Overview Tuberculosis and Vitamin D

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

TB and vitamin D 125 items

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1.5 X higher risk of TB if poor gene that restricts D in blood from gettng to cells (CYP27B1) – Nov 2024

Association of CYP27B1 gene polymorphisms with pulmonary tuberculosis and vitamin D levels
Gene. 2024 Jun 12:148679. doi: 10.1016/j.gene.2024.148679 PDF behind paywall
Murugesan Harishankar 1, Pavithra Sampath 1, A Vamsi Kumar 1, R Srividhya 1, Veerasamy Athikesavan 1, Uma Devi Ranganathan 1, Paramasivam Selvaraj 1, Ramalingam Bethunaickan 2

Background and objectives: Genetic factors are reported to be connected with tuberculosis (TB) infection. Studies have shown that genetic variations in genes involved in the vitamin D pathway influence the levels of vitamin D found in the bloodstream (serum). Cyp27b1 (1α-hydroxylase) is an enzyme that activates the synthesis of bioactive vitamin D3 by hydroxylation of 25(OH)D3.The in vitro studies reported rare gene variants of Cyp27b1 such as rs118204011 and rs118204012, associated with loss of Cyp27b1 function and lower serum vitamin D levels. Globally, a critical gap exists in understanding the link between these gene variants with TB and vitamin D levels. Hence, the study objective is to comprehend the association of Cyp27b1 rs118204009 (G/A), rs118204011 (C/T), and rs118204012 (A/G) with tuberculosis susceptibility/protection and to assess the influence of gene variants on vitamin D levels in both healthy controls (HCs) and those with pulmonary tuberculosis (PTB) in South India.

Methods: Genomic DNA extraction was performed by salting-out procedure and subsequently genotyped through polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) method. Vitamin D level was measured by Enzyme-Linked Immunosorbent Assay (ELISA).

Results: In rs118204012 (A/G), a substantial association was found with PTB susceptibility in allele 'A' [Odds Ratio (OR): 1.52 (1.02-2.26); p = 0.044] and 'AA' genotype [OR: 1.69 (1.02-2.81); p = 0.040] through the dominant model. Allele 'G' [OR: 0.66 (0.44-0.98); p = 0.044) was found to be associated with protection against TB. Males were associated with increased susceptibility towards TB compared to females in the rs118204011 "CC" [[OR: 3.94 (1.94-7.98); p = 0.002] and rs118204012 'AA' [OR: 4.57 (2.13-9.79); p = 0.0001] genotypes. Vitamin D insufficiency (<30 ng/ml) was more prevalent in PTB patients (66.67 %) with the rs118201012 'AA' genotype compared with healthy controls (57.14 %). This genotype was associated with disease susceptible odds ratio of 1.5.

Conclusion: Cyp27b1 rs118204012 'AA' genotype was found to have association with vitamin D insufficiency and TB susceptibility. In terms of gender, our findings suggest that male individuals are correlated with a higher TB risk. This suggest that the gene variants may be involved in the downstream processing of serum Vitamin D levels and its association with the disease.

VitaminDWiki - Genetics chart shows that a poor CYP27B1 restricts vitamin D
  higher D levels are needed for TB

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TB treated by Sunlight, then cod liver oil & Vitamin D, then antibiotics (but TB is becoming resistant)...

Dec 2023: ChatGPT-4 was asked: What is the history of vitamin d treating TB
The use of vitamin D in treating tuberculosis (TB) has a fascinating history that intertwines with the broader understanding of vitamin D's role in human health.

Early Observations and the Sanatorium Movement: In the late 19th and early 20th centuries, before antibiotics were available, TB was a leading cause of death. During this time, it was observed that sunlight and fresh air seemed to benefit TB patients. This observation led to the sanatorium movement, where patients were treated in facilities with abundant sunlight and fresh air.

Vitamin D Discovery and TB Treatment: The discovery of vitamin D in the early 20th century provided a scientific basis for these observations. It was found that sunlight helped the body produce vitamin D, which in turn played a crucial role in immune function and bone health. This led to the hypothesis that vitamin D might be beneficial in treating TB.

Cod Liver Oil and Vitamin D: Cod liver oil, a rich source of vitamin D, was used in the early 20th century as a treatment for TB. This practice was based on the understanding that vitamin D could boost the immune system.

Studies and Decline in Use: As antibiotic therapy became more prevalent with the discovery of streptomycin in 1943 and other antibiotics thereafter, the focus shifted from vitamin D to antibiotic treatment for TB. However, studies continued to explore the role of vitamin D in immune function, particularly its effects on the innate immune system, which is involved in the body's initial response to TB infection.

