By Dr Carin Shuler PT, DPT, MS, CHC

Scientific studies over the last decade have shown important protective effects of Vitamin D against both upper and lower airway infections. Recent studies suggest that Vitamin D may help prevent or decrease the severity of Covid-19.

Vitamin D and the Corona Virus

Could Vitamin D prevent you or a loved one from getting the Corona Virus?  Or might it help to reduce the severity of your symptoms or a loved one’s symptoms? Might Vitamin D even keep you or a loved one out of the ICU and off a breathing machine?

Rehab House Call is pleased to bring you the latest information on this very question! Recent stay at home orders have affected us all. They have been in place across our nation. Therefore, while home, people may be limiting their sun exposure. Sun exposure helps to maintain proper values of Vitamin D in our bodies. Could a normal level of Vitamin D really help you to stay out of the hospital? Low Vitamin D in our bodies may lower our immunity.

Immunity is what helps us to fight against this disease and others. Let’s take a look at what the most recent information tells us.

Vitamin D and Acute Respiratory Distress Syndrome

We have known for a long time that Vitamin D is important in boosting our ability to fight against disease in general.  This has been found to be especially true with lung infections and those progressing to “Acute Respiratory Distress Syndrome” (called ARDS). Vitamin D fights against lung infections, asthma and ARDS. People who develop ARDS do not do as well with the Corona Virus and often do die as a result. (1).

Our body’s chemical messenger system (called the Endocrine System) may have many actions on cells and tissues of various organs involved in this virus’ progression. If Vitamin D can decrease the risk of developing ARDS in Corona Virus cases, it is well worth further study.

The Phases of the Corona Virus

When someone becomes ill with the Corona virus, they first go through the early viral phase. For many, the symptoms are mild to moderate in this phase. The symptoms are quite varied too.  These signs might include fever, a dry cough, shortness of breath, muscle aches, fatigue, abnormal white blood cell counts, and possible positive tests for pneumonia.  If it progresses to the airways in this early phase, it is usually limited to the upper airway.

People go through a second phase if the disease progresses. The symptoms worsen in this second phase.  People then have to fight against lower (deeper) airway infection in the lungs, low oxygen levels with difficult breathing and blood clotting.

The third stage involves severe inflammation. This is called the hyper inflammatory phase. (3). Vitamin D has properties that are both anti-viral and anti-inflammatory.
These properties appear to be especially important in fighting lung infections.

However, for some, the virus becomes even more severe. This may lead to ARDS. This occurs when the virus enters the cells of the gas exchange sacs of the lungs. These sacs are called alveoli. Once this happens, “diffuse alveolar damage” called DAD worsens a person’s ability to breathe. DAD also causes even more damage to small blood vessels that carry oxygen to other parts of the body and to other cells in the alveoli. (4). That is why so many people with Corona Virus have difficulty breathing and require breathing machines called ventilators. ARDS is a common cause of death among people with the Corona Virus.

There is some good news though. A new study from Spain reports positive results when adults with Corona Virus and pneumonia received a form of Vitamin D. There are two main forms of Vitamin D. These are D2 and D3. This study is the first published study that demonstrates that Vitamin D3 may be a simple yet effective treatment for the Corona Virus. Let’s look at this study more closely. (9)

The Results of the Vitamin D Spanish Study

This study is the first of its kind. The findings have been called extraordinary and will be especially true if these results can be repeated (7). Although the number of patients in the study were small, the results are indeed important.   The researchers divided patients who had both the Corona Virus and viral pneumonia randomly into two groups. This was done once they were admitted to the hospital. All were admitted based on a measurement scale used to determine the intensity of their symptoms. One group received high doses of a form of Vitamin D3 by mouth. The second group did not. This form of Vitamin D3 is called calcifediol.  All other treatment was according to the standard of care at the time. This included a combination of the medications of hydroxychloroquine and azithromycin. 

There was a total of 76 people in the study.  Fifty of the people received the Vitamin D3 and of those, only one patient(or 2%) had to go into the ICU. And no one died in this group of 50. 13 of the 26 who did not receive the Vitamin D3 (or 50%) had to be admitted into the ICU. 2 of the 13 in this group died from the virus.   

The results showed that Vitamin D3 could therefore decrease the seriousness of the Corona Virus. It reduced the ICU admissions from 50% to 2%. These results are indeed extraordinary even in a small pilot study. These results regarding the ICU meet the strict statistical research guides to be considered significant.  This was a 93% reduction in the chance of having to be admitted to the ICU.

The researchers determined this after they considered other factors that may have made a difference among patients, such as high blood pressure and Type 2 Diabetes. However, because the number of deaths was so small in the study group, no conclusions could be made about Vitamin D3 preventing death from COVID19.  Despite this, the important findings regarding the ICU admissions will lead to larger and more controlled studies about Vitamin D3 in the treatment of this dreaded pandemic. Stay tuned for further updates as this research becomes available! (1)

How Then Does Vitamin D Help Fight the Corona Virus?

