Vitamin D
Vitamin D: What 339 human studies show, including 228 randomized controlled trials – ordered by area of application and strength of evidence.
We evaluated 339 human studies on Vitamin D, including 228 randomised controlled trials and 88 meta-analyses or systematic reviews; the controlled studies include 142,839 participants in total. As of 3 October 2026.
1. What Is Vitamin D? Occurrence, Origin and Forms
Vitamin D is a group of fat-soluble vitamins, the most important being vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol). The body makes vitamin D3 itself in the skin when it is exposed to the sun's UVB radiation; the liver and kidneys convert it into the storage form 25-hydroxyvitamin D and the active hormone form.
Food provides little vitamin D, mainly from oily sea fish, cod liver oil, egg yolk and mushrooms exposed to UV light. At our latitudes, sunlight in the winter half-year is hardly enough for the body's own production.
Vitamin D3 for supplements is mostly obtained from wool fat (lanolin), for vegan products from lichen; vitamin D2 is made from yeast or fungi. Studies test daily, weekly or infrequent high single doses.
Forms and Preparations Studied
- Vitamin D3 (cholecalciferol) as capsule, tablet or drops
- Vitamin D2 (ergocalciferol)
- Calcifediol (25-hydroxyvitamin D) taken by mouth
- Vitamin D combined with calcium, vitamin K2 or omega-3
- Sunlight and UVB light for the body's own production
Not covered on this page:
- Active vitamin D hormones and analogues as medicines (calcitriol, alfacalcidol, paricalcitol) in kidney and parathyroid disease
- Topical vitamin D analogues for psoriasis (calcipotriol)
2. What Does Vitamin D Do? Results by Area
| Area | Result in controlled studies | Strength of evidence | Studies | Participants |
|---|---|---|---|---|
| Infections and immune system | mostly improved | high | 19 meta-analyses · 40 controlled · 6 other | 7,232 |
| Bones, falls and fractures | mixed | high | 6 meta-analyses · 41 controlled · 8 other | 11,754 |
| Blood sugar and metabolism | mixed | high | 14 meta-analyses · 31 controlled · 6 other | 46,556 |
| Heart, circulation and blood pressure | mostly no difference | high | 11 meta-analyses · 30 controlled · 3 other | 26,146 |
| Mood and depression | mostly improved | high | 5 meta-analyses · 17 controlled · 0 other | 4,067 |
| Pregnancy and children | mixed | high | 5 meta-analyses · 10 controlled · 5 other | 5,476 |
| Autoimmune diseases | mostly improved | high | 4 meta-analyses · 3 controlled · 1 other | 416 |
| Muscle strength | mostly improved | moderate | 2 meta-analyses · 19 controlled · 3 other | 3,004 |
| Cancer risk and course | mixed | low | 0 meta-analyses · 7 controlled · 1 other | 22,796 |
| Other outcomes | mostly improved | high | 41 meta-analyses · 171 controlled · 22 other | 57,783 |
How to read the table: counted are human studies whose results concern the area. “High” means at least one meta-analysis and two controlled studies showing improvement, or at least three controlled studies of which three quarters show improvement, with at least 300 participants in total. “Moderate” means at least two controlled studies showing improvement, as a majority, or one meta-analysis alongside controlled studies. “Low” means one controlled study showing improvement. Where an area has no controlled study, the strength of evidence is at most “low” (result “reviews only” or “observational data only”). Everything else is “unclear”. A study counts as showing improvement when at least half of its outcomes in this area improved. Reviews of combination products do not count as meta-analyses; results that only describe side effects or shares of users do not count as an effect. The same study is counted only once.
3. What the Studies Show in Detail
Vitamin D, Infections and Immune System: Human Studies
For COVID-19, mortality under vitamin D was lower in two meta-analyses and one controlled study, but not robust in one meta-analysis 3153225. In this meta-analysis, ICU admission and ventilation remained without a difference 53, and one review warns that small studies overestimate the benefit 84. In children with asthma, severe attacks decreased in a meta-analysis compared with placebo and in a controlled study under a higher dose 46191. Inflammation markers such as CRP fell more strongly in meta-analyses in type 2 diabetes and in dialysis patients than under control 3664. Overall, vitamin D did not prevent respiratory infections in children in two meta-analyses and one controlled study 1324134, but in schoolchildren in winter the number of days of illness fell 159. Vitamin D did not prevent tuberculosis in one meta-analysis 14. Investigated were predominantly oral vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol) preparations as well as calcifediol. The results depend on form, dose and baseline levels, and many studies were small or short.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 2 Chen et al. 2021 | meta-analysis · 536,105 participants | Vitamin D supplements (form not specified); vs. placebo/control or higher vs. lower vitamin D levels | COVID-19 infection risk with vitamin D deficiency <20 ng/ml: no difference (OR for < 20 ng/ml: 1.61, 95% CI: 0.92-2.80); in-hospital death with vitamin D deficiency <20 ng/ml: no difference (OR for < 20 ng/ml: 2.18, 95% CI: 0.91-5.26); in-hospital death with vitamin D insufficiency <30 ng/ml: no difference (OR for < 30 ng/ml: 3.07, 95% CI: 0.64-14.78) |
| 9 Wang et al. 2024 | meta-analysis · 35,160 participants | Vitamin D supplements; vs. Placebo | Antibiotic use in the general population: no difference (OR = 0.98, p = 0.232); Antibiotic use in elderly participants: no difference (OR = 0.98, p = 0.295); Antibiotic use in participants under 70 years: improved (OR = 0.95, p = 0.015) |
| 11 Meng et al. 2025 | meta-analysis · 19,586 participants | Vitamin D supplementation; vs. Placebo or standard treatment | tuberculosis infection (prevention): unclear (RR 0·75; 95% CI 0·56 to 1·01); sputum smear conversion: no difference; sputum culture conversion: no difference |
