Am J Respir Crit Care Med. 2020 Mar 18, DOI: 10.1164/rccm.201909-1867OC
David A Jolliffe 1, Christos Stefanidis 1, Zhican Wang 2, Nazanin Z Kermani 3, Vassil Dimitrov 4, John H White 5, John E McDonough 6, Wim Janssens 7, Paul Pfeffer 8, Christopher J Griffiths 9, Andrew Bush 10, Yike Guo 3, Stephanie Christenson 11, Ian M Adcock 12, Kian Fan Chung 13, Kenneth E Thummel 2, Adrian R Martineau 14
Stimulus: 120,000 IU of Vitamin D every 2 months for a year
Response: asthmatics 8 ng, COPD 9 ng, controls 16 ng
This has been seen many times: takes 2 to 3X more vitamin D to treat a disease than to prevent it
Possible reasons include
- The disease actually consumes Vitamin D
- Poor Vitamin D genes ==> both disease and need for higher doses
- Poor liver processing
- Poor gut processing
Note: #3 and #4 could be checked by by-passing the gut and liver
Breathing category starts with the following
- Several smoking problems treated by Vitamin D (bi-weekly, 50,000 IU) - RCT Dec 2021
- Asthma and COPD in a few seniors greatly decreased by monthly 100,000 IU Vitamin D – RCT Feb 2021
- Acute respiratory tract infections not reduced by Vitamin D if already have a good level – Jan 2020
- Those with Asthma or COPD had half the response to Vitamin D – March 2020
- Hay Fever treated by Vitamin D (50,000 IU weekly) – RCT July 2019
- COPD trial to use 80,000 IU of vitamin D weekly – RCT 2021
- Childhood colds reduced 25 percent by weekly Vitamin D – RCT Jan 2019
- All asthma problems reduced after 1 year of Vitamin D – Nov 2017
- Vitamin D loading dose then weekly 50,000 IU not help (COPD) if very deficient – Oct 2015
- Respiratory infections (RTI) cut in half by 20,000 IU weekly vitamin D if initially deficient – RCT March 2015
- Asthma reduced by weekly 50,000 IU of vitamin D – RCT Aug 2014
- Overview COPD and Vitamin D
Rationale: Vitamin D deficiency is common in patients with asthma and COPD. Low 25-hydroxyvitamin D (25[OH]D) levels may represent a cause or a consequence of these conditions.
Objective: To determine whether vitamin D metabolism is altered in asthma or COPD.
Methods: We conducted a longitudinal study in 186 adults to determine whether the 25(OH)D response to six oral doses of 3 mg vitamin D3, administered over one year, differed between those with asthma or COPD vs. controls. Serum concentrations of vitamin D3, 25(OH)D3 and 1α,25-dihydroxyvitamin D3 (1α,25[OH]2D3) were determined pre- and post-supplementation in 93 adults with asthma, COPD or neither condition, and metabolite-to-parent compound molar ratios were compared between groups to estimate hydroxylase activity. Additionally, we analyzed fourteen datasets to compare expression of 1α,25[OH]2D3-inducible gene expression signatures in clinical samples taken from adults with asthma or COPD vs. controls.
Measurements and main results:
The mean post-supplementation 25(OH)D increase in participants with
- asthma (20.9 nmol/L) and
- COPD (21.5 nmol/L) was lower than in
- controls (39.8 nmol/L; P=0.001).
Compared with controls, patients with asthma and COPD had lower molar ratios of 25(OH)D3-to-vitamin D3 and higher molar ratios of 1α,25(OH)2D3-to-25(OH)D3 both pre- and post-supplementation (P≤0.005). Inter-group differences in 1α,25[OH]2D3-inducible gene expression signatures were modest and variable where statistically significant.
Conclusions: Attenuation of the 25(OH)D response to vitamin D supplementation in asthma and COPD associated with reduced molar ratios of 25(OH)D3-to-vitamin D3 and increased molar ratios of 1α,25(OH)2D3-to-25(OH)D3 in serum, suggesting that vitamin D metabolism is dysregulated in these conditions.
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