The Role of Vitamin D in Autoimmune Thyroid Diseases: From Immunomodulation to Clinical Implications

TL;DR

Vitamin D may influence autoimmune thyroid diseases by modulating immune responses, but its role as a treatment is still unclear.

Contribution

The paper reviews vitamin D's immunomodulatory effects and evaluates its potential as a risk marker versus a therapeutic target in autoimmune thyroid diseases.

Findings

Low vitamin D levels are linked to increased risk of autoimmune thyroid diseases like Hashimoto’s and Graves’ disease.

Vitamin D supplementation may reduce thyroid autoantibodies in some patients with Hashimoto’s and vitamin D deficiency.

Clinical outcomes on disease progression or relapse prevention remain inconsistent and unproven.

Abstract

Vitamin D is involved in immune regulation through effects on innate and adaptive immune responses mediated by vitamin D receptor activation within immune cells. Experimental and translational studies support its role in promoting regulatory T-cell activity, modulating Th1/Th17 responses, and influencing autoantibody production. At the population level, low serum 25-hydroxyvitamin D concentrations are consistently associated with an increased risk of autoimmune diseases, including autoimmune thyroid disorders such as Hashimoto’s thyroiditis (HT) and Graves’ disease (GD), suggesting a potential preventive association. In contrast, clinical evidence from interventional studies in patients with established disease is heterogeneous. Although vitamin D supplementation has been associated with reductions in thyroid autoantibody titers in some studies—particularly in patients with HT and baseline vitamin D deficiency—consistent effects on thyroid function, disease progression, or relapse prevention have not been demonstrated. Overall, current evidence supports vitamin D deficiency as a potentially modifiable risk marker rather than a confirmed disease-modifying therapeutic target in autoimmune thyroid diseases, highlighting the need for further studies focused on clinically meaningful outcomes.

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