Vitamin D in Injury Risk and Healing- A Comprehensive Review
DOI:
https://doi.org/10.12775/JEHS.2026.87.67737Keywords
vitamin D, cholecalciferol, wound healing, Bone regeneration, tissue repair, supplementation, deficiency, trauma, ulcer, diabetes, burns, brain injuryAbstract
In an era of an aging population, vitamin D deficiencies constitute a significant clinical problem. Its pleiotropic effects encompass key reparative processes in soft and bone tissues, as well as modulation of the nervous and immune systems, suggesting its potentially important role in injury prevention and healing support. The aim of this review was to systematically analyse and synthesise current knowledge regarding: (1) the molecular mechanisms of vitamin D action in repair processes, (2) the efficacy of its supplementation in the context of post-injury healing, and (3) the clinical consequences of its deficiency. The literature review was conducted according to the PRISMA methodology. The PubMed, Scopus, and Web of Science databases were searched using defined keywords related to vitamin D, wound healing, bone regeneration, and trauma. Original and review articles published between 2010 and 2024 were analysed. The synthesis confirmed the key role of vitamin D in regulating cell proliferation, angiogenesis, extracellular matrix synthesis, and inflammation modulation. Clinical data indicate that supplementation is most beneficial for patients with pre-existing deficiency, significantly reducing the risk of complications and improving healing parameters. Groups at particular risk of deficiency requiring monitoring include the elderly, burn victims, diabetics, individuals with dark skin phototypes, and those with malabsorption disorders. For patients with normal or high baseline 25(OH)D levels, the benefits of supplementation are limited or insignificant. Optimising vitamin D levels is a significant, modifiable factor supporting tissue healing, especially in deficient patients. Routine assessment of vitamin D status and targeted supplementation in risk groups should be an integral part of comprehensive post-traumatic care.
References
1 Murray R. K., Granner D. K., Rodwell V. W. (red.). (2012). Harper’s Illustrated Biochemistry [title in Polish]. Warszawa: Wydawnictwo Lekarskie PZWL..
2 Bańkowski, E. (2004). Biochemistry. A textbook for medical students [title in Polish] (, s. 745). Wydaw. Medyczne Urban & Partner, cop.
3 Reboul E. Intestinal absorption of vitamin D: from the meal to the enterocyte. Food Funct. 2015 Feb;6(2):356-62. doi: 10.1039/c4fo00579a. PMID: 25367187.
4 Tuchendler, D. and Bolanowski, M. (2010) 'Seasonality of changes in vitamin D concentrations in the human body' [title in Polish], Endokrynologia, Otyłość i Zaburzenia Przemiany Materii, 6(1), pp. 36–41.
5 Dittfeld, A., Gwizdek, K., Koszowska, A. and Fizia, K. (2014) 'The multidirectional action of vitamin D' [title in Polish], Postępy Higieny i Medycyny Doświadczalnej, 68, pp. 620–628.
6 Marcinkowska, M., Mickiewicz, A. and Fijałkowski, M. (2019) 'The pleiotropic effects of vitamin D' [title in Polish], Choroby Serca i Naczyń, 16(1), pp. 45–52. doi: 10.5603/ChSiN.2019.0007.
7 Armas, L.A.G., and R.P. Heaney, “Vitamin D: The Iceberg Nutrient,” Journal of Renal Nutrition, 21 (2), pp. 134–139 (2011).
8 Overcash, J.A., “Vitamin D in Older Patients With Cancer,” Clinical Journal of Oncology Nursing, 12 (4), pp. 655–662 (2008).
9 Won, S., I. Sayeed, B.L. Peterson, B. Wali, J.S. Kahn, and D.G. Stein, “Vitamin D Prevents Hypoxia/Reoxygenation-Induced Blood-Brain Barrier Disruption via Vitamin D Receptor-Mediated NF-kB Signaling Pathways,” PLOS ONE, 10 (3), p. e0122821 (2015).
10 Kim, D., Meza, C. A., Clarke, H., Kim, J. & Hickner, R. C. (2020). Vitamin D and Endothelial Function. Nutrients, 12(2), 575. https://doi.org/10.3390/nu12020575
11 Napiórkowska, L. & Franek, E. (2009) 'The role of vitamin D testing in clinical practice' [title in Polish], Choroby Serca i Naczyń, 6(4), s. 203–210. Dostępne na: [https://journals.viamedica.pl/choroby_serca_i_naczyn/article/view/12035] (Data odwiedzenia: 16.11.2025).
