Tuberculosis treatment greatly helped by injection of 200,000 IU of vitamin D – RCT

Created April 2016

The role of supplementary vitamin D in treatment course of pulmonary tuberculosis

Egyptian Journal of Chest Diseases and Tuberculosis, doi:10.1016/j.ejcdt.2016.03.004

Essam Gouda Hassaneina, Enas El Said Mohammada, Ayman Ibrahim Baessa, , , Eman Tayae EL-Sayedb, Ahmad Madi Yossefc

Injection of vitamin D has several benefits 1. No concern about patient forgetting to take vitamin D periodically 1. No concern about vitamin D being blocked by poor gut 1. Injection provides a loading dose, which restores vitamin D levels in days, rather than months See also VitaminDWiki * Tuberculosis 4.5X more likely if vitamin D less than 10 nanogram – meta-analysis May 2015 * Multidrug-resistant tuberculosis may be reduced with vitamin D – Sept 2012 * Tuberculosis risk decreased by 6 percent for each 1 ng increase in Vitamin D – Oct 2014 * TB Prevention, not just treatment * Smoking reduces vitamin D - many studies * wonder if Smoking ==> reduce Vitamin D ==> increased risk of TB (and other health problems) * Search VitaminDWiki for INJECTION 768 items as of April 2016 * Review of Vitamin D (including free, frequency, injection, how much.) – Sept 2013 * Vitamin D supplementation protocols: loading, injection, etc – RCT June 2014 * Diabetes (Type II) reduced by single injection of 300,000 IU of vitamin D3 – RCT March 2014 Overview Loading of vitamin D contains the following {include} Intervention AND TB in VitaminDWiki {category}

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Background: Vitamin D insufficiency/deficiency is associated with impaired immune function and increased risk of active pulmonary tuberculosis (TB).

Objectives: To evaluate the role of vitamin D as supplementary treatment with the first line anti-tuberculous drugs (rifampicin, izoniazide, ethambutol and pyrazinamide) in treatment course of patients with active pulmonary tuberculosis.

Methods: We conducted a case-control study in El Maamora chest hospital, Alexandria governorate, Egypt, including 60 adult patients with active pulmonary TB of 30 patients each. Patients in group I (cases) received vitamin D (200,000 IU) intramuscular injection once besides anti-tuberculous drugs, while patients in group II (controls) were randomly selected from the hospital registry who received the first line anti-tuberculous treatment only. The primary outcome was evaluation of conversion time of sputum smear. The secondary outcome was clinical improvement as assessed by TB score.

Measurements and main results: Mean ± SD age of all patients was 41.55 ± 14.91 years. The study included 44 (73.3%) males and 16 (26.7%) females. Vitamin D deficiency/insufficiency was detected in 54 (90%) patients. Comparing the two groups, there was a rapid decline in sputum conversion time and severity classes of TB score in group I compared to group II (p < 0.001 and p = 0.02, respectively). No complications secondary to supplementary vitamin D were met all through the study.

Conclusion: Vitamin D accelerates the improvement observed in vitamin D supplemented TB therapy. Vitamin D is safe when added to anti-tuberculous drugs. Vitamin D deficiency/insufficiency is common among TB patients. Further studies are required to validate this observation and define a cut off of vitamin D level to prevent immunological alterations.

Smoking is bad for TB - Clipped from PDF

"patients who smoke had a fivefold (p < 0.0001) higher odds of having active tuberculosis compared with patients who do not smoke."

Tags: Injection Intervention Tuberculosis