Best pandemic advice: maintain healthy levels of vitamin D!

 

New research shows insufficient blood levels of vitamin D might heighten people's odds for severe or even fatal COVID-19.

Maintaining a healthy level of vitamin D may "reduce the complications, including the cytokine storm (release of inflammatory proteins into the blood too quickly) and ultimately death from COVID-19," according to the study author Dr. Michael Holick. Dr. Holick is a professor of medicine, physiology, biophysics and molecular medicine at Boston University School of Medicine. 

Vitamin D is called the "sunshine vitamin" because it's produced by a cholesterol compound in the skin when skin is exposed to sunlight. But it can also be sourced through certain foods and supplements. 

The findings build upon those of prior research.

Several studies have found that patients with vitamin D deficiency have a worse outcome in COVID-19. Vitamin D has a beneficial effect on the immune system.

Holick and his colleagues assessed vitamin D levels in blood samples from 235 hospitalized COVID-19 patients. The blood samples were also checked for an inflammatory marker called C-reactive protein and for the number of lymphocytes, (immune cells that fight infections.)

Patients who were vitamin D-sufficient -- a blood level of at least 30 nanograms per milliliter -- had a significantly lower risk for serious complications from COVID-19, including losing consciousness, low blood oxygen levels and death. 

Among patients older than 40, those who were vitamin D-sufficient were also 51.5% less likely to die from COVID-19 compared to those who were vitamin D-deficient or insufficient, the team said. 

The study was published Sept. 25 in the journal PLOS ONE.
A prior study by Holick found that having a sufficient amount of vitamin D might also reduce the risk of becoming infected with the new coronavirus by 54%. Along with reducing the risks associated with the new coronavirus, being vitamin D-sufficient does the same against other viruses that cause upper respiratory tract illnesses, including the flu, according to Holick. 

"There is great concern that the combination of an influenza infection and a coronal viral infection could substantially increase hospitalizations and death due to complications from these viral infections," he said in a university news release. 

All in all, vitamin D could offer a simple and cost-effective way to combat the new coronavirus, Holick believes. "Because vitamin D deficiency and insufficiency is so widespread in children and adults in the United States and worldwide, especially in the winter months, it is prudent for everyone to take a vitamin D supplement to reduce risk of being infected and having complications from COVID-19," he said. 

In people who don't take D, the level is usually low, so it may make sense to take D as a supplement. A blood test will reveal your level of vitamin D. Supplements should be in the most bioavailable form of vitamin D, vitamin D-3. A typical adult dose is 4000 to 5000 iu daily.

 

Why We Need Immune-Boosting Vitamin D Right Now

Immune-boosting vitamin D3 is extremely important right now. But why stop at vitamin D? I also advise daily doses of vitamin C, magnesium, omega-3s, and NAC.

Here’s why vitamin D3 is at the top of the list. It plays a central role in supporting our immune system, making all of our immune cells more toxic against invading pathogens. Our white blood cells make chemicals called cytotoxins. These frontline immune cells engulf bacteria or viruses and use those cytotoxins to kill the invaders. 

The role of vitamin D is this: cytotoxins are more lethal to pathogens when vitamin D levels are higher. Vitamin D also facilitates the maturation of monocytes (juvenile white blood cells) into macrophages (the white blood cells that gobble up pathogens and then destroy them).

Vitamin D3 also promotes our body’s production of cathelicidins and defensins, antimicrobial immune warriors that help keep our lungs safe from viral and bacterial infections. Cathelicidin overpowers respiratory viruses like influenza A, which may explain the seasonal fluctuation in influenza that follows the seasonal strength of sunlight, our native source of vitamin D. Cathelicidin also defeats the tuberculosis bacterium which may explain why, in earlier times, people who had tuberculosis were sent to sunnier climates and their health improved.

We are facing a pandemic now, involving a novel coronavirus that attacks the lungs and sometimes leads to severe pneumonia or even acute respiratory distress syndrome in a minority of vulnerable persons. For some, the infection is mild, for others it can be fatal. 

While there have not yet been studies using vitamin D against this coronavirus, there is reason to be positive about the protection vitamin D might offer. Previous studies have shown us that through multiple mechanisms, vitamin D can reduce the risk of infections. Those mechanisms include inducing the previously mentioned cathelicidins and defensins. They can lower viral replication rates and reduce concentrations of pro-inflammatory cytokines (chemicals produced by our cells) that produce the inflammation that injures the lining of the lungs, leading to pneumonia. 

Cathelicidins and defensins also increase concentrations of anti-inflammatory cytokines. Since one of the observations in the current pandemic is of overactive immune responses, described as “cytokine storms,” vitamin D’s ability to calm the storm and return the immune response to balance may prove to be crucial.

Experts such as members of the Vitamin D Council suggest that during the next several months to possibly years, we should strive to get our serum vitamin D levels to a target of 40-60 ng/mL. Normal 25OH D levels range between 30 ng/mL and 100 ng/mL.

On average, adults need a daily intake of 5,000-10,000 IU of vitamin D3 to achieve a serum level in the midrange of normal, or 40-60 ng/mL

Please note magnesium supplementation is recommended when taking vitamin D supplements. Magnesium helps activate vitamin D, which in turn helps regulate calcium and phosphate homeostasis to influence the growth and maintenance of bones. All of the enzymes that metabolize vitamin D seem to require magnesium, which acts as a cofactor in the enzymatic reactions in the liver and kidneys. The dose of magnesium should be in the range of 250–500 mg/d, along with twice that dose of calcium. 

In the Age of Coronavirus Induced Covid 19 Pay attention to Your Vitamin D Levels

An important review of vitamin D and respiratory health was published April 2 in the Journal Nutrients. Here is the abstract followed by the link to the full paper. Be certain you are getting enough vitamin D to support robust lung health.

Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths
Nutrients 2020, 12(4), 988; https://doi.org/10.3390/nu12040988

Abstract: The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40–60 ng/mL (100–150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.

https://www.preprints.org/manuscript/202003.0235/v2