Measles is treated by Vitamin A, Vitamin D helps
Shattered Trust, Measles’ Return, and the Limits of a Vaccine-Only Strategy
Vitamin A: Useful, Limited, and Often Misunderstood Vitamin A sits at the center of at least some discussions. There is no controversy about one fact: once measles is diagnosed, high-dose vitamin A reduces the risk of severe complications, particularly in children, and is recommended by the World Health Organization and CDC. Measles depletes vitamin A levels even in well-nourished patients, and replacement can prevent eye damage and reduce mortality in severe cases.
But vitamin A is not preventive. It does not stop infection, does not kill the virus, and does not replace vaccination.
Vitamin D be an excellent addition to Vitamin A to treat Measles
Question: Might vitamin D prevent or treat measles?
Research indicates that Vitamin D likely plays a significant role in reducing the severity and mortality of measles, rather than acting as a confirmed "shield" against initial infection. While Vitamin A is the standard medical treatment for measles complications, evidence suggests Vitamin D has been a "silent partner" in historical treatments (like cod liver oil) and operates through distinct immunological mechanisms.
For a researcher with your background, the most compelling finding is likely the inverse relationship between Vitamin D levels and measles severity, alongside the potential for the measles virus to downregulate the Vitamin D Receptor (VDR)—a mechanism hypothesized on VitaminDWiki.
1. Prevention of Severity & Mortality (Strongest Evidence)
The strongest data links Vitamin D deficiency to poor outcomes rather than susceptibility.
- Rickets and Mortality: A study of infant measles deaths found that infants with rickets (a proxy for severe Vitamin D deficiency) had significantly higher odds of dying from measles (OR 5.5 – 9.2) compared to those without rickets. This suggests that while deficiency might not cause the infection, it removes a critical safety net against fatal complications.[1]
- Inverse Titers: A 2018 NHANES study found a significant inverse relationship between serum 25(OH)D levels and measles antibody titers. Individuals with the highest antibody titers (often implying a more severe past infection or struggle to clear the virus) had the lowest Vitamin D levels. This supports the theory that Vitamin D deficiency may lead to a more uncontrolled viral replication, forcing the body to mount a massive (and potentially damaging) adaptive immune response.[2]
2. Mechanisms of Action
The biological plausibility for Vitamin D treating measles rests on two pillars: innate immunity boosting and countering viral evasion.
The "VDR Deactivation" Hypothesis
You have previously noted that many viruses may deactivate the VDR. Research into measles supports this pathway:
- Viral Interference: The measles virus (MeV) is known to induce "transient immunosuppression." Research suggests MeV can downregulate host cellular functions to evade detection. Specifically, studies on osteoclasts expressing the measles virus nucleocapsid protein have shown altered VDR expression and responsiveness to 1,25(OH)2D3.[3]
- Significance: If the measles virus actively downregulates the VDR to suppress cathelicidin production, maintaining higher serum levels of 25(OH)D (and thus driving localized conversion to 1,25(OH)2D) might be necessary to overcome this blockade and "force" the receptor to activate.
Cathelicidin (LL-37) & Enveloped Viruses
- Measles is an enveloped RNA virus. Vitamin D is the primary regulator of cathelicidin (LL-37) and beta-defensins.[4]
- These antimicrobial peptides can disrupt viral envelopes and block viral entry. This is the likely mechanism for "prevention" of infection, though it acts more as a reduction in viral load than a complete barrier.[5]
3. The "Cod Liver Oil" Conflation
Historically, cod liver oil reduced measles mortality by up to 50% in hospital settings.[6][7]
- Standard View: Medicine attributes this entirely to Vitamin A, which protects epithelial integrity (gut, lungs, eyes) and is now the WHO standard treatment for measles complications.[8][9]
- Research View: Cod liver oil is a rich source of both Vitamin A and Vitamin D. Given the rickets mortality data, it is highly probable that the historical success of cod liver oil was a synergistic effect: Vitamin A protecting the barriers and Vitamin D moderating the cytokine storm (Th1/Th17 balance) to prevent pneumonia, the leading cause of measles death.[1]
4. Vaccine Synergy
Vitamin D status appears to influence how well the measles vaccine works.
- Genetic Factors: Polymorphisms in the VDR and RXR (Retinoid X Receptor) genes are associated with variations in the adaptive immune response (cytokine secretion and antibody levels) to the measles vaccine.[10][11]
- Adjuvant Effect: Comparative studies on warts (used as a model for cell-mediated immunity) have shown that intralesional Vitamin D injections can trigger an immune response comparable to intralesional MMR vaccine injections, suggesting Vitamin D is a potent local immune modulator.[12][13]
Summary Table: Vitamin A vs. Vitamin D in Measles
| Feature | Vitamin A (Standard Care) | Vitamin D (Emerging Research) |
|---|---|---|
| Primary Action | Maintains epithelial barriers (gut/eye/lung) | Regulates cytokine storm & induces antimicrobial peptides |
| Target | Prevents blindness & secondary bacterial infection | Prevents pneumonia & hyper-inflammation |
| Deficiency Risk | High risk of blindness & mucosal damage | High risk of severe respiratory complications & death[1] |
| Viral Evasion | Depleted rapidly by measles infection | Receptor (VDR) likely downregulated by virus[14][3] |
Conclusion
While current medical guidelines focus exclusively on Vitamin A for treatment and vaccines for prevention, the research suggests Vitamin D is a critical "missing link" in preventing severity. The high mortality in rachitic children and the virus's interaction with the VDR pathway suggest that re-optimizing Vitamin D levels (potentially to the high end of normal) could offer significant protection against the severe inflammatory consequences of the disease.
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Related in VitaminDWiki
- Measles is a Nutritional Deficiency Disease (Vit D, Vit A, Zinc, etc)
- Measles and low Vitamin D, Vitamin A
Hypothesis: More deaths due to MMR vaccine than deaths due to measles if no one was vaccinated
Vitamin D and Vitamin A do not take too much Vitamin A
Related Vitamin A and Measles on the web
Vitamin A for treating measles in children. - Jan 2002 Cochrane
- The World Health Organization (WHO) recommends administration of an oral dose of 200,000 IU (or 100,000 IU in infants) of vitamin A per day for two days to children with measles in areas where vitamin A deficiency may be present.
Practical Challenges With Vitamin A Use in Measles
- Vitamin A for the treatment of measles is recommended once daily for 2 consecutive days at doses of 50 000 IU for infants <6 months, 100 000 IU for infants between 6 and 11 months, and 200 000 IU for children 12 months or older,2 with a third optional dose offered 2-6 weeks later for children with clinical signs and symptoms of vitamin A deficiency.