The Impact of Vitamin D Level on Covid-19: Systematic Review Meta-Analysis | Hacker News Reader

The Impact of Vitamin D Level on Covid-19: Systematic Review Meta-Analysis

ncbi.nlm.nih.gov

182 pointsjb1991207 comments

You can request a test to confirm your level of Vitamin D. If you get the test make sure it is the right one! 25 (OH) stays in the blood longer, so this is the more accurate test. (half life of 3 weeks in your blood). Many experts recommend a level of at least 30 ng/ml ... some actually suggest that 50 ng/ml is recommended. The scale on the test results is: Interpretive Data: Deficiency: <10 ng/mL Insufficiency: 10 to 30 ng/mL Sufficiency: 30 to 100 ng/mL Toxicity: >100 ng/mL

"The majority of 25-OH vitamin D (25-D) in the circulation is derived from the conversion of 7-dehydrocholesterol in the skin that is irradiated with ultraviolet radiation in the UVB range (wavelength 290 nm to 315 nm).1-5 The extent of vitamin D formation is not tightly controlled and depends primarily on the duration and intensity of the UV irradiation. Levels produced typically reach a plateau within 30 minutes of exposure." [1]

"Vitamin D insufficiency is more prevalent among African Americans (blacks) than other Americans and, in North America, most young, healthy blacks do not achieve optimal 25-hydroxyvitamin D [25(OH)D] concentrations at any time of year." [2]

[1]: https://www.labcorp.com/test-menu/36721/vitamin-d-25-hydroxy

[2]: https://www.ncbi.nlm.nih.gov/pubmed/16549493

The association between Vitamin D deficiency (VDD as referred to in this article) and increased risk of respiratory infections is well-known. Mild to moderate Vitamin D supplementation, especially during winter or in those with subpar dietary habits, is a good idea.

However, I've noticed that Vitamin D has been garnered an almost cult-like following on parts of the internet in recent years. Some of the health claims around Vitamin D are getting out of control, and the recommendations for Vitamin D supplementation are far too high in certain circles.

I have to admit that I fell for this to some degree. I started supplementing 5000 IU/day after reading all of the writings about Vitamin D deficiency, the health benefits of Vitamin D, and the arguments that current Vitamin D supplementation recommendations were far too low.

But that 5000 IU/day put me near overdose territory when I got my serum levels checked. Even my doctor, who is very pro-Vitamin D supplementation, warned me to significantly cut my supplementation.

The scary part is that I see recommendations for significantly higher Vitamin D dosing all over Twitter and health forums lately. There's a growing idea that more is better, amplified by health influencers trying to stand out from the crowd and the growing cult-like status of Vitamin D as a wonder vitamin.

I think encouraging mild vitamin d supplementation (or improved dietary patterns with more Vitamin D) is a good step in the right direction, but I'm also worried to see how much of this is being exaggerated and taken to unhealthy extremes.

When in doubt, get a blood test.

A year before covid I was in diagnosed with low vit D and a host of other ailments. Spent a year stuck in bed; then started Vit D among other things. Following summer I spent kayaking. It was one of several things, but my life completely changed.

> I was in diagnosed with low vit D and a host of other ailments.

> then started Vit D among other things

> It was one of several things, but my life completely changed.

Very glad to hear you improved, but your comment is a perfect example of the powerful aura developing around Vitamin D. By your own admission, you were diagnosed with a host of ailments and implemented several other changes, but the only one we're hearing about is Vitamin D.

There are stories like this all over the internet, where people receive a low Vitamin D diagnosis as part of a broader workup for serious ailments and they start Vitamin D supplementation as a part of a multi-pronged treatment approach, but when the anecdotes are distilled online Vitamin D is the only part of the equation that gets noted.

You genuinely had a vitamin D deficiency as diagnosed by blood test, but many other people with as-yet-undiagnosed illnesses might read your comment and assume that excessive Vitamin D supplementation is something they should try. After all, who wouldn't want such a life-changing turnaround?

But like I said, it's important to close the loop with blood tests. Vitamin D deficiency can't be diagnosed by symptoms alone, and high Vitamin D deficiency can be a risk for Hypervitaminosis D, which brings its own set of symptoms.

Mild Vitamin D supplementation is low risk, but Vitamin D isn't going to be life-changing for anyone but those with severe deficiencies.

> but Vitamin D isn't going to be life-changing for anyone but those with severe deficiencies.

Given modern diets, I'd suspect many people have deficiencies in one or more key micronutrients. Given how low risk supplementation is, I think overdoing it and losing out on a bit of money is safer than under doing it. Of course be moderate in the amount you supplement by but the argument that it's just a waste of money never resonated with me. I'd happily sacrifice money on the off chance that I'm actually saving my health.

> I think overdoing it and losing out on a bit of money

Excessive Vitamin D levels are associated with accelerated cardiovascular disease and premature aging of cells.

It's certainly not as simple as losing out on a bit of money. Vitamin D is dirt cheap, but you only get one cardiovascular system.

Excessive anything is a bad idea but what does it mean in the case? Link?

You're presenting this as fact, but without reference, based on your own admitted foray into unhealthy supplementation. It's difficult to take this comment anything but impassioned anecdote, and not as sage advice, without reference.

>>Mild Vitamin D supplementation is low risk, but Vitamin D isn't going to be life-changing for anyone but those with severe deficiencies.

It would be life-changing if it kept you from dying of Covid, though. Which the OP says could happen even if your levels are 20ng, which is not typically considered a severe deficiency.

I was also in your boat, for people with a deficiency supplementation is life changing.

I jumped on the train recently after the wife suggested it. And have heard some promising info from watching some John Campbell's videos and a bit of googling around about it. Been taking 4000/day since August and do feel better overall. Haven't caught any colds yet (knock on wood). From what I had read, 4000 was the max suggested amount to be safe. I'm hoping that I won't get any bad colds this winter by doing this.

> I'm hoping that I won't get any bad colds this winter by doing this.

Unfortunately, I was still getting colds regularly while my blood levels were around 100ng/mL.

This is the type of magical Vitamin D thinking I was talking about: Fixing a vitamin D deficiency is a positive improvement, but it's not a miracle vitamin.

>Fixing a vitamin D deficiency is a positive improvement

Apparently, quite a lot of people are vitamin D deficient. As a computer nerd, I'm pretty sure I was.

As a fellow computer nerd, I bought into the same narratives. That's how I ended up approaching Vitamin D toxicity as I mentioned above.

That's my point: The narratives around Vitamin D are getting greatly exaggerated. Mild supplementation is usually fine, but this idea that we're all deficient and we all need to be taking huge doses is getting out of control on social media.

>but this idea that we're all deficient and we all need to be taking huge doses is getting out of control on social media.

Agreed!

You reached 100ng by supplementing 5000 IU per day? That doesn’t add up.

I was told by my doctor I was, about a year before covid hit. Now I take vitamin D and C supplements and try to spend more time outside. My guess is that a lot of indoor computer workers are going to be deficient, but it's something your bloodwork can show you.

There is little evidence of any health benefit from oral vitamin C supplementation. If you have a normal metabolism and eat at least a little bit of fresh produce then you're probably getting enough. Any excess isn't absorbed, just pissed away.

Intravenous vitamin C might be another story and there is active research underway as a potential treatment for several conditions. I don't think any conclusive results have been reached yet.

Ugh. I just went 8 years without seeing the sun. I need to get my levels checked.

Would you be willing to elaborate how that happened?

Incarceration per other comments iirc

No one got colds "regularly" during last year's "lockdown and mask" periods, or during the summer. Maybe, if you had a kid in preschool, but they have been closed during those periods as well. There is something unique about your situation you are unaware of or perhaps not telling us.

I'd stop giving out advice to a population that is almost certainly, mostly deficient in Vitamin D. Sure, don't overdo it, but as it is quite hard to, probably affecting a tiny percent of the population, is a lesser concern right now.

You didn't mention any negative effects of approaching vitamin D overdose, did you experience any or was this simply a concern of your doctor?

Some of the worst effects aren't immediately obvious, such as metastatic calcification of tissues over time.

Long-term effects aren't fully elucidated because high Vitamin D doses weren't common until recently. However, there is growing evidence that excess Vitamin D can contribute to worsening cardiovascular disease and premature aging of cells.

You won't necessarily feel the effects of too-high Vitamin D levels right away, but years or decades of excess Vitamin D could do a lot of hidden damage without any benefit over moderate levels.

> there is growing evidence

Since you don't say what 'excessive' is, we don't know whether your comment is significant or not. Can you please avoid making statements like this without adding a link to a peer-reviewed paper so that we can assess it.

EU study from 2012: https://efsa.onlinelibrary.wiley.com/doi/pdf/10.2903/j.efsa....

As to excessive dose: " Without calcium supplementation, even very high vitamin D3 supplementation does not cause vascular calcification, especially if another important finding is included. Even when calcium blood levels are high, the culprit for undesirable vascular calcification is not vitamin D but insufficient blood levels of vitamin K2".

