If you weren’t paying attention to the studies (which weren’t being reported in mainstream media), you wouldn’t know that covid is largely a condition of Vitamin D deficiency. The evidence has been there since May of 2020, but virtually no one is reporting on it, or paying attention. Meanwhile, and the government locked you in your house all year, eliminating your Vitamin D production, in order to fight covid!
This curated playlist of Vitamin D videos tracks our year of research and the scientific basis for using Vitamin D to prevent and cure covid.
Vitamin D, Large scale studies
Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study (Federation of European Biochemical Societies Journal)
https://febs.onlinelibrary.wiley.com/doi/full/10.1111/febs.15495
Vitamin D deficiency is a worldwide pandemic
To ...evaluate associations of plasma 25(OH)D levels with the likelihood of coronavirus disease infection and hospitalization
N = 7, 807
February 1st to April 30th, 2020
Participants had one previous blood test for the plasma 25(OH)D level
Suboptimal’ or ‘low’ plasma 25(OH)D. Below 30 ng/mL
Sufficiency more than 30 ng/ml. (75 nmol/L)
Insufficiency, 20 – 29 ng/ml
Deficiency less than 20 ng/ml (50 nmol/L)
7, 807 individuals
Risk by age and sex were as expected
Obesity not significantly associated with increased risk for COVID‐19 infection or hospitalization
Sufficient vitamin D levels
7, 025 tested negative
Low vitamin D levels
782 tested positive
Increased likelihood of COVID‐19 infection
Odds ratio (OR) of 1.45
Increased likelihood of hospitalisation
OR of 1.95
We concluded that low plasma 25(OH)D levels appear to be an independent risk factor for COVID‐19 infection and hospitalization.
The link between vitamin D deficiency and Covid-19 in a large population
https://www.medrxiv.org/content/10.1101/2020.09.04.20188268v1.full.pdf
52, 405 infected patients
524, 050 controls
Greater incidence of COVID-19 with lower vitamin D levels
Highest infection prevalence with lowest vitamin D levels
A significant protective effect in those who had supplemented over the previous 4 months
Joint Guidance on Vitamin D in the Era of COVID-19 from the ASBMR, AACE, Endocrine Society, ECTS, NOF, and IOF
https://www.nof.org/news/joint-guidance-on-vitamin-d-in-the-era-of-covid-19-from-the-asbmr-aace-endocrine-society-ects-nof-and-iof/
Spend at least 15-30 minutes with direct sun exposure each day
Most older and younger adults can safely take 400-1000 IU daily
Vitamin-D and COVID-19: do deficient risk a poorer outcome? (Lancet)
https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30183-2/fulltext?fbclid=IwAR0qzV-kiZcVRQ-KeBAkru6hpGUUVVhbywbU3YgV_KSNaE7X7DVmblO9ysk
Comparing data across nations, mortality from COVID-19 is clearly higher in some countries than in others
Relative vitamin D status of populations
Vitamin D supplementation could be especially important for older people
Functions
Calcium and phosphate balance
Affecting bone growth and turnover
Low vitamin D status
Associated with increased susceptibility to infectious disease
Notably, upper respiratory tract infections
Treating the lowest levels gives most percentage benefit
Vitamin D and COVID-19
Virus emerged and started its spread in the northern hemisphere at the end of 2019
When levels of 25-hydroxyvitamin D are lowest
COVID-19 mortality was significantly associated with vitamin D status in different populations
Nordic countries, widespread fortification of foods
Italy and Spain, prevalence of vitamin D deficiency, surprisingly common
Black and minority ethnic people
UK, more than four times more likely to die from COVID-19
In COVID
Vitamin D supports production of antimicrobial peptides in the respiratory epithelium
Might help to reduce the inflammatory response
Vitamin D is known to interact angiotensin- converting enzyme 2
SARS-CoV-2 down regulates expression of ACE2
Vitamin D promotes expression of this gene
Rose Anne Kenny
Trinity College Dublin
Lead investigator of the Irish Longitudinal Study on Ageing
The circumstantial evidence is very strong
we don’t have randomised controlled trial evidence, but how long do you want to wait in the context of such a crisis?
We know vitamin D is important for musculoskeletal function, so people should be taking it anyway
Vitamin D supplements should normally be given to care home residents unless there is an extremely good reason not to do so.
Adrian Martineau
Queen Mary University of London
At best vitamin D deficiency will only be one of many factors involved in determining outcome of COVID-19
but it’s a problem that could be corrected safely and cheaply
there is no downside to speak of, and good reason to think there might be a benefit
Vitamin D dose
IU mcg
400 10mcg
800 20mcg
1,000 25mcg
2,000 50mcg
4,000 100mcgShow More
Vitamin D, Large scale studies
Low plasma 25(OH) vitamin D level is associated with increased risk of ...
Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study (Federation of European Biochemical Societies Journal)
https://febs.onlinelibrary.wiley.com/doi/full/10.1111/febs.15495
Vitamin D deficiency is a worldwide pandemic
To ...evaluate associations of plasma 25(OH)D levels with the likelihood of coronavirus disease infection and hospitalization
N = 7, 807
February 1st to April 30th, 2020
Participants had one previous blood test for the plasma 25(OH)D level
Suboptimal’ or ‘low’ plasma 25(OH)D. Below 30 ng/mL
Sufficiency more than 30 ng/ml. (75 nmol/L)
Insufficiency, 20 – 29 ng/ml
Deficiency less than 20 ng/ml (50 nmol/L)
7, 807 individuals
Risk by age and sex were as expected
Obesity not significantly associated with increased risk for COVID‐19 infection or hospitalization
Sufficient vitamin D levels
7, 025 tested negative
Low vitamin D levels
782 tested positive
Increased likelihood of COVID‐19 infection
Odds ratio (OR) of 1.45
Increased likelihood of hospitalisation
OR of 1.95
We concluded that low plasma 25(OH)D levels appear to be an independent risk factor for COVID‐19 infection and hospitalization.
The link between vitamin D deficiency and Covid-19 in a large population
https://www.medrxiv.org/content/10.1101/2020.09.04.20188268v1.full.pdf
52, 405 infected patients
524, 050 controls
Greater incidence of COVID-19 with lower vitamin D levels
Highest infection prevalence with lowest vitamin D levels
A significant protective effect in those who had supplemented over the previous 4 months
Joint Guidance on Vitamin D in the Era of COVID-19 from the ASBMR, AACE, Endocrine Society, ECTS, NOF, and IOF
https://www.nof.org/news/joint-guidance-on-vitamin-d-in-the-era-of-covid-19-from-the-asbmr-aace-endocrine-society-ects-nof-and-iof/
Spend at least 15-30 minutes with direct sun exposure each day
Most older and younger adults can safely take 400-1000 IU daily
Vitamin-D and COVID-19: do deficient risk a poorer outcome? (Lancet)
https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30183-2/fulltext?fbclid=IwAR0qzV-kiZcVRQ-KeBAkru6hpGUUVVhbywbU3YgV_KSNaE7X7DVmblO9ysk
Comparing data across nations, mortality from COVID-19 is clearly higher in some countries than in others
Relative vitamin D status of populations
Vitamin D supplementation could be especially important for older people
Functions
Calcium and phosphate balance
Affecting bone growth and turnover
Low vitamin D status
Associated with increased susceptibility to infectious disease
Notably, upper respiratory tract infections
Treating the lowest levels gives most percentage benefit
Vitamin D and COVID-19
Virus emerged and started its spread in the northern hemisphere at the end of 2019
When levels of 25-hydroxyvitamin D are lowest
COVID-19 mortality was significantly associated with vitamin D status in different populations
Nordic countries, widespread fortification of foods
Italy and Spain, prevalence of vitamin D deficiency, surprisingly common
Black and minority ethnic people
UK, more than four times more likely to die from COVID-19
In COVID
Vitamin D supports production of antimicrobial peptides in the respiratory epithelium
Might help to reduce the inflammatory response
Vitamin D is known to interact angiotensin- converting enzyme 2
SARS-CoV-2 down regulates expression of ACE2
Vitamin D promotes expression of this gene
Rose Anne Kenny
Trinity College Dublin
Lead investigator of the Irish Longitudinal Study on Ageing
The circumstantial evidence is very strong
we don’t have randomised controlled trial evidence, but how long do you want to wait in the context of such a crisis?
We know vitamin D is important for musculoskeletal function, so people should be taking it anyway
Vitamin D supplements should normally be given to care home residents unless there is an extremely good reason not to do so.
Adrian Martineau
Queen Mary University of London
At best vitamin D deficiency will only be one of many factors involved in determining outcome of COVID-19
but it’s a problem that could be corrected safely and cheaply
there is no downside to speak of, and good reason to think there might be a benefit
Vitamin D dose
IU mcg
400 10mcg
800 20mcg
1,000 25mcg
2,000 50mcg
4,000 100mcgShow More
Second Vitamin D clinical trial, positive results
Short term, high-dose vitamin D supplementation for COVID-19 disease: ...
Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomised, placebo-controlled, study (SHADE study)
https://pmj.bmj.com/content/early/2020/11/12/postgradmedj-2020-139065.full
It has been observed that vitamin D-deficient individuals
have increased COVID-19 risk and mortality
Pharmacologic treatments for ...coronavirus disease 2019 (COVID-19): a review. JAMA 2020;323:1824–36. doi: 10.1001/jama.2020.6019
The role of vitamin D in the prevention of coronavirus disease infection and mortality.
Aging Clin Exp Res 2020;32:1195–8. doi: 10.1007/s40520-020-01570-8
Association of vitamin D status and other clinical characteristics with COVID-19 test results.
JAMA Netw Open 2020;3:e2019722. (Published 3 Sep 2020).doi: 10.1001/jamanetworkopen.2020.19722
Immunomodulatory role and protective effect of vitamin D against other viral infections
Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017;15:356:i6583. doi: 10.1136/bmj.i6583
An intervention study with calcifediol noticed a reduction in requirement for intensive care among hospitalised patients for COVID19
Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: a pilot randomized clinical study.
