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Information on the latest vitamin D news and research.

Find out more information on deficiency, supplementation, sun exposure, and how vitamin D relates to your health.

Pneumonia

Pneumonia is an inflammation of the lung. It is usually caused by an infection due to bacteria, viruses, or fungi. Pneumonia can also occur after accidentally inhaling a liquid or chemical.

The symptoms of pneumonia include a cough with mucus, fever, and shaking chills. People often have shortness of breath when they move. Pneumonia is the primary cause of death after a flu.

Risk factors

Those at greatest risk for pneumonia are:

  • Infants, especially those who are premature or have low birth weight (Nearly 75% of deaths caused by pneumonia occur in infants under 1 year of age.)
  • Children younger than 2 years of age
  • Children with human immunodeficiency virus (HIV)
  • Children with rickets and adults with low vitamin D levels
  • People older than 65 years of age
  • People who already have health problems (malnutrition, malaria, suppressed immunity, and respiratory infections or flu)
  • People who live in a health care facility

Sunlight exposure and pneumonia risk

Several studies found that low ultraviolet-B (UVB) exposure and low vitamin D levels caused rickets and pneumonia in children.

According to a study in Philadelphia, pneumonia is most common in winter. Solar UVB doses are lowest then. The effect may be more noticeable in younger people.

During 1918–1919, there was an influenza pandemic in the United States. Death rates were lower in southern cities than in northern cities.

Vitamin D and pneumonia

Vitamin D levels

Studies of vitamin D have occurred around the world. In Yemen, children with vitamin D deficiency (levels less than 10 ng/mL [25 nmol/L]) and rickets had poorer survival rates.

How vitamin D works

To aid the body’s immune system, vitamin D:

  • Produces cathelicidin and defensins: These proteins have antiviral effects to combat viruses and antibacterial effects to fight pneumonia. They may also neutralize bacterial toxins.
  • Reduces inflammation: As a result, the lining of the lungs is less disturbed. This makes it harder for bacteria to grow and cause pneumonia.

Prevention

High levels of vitamin D may prevent or lower the risk and symptoms of pneumonia.

Based on studies, the risk of influenza and other respiratory infections may be lowered by:

  • 1000–5000 international units (IU) (25–125 mcg)/day of vitamin D, especially during the winter
  • Vitamin D levels above 40 ng/mL (100 nmol/L)

Treatment

Taking 10,000 IU/day or more vitamin D for a short time strengthens the immune system. This allows the body to fight respiratory infections including pneumonia.

Acknowledgements

This evidence summary was written by:

William B. Grant, Ph.D.
Sunlight, Nutrition, and Health Research Center (SUNARC)
P.O. Box 641603
San Francisco, CA
94164-1603,
USA
www.sunarc.org
wbgrant@infionline.net

