What about Vitamin K too?

Before (or after) reading this blog we do recommend you read the previous blog about Vitamin D.

Let's first be clear, though, about where we now stand about Vitamin D.

We are convinced that it is likely that Vitamin D levels are playing a significant part in the relative individual risk of a SARS-CoV-2 infection developing into potentially lethal COVID-19 disease. Furthermore we think that it is unlikely that Vitamin D levels don’t explain some of the disparities in death rates that have emerged since the virus arrived in Europe.

What’s more, we think that if your vitamin D levels are insufficient - below 20ng/ml (nanograms per millilitre) or 50nmol/L (nanomoles per litre) - you needed to start taking a Vit D3 supplement at greater dosage than is currently recommended for bone health and, what's more, that it's best to do this daily or every other day rather than try to do it in mega-doses (unless your doctor suggests otherwise). In any case we think that optimal levels for protection from COVID-19 are definitely over 30ng/ml, and a reasonable target should be 50ng/ml, especially if you think you’re at risk.

We know that it can take at least 60 days to even begin to see changes in levels so we are also 100% sure that it's best to start this sooner than later because you want to get those levels higher before next winter when they will drop naturally at the same time as we can exepect to see a new wave of disease emerge. And if you believe your levels are lower than 30ng/ml (or you have problems with absorption) you could benefit by taking the highest doses available on the shelves at your local health food store.

Why do we think this? Basically because of the study we discussed in the previous blog and because of the disparities in COVID deaths amongst the elderly, people of colour and the obese compared to the rest of the population - all these groups are known to have susceptibility to low levels of Vitamin D and all of which have been identified in a Public Health England publication which we will discuss further because of its extraordinary omissions. While we accept that these links don’t necessarily demonstrate causation, the fact that Vitamin D supports healthy immunity makes them, in our view, both coherent and compelling. What's more, another study confirming the same thing emerged only yesterday, this tome reviewing data from ten countries.

Safe dosage

Furthermore, we can find no evidence that daily doses of 4,000 IU (that are ten times higher than what is recommended for winter supplementation for bone health here in the UK) is dangerous unless you have a kidney problem or sarcoidosis, and we have two reasons for saying this.

1. Currently the highest commercially available dosage available here in stores is 4,000 IU, and we would suggest that these preparations simply wouldn't be available if there was risk of overdosage from it.

2. If you doubt this, then please also consider that an average sunbathing session that takes you just half way towards burning (i.e, which takes you to the edge of what might be considered unwise from the perspective of skin health, but which is a sunlight dosage which will be highly variable dependant on skin type) will give you a dose of about 20,000 IU - and there are no known harmful effects from this.

We have, however, found one drawback - evidence that higher dosages of Vitamin D can potentially create a secondary problem while solving a primary one. This is because, while it can mobilise calcium in the body (which is why it’s good for bones and teeth), this mineral could also lodge in arterial circulation creating potential cardiovascular risk. Obviously this is a serious consideration but there is also evidence that Vitamin K can obviate this risk – so it’s a good idea to take Vitamin K2 alongside Vitamin D if taken in higher doses (not least because it also helps Vitamin D to absorb).

But as of last Friday it turns out that there’s been something more to this link that adds a further level of protection.

Vitamin K (too)?

Vitamin K produces proteins that regulate clotting as well as protecting against lung disease, and (of course) one of the characteristics of severe COVID disease has been found to be lethal blood clotting. Because of this link some imaginative Dutch scientists (motivated perhaps by the fact that Vitamin K2 occurs in Dutch cheese!) hypothesised that Vitamin K might possibly help reduce the worst risks of severe and critical COVID-19 disease.

So they studied COVID-19 patients who were admitted to the Canisius Wilhelmina hospital in Nijmegen, comparing disease outcomes with Vitamin K levels, and already they are extolling the possible benefits of vitamin K after confirming a link between deficiency and the worst coronavirus outcomes.

What excites us is that, similarly to Vitamin D, Vitamin K is quite safe to use in the general population, and (while they await funding to develop a full clinical trial) Dr Rob Janssen (a lung specialist working on the project) has said that he would now encourage a healthy intake of vitamin K for everyone (except those on blood-thinning medications such as warfarin).

He has further pointed out that in Vitamin K there may be “an intervention which does not have any side effects". He even advises all of those not on anti-clotting medication to “take those vitamin K supplements. Even if it does not help against severe Covid-19, it is good for your blood vessels, bones and probably also for the lungs.”

Vitamin K, incidentally, comes in two forms K1 and K2. K1 is found in spinach, broccoli, green vegetables, blueberries, and all types of fruit and vegetables. K2, however, is better absorbed by the body. It is in Dutch cheese, but also in French cheese as well but is also available as a supplement.

What’s interesting is that it also occurs in some fermented foods, particularly in natto (a Japanese fermented food that for many requires a strong stomach to eat but which is beloved by many in Japan). It also occurs in lower quantities in both miso and koji, also Japanese foodstuffs. Janssen has been advised that in the regions of Japan where natto is eaten in quantities (it is most definitely an acquired taste, by the way) there has not been a single death from COVID-19.

This could well help explain the enormous discrepancies in death rates in different countries: the official current mortality rate per million in Japan is 7; worldwide it is 51.6; while in the UK (now sadly second only to Belgium) it is 596. Other explanations certainly exist – the careful observation of the Japanese towards hand hygiene (which was reckoned to have protected them so well from the original SARS outbreak, for instance), and also their preference for of bowing in greeting rather than shaking hands. But perhaps Janssen is on to something here?

What is certain is that ANYTHING that might reduce these terrible death rates where they are worst should be being urgently considered and (more importantly) a programme should be implemented if remotely possible even if there is not full-blown clinical evidence – most especially if it is safe, simple to implement and cheap (in that order) - which is unquestionably the case.

In the next blog we will wonder why this isn’t already being done, including identifying evidence that (astonishingly) actually the opposite seems to be occurring.