Vitamin D Is Still The Best Candidate For A COVID-19 "Magic Bullet"
Not That The FDA Or The CDC Will Ever Admit It
Back in February, I discussed the role vitamin D plays in immune system health, and its very plausible case as a “magic bullet” against COVID-19.
There is, of course, nothing magic about vitamin D’s role in building a healthy immune system, which remains the best and most reliable way of fending off COVID-19 (and infectious disease more broadly). Good nutrition has always been understood to be foundational to good health.
Since February, additional studies have emerged that serve to amplify the basic thesis that vitamin D supplementation is both effective and essential in warding off the very worst outcomes of SARS-CoV-2 infection at the very least, and increasing one’s chances of avoiding symptomatic infection altogether.
Trinity College Study: Establishing A Causal Link
By far the most interesting study is a meta-study published online in Frontiers In Pharmacology in March by researchers from Trinity College in Dublin, Ireland, which establishes a causal link between vitamin D deficiency and SARS-CoV-2 infection (and in particular severe infection).
We conclude that reverse causality probably makes a minimal contribution to the presence of low vitamin D states in the setting of COVID-19. Applying the Bradford-Hill criteria, however, the collective literature supports a causal association between low vitamin D status, SARS-CoV-2 infection, and severe COVID-19 (respiratory failure, requirement for ventilation and mortality).
One point the authors make clear up front: low vitamin D levels has been unequivocally associated with severe COVID-19. The research on this point approaches the level of “settled science”.
Vitamin D deficiency is prevalent worldwide (Lips et al., 2021) and low vitamin D status is associated with severe COVID-19 disease as described in over 900 papers from a variety of institutions and clinical settings.
900 papers all reaching the same conclusion about low vitamin D status leaves little room for doubt or debate on the point.
More importantly, this study notes that research data shows that low vitamin D levels precede infection, rather than emerging during/after infection.
…even when measures of serum 25(OH)D are unavailable, it appears that a low vitamin D state precedes the onset of severe disease rather than the reverse (Annweiler et al., 2020). For example, in a study of nursing home residents who received a large bolus of vitamin D3 (80,000 IU) less than 1 month before becoming infected, when compared to those who received a bolus more than 1 month prior, the full-adjusted hazard ratio for mortality according to vitamin D3 supplementation was HR = 0.11 [95% CI: 0.03; 0.48], p = 0.003, supporting the hypothesis that low vitamin D status precedes severe disease, rather than the reverse (Annweiler et al., 2020). This theory that low vitamin D levels precede more severe COVID-19 outcomes is also strongly supported by a recent systematic review and meta-analysis incorporating eight studies in which serum 25(OH)D was measured either within 1 day of admission (4 studies) or up to 3–12 months prior to admission (4 studies). After correction for age, sex and presence of diabetes mellitus, this study reported a significant inverse correlation between serum 25(OH)D measured at or prior to admission and in-hospital COVID-19 mortality
This finding is emphasized by the broad research base showing that low vitamin D levels are positivity correlated with testing positive for SARS-CoV-2 infection.
Notwithstanding the methodological heterogeneity of the studies, in those that were adjusted (OR: 1.77; 95% CI: 1.24, 2.53) and non-adjusted (OR: 1.75; 95% CI: 1.44, 2.13) for confounders there was a higher risk of SARS-CoV-2 infection in the vitamin D deficiency groups (Kazemi et al., 2021). Thus a majority of studies support an association between low Vitamin D status and SARS-CoV-2 positivity.
The authors further note that research establishes that not only does vitamin D play an important role in immune system regulation, but that vitamin D impacts SARS-CoV-2 infection and COVID-19 severity in particular, inhibiting both the ability of the virus to invade host cells and the progression of the disease once infection has occurred.
Together, these observations support the hypothesis that a low vitamin D status plays an important role in the progression of disease, in part through elevations in serum IL-6 and prolonged IFNγ elevation.
