Vitamin A
During a serious infection, there is increased urinary excretion of vitamin A; thus the daily requirement is substantially greater. (1) At the same time, vitamin A status is strongly inversely associated with the severity of infection. (2) There is substantial evidence, much of it from controlled trials, that supplementation with the vitamin may diminish susceptibility to infection. (3) For example, when 147 children with a history of frequent respiratory infections randomly received either vitamin A 1,500 IU daily or placebo for 11 months, supplemented children subsequently experienced significantly fewer episodes of respiratory infections compared to controls. (4)
Pharmacologic levels of vitamin A supplementation have also been found to shorten the duration and complications of chicken pox in the absence of clinical evidence of vitamin A deficiency. (5) Similar results have been seen with measles in presumably well-nourished children (half of which were found to be vitamin A-deficient). (6) In fact, both WHO and UNICEF have recommended that, in countries where the fatality rate of measles is 1% or higher, vitamin A supplements be provided to all infected children. (7)
However, in the absence of evidence of vitamin A deficiency or concurrent measles infection, high-dose vitamin A supplements may cause modest adverse effects in children with pneumonia. (8) There is even evidence that, following megadose supplementation, children with a probable subclinical deficiency may have an increased risk of acute respiratory infections and diarrhea. (9)
Vitamin B12
A deficiency of vitamin B12 may be associated with impaired antibody responses to bacterial antigens. (10) Infection with a number of different microbes has been found to be associated with B12 deficiency. Moreover, supplementation--even for B12-suffficient patients--may improve cellular immunity. (11)
Vitamin C
Acute infections may reduce vitamin C nutriture, (12) while a deficiency of the vitamin is associated with impairment of the immune system's phagocytic cells. (13) In mammals, infection is followed by a rapid and often sustained fall in the tissue and urine levels of vitamin C, (14) transfer from plasma to leukocytes to attempt to keep these levels from becoming depressed, (15) and localization of the vitamin at the infected site. (14)
Supplementation may combat infections by stimulating neutrophil motility and enhancing phagocyte antimicrobial activity. (16) In fact, ascorbate supplementation may be specific therapy for primary defects of phagocytic function in patients with recurrent infections. (13) Moreover, in viral infections, the vitamin may increase serum interferon levels. (17)
In chronic bronchitis, vitamin C intake may be decreased. (18) Furthermore, the risk of the illness appears to be inversely correlated with plasma (18) and serum (19) levels.
Ascorbic acid appears to inhibit the growth of viruses both directly and indirectly. Its antiviral activity may be due, in part, to enhanced interferon production. (20) The vitamin has also been shown to combat bacterial infections. (21)
Numerous studies have investigated the efficacy of vitamin C in treating the common cold. While the evidence is that supplementation, in doses ranging from 80 to 2,000 mg daily, fails to reduce the frequency of colds, it may reduce both their severity and their duration. (3) Anecdotal reports suggest that still higher doses of vitamin C have greater efficacy, but scientific confirmation is lacking.
There is also evidence that supplementation may improve recovery in severe, acute respiratory infections, (21) recurrent furunculosis, (22) and gastric infection with Helicobacter pylori. (23)
Vitamin E
A deficiency of vitamin E is associated with increased infections due to diminished membrane-related chemotaxis and ingestion. (24) In a survey of 100 healthy people over age 60, there was an inverse correlation between the plasma alpha tocopherol levels and the number of infections in the previous 3 years. (25)
Supplementation enhances both humoral and cellular immune responses. It increases phagocytic defenses to stimulate body defenses against infectious agents. (26) Animals supplemented with vitamin E have shown increased immune responses and resistance to a number of infectious agents. (27)
Six months after children with chronic respiratory tract infections began treatment with the vitamin, their clinical status was improved. Moreover, there was normalization of their helper T lymphocytes and the ratio of helper to suppressor cells in their peripheral blood. (28)
Doctor Werbach cautions that the nutritional treatment of illness should be supervised by physicians or practitioners whose training prepares them to recognize serious illness and to integrate nutritional interventions safely into the treatment plan.
