Comment by DoreenMichele | Hacker News Reader

Comment by DoreenMichele | Hacker News Reader

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Vitamin D is still being discussed quite a lot on HN. My understanding is that it boils down to "It helps those who are deficient but doesn't do much, if anything, if you aren't deficient."

Now, a lot of people are deficient -- probably more now than usual due to the lock down because people aren't getting out much, so people are getting less sun exposure. So I tend to get downvoted when I say things like "If you are deficient, you should redress that. If you are not, extra Vitamin D seems to do nothing and is potentially bad for you (because it is fat soluble and you can hit toxic levels in your system if you overconsume)."

I think there may somewhat less excitement about it because it helps if you are deficient but not if you are not, so it fails to serve as a drug substitute. People tend to not get excited about the idea that treating nutritional deficiencies helps shore up your body's ability to fight disease, even in cases where that deficiency is fairly widespread and the disease in question is fairly deadly.

Hoomans: Not the most logical species.

One possible candidate drug I’ve read quite a bit about but have not seen anything on HN about is high-dose melatonin, and even typical melatonin use is associated with a lower chance of testing positive. There’s a bunch of papers discussing how it _could_ be useful, there are several studies underway but none have been completed yet.

I'm not at my best today. I've been trying to lay low and not crab at people online.

But zinc is another thing that looks promising from what I gather.

The trouble with that approach is that we don't really know the optimal vitamin D level for human health. There are clear symptoms of severe deficiency. But is 20 or 30 ng/ml really enough? Maybe we should target a level closer to 80?

The issue is further complicated by the interaction with other micronutrients such as calcium and vitamin K. Vitamin D intake has to be adjusted based on those as well. So it's tough to make a blanket recommendation for everyone.

There's always some excuse.

In this situation, I would say that anyone who is high risk and has no affirmative reason to believe Vitamin D is contra indicated should consider trying to take a small supplement and/or get some sunlight regularly.

For optimal absorption, you need to take Vitamin D, Vitamin K and Calcium together. Some Calcium supplements include those two vitamins.

For optimal results, do not consume calcium and iron together. This means if you are trying to improve your nutritional status via diet, do not eat high iron foods (like beef, broccoli) with high calcium foods (like cheese, milk). They interfere with each other in terms of absorption.

If you are in a really fragile state of health, all these details and more (such as bioavailability) matter a helluva lot. If you are not in a really fragile state of health, you may find that you don't need to care so much all these pesky details.

Anyone who is really interested in their own welfare can and should start a food and symptom journal and read, read, read about health stuff (and learn how to sort the wheat from the chaff). If you do that, you can get to a point of noticing symptoms of deficiency at an early stage.

I do this regularly and adjust my diet accordingly.

But these are not answers people want to hear. They want a pill, a shot, a surgery, a solution with a really big and obvious and immediate change so they can look at it and go "I did a thing and got a result." They don't want to hear "You need to track it over time and see how you feel in a week or a month to have any real idea what helps."

It's also inherently hard to isolate nutritional stuff. If you make any change at all to your diet, you have probably made multiple different changes.

The way to isolate it is to start with supplements, stick to your normal diet, make no more than one change per week and keep a journal so you can track it and see what happens.

Anything that has any health benefit will have side effects. Antibiotics routinely cause diarrhea and that's one of the more common side effects of alternative remedies, yet if I tell people that many of them will use that as an excuse to say "Oh, it has side effects. Nope. That's a big fat nope for me. I'm not doing that." even though it's the same side effect that antibiotics have and they wouldn't hesitate to take those.

There's a lot of ignorance and prejudice and inherent resistance to resolving medical things nutritionally. In spite of study after study after study saying "Nutrition and exercise mitigate every known deadly medical condition ever in the history of human kind" when the rubber hits the road, people hand wave off nutrition as not important and "not something that will cure cancer, you dumbass!" and stuff like that.

Is it not any different than suggesting obese people get in shape to reduce their risk?

Low-hanging, non-risky fruit first.

Lots of people who are obese have tried like hell to "get in shape" and failed. It's not actually a slam dunk solved problem to say "Just lose the weight."

It pretty much is a slam dunk solved problem to say "If you are deficient in X, redress that." We know how to redress a vitamin D deficiency pretty confidently, simply and in a straight forward fashion.

I lost several dress sizes without trying by redressing other things, primarily nutrient deficiencies. I focused on eating an aggressively nutritious diet to redress a long list of deficiencies rooted in a genetic disorder that causes gut dysfunction.

So my experience fits with the general idea that "Solving obesity is harder than it looks and the solution may be something non obvious in any given case." Maybe our mental models of what is going on there will evolve and what I am saying will be "the obvious answer" to future generations, but it's not what is currently believed to be what works to solve obesity.

The current mantra is "Calories in. Calories out." and leads to metrics like "Eat less and exercise more" and some people find that wholly unworkable or unsustainable for various reasons.

Sorry, didn't mean to imply it's easy to lose weight, although I see that I did. Just meant that things to be encouraged (to reduce ones covid risk) don't necessarily need to be drugs that are proven to treat the disease.

Including taking your vitamins, even if you don't normally.

Yes, I agree, people should be doing the "easy, obvious, low risk" stuff first (if they can -- lots of people don't have the money, can't exercise adequately because of lock down, etc).

One of the problems is that is an inherently hard sell. People are terrible at measuring the disasters that should have happened but didn't.

If you convinced everyone to take their Vitamin D supplements, you would have an extremely hard time measuring the deaths that didn't happen but should have and an even harder time convincing the general public you weren't making up BS as click bait.

This is the bane of my existence. I have a serious medical condition and I know what the path not taken is supposed to look like and I've been getting better for nearly two decades when the condition is supposed to involve a steady and irreversible decline and I get told all the time that I am full of baloney and I can't possibly know that what I'm doing is effective and "X number of years of steady forward progress is just a wild coincidence -- stranger things have happened" and on and on.

Even people who believed me and took my advice have told me "I gave x, y and z nutritional things to my child and they are in the ER less but they aren't on less medication." by which this person meant the child's maintenance drugs were the same. But they implicitly failed to count the fewer antibiotics, steroids and other emergency treatment drugs as "less medication."

If you normally are in the ER every couple of months and need antibiotics for a month afterwards, being in the ER less constitutes a very significant reduction in use of medication. So this person was seeing results and going "But my child still needs just as much maintenance drugs, so the drug use is the same as before" when it absolutely wasn't the same as before.

So what you will see here is that the general public is much happier if you can tell them "X number of people were saved by a vaccine/antibiotic/ventilator/hospitalization" than if you tell them "We convinced the entire nation to take its vitamins and saw a dramatic reduction in incidence of disease."

If you tell them the second thing, the entire world will rise up and go "You are so full of shit. That's just a coincidence man. We didn't even need to take our vitamins. It just fucking died out for no apparent reason and you made me waste all this money on vitamins, you shit head, you."

So I've mostly quit trying to talk about "Things you -- yes, you as an individual -- can do to try to cope with this global pandemic." because I'm tired of being attacked with bullshit accusations of "practicing medicine without a license" and other crapola of that ilk.

I'm pretty damn sure I will survive this -- unless I stupidly try to be helpful, in which case an angry mob may decide I am somehow to blame for something. So: Whatever. "You fools do whatever the fuck makes sense to you and leave me the hell alone."

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