Vitamin D deficiency and Covid-19 mortality [pdf]
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I had a doctor tell me to take that dose for at least a few months a few years ago after low levels in my bloodwork during the winter. But I've never known if I should lower the dose to take on a continuing basis or adjust during the summer when I get a little more sun (but I still work in an office/at home so spend a lot of time indoors, especially now).
Specifically, Vitamin K:
Ballegooijen, Adriana J. van, Stefan Pilz, Andreas Tomaschitz, Martin R. Grübler, and Nicolas Verheyen. “The Synergistic Interplay between Vitamins D and K for Bone and Cardiovascular Health: A Narrative Review.” International Journal of Endocrinology 2017 (2017). https://doi.org/10.1155/2017/7454376.
And Magnesium:
Uwitonze, Anne Marie, and Mohammed S. Razzaque. “Role of Magnesium in Vitamin D Activation and Function.” The Journal of the American Osteopathic Association 118, no. 3 (March 1, 2018): 181–89. https://doi.org/10.7556/jaoa.2018.037.
I'm also curious on your thoughts on what you consider high for supplementation, vs say sunlight exposure, as a single MED of sunlight exposure is equivalent to about 10-25K IU of oral supplementation.
Engelsen, Ola. “The Relationship between Ultraviolet Radiation Exposure and Vitamin D Status.” Nutrients 2, no. 5 (May 4, 2010): 482–95. https://doi.org/10.3390/nu2050482.
On the flip side, I've seen that in a recent RCT, that recommended sun exposure guidelines were not sufficient in reversing deficiency:
Lee, Yu-Mi, Se-A Kim, and Duk-Hee Lee. “Can Current Recommendations on Sun Exposure Sufficiently Increase Serum Vitamin D Level?: One-Month Randomized Clinical Trial.” Journal of Korean Medical Science 35, no. 8 (January 22, 2020). https://doi.org/10.3346/jkms.2020.35.e50.
What are your thoughts on the research about low Vit D being caused by inflammation as opposed to the reverse?
Also any thoughts on what form of testing works? Seems like many things tested often have variations that are not routinely tested for.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160567/
My autoimmune disorder was initially diagnosed via positive responses to antibiotics. Normal testing confirmed it later on, so I’ve been highly interested in some of these unusual approaches.
result: 13.3 ng/ml, normal range: 25.0 - 80.0 ng/ml
I'm taking Vitamin D3 Max 125MCG per day, is this "overdose"?
Thanks,
Study confirms vitamin D protects against colds and flu
https://news.harvard.edu/gazette/story/2017/02/study-confirm...
If you're getting 105% of your magnesium from these items, then you're also getting 105% of your Vitamin D before taking any additional Vitamin D supplements/sun exposure.
Adding the 5000IU of Vitamin D3 would be increasing your intake to 5840IU (730% of DRV) - assuming you didn't ingest anything else fortified with Vitamin D.
Finally, do you see much difference in getting to that high blood level of vitamin D from sun exposure vs D in diet (fish, etc) vs supplements?
I recently started trying to get more vitamin D from the sun, a sperti vitamin d lamp, and food, in order to reduce the amount of pills needed for a given IU. I use the dminder app to track estimated blood levels between tests.
(All: when you see issues like this affecting HN threads and feel like doing a good deed, please alert us at hn@ycombinator.com. We see all the emails but often have no idea what's going on in the threads.)
Is it really possible to have enough vitamin d exposure just from diet for someone who lives in a northern state which doesn’t get nearly as many sunny days as a place like florida or california?
I've tried searching the internet before about Vitamin D and it's surprisingly confusing, both about dosage as about intake routine. Also confusing that daily requirements are contested to be way off to our real needs, it's just a lot of misinformation lingering around that I, as a layman, can't really parse it.
There is plenty of magnesium in foods.
Men are recommended a bit over 400 mg magnesium per day.
Black beans are quite rich in magnesium, but you still need to eat more than 3.5 cups of it to get the recommended daily amount of magnesium, or 5 cups of cooked brown rice, spinach? That's 2.5 cups of boiled spinach.
Generally, if you eat between 5-10 cups of solid food each day, you are fine no matter what you eat. But that's a lot of food unless you have a very physically active, job.
It used to be mostly true, when most people had physically demanding jobs, it's not true any more.
https://ods.od.nih.gov/factsheets/Magnesium-HealthProfession...
"National Health and Nutrition Examination Survey (NHANES) of 2013-2016 found that 48% of Americans of all ages ingest less magnesium from food and beverages than their respective EARs; "
No affiliation, not a doctor, etc., just thought this particular essay was well stated.
Thanks for coming here to share your expertise!
