Vitamin D improves survival in Covid-19 elderly patients(sciencedirect.com)
sciencedirect.com
Vitamin D improves survival in Covid-19 elderly patients
https://www.sciencedirect.com/science/article/pii/S096007602030296X
111 comments
Honestly, I am not sure why this study is noteworthy. As you pointed you, the evidence is weak. Plus, we have the results of a good randomized controlled experiment. I don't think we need anything more to make up our mind (yes, vitamin D3 works very, very well): https://www.sciencedirect.com/science/article/pii/S096007602...
Note: The study link is for treatment, not prevention.
Note: The study link is for treatment, not prevention.
I think we should be more measured in our conclusions. See https://www.devaboone.com/post/vitamin-d-and-covid
> as far as I can tell - do not explain why these people did not receive their normal Vitamin D supplementation.
My understanding: each patient receives a bolus dose every 2 to 3 months. The intervention group had that date within 1 mo before diagnosis (or 1wk after)
> Here, the "Intervention group" was defined as all COVID-19 residents who received an oral bolus of 80,000 IU vitamin D3 either in the week following the suspicion or diagnosis of COVID-19, or during the previous month
My understanding: each patient receives a bolus dose every 2 to 3 months. The intervention group had that date within 1 mo before diagnosis (or 1wk after)
> Here, the "Intervention group" was defined as all COVID-19 residents who received an oral bolus of 80,000 IU vitamin D3 either in the week following the suspicion or diagnosis of COVID-19, or during the previous month
80000 IU seems a lot, that’s about 100 times the RDA! Not saying it’s bad just interesting...
About 100 times the RDA makes sense if you take it once every 3 months, i.e. 90 days
That's what a "bolus dose" is, a single large dose to raise the levels in the blood to target levels in one go, as opposed to daily maintenance doses.
For what it's worth, there's been a lot of speculation in recent years that the RDA is far too low. 80,000 iu is still a huge dosage though!
>and they - as far as I can tell - do not explain why these people did not receive their normal Vitamin D supplementation
Under subheading 2.2: "All residents in the nursing-home receive chronic vitamin D supplementation with regular maintenance boluses (single oral dose of 80,000 IU vitamin D3 every 2–3 months),"
The comparator (not recent supplement) group was on a different schedule, and had received a supplement probably two months ago.
>Finally, there were four total interventions: corticosteroids, hydroxychloroquine, "dedicated antibiotics" and the observation about Vitamin D. The more things you try, the less surprising it should be that there is a correlation along one of them.
Are you referring to these lines: "use of corticosteroids and/or hydroxychloroquine and/or antibiotics (i.e., azithromycin or rovamycin), and hospitalization for COVID-19 were used as potential confounders."
You only run up against ( https://xkcd.com/882/ ) when you perform multiple statistical tests, not when you merely have a heterogeneous study population. Unless they were also testing these other interventions, that critique does not apply.
Under subheading 2.2: "All residents in the nursing-home receive chronic vitamin D supplementation with regular maintenance boluses (single oral dose of 80,000 IU vitamin D3 every 2–3 months),"
The comparator (not recent supplement) group was on a different schedule, and had received a supplement probably two months ago.
>Finally, there were four total interventions: corticosteroids, hydroxychloroquine, "dedicated antibiotics" and the observation about Vitamin D. The more things you try, the less surprising it should be that there is a correlation along one of them.
Are you referring to these lines: "use of corticosteroids and/or hydroxychloroquine and/or antibiotics (i.e., azithromycin or rovamycin), and hospitalization for COVID-19 were used as potential confounders."
You only run up against ( https://xkcd.com/882/ ) when you perform multiple statistical tests, not when you merely have a heterogeneous study population. Unless they were also testing these other interventions, that critique does not apply.
> Unless they were also testing these other interventions, that critique does not apply.
How do we know they weren't? Since this is not a RTC, but rather an analysis of historical data, we don't know how much they divided up this historical data looking for correlations.
How do we know they weren't? Since this is not a RTC, but rather an analysis of historical data, we don't know how much they divided up this historical data looking for correlations.
The general problem with this line of argument is that it's meant to be a critique of a statistical fishing expedition (sharpshooter fallacy). This study is clearly not a fishing expedition because vitamin D has been a topic of interest in coronavirus disease for months now with multiple studies conducted.
> This study is clearly not a fishing expedition because vitamin D has been a topic of interest in coronavirus disease for months now with multiple studies conducted.
That others have studied something does not preclude these researchers from "fishing" their data looking for a correlation. Since we don't know what process they used, we can't say. When considering the other weaknesses (such as the small number of "comparators"), it furthers my consideration of this study being weak evidence.
That others have studied something does not preclude these researchers from "fishing" their data looking for a correlation. Since we don't know what process they used, we can't say. When considering the other weaknesses (such as the small number of "comparators"), it furthers my consideration of this study being weak evidence.
Meanwhile,
https://news.ycombinator.com/item?id=25133165
Which one is it?
https://news.ycombinator.com/item?id=25133165
Which one is it?
My point was that the submitted article was weak evidence. That is not the same from saying their conclusions are wrong. It very well may be the case that Vitamin D supplementation is effective against COIVD-19. But the submitted article is not strong evidence for that.
As I pointed out elsewhere, a measured take: https://www.devaboone.com/post/vitamin-d-and-covid
As I pointed out elsewhere, a measured take: https://www.devaboone.com/post/vitamin-d-and-covid
Ditto all that, plus the mortality rate in the (very small) comparison group was 44%, which is very high even for the elderly. The mortality rate for the vit D group was not really all that great.
On the flip side, given that they comparison group were receiving vit D3 occasionally, just not lately, it is possible that this underestimates the impact of vit D3 on a group that had long-term insufficient vit D3.
