Post by Emperor AAdmin on Nov 23, 2021 12:02:02 GMT -5
very interesting artile.
Talks also how different races react differently with vitamin D production!
How much does vitamin D protect us from diseases like COVID?
Popping vitamins and sitting in the sun became popular self-care practices during the pandemic.
But doctors are still digging into the sunshine supplement's supposed magic.
By MK Menon | Published Nov 23, 2021 6:00 AM
The latest research on vitamin D and increased immunity from diseases like
COVID-19 shows some interesting, but confounding results.
Deposit Photos
“What is this nonsense?” Erica Rice, a social worker from California, remembers thinking
while she watched the rambling video her aunt had shared on Facebook. A middle-aged
woman in Hunstville, Alabama, stood on her porch telling viewers they needed to get
outside and lay in the sun to prevent “the COVID.”
It was April 2020, early in the pandemic—before masks became like a second skin—and
Rice assumed the minutes-long clip was just one of the many virus-conspiracy theories
plaguing the internet. But telling people to soak in ambient light, breathe fresh air, and
keep their immunity high seemed a lot more benign than advising them to guzzle bleach,
snort cocaine, or even sit in a tanning bed. Besides, her aunt, an astute, college-educated
woman, had posted the idea on her feed. Maybe there was something to it?
The video carried an easy take-home message that gained popularity as COVID-19 rates
skyrocketed in the US, despite the lack of scientific backing. Angelique Campen, an
emergency medicine physician at Ronald Reagan UCLA Medical Center, isn’t surprised by
how much misinformation proliferated during the pandemic—especially given the poor
insight among health care professionals. “Doctors are used to knowing the science and
knowing what to do,” she says. “But this has been a time where you really didn’t know
what treatments worked. People were grasping at straws and holding on to the ones
that fit. It was trial and error.”
And while sunbathing has largely been debunked as a COVID cure, medical experts are
And while sunbathing has largely been debunked as a COVID cure, medical experts are
paying closer attention to the notion that UV rays could play a hand—or at least a pinkie—in
fortifying the human body against disease. For decades, researchers have looked at vitamin
D’s role in illnesses like bone disorders, diabetes, cancer, depression, and autoimmune
diseases with some positive results. But understanding the complex nutrient has proven
challenging and messy, particularly in highly melanated individuals, who often test low for
it. Now, with more than 47 million coronavirus cases logged in the US and variants emerging
rapidly, there’s a new wave of urgency to settle the hype around the “sunshine supplement.”
How vitamin D works in your body
Vitamin D is best known for building strong bones, but it also plays a pivotal role in the
Vitamin D is best known for building strong bones, but it also plays a pivotal role in the
immune and respiratory systems, the main targets of SARS-CoV-2 and its developing variants.
Only a handful of foods are naturally rich in the nutrient—oily fish, egg yolks, mushrooms,
red meat, and liver—which is why it’s added to many cereals, milks, and juices post-process.
But it’s called the sunshine supplement for a reason: The body can produce its own supply,
but it needs solar power to do so.
Your skin already contains a precursor of vitamin D called 7-dehydrocholesterol, but only
Your skin already contains a precursor of vitamin D called 7-dehydrocholesterol, but only
the sort of ultraviolet B radiation found in the sun’s rays can kick off a multi-step process
towards turning that precursor into a functional nutrient. While the body can’t use these
so-called previtamin as-is, it’s a good predictor of how much active ingredient you can
make. In fact, many doctors use one of the previtamins, 25-hydroxyvitamin D, as a
baseline when checking blood vitamin D levels.
Here’s how the process works. When triggered by solar radiation, the vitamin D binding
Here’s how the process works. When triggered by solar radiation, the vitamin D binding
protein (DBP) in your blood plasma grabs 7-dehydrocholesterol and carries it to your liver
and kidney, where it’s chemically reshaped into an active form of vitamin D, or calcitriol.
The homespun nutrient then gets recruited by the immune system to run the power switch
on a number of anti-bacterial and anti-inflammatory defenses (though the exact
mechanisms by which it does so remain a mystery).
But it’s not as simple as sunshine in, vitamins out: In people with certain racial backgrounds,
especially those of African origin, the binding protein may latch on too tightly to the precursor,
which means it can’t produce and release vitamin D as needed. Compounding this is the fact that
the pigment, which darkens skin and hair, acts like a natural sunscreen by absorbing
UV B radiation. Consequently, this slows down the initial binding process and the conversion
of the vitamin D precursor.
