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Autoimmune risk decreased 30 percent by small amount of vitamin D and or Omega-3 – ViTAL Nov 7 2021


Vitamin D and Marine n-3 Fatty Acid Supplementation and Prevention of Autoimmune Disease in the VITAL Randomized Controlled Trial

Presented @ ACR Convergence, November 7, 2021
Jill Hahn1, Nancy Cook2, Erik Alexander3, Sonia Friedman3, Vadim Bubes3, Joseph Walter3, Gregory Kotler3, I-Min Lee3, JoAnn Manson3 and Karen Costenbader4, 1Harvard T.H. Chan School of Public Health, Boston, MA, 2Brigham and Womens' Hospital, Boston, MA, 3Brigham and Women's Hospital/ Harvard Medical School, Boston, MA, 4Brigham and Women's Hospital, Belmont, MA

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NOTE: It appears that the the combined benefits started about year 1.
By year 4 either vitamin D or Omega-3 got similar benefit as the combination

Reduction by just Vitamin D

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Background/Purpose: In observational studies, vitamin D has been inconsistently associated with reduced risk of several autoimmune diseases, and a large randomized, controlled trial has been lacking. Dietary marine-derived long-chain omega-3 (n−3) fatty acids decrease systemic inflammation and ameliorate symptoms in some autoimmune diseases, but no trials have tested whether supplementation lowers risk of developing autoimmune disease. We tested both vitamin D3 and n-3 fatty acids for the prevention of autoimmune disease within a large nationwide randomized, controlled trial.

Methods: VITamin D and OmegA-3 TriaL (VITAL), a U.S. nationwide randomized, double-blind, placebo-controlled trial, enrolled men at least 50 years and women at least 55 years of age in a two-by-two factorial design. Randomization to

  • vitamin D3 (2000 IU/d) and/or
  • n-3 fatty acids (1000 mg/d)

or placebo occurred from November 2011 to March 2014, and treatment continued through December 2017. (VITAL parent trial for cancer and cardiovascular disease prevention was reported in NEJM, January 3, 2019). We tested effects of vitamin D3 and n-3 fatty acids upon autoimmune disease incidence. Incident doctor-diagnosed autoimmune diseases were reported by participants annually and confirmed by medical record review by expert physicians for classification criteria (if existing). The primary endpoint was total incident autoimmune diseases, including rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease, psoriasis, and all others. Pre-specified secondary endpoints included individual most common autoimmune diseases; and probable autoimmune disease (evidence of incident autoimmune disease but lacking enough medical record data to confirm). Results were displayed in cumulative incidence curves and Cox regression models calculated hazard ratios (HR) of incident autoimmune diseases.

Results: 25,871 participants were randomized: 71% self-reported non-Hispanic Whites, 20% Black, and 9% other racial/ethnic groups, 51% women, mean age 67.1 years. During median follow-up of 5.3 years, confirmed autoimmune disease was diagnosed in 117 participants in the vitamin D3 group and 150 in the placebo group (HR 0.78, 95% confidence interval 0.61-1.00, p=0.04). Excluding the first 2 years in pre-specified analyses of the primary endpoint, the HR for vitamin D3 was 0.61 (0.43 – 0.86; 137 cases). Confirmed autoimmune disease was diagnosed in 123 participants in the n-3 fatty acids group and 144 in the placebo group (HR 0.85 (0.67-1.09). Excluding the first 2 years, the HR for the primary endpoint was 0.90 (0.64-1.26). (Table 1) When analyzed by factorial design subgroups, HRs for all three active arms vs. placebo/placebo were reduced by 25-30% (Figures 1-2). The number needed to treat with both agents for 5 years to prevent one autoimmune disease was 167 (94-769).

