14 ms·

Vitamin D supplementation to prevent acute respiratory tract infections (2017)

267 points by luu 7y ago

officialchicken 7y ago
Can any physicians or researchers here verify the credibility of this site, to prevent misinformation?
- pacman83 7y ago
  British Medical Journal? Impact factor 27.604 in 2018. But in scientific publishing the intended audience is not lay people. You really have to know how to read the articles to determine what they mean. I liked their series of articles called "How to Read a Paper."[0] But keep in mind [1]. 0. https://www.bmj.com/about-bmj/resources-readers/publications/how-read-paper https://www.bmj.com/about-bmj/resources-readers/publications... 1. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124 https://journals.plos.org/plosmedicine/article?id=10.1371/jo...
  - officialchicken 7y ago
    Thank you, HN is definitely not the intended audience
- VBprogrammer 7y ago
  Assuming it's the BMJ that I know of that's the 'British Medical Journal' which is highly regarded. https://en.wikipedia.org/wiki/The_BMJ https://en.wikipedia.org/wiki/The_BMJ
  - hestefisk 7y ago
    Yes, together with New England Journal of Medicine and The Lancet, they are the ‘Nature’ equivalent of medical science.
    - russholmes 7y ago
      The BMJ is the Daily Mail of medical journals, its target audience is whisky-nosed old buffers. Real doctors read the Lancet. https://www.dailymotion.com/video/x2nedgv https://www.dailymotion.com/video/x2nedgv
      - hestefisk 7y ago
        According to Wikipedia: “ As of 2008, the five journals that have been cited most frequently by articles published in The BMJ are The BMJ, The Lancet, The New England Journal of Medicine, Journal of the American Medical Association and Cochrane Database of Systematic Reviews.” So your statement is quite incorrect or you are being sarcastic.
- sebbo 7y ago
  This is a well-written meta analysis in a top-tier medical journal which demonstrates a convincing relationship between acute respiratory infection, Vit D baseline levels, and supplementation. However, their conclusion that the findings warrant public health interventions and widespread supplementation is arguable. There are real risks and costs to over-supplementation, and the absolute risk reduction they demonstrate (from 42% to 40%) is not large.
deleted 7y ago
[deleted]
ehnto 7y ago
Interesting! Anecdotally I used to get very, very bad respiratory infections once a year when working in an office full time, getting at best an hour in the sun a day. Now I remote work and get anywhere from 2-6 hours sun most days, and I haven't had a serious infection for more than a year and a half. Could still be coming, but I feel 200% better overall so regardless, highly recommend getting outside more. Edit: maybe this came off as a humble brag? Getting a downvote or two, which I don't mind, but I wouldn't want to give off the wrong impression. I only work from home, I am not a jetsetting nomad, I can just work around my outdoor activities now.
- jgrahamc 7y ago
  Sounds like your exposure to other people might have changed dramatically: working in an office full time -> remote work.
  - arkitaip 7y ago
    Probably. Or maybe a less stressful commute to work, no crazy office politics, a change in diet/exercise (because you now have time to do those things properly)... It's really difficult to accurately establish correlation let alone causality when it comes to changes in one's health.
    - ehnto 7y ago
      Definitely! So many things changed when I went remote that I would never suggest it's entirely down to sun exposure. It would be impossible to say definitively.
  - ehnto 7y ago
    Definitely. One of many factors involved. Less commute, always getting enough sleep I am sure help a bunch. But I can also feel a big difference in my abilities when I don't get outside for a few days, even when all those other benefits stay the same.
- coldcode 7y ago
  In your case avoiding the office is more likely to reduce your infections than the sun.
appstorelottery 7y ago
Unfortunately I can't find the source, but I read somewhere that it wasn't proven that Vitamin D supplements can improve outcomes after infection has occurred. Can anyone find the source on this and verify?
- Spacemolte 7y ago
  I unfortunately can't find the source either, but I read something about you having to take vitamin D suppliments for a while before the change could be detected in the body, ie. if you are already sick it does not matter to take suppliments where you only see the benefit after weeks or months. This seems to support what you read.
narrator 7y ago
Hacker News has gone from the anger to the bargaining phase of grief. 4chan, ahead of the curve naturally, is currently in full blown depression phase.
- ForHackernews 7y ago
  Wait, really?
- bilekas 7y ago
  4chan in full blown depression phase ?? That place breeds depression.
- 99052882514569 7y ago
  I don't recall any anger. Hacker News is in the 'focus on facts' phase of responding to mass panic, and I believe we won't move on to the 'resignation' phase anytime soon.
  - AlexandrB 7y ago
    I see a lot of comments about "megadosing" with vitamins C and D. That sounds like straight-up quackery, not "focusing on the facts".
    - SamBam 7y ago
      Huh, the only comments I saw about "megadosing" were explicitly refuting the notion of megadosing vitamin C, and the effect that that quackery has had on the science. Are we reading the same comments?
eyeball 7y ago
What’s the connection between calcium and D? I recall someone telling me you had to be careful of supplementing D or you could promote calcification in arteries. You had to take with a calcium shop or something. Is that true?
- leto_ii 7y ago
  Vitamin D has a significant role in calcium homeostasis and metabolism. Its discovery was due to effort to find the dietary substance lacking in children with rickets (the childhood form of osteomalacia).[12] Vitamin D supplements are given to treat or to prevent osteomalacia and rickets. taken from the Wikipedia article: https://en.wikipedia.org/wiki/Vitamin_D https://en.wikipedia.org/wiki/Vitamin_D
- vixen99 7y ago
  Can't quote from memory but there is substantial evidence that this is not a problem unless you're taking massive doses (tens of thousands of IU) on a daily basis for a lengthy period. Naturally those interested should check this out for themselves.
- speakeron 7y ago
