Vitamin D: the New Covid-19 Chloroquine?

Did my masters on Vitamin D - It is very difficult to extract CLINICALLY RELEVANT information from retrospective epidemiological studies.<p>However, there a a few things that are clear:<p>1. Calcium absorption from the intestine increases with vitamin D supplementation dose up to around 8-10,000 IU D3 daily.<p>2. 15 minutes of full body exposure in noon sun is equivalent to a dose of ~20,000 IU D3<p>3. There are few cases of vitamin D overdose in the literature - doses in the 1,000,000 IU+ range within days is generally where symptoms are noted - this excludes people with kidney disorders.<p>Personally, I take 10k IU D3 a day. The D3 is important because D2 has 1&#x2F;2 to 1&#x2F;3 the effect per dose in raising calcium absorption levels.<p>I would recommend this level of supplementation to anyone who doesn’t have a kidney disorder.

Since I was a child I’ve been a walking respiratory illness machine. Bronchitis, sinusitis, flu, pneumonia, common cold, etc.<p>During “flu” season I was usually sick for the entire season with a rotating assortment of viral respiratory issues, this lasted until about 7 years ago.<p>8 years ago in September I started taking 10,000 IU of vitamin D3 and 180mg of K2 daily.<p>I haven’t had a deputies illness since. My children were getting sick at their normal clip, my wife the same, but not me. I went from being sick all the time to not getting sick ever. I made one change in my life, adding the D3 and K2.<p>After 2 years of not getting sick my wife and children started supplementing with D3 and K2, everyone stopped getting sick. My son went off to college and stopped taking the D3 and K2 and during the winter semester he got sick twice, he had me sent him the D3 and K2, he hasn’t been sick since.<p>It’s a small sample size, but even at 10,000 IU daily D3 is not dangerous or expensive, the only caveat seems to be that you need to supplement with K2 or you can cause gardening if the arteries due to calcification.<p>My doctor thinks it’s a lot of nonsense, but then again he wants every patient on blood pressure and cholesterol medication “just in case”.

All these articles about different individual nutrients start to feel like heath whack-a-mole.<p>How about this: to be in the best possible position to beat any serious infection, you need to be in generally good health.<p>That means having adequate levels of all essential nutrients - i.e., all the vitamins, minerals, amino acids, enzymes etc that you get from maintaining a good diet and healthy lifestyle over the long term.<p>To focus on just one nutrient as a pandemic looms just isn&#x27;t the answer; it&#x27;s not how health works.<p>That said, I&#x27;ve personally researched what nutrients (note the plural) are most important for beating an infection like this, and have adjusted my nutrient intake somewhat, and recommended to close relatives they do the same. But this is after I and they have spent many years researching and maintaining good health practices.<p>Update: if I was in not-so-good health (and not in medical treatment for a diagnosed condition, in which case, consult your doctor), my approach would be:<p>- boost my amino acids, fatty acids and minerals with a few spoonfuls of hemp seeds every day<p>- take extra supplements of vitamins A, B complex, C and D (and perhaps K?)<p>- do plenty of walking in the fresh air and sun,<p>- keep a generally healthy diet of good quality protein and veg.<p>Update 2: Others are mentioning Vitamin K, which seems like a good idea to supplement if you&#x27;re generally nutrient deficient, but may not be necessary if you have a good diet. [1]<p>Disclaimer: not a health professional, but have had personal reasons to get very knowledgable about health and diet over many years.<p>[1] <a href="https:&#x2F;&#x2F;www.healthline.com&#x2F;nutrition&#x2F;foods-high-in-vitamin-k" rel="nofollow">https:&#x2F;&#x2F;www.healthline.com&#x2F;nutrition&#x2F;foods-high-in-vitamin-k</a>

&quot;Adipose tissue (“belly fat”) appears to absorb but not release vitamin D. If we want to do some armchair hypothesizing, perhaps people historically used to lose weight in winter, which definitely would release the stored vitamin D just when it was needed.&quot;<p>This is an interesting idea. It&#x27;s believed our bodies get fat to ensure we have energy when food is scarce. It makes sense that we&#x27;d also want to have vitamins available too.

