Vitamin D therapy reduces Covid fatalities. Time for a VitD trial.Results in 4 weeks.

[Bettertobehealthy]

Following my earlier posts here on Mumsnet regarding the use of Vitamin D3 and beneficial effects against Covid. A new Lancet paper (Pre-print of study) of 20th Oct papers.ssrn.com/sol3/papers.cfm?abstract_id=3690902

It states: ' Treatment with vitamin D, regardless of baseline serum vitamin D levels, appears to be associated with a reduced risk of mortality in acute in-patients admitted with Covid-19 '

 This is a further indication that we are missing a great opportunity to cut our death rates and severity of illness when infected.   The retrospective study was carried out on the data of over 900 hospitalised patients from Leicester, Tameside and Preston hospital trusts.  Treatments with Vitamin D were either 800 IU -2000 IU   i.e maintenance doses, or  bolus doses of up to 300,000 IU  i.e. shots  

I have been proposing a trial be carried out, of Vitamin D3  loading doses for people that have just been diagnosed, i.e. hopefully at an early stage of illness prior to hospitalisation. The dose levels are perfectly safe for the overwhelming majority.  

The data from a pilot study in Spain (Cordoba Hospital)    <a class="break-all" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456194/" rel="nofollow" target="_blank">www.ncbi.nlm.nih.gov/pmc/articles/PMC7456194/</a> 
which used a Vitamin D derivative,  532 microgram doses of 25hydroxyD3 (i.e.  calciferol, or calcidiol) showed remarkable results.  A 25 fold reduction in patients requiring ICU after admission to hospital, when treated with 25hydroxyD3.   We can try to replicate that success using cholecalciferol ( Vit D3 supplement) ,  available  on the high street, online  etc etc.    By using daily doses of 10,000 IU   (250 microgram)  for 14 days upon diagnosis. Followed by  5000 IU daily for another 14 days .       At the end of this 28 day period , we should see a marked difference in outcomes between treated and untreated Covid positive people.  The two studies mentioned above should give us great hope, that this idea is correct.   Cholecalciferol is rapidly converted in the liver to  25hydroxyD3 (calciferol, ie. calcidiol) .  The half life of cholecalciferol is 24 hrs in the blood. 

  About a month ago I posted a more detailed explanation of this suggested trial here   in "general health".    <a class="break-all" href="https://www.mumsnet.com/Talk/general_health/4039300-A-Strategy-to-Limit-deaths-Caused-by-Covid19-Using-Vitamin-D-Therapy" target="_blank">www.mumsnet.com/Talk/general_health/4039300-A-Strategy-to-Limit-deaths-Caused-by-Covid19-Using-Vitamin-D-Therapy</a> 
            I have been trying to  interest  the health service/gov / parliament/  even media outlets to try and get this trial instigated.  The cost of the trial would be less that the cost of treating just one person that has complications from a stay in ICU. The contact data of Covid positive tested people would be required So the gov. needs to agree. Results should start to be known within 4 weeks.  The trial would involve sending  28 days worth of doses of VitD3  ( total cost £2 per person )  to  a selected sample of  Covid positive people, then, phoning the treated and untreated on a weekly basis, to establish whether they were still at home isolating or  hospitalised, or sent to ICU, or passed away.  The sample of people would be chosen to avoid those rare individuals with hypercalcaemic conditions  or possible contra-indications  such as  those on treatment with digoxin.  Selecting older individuals, such as over 50's, would give quicker results.     

 IF any readers here, can add their input to getting such a  trial done, maybe forward this idea to perhaps some official body, media outlet etc,  then please do. 
         Within a few weeks this could well give this country a way to cut many deaths, prevent ICU's being filled , reduce the need for lockdowns and reduce hospitalisations. At a cost that is insignificant when compared to the potential benefit.  We should start this trial immediately, there is nothing to lose and everything to gain. 
As a private individual, retired, I have no financial interest in VitD . I have  posted quite a bit about the physiology of VitD here on Mumsnet, over quite a number of years. 