  It should be taken with vitamin K2. The theory is that it aids calcium absorption into bones rather than dumping into arteries. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566462/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566462/
KaiserPro 7y ago
Table 4: > When all studies were analysed together, no statistically significant effect of vitamin D was seen on the proportion of participants with at least one upper respiratory tract infection, lower respiratory tract infection, hospital admission or emergency department attendance for acute respiratory tract infection, course of antimicrobials for acute respiratory tract infection, or absence from work or school due to acute respiratory tract infection. However, when this analysis was stratified by dosing frequency, a borderline statistically significant protective effect of daily or weekly vitamin D supplementation against upper respiratory tract infection was seen (adjusted odds ratio 0.88, 0.78 to 1.00; 4483 participants in 11 studies, P=0.05; table 5⇓). Which to me makes it sound like it makes almost no difference. Edit: The above could be for pre-exsisting patients.
- marcosdumay 7y ago
  That one significant result looks like this: https://www.xkcd.com/882/ https://www.xkcd.com/882/
- tomthe 7y ago
  You quoted the paragraph for the secondary outcomes, which doesn't diminish the results quoted in the headline. Said that, the effect of the main outcome is not that big (if I read that correctly, it reduces your chances of getting a respiratory disease by ~4%)
- throwawayhhakdl 7y ago
  Without reading the study in detail, I feel like 4,483 is too few people to detect an effect like this because you can’t easily control for how much vitamin d people get from the sun.
- zebrafish 7y ago
  I believe this is saying that as a treatment it is not effective but as a preventative regimen it is.
- jonnycomputer 7y ago
  The paper indicates that a meta-analysis of primary effects in published research shows a significant effect, but for secondary effects in published research (those not related to study aims), no effect. Ok. Both sorts of reports (of primary and secondary effects) have their own sorts of biases. In general, while there is tendency to only publish and report significant effects (and this applies for both primary and secondary outcomes), study design matters, and a study may not be well designed to detect, or account for other factors, for secondary outcomes- in N, choice of population, control procedures and variables used, or even how accurately and systematically that data was recorded. Does make it hard to evaluate.
darkerside 7y ago
I've been wondering why it is that virus infections are supposed to "disappear" in the summer. Obviously the viruses don't actually go anywhere, so I would expect people to get sick year round. Maybe immunity boosting from Vitamin D could be part of the answer.
- dtjohnnyb 7y ago
  That is one hypothesis, though there are a lot https://en.wikipedia.org/wiki/Flu_season#Cause https://en.wikipedia.org/wiki/Flu_season#Cause
  - Gravityloss 7y ago
    Mind boggling that this kind of a thing isn't known. This says the total economic effect of seasonal influenza in the US alone is 87 billion per year. That's six NASA:s worth: https://www.sciencedirect.com/science/article/pii/S0264410X07003854 https://www.sciencedirect.com/science/article/pii/S0264410X0...
    - adventured 7y ago
      > That's six NASA:s worth The good news is, it's only four NASAs now. Their budget is up to $22.6 billion this year.
    - Marsymars 7y ago
      > Mind boggling that this kind of a thing isn't known. I was blown away recently when I discovered that the causes of myopia aren't really known, but don't seem to be primarily genetic.
      - gameswithgo 7y ago
        some evidence that being indoors too much when young could contribute.
        7y ago
leto_ii 7y ago
I can say from my own experience that the lack of vitamin D can have a significant impact on both mind and body. I suspect that essentially all people living at relatively northern latitudes have some sort of vitamin D deficiency. From what I know you need to have your face and arms exposed to direct sunshine for at least 15 minutes/day to keep healthy vitamin D levels in the body. Good luck with that in the European/Canadian/Northern US winter.
- econcon 7y ago
  I doubt that's the case - for many years when I was a student I lived near equator and never went out. I never felt any impact or mind or body. I even tried some vitamin D3 supplement, smth like 2000IU but had no effects after few weeks, then I quit. The biggest effect anything I had on me is Testosterone Enthante 250mg twice a week. Also I wonder if taking 8,000 IU vitamin D can desentivize the system overtime
- TacoToni 7y ago
  getting my blood panel ran and finding out i was deficient in Vitamin D changed my life for the better once i start daily supplementation of Vitamin D3 (5000 IU). I even live in Florida, but working in an office all day doesn't help. Now that my levels are good, i feel as if my memory is far better and i dont feel tired all the time.
  - leto_ii 7y ago
    > i feel as if my memory is far better and i dont feel tired all the time. I agree. Don't overdo it though, 5000 IU daily seems a bit much :) I live in Amsterdam and take 2000.
    - pdonis 7y ago
      > 5000 IU daily seems a bit much I think it depends on the person. If you get your blood level checked when you have a regular physical, you can adjust the dose as needed to keep the level where you want it (I shoot for the upper end of the normal range, and 5000 IU a day seems to be doing that for me).
kasperni 7y ago
This is a personal experience. But I've been struggling with constant throat infections, tiredness and coughing every winter for years (I live in a Nordic country). Had my 25-Hydroxy-Vitamin D(D3+D2) checked in both autumn and winter 2 years ago. In October it was ~ 110 nmol/L and in February it was ~ 30 nmol/L. (Deficiency is around 50 nmol/L). Seeing the seasonal difference was a bit of an eye-opener. And I have been on high dose Vitamin D supplements this winter. And all of my "winter" issues have more or less disappeared.
- dharma1 7y ago
  how high is high dose for you?
  - kasperni 7y ago
    4,000 IU 4-5 days a week. I did a loading phase with a bit more.
    - agumonkey 7y ago
      so the program is > 4000 at first then stabilize around 4000 ?
      - kasperni 7y ago
        Yes, I didn't start until late December so I did a little loading with a bigger dose [1]. Next time I'm just going to start around October instead of running into a deficiency. [1] http://gmmmg.nhs.uk/docs/nts/NTS-Recommendation-on-Vitamin-D-deficiency-and-insufficiency-adults.pdf http://gmmmg.nhs.uk/docs/nts/NTS-Recommendation-on-Vitamin-D...
