Nutrition and Recovery: Does Low Vitamin D Cause Slow Wound Healing?

October 23, 2025 •

4 min read

A systematic review of studies on hard-to-heal wounds found a strong correlation between low 25-hydroxyvitamin D levels and the presence of slow-healing ulcers, including pressure, diabetic, and venous types. This evidence makes the question, 'Does low vitamin D cause slow wound healing?', critical for nutritional and recovery considerations.

Quick Summary

Vitamin D deficiency can significantly impair the complex process of wound repair by disrupting immune responses, inhibiting cellular proliferation, and delaying key phases of healing. Correcting low vitamin D levels through diet and supplementation has been shown to support faster, more effective wound recovery, particularly in at-risk populations like the elderly or those with diabetes.

Key Points

Vitamin D and Inflammation: Adequate vitamin D helps modulate the inflammatory phase of wound healing, preventing prolonged inflammation that can delay recovery.
Cell Proliferation: Vitamin D promotes the migration and proliferation of essential skin cells like keratinocytes, which is crucial for closing wounds.
Angiogenesis: Sufficient vitamin D levels support the formation of new blood vessels (angiogenesis) to supply oxygen and nutrients to the healing tissue.
Extracellular Matrix: Vitamin D contributes to the healthy deposition of collagen and other components that form the structural framework for new tissue.
Clinical Correlation: Clinical studies have found a strong link between low vitamin D status and hard-to-heal wounds, such as pressure, diabetic, and venous ulcers.
Optimizing Intake: A balanced strategy involving diet, safe sun exposure, and supplements is the most effective way to maintain optimal vitamin D levels for better healing.

The intricate process of wound healing relies heavily on adequate nutritional support. While certain nutrients like protein and vitamin C are widely known for their importance, the critical role of vitamin D is often overlooked. However, a growing body of evidence suggests that insufficient levels of this 'sunshine vitamin' can compromise the body's ability to repair tissue, leading to delayed or chronic wounds.

The Crucial Role of Vitamin D in Wound Healing

Research indicates that vitamin D's influence on wound healing extends beyond its well-known function in bone health. The active form of vitamin D, calcitriol, binds to vitamin D receptors (VDR) found in various skin cells, including keratinocytes and fibroblasts, triggering a cascade of beneficial effects. This interaction is fundamental for orchestrating a coordinated response to skin injury.

Modulating the Inflammatory Response

The initial inflammatory phase is essential for clearing pathogens and damaged tissue from a wound. However, prolonged or excessive inflammation can hinder the healing process. Vitamin D plays a key regulatory role by suppressing pro-inflammatory factors like IL-6 and TNF-α while promoting anti-inflammatory cytokines, such as IL-10. It also facilitates the crucial switch from pro-inflammatory (M1) to anti-inflammatory (M2) macrophages, a transition that helps resolve inflammation and allows the next healing phase to begin. A deficiency can disrupt this delicate balance, causing chronic inflammation and delayed healing.

Promoting Cellular Proliferation and Migration

For a wound to close, skin cells must proliferate and migrate to cover the damaged area, a process called re-epithelialization. Vitamin D promotes the proliferation and differentiation of epidermal stem cells (EpSCs) and keratinocytes, which are responsible for regenerating the epidermis. Studies on mice and human cell cultures have shown that topical application or supplementation of vitamin D accelerates wound closure by stimulating these cell populations.

Supporting Angiogenesis and Extracellular Matrix Formation

During the proliferative phase, new blood vessels must form to supply oxygen and nutrients to the healing tissue (angiogenesis). Vitamin D enhances angiogenesis by upregulating key angiogenic growth factors like VEGF and PDGF. It also supports the formation of the extracellular matrix (ECM), the structural scaffold for new tissue, by promoting fibronectin and regulating collagen deposition. Studies suggest that low vitamin D levels may result in decreased collagen deposition and impaired ECM formation.

Clinical Evidence Linking Low Vitamin D to Slow Healing

Multiple studies have cemented the link between low vitamin D and poor wound outcomes. A systematic review published in 2020 analyzed research on pressure, diabetic, and venous ulcers, finding a consistent correlation between low vitamin D levels and hard-to-heal wounds. For example, a 2019 review noted that vitamin D deficiency compromised healing in dental surgery patients, while a 12-week study involving diabetic foot ulcer patients demonstrated significant improvements in wound healing with vitamin D supplementation. Patients with severe vitamin D deficiency also tend to have higher levels of inflammatory markers, which can interfere with the healing process.