Conclusion: Supplementation for 5 years with vitamin D3 and/or n-3 fatty acids reduced incident autoimmune disease by 25-30% in older adults vs. those who received neither supplement. The effect of vitamin D3 appeared stronger after 2 years of supplementation.
 Download the PDF from VitaminDWiki
Clinical trial listing


Expect more benefit if one or more of the following:

  1. Had increased vitamin D dose for everyone - say 4,000 IU instead of 2,000 IU
  2. Had increased vitamin D dose even more if overweight or obese
  3. Had used non-daily vitamin D dosing (appears to get far more vitamin D to cells)
  4. Had used gut-friendly vitamin D (Important for > 20% of the population)
  5. Had used more Omega-3 ( many studies use 2X as much )
  6. Had decreased Omega-6 in diet (Omega-6 cancels benefits of Omega-3)
  7. Had increased Magnesium - which is needed to get benefits of Vitamin D
  8. Had included any of the 10+ activators of the Vitamin D Receptor

Some ViTAL reports on VitaminDWiki


Vitamin D and Omega-3 category starts with

355 Omega-3 items in category Omega-3 and Vitamin D separately & together help with: Autism (9 studies), Depression (27 studies), Cardiovascular (30 studies), Cognition (47 studies), Pregnancy (33 studies), Infant (24 studies), Obesity (12 studies), Mortality (5 studies), Breast Cancer (5 studies), Smoking, Sleep, Stroke, Longevity, Trauma (12 studies), Inflammation (18 studies), Multiple Sclerosis (9 studies), VIRUS (9 studies), etc

   See also - Overview: Omega-3 many benefits include helping vitamin D


Autoimmune category starts with


VitaminDWiki Omega-3 pages with VITAMIN in title (121 as of Nov 2021)