bad_user 7y ago
I suffer from allergic asthma and tend to catch colds quite frequently. This year I started supplementing with 2000 UI of vitamin D daily and it's as if my immune system started functioning normally, in the last 10 months I only caught a really light cold that I could barely notice, whereas before this the winter season alone would bring 2 severe cold or flu episodes that would knock me down for several days. I can't really say if it's the vitamin D, or other changes in my life, like losing some weight or walking more, or the cold exposure I've been practicing (primarily because I heard it burns calories :-)), it might be even placebo, I haven't isolated these variables well, but my wife and close ones are amazed by the transformation. E.g. 3 weeks ago everyone in my household got the flu, except for me. So now I got everyone in my household on vitamin D, especially b/c of this coronavirus scare. During summer time we might not need it, but the sun doesn't see us during winter. And vitamins are probably no defense against the coronavirus, but a deficiency could amplify the damage (as vit D has a role in our immune system) so it's best to ensure that we aren't deficient. Also we tolerate large doses of vitamin D, so it can't hurt.
- neuronic 7y ago
  > it's as if my immune system started functioning normally Nothing constructive to add, but I wanted to say I am glad you are feeling much better. This is great to hear!
- lmedinas 7y ago
  I suffer from similar issues with allergic asthma, which type of allergy and in which time of the year do you suffer more ?
  - bad_user 7y ago
    Thankfully I don't seem to suffer from pollen allergies, my sensitivities are to cats (saliva) and to moisture and mold, so I don't have a time of year in which I'm sensitive. I do regret not being able to adopt cats :-( When I was in my twenties I've gone through severe asthma episodes, due to exposure to such allergens and once you get inflamed it's really hard to reverse without proper treatment. So I eventually went on a treatment with corticoids and Symbicort and by avoiding the problematic allergens I've been fairly well under control ever since, haven't needed any treatment for years. Before that I was using Ventolin, which wasn't working well and gave me tachycardia episodes, thank god treatment for asthmatics got better. But I remained fairly sensitive to colds, many colds I catch evolve into bronchitis.
mc32 7y ago
So cold viruses do better in cold weather and in northern latitudes with fewer sunlight hours we may expect the combination to result in more cold in winter time?
mherdeg 7y ago
As a layperson it feels to me like research in the "megadose on vitamins to prevent illness" area is kind of tainted by the legacy of Linus Pauling, who was no doubt a genius in his fields and whose published literature advocated the position that vitamin C megadose would reduce cancer deaths by 75% ( https://www.theatlantic.com/health/archive/2013/07/the-vitamin-myth-why-we-think-we-need-supplements/277947/ https://www.theatlantic.com/health/archive/2013/07/the-vitam... ). I guess we know how to avoid the trouble -- make hypotheses and test them. The trouble there is that the placebo effect is not a bad thing -- if you're doing things which you think will improve your wellness and it works, who cares whether there's a chemical mechanism? It works!
- ovi256 7y ago
  >As a layperson it feels to me like research in the "megadose on vitamins to prevent illness" area is kind of tainted by the legacy of Linus Pauling You're completely right, biochemists and medical chemists know fully well it's tainted by Pauling's late work and will tell you so. If even a small positive effect was missed because of that taint, that's a terrible legacy that led to many avoidable deaths (all the people that suffered or died until the positive effect is finally recognized). We should be better at salvaging such effects from their imperfect creators.
- ucha 7y ago
  You can't really megadose on Vitamin D because like most liposoluble vitamins, they are hepatotoxic at large doses.
  - teach 7y ago
    Yeah, but there's a huge gap between current RDA and toxicity. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-toxicity/faq-20058108 https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h... 4000 IU per day would probably help a lot of people and is still an order of magnitude under the intake that's known to be toxic (60,000 IU/day for several months).
- hannob 7y ago
hannob 7y ago
Please note that this is a bit older (2017). As I personally have a cold quite often I was curious to look into this a bit. Around the same time another metaanalysis was published with a similar question [1], but quite different results (i.e. Vitamin D is unlikely to help). Here's [2] an (unfortunately only german) article by an austrian webpage associated with the cochrane collaboration (i.e. that should be considered a relatively trustworthy source) that explains this difference due to the fact that the BMJ metaanalysis included many low quality studies that were excluded in the other metaanalysis. This is an indication that this is might be not a real effect, but an artifact of the low quality evidence this analysis is based on. tl;dr I won't buy Vitamin D supplements. [1] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0162996 https://journals.plos.org/plosone/article?id=10.1371/journal... [2] https://www.medizin-transparent.at/vitamin-d-und-das-immunsystem-was-stimmt/#ref1 https://www.medizin-transparent.at/vitamin-d-und-das-immunsy...
- stjohnswarts 7y ago
  You don't need vit D if your blood levels are not low, but vitamin d supplements absolutely can raise it if it is low, there is not arguing with that fact. It's established science.
drgoodvibe 7y ago
I had a genetic test done (not 23andme or other retail genetic tests) and it turns out I have genes that essentially cause me to have low absorption for vitamins d, b6 and b12 and vitamin e. According to my bloodwork I also had extremely low Vit d in the blood (way below average). I started megadosing and honestly I feel like a different person, when I got a cold before it would last for 7 days, and twice it led to bronchitis and then pneumonia this year since megadosing I’ve had two colds and both lasted no more than 2 days. So I’m not superman, I still get sick but the severity of the colds have been significantly lower than before megadosing.
