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Although this is a notable finding it's important to remember that it doesn't lead to the conclusion that supplementing vitamin D will be very beneficial here.

by ve55 6y ago

Although this is a notable finding it's important to remember that it doesn't lead to the conclusion that supplementing vitamin D will be very beneficial here. When vitamin D is produced in the body naturally via exposure to sunlight there's a huge amount of other things that occur as well, and we don't have a ton of good science to back up if curing a vitamin D deficiency via supplementation of pure vitamin D is really nearly the same as getting it naturally, which is a common problem for supplementing things and nutritional science and epidemiology in general. The extent that covid harms those that are metabolically unfit in many different ways much more than those that are perfectly healthy is still pretty under-discussed imo though, and this is yet another good data point in favor of it, even if Vitamin D is much more of a different proxy than some of the other large correlations we see with covid mortality.

graeme 6y ago
What about this section of the pdf? From a 2016 study on patients with other respiratory diseases. —————- High dose vitamin D administration in ventilated intensive care unit patients: A pilot double blind randomized controlled trial In the study, patients with vitamin D deficiency (<20ng/ml) were divided into three groups: A placebo group, and two groups that were given different doses of vitamin D. The single administration of 250,000 IU of vitamin D was compared with the single administration of 500,000 IU of vitamin D by injection. In addition, the vitamin D levels were increased to 45 and 55 ng/ml, respectively. While the length of stay of the placebo group at the ICU was 36 days, the 250,000 IU group averaged 25 days and the 500,000 IU group averaged 18 days. This is a smooth halving and means that vitamin D is useful not only in prevention but also in acute cases. https://www.sciencedirect.com/science/article/pii/S2214623716300084 https://www.sciencedirect.com/science/article/pii/S221462371... —————— Ah, the pdf has a second such study. Mortality almost half less —————— Intervention was carried out intramuscularly with 300,000 IU of vitamin D. Instead of 28 days only 18 days mechanical ventilation, instead of 29 only 19 on ICU, instead of 61% deaths only 36%. https://pubmed.ncbi.nlm.nih.gov/31531088/ https://pubmed.ncbi.nlm.nih.gov/31531088/
- ve55 6y ago
  I haven't seen that one, that looks pretty impressive, especially for administering it in a single dose that is that large. That's definitely a good data point in favor that some of it is direct causation though.
  - throwanem 6y ago
    31 total subjects, only 13 vitamin D deficient initially, p = 0.03. This study at best suggests further, more rigorous research here may be warranted. It says nothing about causation, for all that its authors seem to feel otherwise - and that they feel otherwise suggests its results should be taken with more than the usual amount of skepticism.
    - graeme 6y ago
      Have a look at table 1. Only 5/31 subjects had “sufficient” vitamin d. In between deficient and sufficient there is the insufficient category, from 20-30 ng/ml. Though I agree further study is warranted. The highest vitamin D group actually had the highest mortality after 84 days. Though this group also had the most pre-existing heart conditions by far, so that could account for it. Ah, there was a second such study in the pdf. Mortality down by almost half. —————— Intervention was carried out intramuscularly with 300,000 IU of vitamin D. Instead of 28 days only 18 days mechanical ventilation, instead of 29 only 19 on ICU, instead of 61% deaths only 36%. https://pubmed.ncbi.nlm.nih.gov/31531088/ https://pubmed.ncbi.nlm.nih.gov/31531088/
  - mtgx 6y ago
    More studies referenced here, also showing ~55 ng/ml being optimum for maximum health benefits. The current recommendations are way below that. Well worth to watch the whole video: https://youtu.be/v3pK0dccQ38?t=4105 https://youtu.be/v3pK0dccQ38?t=4105
- LegitShady 6y ago
  Those dosages are far higher than anyone supplementing vitamin d are likely to take.
xutopia 6y ago
The study showed that supplementing (though it was injection) to between "45 and 55 ng/ml" is "useful not only in prevention but also in acute cases". So yes... sunlight does probably way more benefits for us but supplementation if you are deficient is still showing significant effects.
