Here is an interesting article I found regarding Vitamin D:
Vitamin D appears to play role in COVID-19 mortality rates
by Amanda Morris, Northwestern University
vitamin d
Credit: CC0 Public Domain
After studying global data from the novel coronavirus (COVID-19) pandemic, researchers have discovered a strong correlation between severe vitamin D deficiency and mortality rates.
Led by Northwestern University, the research team conducted a statistical analysis of data from hospitals and clinics across China, France, Germany, Italy, Iran, South Korea, Spain, Switzerland, the United Kingdom (UK) and the United States.
The researchers noted that patients from countries with high COVID-19 mortality rates, such as Italy, Spain and the UK, had lower levels of vitamin D compared to patients in countries that were not as severely affected.
This does not mean that everyone—especially those without a known deficiency—needs to start hoarding supplements, the researchers caution.
"While I think it is important for people to know that vitamin D deficiency might play a role in mortality, we don't need to push vitamin D on everybody," said Northwestern's Vadim Backman, who led the research. "This needs further study, and I hope our work will stimulate interest in this area. The data also may illuminate the mechanism of mortality, which, if proven, could lead to new therapeutic targets."
The research is available on medRxiv, a preprint server for health sciences.
Backman is the Walter Dill Scott Professor of Biomedical Engineering at Northwestern's McCormick School of Engineering. Ali Daneshkhah, a postdoctoral research associate in Backman's laboratory, is the paper's first author.
Backman and his team were inspired to examine vitamin D levels after noticing unexplained differences in COVID-19 mortality rates from country to country. Some people hypothesized that differences in healthcare quality, age distributions in population, testing rates or different strains of the coronavirus might be responsible. But Backman remained skeptical.
"None of these factors appears to play a significant role," Backman said. "The healthcare system in northern Italy is one of the best in the world. Differences in mortality exist even if one looks across the same age group. And, while the restrictions on testing do indeed vary, the disparities in mortality still exist even when we looked at countries or populations for which similar testing rates apply.
"Instead, we saw a significant correlation with vitamin D deficiency," he said.
By analyzing publicly available patient data from around the globe, Backman and his team discovered a strong correlation between vitamin D levels and cytokine storm—a hyperinflammatory condition caused by an overactive immune system—as well as a correlation between vitamin D deficiency and mortality.
"Cytokine storm can severely damage lungs and lead to acute respiratory distress syndrome and death in patients," Daneshkhah said. "This is what seems to kill a majority of COVID-19 patients, not the destruction of the lungs by the virus itself. It is the complications from the misdirected fire from the immune system."
This is exactly where Backman believes vitamin D plays a major role. Not only does vitamin D enhance our innate immune systems, it also prevents our immune systems from becoming dangerously overactive. This means that having healthy levels of vitamin D could protect patients against severe complications, including death, from COVID-19.
"Our analysis shows that it might be as high as cutting the mortality rate in half," Backman said. "It will not prevent a patient from contracting the virus, but it may reduce complications and prevent death in those who are infected."
Backman said this correlation might help explain the many mysteries surrounding COVID-19, such as why children are less likely to die. Children do not yet have a fully developed acquired immune system, which is the immune system's second line of defense and more likely to overreact.
"Children primarily rely on their innate immune system," Backman said. "This may explain why their mortality rate is lower."
Backman is careful to note that people should not take excessive doses of vitamin D, which might come with negative side effects. He said the subject needs much more research to know how vitamin D could be used most effectively to protect against COVID-19 complications.
"It is hard to say which dose is most beneficial for COVID-19," Backman said. "However, it is clear that vitamin D deficiency is harmful, and it can be easily addressed with appropriate supplementation. This might be another key to helping protect vulnerable populations, such as African-American and elderly patients, who have a prevalence of vitamin D deficiency."
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Vitamin D linked to low virus death rate
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Interesting. So much learning will emerge from this Pandemic. Thanks for sharing.
The original research says:
This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has YET TO be EVALUATED and so should NOT BE USED TO GUIDE clinical practice.
And the author in a different article....
"While I think it is important for people to know that vitamin D deficiency might play a role in mortality, we don't need to push vitamin D on everybody," said Northwestern's Vadim Backman, who led the research. "This needs further study, and I hope our work will stimulate interest in this area. The data also may illuminate the mechanism of mortality, which, if proven, could lead to new therapeutic targets."
It really is hard to know what to make of these bits of research that are coming out before being explored further and peer reviewed.
