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Vitamin D & Covid - update

"Vitamin D deficiency, associated with deleterious effects on innate and adaptive immunity, has many small but growing datasets that satisfy all of Hill's criteria as a risk factor for severe COVID-19."

"When deaths were evaluated on the basis of vitamin D deficiency (serum 25-OH-D <20 ng/mL), the fatality rate was 21%, compared to only 3% for those with higher levels. More striking was that vitamin D deficiency was found in 97% of severely ill patients who required ICU admission but in only 33% of asymptomatic cases, suggesting that low levels are a necessary component of severe COVID-19. This is one of numerous studies this year establishing the correlation of low vitamin D levels with an aggravated course of COVID-19, as a meta-analysis by Pereira and colleagues reveals."

"It is our responsibility as physicians not to wait for perfect evidence when making life-and-death decisions. Given the safety profile of vitamin D, the 40% prevalence of vitamin D deficiency in the U.S., and the fact that this season will likely be the deadliest phase of the pandemic to date, we need to act now. Identifying and eradicating vitamin D deficiency with early and aggressive supplementation in COVID-19 has the potential to save thousands of lives and should be one of our highest public health priorities."

John Umhau MD MPH

January 5, 2021

In an Open Letter addressed to key decision makers and health care workers, experts have laid out the research to recommend Vitamin D intake for adults up to 4000 IU (100mcg) daily. Those at an increased risk of deficiency due to excess weight, dark skin, or living in care homes may need higher intakes. Testing can help to avoid levels too low or high.

"The data strongly suggests that vitamin D is the safest, easiest, and most important anti-pandemic measure the world is failing to prioritize," says Karl Pfleger, Ph.D., biotech investor, former Google data scientist, and one of the organizers of VitaminDforAll.org.

Thanks Scuba - interesting stuff. It does seem that there is plenty of data saying that Vitamin D is important for guarding against COVID, and in general supporting a good immune system.

Because of this group, I have been taking VitD supplements for a fair while now which may well have paid off well. I have just recovered from a case of COVID - positive test on the 22nd of Dec, a bit of a nasty week or ten days but not bed-ridden at any time. While my lungs are going to take a little longer to recover fully I’m back in pretty good shape. All four of us in the house had it (kids virtually no symptoms) and the main lasting problem is lack of smell and taste, which I think is slowly coming back.

David.

Hi David,

Thanks for first person account!

Do you know your vitamin D blood level?

Thanks Scuba defo will be taking VitD. Still waiting for my doc to tell me my current level before I commit to higher doses.

David sorry to hear you had COVID but glad to hear that you're fine. My wife had it and I managed to swerve it by sheilding. You'll prob all laugh but I used first defence day and night as there was some study that suggested it traps viruses in the nose well stopping penetration and funny enough they have just annouced this very kind of product here https://www.mirror.co.uk/science/coronavirus-scientists-develop-7pday-na....

Its prob a coincidence but I did everything I could not to get it.

Alex

I’m afraid I don’t. Consults are on the phone at the moment, so it’s not as easy to have a look over the computer screen with my doctor. 

David. 

Hi David, glad you and your family managed to deal with Cvd-19 and are now recuperating. Re: finding your current Vit D3 level, would it be possible for you to ask your doctor to send you your D3 level by email or just tell you over the phone? My doctor sent my result over to me by text. 

Nevertheless, even if you don't know your current level, with a positive infection it may be (still) worth upping your daily dose of Vit D3 to over 20,000 iu daily for 5 days.

As you may remember, I try to keep my D3 level pretty high (at least 90 ng/ml) and I think this is the sole reason I have not had any kind of URT infection for at least the last couple of years, in spite of my job in a busy retail environment. 

We are currently 'not going out' due to the headlines for rising Cvd-19-infection rates in London because of the truly horrifying possible ramifications for the NHS. I have had little contact with anyone outside my household since being forced to close my shop just before Xmas, and now only venture out (with a mask) for walks and basic shopping trips. 