Here is a thread where I posted quite a bit of detail about Vit D , and why we need it, why we are mostly too low, and what we can do about it. It is a long read , but might be helpful to some.
www.mumsnet.com/Talk/general_health/2841497-If-you-are-vitamin-D-deficient-what-have-you-been-prescribed

Best of luck to all
BTBH.
.

I agree @DianaT1969

I wouldn’t be looking for any kind of nutritional advice from the NHS.

We’re going in to winter. We live in a country in the northern hemisphere with a distinct lack of sunny weather. A huge amount of the population will be deficient but let’s tell them not to bother supplementing.

How many studies will it take do we think? Only it will be too late then.

That's pretty much what I said... just standing at a different angle!

And there have been a number of deaths in care homes attributed to overdose of vitamin D, one just last year.

My brother managed to get this raised as a question in the house of lords! The response was still "we will be doing everything we need to in every area" and nothing specific been done with this - even though it could have a massive impact on BAME who are suffering worse with Covid and may have naturally lower Vit D levels.

Actually laughing at the poster above about following the pathways.

I have two elderly parents. No one has mentioned vitamin d to them - ever. I have them both on 5000 iu all winter.

It’s not just for covid - respiratory illness generally not to mention other conditions too

It’s like Groundhog Day.

@Calledyoulastnightfromglasgow

Actually laughing at the poster above about following the pathways.

I have two elderly parents. No one has mentioned vitamin d to them - ever. I have them both on 5000 iu all winter.

It’s not just for covid - respiratory illness generally not to mention other conditions too

That was my point, as I said - take it up with those who should be following them!

20 years ago I ran a project with the care homes inspectorate. I was horrifed back then and havve no expectations of much improvement over the years. The majority of care homes for the elderly are run on a shoestring with only the very basics being done... not going into the quality of care either, I have too many friends who work in care homes and are at their wit's end!

Well funnily enough I did and the GP dismissed her.

This was when she suffered awful chronic UTIs. They offered her antibiotic after antibiotics.

I have got her off long term antibiotics - through a lot of measures - and one is an optimal level of vitamin d. Lots of other stuff too.

After five years of chronic infections she is delighted. Useless GP says it’s a “coincidence”

Couldn’t make it up!!!

I meant nationally!

And I agree. If more people had any idea of what actually does, or does not, happen in every care home across the land there would be a bloody uprising!

But as a society we don't ask!!!

Thanks for your posts @Bettertobehealthy, I fully concur with you. I really hope there's an enquiry about how vitamin D has been so overlooked in this pandemic, and more widely about both infectious and non-communicable diseases. Thing is, it's not so much a vitamin, as a hormone and crucial for metabolic functioning. Over 1000 genes are modulated by it, and with low levels, many things cannot function in the body.

The "standard" RDA given by the NHS of 400 iu is woeful. That is merely the level to prevent death from rickets/osteomalacia. Bones get first dibs on vitamin D, and higher levels are required for immunological benefits to kick in. The upper limit of 4000 iu should be recommended (with the caveat that you check with your doctor if you have any hypercalcaemia related conditions. Also, everyone get tested after a few weeks to check they are on course for optimum levels of 100 - 150 nmol/l). The threshold for severe/mild covid symptoms seems to be 75 nmol/l. UK direct to public postal testing available via NHS Black Country pathology here for £29

www.vitamindtest.org.uk/

Here's a long list of studies showing the efficacy of vitamin D with covid:

www.drdavidgrimes.com/2020/10/covid-19-and-vitamin-d-summary-of.html

My whole family has been taking multivitamins inc 100% of vitamin D since beginning of March because I thought "a few extra vitamins can only help 😂).

@delatron thank you, that's very interesting, I'll look further into this when I get a chance.