Sufficient levels of Vitamin D are good for your health in general, separate from this pandemic. Getting sufficient levels of it is something we all should’ve been doing before anyways, which is not true of Chloroquine.

I&#x27;m surprised the article barely mentions Vitamin K, which is needed along with Vitamin D - D to mobilize the calcium and K2 to put it into the right place.<p><a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC5613455&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC5613455&#x2F;</a>

Welp. I don&#x27;t think it&#x27;s gonna make <i>the</i> difference if I get COVID-19, but I did order some Vitamin D supplements. I live in a low-sunlight area, work indoors, and don&#x27;t drink a lot of milk. 75% of people in my region are Vitamin D deficient. I can put two and two together.

There are so many medical questions that can only be answered definitively with large-scale, years-long randomized experiments. Anything relating to supplements, where effect sizes are probably small, especially. These are expensive and difficult to perform and there&#x27;s (to my knowledge) no institution dedicated to that goal.

I feel like Vitamin D deficiency correlates with every disease. A large % of everyone has a vitamin D deficiency so there is always a high correlation.

This requires a huge correlation != causation flag.<p>The article briefly mentions this, noting that it’s possible vitamin D is just a sign of a healthy person, so of course they’ll do better with COVID. Another correlation that doesn’t get discussed whenever vitamin D comes up is that people with darker skin generally have less vitamin D, because our skin doesn’t absorb sunlight as much. We also know that COVID is disproportionately hitting colored neighborhoods in the US. Is that just because of vitamin D differences? Who knows!<p>By the way, if you are a person of color, you probably need vitamin D supplements. The recommended doses are for white people, so adjust accordingly.

With all this talk about Vitamin D and K deficiencies, which inevitable meanders onto Magnesium and fish oil supplements and whatnot; maybe it&#x27;s time for a &quot;vitamin subscription service&quot;? Enter a bunch of information (location, lifestyle, diet, health issues) and get tailor made supplements sent to your home every month? The levels of some vitamins could vary depending on time of year (more D in winter) or circumstances (more Mg when more active in summer).<p>Ideally all packaged into one tablet or something. I take an unholy cocktail of supplements to help curb my migraines, that&#x27;s 5 tablets&#x2F;caps a day. Not much fun.

FYI also, researchers are suggesting that the Lancet HCQ study everyone (and the WHO) references nowadays is fake: <a href="https:&#x2F;&#x2F;www.theguardian.com&#x2F;world&#x2F;2020&#x2F;may&#x2F;29&#x2F;covid-19-surgisphere-hydroxychloroquine-study-lancet-coronavirus-who-questioned-by-researchers-medical-professionals" rel="nofollow">https:&#x2F;&#x2F;www.theguardian.com&#x2F;world&#x2F;2020&#x2F;may&#x2F;29&#x2F;covid-19-surgi...</a>. The authors could not have had the data they claimed they had. This is just one bit of news you will never find on CNN.

