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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

#381

Post by curryst »

me_me_me wrote: post #374
mrslave wrote: post #330

Earlier quoted context omitted.

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

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

This is not true. Vitamin D is fat-soluble, not water-soluble. Your kidneys can only filter out water-soluble vitamins. B vitamins are water-soluble; that's why there's practically no upper limit to how much you can take. Your kidneys will filter out the extra (assuming you aren't eating buckets full of the stuff).

Vitamin D toxicity occurs specifically because your body can't remove the excess vitamin D stored in your fat.

That's also why severe overdose happens over time, as opposed to instantly. You have to take a huge amount of Vitamin D at once to overdose (like millions of IUs) but you can cause toxicity using smaller doses over longer periods of time. If your body could flush it out, that wouldn't be true. Any excess would be removed and you would start each day "fresh".

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

#382

Post by DenisM »

lhl wrote: post #173
DenisM wrote: post #10

Earlier quoted context omitted.

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…

Thanks for taking the time write it all out, much appreciated.

Do you know if the time of day makes a different? I avoid the Sun between 9am-3pm as that seems relatively easy to get sunburned during that time, but I wonder if the alleged benefits are tied to the same time window?

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

#383

Post by curryst »

t0mas88 wrote: post #377
LegitShady wrote: post #327

Earlier quoted context omitted.

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.

The last I heard, the human body needs/consumes ~700 IU of Vitamin D per day. So I think your US levels are actually the full intake.

One thing to consider is biological inefficiency. A 4,000 IU capsule contains 4,000 IUs, but that doesn't mean your body can't actually extract all 4,000 IUs.

That said, I think 1k IUs is considered a standard dose for people without a deficiency. 4k IUs are generally used by people who are currently deficient, or have other issues that cause the deficiency. Doctors will sometimes prescribe doses up to 10k IUs for deficient people.

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

#384

Post by Jenda_ »

altvali wrote: post #376
Dylan16807 wrote: post #333

Earlier quoted context omitted.

> 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.

And pretty terrible in my experience (tested two, one noname and one branded, unfortunately forgot the manufacturer/model number).

First, there is a fundamental constrain that it measures impedance only through legs and a little bit of belly, but no upper body (at least here in .cz, no consumer-grade scales have hand electrodes). I do road cycling as the only sport, and therefore get extremely skewed results as I have strong legs, but the rest of the body is much weaker.

Second, the measurements are almost non-repeatable. You get tens of percent difference across measurements, god forbid if you suddenly have moist feet etc. However, both scales used firmware cheating to mask this noise: once you set up a "profile", it will remember the initial value, and then change the following measurements only slightly. However, set up a second profile (preferably with a slightly modified age etc. to prevent advanced firmware cheating) and you get completely different results.

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

#385

Post by gridlockd »

rsynnott wrote: post #323
gridlockd wrote: post #319

Earlier quoted context omitted.

You'd be surprised.

I’d suspect that where you see other national leaders pushing HCQ, it’s largely not because Trump is doing it, but for similar reasons to why Trump is doing it. HCQ was the most ‘miracle cure’-y of the early proposed treatments. Most treatments being investigated promised modest reductions in the death rate, whereas some of the claims for HCQ were very extravagant (some people were even pushing it as a _prophylactic_…

I don't see national leaders pushing HCQ because Trump is doing it, I see them pushing against it because Trump is doing it and because they positioned themselves against him.

Trump has poisoned the well. If you bring up HCQ, you are immediately under suspicion of being an anti-science Trump-supporting conspiracy theorist. Guilt by association, reductio ad hitlerum, etc.

As for using HCQ as a prophylactic: That was the whole point right from the beginning. Didier Raoult can be credited with starting the HCQ hype, he has been prescribing HCQ+zinc as a prophylactic for at-risk groups. That's not as outlandish as you make it sound, HCQ has been used as prophylactic for malaria for the longest time and that is considered safe.

The studies that tested HCQ at a late stage (ICU) or without zinc are missing the point. HCQ without zinc doesn't work, zinc without HCQ is at least less effective, because the HCQ works as an ionophore, but if you already have a severe case of COVID, none of it is going to work. It's too late.

There are several studies that suggest that this prophylactic treatment works. There are no big RCTs that show it works, but neither are there big RCTs that disprove that it works.

See also this protocol for prophylaxis of COVID-19:

https://www.evms.edu/media/evms_public/departments/internal_...

It includes zinc and quercetin as an ionophore and is thus politically uncontroversial. However, it's unknown to what extent quercetin really works as an ionophore in vivo.

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

#386

Post by LegitShady »

t0mas88 wrote: post #377
LegitShady wrote: post #327

Earlier quoted context omitted.

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.

Please read the linked paper. The 600 iu dosage recommendation is due to statistical error, and the paper is rather short but goes through it.

200 iu sounds very low.

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

#387

Post by LegitShady »

curryst wrote: post #383
t0mas88 wrote: post #377

Earlier quoted context omitted.

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.

The last I heard, the human body needs/consumes ~700 IU of Vitamin D per day. So I think your US levels are actually the full intake. One thing to consider is biological inefficiency. A 4,000 IU capsule contains 4,000 IUs, but that doesn't mean your body can't actually extract all 4,000 IUs. That said, I think 1k IUs is considered a standard dose for people without a deficiency. 4k IUs are generally used by people wh…

Please don't go by what you last heard and instead read the linked paper to get an idea as to how the recommended dosage was arrived at and how statistical errors caused the recommended dosage to be too low.

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

#388

Post by jamesfisher »

> open label, double-masked clinical trial

Aren't "open label" and "double-masked" contradictory?

"An open-label trial, or open trial, is a type of clinical trial in which information is not withheld from trial participants. In particular, both the researchers and participants know which treatment is being administered." (Wikipedia)

"Double-Masked Study. A type of clinical trial in which neither the participants nor the research team know which treatment a specific participant is receiving." (NIH)

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

#389

Post by valarauko »

me_me_me wrote: post #374
mrslave wrote: post #330

Earlier quoted context omitted.

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

What's the mechanism for "flushing out" excess Vitamin D? The Wikipedia article you've linked offers no such mechanism for dietary Vit D. If anything, the article suggests that toxicity is only really possible through oral supplementation.

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

#390

Post by zamfi »

zamfi wrote: post #360
Izkata wrote: post #345

Earlier quoted context omitted.

> but we do know that it has become a massive political hot potato I posted this a few days ago and got an interesting swing of votes on that comment since then: > So, unfortunately, we don't know very much about Hydroxychloroquine's effectiveness and risks in use For effectiveness it looks like we actually do, thanks to an experiment Switzerland accidentally ran on their population over May and June [0]. On May 27,…

That is quite a spike! Unfortunately the sharpness of the edge makes it pretty likely that a change in therapy is the cause -- time to death from hospital admission has a median of 10-12 days, but this is not a "wall", it's a median. The actual distribution is probably somewhat normal -- you'd expect a gradual increase and decrease around the intervention. We don't know how or when the Hydroxychloroquine was administ…

Ahhh I meant to say "pretty unlikely that a change in therapy is the cause" above.
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