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Vitamin D

Treatment
Wellness
Risk
Access
Cautions
Integrative
Plans
Dosing
More
Information

Vitamin D is fat-soluble vitamin created by the body when skin is exposed to ultraviolet rays in sunlight. It is also found naturally in a small number of foods:¹

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Treating the Cancer

Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action

Clinical Evidence

Benefits seen from vitamin D status or use in treatment:

• Regression and improved metabolic status in cervical intraepithelial neoplasia grade 1⁵
• Slowing of the rate of rise of prostate specific antigen (PSA) in men in a small trial, in combination with naproxen⁶
• Enhanced effects of cryotherapy and radiation therapy⁷
• Higher vitamin D status is strongly associated with better breast cancer survival.⁸

A deficiency of vitamin D has been associated with these outcomes:

• Reduced effectiveness of the medication rituximab in patients with diffuse large B-cell lymphoma⁹
• Lower odds of receiving a pathologic complete response to breast cancer treatment¹⁰
• Breast cancer metastasis¹¹

Vitamin D supplementation "plays an important role in disease-free survival in a number of cancers, particularly breast."¹²

Managing Side Effects and Promoting Wellness

Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being

Cinical Evidence

Benefits with symptoms seen from vitamin D use:

• Improved pain and muscle strength in patients with advanced hormone-refractory prostate cancer¹³
• Improved bone health in patients with prostate cancer or breast cancer when used with calcium¹⁴

Reducing Risk

Reducing the risk of developing cancer or the risk of recurrence

Vitamin D has been associated with lower risks of cancer and cancer mortality.

Clinical Evidence

• Reduced risk of breast cancer¹⁵
• Modest but significantly lower risk of mortality from all cancer types in a review of four trials involving more than 40,000 patients¹⁶
• Reduced risk of colorectal cancer in women not undergoing estrogen therapy; estrogen therapy interacted with this benefit¹⁷
• Reduced risk of melanoma in women with history of nonmelanoma skin cancer¹⁸

A deficiency of vitamin D has been associated with these cancers:

• Advanced pancreatic cancer
• Colorectal cancer

However, vitamin D is also associated with an increased risk of aggressive prostate cancer, and high levels are associated with increased risk of pancreatic cancer, even though a deficiency is also associated with advanced pancreatic cancer..¹⁹

Lab and Animal Evidence

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Cautions

Vitamin D is generally considered safe at moderate levels. A few rare adverse reactions and drug interactions are noted on the About Herbs website.

What’s the Right Amount of Vitamin D?

The Vitamin D Council website provides information about vitamin D testing and a table to assist in interpreting the results.

Higher levels can lead to calcinosis (the deposit of calcium salts in tissues such as the kidneys, heart or lungs) and hypercalcemia.²¹ Increased levels may also significantly increase risk of aggressive prostate cancer. High vitamin D blood levels (greater than or equal to 100 nmol/L) are associated with increased risk of pancreatic cancer.²²

Individuals with disorders of calcium metabolism, gastrointestinal disease, kidney disease, heart disease or liver disease should consult a physician before using vitamin D supplements.

Access

Vitamin D supplements are widely available in two forms: D₂ and D₃. The Vitamin D Council website recommends taking vitamin D₃ (cholecalciferol) rather than vitamin D₂.²³

Dosing

BCCT does not recommend therapies or doses, but only provides information for patients and providers to consider as part of a complete treatment plan. Patients should discuss therapies with their physicians, as contraindications, interactions and side effects must be evaluated. Levels of active ingredients of natural products can vary widely between and even within products. See Quality and Sources of Herbs, Supplements and Other Natural Products.

The National Academies Health and Medicine Division (formerly the Institute of Medicine) recommends a Daily Dietary Allowance of vitamin D at 600 IU/day (increasing to 800 IU/day at age 71) with the Upper Level Intake at 4,000 IU/day starting at age nine for healthy individuals.²⁴

Dosage recommendations with cancer are available from these sources:

• Your Health Solution
• Bladder Cancer Supplement Recommendations
• Breast Cancer Supplement Recommendations
• Colorectal Cancer Supplement Recommendations
• Endometrial Cancer Supplement Recommendations
• Leukemia Supplement Recommendations
• Lung Cancer Supplement Recommendations
• Lymphoma Supplement Recommendations
• Melanoma Supplement Recommendations
• Prostate Cancer Supplement Recommendations
• Renal Cancer Supplement Recommendations
• Thyroid Cancer Supplement Recommendations
• Therapeutic Research Center Natural Medicines Database (requires purchase)
• Also see the protocols below.