COVID-19 Mortality Risk Correlates Inversely with Vitamin D3 Status, and a Mortality Rate Close to Zero Could Theoretically Be Achieved at 50 ng/mL 25(OH)D3: Results of a Systematic Review and Meta-Analysis: Front Public Health. 2021; 9: 624559.

Just found this (staring me in the face, a pdf link)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7973108/pdf/fpu...

A suggestion: your otherwise helpful reply might be more effective without upbraiding the commenter you're replying to. (Yes, irony noted that I'm upbraiding you.)

Also, you can buy supplements that combine D3 with K2, if you are concerned about calcium transport.

My understanding is Vitamin D stays in your system a while. It’s one of the reasons why I believe Vitamin D deficiencies tend to be treated with 1-3 very large doses of Vitamin D, separated by weeks, with what I assume are blood tests in between.

Yes! The half-life of Vitamin D in the body is very long. Toxicity can build over many months of supplementation, which is why it's important to get a blood test after around 6 months of starting supplementation.

What's interesting: There doesn't seem to be toxicity associated with Vitamin D produced by sunlight. The body seems to have mechanisms that prevent overdose, even if you're constantly in the sun.

There was a lady on a reddit sub who claimed she is working in a hospital and having cases of people overdosed with vitamin D that causes calcium to build up in the blood vessels.

Data point: I recently found out my vitamin D levels were extremely low and was prescribed 1 50,000 IU tablet a week for 8 weeks. Halfway through the course I'm already feeling much better.

I’m getting the feeling that you don’t live somewhere like Scandinavia, where we are barely exposed to sunlight for 6 months of the year.

I started moderating my vitamin D intake a little last year too, the blood test is a good idea, but during the initial parts of the outbreak, everything was closed, and rightfully so, so I was relying on gut instincts and luckily didn't overdose.

I'm not a doctor, but I have read that Vitamin D also benefits bone health, especially in people of color. The price of the supplement went up dramatically last year, a $2.50 bottle of 1,000 IU pills here (East Coast US) costs now anywhere from $5.45-$15.00 now in retail stores. It's sad that opportunism is usually always the first move in health care in the US now. It's a shame how much better health (and even proper education on it) depends so much on income/wealth here in the US.

$4.99 for 1k or 5k at Trader Joe's.

Why, it's almost as if some sort of central planning would be a better way of planning healthcare for a nation!

I think the cult-like following for Vitamin D is an inverse of some of the cult-like following for the vaccines. (VACCINES ARE GOOD, FOLKS, DON'T REPLY SAYING I'M AN ANTIVAXXER)

There are people who believe that the vaccines are much more capable than they are, and go as far as lionizing Pfizer in the form of things like tattoos, Fauci fan art, and so on. Yes, they are a very small segment of the population, but I've run into these people in real life. One of my best friends has a faith-like belief in the vaccines to such a point that he totally clams up if I show a shred of skepticism. This was a guy who practiced formal debate and we used to have many intellectual discussions despite our differences.

The people who believe Vitamin D is their Lord and Savior are reacting to the fact that the establishment has almost entirely abandoned the pretense of "diet and exercise" in favor of pharmaceuticals to the exclusion of almost anything else. Vitamin D isn't a cure, but it is very underappreciated, and when the entire medical system not only fails for decades to solve obesity but then fails to tell people to take action in their own lives to get themselves fit and healthy, it's cause to raise an eyebrow no matter what you think about Vitamin D.

Both are a result in a division caused by a system that fails to explain its own legitimacy. I think it's great that we have the vaccines. I think Vitamin D is great. I think both are imperfect. But I can't blame people for attaching themselves to either one as if they are separate churches to attend; what have the establishment done to establish our trust?

> But that 5000 IU/day put me near overdose territory when I got my serum levels checked. Even my doctor, who is very pro-Vitamin D supplementation, warned me to significantly cut my supplementation.

That's interesting. It's been a really long while since I looked at research papers around Vitamin D, but my conclusion was that what was thought to be a daily limit for Vitamin D wasn't entirely justified for the average healthy person, but I'll have to check that again. I've been either getting some sunlight every day or taking 5000 IU supplementally every day and haven't suffered any obvious consequences.

Sunlight really is the best though, and you don't need that much sunlight to get a sufficient dose. It also raises levels of nitric oxide which has its own benefits.

Vaccines are probably 3 orders of magnitude more effective at reducing the spread of covid than vitamin d. Not 3 times, 3 orders of magnitude, probably more than that really. Imperfect as they are it is still an amazing and wonderful thing we were able to create and get them out so quickly, likely millions of lives saved and millions more would have been if not for morons spreading lies

For sure, I don't deny that at all.

My point is that these things are reflections of society (civilization?) as a whole. If society is being fractionated, you'll see it with vitamins and vaccines. From what I've seen, few things haven't seen some amount of fractionation for my whole life.

It doesn't really matter whether or not any of this stuff works if the establishment isn't widely considered to be legitimate. You will inevitably end up with two camps, or possibly an entire loss of control. The point of actually doing things to instill confidence is to give few to no reasons for society to fractionate down the middle.

Like, if you want people to take vaccination seriously, you probably don't want to tell the public you won't take the vaccine because you don't like the current president. You also probably want to level with them and at least tell them some of the truth as opposed to using omission and indirection, and no coercion, to get them to do what you want them to do. Oh, and it would also be a good idea to not villainize skeptics, because there will always be people who are wrong, instead favoring giving them reason to come to your side.

All of the above that I just mentioned happened, at least in the United States. It's not hard to find sound-bites of establishment top-brass saying that they wouldn't take the vaccines because they didn't trust Trump. When people on both sides see this indignance and then see these politicians make a complete 180 once they've restored their power, why in the hell would you expect anyone to trust them with their health? A skeptical person is going to start wondering what else those politicians have lied about and why the establishment health experts haven't told people to improve their health as part of the fight against the pandemic. If mainstream news comes out trying to downplay Vitamin D, they might think "heck, if they're saying that then I should probably believe the opposite".

I'm sure I'll be misunderstood by what I've said there, but hopefully someone reads this and considers it if they haven't before. I've never been anti-vaccine, and if I ever said anything in the past that came off that way, either I misspoke or I was wrong.

I like how the you manage to blame primary pro-vaccine people for not promoting them perfectly for vaccine skepticism ... while completely ignoring pure FUD and lies routinely used by anti-vaccine movements.

And how it is only democrats who are responsible for some anti-vaccine claims despite massive anti-vaccine, anti-masks campaigns from republican politicians.

I could have addressed that side as well, but I didn't think it was necessarily relevant to the point. There's also now diverging definitions of what defines "anti-vaxx". Anti-vaxxers might be against all vaccines, or anti-vaxx might mean being against the mRNA vaccines for SARS-CoV2, and then sometimes I get labeled as such (or as a sympathizer) because I think there are valid concerns about these vaccines.

In terms of the OG anti-vaxxers, I agree that they did and perhaps do still play a significant role in fostering distrust. In my opinion, that's just too easy a point to make. Did I really need to make a point about it? It's not really a controversial opinion to state on HN that people who are out of touch with reality share responsibility for vaccine hesitancy.

What's more important is that we recognize that this issue doesn't exist in isolation. I do not buy that the extreme anti-vaxxers share the bulk of responsibility here. The authorities had a chance to get everyone on board, and they totally blew it. Anti-vaxxers could have not existed before this pandemic and they would have still been created as a part of the radical shifts in global societies and how power structures have used tactics that appear to rather intentionally create divisions.

> And how it is only democrats who are responsible for some anti-vaccine claims despite massive anti-vaccine, anti-masks campaigns from republican politicians.

Yes, that is true, and I corrected myself before I even saw your comment.

You framed or as whole society explanation of universal sociological truth of things splitting to two sides down inthe middle.

And in subsequent analysis you completely ignore active and large campaigns to make people distrust vaccines or that covid exists.

> The point of actually doing things to instill confidence is to give few to no reasons for society to fractionate down the middle.

The expectation is that group you dislike for unrelated reasons have to be perfect. The group you like for unrelated reasons is not responsible for anything they say or do.

> do not buy that the extreme anti-vaxxers share the bulk of responsibility here

People believing anti-vaxxers are responsibility of loud anti-vaxxers. There was no magic happening, it was people believing what those said.

> The authorities had a chance to get everyone on board, and they totally blew it.

Large political movements were anti vaccers for political reasons. There was no chance to get everyone on board, when actual politicians and party operatives actively openly and frequently opposed vaccines.

And your analysis completely misses these people.

Right, and of course - why not both? Low vitamin D causes other problems, easy to happen in the cold months…

My stance might be very different if the state and the mainstream decided to encourage the public to not only get vaccinated but also do things to be healthy. Losing weight, restricting calories, choosing to eat lentils instead of Macaroni and Cheese, going on daily/nightly walks, getting sun exposure, all shouldn't be ignored or treated as obsolete. What exactly is the reason, other than keeping the junk food industry afloat, that we not all be encouraging ourselves? Do we really need a bunch of studies to be performed to conclude that being generally healthy is either helpful against infection or at least won't make infection worse?

