Everyone needs at least 50ng/ml 125nmol/L 25-hydroxyvitamin D for their immune system to function properly.  Without proper vitamin D3 supplementation, most people's 25-hydroxyvitamin D levels are 1/2 to 1/10th this - greatly raising the risk of severe symptoms from COVID-19, Kawasaki disease, Multisystem Inflammatory Syndrome and sepsis.

Robin Whittle  rw@firstpr.com.au  16 October 2021

I am an electronic technician and computer programmer - not a doctor.  Please read the research articles I cite and summarise and make your own decisions - or ask your doctor or other primary healthcare provider to read the the 05-mds/ page so they can learn about the most pertinent research before they advise you.

#contents << To the table of contents.

Most MDs are not aware of the research which shows that vitamin D is the key to solving the COVID-19 crisis, especially when combined with early treatment with ivermectin.  Please read the research articles cited and summarised at:

What every MD, immunologist, virologist and epidemiologist should know about vitamin D and the immune system
05-mds/  

Please also see my https://nutritionmatters.substack.com, where there is currently one article.  Comments can be made there:

Vitamin D and early treatment vs. the COVID Vaccine Juggernaut
https://nutritionmatters.substack.com/p/vitamin-d-and-early-treatment-vs

This includes a transcript of Prof. Andrew Pollard's 2021-08-10 evidence to the evidence to the UK Parliament All-Party Group on Coronavirus, regarding the impossibility of using vaccines to attain herd immunity.

Here is how I supplement vitamin D3.  I am 65 and weigh 69kg:

By the ratios I derived 01-supp/ from Ekwaru et al. 2014, a 70kg non-obese person should take between 0.125mg 5000IU and 0.25mg 10,000IU.  The lower amount is a gram every 22 years.  (One IU is 1/40th of a millionth of a gram - the amount a 6 gram baby rat needs each day to avoid rickets.)  In Australia, the largest generally available vitamin D3 capsules contain only 0.025mg 1000IU D3.  I take one small 1.25mg 50,000IU capsules a week:

Until 2021-09-19 I had a link here to the product's web page.  However, the manufacturer wrote to me: "Due to NSF and FDA regulatory compliance standards, we ask that you remove any direct link or reference to our product and/or our website from your page immediately."  So I removed the link, the name of the product and the name of the company.

This is 0.179mg 7143IU a day.  After a few months, this almost certainly raises my 25-hydroxyvitamin D level safely over the 50ng/ml 125nmol/L my immune system needs to function properly.  Maybe my level is twice this, which is fine.  It is highly unlikely to exceed 150ng/ml, beyond which for some people toxicity may be a problem.  So I feel no need to get my level tested.  Some MDs think this is too much - but based on my understanding of the research, what I am doing is perfectly healthy and desirable.  I bought my capsules from a company in Arkansas, USA.  They are fusspots and financially support two vitamin D researchers / advocates I know.  Searching eBay Australia for vitamin d3 50,000 100  turns up some Australian sellers, which would be a faster way to get some than waiting for shipping from the USA.  AUD$62 for 100 capsules is enough for two people for nearly a year.  I suggest taking it after a meal.

What needs to be done, globally, NOW:

Early treatment

  1. Treat all people newly diagnosed with COVID-19 with calcifediol (which is 25-hydroxyvitamin D) to replete their circulating 25-hydroxyvitamin D levels from the typical unsupplemented levels of 5ng/ml to 25ng/ml (parts per billion) to at least the 50ng/ml 125nmol/L they need for their immune system to work properly.  (See the first  graph below.)  This is a small, single, oral dose of 0.014mg calcifediol per kg bodyweight, which is about 1mg for 55 to 85kg average weight adults. 

    This will replete circulating 25-hydroxyvitamin D levels safely over 50ng/ml in 4 hours.  This is faster than bolus D3 and much faster than the months it would take with ordinary daily vitamin D3 intakes such as 0.125mg 5000IU / day (70kg bw).   See the above-mentioned page and Emeritus Professor of Medicine, Sunil Wimalawansa  (Sri Lanka and New Jersey):  linkedin-2021-06 & linkedin-2021-07 .

  2. Treat them with ivermectin too - which has strong antiviral and anti-inflammatory properties: https://covid19criticalcare.com/ivermectin-in-covid-19/  and https://ivmmeta.com .

  3. Ideally provide extra zinc, vitamin C, magnesium and B vitamins. 
These early treatments should be given ASAP to every person newly diagnosed with COVID-19, or likely to contract it via close contact with infected persons.

This will reduce symptoms, disease severity and duration.  So the average number of viruses shed per infected person will be greatly reduced, reducing transmission and so the number of people infected.  For those infected, this early treatment is inexpensive, safe and greatly reduces the risk of lasting harm and death. 

Vitamin D3 supplementation for all - to strengthen immune responses

  1. Vitamin D3 supplementation, in proper quantities (such as 0.125mg 5000IU/day for 70kg 154lb bodyweight) should be adopted by almost everyone.  The daily intake quantities should be a ratio of bodyweight, with a higher ratio for those suffering from obesity.  (See 01-supp/.)  There's very little D3 in food or multivitamins.  Ultraviolet B light on fair skin can produce plenty of D3, but it damages DNA and so raises the risk of skin cancer.

    The only people who don't need vitamin D3 supplements are babies breast fed from vitamin D replete mothers, and those who in the last month or two have had sufficient, regular UV-B skin exposure.  People with melanin-rich skin need a lot more high-elevation sunlight to generate sufficient D3 than people with unpigmented skin

  2. Government support for population-wide vitamin D3 supplementation should begin with a concerted effort to help the most vulnerable people first, ideally beginning with a bolus (large initial) dose to raise levels faster than the several months it takes for regular D3 intakes to achieve this:

    • The elderly - especially those in care homes.

    • People who live outside the tropics who have melanin-rich skin and/or sun avoidant lifestyles.  Without proper D3 supplementation, Muslim women living far from the equator are at especially high risk of very low vitamin D levels. About half of Arab women, even in sunny Israel have 25-hydroxyvitamin D levels below 12ng/ml: https://aminotheory.com/cv19/#2020-Israel .  See also the 3rd graph below.

    • Medical staff, police, emergency responders.

    • Prison inmates and staff.

    • Drivers, pilots and other staff working in public transport, airlines, taxis and Uber etc., rail and road transport and mail deliveries.

    • People whose work involves high levels of contact with the public - kindergartens, schools, universities, shops, post offices, cafes, hotels, petrol stations etc.

    • Armed forces and the crews of all ships.
In the longer term, full government and MD support for voluntary adoption of healthy vitamin D3 supplementation is the only way most people can be healthy, avoid getting seriously ill from COVID-19, influenza, sepsis etc.  Numerous chronic diseases are at least partly caused by inadequate 25-hydroxyvitamin D levels.  See: https://vitamindwiki.com .

This will reduce the transmission of SARS-CoV-2 and influenza viruses, all year round, to such an extent that it will probably not be necessary to rely on vaccinating most people or on social distancing and lockdowns to suppress epidemic or pandemic transmission.  (Probably since we can't entirely rule out the possibility that current or future SARS-CoV-2 variants will remain highly transmissible even if almost everyone had 50ng/ml 25-hydroxyvitamin D, and was treated with ivermectin promptly on infection.  This seems unlikely, and the sooner we can suppress the pandemic in all countries with high vitamin D levels and with ivermectin early treatment, the less chance there will be of such variants evolving.)

Doctors need to learn about the crucial importance of vitamin D to the immune system, NOW.  You can help them do this.

