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Tuberculosis treatment greatly helped by injection of 200,000 IU of vitamin D – RCT 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
  2. No concern about vitamin D being blocked by poor gut
  3. Injection provides a loading dose, which restores vitamin D levels in days, rather than months

See also VitaminDWiki

Overview Loading of vitamin D contains the following

Loading dose: 203 studies at VitaminDWiki

Vitamin D loading dose (stoss therapy) proven to improve health overview
If a person is or is suspected to be, very vitamin D deficient a loading dose should be given

  • Loading = restore = quick replacement by 1 or more doses
  • Loading doses range in total size from 100,000 IU to 1,000,000 IU of Vitamin D3
    • = 2.5 to 25 milligrams
  • The size of the loading dose is a function of body weight - see below
    • Unfortunately, some doctors persist in using Vitamin D2 instead of D3
  • Loading may be done as quickly as a single day (Stoss), to as slowly as 3 months.
    • It appears that spreading the loading dose over 4+ days is slightly better if speed is not essential
  • Loading is typically oral, but can be Injection (I.M,) and Topical
  • Loading dose is ~3X faster if done topically or swished inside of the mouth
    • Skips the slow process of stomach and intestine, and might even skip liver and Kidney as well
  • The loading dose persists in the body for 1 - 3 months
    • The loading dose should be followed up with on-going maintenance dosing
    • Unfortunately, many doctors fail to follow-up with the maintenance dosing.
  • About 1 in 300 people have some form of a mild allergic reaction to vitamin D supplements, including loading doses
    • it appears prudent to test with a small amount of vitamin D before giving a loading dose
    • The causes of a mild allergic reaction appear to be: (in order of occurrence)
    • 1) lack of magnesium - which can be easily added
    • 2) allergy to capsule contents - oil, additives (powder does not appear to cause any reaction)
    • 3) allergy to the tiny amount of D3 itself (allergy to wool) ( alternate: D3 made from plants )
    • 4) allergy of the gut to Vitamin D - alternative = topical

Intervention AND TB in VitaminDWiki

 Download the PDF from VitaminDWiki

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."

Attached files

ID Name Comment Uploaded Size Downloads
6527 TB injection.jpg admin 05 Apr, 2016 33.64 Kb 1156
6526 TB 200000 IU vitamin D.pdf admin 05 Apr, 2016 783.54 Kb 1882