Dear Dr. Cannell:
I am one of your subscribers and am writing to ask for your input regarding the case of a close friend’s 58 year old wife’s serious medical condition, which I will summarize here.
She is a 50 year-old Caucasian woman, who has had Crohn’s disease and rheumatoid arthritis for 20 years. She has an artificial hip joint. An opportunistic staph infection arose 4 weeks ago in the hip. Her joint was rebuilt 3 weeks ago, and cleaned out removing large amounts of pus, while installing antibiotic pellets. She has also received IV antibiotic therapy 3 times per day for the last 3 weeks.
The doctors have stopped her arthritis medications and the rheumatoid arthritis symptoms are bad. The wound is still weeping and not healing, indicating infection continues. While the white count is now reduced, infection is not deemed under control.
She was tested for vitamin D 4 weeks ago and the level was very low. Her doctors continue to refuse to administer vitamin D to her, claiming insignificance. They are considering a drastic surgery to permanently remove her hip (which would make her leg eight inches shorter) as well as giving her hyperbaric oxygen therapy.
I am hoping that you might be able to consult with her doctors. The patient’s highly educated husband is very open to vitamin D therapy but her doctors are not. What can the husband do?
Tony, New Mexico
I am sorry for your friend. I can’t offer medical advice per your request, obviously, but I can provide information on what some research shows.
She appears to have at least three conditions that vitamin D may or may not help: infection, Crohn’s disease, and rheumatoid arthritis. And a final condition that vitamin D will help: vitamin D deficiency.
The evidence that vitamin D will help infections were recently reviewed in two separate publications, with the conclusion that vitamin D deficiency in infection is probably contributing to the seriousness of the infection. Vitamin D increases the body’s production of a number of naturally occurring antibiotics called antimicrobial peptides.
Likewise, two recent reviews pointed to the remarkably strong likelihood that autoimmune disorders such as Crohn’s disease and rheumatoid arthritis will respond to vitamin D.
Antico A, Tampoia M, Tozzoli R, Bizzaro N. Can supplementation with vitamin D reduce the risk or modify the course of autoimmune diseases? A systematic review of the literature. Autoimmun Rev. 2012 Dec;12(2):127-36.
Now the bad news: I cannot interfere in the management of this case by calling her doctors. I would however, be glad to speak with any of her doctors should they call me.
Also, the husband always has the option to interfere in the case. They do make both 50,000 IU and 5,000 IU capsules at Bio Tech Pharmacal, the former which can be used as a loading dose to quickly raise vitamin D levels, the latter which can be used to maintain vitamin D status. While it’s unlikely that vitamin D will improve her health dramatically, if she does recover, she should find a physician who reads the current medical literature and understands the importance of a good vitamin D level.