Can vitamins and supplements effectively treat allergies. What are the potential side effects of using non-traditional allergy treatments. How do probiotics impact allergy symptoms. Are there any vitamins that can worsen allergic reactions. What does research say about the effectiveness of alternative allergy treatments.

The Rise of Complementary and Alternative Medicine for Allergies

In recent years, there has been a significant increase in the use of complementary and alternative medicine (CAM) among American adults. According to statistics from the National Center for Complementary and Alternative Medicine (NCCAM) and the National Center for Health Statistics, approximately 40% of adults in the United States turn to CAM, including vitamins and herbal supplements, as part of their healthcare regimen. This growing trend reflects a desire for more natural approaches to health management, including allergy treatment.

The popularity of vitamins and supplements stems from their perceived benefits in various aspects of health, such as:

• Boosting immunity
• Strengthening bones
• Improving emotional well-being
• Enhancing overall health

However, the question remains: can these alternative treatments effectively alleviate allergy symptoms? As more individuals explore natural remedies for their allergies, it’s crucial to understand the potential benefits and risks associated with using vitamins and supplements as part of an allergy treatment plan.

The Regulatory Landscape of Supplements in Allergy Treatment

One of the primary concerns surrounding the use of supplements for allergy treatment is the lack of stringent regulations. Unlike prescription medications, supplements are not subject to the same rigorous screening and regulatory processes imposed by the Food and Drug Administration (FDA). This regulatory gap raises important questions about the efficacy and safety of these products.

Do supplements undergo the same level of testing as prescription allergy medications? The short answer is no. Dr. Julie McNairn, an allergist/immunologist in Cincinnati, Ohio, cautions that “If you go to a store to purchase a supplement, you don’t exactly know what you’re getting.” This uncertainty stems from the fact that manufacturers’ claims are often not backed by substantial scientific evidence, particularly in relation to allergy treatment.

The lack of standardized testing and regulation means that consumers must exercise caution when considering supplements as part of their allergy management strategy. It’s essential to consult with healthcare professionals and rely on reputable sources of information when evaluating the potential benefits and risks of these alternative treatments.

Popular Supplements and Herbs Promoted for Allergy Relief

Despite the limited scientific evidence, various herbs, vitamins, and other substances have been promoted for the treatment of allergies and related conditions. These range from common cold remedies to asthma management supplements. Some of the most frequently mentioned include:

• Butterbur
• Bromelain (enzymes extracted from pineapple and related plants)
• Quercetin
• Stinging nettle
• Vitamin C
• Ginkgo biloba
• Aloe
• Evening primrose
• Thymomodulin (an extract from calf thymus glands)
• Vitamin D
• Flavenoids
• Gamma-tocopherol (the primary form of dietary vitamin E)
• Ganoderma tsugae (a mushroom growing on hemlock trees)

While these supplements have gained popularity in the alternative medicine community, it’s important to note that scientific research on their effectiveness for allergy treatment is still ongoing. The National Center for Complementary and Alternative Medicine (NCCAM) is actively investigating the potential benefits of these alternative treatments, aiming to provide more concrete evidence for their use in allergy management.

The Promise of Probiotics in Allergy Treatment

Among the various alternative therapies being explored for allergy treatment, probiotics have emerged as a particularly intriguing option. These “friendly bacteria” are found in certain foods like yogurt and milk, as well as in supplement form. The potential benefits of probiotics in allergy management stem from their ability to potentially bolster the immune system by introducing beneficial bacteria into the gut.

How do probiotics potentially impact allergy symptoms? While the exact mechanisms are still being studied, the theory is that probiotics may help modulate the immune response, potentially reducing allergic reactions. This is particularly relevant for food-related allergies, where the gut plays a crucial role in immune function.

Dr. McNairn notes that while it’s not entirely clear whether probiotics are definitively helpful in treating allergies, there is likely no harm in taking them. This relatively low-risk profile makes probiotics an attractive option for those looking to explore alternative allergy treatments. However, as with any supplement, it’s essential to consult with a healthcare provider before incorporating probiotics into your allergy management plan.

Potential Side Effects and Risks of Non-Traditional Allergy Treatments

While the appeal of natural remedies is undeniable, it’s crucial to understand that “natural” does not always equate to “safe.” Dr. McNairn emphasizes that “There can be adverse effects even though [vitamins and other supplements] are ‘just natural.'” This caution is particularly relevant when considering alternative treatments for allergies.

Can certain vitamins or supplements worsen allergy symptoms? In some cases, yes. For example, individuals with seasonal allergies who take echinacea may experience an exacerbation of their allergic symptoms. This is due to the botanical relationship between echinacea and ragweed, a common allergen. Similarly, chamomile can aggravate allergy symptoms in people sensitive to ragweed pollen.

Beyond allergy-specific concerns, many supplements can have unwanted side effects unrelated to allergies. These may include:

• Gastrointestinal discomfort
• Headaches
• Skin reactions
• Changes in blood pressure
• Interactions with other medications

The risk of adverse reactions is particularly concerning for individuals with asthma related to their allergies. In such cases, the potential benefits of supplements must be carefully weighed against the risks of exacerbating respiratory symptoms.

The Importance of Communication with Healthcare Providers

Given the potential risks and interactions associated with supplements, open communication with healthcare providers is crucial. Before incorporating any new supplement into your allergy treatment regimen, it’s essential to consult with your doctor and pharmacist. They can provide valuable insights into:

• Potential interactions with your current medications
• Specific risks based on your medical history
• Recommended dosages and usage guidelines
• Alternative treatments that may be more suitable for your condition

How can you ensure safe use of supplements for allergy treatment? Start by creating a comprehensive list of all medications, supplements, and vitamins you’re currently taking. Share this list with your healthcare providers and discuss any plans to add new supplements to your routine. This proactive approach can help prevent potentially dangerous interactions and ensure that your allergy management strategy is both effective and safe.

The Role of B Vitamins in Overall Health and Potential Allergy Impact

While not specifically targeted at allergy treatment, B vitamins play crucial roles in overall health and may indirectly influence allergy symptoms through their impact on immune function and overall well-being. Understanding the diverse benefits of B vitamins can provide context for their potential role in a holistic approach to health management, including allergy care.

Vitamin B1 (Thiamin)

Thiamin offers several health benefits that may be relevant to individuals managing allergies and related health concerns:

• Kidney health: In diabetic patients, thiamin has shown promise in reducing albumin levels in urine, a key indicator of kidney damage.
• Menstrual pain relief: Research indicates that thiamine supplementation for 90 days can alleviate menstruation pains in adolescent girls.
• Metabolism support: Vitamin B1 is essential for converting carbohydrates into glucose, the body’s preferred energy source.

Vitamin B2 (Riboflavin)

Riboflavin’s benefits extend beyond basic nutrition and may offer relief for certain conditions:

• Migraine reduction: Studies have found riboflavin effective in decreasing migraine frequency and potentially reducing pain intensity.
• Heart disease prevention: Riboflavin supplementation has been shown to significantly reduce homocysteine levels, a risk factor for heart disease.
• Blood pressure management: In cases where homocysteine levels were reduced, there was also evidence of decreased blood pressure.

Vitamin B3 (Niacin)

Niacin is known for its potential to impact cardiovascular health:

• Cholesterol management: Niacin has demonstrated significant effects on cholesterol levels, potentially contributing to heart health.

While these B vitamins are not direct treatments for allergies, their role in supporting overall health and potentially modulating immune function makes them worthy of consideration in a comprehensive health management strategy. However, it’s crucial to note that high doses of certain B vitamins can have side effects, and their use should be discussed with a healthcare provider, especially in the context of allergy management.

The Future of Alternative Allergy Treatments: Research and Potential

As interest in alternative and complementary medicine continues to grow, so does the body of research exploring these treatments’ efficacy for allergies. The National Center for Complementary and Alternative Medicine (NCCAM) is at the forefront of this research, investigating various alternative forms of allergy treatment, including vitamins and other supplements.

What does current research say about the effectiveness of alternative allergy treatments? As of now, the evidence is insufficient to warrant blanket recommendations for using supplements to treat allergies. However, this field is rapidly evolving, with new studies constantly adding to our understanding of how vitamins, herbal remedies, and other alternative treatments might be safely and effectively used in allergy management.

Some areas of promising research include:

• The role of vitamin D in modulating immune responses and potentially reducing allergy symptoms
• The anti-inflammatory properties of certain flavonoids and their impact on allergic reactions
• The potential of specific probiotic strains to influence gut health and immune function in allergy sufferers
• The use of herbal preparations like butterbur for allergic rhinitis symptoms

As research progresses, scientists hope to gain a more comprehensive understanding of how these alternative treatments can be integrated into allergy management strategies. This ongoing research may lead to more targeted recommendations and potentially new, evidence-based complementary treatments for allergies.

How can individuals stay informed about developments in alternative allergy treatments? Keeping in touch with reputable health information sources, consulting regularly with healthcare providers, and following updates from organizations like NCCAM can help allergy sufferers stay abreast of the latest findings in this dynamic field.

While the future of alternative allergy treatments holds promise, it’s important to approach these options with a balanced perspective. Combining the best of conventional medicine with evidence-based alternative treatments may offer the most comprehensive approach to allergy management. As always, any changes to an allergy treatment plan should be made in consultation with a qualified healthcare provider.

Allergy Treatment with Vitamins and Supplements – Allergy Center

About 4 in 10 American adults use complementary and alternative medicine, such as vitamins and herbal supplements, according to statistics from the National Center for Complementary and Alternative Medicine (NCCAM) and the National Center for Health Statistics. Vitamins and supplements are popular because they are thought to boost immunity, keep bones strong, improve emotional health, and do other positive things for you. But can they also help alleviate allergies?

If you are considering vitamins or other supplements as part of your allergy-treatment plan, here are some things you should know.

Supplements and Allergy Treatment

While there is evidence that supplements may help with certain allergy conditions, supplements are not subjected to the same Food and Drug Administration (FDA) screening and regulations as prescription drugs. This means that despite claims made by manufacturers, there’s little, or no, scientific evidence for the efficacy of these supplements in regard to allergies.

“If you go to a store to purchase a supplement, you don’t exactly know what you’re getting,” says Julie McNairn, MD, an allergist/immunologist in Cincinnati, Ohio, who cautions her patients that supplements don’t always contain what the label states.

Herbs, vitamins, and other substances that have been promoted for the treatment of allergies and related conditions, ranging from the common cold to asthma, include:

• Butterbur
• Bromelain, enzymes extracted from the pineapple and related plants
• Quercetin
• Stinging nettle
• Vitamin C
• Ginkgo biloba
• Aloe
• Evening primrose
• Thymomodulin, an extract made from the thymus glands of calves
• Vitamin D
• Flavenoids
• Gamma-tocopherol, the primary form of dietary vitamin E (as opposed to alpha-tocopherol, the form usually found in supplements)
• Ganoderma tsugae, a mushroom that grows on hemlock trees

NCCAM, an arm of the National Institutes of Health, is investigating the effectiveness of such alternative forms of allergy treatment as vitamins and other supplements. As of now, there is insufficient evidence to warrant recommending a supplement to treat an allergy. As research progresses, scientists hope to better understand how vitamins and herbal remedies can be safely used to treat allergies.

One alternative therapy under investigation for the treatment of allergies — particularly food-related allergies — is probiotics. Probiotics, or “friendly bacteria,” are found in certain foods (e.g., yogurt, milk) and supplements. They are thought to bolster the immune system by introducing beneficial bacteria into the gut. While it is not clear whether probiotics are helpful in treating an allergy, says Dr. McNairn, there is probably no harm in taking them.

Side Effects of Non-Traditional Allergy Treatment

If you choose to take vitamin supplements, it’s important to realize that just because a purported allergy treatment is natural it doesn’t mean it is safe. “There can be adverse effects even though [vitamins and other supplements] are ‘just natural,'” says McNairn.

For example, according to McNairn, people with seasonal allergies who take echinacea may see a worsening of their allergic symptoms. This is because echinacea and ragweed are in the same family. In people who are sensitive to ragweed pollen, chamomile also can exacerbate allergy symptoms.

Many other supplements have unwanted side effects unrelated to allergies, and some can cross-react with your prescription or over-the-counter allergy medications. Adverse reactions can be especially concerning if you have asthma related to your allergies. So talk with your doctor and pharmacist about any supplements you may be taking to find out if they are safe for you.

Vitamins and minerals | Allergy and intolerance guide

Health Benefits 

There are several B Vitamins, all with different health benefits:

Vitamin B1 (Thiamin)

Kidneys – In those with diabetes, thiamin has been shown to reduce the amount of albumin present in urine. Albumin is a crucial indicator of kidney damage.

Menstruation Pains – Research has found that taking thiamine for 90 days is shown to stop menstruation pains in girls aged 12-21

Metabolism – Vitamin B1 is vital to your body’s ability to convert carbohydrates into glucose, your body’s preferred source of energy.

Vitamin B2 (Riboflavin)

Migraines – Research has found Riboflavin to be effective in reducing migraine frequency, and some studies have also seen an impact on the intensity of pain.

Heart Disease – Homocysteine is a risk factor in heart disease. Riboflavin supplementation has been shown to reduce the levels found significantly.

Blood Pressure – For those who saw homocysteine reduction, there was also evidence of a decrease in blood pressure.

Vitamin B3 (Niacin)

Cholesterol – Niacin has been shown to significantly increase HDL cholesterol, otherwise known as “good cholesterol”.  

Triglycerides – Vitamin B3 has also been shown to reduce triglycerides which are a type of fat found in your blood. High levels can lead to an increased risk of heart disease.