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The influence of vitamins on infection.(Nutritional Influences on Illness). Melvyn R. Werbach.
Townsend Letter for Doctors and Patients 268 (Nov 2005): p120(2). (1074 words)
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Vitamin A
During a serious infection, there is increased urinary excretion of vitamin A; thus the daily requirement is substantially greater. (1) At the same time, vitamin A status is strongly inversely associated with the severity of infection. (2) There is substantial evidence, much of it from controlled trials, that supplementation with the vitamin may diminish susceptibility to infection. (3) For example, when 147 children with a history of frequent respiratory infections randomly received either vitamin A 1,500 IU daily or placebo for 11 months, supplemented children subsequently experienced significantly fewer episodes of respiratory infections compared to controls. (4)
Pharmacologic levels of vitamin A supplementation have also been found to shorten the duration and complications of chicken pox in the absence of clinical evidence of vitamin A deficiency. (5) Similar results have been seen with measles in presumably well-nourished children (half of which were found to be vitamin A-deficient). (6) In fact, both WHO and UNICEF have recommended that, in countries where the fatality rate of measles is 1% or higher, vitamin A supplements be provided to all infected children. (7)
However, in the absence of evidence of vitamin A deficiency or concurrent measles infection, high-dose vitamin A supplements may cause modest adverse effects in children with pneumonia. (8) There is even evidence that, following megadose supplementation, children with a probable subclinical deficiency may have an increased risk of acute respiratory infections and diarrhea. (9)
Vitamin B12
A deficiency of vitamin B12 may be associated with impaired antibody responses to bacterial antigens. (10) Infection with a number of different microbes has been found to be associated with B12 deficiency. Moreover, supplementation--even for B12-suffficient patients--may improve cellular immunity. (11)
Vitamin C
Acute infections may reduce vitamin C nutriture, (12) while a deficiency of the vitamin is associated with impairment of the immune system's phagocytic cells. (13) In mammals, infection is followed by a rapid and often sustained fall in the tissue and urine levels of vitamin C, (14) transfer from plasma to leukocytes to attempt to keep these levels from becoming depressed, (15) and localization of the vitamin at the infected site. (14)
Supplementation may combat infections by stimulating neutrophil motility and enhancing phagocyte antimicrobial activity. (16) In fact, ascorbate supplementation may be specific therapy for primary defects of phagocytic function in patients with recurrent infections. (13) Moreover, in viral infections, the vitamin may increase serum interferon levels. (17)
In chronic bronchitis, vitamin C intake may be decreased. (18) Furthermore, the risk of the illness appears to be inversely correlated with plasma (18) and serum (19) levels.
Ascorbic acid appears to inhibit the growth of viruses both directly and indirectly. Its antiviral activity may be due, in part, to enhanced interferon production. (20) The vitamin has also been shown to combat bacterial infections. (21)
Numerous studies have investigated the efficacy of vitamin C in treating the common cold. While the evidence is that supplementation, in doses ranging from 80 to 2,000 mg daily, fails to reduce the frequency of colds, it may reduce both their severity and their duration. (3) Anecdotal reports suggest that still higher doses of vitamin C have greater efficacy, but scientific confirmation is lacking.
