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  • Writer's pictureGary Moller

Vitamin D, Dark Skin, COVID and Influenza

Updated: Mar 26

How our Government and various Health Officials and Professionals have let our darker-skinned populations down: badly!


For the last 40 years, I have lived within our Maori and Pasifika communities. When my children, a mix of Pakeha, Cook Islands Maori, Samoan and Tongan descent were born, I became a vocal opponent of the "Slip-Slop - Cover-Up" campaign which I called racist.


Many more of my articles about sunlight and health are here:


While it now makes some concessions for dark-skinned people, Slip-Slop is still a racist programme because it sets out to protect the fair-skinned while the token gestures to our dark-skinned citizens are insufficient and they get lost in the noise of the bigger message which is to fear sunlight. This racially biased messaging comes at a great cost to the health of New Zealand's dark-skinned people.


Fact: Dark-skinned people have almost zero risk of contracting and dying from sun-related skin cancer - at least 1/50th that of fair-skinned people.

I am fair-skinned whereas my partner Alofa and our children have dark skin. While their needs vary, they need at least ten times as much sunlight as me to manufacture "healthy" amounts of vitamin D.


children
My Niece, Jasmine and son, Mathieson(now 22 yrs). One needs to cover up, while the other thrives on the all-day sun.

Official sunlight guidelines are therefore biased towards the fair-skinned majority which is quite simply wrong and discriminatory of the worst kind because it costs people their lives.


"Would you like a burger and fries voucher with your jab?"

Now, with COVID and influenza, the lies and misinformation about vitamin D not only continue but have been ramped up several more levels. It begs the question as to why nobody is allowed to discuss or promote basic and highly effective health measures such as combating obesity, cutting down on sugar, boosting vitamin D, zinc, selenium and more, including reducing poverty. Moreover, the people who stand to benefit the most from such measures are our Maori and Pasifika people. And now our Minister of Health is about to introduce the Natural Health Products Bill which they will undoubtedly railroad through this time (They have tried and failed on two previous occasions due to professional and public opposition). This Bill threatens the availability and potency of natural products including vitamin D, and also threatened the existence of natural health practitioners. Why are they so intent on reducing people's health choices and freedoms?


We have to wonder what this Government agreed to when it signed up with Big Pharma companies to supply the jabs?

No matter which way we look at it, there is something very dodgy about this whole pandemic programme, including the suppression of any effective health messaging other than wearing a mask, keeping away from other people and getting the jab!


Vitamin D, Dosages

  • While recommended daily doses of vitamin D vary among experts, the general consensus is this:

  • 4,000IU per day for an adult.

  • Titrate downwards for children according to body size, so a 30 Kg child may have 2,000IU per day.

  • On days when your torso is exposed to sunlight, there is no need to supplement.

  • Supplement during Winter.

  • It is better to supplement daily than a big dose once a week or once a month.


Purchase Quality Vitamin D


You may add a couple of these daily to fortify the vitamin D supplementation:


 

The Evidence for Vitamin D: Follow the Science!

The article that follows By Kiwi Blogger: 8wire, VITAMIN D & DARK SKIN IN WINTER

Lifesaving Covid Cure Suppressed is reproduced with permission. This is an excellent overview of the scandalous suppression of health information in New Zealand and is backed up by good research that cannot, in good faith, be ignored.


Enjoy the read and please support independent media such as 8wire:


 

VITAMIN D & DARK SKIN IN WINTER

Lifesaving Covid Cure Suppressed


Your body makes vitamin D when your skin is exposed to sunshine.


Vitamin D is so important to humans that as they migrated to colder climates, they changed their skin tone from dark to light to absorb more of it from the sun.

The vitamin plays a vital role in immunity and is crucial for the development of killer T cells:


In order for T cells to become active members of the body’s immune system, they must transition from so-called “naive” T cells into either killer cells or helper cells (which are charged with “remembering” specific invaders). And, if ample vitamin D is not around, the T cells do not make that crucial transition, “When a T cell is exposed to a foreign pathogen, it extends a signaling device of ‘antenna’ known as a vitamin D receptor, with which it searches for vitamin D,” If there is an inadequate vitamin D level, he noted, “they won’t even begin to mobilize.” Scientific American

T cells help kill viruses including Covid 19. They can work where vaccines fail:


T-cells can fight Omicron when antibodies fail to. Human bodies have a second line of defence against Covid that offers hope in the global fight against the Omicron variant., Australian researchers say. Omicron has a higher number of mutations than other variants, which means it can sometimes slip past the antibodies produced by vaccination or infection. But if it does enter the body, the T-cells – white blood cells that originate in the marrow – will attack. University of Melbourne

They even offer good protection from reinfection caused by new variants:


This study suggests that cross-reactive SARS-CoV-2-specific T-cell responses could be particularly important in the protection against severe disease caused by variants of concern whereas neutralising antibody responses seem to reduce over time. The Lancet

People with darker skin struggle to produce sufficient Vitamin D if they are in low sun environments.


A study showed that 20 percent of Pākehā participants, 39 percent of Māori, 47 percent of Pacific and 72 percent of South Asian participants were Vitamin D deficient.


There is a strong correlation between these numbers and the people who have been most severely impacted by Covid 19 (elderly people also struggle to produce Vitamin D).