- James_Henry 6y ago
  Just to be clear, the study that you are quoting isn't about Sars-Cov 2. This is a quote from a 2016 paper on other respiratory diseases.
  - James_Henry 6y ago
    And here is the quote in context, not that this isn't about Covid-19: "High dose vitamin D administration in ventilated intensive care unit patients: A pilot double blind randomized controlled trial In the study, patients with vitamin D deficiency (<20ng/ml) were divided into three groups: A placebo group, and two groups that were given different doses of vitamin D. The single administration of 250,000 IU of vitamin D was compared with the single administration of 500,000 IU of vitamin D by injection. In addition, the vitamin D levels were increased to 45 and 55 ng/ml, respectively. While the length of stay of the placebo group at the ICU was 36 days, the 250,000 IU group averaged 25 days and the 500,000 IU group averaged 18 days. This is a smooth halving and means that vitamin D is useful not only in prevention but also in acute cases."
BurningFrog 6y ago
Technically true, but you should still eat vitamin D supplements. It's very cheap and safe, so worst case it has less effect than you hope. You can overdose, but you have to really crazy with the dosage. Also 1: Vitamin D supplements do cure rickets. Also 2: All of us who eat supplements should show up in the stats as high in vitamin D, so the data does partially cover that case.
- zzz61831 6y ago
  It's not that safe, not like vitamin C safe. Especially not in doses sold in pills in pharmacies around the world.
  - newsbinator 6y ago
    I still can't figure out the safe + effective dosage of Vitamin D. I was taking 1,000mg a day and that didn't seem to move the needle on my Vitamin D blood work. In recent weeks I've been taking 4,000mg/day (with K2), which is 4x what I've had pharmacists recommend. I plan to keep that up for a couple more weeks while I'm under quarantine (recently flew from a high-risk country to a less high-risk country). After that I'll level off to 2,000mg a day. But I'm shooting in the dark. I have no idea if 2,000mg/day or 4,000mg/day is too much or not enough.
    - James_Henry 6y ago
      The safest way is to take an occasional test for your vitamin d levels. There are tests that you can take at home that aren't too expensive!
      - secabeen 6y ago
        Yep. I work inside a lot, so I started taking 5000IU of D a day. After two weeks, I had my levels tested and it showed a level of 37. When fall comes around, and I'm outside even less, I'll probably up the dosage for a week or two, then test again. Target is between 50 and 70, so I definitely need more.
sharpneli 6y ago
In Finland we put Vitamin D in milk that’s sold on normal shops. And taking a supplement is heavily recommended. Though this is mostly because for 6 months of a year one simply cannot get it the natural way (too cold and sun is too low). And thanks to this we don’t have much deficiency, long time ago we used to have. Not saying it means it would help with covid. But the supplements definitely help with deficiency in a way that does cure/prevent rickets.
- deleted 6y ago
  [deleted]
- graeme 6y ago
  You had a very limited coronavirus outbreak it seems. Does Norway have the same vitamin D supplementation policies? Their outbreak was similar in size to Finland’s. https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Finland https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Finland Edit: Interestingly, the source pdf notes the nordic countries have higher D3 levels than Mediterranean countries. And speculates this may help explain lower incidence up north. ———— The researchers around Petre Cristian Ilie have tested the number of Covid-19 deaths per 1 million inhabitants against the vitamin D level in 20 European countries and come to the following conclusion: The mean vitamin D level in the countries studied (mean 22.4 ng/ml, StDev ±4.24) correlates strictly with the number of Covid-19 infected per million population (mean 295.95, StDev ±298.73, p=0.004) and with mortality (mean 5.96, StDev 15.13, p<0.00001) The death rates in Spain and Italy are much higher than in Scandinavia. The researchers explain this with the statistically significant higher vitamin D level among the inhabitants of the Nordic countries: The study shows that in older people, the average blood vitamin D level in Spain is 10.4 ng/ml, in Italy, 11.2 ng/ml, while in the Scandinavian countries it is 18 ng/ml. The northerners obviously do have the better vitamin D levels, although the sun is not as intense there as in the south. This could either be because they are more active outdoors or because they get more vitamin D from food, e.g. fish, or both. Fat sea fish contains a lot of vitamin D. And southerners tend to spend their midday hours in the shade or indoors. Shadow, window glass and a longer way through the atmosphere (morning/evening, autumn/spring) reduce UVB radiation much more than UVA.
