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The First Randomized Controlled Trial on Vitamin D and Covid-19

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Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#172

Previously on HN, a physician shared some thoughts on treating Vitamin D as a medication and not as a dietary supplement: Part 1: https://news.ycombinator.com/item?id=24138590 Part 2: https://news.ycombinator.com/item?id=24261948 To summarize - popping in large doses of Vitamin D is not exactly safe.

From the evidence I've seen, vitman D deficiency is a bigger problem than vitamin D toxicity.

We already have dozens of RCTs showing that vitmain D supplements prevent respiratory infections.

https://www.bmj.com/content/356/bmj.i6583

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#173
post #10
post #2

Noteworthy that this is in combination with anti-viral drugs at hospital admission: hydroxychloroquine (400 mg every 12 hours on the first day, and 200 mg every 12 hours for the following 5 days), azithromycin (500 mg orally for 5 days). Regardless, I'm going to assume this means being outside and getting sun is good for me.

Except for all the skin cancer, right? FWIW, I was told that when the Sun is above 45 degrees over the horizon you will accrue DNA damage, and it stacks up over your entire lifetime. There is no "reset" or "heal", it just adds up. For that reason I'm doing my darnest best to stay in the shade between 9am and 3pm. Or covering clothing.

I think the tides have been turning on avoiding all sun exposure. While you obviously want to avoid getting burnt, the benefits of adequate sun exposure seem to outweigh the harms.

Rhee, H. J. van der, E. de Vries, and J. W. Coebergh. “Regular Sun Exposure Benefits Health.” Medical Hypotheses 97 (December 1, 2016): 34–37. https://doi.org/10.1016/j.mehy.2016.10.011.

"Since it was discovered that UV radiation was the main environmental cause of skin cancer, primary prevention programs have been started. These programs advise to avoid exposure to sunlight. However, the question arises whether sun-shunning behaviour might have an effect on general health. During the last decades new favourable associations between sunlight and disease have been discovered. There is growing observational and experimental evidence that regular exposure to sunlight contributes to the prevention of colon-, breast-, prostate cancer, non-Hodgkin lymphoma, multiple sclerosis, hypertension and diabetes. Initially, these beneficial effects were ascribed to vitamin D. Recently it became evident that immunomodulation, the formation of nitric oxide, melatonin, serotonin, and the effect of (sun)light on circadian clocks, are involved as well. In Europe (above 50 degrees north latitude), the risk of skin cancer (particularly melanoma) is mainly caused by an intermittent pattern of exposure, while regular exposure confers a relatively low risk. The available data on the negative and positive effects of sun exposure are discussed. Considering these data we hypothesize that regular sun exposure benefits health."

Hoel, David G., Marianne Berwick, Frank R. de Gruijl, and Michael F. Holick. “The Risks and Benefits of Sun Exposure 2016.” Dermato-Endocrinology 8, no. 1 (October 19, 2016). https://doi.org/10.1080/19381980.2016.1248325.

"This review considers the studies that have shown a wide range health benefits from sun/UV exposure. These benefits include among others various types of cancer, cardiovascular disease, Alzheimer disease/dementia, myopia and macular degeneration, diabetes and multiple sclerosis. The message of sun avoidance must be changed to acceptance of non-burning sun exposure sufficient to achieve serum 25(OH)D concentration of 30 ng/mL or higher in the sunny season and the general benefits of UV exposure beyond those of vitamin D."

This change in thinking has been a long-time coming. There have been results showing studies since the 90s showing lower melanoma mortality from those having more sun exposure, as described in this review:

Egan, Kathleen M., Jeffrey A. Sosman, and William J. Blot. “Sunlight and Reduced Risk of Cancer: Is The Real Story Vitamin D?” JNCI: Journal of the National Cancer Institute 97, no. 3 (February 2, 2005): 161–63. https://doi.org/10.1093/jnci/dji047.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#174
This seems pretty promising, though small n, result. Vitamin D is so ably we’ll well attested as a prophylaxis for pulmonary infections — in fact there was a large UK study published in January on this very facto.

