A study released in the most recent edition of Dermato-Endocrinolgy suggests that vitamin D can help patients with cystic fibrosis, particularly after the occurrence of a pulmonary exacerbation.
Grossmann RE, Zughaier ZM, Kumari M, Seydafkan S, Lyles RH, Liu S, Sueblinvong V, Schechter MS, Stecenko AA, Ziegler TR and Tangpricha V. Pilot study of vitamin D supplementation in adults with cystic fibrosis pulmonary exacerbation: A randomized, controlled trial. Dermato-Endocrinology, Volume 4, Issue 2, April/May 2012.
A pulmonary exacerbation is defined as a temporary worsening of lung function, due to infection and inflammation. It is characterized by shortness of breath, coughing, fatigue and decreased pulmonary function.
In this randomized controlled trial, lead investigator Ruth Grossman of Emory University and team administered a one-time dose of 250,000 IU of vitamin D to patients with cystic fibrosis that were admitted to the hospital for a pulmonary exacerbation. Fifteen patients received the vitamin D, while the other 15 received placebo.
In the vitamin D group, vitamin D levels raised from a mean baseline of 30.6 ng/ml to 58.1 ng/ml after one week, while levels dropped off to 36.7 ng/ml after 12 weeks. Parathyroid hormone dropped by 12 pg/ml after 12 weeks. There were no significant changes in these levels in the placebo group.
They found the following results:
- Six months after dosing, the number of hospitalization free days was 169 in the vitamin D group compared to 133 in the placebo group.
- Six months after dosing, the number of IV antibiotic free days was 154 in the vitamin D group compared to 121 in the placebo group.
- After 12 months, a greater percentage of the vitamin D group returned to baseline lung function than the placebo group.
- After 12 months, 5 of the placebo patients died, while 1 of the vitamin D patients died.
All findings were statistically significant despite the low number of participants. The biggest limitation of the study was the small number of participants.
This study suggests that cystic fibrosis patients are likely better off with higher vitamin D levels compared to low baseline levels and that vitamin D sufficiency may improve overall health. The authors speculate that vitamin D’s biggest role in this study’s findings may have been the improvement of overall health.
This study is useful to intensive care units that may choose to integrate vitamin D into their care of admitted cystic fibrosis patients. Raising blood levels to 60 ng/ml led to better prognosis than keeping blood levels around 30 ng/ml. A small loading dose and a daily maintenance dose regimen can achieve this rise in blood levels.
People with cystic fibrosis may also now choose to maintain blood levels around 60 ng/ml. With research to date, we know that 5,000 IU/day usually achieves this, but in some cases, it may take more. Cystic fibrosis is the most common life-shortening inherited disease in Caucasian Americans, so treatment of vitamin D deficiency in these patients can be an important and easy step to improve both the quality and longevity of life.