University of Wisconsin School of Medicine and Public Health study: Vitamin D does not reduce colds in asthma patients

26 Nov

The National Heart, Lung, and Blood Institute describe asthma:

What Is Asthma?

Asthma (AZ-ma) is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning.

Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 25 million people are known to have asthma. About 7 million of these people are children.

Overview

To understand asthma, it helps to know how the airways work. The airways are tubes that carry air into and out of your lungs. People who have asthma have inflamed airways. The inflammation makes the airways swollen and very sensitive. The airways tend to react strongly to certain inhaled substances.

When the airways react, the muscles around them tighten. This narrows the airways, causing less air to flow into the lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways might make more mucus than usual. Mucus is a sticky, thick liquid that can further narrow the airways.

This chain reaction can result in asthma symptoms. Symptoms can happen each time the airways are inflamed….                                                                                                                                          http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/

The Centers for Disease Control and Prevention describe how to tell if you have asthma:

How Can You Tell if You Have Asthma?

It can be hard to tell if someone has asthma, especially in children under age 5. Having a doctor check how well your lungs work and check for allergies can help you find out if you have asthma.

During a checkup, the doctor will ask if you cough a lot, especially at night, and whether your breathing problems are worse after physical activity or at certain times of year. The doctor will also ask about chest tightness, wheezing, and colds lasting more than 10 days. They will ask whether anyone in your family has or has had asthma, allergies, or other breathing problems, and they will ask questions about your home. The doctor will also ask if you have missed school or work and about any trouble you may have doing certain things.

The doctor will also do a breathing test, called spirometry, to find out how well your lungs are working. The doctor will use a computer with a mouthpiece to test how much air you can breathe out after taking a very deep breath. The spirometer can measure airflow before and after you use asthma medicine.

What Is an Asthma Attack?

An asthma attack may include coughing, chest tightness, wheezing, and trouble breathing. The attack happens in your body’s airways, which are the paths that carry air to your lungs. As the air moves through your lungs, the airways become smaller, like the branches of a tree are smaller than the tree trunk. During an asthma attack, the sides of the airways in your lungs swell and the airways shrink. Less air gets in and out of your lungs, and mucous that your body makes clogs up the airways even more.

You can control your asthma by knowing the warning signs of an asthma attack, staying away from things that cause an attack, and following your doctor’s advice. When you control your asthma:

  • you won’t have symptoms such as wheezing or coughing,
  • you’ll sleep better,
  • you won’t miss work or school,
  • you can take part in all physical activities, and
  • you won’t have to go to the hospital.

What Causes an Asthma Attack?

An asthma attack can happen when you are exposed to “asthma triggers”. Your triggers can be very different from those of someone else with asthma. Know your triggers and learn how to avoid them. Watch out for an attack when you can’t avoid the triggers. Some of the most common triggers are tobacco smoke, dust mites, outdoor air pollution, cockroach allergen, pets, mold, and smoke from burning wood or grass….                                                                                       http://www.cdc.gov/asthma/faqs.htm

A 2004 study by Bielory and Gandhi, Asthma and vitamin C examined “what role vitamin C may or may not play in the treatment of asthma.” They concluded:

Clearly from our review, the role of vitamin C in asthma and allergy is not well defined. The majority of the studies were short term and assessed immediate effects of vitamin C supplementation. Long term supplementation with vitamin C or delayed effects need to be studied. Although, the current literature does not support a definite indication for the use of vitamin C in asthma and allergy, the promising and positive studies revive curiosity and interest. With a large portion of health care dollars being spent on alternative medicine and vitamin C in particular, further studies are needed to define its role.

http://www.ncbi.nlm.nih.gov/pubmed/8067602

Some feel vitamin therapy is effective in treating asthma. Web MD lists studies in Vitamins & Supplements Search http://www.webmd.com/vitamins-supplements/condition-1007-Asthma.aspx?diseaseid=1007&diseasename=Asthma

Science Daily reported in Vitamin D does not reduce colds in asthma patients:

Vitamin D supplements do not reduce the number or severity of colds in asthma patients, according to a new study published online ahead of print publication in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

Loren C. Denlinger, MD, PhD, associate professor of medicine at the University of Wisconsin, and colleagues conducted a randomized, controlled trial of adults with mild-to-moderate asthma. Among African Americans in the study, those receiving supplemental vitamin D, rather than a placebo, experienced more colds.

The findings surprised the researchers who had previously published research showing a 40 percent reduction in asthma exacerbations in patients with a vitamin D deficiency who achieved normal levels of the vitamin with supplements. Because colds often trigger exacerbations, they hypothesized that vitamin D supplementation would reduce colds and cold severity.

“Other studies of vitamin D and colds have produced mixed results,” Dr. Denlinger said. “Most of those studies were conducted among healthy patients. We wanted to ask the same question of a patient population in which the impact of a cold carries greater risk.”

The researchers followed asthma patients who were undergoing inhaled corticosteroid (ICS) tapering, Denlinger added, to test the hypothesis that vitamin D might bolster the potency of the ICS.

The multi-center AsthmaNet Vitamin D Add-on Therapy Enhances Corticosteroid Responsiveness (VIDA) trial enrolled 408 adults with mild-to-moderate asthma whose vitamin D levels were insufficient or deficient (25-OH-D3 < 30 ng/mL). Those enrolled had asthma symptoms despite low-dose ICS therapy. The patients were randomized to receive either vitamin D supplementation (100,000 IU once, then 4000 IU daily) or placebo for 28 weeks. Neither the patients nor their physicians knew whether they received vitamin D or the placebo.

During that time, about half the participants experienced at least one cold. The severity of their colds was measured by the Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21).