- jmnicolas 7y ago
  As someone that mega dose vitamin C in summer because it helps with my allergies, I'd be wary to mega dose vitamin D (more than 3k UI a day).
- 52-6F-62 7y ago
  My B12 deficiency was discovered because of a routine blood test. Low hemoglobin, but since anemia runs in the family the rest was simple enough for my GP to put together. Eat more red meat (I rarely touched it in the past), and take a daily supplement was the charge. The mental clarity and well-being improvements are palpable.
- md2020 7y ago
  Do you mind sharing the test you used? Curious to try this myself.
neuronic 7y ago
May I mention the following research on NCBI: https://www.ncbi.nlm.nih.gov/pubmed/28768407 https://www.ncbi.nlm.nih.gov/pubmed/28768407 I will simply quote from the abstract: > This could lead to a recommendation of 1000 IU for children <1 year on enriched formula and 1500 IU for breastfed children older than 6 months, 3000 IU for children >1 year of age, and around 8000 IU for young adults and thereafter. Actions are urgently needed to protect the global population from vitamin D deficiency. Essentially, the recommended intake that pharmacists and labels tell you is outdated and founded in a statistical error. Adults are recommended to take >8,000IU every day and not ~1,000IU as still believed by many professionals who last updated their brainbase decades ago.
- elric 7y ago
  I'll counter that with a quick quote from wikipedia: > Recommendations stemming for a single standard for optimal serum 25(OH)D concentrations ignores the differing genetically mediated determinates of serum 25(OH)D and may result in ethnic minorities in Western countries having the results of studies done with subjects not representative of ethnic diversity applied to them. Vitamin D levels vary for genetically mediated reasons as well as environmental ones. Basically, rarely is anything simple enough for a "one size fits all" approach. Source: https://en.wikipedia.org/wiki/Hypervitaminosis_D https://en.wikipedia.org/wiki/Hypervitaminosis_D
  - aldoushuxley001 7y ago
    I wouldn't say you 'countered' OP with that quote, but you did add some very pertinent and helpful info. From my perspective, though, your info is syngergistic with OP's, not counter to it.
- funklute 7y ago
  While this is a very interesting paper, I'm a little bit wary of research articles that only have a single author. Are you aware of how accepted this viewpoint is in the wider research/medical community? For example, are there any medical bodies that currently actually recommend adults to take 8000 IU of vitamin D supplement per day, if they are at risk of deficiency? Conversely, are the medical bodies that do not make such a recommendation simply slow, or are they in fact disputing the above findings?
kbrisso 7y ago
Magnesium, vitamin D, zinc and mk-7 vitamin k-2 are my daily vitamins coupled with a lot of exercise. I can't say when the last time I was sick.
- Krasnol 7y ago
  I take not vitamin supplements at all, drink my Earl Gray with citron and sugar and spend most days of the year in buildings in front of a computer while travelling between them using public transportation. I don't even get enough sleep. I don't get sick while people around me do. There is no one solution fits them all.
jpdus 7y ago
I am a bit perplexed. Haven't almost all randomized/controlled trials shown (e.g. [1]) that there is basically no measurable effect for healthy people? All "positive" stories are relying on observational studies with the usual confounders, right? EDIT: Look at figure 2 in the Paper. Looks pretty random to me. Result is almost exclusively driven by 4-5 small (<250 participants) and old studies. [1] https://www.vox.com/2018/10/4/17933880/vitamin-d-health-sun-diet https://www.vox.com/2018/10/4/17933880/vitamin-d-health-sun-...
- CodeWriter23 7y ago
  Vitamin D in the study you provide, D2 & D3 in the OP link. Chemistry and source matters. D is synthetic, D2 is plant derived, D3 animal derived.
  - aldoushuxley001 7y ago
    D3 mostly comes from fungi as far as commercial sources for supplements are concerned, I'm pretty sure.
    - posix_me_less 7y ago
      D3 is made by irradiating lanolin (from sheep wool) with UV light [1]. Natural source of D3 is oily fish, beef liver. It's the Vitamin D2 that is made from fungi - UV light helps to create it in mushrooms [2]. [1] https://www.quora.com/What-is-the-industrial-process-involved-in-making-Vitamin-D3?share=1 https://www.quora.com/What-is-the-industrial-process-involve... [2] https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#h3 https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessiona...
durpleDrank 7y ago
https://www.grc.com/health/vitamin-d.htm https://www.grc.com/health/vitamin-d.htm
glaugh 7y ago
I found this to be a useful summary of similar research: https://examine.com/nutrition/supplements-for-cold-and-flu/ https://examine.com/nutrition/supplements-for-cold-and-flu/
open-source-ux 7y ago
In the UK, a science advisory body (Scientific Advisory Committee on Nutrition) published a review of the evidence on vitamin D and health in 2016. Their recommendation: adults and children over one in the UK should take vitamin D supplements in winter. This advice may not be applicable to people living in sunnier climes. Here is an overview of the guidelines on the NHS website which includes a link to the 300 page scientific review. https://www.nhs.uk/news/food-and-diet/the-new-guidelines-on-vitamin-d-what-you-need-to-know/ https://www.nhs.uk/news/food-and-diet/the-new-guidelines-on-...
MrK93 7y ago
I already take vitamin D for weightlifting, I guess I'm covered. Many advantages also for hormones.
_cairn 7y ago
I had my Vitamin D levels tested last year, was enlightening. For those interested it's a pretty painless (small blood sample) and inexpensive test.
- brokensegue 7y ago
  I was recently charged several hundred for a vit D test. The price is basically random in the US.
  - stjohnswarts 7y ago
    That's insane, my whole panel for vitamin d, some other vitamins, insulin levels, immune analysis, etc all are about $120 when I do my annual checkup.
    - brokensegue 7y ago
      Yeah insurance decided not to cover it for some reason even though my doctor ordered the test. The rest of the panel was a few bucks after insurance.
beagle3 7y ago
n=1: 10,000 IU of vit D3 before 10am significantly improves my sleep. Gwern has some of his own relevant n=1 experiments described on his site.

