• Merlin Young

The Vitamin (that is not a vitamin) in the time of COVID

In the last couple of weeks, several sources have suggested that levels of vitamin D may play a part in the host defence against the more severe consequences of infection with SARS-Cov-2 coronavirus. Up until today we thought this might only be theoretical, not least because there have also been published reports which dispute this idea. It’s certainly widely recognised, though, that healthy levels of vitamin D can help support immune systems, and what’s more vitamin D levels might help explain one or two of the many anomalies in respect of how this novel infection is manifesting.

But it might even open a window on a simple way of protecting ourselves against the worst of this disease - and simple protection against infectious agents is something that we in Moxafrica are always interested in.

It seemed to us that it would be really easy to establish whether there was anything to these claims: vitamin D levels could be tested in all those admitted to any hospital (whether COVID-19 positive or otherwise), and levels compared in different categories of patients but in particular the progression of severities of COVID confirmed cases could be tracked to see whether there were correlations between levels of Vitamin D and severity of disease progression.

Well just this week we came across a study that has done almost exactly that and (rather surprisingly) it’s been out there for over a month largely unreported.

A total of 212 patients who were admitted to three hospitals in South Asia with confirmed SARS-CoV-2 infections had their blood levels of Vitamin D checked (technically speaking, this was their 25-hydroxyvitamin D [25(OH)D] levels which is the gold standard for measuring Vitamin D). They were then tracked through their treatment.

The total number of cases reviewed certainly wouldn’t satisfy an epidemiologist (i.e. more research would be necessary to draw any definite conclusions) but they most certainly should have stimulated more research by now given what they imply. This is because they suggest that deficiencies of vitamin D appear to significantly increase the likelihood of developing ‘severe’ (i.e. with respiratory distress) COVID-19 disease as opposed to remaining a ‘mild’case nearly nine-fold. What’s more, they appeared to make it nearly twenty times more likely for the condition to become critical (i.e. with respiratory failure). In other words, looking at it from the opposite perspective, ‘normal’ levels of Vitamin D (defined in this paper as more than 30 ng/ml) might provide significant protection from the more serious ravages of this disease, whilst ‘deficient’ levels (defined in the paper as less than 20 ng/ml) may be a significant risk factor.

Adding some of the recorded percentages may help better illustrate this picture: of those with ‘normal’ levels 86% had ‘mild symptoms with only 8% of them developing severe or critical symptoms; while of those defined having ‘insufficient’ Vitamin D only 1% maintained mild symptoms and 73% developed either severe or critical disease.

We should quickly add that this paper (in ‘Social Science Research Network’) is currently a pre-print version published before any peer review has been undertaken - but the same limitation can equally be said of the majority of more-than 7,000 papers on COVID that are currently in process of peer-review but which have already been hastily published many of which are being jumped on by the media.

What anomalies might this explain?

It's important first of all to understand that Vitamin D is a misnomer because it's not a vitamin at all. It is in fact a fat-soluble prohormone that can normally be produced by the body through sun exposure but which can also be absorbed from certain foods.

With that in mind it may help explain the worryingly disproportionate number of deaths in black and Asian COVID cases being reported across the northern hemisphere. Of course there may be other complex factors involved, but it’s worth noting that vitamin D is known to be 5 to 10 times harder to be naturally absorbed from sunlight and then converted in darker skinned people.

It may also help explain the emerging data on the higher proportion of obese people who develop more serious disease because it’s also well known that it is harder for Vitamin D to be absorbed in the obese, no matter how much is taken in from food or sun exposure. This is because the prohormone is fat soluble, and so gets diverted into fat cells rather than ending up circulating in the blood stream.

Elderly people are also known to be of much higher risk of severe disease and death from COVID-19, and they also are prone to vitamin D deficiency because (for many reasons) older people tend to avoid sunlight exposure, and because their skin creates less vitamin D in sunlight anyway.

So what does this mean?

Well, while a vaccine os being held out as the best hope by many govrnments, and vaccine research may be taking place at pace all over the world, it’s impossible for the necessary studies to be properly completed to see a vaccine actually being rolled out at safe scale in less than a year. What’s more, it’s not yet even certain whether developing an effective long-lasting vaccine is even possible. Either way, there will almost certainly be no vaccine available in this calendar year, so it looks like the populous Northern Hemisphere (which has already taken a battering from this virus) could be in for a very tough winter indeed, as immunity levels generally naturally decline and the virus potentially strengthens. This risk is made more acute by the impact of any normal seasonal flu epidemics which by themselves can take health services in midwinter to the brink of collapse.

It seems logical, therefore, that all of us should do all we can to strengthen our immune systems any way we can, and it’s equally logical that bolstering our Vitamin D levels could help this. It certainly won’t do us any harm – at the same time, in fact, it may help protect against severe COVID-19 disease and seasonal flu at the same time.

But what’s also important to appreciate is that measurable signs of raised vitamin D levels take about 60 days of supplementation to materialise. So if you have any concern about your immunity, or indeed about your relative risk from an infection with this coronavirus, we would consider it a good idea to get a blood test for Vitamin D if you can. And if the levels are found to be less than 30ng/ml, this study would suggest that long-term supplementation through the summer, continued through the winter, would be a good idea. Of course, we would advise you to adhere to whatever your doctor might recommend, but since there is still no effective treatment for this disease, and no vaccine likely until after next winter at the earliest, we doubt if she/he would disagree with a course of supplements along with ome pleasant moderate spells in the sunshine (being extra careful not to burn of course). Doctors are as acutely aware of the risks of this disease as any, not just to those most vulnerable to it but also to existing health service.

We’d also strongly suggest daily moxa to help the cause as well – but your doctor is much less likely to be familiar with that suggestion! So here's a link to our moxa manual.


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