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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

#251

Post by hanklazard »

ghaff wrote: post #137
erentz wrote: post #104

Earlier quoted context omitted.

Greater than 70% of African Americans are suspected to be Vit D deficient. Definitely worth getting tested if you can [1] especially if you live in the more northern latitudes. Doubly so during winter. [1] with the note that generally insurance is a real PITA with vitamin D testing. The trick usually is to list as a diagnosis code a previous history of low vitamin D. Yes it’s like a catch 22. You need prior testing s…

>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.

Primary care doc in MA here. I can tell you that we run into a lot of trouble with getting insurance to pay for these tests in people who don’t have a deficiency or insufficiency on record. I’m glad you haven’t had any problems with yours!

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

#252

Post by function_seven »

agarden wrote: post #92
eholk wrote: post #34

Earlier quoted context omitted.

I'd be really interested to see a comparison of the relative risks between skin cancer and vitamin D deficiency. A lot of what I've read lately suggests we're discovering a lot of benefits of vitamin D that were previously unknown, and some evidence that the recommended vitamin D levels should be higher than they are. For a generation or so we've told people the sun is dangerous because of skin cancer, and obviously…

This article gets into that: https://www.outsideonline.com/2380751/sunscreen-sun-exposure... Short excerpt: People don’t realize this because several different diseases are lumped together under the term “skin cancer.” The most common by far are basal-cell carcinomas and squamous-cell carcinomas, which are almost never fatal. In fact, says Weller, “When I diagnose a basal-cell skin cancer in a patient, the first thin…

> The most common by far are basal-cell carcinomas and squamous-cell carcinomas, which are almost never fatal.

My grandpa died due to complications from a basal-cell skin cancer. He was almost 90 years old. The cancer itself was a few decades old. He served in the Navy during WWII, and likely got it from years of tropical sun exposure with no sunscreen.*

So, yeah, as far as cancers go, that's one you'd rather get if given a choice.

* (Well, and the additional years of fishing and other outdoor activities. Obviously the cause can't be pinpointed like that, but it must have contributed)

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

#253

Post by JshWright »

ellyagg wrote: post #203
maxander wrote: post #3

From the results: “Of 50 patients treated with calcifediol, one required admission to the ICU (2%), while of 26 untreated patients, 13 required admission (50%) p value X2 Fischer test p Which sounds like as strong a signal as a study of this scale could hope to show.

It's useful to note that this study doesn't need to stand on its own as evidence. It contributes to a growing body. As most of you may have already seen, there is a lot of observational evidence that people with low vitamin D have the worst C19 outcomes. Obviously, correlation by itself doesn't mean causation. But it is a hint. On top of the hint, we already have dozens of RCTs that vitamin D supplements suppress res…

> there is a lot of observational evidence that people with low vitamin D have the worst C19 outcomes. Obviously, correlation by itself doesn't mean causation. But it is a hint.

It's a pretty useless one in this case. Old people are much more likely to have vitamin D deficiency. They are also more likely to die of COVID. The low vitamin D is a marker of frailty, not a cause.

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

#254

Post by PaulDavisThe1st »

JabavuAdams wrote: post #86
PaulDavisThe1st wrote: post #28

Earlier quoted context omitted.

Evidence suggests that aerosols can remain in the air for minutes after being placed there by another non-masked individual. You could pass through the aerosol and inhale. Masks make sense outside too, at least in some circumstances.

Considering that the risk of transmission seems to depend on how long you are inhaling shared air from an infected person, and their viral load, I don't think it makes sense to worry about intermittently going through someone else's exhaust plume. I use a mask outside if I'm on a narrow sidewalk, but otherwise, I don't think there's much point. My favourite thing is the people who wear a mask over the mouth, but not…

>I don't think it makes sense to worry about intermittently going through someone else's exhaust plume.

You're welcome to think that. But it's based on faith, not evidence. I admit that I don't evidence to prove that it's dangerous to a specific level either. I just prefer to err on the side of caution.

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

#255

Post by PaulDavisThe1st »

JabavuAdams wrote: post #106
outworlder wrote: post #94

Earlier quoted context omitted.

> Considering that the risk of transmission seems to depend on how long you are inhaling shared air from an infected person, and their viral load You have a lot of faith in your immune system. Absent more data, it's just that, faith.

Not at all. We have the data. It's called summer. Also, I probably have a weaker immune system than most, and have several risk factors. We have simply not seen the increases and flare-ups we would expect if what you're asserting is true. What worries me is October-November. This is for Toronto, Canada. The beaches and parks are fully of people socially distancing-ish. The streets are full of a mix of people social d…

> It's called summer.

Did you somehow miss the season in progress when COVID19 hit southern hemispheric countries in the early US spring?

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

#256

Post by Reelin »

shajznnckfke wrote: post #248
sunpar wrote: post #230

Earlier quoted context omitted.

At 6'1" BMI seems to say I should be between 140lbs and 185 lbs. I'm currently 165 lbs and feel pretty skinny -- I can't imagine being healthy at 140 lbs! The 185 seems about right -- I've been close to 180 lbs and felt like I could lose a few.

I guess people are downvoting because it’s not super relevant to the discussion, but I have a similar opinion that the BMI normal weight range is unreasonable for me. I’ve been in these two modes: 1) genuinely overweight with too much fat and not enough muscle 2) nearly overweight according to BMI while very fit, with low fat and high muscle. got here from the other state by exercising a lot, losing fat and gaining m…

> nearly overweight according to BMI while very fit, with low fat and high muscle

Not knowing you personally, it seems statistically more likely to me that your idea of "fit, low fat, high muscle" is what's at fault here (as opposed to BMI). Sure, you could be an exception. But all things being equal, you probably aren't. (Also maybe I misunderstand - if you mean that BMI was saying you were at the high end of normal then ... isn't that just saying that you're fine?)

