To all governments: advise Vitamin D to your citizens during the covid-19 crisis

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Date of publication: July 16 2020
Latest update: October 21 2020

The world has been hit hard by the Covid-19 crisis. Something that has been overlooked in the battle against the virus is the use of Vitamin D. But wait? It can’t be this simple that a vitamin can help us right? Well, Vitamin D plays a huge role in the immune system and a large part of the world population has too low levels of it (source). Many studies indicate that it plays a large role in handling a covid-19 infection. Taking Vitamin D won’t eliminate the problem all together, however it possibly can contribute in overcoming this crisis.

Short version:

  • Vitamin D is known for its role in immune system (Eg during the flu) and in respiratory infections.
  • More and more studies (20+) show a correlation between low Vitamin D and severe infection of covid-19: An overview
  • Large part of the world population has deficiencies, also in sunny areas
  • Many experts advise to take vitamin D supplements and see that as a possible contribution to managing the covid crisis.


Below video gives during 5 minutes information on why vitamin D is important right now.

YouTube, May 22 2020, Dr. John Campbell in a short video explains the importance of sufficient Vitamine D levels regarding covid-19. Source: YouTube channel John Campbell (over 700K subscribers)

How come our levels are too low?

You will get Vitamin D from your diet, for a small part. But most of it your body itself will create. However it is needed to be in the sun ☀️ for your skin to do that. With modern lifestyle, we spend large part of our days indoors. Not getting as much sun on our skin, causing our Vitamin D levels to go down. (source)

Especially people with darker skin create vitamin D less quickly, because they are more highly protected against sun rays.

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How to get Vitamin D levels up to sufficient?

Be outside daily on sunny ánd cloudy days, to make sure you get your dose of sun exposure, with large part of the skin uncovered. Do take in account that too much unprotected sun exposure can lead to development of skin cancer.

And / or take a Vitamin D supplement. Especially during seasons other than the summer and for those that don’t get much sun exposure it is advised to take a vitamin D supplement. It is already part of governmental policy to advise Vitamin D because deficiencies can easily occur (source).

Take a supplement with below dosage, according to age.

agedosage (microgram)dosage (IU)
7-12 months10 400
1-11 years10400
11 and up251000
Recommended dosage for various age groups. IU = International Units

This is a bit higher than the European food and Safety Authority is recommending. It’s still very much on the safe side. Many studies advise to take a bit higher dose to maintain optimal blood levels (source). Especially for people with a darker skin color. If possible, you can consult your doctor for personal advise.

Regarding sun exposure: several sources (1, 2) report a rule of thumb. This rule says: optimum Vitamin D levels are formed when you spend unprotected in the sun for maximum halve of the time for which it would take for you to get mildly sunburned.

If my vitamin D levels are good, won’t I get infected with Covid-19 anymore?

No, it’s probable you can still get ill from Covid-19. However, there are studies indicating that people with healthy Vitamin D levels will overcome an infection of Covid-19 more easy and more quickly. This would make covid-19 less of a problem. It is not guaranteed that you won’t get severe symptoms from a covid-19 infection when your are Vitamin D sufficient. Keep taking precautions to not get infected and to not pass the virus on.

What about the scientific evidence for its role in covid-19?

The answer to this question is less important than one would think. Huh? It is highly unlikely that there will be harm in taking it for prevention. And very likely it will have a contribution. So why should this advice be applied only after executing trials which take very long time? Governments should look into it now.

The covid crisis has made something clear to me (me = the writer of this webpage). It is very known and scientifically determined that Vitamin D plays a huge part in the immune system (source, Harvard). Until now, there are only so called observational studies available (1, 2, 3, 4 and more) that show the correlation between low levels of vitamin D and a high chance on severe symptoms of a covid-19 infection. And also mechanisms in the body’s response to covid-19 virus are described (source) in which Vitamin D plays a role. In the scientific world, observational studies alone are not enough for taking it up in protocols. For this, so called trials are needed. Trials take months if not years. However: There. Is. No. Time! For medical drugs it’s better understandable that trials are necessary. Cause these are part of treatment protocols and there is a toxicity possibility. But Vitamin D can possibly be used as a prevention, not as a treatment (although it can be part of treatment protocols by doctors too). Vitamin D is a molecule that the body is able to make itself and naturally occuring in nature, very different from a drug.

