Featured article | May 2026
Micronutrients in Autoimmune Diseases: Shining a Light on Vitamin D, Cobalamin, Folate, and Iron Metabolism
Triggianese, P., et al. (2026). Nutrients, 18(4), 561.
This review examines the relationship between micronutrient status and autoimmune disease, with particular focus on vitamin D, cobalamin (vitamin B12), folate, and iron metabolism. These nutrients influence processes involved in immune function, including immune tolerance, inflammation, methylation, DNA stability and repair, and lymphocyte activity.
Discussed in the Article:
Vitamin D shapes immune balance
- Vitamin D helps regulate immune tolerance and may help shift immune responses away from pathways associated with autoimmunity.
- Low vitamin D levels are common in autoimmune diseases such as rheumatoid arthritis, lupus, and multiple sclerosis.
- Deficiency has been associated with greater disease activity.
Folate and B12 support immune stability
- Folate and vitamin B12 are required for DNA synthesis and methylation.
- Deficiencies may impair immune regulation and genomic integrity.
- Low levels can contribute to abnormal immune-cell activity and chronic inflammation.
- Gastrointestinal autoimmune disorders may increase the risk of malabsorption and deficiency.
Iron regulation is altered in autoimmune disease
- Iron is essential for immune-cell function.
- Iron deficiency may worsen fatigue, immune dysfunction, and quality of life.
- Autoimmune diseases commonly disrupt iron metabolism through chronic inflammation.
- Inflammation can trap iron in storage tissues, limiting availability to cells.
Micronutrient deficiencies are common in autoimmune disease
- Patients with autoimmune diseases frequently present with micronutrient deficiencies.
- Chronic inflammation, medications, restricted diets, and malabsorption can all contribute.
- Routine nutrient screening is rarely emphasized in standard autoimmune care.
Nutritional strategies can complement conventional care
- Targeted supplementation may support broader autoimmune management alongside standard therapies.
- Nutritional immunology is receiving increasing scientific and clinical attention.
Why it matters
Micronutrient status may play a more direct role in autoimmune disease than previously appreciated, highlighting the potential value of nutrient assessment and targeted nutritional support in autoimmune care.
“Systematic screening protocols for micronutrient assessment should be included in the baseline evaluation of all newly diagnosed AID [autoimmune disease] patients, with the aim of preventing and promptly treating potential deficiencies through monitored, personalized supplementation.”