The article &quot;Is Sunscreen the new margarine&quot; argues that <i>&quot;what made the people with high vitamin D levels so healthy was not the vitamin itself. That was just a marker. Their vitamin D levels were high because they were getting plenty of exposure to the thing that was really responsible for their good health—that big orange ball shining down from above.&quot;</i> [1]. If this is true, we have mistaken coincidence due to a common latent cause for causation.<p>The article &quot;Limits of Vitamin D supplements&quot; is a summary of the Lancet meta-analysis: &quot;Vitamin D status and ill health: a systematic review&quot;, which is paywalled [2]. The review shows that Vitamin D supplementation has no clinically beneficial outcome on heart disease, stroke, or cancer.<p>FWIW, I have been supplementing with Vitamin D for over a decade. I would rather like Vitamin D to work because I have chronically low levels and it would be good to have such a good silver bullet of a nutrient. I have not stopped my supplementation but I do take more frequent walks in the Sun.<p>[1] <a href="https:&#x2F;&#x2F;www.outsideonline.com&#x2F;2380751&#x2F;sunscreen-sun-exposure-skin-cancer-science" rel="nofollow">https:&#x2F;&#x2F;www.outsideonline.com&#x2F;2380751&#x2F;sunscreen-sun-exposure...</a><p>[2] (<a href="https:&#x2F;&#x2F;well.blogs.nytimes.com&#x2F;2013&#x2F;12&#x2F;11&#x2F;limits-of-vitamin-d-supplements&#x2F;" rel="nofollow">https:&#x2F;&#x2F;well.blogs.nytimes.com&#x2F;2013&#x2F;12&#x2F;11&#x2F;limits-of-vitamin-...</a>)

My anecdote. I learned about the importance of D3 on Steve Gibson&#x27;s podcast about a decade ago. At the time had a kid in preschool and spent almost the whole year sick, so was quite intrigued.<p>Started with 1,000 IU a day and getting sick stopped abruptly. For the last decade or so, haven&#x27;t been sick more than one day, two at max, with one exception.<p>Yes, believe I had CV in March and &quot;walked it off&quot; in about 6 days or so with mild symptoms.<p>Last few years I&#x27;ve taken 5,000 IU several times a week (from Trader Joes, which has an excellent price of $4.99). As compared to Albertsons which disgustingly tries to get $15-20 for the same thing. Unfortunately this news has made both C and D unavailable at Trader Joe&#x27;s for months. We&#x27;ll run out soon and need to buy the gouging price somewhere else.

For me this is a perfect example of wishful thinking.<p>It&#x27;s really hard for average person to accept reality: This virus, like all others, will last for a long time. We won&#x27;t have, in a foreseeable future, a treatment neither a cure. Cancer, HIV or even seasonal flue are good examples examples of diseases that were discovered decades ago for which science still don&#x27;t have a cure, there are a few treatments or easing medication, but none of them can be actually cured.<p>I expect that people will move from crazy solution to another on a regular basis until a final cure is found.. my expectation is this will last for years.

dminder is a great app to estimate Vitamin D &quot;intake&quot;&#x2F;production through sun exposure (and also food, albeit this won&#x27;t matter much for most people):<p><a href="http:&#x2F;&#x2F;dminder.ontometrics.com&#x2F;" rel="nofollow">http:&#x2F;&#x2F;dminder.ontometrics.com&#x2F;</a><p>I only wish the algorithm used to derive the estimates was public&#x2F;documented somewhere ...<p><a href="http:&#x2F;&#x2F;dminder.ontometrics.com&#x2F;Estimation.html" rel="nofollow">http:&#x2F;&#x2F;dminder.ontometrics.com&#x2F;Estimation.html</a>

I definitely dug out my vit D pills as a result of the coverage. Worst case scenario it creates expensive pee. Maybe it&#x27;ll have some upside though

These studies need to keep up until we can fully account for the difference in fatality not only worldwide, but state to state.<p>Why has Japan, with an older population (median age 47), a tiny island, crowded indoor subways —- has only experienced 900 deaths and never locked down! while some zip codes in New York experiences 2x that amount.<p>Even state to state the difference is alarming.

One difficulty in determining if vitamin D actually helps with COVID is determining if vitamin D levels are directly affecting outcomes or whether they are a proxy for something else. For example: are low levels a proxy for people who don&#x27;t go outside much and therefore don&#x27;t exercise?<p>That&#x27;s a huge problem in medical studies generally.

Very good writeup<p>That being said, VitD has <i>much fewer</i> potential side effects than CQ (in the recommended dosage)<p>On this epidemic we should be looking at potential preventative quick gains, especially as the most disrupting solutions are, well, disrupting.

