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The Role of Vitamin D in Endocrine Diseases: Pathophysiology and Treatment

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 4492

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Special Issue Editors

Dr. Marco Gallo

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Guest Editor

Endocrinology and Metabolic Diseases Unit, SS. Antonio e Biagio e Cesare Arrigo Teaching Hospital, 15121 Alessandria, Italy
Interests: thyroid tumor; parathyroide tumor; endocrinology; metabolism; diabetes; oncology
Special Issues, Collections and Topics in MDPI journals

Dr. Umberto Goglia

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Guest Editor

Endocrinology and Diabetology Unit, Local Health Authority CN1, 12100 Cuneo, Italy
Interests: diabetes; oncology; vitamin D; endocrinology; metabolism

Dr. Laura Gianotti

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Guest Editor

Azienda Ospedaliera S. Croce e Carle, 12100 Cuneo, Italy
Interests: clinical nutrition; oncology; vitamin D; endocrinology; metabolism

Special Issue Information

Dear Colleagues,

Vitamin D, one of the most intriguing hormones investigated in the last decade, is a complex of lipophilic pro-hormones involved in crucial metabolic pathways of physiological development in different tissues.

Over a century has passed since the pioneering studies of German pediatrician Kurt Huldschinsky, where it was found that vitamin D helped improve the condition of rachitic children. In addition, vitamin D, with its multiple chemical structures, plays a central role in calcium–phosphorus metabolism, functioning as a precursor, a hormone, and a nutrient.

The multifaceted role of vitamin D in endocrine conditions is demonstrated not only in the physiological and pathophysiological mechanisms of diseases, but also in the different forms of this hormone in therapeutic use, such that today, it is probably the most widely used supplemental treatment.

In this Special Issue, we invite researchers and expert physicians to contribute papers about the role of Vitamin D in skeletal (mainly osteoporosis and rickets) and extra-skeletal (such as obesity, diabetes, autoimmune thyroiditis and MASLD (metabolic dysfunction-associated steatotic liver disease)) conditions, both in terms of its pathophysiological hormonal involvement and its therapeutic potential.

Dr. Marco Gallo
Dr. Umberto Goglia
Dr. Laura Gianotti
Guest Editors

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Keywords

diet
vitamin D
hormone
endocrine conditions
metabolism
metabolic dysfunction-associated steatotic liver disease (MASLD)
diabetes
obesity

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Published Papers (4 papers)

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Research

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19 pages, 1502 KB

Open AccessArticle

Vitamin D Adequacy Conditions the Prolactin-Suppressive Effect of Metformin in Men Receiving Prolactin-Elevating Medications

by Robert Krysiak, Karolina Kowalcze, Giovanni Cangelosi, Andrea Deledda and Bogusław Okopień

Nutrients 2026, 18(7), 1062; https://doi.org/10.3390/nu18071062 - 26 Mar 2026

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Abstract

Background/Objectives: Metformin has been proposed as a potential treatment for hyperprolactinemia irrespective of etiology. Previous studies suggest that vitamin D deficiency attenuates the prolactin-lowering effect of metformin in women. This study examined whether vitamin D status modifies the effects of this agent on prolactin and other anterior pituitary hormones in men with iatrogenic hyperprolactinemia. Methods: Seventy-five adult men with antipsychotic-induced hyperprolactinemia and type 2 diabetes or prediabetes were enrolled. Participants were assigned to three equal groups based on vitamin D status and supplementation: vitamin D-naive men with sufficient levels (group 1), vitamin D-naive men with deficiency (group 2), and men with sufficient vitamin D levels receiving oral supplementation for at least six months (group 3). All participants received metformin (3 g/day) for six months. Plasma 25-hydroxyvitamin D, markers of glucose metabolism, total and monomeric prolactin, TSH, gonadotropins, ACTH, testosterone, and IGF-1 were measured at baseline and after treatment. Results: Baseline characteristics were comparable among groups except for 25-hydroxyvitamin D levels. Seventy participants completed the study. Metformin improved glycemic control and insulin sensitivity in all groups, with greater effects in men with sufficient vitamin D status. Reductions in total and monomeric prolactin were observed only in groups 1 and 3 and were associated with baseline prolactin concentrations and pretreatment 25-hydroxyvitamin D levels. These changes were accompanied by modest increases in LH and testosterone, and improvements in sexual functioning. Vitamin D levels and other hormonal parameters remained unchanged. The magnitude of the metformin effect did not differ between groups 1 and 3. Conclusions: Adequate vitamin D status is necessary for metformin to reduce prolactin levels in men with iatrogenic hyperprolactinemia. Full article

(This article belongs to the Special Issue The Role of Vitamin D in Endocrine Diseases: Pathophysiology and Treatment)

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12 pages, 525 KB

Open AccessArticle

Body Composition Attenuates the Association Between Serum 25-Hydroxyvitamin D and Bone Mineral Density in Early Postmenopausal Women

by Raquel Domingo-Molina, Borja Sañudo, Sergio Tejero, Gonzalo Reverte-Pagola and Mª Ángeles Martínez-Maestre

