Is there a relationship between Vitamin D (Vitamin D) deficiency and peripheral neuropathy?

From the Guidelines

Vitamin D deficiency is associated with an increased risk of neuropathy, and supplementation should be considered to slow disease progression, particularly in patients with high-risk genotype of the vitamin D receptor 1. To address vitamin D deficiency and its potential contribution to neuropathy, it is essential to maintain adequate vitamin D levels, with a target range of 30-50 ng/mL.

• Supplementation typically involves vitamin D3 (cholecalciferol) at doses of 1,000-2,000 IU daily for maintenance or 50,000 IU weekly for 8-12 weeks for severe deficiency, followed by maintenance dosing.
• Blood tests should be conducted every 3-6 months initially to monitor levels.
• Vitamin D is crucial for nerve health as it supports nerve growth, reduces inflammation, and helps regulate calcium levels needed for proper nerve function.
• Beyond supplementation, spending 15-30 minutes in sunlight several times weekly and consuming vitamin D-rich foods like fatty fish, fortified dairy products, and egg yolks can help maintain adequate levels.
• If neuropathy symptoms persist despite vitamin D correction, consult a healthcare provider as other treatments or causes may need to be addressed, such as homocysteine level reduction through vitamin B12 and folate administration 1. Key considerations include:
• Monitoring of body weight and nutritional assessment at least on a yearly basis, as weight changes and malnutrition can impact disease severity and treatment outcomes 1.
• Regular monitoring of vitamin status, including vitamin D, B12, and folate, to prevent neuropathy and other complications associated with deficiencies 1.

From the Research

Vitamin D Deficiency and Neuropathy

• Vitamin D deficiency has been linked to the development and progression of diabetic neuropathy 2, 3, 4, 5
• Studies have shown that vitamin D supplementation can improve peripheral neuropathy in patients with type 2 diabetes 4, 5
• The benefits of vitamin D supplementation for diabetic neuropathy include:
  • Improvement in symptoms and signs of neuropathy 4, 5
  • Reduction in pain scores 5
  • Improvement in mood 5
  • Increase in vitamin D levels 4, 5
• The optimal dose of vitamin D supplementation for diabetic neuropathy is not established, but doses of 5000 IU/day have been shown to be effective 5
• Vitamin D deficiency is associated with an increased risk of painful diabetic neuropathy, with an odds ratio of 9.8 for vitamin D deficiency (<20 ng/mL) and 4.4 for vitamin D insufficiency (<30 ng/mL) 3

Mechanisms and Associations

• Vitamin D deficiency may play a role in the development of peripheral neuropathy, diabetic foot ulcers, and cardiovascular autonomic neuropathy in patients with type 2 diabetes 2
• The relationship between vitamin D levels and neuropathy symptoms is not fully understood, but may involve the regulation of calcium and phosphate metabolism, as well as the modulation of immune responses and inflammation 2, 6
• Further studies are needed to confirm the benefits of vitamin D supplementation for diabetic neuropathy and to establish the optimal dose and duration of treatment 2, 5