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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: 143 studies at VitaminDWiki

If a person is, or is suspected to be, very vitamin D deficient a loading dose is typically given

  • Loading = repletion = quick replacement (previously known as Stoss)
  • Loading doses range in size from 100,000 IU to 1,000,000 IU of Vitamin D3
  • 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, to as slowly as 3 months.
    It appears that spreading the loading dose over 4-20 days is a good compromise
  • Loading is typically oral, but sometimes by injection (I.M,)
  • The loading dose persists in the body for about 3 months
    The loading dose should be followed up with continuing maintenance
    Unfortunately, many doctors fail to follow-up with the maintenance dosing.
  • As about 1 in 300 people have some form of mild allergic reaction to vitamin D supplements,
    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 occurance)
    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 )

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 14:00 33.64 Kb 704
6526 TB 200000 IU vitamin D.pdf PDF 2016 admin 05 Apr, 2016 13:59 783.54 Kb 1105
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