Nutrients 2026, 18(5), 865; https://doi.org/10.3390/nu18050865 - 7 Mar 2026

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Abstract

Background/Objectives: Vitamin D plays a central role in calcium and bone homeostasis; however, evidence linking serum 25-hydroxyvitamin D (25(OH)D) to bone mineral density (BMD) in postmenopausal women remains inconsistent. Because body weight and lean mass strongly influence skeletal loading and may also affect circulating 25(OH)D, we aimed to evaluate the association between serum 25(OH)D and bone outcomes in early postmenopausal women and to determine whether body composition attenuates this relationship. Methods: In this cross-sectional study, 120 women within 10 years after natural menopause (59.5 ± 6.3 years) were assessed. Serum 25(OH)D was measured by chemiluminescent immunoassay. Total body areal bone mineral density (total body aBMD, g/cm²) was assessed by DXA, and trabecular volumetric BMD and cortical thickness were obtained using 3D modeling. Associations were examined using Spearman correlations and multivariable linear and logistic regression models adjusted for age, body weight, lean mass, and years since menopause. Results: Median serum 25(OH)D was 23.7 ng/mL [16.7–30.4]. A modest correlation was observed between 25(OH)D and total body aBMD (ρ = 0.22, p = 0.016), but not with trabecular volumetric BMD or cortical thickness. After adjustment, 25(OH)D was not independently associated with total body aBMD (p = 0.144), whereas body weight remained significantly associated (β = 0.27, p = 0.002). In logistic models, body weight (OR = 0.93, 95% CI 0.90–0.96) and lean mass (OR = 0.97, 95% CI 0.95–0.99) were protective against low BMD, while the association with 25(OH)D was modest. Conclusions: In early postmenopause, the association between serum 25(OH)D and BMD is modest and largely attenuated after accounting for body composition. Body weight and lean mass appear to be stronger determinants of bone outcomes than vitamin D status. Full article

(This article belongs to the Special Issue The Role of Vitamin D in Endocrine Diseases: Pathophysiology and Treatment)

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10 pages, 701 KB

Open AccessArticle

Vitamin D Deficiency and Replacement Challenges in Type 1 Gastric Neuroendocrine Tumors: A Comparative Study

by Elio Benevento, Michele Coletta, Alessia Liccardi, Roberto Minotta, Gianfranco Di Iasi, Massimo Di Nola, Annamaria Colao and Roberta Modica

Nutrients 2026, 18(2), 281; https://doi.org/10.3390/nu18020281 - 15 Jan 2026

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Abstract

Background/Objectives: Type 1 gastric neuroendocrine tumors (gNET) arise in the setting of autoimmune chronic atrophic gastritis and secondary hypergastrinemia. Vitamin D deficiency (VDD) has been associated with bone impairment and adverse outcomes in patients with neuroendocrine tumor (NET); however, data specifically addressing gNET remain limited. This study aimed to evaluate vitamin D status, supplementation requirements, and bone involvement in patients with type 1 gNET compared with those with entero-pancreatic NET (EP-NET). Methods: This retrospective study included patients with type 1 gNET followed at a tertiary referral center between 2010 and 2025 and an age- and sex-matched EP-NET cohort. VDD prevalence, time and dose required for normalization, supplementation formulations, bone status, and dietary habits were analyzed. Results: Twenty-six patients were included (thirteen gNET and thirteen EP-NET). VDD was significantly more prevalent in the gNET group compared with the EP-NET group (92.3% vs. 46.2%, p = 0.03, OR: 14). gNET required significantly higher daily cholecalciferol doses (3198.9 ± 1629 vs. 1580 ± 1121 IU/day, p = 0.008) and more frequently required multiple supplementation formulations (38.5% vs. 0%, p = 0.04). Multivariable linear regression analysis restricted to VDD patients confirmed that gNET was independently associated with higher daily cholecalciferol dose requirements (p = 0.037). Bone impairment, defined as osteoporosis or osteopenia, was significantly more common in the gNET group (61.5% vs. 15.4%, p = 0.04, OR: 8.8). Dietary adherence did not differ between groups. Conclusions: Type 1 gNET show a higher burden of VDD, increased vitamin D supplementation requirements, and a higher prevalence of bone impairment compared with EP-NET, irrespective of dietary habits. These findings suggest disease-specific mechanisms and support the need for tailored management in these patients. Full article

(This article belongs to the Special Issue The Role of Vitamin D in Endocrine Diseases: Pathophysiology and Treatment)

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Review

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13 pages, 1080 KB

Open AccessReview

The Role of Vitamin D in Autoimmune Thyroid Diseases: From Immunomodulation to Clinical Implications

by Giulia Bendotti, Chiara Mele, Luisa Costantini, Alberto Ragni, Paola Leporati, Emilia Biamonte and Marco Gallo

Nutrients 2026, 18(2), 217; https://doi.org/10.3390/nu18020217 - 9 Jan 2026

Cited by 1 | Viewed by 1639

Abstract

Vitamin D is involved in immune regulation through effects on innate and adaptive immune responses mediated by vitamin D receptor activation within immune cells. Experimental and translational studies support its role in promoting regulatory T-cell activity, modulating Th1/Th17 responses, and influencing autoantibody production. At the population level, low serum 25-hydroxyvitamin D concentrations are consistently associated with an increased risk of autoimmune diseases, including autoimmune thyroid disorders such as Hashimoto’s thyroiditis (HT) and Graves’ disease (GD), suggesting a potential preventive association. In contrast, clinical evidence from interventional studies in patients with established disease is heterogeneous. Although vitamin D supplementation has been associated with reductions in thyroid autoantibody titers in some studies—particularly in patients with HT and baseline vitamin D deficiency—consistent effects on thyroid function, disease progression, or relapse prevention have not been demonstrated. Overall, current evidence supports vitamin D deficiency as a potentially modifiable risk marker rather than a confirmed disease-modifying therapeutic target in autoimmune thyroid diseases, highlighting the need for further studies focused on clinically meaningful outcomes. Full article

(This article belongs to the Special Issue The Role of Vitamin D in Endocrine Diseases: Pathophysiology and Treatment)

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