Interesting thing... Vitamin D is one of those things that, when vitamins come up on HN, you will often hear the refrain that "it's the one vitamin that large numbers of people are actually deficient in and ought to supplement."
I've heard that many times over the years and I have taken a Vitamin D supplement on and off (more off than on) over the years.
When this COVID-19 thing first hit, I had a physical scheduled (by chance) just about the same time, and I'd heard about this Vitamin D / COVID-19 connection, so when I went in for my physical, I asked my doctor to order a Vitamin D test as part of my bloodwork.
As it turns out, I was indeed very deficient in Vitamin D. I started taking 4000 IU a day and it's had a noticeable impact on my overall sense of wellbeing. It could, of course, be placebo effect even so. And I have no particular reason to think that it will make any difference one way or the other in terms of me getting COVID-19. But I thought it was worth pointing out one more anecdote that suggests that the old "Vitamin D is worth supplementing" refrain might just be true.
If you're in doubt, and it's an option, do what I did... just ask your doctor to run a Vitamin D test next time you go in for a checkup / physical.
A psychiatrist I saw multiple years ago told me to start taking Vitamin D. I went more or less blindly with 5,000 IU after reading some internet articles.
I got my blood checked last year and decided I should probably actually know if I'm doing too much or too little. I was within 5% of the middle of the healthy range for vitamin D levels. For reference, 5,000 IU is >800% the FDA daily recommended value. People with indoor jobs and hobbies are probably not getting enough.
> For reference, 5,000 IU is >800% the FDA daily recommended value.
Unfortunately the daily recommended value was established erroneously and should be much higher. Many research papers mention this. For example:
> The Institute of Medicine recommendation for adults younger than 70 years of age is 600 IU of vitamin D daily. We are told that this would achieve a level of 50 nmol/L in greater than 97.5% of individuals.6 Regrettably, a statistical error has resulted in erroneous recommendations by the Institute of Medicine leading to this conclusion and it might actually take 8800 IU of vitamin D to achieve this level in 97.5% of the population.7 This is a serious public health blunder.
> A colleague of mine and I have introduced vitamin D at doses that have achieved greater than 100 nmol/L in most of our patients for the past number of years, and we now see very few patients in our clinics with the flu or influenzalike illness. In those patients who do have influenza, we have treated them with the vitamin D hammer, as coined by my colleague. This is a 1-time 50 000 IU dose of vitamin D3 or 10 000 IU 3 times daily for 2 to 3 days. The results are dramatic, with complete resolution of symptoms in 48 to 72 hours. One-time doses of vitamin D at this level have been used safely and have never been shown to be toxic.8 We urgently need a study of this intervention. The cost of vitamin D is about a penny for 1000 IU, so this treatment costs less than a dollar.
Wow. Why isn't this more prominent on the covid radar?
A lot of us actually know of the connection from previous experiences with the Flu. What it seems to really do is to clear out the cough that comes after the Flu when the cough/sorethroat tends to enter your lungs. With VitaminD, that phase of the flu is gone. I dont supplement regularly, and I start taking it the day I feel I am going down with the flu. No point recommending it because you will be seen as someone who constantly talks of the benefits of VitaminD.
The other thing to make sure of while taking Vitamin D is to take adequate Vitamin K2(menaquinone), else you land up with kidney stones. For continued benefits, I also take some amount of sodium borate and magnesium. Anyway, this is my irregular regimen and you will need to talk to your doc before you do this.
Get tested, meet a doc, get the right dose, and understand how it works.
Previous thinking was that it was more time spent indoors woth central heating recirculating air and things like that but i never really bought into that idea. Doesnt really work for more temperate climates that still see lots of outdoors activity in winter, eg. Australia.
The one difference is during winter, your basically go to work in the dark and arrive home in the dark as well.
Unlike software developers, doctors, in my experience(friends and docs I have gone to), don't seem to have the same open mind about things in their field. At least the one's I know. It might seem foreign to us because a lot of our job is to keep an open mind and constantly question the status quo. Doctors tend to dismiss things immediately and unless you push you won't even get them try something that is harmless. I started going to a primary care physician a decade ago that actually listened, didn't rush me and kept an open mind. He was much younger though. Safe to say though I still go to him. Other doctors young and old that I've been to have not been the same.
That is interesting. As a generality I’ve found software developers to be some of the least open minded people. Perhaps a small bit amongst themselves (though the endless disagreements indicate it’s a very small bit), but when interacting with anyone outside the industry regarding some aspect of the industry, open mindedness is essentially non-existent. Perhaps it is the same for doctors interacting with patients.
An interesting thought experiment is would a video showcasing this paper risk being be banned on YouTube? I'm not going to bother checking if the WHO has a Vitamin D recommendation; but recommending many multiples of the FDA dose probably counts as misinformation.
I think a more likely reason for a ban would simply be that the Vitamin D connection was being highlighted by lockdown skeptics for quite some time already, as part of investigating the Swedish outcomes. The problem is that to highly liberal Google employees it might look 'racist' because the Vit-D connection came out of trying to figure out why Swedish migrants were over-represented in ICU cases, also African-Americans.
For instance, in this comment from six days ago I write about a possible vitamin D connection:
YouTube's response is now to simply remove videos containing misinformation while previous policies have seen most related content demonetized. Examples provided by the executive include videos claiming that people can be cured by taking vitamin C or turmeric. Neither has been proven to act as a cure according to the wider health community.
Another example of prominent videos that are being removed, she continues, are those related to 5G as an underlying cause. The policy changes, like the rise of those conspiracy theories, have had to be rapid. As a result, for the time being, Videos that contain claims in direct opposition to information provided by WHO will be removed as well.
YouTube hopes that by removing conspiracy theories and misinformation, it can help keep users better informed.
----
While it may squash some of the stupider and more dangerous ideas floating around right now, it tosses the baby out with the bathwater and harms important discussion about whether those in charge right now do actually have their information right.
"While it may squash some of the stupider and more dangerous ideas floating around right now, it tosses the baby out with the bathwater and harms important discussion about whether those in charge right now do actually have their information right. "
If you watch the videos by Dr John Campbell (British public health expert), he talks about Vitamin D all the time. He also expresses his frustration that this isn't given more attention.
This is actually very true. There are lots of potential treatments that use generic and non-patentable agents, and very few people are willing to look into it. Zinc is the classic example; some people think it maybe reduces the duration of the common cold. The common cold is one of the main causes of missed workdays. If there's a drug that could make you miss 4 days of work a year instead of 5 days of work a year, it would be worth billions. But nobody is funding studies on zinc, because nobody will be able to capture that saved revenue for themselves. (Zicam did try this; by patenting a nasal administration method and then doing controlled studies with that. If the results were good, then they'd say "it doesn't apply to oral zinc, it only applies to our applicator", and they could have their money. As it turned out, it caused people to permanently lose their sense of smell. I think it helped with their colds, though.)
One problem with zinc is that dosing isn't standardized and people use it in stupid ways, cf. nasal sprays. High concentrations of heavy (-er than calcium) metal ions are of course neurotoxic; putting high concentrations of zinc in direct contact with olfactory tissue is to be avoided. Many supplements contain 50 mg of zinc or more, and worse, people take multiple pills. However, studies show similar effects using only 12.5 mg of zinc:
Studies using much higher amounts of zinc do not show larger effects than this. The duration reduction in the above study was 28% while studies using 200 mg found a reduction of 35%:
Simply put, it does not make sense to multiply the dose by a factor of sixteen in order to improve effectiveness by 20%.