J Steroid Biochem Mol Biol 2020;203:105751. doi: 10.1016/j.jsbmb.2020.105751
50 patients treated with calcifediol, one required admission to the ICU (2%), no deaths
26 untreated patients, 13 required admission (50 %) to the ICU, 2 deaths
Immune-modulatory effect of vitamin D is likely to be observed at 25(OH)D levels, which are considered higher than that required for its skeletal effects
Vitamin D to prevent COVID-19: recommendations for the design of clinical trials. Febs J2020;287:3689–92. doi: 10.1111/febs.15534
Positive correlation between circulating cathelicidin antimicrobial peptide (hCAP18/LL-37) and 25-hydroxyvitamin D levels in healthy adults.
BMC Res Notes 2012;5:575. doi: 10.1186/1756-0500-5-575
Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection.
PLoS One 2020;15:e0239799.doi: 10.1371/journal.pone.0239799
Aim
https://pmj.bmj.com/content/early/2020/11/12/postgradmedj-2020-139065.full
Effect of high dose, oral cholecalciferol supplementation on SARS-CoV-2 viral clearance
First cholecalciferol intervention study for asymptomatic and mildly symptomatic SARS-CoV-2 positive individuals
Design
Randomised, placebo-controlled.
Participants
Asymptomatic or mildly symptomatic SARS-CoV-2
RNA positive vitamin D deficient (25(OH) D less than 20 ng/ml)
Calcifediol, calcidiol, 25-hydroxycholecalciferol, or 25-hydroxyvitamin D3
Pre intervention baseline serum 25(OH) D
Intervention group, 8.6 ng/ml
Control group, 9.54 ng/ml (p=0.730)
10 out of 16 patients could achieve 25(OH)D more than 50 ng/ml by
day-7
Another two by day-14
Outcome measure
Proportion of patients with SARS-CoV-2 RNA negative before day-21
Change in inflammatory markers
Intervention group (n=16)
60 000 IU of cholecalciferol (oral nano-liquid droplets) for 7 days
Therapeutic target 25(OH)D more than 50 ng/ml
Cholecalciferol supplementation was continued for those with 25(OH)D less than 50 ng/ml
Fibrinogen levels significantly decreased with cholecalciferol supplementation
10 (62.5%) participants became SARS-CoV-2 RNA negative
Control group (n=24)
Placebo
5 (20.8%) participants became SARS-CoV-2 RNA negative (p less than 0.018)
Both groups
Patients requiring invasive ventilation or with significant comorbidities were excluded
25(OH)D levels were assessed at day 7
Regular measurements of: SARS-CoV-2 RNA, fibrinogen, D-dimer, procalcitonin, CRP, ferritin
Improvements
Calcifediol would have been better
Little and often for preventionShow More
Vitamin D studies confirm correlations
Vitamin D UK biobank https://www.ukbiobank.ac.uk Habitual use of ...
Vitamin D
UK biobank
https://www.ukbiobank.ac.uk
Habitual use of vitamin D supplements and risk of coronavirus disease 2019 (COVID-19) infection: a prospective study in UK Biobank (29th January, 2021)
https://academic.oup.com/ajcn/advance-article/doi/10.1093/ajcn/nqaa381/6123965
The American Journal of Clinical Nutrition
Background ...
Vitamin D supplementation, lower risk of acute respiratory tract infection
Emerging evidence, vitamin D insufficiency is related to a higher risk of coronavirus infection and disease
Objectives
To investigate the prospective association between habitual use of vitamin D supplements and risk of COVID- 19 infection
Associations according to levels of circulating and genetically predicted vitamin D
Methods
N = 8,297 adults
Records of COVID-19 test results from UK Biobank
16 March 2020 to 29 June 2020
Results
Of the 8,297 adults, 1,374 (16.6%) tested positive
Vit D users, n = 363
Non-vit D users, n = 7,934
Unadjusted model
OR 0.78 (p = 0.105)
Adjustment for covariates
Age, sex, race, origin (outpatient or inpatient), blood-type, years of education, TDI, smoking, moderate drinking, physical activity, healthy diet score, use of any other supplements
Inverse association emerged
Between habitual use of vitamin D supplements and risk of COVID-19 infection
OR, 0.66, (P = 0.038)
Habitual use of vitamin D supplements was significantly associated with a 34% lower risk of COVID-19 infection
No association with baseline blood vitamin D levels and risk of COVID-19 infection
Associations between the risk of COVID-19 infection and habitual use of other individual supplements
Vitamin A, vitamin B, vitamin C, vitamin E, folic acid, a
multivitamin,
Calcium, zinc, iron, selenium, glucosamine, fish
Oil
Vitamin D Deficiency and Outcome of COVID-19 Patients
Medical University Hospital Heidelberg, (September 2020)
https://www.mdpi.com/2072-6643/12/9/2757
Identification of modifiable prognostic factors may help to improve outcomes
N = 185, diagnosed and treated in Heidelberg
Median Vitamin D level was 16.6 ng/ml
Associations of vitamin D status with disease severity and survival
Vitamin D status assessed at first presentation
Deficient
25-hydroxyvitamin D (Calcifediol)
level less than 12 ng/mL ( less than 30 nM)
N = 41 (22%)
Median IL-6 levels at hospitalization were significantly higher
70.5 versus 29.7 pg/mL
Insufficiency
Less than 20 ng/mL (less than 50 nM)
N = 118 (64%)
Higher levels
N = 26
Median Vitamin D level was significantly lower in the inpatient versus the outpatient subgroup
Results
Median observation period of 66 days
93 (50%) patients required hospitalization
28 patients required ventilation
Including 16 deaths
Adjusting for age, sex, comorbidities
Deficiency was associated with higher risk of ventilation and death
Mechanical ventilation
HR 6.12
p less than 0.001
Death
HR 14.73
p less than 0.001
Other hazard ratios
Male, 1.69 2.5
Over 60, 3.2 7.7
Comorbidity, 2.7 5.3
Need for interventional studies
Cholecalciferol
Calcifediol
Active form of vitamin D3, 1, 25-dihydroxyvitamin D3 (1,25D3), calcitriol, is
pluripotent hormone and important modulator of both innate and adaptive immunityShow More
Vitamin D deficiency in India
Vitamin D deficiency in India ...
