Connect
MJA
MJA

Vitamin D and tuberculosis

A Stewart Truswell
Med J Aust 2013; 199 (10): . || doi: 10.5694/mja13.11121
Published online: 18 November 2013

There is little evidence to suggest that vitamin D has any therapeutic effect in treating tuberculosis

Before antimycobacterial medicines were introduced (around 1950), the best support for patients with tuberculosis (TB) appeared to be sunshine. For TB patients who needed bed rest, sun-facing balconies in sanatoria were considered to be more therapeutic than the usual dark hospital wards. In 1904, William Osler noted that rabbits inoculated with tubercle bacilli succumbed rapidly if kept in the dark, but not in the open air. He advised patients treated at home to have as many hours as possible in the sunshine. Cod liver oil was also used — a large controlled trial at the Brompton Hospital, London in 1848 showed clear benefit of cod liver oil in treating pulmonary consumption.1


  • University of Sydney, Sydney, NSW.



Competing interests:

No relevant disclosures.

  • 1. Green M. Cod liver oil and tuberculosis. BMJ 2011; 343: d7505.
  • 2. Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266-281.
  • 3. Liu PT, Stenger S, Tang DH, Modlin RL. Cutting edge: vitamin D-mediated human antimicrobial activity against Mycobacterium tuberculosis is dependent on the production of cathelicidin. J Immunol 2007; 179: 2060-2063.
  • 4. MacLachlan JH, Cowie BC. Epidemiology of tuberculosis and levels of vitamin D in Australia: person, place and time. Med J Aust 2013; 199: 655-656.
  • 5. Boyages S, Bilinski K. Seasonal reduction in vitamin D level persists into spring in NSW Australia: implications for monitoring and replacement therapy. Clin Endocrinol (Oxf) 2012; 77: 515-523.
  • 6. Willis MD, Winston CA, Heilig CM, et al. Seasonality of tuberculosis in the United States. Clin Infect Dis 2012; 54: 1553-1560.
  • 7. Brodie MJ, Boobis AR, Hillyard CJ, et al. Effect of rifampicin and isoniazid on vitamin D metabolism. Clin Pharmacol Ther 1982; 32: 525-530.
  • 8. Nnoaham KE, Clarke A. Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int J Epidemiol 2008; 37: 113-119.
  • 9. Talat N, Perry S, Parsonnet J, et al. Vitamin D deficiency and tuberculosis progression. Emerg Infect Dis 2010; 16: 853-855.
  • 10. Wejse C, Gomes VF, Rabna P, et al. Vitamin D as supplementary treatment for tuberculosis: a double-blind, randomized, placebo-controlled trial. Am J Respir Crit Care Med 2009; 179: 843-850.
  • 11. Martineau AR, Timms PM, Bothamley GH, et al. High-dose vitamin D(3) during intensive-phase antimicrobial treatment of pulmonary tuberculosis: a double-blind randomised controlled trial. Lancet 2011; 377: 242-250.
  • 12. Coussens AK, Wilkinson RJ, Hanifa Y, et al. Vitamin D accelerates resolution of inflammatory responses during tuberculosis treatment. Proc Natl Acad Sci U S A 2012; 109: 15449-15454.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.