Winter Vitamin D Update

you are very welcome to this video now i keep a file on my computer and every time i find an interesting study about vitamin d whether it's in favor of vitamin d helping immunity or against vitamin d helping immunity i just keep it in a separate file and i keep the link but i haven't found any that intimate that or indicate that vitamin d is bad for immunity they are all the vitamin d is promoting the immune function so i've put a few of these together mostly from this past month mostly from october 2020 and some other research that really shows how important this is because basically we are missing a trick here you know we all know hands face space that's good everyone's got that one now the two we haven't got are hands face space ventilate doesn't quite rhyme hands face space ventilate ventilation still rubbish and vitamin d is the other one that people are missing out on so i'm going to give you the evidence now you decide for yourself now just by way of a bit of background science vitamin d is essential as an immunomodulator now you probably know this but immunomodulation means that vitamin d can promote the immune response but it prevents an overdrive of the immune response as well because if you get too much immune response you get inflammation and we know that inflammation is part of the problem in people that are very sick with covid19 and indeed a host of other conditions caused by inflammation so it's an immunomodulator so without enough vitamin d you won't have enough basic immunity but then the inflammatory reaction related to the immunity which is no longer controlled can go out of control and you can get severe inflammation so vitamin d is an essential immuno modulator it makes sure the porridge is not too hot and it makes sure the porridge is not too cold that it's just right and this works for the innate and the adaptive immune systems now the innate immune system is is the immunity that we have that works against a wide variety of potentially infecting pathogenic microorganisms and viruses but it's innate it's non-specific where a specific immunity is immune to that requi reacquire which is specific to a particular organism like a particular virus so like if you've had mumps you won't have immunity to chickenpox or something like that each one is specific and vitamin d is essential for the innate immune response working generically against a wide variety of organisms and agents and it's required for the specific acquired immunity as well it's needed for both and we need both for protection against covid19 as indeed with all infections we need it to protect us against all environmental potential infections because out there there's just a million of organisms just waiting to infect us it's our immune system that keeps us sterile on the inside it's all dirty outside we're all sterile inside quite amazing that it can do that so um necessary for both arms of the immune system enhances innate immunity it enhances immune little proteins peptides antiviral effects that disrupt viral envelopes so in this way these immune peptides are working a bit the same way as um soap does breaking down the um the outside envelope of the of the virus not that we should be eating soap of course we shouldn't but it's working in a similar way suppresses the excess expression of pro-inflammatory cytokines now cytokine stormy is a term that's probably entered into the common parlance now too many of these cytokines which are cell to cell communication molecules are released they stimulate this massive inflammatory effect and we get the problems such as severe acute respiratory acute respiratory distress syndrome for example which we don't want because it's caused by the inflammation um so the expert they suppress the excess pro-inflammatory cytokines regulate expression of h2 receptors now this one is quite specific to covered 19 because as you know the h2 receptor is the way the covid19 virus gets into the cell binds onto the cell and just to finish this brief introduction uh epidemiological and clinical evidence is increasing and it's related to the incidence the severity and the mortality in covid19 so there's increasing evidence having good levels of vitamin d reduces the incidence the number of new cases of cavity 19 how sick those people are and how likely they are to die and low levels of vitamin d are also associated with high blood pressure diabetes cancer cardiovascular disease so if people had good levels of vitamin d perhaps there would be less of these but of course you can immediately see whether that's true or not that all of these conditions are co-morbidities the hypertension the diabetes the cancer the cardiovascular disease so we can see it's all kind of going together so lack of vitamin d which is basically a pandemic there's a great lack of vitamin d around the world it's something which would be so easy to correct and yet governments don't seem to be acting on it right let's get down to specific evidence now this is the initial clinical trial study um this was we looked at this in great detail effects of uh calcified dial now some people say i was brought up to say cal kiffy die or some people say calcified dial but i i was brought up to say calcified oil i think that's more the english way to do it um so basically these patients in this clinical trial in spain relatively small number but some were given calcifidiol and some were given nothing now calcified diol is what the body turns the vitamin d that you