The answer is a loss of calcium, so high level found in urine test: if you had way too much vitamin D, then you would start releasing the calcium from your bones.
I don't think that taking calcium supplements would help, because calcium metabolism (https://en.wikipedia.org/wiki/Calcium_metabolism) is much more complex than that.
If you need more information, please ask away.
Last time, i tried 5000IU, but this came after weeks of not taking any D supplement, and I've not taken any since. My reasoning is: that would effectively make the average dose < 400 IU, so shouldn't give me any problems, yet it does. Maybe I'm getting more from the sun than i realize :/
I'm a special case. Trying to explain that is probably a can of worms.
shouldn't give me any problems, yet it does
There may be other factors there, which I could potentially speculate on. But A. It tends to be a can of worms when I start speculating like that and B. You didn't initially give enough info to really warrant such speculation. You only gave enough to make me feel like the safe bet was to comment on the dosage and leave it at that.
A good number of months in and I start getting all of the symptoms - lethargy, constipation, stomach and intestinal pain, urinating very frequently and feeling like I had a kidney infection.
Bloods came back all normal, including vitamin D and calcium. My symptoms chime so much with Vitaminosis D (Vitamin D toxicity) that I wonder whether the serum levels are accurate indicators of such toxicity. Vitamin D is stored in fat and the calcium gets deposited in muscles - two possible mechanisms for this.
However, I do not know for sure. Either way I have been scared sh!tless of self-prescribing anything else. No matter how mundane it seems.
https://info.dralexrinehart.com/articles/vitamin-d-and-vitam...
If your wife wants to write a blog post on the subject, I'm sure there'd be a lot of interest.
> there is virtually no risk of toxicity in supplementing up to 10,000 IU of vitamin D3 daily
https://sci-hub.se/https://www.sciencedirect.com/science/art...
No one who talks about supplementation seems to think a level of 8000 over a long period is necessary to obtain adequate levels.
I think by the same token the recommended supplement level of 600 IU is inadequate to reach a sufficient level. But the paper in question didn’t test their result empirically.
>The authors explicitly point out that each vitamin D supplementation must be accompanied by sufficient vitamin K2. This certainly prevents the rise of the calcium level in the blood, which is often seen as a risk for the supply of vitamin D
People recommend really quite doses: K2-MK7 at 100 to 200mcg, or alternatively K2-MK4 15 to 45 mg (not mcg).
Presumably people on those kind of doses are taking it under medical supervision, or are idiots/under the control of idiots.
I am not a doctor, but without further information it seems that as ever, following the guidance on legit supplies specifically and mainstream medical advice generally is a good rule of thumb.
The extent that covid harms those that are metabolically unfit in many different ways much more than those that are perfectly healthy is still pretty under-discussed imo though, and this is yet another good data point in favor of it, even if Vitamin D is much more of a different proxy than some of the other large correlations we see with covid mortality.
—————-
High dose vitamin D administration in ventilated intensive care unit patients: A pilot double blind randomized controlled trial In the study, patients with vitamin D deficiency (<20ng/ml) were divided into three groups: A placebo group, and two groups that were given different doses of vitamin D. The single administration of 250,000 IU of vitamin D was compared with the single administration of 500,000 IU of vitamin D by injection. In addition, the vitamin D levels were increased to 45 and 55 ng/ml, respectively. While the length of stay of the placebo group at the ICU was 36 days, the 250,000 IU group averaged 25 days and the 500,000 IU group averaged 18 days. This is a smooth halving and means that vitamin D is useful not only in prevention but also in acute cases.
https://www.sciencedirect.com/science/article/pii/S221462371...
——————
Ah, the pdf has a second such study. Mortality almost half less
——————
Intervention was carried out intramuscularly with 300,000 IU of vitamin D. Instead of 28 days only 18 days mechanical ventilation, instead of 29 only 19 on ICU, instead of 61% deaths only 36%.
However, that’s a bit hard to remember so I always have extra on hand. When I have a cold coming on a take a large(r) dose and it certainly seems to help.
Though I agree further study is warranted. The highest vitamin D group actually had the highest mortality after 84 days. Though this group also had the most pre-existing heart conditions by far, so that could account for it.
Ah, there was a second such study in the pdf. Mortality down by almost half.
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Intervention was carried out intramuscularly with 300,000 IU of vitamin D. Instead of 28 days only 18 days mechanical ventilation, instead of 29 only 19 on ICU, instead of 61% deaths only 36%.
