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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.

Vitamin D deficiency and its link to severe asthma

Doctor Audrey Poon, working under senior author Professor Qutayba Hamid of McGill University, recently published an extensive review on vitamin D and severe asthma, including the reasons vitamin D may have a treatment effect in some patients with existing severe asthma.

I want readers to post at the end of this blog about their experiences with vitamin D and severe asthma.

Poon AH, Mahboub B, Hamid Q.  Vitamin D deficiency and severe asthma. Pharmacol Ther. 2013 Jun 18.

Here are some of the key things on what is known about vitamin D and severe asthma.

On severe asthma in general

  • Individuals with severe asthma make up between approximately 5 to 15% of the asthma population. Demographically, these patients use emergency medical care 15 times more often and are 20 times more likely to be hospitalized than patients with the milder forms of asthma.
  • Patients with severe asthma are difficult to control with medication, require high dosages of medication, continue to experience persistent symptoms and asthma exacerbations in spite of aggressive therapy, and they are more likely to have irreversible airflow obstruction associated with airway remodeling.

On vitamin D-asthma observational studies

  • Observational studies have demonstrated an involvement of vitamin D deficiency in severe asthma. Taken together, data from observational studies are suggesting a protective role of vitamin D in severe asthma.
  • In a study of moderate and severe asthmatic individuals who were vitamin D insufficient (defined as less than 30 ng/ml), those who exhibited steroid resistance had a significantly lower frequency of T regulatory cells (Treg cells help the body distinguish self from non-self and prevent the body from attacking itself). Furthermore, in these individuals serum 25(OH)D level was strongly associated with Treg cell number.
  • In a childhood cohort of mild to moderate persistent asthma who received inhaled corticosteroid, lung function improvement was the greatest in the vitamin D sufficient group (defined as greater than 30 ng/ml) as compared to the vitamin D-deficient group (defined as less than or equal to 20 ng/ml).

On mechanisms of vitamin D in asthma

  • Vitamin D regulates transcription of several genes that are involved in airway remodeling in airway smooth muscle cells.
  • The anti-inflammatory effect of vitamin D in airway smooth muscle cells has been demonstrated by the observation that treatment of vitamin D suppressed the secretion of  inflammatory cytokines (IL-5, IL-6, IL-8 and tumor necrosis factor-α).
  • Vitamin D should exert its anti-proliferative and anti-inflammatory effects in existing asthma by modulating cell cycle, transcription, and translation of genes involved in inflammation and airway remodeling.
  • Vitamin D may synergistically promote the anti-inflammatory action of glucocorticoids by recruiting eosinophils away from the site of inflammation via up-regulation of a gene (CXCR4).
  • Evidence exists suggesting that vitamin D would decrease scarring (fibrosis) and promote remodeling in the airways of asthmatic individuals.

On clinical trials

  • In an ongoing study, children with severe asthma taking vitamin D in addition to steroid therapy had a lower percentage of asthma attacks compared to the steroid only group.
  • In the next two years, several large clinical trials of vitamin D supplementation to prevent asthma and related morbidity will be complete, according to the United States Clinical Trial registry.
  • In severe asthma, three trials are in the planning stage to see if vitamin D supplementation would reduce asthma exacerbation rates in moderate to severe asthmatic adults. That is, they will see if vitamin D is effective treatment for existing asthma.

What all this seems to imply is that not only may vitamin D help prevent asthma, but it may have a treatment effect in existing severe asthma. If you have severe asthma and decide to try vitamin D, make sure you use it as add-on therapy. That is, take vitamin D in addition to your regular asthma meds, not in place of your asthma meds.

If you have asthma, or have had asthma, especially severe asthma, please blog about your experience with vitamin D and asthma.

Lastly, check out our patient friendly summary on vitamin D and asthma and be sure to share with your friends.

  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.

14 Responses to Vitamin D deficiency and its link to severe asthma

  1. Rita and Misty says:

    Dear Vitamin D Council,

    A very informative article. Thank you.

    I understand that this is a Members Section article (and it certainly should be!!).

    But, perhaps it might be worth while to pose this question, with perhaps an abbreviated article, to the VDC Facebook readership to see if it draws any anecdotal comments?

    I don’t have Asthma, but my mom does. And her attacks are substantially less on the 10,000 to 16,000 iu d3 that she supplements with on a daily basis.

    Be well,
    Rita

  2. Sondra Rose says:

    My moderate lifelong asthma symptoms are completely gone as long as I keep my 25(OH)D level over 80 ng/ml.

    For me, this requires 8,000 IUs per day year round, since I am Type IV on the Fitzpatrick scale and tan very quickly.

    I experimented last year by dropping my D3 supplementation and sunning in a bikini around noon in Santa Fe, NM for one hour daily from April-June. My blood level dropped to 57 ng/ml and my asthma symptoms came back! 3 weeks of supplementing 12,000 IUs and my asthma symptoms ceased.

    I have been medication-free for almost 4 years. I also supplement350 mg Mag Citrate and 500 mg krill oil. I eat a Lacto-Paleo diet.