Fat loss – Niacin has been linked with increased leptin levels. Leptin is the hormone that tells your body that it has enough energy stored in fat cells and require no more food. 

Folic Acid

Anaemia – A lack of folic acid results in folate-deficiency anaemia which leads to a low level of oxygen-carrying red blood cells.

Cancer – Folate intake can protect against certain cancers, including breast, lung and gut. This is because folic acid can regulate the turning on and off of genes. Low folate levels can lead to problems with this which can cause abnormal cell growth; a causing factor for cancer.

Heart Disease – Similarly to Riboflavin, folic acid has been shown to reduce levels of homocysteine

Vitamin B12

Pregnancy – Vitamin B12 is vital in the healthy development of fetus’ brain and nervous system and can reduce the risk of premature birth or miscarriage.

Bone Health – Low Vitamin B12 levels have been linked to decreased bone density, this can lead to an increased risk of osteoporosis, a condition of weakened bones which are more likely to break.

Mood & Depression – Playing a role in the synthesising and metabolising of serotonin, Vitamin B12 deficiency is associated with twice the risk of severe depression.

Signs Of Deficiency

Loss of appetite

Reduced Reflexes

Muscle Weakness

Blurred Vision

Nausea

Vit B Rich Foods 

Whole Grains

Red Meat

Eggs & Dairy

Seeds and Nuts

Leafy Vegetables

When considering foods that will improve your vitamin B levels, it is essential to find whether certain foods may cause you other problems. A food sensitivity can be identified using an intolerance test.

Other Vitamins & Nutrients (Back to top)

Six supplements that help with allergies

Getty Images

For some people spring means renewal, but for allergy sufferers it means sniffling, sneezing and watery eyes. Allergies — with symptoms ranging from sinus congestion and hay fever to asthma, dermatitis or hives — are a sign of impaired immune function. According to the Asthma Society of Canada, one in five Canadians suffer from respiratory allergies like seasonal allergic rhinitis, better know as hay fever.

Depending on the particular allergy, allergy season can begin in the early spring and persist until late fall. This leads many of us to reach for standard over-the-counter relief like antihistamines and decongestant medications, which can cause undesirable side effects like drowsiness or dizziness. But regardless of your allergy or the season, you can instead opt for immune-enhancing supplements that will keep your immune system strong while providing health benefits instead of unwanted effects.

Here are my recommendations for six supplements to add to your allergy-fighting arsenal.

1. Vitamin C with bioflavonoids
Allergens cause certain cells in the body to produce histamine, which is responsible for common seasonal complaints like tearing, excess mucus and a runny nose. Vitamin C prevents the formation of histamine, while typical over-the-counter antihistamine medications work by interfering with the histamine after it is produced. Vitamin C’s immune-enhancing effect also makes it essential in preventing infection as well as in shortening the duration of an illness.

To maximize effectiveness, vitamin C is best taken with bioflavonoids — the natural pigments in fruits and vegetables — in divided doses spaced throughout the day. The bioflavinoids enhance the activity of vitamin C in the body and help to stabilize mast cells, which secrete the histamine linked to allergic reactions.

Bottom line: Vitamin C is a water-soluble vitamin that is safe even at high doses. It may act as a natural laxative in certain individuals, so be sure to increase the dose slowly and spread it throughout the day. Depending on bowel tolerance, one can easily take 2,000 to 6,000 mg per day for stress protection and immune support.

2. Acidophilus/probiotics
Studies have shown that taking acidophilus, a probiotic, can help reduce the frequency and severity of infections. Acidophilus is the friendly bacteria that lives in our digestive tract. Our gut bacterial balance is affected by the use of antibiotics, the birth control pill or excess sugar and carbohydrate intake. Everyone can benefit from the use of probiotics for healthy digestion and immunity. Acidophilus has also been found useful in the treatment and prevention of skin conditions, allergies and thrush (yeast infections).

Bottom line: Be sure to follow any course of antibiotics with supplements of acidophilus for double the length of time you took the antibiotics. I recommend a probiotic with at least 10 to 15 billion cells per capsule daily, taken separately from eating, such as on rising and/or before bed.

3. Multivitamin/mineral
Vitamins and minerals are necessary for proper growth, metabolism, digestion, immune system function, muscle and nerve function and detoxification processes in the liver. Scientific studies have shown that the majority of us are deficient in many essential nutrients because of poor dietary habits and other factors that may deplete nutrient levels such as caffeine, drugs, stress or pollution. A full-spectrum multivitamin and mineral product, in a highly absorbable form, is essential to ensure the foundation of health.

In a study published in Nutrition Research, researchers found a significant increase in cells and chemicals that play a role in immune function in those who consumed a daily multivitamin, compared with the same markers in those taking the placebo. Compared with individuals taking the placebo, those taking the multivitamin supplement had 53 percent fewer days of illness due to infection.

4. EPA/DHA fish oils
Healthy types of oils are necessary for the formation of every cell in the body. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the components of essential fatty acids, are natural anti-inflammatory agents and my favourite year-round supplement. Their anti-inflammatory action makes them useful in treating and preventing heart disease, and they also have beneficial effects on cholesterol, triglycerides and on the tendency of blood to clot. Essential fatty acids help to moisten the skin and improve bowel function. Symptoms of depression, ADD/ADHD, schizophrenia and memory loss may improve with essential fatty acid supplements. Finally, fish oils are also very useful for the treatment and prevention of skin conditions like eczema or psoriasis.

One German study involving 568 people found that a high content of omega-3 fatty acids in red blood cells or in the diet was associated with a decreased risk of hay fever.

Bottom line: Take 2,000 to 6,000 mg daily with meals (two or three capsules twice daily).

5. Quercetin
Onions are often the cause of our tears, but strangely enough, they do contain an ingredient to treat watery or itchy eyes, asthma and hay fever. Quercetin, the bioflavinoid found in onions, is an effective inhibitor of histamine. It also acts as a natural anti-viral compound, which can help prevent herpes outbreaks and the common cold.

Quercetin is best taken with vitamin C mixed with bioflavonoids, as this improves the antihistamine effect. Vitamin C alone may also have beneficial effects on histamine levels by preventing histamine release from cells and by improving the breakdown of histamine. Quercetin may be effective for allergies, asthma, chronic obstructive pulmonary disease, bronchitis, sinusitis, cold and flu. Much like vitamin C, quercetin stabilizes the mast cells (specialized immune cells) that cause an allergic reaction, and decreases the release of histamine, which could help decrease allergy symptoms.

Bottom line: Take 500 to 1,000 mg two or three times per day.

6. Plant sterols
These are one of my favourite products. Plant sterols modulate your immune system. If some aspects are running too high (as in autoimmune diseases or allergies) they help to bring them down. Or if they are running too low (like with frequent colds or the flu) sterols help to increase your immune system function. They decrease the specific immune factor that causes the allergic response and the release of histamine. Therefore, it is beneficial for allergy sufferers to try to balance their immune system with sterols and sterolins. Sterols also decrease levels of cortisol, the “stress” hormone, which is essential for keeping your immune system strong.

Bottom line: I usually recommend taking these on an empty stomach, such as upon rising and before bed. You may combine them with your acidophilus supplements.

Natasha Turner, N.D., is a naturopathic doctor and author of the bestselling books The Hormone Diet, The Supercharged Hormone Diet and The Carb Sensitivity Program. She’s also the founder of the Toronto-based Clear Medicine Wellness Boutique and a regular guest on The Dr. Oz Show and The Marilyn Denis Show. For more wellness advice from Natasha Turner, click here.  

-Article originally published April 2011. 

Frontiers | Role of Vitamin D in Prevention of Food Allergy in Infants

KEY POINTS

• Vitamin D is a hormone with pleiotropic effects, essential not only for calcium homeostasis and bone mineralization but also for the proper functioning of the immune system.

• However, some patients do not benefit from vitamin D supplementation owing to genetic alterations in metabolism rather than absorption.

• The association between vitamin D and development of food allergy is contradictory.

• There is a potential association between lower sunlight exposure and food allergy, but on the other side, it appears that higher levels of vitamin D might raise the probability of allergic sensitization and food allergy.

• Vitamin D must be considered as a further chance in comprehension and treatment of atopic diseases.

• There is an urgent need for well-planned randomized controlled trials on vitamin D supplementation in food allergy.

Introduction

In recent decades, the occurrence of food allergies has recorded a significant increase in many developed countries worldwide, probably as a result of environmental and lifestyle changes (1, 2). Vitamin D is a hormone with pleiotropic effects, essential not only for calcium homeostasis and bone mineralization but also for the regulatory effects on the immune system (Figure 1) (3).

Figure 1. The role of vitamin D.

Vitamin D receptors (VDRs) are expressed in almost all the tissues of the human body. There is a significant association between vitamin D levels and the risk of immunologic, metabolic, or neoplastic disorders (4). Moreover, epidemiological evidence suggests a role of vitamin D in food allergy pathogenesis (5). Vitamin D impacts the function of macrophages, dendritic cells, B cells, T cells, and epithelial cells, playing a key role in immune response, both innate and adaptive (6, 7). All these cells convert the circulating prohormone form into the active one. Thanks to vitamin D, the innate response is capable to express antimicrobial peptides—such as cathelicidin—and plays an important role for keeping mucosal integrity and reinforce epithelial barrier by stimulating junction genes (8, 9). Regarding the adaptive immune response, it was found that VDR agonists affect the function of Th2 and Th3 cells, stimulate tolerogenic dendritic cells and regulatory CD4⁺CD25⁺ Foxp3⁺ T cells, avoid dendritic cell maturation, and abolish allergen-specific IgE synthesis (10, 11). In in vitro studies, by exposing human CD4 T cells to 1,25(OH)₂D, their conversion into IL-10 secreting Treg cells has been proven; at the same time, there is a suppression of IgE making by B cells, with production of antiphlogistic and tolerogenic cytokines (12, 13).

In our study, we reviewed the current literature to evaluate the role of vitamin D in food allergy in children.

Vitamin D Physiology

In humans, the major source of vitamin D (90%) is the exposure to solar UVB radiation (290–315 nm wavelengths), which determines the formation of cholecalciferol in the skin, which is then metabolized in the liver to 25-hydroxyvitamin D (25-OH-D₃) and finally carried to the kidneys, where it is transformed into the active form [1,25-dihydroxyvitamin D, 1,25-(OH)₂D] (3, 14). Only 10% of vitamin D is obtained through food ingestion.

The best indicator of vitamin D status is serum 25(OH)D₃ levels, which reflect the whole intake of vitamin D, comprehensive sun exposure, integrations, and food intake. In recent decades, it has been observed that there is an increasing evidence of a global vitamin D deficiency (VDD) for all ages (15, 16) owing to a combination of extrinsic and intrinsic factors. In the first group, we can include the intensity of exposure to UVB determined by seasons, latitude, altered eating habits, and behavioral factors, without forgetting campaigns to prevent skin cancer, whereas in the latter we might mention the individual level of skin melanin content and the intestinal absorption of vitamin D. Obese people have a greater risk of VDD, caused by their lifestyle and also probably as a consequence of the uptake in the adipose tissue of this liposoluble vitamin (17). However, some patients do not benefit from vitamin D supplementation owing to genetic alterations in metabolism rather than absorption. In a recent literature review, 35 genes putatively associated with abnormal serum 25 (OH)D₃ were identified (18).

Potential Role of Vitamin D in the Development of Food Allergy

Hypothesis on Pathogenic Mechanisms

The cellular and molecular mechanisms involved in the pathogenesis of food allergy are very complex and encompass genetic, epigenetic, and environmental factors (19–21). Several mechanisms have been proposed aimed at clarifying the role played by VDD in the food allergy pathogenesis. VDD, at a particular time of life, might increase the susceptibility to colonization by abnormal intestinal microbial flora, contributing to increased intestinal permeability, leading to an inappropriate and excessive exposure of the immune system to food allergens. On the other hand, VDD might cause a disequilibrium at the intestinal level that damages immune tolerance, destroys the normal epithelial barrier, and increases the susceptibility to infections (22). Food allergen sensitization can also be driven by percutaneous sensitization, which may be important particularly in children with VDD (23). It can be speculated that decreased antimicrobial factor and non-effective tight junctions caused by VDD may determine, in the skin, an anomalous exposition and thereby a boost of the immune system, driving to allergic sensitization eczema (24) and the onset of food allergy (23), in addition to an important increase in the severity of atopic dermatitis (25).

The current studies in the literature on the possible role of vitamin D in the development of food allergy have been reported in Tables 1, 2, which are detailed below.

Table 1. Summary of studies on the possible role of vitamin D in the development of food allergy.

Table 2. Summary of review on the possible role of vitamin D in the development of food allergy.