Recent Research and Revival of Interest: In recent years, there has been a renewed interest in the role of vitamin D in TB treatment, especially in cases of drug-resistant TB and in populations with high rates of vitamin D deficiency. Research has shown that vitamin D can enhance the immune system's ability to fight TB bacteria. However, it is generally used as an adjunct to standard antibiotic therapy, not as a standalone treatment.

Contemporary Understanding: Today, the role of vitamin D in TB treatment is understood to be more complex and nuanced. While it's not a cure, vitamin D supplementation can be beneficial in certain cases, especially for patients with low vitamin D levels. Its role is seen as supportive, enhancing the effectiveness of conventional TB treatments.

In summary, the history of vitamin D in the treatment of TB reflects the evolving understanding of both the disease and the vitamin. From early empirical observations to modern scientific research, vitamin D has been recognized as playing a supportive role in enhancing the immune response to TB, particularly in conjunction with established antibiotic treatments.
- - - - -
Wonder when doctors will get back to treating TB with Vitamin D
Far less cost & suffering,

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Review of TB and Vitamin D - May 2024

Shedding light on vitamin D in tuberculosis: A comprehensive review of clinical trials and discrepancies
Pulmonary Pharmacology & Therapeutics Volume 85, June 2024, https://doi.org/10.1016/j.pupt.2024.102300 PDF behind paywall
Alan Santos-Mena 1, Oscar E. González-Muñiz 1, Yolanda M. Jacobo-Delgado, Bruno Rivas-Santiago

Over the past few decades, there has been extensive research on the use of vitamin D as an adjunctive therapy in the treatment and prevention of tuberculosis. In vitro studies have provided valuable insights into the mechanisms by which vitamin D activates the immune response to combat Mycobacterium tuberculosis. These encouraging findings have spurred clinical investigations globally to assess the effectiveness of vitamin D as a preventive measure and as an adjunctive treatment for tuberculosis. However, the results from these clinical studies have been contradictory, with some demonstrating clear efficacy while others report only modest or no activity. In this review, we aim to analyze the clinical studies on vitamin D and examine the possible discrepancies observed in their outcomes.

Introduction
Vitamin D is a fat-soluble vitamin that is essential for the proper functioning of the human body. It plays a crucial role in bone health, immune function, and many other physiological processes. Vitamin D plays a crucial role in modulating the immune system. It influences both innate and adaptive immune responses, helping to maintain immune balance and optimal functioning. Vitamin D receptors (VDRs) are present on various immune cells, including T cells, B cells, macrophages, and dendritic cells. Vitamin D enhances the body's natural antimicrobial activity. It promotes the production of antimicrobial peptides such as cathelicidin and defensins, which possess broad-spectrum antimicrobial properties [1]. These peptides help to defend against invading pathogens, including bacteria, viruses, and fungi (see Fig. 1, Fig. 2).

Numerous studies have investigated the association between vitamin D levels and respiratory infections. Several randomized controlled trials (RCTs) have demonstrated that vitamin D supplementation reduces the risk and severity of respiratory tract infections, including influenza and bacterial pneumonia. Notably, a meta-analysis of individual participant data from 25 RCTs reported a protective effect of vitamin D supplementation against acute respiratory infections [2]. While observational studies have suggested a potential link between vitamin D deficiency and increased susceptibility to COVID-19, the clinical evidence for the effectiveness of vitamin D supplementation in COVID-19 remains limited and inconclusive [3].

Tuberculosis (TB) is a contagious bacterial infection that primarily affects the lungs. Despite significant progress in the development of effective treatments, TB remains a major global health concern. In fact, according to the World Health Organization (WHO), TB is one of the top 10 causes of death worldwide, claiming the lives of over 1.4 million people each year 4. One promising avenue for the treatment of TB involves the use of vitamin D. This vitamin has been studied for its potential in the prevention and adjunctive treatment of tuberculosis. Some studies have shown that vitamin D supplementation improves clinical outcomes in TB patients by enhancing antimicrobial immune responses and reducing inflammation [5,6]. However, the evidence remains inconsistent, and more research is required to determine the precise role of vitamin D in TB management [7]. Despite these promising findings, the use of vitamin D as a treatment for TB remains controversial 8. Some studies have suggested that vitamin D may have limited efficacy in treating TB 9, while others have raised concerns about potential side effects and interactions with other medications [7].

