Vitamin D and Inflammation: Potential Implications for Severity of Covid-19
imj.ie
imj.ie
a) 95% of severe covid cases in Indonesia had vitamin D deficiency (n=780)
b) Darker skin in high latitudes is strongly correlated with vitamin D deficiency
c) In Sweden, Somali immigrants make up 40% of the covid hospitalizations despite being .8% of the population.
d) Vitamin D is also a hormone that regulates up to 5% of all gene expression while your immune system cells have vitamin D receptors
e) 70% of Americans have insufficient (a step above deficient) Vitamin D levels
[1] https://www.youtube.com/watch?v=45rlZGRz6Qo&feature=youtu.be,
Then they point to two studies that show that Omega 3 and Vitamin D lenghtened or maintained telomere length against control groups.
The benefits of sauna are supported in a similar fashion.
You can argue that the studies are of poor quality, but that is true for most studies regarding medicine and especially nutrition. You gotta take a chance either way.
See the references below from The Journal of the American Medical Association (JAMA), The New England Journal of Medicine (NEJM), and Dr. Patrick who has interviewed the original researcher.
[1] https://media.jamanetwork.com/news-item/sauna-use-associated...
[2] https://www.jwatch.org/fw109897/2015/02/24/sauna-use-linked-...
[3] https://www.foundmyfitness.com/episodes/sauna-heart-presenta...
Here is another paper with similarly stark data: [2] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3571484
Table 1 in each of those papers show Vitamin D status vs Outcomes. The correlation between Vitamin D status, where Normal is >30 ng/ml (or 75 nmol/L), and death rates is stark.
From [1] (which had n=780 cases) here is the punchline: "98.9% of Vitamin D deficient cases died while only 1.1% of them were active cases. 87.8% of Vitamin D insufficient cases died while only 12.2% of them were active cases. Only 4.1% of cases with normal Vitamin D levels died while 95.9% of them were active cases."
From [2] (which had n=212 cases) here is the punchline: "Of the 212 (100.0%) cases of Covid-2019, 49 (23.1%) were identified mild, 59 (27.8%) were ordinary, 56 (26.4%) were severe, and 48 (22.6%) were critical (Table 1). Mean serum 25(OH)D level was 23.8 ng/ml. Serum 25(OH)D level of cases with mild outcome was 31.2 ng/ml, 27.4 ng/ml for ordinary, 21.2 ng/ml for severe, and 17.1 ng/ml for critical."
Note: the classification for outcomes was "(1) mild – mild clinical features without pneumonia diagnosis, (2) ordinary – confirmed pneumonia in chest computer tomography with fever and other respiratory symptoms, (3) severe – hypoxia (at most 93% oxygen saturation) and respiratory distress or abnormal blood gas analysis results (PaCO2 >50 mm Hg or PaO2 < 0 mm Hg), and (4) critical – respiratory failure requiring intensive case monitoring."
I want to see a dozen more studies like [1] and [2] to see if this holds up to replication.
The show notes for the parent video are quite comprehensive with links to references. The summary above leaves out the detailed discussion of the interplay between Vitamin D, the renin-angiotensin-system, the ACE2 receptor, and SARS-CoV-2: [3] https://www.foundmyfitness.com/episodes/vitamin-d-covid-19
Interestingly, these papers together are much stronger evidence than either apart. This is because they use different methods. The OP is a population level study, while the second link you shared is a retrospective individual level study.
While I have some concerns with the stats in both papers (I'm always suspicious of p-values close to the magic number of 0.05), this does seem like interesting research, and potentially very helpful to dealing with Covid-19.
The irony of course, is that I suspect many of the Northern latitude people with high levels of Vit-D may be getting it through tourism to Southern Europe, which is very unlikely to happen this year.
Also pickled herring is a delicacy in the many countries which have fared well in Europe in the fight against covid 19.
Also oily fish like salmon and mackerel are good for vitamin D.
Yet for many Brits it's a fish we rarely consider but is one of the biggest Concerns about the UK denying access to EU nation's to certain waters I believe with Brexit.
This number seems high, but may be accurate for northen Stockholm (hard to check as only confirmed infections and deaths are tracked in available statistics). Certainly not for the whole of Sweden. Anyway, while the vitamin D deficency may be a part of it, many Somali immigrants live in apartments with a lot of family, often multiple generations.
So, social class is the main factor.
Also, one medical doctor of Somali decent in Stockholm said that it was hard to reach the Somalis with information on good prevention, as health info was at first only available in Swedish and the official minority languages plus English and Arabic. Information in Somali is available now.
This article (about the Assyrian-Syriac immigrants, who aren't as dark skinned as Somali, but are also hard hit) explains how they come into contact with a lot more sick people and thus transmit it:
Earlier this month, the country’s public health agency reported that people in Sweden with foreign backgrounds are disproportionately represented among those who need hospitalization.