Nothing here to say that vit D isn't good for you, especially if you have a deficiency (such as from insufficient time in the sun), but not a stunning piece of info either.
On the flip side, given that they comparison group were receiving vit D3 occasionally, just not lately, it is possible that this underestimates the impact of vit D3 on a group that had long-term insufficient vit D3.
Nothing here to say that vit D isn't good for you, especially if you have a deficiency (such as from insufficient time in the sun), but not a stunning piece of info either.
The important factors for Vitamin D are that it's cheap to manufacture and has well known (low) risks. We have reasons to believe that it might help fight Covid, especially in deficient individuals, even if we do not have controlled studies.
Making it freely available and recommended for anyone who doesn't obviously get enough already is a reasonable strategy. It might not work - the correlation may not be causal. But it might be worth it anyway, because the downsides are minimal.
You could make roughly the same argument for wearing masks.
Making it freely available and recommended for anyone who doesn't obviously get enough already is a reasonable strategy. It might not work - the correlation may not be causal. But it might be worth it anyway, because the downsides are minimal.
You could make roughly the same argument for wearing masks.
Instead of lockdown, why don't Governments issue free Vitamin D to all households and at all pharamcies, all winter? The cost would be a few million - against tens of billions for lockdown.
Because vitamin might make a difference but it's won't be enough to just willy nilly let people catch covid at will without any precautions. IF it was basically a cure as you're implying then it would have been found out a long time ago as the difference would have been obvious even without a controlled experiment.
They put it in milk and other products already just for health.
Because VitD might reduce mortality by 20% to pick a number, which without lockdown still leaves millions of Americans dead - while lockdowns aim to stop the exponential growth and (if adhered to) reduce the number of infections and deaths by 95%+...
Does this include the cheap Vitamin-D3 that's commonly sold at Walgreens and supermarkets?
One of the tiny round capsules claims to have 2,000 IUs, which seems like a lot.
One of the tiny round capsules claims to have 2,000 IUs, which seems like a lot.
Dr. Fauci supposedly takes 6000 IU of Vitamin D daily.
https://vitamindwiki.com/Dr.+Fauci+takes+6%2C000+IU+of+Vitam...
https://vitamindwiki.com/Dr.+Fauci+takes+6%2C000+IU+of+Vitam...
yes
400 is recommended for dark winters, don't take more than 4000.
Source, UK NHS
https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-...
Source, UK NHS
https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-...
One could make a similar argument, but you then run up against a major WHO policy document on public health measures to combat influenza, which states:
"Ten RCTs were included in the meta-analysis, and there was no evidence that face masks are effective in reducing transmission of laboratory-confirmed influenza."
and
"According to the GRADE approach, there was moderate quality of evidence involving >6000 participants that face masks are ineffective in reducing influenza transmission in the community."
and
"Reusable cloth face masks are not recommended. Medical face masks are generally not reusable, and an adequate supply would be essential if the use of face masks was recommended. If worn by a symptomatic case, that person might require multiple masks per day for multiple days of illness."
https://www.who.int/influenza/publications/public_health_mea...
"Ten RCTs were included in the meta-analysis, and there was no evidence that face masks are effective in reducing transmission of laboratory-confirmed influenza."
and
"According to the GRADE approach, there was moderate quality of evidence involving >6000 participants that face masks are ineffective in reducing influenza transmission in the community."
and
"Reusable cloth face masks are not recommended. Medical face masks are generally not reusable, and an adequate supply would be essential if the use of face masks was recommended. If worn by a symptomatic case, that person might require multiple masks per day for multiple days of illness."
https://www.who.int/influenza/publications/public_health_mea...
Good thing it's not an influenza pandemic
People who know more about this than I do: how much do we think the lack of sunlight in the winter (among other factors) contributes to the severity spikes associated with the cold season?
I know the other factors: recirculated indoor air, humidity, etc.
I know the other factors: recirculated indoor air, humidity, etc.
Another big factor is stomach acid. As we age, our stomach acid gets exponentially weaker. This reduces absorption of nutrients and also minimizes the ability to destroy pathogens (not related to covid, just being complete). This becomes a circular problem, as the weaker stomach ph means less B1/zinc absorbed from all sources and less ability to produce stomach acid. This is why elderly often consume digestive enzymes or ACV to assist with digestion.
Friendly reminder: vitamin D3 can affect sleep if taken later in a day. I tend to skip if I forget to take it before noon. Also, D3 without additional K2 may lead to calcium excess.
From what I googled I couldn't find evidence for Vit D causing sleep issues taken at night - I did find articles suggesting that taking with a meal helps absorbsion - https://www.healthline.com/nutrition/best-time-to-take-vitam...
While there are studies on 25-OH-D metabolism impacting melatonin production, I can only find studies done with Multiple Sclerosis patients [1]. There are also studies showing that LOW levels of 25-OH-D may have negative impact on sleep [2][3][4]. While I am unable to present scentific evidence, I would like to state that for me - personally - taking vitamin D3 in the afternoon has similar effects to ingesting caffeine. I have no reason to believe that I might be suffering from Multiple Sclerosis. Without evidence you are free to ignore it as a placebo/nocebo effect. YMMV based on age, ethnicity, sunlight etc.
The "take with meal" instruction is common with substances requiring fat for absorption/bioavailability. Dietary fat increases vitamin D3 absorption [5].