Covid or not, you should test for vitamin deficiency and supplement if necessary. I do it every 3 month via Thriva (UK) and can see the progress.

How can you do science for long term effects?<p>where RCTs are not possible.

Having read this whole piece, I think my review is much more comprehensive in covering all relevant evidence: <a href="http:&#x2F;&#x2F;agingbiotech.info&#x2F;vitamindcovid19&#x2F;" rel="nofollow">http:&#x2F;&#x2F;agingbiotech.info&#x2F;vitamindcovid19&#x2F;</a> Note that the title changed and many improvements made since it was first posted to HN 3 weeks ago here: <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=23119949" rel="nofollow">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=23119949</a><p>In the title of this piece, analogizing to chloroquine is irresponsible. A high % of readers will take the message to stay away from D and never read the rest.<p>I&#x27;m glad he has a similar top-level rec as me: Take all measures to avoid deficiency, probably by D3 of 2000-4000 IU&#x2F;day (I&#x27;d prefer 4000). The piece unfortunately fails to make the other most important top-level comment: that all COVID-19 patients should have their D levels tested and more data on D &amp; COVID-19 severity should be published urgently (possibly based on records that already exist). And all clinical trials for COVID-19 should be testing D levels as well.<p>Overall, this piece is not emphatic enough that vitamin D may significantly help during this COVID-19 crisis.<p>Several important responses to some of the top material in this piece:<p>The NYT article dismissing Holick is terrible and not worthy of being linked at the top of this piece. I won&#x27;t go into the point-by-point criticisms of this article, but it&#x27;s not worthy of a piece that is supposed to be weighing evidence.<p>The bullet point claiming the COVID-19 association could still be a fluke does not adequately acknowledge the causal aspects of the evidence: Many RCTs on D supplementation helping viral&#x2F;respiratory infections (Martineau et al BMJ 2017), D causally affecting rate of aging in roundworms, causal inference model overwhelming supporting D&#x27;s role as causal, studies on the correlation correcting for age, sex, comorbidities, and reverse causality, and causal mechanistic biological arguments. Some portion of the strength of the correlation seen in the 1000+ patient cases published in preprint studies so far may be due to other causal factors, but the causal evidence so far makes it very unlikely for the full extent of the large effect size seen to all be a fluke.<p>The piece wrote: &quot;A healthy full body exposure to sunlight can generate 25000 IU of vitamin D in one sitting, without getting burned. 2000-4000 IU daily of D3 supplements will also work.&quot; No. People wrongly believing that some sun gives them enough is probably one of the causes of widespread deficiency. From my review, in the &quot;Practical considerations for avoiding D levels that are too low&quot; section: There are several studies showing that even a lot of sun exposure leaves many people with insufficient D levels. For one list of studies see Tsiaras &amp; Weinstock, “Factors influencing vitamin D status” Acta dermato-venereologica, 2011: “Studies in Hawaii (97), South Florida (98), Southern Arizona (99), Brazil (100), rural India (101) and Queensland, Australia (102) found that significant proportions of the study populations had low vitamin D levels despite abundant sun exposure.” For example, in the Hawaiian study, 51% of the 93 young, non-obese adults had D&lt;30ng&#x2F;ml despite 29hr&#x2F;week (&gt;4hr&#x2F;day) in the sun at latitude 21 degrees. The variability in both seasonal sun intensity and daily hours of exposure for any given individual provide yet another reason that testing blood levels would be helpful. These studies show that even those who seem to get a lot of sun exposure should probably supplement if not testing to ensure adequacy.<p>Also, the bullet point summary in this piece fails to point out the history of the RDA being set too low by statistical mistake. (Which I&#x27;ve updated my review to include. The story is crazy---the original data used to set the RDA would have resulting in 8000 IU&#x2F;day if it had been analyzed correctly.)