Vitamin D deficiency in India
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060930/
Prevalence of Vitamin D deficiency ranged from 40% to 99%
Most of the studies reporting a prevalence of 80%–90%
Prevalent in all the age groups and high-risk groups ...alike
Factors
Major source, synthesis in skin on exposure to sunlight
Ultraviolet B (UV-B) radiation, wavelength 290–320 nm
Fish, fortified food, supplements
Vegetables and grains are poor sources
Latitude, solar zenith angle, atmospheric pollution, ozone layer, and melanin pigmentation
Defining levels
Threshold levels of serum 25(OH) D required to optimize effects may vary in the various target organs
Deficiency, less than 20 ng/ml (50 nmol/L)
Insufficiency, 21 – 29 ng/ml (52 - 72 nmol/L)
Sufficiency, more than 30 ng/ml (75 nmol/L)
Toxicity, more than 150 ng/ml (375 nmol/L)
Desirable and safe range of serum 25(OH) D level would be 30–100 ng/mL (75 – 250 nmol/L)
Metabolism
Vitamin D is needed to facilitate calcium absorption from the gut
PTH is secreted in response to low blood serum calcium
Maintains serum calcium by moving calcium from bones to blood
At less than 20 ng/mL of serum 25(OH) D, PTH is elevated to maintain serum calcium from bony reserves
At serum 25(OH) D levels of intestinal calcium absorption reaches its peak,
and PTH levels continue to fall up to levels 30 ng/mL
Consequences of Vitamin D deficiency
Rickets
Muscle strength reduction
Autoimmune diseases
Cardiovascular diseases
Depression
Suicide
Parkinson’s
Cancer
Infections
Tuberculosis
Obesity
Diabetes mellitus type 2
Important for:
Immune function
Inflammation
Cell proliferation and differentiation
What to do
Create awareness among the public and healthcare providers about the importance of Vitamin D
and the consequences of deficiency
Indian diet generally fails to satisfy the daily requirement of Vitamin D for a normal adult
Need for fortifying various foods with Vitamin D, through national programs
This silent epidemic should be addressed appropriately with concrete public health action.
we can imagine the burden, this silent epidemic would cause the development of the country.Show More
Ireland, vitamin D report
Report on addressing Vitamin D deficiency as a public health measure ...
Report on addressing Vitamin D deficiency as a public health measure in Ireland.
https://www.oireachtas.ie/en/press-centre/press-releases/20210407-oireachtas-health-committee-launches-report-on-addressing-vitamin-d-deficiency-in-ireland/#:~:text=The%20Joint%20Committee%20on%20Health,established%20to%20address%20that%20deficiency
https://data.oireachtas.ie/ie/oireachtas/committee/dail/33/joint_committee_on_health/reports/2021/2021-04-07_report-on-addressing-vitamin-d-deficiency-as-a-public-health-measure-in-ireland_en.pdf
Vitamin D levels and deficiency with different occupations: a systematic review. Sowah et al. BMC Public Health (2017) ...17:519 doi:10.1186/s12889-017-4436-z
Vitamin D Deficiency Is Associated With an Increased Likelihood of Incident Depression in Community-Dwelling Older Adults. Briggs et al. doi:10.1016/j.jamda.2018.10.006
Vitamin D supplementation for the prevention and treatment of COVID-19: a position statement from the Spanish Society of Geriatrics and Gerontology. Tarazona-Santabalbin et al. nhttps://doi.org/10.1016/j.regg.2021.02.001
The Environment and Disease: Association or Causation? Bradford Hill. Proc R Soc Med 1965 May; 58(5): 295–300. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1898525/
Scientific Opinion on the Tolerable Upper Intake Level of vitamin D. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) (2012) EFSA Journal;10(7):2813. [45 pp.] doi:10.2903/j.efsa.2012.2813.
Scientific Advisory Committee on Nutrition (SACN) Vitamin D and Health. Crown copyright 2016. Report available online at: https://www.gov.uk/government/groups/scientific-advisory- committee-on-nutrition
Dietary Reference Intakes for Calcium and Vitamin D. Institute of Medicine (IOM) (2011) Washington, DC: The National Academies Press
The Safety of Vitamins and Minerals in Food Supplements – Establishing Tolerable Upper Intake Levels and a Risk Assessment Approach for Products Marketed in Ireland (Revision 2). FSAI Scientific Committee on Nutrition (2018) Dublin: FSAI.
