Vitamin D and COVID NEW Studies - Evidence for a Protective Role of Vitamin D in COVID

welcome to another video on vitamin d this one's  going to be about vitamin d as it pertains to   covid 19 so vitamin d has been maligned  and praised throughout 2020 and into 2021   as a cheap supplement that nearly everyone has  access to why is it getting so much attention   well there's lots of studies that show a strong  association between vitamin d deficiency and   increased numbers in severity of respiratory  infections not just covid these studies   show a relationship between vitamin d supplements  in covid 19 not that vitamin d deficiency causes   covid 19 and this distinction is important because  a third variable may actually be responsible for   the effect imagine you're studying 100 people who  have doubled the number of respiratory infections   per year compared to the baseline population they  all have low levels of vitamin d is having low   levels of vitamin d the cause of their increased  risk of respiratory infections maybe they live   in a crowded understaffed nursing home they  don't get outside and they eat a poor diet   these factors could explain the increased risk  for infection and the low vitamin d levels but you   wouldn't know that unless you're looking for it  or you structured your study to remove the effects   of other variables that are not measured here are  five studies that support the relationship between   vitamin d deficiency and more severe respiratory  diseases researchers in germany followed almost   10 000 adults aged 50 to 75 for 15 years to  evaluate their mortality from respiratory diseases   among these study participants 44 had low vitamin  d levels and 15 were vitamin d deficient overall   after adjusting for sex age the season of the  blood draw school education bmi physical activity   and fish consumption 41 of respiratory disease  mortality was statistically because of low   vitamin d levels there's also a meta-analysis  published in the british medical journal in 2017.   i've done a video on this before but in that study  they reviewed 25 randomized double-blinded control   trials that had over 11 000 participants now  vitamin d supplements reduced each individual's   risk by at least one respiratory infection when  all the results were averaged together there was   a slight protective effect while daily in weekly  doses of vitamin d reduced risk single large doses   of vitamin d did not protective effects of vitamin  d they were greatest in those with the lowest   vitamin d levels now in a retrospective study  in 2020 quest diagnostics in the united states   they looked at the labs for vitamin d levels and  sars cov2 positivity for almost 200 000 people the   authors they found a strong inverse relationship  between vitamin d levels and sars positivity   that persisted across latitudes races ethnicities  sexes in age ranges they found the risk of being   positive for styroscopy 2 was 1.6 lower with  each vitamin d increase by 1 ng per ml there's   a previous study that showed that for every 4 ngs  per ml increase in vitamin d there was a seven   percent decrease in risk for seasonal respiratory  infections when researchers at the university of   chicago medicine reviewed the health records of  almost 500 people who had vitamin d testing within   the previous year they found that the relative  risk for testing positive covid 19 was 1.77   times greater for vitamin d deficient patients  but compared to those who were not two-thirds   of the study participants were non-white and 47  percent had a bmi greater than or equal to 30   which is considered obese although the results  were significant this was a retrospective study   and there may be unknown confounding variables  that increase the risk for both vitamin d   deficiency and covid 19. another study published  in nature examined the health records of over 17   million adults of which 10 000 had died of covid  19 risk factors including being male older age   having diabetes asthma obesity or other medical  conditions and having darker skin color supporters   for giving vitamin d point out that older age  obesity and having darker skin color are risk   factors for both covid 19 and vitamin d deficiency  and critics state that other variables may have   had a greater effect what can these studies tell  us there seems to be a fairly strong relationship   between vitamin d deficiency in the number and  severity of respiratory infections including covet the quest diagnostic study and the one from  the university of chicago indicate that yes   your risk of getting a covid 19 infection  increases as your vitamin d level decreases like   wearing masks social distancing avoiding crowds  and poor ventilation and vaccination if you're   vitamin d deficient it's a correctable risk factor  that you can do something about to prevent covid 19   infection of course none of these preventative  methods is 100 protective but they can all help if you're not vitamin d deficient then  taking vitamin d supplements isn't going   to affect your risk for covid 19 infections  but the other preventative measures will the german study that i referenced  earlier suggests that 41   of respiratory disease mortality is statistically  attributable to vitamin d deficiency or   insufficiency this study supports the use of  vitamin d to ease covid 19 severity to answer   these questions more fully there are currently  40 ongoing interventional trials with vitamin d   and covid 19 worldwide a recent study conducted  in barcelona was published as a pre-print which is   a non-peer-reviewed study available for review  and comment before publication in a journal   that barna cova dial study reported  that when vitamin d was given to   patients hospitalized with covid 19 the  mortality rate decreased by 60 percent   it was the first and largest study to directly  evaluate the impact of calcifidiol vitamin d3   these supplements on covid 19 mortality and icu  admission here is the data from the study group   now these results appear to be overwhelmingly  in support of vitamin d supplements   the pre-print results led david davis an advocate  for vitamin d usage and a british politician to   call for the widespread vitamin d supplementation  citing the causal relationship between increased   vitamin d levels and decreased mortality shown  in the study he advocated that the uk government   increased the recommended dose and distribute  free vitamin d to all vulnerable groups he urged   doctors to treat every covid patient in every  hospital in temperate climates with vitamin d   this study shows strong support for adding  vitamin d supplements to treat severe covenanting   do we have all the evidence we would like to  make this claim no now other people have been   more skeptical about these results and in fact  several concerns with the study's methodology   caused it to be withdrawn by the lancet as a  pre-print and sent back to the investigators   for clarification and to address problems with  the investigation including that the trial wasn't   registered with clinicaltrials.gov now registering  the study