| 13 Wang et al. 2025 | meta-analysis · 18,372 participants | Oral vitamin D supplementation; Daily low-dose ≤ 1000 IU/day vs. higher doses; vs. Placebo or no treatment | ARI incidence: no difference (RR = 0.82, 95% CI: 0.64 to 1.06); Hospitalization duration: no difference (MD = 0.03 days, 95% CI: -0.72 to 0.78); Recovery time: no difference (MD = -4.36 h, 95% CI: -11.87 to 3.15) |
| 14 Liu et al. 2025 | meta-analysis · 15,677 participants | Vitamin D supplementation; vs. Placebo | Risk of tuberculosis infection: no difference (OR: 0.95; 95% CI: 0.79-1.14; p = 0.55); Development of active tuberculosis: no difference (OR: 0.77; 95% CI: 0.56-1.05; p = 0.10) |
| 17 Hsu et al. 2026 | systematic review · 11,600 participants | Vitamin D supplements (form not reported); vs. Placebo or control in included RCTs | IL-10 in asthma: unclear (Hedges'g = 18.85, p = 0.04) |
| 18 Patchen et al. 2025 | systematic review · 10,611 participants | vitamin D (form not specified); 200 IU/day to 100,000 IU bolus quarterly; 28 days to two years; vs. placebo/no supplementation or low/standard dose (≤400 IU/day) | childhood airway infections (pregnant/breastfeeding women): no difference (RR 1.00, 95% CI 0.97 to 1.04; 3 studies, 1564 participants; moderate-certainty evidence) |
| 21 Goswami et al. 2025 | systematic review · 4,415 participants | Vitamin D for prophylaxis; 1000 IU or 5000 IU; 4 to 16 weeks; vs. Placebo or lower dose | Influenza-like illness: improved; Respiratory infections: no difference |
Further studies in this area: 24 28 31 32 36 46 52 53 64 66 75 77 84 97 102 108 134 143 147 149 150 155 156 159 163 169 180 191 198 203 207 214 225 226 227 237 238 239 245 256 262 269 273 280 285 287 292 295 296 306 309 317 318 326 327 328 336
Vitamin D, Bones, Falls and Fractures: Human Studies
Children whose mothers received cholecalciferol during pregnancy had higher bone density at primary school age than after placebo 116. In children and young adults with HIV, a relatively high daily dose improved bone density in a meta-analysis 50. For falls in independently living older people, one meta-analysis and two controlled studies found no difference 1094145. Three meta-analyses, by contrast, found fewer falls, depending on dose, daily administration and baseline levels 456. Fewer bone fractures appeared in one meta-analysis only when vitamin D was given together with calcium 6. The strength of evidence in the table is high, but the results depend strongly on form, dose and accompanying supplementation; it remains open which groups and dosages actually benefit.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 4 Wei et al. 2022 | meta-analysis · 61,350 participants | Vitamin D supplement, partly with calcium; high-dose ≥700 IU to 2000 IU daily vs. <700 IU; vs. placebo or no treatment | fall incidence (high-dose vitamin D): improved (RR, 0.87 (95% CI 0.79 to 0.96)); fall incidence (low-dose vitamin D): no difference |
| 5 Tan et al. 2024 | meta-analysis · 58,937 participants | Vitamin D, calcium, or combined supplementation; 800-1000 IU/day vs. >1000 IU/day; vs. Placebo, no treatment, calcium alone | Fall risk with 800-1000 IU/day vitamin D: improved (RR = 0.85, 95%CI: 0.74-0.95); Fall risk with daily 800-1000 IU/day: improved (RR = 0.78, 95%CI:0.64-0.92); Fall risk with intermittent administration: no difference |
| 6 Thanapluetiwong et al. 2020 | meta-analysis · 58,424 participants | Vitamin D supplement, partly with calcium; vs. Placebo or control in RCTs | Fall incidence: improved (RR = 0.948 (95% CI 0.914-0.984; P = .004, I = 41.52)); Fall incidence (vitamin D with calcium): improved (RR = 0.881 (95% CI 0.821-0.945; P < .001, I = 49.19)); Fractures: no difference (RR = 0.949 (95% CI 0.846-1.064; P = .37, I = 37.92)) |
| 7 Cong et al. 2025 | meta-analysis · 43,869 participants | vitamin D plus calcium; vs. control/placebo | bone mineral density at the pelvis: improved (SMD = 0.20, 95% CI: 0.05–0.35, p = 0.01); BMD at lumbar spine, femoral neck, total hip: no difference; fracture risk: no difference (RR = 0.98, 95% CI: 0.89–1.07, p = 0.68) |
| 8 Migliorini et al. 2025 | systematic review · 43,397 participants | Vitamin D and/or calcium supplementation; mean 92.8 ± 228.7 IU vitamin D and 833.6 ± 224.0 mg calcium daily; mean follow-up 25.8 ± 13.3 months; vs. different doses or two or more treatments | bone mineral density (spine, hip, femur neck): no difference; serum bone turnover markers (bone-ALP, NTX, CTX): no difference; pathological vertebral and non-vertebral fractures: no difference |
| 10 Torres-Lopez et al. 2025 | meta-analysis · 23,211 participants | vitamin D supplements; ≤1000 IU/day vs. >1000 IU/day, daily or intermittent; ≤12 months vs. >12 months; vs. placebo or control | fall risk: no difference (OR = 0.99; 95%CI: 0.95-1.03); fall risk in women: no difference (OR = 0.97; 95%CI: 0.92-1.02); fall risk in men: no difference (OR = 1.08; 95%CI: 0.98-1.20) |
| 16 Yang et al. 2021 | meta-analysis · 11,890 participants | Vitamin D (DMOAD class); at least 12 months follow-up; vs. other DMOAD classes or control | Pain: improved (- 0.15 [- 0.27, -0.03]); Function: improved (- 0.18 [- 0.31, - 0.06]) |
| 50 Nguyen et al. 2023 | meta-analysis · 966 participants | Vitamin D supplementation (ergocalciferol or cholecalciferol); 400 to 7000 IU/d; higher dose 1600-4000 IU/d vs. standard 400-800 IU/d; 6 to 24 months; vs. Placebo or higher vs. standard dose | Spine BMD at 12 months: no difference (SMD: -0.09; 95% CI: -0.47, 0.3; P = 0.65); Total BMD at 12 months, higher vs. standard dose: improved (SMD: 0.23; 95% CI: 0.02, 0.44; P = 0.03); Spine BMD at 12 months, higher vs. standard dose: unclear (SMD: 0.3; 95% CI: -0.02, 0.61; P = 0.07) |
Further studies in this area: 56 64 77 80 83 94 95 104 112 116 117 119 121 122 143 145 148 151 152 157 160 170 179 181 185 204 216 227 235 236 243 254 266 267 268 270 273 278 279 286 289 297 302 312 315 316 332
Vitamin D, Blood Sugar and Metabolism: Human Studies