Tithe na Oireachtais; Joint Committee on Health debate. Tuesday, 23 Feb 2021 https://www.oireachtas.ie/en/debates/debate/joint_committee_on_health/2021-02-23/
Perspective: Vitamin D deficiency and COVID-19 severity plausibly linked by latitude, ethnicity, impacts on cytokines, ACE2 and thrombosis. Rhodes, J.M.; Subramanian, S.; Laird, E.; Griffin, G.; Kenny, R.A.. J. Intern. Med. 2020.
Autumn COVID-19 surge dates in Europe correlated to latitudes, not to temperature-humidity, pointing to vitamin D as contributing factor. Walrand, S., Sci. Rep. 2021
COVID-19 Nursing Homes Expert Panel: Final Report. Department of Health, 19 August 2020
Population and Labour Force Projections 2017-2051. Central Statistics Office.
Healthy Ireland Survey 2015, Summary of Findings.
Obesity in an Ageing Society Implications for health, physical function and health service utilisation. Siobhan Leahy, Anne Nolan, Jean O’Connell, Rose Anne Kenny (The Irish Longitudinal Study on Ageing, TCD and St. Vincent’s University Hospital, Dublin) 2014.
A High Prevalence of Vitamin D Deficiency Observed in an Irish South East Asian Population: A Cross-Sectional Observation Study. Laird et al, November 2020. doi:10.3390/nu12123674
Successful nutrition policy: improvement of vitamin D intake and status in Finnish adults over the last decade. Raulio et al., 2017. doi:10.1093/eurpub/ckw154
Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study. Castillo et al; 2020 doi:10.1016/j.jsbmb.2020.105751
Vitamin D and clinically extremely vulnerable (CEV) guidance. UK Government Publications, February 2021.
The Joint Committee on Health
The Committee heard evidence that Vitamin D deficiency is prevalent across the population and the report recommends that public health measures are established to address that deficiency. These public health measures are preventative in nature and are recommended to reduce the risk of respiratory and other illnesses such as osteoporosis.
1 That daily Vitamin D supplementation of 20-25µg/day should be recommended to the entire adult population as a public health measure,
higher doses recommended for vulnerable groups under medical supervision.
2 That a public health policy, which promotes better knowledge of the benefits of Vitamin D, and which encourages Vitamin D supplementation, should be developed in time for consideration in Budget 2022.
3 That reducing the cost of Vitamin D supplementation, in order to promote its uptake, should be considered.
4 That specific measures need to be put in place for vulnerable groups, and for frontline and healthcare workers,
so that Vitamin D supplementation is administered on an opt-out basis,
and for the duration of this pandemic, people should be offered Vitamin D supplements when presenting at Covid-19 test centres.Show More
Vitamins D and K2
Download my two educational text books for free using this link: ...
Download my two educational text books for free using this link: http://159.69.48.3
Hard copy of the Physiology Notes text book on ebay, http://ebay.us/DcmyYV?cmpnId=5338273189
Hard copy of the Pathophysiology text book, https://www.ebay.co.uk/itm/154260052745
Latest on ...Vitamin D
https://www.nice.org.uk/guidance/ng187/chapter/Recommendations
Basically, consider 400 units (10 mcg) per day
But, NHS mid Essex
https://midessexccg.nhs.uk/medicines-optimisation/clinical-pathways-and-medication-guidelines/chapter-9-nutrition-and-blood-2/3051-vitamin-d-deficiency-prescribing-guidance-nov-2018-replaces-separate-guidance-for-adults-children-and-in-pregnancy/file
Routine screening of vitamin D levels and prescribing of Vitamin D is not advisable.
Both clinical symptoms and risk factors must be present before measuring Vitamin D levels (25OHD).
As yet there is no clear evidence to prove the risks from non-symptomatic Vitamin D deficiency.
