The Vitamin D Council Newsletter, Oct 2010

Vitamin D Newsletter October 2010

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Asthma, Eczema, and Vitamin D

Dear Dr Cannell:I have a few questions which I hope to you will be able to help me God willing:

Firstly, My wife is currently breast feeding our first child who is a 5 months old girl and she has is currently suffering from a very, VERY common condition called eczema or atopy, which seems to be affecting almost all new born babies and toddlers in the UK. She also has asthma, which is getting worse. My wife has cut out everything from her diet that it is typically linked to the causes of atopy and she is currently taking vitamin tablets which the NHS in the UK give out free to all women who are pregnant and are breast feeding the content of each tablet is as follows:

Vitamin D

10 ug (400 IU)

Vitamin C

70 mg

Folic acid (Folacin)

400 ug

and we are currently giving our daughter 'Children Vitamin drops' which we instructed to give 5 drops and the 5 drops contain in total:

Vitamin A

233 ug (700 IU)

Vitamin C

20 mg

Vitamin D

7.5 ug (300 IU)

Now would this amount be enough for both mother and baby's Vitamin D level and could there be a link between the eczema/asthma and Vitamin D level?

Secondly, I myself suffer from eczema for a long time since about 2003 and I am 30 years old now. It has been on and off and it especially flares up in winter indifferent places on the body, I have generally managed to control it by watching what I eat especially at winter, now I have read quite a lot from your website and as far as i can understand that i should be taking 1000 IU of Vitamin D for every 25 pounds of body weight and as for the blood test I should take that after 8 weeks of starting the Vitamin D supplement.

Thank you for reading my rather long email but I am learning to avoid that winter fatigue and maybe find out if I can get rid of a few other problems for myself and loved ones.Thank you Geoffrey Bingham Birmingham UK

Eczema is a form of atopy, a disease characterized by a tendency to be "hyperallergic". A patient with atopic allergies often has atopic eczema or atopic dermatitis since infancy and asthma as they grow older. Atopic eczema is an extremely itchy skin condition with a hallmark rash that can involve almost every region of the body. Crusty, scaly, flattened, reddened lesions of atopic eczema can appear almost everywhere, but are worse in certain areas or after exposure to certain irritants (e.g., allergenic soap, freshly cut lawns).

The single most important feature associated with atopic eczema lesions is that they are extremely itchy, and the itch can occur even before the lesions erupt on the skin and are visible. The itchiness often leads to secondary infections.

Atopy and asthma have a complicated relationship to vitamin D, with some studies showing vitamin D — especially cod liver oil in infancy — making eczema worse in later life. However, one would be silly to stay vitamin D deficient, and all that entails, on the chance your eczema will not worsen. Furthermore, in my experience atopy, including asthma, will slowly improve with physiological doses of vitamin D. Like asthma, eczema can become life-threatening if infection occurs. Such infections are thought to be secondary to reductions in the skin of naturally occurring antibiotics, such as cathelicidin.

Recently, Dr. Tissa Hata and a group at UC San Diego conducted a randomized controlled trial that demonstrated a remarkable seven-fold increase in cathelicidin in the skin after adult eczema subjects were given 4,000 IU per day for 21 days.

Hata TR, et al. Administration of oral vitamin D induces cathelicidin production in atopic individuals. J Allergy Clin Immunol. 2008 Oct;122(4):829—31.

Even more important, Dr. Urashima and colleagues at the Jikei University School of Medicine in Japan conducted a randomized placebo controlled trial of young teenagers and found that those with asthma were much less likely to have an attack if they were on vitamin D. Asthma attacks are not an uncommon cause of death among children. They also found that vitamin D significantly reduced the risk of influenza A, which can be much more severe in asthmatics.

Urashima M, et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010 May;91(5):1255—60.

Geoffrey, both you and your baby need to stop all vitamin A supplements, as they will interfere with the vitamin D, and begin taking vitamin D; your infant needs 1,000 IU/day and you need 5,000 IU per day. I wish I could tell you the eczema will rapidly disappear; it will not. However, over a period of several years I predict both the eczema and asthma will slowly improve. More importantly, both you and your infant will have a decreased likelihood of getting a secondary infection in both your skin and your lungs.

John Jacob Cannell MD Executive Director

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