Seasonal trend of C. diff.--what this might indicate

[Hua Kul]

I started searching for studies showing any seasonal trend in cdiff infections and found some evidence there is. This study, Trends and seasonal patterns in hospitalization rates of Clostridium Difficile in the US elderly ( http://apha.confex.com/apha/135am/techp ... 156945.htm ) found the highest rates of C. difficile were observed in mid-March (week 11 ± 0.23).

This study (number 51 on the page, Seasonality of Clostridium difficile Infection Reported by Acute NHS Trusts in England - ( http://www.shea-online.org/Assets/files ... ficile.pdf ) also found a seasonal variation. Check out the fascinating chart here, ( http://files.abstractsonline.com/CTRL/8 ... g415_1.JPG ), it graphically depicts that for a period of four years the cases always peaked in the first quarter.

This seems to be evidence that vitamin D levels are involved in cdiff infections. Our main natural source of vitamin D is sunshine on our skins, which is sorely lacking in winter. This may be the same underlying reason flu cases in the southern hemisphere are 6 months out of phase with flu cases in the north, they are more prevalent in each hemisphere's winter season, when vitamin D levels are naturally depressed. Adequate D levels are critical to the strength of our immune system. My father-in-law recently had his vitamin D level checked and it was 22ng/ml. 20ng/ml is considered severly deficient. The doctor prescribed 50,000IU per week with a recheck in 8 weeks. Could he get that from food? Fortified milk has only 100IU per 8oz glass, so he would have to drink over 31 gallons of milk per week. I bought him 5,000IU capsules and he takes 2 per day for 5 days per week.

If the cdiff seasonal trend truly is because of inadequate vitamin D in the winter then those of you with cdiff you might want to get your D level checked, it should be between 50-60ng/ml. Make sure the lab is testing for 25(OH)D. A lot of people are deficient even in the summer months, especially if not getting enough sun on bare skin or using sunscreen. Even if we do get enough sun, if we shower the same day most of the vitamin D will be lost, as it needs 48 hours to be fully absorbed.

One more thing, milk is fortified with ergocalciferol, a synthetic form of vitamin D called D2. The natural form is D3, cholecalciferol, which the body makes from cholesterol.

God Bless,
--Hua Kul

[Hua Kul]

Roy: It would be interesting to know if theres a pattern to the increasing incidents of community aquired C.diff where there has been no antibiotics taken!

One of the studies I came across, IIRC, did separate out patients in whom it was community aquired, but it was on a site that required an expensive subscription to read anything but the abstract. Man, do I hate that!

--Hua

[beth22]

I too, have read studies about vitamin D helping the immune system - crucial to avoid viruses and such. I am taking a liquid D3 every day, as my level was 26 - not very good either. Will have it rechecked after a few more weeks. I find the liquid form easy to tolerate.

[Hua Kul]

The U.S. gov't recently increased its recommended daily intake to 400 IU from 200 IU but this is still woefully inadequate. 200 IU was the bare minimum to avoid rickets. I take 5,000 IU per day now that we don't see much sun, but it is pretty important to have one's level checked. Optimally it should be in the range of 50-60ng/ml, and I plan to have mine checked in a few weeks.

I searched for studies of vitamin D toxicity. I repeatedly came across the phrase, "The lack of vitamin D toxicity after massive doses of ergocalciferol has yet to be reported in the literature." One study reported the case of a 56-year-old woman who had been taking 150,000 IU orally daily of D2 for 28 years without toxicity. http://www.ncbi.nlm.nih.gov/pubmed/1948 ... $=activity

In another study of different regimens for supplementation for those with low levels it was found that 50,000 IU of D2 taken 3 times weekly for 6 weeks achieved sufficiency in 82% of cases, and in this study they defined sufficiency as > or = 30ng/ml (the optimal level is generally recognized as 50-60ng/ml). http://www.ncbi.nlm.nih.gov/pubmed/1934 ... rom=pubmed

Beth, how many IU's are you taking daily (if I may ask)?


--Hua Kul

[beth22]

Either 1,000 or 500, depending on how many tsps. I take that day. The doctor said to take 1,000 per day and then be re-checked after a few weeks. I live in a sunny climate most of the year too.