Adults
Vitamin D levels less than 30nmol/L (12ng / ml)
Oral capsules, 40,000 units (1,000 mcg or 1 mg) colecalciferol weekly for 7 weeks
(400 units per day = 2,800 units per week)
Vitamin D levels 30 – 50 nmol/L (12 – 20 ng / ml)
Buy your own, 400 units per day
Vitamin D levels more than 50 nmol/L (20 ng / ml)
Buy your own, consider, 400 units per day
Vitamin K1
Phylloquinone
Involved in blood coagulation (1929)
Found in plant foods like leafy greens
Vitamin K2
https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/
https://www.healthline.com/nutrition/vitamin-k2#what-it-is
Menaquinones
Mostly bacterial origin
Animal-based and fermented foods
Adult vitamin K Adequate Intakes, 90 -120 mcg
Fermented foods
Sauerkraut
Natto
High fat dairy from grass fed cows
Eggs
Animal organs
Gut bacteria
Antibiotics
Vitamin K might play a role, osteoporosis and coronary heart disease
Vitamin K-dependent proteins
https://pubmed.ncbi.nlm.nih.gov/22516724/
Vitamin K2 supplements may improve bone and heart health, while vitamin K1 has no significant benefits
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5494092/
Promotes bone calcification
Three-year low-dose menaquinone-7 supplementation helps decrease bone loss in healthy postmenopausal women
https://link.springer.com/article/10.1007/s00198-013-2325-6
May prevent tissue calcification
Tissue-specific utilization of menaquinone-4 results in the prevention of arterial calcification in warfarin-treated rats
https://pubmed.ncbi.nlm.nih.gov/14654717/
Vitamin K2 (MK-4) reduced blood vessel calcification whereas vitamin K1 did not
https://pubmed.ncbi.nlm.nih.gov/14654717/
Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study
https://pubmed.ncbi.nlm.nih.gov/15514282/
K2 may help with dental health
https://pubmed.ncbi.nlm.nih.gov/9076586/
Especially with vitamin D
https://pubmed.ncbi.nlm.nih.gov/8466530/
Links with liver cancer
https://pubmed.ncbi.nlm.nih.gov/16400650/
Links with preventing advanced prostate cancer
Dietary intake of vitamin K and risk of prostate cancer in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg)
https://pubmed.ncbi.nlm.nih.gov/18400723/
Synergistic effect with vitamin D
Vitamins D and K as pleiotropic nutrients: clinical importance to the skeletal and cardiovascular systems and preliminary evidence for synergy
https://pubmed.ncbi.nlm.nih.gov/21155624/
Prevalence of hypercalcemia related to hypervitaminosis D in clinical practice
https://pubmed.ncbi.nlm.nih.gov/26995293/
Determine the concentrations of 25-OH-vitamin D at which the risk of hypercalcemia
N = 25,567
Hypervitaminosis D was defined at serum 25-OH-vitamin D more than160 nmol/L (64 ng / ml)
Results:
382 samples were identified as the first record of hypervitaminosis D
39 presented hypercalcemia (10.2%)
Some had 25-OH-vitamin D levels between 161 and 375 nmol/L.
(most subjects presented hypercalcemia at serum concentrations of 25-OH-vitamin D less than 375 nmol/L, 150 ng / ml)
In 15 subjects, hypercalcemia could be directly attributed to vitamin D
In no case, serum calcium achieved concentrations considered as critical values (more than13 mg/dl).
Conclusion
Hypercalcemia due to vitamin D represented less than 4% of the total hypervitaminosis D detected
Less than 0.1% of the tests performed.
Healthline
https://www.healthline.com/health/foods-high-in-vitamin-k#1.-Kale
No strong evidence proves that moderate amounts of vitamin D are harmful without an adequate intake of vitamin K. However, research is ongoing, and the picture might become clearer in the near future.Show More
The Vitamin D debate with Professor Spector
Many thanks to Tim and the Zoe team who made this possible.
Many thanks to Tim and the Zoe team who made this possible.
Mr David Davis MP and Vitamin D
Thank you for a fascinating and important interview Mr. Davis. ...
Vitamin D deficiency in the UK
1st October, Vitamin D, news and science ...
1st October, Vitamin D, news and science
https://www.youtube.com/watch?v=B01ZlRfMnmU
16th September, Vitamin D and pandemic science
https://www.youtube.com/watch?v=ZqZLMoLvhgk
12th September, Vitamin D, Large scale studies
https://www.youtube.com/watch?v=iNji13yoW9g
6th September, Vitamin D, Frist clinical trial
https://www.youtube.com/watch?v=V8Ks9fUh2k8
27th July, Vitamin D, Science
https://www.youtube.com/watch?v=cv4iINxf4IM
20th June, ...Vitamin D hits the media
https://www.youtube.com/watch?v=qyMFsLFAE5o
10th June, Vitamin D update
https://www.youtube.com/watch?v=_fIMkigtnk4
18th May, Dr Shelton, Part 1, Reports from New Zealand
https://www.youtube.com/watch?v=pRd7TqqIxzg&t=1s
21st May, Dr Shelton, Part 2, Vitamin D
https://www.youtube.com/watch?v=JVg8opQkQXc
10th May, Vitamin D dose
https://www.youtube.com/watch?v=Bga_qG30JyY
15th April, Vitamin D and Immunity, Lots of evidence
https://www.youtube.com/watch?v=GCSXNGc7pfs
9th March, Vitamin D and immunity
https://www.youtube.com/watch?v=W5yVGmfivAk
There is not enough evidence that vitamin D supplements protect people against Covid-19, an expert panel says.