As a result, Black and Hispanic individuals are more likely to be more deficient in vitamin D
As a result, Black and Hispanic individuals are more likely to be more deficient in vitamin D
than their white peers. An extra dose of sunshine can help, but darker-skinned people may
need anywhere from 30 minutes to three hours more time in the daylight to produce the
same amount of the stuff as white folks. Many clinicians suggest supplements for necessary
back-up, even with little evidence of benefits against a virus that’s disproportionately
affecting Blacks and Hispanics.
The vitamin D and COVID-19 connection
While low vitamin D levels can’t be blamed for the many racial inequities in COVID mortalities,
some medical experts are now wondering if the nutrient could be a fringe factor. Studies established
correlations between vitamin D deficiency and higher risks of developing immune system disorders
like multiple sclerosis, arthritis, diabetes and respiratory infections long before the pandemic.
There’s also evidence of supplements helping lab animals and patients with heart disease markers
regain their health.
The link between vitamin D and coronavirus first appeared in a paper by Northwestern University
The link between vitamin D and coronavirus first appeared in a paper by Northwestern University
researchers in April 2020 (the results still have to undergo peer review). They looked at publicly
available hospitalization, recovery, and mortality rates along with reported pre-pandemic
vitamin D levels from 10 countries, including the US. The authors noticed that elderly patients with
low concentrations of vitamin D in their blood had higher COVID-19-related mortality in six of the
countries in the sample. In the end, the authors suggested that the deficiency could be a potential
risk factor for severe COVID-19 infection.
A slew of other COVID-centered data on vitamin D followed later in 2020. David Meltzer, the chief
A slew of other COVID-centered data on vitamin D followed later in 2020. David Meltzer, the chief
of hospital medicine at the University of Chicago Medicine, also conducted a retrospective analysis
of vitamin D levels in 489 hospitalized patients a year prior to COVID. His results, published in The
Journal of the American Medical Association in September of 2020, revealed that patients with low
vitamin D levels were 77 percent more likely to test positive for COVID-19.
“The are multiple streams of evidence that suggest that vitamin D is part of an extremely
complicated system, or at least a complex system that has variability by race.”
David Meltzer, University of Chicago Medicine
Others looked at the impact of supplements in fighting the disease. One meta-analysis in The
Lancet looked at whether treating people with vitamin D impacted the rate of respiratory tract
viral illnesses in 25 randomized double-blind trials. The findings showed that participants with
low vitamin D levels who received daily supplements saw a 70-percent reduction in the
infections. But a randomized clinical trial published around the same time in Brazil didn’t find
any positive or negative outcomes of treating hospitalized COVID patients with vitamin
D supplements.
Monica Gandhi, an infectious diseases doctor and professor of medicine at University of
Monica Gandhi, an infectious diseases doctor and professor of medicine at University of
California-San Francisco, notes that much of this published work is observational, which means
it looks for trends but doesn’t directly measure the effect of a treatment. What’s more, with
small sizes and no control and experimental groups, she says, it’s almost impossible to
establish a scientifically sound conclusion.
Why melanin further colors the question
A few studies published in the past two years have tried to break down vitamin D-COVID
A few studies published in the past two years have tried to break down vitamin D-COVID
impacts by race. That’s where it gets tricky.
CDC data collected over the course of the pandemic holds that non-Hispanic American
Indians, non-Hispanic Blacks, and Hispanic or Latinos in the US were roughly three
times more likely to be hospitalized from COVID than their Non-Hispanic Asian,
Pacific Islander, or white peers. Campen, of Ronald Reagan UCLA Medical Center,
notes that, anecdotally, she saw patients of color suffering from worse
symptoms—but she’s not yet convinced that vitamin D deficiency is the reason.
After all, minorities are more likely to share rooms in multi-generational households
and work essential jobs, which increases their exposure to SARS-CoV-2. Underlying
health conditions such as Type 2 diabetes can also increase the risk of severe infection.
Still, Campen thinks additional effort should be put into understanding how different
Still, Campen thinks additional effort should be put into understanding how different
bodies handle COVID-19, beyond the socioeconomic factors. Meltzer agrees—though
he cautions that it’s difficult to tease out individual variables while investigating the virus.