Evidence on VDD and Anaphylaxis

The first reports regarding a possible association between food allergy and VDD came from the observation that there was a direct relationship among increasing latitude and cases of anaphylaxis, prescription of epinephrine autoinjector, or food allergy–related admissions (30, 40–44). Contrasting results have been reported about the correlation between vitamin D status and atopic dermatitis severity (45). A recent Korean study (28) compared incidence of food-induced anaphylaxis (FIA) and vitamin D serum levels between two regions of high and low solar radiation, finding that, in the region of lower solar radiation, vitamin D levels were lower, with concomitantly higher FIA incidence. These findings suggested the possible causal function of vitamin D levels in food allergy, but data sources of FIA and vitamin D used in the study differed (27, 28, 30, 40–44, 46). Kim et al. (28) designed a study that included 2,814 patients with FIA and 15,367 people with available serum vitamin D measurements. After stratification by age, sex, and area of residence, lower solar radiation region had higher FIA incidence (2.2 per 100,000 person-years vs. 1.8 per 100,000 person-years) and lower vitamin D values (16.5 vs. 17.8 ng/ml) than higher solar radiation region. Camargo et al. (42) examined regional rates of epinephrine autoinjector (EpiPen) prescription in the United States, finding a strong north–south gradient. Mullins et al. (44) evaluated epinephrine autoinjector prescriptions and anaphylaxis hospital admission rates in Australia, used as surrogate markers of anaphylaxis. Both in an unadjusted and adjusted model of children from birth to the age of 4 years, they found a decrease in EpiPen prescription as decreasing absolute latitude. The anaphylaxis admission rates also showed a similar gradient. These data provided additional support and etiologic clues for a possible role of vitamin D in anaphylaxis pathogenesis. However, we cannot demonstrate that food allergy is linked to vitamin D levels and not to any other geographic, seasonal, or sunlight-derived factor (47).

Evidence on VDD and Season of Birth

Other studies showed a relationship between less sunny season of birth and increase of food allergy prevalence. Seasonal differences in UVB exposition result in reduced 25(OH)D₃ levels in autumn and winter months; in the higher latitudes, there is no sufficient UVB intensity in the cooler months for proper synthesis of 25(OH)D₃ to occur, irrespective of sunlight exposure (27). In addition, there are various data that hypothesize the possible link between season of birth and food allergy. The potential mechanisms are consequential to VDD owing to a paucity of UVB exposure. Matsui et al. (59), in their recent review, proposed the hypothesis that autumn and winter birth could worsen eczema, with the risk of excessive food antigen exposure and sensitization. Moreover, the deficiency of UVB exposure may lead to inadequate Treg expansion, potentially responsible for impaired food tolerance regardless of VDD. VDD resulting from an inadequate vitamin D synthesis from skin could compromise the intestinal epithelial barrier and antimicrobial peptides, with the risk of intestinal dysbiosis. Lastly, VDD could also modulate immune response and lead to sensitization and impaired food tolerance. Limitations of considered studies are a precise definition of vitamin D deficiency and the presence of co-factors in the population, such as eczema, skin color, race, residence, skin color, gender, and age. The apparent immune suppressive effect of ultraviolet radiation is not limited to the supposed inverse relationship between vitamin D levels and FIA rate, but it is also thought to be involved in the development of immune-related disorders, such as type 1 diabetes mellitus (43).

Evidence on VDD and Allergic Sensitization

The milestone NHANES study (26), based on extensive nationally representative samples from the United States of more than 3,000 children and adolescents, found an association between VDD and higher levels of specific IgE, and thereby allergic sensitization to several allergens, both environmental and food, in children and adolescents, but not in adults. At the same time, the relationship between increased IgE and excessively high vitamin D levels was not confirmed. By contrast, Hypponnen et al. (60), in an adult population study, showed that both low and excessive circulating 25(OH)D₃ levels were correlated with an increase in IgE in a non-linear relationship. Furthermore, higher rates of food sensitization have been seen in infants born to mothers with low vitamin D intake in pregnancy. Nwaru et al. (31) examined the effect of maternal diet during pregnancy on allergic sensitization in a population-based cohort study with 5-years follow-up, by evaluating 971 children with human leukocyte antigen–caused predisposition to type 1 diabetes, for whom maternal pregnancy dietary survey and allergen-specific IgE measurements at 5 years were recorded. The data showed an inverse correlation between sensitization to food allergens and maternal intake of vitamin D, whereas intake of citrus fruits in childbearing might raise the risk of developing allergic sensitization in the sons. A Korean cross-sectional study (49), which included 226 infants [168 infants with atopic dermatitis (74.3%) and 58 with suspected food allergy without atopic dermatitis (25.7%), aged 3–24 months], demonstrated that VDD increased the risk of food allergen sensitization, especially to milk and wheat, but in this work, the diagnosis of food allergy was only suspected and not confirmed by oral food challenge. An Australian large prospective cohort study proved that infants with low vitamin D levels (25(OH)D₃ <50 nmol/L) at 12 months of age were more likely to be affected by challenge-proven food allergy, in particular to peanuts and egg, and to have multiple food allergies, in comparison with those who had appropriate vitamin D levels. Curiously, this connection was clear only among infants of Australian-born parents, hinting a gene–environment interaction (35). However, other studies did not support this evidence (55). Kull et al., in a prospective birth cohort of 4,089 infants, showed that vitamin D in water-soluble form increased the risk of allergic disease in children up to the age of 4 years, compared with supplementation of same vitamin given in peanut oil, but vitamin D levels were not measured at baseline nor follow-up (29).

In a prospective, observational, case–control study that involved 111 children <2 years of age, Ercan et al. (39) assessed the possible link between cow’s milk protein allergy (CMPA) and 25(OH)D₃ levels in infants with an initial diagnosis of CMPA. Moreover, they also evaluated the association between 25(OH)D₃ levels and skin prick test induration size, specific IgE to milk and specific IgE to casein. For the study purpose, they considered vitamin D deficiency if 25(OH)D₃ values were ≤ 20 ng/ml, insufficiency if they were between 21 and 29 ng/ml and adequate when they were ≥30 ng/ml. No statistically significant relationship was found between the CMPA group and healthy controls in terms of 25(OH)D₃ levels, nor even milk antigen induration diameter and vitamin D levels of CMPA infants. Hence, they concluded that, at the starting diagnosis of infants with CMPA, routine workup of vitamin D levels may have no benefit. Sardecka et al. (48) examined the relationship between Foxp3mRNA expression (the best marker for Treg lymphocytes) and serum concentration of vitamins D and C, and the development of different phenotypes of tolerance in children with CMPA. The results suggest that increased of Foxp3mRNA expression can predict faster tolerance acquisition in infants with CMA. Regardless of whether they acquire tolerance, children with CMPA have lower serum vitamin D levels than healthy children. Recently, also Guo et al. (51) performed a large observational study involving 2,642 children with the aim of evaluating the correlation between serum 25(OH)D₃ and allergic sensitization among childhood 0–2 years of age. Vitamin D was considered insufficient when serum concentration of 25(OH)D₃ was <75 nmol/L and sufficient otherwise. They did not find evidence supporting the link between low levels of 25(OH)D₃ and allergic sensitization to various allergens.

Evidence on VDD, Pre-natal Data, and Birth Cohort Studies

Another matter investigated by some authors has also been the potential link between 25(OH)D₃ concentration in newborns as a marker of risk of future development of food allergies. In the study of Mullins et al. (61) on 115 patients younger than 72 months, it was found that there is an association between peanut allergy and neonatal 25(OH)D₃ levels. In comparison with the reference group (50–74.9 nmol/L), 25(OH)D₃ levels of 75 to 99.9 nmol/L were linked to a reduced risk of peanut allergy. At levels of 100 nmol/L or higher, no additional reduction was found, whereas the probability of peanut allergy at levels lower than 50 nmol/L was substantially equal to that of the reference group. The risk of peanut allergy at levels <50 nmol/L was also not significantly different from the reference group. Jones et al. (33) studied the association among cord blood 25(OH)D₃ and allergic sensitization, eczema, and food allergy at 1 year of age. The lower vitamin D levels at birth were associated to higher likelihood of eczema at 12 months, without significant differences between IgE-mediated and non–IgE-mediated eczema. Although in this high-risk subset there was a greater likelihood of IgE-mediated food allergy and allergen sensitization after the first year of life, the probability to develop IgE-mediated food allergy was not linked to cord blood 25(OH)D₃ (33, 37). Chawes et al. (37), in their Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2000) at-risk mother–child cohort, analyzed the relationship between cord blood 25(OH)vitamin D and asthma and allergy-related conditions during pre-school age in 257 children. After adjusting for season of birth, deficient cord blood 25(OH) vitamin D levels, defined as <50 nmol/L, were not associated with allergic sensitization. On the other hand, Chiu et al. (36), considering a birth cohort of Taiwanese children, found an inverse relationship between cord blood 25(OH)D₃ levels and milk sensitization at the age of 2 years. One hundred eighty-six children aged 0 through 4 years were enrolled and regularly followed up for 4 years. The average cord blood 25(OH)D₃ level was 23.8 ± 9.5 ng/ml, with a high occurrence of VDD (<20 ng/ml) at birth (42%). A trend was found between low cord blood 25(OH)D₃ levels and higher risk of milk sensitization throughout childhood. At the same time, cord blood 25(OH)D₃ levels showed an inverse relationship to the risk of milk sensitization at 2 years old, an age at which a greater occurrence of milk sensitization was markedly associated to the risk of asthma development and allergic rhinitis at the age of 4 years. Nonetheless, low cord blood vitamin D levels do not seem linked to a higher risk of allergic rhinitis, eczema, or asthma in early childhood. Hennessy et al. (38), in their Cork BASELINE Birth Cohort Study, investigated associations between intrauterine vitamin D status and atopic outcomes in an extensively characterized, disease-specific, maternal-infant cohort. In this study, the diagnosis of food allergy was made for all children during the 24-months clinical evaluation visit using skin prick tests. The panel of food allergens included cow’s milk, eggs, peanuts, cod, soybeans, and wheat. In the case of wheals with a diameter of ≥3 mm, a blinded oral food challenge was completed, if the food had not been eaten previously or if there was a story that suggested the risk of food allergy. The investigators did not observe any association between vitamin D during pregnancy or at birth (measured in maternal sera at 15 weeks of gestation and umbilical cord blood) with allergic disease outcomes (eczema, food allergy, asthma, allergic rhinitis) at 2 and 5 years old. A German study (34) focused on the effects of newborn and maternal vitamin D levels and their influence on the development of food allergy in children, and considered 378 mother–child pairs during pregnancy and at childbirth atopic manifestations during the first 2 years of life by using questionnaires filled out by the parents during pregnancy and annually thereafter. They demonstrated that high vitamin D levels in pregnancy and at birth might lead to a greater risk of food allergy, suggesting that, to prevent atopy, integration is not required. Recently, Rosendahl et al. (50) realized a randomized controlled trial of daily vitamin D supplementation of 10 or 30 μg from the age of 2 weeks, measuring food and aeroallergen IgE antibodies at 12 months of age. It was demonstrated that high-dose vitamin D supplementation did not prevent allergic sensitization and allergic diseases during the first year of life. On the other hand, it was observed that there is an increased risk of milk allergy in infants randomized to the higher vitamin D supplementation and an increased risk of milk allergy in infants with high cord blood vitamin D status, thereby suggesting a possible adverse effect of high concentrations of vitamin D. A Cochrane review (53) proved that vitamin D supplementation, during pregnancy, both single-dose or continued, increased 25(OH)D₃ levels at term; however, the clinical implication of enhancing the vitamin D concentration and the possible role of this approach in the standard antenatal care are still to be evaluated because of the limited number of trials and outcomes to deduce implications on safety and efficacy. The presence of mixed results may be a consequence of the gaps in our knowledge about the precise role of vitamin D in the development of food allergy (47). Yepes-Nuñez et al. (56), in a recent systematic review including randomized and non-randomized studies, showed that vitamin D integration for pregnant women, breastfeeding women, and infants might not reduce the probability of allergic disease development, such as food allergies (in pregnant women), asthma and/or wheezing (in pregnant women, breastfeeding women, and infants), allergic rhinitis (in pregnant women and infants), or atopic dermatitis (in pregnant women). However, they concluded that the potential impact of vitamin D on food allergy remains uncertain. Liu et al. (32) evaluated the association among cord and maternal vitamin D level (VDD if cord blood 25(OH)D₃ <11 ng/ml) and atopic outcomes in 649 children recruited at birth and followed from then on, and found that VDD alone was not related with food sensitization. If examined together with SNPs, a significant interaction was found between VDD and IL-4 gene polymorphism. VDD raised the risk of food sensitization among children carrying CC/CT genotypes; comparable but lower relationships were seen for the SNPs. The conclusion of their study is that VDD may enhance the risk of food sensitization among people with specific genotypes. A recent longitudinal Icelandic study, involving 144 children followed up for 6 years, compared infant feeding with particular regard to vitamin D supplementation and 25(OH)₃ levels between IgE-sensitized and non-sensitized children at 6 years. They found that, at 1 year of age, IgE-sensitized children had a reduced intake of vitamin D, partially explained by a reduced, but non-significant, vitamin D supplement use and reduced consumption of vitamin D fortified formula. At 6 years, less IgE-sensitized children used vitamin D supplements regularly. Equally, vitamin D integration at 6 years decreased the ratio of IgE sensitization (52). Nonetheless, the authors did not record a difference in mean serum 25(OH)D₃ between IgE-sensitized and non-sensitized children, nor at 12 months (96.8 ± 33.6 vs. 99.3 ± 32.2 nmol/L, respectively) or 6 years (59.3 ± 15. 9 vs. 56.0 ± 16.7 nmol/L, respectively). In conclusion, their data encouraged, for Nordic infants and children, vitamin D intake from diet and supplements.

Further issues are about the definition of optimum, deficiency, and insufficiency vitamin D serum levels, not worldwide recognized and rather specific for bone outcomes, but not for global health effects (4, 6). Low vitamin D levels are common in healthy newborns (33, 62) and are independently associated with various factors (skin color, diet, maternal levels and intake, supplements, and seasonality) and strengthen the controversy on the benefits of providing vitamin D integration during infancy.