https://www.bbc.co.uk/news/health-55333063?fbclid=IwAR1ifnBFl42oj0uAcF1B-rfXONU8qnsHVIPpjpHIuIG7VK7poO0DOaCUZEk
Institute for Health and Care Excellence
Public Health England
Scientific Advisory Committee on Nutrition
More research needed
Insufficient evidence
Advised to take a daily supplement this winter to keep bones and muscles healthy
10 micrograms (400 international units)
Nobel prize, 1928, Adolf Windaus
Dr Paul Chrisp
We are continuing to monitor evidence as it is published and will review and update the guidance if necessary
Determinants of vitamin D deficiency in the UK (Clinical Nutrition)
University of South Australia (16th December)
https://www.clinicalnutritionjournal.com/article/S0261-5614(20)30639-7/fulltext#%20
https://www.clinicalnutritionjournal.com/article/S0261-5614(20)30639-7/fulltext
https://www.unisa.edu.au/Media-Centre/Releases/2020/alarmingly-high-vitamin-d-deficiency-in-the-united-kingdom/
Using UK Biobank data
https://www.ukbiobank.ac.uk
Severe vitamin D deficiency remains an issue throughout the UK
Cross-ethnic analyses on the prevalence and determinants of vitamin D deficiency
25(OH)D equal to or less than 25 nmol/L Calcifediol
10 ng/ml
Data from 440,581 UK Biobank participants
415,903 identified as White European
7,880 Asian
7,602 Black African
1,383 Chinese
6,473 of mixed ancestry
Prevalence of vitamin D deficiency
Asian ancestry
57.2% in winter or spring
50.8% in summer or autumn
Black African ancestry
38.5% in winter and spring
30.8% in summer or autumn
Mixed ancestry
36.5% in winter and spring
22.5% in summer or autumn
Chinese ancestry
33.1% in winter and spring
20.7% in summer or autumn
White European ancestry
17.5% in winter and spring
5.9% in summer or autumn
Participants with higher socioeconomic deprivation
More likely to have 25(OH)D deficiency compared to less deprived participants (P = less than 1 × 10 −300)
This pattern was more apparent among those of White European ancestry
Regular consumption of oily fish was associated with reduced odds of vitamin D deficiency across all ethnicities
Asians are less likely to eat fish or use vitamin D supplements compared to other ethnicities
Outdoor-time in summer was less effective for Black Africans than White Europeans
Other risk factors
Living further north
Indoor employment
Computer time and games
Professor Elina Hypponen (SA)
The severity of vitamin D deficiency is concerning
especially with the high rates of COVID-19 infections in Europe and elsewhere in the northern hemisphere this winter
Clinical trials have shown that vitamin D supplements are beneficial in the prevention of respiratory infections and even mortality
Vitamin D is not expensive and the doses which have shown the greatest benefits are those that we can all acquire over the counter from the local pharmacy
Given the COVID-19 pandemic, now is really the time for all who may be affected to take actionShow More
Vitamin D news and science
BMJ references in this video relating to 'Covid-19: Do many people ...
BMJ references in this video relating to 'Covid-19: Do many people have pre-existing immunity' are based on a rapid response letter NOT to an empirical paper.
16th September, Vitamin D ...and pandemic science
https://www.youtube.com/watch?v=ZqZLMoLvhgk
12th September, Vitamin D, Large scale studies
https://www.youtube.com/watch?v=iNji13yoW9g
6th September, Vitamin D, Frist clinical trial
https://www.youtube.com/watch?v=V8Ks9fUh2k8
27th July, Vitamin D, Science
https://www.youtube.com/watch?v=cv4iINxf4IM
20th June, Vitamin D hits the media
https://www.youtube.com/watch?v=qyMFsLFAE5o
10th June, Vitamin D update
https://www.youtube.com/watch?v=_fIMkigtnk4
18th May, Dr Shelton, Part 1, Reports from New Zealand
https://www.youtube.com/watch?v=pRd7TqqIxzg&t=1s
21st May, Dr Shelton, Part 2, Vitamin D
https://www.youtube.com/watch?v=JVg8opQkQXc
10th May, Vitamin D dose
https://www.youtube.com/watch?v=Bga_qG30JyY
15th April, Vitamin D and Immunity, Lots of evidence
https://www.youtube.com/watch?v=GCSXNGc7pfs
9th March, Vitamin D and immunity
https://www.youtube.com/watch?v=W5yVGmfivAk
Correcting Britain's Vitamin D deficiency could save thousands of lives (David Davis MP, Matt Ridley)
https://www.telegraph.co.uk/news/2020/09/26/correcting-britains-vitamin-d-deficiency-could-save-thousands/
There is one chemical that:
is known to be safe
known to be needed by many people anyway
known to have a clinically proven track record of helping people fight off
respiratory diseases
is so cheap no big firm is pushing it
vitamin D
Vitamin D Levels Appear to Play Role in COVID-19 Mortality Rates
https://www.mccormick.northwestern.edu/news/articles/2020/05/vitamin-d-levels-appear-to-play-role-in-covid-19-mortality-rates.html
https://www.medrxiv.org/content/10.1101/2020.04.08.20058578v4
China, France, Germany, Italy, Iran, South Korea, Spain, Switzerland, the United Kingdom, United States.
