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Vitamin D and H1N1

Narinder Duggal, MD, FRCPC

Although H1N1 flu infections have declined in the Northern Hemisphere, it is difficult to forecast where or when future outbreaks may occur. In March 2010, the World Health Organization (WHO) announced that the pandemic of H1N1 has not yet peaked.¹ H1N1 virus is a swine-origin influenza virus A and is the mutated form of a previous swine influenza (better known as Spanish flu) virus and other human, avian, and Eurasian swine influenza viruses.^2,3 The Spanish flu was responsible for the deaths of millions of people in 1918. Clinically, it behaves similarly to seasonal influenza with symptoms such as fever, cough, sore throat, body aches, headache, chills and fatigue.⁴ The possibilities of the recurrence of the pandemic due to any further mutations in the virus’ genes cannot be ruled out.

As many as 85 million Americans have been infected with H1N1 swine flu, up to 17,000 have been killed and more than 390,000 hospitalized, from April 2009 to February, 2010, according to the Centers for Disease Control (CDC).⁵ There is substantial evidence that vitamin D deficiency can precipitate the influenza virus. Low vitamin D levels are directly linked to compromised immunity. Vitamin D receptors are present on cells responsible for both the innate and adaptive immune response, including T cells, B cells, macrophages, and dendritic cells. Vitamin D affects the expression of genes involved in an immune response; it increases the gene expression of cathelicidin, which kills bacteria. Lower immunity increases the likelihood of frequent infections such as the common flu and H1N1.

Recent research on vitamin D insufficiency reported shocking figures; 61% of American children and adolescents have insufficient vitamin D levels.⁶  Another study on newborn babies and their mothers concluded that 87% of infants having vitamin D levels less than 20 ng/ml have an increased risk of respiratory infection.

Several studies support the role of vitamin D in prevention of flu infections. Notably, a recent report on postmenopausal African American women concluded that those taking 2000 IU per day of vitamin D had a 90% reduced risk of contracting the flu.  In 2009, A.A.Ginde  analyzed information on vitamin D levels and respiratory infections from 18,883 adults and adolescents who participated in the Third National Health and Nutrition Examination Survey (NHANES III) from October 1988 to October 1994.⁷ The result showed that subjects with vitamin D levels less than 10ng/ml were more susceptible to flu than subjects with levels higher than 30ng/ml. Ginde pointed out that the NHANES data he analyzed had been collected 15 years ago and comparatively, the vitamin D insufficiency is more prevalent today.

Vitamin D deficiency predisposes children to respiratory infections.⁸ The Centers for Disease Control reported that out of 36 pediatric deaths due to H1N1 infections from April to August 2009, 22 children had neurodevelopmental conditions.  Additional analysis of this data indicated that many of the neurodevelopmental conditions were due to childhood vitamin D deficiency. An interventional study by  Rehman in 1994, showed that vitamin D reduces the incidence of respiratory infections in children.8 Children aged 3-12 years were given supplemental vitamin D and calcium for 6 weeks and were observed for a period of six months.It was found that the frequency of respiratory infection was significantly reduced. Further, according to a recent study on school children, it has been suggested that vitamin D3 supplementation during the winter may reduce the incidence of influenza A.⁹

As infectious agents of H1N1 may become more aggressive and more resistant to oseltamivir and zenavimir (drugs used for treating and preventing flu),¹⁰ optimizing vitamin D levels may be one of the best strategies for avoiding flu infections, including H1N1. Maintaining healthy levels of vitamin D can lead to a strong immune system and may assist in the prevention of H1N1 infection. Let supplementation with Synergy Therapeutics Vitamin D10 be your choice to assist in the prevention of H1N1 and influenza. Check our product section and order yours today.

References:

1. http://article.wn.com/view/2010/02/24/H1N1_Pandemic_not_yet_peaked_WHO_experts_advise/. (Open Link)
2. Chang LY, Shih SR, Shao PL, et al. Novel swine-origin influenza virus A (H1N1): the first pandemic of the 21st century. J Formos Med Assoc 2009;108(7):526-32. (PUBMED Abstract)
3.    Gallaher WR. Towards a sane and rational approach to management of Influenza H1N1 2009. Virol J 2009;6:51. (PUBMED Abstract)
4.    http://www.nlm.nih.gov/medlineplus/h1n1fluswineflu.html. (Open Link)
5.    http://www.cdc.gov/h1n1flu/estimates_2009_h1n1.htm. (Open Link)
6.    Kumar J, Muntner P, Kaskel FJ, et al. Prevalence and Associations of 25-Hydroxyvitamin D Deficiency in US Children: NHANES 2001-2004. Pediatrics 2009. (PUBMED Abstract)
7.    Ginde AA, Mansbach JM, Camargo CA, Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med 2009;169(4):384-90. (PUBMED Abstract)
8.    Cannell JJ, Vieth R, Umhau JC, et al. Epidemic influenza and vitamin D. Epidemiol Infect 2006;134(6):1129-40. (PUBMED Abstract)
9.    Urashima M, Segawa T, Okazaki M, et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. (PUBMED Abstract)
10.    Bergstrom KG. Tamiflu: what dermatologists need to know. J Drugs Dermatol;9(1):76-8. (PUBMED Abstract)