All of the foregoing builds to the authors’ key finding that there is sufficient research evidence to support the assertion of a causal link using the Bradford Hill criteria which are a standard methodological tool for establishing causation.
Beyond confirming the causal link between low vitamin D, SARS-CoV-2 infection, and severe COVID-19, the authors also note the potential therapeutic benefits of vitamin D during disease progression.
As alluded to previously, recent meta-analyses indicate that vitamin D supplementation reduces the risk of acute respiratory infections generally, especially in people with the lowest serum 25(OH)D concentrations (Martineau et al., 2017; Jolliffe et al., 2021). These findings have recently been augmented by further meta-analysis of data indicating 3 to 4-fold reductions in risk of mechanical ventilation, ICU admission and mortality amongst hospitalised COVID-19 patients receiving vitamin D supplementation.
It should be noted here that high bolus doses of vitamin D are not an indicated therapy, but lower doses administered daily are most likely to have therapeutic effect.
Bolus doses also stimulate the fibroblast growth factor 23 (FGF 23)/24-hydroxylase counter-regulatory enzymatic pathways, meaning daily modest dosing is probably more effective than infrequent high dose bolus administration.
For the layman, the thrust of this research is clear and unambiguous: Daily vitamin D supplementation not only raises the odds of avoiding SARS-CoV-2 infection altogether, it minimizes symptoms when infection does occur, and additional vitamin D supplementation during the course of the disease can not only shorten the course of the disease but can also ameliorate the more severe outcomes, including ICU admission, mechanical ventilation, and mortality.
Penn State Study: Vitamin D Protects The Lungs
Another important bit of research to come out recently is this study from Pennsylvania State University, posted June 30 on the bioRxiv preprint server, using mice which shows vitamin D plays an important role in protecting the lungs during COVID-19 infection.
One of the more significant aspects of this study is that it analyzes the relevance of vitamin D in protecting against both the SARS-CoV-2 virus and the pandemic strain of H1N1 from 2009—which gives the study fairly broad implications in terms of overall immunological health.
As with the Trinity College study, the Penn State study takes note of the well-established link between vitamin D deficiency and poorer outcomes from infectious disease—COVID-19 in particular.
A recent systemic review concluded that low circulating levels of vitamin D (serum 25(OH)D, 25D) were associated with more severe symptoms, and higher mortality in patients with COVID-19.
Another important result from the H1N1 phase of the study was the results were not dependent on reduced viral replication, indicating that vitamin D plays a role in protecting lung (and presumably other) tissues.
The expression of the influenza M gene at d4 post-infection was not different in the 4 groups of influenza infected mice.
This finding is amplified by the concurrent observation that the vitamin D deficient mice showed signs of lung inflammation before infection with influenza virus.
Vitamin D clearly does much more for the body than simply strengthening the immune system, although within the context of COVID-19 research, the protective effect against COVID-19 within the lungs has particular relevance.
Together the data support an important role for vitamin D and Cyp27B1 in the regulation of the host response to H1N1 and SARS-CoV-2 viruses. The role of vitamin D includes the restraining of the IFN response shortly after infection. Vitamin D deficient hosts had pre-existing inflammation in the lungs that contributed to susceptibility to viral infection.
It is, of course, intuitively obvious that inflammation—and lung inflammation in particular—inherently increases susceptibility to infectious respiratory pathogens.
Further Confirmation On Existing Research
Both the Trinity College study and the Penn State study provide further confirmation of the considerable evidence that vitamin D is not merely effective in minimizing COVID-19, but is in fact essential to that objective.
Since February, the number of Random Controlled Trials analyzed by @CovidAnalysis establishing the benefits of vitamin D has only grown, from eleven to eighteen, showing significant benefits from vitamin D in both early and late treatment, as well as in prophylaxis.
The @CovidAnalysis team has, as of this writing, analyzed some 48 studies showing the benefits of vitamin D in reducing mortality, both as an early and a late treatment, as well as in prophylaxis.
