Public Health England don't hold any data on vitamin D deficiency

[DianaT1969]

Is anyone else surprised by this? I made a FOI request regarding data on vitamin D deficiency in Covid-19 admissions.
They responded that they don't hold any data at all on this subject.
Zero interest by PHE in collating and analysing the data on vitamin D deficiency in the population during a pandemic.

I would try FOI'ing NHS England and the Department of Health as well. NHS England collect all sorts of data related to hospital admissions/activity.

Why would they? Public health England deals with public health concerns of which vit d deficiency isn’t one. Data on Vit deficiency is more of a medical than public health issue so would likely be Held by NHS England so they might be a good place to try ( although don’t get me started on government bodies not communicating properly or sharing data effectively). As a former government researcher I’m sure they are all working ridiculously hard at the moment, but In Contrast to what you read in the daily mail about the civil service, government research is also woefully undermanned, underpaid and underfunded. I imagine they they are flat out and anything on vit d would be a nice to have and not essential at this point!

You see I expected PHE to be interested in eliminating vitamin D deficiency during this pandemic.
Their website says:
We exist to protect and improve the nation's health and wellbeing, and reduce health inequalities.
We are responsible for:

• making the public healthier and reducing differences between the health of different groups by promoting healthier lifestyles, advising government and supporting action by local government, the NHS and the public.

-protecting the nation from public health hazards.

Another report on the benefits of vitamin D in fighting Covid from the University of Australia published this week.
www.eurekalert.org/pub_releases/2020-12/uosa-hv121420.php

VitD deficiency is not a PH issue - NHSE is the best place to look for this info. I think they're overrun with protecting the nation against COVID right now, not that the public aren't getting enough sunlight.

@MaMad9090 - if only catching sunlight was the issue. I think some people on this thread are unaware of research carried out in other countries on vitamin D and Covid. This link is old - from early October, but gives a useful insight.
www.bmj.com/content/371/bmj.m3872/rr-5
A request in the BMJ for PHE to rectify the UK's deficiency.
Out numbers are second only to Belgium in severity in Europe, I believe.
www.bmj.com/content/370/bmj.m3473/rr

Wouldn't SACN be the place to search? I've read reports on deficiencies from them in the past www.gov.uk/government/groups/scientific-advisory-committee-on-nutrition

Thanks for the link. In the UK, SACN appear to be doing rapid reviews of past trials only. No data on 2020 Covid patients. The Queen Mary trial authorised I'm October is a long, slow one - around 6 months, sothe results should be available in Spring. It was also conservative on dosage, in comparison to the recommended dose in other countries.

I don’t think we’re necessarily doubting the link between vit d and covid, it’s well known that vit d helps your immune system so it stands to reason that covid would be no different. Our point is that it’s not a public health issue, and that there are other bodies that are better placed to provide answers. I hope you find the data you’re looking for, but there are many many things in this pandemic that are rightly taking analytical priority at the moment in government, so you might find academia a better resource .

@Aurora791 - thanks for answering. Do you think if the UK's population hadn't been widely vitamin deficient at the start of the pandemic, that there would have been so many serious cases and deaths?
The Cordoba study would strongly suggest not. Let's assume 40% are deficient in winter - I can't find accurate figures, but that seems conservative based on what I've read. Noting thst course elderly, BAME and obese people are more likely to be deficient.
I believe that's an urgent matter for public health bodies to research and rectify. If I was health minister (and I wouldn't want his job 🙂) I wouldn't have led the nation into the 2nd winter wave in a state of vitamin D deficiency. It doesn't cost much - it just needs a strong public message for people to buy it in a dose that can increase levels from deficiency. For care homes and hospitals to give it. The message has been weak to say the least.

Why would widespread vitamin D deficiency not be a public health issue? If most people are deficient by the end of winter it's surely a public health problem.

It's not a nutrition issue, because we don't generally get it from food (unless you eat a HUGE amount of fish)

Medical staff can't be bothered to record it properly - it's too much paperwork

Article in the Times today saying no link between Vit D and protecting against Covid.

I'm not surprised that there is no data on this because the NHS assumes that most people will be deficient in Vit D during a UK winter and so advises that everyone takes a supplement between September and March I think (if that makes sense?).

In my experience GPs are also pretty crap when it comes to Vit D. My DDad had a bad psoriasis flare up a couple of years ago and when I asked if taking it would help the GP was really snarky and asked me why I thought he'd be deficient and then gave a big sigh and said I suppose we could test him if you insist. Lo and behold he was low to the point of needing high strength prescription only ones.

I think GPs should probably be reminding their patients if they see them in autumn but other than that, do people take notice of public health campaigns?

Article in the Times today saying no link between Vit D and protecting against Covid.

I don't think it did say that, I think it said there is 'not enough evidence' to support taking Vit D to prevent Covid 19 and that more research was needed. At least that's what it said in the paper version. I don't know about the on-line version.

