By Susan Macafee

Vitamin D -

Information on low levels of vitamin D and COVID - 19, complications and mortality are slowly becoming available, since Spring is here and the sunshine on the human skin would be making vitamin D. However, the information was not propagated during the winter months, when people were deficient in vitamin D, and COVID - 19 was running rampid in the northern hemisphere of the planet.

Dr. Michael F. Holick, Ph.D., M.D., Professor Boston University School of Medicine and a world expert in vitamin D research, published a medical paper on an extensive over view of vitamin D in 2013, entitled "Sunlight and Vitamin D - A global perspective for health."  In the section, "Factors that Influence Cutaneous (affecting the skin) Vitamin D₃ Synthesis / Zenith Angle" of the medical paper, he states:

 "This is the explanation for why during the winter when living above and below approximately 33° latitude very little if any vitamin D₃ can be produced in the skin from sun exposure. People who live farther North and South often cannot make any vitamin D₃ in their skin for up to 6 mo of the year.⁴¹  33° latitude north - put cursor over desired location and click to expand area.

Dr. Holick, continues and states:

"Air pollution including nitrous oxide and ozone is common in many large cities including Los Angeles and San Diego (Fig. 26) and will absorb solar UVB radiation and therefore reduce the effectiveness of sun exposure in producing vitamin D₃ in the skin (Fig. 27).^40,45 The amount of UVB radiation available for cutaneous vitamin D₃ production is markedly reduced by the increase of sulfur dioxide in San Diego and Los Angeles, offsetting the fact that both cities are at lower latitudes.⁴⁵"  "Figure 26. The amount of sulfur dioxide (ppm) measured over a one hour period in San Diego, Los Angeles, San Francisco, and Sacramento on the same day. ⁴⁵"  

On March 22, 2020, Tom Frieden M,D. former director of the Centers for Disease Control and Prevention (CDC), joins John Roberts on 'Fox News Sunday.' Dr. Frieden gives his opinion in the Fox's Opinion NewsLetter on the challenges the US faces as the COVID -19 pandemic spreads. Former CDC Chief Dr. Tom Frieden: Coronavirus infection risk may be reduced by Vitamin D.

 "Vitamin D supplementation reduces the risk of respiratory infection, regulates cytokine production and can limit the risk of other viruses such as influenza. A respiratory infection can result in cytokine storms – a vicious cycle in which our inflammatory cells damage organs throughout  the body – which increase mortality for those with COVID-19. Adequate Vitamin D may potentially provide some modest protection for vulnerable populations."

"This is especially important for people who are Vitamin D deficient – and, surprisingly, that might include more than 40 percent of US adults. People who live in the northern part of the U.S. are at greater risk of deficiency."

 "We can do lots of things to improve our resistance to infection. Taking a multivitamin that includes Vitamin D, or a Vitamin D supplement, probably can’t hurt, and it might help."

The medical journal Nutrients, published on April 2, 2020, Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. The medical paper of 19 pages, with 157 references, was a group effort by seven people. In addition to vitamin D, vitamin C is also covered, in this open access medical paper, with a down loadable PDF file.

In the abstract, the group stated:

"Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins (mammalian anti‐microbial proteins) that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not."       

  "Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended  that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40–60 ng/mL (100–150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations."

On May 1st 2020, Environmental Health News published "Pittsburgh region is a hotspot for air pollution and COVID-19 deaths: Report." The information was compiled and published by the National Resource Defense Council (NRDC), in response to a recent (May 5th) Harvard study that found Americans with COVID-19 who live in places with high levels of air pollution are more likely to die from the disease than people who live in less polluted places.

Another internationally recognized expert on vitamin D, is Professor Emeritus Dr. Bruce Hollis PhD, Medical University of South Carolina (MUSC), with 40 years of research experience with vitamin D. On May 1, 2020, he was interviewed by NBC WBTW 2 Myrtle Beach, South Carolina. In the news story "MUSC: Could Vitamin D and COVID-19 be linked?," he and a colleague will be leading a research team to study high-risk individuals with low levels of vitamin D, who also had increased severity of COVID-19 infection and worse clinical outcomes.

The 15 member research team will investigate the relationship between vitamin D and COVID -19 patients, the deficiency found in African-Americans, older populations, and  nursing home residents who have little exposure to sunlight. The story also states that "Dr. Hollis recommends taking a Vitamin D supplement daily. His recommendation for the average adult is 4000 to 6000 IU (international units.) Daily supplements of Vitamin D intake can take days to metabolite and about three months to create a steady level, according to Dr. Hollis. He recommends getting Vitamin D blood levels tested once a year if you do not take supplements regularly."

Three YouTube videos on Vitamin D are posted on a Google search for Dr. Bruce Hollis PhD, two videos are posted by the University of California.

Last year, Dr. Ron Hunninghake, MD, Chief Medical Officer of the Riordan Clinics in Kansas, presented information on the combination of Vitamin D3 with Vitamin K2 - MK7. One presentation, Vitamins D3 and K2 - The Dynamic Duo is in print and the second one is a YouTube video The Importance and Safety of High-Dose Vitamin D3.

The Orthomolecular Medicine News Service, on April 9, 2020 release this news story "Vitamin D Supplements Could Reduce Risk of Influenza and COVID-19 Infection and Death."

