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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

#371

As someone with low vitamin D this kinda sucks. Does anyone know how effective OTC vitamin D is at raising vitamin D levels and what kind of doses to take?

Dai (2018): Magnesium status and supplementation influence vitamin D status and metabolism: results from a randomized trial https://pubmed.ncbi.nlm.nih.gov/30541089/

"Our findings suggest that optimal magnesium status may be important for optimizing 25(OH)D status. "

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

#372

Yeah we wear too much sunscreen, a significant number of people are vitamin D deficient. From the UltraMind Solution book, you need the active form cholecalciferol in your supplements. You can safely take 5000-10000 IU a day for 3 months to get up to the optimal levels, then 2000 IU a day for maintenance. The Ideal range is 50 to 80 ng/ml in your blood tests. Also just minimal outdoor sun exposure is the best way to…

Dai (2018): Magnesium status and supplementation influence vitamin D status and metabolism: results from a randomized trial https://pubmed.ncbi.nlm.nih.gov/30541089/

"Our findings suggest that optimal magnesium status may be important for optimizing 25(OH)D status. "

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

#374

Earlier quoted context omitted.

We actually have an expert on this comment here quite often, too high Vit D dose can cause problems with calcium: https://news.ycombinator.com/user?id=devaboone And she's done a series on it: https://www.devaboone.com/post/vitamin-d-part-1-back-to-basi...

IIRC, calcium toxicity is serious, but only a consequence of sustained Vitamin D supplementation. Also there's some Joe Rogan-esque "just take the 5000 IU bro" even though 4000 is the recommended supplement upper bound. And devaboone warns against even using that much.

Taking more than recommended is ok, your body will flush it out.

It is basically wasteful, only in extreme cases you could 'overdose' vitamins.

https://en.wikipedia.org/wiki/Vitamin_D_toxicity

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

#375
post #348

Earlier quoted context omitted.

Randomized trial. This was not simply observational. There will be no correlation between being given higher dose vitamin D and age in this trial, the results appear at first blush to be showing Vitamin D is working independant of age. By the by this /exactly/ why a randomised trial has been the gold standard for medical treatment for so long. False correlations, confounding factors etc are all vastly less likely to…

Yep, in broad strokes, randomisation removes any bias or confounding effects such as age, gender, behaviour, genetic disposition etc. The price you pay is in precision; randomisation and the best practice analysis (intention to treat) tend to produce weaker signals of effectiveness compared to the control treatment. But that price is worth paying because randomisation is really the only way to be sure that you are se…

Randomised trial for parachutes? So yeah slightly more complex than "The only way..."

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

#376
post #277

Earlier quoted context omitted.

I understand the desire to be contrarian, but BMI is widely regarded as totally obsolete with cheap and accurate ways to actually measure body fat percentages. It’s well understood that BMI is totally wrong for athletes or anyone remotely muscular.

> totally obsolete with cheap and accurate ways to actually measure body fat percentages What do you have in mind? With a bit of searching I haven't found much that's cheap. (Obviously you can take some tape or caliper measurements to improve your numbers but that's neither new nor particularly accurate.)

A digital scale that measures body fat is less than $30.

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

#377

Earlier quoted context omitted.

> too high Vit D dose can cause problems Many over-the-counter vitamin D supplements appear dosed for people with problems absorbing the chemical.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4210929/ Not really. It depends on the person obviously but the recommended values are too low due to statistical errors. Up to 4000 iu per day likely ok.

In the Netherlands the recommended intake is 5 mcg, that's equivalent to 200 iu. As far as I understand the US recommends 600.

Both are very far below the 4000 that's often cited here. So I think that 4000 is not a recommended intake but a limit before it becomes risky. For normal people it doesn't make sense to then aim for that maximum dosage.

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

#378
post #368

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…

What is a doze that someone should take daily in winter when exposure to sun is minimal?

5 mcg / 200 iu is a recommended dose for a healthy adult.

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

#379

Earlier quoted context omitted.