The @CovidAnalysis team has, as of this writing, 14 studies which address the risk of mechanical ventilation as a result of COVID-19. 11 of those studies show significant risk reduction when vitamin D is administered in both early and late treatment, as well as in prophylaxis.
14 of the 16 studies addressing the risk of hospitalization analyzed by the @CovidAnalysis team show vitamin D dramatically lowering that risk.
The results of the @CovidAnalysis meta study can be summarized the same way in every category: vitamin D works against COVID-19. Both the Trinity College meta study and the Penn State study confirm the @CovidAnalysis research.
Vitamin D Deficiency Is Its Own Pandemic
It bears repeating that vitamin D deficiency is rampant the world over, and can be a particular health problem for particular ethnicities.
A recent University of Houston study appearing in the Journal of Pediatric Health Care showed that 61% of minority adolescents suffer from vitamin D deficiency.
Sixty-one percent of adolescents had low vitamin D levels. Vitamin D deficiency increased with age, independently of ethnicity or gender.
While vitamin deficiencies are an health concern in their own right, viewed in concert with the Penn State research which indicates vitamin D deficiency contributes to lung inflammation even prior to SARS-CoV-2 infection, the prevalence of vitamin D deficiency arguably becomes a co-morbid condition with respect to COVID-19, but also to infectious respiratory disease broadly.
I will point out that this dovetails with an observation I made last December, that co-morbid conditions indicate a spectrum of immune system dysfunction.
Another implication of this correlation is that comorbidities weaken the immune system and are themselves an indicator of a level of immune system dysfunction. The greater the dysfunction the less effective the vaccines.
While vitamin D should never be regarded as a panacea (there are no such concoctions in the real world), proper attention to one’s bodily health includes ensuring one is getting adequate vitamin D, be it from sunlight, diet, or nutritional supplementation (or some combination of all three). In addition to strengthening overall resistance to infectious disease, adequate vitamin D arguably can aid in preventing or ameliorating a number of the co-morbid conditions which raise the risks associated with COVID-19.
Who Needs Inoculations? Nobody
These latest studies (and, I should point out, there are several more which I have not mentioned for reasons of space and focus) bring me back to a point I made in February: Vitamin D supplementationis as effective or more effective than the mRNA inoculations.
This “best case" for the vaccines is they were 88-93% effective against hospitalization for the Delta variant, falling to 70% effective against the Omicron variant.
By comparison, the Dror study indicates that vitamin D prophylaxis would be ~93% effective against hospitalization and ~94% effective against mortality. In other words, vitamin D is every bit as effective as the vaccines.
Let that thought sink in again: Vitamin D supplementation is as effective or more effective than the mRNA inoculations.
Two points immediately arise from this conclusion:
The mRNA inoculations are utterly, completely, and eternally unnecessary, and always have been.
The mRNA inoculations do not qualify for Emergency Use Authorization.
Recall that a significant consequence of the endless renewals of the Public Health Emergency declaration by the HHS Secretary Xavier Becerra is the ongoing use of Emergency Use Authorizations to allow otherwise unapproved medications—the mRNA inoculations, Paxlovid, molnupiravir, et cetera—to be used against COVID-19.
Perhaps the most impactful consequence of a Section 319 emergency declaration that it opens the door to FDA Emergency Use Authorizations of various unapproved drugs and medical devices, under section 564 of the Federal Food, Drug, and Cosmetic act, codified in the US Code as 21 USC 360bbb-3.
However, while PHE declarations may be made at the whim of the HHS Secretary, there are ostensibly objective criteria for an Emergency Use Authorization which must be met before an EUA can be granted. One of those criteria is that there can be no other option available.
(3) that there is no adequate, approved, and available alternative to the product for diagnosing, preventing, or treating such disease or condition;
Vitamin D is demonstrably adequate for preventing and for treating COVID-19. Vitamin D is obviously available, as it is an over-the-counter nutritional supplement—and the OTC status renders approval status moot. As no prescription is required for vitamin D, there is no need for regulatory approval.
