COPD and Vitamin D deficiency

If you are a COPD patient seeking to proactively manage your condition you might find it worthwhile investigating whether you are receiving enough Vitamin D from exposure to the sun, your diet and nutritional supplementation.

Two recently published research articles examined the connection between Vitamin D deficiency and compromised respiratory health and concluded COPD patients are at risk for Vitamin D deficiency and that COPD patients should consider supplementing their Vitamin D consumption. For your reference, the two studies are cited at the end of this article (one from the journal Clinical and Experimental Immunology and one from the journal Thorax).

As you may recall, humans can produce the majority of daily needed Vitamin D from exposure to the sun (UV-B light from sun interacts with human skin cells to produce Vitamin D naturally in the body). The National Institutes of Health indicates that the average healthy person can produce its daily requirement of Vitamin D with as little as 10 minutes direct sun exposure each day. In addition to the sun, many people receive additional Vitamin D through their diet (many dairy products, cereals and bread products are fortified with essential vitamins and minerals including Vitamin D), or through nutritional supplementation (Vitamin D is sold as a standalone supplement and is typically included in multivitamins – the recommended type Vitamin D as a nutritional supplement is Vitamin D3 in the form of cholecalciferol).

So what does Vitamin D have to do with COPD? As it turns out, quite a bit. Many COPD patients do not receive adequate Vitamin D given sedentary, indoor lifestyles where they do not receive consistent sun exposure to produce their own Vitamin D. This is especially true during the winter months when direct sunlight hours are reduced. Interestingly, COPD exacerbation events (meaning shortness of breath attacks) are most common during the winter months. The Clinical and Experimental Immunology article authors cite Vitamin D deficiency as a possible driver of winter exacerbation events.

In addition to exacerbation events, Vitamin D deficiency has been shown in various studies to be a contributing cause to upper respiratory infections, reduced lung function and skeletal muscle weakness. All three are common symptoms of COPD.

In the Thorax study, the researchers measured the serum levels of Vitamin D in 262 COPD patients and 152 healthy smokers. They discovered that Vitamin D deficiency was common in the COPD patient group but not as much in the healthy smoker group. They also reported that at each successive stage of COPD (there are four stages – Stage I - Mild, Stage II - Moderate, Stage III – Severe, Stage IV – Very Severe), the degree of Vitamin D deficiency was more pronounced.

So if you have COPD and you are not regularly exposed to direct sunlight for 10-30 minutes a day, it is worth discussing supplementing Vitamin D with your doctor. The National Institutes of Health recommends 2,000 IU of daily upper limit of supplemental Vitamin D for adults who do not receive adequate sunlight exposure. It should be noted though that some studies have recommended higher dosage levels for specific health conditions that range from 5,000 – 10,000 IUs but no study has pinpointed a recommended dosage level for COPD patients at this writing. You can find Vitamin D3 supplements for sale in dosages ranging from 100 IU to 5,000 IU. Whatever you choose, make sure you look at the ingredient panel to ensure that the Vitamin D3 you are purchasing is in the form of cholecalciferol. These supplements are widely available and generally inexpensive ($5-10/bottle).

If you are not interested in nutritional supplementation, then get up and go outside for a ten-thirty minute walk each day (making sure you have some portions of your skin directly exposed to sunlight). Not only will your body produce more Vitamin D but you will benefit greatly from the exercise benefits of walking. Both benefits are highly desirable for those with COPD.

Study references:
(Hughes DA, Norton R. Vitamin D and respiratory health. Clinical and Experimental Immunology. 2009 Oct; 158(1):20-5.) The free full text of the article is available by clicking here.

(Janssens W, Bouillon R, Claes B, et al. Vitamin D Deficiency is Highly Prevalent in COPD and Correlates with Variants in the Vitamin D Binding Gene. Thorax. Published online December 8, 2009. doi: 10.1136/thx.2009.120659). The free full text of this article is not available but can be purchased by visiting http://www.thorax.bmj.com/.