take in the table or in your diet or in the sunshine into so if i if i'm exposed to the sun my skin makes this vitamin d3 or if i take vitamin d tablets d2 or d3 tablets that goes into my uh blood but it takes up to about a week for the liver to convert it to calcifidiol which is then further processed by the kidneys it's quite complicated so when these people were sick they gave calcified dial and that basically meant the vitamin d was working straight away rather than waiting a week for the liver to convert it into the active form because these patients could have been dead within a week so that was why they gave calcify dial but basically it's the same as giving vitamin d it's just that it works quicker so and the results of this now are well known um 50 patients treated with calcifidiol one required admission to intensive care um one required admission to intensive care that's two percent of the sample none of them died all discharged all 50 so all 50 patients no deaths or discharge without or discharge without uh without complications zoomed in today maybe there we go um so the patients that were given the calcified dial the vitamin d fast acting vitamin d no deaths or discharged no complications the untreated patients 13 of them required intensive care that's 50 of them and uh two two of those patients unfortunately died now what i was distracted by there was the the leaves blowing into the window it's it's it's autumn time there's less sun we're not making the vitamin d we did in summer and of course we have a massive second surge all over the northern hemisphere at this time uh now this calcified dial trial they are extending this now thousand patients 15 hospitals in spain so at least uh someone's doing a good quality clinical trial on this now so that was the original clinical trial um and basically that's the only clinical trial as such that's been done all these others are observational studies but there's evidence after evidence after evidence and it's just amounting to such an overwhelming case now um so let's let's but let's carry on now this study here vitamin d status in hospitalized patients with sas coronavirus 2 infection published in the journal of clinical endocrinology and metabolism peer-reviewed it's an accepted paper just published a few days ago 27th of october 2020. so bang up-to-date research the aim was to assess the serum 25 hydroxy vitamin d that's the vitamin d in the blood levels in hospitalized patients with the carbon 19 and they wanted to analyze the possible influence of vitamin d status on disease severity now as a retrospective study this is not ideal and it's not really a it's not so it's not a prospective clinical trial but it was case controlled in a sense because they had 216 hospitalized patients and they had 197 population based controls so 216 patients in hospital 197 controls so what they could do is they could compare the serum vitamin d levels in that group and the serum vitamin d levels in that group and see if there is a difference between them so it is fair to say it's case controlled although they weren't given a treatment this group in this group weren't given a placebo or anything like that so it is short of a clinical trial but it's still good because you've got a comparison group so what were the results from that results vitamin d deficiency was defined as a serum vitamin d level of less than 20 nanograms per mil now it's a bit confusing because um we can measure vitamin d levels in nanograms per mil or nanomoles per liter but 20 nanograms per ml is equal to 59 moles per liter so less than that was defined as deficient which is reasonable now the covered patient group the mean the average level of vitamin d in their blood in the hospitalized patients was 13.8 and 82 of them were found to be deficient in vitamin d i mean that is quite a significant finding the community group the controls that weren't in hospital their mean level was a 20.9 so the hospitalized patients 13.8 the non-hospitalized people 20.9 52 millimoles per liter and the p value there is remarkably low that means this result would not have arisen by chance very very small chance that the result arose by chance meaning there's a genuine difference between the two groups and 47.2 in the community group were found to be deficient now still significant a lot of people are still deficient but it was 82 in the hospitalizer group so hospitalized patients community controls clearly a big difference there the hospitalized patients having lower vitamin d levels and also interestingly in this study blood levels lower in men than women of course we know men get more severe covered 19 than women so not a clinical trial but a very good comparison study so i would say that evidence is is quite good of course on its own it means nothing so we need to add other things to it to see what's um to see if it makes sense in context like this study here evidence of uh the protective role of ultraviolet vitamin b ultraviolet radiation b sorry not vitamin b evidence of protective role of ultraviolet b so that's a particular wavelength of ultraviolet that helps the the in combination with the skin produces vitamin d in the skin again 20th of october the 19th of october 2020 so bang up-to-date research now this is published in nature science reports so again prestigious prestigious journal nothing wrong with the science reporting here now ultraviolet b radiation mediated by vitamin d synthesis so the ultraviolet radiation promotes vitamin d synthesis