[1] https://pubmed.ncbi.nlm.nih.gov/23665342/ The influence of vitamin D supplementation on melatonin status in patients with multiple sclerosis
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507736/ 25-Hydroxyvitamin D Concentration and Sleep Duration and Continuity: Multi-Ethnic Study of Atherosclerosis
[3] https://pubmed.ncbi.nlm.nih.gov/28652922/ The relationship between serum vitamin D levels and sleep quality in fixed day indoor field workers in the electronics manufacturing industry in Korea
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331570/ Association between Serum Vitamin D Levels and Sleep Disturbance in Hemodialysis Patients
[5] https://pubmed.ncbi.nlm.nih.gov/25441954/ Dietary fat increases vitamin D-3 absorption
The "take with meal" instruction is common with substances requiring fat for absorption/bioavailability. Dietary fat increases vitamin D3 absorption [5].
[1] https://pubmed.ncbi.nlm.nih.gov/23665342/ The influence of vitamin D supplementation on melatonin status in patients with multiple sclerosis
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507736/ 25-Hydroxyvitamin D Concentration and Sleep Duration and Continuity: Multi-Ethnic Study of Atherosclerosis
[3] https://pubmed.ncbi.nlm.nih.gov/28652922/ The relationship between serum vitamin D levels and sleep quality in fixed day indoor field workers in the electronics manufacturing industry in Korea
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331570/ Association between Serum Vitamin D Levels and Sleep Disturbance in Hemodialysis Patients
[5] https://pubmed.ncbi.nlm.nih.gov/25441954/ Dietary fat increases vitamin D-3 absorption
One more friendly reminder: If Vitamin D dosage is above 4000IU, same amount of Vitamin A should also be supplemented to avoid Vitamin A deficiency (e.g. eat liver). It's also antiviral, so it sounds like a good idea anyway.
More from doctors successfully treating covid with vitamins: https://youtu.be/LwlTQ52Wdro
More from doctors successfully treating covid with vitamins: https://youtu.be/LwlTQ52Wdro
Doctors of "holistic" medicine. One of the people in that video is also a staunch anti-vaxxer.
So, broken clocks, and all that.
So, broken clocks, and all that.
Oh no, 8 hours to late, but thanx for the reminder. ;)
I am curious to know why countries didn't buy large quantities of vitamin D and distribute them to all people? Wouldn't that be cheaper and more effective than complete lockdowns, full hospitals, etc.?
"BORIS Johnson is set to follow the Scottish Government’s lead on giving free vitamin D to vulnerable groups following research suggesting it can reduce the worst symptoms of Covid-19."
https://www.thenational.scot/news/18841488.boris-johnson-set...
https://www.thenational.scot/news/18841488.boris-johnson-set...
Maybe the easiest way to get vitamin d out there would be to politely ask manufacturers to fortify butter.
You might run into the problem that it can be toxic at high doses.
In my anecdotal experience, there seems to be a huge variance in the amount of butter that people eat, among people who regularly eat butter.
Also, does it survive the heat of cooking?
In my anecdotal experience, there seems to be a huge variance in the amount of butter that people eat, among people who regularly eat butter.
Also, does it survive the heat of cooking?
Vitamin D can be bought without prescription and there is currently no shortage, so why should a country (government) distribute it? Anyone who wants some can buy some. Handing out free Vitamin D is like handing out free gym passes. It's not bad, but also not really a government's responsibility except for cases when people would benefit a lot but could not afford it at all.
Same reason governments filter the water or remove lead from paint; just because knowledge is available doesn't mean all citizens can and will act on it, and sometimes lowering the barrier is all that's needed.
Moreover, I'd argue older generations in particular are more susceptible to believing what the doctor says. Just having the research available and the vitamins on the shelf isn't going to have nearly the same uptake as a centralised push.
Moreover, I'd argue older generations in particular are more susceptible to believing what the doctor says. Just having the research available and the vitamins on the shelf isn't going to have nearly the same uptake as a centralised push.
Vitamin D is the only supplement that the NHS suggests that most people should take as a matter of course. But the logistics of getting it out to everyone would be tough. Easier to recommend it and let people buy it.
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I think most places add it to milk. I supplement during the darkest six weeks of the year (which is starting very soon). It does seem like there could be a bigger seasonal push. Maybe not from the government but from somewhere.
I think this would be the best solution: to add it to the milk products during the winter! Most people would get it, there would be (almost) no public discussion about it and the immune systems would be strengthened. People not buying milk could still buy it like today!
This already is done year round. But there are a lot more vegans now.
Vitamin D is added in Alpro soy milk and the Oatly oat milk that I drink in Sweden, along with vitamin B12 and calcium. It's all equal to the levels found in cow's milk. There are organic variants of the above that don't allow fortification, but I choose the fortified ones.
I always find it odd that people take such a hands-off approach when it comes to things like Vitamin D usage, while at the same time cheerleading for governments to crack down hard on things like gyms, birthday parties, church services, elementary schools. Nothing is too extreme in the name of COVID, except that somehow distributing Vitamin D would be going overboard?
Right.. in my state weed and alcohol are essential and remain open but exercise, education, social interaction are now once again limited to your own home and we wonder why mental issues are sky rocketing. The latest order in my state made this week bans all indoor gatherings with people outside your home and it’s about 40 degrees F outside.
You are conflating different viewpoints into a single entity, let's call them "them" for purpose of discussion.
I just don't get your point. No matter how you put it, it's not a government's job to distribute a cheap, universally available subscription-free substance that might benefit their citizen's health. Why does the government not distribute fruits to all citizens? Should they distribute dental floss?
Maybe yes, but only to people in real need who cannot afford any of this or need help (e.g. elderly who are afraid to leave the house due to Covid).
In my opinion, the government's job is not to act like a nanny. There shouldn't be any need for it. They can and should expect a minimum of citizen participation and autonomy.
Is that such a bizarre idea to you?
Maybe yes, but only to people in real need who cannot afford any of this or need help (e.g. elderly who are afraid to leave the house due to Covid).