In adults with type 2 diabetes and in women with polycystic ovary syndrome, several controlled studies showed improvements in fasting glucose, HbA1c and insulin resistance under oral vitamin D3 (cholecalciferol) 3660261. Markers of beta cell function such as C-peptide and HOMA-β developed more favorably compared with the control in type 2 diabetes, prediabetes and newly detected type 1 diabetes in children 241299301. Under ergocalciferol, by contrast, stimulated C-peptide in young people with new type 1 diabetes remained without a difference 280. In contrast, the large randomized studies in adults without diabetes found no difference in newly occurring type 2 diabetes 8990. In healthy people, HbA1c, lipoproteins and BMI remained without a difference 21. In fatty liver disease, there was no difference in insulin resistance, fasting glucose and fasting insulin 62. In adult men with type 2 diabetes, insulin resistance, fasting glucose, insulin, HbA1c and lipid profile remained without a difference 298. In several studies, supplementation raised the vitamin D level in the blood 27215280299. Investigated were predominantly oral vitamin D3 preparations, sometimes vitamin D2 (ergocalciferol). In women with polycystic ovary syndrome, insulin resistance and fasting glucose improved in a meta-analysis, more strongly with metformin than under vitamin D alone 52. One study compared low and higher dosed vitamin D3 with calcium citrate and found no difference between the doses for markers of insulin resistance 154. Vitamin D3 together with whey protein and strength training resulted in no difference in HbA1c and insulin resistance 163. It remains open which patient groups and which dose or form actually benefit, since the results are inconsistent between populations and measured variables.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 17 Hsu et al. 2026 | systematic review · 11,600 participants | Vitamin D supplements (form not reported); vs. Placebo or control in included RCTs | CRP in abnormal glucose homeostasis: improved (Hedges'g = - 0.67); TNF-α in abnormal glucose homeostasis: improved (Hedges'g = - 0.81); IL-6 in abnormal glucose homeostasis: improved (Hedges'g = - 1.93) |
| 20 Kretschmer et al. 2025 | meta-analysis · 4,478 participants | oral vitamin D supplementation; study duration 0.5 to 5 years, at least 6 months; vs. placebo | Regression to normal glucose regulation: improved (1.27 (95% CI, 1.12-1.45)) |
| 21 Goswami et al. 2025 | systematic review · 4,415 participants | Vitamin D for prophylaxis; 1000 IU or 5000 IU; 4 to 16 weeks; vs. Placebo or lower dose | Hemoglobin-A1c, lipoproteins, BMI: no difference |
| 23 Martinekova et al. 2025 | meta-analysis · 4,084 participants | Vitamin D supplementation; 6 to 12 months follow-up; vs. Control group without vitamin D | HOMA-IR: improved (MD, -0.31; 95% CI, -0.62 to -0.01); Triglycerides: improved (MD, -7.59 mg/dL; 95% CI, -15.09 to -0.81); Insulin: improved (MD -0.79 μIU/L; 95% CI, -1.36 to -0.21) |
| 27 Gong et al. 2025 | meta-analysis · 3,460 participants | Vitamin D supplementation; 500 IU to 60,000 IU; 3 to 12 months; vs. Control group | Serum 25(OH)D: improved (SMD: 4.01; 95% CI: 2.43 to 5.59; p < 0.001); HbA1c: no difference (SMD: 0.08; 95% CI: -0.25 to 0.37); HOMA-IR: no difference (SMD: 5.95; 95% CI: -2.87 to 14.77) |
| 35 Hu et al. 2023 | meta-analysis · 2,362 participants | Vitamin D as nutritional supplement; vs. Placebo and other nutritional supplements | Total cholesterol (TC): improved |
| 36 M et al. 2026 | meta-analysis · 2,000 participants | Vitamin D supplementation; vs. Placebo or control in randomized trials | HbA1c: improved (MD = −0.42%, 95% CI: −0.32 to −0.16; I² = 27%); Fasting blood glucose: improved (MD = −9.5 mg/dL; I² = 16%); HOMA-IR: improved (MD = −0.98; I² = 60%) |
| 51 Liu et al. 2026 | meta-analysis · 962 participants | vitamin D supplementation; higher daily doses, particularly up to 5,000 IU/day; vs. placebo | BMI, weight, and IL-6: no difference |
Further studies in this area: 52 60 62 66 71 73 77 78 89 90 128 149 150 154 157 163 175 176 180 187 205 215 216 224 236 238 241 261 263 264 265 276 278 279 280 291 298 299 301 323 330 337 339
Vitamin D, Heart, Circulation and Blood Pressure: Human Studies
For heart, circulation and blood pressure, results without a difference predominate. Several controlled studies found no change in blood pressure under vitamin D 2190107157187228. Cardiovascular mortality also remained unchanged in several controlled studies 86109139. One meta-analysis showed a lower frequency of postoperative atrial fibrillation in patients after coronary bypass surgery 58. Individual blood lipid values improved in reviews in type 2 diabetes and diabetic kidney disease 363977, but not in overweight children and adolescents 73. The evidence is overall high, since numerous controlled studies and meta-analyses are available. It remains open whether certain groups or dosages do benefit.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 1 An et al. 2022 | meta-analysis · 883,627 participants | Vitamin D supplementation; vs. Control group without vitamin D | Cardiovascular or type 2 diabetes risk: no difference (no effect) |
| 3 Fu et al. 2022 | meta-analysis · 86,202 participants | Vitamin D supplements (cholecalciferol, ergocalciferol, calcifediol); various dosages, subgroup analysis; various follow-up periods; vs. placebo | risk of stroke: no difference (RR = 1.02, 95% CI: 0.93-1.13, P = 0.65) |
| 21 Goswami et al. 2025 | systematic review · 4,415 participants | Vitamin D for prophylaxis; 1000 IU or 5000 IU; 4 to 16 weeks; vs. Placebo or lower dose | Cholesterol: improved (5000 IU Vitamin D for four weeks significantly reduced cholesterol, unlike 1000 IU for 16 weeks); Blood pressures: no difference |
| 32 Pilkey et al. 2023 | systematic review · 2,489 participants | native vitamin D (D2/D3); mostly short follow-up; vs. control/placebo in randomized trials | cardiovascular disease: unclear |
| 36 M et al. 2026 | meta-analysis · 2,000 participants | Vitamin D supplementation; vs. Placebo or control in randomized trials | LDL cholesterol: improved (MD = −5.85 mg/dL; I² = 22%); Triglycerides: improved (MD = −6.51 mg/dL; I² = 0%) |
| 39 Lu et al. 2024 | meta-analysis · 1,711 participants | Vitamin D supplementation; higher doses more favorable (subgroup analysis); shorter intervention more favorable (subgroup analysis); vs. control/placebo in 20 RCTs | HDL cholesterol: improved (MD: 1.63 mg/dL, 95% CI: 0.19 to 3.08, P = 0.03); triglycerides: improved (MD: -8.56 mg/dL, 95% CI: -15.23 to -1.89, P = 0.01); LDL cholesterol: no difference |
| 58 Nisa et al. 2026 | meta-analysis · 694 participants | Vitamin D supplementation; vs. Placebo or control | Incidence of postoperative atrial fibrillation: improved (RR: 0.55; 95% CI: 0.40 to 0.76; P=0.0003) |
