Ankylosing Spondylitis – should all patients be tested for low vitamin D – not just yet – Jan 2017

Are Systematic Screening for Vitamin D Deficiency and Vitamin D Supplementation Currently Feasible for Ankylosing Spondylitis Patients?

International Journal of Inflammation, Volume 2017 (2017), Article ID 7840150, 10 pages
https://doi.org/10.1155/2017/7840150
Mickael Essouma1 and Jean Jacques N. Noubiap2
1Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
2Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa

 Download the PDF from VitaminDWiki

Beyond its role in calcium and phosphorus metabolism for healthy bone mineralization, there is increasing awareness for vitamin D contribution in modulation of immune reactions. Given that ankylosing spondylitis (AS) is a chronic inflammatory disease involving excess immune/inflammatory activity and posing great therapeutic challenges, it is conceivable to claim that vitamin D treatment may be a safe and effective treatment to influence or modify the primary disease and its related comorbidities. Nevertheless, consistent body of research supporting this hypothesis is still lacking. In this paper, we examine whether systematic screening and treatment for vitamin D deficiency are feasible at present. We will review the immunomodulatory role of vitamin D and its contribution in initiation and progression of AS, as well as how they would determine the occurrence of comorbid conditions.

Our conclusion is that despite the overwhelmed interest about vitamin D treatment in AS patients, systematic screening and treatment for vitamin D deficiency of all AS patients are not feasible as yet. This stresses the need for further extensive well-designed research to prove vitamin D efficacy in AS beyond bone protection. And if utility is proven, personalized treatment regimes, duration of treatment, and threshold values for vitamin D should be provided.

Seems like 23 interactions of AS with Vitamin D are understood

Other health problems which are currently screened for low vitamin D (from the PDF)

"These include patients with

• underlying conditions
  rickets, osteomalacia, osteoporosis, chronic kidney disease, hepatic failure, malabsorption syndromes, hyperparathyroidism, granuloma-forming disorders, and some lymphomas
• taking medications that interact with vitamin D metabolism
  antiseizure medications, glucocorticoids, AIDS medications, ketoconazole, and cholestyramine),
• obese subjects,
• pregnant and lactating women, and
• older adults with history of falls or nontraumatic fractures as well as
• African-American and Hispanic adults and children "

Reference [16]
M. F. Holick, N. C. Binkley, H. A. Bischoff-Ferrari et al., “Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline,” The Journal of Clinical Endocrinology & Metabolism, vol. 96, no. 7, pp. 1911–1930, 2011.