On 2nd June 2020 New Zealand Prime Minister Jacinda Ardern was advised to supplement this at-risk population by her Chief Science Advisor:


the groups identified as at-risk of deficiency are still considered at-risk: • People with naturally dark skin • People whose skin is not regularly exposed to sunlight • People who live in the South Island (especially south of Nelson-Marlborough) and get little time outdoors in the middle of the day between May and August •Testing for vitamin D status is more expensive than supplementing in NZ, so current policy is to supplement individuals at-risk of vitamin D deficiency at the discretion of GPs. This policy is probably also appropriate for managing individuals at-risk of severe COVID-19 disease in NZ until more information is gathered from clinical trials. Office of the Prime Minister’s Chief Science Advisor

Jacinda Ardern choose not to follow this advice. But she didn’t stop there. The Government (& to an extent, the media) actively suppressed any positive messaging around Vitamin D.


They even blocked all response messages containing ‘Vitamin D’ on the Government UniteAgainstCOVID19 Facebook page.


Stuff News went so far as to publish an article titled ‘Battling Covid with Vitamin D, mouthwash, and a dose of stupidity’.


High profile people who are paid to look after the interests of New Zealanders – ignored all evidence that Vitamin D could be beneficial. They never questioned the government narrative. The focus was to push the vaccine and nothing else.


There is evidence Vitamin D can also reduce the risk of myocarditis. So could have been beneficial in reducing vaccine deaths.


Unfortunately a dangerous negative attitude towards anything other than vaccines has prevailed.


Vitamin D takes a month or so to build up in the system. So giving it after the fact is too late.


Now New Zealand has entered into Winter.


The Government knew in January that Winter would be a time of less Vitamin D from sunlight and that high flu cases would burden hospital capacity.


They had statistics from Denmark showing precisely what an Omicron Winter looks like in a similar population size.


But instead of allowing the virus to spread during Summer when it was safer – they made a conscious decision to delay the spread so that a significant number of cases would occur ‘during’ Winter.


A gamble which has not paid off.


Hospitals and GPs have now been overwhelmed.


Additionally, by ignoring the science around Vitamin D – they have failed people with dark skin, the elderly, and New Zealanders in general.


Further reading –


STUDIES & DATA:


T-cells can fight Omicron when antibodies fail to, Australian researchers say

Human bodies have a second line of defence against Covid that offers hope in the global fight against the Omicron variant, Australian researchers say.

University of Melbourne research, done in conjunction with the Hong Kong University of Science and Technology, has found T-cells should be able to tackle the virus.


Omicron has a higher number of mutations than other variants, which means it can sometimes slip past the antibodies produced by vaccination or infection. But if it does enter the body, the T-cells – white blood cells that originate in the marrow – will attack.


The research has just been published in the peer-reviewed journal Viruses.

Co-leader of the research, the University of Melbourne’s Matthew McKay, said while it was a preliminary study, it was “positive news”.


“Even if Omicron, or some other variant for that matter, can potentially escape antibodies, a robust T-cell response can still be expected to offer protection and help to prevent significant illness,” he said.

“These results overall would suggest that broad escape from T-cells is very unlikely.


Another reason vitamin D is important: It gets T cells going

Vitamin D deficiency has been linked to a rapidly expanding inventory of ailments—including heart disease, cancer and the common cold. A new discovery demonstrates how the vitamin plays a major role in keeping the body healthy in the first place, by allowing the immune system’s T cells to start doing their jobs.


In order for T cells to become active members of the body’s immune system, they must transition from so-called “naive” T cells into either killer cells or helper cells (which are charged with “remembering” specific invaders). And, if ample vitamin D is not around, the T cells do not make that crucial transition, a group of researchers led by Carsten Geisler, head of the Department of International Health, Immunology and Microbiology at the University of Copenhagen, found. They draw this conclusion based on their experiments with isolated naïve human T cells.


“When a T cell is exposed to a foreign pathogen, it extends a signaling device of ‘antenna’ known as a vitamin D receptor, with which it searches for vitamin D,” Geisler said in a prepared statement. If there is an inadequate vitamin D level, he noted, “they won’t even begin to mobilize.”


Although this vitamin requirement might seem like a handicap to the immune system, the researchers proposed that the additional step involving the vitamin D receptor might actually serve an important evolutionary function: keeping T cells from ravaging healthy tissue. “Given that T cells are capable of explosive proliferation, the lag phase imposed by the vitamin D [receptor step] may diminish the risk of unwanted immunopathology,” they noted in the study, which was published online March 7 in Nature Immunology (Scientific American is part of Nature Publishing Group).


The body naturally makes vitamin D when the skin is exposed to sunshine (it can also come from eggs and some fish products), but most people in the U.S. are considered to be deficient in the vitamin. In fact, a 2009 Archives of Internal Medicine study found that 77 percent of U.S. adults and teenagers surveyed did not have the estimated minimum healthful level of 30 nanograms per milliliter in their blood. And just three percent of blacks in the survey were getting enough of the vitamin, the 2009 report found.


Powering up the immune system

The European Food Safety Authority notes, vitamins A, B6, B9, B12, C and D and the minerals zinc, selenium, iron and copper are all needed for the immune system to function as it should.


Each of these micronutrients – as well as vitamin Ehas been shown to play multiple roles in supporting immune function and reducing the risk of infection. Research has found a link between having an impaired immune system and having low amounts of many vitamins and minerals.


Low Vitamin D in Maori, Pacific & South Asian people

In sunny New Zealand it’s hard to believe people would have low vitamin D levels, but we do. The required level for good health at all ages is deemed to be at least 50 nanomoles per litre (nmol/L) of blood. The ViDA study showed that 20 percent of Pākehā participants, 39 percent of Māori, 47 percent of Pacific and 72 percent of South Asian participants had less than 50 nmol/L.