Just cover this possible factor. Maybe afterwards it shows it didn’t help. So what? Don’t present it as a cure, but present it as possible contribution to the problem. It’s a matter of good communication. Don’t let this chance pass.

What can we do right now?

The possible factor of Vitamin D in this crisis is something we can cover quite easily. It will be most widely adapted, if governments will give their citizens advice to take a vitamin D supplement or providing this to them free of cost.
The key in this is awareness. Until now, this option has been overlooked by many. By sharing this message as much as possible, we can reach a lot of people and among them politicians and the responsible persons in governments.

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Is it safe to take Vitamin D supplements?

Yes, very safe. Health institutes are already, before covid-19, advising to get levels up to sufficient. And it’s a vitamin, a naturally occurring nutrient. Do take in account the limit for daily intake, from diet and supplements together. These limits are determined by the EFSA at the following values:

age (years)upper level intake (microgram)upper level intake (IU)
0-125 1000
1-11502000
11 and up1004000
Limits for daily intake determined by the European Food Safety Authority, IU = International Units
Source: European Food Safety Authority – Scientific Opinion on the Tolerable Upper Intake Level of vitamin D

Note: this is the total intake, so from food and supplements. Vitamin D rich foods are for instance fatty fish and eggs (source). Depending on the region or country where you are living, it is also possible that your are taking a product with vitamin D added (fortified), e.g. milk.

But I read in the media that I have to be careful with Vitamin D?

It seems that media sometimes feel responsibility to downplay hypes and make sure people don’t overdo things like taking vitamins. This CNN article is an example of that. Unfortunately, the process of trying to inform you, also causes doubts to rise among the public. This may result in a passive attitude by the public concerning Vitamin D and a lot won’t know what’s best anymore. Which is very unfortunate. Of course there is no evidence for Covid-19 particularly as the article is stating, because it’s a new virus. And of course you shouldn’t take extreme doses. However there is no harm in getting our levels up to sufficient. It’s important to keep using common sense.

What about sunny and warm areas like Brazil and Florida? Covid-19 hit there as well

In the contrary of what you might think, even in these places there can be a deficiency for a large part of the population (source). It’s a result of working indoors during daytime and the use of sunscreen and being covered by clothing.

Why don’t all governments give this advice yet?

A possible explanation is that taking care of healthy vitamin levels for the prevention of disease is often overlooked. A lot of the time, illness is considered to be dealt with when it occurs and not minding it when illness doesn’t show. Next to that, the predominant view is that for a complex problem heavy medical measures probably will be needed. Vitamins and minerals might have a reputation of being ‘simple’ nutrients with no large impact.

It’s not said that covid-19 won’t be a problem anymore when we all get our Vitamin D levels up to sufficient, however it’s a factor we can easily cover. It most probably will contribute and it is very unlikely it will have a negative contribution.

List of countries applying Vitamin D advice during Covid crisis

Egypt (doctors in hospitals, source)
Slovenia (Fragile patients in nursing homes, source)
Scotland (source)
Wales (Source)
Israel (October 2020, source)

Do you know any other country that has made it part of their policy? Please fill out the form below!

Interesting quotes


Commentary, August 3 2020
“Pending results of such trials, it would seem uncontroversial to enthusiastically promote efforts to achieve reference nutrient intakes of vitamin D, which range from 400 IU/day in the UK to 600–800 IU/day in the USA. These are predicated on benefits of vitamin D for bone and muscle health, but there is a chance that their implementation might also reduce the impact of COVID-19 in populations where vitamin D deficiency is prevalent; there is nothing to lose from their implementation, and potentially much to gain.”
Source: Vitamin D for COVID-19: a case to answer? The Lancet, Martineau et al, August 3 2020


“To conclude, our study found that suboptimal plasma vitamin D levels may be a potential risk factor for COVID -19 infection, particularly, for the high hospitalization risks, independent of demographic characteristics and medical conditions. The finding is important, since it could guide healthcare systems in identifying populations at risk, and contribute to interventions aimed to reduce the risk of the COVID-19 infection”
Source: Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study FEBS Journal, Merzon et al, July 23 2020