That squares with the experience of Terez Kino, a resident of the city of Södertälje and member of its large population of Assyrian-Syriacs, an ethnic minority scattered across Turkey, Syria, and Iraq. She used to have five carers, all of immigrant background as well, who would come to her home and tend to her needs. Four are now sick at home with virus symptoms. Her elderly sister has also contracted the virus from her carers, and her brother recently died of the virus. Her son is now taking care of her.
https://www.csmonitor.com/World/Europe/2020/0427/With-scienc...
Lack of information in Swedish had very little to do with why Somalis contracted the virus. Tegnell even pointed this out.
Indonesia is a developing nation, with most people still laboring as rice farmers and making $1 - $2 per day.
I'm sure they're deficient with any vitamin not found in rice, which they eat 3 times per day. (Rice is packed with calories, not vitamins.)
Also, due to corona, there is starvation in the cities. In the West, we use automation to ship groceries, but in Indonesia they unload trucks using manual labor. So the lockdown means they can't unload food trucks, or it gets delayed.
Additionally, many people have no income, or 50% of their former low office salary, and Indonesia is not a welfare state, so people cannot afford food at this time. Very tragic example of lower-income group receiving the worst treatment during this pandemic, basically famine.
It's totally unrealistic to expect them to hang on until 2022.
Vitamin D generally comes from sun exposure, and people laboring outdoors are extremely unlikely to be suffering of this particular deficiency.
It's more likely to be older people who spend all their time indoors.
It'd be interesting to see this controlled for age of deaths.
The problem occurs when people in the same ethnic groups (with the same dark skin) start working indoors and actively avoiding sunlight (often because light-colored skin is seen as high class or aesthetically pleasing).
Not sure what the downvotes are about in this case.
Multiple times in the past days weak studies indicating some beneficial effect of Vitamin D have been posted here. None of them looked like anything even remotely conclusive. This one just cries "confounder!".
But in the comments below a large number of people seem convinced that this is definitive evidence and that they always knew their Vitamin D pills are some kind of magic.
I don't tan either. Sun up here can still give you cancer, and the days are looooooong during the summer.
I've also found that the direct light-on-my-eyeballs has a big difference in waking me up and making me active.
- Dr. Seheult's: https://www.youtube.com/watch?v=NM2A2xNLWR4&t=821s - Dr John Campbell: https://www.youtube.com/watch?v=GCSXNGc7pfs&t=29s
It's cheap and has minimal downside. Pre-covid it was already known to "reduce symptoms of colds or influenza"[0].
[0] Benefits of Vitamin D Supplementation - Journal of American Physicians and Surgeons https://www.grc.com/health/pdf/Benefits_of_Vitamin_D_Supplem...
At this point I'm convinced vitamin supplements are a scam in 99% of situations. The only time they're useful is when you have an actual deficiency as prescribed by your primary doctor.
“The major natural source of the vitamin is synthesis of cholecalciferol in the lower layers of skin epidermis through a chemical reaction that is dependent on sun exposure (specifically UVB radiation)”
https://en.m.wikipedia.org/wiki/Vitamin_D
Which unfortunately doesn’t work well in the winter depending on how far you are from the equator.
It’s fat soluble so levels can be tested.
Actually it's when UVB rays hit the skin, and only during certain times of the day, and north of 37 degrees only during part of the year.
In order to get enough UVB rays to make Vitamin D you need sunlight from around noon, during spring summer and fall
“Except during the summer months, the skin makes little if any vitamin D from the sun at latitudes above 37 degrees north”[1].
Also everybody’s production of vitamin D is different. There are plenty of people who work outside all day and still have insufficient levels.
[1] https://www.health.harvard.edu/staying-healthy/time-for-more...
All of the research on Vit D suggests it has a much stronger impact on wellness than most supplements. I remember a list of "supplements proven to improve performance by studies" and it was basically steroids, creatine, and vitamin D; everything else was marginal or not backed by research.
If there is a pandemic unfolding and low Vitamin D is very strongly correlated with severe disease outcome, I do not wait for some study to conclusively prove that Vitamin D is a causal factor. I pop those 4000 IU pills and hope for the best, because the potential upside is far greater than the downside.
1) A whole lot of people are deficient so could benefit from supplementation anyway, and
2) Supplementation is safe and inexpensive.
As far as potential treatments go, sure, it could turn out to be nothing. But the risk/reward ratio is favorable.
It's probably safe to assume that our not-too-distant ancestors spent a lot more time outside, probably with less clothes, and more skin exposed to the sun.
"EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to vitamin D and contribution to the normal function of the immune system. The Panel considers that vitamin D is sufficiently characterised. Contribution to the normal function of the immune system is a beneficial physiological effect for children. The Panel had previously assessed a claim on vitamin D and contribution to the normal function of the immune system with a favourable outcome. The target population was the general population. The Panel considered that vitamin D plays a regulatory role in the functioning of the immune system. The Panel considers that the role of vitamin D in the functioning of the immune system applies to all ages, including children."
https://www.efsa.europa.eu/sites/default/files/consultation/...
No magic involved as can be determined from a reading of the massive peer-reviewed literature regarding vitamin D.
Taking 1000 IU of Vitamin D a day has pretty much zero risk.
