Vitamin D Recommendations and COVID-19

[jimh111]

There are conflicting views regarding vitamin D levels. I read up on vitamin D in the 1990s, so I am a bit out of touch now.

The (now defunct?) ‘Vitamin D Council’ recommend unusually high levels. I have ignored their publications because I dislike people and organisations that use terms like ‘council’ or ‘academy’ and give a false impression that they are an official body. I suspect they are well meaning learned people who want to campaign for a better knowledge of vitamin D. As a lobby group they may give a less balanced view.

On the other side the NHS recommends we take 10mg (400 IU) of vitamin D daily during the winter months. This is based on recommendations from the ‘Society for Endocrinology’ which is the UK club for endocrinologists. They define ‘deficient’ as <25nmol/l and ‘insufficient’ as <50nmol/l endocrinology.org/endocrino... .

The ‘Endocrine Society’ which is the USA club for endocrinologists define deficient as < 20 ng/ml (50 nmol/l) and insufficient as 21–29 ng/ml (52.5–72.5 nmol/l) academic.oup.com/jcem/artic... . (This paper is not easy to read and they leave out the decimal place sometimes! They also use four circles to denote the strength of evidence, the more plusses in the circles the stronger the evidence. This is explained halfway thought the paper!). The Endocrine Society recommend 600 – 800 IU daily as a minimum for white people who are not elderly, pregnant, or obese and are healthy. They recommend much higher doses for people who are deficient, e.g. 1,500 – 2,000 IU/d and up to 4,000 IU/d.

The USA recommendations take a balanced view and are supported with evidence. It’s possible higher vitamin D levels provide other benefits but at least some studies have found no benefit. e.g. for preventing cancer.

There have been several studies showing associations between SARS-CoV-19 infection and vitamin D status. It could be that people more susceptible to COVID-19 have illnesses that lower vitamin D levels or lifestyles that give reduced exposure to sunlight. My favourite study journals.plos.org/plosone/a... seems to show a clear link between vitamin D and SARS-CoV-19 infection with a vitamin D level around 50 ng/ml (125 nmol/l) being ‘optimal’.

I’ve no idea of my vitamin D level, in the past I’ve supplemented during the winter, but my main strategy has been to try and keep an all year round suntan which is not possible with travel restrictions. Up until now I have tended to follow the NHS guidance of 400 IU/d during winter with a bit extra for luck. I now think this is inadequate and the USA guidance is better and for as long as COVID-19 is around we should aim for a level approaching 125 nmol/l. I am now taking one or two 5,000 IU tablets per week as it is cheaper and easier to take a larger dose less often.

[userotc]

Without knowing your D level, it's difficult to know how much to supplement. I was at ~145nmol/l last test so dropped to 2500iu/day from 5000 maintenance. So I expect to be around the 125 figure you mentioned.

I believe the historical basis of the much lower NHS dosage recommendation is prevention off ricketts? Maybe Mr Hancock' proposed study (?) for covid will update the guidance but I doubt it.

Shame if vitamin D council gone (or maybe website closed down?). Be better to keep alive by allocating the annual NHS budget for guidance to that imo!

[jimh111 in reply to userotc]

The USA recommendations I quoted are for the general population. If you are deficient they recommend higher doses and monitoring as you ate doing.

[Adam10]

I live in Middle East where sun is strong and try to sunbathe 2 to 3 times a week to get my vitamin D quota. However this never seems to work. So I supplement with amounts from single dose 5000 units a day to sometimes single dose of 50,000 units once per week. My last test result was 98 nmol/l so I still can’t reach the local GP doctor quoted recommended level of 120 nmol/l. I disregarded long ago the low NHS recommended figure.

[helvella in reply to Adam10]

When I lived in the Middle East for a while, I felt that the sun was somehow less likely to burn and tan than a clear summer's day in the UK.

Hot, my goodness, yes, it was.

The atmosphere never seemed clear like it can elsewhere - always seemed to be a high level haze. And it is thicker near the equator.

[Hidden]

My GP recommends 1200 I.U. daily, so clearly realises that 400 or 800 IU recommended by the NHS isn't sufficient. Personally I have to take 4000 IU or else my levels begin to drop. I get only very limited sun exposure throughout the year so can't rely on that.

You must test your Vit D level before you start supplementing, though, as otherwise you've no idea what effect any supplementation is having, or how much you need to take. Dr John Campbell on YouTube has numerous videos concerning Vit D and Covid-19 (proper evidence). The latest was out yesterday, showing the results of a clinical trial published in the BMJ recently.

youtube.com/watch?v=7H2c0Zm...(Not working as expected?)

