed with confirmed autoimmune disease (22 percent reduction).
 
Interestingly, among those in the fatty acid arm, confirmed autoimmune diseases occurred in 130 participants in the treatment group and 148 in the placebo group. Supplementation with omega-3 fatty acids alone did not significantly lower incidence of autoimmune diseases, but the study did find evidence of an increased effect after longer duration of supplementation.
 
The clinical trial study included a large and diverse sample of participants, but all participants were older and results may not be generalizable to younger individuals who experience autoimmune diseases earlier in life. The trial also only tested one dose and one formulation of each supplement.
 
The study team notes that longer follow-up may be more informative to assess whether the effects are long-lasting.
 
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