Obviously, 250000 IU or 500000 IU is much higher, but this is a one-shot, not a daily dose. If you take 8000 IU daily dose as correct, then those 2 megadoses correspond to a one month or two month intake. Very high indeed, but not absurd
I'm going to add another 2,000 IU daily to see if I can reach the recommended 100 nmol/L from the OP. [3]
[1] https://news.ycombinator.com/item?id=15867918
[2] converter here: https://www.azcalculator.com/calc/vitamin-d-ngml-nmolL-conve...
It's generally been found that larger doses are required to move the blood levels up, but it doesn't seem like people need to remain at those dosages to maintain those levels.
Whenever your conclusion is that the "official recommendations are flawed", and those were in place for a while now, scrutinize your process. Reading a post on social media is rarely paradigm-changing - and when it is, it's overwhelmingly in the wrong direction.
Secondly, the 8k dose doesn't seem realistic historically. Is there any diet that does not include the products of modern tech, that gets anywhere near those levels consistently? Doesn't seem likely.
Megadoses of anything are not without issues. There will be side-effects with vit D, esp. related to calcium, etc.
The data on the possible connection between vit D and respiratory illness is still way more sketchy than most people assume. There is no solid research yet.
---
That being said:
Vit D deficiency is pervasive in a lot of places. Most people would benefit from taking some supplementation.
1000 UI capsules are cheap and readily available. That dose is not far from the various "official" recommendations (which are all over the range of the hundreds, depending on country). There are no known side-effects at that level.
Because historically most vitamin D intake didn't come from diet, but from sunlight exposure. Varying widely depending on how much skin you're exposing, the color of your skin, latitude, season, etc., estimates of vitamin D hourly vitamin D synthesis can be on the order of tens of thousands.
It is plausible that in an ICU situation with limited time a single, even larger dose makes sense. For an individual not critically ill, more gradual daily boosting of vitamin D is possible. The ICU patients didn’t have this time.
We have dozens of RCTs suggesting that vitamin D supplementation prevents respiratory infections[1]. There is a very good chance people could mitigate C19 risk with supplementation.
And I personally trust the vast majority of people to use reasonable enough dosing that overdose is unlikely, especially with appropriate messaging.
Downplaying the risks of low vitamin D (way more prevalent than vitmain D toxicity) seems as dangerous as the early pandemic messaging in the US that masks are ineffective.
Though this is mostly because for 6 months of a year one simply cannot get it the natural way (too cold and sun is too low). And thanks to this we don’t have much deficiency, long time ago we used to have.
Not saying it means it would help with covid. But the supplements definitely help with deficiency in a way that does cure/prevent rickets.
There's research that suggests that the RDA is way too low, plus many adults don't drink a lot of milk, certainly not enough to make significant impact on their vitamin-D intake.
https://www.cdc.gov/nutrition/infantandtoddlernutrition/food...
[1] A Statistical Error in the Estimation of the Recommended Dietary Allowance for Vitamin D, Paul J. Veugelers* and John Paul Ekwaru https://dx.doi.org/10.3390%2Fnu6104472
I'd wager it's the same in all the Nordic countries, at least it's the same here in Sweden.
A couple a months ago when I spoke to my dad, he told me he had a checkup because he had been unusually tired, turned out that the only thing the testing showed was that he had d-vitamin deficiency.
What surprised me is that he was given prescription d-vitamins, since you can buy them anywhere without prescription.
Also there is vitamin D2 and D3. The normal stuff you take is called D2. The D3 is made by the kidneys from converting D2. But those with certain diseases, the kidneys don't do the conversion so they provide vitamin D3 in the form called calcitriol. Its something I need to take due to my kidney failure.
Calcitriol is actually the most confusing of my medications to manage since the dosage needs to be adjusted based on monthly blood tests. Things like amount of sun exposure can swing my numbers around. And it interacts with so many blood test numbers like PTH, phosphorus and calcium levels.
The dosage did work out to be 50x what was in the standard products though.
https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Finland
Edit: Interestingly, the source pdf notes the nordic countries have higher D3 levels than Mediterranean countries. And speculates this may help explain lower incidence up north.
————
The researchers around Petre Cristian Ilie have tested the number of Covid-19 deaths per 1 million inhabitants against the vitamin D level in 20 European countries and come to the following conclusion: The mean vitamin D level in the countries studied (mean 22.4 ng/ml, StDev ±4.24) correlates strictly with the number of Covid-19 infected per million population (mean 295.95, StDev ±298.73, p=0.004) and with mortality (mean 5.96, StDev 15.13, p<0.00001) The death rates in Spain and Italy are much higher than in Scandinavia. The researchers explain this with the statistically significant higher vitamin D level among the inhabitants of the Nordic countries: The study shows that in older people, the average blood vitamin D level in Spain is 10.4 ng/ml, in Italy, 11.2 ng/ml, while in the Scandinavian countries it is 18 ng/ml. The northerners obviously do have the better vitamin D levels, although the sun is not as intense there as in the south. This could either be because they are more active outdoors or because they get more vitamin D from food, e.g. fish, or both. Fat sea fish contains a lot of vitamin D. And southerners tend to spend their midday hours in the shade or indoors. Shadow, window glass and a longer way through the atmosphere (morning/evening, autumn/spring) reduce UVB radiation much more than UVA.
