Vitamin D and Respiratory Tract Infections

• Ever since the beginning of COVID 19, our perspective for lung health and immunity has changed and prioritization of measures to not only treat respiratory tract infections but also prevent them are a prime focus now. In the same effort, we review the role of Vitamin D in prevention or treatment of respiratory tract infections.

• Observational studies report consistent independent associations between low serum concentrations of 25-hydroxyvitamin D and susceptibility to acute respiratory tract infection (Jolliffe DA, 2013). Vitamin D supports induction of antimicrobial peptides in both bacterial and viral infections. Vitamin D insufficiency has been linked to increased risk of infections, in particular viral respiratory tract infection, tuberculosis, obstructive lung diseases like asthma and COPD (HandsdottirSif, 2011). Results from epidemiological and in vitro data have prompted numerous randomized controlled trials to determine whether vitamin D supplementation can decrease the risk of acute respiratory tract infection.
•  A systematic review and meta-analysis of Individual patient data (IPD) from various randomized controlled trials evaluated the association between Vitamin D and respiratory infections (Martineau A R, 2017). 25 clinical trials were included in the study, with data from about 11,000 patients. Vitamin D supplementation reduced the risk of acute respiratory tract infection among all participants. In subgroup analysis, protective effects were seen in those receiving daily or weekly vitamin D without additional bolus doses.

• Another systematic review to explore the same association was done which included 5 clinical trials also came up with similar finding that vitamin D decreases the event of respiratory tract infections (Charan J, 2012). A prospective cohort study reported that Concentrations of 38 ng/ml or more were associated with a significant (p value, 0.0001) two-fold reduction in the risk of developing acute respiratory tract infections and with a marked reduction in the percentages of days ill (Sabetta JR, 2010).
• Evidences point that maintaining Vitamin D in physiological ranges may help prevent the incidence of respiratory tract infections and thus supplementation of vitamin D could help in reducing the incidence of respiratory infections in population who are insufficient/ deficient.

Please always ensure to check with your Doctor / Healthcare / GP before starting with any new medication or therapy.

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References

Charan J, G. J. ( 2012). Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis. J Pharmacol Pharmacother, 3(4):300-303. doi:10.4103/0976-500X.103685.

HandsdottirSif, M. M. (2011). Vitamin D effects on lung immunity and respiratory . Vitamin and Hormones , 86: 217–237.

Jolliffe DA, G. C. (2013). Vitamin D in the prevention of acute respiratory infection: systematic review of clinical studies. J Steroid Biochem Mol Biol, 356:321-9.

Martineau A R, J. D. (2017). Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ, 356 :i6583.

Sabetta JR, D. P. (2010). Serum 25-Hydroxyvitamin D and the Incidence of Acute Viral Respiratory Tract. PLoS ONE, 5 (6): e11088. doi:10.1371/journal.pone.0011088.