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Does Vitamin D Deficiency Increase The Risk Of Coronavirus?

5/11/2020

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Perhaps. But overdosing will damage your kidneys

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Photo by Marcel Friedrich on Unsplash
Scientists in the UK are calling for ministers to add vitamin D to common foods such as bread and milk to help the fight against Covid-1.

However, the call is controversial.

Back in 2017, Professor Louis Levy, Public Health England's head of nutrition science, responded to calls for fortification by saying that there was not enough evidence that vitamin D would reduce the risk of respiratory infections.

Recently, researchers in Spain found that 82% of coronavirus patients out of 216 admitted to hospital had low vitamin D levels. The picture is mixed; some research shows that vitamin D levels have little or no effect on Covid-19, flu and other respiratory diseases.

How do we get enough vitamin D?

What we do know, is that population studies show that in countries with short summers or low intensity of sunlight, there is typically a vitamin D deficiency.

Globally, vitamin D deficiency is widespread and is on the rise. Ironically, this is mostly due to vigilant sun protection, with effective sunscreen lotions. In fact, some sunscreens even destroy any Vitamin D that has just been formed.  

Vitamin D is best known for its vital role in bone health - it helps our body absorb calcium. Without vitamin D, the body can't absorb the calcium it ingests, so it steals calcium from bones, increasing the risk of osteoporosis and fractures. Vitamin D also helps maintain normal blood levels of phosphorus, another bone-building mineral.
​
Irrespective of whether it is protective of the novel coronavirus, how do you get the vitamin D that our body needs to function strongly?
RELATED: Vitamin D Is Free But We Don't Get Enough And Our Health Is Suffering

It doesn’t take much sunshine 

The best way is through our skin - activated by sunlight. Vitamin D is photo-activated - that is, the energy of light is captured and used in the process of generating vitamin D. Interestingly the different stages of vitamin D synthesis require different wavelengths of incoming sunlight. 

The sun's energy turns a chemical in our skin into vitamin D 3. This is carried to our liver and then our kidneys which transform it into active vitamin D. Dietary vitamin D is absorbed in our small intestine immediately downstream from our stomach. Gut and digestive conditions alter this absorption.

But before you run out and buy expensive pills, consider these three facts:
  1. Vitamin D produced by the skin can last twice as long as dietary vitamin D.
  2. Small amounts of sunlight, taken consistently over spring, summer and autumn, can supply the necessary protection. Between 1000 and 1500 hours of sun exposure over this period is needed. Five to 10 minutes of sun exposure on some or most days of the week to your arms, legs, or back without sunscreen will enable you to make enough of the vitamin. Do this when the UV level is safe.
  3. Vitamin D can also be obtained through other sources, including fatty fish (such as tuna, mackerel, and salmon), foods fortified with vitamin D (such as dairy products, soy milk, and cereals), beef liver, cheese, and egg yolks.

Otherwise some supplementation may be needed

If you are not at risk of deficiency for vitamin D, then the above options are probably sufficient. If you are overweight or older, you may need supplements since your production and metabolism of vitamin D is sub-optimal. (Vitamin D is stored in fat, so in people with obesity, less of the vitamin circulates in the blood, where it's available for use by the body.)

People with conditions such as inflammatory bowel disease, liver disease, or cystic fibrosis, among others, may have trouble absorbing vitamin D, which can lead to deficiencies.

Recommended daily intake (US) is:
  • 600 IU of vitamin D a day for everyone ages 1 to 70.
  • 800 IU of vitamin D a day for those 71 and older.
​
If you rarely get out in the sun, or just aren't confident you are getting 600 to 800 IU of vitamin D a day, taking a supplement containing 400 to 1,000 IU is safe, inexpensive insurance.

Overdoing vitamin D is seriously harmful

Some people are overdoing it with supplements. Researchers looking at US national survey data gathered between 1999 and 2014 found a 2.8% uptick in the number of people taking potentially unsafe amounts of vitamin D — more than 4,000 IU per day, according to a research letter published in the June 20 issue of The Journal of the American Medical Association (JAMA).

For adults, the risk of harmful effects increases above 4,000 IU per day. Too much vitamin D can make the intestines absorb too much calcium. This may cause high levels of calcium in the blood, which can damage the heart, kidneys and lungs. (Excessive sun exposure doesn't cause vitamin D poisoning because the body limits the amount of this vitamin it produces.)

The damage has severe consequences as if the kidneys are damaged or in poor health, the body can no longer make enough vitamin D. Taking more vitamin D to make up for the kidney damage then creates even more damage.

Play safe, and don't overdo it.

Will it help protect against the coronavirus?

For the last two decades, researchers have unexpectedly discovered that vitamin D is active in many tissues and cells besides bone and controls an enormous number of genes, including some associated with cancers, autoimmune disease, and infection.

While there is strong support for vitamin D's role in bone health, the evidence that it prevents other health conditions is not yet conclusive, says Dr JoAnn E. Manson, the Michael and Lee Bell Professor of Women's Health at Harvard Medical School. 

Hardly a month goes by now without news about the risks of vitamin D deficiency or about a potential role for the vitamin in warding off diseases, including breast cancer, multiple sclerosis, and even schizophrenia.

On the other hand, this 2019 study concluded:
"Supplementation with vitamin D did not result in a lower incidence of invasive cancer or cardiovascular events than placebo".

Some evidence for, some against

There is some evidence to suggest that vitamin D might help protect against becoming infected with and developing severe symptoms of, COVID-19.

We know, for example, that people with low vitamin D levels may be more susceptible to upper respiratory tract infections. One meta-analysis found that people who took vitamin D supplements, particularly those who had low vitamin D levels, were less likely to develop acute respiratory tract infections than those who didn't.

Vitamin D may protect against COVID-19 in two ways. First, it may help boost our bodies' natural defence against viruses and bacteria. Second, it may help prevent an exaggerated inflammatory response, which has been shown to contribute to severe illness in some people with COVID-19.

On the other hand, almost everything about COVID-19 is confusing. One of the most perplexing aspects of coronavirus is why it strikes people so differently.

For example, some people sail through without a symptom, while others who are otherwise healthy and relatively young get extremely sick or even die.

Most recent study said no ...

In contrast to the Spanish study mentioned earlier, this "retrospective study from a northern Italian hospital" published on November 2 2020, found "no significant association between vitamin D and COVID-19". 

We can conclude that (1) maintaining the recommended levels of vitamin D through diet is probably sufficient, and possibly with supplements for a total of 1000 IU per day, and (2), the current evidence that it is protective for coronavirus is inconclusive.

Stay safe.
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