Maybe you have heard on the news or social media that part of the reason some people become so ill with Corona Virus progressing to ARDS is due to something called a “cytokine storm”.  This occurs when our immune system goes a bit crazy. What the heck is a cytokine, you might ask?

A cytokine is a molecule that is sent out by our immune cells. There are different types.One type increases inflammation. When our immune system sends out too many of the inflammation type or for too long, it can have a damaging effect.  This is the hyper-inflammation that we talked about earlier. This then increases the seriousness of the Corona Virus symptoms.  It is thought that perhaps Vitamin D3 helps to calm this storm. It may do this by helping to control special white blood cells that our immune system sends out to fight the virus. 

Vitamin D3 may also help to maintain the structure of the lungs’ inner cellular lining. This is called the pulmonary epithelial barrier. As you might think of any type of barrier, this barrier protects the lungs. Vitamin D3 may help to repair this lining too.  Another consequence of the virus is a terrible increase in blood clotting. This is called blood coagulation. Vitamin D3 may also reduce this problem and therefore improve a person’s chance to survive.

Sources of Vitamin D

Where Does Vitamin D Come From?

When we expose our skin to sunlight, our bodies naturally make Vitamin D. Direct sunlight turns a substance in our skin into an active form of the vitamin. This is Vitamin D3. There are two main kinds of Vitamin D. Vitamin D2 is only in plant based foods, like mushrooms. Yeast also has D2. Yeast is used in breads and baking. Vitamin D3 is only available in animal foods like salmon, mackerel and sardines. Vitamin D3 is the type of Vitamin D your body makes with sunlight exposure.

D2 is relatively cheap to make. Therefore it is often added to foods like “fortified” milk or cereals. However, D2 is not well absorbed by the body. D3 is much better absorbed by our bodies.  In fact, it may be almost twice as effective as D2 to normalize our blood levels of this important vitamin. Therefore, supplementing with oral Vitamin D3 is generally recommended. (5) And again, this type was used in the Spanish study.

Although not always necessary, your physician can check your levels of this important vitamin by a blood test. Most active people get enough through their food and sun exposure. However, if you are low in Vitamin D3, your doctor may then recommend taking a supplement. This is the other way we can get Vitamin D3.

Alternatively, feel free to contact Rehab House call at 951-344-6141 or just CLICK HERE to schedule your Free Expert Health Coach Phone Consultation.  You may also email us at: info@rehabhousecall.org

Often, the elderly, the chronically or seriously ill or people with dark skin are low in Vitamin D. Dark skinned people cannot absorb the sun’s rays as well. Also, many people don’t get enough sunshine in the winter. The elderly often do not get outside enough to get adequate sunshine. When they do get outdoors, they often cover themselves well to avoid getting skin cancer. As Americans, we often use sunblock to avoid this too but then this limits our ability to make Vitamin D3 too. Also, with the recent stay at home recommendations, remote online schooling and remote at home working, many people are not getting outdoors enough.

What Are Normal Levels of Vitamin D?

Your doctor will be looking for the results of a blood test to be 20 to 50 nanograms of Vitamin D per milliliter (ng/ml) of blood in most adults. If an otherwise healthy adult is below 20 ng/ml, they are generally considered to have inadequate levels for bone and overall health. (6). Functional Medicine experts report similar levels; 30 to 60 nanograms per milliliter (7).

The recommended amount of Vitamin D3 supplement to take does vary depending upon who you ask. Prior to this pandemic, typical recommendations were 400 International Units (IU) for infants, 600 IU per day thereafter for most children, teens and adults and 800IU for those 70 years and older (11). Most supplements are indicated by micrograms (mcg) instead of IU on the bottles you purchase. 600 IU is equal to 15mcg and 800IU is equal to 20mcg. However, given the results of the Spanish study, functional medicine expert, Chris Kresser recommends 4,000IU (equals 100mcg) up to 8,000 IU or 200mcg per day for adults. Furthermore, he states that up to 8,000IU per day for an adult does not lead to toxic levels of the vitamin.  Kresser further states that there appears to be no risk to supplement with Vitamin D3 up to these levels while awaiting the Spanish study to be repeated and further recommendations to come to light. (7)

Other Benefits of Vitamin D

We’ve already talked a lot about the benefits of VitaminD3 boosting the immune system, helping to prevent airway infections and decreasing the seriousness of ARDS and the Corona Virus.  But what else does Vitamin D do for us? It has long been known to be important in bone health. When low in Vitamin D and calcium, bones can soften or become more brittle. This can lead to bone loss, deformities and broken bones. It can also cause bone pain, muscle weakness and falls. This is one of the major reasons for broken hips. 

If you or a loved one has experienced a fall, please contact Rehab House Call at 951-344-6141 or CLICK HERE NOW for a very important FALLS AND BALANCE ASSESSMENT. This just may save yours or your loved ones life as falls are a major cause of death in adults over 65 years of age.