The reasons that the outbreak has been minimal so far here are more complex though. Norwegians natually socially distance. The joke goes, "I am glad the lockdown is over and we can go back to the usual 5 meters - having to stand 1 meter from people was too close". Basically avoiding people for a few weeks was quite easy for many Norwegians. Younger ones tend to live in one bed flats rather than flat shares. Young people don't visit their parents and grandparents as much as they probably should. Also people buy into society and trust their government here. The PM announced a crisis and most people followed the guidelines for several weeks. Compliance dropped after a few weeks but it was clearly sufficient to break the infection chains.
Historically, the diet in that region included fish and other foods rich in vitamin D. I'm not sure what's the typical diet like these days.
But yeah, up north you definitely need to increase the intake of vitamin D. Same as Alaska in the US.
I don't know what you mean by 'a ton', but there is good evidence that Vitamin D supplements do provide much of the same benefit [0] [1].
> Ultraviolet radiation (either from artificial sources or from sunlight) reduces the incidence of viral respiratory infections, as does cod liver oil (which contains vitamin D).
[0] https://pubmed.ncbi.nlm.nih.gov/16959053/
[1] https://sci-hub.se/https://www.sciencedirect.com/science/art...
It's very cheap and safe, so worst case it has less effect than you hope. You can overdose, but you have to really crazy with the dosage.
Also 1: Vitamin D supplements do cure rickets.
Also 2: All of us who eat supplements should show up in the stats as high in vitamin D, so the data does partially cover that case.
That brand is USP certified which means their product is externally certified (through products purchased at stores) to contain the amount of supplement they say it has.
There are some other similar certification programs that you can look for when choosing supplements, but USP seems to be the most rigorous:
https://www.consumerreports.org/supplements/how-to-choose-su...
I've been using a D3 supplement of 5000 IU from NatureWise, for several years. I take one per day depending on the time of year. It's inexpensive, ~$11-12 for a year supply, and it has worked very well. I take it daily throughout Fall & Winter, and then lighten up on it during Summer.
https://originmaine.com/nutrition/jocko-d3-gel-capsules-360c...
I was taking 1,000mg a day and that didn't seem to move the needle on my Vitamin D blood work.
In recent weeks I've been taking 4,000mg/day (with K2), which is 4x what I've had pharmacists recommend.
I plan to keep that up for a couple more weeks while I'm under quarantine (recently flew from a high-risk country to a less high-risk country). After that I'll level off to 2,000mg a day.
But I'm shooting in the dark. I have no idea if 2,000mg/day or 4,000mg/day is too much or not enough.
- Mayo Clinic says "Taking 60,000 international units (IU) a day of vitamin D for several months has been shown to cause toxicity."
- news-medical.net says "To prevent toxicity, tolerable upper intake levels have been fixed for vitamin D as..." 4000 for adults.
- healthline.com says "A daily vitamin D intake of 1000–4000 IU (25–100 micrograms) should be enough to ensure optimal blood levels for most people."
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h...
https://www.news-medical.net/health/Vitamin-D-Overdose.aspx
https://www.healthline.com/nutrition/how-much-vitamin-d-is-t...
https://www.healthline.com/nutrition/vitamin-d-from-sun#time...
Amazon has a few options in the $50-90 range.
You prick your finger, draw a "small amount" of blood, and send it to a lab.
So yes... sunlight does probably way more benefits for us but supplementation if you are deficient is still showing significant effects.
"High dose vitamin D administration in ventilated intensive care unit patients: A pilot double blind randomized controlled trial In the study, patients with vitamin D deficiency (<20ng/ml) were divided into three groups: A placebo group, and two groups that were given different doses of vitamin D. The single administration of 250,000 IU of vitamin D was compared with the single administration of 500,000 IU of vitamin D by injection. In addition, the vitamin D levels were increased to 45 and 55 ng/ml, respectively. While the length of stay of the placebo group at the ICU was 36 days, the 250,000 IU group averaged 25 days and the 500,000 IU group averaged 18 days. This is a smooth halving and means that vitamin D is useful not only in prevention but also in acute cases."
https://news.harvard.edu/gazette/story/2017/02/study-confirm...
