Galloway, N.J. - Kelly Dougherty, associate professor of Exercise Science, along with collaborators from The Children’s Hospital of Philadelphia, the University of Pennsylvania and Sapienza University in Italy, recently published a manuscript, “Vitamin D Supplementation Improves Health-Related Quality of Life and Physical Performance in Children with Sickle Cell Disease and in Healthy Children.” The article was published in the renowned Journal of Pediatric Health Care in June 2020, shining light on some very important findings.

A dose of Vitamin D

This research was born from a study they conducted in 2011 which showed that maximum muscle strength and peak power were lower in children with sickle cell disease compared to their healthy counterparts.

 “Based upon these results, we started to think about possible interventions to try to reverse these deficits. Individuals with sickle cell disease suffer from periodic ‘painful crises,’ and dehydration is one predisposing factor, which is why you may or may not be able to recommend exercise for children with sickle cell disease to reverse these deficits,” Dougherty said. 

“We began to investigate treating these deficits with Vitamin D supplementation. Vitamin D receptors have been found on muscle, and in other populations Vitamin D supplementation resulted in an increase in muscle strength,” Dougherty continued. “Additionally, previous studies showed that suboptimal Vitamin D status is prevalent in those with sickle cell disease. We wondered if something as readily available and relatively inexpensive as Vitamin D could reverse these deficits in muscle strength and peak power?”

The next step was conducting a dose-finding study to determine what dose would achieve optimal Vitamin D status in those with sickle cell disease. The group assessed the safety and efficacy of two oral daily doses (4,000 vs. 7,000 IU) of cholecalciferol (Vitamin D₃) over a 12-week period in children and young adults with sickle cell disease and healthy controls. 

Results shine light 

“Results showed that daily oral high-dose D₃ supplementation of 4,000 and 7,000 IU was safe and well-tolerated. In both children and young adults with sickle cell disease and controls by 12 weeks, both doses significantly increased Vitamin D status; however, deficient (<20 ng/mL) Vitamin D status was eliminated only in those receiving 7000 IU/d,” Dougherty said. “We also found improvements in hematology and inflammatory status with Vitamin D supplementation in those with sickle cell disease. As part of the dose-finding study, we also assessed health-related quality of life, neuromuscular skills and muscle strength and function, which is the focus of the latest publication.”

The present study published in the Journal of Pediatric Health Care revealed that Vitamin D supplementation for African American children with and without sickle cell disease improved health-related quality of life and physical performance. Specifically, in subjects with sickle cell disease, significant reductions in pain, fatigue and depressive symptoms and improved upper-extremity function were observed with Vitamin D supplementation.

“Vitamin D supplementation may prove to be an effective and feasible treatment for symptoms and prevention of complications for people of all ages living with sickle cell disease in the United States and around the world,” she said. “Considering that in this study cohort, only the 7,000 IU/day dose effectively treated deficiency (25(OH)D of < 20 ng/mL) in both those with sickle cell disease and healthy participants, our next step will be to conduct the full-scale randomized, double-blind placebo-controlled trials to test the impact of higher Vitamin D doses on health-related quality of life and physical performance in children and young adults with sickle cell disease and their healthy counterparts.”

When asked about the significance of The Journal of Pediatric Health Care publishing the recent article, Dougherty commented, “We wanted the results of this study to reach clinicians treating individuals with sickle cell disease. As a result of this series of studies, clinicians at The Children’s Hospital of Philadelphia have begun prescribing Vitamin D supplementation for children with sickle cell disease.”

Reported by Mandee McCullough