Vitamin D and neurodegenerative diseases

Vitamin D and neurodegenerative diseases

Heliyon Volume 9, Issue 1, January 2023, e12877 https://doi.org/10.1016/j.heliyon.2023.e12877

Neurodegenerative diseases, featured by progressive loss of structure or function of neurons, are considered incurable at present. Movement disorders like tremor and postural instability, cognitive or behavioral disorders such as memory impairment are the most common symptoms of them and the growing patient population of neurodegenerative diseases poses a serious threat to public health and a burden on economic development. Hence, it is vital to prevent the occurrence of the diseases and delay their progress. Vitamin D can be transformed into a hormone in vivo with both genomic and non-genomic actions, exerting diverse physiological effects.

Cumulative evidence indicates that vitamin D can ameliorate neurodegeneration by

  • regulating pertinent molecules and signaling pathways including maintaining Ca2+ homeostasis,

  • reducing oxidative stress,

  • inhibiting inflammation,

  • suppressing the formation and aggregation of the pathogenic protein, etc.

This review updates discoveries of molecular mechanisms underlying biological functions of vitamin D in neurodegenerative diseases including

  • Alzheimer’s disease,

  • Parkinson’s disease,

  • multiple sclerosis, and

  • vascular dementia.

Clinical trials investigating the influence of vitamin D supplementation in patients with neurodegenerative diseases are also summarized. The synthesized information will probably provoke an enhanced understanding of the neuroprotective roles of vitamin D in the nervous system and provide therapeutic options for patients with neurodegenerative diseases in the future.

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Top 10 Neurolocial Disease and Vitamin D - Perplexity AI Aug 2025

Rank Neurological Disease Prevalence/Burden Vitamin D Likelihood Evidence Quality Key Research Findings
1 Stroke Leading cause of death and DALYs from neurological conditions Moderate Mixed - observational shows benefit
RCTs show no prevention effect
Low vitamin D associated with increased stroke risk; supplementation doesn't prevent strokes but may aid rehabilitation
2 Migraine/Tension-Type Headache Most prevalent neurological condition (1.16 billion people globally) High Strong - multiple RCTs show reduced frequency and severity Vitamin D supplementation (1000-4000 IU/day) reduces headache frequency by ~2.7 attacks/month
3 Alzheimer's Disease and Other Dementias
56.9 million cases globally

4th highest DALYs
Moderate-High Strong observational
weak RCT - deficiency doubles risk
supplementation trials mixed
Deficiency increases dementia risk by 53-125%; brain tissue contains vitamin D
linked to cognitive function"
4 Parkinson's Disease 8.5 million cases globally
rapid increase in incidence
Moderate Strong observational
weak RCT - consistent association
limited supplementation studies
Consistent inverse relationship between vitamin D levels and motor symptom severity
5 Epilepsy 50+ million cases worldwide
7th highest contributor to DALYs
Moderate Moderate - some studies show seizure reduction
meta-analysis shows no significant effect
Some studies show 30-40% seizure reduction with supplementation; mixed results in controlled trials
6 Multiple Sclerosis 2.8 million cases globally
higher in northern latitudes
High Strong observational
strong RCT - recent major trial shows significant disease activity reduction
D-Lay MS trial: 100,000 IU every 2 weeks reduced disease activity by 34% vs placebo
7 Diabetic Neuropathy 206 million cases globally (tripled since 1990) Low-Moderate Limited evidence for neuroprotection effects Mainly benefits related to diabetes management rather than direct neuroprotection
8 Motor Neuron Disease/ALS Progressive neurodegenerative disease
5th leading cause of neurological deaths
Low Very limited evidence
mainly theoretical neuroprotective mechanisms
Very limited clinical data; mainly preclinical neuroprotective mechanisms
9 Autism Spectrum Disorder 61.8 million cases globally
9th highest contributor to DALYs
Low-Moderate Limited evidence
mainly developmental and genetic factors
Vitamin D important for brain development; deficiency may worsen behavioral symptoms
10 Traumatic Brain Injury High incidence
major cause of disability
Low-Moderate Limited evidence
mainly related to bone health and falls prevention
Benefits mainly related to bone health and fall prevention rather than brain injury prevention