Yet I don't know exactly what GP is talking about. There are loads of studies about zinc for the common cold and there are loads of pills on store shelves containing zinc and claiming to treat the common cold. At least here in the United States, that is. People don't take it because of the side effects and the stupid dose forms available (although the situation seems to be slowly improving).
Interesting. The Zinc supplement that I started taking a couple times of week due to COVID-19 exceeds all upper limits listed on Wikipedia when taken at the recommended daily dose (50 mg).
Please be carefull with trace element as supplements, only take it if your doctor agree and don't self-medicate. When i was younger a kid in my school almost killed himself with iron poisoning (well, rather his parents almost killed him).
"Be careful" as "know which number is bigger than the other"
You're right, people should know that 50mg is bigger than 40mg/25mg (at least for a safe prolonged daily limit - single dosage limit might be higher https://en.wikipedia.org/wiki/Zinc_toxicity ). It's kindergarden level math and still it seems people have trouble with it.
I'm not being ironic, it seems that's a common problem. Maybe explains why the situation got to the point it got.
I don't know about that. From where I'm sitting, lots of companies stand to gain if Vitamin D turns out to make a big difference. For example: American Airlines, Hilton, and McDonald's.
Presumably because they would have customers who weren't quarantined at home unable to purchase goods and services -- any cure is a profitable one for companies not specifically invested in healthcare as a service.
could well be true, same can be said of sleep, the few good papers I've read often showed benefits and I don't recall any instances of harm so safe to try, but no money to pay for anything like the volume of research some rare illnesses get.
> "I would like you to speak to the medical doctors to see if there's any way that you can apply light and heat to cure, you know, if you could. And maybe you can, maybe you can't."
He was talking about 2 things
* UV light kills viruses, so why don't you shine UV light into the body to treat the virus
* Many viruses such as the flu don't transmit as well during the summer due to the weather conditions (heat + humidity), so could heat treat the virus in-vivo
Both of those suggestions are ignorant. He very clearly did not mean that getting some sunlight -> Vitamin D will help Coronavirus.
FYI, there is an actual company working on a medical device to put UV light inside the body to light the lungs. It's unproven but in the works. It was subsequently censored by Youtube and Twitter after the President's comments. https://www.youtube.com/watch?v=TgiHfD_xtvw
My mom did her PhD in micronutrients (sorry, I never really asked for details) and has always been nagging me to take 10000 IU of Vitamin D a day. I have been remiss in this over the years, and my physicals always come back with a note about being Vitamin D deficient. I have gotten better and my bloodwork comes back normal these days. (I have never noticed an effect. Coffee has a large effect on whether or not I feel awake, and getting exercise has a large effect on whether or not I feel good. But I'm sure not being deficient in Vitamin D is helping something.)
To be fair: It isn't just folks with indoor jobs and hobbies.
I've discussed this with my doctor after being severely low on vitamin D. It caused physical pain. I'm far enough north that it is impossible to get the sunlight needed during the winter. I still have days, but they are short without strong sun - not to mention that it is too cold to go without a jacket. So, supplements at least during the winter.
During the summer, I have the option of getting at least 15 minutes of sunlight a day (May through August). Being outside isn't enough: I need to make sure that more than just my face is exposed.
But then, on top of it all, I wound up taking a medicine that not only makes me sensitive to sun, but a bit more prone to a milder form of skin cancer. Sunscreen doesn't help with vitamin D production.
The end result is that I wind up taking vitamin D all year and simply get my levels checked from time to time. Luckily, the over-the-counter stuff does the trick (there isn't the variety in vitamins here as there is in the US).
My doctor told me (as he was telling me I needed to take vitamin D) that really at most latitudes in the US (including SF), the sun light is too weak and you won’t get enough vitamin D from sun exposure. This was all to tell me that I should still take an oral vitamin regardless of how much time I was able to spend outside.
Sunlight exposure is also bad for you; taking it orally is the way to go for most people.
As pointed out upthread, most supplements are hilariously low-dose. I take 20k IU, 3 times per week. (most supplements are like 1000IU per pill, but 3000IU pills can be found)
Damaging high doses can be as little as a few minutes in the Australian summer so I think it's fair to keep that in mind.
On your evolution comment, most Australians don't have dark skin, but the ones who were here before Europeans do. I think that is a good indicator that the body is adjusting to something harmful. On the other hand, many dark skinned people in Britain aren't in a climate they evolved for either. We all have to be mindful that people move around the world faster than evolution now and may need to adjust our habits.
Adding some information for those interested in more precise numbers.
This paper [1] has the recommended exposure time for a few cities in Australia. If you live in the same latitude, as long you live in the same latitude, this can be used as a guideline.
I haven't kept up with the Ozone Hole lately, but I believe it's not uniformly distributed so keep that in mind too if it's still a problem. I'm pretty sure it was usually more of a problem in Australia than South America for example.
I couldn't believe it the first time I went to Singapore, in 35C heat all day in the sun at a theme park, and didn't even get a minor blush on my pale skin due to the humidity and latitude. Definitely eye opening coming from NSW, Australia.
From the table there, for example, in Townsville in summer, with 11% of your body exposed, it takes just 6 minutes to synthesis 1000 IU of vitamin D.
A fair-skinned female friend who studied at James Cook University used to complain she got sunburnt walking between classes... So DWG, if you read this, apologies for telling you off for exaggerating!
I certainly do not recommend taking sunlight orally (lol etc)
Over exposure to sunshine is a bad idea. Depending on latitude, time of year, skin colour and a few other very well understood factors determines what is a safe exposure to the sun. We all know this already. Getting outside generally involves fresh, moving air. There is also the risk of gentle, through moderate to vigorous exercise.
Wear a hat and sunscreen if required but a good thing you can do to fight this nasty (all other things being equal) is take moderate exercise outside daily. Don't overdo it and keep away from other people.
I think a lot of other replies are missing the nuance.
It depends on a lot of things. Time of year, time of day, skin colour, where you live, if you're under an Ozone hole, UV index, personal sensitivity/medications, etc.
This is a good summary[0] for the situation in Australia, possibly the worst in the world when it comes to the sun being deadly. Their strongest statement about avoiding sun:
"During summer in Australia, all states experience long periods during the day when the UV Index is 3 or above (see Table 1). During these periods, a combination of sun protection measures (broad brimmed hat, covering clothing, sunscreen, sunglasses and shade) is recommended when outdoors for more than a few minutes. In summer, most Australian adults will maintain adequate vitamin D levels from sun exposure during typical day to day outdoor activities."
So a few minutes in the sun without protection is enough to raise your cancer risk during the worse times on the worst days and you shouldn't be seeking any sun intentionally for vitamin D during these times. Growing up it was easy to get sunburned in 10-15 minutes on some days, and the advice was that if you burn you definitely raised your cancer risk.
Isn’t some sunlight exposure good in general? I think it’s going too far to declare sunlight as genealogy dangerous. It definitely helps me with my mood.
my understanding standing is that the older you get the less that your body can metabolize from sunlight and it’s sunlight that occurs for a small period of time during the day based on the angle of the sun and the type of UV rays that are filtered. and you need to be naked
I've read a few paper on this subject you are absolutely correct, I don't know why you are have been downvoted.