  - 6y ago
mrfusion 6y ago
> When vitamin D is produced in the body naturally via exposure to sunlight there's a huge amount of other things that occur as well Any further reading on that? On the other hand worth supplementation you don’t get the harmful uv rays.
- nradov 6y ago
  There is no evidence that a brief daily exposure to UV rays is actually harmful in terms of all-cause mortality.
- glofish 6y ago
  UV rays should not be considered harmful de-facto! Overexposure to UV rays is what causes trouble. Slathering on the sunscreen even when not necessary (like walking from point A to point B, or spending 15 minutes outside, is what causes the predominant vitamin D deficiency in the first place.
  - James_Henry 6y ago
    Are you sure the "predominant vitamin D deficiency" isn't caused by the prevalence of metabolic syndrome?
nradov 6y ago
One effect of sunlight exposure is to stimulate production of nitric oxide, which lowers blood pressure. Hypertension is one of the most common comorbid conditions for COVID-19 deaths. I don't know if there's a causal relationship but it could be worth further research.
- disgruntledphd2 6y ago
  That's interesting. Do you have pointers to relevant research?
ColanR 6y ago
> Although this is a notable finding it's important to remember that it doesn't lead to the conclusion that supplementing vitamin D will be very beneficial here....we don't have a ton of good science to back up if curing a vitamin D deficiency via supplementation of pure vitamin D is really nearly the same as getting it naturally I don't know what you mean by 'a ton', but there is good evidence that Vitamin D supplements do provide much of the same benefit [0] [1]. > Ultraviolet radiation (either from artificial sources or from sunlight) reduces the incidence of viral respiratory infections, as does cod liver oil (which contains vitamin D). [0] https://pubmed.ncbi.nlm.nih.gov/16959053/ https://pubmed.ncbi.nlm.nih.gov/16959053/ [1] https://sci-hub.se/https://www.sciencedirect.com/science/article/abs/pii/S0306987709007634?via%3Dihub https://sci-hub.se/https://www.sciencedirect.com/science/art...
ntsplnkv2 6y ago
Personal anecdote - vitamin D supplements did absolutely nothing for my vitamin D levels. it wasn't until I committed to getting more sunlight that my levels increased.
- function_seven 6y ago
  What was your daily IU supplementation, and how long did you supplement before checking your levels again? I take 5000 IU daily, but also wonder if I'd do better with more sunlight instead.
  - ntsplnkv2 6y ago
    I was taking 50000 IU a week. Checked multiple times over periods of months.
    - AuryGlenz 6y ago
      Hey, someone like me. I was upped to that dose 2x a week and then 3x. Now my levels are up and holding.
ellyagg 6y ago
It's frustrating that when this comes up, this comment is always the top one, because it's not true. We have dozens of RCTs suggesting that vitamin D supplementation prevents respiratory infections[1]. There is a very good chance people could mitigate C19 risk with supplementation. And I personally trust the vast majority of people to use reasonable enough dosing that overdose is unlikely, especially with appropriate messaging. Downplaying the risks of low vitamin D (way more prevalent than vitmain D toxicity) seems as dangerous as the early pandemic messaging in the US that masks are ineffective. 1. https://www.bmj.com/content/356/bmj.i6583 https://www.bmj.com/content/356/bmj.i6583
- arkitaip 6y ago
  Dr. Rhonda Patrick on "Vitamin D may reduce susceptibility to COVID-19-associated lung injury": https://www.foundmyfitness.com/episodes/vitamin-d-covid-19 https://www.foundmyfitness.com/episodes/vitamin-d-covid-19
throwaway6000 6y ago
The Harvard Gazette: Study confirms vitamin D protects against colds and flu https://news.harvard.edu/gazette/story/2017/02/study-confirms-vitamin-d-protects-against-cold-and-flu/ https://news.harvard.edu/gazette/story/2017/02/study-confirm... University of Colorado Anschutz Medical Campus: Vitamin D reduces respiratory infections https://www.sciencedaily.com/releases/2016/11/161116103005.htm https://www.sciencedaily.com/releases/2016/11/161116103005.h...