Even if one wanted to make a legal issue over approval status, with over 900 papers attesting to the relevance and efficacy of vitamin D in preventing, mitigating, and treating COVID-19, for the FDA to withhold approval would be on its face an arbitrary and capricious move wholly at odds with the FDA’s explicit mandate to be guided by scientific data and research (a mandate which, admittedly, is at this point observed exclusively in the breach).
Given the volume of research data attesting to vitamin D’s efficacy against COVID-19, arguably all of the medications granted EUA status by the FDA should never have received it. As a matter of legal requirement, the threshold for granting an EUA is, thanks to the wealth of vitamin D material, simply not met for any of them.
Even if one were to accept the premise that COVID-19 qualifies as a Public Health Emergency, because of the significance and established efficacies of vitamin D supplementation in preventing and mitigating COVID-19, none of the Emergency Use Authorizations granted by the FDA should ever have been issued and should therefore be immediately withdrawn.
The FDA Is Unlikely To Act. You Are Still Free To Act
While it is almost certainly a pipe dream to expect the FDA to reform itself and rescind all EUAs pertaining to COVID-19 inoculations and therapeutics, you do not need to wait on the FDA’s pleasure.
You have the power to take charge of your own health, not by getting endless mRNA shots which are poisonous and pointless, but by adjusting your diet and nutritional intakes to ensure that you are getting sufficient vitamin D to ward off COVID-19.
You have the power to supplement your diet with additional vitamin D should you ever develop any of the flu-like symptoms associated with COVID-19 (and with Influenza Like Illnesses broadly).
You can, thanks to the volume of research that has already been done, rest easy that vitamin D supplementation is highly likely to be beneficial regardless of the particular infectious respiratory pathogen which attacks.
Despite the pompous pronouncements of the FDA and the CDC, good health is and always has been the best defense against infectious disease. Despite the corrupt, cavalier, and clueless coercions of the FDA and the CDC to rely on futile mRNA inoculations or the equally futile Paxlovid and/or molnupiravir, vitamin D is almost certainly the best tool in the average person’s healthcare toolbox for defeating not just COVID-19, but all infectious respiratory disease.
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Vitamin D supplementation should be done with care. It is possible to overdose on vitamin D, which can have serious negative health consequences. Know how much vitamin D you’re taking, and never take too much.
Arguably, this threshold is also not met due to the extant research data showing efficacy for both Ivermectin and hydroxychloroquine as well. However, given that both of those medications require a doctor’s prescription, the approval element for both becomes rather more problematic vis-a-vis the necessity for Emergency Use Authorizations in a way that it does not with respect to vitamin D.
There is very little vitamin D3 in food or multivitamins. It can be made in the skin by UV-B light, but this is only naturally available, far from the equator, in the middle of cloudless summer days. UV-B always damages DNA and raises the risk of skin cancer. Also, it does not produce much vitamin D for those who have brown or black skin.
The best approach is for everyone to supplement sufficient vitamin D3 to raise their circulating 25-hydroxyvitamin D (25(OH)D) levels at least to 50 ng/mL 125 nmol/L, which is what the immune system needs to function properly: Quraishi et al. 2014 https://jamanetwork.com/journals/jamasurgery/fullarticle/1782085 https://vitamindstopscovid.info/00-evi/#00-quraishi .
Without proper supplementation or recent extensive UV-B white skin exposure, most people have only 5 to 25 ng/mL 25(OH)D.
Most doctors follow totally inadequate recommendations based on the Institute of Medicine 2011 report, which ignored the immune system, had a 25(OH)D target of only 20 ng/mL and falsely stated that 0.015 mg vitamin D3 a day (600) IU would enable 97.5% of "adults" to attain this level. In fact, this leads to average levels around 20 ng/mL, which is only 40% of what people need.