The researchers analyzed separately the results of the 82 percent of participants receiving supplements who achieved vitamin D sufficiency within 12 weeks. Achieving sufficiency made no difference in number of colds or their severity this group experienced.

The researchers wrote that one possible explanation for the unexpected finding: asthma patients with low vitamin D levels may be more likely to experience upper respiratory infections asymptomatically than those with normal levels of vitamin D, which is known to trigger an inflammatory response. This inflammatory response may, in turn, reduce the risk of lower airway infections, which are triggers for asthma exacerbations……                                                                     http://www.sciencedaily.com/releases/2015/11/151123103632.htm

Citation:

Vitamin D does not reduce colds in asthma patients

Date:         November 23, 2015

 

Source:     American Thoracic Society (ATS)

 

Summary:

Vitamin D supplements do not reduce the number or severity of colds in asthma patients, according to a new study. The findings surprised the researchers who had previously published research showing a 40 percent reduction in asthma exacerbations in patients with a vitamin D deficiency who achieved normal levels of the vitamin with supplements. Because colds often trigger exacerbations, they hypothesized that vitamin D supplementation would reduce colds and cold severity.

Journal Reference:

  1. Loren C. Denlinger, Tonya S King, Juan Carlos Cardet, Timothy Craig, Fernando Holguin, Daniel J Jackson, Monica Kraft, Stephen P Peters, Kristie Ross, Kaharu Sumino, Homer A. Boushey, Nizar N. Jarjour, Michael E Wechsler, Sally E. Wenzel, Mario Castro, Pedro C. Avila. Vitamin D Supplementation and the Risk of Colds in Patients with Asthma. American Journal of Respiratory and Critical Care Medicine, 2015; DOI: 10.1164/rccm.201506-1169OC

Send to:

Am J Respir Crit Care Med. 2015 Nov 5. [Epub ahead of print]

Vitamin D Supplementation and the Risk of Colds in Patients with Asthma.

Denlinger LC1, King TS2, Cardet JC3, Craig T4, Holguin F5, Jackson DJ6, Kraft M7, Peters SP8, Ross K9, Sumino K10, Boushey HA11, Jarjour NN12, Wechsler ME13, Wenzel SE14, Castro M15, Avila PC16; National Heart Lung and Blood Institute AsthmaNet Investigators.

Author information

Abstract

BACKGROUND:

Restoration of vitamin D sufficiency may reduce asthma exacerbations, events often associated with respiratory tract infections (RTIs) and cold symptoms.

OBJECTIVE:

To determine whether vitamin D supplementation reduces cold symptom occurrence and severity in adults with mild to moderate asthma and vitamin D insufficiency.

METHODS:

Colds were assessed in the AsthmaNet Vitamin D Add-on Therapy Enhances Corticosteroid Responsiveness (VIDA) trial, which randomized 408 adult patients to receive placebo or cholecalciferol (100,000 IU load plus 4,000 IU/day) for 28 weeks as add-on therapy. The primary outcome assessed cold symptom severity using daily Wisconsin Upper Respiratory Symptom Survey (WURSS)-21 scores.

RESULTS:

203 participants experienced at least one cold. Despite achieving 25-hydroxyvitamin D levels of 41.9 ng/mL (95%CI, 40.1-43.7 ng/mL) by 12 weeks, vitamin D supplementation had no effect on the primary outcome, the average peak WURSS-21 scores [62.0 (95% CI 55.1-68.9; placebo) and 58.7 (95% CI 52.4-65.0; vitamin D), p = 0.39]. The rate of colds did not differ between groups (rate ratio [RR] 1.2, 95% CI 0.9 to 1.5); however, among African-Americans those receiving vitamin D vs. placebo had an increased rate of colds (RR 1.7, 95% CI 1.1-2.7, p = 0.02). This was also observed in a responder analysis of all subjects achieving vitamin D sufficiency regardless of treatment assignment (RR 1.4, 95% CI 1.1-1.7, p = 0.009).

CONCLUSION:

In patients with mild-to-moderate asthma undergoing an ICS dose-reduction, these results do not support the use of vitamin D supplementation for the purpose of reducing cold severity or frequency. Clinical trial registration available at http://www.clinicaltrials.gov, ID NCT01248065.

KEYWORDS:

WURSS-21; asthma; upper respiratory tract infection; vitamin D

PMID:

26540136

[PubMed – as supplied by publisher]                                                                                                               http://www.ncbi.nlm.nih.gov/pubmed/26540136

The American Academy of Allergy, Asthma & Immunology (AAAAI) provides the following advice:

People with a family history of allergies or asthma are more prone to developing asthma. Many people with asthma also have allergies. This is called allergic asthma.
Occupational asthma is caused by inhaling fumes, gases, dust or other potentially harmful substances while on the job.

Childhood asthma impacts millions of children and their families. In fact, the majority of children who develop asthma do so before the age of five.

There is no cure for asthma, but once it is properly diagnosed and a treatment plan is in place you will be able to manage your condition, and your quality of life will improve.

An allergist / immunologist is the best qualified physician in diagnosing and treating asthma. With the help of your allergist, you can take control of your condition and participate in normal activities.

Keep pace with the latest information and connect with others. Join us on Facebook and Twitter.

http://www.aaaai.org/conditions-and-treatments/asthma.aspx

It is imperative to seek competent medical advice regarding individual treatment options.

Resources:

Asthma.com

http://www.asthma.com/additional-resources.html

Asthma Health Center

http://www.webmd.com/asthma/guide/asthma-support-resources

Asthma Resources

http://www.webmd.com/asthma/asthma-resources

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