Vitamin D deficiency and supplementation in chronic urticaria: A systematic review

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Created On: 15/11/2025

Chronic urticaria (CU), and in particular chronic spontaneous urticaria (CSU), is a persistent skin disorder marked by recurring hives and angioedema lasting beyond 6 weeks.

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Key take away

Vitamin D levels are lower in chronic urticaria patients, and supplementation—especially at higher doses—consistently reduces disease activity and boosts quality of life.

Background

Chronic urticaria (CU), and in particular chronic spontaneous urticaria (CSU), is a persistent skin disorder marked by recurring hives and angioedema lasting beyond 6 weeks. Growing evidence points to a connection between low vitamin D levels and the immune disturbances seen in CU. Owing to the immunomodulatory and anti-inflammatory effects of vitamin D, this review examined its potential role as a therapeutic adjunct in CU management.

Method

Electronic databases including Google Scholar, PubMed, Scopus, and Web of Science were checked utilizing relevant keywords. Eligible studies encompassed randomized controlled trials (RCTs), case–control studies, and observational research assessing serum vitamin D levels or the effects of supplementation in CU patients. Data extraction and quality evaluation were independently carried out via the Cochrane Risk of Bias Tool and the Newcastle–Ottawa Scale.

Result

In total, 11 studies encompassing 1,491 volunteers met the inclusion criteria. Most studies reported markedly lower serum 25(OH)D levels in CU patients as opposed to healthy individuals. Supplementation with vitamin D, specifically in those suffering from deficiency, was linked to reductions in urticaria activity scores, decreased symptom severity, and better quality of life.

High-dose supplementation protocols (e.g., 4,000 IU/day or 60,000 IU/week) exhibited greater efficacy. However, variations in study design, dosing strategies, and patient demographics contributed to heterogeneous results.

Conclusion

Vitamin D supplementation may represent a safe and accessible adjunct to conventional CU therapy, especially in those with documented deficiency. While current evidence indicates potential clinical benefits, further RCTs are required to clarify causality, optimal dosing, and long-term outcomes.