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Common causes of erectile dysfunction include: Vascular conditions atherosclerosis, hypertension, and diabetes can impair blood flow Neurological disorders multiple sclerosis, Parkinson's disease, or spinal injuries Hormonal imbalances low testosterone, thyroid disorders Psychological factors anxiety, depression, stress, relationship difficulties Medications certain antihypertensives (e.g., thiazide diuretics, some beta-blockers), antidepressants (particularly SSRIs), antipsychotics, and 5-alpha-reductase inhibitors Lifestyle factors smoking, excessive alcohol, obesity, sedentary behaviour According to NICE Clinical Knowledge Summary guidance, ED is often an early marker of cardiovascular disease, as the penile arteries are smaller than coronary vessels and may show atherosclerotic changes earlier

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[2] However, once stores are depleted, symptoms can include fatigue, weakness, constipation, loss of appetite, and neurological changes such as numbness, tingling, balance problems, and cognitive difficulties

Vitamin D receptors are expressed by both epithelial and a large number of immune cells in the gastrointestinal tract (357, 358)