| 59 Ashraf et al. 2025 | meta-analysis · 694 participants | Vitamin D supplementation; vs. Control/placebo in 4 randomized trials | Incidence of postoperative atrial fibrillation: improved (RR: 0.55; 95% CI: 0.40 to 0.76; P = 0.0003) |
Further studies in this area: 66 73 77 86 90 107 109 126 129 139 143 150 157 160 167 176 187 203 214 215 219 227 228 234 260 261 263 264 270 276 278 279 288 313 320 321
Vitamin D, Mood and Depression: Human Studies
In adults with diagnosed depression, vitamin D improved depressive symptoms compared with placebo in one meta-analysis and one controlled study 51150. In women with premenstrual syndrome, vitamin D supplementation improved depression, but not anxiety 74. In adults with type 2 diabetes and depressive symptoms, cholecalciferol lowered the depression score more strongly than placebo 241. In perimenopausal women with vitamin D deficiency, cholecalciferol improved mood 208. In children with ADHD, vitamin D3 plus magnesium improved emotional problems 249251. In the same group, vitamin D3 plus magnesium improved anxiety and shyness 250. Vitamin D3 together with zinc improved depressive symptoms in overweight adults 182. In children with autism spectrum disorder, vitamin D reduced irritability and hyperactivity compared with placebo 200. In contrast, a large randomized controlled study with vitamin D3 over several years found no difference in the frequency of newly occurring major depressive disorder 96. A randomized controlled study with cholecalciferol in addition to depression treatment found no difference in the MADRS score 140. In adolescents with vitamin D deficiency and depressive symptoms, vitamin D showed an advantage on only one of three depression scales; the inflammation marker CRP did not change this 220. In adults with chronic spinal cord injury, anxiety and depression remained without a difference under vitamin D3 273. A systematic review on native vitamin D (D2/D3) saw no difference in patient-reported well-being in adults with end-stage renal failure 32. The studies are often small and differ in dose, form and population. Vitamin D did not change the serotonin level in the blood in one meta-analysis 79.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 12 Park et al. 2026 | systematic review · 18,628 participants | Vitamin D supplementation; 2,000 IU daily to 50,000 IU weekly; 6 months to 5.3 years; vs. Placebo or control | Depressive symptoms: improved (p < .050); Depressive symptoms (one trial): no difference; Depression incidence: no difference (hazard ratio, 0.97; 95% confidence interval, 0.87~1.09) |
| 32 Pilkey et al. 2023 | systematic review · 2,489 participants | native vitamin D (D2/D3); mostly short follow-up; vs. control/placebo in randomized trials | patient-reported well-being: no difference |
| 51 Liu et al. 2026 | meta-analysis · 962 participants | vitamin D supplementation; higher daily doses, particularly up to 5,000 IU/day; vs. placebo | change in depressive symptoms: improved (SMD: -0.98; 95% CI - 1.28 to -0.68; p < 0.001) |
| 74 Zainab et al. 2026 | meta-analysis · 436 participants | Vitamin D supplementation; vs. Placebo or standard care | Depression: improved (SMD: -0.78, 95% CI: -1.53, -0.02); Anxiety: no difference |
| 79 Alimohammadi-Kamalabadi et al. 2024 | meta-analysis · 356 participants | Vitamin D supplementation; some below 4000 IU/day; some 10 weeks or longer; vs. control group | serum serotonin levels: no difference (SMD: 0.24 ng/mL, 95% CI: -0.28, 0.75, p > 0.10) |
| 96 Ahl et al. 2026 | randomised controlled · 2,434 participants | Vitamin D3; 1600 IU/day or 3200 IU/day; 5 years supplementation, follow-up until end of 2021; vs. Placebo | Incidence of major depressive disorder during 5 years: no difference (HR, 0.78; 95 % CI 0.35-1.71; P = 0.53); Incidence of major depressive disorder during 5 years: no difference (HR, 0.57; 95 % CI 0.24-1.35; P = 0.20); Incidence of major depressive disorder during extended follow-up: no difference (HR, 0.61; 95 % CI 0.34-1.10; P = 0.10) |
| 140 Mikola et al. 2026 | randomised controlled · 281 participants | Vitamin D (cholecalciferol) as adjunct to existing depression treatment; 100 µg (4000 IU) daily versus 10 µg (400 IU) daily; six months; vs. high-dose versus low-dose vitamin D | change in MADRS score: no difference (Cohen's d = -0.09; 95% CI -0.32 to 0.14) |
| 150 Porto et al. 2025 | randomised controlled · 224 participants | vitamin D supplementation; 50,000 IU per week; six months; vs. placebo (n=112) | depressive symptoms: improved (p = 0.001); suicide risk: improved (p = 0.001) |
Further studies in this area: 182 187 200 202 208 220 232 241 249 250 251 257 273 315
Vitamin D, Pregnancy and Children: Human Studies
A review with meta-analysis found less gestational diabetes and a somewhat higher birth weight 85. With cholecalciferol, spontaneous vaginal births occurred more often because instrumental delivery was less frequent 101. For preeclampsia, two meta-analyses found a lower risk 3382. Another review and a controlled study saw no difference there 85107. For gestational hypertension, no difference was shown 107, as was also the case for prematurity 85101. The results depend on form, dose and baseline levels, and many studies were small.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 17 Hsu et al. 2026 | systematic review · 11,600 participants | Vitamin D supplements (form not reported); vs. Placebo or control in included RCTs | MDA in pregnant women: improved (Hedges'g = - 0.46); TAC in pregnant women: improved (Hedges'g = 2.13); glutathione in pregnant women: improved (Hedges'g = 4.37) |
| 19 Shi et al. 2026 | meta-analysis · 10,262 participants | Combined supplement with magnesium, zinc, calcium and vitamin D; vs. Standard control | cesarean section rate: no difference (RR = 0.44, 95% CI: 0.15, 1.29) |
| 33 Kokkinari et al. 2025 | meta-analysis · 2,461 participants | Vitamin D supplementation during pregnancy; heterogeneous, not specified; not reported; vs. no supplementation (RCT control groups) | risk of pre-eclampsia: improved (RR = 0.61, 95% CI: [0.50-0.75], p < 0.001) |
