As published in Health & Wellness Retailer Magazine, Fall 2018
People suffering from severe asthma attacks are often subjected to expensive and stressful hospitalisations. In addition, the use of drugs to treat and stabilise asthma have themselves many unwanted and undesirable effects on the body over time, for example, corticosteroids are effective treatments but can lead to thinning skin and other damaging effects. Reducing the number and severity of attacks and lowering the amount of medication required for satisfactory treatment would be a major benefit for patients, the healthcare system and the economy.
An almost 1,000 patient study reported in Lancet Respiratory Medicine showed that vitamin D supplementation can for some patients reduce the use of corticosteroids by 30 percent and moreover halve the number of hospital admissions. This study supports an earlier summary by the prestigious Cochrane Reviews which identified vitamin D supplements as an effective way to reduce severe asthma attacks in numerous small studies from around the globe.
As asthma is often thought of as an inflammatory disease with an immune dysfunction, this may suggest that other immune-linked disorders could show similar benefits. Indeed, this is the case and can be illustrated by findings in research into autoimmune disorders such as multiple sclerosis (Ms).
In a major review from Finland of over 800,000 women, those with low vitamin D levels were 43 percent more likely to suffer from Ms than those with normal levels suggesting a way to reduce the prevalence of the disease.
And the list continues to grow even outside effects on immune function and there may even be different benefits for men and women. For example, at least in men, low levels of vitamin D leads to an increased frequency of headaches. On the other hand, in women, there is recent evidence that adequate vitamin D levels are required for successful pregnancy and eventual healthy birth.
Taken together these findings suggest opportunities for identifying and using vitamin D to help reduce the impact of serious illnesses in modern society. There are however many forms of vitamin D and active metabolites, with D2 and D3 being most commonly required by man. In fact, the functional effects are due to active metabolites, not all of which are stable. For example, 1a,25-(OH)2D3 is the biologically active form of D3 but is unstable and short-lived, which is typically only found in medical products rather than as an ingredient on supplements. We do not yet know exactly which form is the most appropriate for each of the disorders that a vitamin D family member may provide relief. We will have to consider not only what is natural but what is appropriate for the intended therapeutic purpose. some therapeutic levels may not be readily achievable by diet alone, but we also need to be aware that more is not always better either.
There is now a race to find the right balance, right formulation and the right technology to produce the best levels and optimal availability of the most appropriate forms of vitamin D and active metabolites for a specific task. Accepted knowledge on the most natural and most organic product, and which is good, and which is bad, has to be tempered by what is appropriate for the purpose intended and what the body actually uses and where. This is a work in progress and will require a greater interaction between basic science, clinical studies and the development of preparations and formulations targeted to the indication.
The role of vitamin D has expanded well beyond that of calcium and phosphorous regulation in the bone to effects on the immune system, liver and kidney function, GI absorption, cardiovascular function, and fertility. The new role of supplement providers will be to match the form and method of delivery to the target, and by doing so, provide improved benefits to patients and the ever more stretched healthcare systems. It means understanding what combinations of other minerals and vitamins are also important to the therapeutic target.