This is especially true for older women. However, bone loss can also occur in males, athletes or people with eating disorders or intestinal absorption issues. Overall, Vitamin D has many potential health benefits (10). Some of these other benefits may also help someone while they are recovering from the Corona Virus due to their weakened state. In addition to what we already discussed, these benefits of Vitamin D include:

• Stronger bones  
• Fewer broken bones ·     
• Fewer falls due to weak bones·     
• Preventing the childhood disease of Rickets ·     
• Improving or protecting brain health and some nervous system diseases. ·     
• Preventing certain types of cancers·     
• Improving certain skin conditions 

Symptoms of Vitamin D Deficiency

Looking at the benefits of Vitamin D, the symptoms of Vitamin D deficiency is just about the opposite of the benefits. For example, we already talked about bone loss and increased fractures and falls.  Similarly, if one is low in Vitamin D, there immune system will be weakened and less able to fight off diseases. Some may present with impaired memory and other neurological conditions. Lastly, skin conditions might arise when low in Vitamin D. 

If you or a loved one are concerned about any of these types of symptoms, contact Rehab House Call for a FREE CONSULTATION now by CLICKING HERE or calling 951-344-6141.

More on Vitamin D Deficiency

As mentioned above, many of those who have died from the Corona Virus suffer from severe lung problems, blood clotting and difficulty breathing. Many doctors and scientists across the world have reported their observations on this.

People who are the most seriously ill, are the ones found with the lowest Vitamin D levels in their blood. However, this tends to be true for any person with any serious or chronic illnesses. In addition, though, countries with the greatest number of deaths from this pandemic have had the people with the lowest levels of Vitamin D (10).

Despite these observations, researchers and doctors do not yet know if taking Vitamin D supplements will actually prevent us from contracting the virus. Deficiency in Vitamin D is common in the elderly, the chronically ill and in dark skinned people. But these same groups are already known to be at higher risk for the Corona Virus. This may or may not be due to their low levels of Vitamin D. (11).  Many scientists across the globe are currently researching these very questions.

More Research is Needed

The most recent research is certainly hopeful. However, it is too soon to know for certain if there is a cause and effect with Vitamin D and prevention or severity of the Corona Virus.  More research is needed.  Keep an eye out for new developments as Rehab House Call reports them!

What This Means for You

If you have not had a blood test to determine your level of Vitamin D in your system, you should not exceed the recommended doses of Vitamin D.  Too much can cause toxic levels.

Toxic levels can cause heart and lung problems. Nor should you sunbathe excessively. We do know that excessive sun exposure can directly causeskin cancer. If you are concerned that you are low in Vitamin D, ask your doctor to order a blood test. Thereafter, your doctor can recommend how much you should supplement with on a daily basis. Your doctor may decide to monitor you on a regular follow up to keep you within the normal limits.

Interestingly, the researchers in the Spanish study did not test blood levels in the subjects as they were already at risk to be low in Vitamin D due to a variety of reasons such as their illness, weakened state, age and darker skin. However, the best current medical advice is to keep Vitamin D within the normal blood levels. That can only be certain through blood tests. You will gain all the known benefits of Vitamin D, including        general immunity, without posing a toxic danger to yourself.

Last but not least, don’t forget to check back with Rehab House Call for updates on the latest research!

For more information, or a Nutritional Health Assessment with a Rehab House Call Certified Health Coach call 951-344-6141 or simply just CLICK HERE!

WE HELP MAKE YOUR HEALTHSPAN EQUAL YOUR LIFESPAN

References:

• https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30366-0/fulltext
• https://www.who.int/emergencies/diseases/novel-coronavirus-2019
• https://medicalxpress.com/news/2020-06-individualized-treatment-covid-patients-based.html
• http://consultqd.clevelandclinic.org
• https://www.onnit.com/academy/vitamin-d-vs-vitamin-d3/
• https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/.
• https://www.facebook.com/chriskresserlac/videos/vb.212758788776392/773240216844839/?type=2&theater
• https://www.webmd.com/food-recipes/features/vitamin-d-vital-role-in-your-health#1
• Castillo ME, Entrenas Costa LM, Vaquero Barrios JM, Alcal ́aD ́ıazJF, Miranda JL, Bouillon R, Quesada Gomez JM, ̈Effect of Calcifediol Treatment and best Available Therapy versus best Available Therapy on Intensive Care Unit Admission and Mortality Among Patients Hospitalized for COVID-19: A Pilot Randomized Clinical study ̈,Journal of Steroid Biochemistry and Molecular Biology(2020),doi:https://doi.org/10.1016/j.jsbmb.2020.105751. (https://www.sciencedirect.com/science/article/pii/S0960076020302764?via%3Dihub
• https://www.webmd.com/lung/qa/what-are-the-symptoms-of-covid19
• https://www.yalemedicine.org/stories/vitamin-d-covid-19/