If we had a campaign of "do your part, eat right, get some walking in, and help the fight against COVID", I'd be like "Hell yeah! Now's our chance to see if we can beat this thing! Get the vaccines, get healthy, and join the fight!"

And now look. :(

https://www.cnbc.com/2021/04/09/fitness-companies-surge-in-d...

I've come across some data supposedly contesting the idea that obesity is a big driver in hospitalizations, but I'm not sure how much I buy it yet, and it certainly doesn't seem like a good reason to just do nothing at all.

It isn't the government's job to endorse someone's regimen of virtue.

Yet we tax vices.

It depends on if you think the government exists for the betterment of society as a whole or for the betterment of the individual.

Personally all the covid restrictions make me so depressed that I don't care about my health. And I never really cared enough about it to lose weight anyway. I was very active before the masks came in (hiking etc) but they enforced them even outdoor when on your own. So the sudden stop in doing that didn't work out well. But generally I just eat wrong, I live alone and hate cooking. So I've always been on the heavier end of the range.

The way life is right now I wouldn't really have any interest in reaching my pension age anyway as there's not much to do.

But promoting this in a situation where people have less motivation is not really going to help. Once the pandemic is over and we can live life again I'll think about it.

But depression factors into it majorly for me and I've been more depressed than ever.

What are you basing your numbers on?

"There are people who believe that the vaccines are much more capable than they are, and go as far as lionizing Pfizer in the form of things like tattoos, Fauci fan art, and so on"

I was genuinely thinking you are making it up. Then I checked the web. First I shook my head, but then I reminded myself US is a nation of 330+ million people. Some are bound to do something outlandish like branding your body with corporate logo for no pay.

Mildly related, I am currently going through Ellul's work and I am in awe of American propaganda machine.

Yeah I'm not pretending that they make up any sort of majority or massive minority, but they are small and can be loud. If there really were that many of them, the Fauci propaganda film on Disney+ wouldn't have been so highly ratio'd, I think.

Plus I live in California and, yeah, we can be pretty weird like that.

Putting aside the particularly enthusiastic individuals, there are many people who really want to believe that this problem is going to go away because the government and Big Pharma will make it happen. I think everyone wants to believe that. I want to believe that science and technology can put a stop to this and maybe we can enter a new renaissance. The difference is that some have gone as far as to view any sort of questions as a form of heresy. Or they've reached a point where they can't handle any amount of disagreement.

I'm a little biased, perhaps. I have a few sets of friends and family that became so heavily invested in the pandemic that they entirely closed themselves off for the last year and a half. My best friend whom I've known almost my whole life and I consider to be a brother not only has decided he can't have an earnest discussion about strategy against the virus but I've only seen him twice in the last year and I've not been able to see his wife or his son who was born last year. I effectively have a non-blood nephew whose first years I'm missing out on, and at this point I just don't find it to be reasonable. One of my cousins and his family remained totally locked up this whole time, going as far as to decontaminate all of his mail and leave it to air out in the garage for a week. I can't meet his children either, and until recently his children couldn't see other children. He and his wife would throw a conniption fit if they know that I was more skeptical than they. None of these people even care that I've been vaccinated.

There's more personal stories I have, but those are the ones that emotionally affect me the most. I've talked to many others on Discord that have similar stories about their own social circles.

So yeah, when some people witness such extreme reactions and realize that the establishment has shown an almost total lack of interest in self-improvement, they are liable to think "Big Phrama doesn't want me to take Vitamin D, so that must mean it works against COVID! And if it doesn't, well, screw Big Pharma anyway."

In another circumstance, although I am kind of a supplement fiend myself, I'd have made fun of the Vitamin D, HCQ, and Ivermectin people in any other circumstance. Now I just see it as just a reflection of our collective ignorant choices rather than as an aberration. And to be honest, I just can't bring myself to shame the people who overestimate Vitamin D because at least they don't act like I carry the black plague.

Illinois here and we are all weird:).

Regarding the enthusiastic individuals and believers in technology in general, I want to run something by you that I heard somewhere, and I think it is applicable here. I think it was a salesguy pitch, but the argument went ( based on the lyrics of:

"The sun'll come out tomorrow So you got to hang on till' tomorrow, come what may! Tomorrow, tomorrow, I love ya, tomorrow You're only a day away!")

that Americans are super optimistic. I remember buying into that description since I was internally comparing it to the old country and basic response to everything being doom and gloom. There is some value to hope, but I agree that blind faith can be counterproductive here.

I hear you on the family front. It has been a very weird experience overall. My extended family and social circles tend on the conservative side with some outliers. As far as I know, all are vaccinated too. As expected, the reactions were all over the place. We have one family unit that locked itself in with their kid and has not seen anyone for months initially and is only now relaxing their protocols somewhat. I do think it is a little over the top, but it really is their choice.. for better or for worse. We have one that is regularly roaming the countryside.

All this is happening, while my wife is still going full time to work at a doctor's office. We have a baby too, but we are going for the middle ground. It probably helps that we are home bodies. In all probability, we will eventually get covid just based on her exposure alone.

Overall, I agree with you -- we all missed out on some memories.

But all this talk about vitamin D reminded me I have to schedule an annual check up. Heavens know I did not move much in 2021.

Anyway, stay healthy.

> but then I reminded myself US is a nation of 330+ million people.

As I type this, there are a few score people gathered together waiting for a long-dead icon of liberal politics to return from beyond the grave and join forces with the previous president, who is politically opposite.

You can find anyone who believes anything in the US of A.

That's totally fair. Perhaps for people such as myself, who grew up in a time where the fringe of society pretty much stayed that way, the publicity that anyone can get today can create a simulation of normalcy.

> the publicity that anyone can get today can create a simulation of normalcy.

It seems like it isn't hard for any belief or belief-system to obtain a critical mass. It feels like a paradox: if the threshold for critical mass has fallen, or the number of people required to reach critical mass has grown for every niche? I'm not sure what's going on, but I'm scared. Maybe this is the "old person scared" thing I giggled about when I was a kid watching my grandmother try to make sense of a computer...

The scientific definition for the COVID vaccine is that it is "leaky". This is true of the flu vaccines as well.

https://www.infectiousdiseaseadvisor.com/home/topics/respira...

They knew this and they lied to us all. That was the worst type of propaganda. And IMO, Fauci is the worst at this type of patronizing behavior.

We cannot vaccine our way out of this pandemic. It is with us, so get healthy.

Getting vaccinated is also a good option if you're concerned about your health.

In fact, the optimal might be to get vaccinated and then get Covid on purpose. Thus you get the mildest possible case. After that your immune system is properly trained and subsequent infections will be milder.

I'm double-vaccinated but strongly considering this option now as corona passports are being discussed in my country. Fuck that logicless shit (restrictions should apply to everyone equally).

I am double vaxxed (6 months) and I sit in the most crowded coffee shops I can all day in a college town, no mask. Nothing yet.

Sure. What's your point?

they are trying to get infected... yes we need some proper research into this idea of vax / infect treatment.

Not that I am really trying, but not avoiding it either. My fear is gone, you know? And I have a mental health comorbidity (but none of the bad ones like diabetes and obesity.) I mean everyone went into hiding after they got the vaccine and then the vaccine wore off. That was the perfect time to gain what should be a broader immunity. Maybe it is like I already had my booster?

There is a lot of talk out there but I know they really do not know how the immune system works, neither do I. But it seems vaccine alone is doing nothing but keeping people alive. So if the vaccine can keep me alive, why avoid the virus?

Stop feeding the antivaxxers then.

We do precautionary actions that may not save us all the time. Seatbelts, shelter in place during tornadoes. Crossing at intersections. Just because these activities fail for a lot of people doesn’t make the practitioners sheeple. This insistence that all of the societal technology that we’ve developed that got us from 100,000 humans to 7 billion is bad is pastoralism at best, a suicide cult at worst.

Sheep weren’t that numerous before humans either, which makes me wonder of the “sheeple” comments are projection, accidental or otherwise. Going back to pre-enlightenment society will reduce us to just another animal.

> Stop feeding the antivaxxers then.

Why should anyone take you seriously after reading this sentence? Although you may not intend this, how am I to know that you aren't implying a level of dishonesty in what I've shared? Because that certainly seems to be what you are saying. Do you think that I think that I'm feeding "antivaxxers" and not being forthright about it? I just don't find it productive when you and countless others make such a statement. In fact I'm not even sure what you define as an "antivaxxer". If you are going to call me out, at least be a bit more precise.

If there's something I said that suggests that I'm merely feeding antivaxxers, or doing so in a way that goes beyond what the system has already done to feed the so-called antivaxxers, by all means, tell me how I'm the problem.