70 percent of Europeans suffer from low vitamin D levels, experts say

A group of experts has prepared a report on vitamin D supplementation for menopausal women after it was revealed that Europeans have suffered an alarming decrease in their levels of this vitamin.


Vitamin D deficiency is a real problem in Europe as levels in the blood are low in 50% to 70% of the population. Pérez-López points out that “healthcare professionals should be aware that this is a common problem which affects a large part of the population in Europe, even those who live in sunny places.”


Therefore, a group of experts from the European Menopause and Andropause society (EMAS), led by Pérez-López, have prepared a report about vitamin D supplementation and the health of postmenopausal women. The text has been signed by 11 experts from international institutions like the John Radcliffe Hospital in Oxford.


According to these experts, vitamin D supplements improve the mineral density of the bones and neuromuscular function and reduce the risk of fracture. Pérez-López believes that “the World Health Organisation or other relevant bodies belonging to the European Union should establish minimum requirements or recommendations on the fortification of foods with vitamin D.”


Vitamin D includes a series of lipophilic hormonal compounds that regulate calcium metabolism by working on the kidneys, the digestive tract, the skeleton and the parathyroid glands. Vitamin D supplements can be taken as vitamin D2 (ergocalciferol) or D3 (colecalciferol).


Vertebrates synthesize vitamin D3 in the skin through exposure to sunlight whereas a small quantity is obtained through foods such as oily fish, eggs and milk. Whether ingested or synthesized through the skin, vitamin D goes through two transformations. The first occurs in the liver and gives rise to calcidiol. The second takes place in the kidneys and other cells and forms calcitriol — the active hormone.


This hormone stimulates calcium and phosphorus absorption and regulates the transcription of different genes. It is also involved in insulin synthesis, heart contraction, it regulates the immune system, it has antimicrobial effects and controls cell proliferation and mechanisms of apoptosis.


The Problems of Vitamin D Insufficiency in Older People

Thus, Westernised and urban communities world-wide, even in tropical countries, have a high prevalence of hypovitaminosis D, even in sunny climes [2, 3]. This is, however, no more a new problem in the old than it is at other ages [4,5]. In 1966 it was suggested that nutritional osteomalacia might ‘contribute to the skeletal rarefaction found in old age’, a suggestion now generally accepted [6]. These older findings make it especially regrettable that, >40 years later, hypovitaminosis D remains a public health problem at all ages, world-wide. This provides a bad start for those getting older, since ageing reduces outdoor activity, food intake and skin synthesis, and also gut absorption of vitamin D which can only worsen the problems relating to hypovitaminosis D in the elderly [79].


Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society

Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) <50 nmol/L or 20 ng/mL) is common in Europe and the Middle East. It occurs in <20% of the population in Northern Europe, in 30-60% in Western, Southern and Eastern Europe and up to 80% in Middle East countries.


Risk groups include young children, adolescents, pregnant women, older people (especially the institutionalized) and non-Western immigrants.


Vitamin D deficiency 2.0: an update on the current status worldwide

Severe vitamin D deficiency with a 25(OH)D concentration below <30 nmol/L (or 12 ng/ml) dramatically increases the risk of excess mortality, infections, and many other diseases, and should be avoided whenever possible. The data on a benefit for mortality and prevention of infections, at least in severely deficient individuals, appear convincing. Vitamin D is clearly not a panacea, and is most likely efficient only in deficiency.


Vitamin D testing has exponentially increased in recent years [1]. The definition and relevance of vitamin D deficiency are still under debate. Recent large observational data have suggested that ~40% of Europeans are vitamin D deficient, and 13% are severely deficient [2].


Vitamin D deficiency in Europe: pandemic?

Results: An overall pooled estimate, irrespective of age group, ethnic mix, and latitude of study populations, showed that 13.0% of the 55,844 European individuals had serum 25(OH)D concentrations <30 nmol/L on average in the year, with 17.7% and 8.3% in those sampled during the extended winter (October–March) and summer (April–November) periods, respectively. According to an alternate suggested definition of vitamin D deficiency (<50 nmol/L), the prevalence was 40.4%. Dark-skinned ethnic subgroups had much higher (3- to 71-fold) prevalence of serum 25(OH)D <30 nmol/L than did white populations.


Conclusions: Vitamin D deficiency is evident throughout the European population at prevalence rates that are concerning and that require action from a public health perspective. What direction these strategies take will depend on European policy but should aim to ensure vitamin D intakes that are protective against vitamin D deficiency in the majority of the European population.


Israel Population Study – Results

Through December 31, 2020, 10,295 adult patients between the ages of 18 and 95 had a recorded COVID-19 related hospitalization in the CHS database. The matching procedure was able to identify control individuals from the general population in ratio 5:1 for 6530 patients in the first cohort, and control patients in ratio 2:1 for 6953 SARS-CoV-2 positive individuals in the second cohort. The characteristics of the matched populations are shown in Table 1.


In addition, we observe interesting patterns in cohort 2, which is designed to identify drugs associated with decreased hospitalization risk in SARS-CoV-2 positive patients: several vitamin or mineral supplementation items appear to have a protective effect, in addition to vitamin D and magnesium citrate, which were identified by both cohorts: vitamin B12 combinations (OR=0.618, CI 0.399 to 0.934), multivitamins for ocular use (OR=0.616, CI 0.376 to 0.976), and calcium-zinc combinations (OR=0.000, CI 0.000 to 0.892).