The steps above will be taken only after a critical mass of doctors understand the immune system's complete reliance on adequate blood levels = 50ng/ml 125nmol/L of 25-hydroxyvitamin D (as measured in blood tests - produced in the liver from vitamin D3) for the internal (autocrine) and nearby (paracrine) signaling systems each cell uses to respond to its changing circumstances.  Most MDs are not familiar with these terms or vitamin D's functions beyond that of the kidney, regarding calcium-bone metabolism.  ("Vitamin D" refers to three compounds: vitamin D3 cholecalciferol, 25-hydroxyvitamin D calcifediol (AKA 25OHD and calcidiol) and 1,25-hydroxyvitamin D calcitriol.)

While awareness of ivermectin for early treatment of COVID-19 is increasing rapidly, MDs all need to understand that the immune system can only work if 25-hydroxyvitamin D levels are 50ng/ml or above.  The 20ng/ml or 30ng/ml standards of repletion which are most widely accepted are just for the needs of the kidneys - not the immune system.

MDs also need to understand the importance of using a single small oral dose of calcifediol to raise 25-hydroxyvitamin D levels safely over 50ng/ml in 4 hours. 

If you wait for doctors to do this, it might take years, or decades.  Some MDs have been working assiduously to raise vitamin D awareness among their colleagues since at least 2008.  We need a critical mass of fully vitamin D (and ivermectin) aware MDs to get above the noise level of social and mass media.  Once this happens, everyone will be talking about it and awareness will spread very rapidly, followed by the actions we all need.

Most MDs live in their profession's thought bubble - which for many reasons (it would be a very long essay . . . ) results in them not learning about simple, safe, solutions to complex problems.  Instead many MDs cannot imagine that a simple nutritional problem could cause such complex and serious health problems. 

Big pharma doesn't want doctors to know about vitamin D, since that would mean they would prescribe much less in the way of the expensive, patented, drugs and vaccines which generate tens of billions of dollars profit.  Bill Grant wrote about this.  (Vitamin D3 cholecalciferol is difficult to make, involving wool fat, difficult chemical transformations, especially tricky short wavelength ultraviolet photochemistry and subsequent purification steps.  Most D3 is made for agricultural animals.  Only a handful of companies in the world make D3. They are not associated with the major drug and vaccine companies.  5000IU/day is a gram every 22 years, and pharma-grade D3 costs USD$2.50 a gram ex-factory.)

Don't wait for doctors to slowly catch up.  Please urge all the doctors and nurses you know to read the most pertinent research, linked to and summarised at:  https://vitamindstopscovid.info/05-mds/ .

URL for this sub-section: https://vitamindstopscovid.info/#business .
Managers and owners of businesses most impacted by the COVID-19 pandemic and the resultant lockdowns: 

There is a way out of this pandemic.  You have an important role to play.

It is now  clear that even high levels of vaccination alone - without vitamin D repletion and early treatment with ivermectin - cannot suppress the COVID-19 pandemic to the point where travel, socialising and group activities can resume, enabling many businesses can return to full operation.

You have a crucial role to play in raising awareness of how the pandemic can be rapidly suppressed with early treatment with calcifediol (25-hydroxyvitamin D) and ivermectin.  In the longer term, population-wide vitamin D3 supplementation is needed to provide the 25-hydroxyvitamin D levels the immune system needs to work properly.  Without such supplements, most people have only 10% to 50% of the 25-hydroxyvitamin D they need.

These changes will only take place when a critical mass of medical doctors understand vitamin D's importance for the immune system, and the effectiveness of the antiviral and anti-inflammatory drug ivermectin.

Individually and through industry associations you can demand that doctors and governments fully understand the importance of vitamin D for immune system health - and how COVID-19 disease severity and transmission can be greatly reduced with early treatment using calcifediol (the 25-hydroxyvitamin D all immune cells need) and the anti-viral, anti-inflammatory drug ivermectin.

Above is a brief account of the steps which must be taken:
  • Early treatment for all people newly diagnosed with COVID-19: calcifediol and ivermectin.

  • D3 supplementation for the most vulnerable people first, with voluntary adoption for the majority of the population as awareness develops and pharma-grade D3 production rises to meet the expanded human demand. (In the short term, a fraction of the much larger quantity of D3 made for agricultural animals can be refined to pharma grade.)
Immediately below is an outline of what all MDs need to learn ASAP.

Below that is a description of how the pandemic will continue to worsen, until and unless, the above steps are taken - in entire countries and ideally in all countries - so international business, social and tourism travel can resume.

Each MD who reads about and understands the latest research means the Vitamin D Repletion Revolution is closer to being realised.  This is the only way normal travel and social relations will return, so customers will return to your business.

The current VACCINES OR ETERNAL LOCKDOWNS (and don't even think about early treatment lest it distract people from VACCINES) approach can't work as long as most people's 25-hydroxyvitamin D levels are so low.  D3 supplementation can raise most people's 25-hydroxyvitamin D to healthy levels all year round. Then there will be no need for lockdowns or for vaccine passports and other restraints on travel and socialising.  Only the most vulnerable would need vaccines.


Outline of what a critical mass of influential MDs need to know, before the above, crucial, steps can be taken to end the COVID-19 pandemic

Above are the essential steps to suppressing the COVID-19 pandemic so we can regain our prior freedoms and restore travel, social contact, concerts, dance parties and sporting events - the full range of economic and social activities on which our health and happiness depends.

These steps will only be taken once enough doctors really understand vitamin D and the immune system.  

I am working with a small team of MDs, most of whom are long-time vitamin D researchers.  We will be writing directly to MDs who treat patients with COVID-19, Kawasaki disease and MIS-C to raise their awareness of vitamin D.   We will also be writing to immunologists, virologists, epidemiologists and public health officials.  To this end we will be writing a peer-reviewed journal article citing and discussing the most important research.  Until we have this article available, the best single source of links to the pertinent research is: https://vitamindstopscovid.info/05-mds/ .

Here is an outline of what all MDs need to know about vitamin D, the immune system, early treatment for COVID-19 and long-term supplementation to suppress the pandemic and tackle numerous health problems:
  1. The immune system depends on good 50ng/ml 125nmol/L 25-hydroxyvitamin D levels (as measured in blood tests) in order to combat viral and bacterial pathogens and to properly regulate inflammatory responses to avoid the cytokine storm self-destructive inflammation which causes severe COVID-19, sepsis, Kawasaki disease in babies and children and Multisystem Inflammatory Syndrome in children, adolescents and young adults.

  2. Doctors have been told that daily D3 intakes of 0.02mg 800IU a day or so are sufficient for adults, and that 20ng/ml 50nmol/L or perhaps 30ng/ml 75nmol/L 25-hydroxyvitamin D levels are sufficient for good health - but these standards were developed for the needs of the kidney in regulating calcium-bone metabolism. 

    Since 2008, MDs and researchers have been calling for vitamin D repletion standards to be set at the 40ng/ml to 60ng/ml needed for immune system health. They were ignored in the 2011 Institute of Medicine report which is still used in most countries as the reference for vitamin D standards. 

    There's very little D3 in food and multivitamins.  Ultraviolet B light on fair skin can produce plenty of D3, but is not always available and damages DNA, raising the risk of skin cancer.  So D3 supplementation is the only way most people can be healthy.

  3. Ordinary healthy quantities of D3 supplementation - such as 0.125mg 5000IU / day (70kg bodyweight)  takes months to achieve these good 25-hydroxyvitamin D levels, and so does not help in medical emergencies.  Bolus D3 is much more effective, such as a single 10mg 400,000IU dose.  However, it still takes time for D3 to be converted in the liver to the circulating 25-hydroxyvitamin D all immune cells need.