> We do precautionary actions that may not save us all the time. Seatbelts, shelter in place during tornadoes. Crossing at intersections. Just because these activities fail for a lot of people doesn’t make the practitioners sheeple. This insistence that all of the societal technology that we’ve developed that got us from 100,000 humans to 7 billion is bad is pastoralism at best, a suicide cult at worst.

I don't think we would have enacted seatbelt laws if the tradeoff was severe restrictions on civil freedoms and possible damage to society as opposed to, you know, the minor inconvenience of just putting on the belt. And putting on a seatbelt isn't really the same argument as injecting a rushed vaccine using technology that hadn't yet been deployed to humans on a wide scale, as well as being at the point of coercing people to do so.

That's a tangent I shouldn't have just entertained, though, because I am not necessarily here to debate such nuances. My point isn't really to argue for or against vaccines per se, despite my having shared some of my personal perspective on the matter. The point that I was making is that both the conspiracy-level skepticism and the science/vaccine zealots are all a result of the same thing, and if we don't wake up to all the extreme divisions we are seeing, it's not going to matter what we do. Vaccines, Vitamin D, whatever. If too many of us can't agree on anything, and the system is operating in such a way where the division is seemingly intentional, how exactly can we blame people in either camp from going to the extreme?

> “sheeple”

This is not a word that I used and, if you reexamine what I've contributed to this thread, you will see that I'm not condemning people in any such way. While I do believe that most people respond to systemic control beyond a point I consider reasonable, I no longer dismiss this as a character flaw more than a symptom of the information age.

I'm sorry if I am reading too far into what you are saying here. I'm just not sure exactly why you brought that up.

> Going back to pre-enlightenment society will reduce us to just another animal.

Agreed. While I think we need to be far more careful about the road we choose to go down as a post-enlightenment world (assuming you were referring to the Age of Enlightenment and the philosophy that came from it), we can't go back and I don't think it would actually be desirable to go back.

> Just because these activities fail for a lot of people doesn’t make the practitioners sheeple

Of course not. What makes people sheeple is treating someone not wearing a seat belt like a war criminal.

> This insistence that all of the societal technology that we’ve developed that got us from 100,000 humans to 7 billion is bad is pastoralism at best, a suicide cult at worst.

Who is making this claim? Some nut on twitter maybe but no one in this thread.

> Going back to pre-enlightenment society will reduce us to just another animal.

It's interesting that you invoke The Englightenment. One definition of The Enlightenment I see is "use science AKA empricism to make decisions". But another part of The Englighenment is liberalism: the idea that individual people are adults who ought to be able to make decisions about their lives. That people can't simply depend on the state, the church, or the law, that every adult human is a moral legislator who must draft his own law and live up to it (or fail to).

With regards to The Vax'ers vs The Vitamin D'ers...

If nothing else this study / paper does raise the question: What was the Vitamin D "status" of those who took part in the vax trials?

That is, perhaps the vax is effective, but as dependant on Vit D levels? Lower D? Less effective vax??

Yeah, hard to study, but given all the sociopolitical implications, certainly someone should make the effort?

> Sunlight really is the best though

The problem is that, for many people, their ability to synthesize Vitamin D from sunlight decreases as they age. (Also you have to be living at a latitude where you can get enough UV from sunlight.) Having your blood levels of Vitamin D checked regularly can help you to decide whether you need supplementation, and if you do, it can help you to adjust your dosage.

Btw I stopped reading at "the establishment" because I know your worldview is informed by random suspicions about a vague cabal that controls the wold.

A parody I found of your friend: https://www.youtube.com/watch?v=o_s5y9Ls83Q

> The people who believe Vitamin D is their Lord and Savior are reacting to the fact that the establishment has almost entirely abandoned the pretense of "diet and exercise" in favor of pharmaceuticals to the exclusion of almost anything else

It doesn't get much more establishment than the NYT, and yet somehow their pages are filled every day with "diet and exercise" articles. Not really sure what you're trying to say here.

> But that 5000 IU/day put me near overdose territory when I got my serum levels checked.

I need to consume 4000 IU/day just to keep my serum levels acceptable. I do agree though that blood tests are necessary. When I started getting into the vitamin D supplements, I had my blood levels tested every 3 months for a few years. I started out dangerously deficient and even 8000 IU/day was barely moving the needle in the beginning. However over a longer period 8000 IU/day ended up being too much, so I cut it down to 4000 IU/day where I've been for years now.

There are a lot of factors going into this and everyone's circumstances are different. Frequent testing to verify assumptions is a must.

I spend a good amount of time outside, going running regularly, and am in decent shape. I also eat 250g of salmon weekly, which contains about 1000-2500 IU. However at the end of the day I live in the north (59 deg lat) and the sun here is of limited impact.

The mammalian liver stores vitamin A and vitamin D (polar bears store so much of the former that polar bear liver will give you vitamin A poisoning, even in small quantities).

If you are deficient that usually means low reserves, so some or most of what you take will go into your liver instead of your blood. Over time your serum levels climb on the same dose, which is why you have to keep testing. It’s also why therapies for vitamin D deficiency can include prescription ultra high dose pills taken once a month for a few months, rather than (or in addition to) daily supplementation.

Body fat also stores Vit D (and A, E and K), so you also need to consider how much has been deposited there and how much of one’s body fat turnsover.

The group https://grassrootshealth.org sells an inexpensive at-home test kit for D3 serum levels. IIRC it includes two tests so that you can make changes if needed then check to see how much they helped, and back off on supplements if desired.

I had also been taking 5000 IU/day with K2, which helped me get up to 50 ng (starting from 39). I stopped taking the supplements because I felt sun exposure was probably the better way to approach it. For one thing I live in a sunny place, and I enjoy the relaxation. Also, my guess is that D3 levels may be a proxy for things like sun exposure, and that the health benefits might derive from those instead, and might be more complex than just one compound.

If I can't reliably get sun exposure though, as in the next three months when my local UV index gets pretty low, I'll go back to supplementation.

I'll attempt to cite this before the edit timer expires.

If you live above 35° North, a full day of sun is not enough to get all the vitamin D you need. There's a reason foods (like bread, milk, cereal) are fortified.

> When in doubt, get a blood test.

Definitely. I would say get one regularly anyway, Vitamin D levels are important enough that they should be part of routine blood work done during a regular physical. Then, if you're supplementing, you can adjust your dosage accordingly based on the results so your blood levels stay in the desired range.

The association between Vitamin D levels often breaks down in interventional studies which points to common causes for both susceptibility for respiratory disease and low Vitamin D levels (For instance Winter both lowers Vitamin D levels as well as increases respiratory diseases).

in my circle it was the joe rogan podcast with dr rhonda patrick during the height of covid mania, that set off the craze for vitamin d obession.

It is quite difficult to overdose vitamin D:

"... healthy adults in a clinical setting, receiving 50,000 IU of vitamin D2 once every 2 weeks (equivalent to approximately 3,300 IU/day) for up to 6 years, maintained 25(OH)D concentrations of 40–60 ng/ml (100–150 nmol/l) without any evidence of VDT [vitamin D toxicity]. Those findings were consistent with the observation by Ekwaru et al. (17) that Canadian adults who ingested up to 20,000 IU of vitamin D3 per day had a significant increase of 25(OH)D concentrations, up to 60 ng/ml (150 nmol/l), but without any evidence of toxicity"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6158375/

Why wouldn't Gates and Fauci promote supplementation given all their other interest in this space? Seems obvious to anyone that spent time reading and looking for ways to mitigate this in early 2020 that vitamin D would likely help.

There is no money to be had and no patents to file for vitamin d.

I don’t know why you’ve gotten downvotes, but it’s true. For example one of the strongest predictors of severe COVID-19 is obesity, but not a peep about maintaining a healthy diet or regular exercise from our top doctors during the entire pandemic.

If the CDC launched a national effort to get Americans outdoors to exercise (Surely a lot cheaper than the stimulus we spent money on) hundreds of thousands of lives would have been saved, not only from COVID but from diabetes and heart disease.

Obesity is killing people for decades now.

Telling people "just get fit" doesn't work.

Covid did motivate a few folks I know to start hiking, even without a government push.

CDC alone can't solve an issue that stems from high sugar food encouraged by the subsidies from the government.

Please note that I'm not knocking on subsidies as a concept but the sugar subsidies which enable the low cost diet in the US.

Nah, they would be demonized for trying to control people's bodies.

https://www.foxnews.com/health/michelle-obama-responds-to-ba...

There are tons of federal fitness programs.

meanwhile I can't get my health insurance's 'health spending account' to pay for my gym membership...

Everyone always trots this one out but it’s horse sh*t. There have been long standing widespread efforts in basically every country to raise the awareness of obesity and the benefits of a balanced diet and exercise. These are enormous public health campaigns which continually fall on deaf ears because people would rather not change their behaviour. These messages have continued for the last 2 years, but are utterly drowned out by the more acute problem which is the spread of covid and morbidity and mortality attached to it

Companies spend massive amounts on encouraging employees to exercise…. are you saying all companies have to do is explain exercise would reduce early mortality rates and then they can cut their fitness incentive spending while saving tons of money on health insurance?! That easy?!