Best to you and your family, 

Sandy

Quickie question for the vit D experts : any formulation you advise ? Or ones to avoid?

Eg i take magnesium, and was advised to stay away from mg carbonate or citrate as they can give dihorea

Quickie question for the vit D experts : any formulation you advise ? Or ones to avoid?

Eg i take magnesium, and was advised to stay away from mg carbonate or citrate as they can give dihorea

I think you need to take Vitamin K2 as well to improve asborption of the Vit D. 

 

Information regarding vitamin D and K2:

https://www.humann.com/nutrition/powerful-combo-vitamins-d3-k2/

Vitamin K2 does not 'improve' absorption of Vitamin D. Taking vitamin D3 with food containing fat helps vitamin D3 absorption from the small intestines into the blood stream. Vitamin D helps improve (dramatically) calcium absorption into the blood.

Vitamin K2 helps transport calcium from soft tissue (i.e. arteries, organs,) to bone. Vitamin D is the pickup and deposit and vitamin K2 is the conveyor belt.

Vitamin K2 uses vitamin D to do its job. It is very difficult to overdose on D (i.e. D > 100 ng/ml) when adequate K2 is around.

Vitamin D3 and K2 should be taken together for calcium balance (reduce atherosclerosis, osteoporosis) and overall health. This is especially true since vitamin D is not easily obtained from food in the dose necessary for immune health and vitamin K2 is almost exclusively available from spoiled fermented bacteria laden "food" (i.e Natto).

(update: it's not necessary to take D3 and K2 at the same time - just so long as they are taken on a mostly daily basis. D3 will store in the body so missing a daily dose and doubling up the next day is fine. Also, best to take D3 before noon. D3 entering the blood in the evening can disrupt sleep. K2 can be taken any time when eating).

Threadjack!

I've had really high blood calcium levels since cml... would it be advisable to take vit d?

What was the cause of your high blood calcium levels?

The parathyroid gland regulates calcium in the blood and works with bone marrow and kidneys to keep calcium levels normal.

Excessive calcium is removed either by  the kidneys (pee a lot), or deposited back into bone or into soft tissue (atherosclerosis, kidney stones) if vitamin K2 is deficient or some other genetic cause.

Complications from cancer treatments can lead to hypercalcemia, but is rare in CML and usually associated with blast crisis (end stage CML).

Vitamin D does enhance absorption of calcium from food, but regulation of calcium in the blood is controlled by the parathyroid glands. Vitamin K2 insures that "excess" calcium is not deposited in soft tissue and is instead directed to bone. But a normal functioning parathyroid gland is necessary in order for this chemistry to work otherwise bone leaching of calcium is going to occur regardless.

In order for vitamin D to overdo calcium in the blood, it would have to be very high for a sustained period (much greater than 120 ng/ml). This is key to understand. Hypercalcemia caused by vitamin D requires vitamin D toxicity and even then is still rare.

  • https://acutecaretesting.org/en/journal-scans/vitamin-d-toxicity-a-very-...
  • "Results of this study confirms the considerable rarity of vitamin D toxicity despite increased use of vitamin D supplementation in recent years, and suggests counterintuitively that hypercalcemia is not necessarily always a feature of vitamin D toxicity anyway, so hypercalcemia due to vitamin D toxicity must be rare indeed."

Given your prior history and concern - be sure to test your vitamin D levels and if you take a vitamin D supplement, tune your intake so your blood vitamin D level is within 50 - 100 ng/ml. You will then get the benefit of vitamin D immune protection and other benefits. Test your calcium level at the same time. If your calcium rises as you increase your D level (even though D is < 100 ng/ml), then you have a different issue requiring specialized care.

 

I asked several times about the calcium levels, but was told not to worry about it.

Its been high since diagnosis, i had very very high white blood levels (consistent with blast crisis) but not actually in blast crisis

EvaH,

What is your calcium blood level?

(blast crisis occurs when blast cell levels rise above 20-30%. Blast cells are precursor blood cells which when normal rapidly differentiate. It is noteworthy that vitamin D facilitates blast cell differentiation including leukemic blast cells.)