It is remarkable that the protective effect of anti-cholesterol drugs was observed mostly for rosuvastatin – and in cohort 1 for pravastatin – but not for other statins. Rosuvastatin was found to significantly increase 25-OH vitamin D levels in the blood (Yavuz et al., 2009), much more than what could be observed with other statins. Yavuz and Ertugrul, 2012 suggested that the increase in 25-OH vitamin D observed following rosuvastatin treatment could be mediated by the Niemann-Pick C1 like 1 (NPC1L1) membrane transporter that is involved in intestinal absorption of vitamin D. Interestingly, the NPC1L1 membrane transporter is also the target of ezetimibe, identified by our study to decrease significantly the hospitalization risk of COVID-19 patients.


In both cohorts, we observed a significant decrease of the odds for hospitalization for COVID-19 patients treated with either vitamin D or magnesium citrate. Vitamin D deficiency has been shown to be associated with increased risk for COVID-19 in multiple studies (Israel et al., 2020; Merzon et al., 2020). Magnesium is needed for vitamin D activation (Uwitonze and Razzaque, 2018) and its levels in drinking water in Israel are low, as water is produced in great part through desalination of sea water (Koren et al., 2017). The decreased hospitalization rate revealed here for patients taking magnesium supplementation may suggest a role for supplementation of this element along with vitamin D. Hospitalization risk was also found to be decreased in patients taking vitamin B12 and calcium-zinc, as identified by other studies (Ragan et al., 2020; Trasino, 2020; Wessels et al., 2020).


Conclusions:

Ubiquinone, ezetimibe, and rosuvastatin, all related to the cholesterol synthesis pathway were associated with reduced hospitalization risk. These findings point to a promising protective effect which should be further investigated in controlled, prospective studies.


Real World Andalusian Study

COVID-19 is a major worldwide health problem because of acute respiratory distress syndrome, and mortality. Several lines of evidence have suggested a relationship between the vitamin D endocrine system and severity of COVID-19. We present a survival study on a retrospective cohort of 15,968 patients, comprising all COVID-19 patients hospitalized in Andalusia between January and November 2020. Based on a central registry of electronic health records (the Andalusian Population Health Database, BPS), prescription of vitamin D or its metabolites within 15–30 days before hospitalization were recorded. The effect of prescription of vitamin D (metabolites) for other indication previous to the hospitalization was studied with respect to patient survival.

Since 2001, the Andalusian Public Health System has been thoroughly storing all the EHRs data of Andalusian patients in the Population Health Base (BPS)25. This makes of BPS one of the largest repositories of highly detailed clinical data in the world (with over 13 million of comprehensive registries)25. BPS constitutes a unique and privileged environment to carry out large-scale RWE studies.


Here we used RWD from BPS to obtain RWE of the effectiveness of the prior prescription of cholecalciferol, calcifediol or calcitriol VDES metabolites with nutrient, pre-hormone or hormone activity respectively, on mortality rate among patients hospitalized for COVID-19.

Vitamin D endocrine system metabolites and survival

The effect of cholecalciferol, calcifediol or calcitriol prescription, both aggregated (ADM) and independently, 15 and 30 days prior hospitalization, was studied with respect to the outcome of death at 30 days. As described in “Methods”, PSM was applied to the treated and untreated patients. This rendered a satisfactory covariate balance and no significant correlations between the covariates was observed in the samples paired by the PSM model (Table 2). Kaplan–Meier curves shows the survival of patients who received a prescription for ADM 15 days (Fig. 1A) and 30 days (Fig. 1B) prior hospitalization, suggesting a significant association between ADM prescription and patient survival. Kaplan–Meier curves for specific cholecalciferol, calcifediol or calcitriol prescriptions (Fig. S2) supporting the same significant association between any of the individual prescriptions and patient survival, except for calcitriol with an erratic (non-significant) behavior due the already mentioned small sample size. The comparison of specific prescriptions supports a significantly increased survival of patients who received a prescription for calcifediol than those who received a prescription for cholecalciferol (see Table 3), pointing to a stronger association of calcifediol (Vitamin D3) with patient survival.


Recently, a larger observational cohort study included patients admitted to COVID-19 wards of Hospital del Mar, Barcelona, Spain. Calcifediol treatment using a similar schedule as in pilot study mentioned above, at hospital admission significantly reduced the need for ICU support and reduced mortality35. Out of 838 patients, 447 received calcifediol, whereas 391 were not treated at the time of hospital admission. The prescription of calcifediol was based on the ward they were assigned to, based on availability of beds. In five out of 8 wards patients received calcifediol whereas this was not the case in the other 3 wards. Treatment was otherwise similar and there were no significant baseline differences in patient characteristics. Among those treated on admission with calcifediol, 4.5% required ICU admission versus 21% in the untreated group. Logistic regression of calcifediol treatment on ICU admission, adjusted by age, gender, linearized 25OHD levels at baseline, and comorbidities showed that treated patients had a reduced risk to require ICU (OR 0.13, 95% CI 0.07–0.23). Moreover, 4.7% treated 55 with calcifediol at admission died compared to 15.9% of non-treated. Adjusted results showed a reduced mortality risk with an OR 0.21 [95% CI 0.10; 57 0.43]. In addition, in a retrospective study reported of patients hospitalized for laboratory confirmed COVID-19 infection, patients from five hospitals in Southern Spain received or not calcifediol (similar schedule mentioned formerly). Patients from one hospital received the option to receive calcifediol whereas this option was not available in the other hospitals. General treatment was otherwise very similar. In-hospital mortality during the first 30 days was 17.5%. The OR of death for patients receiving calcifediol (mortality rate of 5%) was 0.22 (95% CI 0.08–0.61), compared to patients not receiving such treatment (mortality rate of 20%; p = 0.000485). In the multivariable logistic regression model, there were significant differences in mortality for patients receiving calcifediol, compared with patients not receiving (OR = 0.104, 95% CI 0.027–0.404)36.