Current Scenario

The current reviews (54, 56–59) conclude that further studies are needed to evaluate the association between allergy and vitamin D. Vitamin D supplementation controlled studies aimed to clarify its role in food allergy development are still lacking.

Currently, there are more evidence to support vitamin D supplementation in pregnancy and infancy, in light of its positive effects. In fact, VDD may boost the risk of food allergy and sensitization among people with particular genotypes (32). Nevertheless, when studied alone, VDD was not associated with food allergy whereas, on the other hand, it was significantly related with specific gene polymorphisms, supplying evidence on food allergy. Also, the role of vitamin D beyond bone and calcium metabolism is not fully understood.

Conclusions

The role of vitamin D beyond bone and calcium metabolism is alluring but not fully understood. The association between vitamin D and development of food allergy is contradictory (Tables 1, 2).

Potential relationships come from ecologic studies that associate lower sunlight exposure to food allergies. On the other hand, further research found that higher levels of vitamin D might raise the probability of allergic sensitization and food allergy. However, in light of a large literature linking the vitamin D levels to the onset of eczema and allergic diseases, this hormone must be considered as a further chance in the comprehension and treatment of atopic diseases. For this reason, there is an urgent need for well-planned randomized controlled trials on vitamin D supplementation, with particular regard to food allergy, to demonstrate that vitamin D might actually contribute to the prevention of allergic diseases.

Author Contributions

GR, AG, and LB: conceptualization. AG, LB, and JC: resources. GR, AG, and RM: methodology and writing—review and editing. AG, LB, JC, MG, RM, and GR: writing—original draft preparation. RM and GR: supervision. All authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

1. Sicherer SH, Sampson HA. Food allergy: a review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. (2018) 141:41–58. doi: 10. 1016/j.jaci.2017.11.003

PubMed Abstract | CrossRef Full Text | Google Scholar

2. Prescott SL, Pawankar R, Allen KJ, Campbell DE, Sinn JKH, Fiocchi A, et al. A global survey of changing patterns of food allergy burden in children. World Allergy Organ J. (2013) 6:21. doi: 10.1186/1939-4551-6-21

PubMed Abstract | CrossRef Full Text | Google Scholar

7. Dimeloe S, Nanzer A, Ryanna K, Hawrylowicz C. Regulatory T cells, inflammation and the allergic response-the role of glucocorticoids and Vitamin D. J Steroid Biochem Mol Biol. (2010) 120:86–95. doi: 10.1016/j.jsbmb.2010.02.029

PubMed Abstract | CrossRef Full Text | Google Scholar

8. White JH. Vitamin D as an inducer of cathelicidin antimicrobial peptide expression: past, present and future. J Steroid Biochem Mol Biol. (2010) 121:234–8. doi: 10.1016/j.jsbmb.2010.03.034

PubMed Abstract | CrossRef Full Text | Google Scholar

9. Schwalfenberg GK. A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol Nutr Food Res. (2011) 55:96–108. doi: 10.1002/mnfr.201000174

PubMed Abstract | CrossRef Full Text | Google Scholar

12. Wang TJ, Zhang F, Richards JB, Kestenbaum B, Van Meurs JB, Berry D, et al. Common genetic determinants of vitamin D insufficiency: a genome-wide association study. Lancet. (2010) 376:180–8. doi: 10.1016/S0140-6736(10)60588-0

PubMed Abstract | CrossRef Full Text | Google Scholar

13. Chun RF, Lauridsen AL, Suon L, Zella LA, Pike JW, Modlin RL, et al. Vitamin D-binding protein directs monocyte responses to 25-hydroxy- and 1,25-dihydroxyvitamin D. J Clin Endocrinol Metab. (2010) 95:3368–76. doi: 10.1210/jc.2010-0195

PubMed Abstract | CrossRef Full Text | Google Scholar

15. Principi N, Bianchini S, Baggi E, Esposito S. Implications of maternal vitamin D deficiency for the fetus, the neonate and the young infant. Eur J Nutr. (2013) 52:859–67. doi: 10.1007/s00394-012-0476-4

PubMed Abstract | CrossRef Full Text | Google Scholar

16. Christesen HT, Elvander C, Lamont RF, Jorgensen JS. The impact of vitamin D in pregnancy on extraskeletal health in children: a systematic review. Acta Obstet Gynecol Scand. (2012) 91:1368–80. doi: 10.1111/aogs.12006

PubMed Abstract | CrossRef Full Text | Google Scholar

17. Manson JE, Jones G, Kovacs CS, Ross AC, Gallo RL, Gallagher JC, et al. The 2011 dietary reference intakes for calcium and vitamin D: what dietetics practitioners need to know. J Am Diet Assoc. (2011) 111:524–7. doi: 10.1016/j.jada.2011.01.004

PubMed Abstract | CrossRef Full Text | Google Scholar

18. Sepulveda-Villegas M, Elizondo-Montemayor L, Trevino V. Identification and analysis of 35 genes associated with vitamin D deficiency: a systematic review to identify genetic variants. J Steroid Biochem Mol Biol. (2020) 196:105516. doi: 10.1016/j.jsbmb.2019.105516

PubMed Abstract | CrossRef Full Text | Google Scholar

19. Turcanu V, Brough HA, Du Toit G, Foong RX, Marrs T, Santos AF, et al. Immune mechanisms of food allergy and its prevention by early intervention. Curr Opin Immunol. (2017) 48:92–98. doi: 10.1016/j.coi.2017.08.009

PubMed Abstract | CrossRef Full Text | Google Scholar

20. Hofmaier S, Comberiati P, Matricardi PM. Immunoglobulin G in IgE-mediated allergy and allergen-specific immunotherapy. Eur Ann Allergy Clin Immunol. (2014) 46:6–11.

PubMed Abstract | Google Scholar

21. Chinthrajah RS, Hernandez JD, Boyd SD, Galli SJ, Nadeau KC. Molecular and cellular mechanisms of food allergy and food tolerance. J Allergy Clin Immunol. (2016) 137:984–97. doi: 10.1016/j.jaci.2016.02.004

PubMed Abstract | CrossRef Full Text | Google Scholar

22. Vassallo MF, Camargo CA. Potential mechanisms for the hypothesized link between sunshine, vitamin D, and food allergy in children. J Allergy Clin Immunol. (2010) 126:217–22. doi: 10.1016/j.jaci.2010.06.011

PubMed Abstract | CrossRef Full Text | Google Scholar

24. Chatenoud L, Bertuccio P, Turati F, Galeone C, Naldi L, Chatenoud L, et al. Markers of microbial exposure lower the incidence of atopic dermatitis. Allergy Eur J Allergy Clin Immunol. (2020) 75:104–15. doi: 10.1111/all.13990

PubMed Abstract | CrossRef Full Text | Google Scholar

25. Peroni DG, Piacentini GL, Cametti E, Chinellato I, Boner AL. Correlation between serum 25-hydroxyvitamin D levels and severity of atopic dermatitis in children. Br J Dermatol. (2011) 164:1078–82. doi: 10.1111/j.1365-2133.2010.10147.x

PubMed Abstract | CrossRef Full Text | Google Scholar

26. Sharief S, Jariwala S, Kumar J, Muntner P, Melamed ML. Vitamin D levels and food and environmental allergies in the United States: results from the national health and nutrition examination survey 2005–2006. J Allergy Clin Immunol. (2011) 127:1195–202. doi: 10.1016/j.jaci.2011.01.017

PubMed Abstract | CrossRef Full Text | Google Scholar

28. Kim S-H, Ban G-Y, Park H-S, Kim S, Ye Y-M. Regional differences in vitamin D levels and incidence of food-induced anaphylaxis in South Korea. Ann Allergy Asthma Immunol. (2016) 116:237–43.e1. doi: 10.1016/j.anai.2015.12.021

PubMed Abstract | CrossRef Full Text | Google Scholar

29. Kull I, Bergström A, Melén E, Lilja G, van Hage M, Pershagen G, et al. Early-life supplementation of vitamins A and D, in water-soluble form or in peanut oil, and allergic diseases during childhood. J Allergy Clin Immunol. (2006) 118:1299–304. doi: 10.1016/j.jaci.2006.08.022

PubMed Abstract | CrossRef Full Text | Google Scholar

30. Camargo CA, Rifas-Shiman SL, Litonjua AA, Rich-Edwards JW, Weiss ST, Gold DR, et al. Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. Am J Clin Nutr. (2007) 85:788–95. doi: 10.1093/ajcn/85.3.788

PubMed Abstract | CrossRef Full Text | Google Scholar

31. Nwaru BI, Ahonen S, Kaila M, Erkkola M, Haapala AM, Kronberg-Kippilä C, et al. Maternal diet during pregnancy and allergic sensitization in the offspring by 5 yrs of age: a prospective cohort study. Pediatr Allergy Immunol. (2010) 21:29–37. doi: 10.1111/j.1399-3038.2009.00949.x

PubMed Abstract | CrossRef Full Text | Google Scholar

32. Liu X, Wang G, Hong X, Wang D, Tsai HJ, Zhang S, et al. Gene-vitamin D interactions on food sensitization: a prospective birth cohort study. Allergy Eur J Allergy Clin Immunol. (2011) 66:1442–8. doi: 10.1111/j.1398-9995.2011.02681.x

PubMed Abstract | CrossRef Full Text | Google Scholar

34. Weisse K, Winkler S, Hirche F, Herberth G, Hinz D, Bauer M, et al. Maternal and newborn vitamin D status and its impact on food allergy development in the German LINA cohort study. Allergy Eur J Allergy Clin Immunol. (2013) 68:220–8. doi: 10.1111/all.12081

PubMed Abstract | CrossRef Full Text | Google Scholar

35. Allen KJ, Koplin JJ, Ponsonby AL, Gurrin LC, Wake M, Vuillermin P, et al. Vitamin D insufficiency is associated with challenge-proven food allergy in infants. Allergy Clin Immunol. (2013) 131:1109–16.e1-6. doi: 10.1016/j.jaci.2013.01.017

PubMed Abstract | CrossRef Full Text | Google Scholar

36. Chiu C-Y, Yao T-C, Chen S-H, Tsai M-H, Tu Y-L, Hua M-C, et al. Low cord blood vitamin D levels are associated with increased milk sensitization in early childhood. Pediatr Allergy Immunol. (2014) 25:767–72. doi: 10.1111/pai.12304

PubMed Abstract | CrossRef Full Text | Google Scholar

37. Chawes BL, Bønnelykke K, Jensen PF, Schoos A-MM, Heickendorff L, Bisgaard H. Cord blood 25(OH)-vitamin D deficiency and childhood asthma, allergy and eczema: the COPSAC2000 birth cohort study. PLoS ONE. (2014) 9:e99856. doi: 10.1371/journal.pone.0099856

PubMed Abstract | CrossRef Full Text | Google Scholar

38. Hennessy Á, Hourihane JOB, Malvisi L, Irvine AD, Kenny LC, Murray DM, et al. Antenatal vitamin D exposure and childhood eczema, food allergy, asthma and allergic rhinitis at 2 and 5 years of age in the atopic disease-specific Cork BASELINE birth cohort study. Allergy Eur J Allergy Clin Immunol. (2018) 73:2182–91. doi: 10.1111/all.13590

PubMed Abstract | CrossRef Full Text | Google Scholar

39. Ercan N, Bostanci IB, Ozmen S, Tekindal MA. Is there an association between vitamin D levels and cow’s milk protein allergy at infancy? Arch Argent Pediatr. (2019) 117:306–13. doi: 10.5546/aap.2019.eng.306

PubMed Abstract | CrossRef Full Text | Google Scholar

41. Simons FER, Peterson S, Black CD. Epinephrine dispensing patterns for an out-of-hospital population: a novel approach to studying the epidemiology of anaphylaxis. J Allergy Clin Immunol. (2002) 110:647–51. doi: 10.1067/mai.2002.127860

PubMed Abstract | CrossRef Full Text | Google Scholar

42. Camargo CA, Clark S, Kaplan MS, Lieberman P, Wood RA. Regional differences in EpiPen prescriptions in the United States: the potential role of vitamin D. J Allergy Clin Immunol. (2007) 120:131–6. doi: 10.1016/j.jaci.2007.03.049

PubMed Abstract | CrossRef Full Text | Google Scholar

43. Staples JA, Ponsonby AL, Lim LLY, McMichael AJ. Ecologic analysis of some immune-related disorders, including type 1 diabetes, in Australia: latitude, regional ultraviolet radiation, and disease prevalence. Environ Health Perspect. (2003) 111:518–23. doi: 10.1289/ehp.5941

PubMed Abstract | CrossRef Full Text | Google Scholar

44. Mullins RJ, Clark S, Camargo CA. Regional variation in epinephrine autoinjector prescriptions in Australia: more evidence for the vitamin D-anaphylaxis hypothesis. Ann Allergy Asthma Immunol. (2009) 103:488–95. doi: 10.1016/S1081-1206(10)60265-7

PubMed Abstract | CrossRef Full Text | Google Scholar

45. D’Auria E, Barberi S, Cerri A, Boccardi D, Turati F, Sortino S, et al. Vitamin D status and body mass index in children with atopic dermatitis: a pilot study in Italian children. Immunol Lett. (2017) 181:31–35. doi: 10.1016/j.imlet.2016.11.004

PubMed Abstract | CrossRef Full Text | Google Scholar

46. Sheehan WJ, Graham D, Ma L, Baxi S, Phipatanakul W. Higher incidence of pediatric anaphylaxis in northern areas of the United States. J Allergy Clin Immunol. (2009) 124:850–2.e2. doi: 10.1016/j.jaci.2009.06.044