Interviewer: “Should we be trying to increase our vitamin D levels, not least for all the other benificial effects it has, but just in case it might also help in protecting us from developing a more severe coronavirus infection?” Professor: “Yes, definitely.”
Source: Covid-19: the role of vitamin D – podcast – the Guardian, May 27 2020, at 12:58 minutes. Sarah Boseley talks to professor of nutritional science Susan Lanham-New


“In the meantime we recommend that more publicity be given to current guidelines for vitamin D dietary intake and supplementation as denoted by the public health agencies in the USA, UK and Europe. “
Source: Vitamin D and Inflammation: Potential Implications for Severity of Covid-19 Irish Medical Journal, Laird et al

From Letters to the editor (october 6th 2020):
“There is a problem here in that both UK vitamin D/Covid-19 randomised controlled trial (RCT) proposals have been rejected for funding. Moreover, we are unlikely to get results from any large RCT until the spring at the earliest, and find ourselves waiting for the perfect RCT.

[…] Vitamin D is important for the normal functioning of the immune system and is extremely safe and cheap. We need to get on with this.”

Source: Times letters, signed by: George Griffin, emeritus prof. of infectious diseases and medicine; Martin Hewison, prof. of molecular endocrinology; Julian Hopkin, prof. of experimental medicine; Rose Anne Kenny, prof. of medical gerontology, Richard Quinton, senior lecturer in endocrinology; Jonathan Rhodes emeritus prof. of medicine, David Thickett, prof. in respiratory medicine

More sources

youtube

Should you take Vitamin C and Vitamin D for Coronavirus? – Dr. Mike Hansen, MD, March 9 2020

Vitamin D and immunity – John Campbell PhD, March 9 2020

Articles

How Much Vitamin D Should You Take For Optimal Health? – Heathline.com, June 2017

Experts criticise government review of Vitamin D for COVID-19 – NutraIngredients.com, July 2 2020

Calls to add vitamin D to anti-coronavirus arsenal – The Australian, July 20 2020

Coronavirus lockdown has made us more vitamin D deficient – New York Post, July 6 2020

Governmental nutritional information

Vitamin D factsheet – National Health institute USA

Scientific publications:

Gordon Shotwell is publishing since May 2020 on the topic of Vitamin D and covid-19. He set up a Github page with an overview of scientific publications and more.

A Basic Review of the Preliminary Evidence that Covid-19 Risk and Severity is Increased in Vitamin D Deficiency – Linda Benskin PhD, July 2020

Annweiler, Cédric, et al. “Vitamin D and survival in COVID-19 patients: A quasi-experimental study.The Journal of Steroid Biochemistry and Molecular Biology (2020): 105771.
https://www.sciencedirect.com/science/article/pii/S096007602030296X

Carpagnano, Giovanna Elisiana, et al. “Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19. Journal of endocrinological investigation (2020): 1-7.
https://link.springer.com/article/10.1007/s40618-020-01370-x

Mardani, R., et al. “Association of vitamin D with the modulation of the disease severity in COVID-19.” Virus research 289 (2020): 198148.
https://www.sciencedirect.com/science/article/pii/S0168170220310558

Panagiotou, Grigorios, et al. “Low serum 25‐hydroxyvitamin D (25 [OH] D) levels in patients hospitalized with COVID‐19 are associated with greater disease severity.Clinical endocrinology (2020).
https://onlinelibrary.wiley.com/doi/full/10.1111/cen.14276

Any suggestions for this page? Criticism? Articles? Videos? Please leave below

Who is behind this page?

This page is made by me, Johan, an individual from the Netherlands. There is no company behind this page trying to promote Vitamin D whatsoever. I am not a doctor. I don’t have any financial interests in this subject whatsoever. I just happened to have a lot of spare time because of the corona crisis and health is a subject I have been interested in for quite some time. By making this site I tried to make a document with accessible information for the non-expert that is easily shared across social media. With the help of social media it’s possible to spread this important message.

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