In the present review, we will examine the current evidence on the use of vitamin D for the treatment of TB. We will explore the potential mechanisms by which vitamin D may exert its beneficial effects, as well as the clinical evidence supporting its use. Additionally, we will discuss the limitations and challenges associated with the use of vitamin D for TB treatment and consider the implications of these findings for future research and clinical practice.

Section snippets
Vitamin D metabolism and mechanisms of action
Vitamin D is derived from both animal and plant-based foods, specifically in the form of either Vitamin D2 (ergocalciferol) or D3 (cholecalciferol). However, the primary source of Vitamin D is the exposure of the skin to ultraviolet B radiation. This radiation is primarily absorbed by 7-dehydrocholesterol (7DHC), resulting in the production of vitamin D3. Vitamin D3 then enters the bloodstream and travels to the liver, where various enzymes, including CYP27A1, CYP2D25, and most importantly, the ...

Factors affecting the vitamin D pathway and their implications in tuberculosis susceptibility
The vitamin D pathway can be negatively affected by various factors, such as poor dietary intake, malabsorption, or specific genetic variations in the VDR gene. For instance, in Canada, certain communities have shown increased susceptibility to TB due to low vitamin D intake during winter and dietary changes [13]. Another study focused on the Canadian Dené and Cree communities, who are an endemic TB population, revealed the presence of several SNP polymorphisms in the restriction sites Fok1,...

Clinical trials
Numerous studies have indicated a potential connection between inadequate Vitamin D levels and the onset of TB as depicted in Table 1. As a potential solution, the supplementation of Vitamin D has been proposed as an adjunctive therapy for TB treatment. Unfortunately, the results of conducted clinical trials have yielded conflicting outcomes. This variability in findings could be attributed to genetic variations among patients, variances in geographical locations, varying concentrations of

Safety considerations
The safety considerations surrounding adequate dosages of vitamin D are currently a topic of debate. Various factors such as age, administration regimen, UV-light exposure based on geographical region, and potential outcomes like hypercalcemia and hypercalciuria contribute to the differing perspectives [39]. Additionally, the recommended dosage of 4000 IU/day is suggested for achieving sufficient vitamin D levels, including cases where immune response enhancement against pathogens such as Mtb...

Conclusion
Vitamin D is an important modulator of the immune response to Mtb infection and has shown promise as an adjunctive therapy for TB. Epidemiological studies have consistently found an association between Vitamin D deficiency and an increased risk of TB, and several clinical trials have reported positive outcomes with Vitamin D supplementation. However, the quality of evidence is still low to moderate, and larger well-designed RCTs are needed to confirm these findings. Vitamin D supplementation...

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New perspectives on difficult-to-treat tuberculosis based on old therapeutic approaches - March 2020

International J. of Infectious Diseases Vol 92, Supp., March 2020, Pages S91-S99 https://doi.org/10.1016/j.ijid.2020.02.039
Michele Mondoni a, Stefano Centanni a, Giovanni Sotgiu b

Highlights

• Tuberculosis is an important clinical and public health issue worldwide.
• Old TB therapies aimed to improve hygiene conditions, strengthen immune system, achieve the rest of the affected lungs.
• New options based on old therapies have been explored: their potential implementation may be useful for drug resistant TB.

Tuberculosis (TB) is an important clinical and public health issue worldwide. Despite improved treatment success rates following the introduction of antibiotics in daily clinical practice, the expected decline in incidence has been hampered by HIV epidemics and multi- and extensively drug-resistant TB. During the pre-antibiotic era, TB therapies were mainly based on improving hygiene conditions, strengthening the immune system, and targeting the rest of the affected lungs with invasive techniques. Detailed knowledge of old non-pharmacological therapies might support physicians and researchers in the identification of new solutions for difficult-to-treat patients. We performed a narrative literature review on the main old therapeutic options prescribed for patients with TB. The main recommendations and contraindications of sanatorium therapies (i.e., bed rest, fresh air, sunlight) and pulmonary collapse techniques are reviewed, evaluating their physiological basis and their impact on patient outcomes. We report studies describing new interventional pulmonary and surgical techniques and assess new perspectives based on old medical and surgical treatments, whose potential implementation could help complicated patients.
 Download the PDF from VitaminDWiki

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Vitamin D, cod liver oil, sunshine, and phototherapy: Safe, effective and forgotten tools for treating and curing TB - March 2018

Vitamin D, cod liver oil, sunshine, and phototherapy: Safe, effective and forgotten tools for treating and curing tuberculosis infections - A comprehensive review.
J Steroid Biochem Mol Biol. 2018 Mar;177:21-29. doi: 10.1016/j.jsbmb.2017.07.027
McCullough PJ1, Lehrer DS2.