References

  1. Aloia, J. F. Li-Ng, M. Re: epidemic influenza and vitamin D. Epidemiol Infect. 2007 Oct; 135 (7): 1095-6; author reply 1097-8.
  2. Ardizzone, S. Cassinotti, A. Trabattoni, D. Manzionna, G. Rainone, V. Bevilacqua, M. Massari, A. Manes, G. Maconi, G. Clerici, M. Bianchi Porro, G. Immunomodulatory effects of 1,25-dihydroxyvitamin D3 on TH1/TH2 cytokines in inflammatory bowel disease: an in vitro study. Int J Immunopathol Pharmacol. 2009 Jan-Mar; 22 (1): 63-71.
  3. Britten, R. H. The incidence of epidemic influenza, 1918-19. Pub Health Rep. 1932; 47303-39.
  4. Cannell, J. J. Vieth, R. Umhau, J. C. Holick, M. F. Grant, W. B. Madronich, S. Garland, C. F. Giovannucci, E. Epidemic influenza and vitamin D. Epidemiol Infect. 2006 Dec; 134 (6): 1129-40.
  5. Cannell, J. J. Zasloff, M. Garland, C. F. Scragg, R. Giovannucci, E. On the epidemiology of influenza. Virol J. 2008; 529.
  6. Chan, M. C. Cheung, C. Y. Chui, W. H. Tsao, S. W. Nicholls, J. M. Chan, Y. O. Chan, R. W. Long, H. T. Poon, L. L. Guan, Y. Peiris, J. S. Proinflammatory cytokine responses induced by influenza A (H5N1) viruses in primary human alveolar and bronchial epithelial cells. Respir Res. 2005; 6135.
  7. Cheung, C. Y. Poon, L. L. Lau, A. S. Luk, W. Lau, Y. L. Shortridge, K. F. Gordon, S. Guan, Y. Peiris, J. S. Induction of proinflammatory cytokines in human macrophages by influenza A (H5N1) viruses: a mechanism for the unusual severity of human disease?. Lancet. 2002 Dec 7; 360 (9348): 1831-7.
  8. Creanga, A. A. Johnson, T. F. Graitcer, S. B. Hartman, L. K. Al-Samarrai, T. Schwarz, A. G. Chu, S. Y. Sackoff, J. E. Jamieson, D. J. Fine, A. D. Shapiro-Mendoza, C. K. Jones, L. E. Uyeki, T. M. Balter, S. Bish, C. L. Finelli, L. Honein, M. A. Severity of 2009 pandemic influenza A (H1N1) virus infection in pregnant women. Obstet Gynecol. Apr; 115 (4): 717-26.
  9. du Prel, J. B. Puppe, W. Grondahl, B. Knuf, M. Weigl, J. A. Schaaff, F. Schmitt, H. J. Are meteorological parameters associated with acute respiratory tract infections?. Clin Infect Dis. 2009 Sep 15; 49 (6): 861-8.
  10. Ginde, A. A. Liu, M. C. Camargo, C. A., Jr. Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004. Arch Intern Med. 2009 Mar 23; 169 (6): 626-32.
  11. Gombart, A. F. The vitamin D-antimicrobial peptide pathway and its role in protection against infection. Future Microbiol. 2009 Nov; 41151-65.
  12. Grant, W. B. Cannell, J. J. Pregnant women are at increased risk for severe A influenza because they have low serum 25-hydroxyvitamin D levels. Crit Care Med. Sep; 38 (9): 1921; author reply 1921-2.
  13. Grant, W. B. Giovannucci, E. The possible roles of solar ultraviolet-B radiation and vitamin D in reducing case-fatality rates from the 1918-1919 influenza pandemic in the United States. Dermato-Endocrinology. 2009; 1 (4): 215-219.
  14. Hansdottir, S. Monick, M. M. Hinde, S. L. Lovan, N. Look, D. C. Hunninghake, G. W. Respiratory epithelial cells convert inactive vitamin D to its active form: potential effects on host defense. J Immunol. 2008 Nov 15; 181 (10): 7090-9.
  15. Hansdottir, S. Monick, M. M. Lovan, N. Powers, L. Gerke, A. Hunninghake, G. W. Vitamin D decreases respiratory syncytial virus induction of NF-kappaB-linked chemokines and cytokines in airway epithelium while maintaining the antiviral state. J Immunol. Jan 15; 184 (2): 965-74.
  16. Hansdottir, S. Monick, M. M. Lovan, N. Powers, L. Gerke, A. Hunninghake, G. W. Vitamin D decreases respiratory syncytial virus induction of NF-kappaB-linked chemokines and cytokines in airway epithelium while maintaining the antiviral state. J Immunol. 2010 Jan 15; 184 (2): 965-74.