High Likelihood (Strong Evidence) MS, Headache

Multiple Sclerosis emerges as the condition with the strongest evidence for vitamin D benefits. The landmark D-Lay MS randomized clinical trial published in 2025 demonstrated that high-dose vitamin D (100,000 IU every 2 weeks) significantly reduced disease activity by 34% compared to placebo in early multiple sclerosis patients. This represents the most robust clinical evidence available for vitamin D's therapeutic potential in neurological disease. thelancet

Migraine and Headache Disorders show compelling evidence across multiple randomized controlled trials. Meta-analyses consistently demonstrate that vitamin D supplementation at doses of 1,000-4,000 IU daily reduces headache frequency by approximately 2.7 attacks per month, decreases headache days, and lowers disability scores. The mechanism involves vitamin D's role in regulating serotonin neurotransmission and reducing neuroinflammation. jamanetwork+2

Moderate-High Likelihood

Alzheimer's Disease and Other Dementias present strong observational evidence but mixed results from intervention trials. Vitamin D deficiency increases dementia risk by 53-125%, with the risk markedly increasing below 50 nmol/L. Importantly, vitamin D has been found in brain tissue for the first time, with higher concentrations associated with 25-33% lower odds of cognitive impairment. However, supplementation trials have shown limited success in improving cognitive function once dementia develops. wfneurology+3

Moderate Likelihood: Stroke, PD, Epilepsy

Stroke shows a complex relationship with vitamin D. While observational studies consistently link low vitamin D levels to increased stroke risk, multiple meta-analyses of randomized controlled trials demonstrate that vitamin D supplementation does not prevent stroke occurrence. However, supplementation may aid rehabilitation and recovery after stroke. clevelandclinic+3

Parkinson's Disease demonstrates consistent inverse relationships between vitamin D levels and motor symptom severity across multiple studies. Patients in the highest vitamin D quartile show 65% lower risk of developing Parkinson's disease. Limited supplementation studies suggest potential benefits for motor function, but larger randomized trials are needed. centromedicoabc+2

Epilepsy presents mixed evidence. Some studies report 30-40% seizure reduction with vitamin D supplementation, particularly in children. However, a recent meta-analysis found no statistically significant effect of vitamin D supplementation on seizure frequency, indicating the need for more rigorous controlled trials. michiganneurologyassociates+3

Low-Moderate Likelihood

Diabetic Neuropathy , while rapidly increasing globally, shows limited direct evidence for vitamin D neuroprotection. Benefits appear primarily related to diabetes management rather than direct neural protection.

Autism Spectrum Disorder has limited evidence, mainly focused on vitamin D's role in brain development and the observation that deficiency during pregnancy may increase autism risk.

Traumatic Brain Injury shows minimal direct evidence for vitamin D's neuroprotective effects, with benefits mainly related to bone health and fall prevention.

Low Likelihood – ALS

Motor Neuron Disease/ALS has very limited clinical evidence, despite theoretical neuroprotective mechanisms. The evidence remains largely preclinical with minimal human intervention data.

Key Mechanisms of Action

Vitamin D exerts its neurological effects through several mechanisms: neurology+2

  • Neuroprotection : Reduces neuronal apoptosis and supports neuronal survival

  • Anti-inflammatory : Inhibits NF-κB activation and reduces neuroinflammation

  • Neurotransmitter regulation : Modulates serotonin, dopamine, and GABA systems

  • Calcium homeostasis : Essential for synaptic transmission and plasticity

  • Gene expression : Regulates thousands of genes important for brain function

  • Immune modulation : Reduces autoimmune responses in conditions like multiple sclerosis

Clinical Implications

The evidence suggests that vitamin D deficiency assessment should be routine in neurological practice, particularly for conditions showing moderate to high likelihood of benefit. While supplementation shows promise for several conditions, optimal dosing and treatment duration require further investigation through well-designed randomized controlled trials.

For conditions with strong evidence (multiple sclerosis, migraine), vitamin D supplementation appears to offer meaningful clinical benefits as adjunctive therapy. For conditions with moderate evidence, supplementation may be considered given the favorable safety profile and potential benefits, while recognizing the need for additional research to establish definitive efficacy.

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