While on vacation in the Florida Keys, I was impressed with how quickly my legs and forehead turned from white to lobster red…ouch another sunburn! Surely there must be some benefit (and definitely beauty) for all this pain. Your answer awaits….it’s Vitamin D.
Natural medicine and traditional medicine often don’t see “eye to eye”, but Vitamin D is different. In fact, Vitamin D isn’t a vitamin at all, it’s a hormone. Vitamins can’t be produced by the body without an external source in foods or other supplements. Hormones, on the other hand, are manufactured by brain/endocrine cells, and in the case of Vitamin D by the skin.
So why as an allergist do I really care about getting adequate amounts of Vitamin D?
Or at least as sexy as you can get for a vitamin. Of all the vitamins out there, vitamin D has the most PROVEN benefit for allergies & asthma. Remember the cod liver oil? Of course you don’t….you’re not that old!
The importance of vitamin D as an essential nutrient is well known, given its role in calcium and phosphate homeostasis. Over the past two decades, the influence of vitamin D on the immune system has become increasingly clear.Recent work has elucidated that vitamin D harbors actions more akin to hormones and pro-hormones. The discovery of the vitamin D receptor (VDR) has stimulated more research into the nature of this vitamin which has, subsequently, been shown to be a steroid hormone. This steroid constitutes a component of a complex endocrine pathway termed the ‘Vitamin D endocrine system’.Investigators have found that vitamin D plays an integral role in the induction of cell differentiation, inhibition of cell growth, immunomodulation, and regulation of other hormonal systems.This review seeks to highlight the recent research with respect to vitamin D and its role in chronic rhinitis and chronic rhinosinusitis (CRS). The results show higher levels of Vit D are associated with fewer problems with allergy and sinusitis.
Although these results are extremely compelling, the Mulligan study suffers from a small sample size. Future work may extrapolate these data to a larger patient set, ideally through a prospective study, which would help clarify the role of vitamin D in the pathophysiology of CRS. Systemic vitamin D levels could, potentially, be added to the routine workup of patients suffering from CRS and these data could be used to help determine the disease severity and possibly even treatment. To this end, a recent Polish study evaluated the role of vitamin D in the reduction of fibroblast proliferation in vitro from nasal polyps in patients with CRS. A statistically significant decrease in fibroblast proliferation was noted with calcitriol and tacalcitol treatment. Furthermore, increasingly higher doses induced a greater suppressive effect on fibroblast proliferation. This study is a first step towards investigating the utility of topical vitamin D analogs for the treatment of CRS. Wow–topical Vitamin D for treatment of sinusitis?!
Conclusions from this work:
Early research suggests that vitamin D is involved in the pathophysiology of chronic rhinitis and chronic rhinosinusitis (CRS).
It is intriguing to consider the possibility that abnormal vitamin D blood levels – or even the local tissue concentration of vitamin D – could be a critical influencing factor in chronic rhinitis and CRS pathophysiology.
The concept of the unified airway “one airway, one disease” would suggest that similar associations from the asthma literature will be found with regards to allergic rhinitis, chronic rhinitis, and CRS.
Randomized controlled trials are needed to further evaluate vitamin D and its relationship to allergic rhinitis, chronic rhinitis, and CRS.
These findings may then direct researchers to pursue clinical trials aimed at evaluating vitamin D and its analogs as potential therapeutic interventions.
An apple a day might keep the doctor away, but what is modern hospital medicine really like? Follow Dr. Benjamin Kirkland - a Doctor working in Australia - through the pinnacles and pitfalls of everyday hospital medicine!