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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.

RCT: Vitamin D supplementation and TB in Mongolian children

Tuberculosis (TB) is the second most common cause of death from infectious disease in the world, after deaths due to HIV. About a third of the world is infected by tuberculosis as detected by a TB skin test. Globally, new infections occur at a rate of one per second. In the past, cod liver oil and sunshine were mainstays of treatment.

However, most TB infections do not cause disease, as the body fights off the infection, and the infection is present but remains latent or asymptomatic. In 2007, there were an estimated 14 million chronic active, not latent, cases. In 2010, there were 8.8 million new cases of TB diagnosed, and 1.5 million deaths from TB, most of these occurring in developing countries.

Anything that would prevent TB skin tests from turning positive in a population at high risk is good evidence that substance is fighting the infection. Tuberculin conversion occurs if a patient who has previously had a negative tuberculin skin test develops a positive tuberculin skin test at a later date; it is evidence of an infection that may or may not be symptomatic.

In a double blind randomized controlled trial, researchers at Harvard, led by Dr Davaasambuu Ganmaa and supervised by senior author Professor Walter Willett, gave 61 Mongolian schoolchildren 800 IU of vitamin D/day for six months, and compared them to 58 children given placebo.

Ganmaa D, Giovannucci E, Bloom BR, Fawzi W, Burr W, Batbaatar D, Sumberzul N, Holick MF, Willett WC. Vitamin D, tuberculin skin test conversion, and latent tuberculosis in Mongolian school-age children: a randomized, double-blind, placebo-controlled feasibility trial. Am J Clin Nutr. 2012 Aug;96(2):391-6.

The treated children had a trend toward fewer conversions (P=.06) compared to placebo. Only one newly positive TB test occurred in those children who achieved a 25(OH)D of >20 ng/ml. Baseline 25(OH)D in these 12-15 year-old children averaged 7 ng/ml, with 82% of all children having levels below 10 ng/ml before the trial and mean levels falling to 4 ng/ml during January in the placebo group.

In a surprise finding, the treated children grew faster than the placebo children did (P=.0025). As the authors point out, this may explain the fact that children grow faster in the spring and summer.

Eight hundred IU per day only raised 25(OH)D levels by 13 ng/ml, so all children remained below 30 ng/ml after the study, and 60% of the treated children still had levels below 20 ng/ml after 6 months of 800 IU/day, a dose higher than that recently recommended by the U.S. Food and Nutrition Board.

Professor Willett (and a bunch of other experts) has previously recommended that you give your child enough vitamin D to obtain mid normal levels (50 ng/ml) and recommended 1,000 IU/day for every 25 pounds of body weight.

Cannell JJ, Vieth R, Willett W, Zasloff M, Hathcock JN, White JH, Tanumihardjo SA, Larson-Meyer DE, Bischoff-Ferrari HA, Lamberg-Allardt CJ, Lappe JM, Norman AW, Zittermann A, Whiting SJ, Grant WB, Hollis BW, Giovannucci E. Cod liver oil, vitamin A toxicity, frequent respiratory infections, and the vitamin D deficiency epidemic. Ann Otol Rhinol Laryngol. 2008 Nov;117(11):864-70. Review.

  About: John Cannell, MD

Dr. John Cannell is founder of the Vitamin D Council. He has written many peer-reviewed papers on vitamin D and speaks frequently across the United States on the subject. Dr. Cannell holds an M.D. and has served the medical field as a general practitioner, emergency physician, and psychiatrist.

2 Responses to RCT: Vitamin D supplementation and TB in Mongolian children

  1. Vitamin D and TB has gotten a lot of good attention in recent months.

    Here are a few of the titles at VitaminDWiki

    Children with TB vaccinations became 6X more likely to have vitamin D gt than 30 ng – Jan 2012

    Probability of getting TB reduced 60 percent with just 800 IU of vitamin D – RCT Aug 2012

    Patients having both Diabetes and TB treated by vitamin D – June 2012

    Vitamin D and the Lung – professional book 2012

    79 percent of TB in East London less 20 ng vitamin D – April 2012

    TB worst in March, lowest vitamin D – CDC April 2012

    Review of infectious diseases vitamin D trials – Feb 2012

    Lung and Vitamin D – Special Issue Dec 2011

    – – all that and more at: http://is.gd/TBVITD

  2. jsawadsk says:

    Since learning about the many different benefits of Vitamin D, and the many indications from early 20th century TB “sanatoria” about the benefits of sunlight – I have often thought about the 19th century practice of sending British and North European people with TB (who could afford it) to Italy in hope of a cure. (Probably the most famous Britisher who attempted this was John Keats, who was not wealthy and whose TB was probably too far advanced to be helped by the time his friends raised enough funds to send him to Rome in the last stages of his illness.) I don’t think the doctors who recommended this intervention knew what the operative healing variable in Italy was. I believe some postulated that it was the drier air there that helped. As far as I know, there was usually no recommendation for patients to spend any extended time in the sun. It is heartbreaking to think about Keats, who died at 25, as well as all the other wonderful people we may have lost because of ignorance about such a simple remedy (which may have been available even in Britain in summer).