On the contrary: there is plenty of money to be made selling supplements, it's super cheap to do, and in most jurisdictions the supplementation and natural products industry and market are barely regulated.

Sure you can jack up a $5 bottle to $15 perhaps, but that's nothing like the $100 a proprietary-pill-gravy-train that the big, rich corps are looking for. And million dollar campaigns are spent on.

Dr. Anthony Fauci has been speaking about Vitamin D in interviews since the start of the pandemic and he talks about taking Vitamin D supplements himself:

> "If you're deficient in vitamin D, that does have an impact on your susceptibility to infection. I would not mind recommending, and I do it myself, taking vitamin D supplements," he said. "The other vitamin that people take is vitamin C because it's a good antioxidant, so if people want to take a gram or so of vitamin C, that would be fine."

Source: https://www.insider.com/fauci-takes-recommends-vitamin-d-and...

I don't understand why people assume Dr. Fauci is against Vitamin D. He's taking the most well-informed and realistic stance given the evidence, which is that mild Vitamin D supplementation to avoid deficiency can help, but it's nowhere near a solution or cure for COVID-19.

This wasn't disseminated widely and it's not part of any formal preventative recommendation for doctors to implement.

Doctors know about Vitamin D. Not sure why you think they would need Dr. Fauci to tell them about it. I've also been hearing about Vitamin D from every angle on social media for the past 2 years.

I'm not sure how one of hottest COVID pop-culture prevention suggestions could be considered an underground concept at this point.

The misunderstanding might be in the magnitude of effect: Vitamin D moves the needle a little bit, but it's nowhere near a magic bullet against Vitamin D or a solution to the crisis (as many health and fitness influencers have tried to suggest).

> Doctors know about Vitamin D.

Don't be so sure about that. When I first heard about the connection of D3 with the immune system, I asked a friend, who happens to be a cardiologist, about it. He said vitamin D prevents rickets, that's all. And an overdose produces arrhythmia, so be careful with the supplements. Indeed, that's the conventional wisdom found in text books.

According to the internet, a healthy immune system needs much higher levels of vitamin D than those necessary for a functioning calcium metabolism, and a D3 overdose is only bad if you have insufficient levels of vitamin K2. I don't know what to think about all of that. After all, my representative study with a sample size of one and no controls yielded no significant results.

Maybe you shouldn’t talk to a cardiologist about preventive medicine not related to heart issues………we have primary care physicians for that. Every preventative care doctor out there knows the benefits of vitamin d. It’s such a silly anecdote to bring up. And you don’t know what to think? Go read the research and make your own conclusion. I would never trust random people on the internet who make up anecdotes. It’s been proven that Vitamin D is a healthy hormone that is important to your well being. Go get it tested and then at least you will have a reason to do research.

I went to med school 10 years ago (did not complete the programme) and I'm a biochemist. Doctors definitely know about vitamin D, and if they don't then there's something wrong with them.

The old-school, prevents rickets/400 in milk is enough, is what was taught for decades. The new-school, take a few thousand a day and it prevents winter respiratory infections is quite newer and less spread out.

Personally, I stopped having the vast majority of colds during the winter since starting D a decade ago. One or two colds since, and both were over in a day. Definitely a significant life improvement.

There are several dominant threads pushing back here on a professionally done study about the benefits. So no, the important information is not as widespread as you claim.

I was diagnosed with severe crohn's disease in the late 90s. Doctors started learning about Vitamin D and the immune system in the 2000s. My only specialist who knew about it in the 90s is now at an elite hospital. It was rare knowledge 20 years ago. Medicine is still pretty much stuck in the last century with nutrition knowledge. It's all about pushing pills for the most part. The synergistic study of different nutrients is still pretty lacking.

For example, most Drs now know about vitamin D. But do they know about A and K and the dosages and which minerals you should probably take with it when someone is extremely D deficient like in a lot of autoimmune patients? Probably not...

Do doctors know most patients with resections or digestive issues who are B12 deficient can absorb methylcobalamin sublingually? I've never met one that does.

I can go on. Most doctors understanding of B12 is still stuck in the 1970s along with most other aspects of nutrition.

From what I understand, individuals with naturally darker skin tend to be at greater risk from vitamin D deficiency. This is because naturally darker skin reduces the absorption of UV rays. I wonder to what extent vitamin D deficiency could be a contributing factor to the disparate impact that Covid-19 has had on different ethnic communities (at least in the United States). Is anyone aware of any studies done in this regard?

If you are deficient in Vitamin D, obviously supplementing (or otherwise working to improve your Vitamin D status) is what you should do. That's generally good advice, pandemic or no pandemic.

This is the umpteenth Vitamin D article I have seen on HN. Let me suggest that people could look for and post research on other nutrients as well/instead. I will suggest people keep their eye out for articles on zinc, iron and B vitamins as a place to start.

The respiratory component for Covid-19 is being over hyped. The evidence seems to suggest blood clots and other impacts on the circulatory system are a largely overlooked major aspect of the pathology.

> The respiratory component for Covid-19 is being over hyped. The evidence seems to suggest blood clots and other impacts on the circulatory system...

These happen as a result of the respiratory infection getting out of control however. So, preventing that is an understandable priority. Aspirin can help prevent blood-clots when needed.

Most supplements are overrated (and this is coming from someone who has taken quite a few in the past for various issues, then stopped when the issues were resolved).

Most of the time you're better off just eating more bioavailable foods. The risks are more well-known.

The only exception is magnesium. It really does seem like everybody should supplement or get a blood test, since deficiency is so common.

It can also be the source of random panic attacks, especially if you're particularly stressed.

My sister had this issue for a while until she started taking epsom salt baths and discovered it basically made her random panic attacks disappear.

Very true. Drs understanding of magnesium is what vitamin D was in the 1990s.

I agree that most supplements are overrated unless you've got a serious health problem. Then they become very useful but it's hard and expensive to figure out what works. A high quality protein with magnesium does wonders as well. Amino acids are required to build a lot of important things in the body.

If you do supplement vitamin D, D3 is the preferable variety, and be sure to take Vitamin K with it — & be sure to get a K that contains both K1 & K2. K is needed so that calcium does not get deposited willy-nilly through the body (think arteries). There's also evidence that appropriate magnesium levels are also needed for D to properly function.

Oh, here we go with the add ons. This is what I hate about supplementation advice. You start with one, and 6 months later they tell you you've been doing it all wrong, and that without magnesium or some such thing it's essentially worthless. Before you know it, you've got a whole cabinet of pills. And they all run out at staggered times. Been through this before. it's why I swore off vitamin supplents before. But they draw you back in with promotions like this! I don't know what to do.

And then one day you look up and realize you are taking megadoses of B6 and have lost your sense of proprioception.

Hate it when that happens

Yeah, it's obnoxious. The problem is that much of what gives the best results can't be had through diet anymore — for instance, seeing as soil used over and over again is rapidly becoming depleted of minerals, vegetables are left without the nutritional punch they used to pack. Supplementation isn't ideal, to be sure, but it can be done strategically. I've been using Cronometer (and I'm sure there are other great tools out there) to track not just macro- but micronutrients, and that's given me a good idea of what might be useful to add and what I don't need to. I put the note about D without K up simply as a PSA — there are some supplements that really shouldn't be taken alone, especially in large doses.

The only reason I started with vitamin D supplementation is because it stands to reaosn we are mostly deficient in it. I guess I'll start the K too, since they work together. I'm not dismissing the science, I just gotta draw the line somewhere.

Adding to D3 to a multivitamin a few times a week is not that hard.

Yeah, each step is not that hard, I admit. There's ample evidence that vitamin K with it is needed. I just hate how it sucks you in and don't want to waste time popping more and more pills.

Yeah it could, but I found the above is a shortcut. The multi at Trader Joe’s has all these vitamins in M/F versions also.

note that this has been "Published online 2021 Mar 5"

Don't forget your vitamin K. Excessive vitamin D can lead to arterial calcification, but vitamin K reduces this buildup.

In the paper I've quoted elsewhere in this thread, the authors say that there is no danger from this if calcium supplements are absent. They also reiterate your point about vitamin K. Sorry, no direct link. Try sci-hub.

if calcium supplements are absent

Sorry, could you explain that further? I supplement low amounts of both vitamin D and calcium, do I need to be worried about this vitamin k? And could you quote the title of the paper again?

Also shows that when the USA prevented people in nursing homes from even going outside (to get sun exposure) it was the worse thing they could have done. So the "lockdown" had direct impact on increasing likelihood of nursing home deaths.

Now you’re just speculating. The difference between association and causation has been already mentioned in this thread.