University of Colorado Anschutz Medical Campus: Vitamin D reduces respiratory infections
https://www.sciencedaily.com/releases/2016/11/161116103005.h...
Any further reading on that? On the other hand worth supplementation you don’t get the harmful uv rays.
Overexposure to UV rays is what causes trouble.
Slathering on the sunscreen even when not necessary (like walking from point A to point B, or spending 15 minutes outside, is what causes the predominant vitamin D deficiency in the first place.
it wasn't until I committed to getting more sunlight that my levels increased.
I take 5000 IU daily, but also wonder if I'd do better with more sunlight instead.
If there is any truth in what the authors claim, the best they could do is to work with field experts and/or submit their findings to a reputable journal for review and publishing. Someone's health might be on the line following pseudo-scientific works.
https://academic.oup.com/jcem/article/96/7/1911/2833671
You can see that prevalence of deficiency is very high, as this other peer-reviewed study confirms:
https://pubmed.ncbi.nlm.nih.gov/21310306/
In the first article, after correcting the deficiency, the maintenance dose that they give is: 600-1000 IU/d for children; 1500–2000 IU/d for adults; 3000–6000 IU/d for obese. As you can see that's much higher than the current RDA of 400 IU/d.
And to correct the deficiency in the first place, the dose needs to be 2-3 times higher still for 8 weeks.
So around half the people in the US need to be taking a very large dose for 8 weeks, and then a maintenance dose 4-15 times higher than the RDA.
This is all from established studies done long ago that no one has disputed. But their recommendations have yet to be implemented in a lot of places, which might be why some countries fare better than others.
Indeed the first sentence talks about "corona deaths." No qualified medical professional would write that in a paper.
Study confirms vitamin D protects against colds and flu
https://news.harvard.edu/gazette/story/2017/02/study-confirm...
There was just a large trial published in JAMA [1] examining its effectiveness for depression given solid observational data. It was not at all effective.
The reason that Vitamin D is associated with many diseases but is not causative for anything is that Vitamin D level is highly correlated with other metrics of health such as socioeconomic status, active lifestyle, nutritional sufficiency, etc.
We are wasting our time and money looking at Vitamin D again and again and again.
1. https://jamanetwork.com/journals/jama/article-abstract/27689...
Also curious, is it possible that the 15 mins of sunlight per day was the actual cure, rather than the supplements?
There are days where I bask in sunlight and others where I'm mostly in my hidey hole (esp. with the pandemic), so nothing too consistent. My post wasn't too clear about that, but yeah, I had stopped the dermatologist treatments (other than T-Gel shampoo) prior to the Vitamin D thing.
How is it even plausible that sunlight does not have significant health benefits, given that Europeans evolved to have pale skin because they lived in high latitude environments?
No one is arguing that sunlight doesn’t have benefits. We just don’t know if those benefits are mediated through vitamin D (in which case supplementation could be enough!) or something else.
(Perhaps not coincidentally, placebo effects in depression are known to be large).
You rightfully mention a high correlation with other metrics that make, in my opinion, vitamin d health benefits and health disadvantages scientifically impenetrable.
As a tiny datapoint, I refer to the research of the (on hn at least) highly acclaimed Dr. Rhonda Patrick, who states that 70% of Americans are currently deficient on vitD. She also states that vitD has effects on 5% of gene expression, and is very important in the brain formation of foetuses since it assists the production of serotonin.
If anything, and despite of admittedly huge efforts already, vitD is heavily underresearched and many of its mechanisms unexplored.
I seriously doubt that because I think exactly what it does is poorly understood. But we do know that people with cystic fibrosis have serious compromised immune function and, among other things, see terrible, deadly lung infections (and account for a large percentage of lung transplants).
Some of the remarks in this discussion have been helpful to me and I've spent nearly two decades -- ever since my diagnosis in May 2001 -- trying to understand my condition.
New information comes out all the time and new tidbits that are reasonably verifiable as true become building blocks for more complex mental models. I am just beginning to understand things I've been squirreling information away about for a lot of years with a keen interest because my life literally depended upon such understanding.
I have kind of "bookmarked" this discussion, in part to get me ready access to the article it covers. I'm short of sleep today and not following things well and this piece is piquing my curiosity in ways that most discussions of vitamin D fail to do.
I think this is an exciting era in which to be alive if you have a mystery illness that they don't really know how to fix. The amount of information available at your fingertips while literally laying in bed, too sick to get up, overwhelms what I could find at a library as a child. It is game changing in ways that most people seem to fail to appreciate.
I believe there's a plausible mechanism in this case, and related studies on respiratory infections where an effect was found. Also, in terms of studies, often the no effect data is from bolus doses, which don't seem to do a good job moving the needle.