12 Clarke, N.M.P., and J.E. Page, “Vitamin D deficiency” Current Opinion in Pediatrics, 24 (1), pp. 46–49 (2012).
13 Ghorbanzadeh-Moghaddam, A., A. Gholamrezaei, and S. Hemati, “Vitamin D Deficiency Is Associated With the Severity of Radiation-Induced Proctitis in Cancer Patients” International Journal of Radiation Oncology*Biology*Physics, 92 (3), pp. 613–618 (2015).
14 Stöcklin, Elisabeth, and Manfred Eggersdorfer. 2013. "Vitamin D, an Essential Nutrient with Versatile Functions in Nearly all Organs." International Journal for Vitamin and Nutrition Research 83 (2): 92–100. https://doi.org/10.1024/0300-9831/a000151.
15 Hribar, M., Hristov, H., Lavriša, Ž., Korousić Seljak, B., Gregorič, M., Blaznik, U., Żmitek, K., & Pravst, I. (2021). Vitamin D intake in Slovenian adolescents, adults, and the elderly population. Nutrients, *13*(10), 3528. https://doi.org/10.3390/nu13103528
16 van den Heuvel EG, Lips P, Schoonmade LJ, Lanham-New SA, van Schoor NM. Comparison of the Effect of Daily Vitamin D2 and Vitamin D3 Supplementation on Serum 25-Hydroxyvitamin D Concentration (Total 25(OH)D, 25(OH)D2, and 25(OH)D3) and Importance of Body Mass Index: A Systematic Review and Meta-Analysis. Adv Nutr. 2024;15(1):100133. doi:10.1016/j.advnut.2023.09.016
17 Glendenning P, Chew GT, Seymour HM, et al. Serum 25-hydroxyvitamin D levels in vitamin D-insufficient hip fracture patients after supplementation with ergocalciferol and cholecalciferol. Bone. 2009;45(5):870-875. doi:10.1016/j.bone.2009.07.015
18 Gottschlich MM, Mayes T, Khoury J, Kagan RJ. Clinical Trial of Vitamin D2 vs D3 Supplementation in Critically Ill Pediatric Burn Patients. Journal of Parenteral and Enteral Nutrition. 2015;41(3):412-421. doi:10.1177/0148607115587948
19 Wacker M, Holick MF. Vitamin D - effects on skeletal and extraskeletal health and the need for supplementation. Nutrients. 2013;5(1):111-148. Published 2013 Jan 10. doi:10.3390/nu5010111
20 Klein GL, Chen TC, Holick MF, et al. Synthesis of vitamin D in skin after burns. The Lancet. 2004;363(9405):291-292. doi:10.1016/s0140-6736(03)15388-3
21 Zhang Y, Fang F, Tang J, et al. Association between vitamin D supplementation and mortality: systematic review and meta-analysis. BMJ. 2019;366:l4673. Published 2019 Aug 12. doi:10.1136/bmj.l4673
22 Law M, Withers H, Morris J, Anderson F. Vitamin D supplementation and the prevention of fractures and falls: results of a randomised trial in elderly people in residential accommodation. Age and Ageing. 2006;35(5):482-486. doi:10.1093/ageing/afj080
23 Janoušek, J., Pilařová, V., Macáková, K., Nomura, A., Veiga-Matos, J., Silva, D. D. da, Mladěnka, P. (2022). Vitamin D: sources, physiological role, biokinetics, deficiency, therapeutic use, toxicity, and overview of analytical methods for detection of vitamin D and its metabolites. Critical Reviews in Clinical Laboratory Sciences, 59(8), 517–554. https://doi.org/10.1080/10408363.2022.2070595
24 Pramyothin P, Holick MF. Vitamin D supplementation. Current Opinion in Gastroenterology. 2012;28(2):139-150. doi:10.1097/mog.0b013e32835004dc
25 Wei MY, Giovannucci EL. Vitamin D and multiple health outcomes in the Harvard cohorts. Molecular Nutrition & Food Research. 2010;54(8):1114-1126. doi:10.1002/mnfr.200900574
26 Birinci, M. et al. (2024) ‘Effect of Vitamin D Deficiency on Periprosthetic Joint Infection and Complications After Primary Total Joint Arthroplasty’, The Journal of Arthroplasty, 39, pp. S151–S157. doi:10.1016/j.arth.2024.05.012.
