Prolonged high dose daily oral vitamin D3 in the management of psoriasis: A retrospective chart analysis

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Prolonged high dose daily oral vitamin D3 in the management of psoriasis: A retrospective chart analysis
Renu Mahtani, Sudhir Singh, Pradeep MK Nair, Satya Prakash Singh & Mankul Goyal

Published in IP Indian Journal of Clinical and Experimental Dermatology on 26 September 2025
Link: https://doi.org/10.18231/j.ijced.89447.1758864688

Abstract:
Background: Autoimmune disorders, particularly psoriasis, are often associated with vitamin D deficiency and vitamin D resistance. Higher daily doses of vitamin D3 are considered effective in overcoming vitamin D resistance and reversing psoriasis symptoms. This study was conducted to evaluate the safety and efficacy of individualized, prolonged high‑dose daily oral vitamin D3 therapy in patients with moderate‑to‑severe psoriasis.
Materials and Methods: In this study, we present data from 95 patients with moderate‑to‑severe psoriasis who underwent individualized high‑dose daily oral vitamin D3 (cholecalciferol) therapy. From this cohort, six representative cases are described in detail to illustrate the approach to personalized dosing and the monitoring process using biochemical markers such as parathyroid hormone (PTH) and ionized calcium. The efficacy of the intervention was assessed using Psoriasis Area and Severity Index (PASI) scores, while safety was evaluated through regular monitoring of serum creatinine and ionized calcium levels. Statistical analyses were conducted to examine the relationship between vitamin D3 dosage, serum 25(OH)D levels, PTH suppression, and clinical improvement.
Results: Significant clinical improvement or remission was noted, without hypercalcemia or toxicity. PTH levels consistently declined in parallel with clinical response, suggesting vitamin D action.
Conclusion: Monitored oral vitamin D3 therapy in higher than supplemental dose, can be a safe and effective treatment for psoriasis.

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Notebook LLM Audio Summary Podcast Generation (AI generated).

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This is a new and highly relevant study for anyone with CH considering or already following the Vitamin D3 Anti-Inflammatory Regimen. In participants with baseline 25(OH)D3 levels below 20ng/mL, researchers used the same loading dose of 600,000 IU that the regimen recommends. What makes this particularly interesting is that their maintenance doses were substantially higher than the standard 10,000 IU per day typically required to sustain serum levels in the 80–100 ng/mL range.

Across roughly ninety patients these higher doses were well tolerated, with no evidence of renal impairment or disturbances in calcium homeostasis. This offers compelling reassurance for CH'ers who may feel uneasy about achieving or maintaining the regimen’s target vitamin D levels. Regular monitoring remains essential, but this study reinforces that the dosing strategy is safe when managed appropriately. It also suggests that if some CH'ers fail to achieve a therapeutic response with the base regimen they may entertain elevating their 25(OH)D3 level higher in order to reach a therapeutic threshold (again with close monitoring of labs).