Although I have written more about the autism epidemic, another epidemic is occurring among our children, an asthma epidemic. About ten percent of the millions of asthmatic children around the world have severe therapy resistant asthma. These children live a tragic childhood of sickness, breathlessness, hospitalizations and fear that would break your heart to see.
On September 15, 2011, Dr. Atul Gupta and six colleagues from the Royal Brompton Hospital in London published a remarkable, first of its kind, paper on childhood asthma and vitamin D.
Gupta A, Sjoukes A, Richards D, Banya W, Hawrylowicz C, Bush A, Saglani S. Relationship Between Serum Vitamin D, Disease Severity and Airway Remodeling in Children with Asthma. Am J Respir Crit Care Med. 2011 Sep 15. [Epub ahead of print]
First, unlike autism, a number of papers exist on the subject of vitamin D and asthma and the authors review them. Dr. Gupta reminds us that previous studies show associations between low vitamin D levels and asthma control, severity, exacerbation, lower lung function, and response to treatment. Scientists have published enough papers on childhood asthma and vitamin D that one would think that doctors are routinely treating asthmatic children for their vitamin D deficiency but if you thought that, you would be wrong.
Like other scientists before him, the authors found vitamin D deficient asthmatic children are more likely to have lower lung function, poor asthma control, increased medication use and more frequent asthma attacks. Then Dr. Gupta took the next step by taking a tiny piece of lung from children with severe asthma, finding the vitamin D deficient children had more structural airway abnormalities than vitamin D sufficient children.
His conclusion is worth quoting,
“These findings suggest that detecting and treating low serum vitamin D levels in children with asthma may aid in treatment of specific structural airway changes.”
That is, it might be time to treat vitamin D deficiency in asthmatic children.
Why aren’t doctors treating these children with vitamin D if they are deficient? First, the pulmonologists (lung doctors) are too overwhelmed with the epidemic to read the scientific literature. Second, only one very small randomized controlled trial exists on asthma, but it found a dramatic reduction in hospitalizations in the children given vitamin D. Therefore, scientists say we need more studies before we act.
The problem with this argument is that the scientists saying this do not treat patients, with rare exceptions. They are scientists practicing science, not physicians treating patients. Doctors treating patients have always had to act on new scientific information based on what science knows now by doing a risk benefit analysis. You make such an analysis every time you get into your car. The small risk of an auto accident is worth the benefit of going to the movie.
The same is true of vitamin D and childhood asthma. The huge potential benefit is worth the tiny risk of taking vitamin D. Actually, as far as I know, the risk of treating vitamin D deficiency is close to zero. The dose for children is simple.
- Under 25 pounds: 1,000 IU/day
- 25-50 pounds: 2,000 IU/day
- 50-75 pounds: 3,000 IU/day
- 75-100 pounds: 4,000 IU/day
- over 100 pounds: 5,000 IU/day.
If you have or know of asthmatic children, the parents can easily do this on their own without a blood test. With these doses, it is impossible for any child to be toxic although I understand the reasons patients and doctors want to test vitamin D levels.
Just think, millions of children around the world, living a childhood of desperation because the dermatologists won the argument about sun exposure.