The Times (and Sky article) was what prompted by post. It's nothing new. Just SACN and NICE confirming that they haven't researched this. No UK trials. More research required. I'm not sure if they plan to do it during this pandemic, or they'll wait for the next one.
We have blood from 3
100,000+ people who were admitted to hospital with serious Covid. It's not too much to expect that they analyse the data.
It's like me saying: "there's no evidence to suggest I would lose weight on a low calorie diet. Want to know why there's no evidence? I've never eaten a low calorie diet 😄."

I don't know how labs test for Vit D or whether it is a complicated/expensive test, but in my experience GPs seem pretty reluctant to test for it. I guess during a pandemic, lab staff are overwhelmed with testing for the virus plus doing all the tests required for a seriously ill person and so piling more work onto them in the name of research is unjustified. Particularly when people should be taking supplements anyway.

In our household we take low level Vit D all year round and only skip it if we're out in the sunshine during summer.

Some doctors are fully on board with the importance of vitamin d and others aren’t moved at all. I’ve worked with at least one consultant who’s been banging on about it for years and very generous with vitamin D injections to start people off on a loading dose

Particularly when people should be taking supplements anyway

It’s not really that straight forward for everyone. Lots of vitamin and mineral deficiencies aren’t obvious unless they’ve been tested for and not everyone metabolises supplements easily.

I’m consistently low in ferritin and vitamin d (currently around 37 despite taking a strong supplement throughout the summer and consciously monitoring my diet, adequate is considered >50), no idea why but that’s just how I seem to be.

I’m not bugging my GP about it, but we both know I’m deficient and we’re both aware of the importance of it regarding covid. My point is people can do as much as they can independently to manage their vitamin levels but it’s working blind without blood testing.

I agree. My DDad's dermatologist agreed immediately to testing him and issued the high dose prescription before the results were back.

But I think GPs are more variable. I do wonder if all GPs keep up to date with the guidelines. The number of women on MN who have had to quote NICE guidelines to their GPs to get HRT or treatment for an underactive thyroid is worryingly high.

And I agree it is working blind without the testing but I think a lot of GPs are reluctant/unaware of the necessity to do that testing.

I agree some GP’s are reluctant to test. I presume it’s a mixture of cost and not being convinced of the importance of it.

I suppose it depends on whether the GP in front of you is particularly conscious of preventative healthcare over reactive treatment. I have noticed hospital consultants are much keener to make sure their patients have a good foundation regarding their basic health even if it’s not directly related to what they’re treating. GP’s not so much; I can only put that down to different budget priorities but I don’t know that for certain.

Seems bonkers when it’s such a simple process in most cases.

In our area GPs can only request a vitamin D level if there is a specific indication eg if one suspects a patient of having a calcium metabolism problem. In general the assumption is that we are all vitamin D deficient in the uk and that there is no reason not to take supplements . The recommendation has been for all to take vitamin d in the winter for several years now and for the housebound and dark skinned to take it year round. Chemists advise on this regularly. The elderly are now being provided with it free but in general it is something to buy over the counter.

A small percentage of the population will even be aware there is any advice that they should take vitamin D supplements in winter. Not a single mention of this was made to me while pregnant nor whole breastfeeding (for me or my children) by either the midwife or health visitor, even though it was official advice even back then. Even with all the campaigns for years about sunscreen and avoiding strong sun - no mention of the knock on effects on vitamin D in the messaging until very recently; it’s almost as though they don’t want people to make the link between protecting yourself from the sun and ending up deficient in a vital hormone. Recommendations to take supplements are lacklustre at best.

Given the links that have been made between sunlight/vitamin D and multiple sclerosis, the return of rickets and osteomalacia as not-so-rare conditions, and so many people spending most of their daylight hours indoors even pre-pandemic, this does seem bizarre. And to suggest it is not a public health issue is also weird, tbh. It really does come across as not wanting it to be a public health issue, because that would be a hassle, and nobody thinking they can make any profit out of research into it, because vitamin D is cheap.

I think people don't realise that GP's don't have the autonomy to test everyone they might want to. With the growth in demand for vitamin D testing most areas slapped in guidelines about who could be tested (due to budget reasons). As the GPs are many people's main experience of healthcare they presume that the GPs have power but the structures are not like this. Before someone complains about GPs they need to understand how the healthcare system is structured. Here's an example by the way of an area's instructions to primary care on vit D testing. If you search CCG vitamin D testing protocol and the name of the borough you live in you will find your local one which may vary depending on the local population's health profile. www.cityandhackneyccg.nhs.uk/Downloads/gp/Formulary/Clinical%20Guidelines/Vitamin%20D%20deficiency%20in%20primary%20care%20-%20Adult%20pathway%20version%202.pdf

Yes I understand why GPs might not be testing but I do think they could routinely remind their patients that they should be taking vit D over winter.