This randomized controlled trial, with 11000 participants "confirms vitamin D protects against colds and flu":
https://news.harvard.edu/gazette/story/2017/02/study-confirm...
(basically saying they correlate, without leaping onto the cause bandwagon)
In this case, 2,000UI is not a significant amount.
Someone in the UK can generate 10,000UI - 20,000UI from spending 5 mins in the midday summer sun.
This amount various depending on whether they are in the countryside, where about 25% of UVB radiation is absorbed by plants or sunbathing on a concrete/sand surface can reflect 100% of the UVB upwards. If sunbathing in a polluted area, the low level ozone can also reduce the UVB radiation reaching the ground depending on the pollution levels.
The Vit D Receptor has a zinc finger which is seems to only be structural, so it would seem that without enough zinc in the diet, even the 2776 VDR's in the human body according to the Wellcome Trust, Cambridge Aug 2010, most of which are concentrated around the immune system genes wont function optimally.
A point worth noting about Vit D3 supplements derived from Lanolin, aka Sheep Fat/Oil, as most sheep are dipped in organophosphates (Nerve Agents), there is a chance that you could be exposing yourself to harmful residual levels of organophosphates. I've yet to see any legislation which monitors this in Vit D supplements in any region of the world (if you know of any please reply so I can update), so megadosing Vit D3 supplements could be increasing the tiny residual amounts of organophosphates to significant and possibly harmful levels. In a study on different Vit D3 specific supplements, the amounts quoted also varied significantly.
Its also worth noting that due to the way patents work, manufacturers of Vit D serum levels measuring equipment use different methods and markers to calculate your serum 25(O)HD levels, 10 years on, the medical equipment is still not standardised as noted here. https://ods.od.nih.gov/Research/vdsp.aspx In my own limited tests using NHS equipment, the amounts measured varied by 45%.
Like all fat soluble vitamins, D3 (25(O)HD) also has a half life of about 28days so you could do what I have done in the past and purchase some UVB reptile flo tubes and bask under them during the winter months for a few hours a day to monitor serum levels. https://www.reptilecentre.com/blog/2016/09/difference-t8-t5-... If you want to know how UVB levels vary around the world, this is a good resource http://www.uvguide.co.uk/ reptiles like some other mammals also need UVB radiation for good health.
I could go on, I dont agree with some professors in this field, sometimes science seems to be a scientific Ash conformity experiment which can prevent you from becoming a qualified expert and harm your health but as always with health, there is no panacea and a variety of factors influence our health. For example if your kidneys and/or liver are not healthy you wont be able to make as much Vit D. Diet also plays a part, but if you should find yourself getting into hypercalcaemia territory, increase your Vit K intake, eg eat Brussel Sprouts, and increase your Leucine and Lysine intake as these keto amino acids also stimulate all type collagen synthesis and can reduce the calcium in the blood stream.
As the airways are the main entry point, it would seem logical to increase Vit A intake because this is required by all epithilial cells as is choline for cell membrane integrity, and choline also helps to reduce the pressure in alveoli to facilitate gas exchange which also increases physical performance but could make it easier to breath when on a ventilator and Choline also helps clean the blood through methylation. Epithelial cells secrete things, so those two supplements will enable the lungs and airway secretions to work properly producing enough functional mucous in order to trap pathogens before it even gets into the lungs where the real damage can take place. Like I said it would seem logical to do this, but I'm not an expert, just a self taught IT geek like many of you guys. :-)
https://www.nih.gov/news-events/news-releases/influenza-huma...
Why do people tend to get sick in the wintertime and not the summer?
But why do people get more sick in the winter, when they are forced into close proximity with other people, making illness easier to spread, rather than the summer, when people are outdoors more, and can do things like walk to work in the warm summer sun rather than take the bus in the cold winter rain and snow? Stated differently, we naturally do more social distancing in the summer.
Social distancing in summer as a reason why people don't get sick is an interesting theory, any studies that support it?
There are lots of reasons for that. Vitamin-D is just one of those theories. There are also behavioral changes, such as people spending more time indoors and in sealed spaces. There is also the fact that certain viruses may survive better in colder, drier climates. There are also some theories that particles evaporate more quickly in the heat.
Not to mention... humans started wearing closes about 100,000 years ago.
Clothes sure, but still were outside in the sunlight during most of the day without sunblock. Take a look at hunter gather tribes still alive today. Not a whole lot of clothes! But sure, some.
https://news.ycombinator.com/item?id=23023703
https://news.ycombinator.com/item?id=22463713
https://news.ycombinator.com/item?id=23119949
https://news.ycombinator.com/item?id=23390264
https://news.ycombinator.com/item?id=23349962
https://news.ycombinator.com/item?id=23167802
https://news.ycombinator.com/item?id=23188675
https://news.ycombinator.com/item?id=23083619
https://news.ycombinator.com/item?id=22600685
[0] https://hn.algolia.com/?dateRange=pastYear&page=0&prefix=tru...
