Comment by nick_ | Hacker News Reader

Comment by nick_ | Hacker News Reader

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> By contrast, normalizing vitamin D levels, eating healthier (more fruits, vegetables, nuts, seeds, whole grains, etc), achieving a healthy weight, sleeping better, having less stress, having positive social interactions, and so on all have been shown to boost the immune system and reduce the burden of most infectious disease -- along with reducing the economic burden of many other health issues resulting from "diabesity" and also reducing many costly mental issues like depression.

Those are things everyone should be doing for their general health. Citing general health recommendations for a specific illness would be redundant. In other words, not a conspiracy.

Furthermore, general good health does not prevent someone from catching a virus, nor getting ill from it. Of course it may diminish both the likelihood of catching it and the severity of the resulting illness, but, again, the point of the sentence you quote is that a _specific_ tool for mitigating the scale and severity of a _specific_ contagion from the health care system's perspective is effective.

And of course, you can be the healthiest most diligent person in the world, and if you run into a heavy hitter it'll still take its shots at you. Bryan Johnson who is focused on life extension caught covid and measured that it decreased his lung capacity and that many months later it was still decreased compared to prior.

As the old adage goes, an ounce of prevention is worth more than a pound of cure.

From "Here’s How to Avoid Catching Colds and the Flu": https://time.com/4672626/vitamin-d-cold-flu/ "For the new study, a meta-analysis published in The BMJ, researchers looked at individual data from nearly 11,000 people who had participated in randomized controlled trials in more than a dozen countries. The researchers found that people who took daily or weekly vitamin D supplements were less likely to report acute respiratory infections, like influenza or the common cold, than those who did not. Those who had low vitamin D levels before they started supplementation got the biggest benefit: For people with the most significant vitamin D deficiencies (blood levels below 10 mg/dl), taking a supplement cut their risk of respiratory infection in half. People with higher vitamin D levels also saw a small reduction in risk: about 10%, which is about equal to the protective effect of the injectable flu vaccine, the researchers say. No significant benefits were associated with high doses of vitamin D spaced out over larger periods of time."

So, given this BMJ-published research, why can researchers in the article's paper get away with claiming that flu vaccines are more effective than any other option (including vitamin D supplementation) when the research suggests otherwise?

> why can researchers in the article's paper get away with claiming that flu vaccines are more effective than any other option (including vitamin D supplementation) when the research suggests otherwise?

What is the prevalence of <10 mg/dl Vitamin D deficiency in population? (Serious question.)

(I'm pretty sure you mean ng/mL. Some countries measure in nmol/L, too. [1], [2])

Obviously it depends on which "population" you're talking about, but it's pretty common. Insufficiency is also relevant and should be avoided if possible. The NIH estimates perhaps 1 billion global cases of deficiency (including "subclinical deficiency") and "50% of the population" (so ~4 billion) cases of insufficiency. [3] Prevalence unsurprisingly varies by sun exposure (climate and lifestyle) and absorption (i.e., "skin melanin content" as [3] puts it), and also by age.

Vitamin D supplements are quite cheap. I currently take 4000 IU/day and have taken as much as 10000 IU/day (for months at a time) in the past. Whatever the government might imply with its "RDA" or whatever, this should be completely safe, at least for anyone without very specific preexisting medical conditions - and the treatment for excess vitamin D levels (and the commonly associated hypercalcemia) is generally to just lay off for a while ([2], [4], [5]). Supplementation does work - I have blood tests to prove it. Regardless of any of the previous discourse about influenza or any other virus, it's probably a good idea for a very large fraction of the HN audience.

[1]: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessiona...

[2]: https://en.wikipedia.org/wiki/Vitamin_D

[3]: https://www.ncbi.nlm.nih.gov/books/NBK532266/

[4]: https://en.wikipedia.org/wiki/Vitamin_D_toxicity

[5]: https://en.wikipedia.org/wiki/Hypercalcaemia

> pretty sure you mean ng/mL

Re-read your own comment.

> Insufficiency is also relevant and should be avoided if possible

Sure. But that isn't relevant to the clinical question of reducing hospitalisation. About 40% of the American population is deficient to some degree; if we assume half are deficient to your threshold, that explains why vaccines are the most effective method: 40% (flu vaccine efficacy) of 100% (total population) is more than even 100% (assuming 100% efficacy of Vitamin D in preventing ILI hospitalisation, which is of course nonsense) of 20%.

> supplementation does work - I have blood tests to prove it

Nobody debates this. I take vitamin D.

> it's probably a good idea for a very large fraction of the HN audience

It's a good idea to talk to a doctor about it. Vitamin D is a hormone. Self administering large doses of hormones isn't good broad-spectrum advice.

>Re-read your own comment.

My comment says ng/mL and nmol/L, and my sources agree. Your comment says mg/dl, which is different. A milligram of 1,25-dihydroxycholecalciferol is quite a lot; the nanogram range makes much more sense for this measurement. As you say, it's a hormone.

>Sure. But that isn't relevant to the clinical question of reducing hospitalisation.

I answered the question you asked, and I'm not the person you were originally responding to.

>Nobody debates this.

I'm glad that you don't, and that apparently nobody you know does. My personal experience differs.

>Self administering large doses of hormones isn't good broad-spectrum advice.

When I told my primary care physician about what I had done many years ago on the advice of a specialist, he told me quite directly that basically everyone around here should be supplementing vitamin D (particularly given how common it is to spend so much of our lives indoors). Toronto is not even at the 45th parallel. The doses in question are really not large, taken for example in the perspective of their measurable pharmacological effects.

> My comment says ng/mL and nmol/L, and my sources agree

Buddy, I copy pasted ng/mL from your comment. You're correct to have amended it into IUs. (EDIT: Never mind, nothing was amended.)

> he told me quite directly that basically everyone around here should be supplementing vitamin D

Sure. That's medical advice.

>Buddy, I copy pasted ng/mL from your comment.

Yes, that's the point. My comment says ng/mL, because it should say ng/mL, because that is the correct unit for blood serum level (i.e., the thing that is tested in order to determine deficiency). In your first comment, you wrote mg/dl, which is incorrect. I did not "amend" anything to IUs. IUs are the dosage unit for supplementation. It's irrelevant to my initial correction.

>Sure. That's medical advice.

It's medical advice that explicitly indicated that the sort of personal request for medical advice you propose, is not actually necessary.

> My comment says ng/mL

It still says "blood levels below 10 mg/dl" [1]!

[1] https://news.ycombinator.com/item?id=41906361

That is not my comment, but pdfernhout's.

Once again, having vitamin D levels within the recommended range correlates with many aspects of _general health_. It does not have any _specific_ influence on influenza viruses. Not only is it not specific, but taking vitamin D doesn't directly do anything except raise one's existing vitamin D levels.

If you don't understand the difference between A) the general health benefits of not being deficient in a vitamin/mineral/amino-acid/etc., and B) a _specific_ vaccine's effects against a _specific_ pathogen (or group of pathogens), I don't know what else to tell you.

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