In my opinion, the government's job is not to act like a nanny. There shouldn't be any need for it. They can and should expect a minimum of citizen participation and autonomy.
Is that such a bizarre idea to you?
the experts followed the medical "standard of care". there was little discussion of what doctors were actually doing in out patient/ early treatment/prophylactic treatment. I don't think there was any studies about taking medicines or supplements for prevention. the drug studies ive looked at seem to be run by the drug companies and they aren't pushing vitamins and nutrition.
what I've learned while figuring out what supplements I should be taking is that the entire recommended daily allowance is based on avoiding acute diseases like ricketss or scurvy, and not based on a model of what is optimal for our bodies. when you look at diseases by latitute or wonder why our annual influenza pandemic is during the winter months, it makes me wonder why there hasn't already been studies of supplements. it seems like a perfectly straightforward study.
what I've learned while figuring out what supplements I should be taking is that the entire recommended daily allowance is based on avoiding acute diseases like ricketss or scurvy, and not based on a model of what is optimal for our bodies. when you look at diseases by latitute or wonder why our annual influenza pandemic is during the winter months, it makes me wonder why there hasn't already been studies of supplements. it seems like a perfectly straightforward study.
In a similar instance where one country (the United States) realized that distributing a specific medicine widely to all citizens would vastly improve public health, they discovered that — just as with anti-vaxxers/maskers — people will attribute medical issues that are outside of their control and have no known cause to something that is in their control, whether or not it's related.
"In the past five years, 74 cities have voted to remove fluoride from their drinking water, despite thousands of studies showing it prevents cavities." (2018)
So if the United States government attempted to distribute vitamin D to all people, a vocal minority of those people would respond "over my dead body" and immediately begin a nationwide campaign to prevent that distribution, including requesting emergency court orders to stop it. The US governments aren't typically what I would call "strong of will", and often fold on proven public health steps (such as masks) without trying to put up a fight.
Perhaps it's different in other countries?
"In the past five years, 74 cities have voted to remove fluoride from their drinking water, despite thousands of studies showing it prevents cavities." (2018)
So if the United States government attempted to distribute vitamin D to all people, a vocal minority of those people would respond "over my dead body" and immediately begin a nationwide campaign to prevent that distribution, including requesting emergency court orders to stop it. The US governments aren't typically what I would call "strong of will", and often fold on proven public health steps (such as masks) without trying to put up a fight.
Perhaps it's different in other countries?
I wouldn't trust anything a dentist has to offer, they only had their first empirical dentistry journal in the last decade.
[deleted]
Like a lot of things, vitamin D may have a slight effect on COVID mortality rates, but won't accomplish much by itself.
Edit: The study linked below is pretty compelling. My comment appears to be incorrect.
Edit: The study linked below is pretty compelling. My comment appears to be incorrect.
The studies I saw, many of which were posted here, recorded dramatic impact on disease severity from Vitamin D alone.
https://www.sciencedirect.com/science/article/pii/S096007602...
https://www.sciencedirect.com/science/article/pii/S096007602...
Yes. The results of this pilot randomized controlled trial (the first for vitamin D and covid, as I understand it) from Spain were astounding. Patients were given vitamin D supplements during their hospital stays. Of those who received the supplements, only 1 of 50 (2%) required ICU care, while 13 of 26 (50%) of the patients who did not receive supplements required ICU care (and two died). 2% vs. 50%!
Vitamin D supplementation is a low-risk, low-cost, side-effect-free (hard to OD) intervention. I see no reason governments should not encourage vitamin D supplementation (or, better yet, actively enable it via distribution of supplements as in the UK...at least during hospital stays). If it turns out that subsequent RCTs disprove the effects (despite the mountain of retrospective studies that show correlations in vitamin D levels and covid case trajectories), what harm will have been done?
Vitamin D supplementation is a low-risk, low-cost, side-effect-free (hard to OD) intervention. I see no reason governments should not encourage vitamin D supplementation (or, better yet, actively enable it via distribution of supplements as in the UK...at least during hospital stays). If it turns out that subsequent RCTs disprove the effects (despite the mountain of retrospective studies that show correlations in vitamin D levels and covid case trajectories), what harm will have been done?
You're under the absurd illusion that a substance with some weak evidence (that may be just statistical noise and bad interpretation of data) would have a significant effect.
If there's an effect of vitamin D it's likely very small.
If there's an effect of vitamin D it's likely very small.
There's actually a couple dozen studies on Vitamin D's effects on Covid-19: https://c19vitamind.com/
Some are retrospectives some are randomized clinical trials.
Vitamin D has a major effect on the immune system that is well documented.
OP is right. Even if supplementation reduced the death rate by only 25%, the cost-benefit analysis says that it would absolutely have made sense for countries to issue free Vitamin D and promote its use.
Some are retrospectives some are randomized clinical trials.
Vitamin D has a major effect on the immune system that is well documented.
OP is right. Even if supplementation reduced the death rate by only 25%, the cost-benefit analysis says that it would absolutely have made sense for countries to issue free Vitamin D and promote its use.
This lists 2 RCTs (related to Covid-19 + a few others for other infections). One is very small (16 people), the other is dubious, it seems to be the one that combines with hydroxychloroquine "standard of care". (I believe this was discussed on HN before.)
It almost certainly won't reduce death rate by 25%. Very few medical interventions have an effect size that large.
It almost certainly won't reduce death rate by 25%. Very few medical interventions have an effect size that large.
https://www.sciencedirect.com/science/article/abs/pii/S09600...
Vitamin D levels in summer months are associated with 25% lower mortality rates for all causes. Vitamin D almost certainly influences the immune system to fight off Covid in the same way it does the seasonal flu and other pneumonia. There's hundreds more studies on Vitamin D. Read up when you get a chance.
