ADJUNCTIVE VITAMIN D IN ALLERGIC RHINITIS: A RANDOMIZED CONTROLLED STUDY
DOI:
https://doi.org/10.67772/25w0pj45Keywords:
Allergic rhinitis, Vitamin D, Total Nasal Symptom Score, Fluticasone, SupplementationAbstract
Allergic rhinitis (AR) is a very common chronic inflammatory condition of the nasal mucosa, which has a negative impact on life, sleep and productivity. The immunomodulatory effects of vitamin D (Vit D) have been well established and its effects on allergic inflammation are likely but the effects of Vit D as an adjunctive therapy for AR is still being studied. We conducted a randomized controlled trial to assess the effectiveness of Vit D supplementation, in addition to intranasal corticosteroid therapy, in Vit D deficient patients with allergic rhinitis. A total of 300 patients were evaluated and 110 who had 20-29 ng/mL of serum 25-hydroxyVit D were randomly divided into two groups of 55 patients. Fluticasone alone was given to Group A and fluticasone in combination with Vit D to Group B. Total Nasal Symptom Score (TNSS) was evaluated at baseline, 4 weeks and 8 weeks, and the serum Vit D was measured. 80% of screened patients were found to have hypovitaminosis D. The TNSS gradually decreased in both groups, but Group B showed more improvement from 8.15 at baseline to 4.90 at 4 weeks and 2.77 at 8 weeks, while Group A went from 8.35 at baseline to 6.80 at 4 weeks and 5.24 at 8 weeks. There was a significant difference between the two groups in the post-treatment (p < 0.0001). Vit D could thus be an adjunctive medication providing extra symptomatic relief in Vit D deficient allergic rhinitis patients.
References
1.Akdis, C. A., & Agache, I. (Eds.). (2014). Global atlas of allergy. European Academy of Allergy and Clinical Immunology.
2.Arshi, S., Ghalehbaghi, B., Kamrava, S. K., & Aminlou, M. (2012). Vitamin D serum levels in allergic rhinitis: any difference from normal population?. Asia Pacific Allergy, 2(1), 45.
3.Arshi, S., Ghalehbaghi, B., Kamrava, S. K., & Aminlou, M. (2012). Vitamin D serum levels in allergic rhinitis: any difference from normal population?. Asia Pacific Allergy, 2(1), 45.
4.Bakhshaee, M., Sharifian, M., Esmatinia, F., Rasoulian, B., & Mohebbi, M. (2019). Therapeutic effect of vitamin D supplementation on allergic rhinitis. European Archives of Oto-Rhino-Laryngology, 276(10), 2797-2801.
5.Bhardwaj, B., & Singh, J. (2021). Efficacy of vitamin D supplementation in allergic rhinitis. Indian Journal of Otolaryngology and Head & Neck Surgery, 73(2), 152-159.
6.Blaiss, M. S. (2010, September). Allergic rhinitis: Direct and indirect costs. In Allergy & Asthma Proceedings (Vol. 31, No. 5, p. 375).
7.Bousquet, J., Khaltaev, N., Cruz, A. A., Denburg, J., Fokkens, W. J., Togias, A., ... & Williams, D. (2008). Allergic rhinitis and its impact on asthma (ARIA) 2008. Allergy, 63, 8-160.
8.Bousquet, J., Van Cauwenberge, P., & Khaltaev, N. (2001). Allergic rhinitis and its impact on asthma. Journal of allergy and clinical immunology, 108(5), S147-S334.
9.Brożek, J. L., Bousquet, J., Agache, I., Agarwal, A., Bachert, C., Bosnic-Anticevich, S., ... & Schünemann, H. J. (2017). Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines—2016 revision. Journal of Allergy and Clinical Immunology, 140(4), 950-958.