makes investigators openly state their   plans and review criteria up front also it wasn't  a randomized control study the gold standard for   scientific studies it used clustering instead of  randomization also the statistical method used   was not appropriate for a study that used clusters  and males and females were not evenly distributed   between the control and experimental groups and  also there are 551 people in the treatment group   and 359 in the control group so there is an uneven  distribution also the baseline vitamin d levels   were 15 ng per ml in the treatment group and 12  ng per ml in the control group this difference in   baseline vitamin d levels could have significantly  affected the study results a study by uk biobank   recruited over 500 000 people between 2006 and  2010. baseline data on exposure to covid 19   vitamin d levels and ethnicity were linked to  covid 19 results after adjusting for confounding   variables researchers found no association between  vitamin d levels and the risk for covid 19   infection critics state that participants may have  taken vitamin d supplements in the years between   when vitamin d levels were obtained and  then exposure to covid 19 infection a   study that is not yet peer reviewed enrolled  240 hospitalized patients in a multi-center   double-blinded randomized placebo-controlled  trial and two centers in brazil study participants   received a single oral dose of 200 000 ius of  vitamin d3 or placebo the study found that vitamin   d levels increased in the treated patients but  had no effect on hospital length of stay mortality   admission to the icu or need for mechanical  ventilation now critics would point to a single   large dose as the reason that no effect was  seen when 137 study participants in the uk   either received a single large dose of vitamin d  along with a daily low dose versus placebo there   was no difference between the two groups in terms  of number or severity of respiratory infections   critics of this study state that  the timing of the vitamin d levels   in the single large dose of vitamin d were  problematic the nih recommendation states that   there is insufficient data to recommend either for  or against vitamin d to prevent or treat covid 19   there are several unknowns regarding vitamin d and  immune health the optimal level of vitamin d for   bone health has been well studied but the optimal  level for immune health has not blood vitamin d   levels may not adequately represent tissue levels  because it's possible that you have tissue levels   within your cells that are different from  the amount that you have in your bloodstream   so how much vitamin d should people take well  the endocrine societies recommend that most   adults 19 years and older should get around  400 to 1000 international units meaning ius   of vitamin d daily from food and or supplements  the nih and endocrine societies recommend that   adults 50 to 70 require at least 600 ius per day  and those over the age of 70 get at least 800 ius   per day it's also recommended that for populations  at risk for vitamin d deficiency who are age 80 or   older should get 6 000 ius per day under medical  supervision in order to reach a level that's above   30 ngs per ml followed by a maintenance dose of  1500 to 2 000 ius per day otherwise populations   at risk should receive the rda of 600 ius per  day with an upper limit of 4 000 iu's per day   obese individuals over the age of 8 should receive  4 000 ius per day and as high as 10 000 iu's per   day under medical supervision may be needed for  obese adults to correct vitamin d deficiency   vitamin d levels can vary by type of measurement  and by the organization so quest diagnostics they   list optimal vitamin d levels as 30 to 100 ngs  per ml and 20 to 29 is considered sub-optimal   and levels less than 20 ngs per ml are vitamin d  deficient the nih classifies adequate levels as   being 20 to 50 ngs per ml inadequate if it's 12  to 20 and then vitamin d deficient if it's less   than 12 once you start getting to levels more  than 50 ngs per ml that's where you have the   potential for adverse effects especially when  you start getting to levels of 150 ngs per ml vitamin d deficiency it doesn't have any symptoms  so the only way to know if you're deficient is by   getting a blood test many insurance companies  even medicare they don't cover vitamin d levels   unless you have a medical condition that puts  you at high risk of having vitamin d deficiency   for example chronic kidney disease in  a study done in the united states about   40 percent of about 5 000 people over  the age of 20 were vitamin d deficient   another study found that the overall  prevalence rate of vitamin d deficiency was 42   with the highest rate in blacks at 82 percent  followed by hispanics at 69 percent at 40 degree   latitude there's virtually no vitamin d effective  uv radiation in december january and february   at 90 degree latitude there's no vitamin d  effective radiation for 8 of the 12 months   anyone living above the 35th parallel which  cuts through the middle of the united states   will not get enough vitamin d in the winter  because the sun's angle with the earth is too   great even in the summer you may be at risk  for vitamin d deficiency as a survey showed   that americans spend only 7.6 percent of  their time outdoors aging increased skin   pigmentation a diet high in fructose corn syrup  and obesity can lead to decreased vitamin d levels   in the middle of winter most people in the u.s  are likely to be vitamin d deficient this is a   convincing argument to take vitamin d supplements  especially if it may decrease your risk of   respiratory infections however it is possible to  overdose on vitamin d but this is really hard to   do excess vitamin d is toxic vitamin d increases  the absorption of calcium from the gi tract   excessive calcium in the blood that can lead to  nausea vomiting muscle weakness neuropsychiatric   disturbances pain loss of appetite dehydration  excess of urination and thirst and kidney stones   in extreme cases excessive vitamin d can cause  kidney failure heart rhythm abnormalities and   death although i gotta say again this is  extremely rare and hard to do there was a   case report from 2019 that described the person  who suffered kidney damage from excess vitamin d   in a more recent case in ohio a patient  took vitamin d to treat covid 19   leading to several medical  issues dr oppermann his physician   he said that quote high calcium levels from high  dose vitamin d that can lead to confusion kidney   stones and ultimately hospitalization in this  situation ultimately whether vitamin d helps   prevent infection reduces disease progression  or decreases mortality in patients with covid 19   it's unknown so it's best to either take vitamin  d following the recommended daily allowances or   speak with your doctor about an increased  dose if you might be vitamin d deficient

Channel: Doctor Mike Hansen

Views: 492,168

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Id: _MHsJB3m1go

Length: 15min 47sec (947 seconds)

Published: Sat Feb 27 2021