by ve55 6y ago

graeme 6y ago

What about this section of the pdf? From a 2016 study on patients with other respiratory diseases. —————- High dose vitamin D administration in ventilated intensive care unit patients: A pilot double blind randomized controlled trial In the study, patients with vitamin D deficiency (<20ng/ml) were divided into three groups: A placebo group, and two groups that were given different doses of vitamin D. The single administration of 250,000 IU of vitamin D was compared with the single administration of 500,000 IU of vitamin D by injection. In addition, the vitamin D levels were increased to 45 and 55 ng/ml, respectively. While the length of stay of the placebo group at the ICU was 36 days, the 250,000 IU group averaged 25 days and the 500,000 IU group averaged 18 days. This is a smooth halving and means that vitamin D is useful not only in prevention but also in acute cases. https://www.sciencedirect.com/science/article/pii/S2214623716300084 https://www.sciencedirect.com/science/article/pii/S221462371... —————— Ah, the pdf has a second such study. Mortality almost half less —————— Intervention was carried out intramuscularly with 300,000 IU of vitamin D. Instead of 28 days only 18 days mechanical ventilation, instead of 29 only 19 on ICU, instead of 61% deaths only 36%. https://pubmed.ncbi.nlm.nih.gov/31531088/ https://pubmed.ncbi.nlm.nih.gov/31531088/

ve55 6y ago
I haven't seen that one, that looks pretty impressive, especially for administering it in a single dose that is that large. That's definitely a good data point in favor that some of it is direct causation though.
- throwanem 6y ago
  31 total subjects, only 13 vitamin D deficient initially, p = 0.03. This study at best suggests further, more rigorous research here may be warranted. It says nothing about causation, for all that its authors seem to feel otherwise - and that they feel otherwise suggests its results should be taken with more than the usual amount of skepticism.
  - graeme 6y ago
    Have a look at table 1. Only 5/31 subjects had “sufficient” vitamin d. In between deficient and sufficient there is the insufficient category, from 20-30 ng/ml. Though I agree further study is warranted. The highest vitamin D group actually had the highest mortality after 84 days. Though this group also had the most pre-existing heart conditions by far, so that could account for it. Ah, there was a second such study in the pdf. Mortality down by almost half. —————— Intervention was carried out intramuscularly with 300,000 IU of vitamin D. Instead of 28 days only 18 days mechanical ventilation, instead of 29 only 19 on ICU, instead of 61% deaths only 36%. https://pubmed.ncbi.nlm.nih.gov/31531088/ https://pubmed.ncbi.nlm.nih.gov/31531088/
- mtgx 6y ago
  More studies referenced here, also showing ~55 ng/ml being optimum for maximum health benefits. The current recommendations are way below that. Well worth to watch the whole video: https://youtu.be/v3pK0dccQ38?t=4105 https://youtu.be/v3pK0dccQ38?t=4105
LegitShady 6y ago
Those dosages are far higher than anyone supplementing vitamin d are likely to take.

xutopia 6y ago

The study showed that supplementing (though it was injection) to between "45 and 55 ng/ml" is "useful not only in prevention but also in acute cases". So yes... sunlight does probably way more benefits for us but supplementation if you are deficient is still showing significant effects.

