Possible Interaction: Steroids and Vitamin D

“Steroid-binding globulins (SBGs) such as sex hormone binding globulin, corticosteroid binding globulin, and vitamin-D binding protein are receiving increasing notice as being actively involved in steroid actions.”

“Summary: Sex steroids were suggested as regulators of vitamin D metabolism.”

“The mean vitamin D levels were higher in the group not receiving steroids when compared to those groups with dosages of 0.5-1mg/kg/d [p=0.048].”

“ Vitamin D3 downregulates cellular adhesion molecule expression by inhibiting TNF-α mRNA expression, which has been suggested as a mechanism that alleviates pruritus in patients with steroid refractory prurigo [7].”

“Steroid resistance and pathologic interleukin (IL)‐17 responses are features of severe asthma, and vitamin D beneficially enhances the response to steroids in these individuals.”

“Vitamin D deficiency is increasingly recognised in association with autoimmune and inflammatory diseases, also with evidence from the field of asthma where vitamin D supplementation may overcome steroid resistance.”

“… steroids … vitamin D catabolism and increase PTH and FGF23 levels; moreover, the cumulative prednisone dose was inversely correlated with 1,25(OH)2D3 levels 2 years … the study although it represents a kind of stone guest in the field of renal transplantation as well as in chronic kidney disease.”

“Although the mechanism through which vitamin D may increase risk is unknown, vitamin D concentration could influence circulating sex steroid hormones that may be associated with prostate cancer; an alternate explanation is that it could be associated with prostate‐specific antigen (PSA) concentration causing detection bias.”

“ Vitamin D may improve lung function and response to steroids therapy , reduce airway remodeling and disease exacerbations.”

“So in accordance with new vitamin D recommendations, we recommend that a child with rheumatic disease, especially if treated with steroids , needs at least 2-3 time higher doses of vitamin D than the dose recommended for age (approximately 2000 UI/day).”