"Vitamin D deficiency has been found to contribute to acute respiratory distress syndrome, a major cause of death associated with COVID-19 [3]. An analysis of case-fatality rates in 12 U.S. communities during the 1918-1919 influenza pandemic found that communities in the sunny south and west had much lower case-fatality rates (generally from pneumonia) than those in the darker northeast [4]."

 "To reduce risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/day (250 micrograms/day) of vitamin D for a few weeks to rapidly raise 25-hydroxyvitamin D [25(OH)D] concentrations, followed by at least 5000 IU/day. The goal should be to raise 25(OH)D concentrations above 40-60 ng/ml (100-150 nmol/l), taking whatever is necessary for that individual to achieve and maintain that level."

On May 7, 2020, Science News posted an article Vitamin D levels appear to play role in COVID-19 mortality rates: Patients with severe deficiency are twice as likely to experience major complications. The article was about findings from a  group of researchers from Northwestern University, who analyzed patient data from 10 countries.

"By analyzing publicly available patient data from around the globe, Backman and his team discovered a strong correlation between vitamin D levels and cytokine storm -- a hyperinflammatory condition caused by an overactive immune system -- as well as a correlation between vitamin D deficiency and mortality."

"Cytokine storm can severely damage lungs and lead to acute respiratory distress syndrome and death in patients," Daneshkhah said. "This is what seems to kill a majority of COVID-19 patients, not the destruction of the lungs by the virus itself It is the complications from the misdirected fire from the immune system."

In a Medscape News Alert on May 11th, 2020, in the section "Perspective > Medscape Ob/Gyn > Manson on Women's Health," Dr. JoAnn E. Manson, MD, DrPH, a professor of medicine at Harvard Medical School, and  chief of the Division of Preventive Medicine at Brigham and Women's Hospital, in Boston, Massachusetts, provided a commentary. Does Vitamin D Protect Against COVID-19?  Dr. Manson during COVID - 19, recommends, "a multivitamin or supplement containing 1000-2000 IU/daily of vitamin D would be reasonable."

"Vitamin D is important to innate immunity and boosts immune function against viral diseases. We also know that vitamin D has an immune modulating effect and can lower inflammation, and this may be relevant to the respiratory response during COVID-19 and the cytokine storm that's been demonstrated."

"There are laboratory (cell-culture) studies of respiratory cells that document some of these effects of vitamin D. There's also evidence that  patients with respiratory infections tend to have lower blood levels of 25-hydroxy-vitamin D."

 "There's now some evidence from COVID-19 patients as well. In an observational study from three South Asian hospitals, the prevalence of vitamin D deficiency was much higher among those with severe COVID illness compared with those with mild illness. In fact, there was about an eightfold higher risk of having severe illness among those who entered with vitamin D deficiency compared with those who had sufficient vitamin D levels."

On May 12,2020, Science Daily posted in "Science News," the news story "Vitamin D determines severity in COVID-19 so government advice needs to change, experts urge - Researchers point to changes in government advice in Wales, England and Scotland'."

"Researchers from Trinity College Dublin are calling on the government in Ireland to change recommendations for vitamin D supplements."

"The authors of the article, just published in the Irish Medical Journal, analysed all European adult population studies, completed since 1999, which measured vitamin D and compared vitamin D and death rates from COVID-19. The article can be viewed at: Arrows on first page - bottom left to get Page #4, "Vitamin D Debate," - "Vitamin D and Inflammation:"  Page 81,

                    http://imj.ie/irish-medical-journal-may-2020-vol-113-no-5/

Also on May 12, 2020, Samuel Lovett wrote an article in the "Health Section" of the English newspaper the Independent, "Coronavirus: Vitamin D likely to reduce complications among patients, study finds," 'Strong circumstantial evidence of associations between vitamin D and the severity of Covid-19 responses, including death,' say researchers."

"Researchers from Trinity College Dublin, the University of Liverpool and   the Irish Longitudinal Study on Ageing (TILDA) examined the association between vitamin D levels and Covid-19 mortality rates."

Dr Eamon Laird and Professor Rose Anne Kenny, who co-authored the paper, found vitamin D can help support the immune system through a number of pathways involved in fighting SARS-CoV-2, the virus that causes Covid-19.

“Whereas there are currently no results from randomised controlled trials to conclusively prove that vitamin D beneficially affects Covid-19 outcomes, there is strong circumstantial evidence of associations between vitamin D and the severity of Covid-19 responses, including death,” said  Professor Kenny of Trinity College."

A YouTube video Vitamin D Suppresses the Cytokine Storm, was posted on May 14, 2020 by Dr. Eric Berg, a.k.a 'The Knowledge Doc,' Acquires 3.5 Million Followers on YouTube - MarketWatch. Dr. Berg D.C., is a former chiropractor, with two years of medical school education, is a bestselling Amazon author, blogger and health educator from Alexandria, Virginia. He also worked as a part-time adjunct professor at Howard University, Washington, DC. 

Additional information - The Orthomolecular Medicine News Service

Susan,

Thank you for so thoroughly making the case for Vitamin D and the immune system.

Too bad we don't see more of this information in the news today.

I wonder how many of us are taking Vitamin D supplements?  I am.....

Joyce (Wilson) Hodgkinson