Also, I bought some cod liver oil tablets from Aldi yesterday for DH. It says on the back it contains 5 µg (200 iu) of vitamin D and is 100% of the RDA. This is ridiculously low and gross misinformation and likely to lead to many people who don't read up on vitamin D to think they're taking a sufficient dose... it's like giving someone crossing the Sahara a thimble full of water, it doesn't touch the sides.

(We both take 5000 iu of vitamin D3 per day separately, which is slightly above the upper RDA, but monitor our estimated levels via the DMinder app, which is calibrated to the parameters you set, such as weight, BMI, age, ethnicity, latitude etc)

The unfortunate thing about the Córdoba trial, excellent though it was, is that it was self-named a "pilot study". It was a legitimate RCT, but the word "pilot" means that it is not having the influence that is required.
If we are wanting to PREVENT Covid-19 infection, then vitamin D itself is adequate, ideally in a dose of 4,000 units daily. If someone is ill with Covid-19, TREATMENT is necessary, and this must be in the form of Calcifediol as was used in the Córdoba trial. Calcifediol is the part activated form of vitamin D, 25(OH)VitD. This is what is measured in the blood and it has been activated in passing through the liver. This can be a slow process. If vitamin D is taken by mouth, whatever the dose it takes one or two weeks to achieve optimal blood levels (>30ng/ml, >75nmol/L). Calcifediol given mouth achieves high blood levels within 2 hours. This is why it is this form of vitamin D that must be given as treatment.

@DavidGrimes - thank you for this. Can you speculate why consultants aren't giving all Covid admissions Calcifediol? Given that the Cordoba results were incredible and this treatment for most treatment has no adverse side effects?

I've also heard about the potential D vitamin link, that would be fab if it helps to lower mortality rates and the seriousness of the virus

@BahHumbygge

Also, I bought some cod liver oil tablets from Aldi yesterday for DH. It says on the back it contains 5 µg (200 iu) of vitamin D and is 100% of the RDA. This is ridiculously low and gross misinformation and likely to lead to many people who don't read up on vitamin D to think they're taking a sufficient dose... it's like giving someone crossing the Sahara a thimble full of water, it doesn't touch the sides.

(We both take 5000 iu of vitamin D3 per day separately, which is slightly above the upper RDA, but monitor our estimated levels via the DMinder app, which is calibrated to the parameters you set, such as weight, BMI, age, ethnicity, latitude etc)

There is a load of bad communication about the required dose of vitamin D.

The thing that I always remember when people say that 4000 IU is dangerous is that your body naturally produces ~4000IU of Vitamin D after half an hour in the sun.

The doses recommended by the NHS guidelines are way too low.

Thank you for this interesting thread.

I really hope more research is done into this

"a few extra vitamins can only help"

It's sadly common for them to contain very high doses of the ones that are cheap to put in which can be dangerous if taken for a long time. I'd check for warning labels on the bottle on multivitamins and anything being sold as high or megadoses. Supplemented B6, for example, is linked to nerve and brain damage at on-going high doses and B vitamins in general are the ones most likely to be overdone this way.

@Bettertobehealthy I've been on the high doses you're recommending, a few times. Vitamin D is a hormone (the supplements are a pro/prehormone) and there are Vitamin D receptors pretty much everywhere in the body. This can mean unexpected side effects which is why those on high doses should be overseen. On a 200,000 IU daily dose, my appetite went into the toilet to the point I could barely eat half a flatbread without feeling painfully full for nearly 12 hours and I started to heavily menstruate for several days even though my sex hormones were all normal. It definitely has its benefits, it would be great if more professionals thought to include nutrient panels for this sort of thing, but even without hypercalcaemia there are more risks to consider especially for those who are already ill and possibly have multiple deficiences. It's really not as simple as citrus.

We can't compare this to fruit or any other food. Vitamin D supplements are a dietary supplement, not a food supplement. For research and medicine there is an important difference. Nutritional yeast is very different to giving a Vitamin B supplement. Sitting in the sun is very different to a Vitamin D supplement. The body treats them very differently. We're not entirely sure why yet, that's part of further research much like the research being done on the importance of Vitamin K2 and more in Vitamin D being properly used by the body, but we already have guidelines for professionals to do as you're suggesting without further medical trials which won't guarantee any changes in behaviour.