Conclusions: This study strongly suggests that calcifediol (Vitamin D3) or cholecalciferol (Vitamin D3) prescriptions established previously to hospitalization were associated with a better survival rate among hospitalized COVID-19 patients. A significant reduction in mortality between 10 and 50% is observed when the prescription of cholecalciferol and calcifediol, respectively, was made within 15 days prior to hospitalization, and from 5 to 43% if the period considered for vitamin D prescription expands to 30 days. Most likely this effect occurs through VDR stimulation. VDES metabolite treatment may represent an effective, accessible, safe, well-tolerated and cost-effective preventive therapeutic approach for COVID-19, which is dramatically increasing in incidence and for which few validated treatments currently exist. Further large prospective, preferably interventional, Randomized Controlled Trials are needed to confirm whether regular treatment or supplementation of older adults with calcifediol or vitamin D3 improves COVID-19 outcomes.


The results reported here support the establishment of public health policies that make it possible to maintain adequate levels of 25OHD for the synthesis of calcitriol to enable a better prognosis in patients affected by COVID-19. In the light of the results obtained, calcifediol preferably, or cholecalciferol with a lower effect, can adequately meet these objectives. In fact, calcifediol may have some advantages over native vitamin D3. Thus, the former has a more reliable intestinal absorption (close to 100%) and can more rapidly restore serum concentrations of 25OHD as it does not require hepatic 25-hydroxylation33,51. In fact, calcifediol is three times more potent than oral cholecalciferol in raising serum 25OHD levels52. This is especially relevant in clinical situations whereby rapid restoration of serum 25OHD is desirable and CYP2R1 expression is compromised52, explaining and giving causal consistency to the stronger association between survival and the prescription of calcifediol fifteen and thirty days prior to hospitalization by COVID-19.


This cost-effective and widely available treatment could have positive implications for the management of COVID-19 worldwide, particularly in developing countries.


Calcidiol Vitamin D

Vitamin D must go through several processes in your body before your body can use it. The first transformation occurs in the liver. Here, your body converts vitamin D to a chemical known as 25-hydroxyvitamin D, also called calcidiol.


Oxford University Study Conclusions

Early in acute COVID-19, both vitamin K and vitamin D deficiency were independently associated with worse COVID-19 disease severity, suggesting a potential synergistic interplay between these 2 vitamins in COVID-19.


20-Week Study of Over-the-Counter COVID-19 Prophylaxis

We present a 20-week study of our clinical experience with a multi-component over-the-counter (OTC) “core formulation” regimen used in a multiply exposed, high risk population. The OTC core supplementation formulations used include zinc and zinc ionophores; vitamins C, D3 and E; and l-lysine.


Results While both groups were moderate in size, the difference between them in outcomes over the 20-week study period was large and stark: Just under 4% of the compliant test group presented flu-like symptoms, but none of the test group was COVID-positive; whereas 20% of the non-compliant control group presented flu-like symptoms, three-quarters of whom (15% overall of the control group) were COVID-positive.


Conclusions Offering a low cost, readily implemented anti-viral approach, the study regimen may serve, at the least, as a stopgap modality and, perhaps, as a useful tool in combatting the pandemic.


Trinity College and the University of Edinburgh and Zhejiang University

What were the findings? Researchers found that ambient UVB radiation at an individual’s place of residence preceding COVID-19 infection was strongly and inversely associated with hospitalisation and death. This suggests that vitamin D may protect against severe COVID-19 disease and death.


COVID-19 Mortality Risk Correlates Inversely with Vitamin D3 Status, and a Mortality Rate Close to Zero Could Theoretically Be Achieved Results of a Systematic Review and Meta-Analysis

In this publication, we used a meta-analysis of two independent sets of data. One analysis is based on the long-term average vitamin D3 levels documented for 19 countries. The second analysis is based on 1601 hospitalized patients, 784 who had their vitamin D levels measured within a day after admission, and 817 whose vitamin D levels were known preinfection. Both datasets show a strong correlation between the death rate caused by SARS-CoV-2 and the vitamin D blood level. At a threshold level of 30 ng/mL, mortality decreases considerably. In addition, our analysis shows that the correlation for the combined datasets intersects the axis at approximately 50 ng/mL, which suggests that this vitamin D3 blood level may prevent any excess mortality. These findings are supported not only by a large infection study, showing the same optimum but also by the natural levels observed in traditional people living in the region where humanity originated from that were able to fight down most (not all) infections in most (not all) individuals.


Therefore, based on our data, the authors strongly recommend combining vaccination with routine strengthening of the immune system of the whole population by vitamin D3 supplementation to consistently guarantee blood levels above 50 ng/mL (125 nmol/L). From a medical point of view, this will not only save many lives but also increase the success of vaccination. From a social and political point of view, it will lower the need for further contact restrictions and lockdowns. From an economical point of view, it will save billions of dollars worldwide, as vitamin D3 is inexpensive and—together with vaccines—provides a good opportunity to get the spread of SARS-CoV-2 under control.


