Vitamin D & Asthma

“Are there any nutritional treatments for asthma?” is a question I am often asked. My usual reply? “Not that we know for certain.”
For me, as is probably true of most modern physicians who have been trained in ‘traditional medicine’ in the United States, I am a bit on the skeptical side. That is, I like to see solid data from well performed clinical trials, peer-reviewed and published, demonstrating clinical efficacy of any medication, treatment or therapy before I recommend it to my patients

In fact, it usually takes several such successful experiments for me to be really convinced. I believe that overall this is a good approach, intended to prevent unproven or untested therapies from being haphazardly used on trusting, unsuspecting patients. In general, evidence-based medicine, which is part of the thinking process behind most published practice parameters, demands it.

Having said this, I am intrigued by the potential of using Vitamin D in the treatment of asthma.

Why do I say this?

It is because of two fairly recent publications.

First, in his book entitled “The Vitamin D Solution”, (published in 2010 by Hudson Street Press) Michael F. Holick, PhD, MD, arguably the world’s foremost expert on Vitamin D explains the biologic importance of Vitamin D (vit D), and the role that it plays in maintaining health, as well as the role deficiency plays in multiple disease states including osteoporosis, heart disease, autoimmune disease, depression and asthma, among others. In his book, Dr Holick outlines a rational plan involving measurement of Vitamin D levels (specifically 25-hydroxy vitamin D levels) to determine the presence of vit D sufficiency or deficiency (vit D deficiency seems to be widespread). He then reviews the use of diet, vit D supplementation, and judicious (limited) unprotected sun exposure to correct vit D deficiency. His book is excellent “food for thought”. I recommend it to all, especially those concerned with the rational use of vitamins in health and disease.

Secondly, a review article titled “The role of vitamin D in asthma” published in Annals of Allergy, Asthma & Immunology, Volume 105, pp 191-199, September 2010. This is a major, peer-reviewed professional medical journal. In this article, Drs Sandhu and Casale review the medical literature on vitamin D and asthma from 1950 to 2009. They point out that “Vitamin D deficiency has been associated with epidemiologic patterns observed in the asthma epidemic” and show the evidence suggesting the association of vit D deficiency with twitchy airways, lower lung function, reduced asthma control and possibly steroid resistance in asthma! In this excellent article they hypothesize that use of vit D supplementation may help improve asthma control by reducing inflammation in the lungs. They are careful to point out in their conclusion the need for “carefully designed long-term interventional trials with vitamin D in patients with asthma.”

I agree with the need for further clinical trials to fully elucidate the role of vitamin D in asthma and the use of increasing vitamin D levels as a potential treatment.

As I said earlier, I like to see the evidence first. I am, however, excited by the possibilities. I see little downside to measuring vitamin D levels and using Dr Holick’s strategy for raising levels in those found to be deficient.

My recommendation is that you first discuss this with your allergist or primary physician. Be careful, but be hopeful. It is not wise to blindly use any supplement or vitamin. I patiently await further research evidence but see little downside to the rational use of vitamin D supplementation in asthma where deficiency is found.

Be kind to yourself!

Category Archives: Nutrition and asthma treatment

Vitamin D & Asthma

“Are there any nutritional treatments for asthma?” is a question I am often asked. My usual reply? “Not that we know for certain.”
For me, as is probably true of most modern physicians who have been trained in ‘traditional medicine’ in the United States, I am a bit on the skeptical side. That is, I like to see solid data from well performed clinical trials, peer-reviewed and published, demonstrating clinical efficacy of any medication, treatment or therapy before I recommend it to my patients

In fact, it usually takes several such successful experiments for me to be really convinced. I believe that overall this is a good approach, intended to prevent unproven or untested therapies from being haphazardly used on trusting, unsuspecting patients. In general, evidence-based medicine, which is part of the thinking process behind most published practice parameters, demands it.

Having said this, I am intrigued by the potential of using Vitamin D in the treatment of asthma.

Why do I say this?

It is because of two fairly recent publications.

First, in his book entitled “The Vitamin D Solution”, (published in 2010 by Hudson Street Press) Michael F. Holick, PhD, MD, arguably the world’s foremost expert on Vitamin D explains the biologic importance of Vitamin D (vit D), and the role that it plays in maintaining health, as well as the role deficiency plays in multiple disease states including osteoporosis, heart disease, autoimmune disease, depression and asthma, among others. In his book, Dr Holick outlines a rational plan involving measurement of Vitamin D levels (specifically 25-hydroxy vitamin D levels) to determine the presence of vit D sufficiency or deficiency (vit D deficiency seems to be widespread). He then reviews the use of diet, vit D supplementation, and judicious (limited) unprotected sun exposure to correct vit D deficiency. His book is excellent “food for thought”. I recommend it to all, especially those concerned with the rational use of vitamins in health and disease.

Secondly, a review article titled “The role of vitamin D in asthma” published in Annals of Allergy, Asthma & Immunology, Volume 105, pp 191-199, September 2010. This is a major, peer-reviewed professional medical journal. In this article, Drs Sandhu and Casale review the medical literature on vitamin D and asthma from 1950 to 2009. They point out that “Vitamin D deficiency has been associated with epidemiologic patterns observed in the asthma epidemic” and show the evidence suggesting the association of vit D deficiency with twitchy airways, lower lung function, reduced asthma control and possibly steroid resistance in asthma! In this excellent article they hypothesize that use of vit D supplementation may help improve asthma control by reducing inflammation in the lungs. They are careful to point out in their conclusion the need for “carefully designed long-term interventional trials with vitamin D in patients with asthma.”

I agree with the need for further clinical trials to fully elucidate the role of vitamin D in asthma and the use of increasing vitamin D levels as a potential treatment.

As I said earlier, I like to see the evidence first. I am, however, excited by the possibilities. I see little downside to measuring vitamin D levels and using Dr Holick’s strategy for raising levels in those found to be deficient.

My recommendation is that you first discuss this with your allergist or primary physician. Be careful, but be hopeful. It is not wise to blindly use any supplement or vitamin. I patiently await further research evidence but see little downside to the rational use of vitamin D supplementation in asthma where deficiency is found.

Be kind to yourself!

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