• 1 Summit Behavioral Healthcare, Ohio Department of Mental Health and Addiction Services, Cincinnati, OH, 45237, USA; Department of Psychiatry, Wright State University Boonshoft School of Medicine, Dayton, OH, 45435, USA. Electronic address: patrick.mccullough at mha.ohio.gov.
• 2 Summit Behavioral Healthcare, Ohio Department of Mental Health and Addiction Services, Cincinnati, OH, 45237, USA; Department of Psychiatry, Wright State University Boonshoft School of Medicine, Dayton, OH, 45435, USA.

Tuberculosis remains an epidemic throughout the world, with over 2 billion people, or more than one third of the world's population, infected with TB. In 2015, there were an estimated 10.4 million new cases of tuberculosis, and 1.8 million deaths, making TB one of the top ten causes of death worldwide. Approximately 95% of new TB cases occur in developing countries, where the costs of treatment force many patients and their families into poverty. The United Nations and the World Health Organization are working to end this global epidemic.
Historically,

• cod liver oil in the 1840's,
• phototherapy in the 1890's,
• sunshine in the 1890's and 1930's,
• oral vitamin D in doses of 100,000-150,000 international units a day the 1940's, and
• injectable vitamin D in the 1940's

were all shown to be able to safely treat tuberculosis.
However, for reasons that are unclear, these treatments are no longer being used to treat tuberculosis. We will review several reports that documented the clinical efficacy of these seemingly disparate treatments in treating tuberculosis. Taken together, however, these reports show the consistent efficacy of vitamin D in treating tuberculosis infections, regardless of whether the vitamin D was produced in the skin from the effects of phototherapy or sunshine, taken orally as a pill or in cod-liver oil, or put into solution and injected directly into the body. We will discuss how vitamin D, through its action as a steroid hormone that regulates gene transcription in cells and tissues throughout the body, enables the body to eradicate TB by stimulating the formation of a natural antibiotic in white blood cells, the mechanism of which was discovered in 2006. We will speculate as to why vitamin D, cod liver oil, sunshine, and phototherapy are no longer being used to treat tuberculosis, in spite of their proven efficacy in safely treating this disease dating back to the early 1800's. In fact, in 1903 the Nobel Prize in Medicine or Physiology was awarded to a physician who was able to cure hundreds of cases of long-standing lupus vulgaris (cutaneous TB) with refracted light rays from an electric arc lamp. Vitamin D, cod liver oil, sunshine, and phototherapy have never been shown to lose their ability to safely eradicate tuberculosis infections, and deserve consideration to be re-examined as first-line treatments for tuberculosis. These treatments have the potential to help cost-effectively and safely end the global TB epidemic.
 Download the PDF from Sci-Hub via VitaminDWiki

Study was cited 38 times as of Dec 2023

Google Scholar

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Excelent video introduction to TB (nothing about Vitamin D?) by Kurzgesagt June 2024

1.3 million deaths from TB in 2023
11 minutes

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See also VitaminDWiki

• Tuberculosis still associated with low vitamin D – 12th meta-analysis June 2021
• TB patients had low Vitamin D and poor Vitamin D receptor – June 2019
• Review of Tuberculosis and Vitamin D – May 2018
• Tuberculosis recovery speeded up by single 450,000 IU dose of vitamin D – RCT Jan 2017
• Million TB deaths annually, yet proven treatments of Vitamin D, sunshine, etc are not used – July 2017
• Vitamin D in respiratory diseases – Spring 2017
• Tuberculosis recovery speeded up by single 450,000 IU dose of vitamin D – RCT Jan 2017
• The Antibiotic Effects of Vitamin D – 2014
• Every TB patient benefited from 2 doses of 600,000 IU of vitamin D – RCT Jan 2013
• Children with active TB were 4.6X more likely to have low vitamin D – Dec 2014
• TB conversion 6 percent less likely with just 1 ng more vitamin D – Oct 2014
• Tuberculosis, ethnic differences, and vitamin D – July 2013
• Vitamin D and infectious diseases like RTI, TB and Sepsis – Nov 2014
• Multidrug-resistant tuberculosis may be reduced with vitamin D – Sept 2012
• Study of TB seasonality over 28 years PDF is attached at the bottom of this page
• Early Clearance of Mycobacterium tuberculosis: a new frontier in prevention - 2013 PDF is attached at the bottom of this page
  • Vitamin D has been shown to prevent TB conversion
• Boron and Granulomas (TB, Rheumatoid arthritis, Crohn's, Rheumatic Fever etc.) - 2015
• TB in Wikipedia from a vitamin D perspective – Aug 2010 - which has the following graphic