Vitamin D and lumisterol novel metabolites can inhibit SARS-CoV-2 replication machinery enzymes

Promising new data from a recent study indicates that active forms of vitamin D can inhibit the replication and expansion of COVID-19. The study’s findings also suggest lumisterol, produced by a chemical reaction in the body using light, works to block COVID-19. Vitamin D and lumisterol metabolites were able to block two specific enzymes (RdRP and Mrpo) required for the SARS-CoV-2 life cycle, according to the team of researchers from the University of Alabama at Birmingham; the Centre for Interdisciplinary Research in Basic Sciences in New Delhi, India; and the University of Western Australia.


A plethora of reports strongly suggests that vitamin D plays a vital role in protection against SARS-COV-2, which includes preventing infected patients from developing severe disease. Here, we report for the first time that a range of vitamin D3-related compounds, including 7-DHC and L3 hydroxyderivaties, display anti-SARS-CoV-2 activities and we provide a possible target on which they may act directly. Vaccines against SARS-CoV-2 are clearly a major advance in controlling COVID-19; however, new viral variants emphasize the need for alternative therapeutic approaches. This study presents novel vitamin D and L3 metabolites as candidates for antiviral drugs.


Effect of calcifediol treatment on mortality among patients hospitalized for COVID-19

One of the most intriguing studies on vitamin D and covid, however, comes from the Spanish city of Cordoba.[24] There, 76 hospitalised covid patients were separated into two groups in a randomised controlled trial on a 2:1 ratio. Fifty patients were given 21280 IU of vitamin D in its calcifediol form on the day of admission, and top-up doses of 10640 IU on days three and seven, then weekly until either discharge or admission to intensive care – whichever came first.


One of the most intriguing studies on vitamin D and covid, however, comes from the Spanish city of Cordoba.[24] There, 76 hospitalised covid patients were separated into two groups in a randomised controlled trial on a 2:1 ratio. Fifty patients were given 21280 IU of vitamin D in its calcifediol form on the day of admission, and top-up doses of 10640 IU on days three and seven, then weekly until either discharge or admission to intensive care – whichever came first.


“All hospitalized patients received as best available therapy the same standard care (per hospital protocol) including a combination of hydroxychloroquine and azithromycin. Outcomes of effectiveness included the rate of ICU admission and deaths. Only 1 of 50 patients treated with calcifediol (2%), but 13 of 26 untreated patients (50%), required ICU admission.”[25]


It was a glittering result for vitamin D, reducing ICU admissions from 50% to 2%, but at the same time a damning result for hydroxychloroquine.


Vitamin K & D Deficiencies Are Independently Associated With COVID-19 Disease Severity

Our findings suggest a potential relationship between vitamins D and K at the time of acute COVID-19 and an association with worse disease severity. Interestingly, both vitamin D and vitamin K may display complementary effects on the cytokine storm, thrombosis, and lung damage during COVID-19. Specifically, they display similar inhibitory effects on inhibition of NF-kB and cytokine release, and vitamins D and K appear to work synergistically to help protect against calcification and damage in the lungs.


Several factors are frequently cited as risk factors for severe COVID-19 outcomes, including race, BMI, and comorbidities. Black individuals have higher mortality in the United States, with an infection rate >3-fold higher in predominantly Black counties compared with predominantly White counties [30]. Hypertension has been identified as the most common comorbidity in COVID-19, and obesity is a risk factor for COVID-19 disease severity. In our study, being non-White and having a higher BMI were independently associated with worse vitamin D and K levels; however, neither race nor BMI was associated with COVID-19 outcome after adjusting for vitamin D and vitamin K status. Similarly, hypertension was independently associated with worse vitamin K status but not with COVID-19 severity when adjusting for vitamin D and K levels. Most African Americans lack normal serum levels of vitamin D; in addition, greater adiposity is associated with lower vitamin D levels, suggesting a role for vitamin D in abdominal fat storage and function. Race, BMI, and comorbidities, specifically hypertension, may be inter-related, and racial differences in COVID-19 disease severity may be due to additional socioeconomic and health care disparities; however, our findings suggest that vitamins D and K may play a role in modulating the associations between these factors and COVID-19 disease severity.


Overview of results from the Vitamin D Assessment (ViDA) study

The study was carried out in Auckland, New Zealand, among 5110 adults, aged 50–84 years, who were followed for a median 3.3 years. The intervention was vitamin D3 (2.5 mg or 100,000 IU) or placebo softgel oral capsules, mailed monthly to participants’ homes, with two capsules sent in the first mail-out post-randomisation (i.e. 200,000 IU bolus, or placebo), followed 1 month later (and thereafter monthly) with 100,000 IU vitamin D3 or placebo capsules. Outcomes were monitored through routinely collected health data and self-completed questionnaires.


Results

The results showed no beneficial effect of vitamin D supplementation on incidence of cardiovascular disease, falls, non-vertebral fractures and all cancer. However, beneficial effects from vitamin D supplementation were seen: for persistence with taking statins in participants on long-term statin therapy; and also in bone mineral density and arterial function in participants with low 25-hydroxyvitamin D levels, and in lung function among ever smokers (especially if vitamin D deficient). The latter findings are consistent with several previous studies,

Statin therapy is widely used for both the secondary and primary prevention of atherosclerotic cardiovascular disease. Statins are drugs that can lower your cholesterol.