The usual process for publishing research has gone into hyperspeed due to the web and covid19 in this case. People are hanging their personal research interests onto covid19 in anyway they can in attempts to get research funds.
In my view excellent research doesn't get done in a few weeks or months, it can take years. We do need data, but some interpretations are premature or so wide ranging as to be of little use. It could well be the case that vit d offers some protection for some people, but 50/50 chances, or a potential correlation isn't causative. But as pmrpro says unlike some suggestions vitd isn't as dangerous as some "treatments" put out there. Though of course too much vit d can be a problem and cause as harsher symptom as too little.
And of course it must always be remembered that with the right stats you can "prove" your personal hypothesis - the most important member of the research team is the statistician who tells you how to go about getting the answer YOU want. Hence the value of peer reviewal - and they also say clearly that you were trying to fudge some weak numbers.
There is not going to be one simple answer to Covid-19. Whether it is PC to say so or not, probably as important as any other factor is going to be "get that weight off". There is an undeniable association with obesity - which is associated with poverty and poor diet as well as eating far too much of the wrong things just because you can.
Agree. I realise there's no time yet to do fulsome reviewing and data checking but if you don't know that good research is checked , checked, and double checked and some projects take years, then it's difficult to seperate the wheat from the chaff. I get even more ansty when "bad science" underpins the development of something like MMS. People who hate big pharma then make a personal fortune and other companies make millions or billions. Sorry ranty country again.
When I saw that the BMI of equal or over 40 was a key factor I worked mine out ...breathed a sigh of surprise and relief and determined to go down further.
What is worrying - in general too - is that even doctors struggle to recognise obesity. I mentioned my concern about weight gain when PMR first started and I simply couldn't move (he didn't recognise PMR either) and he told me I wasn't obese. I was, well over a BMI of 30 at the time. But my build makes it less obvious - if I had 4 in longer legs, to match my upper body shape, not only would every pair of trousers not have to be shortened but I would also have an acceptable BMI!!!
The "specialist" I saw a few weeks back for my bowel issues declared "you are fat, that's all that's wrong with you. If you were not fat you wouldnt have problems". I am about a stone over my ideal weight!! Any excess weight is due to pred as I pointed out numerous times and my bowel problems were here way before any weight gain or pred use which my gp had stated in my referral letter!! He was so determined to have my problems blamed on my weight I had to force him to investigate further. Not everything is down to weight and one bloody stone over ideal does not cause every ailment. YBB
Too skinny!! Its his fault he has problems as he doesnt eat enough!! Its ridiculous blaming everything on weight. Under or over. My youngest is just over 7 stone and really fit but after she had some gynae issues the consultant said she needed to lose weight! Just checked my bmi and its 27!!! Not exactly huge.
It's ridiculous the amount of bullying these specialists do. I am luckily quite gobby and know that my weight gain will drop when the pred goes down and I am fortunately not paranoid about my weight but if you were sensitive about weight a doctor telling you that everything is down to your fat could send you off on a downward spiral. YBB
ARE you much overweight? I was - and she would have found no suggestion of inflammation in my blood results. I suspect that the concept of raised ESR/CRP in overweight patients may be greatly overegged. There is something else going on in the background. And I had been oveweight a lot of my life - but didn;t have PMR symptoms. It was different.
By then I'd gone up to nearly 17 stone, which was nearly 3 stone more than when I started Pred, so yes overweight. That was why I was so desperate to get off Pred but couldn't get below 5 without feeling really lousy. In those days I'd never heard of low carb eating and was doing low calorie, as advised by my GP, and it wasn't working. I'm about 2.5 stone lighter now at 14.5 st thanks to low carb but inflammation markers were still high-ish, until the amazing depo-medrone injections got CRP down to 9 a month ago. For you continentals I'm about 94 kilos and would really like to get back to about 80-85 ideally, though as I'm 10 years older now I don't know if that's possible.
Shame Depot-medrone doesn't also act as a weight loss miracle but it does suggest there was something up with your absorption of oral pred. Or you reacted to prednisolone like I did to oral methyl pred - I gained weight and had all the steroid adverse effects - it just didn't combat the inflammation!