This list is automatically updated

Items found: 125
Title Modified
NAFLD not reduced by 1680 IU of vitamin D plus Omega-3 (no surprise) – RCT Jan 2022 24 Jan, 2022
Cluster headaches substantially reduced by 10,000 IU of Vitamin D and cofactors in 80 percent of people 18 Jan, 2022
FDA allows 2 specific Vitamin D and 2 Omega-3 health claims - 2019 31 Dec, 2021
Dementia 4.1 X high risk in those with low Vitamin D, Omega-3, etc.2 decades before (behind paywall) – Nov 2021 22 Nov, 2021
Autoimmune risk decreased 30 percent by small amount of vitamin D and or Omega-3 – ViTAL Nov 7 2021 08 Nov, 2021
Autoimmune risk decreased 30 percent by small amount of vitamin D and or Omega-3 – ViTAL Nov 7 2021 08 Nov, 2021
Mental health not helped by vitamin D monotherapy (adding Omega-3 and Magnesium help) – review Nov 2021 05 Nov, 2021
COVID-19 decreased risk if add Vitamin D, A, C, NAC, Se, Zn, or Omega-3 – Dec 2021 01 Nov, 2021
Omega 3 increased by 60 percent the ACTIVE vitamin D in the blood – many studies 21 Oct, 2021
Early brain development helped by Iron, Iodine, Vitamin D, Omega-3. Zinc etc. – Oct 2021 08 Oct, 2021
Benefits of Omega-3 plus Vitamin D were additive – RCT Sept 2021 27 Sep, 2021
Reasons for low response to vitamin D 22 Sep, 2021
Overview: Omega-3 many benefits include helping vitamin D 19 Sep, 2021
COVID-19 risk reduced 4X by each of: Vitamin D, Omega-3, Curcumin, Zinc 15 Sep, 2021
Colorectal Cancer treatment aided by omega-3 plus weekly Vitamin D – RCT Sept 2019 25 Jul, 2021
Prostate Cancer PSA reduced by 60 ng of Vitamin D, Vitamin B complex, Omega-3, Curcumin and diet – June 2021 20 Jun, 2021
The End of Alzheimer's - if custom adjust Vitamin D, B-12, Iron, Omega-3, etc. 14 Jun, 2021
How Vitamin D, Magnesium, Omega-3 and Zinc prevent and treat COVID-19 and many other health problems – June 2021 04 Jun, 2021
Many supplements appear to fight COVID-19 – vitamin D cited 52 times – May 2021 05 May, 2021
Rett syndrome associated with low vitamin D, treated by Omega-3 26 Apr, 2021
COVID-19 Cytokine storms attenuated by Vitamin D, Omega-3, Mg, Resveratrol, etc – April 2021 18 Apr, 2021
Pregnancy recommendations – huge differences in Vitamin D, Mg, iron, Iodine, DHA, etc – April 2021 13 Apr, 2021
Vitamin D Cofactors in a nutshell 17 Mar, 2021
Some Religious dietary practices may result in low iron, B12, vitamin D, Zinc, etc. 29 Nov, 2020
ADHD risk factors include low Zinc, Vitamin D, Magnesium and Omega-3 (umbrella review) – Oct 2020 20 Oct, 2020
Endometriosis treated, and perhaps prevented, by vitamin D 21 May, 2020
Less muscle loss associated with eating more fish (Omega-3, Vitamin D, Magnesium, etc) – Jan 2020 30 Jan, 2020
Depression treatments: diet, exercise, bright light, Vitamin D, B12, Omega-3, Zinc, Music, etc. – May 2019 08 Dec, 2019
Magnesium, Vitamin D, Omega-3, TSH - importance and testing - Dean and Baggerly - Oct 2019 30 Oct, 2019
T1 Diabetes treated by Vitamin D and Omega-3 (many other studies agree) Jan 2018 23 Oct, 2019
Vitamin D 5,000-8,000 IU and Omega-3 2.5 grams– Life Extension Nov 2019 19 Oct, 2019
Type 1 diabetes trial having problems getting participants – too many taking Vitamin D or Omega-3 – Aug 2019 03 Oct, 2019
Multiple Sclerosis 40 percent less likely if consume tinned fish (Vitamin D and Omega-3) – Sept 2019 30 Sep, 2019
T1 Diabetes reduction by high Omega-3 and Vitamin D – GRH ongoing observation 12 Sep, 2019
Fat-soluble vitamins critical for conception, pregnancy and breast feeding (pigs) – Sept 2019 03 Sep, 2019
Preterm Births reduced by Omega-3, Zinc, and Vitamin D – Aug 2019 09 Aug, 2019
Inflammation is reduced by each of the following: Vitamin D, Omega-3, Diet 01 Jul, 2019
Food allergies in children may be due to earlier low Vitamin D, Omega-3 and Zinc – Aug 2017 24 Jun, 2019
Dry Eyes treated by Omega-3 (and also by Vitamin D) – 2017, 2018, 2019 30 Apr, 2019
Type 1 Diabetes prevention with Vitamin D and Omega-3 – Symposium April 2019 25 Apr, 2019