Integrative Plans, Protocols and Medical Systems

• Plans, protocols and programs
• Abrams & Weil integrative medicine approaches²⁵
  • Breast cancer
  • Colorectal cancer
  • Lung cancer
  • Prostate cancer
• Alschuler & Gazella complementary approaches²⁶
  • Breast cancer
  • Colon cancer
  • Kidney cancer
  • Lung cancer
  • Melanoma
  • Ovarian cancer
  • Prostate cancer
• Bastyr University Integrative Oncology Research Center protocol for stage IV breast cancer²⁷
• Block program²⁸
  • Core diet plan: vitamin supplementation
  • Symptom management: osteoporosis
  • Glycemic support and terrain modification
  • Progression pathway targeting
  • Remission maintenance program: chemoprevention
• Chang strategies²⁹
• Lemole, Mehta & McKee protocols³⁰
  • Bladder cancer
  • Breast cancer
  • Colorectal cancer
  • Endometrial cancer
  • Leukemia
  • Lung cancer
  • Lymphoma
  • Melanoma
  • Prostate cancer
  • Renal cancer
  • Thyroid cancer
• McKinney protocols³¹
  • General cancer
  • Breast cancer
  • Leukemia
  • Lung cancer
  • Lymphoma
  • Melanoma
  • Multiple myeloma
  • Myelodysplastic syndrome
  • Pancreatic cancer
  • Prostate cancer
  • Sarcoma
  • Skin cancer

Written by Nancy Hepp, MS, with review by Laura Pole, RN, MSN, OCNS; most recent update January 15, 2019. Note: BCCT has not conducted an independent review of research of Vitamin D. This information draws from the About Herbs website, the National Cancer Institute: Prostate Cancer, Nutrition, and Dietary Supplements (PDQ®)–Health Professional Version, and other sources as noted.

1. Office of Dietary Supplements. Vitamin D Fact Sheet for Health Professionals. National Institutes of Health. February 11, 2016. Viewed November 30, 2017; Vitamin D. Council. What is vitamin D? Viewed November 30, 2017; Onusic S. Debunking the absurd notion of vitamin D in mushrooms. The Healthy Home Economist. March 12, 2017. Viewed November 30, 2017.
2. Keegan RJ, Lu Z, Bogusz JM, Williams JE, Holick MF. Photobiology of vitamin D in mushrooms and its bioavailability in humans. Dermatoendocrinology. 2013 Jan 1;5(1):165-76.
3. Derrer DT. March 20, 2016. Top foods for calcium and vitamin D. WebMD. Viewed November 30, 2017.
4. Office of Dietary Supplements. Vitamin D Fact Sheet for Health Professionals. National Institutes of Health. February 11, 2016. Viewed November 30, 2017; Vitamin D. Council. What is vitamin D? Viewed November 30, 2017.
5. Vahedpoor Z, Jamilian M et al. Effects of long-term vitamin D supplementation on regression and metabolic status of cervical intraepithelial neoplasia: a randomized, double-blind, placebo-controlled trial. Hormones & Cancer. 2017 Feb;8(1):58-67.
6. Srinivas S, Feldman D. A phase II trial of calcitriol and naproxen in recurrent prostate cancer. Anticancer Research. 2009 Sep;29(9):3605-10.
7. National Cancer Institute: Prostate Cancer, Nutrition, and Dietary Supplements (PDQ®)–Health Professional Version. October 20, 2017. Viewed November 30, 2017.
8. Kim Y, Je Y. Vitamin D intake, blood 25(OH)D levels, and breast cancer risk or mortality: a meta-analysis. British Journal of Cancer. 2014 May 27;110(11):2772-84.
9. Bittenbring JT, Neumann F et al. Vitamin D deficiency impairs rituximab-mediated cellular cytotoxicity and outcome of patients with diffuse large B-cell lymphoma treated with but not without rituximab. Journal of Clinical Oncology. 2014 Oct 10;32(29):3242-8.
10. Chiba A, Raman R et al. Serum vitamin D levels affect pathologic complete response in patients undergoing neoadjuvant systemic therapy for operable breast cancer. Clinics in Breast Cancer. 2017 Dec 11. pii: S1526-8209(17)30324-5.
11. NCI Staff. Vitamin D deficiency may promote spread of some breast cancers. National Cancer Institute. April 14, 2016. Viewed November 30, 2017.
12. Griffin N, Dowling M. Vitamin D supplementation and clinical outcomes in cancer survivorship. British Journal of Nursing. 2018 Oct 18;27(19):1121-1128.
13. Van Veldhuizen PJ, Taylor SA, Williamson S, Drees BM. Treatment of vitamin D deficiency in patients with metastatic prostate cancer may improve bone pain and muscle strength. Journal of Urology. 2000 Jan;163(1):187-90.
14. Handforth C, D'Oronzo S, Coleman R, Brown J.  Cancer treatment and bone health. Calcified Tissue International. 2018 Feb;102(2):251-264.
15. Sofi NY, Jain M et al. Reproductive factors, nutritional status and serum 25(OH)D levels in women with breast cancer: A case control study. Journal of Steroid Biochemistry and Molecular Biology. 2018 Jan;175:200-204.
16. Bjelakovic G, Gluud LL et al. Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Systematic Reviews. 2014 Jan 10;(1):CD007470.
17. Ding EL, Mehta S, Fawzi WW, Giovannucci EL. Interaction of estrogen therapy with calcium and vitamin D supplementation on colorectal cancer risk: reanalysis of Women's Health Initiative randomized trial. International Journal of Cancer. 2008 Apr 15;122(8):1690-4.
18. Tang JY, Fu T et al. Calcium plus vitamin D supplementation and the risk of nonmelanoma and melanoma skin cancer: post hoc analyses of the women's health initiative randomized controlled trial. Journal of Clinical Oncology. 2011 Aug 1;29(22):3078-84.
19. Van Loon K, Owzar K et al. 25-Hydroxyvitamin D levels and survival in advanced pancreatic cancer: findings from CALGB 80303 (Alliance). Journal of the National Cancer Institute. 2014 Aug 6;106(8). pii: dju185.
20. Krishnan AV, Swami S, Feldman D. Equivalent anticancer activities of dietary vitamin D and calcitriol in an animal model of breast cancer: importance of mammary CYP27B1 for treatment and prevention. Journal of Steroid Biochemistry and Molecular Biology. Jul 2013;136:289-295.
21. National Cancer Institute. Vitamin D and Cancer Prevention. October 21, 2013. Viewed November 30, 2017.
22. Memorial Sloan Kettering Cancer Center. About Herbs: Vitamin D. September 14, 2017. Viewed November 30, 2017.
23. Vitamin D. Council. How do I get the vitamin D my body needs? Viewed January 15, 2018.
24. The National Academies Health and Medicine Division. DRIs for Calcium and Vitamin D. November 30, 2010. Viewed November 30, 2017.
25. Abrams DI, Weil AT. Integrative Oncology, 2nd Edition. New York, NY: Oxford University Press. 2014.
26. Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010; Alschuler LN, Gazella KA. The Definitive Guide to Thriving after Cancer. Berkeley, California: Ten Speed Press. 2013.
27. McKinney N. Naturopathic Oncology, 3rd Edition. Victoria, BC, Canada: Liaison Press. 2016. p. 316.
28. Block KI. Life over Cancer: The Block Center Program for Integrative Cancer Treatment. New York: Bantam Dell. 2009.
29. Chang R. Beyond the Magic Bullet: The Anti-Cancer Cocktail. New York: Square One Publishers. 2012.
30. Lemole G, Mehta P, McKee D. After Cancer Care: The Definitive Self-Care Guide to Getting and Staying Well for Patients with Cancer. New York, New York: Rodale, Inc. 2015.
31. McKinney N. Naturopathic Oncology, 3rd Edition. Victoria, BC, Canada: Liaison Press. 2016.
32. Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010.
33. Autier P, Mullie P et al. Effect of vitamin D supplementation on non-skeletal disorders: a systematic review of meta-analyses and randomised trials. Lancet Diabetes & Endocrinology. 2017 Dec;5(12):986-1004.