| 76 Saha et al. 2020 | meta-analysis · 380 participants | Vitamin D containing supplements; vs. Placebo | Risk of cesarean section: improved (RR: 0.61, p=0.002, 95% CI: 0.44,0.83); Risk of macrosomia: improved (RR: 0.31, p=0.006, 95% CI: 0.13,0.72); Pre-eclampsia, preterm delivery, polyhydramnios: no difference |
| 82 Wang et al. 2026 | meta-analysis | Oral nutritional supplements, including vitamin D; vs. Placebo and calcium | Preeclampsia: improved (OR=0. 34, 95% CI 0.17, 0.65); Gestational hypertension: no difference |
| 85 Yang et al. 2025 | systematic review | Vitamin D supplements; Median 2000 IU/day (range 400-60 000); vs. Placebo, no intervention, or active control (≤600 IU/day) | Risk of preeclampsia: no difference (RR, 0.81 [95% CI, 0.43-1.53]); Risk of gestational diabetes mellitus: improved (RR, 0.65 [95% CI, 0.49-0.86); Infant birth weight: improved (53 g (95% CI, 16-90)) |
| 99 Subramanian et al. 2025 | randomised controlled · 1,298 participants | Vitamin D3 supplement; 4200, 16,800 or 28,000 IU per week; from mid-pregnancy until birth; vs. placebo | placental VEGF-A expression: no difference; placental PlGF expression: no difference; number and surface area of terminal villi: no difference |
| 101 Moon et al. 2023 | randomised controlled · 965 participants | Cholecalciferol 1000 IU/day; 1000 IU daily; from 14 weeks' gestation until delivery; vs. placebo, double-blind randomized | preterm birth: no difference (cholecalciferol 5.7%, placebo 4.5%, P = 0.43); spontaneous vaginal delivery: improved (RR 1.13, 95% CI 1.02,1.25); instrumental delivery: improved (RR 0.68, 95%CI 0.51,0.91) |
Further studies in this area: 103 106 107 133 149 175 183 198 311 323 325 331
Vitamin D and Autoimmune Diseases: Human Studies
In systemic lupus erythematosus, vitamin D reduced disease activity and improved complement values C3 and C4 in a meta-analysis 55. In rheumatoid arthritis, disease activity and pain decreased compared with the control group 211. In clinically isolated syndrome, an early form of multiple sclerosis, cholecalciferol reduced MRI activity and new lesions compared with placebo, but not relapses 132. A meta-analysis in multiple sclerosis found a lower annual relapse rate only at low to medium dose, with no overall difference 49. A systematic review of vitamin D3 and/or vitamin D2 saw protection against autoimmune reactions 21. In a large placebo-controlled study, vitamin D reduced the number of confirmed autoimmune diseases over five years, while omega-3 fatty acids alone did not significantly 305. These are contrasted by results showing no difference: The EDSS score remained unchanged in the MS meta-analysis 49. In lupus, no differences were shown in erythrocyte sedimentation rate and anti-dsDNA levels 55. Another lupus meta-analysis found no difference in either the disease activity index or anti-dsDNA positivity 70. The evidence is strong, but the studies tested different forms and doses, and the participant numbers of the individual controlled studies remain partly small 132211.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 21 Goswami et al. 2025 | systematic review · 4,415 participants | Vitamin D for prophylaxis; 1000 IU or 5000 IU; 4 to 16 weeks; vs. Placebo or lower dose | Protection against autoimmune reactions: improved |
| 49 Zhang et al. 2025 | meta-analysis · 1,078 participants | Vitamin D supplementation; low/medium dose vs. high dose (subgroups); vs. intervention group vs. control group | Annualized relapse rate (ARR): no difference (pooled MD = -0.07, 95%CI [-0.18,0.03], Z = -1.37, p = 0.17); Annualized relapse rate, low/medium dose: improved (pooled MD = -0.14, 95%CI [-0.26, -0.03], p = 0.01); Annualized relapse rate, high dose: no difference (pooled MD = 0.05, 95%CI [-0.08, 0.18], p = 0.42) |
| 55 Lu et al. 2026 | meta-analysis · 847 participants | Vitamin D supplementation; vs. Control group (placebo/standard care) | Disease activity in SLE: improved (SMD = -0.54, p < 0.001); Complement component C3: improved (MD = 14.49, p = 0.03); Complement component C4: improved (SMD = 2.08, p = 0.04) |
| 70 Zheng et al. 2019 | meta-analysis · 490 participants | Vitamin D supplementation; vs. Placebo | SLE disease activity index score: no difference (SMD = -0.507, 95% CI: -1.055-0.041, P = 0.070); Positivity of anti-double-stranded DNA antibodies: no difference (Risk ratio = 0.880, 95% CI: 0.734-1.054, P = 0.165) |
| 132 Thouvenot et al. 2025 | randomised controlled · 316 participants | oral cholecalciferol 100 000 IU vs placebo; 100 000 IU every 2 weeks; 24 months; vs. placebo, double-blind randomized | disease activity (relapse and/or MRI activity): improved (HR, 0.66 [95% CI, 0.50-0.87]; P = .004); MRI activity: improved (HR, 0.71 [95% CI, 0.53-0.95]; P = .02); new lesions: improved (HR, 0.61 [95% CI, 0.44-0.84]; P = .003) |
| 211 Rexhepi et al. 2025 | randomised controlled · 100 participants | Vitamin D 4000 IU/day; 4000 IU/day; 6 months; vs. RA patients without vitamin D supplementation | Disease activity (DAS28): improved (U'=2285.5; P < 0.0001) |
| 305 Hahn et al. 2022 | randomised controlled | Vitamin D (2000 IU/day) or placebo, plus omega 3 fatty acids or placebo; 2000 IU/day vitamin D; 1000 mg/day omega 3 fatty acids; median 5.3 years follow-up; vs. placebo (two-by-two factorial design) | Confirmed autoimmune disease (vitamin D arm vs placebo): improved (hazard ratio 0.78, 95% confidence interval 0.61 to 0.99, P=0.05); Confirmed autoimmune disease (omega 3 arm vs placebo): no difference (0.85, 0.67 to 1.08, P=0.19); Confirmed autoimmune disease (vitamin D plus omega 3 vs reference arm): improved (0.69, 0.49 to 0.96) |
| 335 Basti et al. 2026 | cohort study · 101 participants | Vitamin D3 supplementation; increase by 1000 IU/day, maximum 2000 IU/day; 12 months; vs. patients with low vs normal baseline 25(OH)D | 12-month disease relapse: no difference (7.3% vs 10%; p=0.64); relapses in patients who corrected vitamin D deficiency: improved (no relapses) |
Vitamin D and Muscle Strength: Human Studies