Hell even if it was a 5% reduction we're talking an abundant vitamin that costs pennies to manufacture.
Vitamin D levels in summer months are associated with 25% lower mortality rates for all causes. Vitamin D almost certainly influences the immune system to fight off Covid in the same way it does the seasonal flu and other pneumonia. There's hundreds more studies on Vitamin D. Read up when you get a chance.
Hell even if it was a 5% reduction we're talking an abundant vitamin that costs pennies to manufacture.
> the other is dubious, it seems to be the one that combines with hydroxychloroquine "standard of care".
I believe you're referring to this one, the RCT run in a hospital in Spain, with a startlingly huge effect size:
https://www.sciencedirect.com/science/article/pii/S096007602...
It seems that giving all patients hydroxychloroquine and azithromycin was the policy at that hospital at the time the experiment was run, so the RCT didn't vary that between control and experimental groups; they just gave vitamin D pills to one group and not the other. Is there some problem with this?
I believe you're referring to this one, the RCT run in a hospital in Spain, with a startlingly huge effect size:
https://www.sciencedirect.com/science/article/pii/S096007602...
It seems that giving all patients hydroxychloroquine and azithromycin was the policy at that hospital at the time the experiment was run, so the RCT didn't vary that between control and experimental groups; they just gave vitamin D pills to one group and not the other. Is there some problem with this?
With respect, and this is coming from just another measly user so take it with a grain of salt and feel free to disagree: I think your comment would be a lot more effective (and just as meaningful) without such an inflammatory tone in the first sentence. I think there are times and places to be more forceful, but an initial reply to a question presumed to be in good faith probably isn't one of them.
> 82.5 % of participants in the Intervention group survived COVID-19, compared to only 44.4 % in the Comparator group
So the intervention with vitamin D3 slashes the death rate from 55.6% to 17.5%, that's by a factor of over 3, or simply put three times less dead people.
So the intervention with vitamin D3 slashes the death rate from 55.6% to 17.5%, that's by a factor of over 3, or simply put three times less dead people.
According to this small Spanish randomized controlled trial, it can be even better: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456194/
Estimating the odds ratio is basically impossible with these data. The control group has just nine participants; you can get statistical significance with that (and they did) but the 95% CI gives you an OR of anywhere from 0.03-0.48 which is pretty much useless.
> All residents in the nursing-home receive chronic vitamin D supplementation with regular maintenance boluses (single oral dose of 80,000 IU vitamin D3 every 2–3 months), without systematically performing serum control test as recommended in French nursing-homes due to the very high prevalence of hypovitaminosis D reaching 90–100 % in this population. Here, the "Intervention group" was defined as all COVID-19 residents who received an oral bolus of 80,000 IU vitamin D3 either in the week following the suspicion or diagnosis of COVID-19, or during the previous month. The "Comparator group" corresponded to all other COVID-19 residents who did not receive any recent vitamin D supplementation. None received D2 or intramuscular supplements. All medications were dispended and supervised by a nurse.
All of these vitamin D studies seem to expose a single truth; serum vitamin D tests are too expensive. I suspect that these papers with inferred rather than measured vitamin D levels will continue until an easy and low cost vitamin D test is developed.
All of these vitamin D studies seem to expose a single truth; serum vitamin D tests are too expensive. I suspect that these papers with inferred rather than measured vitamin D levels will continue until an easy and low cost vitamin D test is developed.
This isn't new, we knew about this in April. If you don't get much sunlight or do but have melenated skin which reduces absorption and live in a northern climate, you should be taking supplements.
You're right that this isn't new, but that's only because it's just as weak as all the other "evidence" on this topic.
The reality is, there is a very weak body of evidence that maybe vitamin D provides a slight benefit. And yet, its proponents engage in the same hyperbole as the medical marijuana crowd.
Take it if you want, it's not going to hurt you at any kind of reasonable dose, but it's not some miracle cure that is going to solve everyone's health issues.
The reality is, there is a very weak body of evidence that maybe vitamin D provides a slight benefit. And yet, its proponents engage in the same hyperbole as the medical marijuana crowd.
Take it if you want, it's not going to hurt you at any kind of reasonable dose, but it's not some miracle cure that is going to solve everyone's health issues.
You know when I first read your comment about the medical marijuana crowd, I wanted to shoot up and defend it. It's brought me great benefits for my specific medical condition that it applies to.
However that's just it, my specific medical condition (migraines) isn't everyone's. So many people in the "crowd" are going around telling everyone it will cure their depression, anxiety, and basically anything that's painful or uncomfortable for them. It's not a miracle cure, and has it's clear detriments.
However that's just it, my specific medical condition (migraines) isn't everyone's. So many people in the "crowd" are going around telling everyone it will cure their depression, anxiety, and basically anything that's painful or uncomfortable for them. It's not a miracle cure, and has it's clear detriments.
I'm against Vitamin supplementations altogether but I'll try to share a reason why supplementing Vitamin D in particular is not a good idea.
The only form of Vitamin D that matters is D3. If you are not getting that, you're just ingesting a toxin that is useless at best.
Even if you are taking D3, it is not effective without K2. So, if you're just taking D3, again, it's useless at best.
Let's say you're taking D3+K2 as oral supplementation. How much are you taking? One of the richest natural sources of Vitamin D3 is Salmon. You'd have to eat a kilo (2.2 lbs) of Salmon just to get 8400 IU of D3. If you're taking a lot more (for example, 80,000 IU as used in this study), your liver has to deal with it... and it has not evolved to deal with that amount. The D3 produced in your body because of sun exposure doesn't have to go through the liver.
