Several papers reported increased risk of anemia for those with lower serum 25-hydroxyvitmin D [25(OH)D] levels.
A study in Australia on those with noncholestatic chronic liver disease (CLD) found serum 25(OH)D levels of less than 25 nmol/L predicted coagulopathy, hyperbilirubinemia, hypoalbuminemia, increased alkaline phosphatase, and anemia and thrombocytopenia. Vitamin D inadequacy is common in noncholestatic CLD and correlates with disease severity, but secondary hyperparathyroidism is relatively infrequent. Management of CLD should include assessment of vitamin D status in all patients and replacement when necessary1.
A study of pregnant women in Tanzania with low serum 25(OH)D levels had a 46% higher risk of developing anemia than those with adequate serum 25(OH)D levels2.
In a study of chronic kidney disease patients in the United States, 41% had anemia. Both 25(OH)D and 1,25-dihydroxyvitmin D [1,25(OH)2D] levels were associated with decreased hemoglobin levels and anemia in this study3.
A study in Los Angeles found vitamin D deficiency correlated with presence of anemia: Vitamin D has been suggested to have an effect on erythropoiesis. We sought to evaluate the prevalence of anemia in a population of individuals with vitamin D deficiency compared with those with normal levels in a population of a large integrated healthplan. A cross-sectional analysis in the period 1 January 2004 through 31 December 2006 of subjects with documented concurrent levels of 25-hydroxyvitamin D and hemoglobin were evaluated. Vitamin D deficiency was defined as <30 ng/mL and anemia was defined as a hemoglobin <11 g/dL. A total of 554 subjects were included in the analysis. Anemia was present in 49% of 25-hydroxyvitamin D-deficient subjects compared with 36% with normal 25-hydroxyvitamin D levels (p < 0.01). Odds ratio for anemia in subjects with 25-hydroxyvitamin D deficiency using logistic regressions and controlling for age, gender, and chronic kidney disease was 1.9 (95% CI 1.3-2.7). 25-hydroxyvitamin D-deficient subjects had a lower mean Hb (11.0 vs. 11.7; p = 0.12 ) and a higher prevalence of erythrocyte stimulating agent use (47% vs. 24%; p < 0.05). This study demonstrates an association of vitamin D deficiency and a greater risk of anemia, lower mean hemoglobin, and higher usage of erythrocyte-stimulating agents. Future randomized studies are warranted to examine whether vitamin D directly affects erythropoiesis4.
In a cross-sectional study in the United States, “Vitamin D deficiency was associated with anemia prevalence independent of age, sex, or race/ethnicity (OR 1.47, 95% CI 1.06; 2.05, p=0.02) and varied significantly by anemia subtype (p overall =0.003). The prevalence of vitamin D deficiency was 33.3% in the non-anemic population, 56% in anemia of inflammation (AI) (p=0.008), and 33.0% in unexplained anemia (p=0.55). Non-Hispanic blacks had a 7-fold increased risk of AI compared with whites, and this was partially attenuated after adjusting for vitamin D deficiency5.”
Thus, there is good evidence that lower vitamin D levels are associated with increased risk for anemia.
Page last edited: 08 May 2011
- Fisher, L. Fisher, A. Vitamin D and parathyroid hormone in outpatients with noncholestatic chronic liver disease. Clin Gastroenterol Hepatol. 2007 Apr; 5 (4): 513-20.
- Mehta, S. Giovannucci, E. Mugusi, F. M. Spiegelman, D. Aboud, S. Hertzmark, E. Msamanga, G. I. Hunter, D. Fawzi, W. W. Vitamin D status of HIV-infected women and its association with HIV disease progression, anemia, and mortality. PLoS One. 2010; 5 (1): e8770.
- Patel, N. M. Gutierrez, O. M. Andress, D. L. Coyne, D. W. Levin, A. Wolf, M. Vitamin D deficiency and anemia in early chronic kidney disease. Kidney Int. 2010 Apr; 77 (8): 715-20.
- Sim, J. J. Lac, P. T. Liu, I. L. Meguerditchian, S. O. Kumar, V. A. Kujubu, D. A. Rasgon, S. A. Vitamin D deficiency and anemia: a cross-sectional study. Ann Hematol. 2010 May; 89 (5): 447-52.
- Perlstein, T. S. Pande, R. Berliner, N. Vanasse, G. J. Prevalence of 25-hydroxyvitamin D deficiency in subgroups of elderly persons with anemia: association with anemia of inflammation. Blood. 2011 Jan 14;
- Constantini, N. W. Arieli, R. Chodick, G. Dubnov-Raz, G. High prevalence of vitamin D insufficiency in athletes and dancers. Clin J Sport Med. 2010 Sep; 20 (5): 368-71.
- Cannell, J. J. Hollis, B. W. Sorenson, M. B. Taft, T. N. Anderson, J. J. Athletic performance and vitamin D. Med Sci Sports Exerc. 2009 May; 41 (5): 1102-10.