267 points by luu 7y ago

officialchicken 7y ago

Can any physicians or researchers here verify the credibility of this site, to prevent misinformation?

pacman83 7y ago
British Medical Journal? Impact factor 27.604 in 2018. But in scientific publishing the intended audience is not lay people. You really have to know how to read the articles to determine what they mean. I liked their series of articles called "How to Read a Paper."[0] But keep in mind [1]. 0. https://www.bmj.com/about-bmj/resources-readers/publications/how-read-paper https://www.bmj.com/about-bmj/resources-readers/publications... 1. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124 https://journals.plos.org/plosmedicine/article?id=10.1371/jo...
- officialchicken 7y ago
  Thank you, HN is definitely not the intended audience
VBprogrammer 7y ago
Assuming it's the BMJ that I know of that's the 'British Medical Journal' which is highly regarded. https://en.wikipedia.org/wiki/The_BMJ https://en.wikipedia.org/wiki/The_BMJ
- hestefisk 7y ago
  Yes, together with New England Journal of Medicine and The Lancet, they are the ‘Nature’ equivalent of medical science.
  - russholmes 7y ago
    The BMJ is the Daily Mail of medical journals, its target audience is whisky-nosed old buffers. Real doctors read the Lancet. https://www.dailymotion.com/video/x2nedgv https://www.dailymotion.com/video/x2nedgv
    - hestefisk 7y ago
      According to Wikipedia: “ As of 2008, the five journals that have been cited most frequently by articles published in The BMJ are The BMJ, The Lancet, The New England Journal of Medicine, Journal of the American Medical Association and Cochrane Database of Systematic Reviews.” So your statement is quite incorrect or you are being sarcastic.
sebbo 7y ago
This is a well-written meta analysis in a top-tier medical journal which demonstrates a convincing relationship between acute respiratory infection, Vit D baseline levels, and supplementation. However, their conclusion that the findings warrant public health interventions and widespread supplementation is arguable. There are real risks and costs to over-supplementation, and the absolute risk reduction they demonstrate (from 42% to 40%) is not large.

deleted 7y ago

[deleted]

ehnto 7y ago

Interesting! Anecdotally I used to get very, very bad respiratory infections once a year when working in an office full time, getting at best an hour in the sun a day. Now I remote work and get anywhere from 2-6 hours sun most days, and I haven't had a serious infection for more than a year and a half. Could still be coming, but I feel 200% better overall so regardless, highly recommend getting outside more. Edit: maybe this came off as a humble brag? Getting a downvote or two, which I don't mind, but I wouldn't want to give off the wrong impression. I only work from home, I am not a jetsetting nomad, I can just work around my outdoor activities now.

jgrahamc 7y ago
Sounds like your exposure to other people might have changed dramatically: working in an office full time -> remote work.
- arkitaip 7y ago
  Probably. Or maybe a less stressful commute to work, no crazy office politics, a change in diet/exercise (because you now have time to do those things properly)... It's really difficult to accurately establish correlation let alone causality when it comes to changes in one's health.
  - ehnto 7y ago
    Definitely! So many things changed when I went remote that I would never suggest it's entirely down to sun exposure. It would be impossible to say definitively.
- ehnto 7y ago
  Definitely. One of many factors involved. Less commute, always getting enough sleep I am sure help a bunch. But I can also feel a big difference in my abilities when I don't get outside for a few days, even when all those other benefits stay the same.
coldcode 7y ago
In your case avoiding the office is more likely to reduce your infections than the sun.

appstorelottery 7y ago

Unfortunately I can't find the source, but I read somewhere that it wasn't proven that Vitamin D supplements can improve outcomes after infection has occurred. Can anyone find the source on this and verify?

Spacemolte 7y ago
I unfortunately can't find the source either, but I read something about you having to take vitamin D suppliments for a while before the change could be detected in the body, ie. if you are already sick it does not matter to take suppliments where you only see the benefit after weeks or months. This seems to support what you read.

narrator 7y ago

Hacker News has gone from the anger to the bargaining phase of grief. 4chan, ahead of the curve naturally, is currently in full blown depression phase.

ForHackernews 7y ago
Wait, really?
bilekas 7y ago
4chan in full blown depression phase ?? That place breeds depression.
99052882514569 7y ago
I don't recall any anger. Hacker News is in the 'focus on facts' phase of responding to mass panic, and I believe we won't move on to the 'resignation' phase anytime soon.
- AlexandrB 7y ago
  I see a lot of comments about "megadosing" with vitamins C and D. That sounds like straight-up quackery, not "focusing on the facts".
  - SamBam 7y ago
    Huh, the only comments I saw about "megadosing" were explicitly refuting the notion of megadosing vitamin C, and the effect that that quackery has had on the science. Are we reading the same comments?

eyeball 7y ago

What’s the connection between calcium and D? I recall someone telling me you had to be careful of supplementing D or you could promote calcification in arteries. You had to take with a calcium shop or something. Is that true?

leto_ii 7y ago
Vitamin D has a significant role in calcium homeostasis and metabolism. Its discovery was due to effort to find the dietary substance lacking in children with rickets (the childhood form of osteomalacia).[12] Vitamin D supplements are given to treat or to prevent osteomalacia and rickets. taken from the Wikipedia article: https://en.wikipedia.org/wiki/Vitamin_D https://en.wikipedia.org/wiki/Vitamin_D
vixen99 7y ago
Can't quote from memory but there is substantial evidence that this is not a problem unless you're taking massive doses (tens of thousands of IU) on a daily basis for a lengthy period. Naturally those interested should check this out for themselves.
speakeron 7y ago
It should be taken with vitamin K2. The theory is that it aids calcium absorption into bones rather than dumping into arteries. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566462/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566462/