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15 Items in TB and Intervention:

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Is Tuberculosis associated with a poor gut? (Yes) – asked Perplexity AI March 2024

Based on the search results provided, there appears to be an association between tuberculosis (TB) and gut microbiome dysbiosis:

• The gut microbiome may be a potential modifiable host factor that can impact TB susceptibility and treatment response. Alterations in the gut microbiome composition have been observed in individuals with active TB and recurrent TB compared to healthy controls
• Depletion of beneficial gut bacteria like Clostridia, Lachnospira, and Prevotella, along with overgrowth of potentially pathogenic bacteria like Actinobacteria and Proteobacteria, have been reported in TB patients . This gut dysbiosis may contribute to impaired immune responses against Mycobacterium tuberculosis
• Gut microbiome composition has been shown to reflect the immune status of individuals with latent TB infection, especially in those with poorly controlled diabetes, a major risk factor for TB. Reduced levels of anti-inflammatory cytokines like IL-17F and TNF-α were correlated with specific gut microbial changes in latent TB.

Gut microbiome dysbiosis can also be a consequence of anti-TB drug therapy, which may increase susceptibility to TB recurrence or reinfection. Probiotics have been proposed as a potential adjunct therapy to help restore gut microbiome balance and improve TB treatment outcomes.

• In summary, the available evidence suggests that tuberculosis is associated with a dysbiotic gut microbiome, which may play a role in TB susceptibility, progression, and treatment response. Maintaining a healthy gut microbiome composition could be an important factor in TB prevention and management

References etc

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Treatment of TB with Vitamin D should include gut-friendly forms of Vitamin D

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What is the cost to treat TB: Asked Chat-GPT-4 Dec 2023

The cost of treating tuberculosis (TB) varies significantly depending on several factors, including the type of TB (drug-susceptible or drug-resistant), the country or region, the healthcare setting (public or private), and the specific treatment regimen. Here's a general overview:

Drug-Susceptible TB:
In many low- and middle-income countries, the basic treatment for drug-susceptible TB is often provided free of charge by public health programs, supported by organizations like the World Health Organization (WHO) and the

Global Fund.
The treatment typically includes a combination of antibiotics taken for 6 to 9 months. The cost of these medications can range from a few dollars to several hundred dollars for the full course, depending on the country and whether generics are available.

Drug-Resistant TB:
Treating drug-resistant TB (such as multi-drug-resistant TB or extensively drug-resistant TB) is much more complex and expensive. These forms of TB require longer treatment courses (up to 2 years) with more expensive and potentially toxic drugs.
The cost can range from a few thousand to tens of thousands of dollars per patient. In some countries, these costs may be covered by public health programs, but in others, patients may bear some or all of the cost.

Additional Costs:
Besides medication, costs may include

• diagnostic tests,
• monitoring,
• hospital stays (if required), and
• treatment of side effects or comorbid conditions.
• Indirect costs can also be significant, including
  • loss of income due to illness,
  • travel expenses for treatment, and the
  • impact on family members.

Global Funding and Aid:
International aid and funding initiatives play a crucial role in reducing the financial burden of TB treatment, especially in low-income countries.
Organizations like the Global Fund, WHO, and various non-profits work to subsidize or provide free TB treatment in regions most affected by the disease.
It's important to note that the actual cost can vary greatly depending on individual circumstances and the healthcare infrastructure of the country in question. Access to affordable TB treatment remains a significant global health challenge, particularly in developing countries and for drug-resistant strains of the disease.

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2021 Deaths: TB caused more than COVID

The telegraph Oct 26, 2022    1.6 million TB deaths in 2021

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2022 Deaths: COVID = 7 million, TB = 1.3 million, Malaria = 0.6 million

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See also web

• Podcast - Economist Nov 2, 2022 - problems with TB treatment (ignoring the cost)
  • :...the treatment on offer is, quite frankly, horrible. Most patients have to take fistfuls of pills every morning for months. They will likely suffer from nausea and dizziness. The pills can impair hearing and damage the kidneys. If a patient has a drug-resistant form of the disease, the treatment is usually longer and can also include painful injections. "
  • "Those who get sick are mostly people with weak immune systems. Diabetics, smokers and alcoholics are at higher risk."
    • Note - all are associated with low Vitamin D
• TB and HIV Deaths Gapminder 4 million deaths/year in Nigeria
  