Hi guys, i took too much Vit D, now i have 147, i am on a diet, but i have kidney stones probably for the vit d.  i am taking imatinib. Anyone knows how long is vit d going to be in my body? i mean how long takes to reduce. And my doctor told me that vitamins are not allow for hematology neoplastic diseases, there is no evidence. Is this true?  My calcium serum level is 8.6. Do you think guys is it going to be higher? i am so afraid of it. Thank you. And sorry for my grammar, its because i am from spain, so my english is not so good. Hope you guys understand me. Thank you! 

 

Hi guys, i took too much Vit D, now i have 147, i am on a diet, but i have kidney stones probably for the vit d.  i am taking imatinib. Anyone knows how long is vit d going to be in my body? i mean how long takes to reduce. And my doctor told me that vitamins are not allow for hematology neoplastic diseases, there is no evidence. Is this true?  My calcium serum level is 8.6. Do you think guys is it going to be higher? i am so afraid of it. Thank you. And sorry for my grammar, its because i am from spain, so my english is not so good. Hope you guys understand me. Thank you! 

 

How much vitamin D (D3) were you taking?

Half life of vitamin D in the body is about two months. So you can expect your D level to drop by half in that time. I would avoid any vitamin D supplement for the next 8 weeks. You have plenty of vitamin D! - it will drop normally as we are in winter.

Although you are above the upper desired limit of vitamin D, you are below the toxic level (> 150-200 ng/ml). Just let your body use up your vitamin D naturally. You  should be fine. Your blood calcium is normal. And that is to be expected. Your body will 'deposit' and/or excrete excess calcium. Taking vitamin K2 (MK-7 form), will help use vitamin D and move calcium out of soft tissue into bone. Excess vitamin D without K2 can certainly contribute to kidney stones as well as atherosclerosis, but would take some time.

Your doctor is misinformed about vitamin D and neoplastic diseases.

Just keep in mind, once you get your vitamin D level down below 70 , you will need to supplement again, just don't over do it and be mindful of seasons. I don't take anywhere near as much vitamin D3 in the summer as I do in winter, but I live at 30 degrees north latitude. Summer sun is plenty strong.

Thank you so much for letting me know, i really find this group very informative. Thank you some much for sharing your knowledge and own experiences.Thank u! 

Scuba, thank you so much for letting me know, i really find this group very informative. Thank you some much for sharing your knowledge and own experiences.Thank u! 

I took Ergocalciferol 600 000 U, i took one per month per around 5-6 months, but the last month i took 2 per month and also i was eating plenty of dairy products. My last dose was on december 15th, i was thinking to take one dose again in january 2021, but i had some discomfort in my right abdomen per weeks, i thought it was my liver, and also i felt so tired all december, so I decided to take some lab test one week ago and  then i knew that i had 2 kidney stones and also my vit D level was in 147 and my calcium was in 8.6. I’ve been worried about it. Hope i get well soon. 

Ergocalciferol is vitamin D2 and usually prescribed by doctors.

I would never ever take that much vitamin D (in any form) at one time ever. It is not how the body works and why doctors prescribe that amount in one dose is beyond me. The best way to increase vitamin D levels is gradually through dose levels that approximate nature. On any given day, in the summer at noon, our bodies can manufacture about 10,000 - 20,000 IU's per day - per day. Not 600,000 IU's per one day per month. The most vitamin D3 (the best form to take orally) I would every take in one day is 10,000 IU's and then only in winter.

Don't take any vitamin D right now for two months and allow your body to adjust downward. At that time test again and you should be around 70 ng/ml perhaps even lower, but still higher than 50 ng/ml. Once you achieve this reduction, consider re-starting a supplement program but use over the counter vitamin D3 (reputable brand) and keep your dose no higher than 10,000 on any given day in winter. You will need to experiment in summer what you need. I take 5,000 per day in summer, but only on days I am not in the sun scuba diving (which is not often enough).

Also look into taking vitamin K2 which is a natural pair with vitamin D and will help minimize the chance of vitamin D toxicity. They work together.