James_Henry 6y ago
Just to be clear, the study that you are quoting isn't about Sars-Cov 2. This is a quote from a 2016 paper on other respiratory diseases.
- James_Henry 6y ago
  And here is the quote in context, not that this isn't about Covid-19: "High dose vitamin D administration in ventilated intensive care unit patients: A pilot double blind randomized controlled trial In the study, patients with vitamin D deficiency (<20ng/ml) were divided into three groups: A placebo group, and two groups that were given different doses of vitamin D. The single administration of 250,000 IU of vitamin D was compared with the single administration of 500,000 IU of vitamin D by injection. In addition, the vitamin D levels were increased to 45 and 55 ng/ml, respectively. While the length of stay of the placebo group at the ICU was 36 days, the 250,000 IU group averaged 25 days and the 500,000 IU group averaged 18 days. This is a smooth halving and means that vitamin D is useful not only in prevention but also in acute cases."

BurningFrog 6y ago

Technically true, but you should still eat vitamin D supplements. It's very cheap and safe, so worst case it has less effect than you hope. You can overdose, but you have to really crazy with the dosage. Also 1: Vitamin D supplements do cure rickets. Also 2: All of us who eat supplements should show up in the stats as high in vitamin D, so the data does partially cover that case.

zzz61831 6y ago
It's not that safe, not like vitamin C safe. Especially not in doses sold in pills in pharmacies around the world.
- newsbinator 6y ago
  I still can't figure out the safe + effective dosage of Vitamin D. I was taking 1,000mg a day and that didn't seem to move the needle on my Vitamin D blood work. In recent weeks I've been taking 4,000mg/day (with K2), which is 4x what I've had pharmacists recommend. I plan to keep that up for a couple more weeks while I'm under quarantine (recently flew from a high-risk country to a less high-risk country). After that I'll level off to 2,000mg a day. But I'm shooting in the dark. I have no idea if 2,000mg/day or 4,000mg/day is too much or not enough.
  - James_Henry 6y ago
    The safest way is to take an occasional test for your vitamin d levels. There are tests that you can take at home that aren't too expensive!
    - secabeen 6y ago
      Yep. I work inside a lot, so I started taking 5000IU of D a day. After two weeks, I had my levels tested and it showed a level of 37. When fall comes around, and I'm outside even less, I'll probably up the dosage for a week or two, then test again. Target is between 50 and 70, so I definitely need more.

sharpneli 6y ago

In Finland we put Vitamin D in milk that’s sold on normal shops. And taking a supplement is heavily recommended. Though this is mostly because for 6 months of a year one simply cannot get it the natural way (too cold and sun is too low). And thanks to this we don’t have much deficiency, long time ago we used to have. Not saying it means it would help with covid. But the supplements definitely help with deficiency in a way that does cure/prevent rickets.

deleted 6y ago
[deleted]
graeme 6y ago
You had a very limited coronavirus outbreak it seems. Does Norway have the same vitamin D supplementation policies? Their outbreak was similar in size to Finland’s. https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Finland https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Finland Edit: Interestingly, the source pdf notes the nordic countries have higher D3 levels than Mediterranean countries. And speculates this may help explain lower incidence up north. ———— The researchers around Petre Cristian Ilie have tested the number of Covid-19 deaths per 1 million inhabitants against the vitamin D level in 20 European countries and come to the following conclusion: The mean vitamin D level in the countries studied (mean 22.4 ng/ml, StDev ±4.24) correlates strictly with the number of Covid-19 infected per million population (mean 295.95, StDev ±298.73, p=0.004) and with mortality (mean 5.96, StDev 15.13, p<0.00001) The death rates in Spain and Italy are much higher than in Scandinavia. The researchers explain this with the statistically significant higher vitamin D level among the inhabitants of the Nordic countries: The study shows that in older people, the average blood vitamin D level in Spain is 10.4 ng/ml, in Italy, 11.2 ng/ml, while in the Scandinavian countries it is 18 ng/ml. The northerners obviously do have the better vitamin D levels, although the sun is not as intense there as in the south. This could either be because they are more active outdoors or because they get more vitamin D from food, e.g. fish, or both. Fat sea fish contains a lot of vitamin D. And southerners tend to spend their midday hours in the shade or indoors. Shadow, window glass and a longer way through the atmosphere (morning/evening, autumn/spring) reduce UVB radiation much more than UVA.
- 6y ago

mrfusion 6y ago

> When vitamin D is produced in the body naturally via exposure to sunlight there's a huge amount of other things that occur as well Any further reading on that? On the other hand worth supplementation you don’t get the harmful uv rays.