Vitamin D is only produced with in UVB wavelength [1]. No vitamin D is produced over 318nm. I wonder if that's the reason they divided the range in UVA, UVB and UVC.
The solar ray incidation angle, pollution and altitude (higher, more UVB) affects the amount of UVB that hits the surface [2].
Therefore, the time of the day you are sunbathing is important to optimize Vitamin D synthesis. Midday is the best time. If you live bellow 25 degree latitude, the UVA/UVB ratio on winter is about the same on summer. Of course, you should take in consideration the weather and the UV index. I'm talking only about the ratio.
This paper [3] has guideline for sun exposure for Australian. It is possible to correlate the data for other places in the same latitude -- taking in consideration the Australian differences in UV index.
> People with indoor jobs and hobbies are probably not getting enough.
I argue that if you go outside and wear the appropriate sun protection—long pants,long sleeves, neck covered, broad rim hat, and wear sunscreen on the exposed parts—you can't get enough sun exposure to produce enough Vitamin D.
Okay now I'm wondering if I should go get tested for vitamin d deficiency. I live in Colorado and therefore we have a lot of ultraviolet light and I do get outside as much as possible. However I'm wondering if that's still not enough.
Seems reasonable that it's not based on your experience.
I live in Colorado, though I definitely don't try to get outside as much as possible. If you have symptoms of deficiency, nothing wrong with asking for testing vitamin d levels when you get a blood test. If you don't have symptoms, nothing to fix.
Vitamin D intake via supplements (vitamin pills) results in vitamin D storage in fat in you body. The storage decays over time, and it appears that intake via supplements decays twice as fast as intake via sun exposure.
Then it’s probably not a vitamin if we can synthesize enough of it to function fine.
The definition of vitamin is that it’s gotta be organic, necessary for healthy functioning, and we must be incapable of synthesizing enough of it to survive, even if it’s also available in our food. This is why cholesterol isn’t a vitamin; it’s necessary for us to live, but we’re fully capable of synthesizing enough of it on our own.
“A vitamin is an organic molecule (or related set of molecules) that is an essential micronutrient which an organism needs in small quantities for the proper functioning of its metabolism. Essential nutrients cannot be synthesized in the organism, either at all or not in sufficient quantities, and therefore must be obtained through the diet.”
By this definition you might argue that it's a vitamin north of some geographic line and a hormone south of that line ....
Also, nicotinamide (one form of Vitamin B3) is a metabolite of niacin (nicotinic acid, another form of Vitamin B3). Humans can produce the former from the latter, but require at least one of them from the diet. Does that make niacin a vitamin, but nicotinamide a hormone? They are not equivalent, but as far as "being essential", they are substitutes.
I believe the capability of humans to synthesize sufficient amounts of D3 under many circumstances makes it a hormone, not whether or not I’m synthesizing it right now. It doesn’t suddenly go from being a hormone to a vitamin once I took up an office job, I just stopped doing the activities required to self-synthesize it.
I think things get very tricky to define when you need at least one compound that can complete some biological process, but there are several different potential compounds that could do the job, some of which have to come from diet and others can by synthesized by the human body.
> I believe the capability of humans to synthesize sufficient amounts of D3 under many circumstances makes it a hormone
Its molecular structure precursor is cholesterol, a steroid hormone which by convention is a molecule with 3 hexanes attached to pentane and an R group, it under goes a series of cleaves in the presence of UV light to yield D3.
D3 and its known analogue's behavioiur and bioactivety also behaves like a steroid/hormone in that it can passively diffuse across a membrane. and helps down-regulate other metabolic reactions. Its effects on reducing inflammation in IG patients is well documented and worth checking out.
Here is a good review on Corticosteroids, specifically on there effects on inflammation treatment.
Well yes, Vitamin D is pretty hard to come around in the northern hemisphere so no surprise there. Mind you, it's far not the only thing - magnesium, zinc, selenium are just a few which most people are missing. I mean unless your diet consists entirely of tuna and salmon probably. Over the last few years, I've stressed significantly on my physical health(after being very overweight for the most of my adult life and now happy to say this is not the case anymore at all). And while Vitamin D has been one of the things I've become very strict about, my supplements menu has significantly expanded. And there are plenty of products which come bundled with your daily intake of vitamins and minerals. And one in particular has become a part of my breakfast at this point. I haven't had as much as a sneeze in the last two years, haven't felt even mild fatigue or exhaustion, even after the toughest of days. But as you said, it's best to consult a doctor first, especially if you have bad medical history. If you are healthy and fit though then there are plenty of good options to go with.
Interestingly enough, a few years ago some scientists hypothesized the lack of selenium in certain parts of China may have contributed to the spread of the SARS 2003 epidemic, since viruses that infect organisms deficient in selenium mutate at much faster rate (although some scientists dispute that).
Or move to a country with selenium-rich soil. Iirc Finland started mandating selenium to be added to fertiliser in the 80s and suddenly people started getting better selenium levels.
I talked to a Finnish nutritionist a while ago and she said it was about as much a success for public health as when they started adding iodine to salt. We didn't talk about the situation today, so it might have changed. I just found it interesting.
Oh my. As per usual Gwern, an amazingly detailed and long post about magnesium. I skimmed it in about a minute and just got a sense that I would need an entire afternoon just to properly read it. I don't know how he does it, frankly. But I'm thankful.
I go for a bundle of these[1] every 2 or 3 days, depending on how often I train and in the days between D-3 (1000 IU), vitamin C+zinc (1000mg for C), magnesium citrate 200mg.
IMPORTANT NOTE: I do train a lot and I'm in the 6-8% body fat range so generally I have higher needs. The ones in the link are bundled up in small bags of 11 pills and the values are for 2 packs of 11 which is a complete overkill if you are not a top tier athlete. 1 pack of 11 every 2 or 3 days is sufficient for regular people.
I also had a vitamin D deficiency that was found after a particularly bad string of colds, my Dr told me to take a supplement(5000ius daily) of vitamin D and have not seen anything like it since. Apparently windows cars/office block sunlight's ability to create vitamin D in a person so a car ride or sitting near an office window does not provide any help. And if you are in a office job you are def. not getting enough vitamin D.
> if you are in a office job you are def. not getting enough vitamin D.
I think this really depends on location and lifestyle. Anyone in a Mediterranean or sunnier climate that spends more than 30mn a day outside will be fine
I spend lots of time outside and I live in California. I still had life-long vit D deficiency, probably since birth. No idea why, might be something genetic.
The only way I could figure it out was via blood tests, spaced a few years apart. First time the doctor said "hm, you're pretty low on vit D, you should supplement it". Second time, it was more like "you're really low and you should take XXX amount each day, NOW!"
Big changes in terms of mood and "energy". I'm now kicking myself for not taking it earlier.
Vitamin D is not absorbed instantly when exposed to the sun. Soap and hot showers removes what is left so levels are also affected by personal hygiene habits.
Does anyone know of a rule of thumb for how much time spent in direct sunlight is equivalent to a Vitamin D supplement? Is an hour per day (on average) sufficient?
