Comment by DoreenMichele | Hacker News Reader

Comment by DoreenMichele | Hacker News Reader

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Redressing nutritional deficiencies to protect against disease doesn't work like taking antibiotics. It takes time for the body to incorporate the missing nutrient into underperforming systems and get them back up to speed and you typically need other nutrients along with the one you are obviously deficient in to make proper use of it.

Generally speaking, I wouldn't expect much in the way of good results to give massive doses of vitamin D to people so sick they have been hospitalized with Covid-19. But I think there is plenty of evidence to suggest that a good recommendation is "If you are vitamin D deficient and would like to actually survive the pandemic, raising your vitamin D status is the smart thing to do."

I mean, you should do that anyway, even if there were no pandemic. It's just a hair more urgently life threatening at the moment.

It's sound advice generally to say "If you are vitamin D deficient, you should seek to remedy that." It's sound advice with or without a global pandemic happening around you.

Can you elaborate on your knowledge in the first graph? I thought I remember reading that scurvy patients recover pretty quickly, and according the the NHS[0], it's about 48 hours to start feeling better and 2 weeks to recovery. Maybe scurvy is different, or perhaps we are assigning different timelines to the "it takes to to incorporate the missing nutrient", but that does seem to be in opposition with your statement.

(Please note - this is not a "show your sources" challenge, I'm genuinely trying to understand the recovery process from malnutrition better. My guess would have been that the malnutrition is quickly remedied, but the 2nd order damage might take longer. Is that what you meant, and I just misunderstood?

Can you elaborate on your knowledge in the first graph? I thought I remember reading that scurvy patients recover pretty quickly, and according the the NHS[0], it's about 48 hours to start feeling better and 2 weeks to recovery.

Scurvy is vitamin C deficiency. Vitamin C is water soluble.

Vitamin D is fat soluble. Fat soluble vitamins generally work on a longer, slower time scale. It takes longer to incorporate them into the body and longer to become deficient.

People who are deficient in vitamin C may simply not be getting enough of it in their diet. Because vitamin D can actually be manufactured in the body, it tends to correlate to other underlying issues.

People with other underlying issues tend to require more time to recover from anything, medically speaking. They may even have inherent challenges in absorbing vitamin D properly or using it properly.

I have a genetic disorder that predisposes me to deficiency in all fat soluble vitamins, including vitamin D. I'm sure my firsthand experience with being slow to heal and my body being slow to adequately resolve nutritional deficiencies (on the order of months of supplementation to fix things) is on the fairly extreme side, but most Covid-19 patients in danger of dying from it are elderly and have underlying health issues. So I would expect my experiences to be somewhat similar to their situation.

Does that make sense? Did I answer the question?

So the fat solubility moderates the rate at which we can store/release from stores, is that the essence of it? I'm out over my skiis on biochem.

Or is it that fat soluble nature moderates how quickly we can release the molecule, which is why we can store too much and suffer harm?

I'm not a doctor. I'm a former homemaker who spent years homeless.

But based on those stellar credentials, if I am understanding your question correctly, the answer is "both." It is both slower to access and also the reason you can wind up vitamin D toxic in a way that doesn't generally happen with water soluble vitamins.

You can get get too much of water soluble vitamins and they can do bad things to the body, but those bad things aren't described as "toxicity" because you don't build up excessive stores of them in the body like you can with fat soluble vitamins. Off the top of my head, some people who take way too much vitamin C end up harming their dental health by harming the tooth enamel and a certain B vitamin when taken in excess is associated with, iirc, kidney stones.

s/scurvy/rickets/g

Rickets is most commonly caused by vitamin D deficiency. I suspect the comment which you replied to made an honest mistake confusing scurvy with rickets.

When I google both scurvy and rickets, my impression is that no such error was made. Materials about scurvy match the remark made above. Materials about rickets do not.

Most people treated for scurvy feel better within 48 hours and make a full recovery within 2 weeks.

https://www.nhs.uk/conditions/scurvy/

Most children with rickets see improvements in about one week.

Skeletal deformities will often improve or disappear over time if rickets is corrected while the child is still young. However, skeletal deformities can become permanent if the disorder isn’t treated during a child’s growth period.

https://www.healthline.com/health/rickets#outlook

A really quick look suggests rickets is much, much more serious than scurvy which fits with what I said above.

You might find this study interesting then: https://www.sciencedirect.com/science/article/pii/S096007602...

Thank you for that, though it doesn't fundamentally change my point of view.

Please keep in mind that my point of view is probably not adequately expressed in a single internet comment. It boils down to: for best results, we should be generally trying to address vitamin D deficiency as a means to try to halt the pandemic and not waiting for people to end up hospitalized with Covid-19 before checking their status and trying to do something about it.

I'm not saying it's "useless" to give supplements at that point. I'm just saying I would expect vastly better results if you have more lead up time to redress the issue rather than waiting until you are deathly ill from the current pandemic before you think taking action makes sense.

Don’t wait until the last minute, in other words.

"An ounce of prevention is worth a pound of cure."

Not sure that this is true. It might be. But more likely being active enough such that you get the 15 minutes of sunlight daily needed to maintain normal vitamin D levels is better advice.

We are in complete agreement there.

You are inferring that I am recommending supplements as the means to redress this. I am not and have suggested otherwise elsewhere and, wow, has it gotten ridiculous levels of push back:

https://news.ycombinator.com/item?id=24913072

Reply on news.ycombinator.com