Conclusion

Monthly high-dose vitamin D supplementation does not prevent a range of diseases, but may be beneficial for some intermediate outcomes in people who are vitamin D deficient.


Vitamin D is increasingly being linked to asthma

Higher Vitamin D levels are associated with decreased airway hyperresponsiveness and decreased inflammatory markers. Low levels of vitamin D may be associated with poor asthma control and increased severity.


Conclusion

Vitamin D levels were low in patients of asthma. There was highly significant improvement in asthma control and severity after supplementation with Vitamin D.

A new Cochrane Review published in the Cochrane Library has found evidence from randomized trials that taking an oral vitamin D supplement in addition to standard asthma medication is likely to reduce severe asthma attacks.


Low blood levels of vitamin D have been linked to increased risk of asthma attacks in children and adults with asthma. There has been a growing interest in the potential role of vitamin D in asthma management, because it might help to reduce upper respiratory infections (such as the common cold) that can lead to exacerbations of asthma. Several clinical trials have tested whether taking vitamin D as a supplement has an effect on asthma attacks, symptoms, and lung function in children and adults with asthma.


The team of Cochrane researchers found seven trials involving 435 children and two studies, involving 658 adults. The study participants were ethnically diverse, reflecting the broad range of global geographic settings, involving Canada, India, Japan, Poland, the UK, and the US. The majority of people recruited to the studies had mild to moderate asthma, and a minority had severe asthma. Most people continued to take their usual asthma medication while participating in the studies. The studies lasted for between six and 12 months.


The researchers found that giving an oral vitamin D supplement reduced the risk of severe asthma attacks requiring hospital admission or emergency department attendance from 6% to around 3%. They also found that vitamin D supplementation reduced the rate of asthma attacks needing treatment with steroid tablets.


Meta-analysis of vitamin D and lung function in patients with asthma

Results This quantitative synthesis found that asthma patients with low vitamin D levels had lower forced expiratory volume. Subgroup analysis indicated that the positive correlation between vitamin D and lung function remained significant in both children and adults.


Conclusion The pooled estimates from the observational studies show that high blood vitamin D levels can benefit lung function and slow asthma exacerbation. Due to the limited data, we are unable to determine an optimal cut-off dose of vitamin D for asthma lung function and control. More comprehensive randomised controlled clinical trials with sufficient power and longer follow-up duration are needed to confirm the results.


Vitamin D receptor restricts T helper 2-biased inflammation in the heart

Background and aims The aberrant immune responses play a critical role in the pathogenesis of myocarditis. Vitamin D receptor (VDR) has immune regulatory functions. This study aims to investigate the role of VDR in restricting the immune inflammation in the heart.


Conclusions VDR-deficiency contributes to the pathogenesis of myocarditis. To enhance the VDR expression in CD4+, T cells haves the therapeutic potential for the treatment of myocarditis.


Published data indicate that vitamin D (VitD) is associated with immune regulation.12 The essential roles of VitD include facilitating the absorption of calcium and involving in the bone metabolism. In the recent years, it has been found that VitD is also a regulator of immune activities,12 such as VitD-deficiency or insufficiency may be a critical factor involved in the pathogenesis of cardiovascular diseases,13 allergic asthma14 and inflammatory bowel disease.15 VitD modulates cell functions via the VitD receptor (VDR). VDR-insufficiency is also involved in the pathogenesis of cardiac diseases.16 VitD can suppress the activities of Toll-like receptors to prevent microbial stimulation-induced inflammation.17 It is also found that VitD is capable of inducing anti-microbial molecules in the immune cells to inhibit inflammation by reducing the production of pro-inflammatory cytokines via modulating their gene transcription.18


Vitamin D deficiency cardiomyopathy in Scotland: a retrospective review of the last decade

Conclusions This case series demonstrates a previously unreported demographic in Scotland, as 50% of cases presented in Caucasian children. Although vitamin D deficiency DCM is relatively rare, it is wholly preventable. Our study confirms that vitamin D deficiency cardiomyopathy is reversible with prompt identification and supplementation. The current implementation of public health policy in the UK is failing to prevent children from developing the most severe manifestation of vitamin D deficiency.


Study of Vitamin D Status in Patients with Dilated Cardiomyopathy

Conclusion Patients with DCMP had lower Vitamin D levels than controls, and Vitamin D deficiency had a significant correlation with cardiac function. Therefore, screening for Vitamin D deficiency along with prompt treatment is recommended in patients with DCMP.


The heart is particularly noteworthy in that plasma 25-hydroxyvitamin D3 [25(OH) D3] levels have been shown to correlate inversely with the incidence of a variety of cardiac disorders including ischemic heart disease and heart failure.[3,4] Role of Vitamin D in myocardial contractility was demonstrated in a community study of 870 elderly patients without heart disease during which higher circulating Vitamin D levels were found to correlate with better left ventricular (LV) systolic function and smaller LV end-systolic diameter (LVESD).[


Vitamin D – Cardiomyopathy

Consequently, it has been considered that the leading cause cardiomyopathy in patients with rickets was longstanding hypocalcemia, but the exact mechanism of cardiomyopathy has not been understood [4].