  4. A single oral dose of 1mg (for 70kg bodyweight) of calcifediol (the pharmaceutical name for 25-hydroxyvitamin D) will raise circulating 25-hydroxyvitamin D levels safely over 50ng/ml in 4 hours.  Regular D3 in the following days and weeks will sustain these healthy levels.

    This safe, immediate, restoration of proper 25-hydroxyvitamin D levels is urgently needed for most people, since without supplementation their levels are usually in the 5ng/ml to 25ng/ml range.

    This treatment, alone, will enable most people to rapidly and effectively combat the SARS-CoV-2 virus and will strongly protect them from the hyper-inflammatory dysregulated immune responses which cause severe COVID-19 and the other diseases mentioned above.

  5. This early treatment should be combined with zinc, vitamin C, B vitamins. magnesium and especially the anti-viral, anti-inflammatory, drug ivermectin: https://covid19criticalcare.com/ivermectin-in-covid-19/ and https://ivmmeta.com.

    Ivermectin, on its own, even with typical low 25-hydroxyvitamin D levels, is highly effective at preventing or reducing symptoms and shortening the course of COVID-19 disease.

  6. The combination of these treatments: calcifediol (4hr vitamin D repletion), ivermectin and the other nutrients should be given to everyone who is diagnosed with COVID-19, or who is likely to contract it via close contact with someone who is already infected, ASAP.  Those few who have been robustly supplementing D3 for months don't need the calcifediol, but it won't cause them any harm - so there is no need for 25-hydroxyvitamin D blood tests.

    This will reduce disease intensity and duration, and so greatly reduce the total number of viruses shed.  This will reduce overall transmission rates, all year round, and so reduce the number of people being infected.  The combination will very strongly protect against lasting harm, the need for hospital treatment, and death.

  7. Ivermectin can be used for short periods to protect against infection, and to reduce disease intensity if infected.  However, it is not practical or desirable for everyone to use indefinitely.  Calcifediol is the best way of repleting 25-hydroxyvitamin D levels in a few hours, but there is no need for it in the long term since it is more expensive and harder to obtain than D3.

    For dozens of health reasons - one of which is COVID-19 - everyone needs to supplement with vitamin D3, all year round,- except perhaps those who get plenty of UV-B skin exposure in summer.  (However, this is not recommended, since this raises skin cancer risks.)  There is very little D3 in food or multivitamins.  A "balanced diet" is no help at all for attaining the 50ng/ml circulating 25-hydroxyvitamin D levels we need to be healthy.

    In order to have good health, with fully functioning immune systems, everyone apart from babies breast-fed from vitamin D replete mothers needs to supplement vitamin D3 at levels higher than many doctors currently consider necessary or desirable.



Quraishi et al. 2014: https://jamanetwork.com/journals/jamasurgery/fullarticle/1782085  discussed at: https://vitamindstopscovid.info/05-mds/ .



Refs: https://aminotheory.com/cv19/#vc

#uklevels



https://sci-hub.se/10.1016/j.clnu.2020.11.019  The situation is bad enough for UK Caucasians in winter and spring: 92% of people have 30ng/ml circulating 25-hydroxyvitamin D or less, and 18% have just 10ng/ml or less.  The levels of people with melanin-rich skin are disastrously low, all year round - especially for those of Bangladeshi, Pakistani and Indian (Asian) ancestry.

Until and unless MDs learn about vitamin D and the immune system - and ivermectin for early treatment - the pandemic and the devastating lockdown attempts to contain it will continue indefinitely along these lines:

The Delta variant means the virus will probably continue to spread, even among vaccinated people and even in a strongly vaccinated country such as Israel, because the vaccines don't protect from transmission or symptomatic cases nearly as well. But that doesn't mean the vaccines don’t work, especially when it comes to preventing the worst of the disease.


Be sure to read the Disclaimer: about/ .

Please see https://vitamindwiki.com and Over 200 Scientists, Doctors, & Leading Authorities Call For Increased Vitamin D Use To Combat COVID-19https://vitamindforall.org/letter.html  Also, an anonymous meta-analysis of recent vitamin D COVID-19 observational and intervention trials: https://vdmeta.com .

The introductory page for doctors, nurses, other healthcare professionals and healthcare administrators, as well as for virologists and immunologists, is:

05-mds/   What every MD should know about vitamin D and the immune system

Most MDs are not aware of important research which shows that vitamin D is the key to solving the COVID-19 crisis.

My suggestions for how much vitamin D3 to supplement with, as a ratio of bodyweight is at 01-supp/ .

#contents

Contents

Page
Description
Last update
about/
Purpose, contact and copyright details.  The Nutrition for Immune System Health email discussion list. The Open Letter Google Groups discussion list of Karl Pfleger and Gareth Davies. Disclaimer - I am not a doctor etc.
2020-11-16
#update-2021-01-31
Many possible, current and likely future mutations to the spike protein receptor binding domain of the SARS-CoV-2 virus have been evolved in yeast.  These mutations, in various combinations, provide much stronger binding affinity than older COVID-19 variants.  It is reasonable to expect SARS-CoV-2 variants to evolve some or all of these mutations with the likely result that such variants will be still more transmissible, cause still more serious disease, and somewhat evade immune responses which arose from vaccination or prior infection than the Delta variant and others which are now most prevalent.
2021-01-31
01-supp/
My suggestions for how to calculate vitamin D supplementation quantities as a ratio of bodyweight, rather than using the traditional approach of age groups, where age is a proxy for weight. 

The story behind the US Institute of Medicine, in 2011, calculating the RDA for vitamin D3 to attain at least 20ng/ml 25OHD in 97.5% of the population as 600 IU, when the real figure is closer to 7000 IU.  Most doctors and D3 recommended intake committees are working as if the 600IU figure was true.

My proposed 25plusD3 dual 25OHD and bolus D3 suggestion for treating severe or potentially severe COVID-19 and influenza, and sepsis.  (Sepsis is always potentially deadly within hours.)
2020-12-12
01-supp/a-ratios/ How I derived these ratios from the work of Ekwaru et al. 2014.
2020-11-06
01-supp/b-grh/
Analysis of the results of the GrassRootsHealth vitamin D supplementation calculator, which works internally on ratio of bodyweight.
2020-11-06
02-autocrine/
An illustrated explanation of autocrine and paracrine signaling, with two examples from peer-reviewed articles.

Almost all of the functions of the vitamin D compounds involve autocrine signaling (inside a cell) and paracrine signaling (to nearby cells).   Yet few people understand this, and mistakenly think "vitamin D is a hormone" or some other mixed up idea such as circulating 1,25OHD (the hormonal function, for calcium-bone metabolism) somehow "regulating" immune responses.

Read this page and understand!   Then you will be able to understand the highly significant McGregor et al. article which describes exactly how lack of 25OHD in the lungs of patients with severe COVID-19 causes autocrine signaling in Th1 lymphocytes to fail - leaving them in the hyper-inflammatory state which causes severe COVID-19/
2021-09-25
03-not-orphan/
In April 2021 the BMJ published an article which described both Ivermectin and vitamin D as "orphan treatments" - as if they were useless, or at least not proven yet to be useful, and that some MDs used them despite all the evidence of them being ineffective.

Nothing could be further from the truth!   So I wrote an introduction to the most pertinent research into vitamin D, the immune system and COVID-19, as a rapid response (a formal comment) to the BMJ article.  Here is that rapid response, as an easier to read web page, with lots of infographics illustrating the key findings of the research I cite.
2021-05-12
04-calcifediol/
In April 2021, DSM released a new non-prescription calcifediol product for online sales to customers in the USA and Canada: d.velop

This, together with a similar product Fortaro for Australian consumers, is the first widely available, affordable, source of pharma grade calcifediol.

