Prolonged high dose daily oral vitamin D3 in the management of psoriasis: A retrospective chart analysis

• Author Details:   
• Renu Mahtani
• Sudhir Singh ^*
• Pradeep MK Nair
• Satya Prakash Singh
• Mankul Goyal

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Background: Autoimmune disorders, particularly psoriasis, are often associated with vitamin D deficiency and vitamin D resistance. Higher daily doses of vitamin D3 are considered effective in overcoming vitamin D resistance and reversing psoriasis symptoms. This study was conducted to evaluate the safety and efficacy of individualized, prolonged high-dose daily oral vitamin D3 therapy in patients with moderate-to-severe psoriasis.

Materials and Methods: In this study, we present data from 95 patients with moderate-to-severe psoriasis who underwent individualized high-dose daily oral vitamin D3 (cholecalciferol) therapy. From this cohort, six representative cases are described in detail to illustrate the approach to personalized dosing and the monitoring process using biochemical markers such as parathyroid hormone (PTH) and ionized calcium. The efficacy of the intervention was assessed using Psoriasis Area and Severity Index (PASI) scores, while safety was evaluated through regular monitoring of serum creatinine and ionized calcium levels. Statistical analyses were conducted to examine the relationship between vitamin D3 dosage, serum 25(OH)D levels, PTH suppression, and clinical improvement.

Results: Significant clinical improvement or remission was noted, without hypercalcemia or toxicity. PTH levels consistently declined in parallel with clinical response, suggesting vitamin D action.

Conclusion: Monitored oral vitamin D3 therapy in higher than supplemental dose, can be a safe and effective treatment for psoriasis.