27 Chiang CM, Ismaeel A, Griffis RB, Weems S. Effects of Vitamin D Supplementation on Muscle Strength in Athletes: A Systematic Review. J Strength Cond Res. 2017;31(2):566-574. doi:10.1519/JSC.0000000000001518
28 Wen Y, Latham CM, Moore AN, et al. Vitamin D status associates with skeletal muscle loss after anterior cruciate ligament reconstruction. JCI Insight. 2023;8(23):e170518. Published 2023 Dec 8. doi:10.1172/jci.insight.170518
29 Bikle DD. Role of vitamin D and calcium signaling in epidermal wound healing. J Endocrinol Invest. 2023;46(2):205-212. doi:10.1007/s40618-022-01893-5
30 Romano F, Serpico D, Cantelli M, et al. Osteoporosis and dermatoporosis: a review on the role of vitamin D. Front Endocrinol (Lausanne). 2023;14:1231580. Published 2023 Aug 24. doi:10.3389/fendo.2023.1231580
31 Seth I, Lim B, Cevik J, et al. Impact of nutrition on skin wound healing and aesthetic outcomes: A comprehensive narrative review. JPRAS Open. 2024;39:291-302. Published 2024 Jan 23. doi:10.1016/j.jpra.2024.01.006
32 Tang W, Chen S, Zhang S, Ran X. The Multi-Dimensional Role of Vitamin D in the Pathophysiology and Treatment of Diabetic Foot Ulcers: From Molecular Mechanisms to Clinical Translation. International Journal of Molecular Sciences. 2025; 26(12):5719. https://doi.org/10.3390/ijms26125719
33 Zhao H, Wu X, Li H, Lan Y. Effects of Oral Cholecalciferol on Chronic Wound Healing in Patients with Vitamin D Insufficiency or Deficiency. J Multidiscip Healthc. 2025;18:6887-6900. Published 2025 Oct 24. doi:10.2147/JMDH.S543380
34 Yuan Y, Das SK, Li M. Vitamin D ameliorates impaired wound healing in streptozotocin-induced diabetic mice by suppressing NF-κB-mediated inflammatory genes [retracted in: Biosci Rep. 2022 Dec 22;42(12):BSR-2017-1294_RET. doi: 10.1042/BSR-2017-1294_RET.]. Biosci Rep. 2018;38(2):BSR20171294. Published 2018 Mar 5. doi:10.1042/BSR20171294
35 Oda Y, Hu L, Nguyen T, Fong C, Tu C, Bikle DD. Combined deletion of the vitamin D receptor and calcium-sensing receptor delays wound re-epithelialization. Endocrinology. 2017;158(6):1929-1938. doi:10.1210/en.2017-00061
36 Rech MA, Colon Hidalgo D, Larson J, Zavala S, Mosier M. Vitamin D in burn-injured patients. Burns. 2019;45(1):32-41. doi:10.1016/j.burns.2018.04.015
37 Jiang H, Yang X, Wang Y, Zhou C. Vitamin D Protects against Traumatic Brain Injury via Modulating TLR4/MyD88/NF-κB Pathway-Mediated Microglial Polarization and Neuroinflammation. Biomed Res Int. 2022;2022:3363036. Published 2022 Jul 15. doi:10.1155/2022/3363036
38 Zheng S, Yang J, Hu X, et al. Vitamin D attenuates lung injury via stimulating epithelial repair, reducing epithelial cell apoptosis and inhibits TGF-β induced epithelial to mesenchymal transition. Biochemical Pharmacology. 2020;177:113955. doi:10.1016/j.bcp.2020.113955
39 Vila Cuenca M, Ferrantelli E, Meinster E, et al. Vitamin D Attenuates Endothelial Dysfunction in Uremic Rats and Maintains Human Endothelial Stability. J Am Heart Assoc. 2018;7(17):e008776. doi:10.1161/JAHA.118.008776
40 Li W, Lin Y, Luo Y, et al. Vitamin D Receptor Protects against Radiation-Induced Intestinal Injury in Mice via Inhibition of Intestinal Crypt Stem/Progenitor Cell Apoptosis. Nutrients. 2021;13(9):2910. Published 2021 Aug 24. doi:10.3390/nu13092910
41 Li N, Yao M, Liu J, et al. Vitamin D Promotes Remyelination by Suppressing c-Myc and Inducing Oligodendrocyte Precursor Cell Differentiation after Traumatic Spinal Cord Injury. Int J Biol Sci. 2022;18(14):5391-5404. Published 2022 Aug 29. doi:10.7150/ijbs.73673
42 Mende LK, Kuthati Y, Wong CS. Curcumin and Vitamin D Supplement Attenuates Knee Osteoarthritis Progression in ACLT + MMx Rat Model: Effect on Cartilage Protection and Pain Reduction. Nutrients. 2025;17(2):349. Published 2025 Jan 19. doi:10.3390/nu17020349