We actually have an expert on this comment here quite often, too high Vit D dose can cause problems with calcium: https://news.ycombinator.com/user?id=devaboone And she's done a series on it: https://www.devaboone.com/post/vitamin-d-part-1-back-to-basi...

IIRC, calcium toxicity is serious, but only a consequence of sustained Vitamin D supplementation. Also there's some Joe Rogan-esque "just take the 5000 IU bro" even though 4000 is the recommended supplement upper bound. And devaboone warns against even using that much.

The information can be a bit confusing though.

For breastfed babies, France recommend an intake of 25µg to 30µg but it's half of that in the UK (8.5 to 10µg).

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

#380
post #293

Earlier quoted context omitted.

I don't think her point was that people shouldn't take Vitamin D to combat Covid. Her point is that people shouldn't be taking high dosages of Vitamin D as a preventative against Covid as the risks can outweigh the rewards. But for those who already have Covid, the risk and rewards may be significantly skewed in favor of Vitamin D, as per this study.

Another part of her point is that self-administering Vitamin D is far more dangerous than people, including many MDs, often think. In an era where people are apparently seriously contemplating megadoses of hydroxychloroquine or I.V. bleach for COVID-19 prophylaxis, the caution seems warranted---even if the study results are promising.

> Another part of her point is that self-administering Vitamin D is far more dangerous than people, including many MDs, often think.

In absurdly high doses, sure. The Institute of Medicine certifies 4,000 IUs as the upper safe daily limit, although doctors will prescribe higher doses for people with a Vitamin D deficiency.

The Mayo clinic did a study of Vitamin D levels in 20,308 people across 10 years. The result was that 8% of people had Vitamin D levels higher than 50ng/ml (typically a sign of Vitamin D toxicity) but found no correlation between those levels of Vitamin D. They found one, one person out of 20k, who actually displayed symptoms of Vitamin D toxicity. Their blood levels of Vitamin D were over 350ng/ml. They had been taking 100k IUs (25x the suggested dose) as a routine daily supplement. I can only find one reported death from Vitamin D overdose, and it was a 10 year old boy who was mistakenly given 600,000 IUs of Vitamin D a day instead of growth hormone by a hospital in 2015.

Let's compare that to Tylenol (acetaminophen). Tylenol contains 500mg of acetaminophen. Maximum suggested daily dose is 8 tablets, so 4g. 25 times that is 100g. So someone abusing tylenol as hard as that person abused Vitamin D would be consuming 100g of tylenol a day. Medical literature suggests that you go to the ER immediately if you consume over 10g of acetaminophen. Of people who hit blood levels requiring treatment, 5% die and 58% have severe liver damage as a result. I can't find a good, easy correlation between the blood levels requiring treatment and amount taken, but I'm going to go out on a limb and guess that taking 200 Tylenols puts you there.

So if we compare the risk, relatively, Vitamin D requires you to take over 150 times your maximum daily dose for an extended period of time (dosing for children is lower than adults) to cause death. If you take 25x the amount of Tylenol once, there's a good chance you die or have severe long term outcomes.

Vitamin D is amazingly safe, provided you treat it like a medication and don't randomly swallow fist fulls of the capsules. Many people in the US (and some parts of Europe, especially in the north) should actually already be taking a supplement. Low Vitamin D levels are exceptionally common now. In the case of the US, obesity causes low Vitamin D levels, not going outside often enough causes low Vitamin D, and not eating foods containing vitamin D causes low Vitamin D. That's a disease practically tailored to our obese, couch-bound, junk-food inhaling residents. In northern Europe, I think they largely blame the seasonal changes in daylight patterns.

I'm all for calling out danger, I just don't see any here. I don't doubt that some people will manage to hurt themselves. I can already hear someone thinking "if 4,000 IUs keeps me a little safe, I can take 1,000,000 IUs and not wear a mask". If we're really that concerned that someone will harm themselves, we should be able to just add Vitamin D to the tracking system we use for Sudafed. Don't let anyone but more than 10k IUs per day. That's enough for 2 adults and a child at healthy doses, but low enough that taking that much every day is unlikely to harm you in the immediate future (and doesn't seem to be likely to harm you at all, but it is above the suggested dose).

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