A new randomized controlled trial out of Brazil suggests that vitamin D may help in healing leg ulcers.
The study, led by Claudine Juliana Burkiewicz and colleagues out of Evangelical University Hospital of Curitiba, examined whether vitamin D had any beneficial effect on the healing of leg ulcers versus placebo.
Ulcers are wounds or open sores that will not heal or keep returning. A number of comorbidities like poor circulation, high blood pressure, diabetes and other conditions that impair blood circulation can cause them. For most patients, ulcers are treated inadequately, with nearly half of cases lasting a year and nearly 40% of cases lasting between two to ten years. Here, the authors studied venous ulcers, which account for 80 to 90 percent of all leg ulcers and affect over a half-million people in the United States every year. Traditional treatments include leg compression and topical dressings, as well as casts.
The researchers believed that vitamin D could play a role because of its regulatory effect on keratinocytes, which can affect wound healing. Keratinocytes are the predominate cells on the skin’s outermost layer, and vitamin D plays a significant hand in the growth and differentiation of these cells.
The researchers recruited 26 patients with chronic leg ulcers. They also recruited 26 patients without leg ulcers to act as controls, to see how the group with leg ulcers looked in comparison. The researchers found that the vitamin D levels in ulcer patients was a median 17.1 ng/ml compared to 22.8 ng/ml in the control group.
The 26 ulcer patients were then screened (4 did not meet inclusion criteria) and then randomized to receive either vitamin D at 50,000 IU/week or placebo for two months. Nine patients received placebo, thirteen received the vitamin D. There was no mention of whether the vitamin D was D3 or D2.
Here is what they found:
- The researchers did not observe a statistically significant difference in ulcer size between the two groups after the course of vitamin D or placebo treatment.
However, when analyzing the change in ulcer size pre and post treatment, here is what they found:
- Vitamin D decreased the size of ulcers in the vitamin D group by a median .75cm2.
- The placebo group experienced a median increase of 4cm2.
- These finding weren’t quite statistically significant (p=.06), but trending.
Limitations of their findings are small number of subjects and small length of study. These short comings could explain their inability to reach statistical significance, but they also leave open the possibility that the “trending” observed was by chance. Put bluntly, the authors state, “Replacement of vitamin D in deficient individuals did not accelerate healing of ulcers, although it displayed a tendency to do so.”
They also note:
“Presently, venous ulcers have no effective therapeutic options and have a high treatment cost due to very slow healing…The study of vitamin D as a potential treatment can be a worthwhile innovation.”
For the time being, this study gives some reason to make sure patients with leg ulcers are sufficient in vitamin D, and it also paves the way for more research in the area.