KaiserPro 7y ago

Table 4: > When all studies were analysed together, no statistically significant effect of vitamin D was seen on the proportion of participants with at least one upper respiratory tract infection, lower respiratory tract infection, hospital admission or emergency department attendance for acute respiratory tract infection, course of antimicrobials for acute respiratory tract infection, or absence from work or school due to acute respiratory tract infection. However, when this analysis was stratified by dosing frequency, a borderline statistically significant protective effect of daily or weekly vitamin D supplementation against upper respiratory tract infection was seen (adjusted odds ratio 0.88, 0.78 to 1.00; 4483 participants in 11 studies, P=0.05; table 5⇓). Which to me makes it sound like it makes almost no difference. Edit: The above could be for pre-exsisting patients.

marcosdumay 7y ago
That one significant result looks like this: https://www.xkcd.com/882/ https://www.xkcd.com/882/
tomthe 7y ago
You quoted the paragraph for the secondary outcomes, which doesn't diminish the results quoted in the headline. Said that, the effect of the main outcome is not that big (if I read that correctly, it reduces your chances of getting a respiratory disease by ~4%)
throwawayhhakdl 7y ago
Without reading the study in detail, I feel like 4,483 is too few people to detect an effect like this because you can’t easily control for how much vitamin d people get from the sun.
zebrafish 7y ago
I believe this is saying that as a treatment it is not effective but as a preventative regimen it is.
jonnycomputer 7y ago
The paper indicates that a meta-analysis of primary effects in published research shows a significant effect, but for secondary effects in published research (those not related to study aims), no effect. Ok. Both sorts of reports (of primary and secondary effects) have their own sorts of biases. In general, while there is tendency to only publish and report significant effects (and this applies for both primary and secondary outcomes), study design matters, and a study may not be well designed to detect, or account for other factors, for secondary outcomes- in N, choice of population, control procedures and variables used, or even how accurately and systematically that data was recorded. Does make it hard to evaluate.

darkerside 7y ago

I've been wondering why it is that virus infections are supposed to "disappear" in the summer. Obviously the viruses don't actually go anywhere, so I would expect people to get sick year round. Maybe immunity boosting from Vitamin D could be part of the answer.

dtjohnnyb 7y ago
That is one hypothesis, though there are a lot https://en.wikipedia.org/wiki/Flu_season#Cause https://en.wikipedia.org/wiki/Flu_season#Cause
- Gravityloss 7y ago
  Mind boggling that this kind of a thing isn't known. This says the total economic effect of seasonal influenza in the US alone is 87 billion per year. That's six NASA:s worth: https://www.sciencedirect.com/science/article/pii/S0264410X07003854 https://www.sciencedirect.com/science/article/pii/S0264410X0...
  - adventured 7y ago
    > That's six NASA:s worth The good news is, it's only four NASAs now. Their budget is up to $22.6 billion this year.
  - Marsymars 7y ago
    > Mind boggling that this kind of a thing isn't known. I was blown away recently when I discovered that the causes of myopia aren't really known, but don't seem to be primarily genetic.
    - gameswithgo 7y ago
      some evidence that being indoors too much when young could contribute.
      - 7y ago

leto_ii 7y ago

I can say from my own experience that the lack of vitamin D can have a significant impact on both mind and body. I suspect that essentially all people living at relatively northern latitudes have some sort of vitamin D deficiency. From what I know you need to have your face and arms exposed to direct sunshine for at least 15 minutes/day to keep healthy vitamin D levels in the body. Good luck with that in the European/Canadian/Northern US winter.

econcon 7y ago
I doubt that's the case - for many years when I was a student I lived near equator and never went out. I never felt any impact or mind or body. I even tried some vitamin D3 supplement, smth like 2000IU but had no effects after few weeks, then I quit. The biggest effect anything I had on me is Testosterone Enthante 250mg twice a week. Also I wonder if taking 8,000 IU vitamin D can desentivize the system overtime
TacoToni 7y ago
getting my blood panel ran and finding out i was deficient in Vitamin D changed my life for the better once i start daily supplementation of Vitamin D3 (5000 IU). I even live in Florida, but working in an office all day doesn't help. Now that my levels are good, i feel as if my memory is far better and i dont feel tired all the time.
- leto_ii 7y ago
  > i feel as if my memory is far better and i dont feel tired all the time. I agree. Don't overdo it though, 5000 IU daily seems a bit much :) I live in Amsterdam and take 2000.
  - pdonis 7y ago
    > 5000 IU daily seems a bit much I think it depends on the person. If you get your blood level checked when you have a regular physical, you can adjust the dose as needed to keep the level where you want it (I shoot for the upper end of the normal range, and 5000 IU a day seems to be doing that for me).

kasperni 7y ago

This is a personal experience. But I've been struggling with constant throat infections, tiredness and coughing every winter for years (I live in a Nordic country). Had my 25-Hydroxy-Vitamin D(D3+D2) checked in both autumn and winter 2 years ago. In October it was ~ 110 nmol/L and in February it was ~ 30 nmol/L. (Deficiency is around 50 nmol/L). Seeing the seasonal difference was a bit of an eye-opener. And I have been on high dose Vitamin D supplements this winter. And all of my "winter" issues have more or less disappeared.

dharma1 7y ago
how high is high dose for you?
- kasperni 7y ago
  4,000 IU 4-5 days a week. I did a loading phase with a bit more.
  - agumonkey 7y ago
    so the program is > 4000 at first then stabilize around 4000 ?
    - kasperni 7y ago
      Yes, I didn't start until late December so I did a little loading with a bigger dose [1]. Next time I'm just going to start around October instead of running into a deficiency. [1] http://gmmmg.nhs.uk/docs/nts/NTS-Recommendation-on-Vitamin-D-deficiency-and-insufficiency-adults.pdf http://gmmmg.nhs.uk/docs/nts/NTS-Recommendation-on-Vitamin-D...