Going outside in the sun around noon, without too much clothing (or sunblock, of course!), for about 15 minutes a day also has pretty much zero risk. (In fact, it likely has benefits other than vitamin D, such as nitric oxide production, which lowers blood pressure.)
There is substantial evidence that these measures would reduce severity of infections such as influenza and covid-19, at very small to zero monetary cost. It's not a certainty, of course, but it is highly unlikely that Vitamin D deficiency is actually protective against covid-19.
Therefore, all public health organizations should be strongly recommending that everyone take 1000 IU of Vitamin D and get some sunlight, and heavily publicizing this recommendation.
The fact that they are not doing this is sadly an indication that the people in charge of these organizations do not actually have a mental orientation of solving the problem. (As you probably know, there are many other indications of this as well.)
Are studies like this done to justify an actual Vitamin D study? They need to take a sample of confirmed COVID patients and test their Vitamin D levels individually.
Maybe the poison doesn’t work for carriers of certain genes. Maybe it’s temperature reactive. Maybe it’ll take weeks to kill.
Just because the King observes something do not make his causal conclusions from that observation valid. Adequate sample-sized statistics aim to bridge that gap.
There ain't no such thing as statistical certainty my friend.
Just thinking.
https://www.medrxiv.org/content/10.1101/2020.04.24.20075838v...
Started reading it and it has an incredibly small sample size. I agree, all these studies are weak. People are rushing to publish any crap they can right now.
https://www.ncbi.nlm.nih.gov/pubmed/32397511 "5-Hydroxyvitamin D Concentrations Are Lower in Patients with Positive PCR for SARS-CoV-2"
First, correlation does not prove causation. This kind of study is fairly common for medical stuff and it's not some double-blind study, so it's rather hard to draw firm conclusions.
Second, I have no doubt Vitamin D plays an important role in immune function. It is one of the vitamins people with cystic fibrosis are typically deficient in and this is a population very prone to respiratory infections, among other things.
But, in the current context some thousands of IUD should be something easy to do.
Like the thyroid risk and iodine for kids: you dont want to have to but you know you can.
Second upside: D is now indicated in depression. And its always be suspected in MS (higher prevelance in women, and in northern hemisphere dark winter economies)
I'm not familiar with these. Can you explain?
Showing that inflammation is causative tends to be the hard part, since it's often a consequence of the underlying damage.
This is perhaps what you read, and doesn't invalidate thre findings here.
I thought that as you age your body slowly loses the ability to synthesize it, hence the need for supplements.
There are a lot of risks to being in UVB light too much, but excess endogenous Vitamin D production isn't one of them.
Better to eat oranges and go outside as much you can: balcony/roof/near private home etc.
Don't be gullible, check your facts!
Not effective?
In the north this happens only during brief periods of time. It’s also usually during office hours...
To rephrase would overdosing something like this actually create skin burning/tanning similar to tanning beds?
Would these lamps be more effective if they pointed the lamps towards exposed arms/legs (greater surface area)?
Amazon results for vitamin D lights seem dubious to me... the only thing I found was some reptile uvb lamps but not sure I want to risk those on myself :-/
It's a junk correlation study, done at a particular time when Southern Europe was hit the worst. If they did it now, with Britain surpassing all those countries they'd get a different result.
Maybe they should do a correlation study of "Vitamin D vs Estimated number of Covid cases in country at date of lockdown" and see what they get.
(Also I'd note they conveniently fail to point out that Northen Italy was hit much more badly than Southern Italy).
They do.. without pointing out that's where the outbreak first originated, or comparing with Southern Italy by offsetting infection dates.
With epidemics the originating location (and the dynamics around it) is the key factor, and their failure to note that is what I'm calling out.
But this is also why any advice from government and WHO "experts" must be taken with a pinch of salt. They're as clueless as anybody else and all of their policies not evidence based, but are based on panic and power grabs.
I suspect there is some correlation the case of Vitamin D though. It has long been known of D's role in immune function and people not getting enough sunlight are often inflicted with various ailments. Fresh air has also been suggested for common colds.
There is also scant evidence that COVID is a serious transmission risk between people in open spaces. Infection appears to be more prevalent when large numbers of people are condensed in closed spaces, such as public transport, clubs etc.
The other elephant in the living room is obesity, which the media don't want to talk about for fear of upsetting or "fat shaming" unhealthy people.
If it does turn out to be the case, then all government advice to "stay at home" so far will have been iatrogenic and the government witchdoctors and henchmen are really contributing to iatrocide in those who are vulnerable when they're forcing lockdown rules through violence or fines.
The position of lockdowns should be completely reversed and official government advice should be to get out, get sunlight, fresh air and exercise in open spaces. This doesn't need to exclude social distancing rules, although it will probably be difficult to achieve in densely packed cities. Fortunately we have plenty of open space in national parks. Trips out are good for mental well-being and can be educational for kids. More picnics now!
The issue with businesses which operate in closed spaces, the restaurants etc, I'm not entirely decided on, but since I believe in personal liberty, it should be ones own decision whether or not they're going to enter these closed spaces and take the risk. Leave it up to the owners and the market to decide their fate. Lockdown is far more damaging than COVID.