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Children with cystic fibrosis not well covered by guidelines for vitamin D needs
Date:10/9/2008

igators say, doctors caring for patients with CF should think about increasing the vitamin D intake beyond the current recommendations in those who are vitamin D deficient. They should also check vitamin D levels at least once a year in all CF patients and more frequently in those with abnormally low levels.

In the current study of CF patients treated at Hopkins Children's between 2003 and 2006, investigators found that 86 percent were vitamin D deficient in 2003, 50 percent were deficient in 2004, 54 percent were deficient in 2005, and 46 percent were deficient in 2006.

Comparing different weekly intakes of ergocalciferol, the Hopkins team found that the currently recommended 50,000 IU per week for eight weeks was effective in only 33 percent of the patients with vitamin D deficiency, while increasing the therapy to twice a week was effective in 26 percent of patients. Delivering the same dose three times a week corrected the deficiency in just 43 percent of children. Vitamin D levels appeared to follow fluctuations in seasonal sun exposure, dropping sharply in the fall and winter and peaking during spring and summer.

Vitamin D deficiency was worst during the fall, with 83 percent of patients testing deficient, while only 41 percent were vitamin D deficient in the summer. Sun exposure is critical for vitamin D synthesis and production. Some doctors recommend sun exposure twice a week for up to 30 minutes at a time, but the debate is ongoing because sun exposure without protection increases the risk of skin cancer.

"Clearly we haven't established an optimal dose for treating vitamin D deficiency and more research is needed to do so," says senior researcher Peter Mogayzel, M.D. Ph.D., director of Hopkins Children's Cystic Fibrosis Center. "But what we know for sure is that the current recommendations are too low, and doctors should treat their patients with vitamin D deficiencies more aggressively,"

New therapies and ear
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Contact: Katerina Pesheva
epeshev1@jhmi.edu
410-516-4996
Johns Hopkins Medical Institutions
Source:Eurekalert

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