• The lung microbiome, vitamin D, and the tuberculous granuloma: A balance triangle June 2019 10.1016/j.micpath.2019.03.041
• Blacks born in Africa and moved to US had 27X higher rate of TB than people born in the US 2000-2009
• Clinical Trials: Tuberculosis AND "Vitamin D" INTERVENTION 36 trials Nov 2022
• Vitamin D Suplementation in TB Prevention Started Oct 2014
  Using just 28,000 IU of vitamin D every 2 weeks (which is too little), 2800 children, 5 year study,
  same dose for those weighing 50 lbs and those who weigh 150 lbs - dose should be proportional to weight
• Pulmonary Tuberculosis and Vitamin D - 60,000 IU weekly with Calcium
• A Clinical Trial to Study the Effect of the Addition of Vitamin D to Conventional Treatment in New Pulmonary Tuberculosis Patients 100,000 IU single dose
• Disease Database has lots of links to TB information (not vitamin D
• TB - World Health Organization
  • TB is one of the top 10 causes of death worldwide.
  • In 2017, 10 million people fell ill with TB, and 1.6 million died from the disease
  • 558 000 new cases with resistance to rifampicin – the most effective first-line drug, of which - 82% had MDR-TB.
  • People infected with TB bacteria have a 5–15% lifetime risk of falling ill with TB.
  • However, persons with compromised immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, have a much higher risk of falling ill.
    • Note by VItaminDWiki - all of the risk factors are associated with lower levels of VItaminD
• Vitamin D accelerates resolution of inflammatory responses during tuberculosis treatment PNAS Sept 2012
  abstract describes vitamin D intervention clinical trial, details are behind a paywall
  those who were taking vitamin D, taking an average of 23 days to become undetectable under the microscope
  compared to 36 days in the patients who were taking the placebo.
• Vitamin D status and incidence of pulmonary tuberculosis, opportunistic infections, and wasting among Tanzanian adults initiating antiretroviral therapy Nov 2012
  Puliminary TB 2.9X more likely if < 20ng of vitamin D
• What’s the Biggest World Pandemic Risk Today—Untreatable by Conventional Medicine? Sept 2012 Alliance for National Health
  TB is second only to HIV as the leading infectious killer of adults worldwide
  TB is the third largest cause of death among women aged 15 to 44.
  Conventional medicine is panicking because TB is becoming resistant to multiple drugs and fear it may become “virtually untreatable.”
• 25-Hydroxyvitamin D levels after recovery from tuberculosis: Insights into pathogenesis. Nov 2013
  People with prior TB had 25 ng of vitamin D, vs controls had 33 ng.
  8 ng lower of dark skin, 9 ng lower if winter
• Association of vitamin D receptor BsmI gene polymorphism with risk of tuberculosis: a meta-analysis of 15 studies June 2013
  BSML reduces risk of TB, pdf attached at the bottom of this page
  TB cases increase in U.S. for first time in 23 years Washington Post March 2016
  Nothing about vitamin D. Asian TB 280, whites TB 40 per million
  No mention of darker skin and TB
• TB patients low on Vitamins D, A, and E - Nov 2016
  Evaluation of Vitamin Status in Patients with Pulmonary Tuberculosis
  Publisher wants $36 for the PDF
• Addressing the Tuberculosis Epidemic 21st Century Research for an Ancient Disease JAMA Sept 2018
  "More than 1 billion people died from TB during the last 200 years,
  more deaths than from malaria, influenza, smallpox, HIV/AIDS, cholera, and plague combined"
  The words UV, Sun, or Vitamin D do not occur once in the JAMA article

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A. Martineau: TB and Vitamin D

• Search VitaminDWiki for Martineau 491 items as of June 2019
• The role of vitamin D in tuberculosis pathogenesis and treatment April 2014
  A. Martineau, presented at 16th International Congress on Infectious Diseases - abstract-only online
  32% of people are infected with TB
  Vitamin D was used to treat TB in the pre-antibiotic era, and its active metabolite,
  1,25-dihydoxyvitamin D, has long been known to enhance the immune response to mycobacteria in vitro.
  Vitamin D deficiency is common in patients with active TB,
• A. Martineau organized the Vitamin D conference in England - April 23-25 2014
• Vitamin D and tuberculosis: more effective in prevention than treatment?
  Int J Tuberc Lung Dis. 2015 Aug;19(8):876-7. doi: 10.5588/ijtld.15.0506.
  Davies PD1, Martineau AR2. text not available for 6 months (Jan 2016)