It depends on your skin color [0]. For people with light skin, 13 minutes of direct midday sunlight three times a week may be enough. But for people with dark skin, you may need 30 minutes to 3 hours of direct sunlight (the article doesn't make it clear whether that is three times a week or once a day) to get enough vitamin D.
the sun must be above 50' above horizon for UVB to penetrate the atmosphere to reach the skin. When your skin is exposed to sunlight, it makes vitamin D from cholesterol
I read Michael Holick's book (can't find it at the moment) he was the guy who discovered the circulating form of vitamin D.. IIRC you get vitamin D from the sun in rather large quantities. Just 15 minutes per day with only your face and hands exposed with the sun up at 45 degrees or more will be enough. I'm sure my data is not accurate, but it's in the ballpark. He has tables that depend on how dark your skin is and what latitude you live at.
So, this is only partly true. You need direct sunlight AND the amount varies wildly depending on your skin color. If you're rather pale, it may be only 15 min. But it can go up to several hours if you're dark-skinned.
What if it's cloudy? We are lucky to get 3 days a week where the midday sun isn't covered by cloud. Is it still sufficient filtering through the atmosphere?
UV rays penetrate clouds, but the clouds do filter some of it, so you'll likely need to increase the amount of time you spend outside depending on how cloudy it is.
My doctor's advice: 15-30 minutes of sun per day, with more than just your face exposed. So yes, an hour a day might be sufficient. You don't need to sunbathe, luckily, and cloudy days count too.
For me, this only counts from May to August: I'm pretty far north, and there isn't proper sun strength much of the year.
The Solar Zenith Angle is the most important. This is what changes from winter to summer and morning to night.
Vitamin D production is only made on the UVB range that is highest at midday. Both UVA and UVB causes erythema. Counterintuitively to common sense, it is better to sun bath midday than early in the morning.
If you sunbath at 8 you might need twice as many time to produce the same amount of vitamin D and you be exposed to much more UVA, thus more like to get burn.
"During active COVID-19 infection symptoms (fever, cough), please AVOID these common supplements: Echinacea, Elderberry, Polysaccharide extracts from Medicinal Mushrooms and Vitamin D as these MAY theoretically exacerbate the cytokine inflammatory storm. It's OK to take them preventively (if you are already doing so) but please stop at the first sign of COVID-19 symptoms."
Hence I've been avoiding adding Vitamin D to my daily ritual; anyone have any supporting data?
> "During active COVID-19 infection symptoms [...], please AVOID[...]"
> Hence I've been avoiding adding Vitamin D
Do you have active symptoms?
The concern is about a studied connection between Vitamin D supplementation and an increase in concentration of the IL-1b inflammation marker (see, e.g., [1]), which has been implicated in cytokine storms. The other supplements mentioned have similar effects.
This correlation suggests that you might not want to be taking Vitamin D if you're as risk of a cytokine storm hurting you.
That said, however, vitamin D is also associated with strong anti-inflammatory properties of other markers, so really -- it's super hard to predict what will happen. As far as I know, no one has observed a connection between Vitamin D and cytokine storms directly, so the whole thing is kind of hypothetical.
Hmm, I consider that paper to be pretty weak evidence -- as elsewhere, it shows a hypothesized connection via some intermediaries: they show Vitamin D inhibits inflammatory cytokines, but then presume that this inhibition must therefore help avoid hypercytokinaemia (cytokine storms), despite hypercytokinaemia being an edge case/failure mode of the immune system that is not particularly well-understood.
The paper I shared in my previous post cites work showing that Vitamin D promotes other kinds of inflammatory cytokines.
So, yeah. Vitamin D might reduce the likelihood of a cytokine storm, and circumstantial evidence relying on mechanism-of-action suggests that it does -- but this hasn't been demonstrated conclusively.
What is known, however, and which this paper reiterates, is that if you're deficient in Vitamin D, you're more likely to suffer from respiratory tract infections. Take a supplement!
The paper you cited only deal with cell lines (i.e. in-vitro studies), whereas you can find good quality in-vivo RCT studies about both low grade inflammation and cytokines storm. Hell, you can event find meta-analysis for specific conditions and related inflammatory state (CHF, type 2 diabete, ...)
Hell, we even have preliminary human studies dealing with just that: clinical outcome for patients admitted in intensive care unit, with or without a single mega-dose of vitamin D: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939707/
> Hell, we even have preliminary human studies dealing with just that: clinical outcome for patients admitted in intensive care unit, with or without a single mega-dose of vitamin D: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939707/
Thank you, this is what I was looking for! Great outcome.
The other three papers you cite are also all correlations of Vitamin D with inflammatory factors, not with disease outcomes. I must have missed the study that looks specifically at cytokine storms as a dependent variable. Could you point it out to me?
I don't know if I had COVID-19 since I couldn't get a test. I had dry cough for 4 weeks since early May. It didn't go away.
I increased Vitamine D supply by taking a supplement and eating more fish (salmon, herring). The cough became better but became much better only when I also added Echinacea.
I was also tested for Vitamin D deficiency and my doctor prescribed 50,000 ICU a week, followed by a much smaller amount per day afterwards. I noticed an improvement in my well-being as well (could have been psychological). My armchair hypothesis is that modern humans tend to be indoor creatures, yet our bodies evolved as if we were outdoor creatures, therefore we're supposed to be getting more sunlight and Vitamin D than we actually are.
Same thing happened to me. I was in the single digits for Vitamin D, and my doc had me taking 10000 a day (or week) I think. Within a month, I started to feel way more energy in the afternoon (I used to feel dead by 1pm). I also mysteriously kept getting sick with small colds that winter before supplementing, and those also went away.
USDA experiments have shown that exposing certain mushrooms to UV light converts cholesterols in the mushrooms to vitamin D. Since sunlight contains UV, an easy solution would be to leave some portabella mushrooms out in the noonday sun for a while. So far I can't find any articles that give a precise number for how long the mushrooms were exposed, though.
How is it taken in the rest of the world? In Norway, it's traditionally done by drinking cod liver oil daily during the winter months. At least that's what I do.
It doesn't really say that: it just repeats the standard advice that 4000 IU is the safe upper limit. The real answer is to get yourself tested regularly if you supplement large amounts of D3. (I'd advise taking K2 with it too, but do your own research.)
Since you're taking Vitamin D, you might also want to see if you need Zinc. Both Vitamins account for the largest deficits in the population. You might want to consider taking a Magnesium supplement since taking Vitamin D which can lead to a deficiency in Magnesium. Vitamin C is worth taking a few times through out the day.
The Trifecta is D,Zinc and C (with a magnesium supplement a few times a week).
I have read more than one study in the years past that consistent use of vitamin C supplements actually leads to a weaker immune system in the long term.
I went to my doctor complaining about the general lack of energy. Turned out to be Vitamin D. I grew up in the tropics and the lack of sun had put me under a severe deficiency. Had to take prescription strength to get to normal. Since then that’s one supplement I never miss.
I had mine checked because I was curious when I went for bloodwork a couple of years ago. I was expecting it would be low since I work indoors on a computer all day and my exposure to the sun in winter is limited.
I think I was tested in late fall, and it was fairly expensive to have done (roughly $100 where I was in Europe). From what I remember, you're deficient if you're less than 12 ng/mL and mine was around 6 ng/mL.
Of course I want to say I feel better, experience less winter blues, get sick less often, and have more energy since I started taking a supplement. I can't be certain of any of those things though. Maybe it makes a difference, maybe it doesn't. I feel decent these days, the numbers say I should take it, so that's why I take it.
You'd have to get follow up to see if Vitamin D has gone up after taking it.
I was Wrong on the internet (lots of food has vitamin D including Eggs and Mushrooms): Vitamin D supplements may not be absorbed as digestion isn't the normal process for obtaining it.