Many reports of with hypocalcemia-associated reversible heart failure and dilated cardiomyopathy have appeared in international publications. Yilmaz et al. showed that eight patients who developed dilated cardiomyopathy and congestive heart failure because of marked rickets-associated hypocalcaemia were described between 1999 and 2012 in our country [9]. Brown et al. reported four patients with signs of dilated cardiomyopathy related to rickets and congestive heart failure at the ages of 4-10 months [10]. At admission, extremely low calcium and vitamin D levels were revealed in our patients. After calcium and vitamin D replacement, abnormal findings of calcium and vitamin D were corrected rapidly with the normalization of parathyroid hormone and left ventricular function improved.


Vitamin D3 could help heal or prevent cardiovascular damage

A new study shows that Vitamin D3 could help restore damage to the cardiovascular system caused by diseases like hypertension and diabetes.


Most importantly, these studies show that treatment with vitamin D3 can significantly restore the damage to the cardiovascular system caused by several diseases, including hypertension, atherosclerosis, and diabetes, while also reducing the risk of heart attack. These studies, performed on cells from Caucasian Americans and African Americans, yielded similar results for both ethnic groups.


“There are not many, if any, known systems which can be used to restore cardiovascular endothelial cells which are already damaged, and Vitamin D3 can do it,” Malinski said. “This is a very inexpensive solution to repair the cardiovascular system. We don’t have to develop a new drug. We already have it.”


Malinski’s team has developed unique methods and systems of measurements using nanosensors, which are about 1,000 times smaller in diameter than a human hair, to track the impacts of Vitamin D3 on single endothelial cells, a vital regulatory component of the cardiovascular system. A major discovery from these studies is that vitamin D3 is a powerful stimulator of nitric oxide (NO), which is a major signaling molecule in the regulation of blood flow and the prevention of the formation of clots in the cardiovasculature. Additionally, vitamin D3 significantly reduced the level of oxidative stress in the cardiovascular system.


Magnesium and Vitamin D Deficiency as a Potential Cause of Immune Dysfunction, Cytokine Storm and Disseminated Intravascular Coagulation in covid-19 patients

Magnesium and vitamin D each have the possibility of affecting the immune system and consequently the cytokine storm and coagulation cascade in COVID-19 infections. Vitamin D is important for reducing the risk of upper respiratory tract infections and plays a role in pulmonary epithelial health. While the importance of vitamin D for a healthy immune system has been known for decades, the benefits of magnesium has only recently been elucidated. Indeed, magnesium is important for activating vitamin D and has a protective role against oxidative stress. Magnesium deficiency increases endothelial cell susceptibility to oxidative stress, promotes endothelial dysfunction, reduces fibrinolysis and increases coagulation. Furthermore, magnesium deficient animals and humans have depressed immune responses, which, when supplemented with magnesium, a partial or near full reversal of the immunodeficiency occurs. Moreover, intracellular free magnesium levels in natural killer cells and CD8 killer T cells regulates their cytotoxicity. Considering that magnesium and vitamin D are important for immune function and cellular resilience, a deficiency in either may contribute to cytokine storm in the novel coronavirus 2019 (COVID-19) infection.


Analysis of serum cytokine and protective vitamin D levels in severe cases of COVID-19

Vitamin D is a group of fat-soluble steroids with a four-ringed cholesterol backbone. It is involved in calcium absorption, immune function, and protecting bone, muscle, and heart health. The most common vitamin D cholecalciferol (Vitamin D3) and ergocalciferol (Vitamin D2) are precursors of 1,25 (OH) 2D3 the active form of vitamin D.13 Previous clinical studies have been shown that vitamin D regulates cytokine and immune in acute viral respiratory infections.1417 Vitamin D increased the anti-inflammatory phenotype while the pro-inflammatory cytokines induced an inflammatory phenotype. Similar studies have shown that vitamin D inhibits the production of pro-inflammatory cytokines (IL-6, tumor necrosis factor-α [TNF-α], IL-1, IL-21, IL-10) by macrophages and T cells.1721 Analyzing data during the COVID-19 outbreak suggests that vitamin D plays a role in reducing the development of pneumonia and improving case fatality rates.17 Inflammatory cytokines include TNF-α, IL-1, and IL-6. IL-10 is an anti-inflammatory cytokine that downregulates the expression of Th1 cytokines, MHC class II antigens, and costimulatory molecules on macrophages. IL-21 is a cytokine that has potent regulatory effects on cells of the immune system, including NK cells and cytotoxic T cells that can destroy virally infected or cancerous cells. It has been associated with allergies, cancer, and viral infections.22


CONCLUSIONS COVID-19 virus induces cytokine production. It induces pro-inflammatory responses, proliferates efficiently from the human respiratory tract, those infected with viruses increase pro-inflammatory cytokine and chemokine production within 24 h. Levels of all viruses tested were measured and high cytokines were found, especially IL-6, TNF-α levels were found to be significantly higher. Our data in Table 1 show that the virus enables uptake and cytokine storm production. High levels of cytokine storm syndrome’ may be one of the critical hallmarks of COVID-19 disease severity. There is ample evidence that vitamin D is essential for normal immune and lung functions to fight pathogens and prevent autoimmune diseases. It is demonstrated that there exists the potential of vitamin D supplementation to prevent acute respiratory infection by modulating the innate immune response. As vitamin D therapy can reduce the COVID-19 disease burden, so daily supplementation is preferred to better outcomes in COVID-19 patients. Preventing vitamin D deficiency in patients with severe COVID-19 seems prudent as vitamin D deficiency is very common and it is associated with both an increased risk of various inflammatory diseases and increased susceptibility to infections including COVID-19.

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