Since these tablets are inexpensive and readily available they should be used for rapid repletion of blood vitamin D (circulating 25OHD) in emergency situations such as when a person has sepsis, Kawasaki Disease, Multisystem Inflammatory Syndrome and of course severe or potentially severe COVID-19.

Around 1 milligram of calcifediol, in a single oral dose, for 55 to 85kg body weight is all it takes to make a huge difference to outcomes in people suffering from COVID-19.  

All doctors should be aware of this, and should understand vitamin D autocrine / paracrine signaling for immune system cells, which can only work with good, ~50ng/ml vitamin D blood levels.  1 milligram of calcifediol can attain this in a few hours, while even bolus D3 takes days or a week or so.
2021-07-19
05-mds/
What every MD should know about Vitamin D and the Immune System

Likewise all healthcare professionals, virologists, immunologists - and vitamin D aware people who don't understand autocrine/paracrine signaling and/or who think hormonal 1,25OHD affects immune cells.

This includes discussion of the SARS-CoV-2 Delta variant and other related matters.

Also, how we would not be having a COVID-19 pandemic if MDs had been doing their job regarding vitamin D for the last 15 years.  This involves taking an active interest in the best research, rather than dreaming up ideas for why vitamin D is not important, or demanding RCTs before changing their minds about these compounds.
2021-09-18
06-adv/
Advanced vitamin D topics - some people need much more D3 than normal, to suppress rheumatoid arthritis, multiple sclerosis, psoriasis, cluster headaches, migraine etc.; newly discovered vitamin D compounds; helminths, the immune system and severe COVID-19

This page is far from complete.  It currently lists some articles I plan to discuss. 

This page links to a well developed Protocol for higher than normal D3 intakes (with other nutrients) for reducing the incidence and severity of, or eliminating, cluster headaches and migraine.
2021-10-02

Please also see my original and more extensive site: https://aminotheory.com/cv19/ and my Twitter outpost: https://twitter.com/RobinWhittle3 .


#update-2021-01-31

#update-2021-01-31 for aminotheory.com/cv19/ and VitaminDStopsCOVID.info

The domain name, based on Vitamin D Stops COVID has turned out to be overly-optimistic, considering new variants of the virus which are significantly more transmissible than those which were strongly suppressed in the UK summer of 2020.   More worryingly, researchers have evolved further mutations (without creating viruses with these mutations) which will be very much more transmissible than even the currently most transmissible variants: the independently evolved but otherwise identical South African and Brazilian variants, which are more transmissible than the recent "British" variant.

I will retain the domain name for now, but please read the following update: Vitamin D is vitally important, but I think vaccination and some masks and social distancing will play an important role in suppressing COVID-19 (hopefully not outright lockdowns and travel restrictions) for the next few years and perhaps indefinitely.   If we could suddenly get everyone, in most or all countries, up to 50ng/ml vitamin D blood levels, then this would make a huge difference, but is probably not enough on its own to render all other control measures unnecessary.   There's no prospect of this occurring in the next year or so, because the forces of resistance against such population-scale vitamin D supplementation remain very strong and because there is not yet sufficient global production capacity to supply this.


In mid- to late-2020 my sites https://aminotheory.com/cv19/ and https://VitaminDStopsCovid.info conveyed arguments including my view that the UK 2020 summer lull in COVID-19 transmission and severity was due primarily to increased solar UV-B skin exposure raising vitamin D (25OHD blood levels) of most people in the country sufficiently to, on average:

1 - Strengthen the direct immune responses to the virus, which are especially weak, on average, in winter and spring.  Low vitamin D causes autocrine (internal) signaling in immune and other cells to fail: https://vitamindstopscovid.info/02-autocrine/ .  So initial defenses were stronger in summer and autumn.

2 - Reduce the hyperinflammatory immune dysregulation (also caused by autocrine signaling failure in immune cells due to low blood vitamin D 25OHD levels), which causes some people to have severe, debilitating, lastingly harmful and sometimes deadly, severe COVID-19.  Low vitamin D is the most common, most important, easily correctable cause of this.  See also https://aminotheory.com/cv19/#helminthsgone for why, without intestinal parasites, and with considerable individual genetic variation, almost all humans (and domestic dogs and cats) have systematically overly-strong, self-destructive, inflammatory immune responses.

3 - Reduce the more thorough spread (with winter-spring low vitamin D levels) of the virus in the body and so overall symptom severity.  This summer increase in vitamin D levels across the UK population reduces the total number of viruses shed by each infected person, on average.   I regard this as the most important cause of reduced transmission, with UV-B inactivation of viruses outdoors a second factor.   I surveyed the research on UV-B seasonality (I have not had time to finalise this on a web page, but if you want a copy of the draft, please email me) and found strong results showing COVID-19 seasonality is driven primarily by UV-B radiation changes.  There was mixed research results and unconvincing arguments for the importance of outdoor high temperatures and/or humidity.  (These are of marginal importance, since in-building and in-vehicle conditions are generally maintained by heating and air conditioning to be the opposite of summer and winter extremes - and most close human contact occurs in vehicles and buildings.)

The high UV-B of summer-autumn has two possible mechanisms for suppressing COVID-19, influenza etc. transmission and severity: Firstly, high vitamin D levels, which are pervasive, last for months and profoundly affect immune responses.  Secondly, and I am sure much less importantly, UV-B inactivates viruses on surfaces and in aerosols, but only outside buildings and vehicles, since glass blocks UV-B.

Since, as best we know, UK average 25OHD levels were around 25ng/ml in summer, I argued that robust (e.g. 0.125mg 5000 IU D3 / day for 70kg adults: https://vitamindstopscovid.info/01-supp/ ) supplementation, which will raise average 25OHD levels to about 50ng/ml all year round, and so roughly double the peak summer UK average levels, would suppress COVID-19 transmission and severity much more substantially than in that UK summer (as with influenza) to the point of, as I wrote:

. . . there would be no need for lockdowns, social distancing, masks or vaccines.

However, I am no longer confident about this, primarily because of current and likely future mutations in the viral genome which significantly enhance its transmissiblity - and perhaps (it would not be surprising) the severity of symptoms.  The combination of three  mutations in a South African / Brazilian (the two evolved separately but are the same) variant is raising most concern in late January 2021:

The lethal triad: SARS-CoV-2 Spike, ACE2 and TMPRSS2. Mutations in host and pathogen may affect the course of pandemic
Matteo Calcagnile, Patricia Forgez, Marco Alifano, Pietro Alifano Preprint 2021-01-14
https://www.biorxiv.org/content/10.1101/2021.01.12.426365v1

Shin Jie Yong's 2021-01-30 research roundup at  https://shinjieyong.medium.com/

More detailed, and worrying, molecular-level, details can be found in this French - Israeli preprint (AKA not yet peer reviewed):



#zahradnik

SARS-CoV-2 RBD in vitro evolution follows contagious mutation spread, yet generates an able infection inhibitor
Jiri Zahradnik et al.  Preprint (2nd version) 2021-01-29
https://www.biorxiv.org/content/10.1101/2021.01.06.425392v3

Here are some key points - but remember that I am an electronic technician trying to understand and summarize bleeding edge virology: 
  • The researchers used yeast rather than viruses to evolve genetic variations on the SARS-CoV-2 spike protein Receptor Binding Domain (RBD the part of the protein which matches the ACE-2 receptor.  This automated process evolves genetic variants far faster (days weeks and maybe a month or two) than can occur in SARS-CoV-2 viruses in the wild (months and years).

  • They were primarily interested in finding novel structures which would bind very tightly to the ACE-2 receptor without upsetting its normal enzymatic function in the body, for the purpose of introducing such molecules as a drug, in necessarily low concentrations, to attach to most ACE-2 receptors and so prevent viruses from attaching to them and so gaining entry into cells.  This is a promising form of antiviral therapy.