Yeah, even when I did keto before Easter the weight loss was still the same, 1/2 to 1 lb a week. I think I'm actually very sensitive to even small changes in steroid though but IMHO a number of things went wrong. It took over a year until I was diagnosed then my starting dose was only 10 back in 2012, though that felt miraculous at first but then I was told to taper 1 a month so I was down to 5 very quickly and was stuck there going into the 3rd year which was when I asked for a referral to a rheumatologist and things subsequently went from bad to even worse when they said I was too young to have PMR. I remember being in absolute agony on 5 Pred also had plantar fasciitis which I had steroid injections in my feet for (miraculous) but I wanted to press on and get the weight off as PMR goes in 2 years, or so I was told at the time. I think I've always had too low a dose.
A relative who got PMR last Sept aged 56 is havng a much easier time. Started on 25 Pred and has only been allowed to taper down slowly first to 20 then now to 15 when blood tests show inflammation is under control, not before. She doesn't know why I made such a fuss and smugly says PMR hasn't changed her life, she still goes to work, feels a bit tired but ignores it. Thinks I'm a wuss. I tell her things were very different 8 years ago.
Not just that - send her here. Everyone is different and has a different journey. She has been very lucky. My ESR/CRP have never been out of range - so how do I (and lots of others) go about it?
I keep trying to offer her advice but she thinks she knows everything and everything is under control. It does seem she has a very good rheumy, her GP referred her to one because of her age. We'll see what happens in the course of time as she drops the steroid dose.
Except with i.m. - this is really interesting. I would ask Christian - except I had a horrendous experience with oral methyl pred and lord knows when I get to see him ...
No sorry I meant if I have to take Pred it has to be 15 a day, another reason why I prefer the IM D-M as it's a much lower overall dose but does the job better, maybe because it's more directly absorbed.
I knew what you meant - the i.m. is 100% bioavailability but oral is usually thought of as 50-90%, doctors tell you 70%. It would be unusual to only absorb about a third. But it suggests that when we have trouble reducing the dose that trying i.m. might be worth a whirl. The Medrol I had did nothing for the inflammation - but caused awful adverse effects. You would imagine I was absorbing it by them, but not the effect on the PMR!!
As you know I think IM Depo is amazing. In 3 months it managed to do what 5-8 years of Pred failed to do which was really bring my inflammation down and give me life back. I really am surprised it's not more widely used eg for people struggling to get below 5 Pred. If rheumies are so obsessed with Cumulative dose and this could reduce it by at least a third it's well worth looking at. I also think it's quite possible that if people took it early on it might 'nip things in the bud' rather than the average of 5.9 years. It's definitely worth a try before MTX which is their next go-to after Pred. It's always been there but nobody uses it. Reminds me of that cartoon you see of somebody cutting the grass with a scythe and someone tapping him on the shoulder from behind holding a lawnmower and he says 'not now I'm too busy cutting the grass'.
They would if it made them feel great as I do and without the side effects of Pred, I really don't want ot go back to Pred. It's never even suggested as an option, you have to be in the know to ask about it. it's a quick injection in the bum and doesn't hurt.
I guess it could go wrong for you if you had a bad reaction to methyl, but then again it's different and offered as an option for those who can't take oral steroids. Maybe you could try 1 vial (40m) first to see?
It wasn't re the GCA, it was her dodgy knee. But she had gained weight because of the pred - no other reason. When she stopped, without changing anything about diet the 6st disappeared the way it had some though it did take a bit longer!
They are so determined to blame everything on weight yet most stuff like thyroid probs and diabetes come with weight issues both gaining and losing depending on the type of your disease. Yes obesity is a problem especially in some youngsters but they cant blame everything on weight gain. Eldest wont gave grandson measured or weighed by the school health people because they have declared so many kids as overweight that werent. Grandson is really tall and has the weight to match but is in exactly the right percentiles for weight and height so although taller than 95% of his class his weight is ideal for that height but the health so called professionals only see weight!!
A question - I have taken a vit D supplement for years (RA for 9 years) and on a recent test the nurse said with some surprise "you're nearly normal!" If vit D works against inflammation, and my levels are so good, why am I still so affected by inflammation?
Vit D is only part of a very large picture. Mind you - it does depend on what she regards as "normal". Normal is a figure established by measuring levels in a large population of people and the normal range is the range of levels found in 95% of that population. That isn't the same as an optimal level - if everyone is vit D deficient the normal range will be low.
Thanks for this. As far as weight is concerned I’m sure most of us do what we can. When other medications screw it up a little you just have to carry on being as sensible as you can.
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but it does suggest there was something up with your absorption of oral pred. Or you reacted to prednisolone like I did to oral methyl pred - I gained weight and had all the steroid adverse effects - it just didn't combat the inflammation!
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