To be clear, I'm not saying vitamin D deficiency in relation to Covid mortality isn't a valid line of inquiry for the health community to take their research in. But from what I can tell, this is far outside the authors' areas of expertise.
I'd say this kind of thing in particular has the potentially to be even more dangerous than irresponsibly discussing the effects of something like hydroxychloroquine, because so many people don't realize how dangerous vitamins and other such 'natural' remedies can be when taken without the supervision of a medical professional.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3447083/ https://www.cantonmercy.org/healthchat/42-percent-of-america... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6075634/
I agree that causation hasn't been completely proven, but there's a lot of data to support it could be causative.
> After correction for age, sex and previous illnesses, the risk of death is 10 times higher for people with vitamin D deficiency.
That said, it could still be correlative and not causative with some different underlying health issue.
On the other hand, maybe Vitamin D deficiency is the cause or one the causes of those underlying health issues.
Per Nicholas Taleb this is "optionality", very low risk and potentially very high reward.
https://www.thelancet.com/journals/landia/article/PIIS2213-8...
Research paper warning alarm sounding here.
This is a hugely overstated conclusion - and none of the studies presented are able to make causal claims to back this up. This is a load of malarkey.
Instead I sent a letter full of references to published research, and citing other letters (peer reviewed) urging public health officials to recommend safe levels of supplementation. I received 0 engagement. I should really send the letter every day until someone responds.
Aside from all of the promising anecdotal evidence and population studies, there is plenty of established theory to understand just how Vitamin D might help lessen the load of Covid-19. Decades of published, reviewed research have shown that Vitamin D:
- helps regulate calcium metabolism and ionization... disregulated calcium levels are also linked to poor covid outcomes
- downregulates some of the same inflammatory cytokines involved in the positive feedback loops seen in bad covid cases
- directly regulates the expression of ACE-2 genes
- regulates the renin-angiotensin system
- regulates circadian rhythm
Other supplements that work with Vitamin D to help regulate calcium metabolism and ionization are also promising, including K2 and magnesium.
https://www.medrxiv.org/content/10.1101/2020.06.01.20112334v...
A friend of mine who's a doctor also told me that a lot of people with bad covid outcomes just have general electrolyte imbalances. To what degree is this pandemic just a manifestation of basic malnutrition on a massive scale?
At this point, I've come to the conclusion that there is a systemic conflict of interest in many health systems around the world. It's most blatant in the US. Specifically: It seems that there are certain "neo-Malthusian" individuals high up in the chains of command who simply have no interest in implementing low risk, low cost measures that prevent loss of life, and instead use their power to further cater to the already privileged groups of people they deem fit for life. This goes beyond covid-19.
In line with how Monsanto covered up studies showing the dangers of Roundup (and faked other studies that indicated no danger, and did a fair bit of astroturfing, iirc), I'd expect to see a lot of misinformation in the future about the ineffectiveness - maybe even the danger? - of Vitamin D supplements.
Quite why there is so much objection to something that is likely a good thing in any case makes you wonder what the issue is with it.
https://www.thelancet.com/journals/landia/article/PIIS2213-8...
People with the power to regulate health care "markets", to shape the incentive structures and make them less overtly biased in favor of wealthy people, sometimes they do this and sometimes they don't. Currently, at least in the US, in the midst of this unfolding crisis, the power balance seems skewed toward the "let's take a violent trek toward 'herd immunity' as soon as possible" decision makers, many of whom are more or less blatantly eugenic.
It sounds like you have too much confidence in published research and not enough confidence in your local health officials.
I can't figure out if you're being sarcastic, or if you really do think that a local politician knows more about medicine than is contained in actual medical research.
Do you actually know that?
> In other words, correlation does not imply causation.
Sorry, but just because correlation does not imply causation doesn't mean that Vitamin D deficiency isn't a cause.
Especially the push for new expensive drugs like Remdesivir--by people who stand to profit from the sale thereof--over existing safe, effective, and cost effecient treatment protocols like HCQ-Zn-azithromicin[0].
Group B is going to have a vitamin D deficiency compared to group A. Group A is also much more likely to survive Covid. However, this wouldn't give you any evidence that vitamin D is the cause of better survival rates. You should assume that it might just be an indicator of better health over all unless you can find some way to control for all the other health factors.