In adults with chronic intestinal failure and vitamin D deficiency, intramuscularly administered ergocalciferol (vitamin D2) improved handgrip strength, 6-meter walking speed and skeletal muscle mass index 300. Children of mothers who received daily cholecalciferol during pregnancy had more lean mass at primary school age than after placebo 116. Together with exercise training, knee extension strength increased compared with training alone in a meta-analysis, and handgrip strength increased in older adults 40. A review found better values on the Short Physical Performance Battery and stair climbing 42. In older people with sarcopenia, vitamin D3 in addition to thermotherapy and strength training improved muscle mass and handgrip strength 180. In contrast, several controlled studies found no difference in hand and grip strength with administration of cholecalciferol or ergocalciferol alone 178217273, and vitamin D3 together with omega-3 fatty acids also did not change grip strength, walking speed and functional tests 100. The evidence is moderate; the results depend strongly on the form, the combination with training or protein and the group studied; whether supplementation alone, without accompanying measures, increases muscle strength remains open.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 32 Pilkey et al. 2023 | systematic review · 2,489 participants | native vitamin D (D2/D3); mostly short follow-up; vs. control/placebo in randomized trials | muscle strength/function: unclear |
| 37 Serag et al. 2025 | meta-analysis · 1,903 participants | Vitamin D supplements as add-on therapy; Subgroup analysis: treatment longer than 12 months; vs. Controls | Timed 25-foot walk: no difference (p = 0.54) |
| 40 Kazeminasab et al. 2025 | meta-analysis · 1,675 participants | vitamin D plus exercise; vitamin D dose in IU/wk, variable; vs. exercise alone | leg press strength: no difference (P > .05); knee extension strength: improved (WMD, 4.36 kg; P = .039); handgrip strength: improved |
| 42 Zhang et al. 2025 | systematic review · 1,483 participants | Vitamin D3 supplementation combined with exercise training; vs. Exercise intervention alone | Short Physical Performance Battery: improved; Stair climbing: improved; Skeletal muscle mass: no difference |
| 63 Chang et al. 2023 | meta-analysis · 637 participants | Whey protein, leucine, and vitamin D; vs. Control group without nutritional supplementation | Appendicular muscle mass: improved (significantly improved); Handgrip strength: no difference (no significant differences); SPPB score: no difference (no significant differences) |
| 100 Chou et al. 2024 | randomised controlled · 1,054 participants | Vitamin D3 (cholecalciferol) and/or marine omega-3 fatty acids vs placebo; 2000 IU/day vitamin D3; 1 g/day omega-3; 2 years; vs. placebo, 2x2 factorial design | grip strength: no difference; walking speed: no difference; Short Physical Performance Battery: no difference |
| 116 Moon et al. 2024 | randomised controlled · 454 participants | Cholecalciferol 1000 IU/d or placebo; 1000 IU per day; from 14-17 wk gestation until delivery; vs. Placebo | Lean mass: improved (0.09 SD, 95% CI: 0.00, 0.17) |
| 163 Miller et al. 2021 | randomised controlled · 198 participants | Whey protein plus vitamin D3, with progressive resistance training; 20 g whey protein each morning and postexercise; vitamin D3 2000 IU/day; 24 weeks; vs. Resistance training without supplementation | 30-s sit-to-stand performance: improved (1.0 [95% CI, -0.05, 1.5], p = .047) |
Further studies in this area: 173 176 178 180 189 201 214 217 238 248 263 264 273 295 300 312
Vitamin D, Cancer Risk and Course: Human Studies
In cancer diseases, a mixed picture emerges: A randomized controlled study in patients with advanced cervical cancer undergoing radiotherapy found a higher rate of complete remissions with cholecalciferol 190, and another randomized controlled study in women with breast cancer before neoadjuvant chemotherapy reports pathological complete remission more often 231. In curatively resected gastrointestinal tumors, cholecalciferol improved recurrence-free survival in subgroups with low parathyroid hormone levels, while no difference occurred in the group with high parathyroid hormone levels 123; in digestive tract cancer, the effect on recurrence or death depended on vitamin A levels, with benefit at medium levels and disadvantage at the lowest levels 130. In contrast, the largest randomized controlled study in older adults found no difference in cancer incidence 91, and in curatively resected cutaneous melanoma, cholecalciferol showed no advantage in either recurrence-free survival or melanoma mortality 118. The evidence is overall low: The controlled studies are mostly small, concern different tumor types and treatment situations, and the positive findings come predominantly from subgroup or single studies; cholecalciferol was mostly studied as a capsule or tablet, sometimes daily, sometimes as a single dose. It remains open whether and for which tumor types and baseline levels administration actually helps.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 91 Neale et al. 2025 | randomised controlled · 21,308 participants | Vitamin D3 or placebo; 60,000 IU per month; up to 5 years; vs. placebo | cancer incidence (at least one cancer diagnosis): no difference (HR 1.02; 95 % CI 0.95-1.10); cancer incidence excluding cutaneous melanomas: no difference (HR 1.04; 95 % CI 0.95-1.14) |
| 118 De et al. 2024 | randomised controlled · 436 participants | Cholecalciferol (vitamin D3); 100 000 IU monthly; minimum 6, maximum 42 months; median follow-up 52 months; vs. Placebo (218 vs. 218) | Relapse-free survival at 72 months: no difference (26.51% in the vitamin D supplemented arm (95% CI 19.37-35.64) vs. 20.70% (95% CI 14.26-29.52) in the placebo arm (hazard ratio 1.27, 95% CI 0.79-2.03; P = 0.32)); Melanoma-related deaths: no difference (n = 10 and n = 11, respectively) |
| 123 Sasaki et al. 2026 | randomised controlled · 410 participants | Vitamin D3 versus placebo; 2000 IU/day; maximum follow-up 7.5 years; vs. placebo, randomized double-blind | relapse-free survival (lower PTH subgroup): improved (HR, 0.45; 95% CI, 0.24-0.81; p = 0.008); relapse-free survival (higher PTH subgroup): no difference (HR, 1.25; 95% CI, 0.64-2.44; p for interaction = 0.016); relapse-free survival (low PTH and p53-positive): improved (HR, 0.38; 95% CI, 0.18-0.78; p = 0.009) |