  • The affinity of a particular RBD for the ACE-2 receptor (here ignoring considerable genetic variation in the ACE-2 structure) is expressed as the concentration required to bind to half of a population of such receptors.   The affinity of the normal (wild type, before South African / Brazilian mutations) viral spike protein RBD for the ACE-2 receptor is 1600pM (picomols concentration).  (This is really inverse affinity, since a higher affinity means a lower concentration of spike proteins with a particular RBD pattern will bind to 50% of the ACE-2 receptors.)

  • The (inverse, to my way of thinking) affinity of the "British" mutation RBD is 455pM, meaning that this RBD has a 1600 /  455 = 3.5 times the affinity of the WT (wild type) original SARS-CoV-2 RBD.  

  • The South African / Brazilian RBD (with the same, independently evolved, three - Triad, above -  mutations) has an (inverse) affinity of 126pM, and so an affinity 1600 / 126 = 12.7 times the affinity of the WT RBD, which was the main type of SARS-CoV-2 virus present in the UK in the summer of 2020.  The current prevalence of this strain, and its likely spread throughout the world, is the primary reason for me thinking that population average 50ng/ml vitamin D levels may not "stop" COVID-19, meaning very substantially suppress its transmission and severity, as much as I anticipated in late 2020.

  • The researchers' evolutionary system reliably produced variants with the same three mutations as the South African / Brazilian variant.  It also produced variants with further mutations which increased the binding affinity a lot more.  Their best mutation "RBD-62" produces and RBD with an (inverse) affinity of 2.5pM.  This RBD has an affinity for the ACE-2 receptor of 1600 / 2.5 = 640 times the affinity of the ordinary, wild-type (not counting British, South African or Brazilian variant) SARS-CoV-2 RBD.

    If a soluble form of this RBD was made, it would be a good drug to reduce SARS-CoV-2 infections, since (depending on its concentration, which could be quite low) such molecules will bind to most ACE-2 receptors and so prevent viruses from binding to them.

  • However . . . this research, which is perfectly legitimate (and does not involve making viruses with these genetic variations - they are not allowed to) shows the specific set of mutations which would give a SARS-CoV-2 virus a very much greater affinity RBD than even the South African / Brazilian variant.

    This, and other combinations of mutations they discovered show that there is tremendous scope for the various SARS-CoV-2 strains to evolve still higher affinity RBDs, and so become much more transmissible - since each virus has a higher chance of binding to an ACE-2 receptor.

    The 12.7 times higher affinity of the South African / Brazilian RBD does not translate directly into 12.7 times more transmissibility - however this might be measured - but the increased transmissibility is obviously significant, since these variants are spreading faster than the strains which lack this combination of mutations.   The exact effect of some mutations depends on the presence of others (epistatic), and may be affected by individual and racial genetic differences in the structure of the ACE-2 receptor.

    SARS-CoV-2 is evolving faster than anticipated.  There's no way of predicting how rapidly still higher affinity strains will evolve, but it is reasonable to assume that they will evolve in months or years, not decades.

    (Of course, with the information in this article, a person with suitable equipment and the very worst of intentions could produce a SARS-CoV-2 virus with these exact mutations and release it.)

    Blue boxes on these pages denote quotes from the aforementioned article, with my notes in [square brackets].

    This suggests that with the spread of the "British", "Brazilian", and "South African" variants, we project that the Q498R mutation will appear in the future, on top of these mutations. The synergism of Q498R with N501Y and E484K increases ACE2 binding by ~50-fold relative to WT [ordinary SARS-CoV-2 before the British or South African / Brazilian mutations, which have affinities 3.5 and 12.7 times that of WT].

    If anyone can find a qualified virologist who can attest that the above scenario is either exceedingly unlikely, or not cause for a very high level of alarm, please let me know!

    It seems reasonable to assume that these are the early days of SARS-CoV-2 and so the COVID-19 pandemic, with the viruses likely to evolve to be very much more transmissible, and likely cause more serious symptoms, due to being able to spread even when at much lower concentrations in the body than are required with today's variants.

  • There are other important characteristics of the RBD part of the spike protein apart from its affinity for the ACE-2 receptor.  One is its stability at higher temperatures.  The mutations mentioned in this summary are all no less stable than the WT RBD.

    Another is to what extent the changes in the RBD mean that neutralizing antibodies [WP] produced in the body by various methods are less likely to bind to a virus with these altered RBD sections of their spike protein.  My understanding of the text at the top of page 14 is that for this (yet to evolve in viruses) RBD-62 genetic pattern of RBD, over half of the tested antibodies (raised by infection and/or vaccination, I guess) were less able to attach to these spike proteins than they do with the current strains of SARS-CoV-2.   So this particular, exceedingly high binding affinity RBD genetic pattern, if it evolved in SARS-CoV-2 viruses, would have significant survival advantages by way of lower chance of being found by antibodies, in addition to the immense benefit provides the virus by way of its higher binding ACE-2 binding affinity.


Resistance to proper, robust, population-wide vitamin D3 supplementation remains very strong, in part because many MDs cannot imagine, and do not care to research, the profound importance of vitamin D levels being well above the low, to disastrously low (UK winter) levels they are accustomed to.   This is in part due to lack of understanding of autocrine signaling, and false ideas of vitamin D acting primarily or solely as a hormone.

It is also hard for MDs to accept that a lot of the chronic diseases they battle, with great complexity, effort and skill, would be very much less prevalent if everyone had proper levels of vitamin D and other nutrients.  (A gram of D3 every 22 years is all a 70kg adult needs to achieve these healthy levels, and a gram costs USD$2.50 ex-factory in 1kg lots.)

Nothing in this update detracts from the importance of raising everyone's 25OHD levels to, on average, 50ng/ml (125nmol/L) or so.  Its just that I now think the SARS-CoV-2 virus variants are mutating in ways which mean this disease will be a serious burden for all people, indefinitely, despite this.  However, the impact of COVID-19 will be very much less if we get the average levels to 50ng/ml than if we fail to do so, and leave them as they are, below 20ng/ml in many countries in winter, rising to the mid-20s or perhaps mid-30s if we are lucky in summer.


It is all the more important to have good vitamin D levels when being vaccinated for COVID-19.   This is well established with influenza vaccines, where stronger immune responses are elicited in people with higher vitamin D levels:

Effect of 25-hydroxyvitamin D status on serological response to influenza vaccine in prostate cancer patients
Manpreet K Chadha, Marwan Fakih, Josephia Muindi, Lili Tian, Terry Mashtare, Candace S Johnson, Donald Trump
Prostate 2010-09-01
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718551/

Baseline Serum Vitamin A and D Levels Determine Benefit of Oral Vitamin A&D Supplements to Humoral Immune Responses Following Pediatric Influenza Vaccination
Nehali Patel et al.  Viruses 2019-09-25
https://www.mdpi.com/1999-4915/11/10/907


Vaccines vary in their effectiveness and risks of serious ill-effects.  It is far too early to tell to what degree any one vaccine will really protect against COVID-19 infection, for all the strains of the virus in circulation now or in the future.   We don't know how long vaccine-induced immunity will last, or to what degree it is specific to particular strains of the virus.  There are concerns about lack of testing in frail older folks, with potentially poorer immune responses and higher risks of serious ill-effects, such as Bells Palsy: https://covid.us.org/2020/12/23/is-there-a-risk-of-bells-palsy-with-mrna-covid-19-vaccines/ .