[jimh111 in reply to Hidden]

The USA 600 iu per day is a minimum recommendation. I don't think you need to measure vitamin D to do this. It's a bit like the recommendation of 5 fruit or vegetable a day, it's a baseline for the mass of the population who don't know their vitamin D level.

The main point of my post is to draw attention to an official and I think balanced recommendation that is quite different to the UK position.

[Hidden in reply to jimh111]

I'd say that if you are interested in having Vit D levels that are useful in preventing the worst Covid symptoms, then you really should measure your levels. But, your body, your choice!

[Mouldyoledoll]

Watch dr John Campbell on YouTube, he is fab, and has lots of videos regarding vit D and covid

[juliat]

I take 20,000 iu a day, Hux D3, with one Super K (that's important) Read the history of vitamin D ( which is not a vitamin but a seco steroid) It was one of the first Cancer 'drugs' at 50,000 iu a day) I've taken up to 60,000 a day (with 3 x super K) and have got rid of any double hip arthritis symptoms that were ruining my life. (known as bone remodeller amongst other things) it's also keeping me safe from return of triple negative breast cancer. Reading suggestion 'The miraculous results of extremely high doses of Vitamin D...' Jeff T Bowles.Be aware of the units your vit D is being measured in

ng/ml (USA) we do nmol/L in uk

to go from ng/ml to nmol/L x by 2.5

AIM for 75 ng/ml to 150 ng/ml (I've not got near top end of that)

20mg = 1 million iu (international units)

Best not to take with calcium, especially with breast cancer.

recommend canceractive.com for other papers and info on vit D

Live long and prosper! xJulia

[juliat]

Oh and good luck getting a vitamin D test via GP...absolute NO!

[bookish]

Most of the people I read seem to suggest 40-60 ng/ml (100-150 nmol/ml) so I've been trying to keep at that sort of level (with the occasional private test). I did get to 150 once but even though I take 2000 IU daily, it has still dropped to 122 then 113, so I've just gone up to 4000 IU twice weekly for the winter, 2000 IU the rest of the week. I take K2 and magnesium too.

[SlowDragon Administrator]

Unlikely enough

When supplementing we should test twice yearly, certainly until you work out what you, personally need.

Dose required can vary substantially from person to person

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Or via

vitamindtest.org.uk

This option was rather slow getting results out last week....as inundated with people testing

[Angel_of_the_North]

This is interesting on vit D: drdavidgrimes.com/2020/11/c...

[Marz in reply to Angel_of_the_North]

Great link - have just spotted it on Dr Kendricks Blog and filed it. A must read 😕

[jimh111 in reply to Angel_of_the_North]

A lot of the excess COVID infections is due to lifestyle and behaviour. There are disproportionate levels of diabetes and obesity in some ethnic groups and some groups refuse to wear masks in shops and transport. This may represent a minority of the group but increasing the 'R' number from e.g. 1.2 to 1.4 will have dramatic effects over a period of months - that's how exponentials work. It's interesting to note that in countries in Africa and Asia where behaviour is better COVID is not as devastating as we might expect. Thus, we need to try and separate out cultural and behaviooural effects from vitamin D status.

I like the study I quoted because it shows the association of vitamin D with COVID in each ethnic group with consistent results. Association is not causation so it is just possible unhealthy people have lower vitamin D levels and this is why there is the association. My guess is that vitamin D is protective and so it make sense to supplement.

[Marymary7 in reply to Angel_of_the_North]

Thanks, very interesting article. 😎

[asiatic]

As a sun lover with healthy diet I was surprised that my VitD level when tested recently was 52nm/l so decided to supplement. I used the calculator on grassrootshealth web site which suggested a weeks loading dose of 25000 IU and then maintenance dose of 5000IU or without loading dose it would take 3 months to achieve the recommended level. I was surprised that it would take this long. I hadn't ever heard that mentioned before. The 25000IU freaked me out a bit so settled for 5000.

[Ania22]

I know that 50 yeats ago, maybe not in the UK, the recommendation was 10 000iu per kg of body weight...which would make sense as if you get an antibiotique from the gp, you get the dose appropriate for your body weight (body weight is taken onto consideration).With vit D, 40kg adult or 140kg adult needs apparently the same dose.

It is crucial to take vit D with vit K, best one K2 (MK&), so the calcium goes in the right place.