Patients with severe deficiency are twice as likely to experience major complications
Spanish clinical trial
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456194/
Calcifediol group, 2% required admission to the ICU
Control group 50% admitted to ICU
Put another way, the use of Vitamin D reduced a patient’s risk of needing intensive care 25-fold
The Government should now act on this latest evidence
We have good reason to think vitamin D supplementation will help reduce mortality from Covid-19
we know it can reduce the incidence and severity of the other acute respiratory illnesses
pressures from influenza during the winter months
This will no doubt save thousands of lives in any second wave
There is now no reason not to act
Covid-19: Do many people have pre-existing immunity? (21 September 2020, Eshani M King, BMJ)
https://www.bmj.com/content/370/bmj.m3563/rr-6
Many have T cells that act against SARS-CoV-2 epitopes
Killing intracellular parasites
Critical in viral immunity
T cell response might be more important that B cell response
https://onlinelibrary.wiley.com/doi/full/10.1111/pai.13263
B‐cell response might be important, but is not strictly required to overcome the disease
Vaccines focused on antibody levels
Mild or asymptomatic cases, many T-cells are produced
In these mild cases, few or no detectable antibodies
Men produced fewer T-cells than women
Older men produce less T cells than younger men
Vitamin D controls T cell antigen receptor signaling and activation of human T cells, (University of Copenhagen)
https://pubmed.ncbi.nlm.nih.gov/20208539/
Vitamin D essential to facilitate maturation of naïve T cells to dedicated, specific T cells
When a T cell is exposed to a foreign pathogen, it extends a vitamin D receptor, with which it searches for vitamin D
If there is an inadequate vitamin D level,
they won't even begin to mobilize
Also
Physical mucosal defences
All other immune cells
Modulating cytokines
Problems
https://osf.io/preprints/nutrixiv/73whx/
Obesity
Diabetes
BAME
Male
Elderly
City dwellers
Japan
Low death rate
Active elderly
Vitamin D levels of over 30 ng/ml (75 nmol/l) in 95%
UK average levels are below 20ng/ml (50 nmol/l)
The Role of Vitamin D deficiency in COVID-19 related deaths in BAME, Obese and Other High-risk Categories
https://osf.io/preprints/nutrixiv/73whx/
To convert ng/ml of 25(OH)D to nmol/l the conversion factor is 2.5.
20ng/ml enough to prevent rickets, osteoporosis and osteomalacia
40-60ng/ml or more is required to achieve optimum immune system and cancer fighting capability
30 ng/ml being sufficient but not optimal
40-60ng/ml Maasai
IU mcg
400 10mcg
800 20mcg
1,000 25mcg
2,000 50mcg
4,000 100mcg
6,000 150mcgShow More
Vitamin D, First clinical trial
...
https://www.healthline.com/nutrition/how-much-vitamin-d-to-take#How-Common-Is-Vitamin-D-Deficiency
About 42% of the US population is vitamin D deficient
82% in black people
70% in Hispanics
Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results, (JAMA Open, 3rd ...September, Chicago)
https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2770157/meltzer_2020_oi_200688_1598473478.89934.pdf
Cohort study of 489
Patients who had a vitamin D level measured in the year before COVID-19
testing
Relative risk of testing positive for COVID-19 was 1.77 times
First clinical trial on vitamin D and COVID
Therapy versus best Available Therapy on Intensive Care Unit Admission and Mortality Among Patients Hospitalized for COVID-19: A Pilot Randomized Clinical study" (Spain, Journal of steroid biochemistry and molecular biology)
https://www.sciencedirect.com/science/article/pii/S0960076020302764
Objective
Vitamin D decreases Acute Respiratory Distress Syndrome
Effect of calcifediol treatment
Calcifediol can rapidly increase serum 25OHD concentration
25-hydroxyvitamin D
Intensive Care Unit Admission and Mortality
Spanish patients hospitalized for COVID-19.
Design
Parallel pilot, randomized, double-masked clinical trial
Setting
Reina Sofia University Hospital, Córdoba, Spain
Participants
76 consecutive patients hospitalized with COVID-19 infection
Clinical picture of acute respiratory infection
Confirmed by a radiographic pattern of viral pneumonia
Positive SARS-CoV-2 PCR
Procedures
All hospitalized patients received as best available therapy
Hydroxychloroquine and azithromycin
Allocated at a 2 calcifediol:1
Oral calcifediol (0.532 mg), or not
Oral calcifediol (0.266 mg) on day 3 and 7
Then weekly until discharge
End points, ICU admission and deaths.
Results
50 patients treated with calcifediol
One required admission to the ICU (2%),
Of 26 untreated patients, 13 required admission (50%)
p less than 0.001
Of the patients treated with calcifediol, none died, and all were discharged, without complications
Of the patients not treated, 2 died
Conclusion
Calcifediol seems to be able to reduce severity of the disease
Larger trials with groups properly matched will be required to show a definitive answer
Rationale, activation of the vitamin D receptor (VDR) signalling pathway
Reduced ARDS
Cytokine/chemokine storm
Regulating the renin angiotensin system
Modulating neutrophil activity
Maintaining the integrity of the pulmonary epithelial barrier
Stimulating epithelial repair
Tapering down the increased coagulability
Ventilate
Don't abdicate
Dilute that virus
So you stay great
Ventilate
Don't complicate,
Complain or whine
You'll acclimate
Contemplate
When you congregate
Does the air here circulate
Instigate, Nominate
Educate, Motivate
I hope this message will resonate
That when we populate
Instead of isolate
Ventilate
Don't abdicate
Dilute that virus
So you stay greatShow More