The popular vision, driven by popular hope and the statements of politicians, is that once most people are vaccinated, life can return to normal.   There is no prospect of this being true, since the viral strains will continue to mutate, since immunity from vaccines and prior infections will fade, since vaccine effectiveness will vary with numerous personal characteristics - including especially age, obesity and low vitamin D levels.

Close to the equator, some countries are doing pretty well.  But people there tend to have dark skin and, wisely, avoid direct sunlight - so vitamin D levels can still be lower than required for proper immune function.

Far from the equator, seasonal variation in UV-B skin exposure will drive very strong seasonal patterns in COVID-19 transmission and severity.

Even if more than half the population of many countries are vaccinated by the end of 2021, the virus will still be transmitted, with increasing likelihood of variants which infect people with immunity to prior forms of the virus, either through prior infection or vaccine-induced immunity.  The vaccination programs put the virus under selection pressure to evolve in ways which avoid being detected by the immunity raised by current vaccines.  So this will be a global cat and mouse game between the virus variants and the vaccine manufacturers.

Moderate or severe COVID-19 can cause very long lasting problems - probably permanent loss of capacity - for quite a high proportion of people.   It is a serious disease, and people who minimise its importance, such as by quoting average ages of those killed by, or with, COVID-19, are avoiding the impact it has on many people in their twenties to fifties.  They are also avoiding the impact it has on children by triggering Kawasaki disease or Multisystem Inflammatory Syndrome: https://aminotheory.com/cv19/#2015-Stagi .

Even if governments decided to have their entire populations supplement D3 properly tomorrow, world production of pharma grade D3 would soon be overwhelmed if more than a few tens of millions of people adopted this.   D3 factories take years to build by ordinary means - and those running now operate 24 hours a day.  Governments should work together globally with an urgency normally only found in times of war to build new pharma-grade D3 factories.  In the meantime, we should direct some of the much greater animal feed grade D3 production for humans.

Omega 3 fatty acids should also be recommended to the population for substantial daily supplementation.  There are numerous health reasons for this, and now must urgently regarding COVID-19: Asher et al. https://www.plefa.com/article/S0952-3278(21)00013-2/  The trouble is people need grams of fish or algae oil a day, when they only need, on average 1/8000 of a gram of D3.   I can't imagine how global production could be ramped up to a few grams per day per person, which is what everyone needs.   B vitamins: the same story but the quantities are smaller than for omega-3 fatty acids, so production could be ramped up.  But all these are far more expensive than vitamin D, and vitamin D is surely the most important nutritional deficiency which needs to be fixed for reasons of general health and COVID-19 in particular.  Zinc - best to take 25mg or so a day as chelate.  Some people are sensitive to excess zinc, so more than this may be a problem.

In the coming months or years it seems likely that SARS-CoV-2 variants will become very much more transmissible than they are today.  Then, perhaps, vaccines would not be able to produce the very high concentrations of antibodies, to the various strains, which would be required to either prevent infection or seriously reduce the risk of severe symptoms.

This would leave us with the following options for avoiding severe symptoms, and reducing transmission to some extent:
  1. High, continual, doses of antiviral drugs for a substantial fraction, or most, of the population.  This would be extraordinarily expensive, difficult to ramp up to this massive scale, and would surely cause significant ill-effects. 

    There are quite a number of possible antiviral drugs and combinations of nutrient which directly reduce viral replication, so these should not be ruled out for vulnerable people, but this is not a solution to the whole problem.

  2. More mask, social distancing and lockdowns - we are already at our limit with these and the costs are extraordinarily high.   This is no way to live into the indefinite future.

  3. Nutritional supplements to boost direct antiviral immune function and, most importantly, to greatly reduce the tendency of many or most people to having dysregulated, hyper-inflammatory, immune responses to SARS-CoV-2, influenza etc. 

    First and foremost this means population-scale vitamin D supplementation to attain average 25OHD levels of around 50ng/ml .  

    The costs and practicalities of other supplements are more challenging than D3 supplementation.   Boron is likely to be helpful, but it needs to be taken every day and many people do not recognise it as a nutrient.  Borax is banned in the EU, for no good reason.   Vitamin C is also a daily intake nutrient.   Various B vitamins are surely important.  Zinc needs to be taken once a day, and some people are sensitive to higher levels - but as far as I know 25mg a day is OK for adults.  (Zinc and other minerals have some interactions at the time of ingestion, so it can be complex to schedule when to have such nutrients.   Also, zinc as oxide is not as bioavailable as chelate.)

    Selenium may help too.

    Omega 3 fatty acids are surely beneficial but these are bulky and expensive, and it takes months, as far as I know, to alter the omega-3 to omega-6 ratio in the body's overall circulating, stored and in-membrane fatty acid makeup.
In short, very much increased SARS-CoV-2 transmissibility may make vitamin D and other nutrients the only long-term sustainable way we can cope with these viruses.   All the above nutritional supplements have broad, profound, health benefits, and are worth doing anyway even if there was no COVID-19 pandemic.





Some older infographics:



This is UK-USA-Australia-deaths.png .  OurWorldInData graph.



Infographic for #VitaminDStopsCOVID


This is VitaminDStopsCOVID.png .


Links and other items regarding the infographic

2008 Call to D*Action: https://www.grassrootshealth.net/project/our-scientists/ .

Immunologic Effects of Vitamin D on Human Health and Disease: https://doi.org/10.3390/nu12072097 .

UK vitamin D levels: Fig. 1D of:  https://academic.oup.com/jpubhealth/article/42/3/451/5859581 .

UK COVID-19 hospitalisation graphs: https://coronavirus.data.gov.uk/details/healthcare .

Kawasaki disease and Multisystem Inflammatory Syndrome, frequently triggered in children and adolescents by COVID-19: https://sci-hub.se/10.1007/s10067-015-2970-6https://aminotheory.com/cv19/#2015-Stagi and rebelem.com/...kawasaki-disease/ .

Barbara Gilchrist 2008: Sun exposure and vitamin D sufficiency

Greater viral shedding with more severe symptoms: Fig 1 [annotated here] in  https://www.jci.org/articles/view/138759 .

My suggestion for vitamin D3 supplementation quantities as a ratio of bodyweight: 01-supp/ This includes links to research which shows that the 2010 Institute of Medicine vitamin D recommended intake levels, as relied upon to this day by many health authorities, was completely miscalculated.

Excellent video 2020-09-24 with Rufus Greenbaum, Michael Holick MD, Bill Grant PhD, Gareth Davies PhD and David Grimes MD.

Be sure to see https://VitaminDWiki.com .

For background on how we all got into this mess of almost universally inadequate vitamin D levels, despite it being a very safe and inexpensive nutrient - with tiny quantities such as 1/22 gram per year needed for repletion - please read Bill Grant's article:

Vitamin D acceptance delayed by Big Pharma following the Disinformation Playbook
William B. Grant  Orthomolecular Medicine News Service, 2018-10-01
http://orthomolecular.org/resources/omns/v14n22.shtml

Orthomolecular is an awkward term for a field in which nutrition is given greater prominence for disease prevention and perhaps cure than is common in Western medicine.

An older introduction and elaboration upon the infographics

COVID-19 and influenza are only serious problems due to many people having weak and/or dysregulated immune responses - overly-inflammatory, cytokine storm responses which kill healthy cells and damage organs.   Sepsis is a condition in which a variety of infections - and sometimes burns - trigger extreme immune system dysregulation which damages organs. 

The biggest single cause of these weak and dysregulated immune responses is also the one which is most easily corrected: vitamin D deficiency

Inadequate zinc also drives COVID-19 severe symptoms.  25mg zinc, as chelate, every day is safe and will guard against deficiency in this important mineral, which is part of approximately 2000 enzymes and 750 gene-controlling transcription factors [Read et al. 2019] and which which reduces the ability of the SARS-CoV-2 virus to replicate its RNA.  [See these graphs of zinc and COVID-19 from Vogel-Gonzalez et al. 2020.]     