PubMed Abstract | CrossRef Full Text | Google Scholar

47. Douros K, Boutopoulou B, Fouzas S, Loukou I. Asthma and allergy ‘Epidemic’ and the role of vitamin D deficiency. In: Ultraviolet Light in Human Health, Diseases and Environment. Cham: Springer (2017). p. 169–83. doi: 10.1007/978-3-319-56017-5_14

CrossRef Full Text | Google Scholar

48. Sardecka I, Łoś-Rycharska E, Gawryjołek J, Toporowska-Kowalska E, Krogulska A. FOXP3 expression, vitamins D and C in the prediction of tolerance acquisition in infants with cow’s milk allergy. J Investig Allergol Clin Immunol. (2019) 30:182–90. doi: 10.18176/jiaci.0422

CrossRef Full Text | Google Scholar

49. Baek JH, Shin YH, Chung IH, Kim HJ, Yoo E-G, Yoon JW, et al. The link between serum vitamin D level, sensitization to food allergens, and the severity of atopic dermatitis in infancy. J Pediatr. (2014) 165:849–54.e1. doi: 10.1016/j.jpeds.2014.06.058

PubMed Abstract | CrossRef Full Text | Google Scholar

50. Rosendahl J, Pelkonen AS, Helve O, Hauta-alus H, Holmlund-Suila E, Valkama S, et al. High-dose vitamin D supplementation does not prevent allergic sensitization of infants. J Pediatr. (2019) 209:139–45.e1. doi: 10.1016/j.jpeds.2019.02.021

PubMed Abstract | CrossRef Full Text | Google Scholar

51. Guo Y, Yu L, Deng YH, Ke HJ, Wu JL. Associations between serum 25-hydroxyvitamin D levels and allergic sensitization in early childhood. Allergol Immunopathol. (2020) 48:84–89. doi: 10.1016/j.aller.2019.06.016

PubMed Abstract | CrossRef Full Text | Google Scholar

52. Thorisdottir B, Gunnarsdottir I, Vidarsdottir AG, Sigurdardottir S, Birgisdottir BE, Thorsdottir I. Infant feeding, vitamin D and ige sensitization to food allergens at 6 years in a longitudinal icelandic cohort. Nutrients. (2019) 11:1–13. doi: 10.3390/nu11071690

PubMed Abstract | CrossRef Full Text | Google Scholar

53. De-Regil LM, Palacios C, Ansary A, Kulier R, Peña-Rosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Syst Rev. (2016) CD008873. doi: 10.1002/14651858.CD008873.pub3

CrossRef Full Text | Google Scholar

54. Mirzakhani H, Al-Garawi A, Weiss ST, Litonjua AA. Vitamin D and the development of allergic disease: how important is it? Clin Exp Allergy. (2015) 45:114–25. doi: 10.1111/cea.12430

PubMed Abstract | CrossRef Full Text | Google Scholar

55. Willits EK, Wang Z, Jin J, Patel B, Motosue M, Bhagia A, et al. Vitamin D and food allergies in children: a systematic review and meta-analysis. In: Allergy and Asthma Proceedings. Rhode: OceanSide Publications Inc. (2017). p. e21–8. doi: 10.2500/aap.2017.38.4043

PubMed Abstract | CrossRef Full Text | Google Scholar

56. Yepes-Nuñez JJ, Brozek JL, Fiocchi A, Pawankar R, Cuello-García C, Zhang Y, et al. Vitamin D supplementation in primary allergy prevention: systematic review of randomized and non-randomized studies. Allergy. (2018) 73:37–49. doi: 10.1111/all.13241

PubMed Abstract | CrossRef Full Text | Google Scholar

57. Saggese G, Vierucci F, Prodam F, Cardinale F, Cetin I, Chiappini E, et al. Vitamin D in pediatric age: consensus of the Italian pediatric society and the Italian society of preventive and social pediatrics, jointly with the Italian federation of pediatricians. Ital J Pediatr. (2018) 44:51. doi: 10.1186/s13052-018-0488-7

PubMed Abstract | CrossRef Full Text | Google Scholar

59. Matsui T, Tanaka K, Yamashita H, Saneyasu K ichi, Tanaka H, Takasato Y, et al. Food allergy is linked to season of birth, sun exposure, and vitamin D deficiency. Allergol Int. (2019) 68:172–7. doi: 10.1016/j.alit.2018.12.003

PubMed Abstract | CrossRef Full Text | Google Scholar

60. Hyppönen E, Berry DJ, Wjst M, Power C. Serum 25-hydroxyvitamin D and IgE–a significant but nonlinear relationship. Allergy Eur J Allergy Clin Immunol. (2009) 64:613–20. doi: 10.1111/j.1398-9995.2008.01865.x

PubMed Abstract | CrossRef Full Text | Google Scholar

61. Mullins RJ, Clark S, Wiley V, Eyles D, Camargo CA. Neonatal vitamin D status and childhood peanut allergy: a pilot study. Ann Allergy Asthma Immunol. (2012) 109:324–8. doi: 10.1016/j.anai.2012.07.009

PubMed Abstract | CrossRef Full Text | Google Scholar

62. Camargo CA, Ingham T, Wickens K, Thadhani RI, Silvers KM, Epton MJ, et al. Vitamin D status of newborns in New Zealand. Br J Nutr. (2010) 104:1051–7. doi: 10.1017/S0007114510001674

CrossRef Full Text | Google Scholar

Vitamin D and Its Role as a Protective Factor in Allergy

The relationship between vitamin D status and asthma has been subject to several studies in the last decade. Epidemiological data suggest that incidence of asthma and atopic diseases increased significantly in most Westernized countries. The significant variation between countries suggests that besides genetic factors, environmental aspects play a role in the pathogenesis of atopy. The prevalence of hypovitaminosis D is high in many industrialized countries. In addition to its relationship with bone metabolism, vitamin D is recognized as an immunomodulator, with important effects on both adaptive and innate immunity. Correlations between vitamin D status and asthma have been formulated, with a considerable interest in assessing whether this vitamin protects against or reduces asthma morbidity. In this review, we discuss recent findings regarding vitamin D status throughout Europe and its influence over asthma and allergic rhinitis prevalence. Geographical latitude and dietary habits may explain the lower prevalence of allergic disease in Albania. We also consider the effects of vitamin D supplementation in allergic disease. Several clinical trials are under way and their results are needed in order to make definitive recommendations about the optimal dose of vitamin D for prevention and treatment of asthma and allergic disease.

1. Introduction

Vitamin D is a hormone with multiple physiological actions, many effects of which have been found to occur outside its classical role in calcium homeostasis. We now know that vitamin D receptors (VDRs) are expressed in many cell types [1], including various immune cells, suggesting the role of vitamin D on immune system [2]. These recent findings have increased interest in vitamin D status and its link to several nonskeletal diseases [1].

The main source of vitamin D in humans is solar UV-B (290–315 nm wavelengths) radiation, which influences the formation of previtamin D in the skin (cholecalciferol). Cholecalciferol from the skin or derived from nutrition is metabolized in the liver to 25-hydroxyvitamin D (25-OH-D). This is the major circulating form; thus it is usually used to measure serum vitamin D levels. 25-OH-D is then transported to the kidneys where it is metabolized to its active form calcitriol (1,25(OH)D,1,25-dihydroxyvitamin D) (Figure 1) [2, 3]. Although thresholds of serum 25(OH)D are still debated, guidelines from the Institute of Medicine (IOM) for bone health define “vitamin D deficiency” as serum 25(OH)D levels below 30 nmol/L (<12 ng/mL), while sufficient vitamin D levels should be considered serum levels of at least 50 nmol/L (20 ng/mL) [4]. Due to evidence of vitamin D insufficiency on allergic disease prevalence, many researchers categorized vitamin D sufficiency as >75 nmol/L (30 ng/mL) [1].

Since 1999, when Wjst and Dold were the first scientists to hypothesize a link between vitamin D and allergic diseases, two conflicting hypotheses are raised. The first hypothesis tries to correlate high serum vitamin D levels with the rise in prevalence of allergies and asthma [5]. The authors suggest that the geographic trend of higher disease prevalence in more developed countries runs in parallel with vitamin D exposure [5]. The first study that investigated this possible connection was a birth cohort study conducted in Finland. The authors found that higher risk for atopy, allergic rhinitis, and asthma was associated with increase in vitamin D supplementation for newborns in order to prevent infantile rickets [6]. A second hypothesis developed later suggested that vitamin D deficiency may contribute to the recent increase in allergies in Western countries [7, 8]. There is an increasing body of evidence to support the hypothesis that this widespread vitamin D deficiency correlates with atopy, asthma, and food allergy [8–12]. Prevalence of hypovitaminosis D varies among different countries and among different population groups within a given country and for each population over time. In many industrialized countries, up to 50% of the population has insufficient vitamin D [1]. Based on one study, vitamin D insufficiency in the United States increased from 55% to 77% between data collection ranges of 1988–1994 to 2001–2004 [13].

There is a combination of different factors which determine 25(OH)D serum levels and vitamin D deficiency like skin pigmentation, low sun exposure, more time spent indoors, obesity, higher latitudes, and winter season [13, 14]. Other secondary causes that could affect vitamin D serum levels are diseases including rheumatoid arthritis, cystic fibrosis, ulcerative colitis, Crohn’s disease, celiac disease, rickets, and medications [15].

In this review, we outline the basic metabolism of vitamin D and its effects on the immune system. In addition, we discuss recent findings regarding vitamin D status and its relation to allergy, specifically throughout Europe and Mediterranean countries. We also considered the effects of vitamin D supplementation in allergic disease, highlighting the recent recommendations.

2. The Effects of Vitamin D on the Immune System

The human immune system is divided into two branches: adaptive and innate immunity. There is plenty of evidence to show that vitamin D has significant effects on both of them. Its immunomodulatory role has been recognized recently with the discovery of vitamin D receptor (VDR) and the hydroxylation of 25(OH)D on distinct cell types. VDRs have been identified in many tissues and cells in the human body, including nearly all cells of the immune system (T cells, B cells, neutrophils, macrophages, and dendritic cells) [16]. It has been demonstrated that vitamin D affects several aspects of innate immunity. Vitamin D inhibits the expression of TLR (Toll-like receptor) on monocytes, inhibits proinflammatory cytokine production, and induces antimicrobial peptide synthesis [17, 18]. Vitamin D also impacts the adaptive immune system, specially affecting T-cell activation and antigen-presenting cells function. In recent studies, vitamin D is associated with reduction of Th2 cytokine secretion and inhibition of T cells proliferation. The association of vitamin D and Th3 cells is less clear and contradictory, with report of both increased and decreased expression of the Th-2 cytokines IL-4, IL-5, and IL-10 in adult peripheral blood cell cultures [19, 20]. In conclusion, it seems that vitamin D has a key role in Th2-Th3 balance, which could be relevant in allergic disease.

3. Vitamin D, Asthma, and Allergic Rhinitis

Vitamin D deficiency has been blamed as a cause of increased incidence of asthma and allergy symptoms. In a study conducted by Hollams et al. in Australia, 689 subjects were seen longitudinally at both ages of 6 and 14 years [21]. This study showed that vitamin D levels at ages 6 and 14 years were predictive of allergy/asthma outcomes at both ages, but more importantly, vitamin D levels at age 6 years were predictive of subsequent atopy and asthma-associated phenotypes at age 14 years. This is the first study which demonstrates the association between vitamin D and asthma in older children, comparing with the early-life birth cohort studies.

In addition to the relationship between vitamin D status and asthma, there is considerable interest in assessing whether this vitamin protects against or reduces asthma morbidity. It is now well known that there is a significant association between vitamin D deficiency and infections. This association becomes particularly significant in children with respiratory disease such as asthma. The most common causes of acute asthma exacerbations are viral upper respiratory tract infections. The human rhinovirus (HRV) is the commonest trigger for acute asthma. Up to 80% of asthma exacerbations are triggered by a “cold. ” A recent clinical trial showed that vitamin D supplementation (500 IU/day) given as adjuvant therapy to inhaled corticosteroids in children with asthma reduced the risk of asthma exacerbation triggered by respiratory tract infections [22]. Other researchers in Costa Rica studied vitamin D levels in children with asthma and demonstrated that lower vitamin D levels were associated with increased airway responsiveness, higher eosinophilic counts and total IgE levels, and increased risk of severe asthma exacerbations [23]. This finding suggests that sufficient vitamin D levels may help to control infections and reduce inflammatory responses, resulting in viral infections causing less severe symptoms. The same authors conducted a longitudinal study based on Childhood Asthma Management Program and showed that the group with the lower risk of exacerbations was the group with 25(OH)D ≥ 30 ng/mL and who were receiving inhaled corticosteroids [24]. The hypothesis that vitamin D supplementation might potentiate the anti-inflammatory function of corticosteroids is intriguing because glucocorticoid resistance is an important obstacle to effective treatment in some patients with asthma. Searing et al. in their study of asthmatic children demonstrated a significant association between lower vitamin D levels and greater use of inhaled or oral corticosteroids and total steroid dose [25]. Similar results were obtained in studies conducted on asthmatic adults [26]. Xystrakis et al. demonstrated the same association in vitro by using cell cultures obtained from steroid sensitive and steroid-resistant asthmatic subjects. Adding vitamin D to CD4+ T-cell cultures from steroid-resistant patients enhances the response to dexamethasone by inducing the production of IL-10 [27]. Furthermore, they showed that oral administration of vitamin D in severe asthmatics inverted steroid resistance through induction of IL-10-secreting Tregs (regulatory T-cells). These observations, together with clinical and experimental studies, justify the use of vitamin D in the treatment of severe asthma, particularly to enhance action of steroids.