Autistic symptoms reduced by Vitamin D and or Omega-3 – RCT March 2019 11 Apr, 2019
Omega-3 helped Alzheimer’s only if good level of B vitamins – RCT April 2019 10 Apr, 2019
Preterm Births - promising preventions – anti-oxidants, Vitamin D, Omega-3, Zinc, etc. – Jan 2019 04 Mar, 2019
Estradiol, vitamin D, Omega-3 – RCT Feb 2019 05 Feb, 2019
Multiple Sclerosis and (lots of) Vitamin D - book by patient on Coimbra protocol - Feb 2016 19 Jan, 2019
World's Top Authors in Vitamin D, VDR, Vitamin K, Omega-3, etc - Jan 2019 12 Jan, 2019
Vitamin D search term popularity in Mercola and Google in 2018 24 Dec, 2018
Autism treated in one person by Omega-3 plus Vitamin D – Dec 2018 15 Dec, 2018
Heart problems such as Afib related to little Magnesium, Omega-3, Vitamin D getting to tissues 14 Dec, 2018
APOE4 gene problems (Alzheimer’s) reduced by both Vitamin D and Omega-3 - Dec 2018 12 Dec, 2018
Healthy aging associated with higher levels of both Vitamin D and Omega-3 – Dec 2018 12 Dec, 2018
Vitamin D and Omega-3 may treat Type 1 Diabetes – RCT 2024 24 Nov, 2018
Vitamin D and Omega-3 Ineffective for Preventing Cancer and Heart Disease (too little was used) – Nov 2018 21 Nov, 2018
Farmed fish have 2X less Omega-3, 4X less Vitamin D – May 2017 18 Nov, 2018
Omega-3 reduced vitamin D3 inflammation for obese – RCT Jan 2013 03 Nov, 2018
Autism problems reduced by Vitamin D, Omega-3 – RCT Oct 2018 30 Oct, 2018
Less DNA repair if nutrient deficient (Vitamin D, Magnesium, Omega-3, Vitamin K, etc) – Ames Oct 2018 20 Oct, 2018
ADHD and Vitamin D Deficiency 14 Sep, 2018
Bulk supplementation of Vitamin D, Magnesium, Zinc, B-12, K2, Boron etc. - lower cost and easier than pills 07 Sep, 2018
NAFLD is treated by Vitamin D, Omega-3, Curcumin, Silymarinm, etc. Aug 2018 26 Aug, 2018
Low cost cofactors for vitamin D 11 Aug, 2018
IQ levels around the world are falling (perhaps lower Vitamin D, Iodine, or Omega-3) 01 Aug, 2018
Pancreatic Cancer is increasing – Vitamin D and Omega-3 should reduce the risk 23 Jul, 2018
PCOS treated by a combination of Vitamin D and Omega-3 – RCT Oct 2018 12 Jul, 2018
Multiple Sclerosis treated by 50,000 IU Vitamin D bi-weekly plus Omega-3 – RCT July 2018 07 Jul, 2018
Improve Cognitive Health and Memory with Vitamin D and Omega-3 – World Patent March 2018 28 Jun, 2018
Adding Vitamin D, Omega-3, etc to children’s milk improved memory (yet again) – RCT June 2018 09 Jun, 2018
Olympic Committee consensus on Vitamin D, Omega-3, Zinc, etc– May 2018 07 May, 2018
Pollutants increase Respiratory problems, Vitamin D, Omega-3, etc. decrease them – May 2018 05 May, 2018
Vitamin K2 and Omega-3 associations (how about a vitamin D association) – 2018 01 May, 2018
Italian consensus of recommended Vitamin D, Omega-3, etc – Oct 2016 27 Apr, 2018
Live longer if high Vitamin D or Omega-3 (probably both) 04 Apr, 2018
Omega-3, Vitamin D, Folic acid etc. during pregnancy and subsequent mental illness of child – March 2018 29 Mar, 2018
Depression – is it reduced by Vitamin D and or Omega-3 – RCT 2019 09 Mar, 2018
During NFL season – Omega-3 down by 2.5 points while Vitamin D up by 9 ng – March 2018 03 Mar, 2018
Fish oil increased Vitamin D levels, krill oil decreased them – RCT Jan 2018 27 Jan, 2018
Supplementation while pregnant and psychotic – 20 percent Omega-3, 6 percent Vitamin D – June 2016 20 Jan, 2018
Vitamin D use increased 3.7 X, Omega-3 increased 9 X (US 1999-2012) – JAMA Oct 2016 17 Jan, 2018
Gestational diabetes treated by Vitamin D plus Omega-3 – RCT Feb 2017 02 Jan, 2018
Diesel air pollution causes liver problems (and low vitamin D) if low Omega-3 (mice) – Jan 2018 25 Nov, 2017
Preterm births strongly related to Vitamin D, Vitamin D Receptor, Iodine, Omega-3, etc 13 Nov, 2017
Vitamin D and Omega-3 10 Nov, 2017
Can burn pain be relieved by 4 g of Omega-3 and 2,000 IU of vitamin D – RCT due 2021 18 Oct, 2017
Unipolar depression treated by Omega-3, Zinc, and probably Vitamin D – meta-analysis Oct 2017 11 Oct, 2017
