Comment by synaesthesisx | Hacker News Reader

Comment by synaesthesisx | Hacker News Reader

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So this is extremely interesting, because recently several studies have shown an association between low Vitamin D levels and severe COVID-19 outcomes. This is particularly relevant, because Vitamin D appears to play a role in clotting factors as well; low Vitamin D levels have been independently associated with an increased risk of clotting events and death. There are studies investigating whether Vitamin D deficiency can cause increased thrombin generation and a hypercoagulable state.

"Of 49 patients with mild symptoms of Covid-19 in three hospitals in southern Asian countries, only two had low levels of vitamin D; of 104 patients with critical or severe symptoms, only four did not have low levels of vitamin D." https://www.telegraph.co.uk/news/2020/05/03/time-take-seriou...

"The VDI (Vitamin D Insufficiency) prevalence in ICU patients was 84.6%, vs. 57.1% in floor patients. Strikingly, 100% of ICU patients less than 75 years old had VDI. Coagulopathy was present in 62.5% of ICU COVID-19 patients, and 92.3% were lymphocytopenic. Conclusions: VDI is highly prevalent in severe COVID-19 patients" https://www.medrxiv.org/content/10.1101/2020.04.24.20075838v...

"Vitamin D has been shown to have an anticoagulant effect. A decrease in 25-hydroxyvitamin D [25(OH)D] concentration has also been associated with an increased risk of venous thromboembolism. " https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4069050/

There is also other literature suggesting that Vitamin D can reduce the risk for the "cytokine storm" which leads to acute respiratory distress syndrome by reducing the production of pro-inflammatory cytokines (while increasing the expression of anti-inflammatory cytokines). Again, I'm not a doctor but supplementation is likely to be fairly low risk. There is increasing evidence that there's some sort of correlation and it may be worth exploring.

You might want to take Vitamin K along with your Vitamin D, particularly if you're taking large doses of the latter, which can cause calcification of the soft tissues in your body, while Vitamin K makes sure that calcium gets deposited in your bones, as it should. Here is one of many articles that talks about the connection:

https://www.healthline.com/nutrition/vitamin-d-and-vitamin-k

Vitamin K also increases risk of blood clots. https://health.clevelandclinic.org/vitamin-k-can-dangerous-t...

When you get a blood clot, Warfarin that they give you for it is literally a vitamin K blocker.

Warfarin is also literally used as rat poison, with the same mechanism of action.

"The dose makes the poison."

Botox is a pretty powerful tool for doctors when applied locally in small quantities, but often fatal in Botulism. Water is necessary for life, but hyponatremia is a real thing.

To my understanding, not if you don't take warfarin. There's no upper limit of vitamin K intake for healthy people.

There's also a connection with magnesium.

https://www.livescience.com/61866-magnesium-vitamin-d.html

Yep. K2 MK7 specifically. Cheese (most) and natto are good dietary sources of K2. The better D3 supps are formulated with an optimal D3 to K2 ratio.

I believe Vit K deficiency is less common than Vit D deficiency

vitamin K deficiency is also associated with covid19 symptoms.

https://www.preprints.org/manuscript/202004.0457/v1

This is interesting, because although circumstantial, what's happened here in Iceland, is that we have had markedly better outcomes than other countries. If you're interested:

http://covid.is

It would be correct to think that at 66 degrees north, and a lot of cloud cover, there is significant risk for Vitamin D deficiency. The consequence is near religious attention to taking fish oil supplements. Doctors routinely screen, Vitamin D tablets are prominently on sale in all the supermarkets etc. It's definitely a data point.

Iceland is also far less densely populated

Honest question, is that relevant? Two thirds of the population live in the capital region, measuring just over 1% of the area of the country. Iceland is according to some measures one of the most urbanized countries in the world [0]. The virus can't "feel" there are vast swathes of uninhabited land out there, can it?

0: https://en.m.wikipedia.org/wiki/Urbanization_by_country

No packed mass transit like other dense urban centers. Even their "urban center" is much less dense than other cities.

Yes but the population of Island (364K) is way less than many other countries, so it's much easier to control the disease.

To put things in perspective, the US population is 328M.

The population of Iceland is also highly concentrated in one spot on the west of the island. We're talking over 1/3 of the country. If you take in the Greater Reykjavik area, you're talking about 2/3 of the population.

People bring this up when it comes to smaller countries, but it doesn't take into account population concentration, which is much more important than sheer population size or density.

Iceland has been very effective.

takes 4000iu vitamin D pill What me, easily marketed to?

I wonder if any of the results show supplements work as well as diet/sunlight?

They can be, but the oral absorption pathways are complicated. You need to be sufficient in other vitamins, I can’t remember which, in order to absorb vitamin D from your food.

Generally it’s recommended that sun > supplements, for a few reasons. But if you can’t get some sunlight supplements are not a bad choice at all.

> sun > supplements This is interesting, a recent article/study mentioned this, it appears that there is a link between sunlight and lower blood pressure in dialysis patients among other benefits. It would also explain why death rates/severe covid-19 in warmer climates is lower than colder climates.

https://www.outsideonline.com/2410015/sun-exposure-blood-pre...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5593895/

sun exposure increases nitric oxide which decreases bp

Ecuador (literally on the equator) being the catastrophic and tragic exception.

Sunlight involves going outside, which we know is good for your health (barring pollution, of course).

Also, and probably the direct mechanism of action, sun exposure doesn’t just produce vitamin d. It also increases nitric oxide levels which should reduce BP

——

People are taking more walks and runs in my neighborhood than ever before. Social distancing != hiding indoors.

Patios and yards exist, you know.

Mine doesn't.

For many people diet/sunlight is insufficient - there's a host of cofactors and things that probably play a role in this. I'm not too sure on just how effective supplements are but I've personally used them to raise my serum D levels with success.

> because recently several studies have shown an association between low Vitamin D levels and severe COVID-19 outcomes

Closer research shows it probably isn't relevant.

https://www.cebm.net/covid-19/vitamin-d-a-rapid-review-of-th...

I'm glad someone has looked into but it doesn't confirm or deny much. They were -measuring mortality- against those already infected and those "instituionalized but asymptomatic". It doesn't seem to say anything about making symptoms milder for those that contracted covid-19 after taking supplements or for those who have already contracted, which is what I think OP was suggesting.

How do you get to that conclusion from that paper?

All I see from that paper is that there is "no evidence" that Vitamin D is beneficial with COVID-19 (and some qualified evidence that it may help other respiratory infections).

They mentions several planned/registered studies on the question, but none that have reported results yet.

That’s calling out a lack of formal trials providing evidence, not discrediting the data that is emerging.

Either way, they still recommend supplementing if deficient(which the numbers for people with IVD are quite high in most regions).

In India,one of the slogans of Lockdown is Stay Home,Stay Safe. I think many other countries have urged their citizens to stay at home aswell.

My concern is, if the risk of transmission is more indoors than outdoors as this study indicates(https://theprint.in/health/sharing-indoor-space-major-infect...), Is staying at home making people Vit-D deficient coz of less exposure to sunlight?

And If this is true, is it one of the factors responsible for severe Covid19 outcomes?

Is this also the reason why old folks are severely affected from Covid19, coz they may tend to stay indoors more, relative to other age groups?

"Stay home, stay safe" only works if the other people in your home stay home too. It's not surprising people get infected indoors - one sick person in a household, office building, or restaurant will infect those nearby. You're far less likely to get it from a random passerby on the sidewalk, as your exposure time is much more limited.

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