Another retrospective study he published in March 2021 suggests that Black people with
vitamin D levels lower than 40 nanograms per milliliter may be more susceptible to
COVID than white individuals.
“There are multiple streams of evidence that suggest that vitamin D is part of an
“There are multiple streams of evidence that suggest that vitamin D is part of an
extremely complicated system, or at least a complex system that has variability by
race,” Meltzer says. “But we absolutely would never want to argue that the
differences we see in COVID risks or outcomes by race are some product of a
particular biological mechanism. It’s clear that race is way bigger than vitamin D.”
“That’s not to say that vitamin D is not part of what we see by race or that we may
have different needs because of the backgrounds that we come from,” Meltzer
continues. “Research that tries to understand those needs could potentially be an
important part of addressing these challenges.”
In the context of other at-home COVID treatments
Unfounded coronavirus treatments have put health care professionals on edge
Unfounded coronavirus treatments have put health care professionals on edge
throughout the pandemic. But the disease has presented a moving target for researchers
and people desperate for solutions at home. Some COVID-19 studies (more than 100,
according to Retraction Watch) have been pulled from publications due to questionable
data or results. The most prominent one was a June 2020 paper in the Lancet, which
claimed the malaria drug hydroxychloroquine could severely harm hospitalized
COVID-19 patients. The FDA ultimately revoked the use of the treatment, but only
because of poor efficacy and other safety concerns.
While far more benign, vitamin D shouldn’t be billed as a miracle drug against
COVID-19 either. “Vitamin D is really complicated,” Meltzer says. “There’s meaningful
racial diversity; there’s exposure through both diet and environment.” Combine that
with the fact that supplements are largely unregulated in the US, and the intricacies
of human physiology—the many pathways for ingestion, binding, and production—and
you have a maze of medical quandaries that still need to be mapped out.
But there hasn’t been a big push to dig deeper, despite the loose correlation between
But there hasn’t been a big push to dig deeper, despite the loose correlation between
vitamin D supplementation and severe outcomes of COVID and other diseases. The
nutrient is cheap, accessible, and unpatentable, which makes it hard to raise capital
and interest for a randomized study involving tens of thousands of patients, both
Campen and Gandhi say.
Nonetheless, neither of them sees a problem with people taking vitamin D in a bid to
Nonetheless, neither of them sees a problem with people taking vitamin D in a bid to
outlast the pandemic (it’s harmless unless taken in extreme quantities). In fact, Gandhi
says it’s good for individuals to keep their levels up, given the many benefits that
calciferol carries for the body. Interestingly about 50 percent of the world’s population
is vitamin D-deficient to varying degrees. But that shouldn’t be a substitute for proven
COVID defenses, like getting vaccinated and wearing masks in public.
Another positive aspect of the “sunshine supplement” and COVID debate is that it
brings the lack of medical knowledge on Black and Hispanic communities into focus.
There needs to be more research on how social inequities like health care access and
workplace safety affect a person’s immunity—and how they compound with genetic and
molecular differences across racial backgrounds. The vitamin D binding protein is a
stark example.
Understanding the inner workings of a novel virus in a space as unstable as the human
Understanding the inner workings of a novel virus in a space as unstable as the human
body is an enormous feat. The past two years have been devoted to that—maybe now
doctors will have an opening to tackle the other eyebrow-raising ideas on Facebook feeds.
Comments:
Robin Whittle
3 hours ago
3/3 Although some of the trial's success can be attributed to the control group having
more co-morbidiities, most of the stunning results were due to this single dose boosting
25-hydroxyvitamin D levels safely over 50ng/ml in 4 hours. ICU admissions were
reduced from 50% to 2% and deaths from 8% to zero.
The Harvard guide is based on the needs of the kidney - not the needs of the immune
The Harvard guide is based on the needs of the kidney - not the needs of the immune
system. Quraishi et al. 2014 "Association Between Preoperative 25-Hydroxyvitamin D
Level and Hospital-Acquired Infections" found that the risk of post-operative infections
rose dramatically above 2.5% the more pre-operative 25-hydroxyvitamin D levels were
below 50ng/ml 125nmol/L. This - and the calls of researchers and MDs since 2008
"Call to D*action" - mean that 50ng/ml is a good target.