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14,000 IU of vitamin D weekly was not enough to prevent TB (mean of only 31 ng) - July 2020

End of trial mean Vitamin D = 31 ng per milliliter
Vitamin D Supplements for Prevention of Tuberculosis Infection and Disease
Authors: Davaasambuu Ganmaa, Ph.D., Buyanjargal Uyanga, M.D., Xin Zhou, Ph.D., Garmaa Gantsetseg, M.D., Baigali Delgerekh, M.D., Davaasambuu Enkhmaa, Ph.D., Dorjnamjil Khulan, M.D., +15, and Adrian R. Martineau, Ph.D.
N Engl J Med 2020;383:359-368 DOI: 10.1056/NEJMoa1915176
 Download the PDF from VitaminDWiki

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TB arrested by cod-liver oil (containing vitamin D) in 1848 was 3X better than other treatments at the time

CLICK HERE if registered (free) for updated analysis of the 1848 study

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TB risk increases by 10% to 40% depending on ethnicity and type of Vitamin D Receptor - meta-analysis April 2022

Correlation between polymorphism of vitamin D receptor TaqI and susceptibility to tuberculosis – An update meta-analysis
Medicine 101(16):p e29127, April 22, 2022. | DOI: 10.1097/MD.0000000000029127
Li, Bin MDa,∗; Wen, Feib; Wang, Zhaofen MDa

Background:
To investigate the association between TaqI polymorphism of the vitamin D receptor gene and tuberculosis (TB).

Methods:
A systematic search was performed in PubMed, Embase, Web of Science, Elsevier Science Direct, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang, and Chongqing VIP databases for case-control study on TaqI gene polymorphism and TB susceptivity. Quality assessment of studies was performed using the Newcastle–Ottawa Scale for the methodological assessment of case-control studies, and R 4.0.5 software was used for the meta-analysis.

Results:
Among the 243 selected articles, 27 in the meta-analysis. The meta-analysis showed that the TaqI gene polymorphism allene gene model (t vs T, odds ratio [OR]: 1.12, 95% confidence interval [CI]: 0.99–1.27); dominant model (tt + tT vs TT, OR: 1.12, 95% CI: 0.98–1.29); recessive model (tt vs tT + TT, OR: 1.25, 95% CI: 1.03–1.51); codominant A (tt vs TT, OR: 1.37, 95% CI: 1.00–1.87); codominant B (tT vs TT, OR: 1.09, 95% CI: 0.99–1.19). And subgroup dominant model (tt + tT vs TT, OR: 1.27, 95% CI: 1.03–1.55) in Indianas, recessive model (tt vs tT + TT, OR: 1.49, 95% CI: 1.05–2.11) in Iranians, co-dominant B (tT vs TT, OR: 1.28, 95% CI: 1.03–1.59; OR: 1.42, 95% CI: 1.05–1.93) in Indianas (Indians) and Iranians.

Conclusion:
This meta-analysis suggests a significant association between TB and the risk of TaqI in Iranians and Indians, but the vitamin D receptor polymorphism TaqI was not associated with Chinese. Thus, validation studies will be required to confirm these findings.
 Download the PDF from VitaminDWiki

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TB patients are 10X more likely to have low vitamin A and 2X more likely to have low vitamin D – meta-analysis Sept 2024

Association of variant vitamin statuses and tuberculosis development: a systematic review and meta-analysis
Ann Med 2024 Dec;56(1):2396566. doi: 10.1080/07853890.2024.2396566
Yiqing Zhou 1, Qian Wu 2, Fei Wang 2, Songhua Chen 2, Yu Zhang 2, Wei Wang 2, Chenxi Huang 3, Kui Liu 2 4, Bin Chen 2

Background: Several studies have suggested an association between vitamin deficiency and the development of tuberculosis; however, the precise impact remains unclear. This study aimed to elucidate the relationship between distinct vitamin statuses and the occurrence of tuberculosis.

Materials and methods: Retrieval was conducted using several databases without language restrictions to capture the eligible studies on tuberculosis and vitamin status. Pooled odds ratios (ORs), relative risks (RRs), and hazard ratios (HRs) were used with 95% confidence intervals (CIs) to clarify the relationship between the different vitamin statuses (A, B, D, and E) and the occurrence of tuberculosis. Subgroup analysis, sensitivity analysis, meta-regression analysis, and Galbraith plot were performed to determine sources of heterogeneity. Potential publication biases were detected using Begg's test, Egger's test, and the trim-and-fill test.