Another aspect involved in the relationship between vitamin D deficiency and asthma relates to lung function impairment. Consistent with the role of vitamin D on enhancing steroid responsiveness, several studies of children and adults have shown that a low vitamin D level is associated with impaired lung function. Children with insufficient vitamin D levels were found to have a slightly lower mean FEV1 than children with sufficient vitamin levels [25]. Other studies in adults show a strong relationship between serum concentrations of vitamin D, forced expiratory volume in 1 second (FEV1), and forced vital capacity, where decreasing pulmonary function is associated with vitamin D deficiency [26, 28].

It has been found that different gene polymorphisms of the vitamin D receptor (VDR) and vitamin D binding protein (VDBP) have variable associations with asthma. Together with different serum levels of vitamin D, also VDR and VDBP variants seem to represent a risk factor for asthma [29]. The vitamin D receptor is present in bronchial smooth muscle cells which are associated with active protein synthesis. It has been demonstrated that vitamin D inhibits bronchial smooth muscle proliferation induced by platelet-derived growth factor and it also influences the microarray gene expression signature in bronchial smooth muscle cells [30–32]. This finding suggests a role of vitamin D in cell growth and survival and morphogenesis and airway remodeling, which may be important in asthma pathophysiology and treatment [32].

Of the different allergic disorders, perhaps asthma has been the most closely examined in the context of vitamin D. Although the underlying mechanisms of how vitamin D modulates the pathogenesis of asthma have not been completely understood, the available data suggest an association between vitamin D deficiency and asthma. On the other hand, there is insufficient and weak evidence for an association between vitamin D status and atopic disease other than asthma. In a cross-sectional study, Hyppönen et al. showed a U-shaped relation between serum vitamin D and total IgE in adults, at 45 years of age. Thus, IgE concentrations were higher for participants with low (<25 nmol/L) and with very high vitamin D serum levels (>135 nmol/L) compared with a reference group (100–125 nmol/L) [33]. Correcting serum concentrations of 25(OH)D to physiological levels reduced the IgE level significantly, further supporting an allergy-protective role for vitamin D in adults. Following patients with chronic rhinosinusitis (CRS), current clinical studies have shown that CRS patients had serum vitamin D levels 40–50% lower than the serum levels in the control group [34, 35]. In a study performed in Iran, vitamin D levels were assessed in 50 patients with allergic rhinitis and the study results were compared with vitamin D status in normal population. The prevalence of severe vitamin D deficiency was higher in patients with allergic rhinitis than in normal population, 30% and 5.1%, respectively [36].

The relationship between vitamin D status and asthma has been the subject of several studies in the last decade. As mentioned in the introduction the prevalence of hypovitaminosis D is high in many industrialized countries. Furthermore, epidemiological studies suggest that atopic diseases increased significantly in most Westernized countries. According to ISAAC Phase Three (1999–2004) prevalence of asthma symptoms in children aged 6-7 years and 13-14 years was, respectively, from <5% to 14.5% and <5% to 11.2% for the east Europe and for west Europe 5.4%–20.9% and 4.1%–27.8%, respectively. On the other hand, the prevalence of allergic rhinoconjunctivitis symptoms in children aged 6-7 years and 13-14 years was <5%–7.1% and ≈5%–19.3% for each group, respectively, at east Europe and 6.2%–11.1% and 7.1%–22.2% at west Europe. In addition, a similar north-south gradient has been observed in Europe for atopic diseases, with countries like Albania and Greece presenting the lowest prevalence [7]. This remarkable variation suggests that environmental factors play an important role in the pathogenesis of allergic diseases. Factors like geographical latitude and Mediterranean diet with fresh fruits, vegetables, and nuts are protective factors which may determine the beneficial role of vitamin D in our region.

4. Maternal Vitamin D and the Risk of Allergic Disease Development in Children

There has been growing interest in the influence of maternal vitamin D intake during pregnancy on the development of allergic diseases in children. As the insufficiency of this vitamin is high in pregnant woman several studies tried to examine the associations between a mother’s vitamin D intake and the allergy risk in her child. Camargo Jr. et al. conducted a birth cohort study and in early 2006 they published results of their 2- and 3-year follow-ups. The authors reported that higher maternal intake of vitamin D was associated with a lower incidence of wheeze in the child. For each 2.5 μg/day (100 IU) incremental increase in vitamin D intake the authors found a 10% decrease in risk of wheeze [8, 37]. A similar inverse association was also reported by other cohort studies [38, 39]. In addition Erkkola et al. found similar association between maternal intake of vitamin D and risk of developing asthma and allergic rhinitis in 5-year- old children [10]. All of these studies did not measure vitamin D directly but looked at maternal vitamin D intake, mostly from supplements. During pregnancy the fetus is exposed to vitamin D through cord blood supply and the ability of 25(OH)D to cross the placenta. In a recent study Camargo Jr. et al. measured cord blood 25(OH)D and found an inverse association with the risk of respiratory infections and childhood wheezing, but not with incident asthma [11].

Vitamin D deficiency is very common in pregnant women globally, but until now very little information is available on the impact of this deficiency on neonatal immune function and future risk of allergic disease [40]. The prevalence of vitamin D deficiency among pregnant women was found to be 21.2% in UK, 44.6% in Belgium, and 83.6% in China [40–42]. On a molecular level, maternal vitamin D intake during pregnancy increases the mRNA levels of the immunoglobulin-like transcripts ILT3 and ILT4 in umbilical cord blood. As these receptors are critical for the generation of T suppressor cells, this finding may point towards an early induction of immunological tolerance by maternal vitamin D intake in the developing child [43]. Future studies with longitudinal cohorts are needed to light on the vitamin D hypothesis in fetal life. A randomized trial supported by the US NIH has already started on vitamin D supplementation in pregnant women (4000 IU/day) and onset of asthma in their children; the results will be available by June 2014 [15]. Still, high vitamin D intake during pregnancy might also be harmful with respect to allergic disease development: children whose mothers had a 25(OH)D concentration during pregnancy greater than 75 nmol/L had an increased risk of atopic eczema on examination at 9 months and asthma at the age of 9 years compared with children whose mothers had a concentration of <30 nmol/L [40].

Future research should differentiate oral intake from endogenous contributions to 25(OH)D status in order to explain the immunological effects of each.

5. Vitamin D and Food Allergy in Children

While the incidence of asthma appears to have reached a plateau in some developed nations, many of these regions are now facing a “second wave” of the allergy epidemic, which, according to Jones et al., appears to be the rising incidence of food allergy [44]. Based on epidemiological data, the recent increase in food allergen sensitization parallels the epidemic of vitamin D deficiency caused by several factors. Factors like obesity and race, which are risk factors for vitamin D deficiency, are associated with food allergy. Although the precise biological mechanism for these epidemiologic associations is not yet known, there are hypotheses that this hormonal deficiency contributes to food allergy risk [12]. Several studies have described higher rates of food allergy among children born in seasons of low UV-B intensity (autumn/winter), associated with lower vitamin D levels [45, 46]. Other authors reported a negative association of maternal vitamin D intake during pregnancy with the risk of food allergen sensitization in early childhood [47]. Accordingly, vitamin D deficiency might contribute to early-life sensitization by further compromising the immaturity of the infant immune system.

Vassallo and Camargo Jr. proposed a “multiple-hit” model in which vitamin D deficiency, in addition to compromising immune tolerance, increases susceptibility to infections and alters microbial ecology at the gastrointestinal tract, contributing to abnormal intestinal barrier permeability. These factors might synergistically promote maladaptive allergic responses to food antigens, which manifest as food allergy in genetically susceptible subjects. The authors suggest that correction of vitamin D deficiency during pregnancy and childhood might promote immunologic tolerance, suppress proallergic immune responses, improve mucosal defenses, optimize microbial flora, and thereby limit food allergy epidemic in children [12].

6. Sources of Vitamin D

As mentioned previously humans acquire most of their vitamin D through sun exposure and about 10% via ingested food. Vitamin D is absorbed through the gut as either vitamin D2 (ergocalciferol) or vitamin D3 (cholecalciferol) [3].

Natural sources of vitamin D include a few foods such as fatty fish (e.g., salmon, eel, and sardine), fish liver, or cod liver oil. Some fungi such as mushrooms are a natural source of vitamin D2. Animal foods such as fatty fish, liver, fish liver oils, cheese, and egg yolks contain vitamin D3. In some industrial countries, other sources of vitamin D are fortified foods (most often milk, margarine and/or butter, and breakfast cereals) and dietary supplements.

According to European Food Safety Authority (EFSA), mean intake of vitamin D in European countries varies according to sex, age, and supplementation habits. In adults, mean intake of vitamin D from foods varied from 1.1 μg/day in Spain to 8.2 μg/day in Finland. The range of vitamin D intake reported from 14 European countries is considerable. In high consumers (95th percentile), intake from foods is up to 16 μg/day and about 1.5-fold this value in those that consume supplements in addition to foods. For infants, mean intake from foods and supplements was available from Finland (8.9 μg/day) and The Netherlands (12.5 μg/day). In children 1–5 years, mean intake from foods varied from 1.7 μg/day, in Denmark, to 5.6 μg/day, in Greece. In older children, mean or median intake from foods only varied from 1.4 μg/day in Spain and Ireland to 2.7 μg/day in The Netherlands [48].

The main factors which determine 25(OH)D serum levels are skin pigmentation, sun exposure, age, gender, latitude of residence, winter season, dietary habits, and dietary vitamin D fortification [49]. Below latitude of approximately 35° North, UV-B radiation is sufficient for vitamin D3 synthesis all year round. At higher latitudes, there is no cutaneous vitamin D3 synthesis during the winter months [48].

7. Recommendations

Many countries recommend the intake of supplements with vitamin D usually containing 5–25 μg (200–1000 IU) cholecalciferol or ergocalciferol. The two forms differ by their side chains on the sterol skeleton [50]. Cholecalciferol is more effective than ergocalciferol in elevating total 25(OH)D concentrations and maintaining those levels for a longer time [51]. Currently, EFSA proposed a daily intake of 100 μg (equal to 400 IU) vitamin D for adults including pregnant and lactating women. Vitamin D intake in children and adolescents was adapted to 100 μg/day for ages of 11–17 years, considering the phases of rapid bone formation and growth in this age group. For children aged 1–10 years, the upper limit dose of 50 μg/day was suggested, taking into account their smaller body size. For infants, the upper limit dose of 25 μg/day was recommended [48].

In the UK, elderly people (>65 years) are recommended to take 10 μg (400 IU) of vitamin D as a supplemental dose. The Nordic dietary vitamin D recommendation for children of 3 years to adults of 60 years is 7.5 μg/day (300 IU) vitamin D. Infants younger than 3 years and adults over 65 years old are recommended to take 10 μg/day (400 IU) [52].

The Institute of Medicine’s Committee (IOM) in the new 2011 report on dietary requirements for vitamin D concludes that dietary reference intake for this nutrient can only be established according to bone health outcomes. The report estimated that children over 1-year old need at least 600 IU of vitamin D a day, with a maximum upper limit of 2500 IU for children aged 1–3 years, 3000 IU for children from 4- to 8-year old, and 4000 IU/day for children aged 9 or more years old. According to extraskeletal outcomes (e.g., respiratory health) the evidence is still insufficient [4].

Clinical trial results are needed to make definitive recommendations about the optimal dose of vitamin D for immune system functioning, for asthma prevention, and for the use of vitamin D with inhaled corticosteroids to prevent steroid resistance. Several trials are under way for asthma prevention (clinicaltrials.gov, identifiers NCT00920621 and NCT00856947), for steroid efficacy (NCT01248065), or for prevention of exacerbations (NCT00978315).

8. Conclusions

In recent years, many studies have been published on the effects of vitamin D and its role in various diseases. Furthermore, several studies have sought to determine the effect that vitamin D has on the immune system and specifically allergic diseases. It is worth noting that different in vivo and in vitro human studies have shown effects of vitamin D on allergy, asthma, lung function, airway responsiveness, and bronchodilator response. It seems that this hormone might lead to an innovative treatment of these increasingly common conditions.

An essential issue for any vitamin D intervention concerns its dosage. The currently recommended levels of circulating serum 25(OH)D are thought to be the minimum needed for bone health, but the optimal levels for immune system function, prevention of atopy, and defense against respiratory infections are still not known. It seems that maternal supplementation during pregnancy may prevent asthma and allergy and vitamin D supplementation after birth will also probably be necessary to maintain normal immune function in the long term.

The remarkable variation in prevalence of allergic diseases and asthma between European countries suggests that geographical latitude and Mediterranean diet are important factors which determine the beneficial role of vitamin D in our region. It would be advisable to measure the vitamin D serum level in children and adults who are part of high risk groups for vitamin D deficiency. Another group would be children with respiratory viral infections and atopy in early life which are at high risk for asthma in later childhood [53]. Vitamin D supplementation is only recommended for patients who have serum level less than 20 ng/mL. Randomized clinical trials regarding treatment with vitamin D supplementation will help determine the effects on the immune system and any potential role in preventing allergic disease.

Conflict of Interests

The authors declare that there is no conflict of interests regarding the publication of this paper.

The Top 2 Vitamins For Allergy Relief

Pollen is everywhere during the summer months, which means that allergens get extremely difficult to avoid. Thankfully there are vitamins for allergy relief that can help to relieve some symptoms naturally.