Nutrition science is hard but nutrition is easy. Just eat what people have been eating for hundreds of thousands of years. Supplements are almost always a bad idea.
The only form of Vitamin D that matters is D3. If you are not getting that, you're just ingesting a toxin that is useless at best.
Even if you are taking D3, it is not effective without K2. So, if you're just taking D3, again, it's useless at best.
Let's say you're taking D3+K2 as oral supplementation. How much are you taking? One of the richest natural sources of Vitamin D3 is Salmon. You'd have to eat a kilo (2.2 lbs) of Salmon just to get 8400 IU of D3. If you're taking a lot more (for example, 80,000 IU as used in this study), your liver has to deal with it... and it has not evolved to deal with that amount. The D3 produced in your body because of sun exposure doesn't have to go through the liver.
Nutrition science is hard but nutrition is easy. Just eat what people have been eating for hundreds of thousands of years. Supplements are almost always a bad idea.
The only form of Vitamin D that matters is D3. If you are not getting that, you're just ingesting a toxin that is useless at best.
You say this with authority (but no sources), but it does not appear to be true. D3 seems to be preferable, and more efficacious, but that does not mean that D2 does nothing.
https://www.healthline.com/nutrition/vitamin-d2-vs-d3
https://pubmed.ncbi.nlm.nih.gov/22552031/
https://pubmed.ncbi.nlm.nih.gov/23792937/
https://www.health.harvard.edu/newsletter_article/vitamin-d2...
Just eat what people have been eating for hundreds of thousands of years.
And spend 8 hours a day hunting, foraging, or working the fields, I suppose.
You say this with authority (but no sources), but it does not appear to be true. D3 seems to be preferable, and more efficacious, but that does not mean that D2 does nothing.
https://www.healthline.com/nutrition/vitamin-d2-vs-d3
https://pubmed.ncbi.nlm.nih.gov/22552031/
https://pubmed.ncbi.nlm.nih.gov/23792937/
https://www.health.harvard.edu/newsletter_article/vitamin-d2...
Just eat what people have been eating for hundreds of thousands of years.
And spend 8 hours a day hunting, foraging, or working the fields, I suppose.
Vitamin D2 is produced in plants because they use that. Similarly, D3 is produced in animals because they use that. Supementation of D2 has no effect on how much D3 animals end up with.
From your 3rd link:
Total serum 1,25(OH)2D did not change significantly with either treatment (p>0.05, post-treatment vs baseline).
From your second link:
only 3 of 10 possible studies included in the meta-analysis were randomized, controlled, double-blind, parallel intervention studies, which is the gold-standard design in nutrition research. Therefore, because of the lack of specific information surrounding the randomization and allocation of intervention to participants in all studies, there was an unknown degree of selection, performance, and detection bias.
A meta-analysis of RCTs indicated that supplementation with vitamin D3 had a significant and positive effect in the raising of serum 25(OH)D concentrations compared with the effect of vitamin D2 (P = 0.001).
From your 3rd link:
Total serum 1,25(OH)2D did not change significantly with either treatment (p>0.05, post-treatment vs baseline).
From your second link:
only 3 of 10 possible studies included in the meta-analysis were randomized, controlled, double-blind, parallel intervention studies, which is the gold-standard design in nutrition research. Therefore, because of the lack of specific information surrounding the randomization and allocation of intervention to participants in all studies, there was an unknown degree of selection, performance, and detection bias.
A meta-analysis of RCTs indicated that supplementation with vitamin D3 had a significant and positive effect in the raising of serum 25(OH)D concentrations compared with the effect of vitamin D2 (P = 0.001).
Yes. Like I said. More efficacious. That doesn't make D2 "useless at best". Both D2 and D3 have metabolites that bind to the (human) Vitamin D receptor[1]. BTW both need to go through liver/kidney[2], D3 by itself is similarly "useless" otherwise.
[1] https://en.wikipedia.org/wiki/Ergocalciferol#Mechanism
[2] https://en.wikipedia.org/wiki/Cholecalciferol#Mechanism_of_a...
[1] https://en.wikipedia.org/wiki/Ergocalciferol#Mechanism
[2] https://en.wikipedia.org/wiki/Cholecalciferol#Mechanism_of_a...
> The D3 produced in your body because of sun exposure doesn't have to go through the liver.
Most people don’t have access to that much sunlight, whether it’s because they have to spend most of the day working indoors, or, like me, they live in a polar region where you literally can’t get sun most of the year.
While it may be better for your liver not to have more to process, I highly doubt taking vitamin supplements is worse than living with a deficiency.
Also, in polar cultures, eating large amounts of vitamin D rich foods is exactly what people have been doing for thousands of years, without it causing health problems. And I can tell you from experience, that failing to get that vitamin D WILL cause health problems.
Most people don’t have access to that much sunlight, whether it’s because they have to spend most of the day working indoors, or, like me, they live in a polar region where you literally can’t get sun most of the year.
While it may be better for your liver not to have more to process, I highly doubt taking vitamin supplements is worse than living with a deficiency.
Also, in polar cultures, eating large amounts of vitamin D rich foods is exactly what people have been doing for thousands of years, without it causing health problems. And I can tell you from experience, that failing to get that vitamin D WILL cause health problems.
>they live in a polar region
People have been living in the polar regions for at least 10,000 years and they never took supplements and never had vitamin deficiency.
People have been living in the polar regions for at least 10,000 years and they never took supplements and never had vitamin deficiency.
I'm not following your explanation.
> Let's say you're taking D3+K2 as oral supplementation [...] You'd have to eat a kilo (2.2 lbs) of Salmon
So, what's so bad about D3+K2 if you do not want to eat a kilo of Salmon a day?