    Two other women on the PaleoHacks forum have shared a similar need for at least 80 ng/ml for symptom cessation. I suspect that future studies will need to be more liberal in their dosages in order to replicate these real-world results.

  3. Magic says:

    Sondra,

    I have been plagued with asthma and other nasal problems for my entire life. I have eased into the use of D3 but as I learned more I use more. Right now I am taking 20,000 a day. I am completely free……I breathe freely. I take no prescription meds at almost 80 years of age. I have never had any of those toxic indications in the close to 5 years I have been using D3.

    My wife is taking 40,000 a day. She had been in a care center for more than a year and was only getting 1000 a day. The only prescription meds were for BP and she got off them entirely last month. Her reading yesterday was 119 over 81. She has been in that range for a month.

    We also take vitamins recommended on this site.

    ALSO……….I go to the dog park almost every day. I get 2-3 miles of walking or jogging.

    Magic

  4. watercolor6539@aol.com says:

    The story in our family is that I came into the world allergic 74 years ago.. My Mother had childhood rickets & became depressed if she was not walking in the sun in the winter. I well remember the horrible childhood nights of not being able to breathe. In the first grade I was taken to a children’s hospital angering the “sisters/Catholic” as I woke up with night terrors many times breaking my water glass in my terror of being smothered. Afterwards I went to live with my aunt as “they” felt I had an aversion to my mother & she was asked not to visit me as I became upset when she left. Finally my brother, nursemaid, & I were given permission to join a troop train (WW2) to FA to rejoin our parents..
    As I ran on the beach with my older brother, I in his outgrown swim trucks (no top), I really began to improve even though he liked to taunt me during the black outs of what the Germans in submarines would do to little girls.. (I’m going into the psychological aspects which was the main theory of asthma at that time) Even though I taught psychology at the college level & became a psychotherapist, I believe that asthma is directly related to VD.. I really “outgrew” it when I was old enough to walk to the swimming pool in Jr. High. I only got it again 2 winters when I was in a prep school in VA, & we had to keep well covered up including gloves when out of the building.
    Finally in 2002 when a stage 2 Melanoma mole was removed from my back & knowing my Dad had died of Melanoma, I began avoiding the sun!! Because my art career began “taking off”, I didn’t really pay enough attention to how my health was declining. When I was diagnosed with hashimoto thyroiditis, CFS, & fibromyalgia. I finally I began to study the books on VD3 & this website & began taking 2000 IU of D3 a day.. Than I upped it to 5000 IU & finally now about 13,000 IU,, This was the time of the H1N1 scare & many of us wanted #s close to 100ng. Right now I am at around 130 ng which does not worry me. It seems that our recommended #s went down with the awful low #s of the IOM report. I also eat organic GMO free & spend much time promoting healthy food & attempting to wake up the poor SAD USA people!!

  5. Rita and Misty says:

    A very dear friend of mine was diagnosed as an “elderly asthmatic” towards her 70th year of life.

    She asked her doctor why at this stage in her life she should develop this condition.

    His answer was something to the effect that the development of asthma in the elderly was common.

    Since learning about vitamin d, I often wonder if the elderly may develop asthmatic conditions (in particular if they don’t supplement) because the elderly have a difficult time synthesizing vitamin d from the sun’s rays via skin mechanisms. And of course, if they are housebound or in a nursing care facility, they are most likely severely deficient in D.

    @watercolor…Your story is awesome. I too am concerned about the IOMs stance on the 25(OH)D…20 ng/ml is just plain unhealthy in my opinion. Thank you for sharing your 25(OH)D level of 103 ng/ml. Mine currently is 166 ng/ml. I think this is high, and I’ve stopped supplementing for the summer, though I do love my sunshine.

    Be well!
    :)

  6. watercolor6539@aol.com says:

    Yes or COPD..an elderly friend recently went to the hospital with pneumonia, one of the side effects of Advair??sp medication. While she was there, she developed another stomach bug and had part of her colon removed and now wears a bag..

  7. watercolor6539@aol.com says:

    Also because the VDC is advocating lower ng levels since the IOM recommendation even though they criticized it, I don’t post as much.. In the old days, people who achieved postive results were minimum of 80 ng to 160 ng. 200 ng was considered the cut off!! It was so enlightening to me when Dana Clark had us post our numbers, how high they were among people getting GOOD results!!

  8. Rita and Misty says:

    @watercolor6539@aol.com,

    I love the Vitamin D Council specifically because it does try to provide unbiased information to us. I’ve been a member for about 1.5 years now, and for as long as I have been a member, the VDC has recommended 50 ng/ml to 80 ng/ml as being an optimal 25(OH)D range. I do understand that there are doctors in Brazil, and some in California even, utilizing higher 25(OH)D levels, but these doctors are using vitamin D as a drug and they are monitoring their patients for hypercalcemia, etc.

    Do I think 50 ng/ml — 80 ng/ml is optimal for most healthy folks? Yes. And I draw this conclusions from the natural 25(OH)D levels of current hunter/gatherer cultures. The Vitamin D Council has written about this before.

