REVIEW article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1576850
Vitamin D Deficiency in Hashimoto's Thyroiditis: Mechanisms, Immune Modulation, and Therapeutic Implications
Provisionally accepted
- Henan Provincial People's Hospital, Zhengzhou, China
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Background: To evaluate vitamin D's role in thyroid autoimmunity modulation, establish evidence-based supplementation protocols, and address surgical implications in HT care. Vitamin D deficiency is prevalent in Hashimoto's thyroiditis (HT) patients and correlates with accelerated autoimmune progression. This review synthesizes mechanistic insights and clinical implications of vitamin D repletion in HT management. Objective: To evaluate vitamin D's role in thyroid autoimmunity modulation, establish evidence-based supplementation protocols, and address surgical implications in HT care. Key Findings: Pathogenic Mechanism: Vitamin D deficiency (25(OH)D <20 ng/mL) disrupts VDR-mediated Treg/Th17 balance, increasing anti-TPO titers by 40-60% and hypothyroidism progression risk. Therapeutic Window: Supplementation (2000-4000 IU/day) reduces antibodies by 15-30% only in euthyroid TPOAb+ patients with baseline deficiency (<20 ng/mL), but efficacy diminishes in overt hypothyroidism. Surgical Imperative: Preoperative optimization (25(OH)D >30 ng/mL) lowers post-thyroidectomy hypocalcemia risk by 50% in HT patients. Conclusion: Vitamin D modulates HT through immune pathway regulation, yet response heterogeneity necessitates: Genotype-guided dosing (VDR-FokI FF carriers require 30% lower doses).Vitamin D supplementation has demonstrated potential to modulate immune responses, alleviate symptoms, and improve quality of life.
Keywords: Vitamin D, Hashimoto's thyroiditis, Thyroid function, Antibody levels, Autoimmunity
Received: 08 Mar 2025; Accepted: 24 Jun 2025.
Copyright: © 2025 Sun, Ding, Wang, Li, Su and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xinhui Wang, Henan Provincial People's Hospital, Zhengzhou, China
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