In a prospective, double-blinded, single-center study, 42 patients with chronic urticaria were randomized to high (4,000 IU/d) or low (600 IU/d) vitamin D3 supplementation for 3 months (12 weeks).All subjects were provided with a standardized triple-drug therapy (cetirizine, ranitidine, and montelukast) and a written action plan.
Triple-drug therapy decreased Urticaria Symptom Severity (USS) scores by 33% in the first week.
There was a further significant decrease (40%) in USS scores in the high (4000 IU/day), but not low (600 IU/day), vitamin D3 treatment group by week 12.
Mnemonic:
3ple drug therapy
33% decrease in symptoms
4,000 IU vitamin D per day
40% decrease in symptoms
Beneficial trends for sleep quality and pruritus scores were observed with high vitamin D3.
Serum 25-hydroxyvitamin D levels increased with high vitamin D3 supplementation, but there was no correlation between 25-hydroxyvitamin D levels and USS scores. There was no difference in allergy medication use between groups.
Add-on therapy with high-dose vitamin D3 (4,000 IU/d) could be considered a safe and potentially beneficial immunomodulator in patients with chronic urticaria.
Chronic Urticaria Treatment Options in 6 Steps (click to enlarge the image).
References:
Beneficial role for supplemental vitamin D3 treatment in chronic urticaria: a randomized study. Rorie A, Goldner WS, Lyden E, Poole JA. Ann Allergy Asthma Immunol. 2014 Apr;112(4):376-82. doi: 10.1016/j.anai.2014.01.010. Epub 2014 Feb 5.
http://www.ncbi.nlm.nih.gov/pubmed/24507460
Image source: Urticaria, Wikipedia, public domain.