View All References

More Information

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4037823/Memorial Sloan Kettering Cancer Center. About Herbs: Vitamin D
• National Cancer Institute: Prostate Cancer, Nutrition, and Dietary Supplements (PDQ®)–Health Professional Version
• American Institute for Cancer Research (refine the search for a specific type of cancer)   
• Vitamin D Council: About Vitamin D
• TRC Natural Medicines database (subscription required): in-depth information, ratings of effectiveness and safety and evaluation of specific vitamin D products
• Consumer Labs: Product Review (subscription required): Vitamin D Supplements Review (Including Calcium, Vitamin K, Magnesium)
• Moss Reports (purchase required): Select from the list of cancers down the left side of the page for a report describing uses of conventional, complementary, alternative and integrative therapies related to that cancer. Ralph Moss is among the most knowledgeable and balanced researchers of integrative cancer therapies. The cost of his Moss Reports is not negligible, but many patients find them of considerable value. Moss is also available for consultations.
• National Cancer Institute: Complementary and Alternative Medicine for Health Professionals
• National Cancer Institute: Office of Cancer Complementary and Alternative Medicine
• Lone Star Medical Group: Natural Alternative Treatments
• Keith I. Block, MD: Life over Cancer: The Block Center Program for Integrative Cancer Treatment
• Lise Alschuler, ND, FABNO, and Karolyn Gazella: The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing
• Neil McKinney, BSc, ND: Naturopathic Oncology, 3rd Edition
• Donald I. Abrams, MD, and Andrew T. Weil, MD: Integrative Oncology, 2nd Edition
• Raymond Chang, MD: Beyond the Magic Bullet: The Anti-Cancer Cocktail
• National Cancer Institute at the National Institutes of Health: PDQ® Cancer Information Summaries
• The New School at Commonweal: Dwight McKee, MD: 40 Years Practicing Integrative Cancer Medicine, Part 2
• Dwight McKee, MD, editor: Clinical Pearls
• Keith Block and others: A Broad-Spectrum Integrative Design for Cancer Prevention and Therapy