> Let's say you're taking D3+K2 as oral supplementation [...] You'd have to eat a kilo (2.2 lbs) of Salmon
So, what's so bad about D3+K2 if you do not want to eat a kilo of Salmon a day?
The point is our bodies haven't evolved to process large amounts of ingested D3.
Ok, I see what you mean now. Interesting. Do you know how much time one would have to stay outside to get, say, 5,000 IU?
You can use this https://fastrt.nilu.no/VitD_quartMEDandMED_v2.html to calculate how much to get the recommended amount from the Sun which I think is 1000 IU
I think 4000 IU is sun burn territory for a single sitting outside. But I only just scanned the website above.
I don't know how long it lasts, or if its cumulative, but I heard Vit D is stored in your fat so theres a bit of storage going on.
Perhaps therefore, sitting outside in Summer each day during lunch would be enough to get 5000 IU / week.
I think 4000 IU is sun burn territory for a single sitting outside. But I only just scanned the website above.
I don't know how long it lasts, or if its cumulative, but I heard Vit D is stored in your fat so theres a bit of storage going on.
Perhaps therefore, sitting outside in Summer each day during lunch would be enough to get 5000 IU / week.
Depends. Sunlight just converts a precursor molecule (7-dehydrocholesterol) to D3. The precursor is a product of the cholesterol synthesis system.
I personally believe you don't need any exposure to direct sunlight to get required D3 as long as you eat food natural to humans, specially if the diet is close to that of indigenous groups living in similar environment for thousands of years. We store D3 in our fat and you can also get it when you eat animal fat.
However, if you really want to use sun exposure, I recommend an app called dminder which tells you, based on your location, if and when sun exposure will give you Vitamin-D.
I personally believe you don't need any exposure to direct sunlight to get required D3 as long as you eat food natural to humans, specially if the diet is close to that of indigenous groups living in similar environment for thousands of years. We store D3 in our fat and you can also get it when you eat animal fat.
However, if you really want to use sun exposure, I recommend an app called dminder which tells you, based on your location, if and when sun exposure will give you Vitamin-D.
What is it with the obsession over vitamin D on HN?
I believe it's related to its potential to save tens or hundreds of thousands of lives.
>I believe it's related to its potential to save tens or hundreds of thousands of lives.
Not just specifically with COVID-19. In general, there's at least a few front page stories a month.
Google seems to confirm this: https://www.google.com/search?biw=1660&bih=865&tbs=qdr%3Ay&e...
Not just specifically with COVID-19. In general, there's at least a few front page stories a month.
Google seems to confirm this: https://www.google.com/search?biw=1660&bih=865&tbs=qdr%3Ay&e...
Lots of recent scientific studies coming out over the past few weeks regarding vitamin d.
Maybe it's due to the fact that most of HN'ers have indoor jobs(or education) and typically work long hours, leading to endemic Vitamin D deficiency.
Does Vitamin D improve the overall survival of elderly patients who are not suffering Covid?
Yes, reduces cold and flu-related difficulties as well.
It was recognized a century ago that tuberculosis patients who were taken outside in the sun did better than those who weren't.
It was recognized a century ago that tuberculosis patients who were taken outside in the sun did better than those who weren't.
The headline here (HN) is not the one of the source. It's also not what the study says.
The study says:
>Bolus vitamin D3 supplementation during or just before COVID-19 was associated with better survival rate in frail elderly.
That's rather close to the headline.
>Bolus vitamin D3 supplementation during or just before COVID-19 was associated with better survival rate in frail elderly.
That's rather close to the headline.
No.
The HN headline implies causation. The study result does not. (The study authors try to imply causation as well, but that's not what the study says.)
Agreed. To support what you said: the phrase "was associated with" is not a causative claim. You cannot go from that phrase to "improves."
This is hardly worth writing up for n=57. I scanned the full text and didn't see any notation regarding vitamin d blood levels in patients, which would have been useful to know. Maybe nobody wanted to pay for those tests? A helpful result would be something like, "blood levels of X ng/ml improved survival rates Y% with a confidence interval of Z."
Instead, we have an odd and vague dosage, "80,000 IU vitamin D3 every 2–3 months." I gather this study was constructed given the supplement regimen that was in-place. Why were the patients being supplemented that way? What standard of care is that?
Instead, we have an odd and vague dosage, "80,000 IU vitamin D3 every 2–3 months." I gather this study was constructed given the supplement regimen that was in-place. Why were the patients being supplemented that way? What standard of care is that?
Everyone on HN always says they are taking like 10x the RDA and it's the only thing that makes them survive the winter, blah blah blah. Intentionally hyperbolic, but not far off.
Every time I try just 400 IU per day for a week it makes me dizzy and woozy. I eat plenty of meat and veggies with K2, and nuts and fish with magnesium. Vitamin-D containing foods like milk, eggs and fish are totally fine. I can bake all day in the sun and don't burn easily.
There's something different about synthetic D3, and I wish I could get all the benefits that people here claim.
Every time I try just 400 IU per day for a week it makes me dizzy and woozy. I eat plenty of meat and veggies with K2, and nuts and fish with magnesium. Vitamin-D containing foods like milk, eggs and fish are totally fine. I can bake all day in the sun and don't burn easily.
There's something different about synthetic D3, and I wish I could get all the benefits that people here claim.
> Every time I try just 400 IU per day for a week it makes me dizzy and woozy.
I guarantee that you're consuming more than 400IU of Vitamin D in your regular diet. You can consume almost double that amount just by eating a decent sized salmon filet.
I doubt the miniscule amount of Vitamin D (10 micrograms) in your supplement is causing your problems. It's possible that you're allergic to the capsules themselves, or fillers, or something unique to the supplements.