What Are Allergies?

An estimated 21 million adults in the UK suffer from at least one allergy, with numbers continuing to rise year on year! Allergies are caused by an exaggerated immune response to substances that aren’t actually harmful to the body such as pollen, mould and dust. Both genetic and environmental factors play a role in this over sensitive immune response that causes itching, swelling skin irritation/rashes, coughing, runny noses and muscle spasms.

How To Treat Symptoms?

Avoiding the allergen itself is the best way to avoid symptoms however this can be incredibly difficult if the allergen is something like dust or pollen which you are inevitably going to come across in your daily life. If you go and visit your doctor, they will probably prescribe you an antihistamine tablet (these can also be purchased over the counter). They can be taken as tablets, in a liquid form, a nasal spray, or eye drops depending on the allergy and associated symptoms.

Antihistamines work by blocking histamine, a substance which is released by the immune system cells, which then attaches to the receptors in blood vessels, causing them to enlarge. Histamine also binds to other receptors causing other symptoms such as redness, swelling and itching. By blocking histamine and keeping it from binding to receptors, antihistamines prevent these symptoms.

While antihistamines can be effective at treating the symptoms of mild and seasonal allergies in particular, there are a number of potential side effects or issues associated with taking them. They can cause you to feel drowsy and cloud the thinking, but more significantly they do not stop the problem from happening in the first place, they just mask the symptoms.

There is, however, a natural alternative in the form of vitamins for allergy relief.

Vitamins For Allergy Relief

Traditional western medicine and alternative health practitioners agreeing that nature’s top edible antihistamines are found in foods. The top two recommended vitamins for allergy relief are found in foods like fish and citrus fruits.

1. Buy now
   with myvitamins

   Vitamin C

   Vitamin C is considered as a natural antihistamine. It works by destroying the molecular structure of histamine, thereby decreasing the amount of histamine in the blood.

   It has also been suggested that taking bioflavonoids alongside Vitamin C actually enhances the action of this vitamin which means that allergy relief symptoms will be even greater. Bioflavonoids can be added to a supplement form of Vitamin C and are also found in rose hips.

   The absorption of Vitamin C is highly dependent on the amount ingested therefore it is recommended that more than 500mg per day is taken. For anyone who doesn’t like to table tablets, there are also chewable tablets and powder available.

   Buy now with free delivery

2. Buy now
   with myvitamins

   Omega 3

   As an essential fatty acid, Omega 3 has anti-inflammatory effects. Natural anti-inflammatories, like Omega 3, are believed to reduce immune responses associated with allergies.

   It is thought that Omega 6 is less helpful in controlling allergic symptoms. That’s because it can encourage the production of arachadonic acid, which led to your immune system reacting with allergic inflammation. So a diet low in Omega 6 but high in Omega 3 is recommended.

   A supplement, like Cod Liver Oil, is a more convenient (and potentially less smelly) way of increasing Omega 3 intake whilst avoiding increasing Omega 6 intake. As a vegan-friendly alternative, Algae Oil is a great source of Omega 3.

   Buy now with free delivery

References

• Cathcart, R. F. (1986). The vitamin C treatment of allergy and the normally unprimedstate of antibodies. Medical Hypotheses 21(3) 307-321.

• Kompauer,I.,  Heinrich, J., Wolfram, G., & Linseisen, J. (2007). Association of carotenoids, tocopherols and vitamin C in plasma with allergic rhinitis and allergic sensitisation inadults. Public Health Nutrition 9 (4) 472-479.

• Willers,S. M., Wijga, A. H., Brunekreef, B., Scholtens, S. (2010). Childhood diet and asthma and atopy at 8 years of age: the PIAMA birth cohort study. European Respiratory Journal, 37 (5) 1060-1067.

Chronic Cough With Allergies: 5 Natural Supplements To Decrease Allergy Symptoms

Are There Natural Ways To Treat Allergies?

Chronic coughing, sneezing, and sniffling can be frustrating. People dealing with allergy symptoms often want to find ways to treat the problem naturally. Patients should always speak with a healthcare provider to learn more about allergy medication and supplement options. Additionally, there are 5 natural options that may be worth looking into.

1. Bromelain

This supplement is an enzyme mixture that comes from the stem and fruit of a pineapple. Bromelain is commonly used as a natural way to decrease inflammation and swelling. This can work in the nasal passages to thin mucus and make breathing easier. Bromelain can work particularly well when coupled with medication for sinus infections.

2. Stinging nettle

This botanical supplement contains a mix of vitamin K, carotene, and quercetin. Stinging nettle is a common supplement for allergy symptom relief, especially in cases of hay fever. The plant can help to reduce inflammation and relieve symptoms such as sneezing, watery or itchy eyes, and a runny nose.

3. Quercetin

One of the ingredients in the stinging nettle plant, quercetin is also found in wine and many fruits and vegetables. The supplement can work as a natural antihistamine, decreasing inflammation. While research is still ongoing, preliminary studies have found the supplement works well and has few side effects for most patients.

4. Butterbur

One of the most popular natural remedies for allergies, butterbur has some of the most evidence of working to treat allergies. The herb helps to block some of the chemicals that can lead to swelling in the nasal passages, causing a stuffed up nose or sneezing. Some research has even shown that butterbur can be just as effective at treating allergy symptoms as over-the-counter antihistamines.

5. Vitamin D

Most people know the benefits of vitamin D for boosting bone health and improving mood. Research has also shown a link between vitamin D, immune function, and the development of allergies. One study found that patients who were deficient in the vitamin experienced allergy symptom improvement from taking a supplement.

What else can I do?

Besides taking supplements, people can make some lifestyle changes to relieve allergy symptoms naturally. Pay attention to allergy triggers and work to remove pollen, dust, or other allergens from the home. Some people also benefit from irrigating the nasal passages with saltwater. For more information about allergy medication or supplements, speak with a healthcare provider or pharmacist.

Vitamin C allergy

Vitamin C allergy: watch out!

Doctors declare that there can be no real allergy to vitamin C . At most, you may experience mild itching and hives. Allergy, in the conventional sense, can appear with the use of concentrated vitamin C or with its use intramuscularly or intravenously.

The optimal dose of vitamin C in the body is 100-400 mg per day. This dose is found in 2 oranges or a pound of unsweetened apples.During epidemics, it is advised to increase this dose to 500-600 mg. Moreover, it is better to take vitamin C in its natural form, since fruits and vegetables contain a whole storehouse of useful elements. You can find vitamin C, for example, in citrus fruits, rose hips, tomatoes, potatoes, sour and sweet and sour berries, melon, cabbage, bell peppers, dark green vegetables. Even milk contains vitamin C, though more in kumis or mare’s milk.

In case of an overdose of vitamin C in the body, your blood pressure and blood sugar may rise, sleep disturbances may occur, urinary stones may form, and nausea, vomiting, and diarrhea may appear.All of these symptoms can be easily prevented by taking a preparation containing the vitamin after meals, and it is best to reduce the dose.

The main consequences of any food allergy, and, in this case, allergy to vitamin C, are rash, itching, urticaria, swelling, redness, runny nose, cough … In case of a complicated reaction to a component, there may be anaphylactic shock and Quincke’s edema. Which is very, very dangerous.

Allergy to vitamin C: prevention and treatment

If you have signs of allergy to vitamin C, you should first take any antihistamine and refuse foods and medicines containing vitamin C.Then you should consult an allergist to really confirm your allergy to vitamin C, and not to something else. If this is really an allergy to vitamin C, the doctor will select medications for you without adding it, and also prescribe a hypoallergenic diet. Its essence lies in the exclusion of highly allergenic foods from the diet (this group includes foods containing vitamin C). Then, if the allergy still makes itself felt, exclude moderately allergenic foods such as meat, wheat, potatoes, legumes and a number of fruits.

This diet should be followed for 2-3 weeks. After the allergy to vitamin C has receded, you can gradually return the excluded foods to the diet. Thus, this diet fulfills not only a therapeutic, but also a diagnostic function. Recall that vitamin C allergy is extremely rare, it is mainly caused by either an overdose of vitamin C or an allergy to a certain product. And, returning products gradually, it is easy to understand which particular fruit or dish is causing the allergy.

It is worth noting that it is best to treat the liver with the elimination of the causes of allergy and establish the exact cause of the allergic reaction. It is important not only to remove the symptoms, how much to prevent their recurrence, but an examination by a specialist doctor will help you with this.

Allergy to B vitamins: B12, B6, B1

Allergy to B vitamins is rare, but creates great difficulties, since these biologically active substances play an important role in the functioning of the body and therefore are used to treat many diseases.

Causes of vitamin B allergy

In most cases, an allergic reaction to B vitamins is associated with an overdose due to excessive consumption of certain foods or misuse of medicines. An excess of vitamin B1 (thiamine) is considered the most dangerous, because it stimulates the production of acetylcholine, a substance that is involved in the development of allergies. In addition, a negative reaction to thiamine from the immune system can lead to impaired liver and kidney function.

Vitamins B6 and B12 cause allergies much less frequently. Particular attention should be paid to the amount of vitamin B12 consumed. It tends to accumulate in the body, since its half-life is approximately 1.5 years. Vitamin B allergy can occur even if taken in moderation. Causes may include the following conditions:

• hypersensitivity;
• weakened immunity;
• diseases accompanied by metabolic disorders (for example, renal or liver failure).

It should be noted that taking vitamins in tablets or capsules is often accompanied by a deterioration in well-being. The reason may not be at all an allergy to vitamin B as such, but a negative reaction to excipients: gelatin, starch, dyes and flavorings.

It has been noticed that an allergic reaction develops several times more often in people who take multivitamin or vitamin-mineral complexes. This is due to the interaction between all the components of such drugs.Some experts believe that the absorption of vitamins and minerals from these drugs is much worse, which is why undigested compounds are perceived by the immune system as foreign agents.

Symptoms of vitamin allergy

It is important to be able to distinguish the symptoms of an allergic reaction from the signs of an overdose, since the treatment for these conditions is carried out in different ways. All representatives of B vitamins have a different level of activity, so the severity of allergies may vary.Symptoms for mild allergies to thiamine, B12 or other types are limited to skin manifestations:

• redness;

90,033 itching and burning;

90,033 rashes in the form of small vesicles and desquamation;

• urticaria.

If B vitamins are injected intramuscularly, edema, redness and pain may occur at the injection site.

In more severe cases, vitamin B1 allergy is accompanied by nasal congestion, runny nose, cough, watery eyes, and fever.A particularly severe course is characterized by the fact that symptoms of angioedema appear:

• hoarseness and suffocation;

90,033 swelling of the face;

• swelling and numbness of the limbs;
• acute abdominal pain;
• a sharp drop in blood pressure.

This condition is life threatening, therefore, if signs of Quincke’s edema appear, you need to see a doctor as soon as possible. In very rare cases, anaphylactic shock develops after the injection of the vitamin solution.

An overdose of vitamin B12 or other representatives of B vitamins is manifested as follows:

• nausea and vomiting;

90,033 diarrhea;

• weakness, dizziness;
• increase in heart rate;
• characteristic changes in blood and urine tests.

Often, symptoms of an allergic reaction and an overdose occur simultaneously.

Treatment of vitamin allergy

In order for the allergic reaction to stop, you need to stop the entry of the allergen into the body: refuse injections or taking multivitamin complexes.If such measures are not enough, then it is recommended to follow a special diet with a minimum amount of products containing vitamin B12 or any other representatives of group B. If it is impossible to completely exclude such products, it is recommended to carry out heat treatment, which contributes to the destruction of the vitamin.

The doctor prescribes the drug treatment regimen, the choice of drugs, dosages and the duration of the course of administration depends on the symptoms. For oral administration, antihistamines are prescribed: “Erius”, “Zirtek”, “Tavegil”, “Eden”.

If the use of these funds does not give a positive effect, treatment with hormonal drugs is indicated: “Prednisolone” or “Dexamethasone”. To eliminate skin symptoms of allergy to vitamin B, as well as nasal congestion, ointments with antiallergic components (Fenistil-gel, Gistan) and nasal drops with decongestants (Galazolin, Tizin, Nazol) are used. In case of a severe skin reaction, the doctor prescribes an ointment with a hormonal component (“Beloderm”, “Lorinden S”).

In order to remove the remnants of B12 or another allergen from the body, the administration of adsorbing agents (activated carbon, Enterosgel, Polyphepan) can be prescribed, as well as a cleansing enema. In case of an increase in body temperature, infusion therapy (dropper) is indicated. Additional elimination of vitamin B12 is helped by drinking plenty of drinking water and a hypoallergenic diet.

Prevention of allergy to B vitamins

To protect yourself from vitamin B allergy, it is recommended to follow a few rules.

1. Do not overuse vitamin supplements: more is not better. People who lead an active lifestyle, eat variedly and feel good, as a rule, there is no urgent need for the constant use of vitamin-mineral complexes.

2. When choosing drugs, give preference to monovitamins, as multivitamin and vitamin-mineral complexes cause allergies much more often.To find out which substance is deficient, it is enough to make a blood test.
3. Try to take vitamin medicines containing the minimum amount of excipients. For example, drugs for children come in the form of sweet syrups or colored pills, but they contain many more potential allergens than simple tablets.
4. Note that manufacturers have recently added B vitamins to skin and hair care products.In the presence of allergies, cosmetics with such additives can cause contact dermatitis of varying severity.

Vitamin preparations are not as harmless as many people think. Incorrect use of these funds can harm the body in the form of allergies or intoxication (to a greater extent, this applies to vitamin B12).