(Of course if a medical professional or academic specializing in such matters also thought BMI was inaccurate in your case then I would tend to view things differently.)

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

#257

Post by shajznnckfke »

Reelin wrote: post #256
shajznnckfke wrote: post #248

Earlier quoted context omitted.

I guess people are downvoting because it’s not super relevant to the discussion, but I have a similar opinion that the BMI normal weight range is unreasonable for me. I’ve been in these two modes: 1) genuinely overweight with too much fat and not enough muscle 2) nearly overweight according to BMI while very fit, with low fat and high muscle. got here from the other state by exercising a lot, losing fat and gaining m…

> nearly overweight according to BMI while very fit, with low fat and high muscle Not knowing you personally, it seems statistically more likely to me that your idea of "fit, low fat, high muscle" is what's at fault here (as opposed to BMI). Sure, you could be an exception. But all things being equal, you probably aren't. (Also maybe I misunderstand - if you mean that BMI was saying you were at the high end of normal…

I can believe it. I’m curious what typical body types were like in the hunter/gather societies human evolved in, and whether those are ideal for longevity and quality of life in modern society.

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

#258

Post by ac29 »

lrem wrote: post #228
graeme wrote: post #216

Earlier quoted context omitted.

That’s about 60,000 IU? Not necessarily out of line for such interventions. In cases of deficiency doctors will often prescribe weekly doses of 50,000 I believe. Have also seen RCT on vitamin d and the flu where groups where given 250,000-500,000 IU’s in one shot. ....obviously nobody reading this should take anything near those doses without consulting a doctor and without knowing your current blood level, to be cle…

Yup, 60kIU from my understanding. And here I am wondering if the 2kIU I'm doing would have any effect...

The amount used as an interventional or short term treatment can greatly exceed what is a prudent amount to take daily. Taking 50k/day long term is probably a bad idea.

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

#259

Post by perl4ever »

sunpar wrote: post #230
graeme wrote: post #218

Earlier quoted context omitted.

It’s actually pretty decent. It can make errors in the case of people with extreme muscle mass, or very low muscle mass for their size, or the very short, or the very tall. But for most people, if you’re over 25 bmi you probably could lose some weight. And at a population levels the errors above average out, even in a smaller group. People make a big deal over the exceptions to it while ignoring that it is broadly ac…

At 6'1" BMI seems to say I should be between 140lbs and 185 lbs. I'm currently 165 lbs and feel pretty skinny -- I can't imagine being healthy at 140 lbs! The 185 seems about right -- I've been close to 180 lbs and felt like I could lose a few.

Assuming you're male, 140 is the lower bound, so, you know, much lower than that might be considered anorexic, but in the 140s is not necessarily unhealthy per se. That's why it's the lower bound.

I am your height and when I was in my 20s, I think I was in the 140s, later I was a little over 200, and now I am just about 185. So the range makes sense to me, but I've never been far from completely sedentary. I know a pro sports player at ~200 would be very skinny. I think Mariano Rivera was an example.

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

#260

Post by gojomo »

azinman2 wrote: post #68
gojomo wrote: post #35

Earlier quoted context omitted.

While neither azithromycin nor hydroxychloroquine are primarily thought of as anti-virals, both are hypothesized by some to have some anti-viral effect, and it's still unclear whether any potential effects they have on Covid-19 are via such anti-viral effects, or other effects.

Just because something helps with issues created by a virus doesn’t make it an anti-viral. For example it seems to be now that steroids are aiding those in the ICU with covid, but I don’t think anyone could plausibly call a steroid an anti-viral, as much as a bandaid can’t be called an antibiotic even if it helps heal a cut and prevent additional bacterial infection.

True, but if you look in the literature, you will find both of these compounds referred to as having some anti-viral effects, and their hypothesized mechanism(s) against Covid-19 may involve those effects.

For example, in " rel="nofollow">https://www.clinicalmicrobiologyandinfection.com/article/S11..., even though the study concludes other anti-virals are better, we see the footnoted, uncontroversial claim: "The antiviral properties of CQ were first explored against viral hepatitis as far back as 1963 [1]. Since then many observations from in vitro and animal experiments have suggested a beneficial role of HCQ and CQ in viral infections [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13]." There are of course hundreds more such authoritative references to observed anti-viral activity.

Or regarding Azithromycin (AZM) in " rel="nofollow">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290142/>, we see: "It has been shown that AZM has significant antiviral properties. In contrast with CQ or HCQ, its antiviral activity has been shown in vitro and/or in vivo on a large panel of viruses: Ebola, Zika, respiratory syncytial virus, influenzae H1N1 virus, enterovirus, and rhinovirus [4–13]. Its activity against respiratory syncytial virus has been demonstrated in a randomized study in infants [10]. Azithromycin exhibited a synergistic antiviral effect against SARS-CoV-2 when combined with HCQ both in vitro [11] and in a clinical setting [13]."

That HCQ is mainly known as an antimalarial doesn't refute that it has, and is often tried for, antiviral effects. That AZM is mainly known as an antibiotic doesn't refute that it has shown broad antiviral effects as well.

(If you're stuck on 'antiviral' as some binary category, or mutually-exclusive with other categories, you're going to miss all the interesting incremental effects in real chemistry/biology. That sort of "sharply-bounded categories" thinking has killed a lot of people recently, as with those insistent on 'droplets vs aerosols' instead of a continuum including every size/variant of both.)

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