The only proper way to calculate how much vitamin D3 to take per day (or in larger quantities every week or so, averaging to the best daily intake) is as a ratio of bodyweight, with higher ratios for those suffering from obesity. Please see this recommendation by Professor of Medicine Sunil Wimalawansa and the research articles on which it is based:
For an average weight adult (70 kg 154 lb) the best intake quantities are 0.125 to 0.175 milligram a day (5000 to 7000 IU/day). "5000 IU" sounds like a lot, but it is a gram every 22 years, and pharma grade vitamin D3 costs about USD$2.50 a gram ex-factory.
This takes about 3 months to raise circulating 25(OH)D, due to the need for hydroxylation in the liver. This will strengthen innate and adaptive immune responses to bacterial, viral and fungal pathogens while greatly reducing the risk of self-destructive, wildly dysregulated, hyper-inflammatory responses such as those which drive sepsis, severe COVID-19, Kawasaki disease and MIS-C.
Chauss et al. 2021 https://www.nature.com/articles/s41590-021-01080-3 who show how TH1 regulatory lymphocytes from the lungs of hospitalised COVID-19 patients remain stuck in their pro-inflammatory startup program, never responding to their circumstances by switching to the anti-inflammatory shutdown program, primarily or solely due to these cells not having enough 25-hydroxyvitamin D to run their intracrine (AKA, not quite accurately autocrine) internal signaling system. For a summary of this dense article: https://aminotheory.com/cv19/icu/#2021-Chauss
For the great majority of people who do not supplement vitamin D3 properly, or have not done so for the few months it takes to raise their circulating 25(OH)D levels above 50 ng/mL 125 nmol/L, by far the most important early or late treatment is to boost their levels over this as soon as possible. For 70 kg bodyweight people, this is best done by a single oral dose of 1 milligram of calcifediol, which _is_ 25-hydroxyvitamin D. This goes straight into solution and raises the level over 50 ng/mL in about 4 hours. See: https://vitamindstopscovid.info/00-evi/#castillo for how 0.532 mg calcifediol was the primary cause for ICU admissions dropping from 50% to 2% and deaths from 8% to zero. 60 small 0.01 mg calcifediol tablets are non-prescription, for USD$20: https://dvelopimmunity.com/products/vitamin-d and https://nutritionmatters.substack.com/p/calcifediol-to-boost-25-hydroxyvitamin . This too is a recommendation from Prof. Wimalawansa - and both these recommendations have bean adopted by the FLCCC.
The second best approach, if calcifediol is not immediately available, is a single large (bolus) dose of vitamin D3 calcifediol. For 70 kg BW, 10 milligrams 400,000 IU is sufficient. This takes, very approximately, 4 days to raise the 25-hydroxyvitamin D level above 50 ng/mL, because it needs to be hydroxylated in the liver.
I support what you wrote, but am providing important details about target 25(OH)D levels, the quantities of vitamin D3 to take to attain this after several months, and the totally different approach which is needed for 4 hour repletion of 25(OH)D in clinical emergencies such as sepsis, COVID-19 etc.
Regarding higher vitamin D3 intakes to suppress auto-immune diseases such as MS, psoraisis, rheumatoid arthritis, cluster headache and migraine, please see the Coimbra, McCullough and Batcheller protocols cited at: https://vitamindstopscovid.info/06-adv/ .
We've known about the association between vitamin D deficiency and poor Covid outcomes for more than two years now. It absolutely boggles my mind that "public health authorities" the world over haven't been shouting it from the rooftops. The excuse I hear from the doubters is, "Well, than means the public health people most think it won't work." So what? Even if it doesn't work, what's the harm in recommending it? There's basically no risk and potentially a great deal of benefit if all adults supplemented with a few thousand IU per day, and the cost is literally pennies.
FWIW, my wife and I take 5000 IU per day, except when we know we're getting good sun exposure with the sun no lower than 45 degrees above the horizon (which is isn't very difficult when we're in Florida).