Starting in February I went on a prophylactic supplement of Vit D, Vit C and aspirin because of the then-unnamed Covid-19 virus. The aspirin (actually started that in april) is because of the pervasive excess clotting and sudden strokes in young people showing up in ERs (less attested in the US than some other countries for reasons I’m not sure about). I’d never taken supplements before.

I’m immuno compromised so with my doctor we worked out the regime above plus some prescription drugs I won’t mention.

So far, so good, but I’m isolating' so this could be a case where I’m also preventing tiger attacks.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#175

Previously on HN, a physician shared some thoughts on treating Vitamin D as a medication and not as a dietary supplement: Part 1: https://news.ycombinator.com/item?id=24138590 Part 2: https://news.ycombinator.com/item?id=24261948 To summarize - popping in large doses of Vitamin D is not exactly safe.

Thank you thank you thank you. There is a craze for popping Vitamin D related to the raft of observational studies, here... so many of which never find a causal link. Take my own particular condition: an inherited vascular dysplasia which causes frequent nose and GI bleeds. People with low Vitamin D seem to have a worse time of it in OBSERVATIONAL studies. But people with GI bleeds so bad they have daily diarrhea fro…

People dose themsevles with OTC vitamin D all the time, including me. It doesn't appear to be a crisis. C19, otoh...

You saw the apparent effect size in this study, right?

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#176
post #174

This seems pretty promising, though small n, result. Vitamin D is so ably we’ll well attested as a prophylaxis for pulmonary infections — in fact there was a large UK study published in January on this very facto. Starting in February I went on a prophylactic supplement of Vit D, Vit C and aspirin because of the then-unnamed Covid-19 virus. The aspirin (actually started that in april) is because of the pervasive exce…

N can be small when the effect size is huge.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#178
post #137

Earlier quoted context omitted.

>generally insurance is a real PITA with vitamin D testing FWIW, vitamin D has been among the things tested when I have my blood work for an annual physical and never had any insurance issue about it. And I do take supplements because it was low.

Interesting. I had to pay something like $100 out of pocket for my recent vitamin D test (unsurprisingly it was low).

I suspect his doctor just knew to code it properly as low vitamin D for monitoring of replacement therapy. Since he legitimately has low D and is on replacement therapy there’s no issue. For first timers not sure if they are or not an experienced doctor will just label it this way anyway and tell you 9/10 it’ll work. 1/10 you’ll have to pay the fee. It’s just another example of our nonsensical health system at work.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#179

Anyone knows what rol sunscreen plays in vitamin D intake/generation by sunlight?

the body makes vitamin D3 when UVB rays hit cholesterol in the skin

sunscreen either blocks, scatters, or absorbs those rays

seems to reason that sunscreen slows down sun burn and vitamin D3 production

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#180
post #39

Earlier quoted context omitted.

Wiki says that "Hydroxychloroquine is being studied to prevent and treat coronavirus disease 2019 (COVID‑19), but all clinical trials conducted during 2020 found it is ineffective and may cause dangerous side effects." https://en.wikipedia.org/wiki/Hydroxychloroquine

millions of people take HCQ on a daily basis for their lupus. Ask any rheumatologist, the danger of Torsades de Points is only a concern for HCQ if the patient already has a serious heart condition, or if the patient has been taking HCQ for years. Millions more take HCQ as a malaria treatment. It is generally recognized as safe, if you do not have a heart condition (and even then a short course is unlikely to yield a…

> Millions more take HCQ as a malaria treatment. It is generally recognized as safe, if you do not have a heart condition (and even then a short course is unlikely to yield adverse outcomes).

COVID-19 can infect the heart and damage it. As safe as HCQ might be on its own, here it's adding extra load to a system that's already under stress.

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