10.Chiewchalermsri, C., Sangkanjanavanich, S., Pradubpongsa, P., Mitthamsiri, W., Jaisupa, N., Jindarat, S., ... & Boonpiyathad, T. (2023). Randomized, double-blind, placebo-controlled trial of vitamin D supplementation in the build-up phase of house dust mite-specific immunotherapy. Allergy, Asthma & Immunology Research, 15(3), 336.
11.Demain, J. G., Choi, Y. J., & Oh, J. W. (2021). The impact of climate change on the pollen allergy and sporulation of allergic fungi. Current Treatment Options in Allergy, 8(1), 60-73.
12.Galli, S. J., Tsai, M., & Piliponsky, A. M. (2008). The development of allergic inflammation. Nature, 454(7203), 445-454.
13.Greiner, A. N., Hellings, P. W., Rotiroti, G., & Scadding, G. K. (2011). Allergic rhinitis. The Lancet, 378(9809), 2112-2122.
14.Grossman, J. (1997). One airway, one disease. Chest, 111(2), 11S-16S.
15.Guo, M. (2023). Vitamin D supplementation improves the therapeutic effect of mometasone on allergic rhinitis. Acta Biochim Pol, 70(3), 583-9.
16.Kawada, K., Sato, C., Ishida, T., Nagao, Y., Yamamoto, T., Jobu, K., ... & Abe, S. (2025). Vitamin D supplementation and allergic rhinitis: A systematic review and meta-analysis. Medicina, 61(2), 355.
17.Li, L., Cui, X., Zhang, X., Zheng, L., Sun, X., Yang, C., ... & Liu, G. (2023). Serum vitamin D3 deficiency can affect the efficacy of sublingual immunotherapy in children with allergic rhinitis: a retrospective cohort study. Journal of thoracic disease, 15(2), 649.
18.Mahesh, P. A., Moitra, S., Mabalirajan, U., Garg, M., Malamardi, S., Vedanthan, P. K., ... & Krishna, M. T. (2023). Allergic diseases in India–Prevalence, risk factors and current challenges. Clinical & Experimental Allergy, 53(3), 276-294.
19.Modh, D., Katarkar, A., Thakkar, B., Jain, A., Shah, P., & Joshi, K. (2014). Role of vitamin D supplementation in allergic rhinitis. Indian Journal of Allergy, Asthma and Immunology, 28(1), 35-39.
20.Park, S. C., & Park, D. Y. (2024). Vitamin D deficiency as a contributing factor to chronic rhinitis in middle-aged and older adults: an epidemiological study. Nutrients, 16(19), 3385.
21.Pawankar, R., Canonica, G. W., Holgate, S. T., Lockey, R. F., & Blaiss, M. (2011). World Allergy Organization (WAO) white book on allergy. Wisconsin: World Allergy Organisation.
22.Singh, A. K., Shaili, S., Siddiqui, A., Ali, A., Choubey, A., Jain, P., ... & Iqbal, Z. (2025). Unravelling allergic rhinitis: exploring pathophysiology, advances in treatment, and future directions. Frontiers in Allergy, 6, 1636415.
23.Small, P., Keith, P. K., & Kim, H. (2018). Allergic rhinitis. Allergy, asthma & clinical immunology, 14(Suppl 2), 51.
24.Tian, H. Q., & Cheng, L. (2017). The role of vitamin D in allergic rhinitis. Asia Pacific Allergy, 7(2), 65.
25.Wallace, D. V., Dykewicz, M. S., Bernstein, D. I., Blessing-Moore, J., Cox, L., Khan, D. A., ... & Tilles, S. A. (2008). The diagnosis and management of rhinitis: an updated practice parameter. Journal of allergy and clinical immunology, 122(2), S1-S84.
26.Wjst, M., & Hyppönen, E. (2007). Vitamin D serum levels and allergic rhinitis. Allergy, 62(9), 1085-1086.
27.Zhang, P., Xu, Q., & Zhu, R. (2024). Vitamin D and allergic diseases. Frontiers in immunology, 15, 1420883.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Author
This work is licensed under a Creative Commons Attribution 4.0 International License.