There is also evidence that supplementation may improve recovery in severe, acute respiratory infections, (21) recurrent furunculosis, (22) and gastric infection with Helicobacter pylori. (23)
Vitamin E
A deficiency of vitamin E is associated with increased infections due to diminished membrane-related chemotaxis and ingestion. (24) In a survey of 100 healthy people over age 60, there was an inverse correlation between the plasma alpha tocopherol levels and the number of infections in the previous 3 years. (25)
Supplementation enhances both humoral and cellular immune responses. It increases phagocytic defenses to stimulate body defenses against infectious agents. (26) Animals supplemented with vitamin E have shown increased immune responses and resistance to a number of infectious agents. (27)
Six months after children with chronic respiratory tract infections began treatment with the vitamin, their clinical status was improved. Moreover, there was normalization of their helper T lymphocytes and the ratio of helper to suppressor cells in their peripheral blood. (28)
Doctor Werbach cautions that the nutritional treatment of illness should be supervised by physicians or practitioners whose training prepares them to recognize serious illness and to integrate nutritional interventions safely into the treatment plan.
References
1. Stephensen CB et al. Am J Clin Nutr 60:388-92, 1994
2. Dudley L et al. S Afr Med J 87(1):65-70, 1997
3. Beisel WR. Am J Clin Nutr 35:417-68 (Suppl), 1982
4. Pinnock CB et al. Aust Paediatr J 22(2):95-99, 1986
5. Ozsoylu S et al. Letter. J Pediatr 125(6 Pt 1):1017-18, 1994
6. Arrieta A et al. J Pediatr 121(1):75-8, 1992
7. Anonymous. Editorial. Lancet i:1067-8, 1987
8. Stephensen CB et al. Pediatrics 101(5):E3, 1998
9. Stansfield SK et al. Lancet 342:578-82, 1993
10. Fata FT et al. Ann Intern Med 124(3):299-304, 1996
11. Tamura J et al. Clin Exp Immunol 116(1):28-32, 1999
12. Pfitzenmeyer P et al. Ann Nutr Metab 41(6):344-52, 1997
13. Patrone F, Dallegri F, Acta Vitaminol Enzymol 1(1-6):5-10, 1979
14. Stacpoole PW. Med Hypotheses 1:42-6, 1975
15. Tanzer F, Ozalp I. Mater Med Pol 25(1):5-8, 1993
16. Anderson R et al. Am J Clin Nutr 33(1):71-6, 1980
17. Geber WF et al. Pharmacology 13(3):228-33, 1975
18. Singh RB et al. J Nutr Environ Med 5:235-42, 1995
19. Schwartz J, Weiss ST. Am J Epidemiol 132(1):67-76, 1990
20. Leibovitz B, Siegel BV. Adv Exp Med Biol 135:1-25, 1981
21. Rawal BD et al. Med J Aust 1(6):169-74, 1974
22. Levy R, Schlaeffer F, Int J Dermatol 32(11):832-4, 1993
23. Rokkas T et al. Dig Dis Sci 40(3):615-21, 1995
24. Baehner RL, Boxer LA. Am J Pediatr Hematol Oncol 191):71-6, 1979
25. Chavance M et al. Br Med J November 9, 1985, pp. 1348-49
26. Tengerdy RP. Ann N Y Acad Sci 570:335-44, 1989
27. Nockels CF. Fed Proc 38:2134-8, 1979
28. Skodinska-Rozewska E et al. Arch Immunol Ther Exp (Warsz) 35(2):207-10, 1987
Doctor Werbach has teamed with Michael Murray ND again for the second edition of Botanical Influences on Illness, their acclaimed sourcebook for clinicians practicing herbal medicine, which is twice the size of the original edition. For information, contact Third Line Press Inc., 4751 Viviana Drive, Tarzana, California 91356. (800-916-0076; 818-996-0076; Fax: 818-774-1575; E-mail: tlp@third-line.com; Internet:
http://www.third-line.com)
by Melvyn R. Werbach, MD
4751 Viviana Drive * Tarzana, California 91356 USA
Phone 818-996-0076 * Fax 818-774-1575
Source Citation: Werbach, Melvyn R. "The influence of vitamins on infection.(Nutritional Influences on Illness)." Townsend Letter for Doctors and Patients 268 (Nov 2005): 120(2). InfoTrac OneFile. Thomson Gale. Oakland Community College. 3 Apr. 2007
.