The First Randomized Controlled Trial on Vitamin D and Covid-19 • Hacker News Board

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

#261

Post by gumby » Thu, Sep 03, 2020, 9:32 PM UTC

ellyagg wrote: post #176

gumby wrote: 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.

It can be, depending on the protocol. This was a double blind yet open label (?) study. I’ve never done an open label study so don’t know how they have to be powered (and I’m not a biostatistician so won’t render a guess)

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

#262

Post by noodlesUK » Thu, Sep 03, 2020, 9:33 PM UTC

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…

(Not OP) I’m not an athlete anymore, but I used to be. It would be physically impossible for me to maintain my muscle mass and have a BMI considered normal, whilst also having a body fat percentage >5%. I know many other (pretty much exclusively taller men) people in the same situation.

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

#263

Post by Reelin » Thu, Sep 03, 2020, 9:39 PM UTC

shajznnckfke wrote: post #257

Reelin wrote: post #256

Earlier quoted context omitted.

> 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.

> and whether those are ideal for longevity and quality of life in modern society

This seems like the real question to me; I assume pre-agrarian humans were biologically optimizing to survive famine. Not being an expert on the subject, I wonder what sort of tradeoffs are associated with intense exercise regimes (and how the balance ultimately comes out with respect to modern society).

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

#264

Post by woeirua » Thu, Sep 03, 2020, 9:40 PM UTC

cameldrv wrote: post #73

woeirua wrote: post #26

Looks promising, but I would want to see a true double blinded RCT on a few thousand people before we say that Vitamin D is an effective treatment. Also, there's going to be a confounding question based on this study: is it just Vitamin D, or is it Vitamin D in combination with HCQ / Azithromyacin? That said, it probably wouldn't hurt you to supplement with Vitamin D this winter, even if it doesn't treat Covid.

It's difficult to imagine how the placebo effect could produce this result. Both arms of the trial were receiving HCQ and Azithromycin, so to the extent that there is a placebo effect, you'd think that adding a vitamin wouldn't change the result very much.

I’m not saying it’s a placebo effect. Instead there could be unknown interactions between Vitamin D and HCQ/Az that could be the causal effect.

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

#265

Post by perl4ever » Thu, Sep 03, 2020, 9:43 PM UTC

icelancer wrote: post #242

read_if_gay_ wrote: post #229

Earlier quoted context omitted.

Since it’s dirt cheap and basically impossible to take too much of, just skip the tests and take supplements preemptively.

This is definitely not true. Elevated blood calcium and creatinine levels are definitely possible if you take too much, and people are sensitive at different rates.

I tried taking some Vitamin D alone, and I rapidly got a very uncomfortable sensitivity in my teeth. I thought maybe this has something to do with what it does to calcium.

So I tried a combination calcium + Vitamin D capsule, and it didn't seem to have the same effect.

Maybe the second one is safe, but I'm wondering what was going on and if there are potential drawbacks to either one.

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

#266

Post by Reelin » Thu, Sep 03, 2020, 9:46 PM UTC

noodlesUK wrote: post #262

Reelin wrote: post #256

Earlier quoted context omitted.

> 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…

(Not OP) I’m not an athlete anymore, but I used to be. It would be physically impossible for me to maintain my muscle mass and have a BMI considered normal, whilst also having a body fat percentage >5%. I know many other (pretty much exclusively taller men) people in the same situation.

I guess it would be interesting to see how those numbers interacted graphically. Are the "bad" areas (ie high muscle mass at reasonable fat percentage) associated with health problems according to experts? Or should people with significantly above average muscle mass be using a different scale instead?

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

#267

Post by MayeulC » Thu, Sep 03, 2020, 9:46 PM UTC

kyleee wrote: post #81

asah wrote: post #30

Non-white skinned people: sunlight may not be enough to increase your vitamin D. https://www.google.com/search?q=dark+skin+vitamin+d+minutes

Is there a scientific classification system for evaluating how light vs. dark a person's skin is? I'd like to know how much my relatively darker skin is preventing vit D uptake / creation in the body

I think skin color is most likely correlated, without being the cause.

Populations with lighter skin colors tend to live at higher lattitudes, where there is less sun. Inherited genes probably compensate for this, while also transmitting the paler/darker skin allele.

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

#268

Post by organsnyder » Thu, Sep 03, 2020, 9:46 PM UTC

icelancer wrote: post #156

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…

Using online labs it's super cheap to get it done yourself for less than $50/test. Not worth dealing with insurance BS and your doctor's likely nonsensical ravings about it, just do it and reimburse using your HSA if you have one.

$50/test is a significant cost for many people (many of whom don't have HSAs).

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

#269

Post by epmaybe » Thu, Sep 03, 2020, 9:50 PM UTC

You know, at this point, I'm basically over debating the merits of vitamin d. Take it, don't take it, I don't really care, just please tell your doctor you're taking it.

To pharmaceutical companies or supplement companies, or the NIH: fund a well powered study, pretty please?

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

#270

Post by elliekelly » Thu, Sep 03, 2020, 9:57 PM UTC

JshWright wrote: post #253

ellyagg wrote: post #203

Earlier quoted context omitted.

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.

How can you say that with such certainty?