And you are only referencing the linked (now somewhat old) study. Other newer studies have already proven the link.

https://pubmed.ncbi.nlm.nih.gov/34684596/

Conclusions: The datasets provide strong evidence that low D3 is a predictor rather than just a side effect of the infection. Despite ongoing vaccinations, we recommend raising serum 25(OH)D levels to above 50 ng/mL to prevent or mitigate new outbreaks due to escape mutations or decreasing antibody activity.

>Also shows that when the USA prevented people in nursing homes from even going outside (to get sun exposure) it was the worse thing they could have done.

Is this something you feel is supported by the article or is this your own synthesis? And if it's the latter what sources led you to that conclusion?

Aside from denying them the benefits of Vitamin D and sun exposure, you're basically confining residents to a petri dish of circulating virus.

Have you not set foot in a poorer nursing home? You don't need a source to understand they aren't let outside much or given vitamin D. Just go pay those old people a visit and ask.

Of course the scientist control for seasons. Levels of vitamin D of course are related to sunshine. There's also correlation with obesity, etc. etc.

Very difficult to find out if then actually taking vitamin D as a supplement would do something valuable.

It's not difficult to discover this. Look at basic research with autoimmune patients. It's already well known.

Reminder that Vitamin D is a substance that can be toxic if taken in large doses.

How large? Kilos? Cubic Meters? Please give us a link.

Consult a doctor and get your levels tested instead.

Doses vary by person. Consult a physician.

"Acute toxicity would be caused by doses of vitamin D probably in excess of 10,000 IU/day, which result in serum 25(OH)D concentrations >150 ng/ml (>375 nmol/l). That level is clearly more than the IOM-recommended UL of 4,000 IU/day. Potential chronic toxicity would result from administration of doses above 4,000 IU/day for extended periods, possibly for years, that cause serum 25(OH)D concentrations in the 50–150 ng/ml (125–375 nmol/l) range (15)." (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6158375/)

As can coffee, sugar and even water.

Based on what I've seen I'm not convinced vitamin D is responsible for all of the benefits that get attributed to it. It is very hard to separate the impact of getting vitamin D from the sun from other effects like exercise and spending time in nature. If you're worried about vitamin D levels and can do it, I'd suggest small lifestyle changes like taking a 10 minute walk outside after meals before supplementing. Having said that, I do currently also supplement vitamin D since its winter.

> Conclusions: In conclusion, low serum 25 (OH) Vitamin-D level was significantly associated with a higher risk of COVID-19 infection. The limited currently available data suggest that sufficient Vitamin D level in serum is associated with a significantly decreased risk of COVID-19 infection.

This is not as strong a conclusion as it first sounds, for two reasons.

1. This says nothing about Vitamin D as a cure once you got infected. It might work, or it might not, but this study simply does not address the question at all.

2. Correlation (in this case the word used was "association") does not mean causation. A simple example would be something like this: people deficient in Vitamin D are more likely to spend a lot of times indoors, where the transmission of the virus via aerosols is higher. People who spend a lot of time outdoors will get both more Vitamin D and less exposure to the virus. So, if you supplement with Vitamin D but you spend a lot of time indoors, you might, or you might not get higher protection, but this study does not say it.

Getting more sun and/or taking vitamin D supplements (in moderation) seem like low risk things to try given the potential benefit.

I agree in the short term, but in the long term, sun exposure is a skin cancer risk.

In other news, living is strongly correlated to eventually dying

Almost everyone who has ever been alive eventually died.

It's a dangerous condition.

> in the long term, sun exposure is a skin cancer risk. That is not so clear. Moderate, non-burning sun exposure might have benefits that exceed the risks, according to [1]. I'll leave here the relevant quote:

  The message of sun avoidance must be changed to acceptance of non-burning sun exposure sufficient to achieve serum 25(OH)D concentration of 30 ng/mL or higher in the sunny season and the general benefits of UV exposure beyond those of vitamin D.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129901/

Skin cancer also has a very low mortality rate if you detect it early, which is pretty simple because you can see it growing on you.

Kinda hard to see it growing on your back. (As a kid I got sunburned--mostly on my back--several times, and am therefore at risk.)

Also, as one (or at least I) gets older, you get a lot of other skin "things": "age" spots, basal and squamous cell carcinomas (kinds of skin cancer, but not as concerning as melanoma), actinic keratosis (non-cancerous), keloids, freckles, and on and on. There are lots of guides on-line to distinguishing among them, but I've seen spots on myself that looked concerning, only to have my dermatologist (old and very experienced) tell me they're nothing to worry about--and sure enough, ten years later nothing has happened.

And on the other hand he found and removed a squamous cell carcinoma that I couldn't even see (yes, even with my glasses on!), confirmed by biopsy.

So I would never trust myself to detect a melanoma, or even a basal or squamous cell carcinoma. I visit the dermatologist once or twice a year, and he always reminds me to stay out of the sun (because cancer) and out of the full moon (because werewolf).

https://pubmed.ncbi.nlm.nih.gov/34684596/

Well. Maybe people exposed to sunlight are on holiday, and therefore less stressed and having a better lifestyle.

Remember “half of Italy” died in the beginning. Plent of vitamin d there

Not as much as you'd think; Rome is about the same latitude as Chicago, and they get a similar amount of sunshine (2,500 hours annually, according to a quick Google).

Most people don’t work outdoors, latitude does not matter much.

On the contrary. When it comes to skin type vs. vitamin D levels, then people with darker skin who live in the North are more deficient as you would expect.

Coincidentally or not, PoC/BAME folks have worse COVID outcomes in these countries, which could be due to vitamin D deficiency. There is of course socio-economic component too.

Italy has very high vitamin d deficiency

Italy is not a tropical Caribbean island as some people like to think. Torino and Milano even have sub 0C temperatures in the winter.

Sure, but it would rule out that Vitamin D is harmful wrt. COVID-19, right?

And you could look at the subset of data where people have a high vitamin D level due to supplements. If there is still a relationship there, then the argument for a causal relationship would be stronger.

> This is not as strong a conclusion as it first sounds, for two reasons.

1. This says nothing about Vitamin D as a cure once you got infected. It might work, or it might not, but this study simply does not address the question at all.

Huh? Everyone I know who thinks vitamin D might be helpful says you need to supplement with it on a consistent, ongoing basis, not try to take big catch-up doses once you get sick or wind up in the hospital. Given how safe and cheap it is (and that adequate vitamin D levels may be associated with a range of other improved health outcomes as well), even a 25% reduction in those risks would be a big deal.

Your points seem like massive strawmen to me:

> This says nothing about Vitamin D as a cure once you got infected.

I mean, yeah. There is literally nothing in the study, or literally any of the research I've read, that says anything about vitamin D being a benefit after you get infected, so I'm not sure why one would appear to think that's implied. It's like saying "Hey, this study isn't as strong as you think, because this study says nothing about vitamin D increasing your IQ."

The "correlation is not causation!!" bromide, while useful to understand in context, is overused, often given with examples that are more likely to be outlandish, with no backing evidence, than with a more straightforward explanation. As others have commented, there is evidence that vitamin D itself has a protective effect.

> The "correlation is not causation!!" bromide, while useful to understand in context, is overused, often given with examples that are more likely to be outlandish

I beg to differ. In fact way too many times people fall afoul of the ecological fallacy and it takes a bloody long time to be noticed.

> The "correlation is not causation!!" bromide, while useful to understand in context, is overused.

Maybe then we should take a look at an actual double blind randomized controlled trial. Preferably one with thousands of participants. Luckily, exactly such a trial just ended. It lasted 5 years, it started in 2016 and ended in 2021. It considered acute respiratory infections; Covid was not one at the beginning of the trial, but was by the end of it.

Here's the conclusion:

  Monthly bolus doses of 60 000 IU of vitamin D did not reduce the overall risk of acute respiratory tract infection, but could slightly reduce the duration of symptoms in the general population. These findings suggest that routine vitamin D supplementation of a population that is largely vitamin D replete is unlikely to have a clinically relevant effect on acute respiratory tract infection.

https://www.thelancet.com/journals/landia/article/PIIS2213-8...

For me the key words in this conclusion are “[…] largely vitamin D replete” but for example, during winter in the Northern hemisphere, are we as a population really Vit. D replete?

My understanding that, at least in the UK, vitamine D deficiency is relatively common.

As someone born and raised in sunny southern Europe, my GP prescribed Vitamin D supplements to take indefinitely because I had a deficiency after ten years in the UK.

Anecdotally they seemed to improve both my mood and my general health.

This is in Australia, the placebo group had no deficiency in the first place. By contrast, deficiency is commonplace in the northern hemisphere during winter.

Furthermore, other studies suggest that daily supplementation is superior to monthly boluses, as far as I remember.

Vitamin d deficiency is correlated to lower physical activity. We know health is correlated to Covid-19 outcomes. You need a double blind study to say there is evidence that it has a protective effect.

https://pubmed.ncbi.nlm.nih.gov/28289868/

Yes. Correlation does not implies causation. People with any kind of vitamin deficiency are probably less careful with their own health. There are many variables that must be removed before we can finally say anything with confidence about any vitamin and COVID-19.