Omega 3 fatty acids, vitamin C and several of the vitamin B family are also important to good immune health, are frequently deficient, and can be easily and safely supplemented.

#d
Vitamin D refers primarily to three compounds which are essential for human health:

D3 cholecalciferol, [WP] which is produced from 7-dehydrocholesterol when the skin is exposed to short-wavelength 297 nanometre UVB light.   This can occur naturally with high elevation sunlight and bare skin - no sunscreen or glass.  There is very little D3 in food or multivitamins, so people who do not have substantial all-year-round UVB sun exposure need to take vitamin D3 supplements regularly.

D3 itself helps stabilize endothelial cells, which line our blood vessels. [Gibson et al. 2015]  COVID-19 and immune system destruction of these cells, particularly in the lungs, restricts the ability to breathe and causes the blood to become hypercoagulative.  This hypercoagulative state causes microembolisms and larger blood clots in all organs,  damage to the lungs, heart, brain, kidneys and liver and to death due to stroke and heart failure.


25 hydroxyvitaminD3 AKA 25(OH)D,  25OHD and calcifediol [WP] is produced in the liver, over several days, by an enzyme which attaches an oxygen-hydrogen hydroxyl group at the 25 position of D3. 
   


25OHD circulating in the bloodstream has a half-life of a month or two.  Higher 25OHD levels have a shorter half-life as a self-limiting degradation process kicks in.  Vitamin D blood tests report 25OHD levels as, for instance, 50ng/ml or 125nmol/L, which is one part in 20 million.  Circulating 25OHD supplies all cells in the body.  Many cell types consume 25OHD for their autocrine (internal) and paracrine (nearby cells) signaling systems.


Another enzyme can add a hydroxyl group to the 1 position of 25OHD, which converts it into 1,25dihydroxyvitaminD3, AKA 1,25OHD and calcitriol [WP] which has a half-life of a few hours. 

A small fraction of the circulating 25OHD is converted by this enzyme in the kidneys to a much lower level - around one part in 30 billion - of 1,25OHD which also circulates in the blood.  The exact blood level of 1,25OHD is tightly regulated by parathyroid hormone.  This is the only hormonal (long range signaling, via the bloodstream) function of vitamin D: to regulate calcium and bone metabolism.

All other known functions of vitamin D are in the autocrine and paracrine signaling systems of a large number of cell types, including especially those of the immune system.  Each type of cell responds to particular circumstances by converting 25OHD to 1,25OHD which activates vitamin D receptors [WP] inside the cell (autocrine) and which may diffuse to other nearby cells (paracrine) to alter their behaviour too.  In both cases, the activated receptor migrates to the nucleus and turns up the replication of multiple genes into messenger RNAs [WP], with each cell type upregulating different sets of genes.  These mRNAs instruct ribosomes [WP] to make particular proteins which cause the cell to respond properly to its conditions.  [Fuller explanation of autocrine and paracrine signaling.]

Researchers recently found that Th1 lymphocytes from the lungs of hospitalised COVID-19 patients failed to respond to their circumstances.  They are supposed to turn off their inflammatory cytokine [WP] production and instead produce an anti-inflammatory cytokine.  The sole reason their autocrine signaling systems were not working was that they did not have enough 25OHD. [McGregor et al. 2020

The critical role circulating 25OHD levels play in COVID-19 was further illustrated by the Cordoba trial [Castillo et al. 2020], in which just 0.532mg oral 25OHD calcifediol, raised circulating 250HD to over 100ng/ml (one part in 10 million) within a few hours [graph].  These Spanish-made Hidroferol capsules cost only one or two Euros each.  The supplementation group received another capsule on days 3, 7, 14, 21 etc.  Half the 26 patients in the control group needed intensive care and two of them (8%) died.  Of the 50 patients in the supplementation group, only one required intensive care and none died.

If all people with serious COVID-19 were treated as soon as possible, Cordoba-style, with 0.5mg calcifediol plus a 7.5mg or so loading dose of D3 (300,000IU), they would get better very much faster than most patients do today with conventional treatment, and probably with less need for corticosteroids.

Vitamin D is not strictly-speaking a vitamin, since we can make it ourselves if short wavelength ultraviolet UVB light strikes our skin.  However, this UVB light also damages DNA, and most people do not have access to sufficient UVB light all year round.   So for almost all people, vitamin D is an essential nutrient - not a mineral, but a vitamin.

Vitamin D's one hormonal role regulating calcium and bone metabolism is well known and it seems that many doctors still think of vitamin D as a hormone - or at least of 25OHD as the pro-hormone to the 1,25OHD hormone.  In recent decades researchers have discovered more about vitamin D's role in autocrine and paracrine signaling of many cell types.   Researchers have found that 25OHD levels of 40ng/ml (100nmol/L) or more are required so that these autocrine and paracrine signaling systems function properly. [Fabbri et al. 2020].


Traditionally living Maasai pastoralists and Hadzabe hunter gatherers in Africa average 46ng/ml [Luxwolda et al. 2012].  This is the best indication we have of the 25OHD levels of our African ancestors during the time when our present-day immune systems evolved.

Since 2008 [Call to D*Action] researchers and MDs have been advocating that everyone  supplement sufficient D3 to aim for 40 to 60ng/ml (100 to 150nmol/L) 25OHD.    A recent article confirms this:

Immunologic Effects of Vitamin D on Human Health and Disease
Nipith Charoenngam, Michael F. Holick 2020-07-15
Nutrients 2020, 12(7), 2097

https://doi.org/10.3390/nu12072097

You can see in the four wavy lines of the infographic above how the average 25HOD levels of white and Black, Asian and Ethnic Minority people in the UK vary throughout the year.  These averages are far lower then the 40 to 60ng/ml range researchers have known since 2008 is healthy.  Up to 100ng/ml is normal and healthy too.  Toxicity may become a concern for some people if their 25OHD levels exceed 150ng/ml (375ng/ml) - but this can only occur with far greater D3 intakes than is necessary to achieve healthy levels, as you can see from the way the 25OHD levels fail to rise so much for higher D3 intakes:



The above graph is adapted from Ekwaru et al. 2014.


This chart from Weishaar et al. 2013 indicates how low many people's vitamin D levels are today, compared to the healthy 40 to 60ng/ml range.  The right curve represents the distribution of 25OHD levels in the Luxwolda et al. African study.



There are various definitions of vitamin D deficiency, insufficiency etc.   A recent analysis of all available research by Karl Pfleger arrived at an estimate of 53% of the world's population having 25OHD levels below 20ng/ml (50nmol/L) and 83% below 30ng/ml (75nmol/L).  These two thresholds are still widely used to define deficiency, but the research of the last decade or so indicates we should be aiming for higher levels than to ensure the autocrine signaling systems of many cell types work properly.  This enables the cells to respond rapidly and fully to their changing conditions.

Another way of viewing the variation in 25OHD levels between individuals is this scatter plot of the levels of individual white women in the USA with no supplementary vitamin D3, and with 0.01mg (400IU), 0.02mg (800IU), 0.04mg (1600) and 0.06mg (2400IU) D3 a day:



Supplementing 0.125mg (5000IU) D3 a day will, after several months, raise the 25OHD vitamin D levels of 70kg (154lb) adults to, on average 50ng/ml (125nmol/L). [Ekwaru et al. 2014 and their graph, above.]   It is fine to take D3 in larger amounts, once a week or so.