If taking multivitamin complexes caused an allergic reaction, additional research is needed.They will help to determine exactly which representative of group B acted as the allergen. For this purpose, skin tests are carried out: drip, scarification and intradermal, as well as a blood test for immunoglobulins. Based on such analyzes, the doctor will be able to choose the most appropriate diet and drug therapy regimen.

90,000 Pet allergies. Most common allergens

Contents:

Does your pet have severe itching, skin redness, otitis media and an upset gastrointestinal tract? These can all be symptoms of an allergy.Many owners immediately exclude certain foods from the diet, as they consider them to be strong allergens. In this article we will tell you: why the pet has an allergy and what allergens provoke the appearance of this disease.

What are allergies?

Allergies can be divided into several large groups. Among the most common:

1. Allergy to fleas.

Flea saliva allergy is a common cause of itching in dogs.The constant bites of parasitic insects cause unbearable itching and irritation of the skin. Therefore, their saliva is classified as a strong allergen.

Important! Flea prophylaxis must be carried out all year round.

2. Allergy to environmental components.

Also known as atopy, the body’s response to certain substances that are present in the environment. How can a dog “catch” this type of allergens? Easily! She can inhale them – pollen or through tactile contact – for example, while playing in chemically treated grass.

The most common allergens in this group are pollen, dust mites, mold spores, etc.

3. Allergy to medicinal substances.

Allergies can be caused by many substances, and medications are no exception. Therefore, only a veterinarian can prescribe all medications for a pet. Incorrectly selected funds will lead to a reaction on the part of the body.

4. Food allergy.

Many owners believe that this group of allergies is the most common.But this is not the case! A reaction to certain foods in dogs occurs in only 10% of all skin diseases.

The foods that most commonly cause allergies in dogs are:

• beef;
• dairy products;

90,033 chicken;

90,033 wheat;

90,033 soybeans;

90,033 lamb;

• egg.

Allergy symptoms

The most common allergy symptoms in dogs are:

• Itching.
• Combs.
• The dog is constantly licking itself.
• Red, inflamed skin.
• Baldness.
• Recurrent skin and ear infections.
• Disorders of the digestive tract.

The most insidious thing is that all types of allergies have similar symptoms and it is almost impossible to distinguish one from the other.

The process of determining the causes of itching can take several months and it is not completely clear what triggered the allergy: improper diet or plant pollen.

But since allergies greatly reduce the quality of life of the dog, because the pet experiences constant itching and soreness in the places of scratching, it is necessary to immediately adjust its diet, excluding the most powerful allergens.

Hill’s has developed HILL’S PRESCRIPTION DIET Derm Complete . It uses egg white as the main source of animal protein.

Thanks to the content of Omega-3-6 fatty acids, vitamins E and C, the wound healing process is faster, inflammation and redness of the skin are reduced.Zinc, vitamins A and B help to restore the skin barrier, and the unique Histaguard complex helps to reduce itching.

Ask your veterinarian if Hill’s Prescription Diet Derm Complete is right for your pet!

We also recommend

Allergy to vitamin B12

Allergy to cobalt can be caused by ingestion of vitamin B12 (cobalamin) because the cobalamin molecule contains a cobalt atom.Taking large amounts of vitamin B12 (oral or injectable) can lead to contact dermatitis, which causes rashes and itching in people with a history of cobalt allergy.

There have been some reports of patients developing these reactions due to vitamin B12 supplementation. Contact dermatitis is a rash that is usually not life-threatening. The rare vitamin B12 allergy condition can be life-threatening, although there are few reports of it in the medical literature.

Symptoms

Contact dermatitis is a red, sometimes blistering, skin rash usually caused by direct skin contact. There are two types of contact dermatitis: irritant and allergic.

While irritants cause irritant dermatitis in most people who are exposed to sufficient amounts of a harmful chemical, allergens only cause allergic contact dermatitis in people sensitized (i.e. allergic) to these substances.

Contact dermatitis results in millions of doctor visits each year in the United States and affects all ages. Research shows that 20% of all people have this condition. Women are affected slightly more often than men, and adolescents and middle-aged adults appear to be the most common age groups.

On rare occasions, intramuscular injections of vitamin B12 have also been associated with life-threatening anaphylaxis. Symptoms of anaphylaxis may include itching, hives, shortness of breath, wheezing, vomiting, diarrhea, or anaphylactic shock.

Reasons

Vitamin B12, also called cobalamin, is a water-soluble vitamin that plays an important role in the formation of blood cells and the normal function of nerve symptoms.3 Cobalamin is usually available from dietary sources, and most multivitamins contain some amount of vitamins. vitamin B12 is sufficient for good health.

Vitamin B12 deficiency

Absorption of vitamin B12 is very difficult: it involves various steps that can lead to defects that can lead to poor absorption of vitamin B12 from the small intestine.As a result, vitamin B12 deficiencies are common.

People with this condition may need oral or injectable vitamin B124 supplements. Other people take large amounts of vitamin B12, especially with other forms of the B vitamin associated with the vitamin B complex, in the hope of improving their health.

Allergy to cobalt and vitamin B12

A cobalt allergy usually occurs when a person who is exposed to cobalt in cosmetics (particularly eye makeup), tattoos, or manufactured products develops an itchy, red, scaly rash that can sometimes even form blisters.

If a patient becomes sensitized to cobalt, they will develop a rash (allergic contact dermatitis) after repeated exposure (i.e. skin contact) to cobalt. While these reactions are unlikely to be dangerous, they can lead to a nasty itchy rash. However, in most cases of cobalt contact allergy, this is not the case.

Therefore, people with a vitamin B12 deficiency and a cobalt allergy should take as much vitamin B12 as necessary to maintain adequate levels.

Diagnostics

A diagnosis of cobalt allergy is made with a patch, which involves applying cobalt along with other chemicals to the back for about 48 hours (this is not the same as an allergy skin prick) .6 This is usually done with a paper tape system such as as a TRUE test.

TRUE test is the only FDA-approved contact dermatitis test in the United States, although some allergists and dermatologists will develop more extensive patch panels with chemicals purchased in Canada or Europe.

Test results are interpreted 48 hours after placement and again 72 or 96 hours after placement.

A positive test result is confirmed if blisters, redness and / or mild swelling appear at the site of exposure to a specific chemical. The site of a positive test usually itches, although the size of the reaction is usually limited to the site of contact and is therefore usually less than a dime.

Leaving

Rash associated with contact dermatitis due to cobalt allergy can be treated with topical corticosteroids or systemic corticosteroids (oral or injectable).However, cobalt allergies are best treated by avoiding high doses of vitamin B12.

People with a vitamin B12 deficiency should only take the minimum amount of vitamin B12 required to maintain normal vitamin B12 levels as determined by blood tests.

90,000 For children with allergies to synthetic vitamins and minerals

Whole grain cereals for children

Baby puree

• Carrot

• Sweet potato

• Pumpkin

• Apple

• Pear

• Prunes

• Mango

• Apple and Prunes

• Apple and Rosehip

• Apple and Blueberry

• Apple, Pear and Banana

• Apple, Banana, Blackcurrant and Blueberry

• Sweet Potatoes and Pumpkin

• Sweet Potatoes, Carrots and Broccoli

• Apple and Parsnip

• Apple, Carrot and Parsnip

• Apple, Banana with Yogurt

• Apple, Banana, Blueberry with Yogurt

• Mango, Peach, Apple with Yogurt

• Apple, Pumpkin, Carrot and Quinoa

• Apple, Banana, Raspberry and Quinoa

Baby olive oil

Children’s bars

Baby croutons and sticks

Baby juices

Children’s juice with water

Baby water

For the whole family

90,000 Vitamin D deficiency, symptoms and ways to prevent it.

Recently, the often forgotten vitamin D has come to the fore. Numerous studies have shown that low levels of vitamin D in the body allow diseases to progress faster, while sufficient amounts of this solar vitamin not only reduce the risk of disease, but also helps to fight existing diseases. It is difficult to detect vitamin D deficiency by symptoms alone, as the symptoms are often incomprehensible, such as fatigue, general weakness, bone pain, and frequent illnesses.It is important to remember that most people do not experience these symptoms.

The Importance of Vitamin D

Vitamin D is important for maintaining healthy bones and also reduces the risk of heart disease, diabetes and some cancers. It is very important for the absorption and metabolism of calcium and phosphorus. In addition to this, it:

• Regulates and supports the immune system;
• Supports a healthy body weight;
• Reduces the risk of developing multiple sclerosis;
• Preserves brain function during aging;
• Reduces the frequency and severity of asthma symptoms;
• Reduces the risk of developing rheumatoid arthritis in women.

5 reasons that can cause a lack of vitamin D in the body

1. You are not getting enough sun . Regular summer sun exposure will usually give you the dose of vitamin D you need, unless you have to spend a lot of time indoors for work or lifestyle reasons. However, in the period from October to April, the sunlight in Latvia is not intense enough to stimulate the necessary synthesis of vitamin D in the body.
2. You are not using vitamin D as a dietary supplement or you have been using it for a long time less than the recommended dose.
3. The kidneys cannot convert 25 (OH) D into the active form , and the absorption of vitamin D from the digestive tract is insufficient.
4. You need more vitamin D – during pregnancy or if you are overweight.
5. You are on a diet deficient in vitamin D – milk allergy, lactose intolerance, vegetarianism or veganism.

Symptoms of Vitamin D Deficiency

It is difficult to detect vitamin D deficiency by symptoms alone, as the symptoms are often incomprehensible, such as fatigue, general weakness, bone pain, frequent illnesses. It is important to remember that most people do not experience these symptoms. The only way to make sure that you have enough vitamin D in your body is to have blood tests done in a laboratory to determine your vitamin D. about the critical deficiency of this vitamin.The optimal concentration of vitamin D in the blood, which must be constantly maintained, is 40–70 ng /

How to increase your vitamin D level

If you decide to increase your vitamin D level, you can follow the table – according to your current vitamin level ( ng / ml), select a target (ng / ml) and see how many days you will need on average using a specific dose read here.

Risk groups

Some studies have shown that more than 50% of the world’s population is vitamin D deficient.It is ascertained both in Europe and Northern Europe, as well as in the countries of Asia and Africa, especially in people of age. In fact, anyone can have vitamin D deficiency, but those at particular risk are:

• Children under 5 years of age and pregnant and breastfeeding women;
• Inhabitants of the Northern Hemisphere, including residents of Latvia, because we have only in spring and summer the sun is strong enough to contribute to the production of the required amount of vitamin D in the body;
• People over 65 because their skin has fewer receptors that convert sunlight into vitamin D;
• People with high overweight (body mass index over 34).

Chronic diseases that are aggravated by vitamin D deficiency

Migraine, osteoporosis, asthma, hypertension, infertility, heart disease, autism, cancer, Alzheimer’s disease, cystic fibrosis, dementia, depression, diabetes (types 1 and 2), eczema, psoriasis, hearing loss, inflammatory bowel disease, insomnia, macular degeneration of the eye, multiple sclerosis, Crohn’s disease, muscle pain, obesity, rheumatoid arthritis, schizophrenia, seizures, periodontal disease (periodontitis, tooth loss), hemorrhagic septicemia, tuberculosis.

Sources of vitamin D

1. The best natural source of vitamin D is the ultraviolet rays of the sun . It is recommended to spend 10-15 minutes in the sun at least twice a week without sun protection cream with SPF so that the sun’s rays reach the face, arms, legs and back. How to get the all-important vitamin D in the sun while protecting yourself from premature aging and skin cancer, read here.

2. The second source is high-quality nutritional supplements – vitamin D3 , which is recommended to be consumed from October to April, when the sunlight in our climate is not intense enough to stimulate the necessary synthesis of vitamin D in the body (vitamin D is synthesized only starting from UV3) …

The latest development in science is vitamin D in spray form. This type of vitamin intake is up to 95% more effective than tablets, capsules and drops, because, firstly, there is no oxidation of vitamin D and, secondly, the spray form through the oral mucosa enters the circulation into the system and then spreads throughout the body bypassing the gastrointestinal tract (acid hydrolysis) and the effects of the liver.

3. The third source is food – salmon, tuna, sardines, mackerel, fish oil, fresh dairy products, cheese, yogurt, eggs and mushrooms.To ensure the minimum required daily intake (50 µg), you should eat 250 g of fresh salmon, 40 eggs or drink 10 cups of milk daily.

Seasonal allergies – how to deal with them with vitamins

Cookie information for users:

We use cookies to improve the experience of our visitors.

Cookies are small files consisting of a series of letters and numbers placed on your device by the servers of the website.They allow the website owner to distinguish you from other users of the website. Cookies cannot be executed as code or used as a carrier of viruses and cannot allow us to access your hard drive. We cannot read any information from your hard drive, even if cookies are stored there.

The information generated on the website using cookies can be used for various purposes and can be qualified as absolutely necessary.For example, to navigate the site and use its features, such as visiting protected areas of the site or adding products to the shopping cart.

To improve performance, these cookies collect information about how users use the site, such as which pages they visit most often and whether they receive error messages. These cookies are used to improve the site’s performance in other future versions.

To improve functionality, cookies allow a website to remember your choices, such as your username, language or region, and provide an improved personalized visit to the site.

With regard to targeting or advertising, cookies are used to show you the most relevant content based on your interests.

Types of cookies used by websites:

– Session cookies allow the site to remember previous choices made by the User (for example, username, language selection, etc.), thereby providing a more efficient and personalized service. The information obtained through tracking cookies improves the usability of the website;

– Persistent cookies are necessary in order to navigate the site and use its functions.