43 Sharma S, Kumar A, Choudhary A, et al. Neuroprotective Role of Oral Vitamin D Supplementation on Consciousness and Inflammatory Biomarkers in Determining Severity Outcome in Acute Traumatic Brain Injury Patients: A Double-Blind Randomized Clinical Trial. Clin Drug Investig. 2020;40(4):327-334. doi:10.1007/s40261-020-00896-5
44 Lee JM, Jeong SW, Kim MY, Park JB, Kim MS. The Effect of Vitamin D Supplementation in Patients with Acute Traumatic Brain Injury. World Neurosurgery. 2019;126:e1421-e1426. doi:10.1016/j.wneu.2019.02.244
45 Intiso D, Fontana A, Copetti M, Di Rienzo F. Serum vitamin D deficiency in subjects with severe acquired brain injury and relationship with functional severity. Brain Injury. 2018;32(13-14):1817-1823. doi:10.1080/02699052.2018.1537512
46 Sato Y, Iwamoto J, Kanoko T, Satoh K. Low-Dose Vitamin D Prevents Muscular Atrophy and Reduces Falls and Hip Fractures in Women after Stroke: A Randomized Controlled Trial. Cerebrovascular Diseases. Published online September 7, 2005:187-192. doi:10.1159/000087203
47 Rebolledo BJ, Bernard JA, Werner BC, et al. The Association of Vitamin D Status in Lower Extremity Muscle Strains and Core Muscle Injuries at the National Football League Combine. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2018;34(4):1280-1285. doi:10.1016/j.arthro.2017.10.005
48 Hernigou P, Sitbon J, Dubory A, Auregan JC. Vitamin D history part III: the “modern times”—new questions for orthopaedic practice: deficiency, cell therapy, osteomalacia, fractures, supplementation, infections. International Orthopaedics. 2019;43(7):1755-1771. doi:10.1007/s00264-019-04334-w
49 Abdehgah AG, Monshizadeh A, Tehrani MM, et al. Relationship Between Preoperative 25-Hydroxy Vitamin D and Surgical Site Infection. Journal of Surgical Research. 2020;245:338-343. doi:10.1016/j.jss.2019.07.036
50 Coskun Benlidayi I, Basaran S, Seydaoglu G, Guzel R. Vitamin D profile of patients with spinal cord injury and post-stroke hemiplegia: All in the same boat. J Back Musculoskelet Rehabil. 2016;29(2):205-210. doi:10.3233/BMR-150615
51 Siregar FD, Hidayat W. The Role of Vitamin D on the Wound Healing Process: A Case Series. Int Med Case Rep J. 2023;16:227-232. Published 2023 Apr 1. doi:10.2147/IMCRJ.S402005
52 Lakhera KK, Babu A, Patel P, et al. Association Between Pre-operative 25-Hydroxy Vitamin D Deficiency and Surgical Site Infection After Oral Cavity Oncology Surgery: a Cross-Sectional Study in a Tertiary Cancer Center in Northwestern India. Indian J Surg Oncol. 2024;15(2):218-224. doi:10.1007/s13193-023-01862-1
53 Pirdastan S, Mahdavi Roshan M, Mobayen M, et al. Effect of vitamin D on clinical outcomes in patients with thermal injury. Int Wound J. 2024;21(2):e14641. doi:10.1111/iwj.14641
54 Zhang Z, Yang X, Li M, Li B. Serum 25-Hydroxyvitamin D Levels and the Risk of Post-Traumatic Wound Infection. J Nutr Sci Vitaminol (Tokyo). 2025;71(2):110-117. doi:10.3177/jnsv.71.110
55 KORGAVKAR K, XIONG M, WEINSTOCK MA. Review: Higher vitamin D status and supplementation may be associated with risks. European Journal of Dermatology. 2014;24(4):428-434. doi:10.1684/ejd.2014.2318
56 Liu S, Sulovari A, Joo P, Thirukumaran C, Benn L, Mesfin A. Relationship between 25-hydroxy Vitamin D level and surgical site infection in spine surgery. Surg Neurol Int. 2024;15:173. Published 2024 May 24. doi:10.25259/SNI_135_2024
57 Pritchett K, Pritchett RC, Stark L, Broad E, LaCroix M. Effect of Vitamin D Supplementation on 25(OH)D Status in Elite Athletes With Spinal Cord Injury. International Journal of Sport Nutrition and Exercise Metabolism. 2019;29(1):18-23. doi:10.1123/ijsnem.2017-0233
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