bad_user 7y ago

I suffer from allergic asthma and tend to catch colds quite frequently. This year I started supplementing with 2000 UI of vitamin D daily and it's as if my immune system started functioning normally, in the last 10 months I only caught a really light cold that I could barely notice, whereas before this the winter season alone would bring 2 severe cold or flu episodes that would knock me down for several days. I can't really say if it's the vitamin D, or other changes in my life, like losing some weight or walking more, or the cold exposure I've been practicing (primarily because I heard it burns calories :-)), it might be even placebo, I haven't isolated these variables well, but my wife and close ones are amazed by the transformation. E.g. 3 weeks ago everyone in my household got the flu, except for me. So now I got everyone in my household on vitamin D, especially b/c of this coronavirus scare. During summer time we might not need it, but the sun doesn't see us during winter. And vitamins are probably no defense against the coronavirus, but a deficiency could amplify the damage (as vit D has a role in our immune system) so it's best to ensure that we aren't deficient. Also we tolerate large doses of vitamin D, so it can't hurt.

neuronic 7y ago
> it's as if my immune system started functioning normally Nothing constructive to add, but I wanted to say I am glad you are feeling much better. This is great to hear!
lmedinas 7y ago
I suffer from similar issues with allergic asthma, which type of allergy and in which time of the year do you suffer more ?
- bad_user 7y ago
  Thankfully I don't seem to suffer from pollen allergies, my sensitivities are to cats (saliva) and to moisture and mold, so I don't have a time of year in which I'm sensitive. I do regret not being able to adopt cats :-( When I was in my twenties I've gone through severe asthma episodes, due to exposure to such allergens and once you get inflamed it's really hard to reverse without proper treatment. So I eventually went on a treatment with corticoids and Symbicort and by avoiding the problematic allergens I've been fairly well under control ever since, haven't needed any treatment for years. Before that I was using Ventolin, which wasn't working well and gave me tachycardia episodes, thank god treatment for asthmatics got better. But I remained fairly sensitive to colds, many colds I catch evolve into bronchitis.

mc32 7y ago

So cold viruses do better in cold weather and in northern latitudes with fewer sunlight hours we may expect the combination to result in more cold in winter time?

mherdeg 7y ago

As a layperson it feels to me like research in the "megadose on vitamins to prevent illness" area is kind of tainted by the legacy of Linus Pauling, who was no doubt a genius in his fields and whose published literature advocated the position that vitamin C megadose would reduce cancer deaths by 75% ( https://www.theatlantic.com/health/archive/2013/07/the-vitamin-myth-why-we-think-we-need-supplements/277947/ https://www.theatlantic.com/health/archive/2013/07/the-vitam... ). I guess we know how to avoid the trouble -- make hypotheses and test them. The trouble there is that the placebo effect is not a bad thing -- if you're doing things which you think will improve your wellness and it works, who cares whether there's a chemical mechanism? It works!

ovi256 7y ago
>As a layperson it feels to me like research in the "megadose on vitamins to prevent illness" area is kind of tainted by the legacy of Linus Pauling You're completely right, biochemists and medical chemists know fully well it's tainted by Pauling's late work and will tell you so. If even a small positive effect was missed because of that taint, that's a terrible legacy that led to many avoidable deaths (all the people that suffered or died until the positive effect is finally recognized). We should be better at salvaging such effects from their imperfect creators.
ucha 7y ago
You can't really megadose on Vitamin D because like most liposoluble vitamins, they are hepatotoxic at large doses.
- teach 7y ago
  Yeah, but there's a huge gap between current RDA and toxicity. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-toxicity/faq-20058108 https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-h... 4000 IU per day would probably help a lot of people and is still an order of magnitude under the intake that's known to be toxic (60,000 IU/day for several months).
hannob 7y ago

hannob 7y ago

Please note that this is a bit older (2017). As I personally have a cold quite often I was curious to look into this a bit. Around the same time another metaanalysis was published with a similar question [1], but quite different results (i.e. Vitamin D is unlikely to help). Here's [2] an (unfortunately only german) article by an austrian webpage associated with the cochrane collaboration (i.e. that should be considered a relatively trustworthy source) that explains this difference due to the fact that the BMJ metaanalysis included many low quality studies that were excluded in the other metaanalysis. This is an indication that this is might be not a real effect, but an artifact of the low quality evidence this analysis is based on. tl;dr I won't buy Vitamin D supplements. [1] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0162996 https://journals.plos.org/plosone/article?id=10.1371/journal... [2] https://www.medizin-transparent.at/vitamin-d-und-das-immunsystem-was-stimmt/#ref1 https://www.medizin-transparent.at/vitamin-d-und-das-immunsy...

stjohnswarts 7y ago
You don't need vit D if your blood levels are not low, but vitamin d supplements absolutely can raise it if it is low, there is not arguing with that fact. It's established science.

drgoodvibe 7y ago

I had a genetic test done (not 23andme or other retail genetic tests) and it turns out I have genes that essentially cause me to have low absorption for vitamins d, b6 and b12 and vitamin e. According to my bloodwork I also had extremely low Vit d in the blood (way below average). I started megadosing and honestly I feel like a different person, when I got a cold before it would last for 7 days, and twice it led to bronchitis and then pneumonia this year since megadosing I’ve had two colds and both lasted no more than 2 days. So I’m not superman, I still get sick but the severity of the colds have been significantly lower than before megadosing.