 

Thank you for taking your time to answer my doubts and for your advices Scuba. 

" i took too much Vit D, now i have 147,....."

Hi Mil, 

is your Vit D level result 147 ng/ml (nanogram per millilitre)

Or  

147 nmol/L (nanomols per Litre) ?

Sandy

Any suggestions for someone who can't get enough sunlight in a day?

In order to keep my vitamin D level above 50 ng/ml and below 100 ng/ml, I take on average 5,000 IU's per day vitamin D3 (over the counter) in summer and average 7500 IU's per day in winter. In summer, I avoid taking vitamin D3 on days I am in the noon time sun around the ocean. Summer for the purposes of vitamin D supplement amount begins for me in March and ends in September. I test twice a year.

I also take vitamin K2 (200 mcg) which works with D to prevent calcium deposition in soft tissue. As long as you supplement below 10,000 IU's vitamin D3 per day and take vitamin K2, it will be difficult to achieve D toxicity. Current RDA requirement of 600 - 1,000 IU's per day D3 in order to achieve D levels above 20 ng/ml are for ricketts prevention. It is insufficient for strong immune system health.

I take Vitamin D3 (5000 IU) and Vitamin k2 MK7 (180mcg) combo, every other day (namely 4 times per week) to maintain my blood level between 80-90 ng/ml. I live in California. I tried to take the pill combo every day and my blood level was above 100. 

Good information. This is why testing is so important. We all metabolize vitamin D differently and absorb differently. I have a friend of mine who takes 10,000 IU's per day and barely maintains 50 ng/ml. I suspect more of an absorption issue. Taking D3 with food that has fat (avocado, cheese, etc.) helps D absorption. Taking vitamin D3 with oatmeal will lead to very low absorption.

Hi Scuba,

I started taking Sprycel again today. If I’m going to take Sprycel at 8pm, what is the best time to take Vitamin D? Is it okay to take Spycel before dinner time?

Any suggestion pls?

Thanks

Best time to take vitamin D3 is in the later morning, ideally around noon.

Avoid taking D3 after the sun goes down as it can interfere with sleep.

I take sprycel in the evening before sleep. Sprycel can be taken with or without food.

Additional information on vitamin D, sun & skin exposure times.

The study was done in Japan - for reference, Naha, Japan is at 26 North latitude. In summer, peak synthesis of vitamin D in the skin

with normal clothing (face, neck, back of hands exposed), was approximately 220 IU's equivalent after 3.5 minutes exposure. At this rate to reach 5,000 IU's exposure, it would take over an hour. This is certainly possible and explains why, in southern latitudes, summer exposure to sun during mid day can elevate blood vitamin D levels.

In contrast at Sapporo, Japan (latitude ~ 43 degrees North), it took over an hour to achieve 220 IU's in December.

Vitamin D synthesis varies considerably from time of day and time of year with low latitude, around noon for an hour exposure necessary to build vitamin D levels in the blood. People with darker skin will produce considerably less vitamin D.

Given the amount of vitamin D needed to fully activate our immune system, it is clear why supplementation is absolutely required to achieve protective effects. Unless one is running around on a beach in southern latitudes for hours a day, sun exposure alone is insufficient to protect the body.

Likewise, sudden exposure to large amounts of sun while the body is vitamin D deficient risks skin cancer. Vitamin D levels need to be brought up above 50 ng/ml gradually during spring (or through supplementation) so that by summer, vitamin D blood levels are high enough to provide skin damage protection. From an evolutionary perspective, probably the reason our bodies developed sun activated D synthesis in the first place. To protect against skin mutagenesis from ultraviolet radiation.

My personal experience bears this out - I no longer sunburn like I used to during summer ocean activities. In fact, I hardly sunburn at all and I stopped wearing sunscreen when I first learned about vitamin D. My skin will tan during this time and peak by August. My blood level of D will approach 90 ng/ml. falling back sometimes to near 50 in late winter. I try and maintain a cycle of between 50 to 100 ng/ml.