Almost 30% of Americans have liver disease, the most common form being non-alcoholic fatty liver disease (NAFLD), which is a manifestation of the metabolic syndrome and obesity. Others have hepatitis C or have injured their liver from drinking too much. The business of liver transplants is a rapidly growing field in medicine due to the dramatic increase in liver disease, mainly secondary to the obesity epidemic.
In December of 2012, Drs. Matthew Kitson and Stuart Roberts of Melbourne Australia published a review of vitamin D and liver disease in the Journal of Hepatology.
The authors report that the literature is rapidly growing and that virtually everyone with liver disease need to be on vitamin D or get UVB exposure. They are both liver experts, and they give this advice unreservedly, despite the fact that some doctors say, “Vitamin D is metabolized by the liver, so it should not be given to patients with liver disease.”
Indeed, the literature shows just the opposite:
- The liver is able to metabolize vitamin D, even in advanced cirrhosis.
- Vitamin D deficiency is almost universal in patients with liver disease.
- In severe liver disease, the blood markers of disease severity (bilirubin, liver enzymes, and albumin) are inversely related to vitamin D levels. That is, the better your vitamin D levels, the better your liver tests.
- In liver transplants, vitamin D deficiency is associated with rejection of the transplant.
- In liver transplant, vitamin D supplements help prevent rejection.
- In hepatitis C, vitamin D levels correlate with better liver function.
- In hepatitis C, two randomized controlled trials show vitamin D supplements improve standard anti-viral treatment effectiveness.
- In the most common liver disease, suffered by up to 30% of Americans, NAFLD, low vitamin D levels are closely associated with severity of inflammation, histology, and fibrosis.
- In animal models of NAFLD, vitamin D supplements improve markers in a dose dependent manner.
- Vitamin D improves the ability of the liver to play its roles in both adaptive and innate immunity.
The authors conclude,
“Vitamin D deficiency is a common problem in chronic liver disease and is closely associated with disease severity. The anti-inflammatory and immune-modulatory properties of vitamin D provide plausible mechanisms by which vitamin D may impact disease progression and severity.”