Before my first vaccine dose I asked a former student (who admitted Mt Sinai's first case, and watched countless patients die) about my vitamin D and Clemastine regimen. I didn't want to interfere with the vaccine.

"No good deed goes unpunished!" is a bromide, that I was worried about here. "Correlation does not mean causation" is standard statistical caution.

She advised me to stop the Clemastine, despite no news whatsoever about its effects after the initial study I'd read, just in case it did work.

She advised me that my Vitamin D was irrelevant, that the prevailing consensus was that Vitamin D deficiency identified individuals at risk, but that taking Vitamin D didn't alleviate the correlated risk factors.

(On the subject of statistical reasoning, I'm not one for conspiracy theories. Conspiracy fatigue is however just as real as COVID fatigue. Even the LA coroner said RFK was shot point blank from behind, but after JFK... Still, a bat virus lab in Wuhan? I don't know about causality, but that's a pretty choice correlation.)

Dr. John Campbell has been talking about vitamin D effectiveness against Covid-19 for months now on his channel[1].

I find it frustrating that I get more thorough and well presented information from third party youtubers than from my government officials.

[1]: https://www.youtube.com/c/Campbellteaching

He's actually been talking about Vitamin D since April 2020 [0] and discussed the encouraging first clinical trial in September 2020 [1].

There are plenty of published studies on Vitamin D and its effects on Covid. I don't understand why healthcare guidelines don't mention or promote it more. The only reason I've come up with so far is that the pharmaceutical companies don't focus on it since there is no money to be made. Vit. D is basically free (€4 for a year's supply of 20 mcg/day). Without the push and lobbying from Pharma, I guess it doesn't get enough attention?

[0] https://www.youtube.com/watch?v=GCSXNGc7pfs

[1] https://www.youtube.com/watch?v=V8Ks9fUh2k8

He's also been credulously spreading nonsense about ivermectin and vaccine adverse events. Not someone worth listening to.

FWIW, he's also not a medical doctor. Not that he explicitly claims to be, but presenting medical information with a "Dr." in front of your name and no M.D. or Ph.D in a medically relevant field is kinda sketchy.

Oh come on. He's spent decades in the field as a nurse. He explains the latest literature on the subject in terms people can understand, and he obviously has the experience to do it. To dismiss him just because he's not a medical doctor is to ignore all the other medical fields. From what I've experienced, often times its the nurses who better equipped to understand the latest studies better than the doctors do, because they are more hands on. To dismiss so off-handedly indicates you are more politically motivated in your criticism than you care to admit. You are merely boosting for a "side".

By the way, he is merely pointing to the latest studies from the leading publications on ivermectin. He's pointed to both the good and bad. He even admitted that it's results were somewhat disappointing, but still showed a somewhat beneficial effect. And he points to the studies themselves.

Medicine seriously hurts its credibility when it doesn't report the shades of gray. When you don't do that, people don't trust it. Dr. John Campbell has proven to be a valuable resource in this pandemic, because he is playing it straight.

Nah. He signal boosts all the worst conspiracies of the pandemic; "Pfizermectin", abuse of VAERS data, the Pfizer "whistle blower", you name it. While trying to maintain the appearance of showing both sides neutrally and objectively. But look at his most watched videos and the comments on his videos. He's clearly playing into the anti-vax crowd, whether intentionally or not.

I completely reject the notion that nurses are better equipped than doctors to interpret studies in this context; biology, pharmacology etc. In some practical applications of medicine, maybe.

There’s a reason why my nursing colleagues have a (relatively) high degree of vaccine hesitancy and are losing their jobs - a proportion of them are just not capable of understanding the science and think that their experience (and Facebook feeds) are worth more than actual data. All of my anti vax leaning social media content comes from those colleagues (although let’s be clear it’s a small percentage and like all broad sweeping statements it applies in general only)

Not capable of understanding science? that's incredibly arrogant statement to make. Nurses study the science as part of their accreditation. I could just as easily say doctors are so busy treating patients and reading up on the latest CDC guidelines and bureaucracy they don't have time to read the latest science and explore any skepticism. But it's essential to science.

And if i didn’t know so many of them I would agree with you. However after numerous experiences beginning with the midwife who explained to me that demonstrating the plantar reflex too many times would result in the child having a stutter. Just one example of 10,000, however it is by no means definitive of the profession - what you don’t see however is 10%+ of doctors refusing the vaccine or sprouting nonsense. I don’t know what exactly point you’re trying to refute - nurses are practical but a proportion of them have no scientific capacity. A proportion that is a logarithmic difference from their doctor or allied health colleagues. And I basically went to slightly less lengths to caveat this in my previous post, but apparently you’re a pedant

wow. It's almost like you meant to reply to some other post. That's not at all what this thread is talking about. Dr. Campbell was not a midwife. He was a teaching nurse. He's accustomed to reading these studies.

Not sure how you equate him with anti-vax. He's adamantly pro-vax.

And that is all irrelevant because I am not at all talking about whoever this Dr Campbell person is who I have never heard of until you brought them up in your earlier thread. My original post is completely seperate to any context of him and it should be read as such- but at least you’re finally becoming capable of parsing my posts

The pfizer whistleblower was published in the British Medical Journal, not exactly a shabby publication. True or false, it was a news event and at least should be addressed. The fact that it's been largely swept under the rug is not a good sign for science, which is built on skepticism, not compliance. I am willing to dismiss the whistleblower as nothing but smoke, if someone answered it. So far, they have not. Which is telling.

VAERS data is self-reported data, so it is far from conclusive. However, it was put there for a reason and shouldn't be ignored. It was put there to flag problems that need to be investigated.

Pfizermectin is not a conspiracy. He's just noting both ivermectin and the pfizer therapeautic are both protease inhibitors. That's all he said.

None of these are "conspiracies". So far, they are inconvenient truth assertions that a certain people seem to want to put down. We deserve, we are entitled to a fuller discussion than they are given.

The conspiratorial aspect of the whistleblower situation isn't that it happened. It undoubtedly did. It's making a mountain out of a molehill and implying that the larger body of vaccine safety/efficacy data is suspect because of it. Maybe he doesn't imply this in so many words, but look at the titles of all his videos on vaccines (nearly universally highlighting supposed negative aspects) and tell me that's not the angle he's trying to convey.

"Pfizermectin" is absolutely a full blown conspiracy theory that contends Paxlovid is functionally the same as ivermectin and there was an effort by Big Pharma to suppress ivermectin while they developed an on patent alternative. He repeatedly emphasizes that ivermectin is cheap in his video. I can't put myself through watching any more of it, but I can only assume he doesn't mention that the required concentrations for ivermectin to display said protease inhibition aren't achievable in vivo.

"making a mountain out of a molehill" is not a conspiracy. I've noticed a long running trend with people calling something a conspiracy as a means to conveniently dismiss something they'd rather not bother with. The whistleblower was hired by the company pfizer contracted to do the trials as an auditor. Her very job was to audit the trials to ensure it was being done right. She claims she was fired for bringing it up. You don't see a problem with that? Why do they even have auditors?

Dr. Campbell did say it was cheap, because it IS cheap. Why do you assume its something nefarious. He also didn't make any promises that it was a miracle drug, only that read a good study in which it demonstrated SOME efficacy. That can mean thousands of lives saved, if there is no other alternative. I think the number was 62% effectiveness, but i'm not sure. He gave the good and bad. That's the sign of a straight shooter. Someone who treats their viewers like adults that can make up their own mind.

The whistleblower situation is an issue. It is not substantial cause for concern about the body of data demonstrating vaccine safety/efficacy. If you're interested, here's a thorough breakdown of the situation: https://sciencebasedmedicine.org/what-the-heck-happened-to-t...

There are no good studies on ivermectin indicating anything like 62% effectiveness on any metric. The fact that he would present such a study to his audience indicates he is either: not equipped to interpret the studies, or deliberately spreading misinformation.

yeah, I read that response to the BMJ article. I find their dismissal of the concerns to be unconvincing and an unserious attempt to respond. Just the title - "what the heck happened to the BMJ?" - conveys that message. Then they proceed to impugn the character of the reporter and the whistleblower. Using ad hominen attacks and trying to wave it off as "all handwavy stuff" should be a red flag.

He was the one who decided to stick “dr” in front of his name. That was optional.

Isn't he a doctor of nursing who teaches nurses?

I'm a doctor too, if not having a medical degree counts when providing medical advice.

When your nurse practitioner gives you medical advice do you claim you're just as much a doctor as them and their degree doesn't qualify them to give medical advice? It is absurd to claim someone with a doctor in nursing doesn't have a medical degree.