Researchers would love if this was as easy as you put across, it would be great if everything that killed people and everything of merit got the funding, time, and tools needed to dig into. @How2Help's great posts didn't deserve those snide responses - being realistic is important if a goal is important.

Also, research has its limitations. I think we should focus more on the good research and recommendations already out there and question those who should be following them as @CuriousaboutSamphire mentioned.

I've dealt with professionals not following the guidelines a lot, it's a big issue, but more research into why the guidelines are good doesn't make more people follow them. It'd be great if research alone could do that, but for that kind of change, we'd need social (dis)incentives and systemic changes. I think that needs far more focus that than whether dealing with Vitamin D deficiencies helps the immune system. We already know that - knowing has never meant doing.

In response to DianaT1969, I find it incomprehensible that patients admitted to hospital with Covid-19 pneumonia are not treated with Calcifediol. The result of the Córdoba trial is the best that we have, supplemented by a further 18 studies demonstrating the importance of vitamin D. There is clearly no professional leadership. NICE has stated that the result of this study should not lead to any change in previous treatment. This is outrageous. Since the result of the Córdoba study became available on September 3rd, 6198 people in the UK has died from a combination of Covid-19 and negligence in not receiving the best treatment available. I despair at the unnecessary loss of life.

www.drdavidgrimes.com/2020/10/covid-19-and-vitamin-d-nice-fails-us.html

• Post edited to remove link

No no no, Mr Grimes!

You don't get to come here and direct us all to your wares!

You have just overstepped the T+Cs here and competely undermined anything you had to offer!

Shame on you usng the very real fears of people to self promote!

And yes, reported!

DavidGrimes I do believe that we have met in a previous life

This is an interesting thread. I myself have suffered with low vitamin D in the past, I have some absorption issues and my levels have taken years to rise to a good level on 4000 IU per day of D3. I have just had my levels checked via Medichecks to make sure that I have not gone too high. I will continue to take them throughout the winter months and will get them re-checked again at some point.

My levels were:

in 2013 - 18
in 2017 - 68
last week - 74

I have been trying get DH to take it too but no luck, he says that they make him dizzy, maybe I should try him on a lower dosage?

Re Covid, yes it utterly confusing why patients are not treated routinely with Vit D, it costs hardly anything?

OP I've been saying this since the start of Covid. Vitamin D is important in the body's ability to fight respiratory infection.

I'm BAME and only realised how important vitamin D is when I had my last child. He was born with his fontonelle open. The paediatrician was 100% it was due to low vitamin d levels. Low and behold we were both extremely low in vitamin d.

BAME pregnant women should be prescribed this as a general pregnancy related medication. And my opinion is it should be used in COVID patients.

@buttonmoon - I'm glad your deficiency was picked up and treated. I only found out recently that breast milk is generally deficient in vitamin D. It's no surprise when you think that many mothers are deficient themselves of course, but it doesn't seem widely talked about.

@DianaT1969 yes I'm glad it's been picked up. I've just had it re-checked and I was low again. I may have difficulty absorbing it.

I can fully imagine that the scale of vitamin d deficiency is far wider than thought, especially in pregnant/breastfeeding women. In particular those from the BAME community.

I think there will be an inquiry eventually probably 10 years down the line as to why the NHS didn't adopt the vitamin d treatment approach when it's effectiveness was proven.

The whole handling of Covid in the UK has been utterly awful.

@buttonmoon - regarding difficulty absorbing Vitamin D, I have heard that insulin resistance can block absorption. I don't have a medical background, so don't know how true this is. But if you are pre-diabetic, or over 40lbs overweight, or have yo-yoing weight issues, apparently insulin resistance is likely. There are ways to reduce resistance and become insulin sensitive again though. Intermittent fasting, low carb, Mediterranean diet, low GI foods, 5:2 etc.