5 supplements that flat out work (Omega-3, Vitamin D, etc.) - examine.com Oct 2017 08 Oct, 2017
Prostate Cancer treatment (Vitamin D, Omega-3, Tumeric) RCT ending Dec 2018 26 Sep, 2017
Serotonin regulated by Vitamin D – part 1 autism – Feb 2014 26 Aug, 2017
Cardiovascular calcification prevented by Omega-3, Magnesium, Vitamin K, and Vitamin D – April 2015 09 Aug, 2017
Importance of Vitamin D and fish rarely mentioned during midwife-led prenatal booking visits – July 2017 07 Aug, 2017
Omega-3 reduced fractures by a quarter (note: Omega-3 increases vitamin D in cells by a quarter) – July 2017 31 Jul, 2017
Fatty liver disease in children nicely treated by combination of Vitamin D and Omega-3 – RCT Dec 2016 09 Jul, 2017
Fish (Omega-3, Vitamin D) as Medicine for Rheumatoid Arthritis – June 2017 21 Jun, 2017
Breast cancer cells killed synergistically by Vitamin D plus Omega-3 (lab) – June 2017 20 Jun, 2017
Hypothesis – anticancer benefits from synergy of omega-3 and vitamin D – May 2011 20 Jun, 2017
Vitamin D monotherapy is good, Vitamin D multitherapy is great 31 May, 2017
Health benefits of seafood: Vitamin D, Omega-3, and Selenium – Jan 2013 26 May, 2017
Cardiovascular diseases – conflicting data on benefits of Omega-3 and vitamin D – Feb 2014 24 May, 2017
Cataracts associated with low Omega-3, Vitamin D, etc – April 2017 16 May, 2017
Type 2 Diabetes helped by Omega-3 and Vitamin D – Feb 2014 03 Jan, 2017
Typical pregnancy is now 39 weeks – Omega-3 and Vitamin D might restore it to full 40 weeks 17 Oct, 2016
Alzheimer’s and Vitamins D, B, C, E, as well as Omega-3, metals, etc. – June 2013 13 Oct, 2016
Traumatic brain injury treated by Vitamin D Progesterone Omega-3 and glutamine – May 2013 11 Sep, 2016
How much vitamin D and other nutrients do I take 11 Jun, 2016
Autism risks include chemicals, deficiency of vitamin D, Omega-3 – mini-review April 2016 10 May, 2016
Kidney failure – still debating what form of vitamin D to use – April 2016 28 Apr, 2016
Sickle Cell children need more than 7,000 IU of vitamin D daily – May 2015 06 Apr, 2016
10 Diseases associated with Multiple Sclerosis are also associated with low Omega-3 and vitamin D – Feb 2016 14 Mar, 2016
Popular supplements 1 Vitamin D, 2 fish oil, 3 CoQ10, 4 multivitamins 5 probiotics - Feb 2016 27 Feb, 2016
Vitamin and Mineral deficiencies – Ames Triage Theory Sept 2012 25 Feb, 2016
Vitamin D, DHA, Folic, Iodine benefits during pregnancy – July 2012 14 Oct, 2015
If you add Omega-3, also add Vitamin E to protect it – Aug 2015 24 Aug, 2015
Omega-3, Vitamin D, and other nutrients decrease mental health problems – March 2015 11 Aug, 2015
Cognitively impaired brain atrophy was slowed 40 percent by Omega-3 and B vitamins – RCT July 2015 15 Jul, 2015
Vitamin D and Omega-3 may reduce cortical atrophy with age – Nov 2013 15 Jul, 2015
Vitamin D, Omega-3 supplementation helps cognition – perhaps due to serotonin – Feb 2015 01 Jun, 2015
Cardiovascular system benefits from both Omega-3 and vitamin D – Dec 2012 14 May, 2015
Fractures reduced 30 percent by Omega-3 (Omega-3 activates vitamin D) – May 2015 13 May, 2015
Supplements survey: Fish oil 1st, Vitamin D 4th, Magnesium 6th, Calcium 7th - March 2015 01 Mar, 2015
Longer time to fall to sleep in winter unless eat salmon (vitamin D and Omega-3) – May 2014 11 Feb, 2015
Salmon intervention (vitamin D and Omega-3) improved heart rate variability and reduced anxiety – Nov 2014 11 Feb, 2015
Vitamin D and Omega-3 are the first focus of Global Nutrition and Health Alliance 18 Sep, 2014
Unsaturated Fatty acids important for both MS and Vitamin D – Oct 2012 24 Nov, 2012
Vitamin D and omega-3 are the only supplements which show benefit in meta-analysis – Jan 2012 24 Nov, 2012
Vitamin D Omega 3 and Exercise are being used in controlled trial to support healthy ageing – Feb 2012 24 Nov, 2012
US supplements survey – 34 percent take omega-3, 30 percent take vitamin D – Aug 2012 24 Nov, 2012




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