Sepsis, mistakenly called blood poisoning, kills millions of people every year. I wrote about sepsis two years ago.
Vitamin D Council board member, Dr. William Grant, was the first to suggest that vitamin D and sepsis may be related.
In sepsis, disease severity partly determines the outcome with the risk of death from uncomplicated sepsis being as high as 30%, severe sepsis as high as 50%, and septic shock as high as 80%. The really scary thing about sepsis is that the incidence of sepsis is increasing every year. The increasing incidence of sepsis may correlate with increasing sun avoidance, but no one has studied that.
This month, I saw a meta-analysis of the risk of sepsis and 25(OH)D levels published.
The authors noted that vitamin D up-regulates antimicrobial peptides, such as cathelicidin, which has broad anti-microbial activities against an astonishing number of bacteria, viruses and fungi. Therefore, the authors conducted a meta-analysis with 10 of the most relevant of 647 studies they reviewed. The objective of this systematic review and meta-analysis of observational studies was to comprehensively determine the strength of the association between vitamin D deficiency and sepsis in hospitalized patients compared with optimal vitamin D group.
The results from studies that reported the number of participants with sepsis in vitamin D deficiency and control groups revealed that the pooled odds ratio (OR) of sepsis in vitamin D deficient participants was 1.78 (p < 0.01) compared with controls. This means that if you are vitamin D deficient, your risk of sepsis is almost double. In studies that reported an adjusted OR of vitamin D deficiency for developing sepsis as an outcome, the pooled OR was 1.45 (p < 0.01). The study between-study heterogeneity (differences in how the studies were conducted) was very low.
Randomized controlled trials have not shown any benefit of vitamin D supplementation in preventing sepsis. However, all of these negative studies have dosing errors, either under dosing or bolus dosing. Also ICU patients need rapid treatment of their vitamin D deficiency; they need very high doses from day one.
For example, compare the negative findings from the RCT above to the results a surgeon at Grady Memorial Hospital, director of the surgical ICU, receives when he gives all ICU patients high doses of vitamin D.
Dr. Mathews has a paper coming out in which he studied 600 IU/day, 50,000 IU/day and 100,000 IU/day. This is a study of surgical ICU patients who were given the high doses for the first 5 days of their hospitalization. His soon-to-be reported results are remarkable in that mortality was much better in the 100,000 IU/day group then the other groups as was length of stay, infections and other complications.