Weekly cholecalciferol supplementation results in significant reductions in infection risk among the vitamin D deficient: results from the CIPRIS pilot RCT
Steve Simpson Jr Corresponding author Email: steve.simpson at utas.edu.au
Ingrid van der Mei1. Email: ingrid.vandermei at utas.edu.au
Niall Stewart 2,3. Email: niall.stewart at utas.edu.au Leigh Blizzard1
1Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, Australia
2School of Pharmacy, University of Tasmania, Hobart, Australia 3School of Medicine, University of Tasmania, Hobart, Australia
Background
Observational studies suggest vitamin D deficiency may contribute to the risk of acute infections. We undertook a randomised controlled trial (RCT) of cholecalciferol supplementation as an intervention against acute infections.
Methods
A cohort of 34 healthy adults was randomised to 20,000 IU/week cholecalciferol or identical placebo and followed for 17 weeks during winter 2012. Acute infections, defined as the occurrence of sustained (at least an hour) infection symptoms, either of severity 2/5 or greater or sustained over 24 h, were monitored by daily online symptom reporting, with potential infections assessed in clinic. No microbiological verification of symptoms was available, however. Primary endpoint was the occurrence of acute infection; secondary endpoints were infection duration and infection severity; and tertiary endpoints were change in serum 25- hydroxyvitamin D (25(OH)D) and adverse events.
Results
No treatment effect was observed for infection risk (HR: 0.83, 95% CI: 0.53, 1.31), nor duration or severity. However, on stratification by baseline serum 25(OH)D (levels chosen on the basis of average levels in our cohort and known minimums needed for bone health), a significant treatment effect on infection risk was evident among those who were vitamin D deficient at the start of the study, such that those of baseline 25(OH)D < 40 nmol/L (n = 4) realised a 44% reduction in infection risk (HR: 0.56; 95% CI: 0.32, 0.96; P = 0.007), this increasing to 73% on restriction to clinically verified infections (HR: 0.27; 95% CI: 0.07, 1.00; P = 0.050). A similar but less consistent and nonsignificant effect was seen for infection severity. Treatment was associated with significantly higher 25(OH)D compared to placebo; however, the maximum 25(OH)D was 154 nmol/L and no adverse events occurred.
Conclusions
The results of this study suggest a protective effect of vitamin D supplementation against acute infection risk among persons who are vitamin D deficient. Larger studies are needed to validate these findings.
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See also VitaminDWiki
VitaminDWiki RTI studies 26 as of Sept 2021
- Small vitamin D doses provide small benefits for acute respiratory infections – Meta-analysis March 2021
- Respiratory Tract Infection risk reduced 2X by Vitamin D loading doses – meta-analysis Jan 2021
- Common cold prevented and treated by Vitamin D, Vitamin C, Zinc, and Echinacea – review April 2018
- Vitamin D and Respiratory Tract Infections – meta-analysis with charts June 2013
- Respiratory infections reduced by 63 percent with 4000 IU vitamin D daily - RCT Dec 2012
- One pill every two weeks gives you all the vitamin D most adults need
The one pill is 50,000 IU - very similar to the dose rate to cut the RTI rate in half - Respiratory Infection associated with vitamin D less than 40 ng – March 2015 which has the following chart