Vitamin D as an Adjunctive Treatment to Standard Drugs in Pulmonary Tuberculosis Patients: An Evidence-Based Case Report
Advances in Preventive Medicine, Volume 2019, https://doi.org/10.1155/2019/5181847
Diajeng Ayesha Soeharto,1 Diana Ashilah Rifai,1 Stella Marsudidjadja,1 Aisha Emilirosy Roekman,1 Chadijah Karima Assegaf,1 and Melva Louisa2
- Majority of the trials lasted only 8 weeks, which is not long enough for Vitamin D levels to plateau
- Standard vitamin D is known to have a poor response in those with poor guts
- Perhaps TB drugs decrease Vitamin D response
Overview Tuberculosis and Vitamin D has the following summary
Many studies have found that Vitamin D both PREVENTS and TREATS TB
- As with many other diseases, we expect that there will be at least a 4X range of vitamin D due to:
- 4X range in the response in the vitamin D blood level for the same IU dose - for healthy, non-obese, people
- Poor Vitamin D Receptor activation results in far less vitamin D getting to cells
- However, a VDR restriction is not noticed by Vitamin D blood tests
- UV appears to be as powerful or perhaps more powerful than vitamin D in TREATING TB
- Tuberculosis -100 percent cure rate with 10,000 IU of vitamin D daily – RCT 2006
- TB 10X less likely to catch if have sufficient vitamin D – Dec 2011
- Trials using small vitamin D doses neither prevent nor treat TB 2023 2022 2020
- No tuberculosis if more than 80 ng of vitamin D (cattle) - Jan 2022
- Humans need a lot of Vitamin D as well
- Tuberculosis (multi-drug resistant) was 13.4 X more likely to be quickly cleared with Vitamin D - Meta-analysis Feb 2019
- Million TB deaths annually, yet proven treatments of Vitamin D, sunshine, etc are not used – July 2017
Items in both categories TB and Radomized Controlled Trials are listed here:
- Spinal TB surgery now includes Vitamin D as the standard of care (5,000 IU daily) – Sept 2024
- TB treatment helped by the addition of Vitamin D (100,000 IU bi-weekly) – RCT April 2024
- Tuberculosis not prevented by a tiny amount of vitamin D (equiv to 1,400 IU daily) – RCT May 2023
- Tuberculosis treatment helped a bit by a bit of Vitamin D - RCT Feb 2022
- TB not prevented by a small amount of Vitamin D (2,000 IU daily average, Mongolia) – RCT July 2020
- TB not treated by vitamin D given for only 2 months – RCT Sept 2017
- Tuberculosis recovery speeded up by single 450,000 IU dose of vitamin D – RCT Jan 2017
- Tuberculosis treatment greatly helped by injection of 200,000 IU of vitamin D – RCT April 2016
- Tuberculosis -100 percent cure rate with 10,000 IU of vitamin D daily – RCT 2006
- Tuberculosis not treated by lots of vitamin D for 16 weeks – RCT Sept 2015
- Every TB patient benefited from 2 doses of 600,000 IU of vitamin D – RCT Jan 2013
- TB treatment helped with Vitamin D – RCT Sept 2012
- Probability of getting TB reduced 60 percent with just 800 IU of vitamin D – RCT Aug 2012
- Overview Tuberculosis and Vitamin D
- Evaluating the vitamin D evidence - Heaney Dec 2010
Items in both categories TB and Meta-analysis are listed here:
- Latent Tuberculosis 44 percent less likely if Vitamin D more than 30 ng - 14th meta-analysis Jan 2022
- Those with TB were 3.2 X more likely to have low vitamin D – 13th meta-analysis Sept 2021
- Tuberculosis still associated with low vitamin D – 12th meta-analysis June 2021
- Tuberculosis 3X more likely if less than 12 ng of Vitamin D - meta-analysis Sept 2019
- Tuberculosis increased risk if poor Vitamin D receptor varies by race – meta-analysis Feb 2019
- Tuberculosis (multi-drug resistant) was 13.4 X more likely to be quickly cleared with Vitamin D - Meta-analysis Feb 2019
- Catching Tuberculosis from family member 2 X more likely if low vitamin D – meta-analysis Dec 2018
- Tuberculosis in children 1.7 X more likely if low vitamin D – meta-analysis Aug 2018
- Low vitamin D is a risk factor for tuberculosis – meta-analysis Dec 2016
- Tuberculosis 1.3 times more likely if poor Vitamin D Receptor – meta-analysis Oct 2016
- Tuberculosis 4.5X more likely if vitamin D less than 10 nanogram – meta-analysis May 2015
- Tuberculosis, genes and vitamin D – Meta-Analysis Dec 2013
- TB associated with low vitamin D in a review and meta-analysis – 2008
- TB and vitamin D updated review and meta-analysis – plays a role Jan 2010
Download the PDF from Sci-Hub via VitaminDWiki
Background. Vitamin D has a prominent role in the body’s innate immunity as it is important in the maintenance of macrophages and monocytes and its function in defending against infections. In-vitro studies have established vitamin D’s potential role in tuberculosis (TB) infection, in that it restricts Mycobacterium tuberculosis growth, thus implying the potential benefit of vitamin D as an adjunctive treatment for TB. However, clinical trials and reviews have contradicting findings regarding the true clinical efficacy of adjunctive vitamin D, particularly in reducing the sputum conversion rate (SCR).
Objective. This study aims to update the current evidence regarding vitamin D supplementation as an adjunctive treatment in achieving the smear sputum conversion rate (SCR) among pulmonary TB patients.
Method. A comprehensive search was conducted in October 2018 in PubMed-NCBI, MEDLINE-OVID, SCOPUS-Elsevier, and Cochrane. The selection of studies was done as per the predetermined inclusion and exclusion criteria of this EBCR and resulted in the inclusion of 11 eligible studies (8 RCTs and 3 systematic reviews). The selected studies were then critically appraised for their validity, importance, and applicability according to the CEBM (Centre for Evidence-Based Medicine) appraisal tools.
Results. Overall, most of the trials showed no statistically significant changes in terms of the proportion of TB patients with a negative sputum smear conversion in the group treated with an adjunctive therapy vs. the group treated with standard antituberculosis therapy alone. Only one trial showed significant results, which was conducted in a population of TB patients with vitamin D deficiency. Furthermore, overall the reviews showed no significant change in the 8-week sputum smear conversion after treatment within the group given vitamin D in comparison to those who were not.
Conclusion. Vitamin D as adjunctive therapy in TB patients shows no clinical improvement in terms of sputum conversion to antituberculosis management.
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