Afshar et al. 2020 "Suggested role of Vitamin D supplementation in COVID-19 severity"
Afshar et al. 2020 "Suggested role of Vitamin D supplementation in COVID-19 severity"
found that 70 to 100IU D3 per day per kilogram bodyweight consistently resulted in
25-hydroxyvitamin D levels between 40 and 79ng/ml, which is an excellent outcome.
For 70kg 154lb bodyweight, this is 0.123 to 0.175 milligrams, 4900 to 7000IU/day.
4 hours ago
1/3 Neither food not multivitamins contain vitamin D3 in the
quantities required for full immune function. UV-B skin exposure can
provide sufficient D3, but raises the risks of skin cancer.
Supplementation is the most practical way of attaining the 50ng/ml
125nmol/L 25-hydroxyvitamin D levels required for rapid, full and
properly regulated immune responses, all year round.
1/3 Neither food not multivitamins contain vitamin D3 in the
quantities required for full immune function. UV-B skin exposure can
provide sufficient D3, but raises the risks of skin cancer.
Supplementation is the most practical way of attaining the 50ng/ml
125nmol/L 25-hydroxyvitamin D levels required for rapid, full and
properly regulated immune responses, all year round.
This article's description of the three vitamin D compounds is
incorrect. 7-dehydrocholesterol is converted in the skin, by UV-B, into
vitamin D3 cholecalciferol. This - and any D3 which is ingested - goes
into circulation and over a period of days is hydroxylated in in the
liver to circulating 25-hydroxyvitamin D AKA calcifediol, as measured in
blood tests. Some of this is hydroxylated again in the the kidneys to
produce a very low level of circulating 1,25-dihydroxyvitain D
(calcitriol) which acts as a long distance, blood-borne signaling
molecule (hormone) to regulate calcium-bone metabolism. The kidneys and
the parathyroid gland work together to tightly control this very low
level of 1,25-dihydroxyvitamin D.
Immune cells are not affected by this stable, low, hormonal
level of 1,25-dihydroxyvitamin D. They require a good level of
25-hydroxyvitamin D as an input to their autocrine (within each cell)
and paracrine (to nearby cells) signaling systems, which are crucial
mechanisms which enable each cell to respond to its changing
circumstances.
2/3 These systems are only activated at particular times and
the 1,25-dihydroxyvitamin D produced when they are activated is at a
much higher level than the background of hormonal 1,25-dihydroxyvitamin
D.
Without proper D3 supplementation or recent UV-B skin exposure,
most people's 25-hydroxyvitamin D levels are only 5 to 25ng/ml - so
their immune systems cannot mount strong innate and adaptive responses
to pathogens, and are at higher risk of generating the wildly
dysregulated inflammatory (cell destroying) responses which drive severe
COVID-19, sepsis, Kawasaki disease and Multisystem Inflammatory
Syndrome.
The Murai (Brazil) trial of bolus (high, single, dose) D3
failed because it was given so late in the disease progression.
Absorption and poor liver function may al
so have played a role.
Castillo et al. 2020 "Effect of a Single High Dose of Vitamin D3 on
Hospital Length of Stay in Patients With Moderate to Severe COVID-19
" used a single oral dose of 0.532mg calcifediol (which is 25-hydroxyvitamin
D) at the earliest opportunity with hospitalised COVID-19 patients.
the 1,25-dihydroxyvitamin D produced when they are activated is at a
much higher level than the background of hormonal 1,25-dihydroxyvitamin
D.
Without proper D3 supplementation or recent UV-B skin exposure,
most people's 25-hydroxyvitamin D levels are only 5 to 25ng/ml - so
their immune systems cannot mount strong innate and adaptive responses
to pathogens, and are at higher risk of generating the wildly
dysregulated inflammatory (cell destroying) responses which drive severe
COVID-19, sepsis, Kawasaki disease and Multisystem Inflammatory
Syndrome.
The Murai (Brazil) trial of bolus (high, single, dose) D3
failed because it was given so late in the disease progression.
Absorption and poor liver function may al
so have played a role.
Castillo et al. 2020 "Effect of a Single High Dose of Vitamin D3 on
Hospital Length of Stay in Patients With Moderate to Severe COVID-19
" used a single oral dose of 0.532mg calcifediol (which is 25-hydroxyvitamin
D) at the earliest opportunity with hospitalised COVID-19 patients.