Vitamin D – Part 3
In the first two articles of this series (here and here), I described vitamin D from concept, deficiency, toxicity to what is the recommended vitamin D levels during the pandemic.
In this third article, I am going to talk about the results of the first randomized controlled trial on vitamin D after the pandemic, important takeaways on vitamin D to keep in mind, and the recommendations for adequate vitamin D intake.
What says the first randomized controlled trial on vitamin D?
Thankfully, on August 29/2020, we had released the first study on vitamin D, a randomized controlled trial. The trial was conducted in Cordoba, Spain, at the Reina Sofia University Hospital, and included 76 hospitalized patients with COVID-19 with acute respiratory infection, and the results are remarkable, as you can see below: (1)
All the 76 COVID-19 patients received the same hospital protocol treatment or a combination of:
. Hydroxychloroquine (400 mg every 12 hours on the first day, and 200 mg every 12 hours for the following 5 days).
. Azithromycin (500 mg orally for 5 days) and for patients with pneumonia a “broad-spectrum antibiotic (ceftriaxone2 g intravenously every 24 hours for 5 days) was added to hydroxychloroquine and azithromycin.”
And then, they divided these 76 patients in 2 groups:
. 50 patients received the treatment above plus vitamin D supplements.
The 25(OH)D doses used in this study were described in mcg (microgram), and the equivalent in IU (international unit) is 106,400 UI on day 1, 53,200 IU on days 3 and 7, and 53,200 IU weekly subsequently. And if these doses were given as daily doses, would be around of 30,400 per day for the first week, followed by a maintenance dose of 7,600 IU per day until discharge, ICU admission, or death.
. 26 patients just received the treatment above, and no vitamin D supplementation.
The results:
. In the controlled group that was not taking 25(OH)D, 50 percent of the patients required ICU admission, and there were two deaths.
. And in the group taking vitamin D, only 2 percent of the patients were admitted to the ICU, and all patients were discharged, with no deaths.
What is the significance of this RCT result?
The findings in this study are very significant, and Chris Kresser in his email on this topic commented,“in short, taking vitamin D virtually eliminated the risk of ICU admission—and may completely eliminate the risk of death—from COVID-19”
Chris also said that “these results will need to be replicated before we can get too excited. But if that happens, they are truly game-changing. They suggest that maintaining adequate vitamin D levels should be a strong part of the public health messaging around protecting against COVID-19, and that therapeutic doses of vitamin D should be used in the treatment”. And for more details at the relationship between vitamin D and COVID-19 and instructions on supplementation he recommends to visit www.StopCOVIDCold.com.
Likewise, Dr Masterjohn said that the results of this first randomized controlled trial “of vitamin D in COVID-19 are astounding because vitamin D nearly abolished the odds of requiring treatment in ICU. Although the number of deaths was too small to say for sure, vitamin D may actually abolish the risk of death from COVID-19”.
Amazing, isn’t it?
Recommendations for adequate Vitamin D intake
It is very difficult to determine a precise minimum vitamin D intake to sustain serum 25(OH)D concentration in the normal range. And the exact vitamin D dose you need will differ depend on many variables as you can see below: (2)
. Your 25(OH)D level or your mobilized body store level
. How far below 30 ng/mL your 25(OH)D level is
. Your body weight
. Your health status or if you are overweight or any health condition
. Your culture and skin color
. Your gut health and how you are absorbing your nutrients
. Your nutrient status
Chris Kresser says that “since many of these factors are not easily knowable, most people can target a dose of ~4,000 to 8,000 IU/day. If your 25(OH)D levels are well below 30 ng/mL, and/or you are overweight or have other health conditions, aim for the higher end. If your levels are close to 30 ng/mL already, and/or you are lean and healthy, aim for the lower end. The overwhelming majority of studies have shown that there is no risk of taking up to 8,000 IU of vitamin D per day.”
Also, Chris recommends " to consider a higher dose of vitamin D if you contract COVID-19. If you happen to contract COVID-19, consider taking a higher dose of vitamin D for a short period of time—especially if you don’t know what your D levels are, or if you know you’re deficient”.
Dr Chris Masterjohn said that” maintaining 25(OH)D 30-40 ng/mLis likely to be strongly protective against having a severe or fatal COVID-19 case. Also, he recommends that If one goes into an illness with 25(OH)D levels much lower than this, one could quickly bring the level up using a bolus dosing approach as described in the RCT by using 100,000 IU on the first day, 50,000 IU on the third day, 50,000 IU on the seventh day, and then switching to the maintenance dose of vitamin D used in this study by taking 7,600 IU per day upon the onset of symptoms through recovery.
Otherwise, Dr Masterjohn says that “supplementing with a maintenance dose of 7-8,000 IU per day during illness, is likely to be strongly protective against severe and fatal cases”.
And this gives us so much hope…
Important tips on Vitamin D to keep in mind
Based on the information above, you can find below the most important tips on vitamin D:to keep in your mind:
. The safest way before start taking D vitamin in the form of supplement is to ask your doctor to test your blood 25(OH)D levels to be sure if you should take supplements (or not)
. If your 25(OH)D levels are between 30 and 60 ng/mL you don’t need supplements
. If your 25(OH)D level is 20 or less, you should consider taking a vitamin D supplement. Likewise, you should do changes in your diet and lifestyle in order to raise faster your vitamin D levels
. If your 25(OH)D level is slightly below 30 ng/mL, you need supplements, carefully monitored by a healthcare professional
. If your 25(OH)D level is between 30-40 (ideal level), you should avoid taking vitamin D supplements at all, and need to keep doing everything you are doing to maintain your levels between these numbers
. Re-testing 25(OH)D levels after supplementing for 2-3 months is the safest way to know if you should continue taking supplements or not. Also, following up with a 25(OH)D blood work will help your vitamin D blood levels not to rise way too far into a toxic level
. When 25(OH)D levels return to a normal/healthy level, you should reduce the dose or discontinue the use of supplements
Also, it is important to keep in mind that nutrients usually don’t do their job in isolation and depend on one another to maintain their balance. They work in a perfect synergy. For this reason, we should keep monitoring 25(OH)D levels while supplementing in order to avoid imbalances in our fatty soluble vitamins in our body. (And I am going to talk about this topic in the next article) (3, 4, 5, 6)
In the next article, I am going to talk about how we can get vitamin D, the basics of each vitamin D source, the use of sunscreen, and more.
I hope it was helpful.
Please, leave a comment or question in the link below.
See you soon.