"...a Ph.D. in Nursing program is a research and science-focused degree that prepares nurses for careers conducting important medical research that will advance the entire nursing profession and for teaching nursing at the college level."

https://www.registerednursing.org/phd/

What ivermectin nonsense are you referring to? In every video I've watched he is summarizing from respected peer reviewed journals, and all sources are mentioned and / or linked.

If we consider that most people are possibly deficient in Vitamin D, then it’s not surprising to see. That really doesn’t tell us anything. Or do I misunderstand?

Also by curiosity, are there any conclusive evidences that supplementing Vitamin D is beneficial for anything? I’m taking it as recommended by my doctor but I’m wondering.

Why not try reading the linked article?

I did but I’m not a scientist and I don’t know how to interpret the full study either. I’m asking a legitimate question based on the abstract. I’m trying to understand something and I get downvoted instead.

What happened to this community?

I thought the abstract was pretty readable. There have been many articles on this and the site as well.

HN has a weird philosophy and has always been downvote happy. Wouldn’t take it personally, think of people trying to get the best comments to the top, and have limited tools. Still, when HN is good it’s the best.

Rereading your comment it kinda has a “please do my homework” vibe.

This is an "old" publication. Are there newer analyses?

The irony of being confined to my house during one of the best summers my country has ever known, to "fight" a disease that is well-known to be worse for vit-D deficient people.....

First, I am not an anti-vaxxer, I think we need vaccines AND better health and nutrition to get through the pandemic.

So why is this a surprise? Why do you think we need these vitamins and hormones? (Vitamin D is actually a hormone) For our health! You will find that many of the risk factors of COVID are also outcomes of vitamin D deficiency.

https://portlandpress.com/biochemj/article-abstract/474/8/13... https://clinicalhypertension.biomedcentral.com/articles/10.1...

But what should be being studied even more than Vitamin D?

ZINC.

A zinc deficiency not only effects ACE and ACE2, but also ADAM17, which cleaves ACE2 off the cell to make soluble ACE2. When the virus attaches to soluble ACE2 it cannot enter the cell.

https://www.mdpi.com/viruses/viruses-12-00491/article_deploy...

More studies on Soluble ACE2 and COVID that are constantly ignored:

A novel soluble ACE2 protein protects from lethal SARS-CoV-2 infection https://pesquisa.bvsalud.org/global-literature-on-novel-coro...

Bioengineered angiotensin-converting-enzyme-2: a potential therapeutic option against SARS-CoV-2 infection https://www.nature.com/articles/s41371-021-00636-y

Tumor Necrosis Factor-α Convertase (ADAM17) Mediates Regulated Ectodomain Shedding of the Severe-acute Respiratory Syndrome-Coronavirus (SARS-CoV) Receptor, Angiotensin-converting Enzyme-2 (ACE2) https://www.sciencedirect.com/science/article/pii/S002192582...

AKI in a mouse model of COVID-19: Therapeutic potential of a novel soluble ACE2 variant https://pesquisa.bvsalud.org/global-literature-on-novel-coro...

Killing Two Birds with One Stone by Administration of Soluble ACE2: A Promising Strategy to Treat Both Cardiovascular Diseases and SARS-CoV-2 Infection https://www.mdpi.com/1999-4915/13/11/2243

Potent prophylactic and therapeutic efficacy of recombinant human ACE2-Fc against SARS-CoV-2 infection in vivo https://www.nature.com/articles/s41421-021-00302-0

Soluble ACE2 in SARS-CoV-2 infection https://www.nature.com/articles/s41581-021-00422-6

Zinc supplementation bolsters repurposed antivirals against SARS-CoV-2 https://www.news-medical.net/news/20210202/Zinc-supplementat...

COVID-19: Poor outcomes in patients with zinc deficiency https://www.sciencedirect.com/science/article/pii/S120197122...

I agree. Take a zinc copper combination. Taking one will lower the other and vice versa.

Just a correction, Zinc only lowers copper, copper does not lower zinc. Zinc creates metallothioneins that stops copper from being absorbed into circulation from the intestine.

https://onlinelibrary.wiley.com/cms/asset/209a432f-1eb4-4c01...

there is Doctor in Brazil "Dr coimbra". who is famous for defending huge doses daily of Vitamin D > 10.000UI/day ( sometimes 100.000UI/day ). He have followers similar to a cult, its impressive how preenche the use of vitamin-d to every Kind of desease.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6158375/

Vitamin D is great for the immune system. Should help with all infections. Including Covid. Always good to do the research ofc. But I'm not exactly surprised.

Given that a lot of the COVID morbidity and mortality is the cytokine storm rather than the infection itself, I wouldn't consider it a priori clear that Vitamin D helps, is neutral, or harms patients who get COVID.

The result isn't sufficient to answer the question. It establishes, generally, that Vitamin D deficient people are more likely to get COVID. It is not able to establish whether these suffer a common cause which affects both Vitamin D levels and COVID (even simple geography or SES would matter -- poor people are more likely to be vitamin deficient, and also more likely to work and live in a manner that exposes them to COVID). The included studies in the meta-analysis seem inconsistent about whether they attempt to adjust (in a "selection on observables" sense) for confounders, but only a few even mention confounders. For that reason I am not sure the use of the causal language "impact of... on" in the title is justified.

I would consider this a lead that is worth investigating, but haven't really adjusted my very diffuse priors on the basis of this MA.

> Given that a lot of the COVID morbidity and mortality is the cytokine storm rather than the infection itself, I wouldn't consider it a priori clear that Vitamin D helps, is neutral, or harms patients who get COVID.

Autocrine vitamin D signaling switches off pro-inflammatory programs of cells: https://www.nature.com/articles/s41590-021-01080-3

You're identifying the right threat with Covid but you're misrepresenting the role of vitamin D: it is exactly through cytokine regulation that increased Vitamin D concentration is beneficial.

See for example this study, from 2014: https://pubmed.ncbi.nlm.nih.gov/25331710/

In conclusion, severe vitamin D deficiency is associated with elevated inflammatory cytokine concentrations in diabetic patients

Interesting. Thank you.

Vitamin D is also correlated with exposure to ultraviolet light, i.e. sunlight. In that case, exposure to sunlight is a direct cause of vitamin D synthesis.

Exposure to sunlight causes other things to happen. One of those things is that trans-urocanic acid—a substance synthesized by the body and found on the skin—is converted to the cis isomer, so into cis-urocanic acid, which induces immune suppression by activating serotonin receptor 5-HT2A. Sunlight reduces inflammation through the end result of activating a serotonin receptor! (This is wild!)

Source:

• Cis-urocanic acid, a sunlight-induced immunosuppressive factor, activates immune suppression via the 5-HT2A receptor, Proceedings of the National Academy of Sciences, 2006 — https://doi.org/10.1073/pnas.0603119103

It's all very interesting. I'm super curious.

(As far as I know, the 5-HT2A receptor is unusual among serotonin receptors in that it causes immune suppression; As I understand it, most of the other serotonin receptors cause immune system activation in the context of the immune system. And afaik serotonin receptors are widely purposed in the immune system.)

Now. COVID-19 is a disease of inflammation and clotting. As far as I know, plasma serotonin is greatly elevated in COVID illness. Platelets have both serotonin transporters and serotonin receptors – type 5-HT2A. (In platelets, that receptor happens to induce clotting, not immunomodulation.) There is a strong correlation between SSRI use—serotonin reuptake inhibitors—and people faring much better with a COVID-19 infection.

Randomized clinical trials have shown this:

• Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial – The Lancet, October 17, 2021: https://www.thelancet.com/journals/langlo/article/PIIS2214-1...

Observational studies have shown a correlation. Here's a recent, large one:

• Mortality Risk Among Patients With COVID-19 Prescribed Selective Serotonin Reuptake Inhibitor Antidepressants – Journal of the American Medical Association, November 15 2021: https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

And there are plausible mechanisms of action:

• Fluvoxamine: A Review of Its Mechanism of Action and Its Role in COVID-19 – Frontier in Pharmacology, April 2021: https://www.frontiersin.org/articles/10.3389/fphar.2021.6526...

The following preprint on the proposed mechanism of action is super interesting. It's a preprint but as far as I know the mechanisms have shown to hold true.

• COVID-19 Pathophysiology: Are Platelets and Serotonin Hiding in Plain Sight?, preprint dated February 5, 2021: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3800402

Frankly, I'd be willing to bet real money that at least part of the correlation between having little vitamin D and faring poorly with COVID-19 is a reflection of a causative relationship: Little exposure to sunlight causing less than usual 5-HT2A-receptor immunomodulation causing more severe disease.

How? Not exactly sure. But the papers try to present the case (and do so much better than a HN rando). I'm thinking receptor up/downregulation might have something to do with it maybe. And what seems to be the role of the 5-HT2A receptor as a negative feedback point in general in the immune system.

> Vitamin D is great for the immune system.

> Always good to do the research ofc. But I'm not exactly surprised.

How can you say whether it’s good or not without doing the research in the first place?

If you are vitamin D deficient. If not, taking supplements is a waste of time and may cause other long-term problems.

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