in the skin now what this group did was they took data a lot of data from 152 countries over 108 days from 6524 patients so a significant international data collecting exercise um and they found a permanent unit increase in ultraviolet index is associated with a 1.2 percentage points decline in the daily growth rates for cumulative covered 19. so every time the ultraviolet index went up a unit the um the percentage of covered 19 daily growth rate in cases was down by 1.2 percent so in other words moral ultraviolet light in the weather um more ultraviolet light more vitamin d produced new cases of covid 19 went down and also the case fatality rate went down as well so and a 1 points decline in the case fatality rate again related to the ultraviolet index so again as the amount of ultraviolets over summer went up the amount of deaths from covered 19 went down and this is a trend remember identified from 152 countries six and a half thousand patients and globally they calculated using clever mathematics i don't fully understand um that there would be twelve percent minus 12 of cumulative covered 19 deaths uh and minus 38 on the case fatality rate so globally they found between a 12 and a 38 reduction in fatalities so that is that is really quite a significant potential reduction and i'm going to give some direct quotes from these authors now um it's in a i'll put it in italics of its direct quote so we find a significant negative association between ultraviolet index and covid 19 deaths in other words the ultraviolet goes down the covered 19 deaths go up the ultraviolet goes up the cop in 19 deaths go down it's a negative or an inverse association they're going to say indicating evidence of the protective role of ultraviolet b in mitigation in mitigating covid19 deaths if confirmed via clinical studies which is what we so desperately need then the possibility of mitigating covered 19 deaths via a sensible sunlight exposure or vitamin d intervention would be very attractive so frustrating because of course this proves nothing because it's an association correlation study but they all seem to be giving the same results we need this large-scale clinical trial to prove it but it's just everything you read just seems to add and add to the evidence let's uh let's keep going this study here vitamin d deficiency sorry vitamin d sufficiency when vitamin d is sufficient okay and they say at least 30 nanograms per mil is sufficient um some people put it higher than that but anyway they found an association between blood levels of vitamin d in the blood 25 hydroxy vitamin d levels and its effect on adverse clinical outcomes that was what they were studying and they studied 235 patients what did this study find now based on the centers for disease control criteria among study patients 74 had severe covered 19 infection and 32.8 were all were vitamin d sufficient so among our study so 74 percent 74 of the patients had severe covered and of those 74 of patients that had severe covered 32.8 were found to be uh sufficient in vitamin d sufficient in vitamin d so that means that 68 were deficient doesn't it now just putting it the other way around right so again you know pretty pretty consistent data vitamin d sufficiency um that they say is 30 nanograms per ml which is 75 nanomoles per liter was the level that they were using uh this resulted in reduction in clinical severity reduction in inpatient mortality and reduction in levels of c-reactive protein so reduction in clinical severity less severe less people dying less c-reactive protein in the blood and this c-reactive protein is an inflammatory mediator so the more c-reactive protein the more inflammation so they found that people that were vitamin d-sufficient had less c-reactive protein in the blood and they also found in terms of the immune system increased lymphocyte percentage and it's the lymphocytes you might remember the lymphocytes are the b and the t lymphocytes which are so vital for viral immunity the b lymphocytes producing the antibodies and the t lymphocytes killing the virally infected cells as we've looked at several times so again it's not a clinical trial but the data again is completely consistent um now vitamin d vitamin d deficient groups um i'm going to give you some information now it's a little bit surprising vitamin d insufficiency in southern arizona now i've never been to arizona but i've seen the westerns and it's all desert and sunshine isn't it so it's a very sunny state and yet there's vitamin d deficiency there because um people often just don't go in the sun it's too hot so um this was from the american journal of clinical nutrition and again peer-reviewed accepted paper so in um southern arizona the population average was a 26.1 nanograms per mil um below 29 grams per mil the the low rates were taken as below 29 grams per per meal fair enough so that was the average in the population 26.1 nanograms per ml but then they looked at how many people had less than 20 nanograms per meal how many people had less than 20 nanograms per ml or 50 nanomoles per liter so 29 grams per mil 59 moles per day so how many were below that now in african-american derived peoples it was 55 percent in hispanics it was 37 and in white population it was 22 and of course we've looked recently that these populations have more than four times the rate more than four times the rate of hospitalization compared to this sector of the population hospitalized four times more and there was also more obesity