Venous ulcers healed 4X faster with weekly 50,000 IU vitamin D – RCT Oct 2012

Vitamin D and skin repair: a prospective, double-blind and placebo controlled study in the healing of leg ulcers.

Rev Col Bras Cir. 2012 Oct;39(5):401-407.
[Article in English, Portuguese]
Burkiewicz CJ, Guadagnin FA, Skare TL, Nascimento MM, Servin SC, Souza GD.
Faculdade Evangélica do Paraná, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brasil.

OBJECTIVE:
To analyze the relation between vitamin D insufficiency and wound healing in patients with venous ulcers; to correlate vitamin D insufficiency with characteristics of the ulcer (size and pain) and to evaluate if reposition of vitamin D in these subjects expedites ulcer healing.

METHODS:
We selected 26 patients with leg ulcers, and 26 control patients without ulcers, matched for gender, age, systemic arterial hypertension and tobacco use. The venous ulcer group was divided in two subgroups: one that received placebo (nine patients) and other receiving vitamin D, 50.000 IU per week over two months (13 patients). Blood was collected for 25 OH vitamin D dosage before and after the medication. In the ulcer group, we obtained data concerning demographics, leg ulcer size, as well as pain severity, measured by an analogical visual scale. Data was grouped in contingency and frequency tables, the tests of Fisher and chi-squared being used for nominal variables and Mann-Whitney for numerical variables. The adopted significance was of 5%.

RESULTS:
We found vitamin D insufficiency in the great majority of the patients.
The median level in the ulcer group was 17.05 ng/dl and 22.75 ng/dl in the group without ulcer (p=0,0182)
No relation was found between the ulcer size without treatment and the level of vitamin D.

After treatment, the average size of the ulcer changed from

• 25 cm² to 18 cm² in the patients that took vitamin D and from
• 27 cm² to 24,5 cm² in the placebo group (p=0,7051 and p=0,7877, respectively).

Considering the variability of the size of the ulcer in the treatment group versus placebo group, the average size was equal to -0,75 cm² in the first group and +4cm² in the second (p=0,0676)

CONCLUSION:
Patients with leg ulcers have more vitamin D deficiency.
No difference in the ulcer characteristics was noted between those with and without vitamin D deficiency.
There was a trend toward a better healing in those with vitamin D reposition.

PMID: 23174792
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Decrease in size was computed by VitaminDWiki from the above abstract

Vitamin D: 1 - 18/25 =38%
Placebo: 1 - 24.5/27 = 9%
Ulcers of Vitamin D group decreased 4X faster than placebo group

The results of this small study were not statistically significant, but very interesting.

VitaminDWiki Observations:

Suspect that had the vitamin D deficiency been previously treated that there would have been fewer leg ulcers.
Suspect that many of the leg ulcers were those of diabetics - who typically have a low level of vitamin D

A previous paper on same study by the same authors had the following graphic and caption

Distribution in percentages of serum 25 OH-vitamin D in control subjects (n=58) and with venous ulcers (n=27) with p=0.04.
It can be seen that 46.1% of patients with ulcers have values of 25 OH-vitamin D between 8 and 20 ng/dl and 43% of control patients have values above 30 ng/dl (p=0.04).

Additional possible reasons for low vitamin D levels were given in discussion in the previous paper

The authors speculate that this can be due to the fact that patients with venous ulcers were told to stay at home as part of treatment.
They also use more clothes in order to avoid the unpleasant odor and bad aesthetic appearance of the wounds, factors that can promote deficiency by decreasing the synthesis of epidermal action of ultra violet rays.

PDF (in English) is attached at the bottom of this page

See also VitaminDWiki

• Hard-to-heal Wounds associated with low vitamin D – review June 2021
• 70 % of some skin problems resolved with 7100 IU vitamin D (50000 weekly) – Jan 2011
• Proof that Vitamin D Works
• Search VitaminDWiki for ulcers skin (both words) 164 items as of May 2017
• Venous ulcers 2X more likely if low level of vitamin D – Aug 2012
• Diabetic foot ulcer associated with extremely low vitamin D levels – Sept 2013
• Pressure Ulcers (bed sores) 1.87 more likely if vitamin D less than 25 ng – 2011
• Vitamin D and the skin: Focus on a complex relationship - Nov 2015
• Burns, ulcers, and wounds healed by Vitamin D - many studies

See also web

• Dietary intake in clients with chronic wounds Summer 2011
  increasing wound severity was associated with decreased intakes of vitamin A, vitamin K, magnesium, and protein
• Blog on this study behind a $5/month firewall at Vitamin D Council
• Vitamin D and skin repair: a prospective, double-blind and placebo controlled study in the healing of leg ulcers Sept 2012
  50,000 IU of vitamin D /week - full text online
• The effects of vitamin D supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double-blind, placebo-controlled trial April 2017
  50,000 IU every 2 weeks for 12 weeks - helped a lot
• Association between vitamin D and pressure ulcers in older ambulatory adults: results of a matched case-control study 2011
  "Vitamin D deficiency (levels < 25 ng/mL) was associated with pressure ulcers (odds ratio: 1.871, P = 0.0154). "
   Download the PDF from VitaminDWiki
• The effects of vitamin D supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double-blind, placebo-controlled trial 2017
  "50,000IU vitamin D supplements every 2weeks for 12weeks helped a lot
  -2 vs. -1. cm, width ; -2 vs. -1 cm, length; -1 vs. -0.5cm, depth - many ways other than size reduction
  Publisher wants $36 for the PDF
• 25-Hydroxyvitamin D 25(OH)D levels and diabetic foot ulcer: is there any relationship? July 2013
   Download the PDF from VitaminDWiki

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