    Everyone (everyone) here on the VDC members blog, and perhaps in the entire City of New Haven (where I work and outreach), already knows my health story. But at the risk of personal embarrassment (and sometimes even brazen me feels embarrassed about all this personal sharing) and overall redundancy, I will share it again:

    For years I was taking 6,000 iu d3 daily, and my 25(OH)D level was only 32 ng/ml. At age 40 I went thru idiopathic early menopause (or so I was told). I was put on hormones. I proceed to get prematurely old, cranky and fat. I was depressed and tired as well. At age 46 thru serendipity, I discovered the Vitamin D Council organization. I learned about optimal 25(OH)D levels, and I learned that it is only the vitamin d blood level that matters and not the daily dosage. In other words, some of us have to take more than 5,000 iu d3 daily to raise our levels to optimal, and that is okay–as long as we test our blood routinely.

    For everyone’s information, my menses returned after a six year hiatus, upon my raising my 25(OH)D level to 74 ng/ml. I am now heading towards my 49th birthday. My cycle is more regular than ever. I no longer suffer from fibroids. I still ovulate. These things matter to a woman’s overall health and well being.

    Be well,
    Rita

  9. watercolor6539@aol.com says:

    Thanks for sharing, Rita, & congratulations! You do a wonderful job here with your posts & on your own page.. As I mentioned, I tuned out for a time as I was working hard to get GMOs Labeled in CA. And when I did look at the page, those low official blood #s put me off. From what you have told us, your own personal #s are MUCH higher.. When we did have a forum to share our #s, both ng & IU, I noticed that people who were relying on D3 #’s rapidly went down when they relied only on sunbathing..
    Here in No. CA. we have bioengineering or chemtrails which is dropping aluminum oxide on us which is keeping us from absorbing much of the sunlight we use to.. Why aluminum & other toxins?? ( to create more water, perhaps which is needed in So CA, to stop global warming, or control over population??) In checking with FB friends, it does seem to be world wide, but not to the degree here :(
    Can you please create a confidential way for logged in members to share, maybe just a question like Dana did??
    Many thanks for your hard work & all that you bring us,
    Blessings,
    Marianna Love

  10. watercolor6539@aol.com says:

    Almost forgot, when I take my D3, I also take K2 with it so that the calcium will go into the bones..

  11. Rita and Misty says:

    Greetings Marianna!

    Thank you for your lovely compliments!

    I should mention here that I never utilized Facebook very much until realizing that social networking was indeed a splendid way to perform vitamin D outreach. I hope I have touched a few hearts with my Facebook page….I’ve met so many nice people. And, I’ve had some splendid adventures :) .

    Funny, but for me, my vitamin d research and outreach is such a pleasure I consider it relaxation from those other dreary life events we all have…it truly is a bright spot in my life…and not work at all! It is most certainly my joy.

    The Vitamin D Council couldn’t shoosh me away with a cyberspace broom (as I’m certain Brant already knows :)

    Regarding your request for me to “please create a confidential way for logged in members to share, maybe just a question like Dana did” our 25(OH)D levels and daily d3 dosage, I will have to rely on the Vitamin D Council’s thoughts on this item. I don’t know how I would be able to create such a log on my Facebook page, and I’m uncertain if the Vitamin D Council wants to create such a log on its members section. Though, to me, it sounds like an excellent idea. I would definitely list my level and daily dosage!

    Marianna, I agree with you 100% regarding K2. I take mine daily. I also take Boron, Zinc, Magnesium, Iodine and Selenium.

    Blessings right back to you, Marianna Love! You have turned my humdrum Sunday into something so very special. I am grateful to you!

    Fondly,
    Rita

  12. Rita and Misty says:

    Marianna, if you are truly interested in getting involved in climate change, and to me it certainly sounds like you are, then please check out http://realclimate.org/

    These guys are good.

    I used to try to participate–but their knowledge is vastly superior to mine on the subject of climate change…and try and try as I might, I just couldn’t keep up with their comments…much to my dismay. :(

  13. watercolor6539@aol.com says:

    Rita, dear, I am thinking more of a question that asks about our ng levels & progress not really a log so we can discuss with each other.. You are super great!!
    Love & blessings,
    Marianna

  14. randolph.mahoney@orange.fr says:

    Was diagnosed with Asthma around 20 years ago.Prescibed corticosteroid Seratide250 etc etc. I felt that any symptoms I may have had were relatively mild & hated being on chemicals with all their unpleasant side-effects.
    After communication with Dr Cannell in 2011,his response to me was “I have had some experience with adult asthma and it does seem to get better on Vit D, but it takes years to do so”
    I gradually phased out the Seratide and finally stopped completely on 16th September 2012.
    I continued my daily VitD3 at 10,000 IU per day. This keeps my level in a good mid-range –
    about 73 to 75 ngml (ZRT) and also over this period of nearly a year, I have had absolutely
    NO asthmatic symptoms.
    So, very grateful thanks to Dr Cannell for his guidance.
    Sincerely

    Pamela Randolph