My guess is that it helps more than hurts to supplement vitamin D if you are deficient or insufficient. I'd also guess that it is no miracle cure like Borsche and Glauner seem to want people to think.
The results are compelling, and I suppose it would not hurt to take a prophylaxis of vitamin D (5,000 units per the article?) as compared to a prophylaxis of something else, such as hydroxychloroquine (or Lysol!)
I am a bit stunned that people are still going on about HCQ after all this time and the many trials. I feel this comment by a virologist is the key to understanding why it got so hyped and is not working:
https://www.sciencedirect.com/science/article/pii/S016635422... (May 2020)
"Highlights
• In vitro data suggest that chloroquine inhibits SARS Cov-2 replication. • In past research, chloroquine has shown in vitro activity against many different viruses, but no benefit in animal models. • Chloroquine has been proposed several times for the treatment of acute viral diseases in humans without success. • The outcomes of some current clinical trials of chloroquine in China have been announced, without access to the data. • Peer review of the results and an independent assessment of the potential benefit for patients are essential."
"...an extensive discussion of the differences between the death rates of New York City and Lagos, Nigeria, which both received infected travelers around the same time. NYC's high rate has been linked to population density, poverty, overcrowding, and ethnicity. Lagos is a crowded urban center of about 22 million people with 30 families often in a single building sharing the same bathroom, and none of the factors mentioned favor reduced death rates in Lagos. Lagos further has lower quality of medical care. Yet NYC had a death rate 600 times higher. The younger population can only account for a small part of this difference. Mitchell concludes that there is a crossover prophylactic effect of antimalarial agents against COVID-19."
I will grant that prophylaxis use of HCQ is much more interesting than its use in treatment, but I don't think this paper is very strong.
There is an app I've been using to track my Vitamin D for a few years now: http://dminder.ontometrics.com
(Not affiliated with the app, just happy with it.) It tells you the sun angle, peak hour of the day, and maximum time you should be in that day's sun based on your skin type, to avoid getting burnt while still getting enough D.
Be careful though - you might get a little OCD about Vitamin D tracking with this app. I did, and mainly use it now for checking how long it is safe to stay outdoors. (Instead of full blown tracking.)
[0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202265/pdf/405...
[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939707/pdf/mai...
What steps should I take to verify information without becoming an expert in the field?
What about more nuanced political topics?
Dark humor aside, that is one hell of a chart. Really helps explain the huge drop in death rate over the summer.
I must say it’s a bit of a missed opportunity to build up herd immunity while the sun is shining here in the northern hemisphere.
Another thing you can try is to use red to near infrared light which has been shown to affect the mitochondrial electron transport chain. I read "Brain Photobiomodulation Therapy: A Narrative Review" a couple of days ago which is pretty interesting.
It may be a risky, but given that people that work outside have half the risk of melanoma as people who work indoors, I think regular low dose UV exposure may be a net positive even for cancer risk.
Spending 5 minutes under UV lamps is a guaranteed way to get a huge dose reasonably safely, and you will know the effect almost immediately. The vitamin D seems to be maintained for 2-3 weeks after as well.
The salons call the cheap machines “sun burning” machines to up sell the more expensive “browning beds”, but just use that cheap machine and only use it for say 5 minutes instead of the max 20.
I also cover my face. I am in no way noticeably tan after years of doing this, and the low dose protocol I use makes my body similar to the color my forearms are from normal sun exposure.
I hope that is helpful, and it was years ago that I was evaluating the risks and I don’t have the exact figures anymore, but you can lookup the UV profile of the bulbs that are in the machine. Just google search the numbers on the bulb.
Honestly the best thing vitamin D has going for it is being super inexpensive and safe. Because of that you can supplement vitamin D for almost any reason and expect to see at worst a very small cost (someone up thread said 3 cents a day, which seems in the ball park) and at best a significant subjective benefit (even if it's from a placebo effect).
Is 20 a high enough sample size for any meaningful conclusion from a study like this?
https://news.harvard.edu/gazette/story/2017/02/study-confirm...
University of Colorado Anschutz Medical Campus: Vitamin D reduces respiratory infections
https://www.sciencedaily.com/releases/2016/11/161116103005.h...
We cannot know for sure of course, but is it unreasonable to even consider?
"A lockdown would then be just as unnecessary as the justified fear of our elderly fellow citizens and the risk groups, which imposes an abnormal life on all of us."
https://www.thelancet.com/journals/landia/article/PIIS2213-8...
My point above was that posting a PDF online is not good enough in scientific circles. The charts themselves have a number of issues which I'd ask the authors, I don't know if they've properly adjusted for the risk factors and I'm not sure I agree with their choice of denominators.