Optimizing Vitamin D for Enhanced Recovery

For those with documented vitamin D deficiency, a multifaceted approach is recommended to optimize levels and support better wound healing.

Dietary Sources: While few foods are naturally rich in vitamin D, options include fatty fish (salmon, tuna, mackerel), fish liver oils, beef liver, egg yolks, and certain mushrooms. Many foods like milk, cereals, and orange juice are also fortified.
Safe Sun Exposure: The body synthesizes vitamin D from sunlight exposure (UVB rays). Aim for 10–30 minutes of midday sun on exposed skin a few times per week, depending on location, skin type, and season. However, balance this with sun protection to minimize skin damage.
Supplementation: Supplements are a reliable way to boost vitamin D levels, especially for those with limited sun exposure or dietary intake. The recommended daily dose varies, so consult a healthcare professional for personalized guidance. Taking supplements with a fatty meal can also significantly improve absorption.

Nutritional Support for Wound Healing

Comparison of Wound Healing with Adequate vs. Deficient Vitamin D


Feature	Adequate Vitamin D	Deficient Vitamin D
Inflammatory Response	Modulated and regulated; transitions smoothly to proliferative phase.	Prolonged and excessive inflammation; delays transition to proliferative phase.
Cellular Proliferation	Efficient proliferation and migration of keratinocytes and fibroblasts.	Impaired proliferation and migration of skin cells, leading to delayed re-epithelialization.
Angiogenesis	Enhanced formation of new blood vessels, ensuring oxygen and nutrient supply.	Impaired formation of new blood vessels, leading to reduced tissue perfusion.
Collagen Synthesis	Supports appropriate deposition of collagen for new tissue formation.	Reduced collagen deposition and impaired extracellular matrix formation.
Wound Closure	Expedited wound closure and reduced risk of chronic wounds.	Delayed wound closure, potentially leading to chronic, hard-to-heal ulcers.

Conclusion

It is clear from various studies that low vitamin D levels can impair the complex biological processes involved in wound healing, confirming that does low vitamin D cause slow wound healing is a valid and medically significant question. From modulating the inflammatory response to promoting cellular activity and tissue regeneration, vitamin D is a critical component of nutritional support for recovery. Ensuring adequate levels through a combination of diet, safe sun exposure, and potentially supplementation is a vital strategy for supporting efficient wound healing, especially for at-risk individuals like the elderly or those with chronic diseases. A comprehensive approach to wound care should therefore always include assessing and addressing a patient's nutritional status, including their vitamin D levels.

Frequently Asked Questions

Yes, research suggests a strong correlation between low vitamin D levels and hard-to-heal wounds. The nutrient's role in regulating inflammation and supporting tissue repair means a deficiency can impair the healing process and potentially contribute to chronic wound development.

Vitamin D promotes the proliferation and differentiation of epidermal stem cells (EpSCs) and keratinocytes, which are the main cell types involved in regenerating the skin. This process, called re-epithelialization, is crucial for wound closure.

Yes, vitamin D plays a critical role in modulating the body's inflammatory response during wound healing. It helps suppress pro-inflammatory markers and facilitates the shift towards an anti-inflammatory state, which is necessary for the next phase of healing.

Studies have shown that vitamin D supplementation improved wound healing outcomes in patients with diabetes-related foot ulcers. This is likely due to its effects on inflammation and tissue repair processes.

Optimizing vitamin D involves a combination of strategies. This includes consuming vitamin D-rich foods (fatty fish, fortified milk), getting safe sun exposure, and considering a daily supplement, especially if you have limited sun exposure or malabsorption issues.

While some studies indicate vitamin D can affect collagen production by fibroblasts, the balance of evidence suggests adequate vitamin D supports the deposition of a healthy extracellular matrix, which is vital for tissue strength and proper wound remodeling.

Groups at higher risk include older adults, people with limited sun exposure, those with darker skin, individuals with obesity, and patients with conditions that affect fat absorption. These populations may be more susceptible to poor wound healing due to insufficient vitamin D levels.