"Very few foods in nature contain vitamin D. The flesh of fatty fish (such as salmon, tuna, and mackerel) and fish liver oils are among the best sources [1,11]. Small amounts of vitamin D are found in beef liver, cheese, and egg yolks. Vitamin D in these foods is primarily in the form of vitamin D3 and its metabolite 25(OH)D3 [12]. Some mushrooms provide vitamin D2 in variable amounts [13,14]. Mushrooms with enhanced levels of vitamin D2 from being exposed to ultraviolet light under controlled conditions are also available."
Wouldn't a doctor simply test? I know when I was really low, the doctor scheduled me for a blood test after 3 months of prescription-dose vitamin D pills. We've also spot checked since then.
Yeah, when I got back for my next checkup, I definitely plan to ask my doctor to order the Vitamin D test again so we can see how it's changed over time.
For generally fighting off viruses, I wonder if Vitamin D is the reason why many colds / flues tend to peak in the winter months and subside over the summer.
Likely placebo. Vitamin D is extremely soluble in our bodies and takes months of consistent supplement dosage to have an effect on our baseline levels.
I had winter depression for years, and Vitamin D supplementation has all-but completely cured it. If I forget to take it for a few days (in the winter), then I really notice the difference, and taking the supplement (via drops) reliably helps within 2-3 hours of taking them.
I don't see how this could be a placebo as 1. I wasn't really expecting them to work in the first place. 2. I've tried all sorts of things over the years to try and relieve my depression, and nothing else has worked.
It's possible that raising baseline levels isn't actually required to have beneficial effects. Of course, the quantities of vitamin that aren't raising baseline levels must be going somewhere. It doesn't seem unlikely to me that at least some of it is going directly towards production of whatever things the body uses vitamin D for.
The only way to be sure is to randomly take either the real preparation or some placebo that looks, tastes, smells etc. exactly the same so you can’t tell the difference. The placebo effect does not require you to believe in the cure.
To be sure, yeah, but if you've tried a bunch of things with no success, and then one thing works despite your having no real optimism for it, that's pretty suggestive of a non-placebo effect.
I'll have to get checked next time I'm at the doc. I'm pretty far south, so sunlight isn't normally an issue. I also enjoy a glass of milk every night for 'dessert'. It is fortified with some vitamin D, but I'm not sure how much. My bigger concern is probably skin cancer over lack of vitamin D though.
the benefits of sunlight outweigh the risks. Avoid burning, but know that tanning is not correlated with melanoma (assuming you have skin that tans; otherwise, ignore this).
This conflicts with what I've always been taught, and with every high google result for 'tanning skin cancer'. (I'm in Australia, where the sun is especially damaging; but I'd be surprised if tanning were very dangerous here but fine elsewhere, and in any case the search results were not all local.) What are you basing it on?
It gets complicated. Sunburn (occasional high dose of sun) is unequivocally bad, and highly correlated with skin cancer. Regular, moderate exposure (could be described as tanning) is correlated to lower risk of cancer than getting little sun.
An examination of the current state of the scientific research shows that (i) severe sunburns are linked to increased risk of melanoma but non-burning sun exposure is linked to reduced risk of melanoma
What is your usual residence location?
When I was in Australia I had no vitamin D deficiency at any part of my life. I moved to Canada two years ago and suddenly I was severely vitamin D deficient.
And this also means that people with higher melanin residing in northern hemispheres are more at risk.
If this has been suggested for some time it would be kind of odd that only one study has noticed the connection; this seems rather easy to test, right?
It seems that the authors misunderstood the Boston study they are citing:
> In a Boston homeless shelter, 100% of 147 COVID-19 positive subjects were asymptomatic [3].
That study actually excluded N=15 symptomatic people:
> The original cases (N=15) were identified sequentially over a 5-day period, and each was expeditiously removed from the shelter population at the time of symptom recognition. These individuals predated the implementation of universal testing procedures and are excluded from this study.
So, it's rather unsurprising that 100% of the remaining people were asymptomatic.
This is a very weak study because it is retrospective: they just looked at existing medical records. And they only found 20 COVID patients that had vitamin D levels recorded. But the finding is compelling enough that we should demand better studies.
Actually there already is a better study where they actually tested vitamin D levels of many COVID patients [1]. It found vitamin D was strongly associated with less severe outcomes:
> Only 26% of the cases had 25(OH)D in the normal range, and virtually all of them (86%) had a mild outcome. ...
Just over a third (38%) had 25(OH)D in the insufficient range, and only one of them (1.3%) had a mild outcome. ...
Just over a third (36%) had 25(OH)D in the deficient range, and their distribution was pushed further toward severe and critical outcomes. Only one patient (1.4%) had a mild outcome, while 26% had an ordinary outcome, 40% had a severe outcome, and 33% had a critical outcome.
Now we should demand a controlled trial where they actually give a vitamin D intervention: this would provide causal evidence. However, avoiding vitamin D deficiency is already very well studied and has so many benefits that I think it is worth everyone's time and effort to do so.
Many people are advising high levels of vitamin D supplementation. However, there is reason to not overdo it on vitamin D supplementation and take just 1700 IU/day (or to just get sunshine) [2]. Of course, getting your vitamin D levels tested (with the help of by a doctor) is the safe way to go about this.
this doesnt pass the correlation vs causation smell test for me.
i suspect VID correlates well with COVID comorbidities, like a sedentary lifestyle, hypertension, and weight problems. the opposite is also probably true, that people with good vit D levels correlate with healthier lifestyles and fewer comorbidities.
This systematic meta-analysis paper[1] may be more convincing. The popular youtube COVID-commentating Dr. John Campbell did a review of it about a month ago[2] and has some good comments on the meaningful statistical power and experiment design.
The overall takeaway is this: in people with Vitamin D deficiency (which is very, very common), continuous daily supplementation can lead to up to a 70% reduction in contracted viral respiratory infections. It has a smaller effect the less deficient you are, and is not associated with any adverse effects.
It's not even correlational. They didn't even have a group of non-COVID patients to compare to, which would have been really easy. They could have looked at non-COVID ICU patients as well and did not. That would have at least been correlational.
I feel like this is a very expected finding. It would be more compelling to see the covid-19 severity among patients with and without VDI but matched by egfr or one of the many many other confounders. A lot of things are correlated with severity of metabolic disease that could be the thing that makes covid-19 severe in this population.
This mess started towards the end of the winter, a long period of low sunlight and presumably lower vit D levels. What's the rate of VDI in 75 year olds in general towards the end of winter? I can't find any numbers, but I suspect it'll be close to 100% in any non-warm climate.
In recent years there's been some question about whether there is a link between autism and Vitamin D deficiency in some African immigrants. Minnesota has a large population of Somali immigrants (ISTR the largest population outside Somalia itself) and in that community, autism has been nicknamed the "Minnesota disease" because of how prevalent it has become in children of immigrants.
> In an Institutional Review Board approved study performed at a single, tertiary care academic medical center, the medical records of COVID-19 patients were retrospectively reviewed. Subjects were included for whom serum 25-hydroxycholecalcifoerol (25OHD) levels were determined. COVID-19-relevant data were compiled and analyzed. We determined the frequency of VDI among COVID-19 patients to evaluate the likelihood of a VDI-COVID-19 relationship. Results: Twenty COVID-19 patients with serum 25OHD levels were identified; 65.0% required ICU admission.The VDI prevalence in ICU patients was 84.6%, vs. 57.1% in floor patients. Strikingly, 100% of ICU patients less than 75 years old had VDI.