associated with these two groups as well and obese is very relevant for vitamin d because if someone's low in vitamin d and they take vitamin d because it's a fat soluble vitamin most of the vitamin d that's taken initially just goes into the fat soluble tissue it doesn't get into the blood so obesity is a risk factor for vitamin d deficiency now yesterday we looked at first first nation american populations and here's another study this one is uh northern arapaho and eastern shushong tribes in wyoming uh part of a census for disease control study so um now when i read this i was actually quite shocked these people groupings the northern arapaho and the eastern shushong peoples die an average of 30 years earlier than white people in the state now that is just absolutely shocking that this state of affair affairs is allowed to continue it really is appalling a 30-year difference in in life expectancy amongst native americans as opposed to white americans huge difference and studies show that nearly eighty percent of all adults have deficiency of vitamin d levels at very low levels equal two or less than twenty nanograms per ml so very low vitamin d levels again it's not proof it's an association but it's another consistent association to go with the many others assist consistent associations we've shown and what i'll do in the link below this video i'll put um i'll put the link to previous videos we've done because we've looked at so much evidence for this now now obesity was also a problem in these uh in these indian groups way circumference which was associated with a high risk of obesity related disease in women it was 95 or obese men were 80 well too much abdominal adiposity anyway and there was also hypertension and diabetes that's associated with lack of vitamin d that's associated with lack of vitamin d people that are obese are significantly more at risk for lack of vitamin d it's all completely consistent now um just to finish east virginia medical school protocol um have taken this on evms east virginia medical school check check out the website absolutely excellent now for prophylaxis of covered they're recommending between a thousand and three thousand international units of vitamin d a day now it's a bit confusing because there's two ways of measuring it so three thousand international units a day we see would go in there so three thousand international units a day would equal 75 micrograms 75 micrograms and of course there's a thousand micrograms in a milligram so that's the conversion between international units and micrograms but that's what east virginia medical school are written in there in their protocol note recommended daily amounts is 800 to a thousand in the united states in the uk it's even less so they're advocating the higher end of that or up to three thousand to prevent confident 19 in the community prophylaxis they say the safe upper limit safe upper limit daily dose is likely greater than more than 4 000 international units a day is what that website is saying check it out for yourself now what about patients at home who develop coverage 19 well they're advising two to four thousand international units a day people mild asymptomatic patients in hospital they're giving uh much larger doses twenty to six thousand twenty to sixty thousand international units as a single dose or calcified which would work quicker two to five hundred micrograms as an alternative and just to remind ourselves again um that is the that is the conversion that it's useful to remember personally i take uh 2000 international university now the sun has dropped out of the northern english sky so massively increasing cases in the northern hemisphere no two ways around that we anticipated this we didn't quite know how quickly it would be it's quicker than most people have thought the uh the projections for increased deaths in the uk are higher than people thought but the factors are people congregating in together lack of sunlight i believe lack of vitamin d is a big factor now that autumn is here and it really is time we had proper government advice on vitamin d now the government don't have the clinical trial data to draw on because it's not there but there are so many associations now with vitamin d and we have this scientific advisory group for emergencies it's really time they look to all the data i've presented on this series of videos now and uh in my view there's more than enough evidence there to to recommend at least somewhat increasing doses of vitamin d for the public over over this coming winter time because it is going to be a difficult winter because the vaccines aren't going to be here till next spring essentially at the earliest so there we are more more evidence on vitamin d i'm convinced by it look at the evidence yourself see if you're convinced i could have picked many many more things just i didn't want to go on for hours and hours on the video but i didn't find any any contrary evidence so um that's that's what i'm doing that's what the east virginia medical school recommends look at the evidence talk to your own health care providers and make your own decisions on that and as always thank you for watching this video and if you've got an mp why don't you write to him and say wait to talk to talk to matt hancock and say get this sorted out thanks for watching

Channel: Dr. John Campbell

Views: 800,926

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: HxtddpoPMKo

Length: 27min 43sec (1663 seconds)

Published: Sat Oct 31 2020