The Health Effects of Vitamin D and Probiotic Co-Supplementation: A Systematic Review of Randomized Controlled Trials

Nutrients
Q1
Dec 2020
Citations:38
Influential Citations:1
Systematic Reviews / Meta-Analyses
81
S2 IconPDF Icon

Enhanced Details

Methods
Seven randomized controlled trials (RCTs). Six double-blind; one single-blind. Participants included: adults with schizophrenia (Ghaderi, n=60; ages 25–65), osteopenia (Jafarnejad, n=50; women), gestational diabetes (Jamilian, n=87; pregnant women), PCOS (Ostadmohammadi, n=60; women), type 2 diabetes with CHD (Raygan, n=60; ages 45–85; ~50% men), IBS (Tazzyman, n=51; adults), and newborns with infantile colic (Savino, n=105).
Intervention
Regimens varied across seven randomized controlled trials. Ghaderi 2019: Vitamin D3 50,000 IU every 2 weeks + probiotic capsule totaling 8×10^9 CFU/day for 12 weeks (oral). Jafarnejad 2017: Probiotic mix (multiple strains) with Vitamin D 200 IU daily + Calcium 500 mg daily for 6 weeks (oral); Vitamin D given to all arms. Jamilian 2018: Vitamin D 50,000 IU every 2 weeks + probiotic 8×10^9 CFU/day; Vitamin D3 1000 IU daily plus folic acid 400 mcg and ferrous sulfate 60 mg; duration 6 weeks (pregnant). Ostadmohammadi 2019: Vitamin D 50,000 IU every 2 weeks plus probiotic 8×10^9 CFU/day for 12 weeks. Raygan 2018: Vitamin D 50,000 IU every 2 weeks plus probiotic 8×10^9 CFU/g for 12 weeks. Savino 2015: Vitamin D 400 IU daily plus Lactobacillus reuteri DSM 17938 1×10^8 CFU for 12 weeks in newborns. Tazzyman 2015: Vitamin D3 3000 IU daily (sublingual spray) + multi-strain probiotic 2.5×10^10 CFU per capsule for 12 weeks; trial included double placebo and placebo+Vitamin D arms. Jamilian 2019: Vitamin D 1000 IU daily plus probiotic 8×10^9 CFU/day for 6 weeks in gestational diabetes; All groups also received Vitamin D 1000 IU and standard prenatal supplements including folic acid 400 mg and iron 60 mg.
Results
Co-supplementation with vitamin D and probiotics generally yielded greater health benefits than comparators (placebo or vitamin D alone) across seven RCTs, including improvements in psychiatric/metabolic/inflammatory markers, insulin sensitivity, inflammatory and oxidative stress markers, lipid profiles, mental health, and reduced healthcare use; IBS did not show added benefits in one trial. Authors conclude a dose-dependent synergistic effect and call for more high-quality trials to confirm findings and determine optimal form, composition, and frequency.
Limitations
Small number of trials (n=7); small sample sizes (≈50–105 per trial); short duration (6–12 weeks); heterogeneity in populations and outcomes; variations in vitamin D dose, form, and probiotic strains; only two trials reported probiotic strain details; no gut microbiota analyses; unable to pool results; incomplete data reporting in some trials.

Abstract

Evidence of synergic health effects of co-supplementation with vitamin D and probiotics is emerging. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA statement, scientific databases and the grey literature were ...