  17. Hanslik, T. Boelle, P. Y. Flahault, A. Preliminary estimation of risk factors for admission to intensive care units and for death in patients infected with A(H1N1)2009 influenza virus, France, 2009-2010. PLoS Curr Influenza. RRN1150.
  18. Harris, S. S. Dawson-Hughes, B. Seasonal changes in plasma 25-hydroxyvitamin D concentrations of young American black and white women. Am J Clin Nutr. 1998 Jun; 67 (6): 1232-6.
  19. Heaney, R. P. Davies, K. M. Chen, T. C. Holick, M. F. Barger-Lux, M. J. Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr. 2003 Jan; 77 (1): 204-10.
  20. Hope-Simpson, R. E. The role of season in the epidemiology of influenza. J Hyg (Lond). 1981 Feb; 86 (1): 35-47.
  21. Hypponen, E. Power, C. Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr. 2007 Mar; 85 (3): 860-8.
  22. Hypponen, E. Power, C. Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr. 2007 Mar; 85 (3): 860-8.
  23. La Ruche, G. Tarantola, A. Barboza, P. Vaillant, L. Gueguen, J. Gastellu-Etchegorry, M. The 2009 pandemic H1N1 influenza and indigenous populations of the Americas and the Pacific. Euro Surveill. 2009; 14 (42):
  24. Liu, P. T. Stenger, S. Tang, D. H. Modlin, R. L. Cutting edge: vitamin D-mediated human antimicrobial activity against Mycobacterium tuberculosis is dependent on the induction of cathelicidin. J Immunol. 2007 Aug 15; 179 (4): 2060-3.
  25. Manaseki-Holland, S. Qader, G. Isaq Masher, M. Bruce, J. Zulf Mughal, M. Chandramohan, D. Walraven, G. Effects of vitamin D supplementation to children diagnosed with umonia in Kabul: a randomised controlled trial. Trop Med Int Health. 2010;
  26. McNally, J. D. Leis, K. Matheson, L. A. Karuananyake, C. Sankaran, K. Rosenberg, A. M. Vitamin D deficiency in young children with severe acute lower respiratory infection. Pediatr Pulmonol. 2009 Oct; 44 (10): 981-8.
  27. Mookherjee, N. Rehaume, L. M. Hancock, R. E. Cathelicidins and functional analogues as antisepsis molecules. Expert Opin Ther Targets. 2007 Aug; 11 (8): 993-1004.
  28. Muhe, L. Lulseged, S. Mason, K. E. Simoes, E. A. Case-control study of the role of nutritional rickets in the risk of developing pneumonia in Ethiopian children. Lancet. 1997 Jun 21; 349 (9068): 1801-4.
  29. Sabetta, J. R. DePetrillo, P. Cipriani, R. J. Smardin, J. Burns, L. A. Landry, M. L. Serum 25-hydroxyvitamin d and the incidence of acute viral respiratory tract infections in healthy adults. PLoS One. 2010; 5 (6): e11088.
  30. Shaman, J. Kohn, M. Absolute humidity modulates influenza survival, transmission, and seasonality. Proc Natl Acad Sci U S A. 2009 Mar 3; 106 (9): 3243-8.
  31. Shaman, J. Pitzer, V. E. Viboud, C. Grenfell, B. T. Lipsitch, M. Absolute humidity and the seasonal onset of influenza in the continental United States. PLoS Biol. 2010 Feb; 8 (2): e1000316.
  32. Urashima, M. Segawa, T. Okazaki, M. Kurihara, M. Wada, Y. Ida, H. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010 May; 91 (5): 1255-60.
  33. White, A. N. Ng, V. Spain, C. V. Johnson, C. C. Kinlin, L. M. Fisman, D. N. Let the sun shine in: effects of ultraviolet radiation on invasive pneumococcal disease risk in Philadelphia, Pennsylvania. BMC infectious diseases. 2009; 9196.
  34. Yamshchikov, A. V. Desai, N. S. Blumberg, H. M. Ziegler, T. R. Tangpricha, V. Vitamin D for treatment and prevention of infectious diseases: a systematic review of randomized controlled trials. Endocr Pract. 2009 Jul-Aug; 15 (5): 438-49.

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