Does this mean they have checked 20 people, 13 (65%) of them were severe and all in the below-75 subset of these 13 people were deficient in vitamin D? Doesn't seem credible to me, I'd prefer some hundreds of people from completely different parts of the country.
By the way, isn't almost everybody deficient in vitamin D anyway? (see doi:10.1101/2020.04.24.20075838)
But they didn't even check the Vitamin D levels. They only checked patients that had Vitamin D levels checked by physicians. So presumably this was a different population that was more sick by definition, because their physicans were checking them for Vitamin D deficiency. There aren't many good inpatient indications for checking Vitamin D. It's check for not good reasons sometimes, but most likely these patients were being followed by an outpatient doctor who was looking for something to explain some symptom, test result or problem that they were having.
Most of us are Vitamin D deficient. We do not spend enough time in direct sunlight for an hour with all our limbs exposed.
I've been taking 5000 IU for last 10 years to maintain ~55 ng/mL after finding out I was dangerously low at 12 ng/mL. And I used to live in Australia, the land of constant sunshine.
I avoid listening to the FDA recommended dose which has historically been increasing every few years. Just get your blood work done and supplement to maintain around ~ 55 ng/mL. That's better than listening to generic advice.
Btw. This pissed me off when BlueShield few years ago stopped covering Vitamin D blood tests because of this nonsense:
"The U.S. Preventive Services Task Force recently found the current medical evidence insufficient to assess the balance of benefits and harms of screening for vitamin D deficiency in asymptomatic adults."
"The American Society of Clinical Pathology contributed the following recommendation to Choosing Wisely®, “Many people have low levels of vitamin D, but few have seriously low levels. Most of us don’t need a vitamin D test. We just need to make simple changes so we get enough vitamin D.”"
20 Patients in Study with COV19
* 65% of them went to ICU (13 patients)
* 35% of them did not (7 patients)
Of the 13 Patients in the ICU 84.6% (11 patients) had VDI
Of the 7 Patients not in ICU 57.4% (4 Patients) had VDI
Thin gruel indeed. But all they are saying is that it's perhaps worth doing a real study. That's fair.
They’ve also been sitting inside a hospital for who knows how long. They cite another paper as saying ICU prevalence is 30-40%, but that’s an entirely different patient population. There is no control
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!
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]
I think 80 is a better level. People living in Spain and similar regions, who work outside most of the year, have levels up to 220 and they have no problems with it. You should not pursue that value via supplements. Taking 2000IU or 4000IU daily is healthy, but go much higher for longer periods and you end up with calcification of your bones. That's not reversible, and it might kill you in the end.
I posted the correct test and got down voted. The other Vitamin D test is not accurate. If you ask for the test from your doctor, he has to specify the one I linked. You can decide for yourself what level you want to target. The other test is not accurate so you can't manage your levels...
True story: my mom has plaque psoriasis and I was starting to develop symptoms as well (the condition seems to be heritable). I saw a dermatologist about it, and she prescribed a particular cream as well as doing 15 mins of UV therapy every day on the affected areas (knees and elbows were the worst). I wasn't the best at following medical advice at the time, but the cream helped some.
About a year and a half ago, I started taking vitamin D after my doctor told me I was slightly deficient. Within two months, there was no indication of plaques on my knees or elbows, and the little nodules that would appear on my palmar surfaces on my hands and feet became much less frequent. I am convinced that supplementing vitamin D was much more effective than any cream, and definitely less obnoxious than holding my knees and elbows to the sun at an open window on a sunny day. When I get outside frequently, I notice that basically all of my symptoms go away.
Long story short, take your vitamin D! Consult a doctor and don't take too much, since it's fat soluble and can build up to toxic levels in your system; also, since it is fat soluble, make sure your diet has enough good fats to help absorb it (guacamole and olive oil are two of my favorite supplementary foods with vitamin D).
There are other papers that argue similar. On April 20, Alimentary Pharmacology and Therapeutics: low population mortality from COVID‐19 in countries south of latitude 35 degrees North supports vitamin D as a factor determining severity
> It could be argued that the virus spread later to the Southern Hemisphere and that countries there are simply behind those in the Northern Hemisphere but as time goes by this argument looks increasingly weak.
I think it's worth pointing out the conclusion in their abstract and what the authors are trying to accomplish: "...we suggest that prospective, randomized controlled studies of VDI in COVID-19 patients are warranted."
The alt-text of xkcd 552 comes to mind: "Correlation doesn't imply causation, but it does waggle its eyebrows suggestively and gesture furtively while mouthing 'look over there'."
But at the same time, isn't it suspected that vitamin D insufficiency is linked with a worse immune system generally?
(Anecdotally it made a big difference for me not getting winter colds ever since my doctor pointed out I had a significant wintertime deficiency and I started supplementing.)
In other words, there's unlikely to be any unique link between vitamin D and COVID-19. That this just falls in the wide bucket of "unhealthier people are more affected by COVID-19", similar to obesity.
Okay, let's play with this. Let us extrapolate from the strong correlation found by this retrospective review, and postulate that Vitamin D Insufficiency (VDI) is indeed a major contributing factor in either the severity of a COVID-19 infection, or the chances of contracting it. (I am not claiming this is indeed true, correlation != causation, but I think strong correlations are certainly worth looking at and playing with).
It is my observation that in my local area, the shelter-in-place order has resulted in more people spending more of their time indoors and not going outside as much. The park in my neighborhood is empty. I see less people on the bike trails visible from the roads I take to the grocery store. A nature park 20 minutes from my house, the kind that people go to to get out of the city and the hell away from other people, is closed with COVID-19 as the justification and scary signs threatening fines posted at all the entrances. And so on.
With less people getting outside, and less often, that means more people are getting less sun exposure, and less vitamin D. Assuming that their diets aren't changing to make up for that, that means more people with VDI, and those already with VDI getting worse. As such, if VDI will make it easier to catch COVID, or make the symptoms worse once caught, I can't help but wonder if these shelter-in-place orders intended to slow the spread won't end up shooting us in the foot, setting us up for a 2nd wave more brutal than had people been encouraged and incentivized to get outside more.
Vitamin D is the only vitamin that the UK’s NHS recommends most people take - usually they recommend during winter. With the Covid lockdown they have extended the advice to say keep taking it.
Lots of people have been claiming that the currently-summer countries haven't gotten as hard hit. Their reasoning has been that the extra UV is killing the virus.
I wonder if they were correct, but for the wrong reasons. Vitamin D in humans primarily comes from a chemical reaction with sunlight in the skin. Maybe there's an indirect effect there that explains what they were seeing?
I've been sick for almost ten years and had low vitamin D levels. Last two years I've finally found some treatments that work for me, now that I'm healthier my vitamin D level has gone up to about 40 even though I rarely go outside and don't supplement. It's typically 5 without supplementation.
Previously, I tried supplementing with 10,000IU daily, didn't help me feel any better and took a long time to get my levels up. Doctor even told me to lie outside in a bikini every day in the sun and not to burn myself. My doc's theory is that some process in sick people uses up their vitamin D and calcium, and that's what needs to be stopped. He says he has seen patients with Vitamin D deficiency where they are cured with supplementation and/or sun, but it's not very common. It's cheap, easy, and harmless enough though to try before moving on to other things.