nradov 6y ago
There is no evidence that a brief daily exposure to UV rays is actually harmful in terms of all-cause mortality.
glofish 6y ago
UV rays should not be considered harmful de-facto! Overexposure to UV rays is what causes trouble. Slathering on the sunscreen even when not necessary (like walking from point A to point B, or spending 15 minutes outside, is what causes the predominant vitamin D deficiency in the first place.
- James_Henry 6y ago
  Are you sure the "predominant vitamin D deficiency" isn't caused by the prevalence of metabolic syndrome?

nradov 6y ago

One effect of sunlight exposure is to stimulate production of nitric oxide, which lowers blood pressure. Hypertension is one of the most common comorbid conditions for COVID-19 deaths. I don't know if there's a causal relationship but it could be worth further research.

disgruntledphd2 6y ago
That's interesting. Do you have pointers to relevant research?

ColanR 6y ago

> Although this is a notable finding it's important to remember that it doesn't lead to the conclusion that supplementing vitamin D will be very beneficial here....we don't have a ton of good science to back up if curing a vitamin D deficiency via supplementation of pure vitamin D is really nearly the same as getting it naturally I don't know what you mean by 'a ton', but there is good evidence that Vitamin D supplements do provide much of the same benefit [0] [1]. > Ultraviolet radiation (either from artificial sources or from sunlight) reduces the incidence of viral respiratory infections, as does cod liver oil (which contains vitamin D). [0] https://pubmed.ncbi.nlm.nih.gov/16959053/ https://pubmed.ncbi.nlm.nih.gov/16959053/ [1] https://sci-hub.se/https://www.sciencedirect.com/science/article/abs/pii/S0306987709007634?via%3Dihub https://sci-hub.se/https://www.sciencedirect.com/science/art...

ntsplnkv2 6y ago

Personal anecdote - vitamin D supplements did absolutely nothing for my vitamin D levels. it wasn't until I committed to getting more sunlight that my levels increased.

function_seven 6y ago
What was your daily IU supplementation, and how long did you supplement before checking your levels again? I take 5000 IU daily, but also wonder if I'd do better with more sunlight instead.
- ntsplnkv2 6y ago
  I was taking 50000 IU a week. Checked multiple times over periods of months.
  - AuryGlenz 6y ago
    Hey, someone like me. I was upped to that dose 2x a week and then 3x. Now my levels are up and holding.

ellyagg 6y ago

It's frustrating that when this comes up, this comment is always the top one, because it's not true. We have dozens of RCTs suggesting that vitamin D supplementation prevents respiratory infections[1]. There is a very good chance people could mitigate C19 risk with supplementation. And I personally trust the vast majority of people to use reasonable enough dosing that overdose is unlikely, especially with appropriate messaging. Downplaying the risks of low vitamin D (way more prevalent than vitmain D toxicity) seems as dangerous as the early pandemic messaging in the US that masks are ineffective. 1. https://www.bmj.com/content/356/bmj.i6583 https://www.bmj.com/content/356/bmj.i6583

arkitaip 6y ago
Dr. Rhonda Patrick on "Vitamin D may reduce susceptibility to COVID-19-associated lung injury": https://www.foundmyfitness.com/episodes/vitamin-d-covid-19 https://www.foundmyfitness.com/episodes/vitamin-d-covid-19

throwaway6000 6y ago

The Harvard Gazette: Study confirms vitamin D protects against colds and flu https://news.harvard.edu/gazette/story/2017/02/study-confirms-vitamin-d-protects-against-cold-and-flu/ https://news.harvard.edu/gazette/story/2017/02/study-confirm... University of Colorado Anschutz Medical Campus: Vitamin D reduces respiratory infections https://www.sciencedaily.com/releases/2016/11/161116103005.htm https://www.sciencedaily.com/releases/2016/11/161116103005.h...