jmnicolas 7y ago
As someone that mega dose vitamin C in summer because it helps with my allergies, I'd be wary to mega dose vitamin D (more than 3k UI a day).
52-6F-62 7y ago
My B12 deficiency was discovered because of a routine blood test. Low hemoglobin, but since anemia runs in the family the rest was simple enough for my GP to put together. Eat more red meat (I rarely touched it in the past), and take a daily supplement was the charge. The mental clarity and well-being improvements are palpable.
md2020 7y ago
Do you mind sharing the test you used? Curious to try this myself.

neuronic 7y ago

May I mention the following research on NCBI: https://www.ncbi.nlm.nih.gov/pubmed/28768407 https://www.ncbi.nlm.nih.gov/pubmed/28768407 I will simply quote from the abstract: > This could lead to a recommendation of 1000 IU for children <1 year on enriched formula and 1500 IU for breastfed children older than 6 months, 3000 IU for children >1 year of age, and around 8000 IU for young adults and thereafter. Actions are urgently needed to protect the global population from vitamin D deficiency. Essentially, the recommended intake that pharmacists and labels tell you is outdated and founded in a statistical error. Adults are recommended to take >8,000IU every day and not ~1,000IU as still believed by many professionals who last updated their brainbase decades ago.

elric 7y ago
I'll counter that with a quick quote from wikipedia: > Recommendations stemming for a single standard for optimal serum 25(OH)D concentrations ignores the differing genetically mediated determinates of serum 25(OH)D and may result in ethnic minorities in Western countries having the results of studies done with subjects not representative of ethnic diversity applied to them. Vitamin D levels vary for genetically mediated reasons as well as environmental ones. Basically, rarely is anything simple enough for a "one size fits all" approach. Source: https://en.wikipedia.org/wiki/Hypervitaminosis_D https://en.wikipedia.org/wiki/Hypervitaminosis_D
- aldoushuxley001 7y ago
  I wouldn't say you 'countered' OP with that quote, but you did add some very pertinent and helpful info. From my perspective, though, your info is syngergistic with OP's, not counter to it.
funklute 7y ago
While this is a very interesting paper, I'm a little bit wary of research articles that only have a single author. Are you aware of how accepted this viewpoint is in the wider research/medical community? For example, are there any medical bodies that currently actually recommend adults to take 8000 IU of vitamin D supplement per day, if they are at risk of deficiency? Conversely, are the medical bodies that do not make such a recommendation simply slow, or are they in fact disputing the above findings?

kbrisso 7y ago

Magnesium, vitamin D, zinc and mk-7 vitamin k-2 are my daily vitamins coupled with a lot of exercise. I can't say when the last time I was sick.

Krasnol 7y ago
I take not vitamin supplements at all, drink my Earl Gray with citron and sugar and spend most days of the year in buildings in front of a computer while travelling between them using public transportation. I don't even get enough sleep. I don't get sick while people around me do. There is no one solution fits them all.

jpdus 7y ago

I am a bit perplexed. Haven't almost all randomized/controlled trials shown (e.g. [1]) that there is basically no measurable effect for healthy people? All "positive" stories are relying on observational studies with the usual confounders, right? EDIT: Look at figure 2 in the Paper. Looks pretty random to me. Result is almost exclusively driven by 4-5 small (<250 participants) and old studies. [1] https://www.vox.com/2018/10/4/17933880/vitamin-d-health-sun-diet https://www.vox.com/2018/10/4/17933880/vitamin-d-health-sun-...

CodeWriter23 7y ago
Vitamin D in the study you provide, D2 & D3 in the OP link. Chemistry and source matters. D is synthetic, D2 is plant derived, D3 animal derived.
- aldoushuxley001 7y ago
  D3 mostly comes from fungi as far as commercial sources for supplements are concerned, I'm pretty sure.
  - posix_me_less 7y ago
    D3 is made by irradiating lanolin (from sheep wool) with UV light [1]. Natural source of D3 is oily fish, beef liver. It's the Vitamin D2 that is made from fungi - UV light helps to create it in mushrooms [2]. [1] https://www.quora.com/What-is-the-industrial-process-involved-in-making-Vitamin-D3?share=1 https://www.quora.com/What-is-the-industrial-process-involve... [2] https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#h3 https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessiona...

durpleDrank 7y ago

https://www.grc.com/health/vitamin-d.htm https://www.grc.com/health/vitamin-d.htm

glaugh 7y ago

I found this to be a useful summary of similar research: https://examine.com/nutrition/supplements-for-cold-and-flu/ https://examine.com/nutrition/supplements-for-cold-and-flu/

open-source-ux 7y ago

In the UK, a science advisory body (Scientific Advisory Committee on Nutrition) published a review of the evidence on vitamin D and health in 2016. Their recommendation: adults and children over one in the UK should take vitamin D supplements in winter. This advice may not be applicable to people living in sunnier climes. Here is an overview of the guidelines on the NHS website which includes a link to the 300 page scientific review. https://www.nhs.uk/news/food-and-diet/the-new-guidelines-on-vitamin-d-what-you-need-to-know/ https://www.nhs.uk/news/food-and-diet/the-new-guidelines-on-...

MrK93 7y ago

I already take vitamin D for weightlifting, I guess I'm covered. Many advantages also for hormones.

_cairn 7y ago

I had my Vitamin D levels tested last year, was enlightening. For those interested it's a pretty painless (small blood sample) and inexpensive test.

brokensegue 7y ago
I was recently charged several hundred for a vit D test. The price is basically random in the US.
- stjohnswarts 7y ago
  That's insane, my whole panel for vitamin d, some other vitamins, insulin levels, immune analysis, etc all are about $120 when I do my annual checkup.
  - brokensegue 7y ago
    Yeah insurance decided not to cover it for some reason even though my doctor ordered the test. The rest of the panel was a few bucks after insurance.

beagle3 7y ago

n=1: 10,000 IU of vit D3 before 10am significantly improves my sleep. Gwern has some of his own relevant n=1 experiments described on his site.