Nobody really knows what the “normal” level of Vit D is. My baseline level is lower than that of my white-skinned father and higher than that of my darker-skinned mother. Does he have too much? Certainly we all live at a latitude higher than where her ancestors lived and lower than where his did. Which of us has a “normal” level?
Outside extreme deficiencies though, I’m not sure that the band isn’t relatively large. But it is documented that D supplements for people with low levels of D does seem to reduce the incidence of pulmonary infections in general. There was a good paper on the subject published last December in Lancet (IIRC — i failed to save it in Zotero). So even before COVID-19 became a concern I upped my daily dose.
I would argue that they are not perfectly healthy. Non-severe Vitamin D deficiency has no acute effects, but lifetime risk for developing severe illness does go up.
(Not affiliated with the app, just happy with it.) It tells you the sun angle, peak hour of the day, and maximum time you should be in that day's sun based on your skin type, to avoid getting burnt while still getting enough D.
Be careful though - you might get a little OCD about Vitamin D tracking with this app. I did, and mainly use it now for checking how long it is safe to stay outdoors. (Instead of full blown tracking.)
Yes, if you want it to. Looking at my notifications screen in the app, it can notify about "D Window Events", and you can even specify the minimum angle of interest.
It can also notify upon solar noon, sunrise and sunset (not the same as a D window of opportunity), and give a daily supplement reminder. Each of these is individually configurable.
Interesting...in the UK, the NHS (National Health Service) recommendation is for adults to take a 10mcg (micrograms) vitamin D supplement daily (10mcg = 400IU). This advice was issued in 2016 after a science advisory body (Scientific Advisory Committee on Nutrition) published a 300 page report of the evidence on vitamin D and health. [1][2]
The NHS also say more recently in response to the lockdown [3]:
Consider taking 10 micrograms of vitamin D a day to keep your bones and muscles healthy.
This is because you may not be getting enough vitamin D from sunlight if you’re indoors most of the day.
There have been some news reports about vitamin D reducing the risk of coronavirus. However, there is no evidence that this is the case.
Do not buy more vitamin D than you need.
They also warn:
Taking too many vitamin D supplements over a long period of time can cause too much calcium to build up in the body (hypercalcaemia). This can weaken the bones and damage the kidneys and the heart.
If you choose to take vitamin D supplements, 10 micrograms a day will be enough for most people.
Do not take more than 100 micrograms of vitamin D a day as it could be harmful. This applies to adults, including pregnant and breastfeeding women and the elderly, and children aged 11 to 17 years.
There is strong evidence that Vitamin D does nothing. Large scale studies of vitamin D supplements show no benefit.
The article above argues that it is actually sun exposure that brings health benefits, and that vitamin D is just a byproduct. This makes sense. If vitamin D levels are strongly correlated with good health, it doesn't mean that it causes it. There might be some third factor.
Question for those more knowledgeable: From the abstract it doesn't seem like they compared this group with other people in the ICU - could the lack of sun exposure for that population play a role? ICU patients with COVID-19 have likely gone from sheltering in place at home to experiencing symptoms that make them unlikely to venture outside to the hospital where they can't leave, all of which means less exposure to the sun. Is a few weeks of staying indoors enough to cause this?
Note that some doctors are clueless and diagnose a deficiency of vitamin D based on just one metabolite. Test for both, and don't damage yourself with excessive supplementation.
It seems difficult to reach excess vitamin D levels though. From [1]: "Taking 60,000 international units (IU) a day of vitamin D for several months has been shown to cause toxicity. This level is many times higher than the U.S. Recommended Dietary Allowance (RDA) for most adults of 600 IU of vitamin D a day."
5000-7000 IU per day is probably a safe amount, despite the official recommended daily intake being 600 IU.
So what's the ideal amount of sun exposure to produce enough for a white guy at 45 north? Is there anywhere reputable that calculates this kind of thing?
You can read up on it in the book by Dr Holick. He recommends 4000IU daily, but if you're afraid that's too much, go with 2000IU/day. I take 4000IU daily since several years. Get a test before you start, so you have a base value. Test again after a month or two maybe three, and see what the change is.
With sun exposure, the book recommends the following. Go sit in the sun on a sunny day, until you get a mild rose burn. How long does that take? Divide that time over a week, and you're safe. This rose-burn time depends on the time of year, how high is the sun in the skye? How clear is the skye? What is the time of the day? So this value changes a lot for people in norther Europe, compared to people living in Africa.
> Get a test before you start, so you have a base value. Test again after a month or two maybe three, and see what the change is.
This is sound advice, but isn't there a chicken and egg problem right now? We're in a significant part of the pandemic, which I would imagine (assumption) that "routine" tests such as that may not be easy to come by. While at the same time there is notable evidence that VDI is prevalent in severe cases. By the time you get an answer to know the base line, it seems like it would be largely too late to make a possible difference in the short term?
Is there a "safe" amount you could increase it without knowing your base line?
It's not a study, you can't have a control group in a retrospective review, you can only sort data from the data set. You can complain about the small N, though.
> Among ICU subjects, 11 (84.6%) had VDI, vs. 4 (57.1%) of floor subjects. Strikingly, 100% of ICU patients less than 75 years old had VDI (n=11; Table 2).
Yes, vitamin D is well-known to be harmful in excess [0] and to be fat-soluble, meaning that it can build up gradually over time. You might not hear of such conditions very often, though, since getting excess vitamin D usually takes effort.
It takes a LOT of effort. Like in excess of 50K UI a day for months. And then it needs co-factors to do harm, like excess calcium intake along with a K2-MK7 deficiency and/or a potassium deficiency (both of which are, unfortunately, very common). All in all, it's a very complex system that interacts with the body's buffering mechanisms.
From Wikipedia: “according to some research, the tolerable upper intake level (UL) is 4,000 IU/day for ages 9–71 (100 µg/day). Other research concludes that, in healthy adults, sustained intake of more than 1250 μg/day (50,000 IU) can produce overt toxicity after several months”
Of course literally everything is harmful in excess, including essentials such as water and oxygen. The harmful dose being very different to the normal/helpful dose is as good as it gets.
Certain vitamins and minerals. Fat soluble vitamins can build up to the point of causing problems. Excess of iron and magnesium may have negative effect AFAIK.
For most people, excess magnesium levels would be pretty hard to reach. Unless you count loose stools as harmful, which some forms of magnesium supplements can cause.
Combining calcium and vitamin D can be seriously problematic. And high doses of calcium in general can make you more likely to end up with kidney stones -- those are not fun to pass!
Some supplements can even compete with each other for absorption (calcium & magnesium come to mind), so taking them together in a multivitamin is probably not the way to go.
There is no reason why your body should use the supplement vitamins or minerals if your diet is normal (not deficient). For example, a lot of people eat a bunch of animal products rich in calcium, D3, protein etc. and end up with diseases like osteoporosis, sarcopenia etc. Even with real food their bodies did not do anything with it.
Intervention studies with supplements on these kinds of people show that they rarely help or help very little (not long-term).
You need to make your body use the stuff you give it.
I read up on this because I had a really bad sinus infection a couple months ago and found myself taking "Emergen-C" every morning, which advertises "1000% your daily value of Vitamin C". Immediately after my sinus infection cleared up the virus stuff started, so I kept taking it for a while.