Results: We identified 10,266 original records from our database searches, and 69 eligible studies were considered in this study. The random-effect model showed that people with tuberculosis may exhibit vitamin A deficiency (OR = 10.66, 95%CI: 2.61-43.63, p = .001), while limited cohort studies showed that vitamin A supplementation may reduce tuberculosis occurrence. Additionally, vitamin D deficiency was identified as a risk factor for tuberculosis development (RR = 1.69, 95%CI: 1.06-2.67, p = .026), and people with tuberculosis generally had lower vitamin D levels (OR = 2.19, 95%CI: 1.76-2.73, p < .001) compared to other groups. No publication bias was detected.

Conclusions: This meta-analysis indicated that people with tuberculosis exhibited low levels of vitamins A and D, while vitamin D deficiency was identified as a risk factor for tuberculosis. More randomized controlled interventions at the community levels should be recommended to determine the association between specific vitamin supplementation and tuberculosis onset.
 Download the PDF from VitaminDWiki

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Suggestion: People with TB should supplement with water-soluble Vitamin A, Vitamin D

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Do people with TB have poor digestion of fats - like vitamin A? - asked Perplexity AI - Sept 2024

Yes, people with tuberculosis (TB) often have poor digestion and absorption of fats, including fat-soluble vitamins like vitamin A. This can lead to vitamin A deficiency in TB patients.Several factors contribute to malabsorption and vitamin A deficiency in TB:

1. TB infection itself can cause malabsorption by damaging the intestinal mucosa and reducing absorption of nutrients, including fat-soluble vitamins like vitamin A.
2. TB patients often have reduced appetite and intake of vitamin A rich foods due to the disease. This can worsen vitamin A status.
3. Altered metabolism in TB leads to increased utilization and losses of vitamin A, further depleting vitamin A stores.
4. TB patients may have co-infections like HIV or parasites that impair vitamin A absorption.

Studies have found vitamin A deficiency is very common in TB patients, with 56-60% of patients being deficient in some populations. The odds of vitamin A deficiency are 2-10 times higher in TB patients compared to healthy controls.Vitamin A supplementation during TB treatment helps correct this deficiency and improves outcomes like sputum conversion. However, vitamin A deficiency likely persists in many TB patients due to the factors impairing fat and vitamin A digestion and absorption. Screening for and treating vitamin A deficiency should be considered in TB care.
7 references at Perplexity AI

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4X more likely to get TB if Vitamin A deficient - Dec 2022

The Impact of Vitamin A Deficiency on Tuberculosis Progression
Clinical Infectious Diseases, Volume 75, Issue 12, 15 Dec 2022, Pages 2178–2185, https://doi.org/10.1093/cid/ciac326
Brendan K Podell, Omowunmi Aibana, Chuan-Chin Huang, James E DiLisio, Macallister C Harris, David F Ackart, Kody Armann, Alexander Grover, Patrice Severe, Marc Antoine Jean Juste ..

Background
Although previous studies have shown that vitamin A deficiency is associated with incident tuberculosis (TB) disease, the direction of the association has not been established. We investigated the impact of vitamin A deficiency on TB disease progression.

Methods
We conducted a longitudinal cohort study nested within a randomized clinical trial among HIV-infected patients in Haiti. We compared serial vitamin A levels in individuals who developed TB disease to controls matched on age, gender, follow-up time, and time to antiretroviral therapy initiation. We also evaluated histopathology, bacterial load, and immune outcomes in TB infection in a guinea pig model of dietary vitamin A deficiency.

Results
Among 773 participants, 96 developed incident TB during follow-up, 62.5% (60) of whom had stored serum samples obtained 90–365 days before TB diagnosis.
In age- and sex- adjusted and multivariate analyses, respectively, incident TB cases were 3.99 times (95% confidence interval [CI], 2.41 to 6.60) and 3.59 times (95% CI, 2.05 to 6.29) more likely to have been vitamin A deficient than matched controls. Vitamin A–deficient guinea pigs manifested more extensive pulmonary pathology, atypical granuloma morphology, and increased bacterial growth after experimental TB infection. Reintroduction of dietary vitamin A to deficient guinea pigs after established TB disease successfully abrogated severe disease manifestations and altered cellular immune profiles.

Conclusions
Human and animal studies support the role of baseline vitamin A deficiency as a determinant of future TB disease progression.