Can Vitamin D Lower the Risk of Respiratory Infections?

When it comes to a healthy immune system to fight respiratory infections, there’s some conflicting views about what actually helps and what does not. The research on the efficacy of vitamin D for fighting off an infection is particularly impressive, especially when compared to that of other vitamins and supplements. For example, a 2017 study, published in the British Medical Journal (BMJ) found that taking a vitamin D supplement reduced the risk of acute (sudden and severe) upper respiratory infection in every participant involved in the study.

What is it about vitamin D that lends itself to such impressive study results? Can vitamin D really help prevent the common cold?

What Is Vitamin D?

Vitamin D is a fat-soluble vitamin that can be found in just a few food sources. It can also be synthesized (made) in the human body as a result of exposure to the ultraviolet (UV) rays in sunlight. A fat-soluble vitamin is one that can be dissolved in fats and oils, is absorbed along with fats in the diet, and is stored in fat tissue in the body.

The Function of Vitamin D

A primary function of vitamin D is to promote calcium absorption (needed for healthy bones). This is one reason Vitamin D is added to milk products, ensuring that calcium in milk is readily absorbed by the body to promote healthy bone growth.

Vitamin D supplementation in U.S. milk products began in an effort to prevent rickets (a childhood disease involving soft, distorted bones, often resulting in bow-legs, from vitamin D deficiency). Vitamin D also helps protect against osteoporosis in older people.

Vitamin D is also used by the body to:

  • Promote cell growth
  • Promote neuromuscular (nerves and muscles) function
  • Reduce inflammation
  • Influence immune function

Vitamin D and the Immune System

The immune system defends the body against foreign organisms such as bacteria, viruses, and parasites. Not only does the immune system kill foreign invaders, but it also develops a protective ability (acquired immunity) to prevent future infections.

Vitamin D has been shown to have many effects on immune cells, enhancing the body’s ability to fight infection and decrease inflammation. Vitamin D has also been found to regulate acquired immune response (also called the adaptive immune response). A deficiency of vitamin D is linked to increased susceptibility to infection.

Historical Use

In the past, Vitamin D was unintentionally used to treat infections, such as tuberculosis, before antibiotics were available. Tuberculosis patients were sent to long-term care centers called sanitariums. They were treated with sunlight, which was thought to kill tuberculosis, when in fact the sunlight was producing vitamin D in the body. The vitamin D, not the sunlight is now thought to be the causative factor in the positive response the tuberculosis patients realized from sunlight exposure.

Another common treatment for tuberculosis was cod liver oil (rich in vitamin D). Cod liver oil has been used for many years as a preventative measure to protect from infections.

Studies on Vitamin D to Prevent Respiratory Infections

A systematic review of 25 controlled studies published in The BMJ found that vitamin D supplementation “reduced the risk of acute respiratory infection among all participants,” according to the study authors. The study also found that those who have low vitamin D levels, who take vitamin D3 supplements daily or weekly (rather than in one large dose), realized the highest level of benefits when it came to preventing acute respiratory infections.

The type of infections that are considered acute respiratory infections (ARTIs) include:

Coronavirus (COVID-19) and Vitamin D

The positive results from studies on vitamin D and the immune system have led many to wonder if vitamin D could possibly prevent COVID-19 infection. But, according to Harvard Health, there is not enough direct evidence to form a link between prevention of COVID-19 and vitamin D.

The Harvard Health report adds that taking a supplemental dose of 1000 to 2000 IU per day of vitamin D is optimal. This is particularly appropriate for those who have reason to believe that they have low levels of vitamin D (such as dark-skinned people who do not get the optimal benefits of sunlight exposure, and those who live in Northern climates or who otherwise do not get enough sunlight exposure).

Sources of Vitamin D

Food

Foods rich in vitamin D include:

  • Flesh from fatty fish (such as salmon and mackerel)
  • Fish liver oils (such as cod liver oil)

Foods with small amounts of vitamin D include:

  • Beef liver
  • Cheese
  • Egg yolks
  • Some mushrooms (vitamin D2)

Fortified foods provide most of the vitamin D in the American diet, these include:

  • Milk
  • Breakfast cereals
  • Some orange juice, yogurt, and margarine brands
  • Some plant-based milk products (such as almond milk, soy or oat milk)

Sun

It’s difficult to get all of your required vitamin D from food (because there are limited sources), but the body (in humans and animals) is capable of making vitamin D when the skin is exposed to sunlight.

When ultraviolet B (UVB) light rays from sunlight penetrate the skin, it triggers the synthesis of vitamin D3 in the body. UVB rays convert a protein in the skin called 7-DHC into Vitamin D3.

Some experts suggest that approximately five to 30 minutes of sun exposure (between 10:00 a.m. and 3:00 p.m.) at least two times per week is adequate sunlight exposure to lead to sufficient vitamin D synthesis in the body.

Most people get at least some of their vitamin D supplies from sunlight exposure. But there are factors that influence the absorption of sunlight and subsequently, the conversion of ultraviolet light rays to vitamin D. These factors include:

  • Season
  • Time of day
  • Amount of cloud cover
  • Level of environmental smog
  • Concentration of skin melanin (dark-skinned people receive less ultraviolet light penetration than light-skinned people)
  • Use of sunscreen (which blocks the absorption of UV rays)

Some of the vitamin D produced by the skin during warm weather months is stored in the liver and fat tissue for later use. In this way, even in northern winter climates, people are able to utilize stored vitamin D rather than relying completely on dietary sources. Those with limited sunlight exposure should be sure to eat enough vitamin D rich foods or take a vitamin D supplement.

Supplements

There are two types of vitamin D supplements available for purchase; these include vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D2 comes from plant sources (such as mushrooms) and vitamin D3 is found in the body. Sunlight stimulates the synthesis of D3, and is also found in animal sources (such as from fatty fish).

Because vitamin D2 is less expensive to produce, most foods that are fortified with vitamin D are fortified with D2, so be sure to check the labels. Fortified milk is the exception to this rule; it is fortified with vitamin D3.

Although some experts debate which type of vitamin D supplement is more effective at raising levels of vitamin D in the human body, there is evidence that D3 may be better. A 2012 meta-analysis of randomized controlled trials compared D2 and D3 supplements and found that D3 led to more of an increase in blood levels of the vitamin, and this effect lasted longer than with D2.

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  1. Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583. doi:10.1136/bmj.i6583

  2. NIH. National Cancer Institute. NCI Dictionary of Cancer Terms.

  3. National Institutes of Health. Vitamin D fact sheet for health professionals. Updated March 24, 2020.

  4. Aranow C. Vitamin D and the immune system. J Investig Med. 2011;59(6):881-6. doi:10.2310/JIM.0b013e31821b8755

  5. Harvard T.H. Chan School of Public Health. Vitamin D. Updated March 2020.

  6. Skin Cancer Foundation. Sun protection and vitamin D. Updated May 14, 2018.

  7. Tripkovic L, Lambert H, Hart K, Smith CP, Bucca G, Penson S, Chope G, Hyppönen E, Berry J, Vieth R, Lanham-New S. Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: A systematic review and meta-analysisThe American Journal of Clinical Nutrition. 2012;95(6):1357-64. doi:10.3945/ajcn.111.031070