Vitamin D May Help Prevent COPD Exacerbations
From time to time, most everyone who has COPD will experience what is called an exacerbation, or flare-up. An exacerbation is a medical term for when your usual COPD symptoms worsen greatly and start to interfere more with daily life. A recent study suggests that vitamin D, taken in high daily doses, might be useful in preventing this type of COPD attack.1
What is an exacerbation of COPD?
Symptoms such as the following are par for the course when you have COPD:2
- Chronic cough
- Breathlessness, with exertion
- Wheezing
- Fatigue
But these symptoms are seldom constant, at least not in the earlier stages of the disease. When they do become more constant or worsen in intensity, you could be in the throes of a flare-up. For example, you might find that you're coughing up more mucus than usual, or that the mucus has become thick and sticky. Or it may be yellowish, greenish or even have flecks of blood in it, rather than being clear. The cough might also be deeper and harder or occur more often.
You might also notice that you get short of breath even with routine activities that don't normally tax you. You might be more tired than usual, or have trouble falling and staying asleep.
Other symptoms of an exacerbation might include:3
- Headache on waking up
- Mental confusion
- Lower oxygen levels than usual, if you use a pulse oximeter
- Fever
Not everyone will have the same symptoms with a COPD flare-up. It's important to take note of your symptoms so that if it happens again, you'll know what might be going on.
What causes COPD exacerbations?
Causes can vary between people, but what is most common is some sort of respiratory infection. Infections can be caused by both bacteria, such as with pneumonia, and viruses, such as the common cold.3 But flare-ups can also be triggered by breathing in toxic or irritating fumes or substances, or even by an allergy attack if you have allergies.
No matter the trigger, inflammation in the airways is the result. And that causes the airways to narrow, swell, and produce more mucus. This results in the symptoms listed above.
How to prevent a COPD exacerbation
You may or may not be aware of these standard ways to help prevent COPD exacerbations:3
- Quit smoking, and/or avoid secondhand smoke.
- Avoid contact with other people who have respiratory infections, especially the flu.
- Use good handwashing technique to reduce spreading any infection you may come into contact with.
- Get a yearly flu vaccine.
Exacerbations are serious and can lead to hospitalization and even death. So, it's important to do everything you can to avoid them. It's not always possible to prevent every flare-up, but you need to try your best.
Now, perhaps vitamin D is another strategy to be used?
Details of a recent study on vitamin D to help with COPD
A number of studies have been done in the past to look at the value of vitamin D supplementation in improving outcomes in both COPD and asthma patients. So, researcher Adrian Martineau, a professor at Queen Mary University of London, worked with colleagues to analyze data from three clinical trials that took place in the United Kingdom, Belgium and the Netherlands. Here are some details of their research, which was published in the Thorax journal in January 2019:1
- 469 COPD patients from the 3 studies were analyzed
- All participants received vitamin D supplements
- Some participants had vitamin D deficiencies at the start of their clinical trials, while others did not
After analyzing the data, researchers found that:
- In patients who were deficient in vitamin D to start with, taking the supplements reduced their frequency of COPD flare-ups by 45%.
- No such protective effect was seen in those who were not deficient in vitamin D at the outset.
- No differences were seen between the 2 groups in terms of likelihood of having at least one serious exacerbation.
So, researchers concluded that taking a vitamin D supplement "safely and substantially reduced the rate of moderate/severe COPD exacerbations in patients with [vitamin-D deficiency]."
What might cause a vitamin D deficiency?
Certain health problems can cause you to be deficient in vitamin D. These can include:4
- Kidney or liver disease
- Cystic fibrosis
- Crohn's disease
- Celiac disease
- Gastric bypass surgery
- Obesity
Also, older adults, people who are homebound or housebound or people with darker pigmented skin are prone to not having enough vitamin D. Clearly, this could include a number of people who have COPD.
And finally, certain medications can cause low levels of vitamin D:
- Laxatives
- Steroids
- Cholesterol-lowering medicines
- Seizure-control drugs
- Rifampin (given for tuberculosis)
- Orlistat (used for weight loss)
Should you take vitamin D if you have COPD?
The answer to this is, "perhaps." But this is a decision that should be make in concert with your health care team. First of, you need to know if you have a vitamin D deficiency. If you don't, it looks like there might not be any value in supplementing what you may already be getting through diet or by being outside in the sun.
Vitamin D is a nutrient that helps your bones absorb calcium, so they stay strong and healthy.4 Vitamin D can also help with muscle function and your body's immune system. Besides helping to prevent COPD flare-ups, there have also been studies to suggest that it might help prevent or treat:4
- certain types of cancers, such as colon, prostate and breast
- diabetes mellitus
- heart disease
- high blood pressure
- multiple sclerosis
Not all of these studies are considered valid or conclusive, however. More definitive research is needed before we can be sure.
Many people can get enough vitamin D by sunshine exposure or through their diet. This vitamin can be found in a number of different foods, especially dairy products, but also including:
- Tuna, salmon and sardines
- Fortified orange juice
- Beef liver
- Egg yolks
- Certain fortified cereals
If your doctor does decide after testing your blood that you need more vitamin D, a supplement may be the answer. Vitamin D supplements are quite safe to take if you stick to the recommended limits. Most adults will need somewhere between 600 and 2,000 international units (IU) of vitamin D daily.5 It is possible to get too much vitamin D, which can cause side effects, so be sure to follow your doctor's specific prescription for vitamin D supplementation.
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