| 130 Kohmura et al. 2026 | randomised controlled · 363 participants | Vitamin D3 supplementation versus placebo; 5-year relapse-free survival; vs. Placebo | Relapse or death (5-year RFS) in middle vitamin A range (deciles 6-8): improved (81.4% vs. 54.9%; HR, 0.31; 95% CI, 0.14-0.69; P = 0.004); Relapse or death in lowest vitamin A decile (decile 1): worsened (HR, 2.05; 95% CI, 1.10-3.84; P = 0.03); Interaction vitamin A x vitamin D on relapse or death: unclear (Pinteraction = 0.008) |
| 190 Suardi et al. 2025 | randomised controlled · 123 participants | Cholecalciferol; 10 000 IU daily; 7 weeks during and 12 weeks after radiotherapy; vs. Placebo plus same radiotherapy protocol | complete response rate: improved (82.61% in the Treatment group and 64.8% in the Control group) |
| 231 Omodei et al. 2025 | randomised controlled · 80 participants | Cholecalciferol 2,000 IU daily vs. placebo; 2,000 IU daily; 6 months; vs. placebo | Pathological complete response (pCR): improved (43% vs. 24%, p = 0.04) |
| 237 Tirgar et al. 2024 | randomised controlled · 76 participants | Vitamin D alone, synbiotics alone, or their combination vs. placebo; four months; vs. Placebo | pathological complete response (pCR): no difference; Ki-67 index: no difference |
| 321 Yao et al. 2026 | cohort study · 3,995 participants | serum 25-hydroxyvitamin D levels (no supplementation); median follow-up 12.2 years (0.2-16.3); vs. sufficient versus deficient vitamin D levels | overall survival: improved (HR, 0.76; 95% CI, 0.62-0.93; P for trend =.005); second primary cancer-free survival: improved (HR, 0.75; 95% CI, 0.63-0.90; P for trend =.003); disease-free survival: improved (HR, 0.82; 95% CI, 0.70-0.97; P for trend =.05) |
Vitamin D: Further Outcomes in Studies
In this area, numerous controlled studies and meta-analyses investigated very different outcome measures; the evidence is strong, but the results vary widely depending on the outcome. The storage form 25(OH)D in blood reliably increased, for example in meta-analyses in multiple sclerosis, lupus and fatty liver disease 495562. In diabetic foot ulcer, wounds healed more often than with control in a meta-analysis 66. Calcium, phosphate and urinary calcium values remained without difference between the groups in several studies 64119174204; in two studies, serum calcium increased 149267. Cholecalciferol (vitamin D3), ergocalciferol (vitamin D2) and calcifediol were predominantly studied as a capsule, tablet, drops or injection. It remains open which dose, form and treatment duration is actually of benefit for which patient group, since the studies included very different populations and comparison groups.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 7 Cong et al. 2025 | meta-analysis · 43,869 participants | vitamin D plus calcium; vs. control/placebo | serum 25-hydroxyvitamin D: improved (Z = 10.48, p < 0.001) |
| 8 Migliorini et al. 2025 | systematic review · 43,397 participants | Vitamin D and/or calcium supplementation; mean 92.8 ± 228.7 IU vitamin D and 833.6 ± 224.0 mg calcium daily; mean follow-up 25.8 ± 13.3 months; vs. different doses or two or more treatments | gastrointestinal adverse events (r = - 0.5; P = 0.02); mortality: improved (r = - 0.7; P = 0.03) |
| 11 Meng et al. 2025 | meta-analysis · 19,586 participants | Vitamin D supplementation; vs. Placebo or standard treatment | tuberculosis score at 8 weeks: improved (MD - 0·39; 95% CI -0·57 to -0 22); tuberculosis score at 12 weeks: improved (MD - 0·53; 95% CI - 0·84 to - 0·22); TB score at 8 weeks (daily dosing): improved |
| 13 Wang et al. 2025 | meta-analysis · 18,372 participants | Oral vitamin D supplementation; Daily low-dose ≤ 1000 IU/day vs. higher doses; vs. Placebo or no treatment | All-cause mortality: no difference (RR = 0.88, 95% CI: 0.60 to 1.28); Serious adverse events (RR = 0.83, 95% CI: 0.71 to 0.96) |
| 14 Liu et al. 2025 | meta-analysis · 15,677 participants | Vitamin D supplementation; vs. Placebo | Serious adverse events (OR: 1.02; 95% CI: 0.76-1.38; p = 0.87) |
| 15 Matukaitienė et al. 2025 | systematic review · 13,000 participants | Vitamin D (level measurement or supplementation); vs. Men with mild vs. moderate-to-severe or arteriogenic ED; supplementation vs. control | Serum vitamin D levels in moderate-to-severe or arteriogenic ED: worsened (significantly lower serum VD levels); Erectile function with low vitamin D status: worsened (poorer erectile function scores); ED prevalence with vitamin D deficiency: worsened (independently associated with higher ED prevalence) |
| 17 Hsu et al. 2026 | systematic review · 11,600 participants | Vitamin D supplements (form not reported); vs. Placebo or control in included RCTs | inflammatory markers in obesity/asthma: no difference |
| 18 Patchen et al. 2025 | systematic review · 10,611 participants | vitamin D (form not specified); 200 IU/day to 100,000 IU bolus quarterly; 28 days to two years; vs. placebo/no supplementation or low/standard dose (≤400 IU/day) | early childhood asthma (pregnant/breastfeeding women): improved (RR 0.17, 95% CI 0.05 to 0.61; 1 study, 236 participants; low-certainty evidence) |
Further studies in this area: 21 22 23 25 26 29 30 32 34 37 38 40 41 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 61 62 64 65 66 67 68 69 70 71 72 74 77 78 81 86 87 88 92 93 94 95 98 103 105 110 111 113 114 115 117 118 119 120 124 125 127 129 131 134 135 136 137 138 139 141 142 143 144 145 146 149 150 153 155 157 158 160 161 162 164 165 166 168 169 170 171 172 174 175 176 177 178 180 181 182 184 185 186 187 188 189 190 192 193 194 195 196 197 199 200 201 204 205 206 207 208 209 210 211 212 213 214 216 217 218 219 221 222 223 224 225 226 227 228 229 230 231 232 233 236 239 240 241 242 244 245 246 247 248 249 250 251 252 253 254 255 256 258 259 260 261 263 264 265 267 268 270 271 272 273 274 275 276 277 279 281 282 283 284 285 287 288 290 291 293 294 295 296 297 298 299 300 301 302 303 304 306 307 308 309 310 311 312 314 315 317 318 319 322 324 329 332 333 334 338
4. How Is Vitamin D Dosed? Preparation, Dose and Duration in Studies
The studies used predominantly oral preparations with cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2), sometimes calcifediol, as a capsule, tablet, drops or injection. Some studies tested vitamin D together with calcium, vitamin K2, omega-3 fatty acids, magnesium, zinc or probiotics. The doses and intake schedules are shown in the table.