> I eat plenty of meat and veggies with K2, and nuts and fish with magnesium. Vitamin-D containing foods like milk, eggs and fish are totally fine. I can bake all day in the sun and don't burn easily.
If you're getting plenty of Vitamin D from diet and sunlight, you don't need to supplement. I know the popular sentiment will beat the drum of "more is better", but it's not true. The goal is to get Vitamin D levels into an optimal range and keep them there, which, despite internet opinion, is entirely possible on a healthy diet with light sun exposure.
I guarantee that you're consuming more than 400IU of Vitamin D in your regular diet. You can consume almost double that amount just by eating a decent sized salmon filet.
I doubt the miniscule amount of Vitamin D (10 micrograms) in your supplement is causing your problems. It's possible that you're allergic to the capsules themselves, or fillers, or something unique to the supplements.
> I eat plenty of meat and veggies with K2, and nuts and fish with magnesium. Vitamin-D containing foods like milk, eggs and fish are totally fine. I can bake all day in the sun and don't burn easily.
If you're getting plenty of Vitamin D from diet and sunlight, you don't need to supplement. I know the popular sentiment will beat the drum of "more is better", but it's not true. The goal is to get Vitamin D levels into an optimal range and keep them there, which, despite internet opinion, is entirely possible on a healthy diet with light sun exposure.
Paul Stemets, a mycologists, had worked out a way to get button or shitake mushrooms to generate a lot of vitamin D. You simply expose them to sunlight for about a "day" (and no more). (Unfortunately, I wish there were more detailed study on this; how many hours of sunlight are we talking about? Is it latitude dependent?)
My point is that there are ways to generate supplemental vitamin-d without having to go get synthetic supplements.
My point is that there are ways to generate supplemental vitamin-d without having to go get synthetic supplements.
There are plenty of foods that are high in Vitamin D without resorting to specialized mushroom farming.
I know Paul Stamets is held in high regard in certain circles, but be careful. He's a personal brand builder, first and foremost, and many of his claims range from dubious to pure pseudoscience. Even though he's become a figurehead for mushroom research, his own line of supplements is notoriously inferior to many other products on the market. Fun guy (hah) to listen to on podcasts, as long as you don't take him too seriously or get hooked by his disguised sales pitches for his products.
I know Paul Stamets is held in high regard in certain circles, but be careful. He's a personal brand builder, first and foremost, and many of his claims range from dubious to pure pseudoscience. Even though he's become a figurehead for mushroom research, his own line of supplements is notoriously inferior to many other products on the market. Fun guy (hah) to listen to on podcasts, as long as you don't take him too seriously or get hooked by his disguised sales pitches for his products.
The mushrooms produce vitamin D2 though, not D3.
A small fraction of people have trouble absorbing it, another fraction don't handle the supplements well. Pretty rare however.
Have you tested your level in the winter? You may not need it.
I've been taking 5k a few times a week and haven't been sick longer than a day for perhaps a decade.
Have you tested your level in the winter? You may not need it.
I've been taking 5k a few times a week and haven't been sick longer than a day for perhaps a decade.
Awareness of Vitamin and immune boosting nutrition needs to be mentioned alongside the call for masks
They never really explain anything or offer any basic advice (like cutting out alcohol to reduce suppression of your immune system). They just bark orders (wear a mask! cancel thanksgiving!) and call anyone who questions it "anti-science".
"All residents in the nursing-home receive chronic vitamin D supplementation with regular maintenance boluses (single oral dose of 80,000 IU vitamin D3 every 2–3 months)"
Holy shit that's a lot of vitamin D
Holy shit that's a lot of vitamin D
AFAICT the bolus supplements are meant to take months to absorb. This is probably easier and definitely cheaper than giving daily supplement pills. I'm not sure if there are serious downsides to bolus supplementation, but it's probably not worse than most nursing-home cost-cutting tactics.
However fishy this study may be, eating some herring is definitely not bad. It's delicious! So: good idea, thank you, I'll get some for the week end.
“A quasi-experimental study” - love the honesty
Should McDonalds add vitamin D to bigmacs?
No shit.
Take HCQ + Zinc. Supplement with vitamin D. This is "verboten" to our benevolent technocratic overlords but it's plain science.
Take HCQ + Zinc. Supplement with vitamin D. This is "verboten" to our benevolent technocratic overlords but it's plain science.
Sounds like we should get the light inside the body to kill the virus
Get more Sunlight if possible to get Vitamin D produced by your body. Unfortunately not enough sunlight in Northern latitudes at this time.
Vitamin D + Fat should increase Testosterone.
Maybe Testosterone is what helps but they don't want to communicate it like that.
I am not expert, doctor, scientist nor politician.
In my reading, this study is weak evidence. This was not a randomized, controlled trial, but historical analyses of a natural experiment. In itself, that's not a problem: we can learn a lot from natural experiments. But I don't think this instance is much of an "experiment."
As I understand it, all of the residents (96 in total) of a particular nursing home receive regular Vitamin D supplementation. Of the total residents, 66 got COVID-19. Among that group, they realized that 57 of them had received their Vitamin D supplementation either within a week of being diagnosed with COVID-19, or one month prior. That is the intervention group. The remaining 9 people are the "comparator" group. They found the intervention group had better survivability.
The main three reasons I consider this study weak evidence is that the number of people in the "comparator" group is very small (9!), and they - as far as I can tell - do not explain why these people did not receive their normal Vitamin D supplementation. The "comparator" group is supposed to have had a similar baseline, but there's still, to me, a strong possibility of a confounding factor. Finally, there were four total interventions: corticosteroids, hydroxychloroquine, "dedicated antibiotics" and the observation about Vitamin D. The more things you try, the less surprising it should be that there is a correlation along one of them.