From what I read, at least with Vitamin C, you have to get into the 2000% range before there start being negative side-effects.
The other thing I've always heard is that taking more than the recommended amount is pointless, because your kidneys filter it out. I definitely wouldn't take the time to adjust to an even higher dose. I was mainly only taking the dose I was because I didn't want to try and subdivide the little packets.
If you're a man, you can give blood to get this effect. I believe there was a study linking this to a decline in diabetes risk (or something like that).
Excess iron appears to be more of a risk factor for heart disease than diabetes. This is suspected as a reason why pre-menopausal women have a lower risk of heart attack than men and post-menopausal women. This is still an area of active research and not really proven.
Yes, that, too. I was thinking of this, but I think they're all closely related. And hey, even if the science doesn't pan out, you've still probably helped someone out with your donation.
I am male and have the opposite issue. I become anemic without supplements. There seems to be some correlation with autism and low iron/b12.
I take Floradix, which is a German-made liquid made from vegetables and yeast. It has probably saved my life, because without it I become lethargic then severely depressed.
I joke that I'm a vampire and it is my human blood substitute that I take so I don't have to feed on people.
Interesting conclusions, but small sample size: N=20.
Vitamin D at normal doses is quite safe, though, so I'll be supplementing my intake now even if broader long-term study shows this to be ineffective for C19.
i loaded up on a bottle of costco vitamins and d3 supplement before we went on lockdown. There seems to be something in the multivitamins that i'm allergic to in high quantities, i.e. after taking them for 3-4 days straight I'll start getting hives. I reduced consumption to 1 mv tablet every 3 days and no problems so far. I'll probably increase d3 intake to 1 2000iu tablet per day and see how it goes.
Weird that it took a few days for the allergy to kick in. Do you get hives from other stuff?
I had a bad allergic reaction recently to wine (which was never a problem before), that started as bad hives and progressed to me nearly fainting. Doctor tested me as positive for a grape allergy, but negative to the shellfish allergy that caused hives as a kid.
Anyhow, all of that is to say that the doctor prescribed me an epipen, because apparently it's possible to experience anaphalaxis without having breathing issues. And full-body hives is one sign of that. The near-fainting I experienced was likely due to low-blood pressure, which is another symptom. So just be careful. I had always thought hives weren't a big deal (other than being extremely annoying), but I'm definitely going to take them more seriously from here on out.
The brilliant authorities around the world have made it illegal to go to parks. In some places, it is illegal to be outside, in front of your own house.
> Interesting thing... Vitamin D is one of those things that, when vitamins come up on HN, you will often hear the refrain that "it's the one vitamin that large numbers of people are actually deficient in and ought to supplement."
Well, let me add to the narrative, as this was the concentration of my Undergrad studies. Vitamin D, and its analogues are not actually vitamins, they're steroid-hormones and behave as such; look at its molecular structure [1] and its synthesis in the presence of UV light (as this actually how you should be acquiring it).
Most people are deficient in Vitmanin D, the recommended dose of 600 IU are actually not sufficient as many studies, research lends credence to as those that induced viable therapies were often upwards of 4000-10000 IU. The IOM is to blame for this, and a heated debate amongst researchers.
I won't go into full detail on that, but Vitamin D is a critical precursor and reactant in many vital metabolic reactions, my personal concentration was in inducing apoptosis in certain cancer cells with calcitriol, EB 1089, CB 1093, and p53. My proposals were rejected for Independent Studies and I never undertook it in the lab, unfortunately.
> Unfortunately the daily recommended value was established erroneously and should be much higher. Many research papers mention this...
Exactly. My bible was a Vitamin D book with 100+ chapters detailing researchers that published papers detailing how their models were showing that such low IU of Vitmain D were insufficient, going against the IOM's RDL.
If any of you are so inclined the 2nd Volume of Vitamin D by Feldman has been released [2], its expensive but still way less than what the last copies of vol 1 were that I paid back then.
> Nobody makes any money if it turns out to be a good treatment, so nobody will fund the research
You have no idea the amount of dismay I felt when I realized this was the case when I was in school; though I would argue they've fund(ed) it in the past, the problem is their is no way to place IP on Vitamin D itself and therefore Big Pharma's business model doesn't apply, so it can show favourable results but it will be killed because their is nothing to bring to Market as an exclusive seller like they do for drugs. Many therapies could have been explored since H1N1, 2009, but it falls on deaf ears and it takes pandemics like these to shake people into delving into Public Health more seriously.
I hope changes are made by motivated students and researchers, ideally outside of Universities because I know I no longer have the patience or drive to try any more.
Honestly, if you live in CA like most here just sun bathe for 15-20 mins daily on exposed skin, your body actually has a 'built-in' start-stop system that will actually stop producing vitamin D innately due to a feedback loop. You need to stop before your skin becomes irritated and begins to burn, obviously, to avoid damage. 17 mins for me is the sweet spot for ideal blood serum levels.
> what should we be taking and how much?
If taken as a dietary supplement that is way beyond me, as I'm not a physician and its irresponsible to give medical advice as its specifically related to you and your health.
But someone even mentioned the 10000 IU doses that can be administered in severe cases with little to no harm and that's worth noting in terms of toxicity risk.
Personally, I moved to CO from the coastal part of CA partly because of the elevation difference and intensity of Sun in the Fall and Winter months to mitigate my Vitamin D level decreasing and how it affects my health; so my personal optimized blood serum wouldn't be compatible to your own, so even that wouldn't work.
> I just want to pip install vitamin-d and be on my way.
Biohacker hat on: Get some Vitmain D pills and start with taking 1000 IU (as a baseline) and increase the dosage incrementally on a weekly basis while documenting your mood, and overall health and decide for yourself. You get several types of endorphins from it, so when I started to find my effective doses I noticed it alleviated my irritability and frequent headaches.
Yeah, and Italy, Spain, and France are some of the sunnier countries in Europe (compared to Germany, UK, Belgium, Scandinavia, etc). If anything I would expect vitamin D deficiency to be less common there.
I don't know about Spain, but in both Italy and France the regions most affected are the northern overcast places. The impact around the Med is much smaller, despite much much more retirees
We had enough (more than enough, actually) sun this past winter here. The lock down happened after the virus hit us hard so your comment doesn't make much sense.
Anyway, we have VDI too even with our sunny weather. Not everybody likes sunbathing and the use of sunscreen with a high SPF is common.
It really is too bad that all our front doors lead directly to beaches, parks and hikes. How many people could have been saved if we had gardens, roofs and streets?
I've heard that many times over the years and I have taken a Vitamin D supplement on and off (more off than on) over the years.
When this COVID-19 thing first hit, I had a physical scheduled (by chance) just about the same time, and I'd heard about this Vitamin D / COVID-19 connection, so when I went in for my physical, I asked my doctor to order a Vitamin D test as part of my bloodwork.
As it turns out, I was indeed very deficient in Vitamin D. I started taking 4000 IU a day and it's had a noticeable impact on my overall sense of wellbeing. It could, of course, be placebo effect even so. And I have no particular reason to think that it will make any difference one way or the other in terms of me getting COVID-19. But I thought it was worth pointing out one more anecdote that suggests that the old "Vitamin D is worth supplementing" refrain might just be true.
If you're in doubt, and it's an option, do what I did... just ask your doctor to run a Vitamin D test next time you go in for a checkup / physical.