| Preparation or form | Dose | Duration | Study |
|---|---|---|---|
| Vitamin D3 (cholecalciferol), 2000 IU/day, vs. placebo | 2000 IU/day | median follow-up 5.3 years | 89 |
| oral vitamin D3, monthly dose | 60,000 IU monthly | median 4.6 years follow-up | 90 |
| Vitamin D3 or placebo | 60,000 IU per month | up to 5 years | 91 |
| Vitamin D (2000 IU/day) and/or omega-3 (1 g/day) | 2000 IU vitamin D daily; 1 g omega-3 daily | median 5.3 years | 92 |
| Vitamin D (60,000 IU) or placebo monthly | 60,000 IU per month | up to 5 years, assessed at 3 years | 93 |
| Vitamin D3 (cholecalciferol) | 1600 IU/day or 3200 IU/day | 5 years | 94 |
| Vitamin D3 | 1600 IU/day or 3200 IU/day | 5 years supplementation, 7.3 years follow-up | 95 |
| Vitamin D3 | 1600 IU/day or 3200 IU/day | 5 years supplementation, follow-up until end of 2021 | 96 |
| oral vitamin D3 | 9600 IU/d for 2 d, then 3200 IU/d for 4 wk | 4 weeks | 97 |
| Vitamin D3 2000 IU/d, partly combined with omega-3 fatty acids 1 g/d | 2000 IU vitamin D3 daily; 1 g omega-3 daily | 5 years | 98 |
| Vitamin D3 supplement | 4200, 16,800 or 28,000 IU per week | from mid-pregnancy until birth | 99 |
| Vitamin D3 (cholecalciferol) and/or marine omega-3 fatty acids vs placebo | 2000 IU/day vitamin D3; 1 g/day omega-3 | 2 years | 100 |
| Cholecalciferol 1000 IU/day | 1000 IU daily | from 14 weeks' gestation until delivery | 101 |
| Oral vitamin D (cholecalciferol) | 4000 or 10,000 IU/day versus 400 IU/day | up to 9 months | 102 |
| Vitamin D 4000 IU/day or placebo | 4000 IU/day | up to 90 days until trigger day | 103 |
5. Is Vitamin D Safe? Side Effects in Studies
Two meta-analyses found no more adverse events under vitamin D than under placebo, nor more cases of hypercalcemia 1464. One review warns that very high doses can lead to hypercalcemia 21.
| Study | Reported side effects |
|---|---|
| 8 Migliorini et al. 2025 | vitamin D associated with fewer gastrointestinal adverse events |
| 11 Meng et al. 2025 | similar safety profiles between the two groups |
| 13 Wang et al. 2025 | Fewer serious adverse events, RR = 0.83, 95% CI: 0.71 to 0.96 |
| 14 Liu et al. 2025 | Serious adverse events comparable to placebo; none attributed to vitamin D |
| 18 Patchen et al. 2025 | evidence on adverse events very uncertain |
| 21 Goswami et al. 2025 | Concern for hypercalcemia at high doses mentioned |
| 24 Jolliffe et al. 2025 | not reported |
| 26 Zhou et al. 2024 | Vitamin D among three safest (SUCRA 0.19) |
| 27 Gong et al. 2025 | similar to control (RR 1.19; 95% CI 0.79 to 1.80) |
| 32 Pilkey et al. 2023 | safe and well-tolerated |
| 33 Kokkinari et al. 2025 | not reported |
| 43 Chen et al. 2025 | adverse events comparable (RR 1.02, 95% CI 0.94-1.10) |
6. What Remains Open: Limits of the Evidence
- The results depend strongly on form, dose and baseline levels, so it remains unclear which groups and dosages benefit.
- Many controlled studies were small or short, which limits their informative value.
- With combination preparations, the contribution of vitamin D alone often cannot be separated out.
- For cancer diseases, the strength of evidence is low, since the studies are mostly small and concern different tumor types.
- It remains open whether supplementation alone, without accompanying measures such as training or protein, increases muscle strength.
7. Bottom Line: What Is Established About Vitamin D
In human studies, vitamin D shows a broad spectrum of effects. Controlled studies and meta-analyses found improvements above all in depressive symptoms, disease activity of autoimmune diseases, asthma attacks in children and inflammation markers. Muscle strength mostly increased only together with training. For bones, metabolism, heart and cancer, the results are mixed or predominantly without a difference, for example for blood pressure, falls and cancer incidence. The strength of evidence is overall high, but the results depend strongly on form, dose and population, and many studies were small or short.
Frequently Asked Questions
How well has Vitamin D been studied in humans?
We evaluated 339 human studies on Vitamin D, including 228 randomised controlled trials and 88 meta-analyses or systematic reviews; the controlled studies include 142,839 participants in total. As of 3 October 2026.
Does Vitamin D help with infections and immune system? What the studies show
Does Vitamin D help with bones, falls and fractures? What the studies show
Does Vitamin D help with blood sugar and metabolism? What the studies show
Does Vitamin D help with heart, circulation and blood pressure? What the studies show
Does Vitamin D help with mood and depression? What the studies show
Does Vitamin D help with pregnancy and children? What the studies show
Which forms of vitamin D were investigated in the studies?
The studies used predominantly oral preparations with cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2), sometimes calcifediol. Some studies tested vitamin D together with calcium, vitamin K2, omega-3 fatty acids, magnesium, zinc or probiotics. The exact doses and forms are shown in the table.
Do human studies show an effect on the immune system?
What do studies show about bones and falls?
Children whose mothers received cholecalciferol during pregnancy had higher bone density at primary school age than after placebo 116. In children and young adults with HIV, a relatively high daily dose improved bone density in a meta-analysis 50. For falls in independently living older people, one meta-analysis and two controlled studies found no difference 1094145. Three meta-analyses, by contrast, found fewer falls, depending on dose, daily administration and baseline levels 456. Fewer bone fractures appeared in one meta-analysis only when vitamin D was given together with calcium 6.
How safe is vitamin D?
Two meta-analyses found no more adverse events under vitamin D than under placebo, nor more cases of hypercalcemia 1464. One review warns that very high doses can lead to hypercalcemia 21. In one study, kidney stones occurred in some of the participants, without a clear difference between the groups 98.
Are there limitations of the studies?
The results depend strongly on form, dose and baseline levels, so it remains unclear which groups and dosages benefit. Many controlled studies were small or short. With combination preparations, the contribution of vitamin D alone often cannot be separated out. For cancer diseases, the strength of evidence is low.
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Every statement on this page carries its evidence tier — proven, plausible or hypothesis — and leads to the original work. The decision in the individual case rests with the practitioner; we provide the connections.