This is only 45 milligrams of vitamin D3 a year.  To give some idea of this, 0.045 grams is the mass of a piece of office paper 42mm (1.65") square.  Pharmaceutical grade D3 costs about USD$2.50 a gram ex-factory, so this is 13 US cents per year.   0.125mg is the mass of a 2.2mm square piece of office paper.  IU means International Unit, 1/40,000,000th of a gram of D3. One IU of D3 is sufficient for a 10 gram mouse for a day, and for a 70kg human to maintain about 50ng/ml 25OHD for 17 seconds.   IU (International Units) is a silly unit of measurement.  The large numbers involved make some people concerned they are taking excessive amounts of D3.

If all, or almost all, people supplement with sufficient D3 to raise the average blood levels to 50ng/ml, all year round, this will greatly reduce or eliminate the weakened and dysregulated (overly-aggressive, hyper-inflammatory, self-destructive) immune responses which cause severe symptoms and high rates of viral shedding of influenza and COVID-19.   Likewise, the incidence of the gross immune dysregulatory disorder, sepsis [WP], will be greatly reduced.  Numerous other health benefits will result from ending the Vitamin D Deficiency Pandemic.

Further explanation, including regarding reduced viral shedding, is on the 01-supp/ page.


The causes of weak and/or deregulated immune system responses

Here are some important points about the common human proclivity for weak and/or dysregulated immune responses in humans.  These may also apply to companion and agricultural animals who lack proper nutrition and/or UVB exposure and/or who no longer have the helminths which infested the digestive tracts of their wild ancestors.
  1. SARS-CoV-2 (the virus which causes the COVID-19 disease) and influenza are only a significant problem for humanity because a large fraction of the population have weak and dysregulated immune responses, at least in winter.

  2. By far the most important, easily correctable, cause of these weak and dysregulated immune responses is inadequate vitamin D - due to inadequate supplementation if the person has not had sufficient UVB light exposure to synthesize sufficient D3 in their skin.

  3. Another major reason for our immune systems being poorly regulated, is that we now lack the intestinal worms (helmlinths [WP]) which infested our human and pre-human ancestors over the past tens of millions of years during which our immune systems evolved.  These helminths downmodulated some immune responses for their own protection, and our ancestors' immune systems evolved to be overly inflammatory ( overly-destructive) to counter this expected downmodulation which no longer exists for most humans today.  This is a tough problem to solve, but for most people these problems will not be significant once they have healthy vitamin D levels of 40ng/ml or more.  See my explanation https://aminotheory.com/cv19/#helminthsgone and https://helminthictherapywiki.org/wiki/index.php/Helminthic_Therapy_Wiki .   

  4. Other nutritional deficiencies drive weak and/or dysregulated immune responses.  One which is particularly important for COVID-19 is zinc, as previously mentioned.  Inadequate omega 3 fatty acids, B vitamins, magnesium and vitamin C are also widely recognised as common causes of immune system weakness and/or dysregulation.   Low boron intakes are also a likely cause of this, but most doctors have never heard of this as a nutrient and are unaware of the research which shows its importance in limiting chronic inflammation to reduce osteoporosis and arthritis.   See https://aminotheory.com/cv19/#08-boron .

  5. There are reasons to believe that excessive fructose lowers vitamin D levels, so this a nutritional excess which upsets the immune system.

  6. Fever is a healthy, early, response to viral infection and lowering it with drugs is widely regarded as a bad idea.  See the research I cite at: https://aminotheory.com/cv19/fever/
If this sounds too good to be true - 13 cents worth of vitamin D3 a year protecting an average weight adult from COVID-19 - then please read on and learn more about the immune system, COVID-19 and how low vitamin D levels drive the seasonal (winter and spring) spread of influenza and now COVID-19, with severe symptoms and high rates of viral shedding causing more people to become infected.



I am one of many people with no medical or nutritional training who are raising awareness of we must do to end the Vitamin D Deficiency Pandemic

Ordinarily electronic technicians wouldn't be meddling with the work of nutritionists and doctors - and these healthcare professionals wouldn't be messing with the work of electronic technicians.   Indeed they don't mess with our work, because electronic technicians are generally doing a good job.

Doctors have a huge range of responsibilities and must amass and maintain a vast body of knowledge and skills.   Unfortunately, for a number of reasons - including shortage of time and constant schmoozing by drug and vaccine companies - many doctors' understanding of nutrition has not kept pace with the best research.   The conventional approach of most members of the medical profession to vitamin D has for some decades been disastrously out of touch with reality.  

If nutritionists and doctors had been doing this part of their work well, then the populations of all countries would be supplementing D3 and, on average, have vitamin D levels (as measured by 25 hydroxyvitmainD3 - 25OHD) in the healthy 40 to 60ng/ml range, and sometimes higher - all year round

Then, influenza would cause little trouble and there would be no need for vaccines. 

Then, there would be little sepsis, which according to researchers from the Global Burden of Disease project, accounts for 20% of deaths worldwide. 

Then. SARS-CoV-2 would hardly spread and only very rarely harm or kill anyone.  So there would be no COVID-19 pandemic or the approximately equally harmful and deadly lockdowns, social distancing and economic and social devastation which has, so far, been governments' only response.

I am one of an increasing number of people, including doctors, nurses and a surprising number of physicists, electronic engineers/technicians, computer programmers etc. who have been working assiduously for years, and sometimes decades, researching and raising awareness of nutrition in general and of vitamin D in particular.   I figured out the critical role vitamin D deficiency plays in the COVID19 pandemic in late March - just by reading research articles.

People trust their doctors to advise them, and doctors trust panels of experts to advise them - because they generally cannot navigate the vast volumes of research to decide which articles  are the most important.  Doctors also rely on government guidelines, in part so they can work without unreasonable risk of being sued for malpractice.  

Yet many of these official guidelines are based on the work of the US Institute of Medicine, who in 2011 calculated an RDA (Recommended Daily Allowance) of vitamin D of 0.015mg (600 IU).   The real RDA (for the low 25OHD level of 20ng/ml) is about 0.175mg (7000 IU).  The IOM made a simple, but crucial, statistical error.   It seems likely that if they had not made this error, many people would now be supplementing with adequate quantities of vitamin D and there would be little trouble from influenza or COVID-19, all year round.  The IOM's error was identified in peer reviewed journal articles in 2014 and 2015.  No critiques of these articles have surfaced and it is reasonable to conclude that the IOM really did make this enormous mistake.   Yet the impact of this mistaken calculation continues with government recommended vitamin D supplemental intakes of 0.01mg (400 IU) and 0.015mg (600 IU) in many countries, which are less than a tenth of what is really needed.  (See the 01-supp/ page for links to these articles.)

If these advisory committees and the doctors who rely on them had been doing their work properly, we wouldn't be in the current disastrous predicament, and we physicists, IT people, technicians, engineers and lots of other non-medical people would not be working outside our fields, attempting to fix the disastrous failings in particular aspects of nutrition and medicine.

One such retired electronics engineer is Henry Lahore, in Washington State, who now collaborates on articles with leading vitamin D researchers and works tirelessly to document research into vitamin D and several other nutrients at:

https://vitamindwiki.com

Another person taking a keen interest in this field is AI PhD Karl Pfleger, with his Low Vitamin D Worsens COVID-19 Risk article, listing recent research:

https://agingbiotech.info/vitamindcovid19/

Gordon Shotwell, who trained in law and works as a data scientist, maintains a page of recent COVID-19 and vitamin D research:

https://vitamin-d-covid.shotwell.ca

Here is my adaptation of graphs from some recent observational research showing how low vitamin D levels are strongly associated with, and surely largely the cause of (rather than caused by) COVID-19 severe symptoms and death: https://doi.org/10.3390/nu12092757 .



© 2021 Robin Whittle   Daylesford, Victoria, Australia