Lack of Vitamin D is associated with SARS-CoV-2 infection and mortality | Hacker News Reader

Lack of Vitamin D is associated with SARS-CoV-2 infection and mortality

ncbi.nlm.nih.gov

108 pointstaf2132 comments

Wow, anyone reading the source paper in detail (or trying to take away conclusions) has to know that the stats are really, really rough.

The authors are almost just doing internet desk research -- counting the number of Covid deaths/cases and just plotting that against the average Vitamin D level in the population of each Indian state in general. Based on a couple thousand healthy patients of the general population. (BTW, I think it's really important that everyone learn to see through the math/symbols/technical jargon when reading such research papers to understand the populations really being studied. All those r and p numbers are meaningless if the underlying patient data are flawed.)

That is really rough. I could not imagine this would be credible if you substituted for example (just to think about it locally with a population you might know), "New York" for "Maharastra" state in the plot and asked if you believed the strength of finding that average Vitamin D level in New York state correlates with Covid death rate. How about for Florida -- would that be believable too? And also, the noticeable points making up the perceived trend are so few, and the points are not even weighted for population size (?)!

Much more work in detail -- at the patient level with Vitamin D measurement -- would have to be done to be credible. I would not act on this information in the present form.

It doesn’t seem like they controlled for any other variable at all - even time. From the paper: “Various literature databases like PubMed and Google Scholar were searched to find the mean of 25-hydroxyvitamin D [25(OH)D] levels in different states and union territories of India”. I would have to assume not all those studies were done at the same time.

This would maybe be a great elevator pitch to get some resources. Not sure if that’s the intent.

Relatedly, have there been proper double-blind studies for vitamin d injections & COVID outcomes? I would guess there’s not a lot of interest given other substances that have better “method of action” hypotheses. Or maybe it’s just lack of funding (hence we see an article like this every month or so)?

> Relatedly, have there been proper double-blind studies for vitamin d injections & COVID outcomes?

I think there was a study that saw improved clinical outcomes when a metabolized version of vitamin D was administered. Don't know where to find it though.

It was this one from the Reina Sofia University Hospital in Spain (high dose of Calcifediol significantly reduced need for ICU treatment):

https://www.sciencedirect.com/science/article/pii/S096007602...

This site has a fairly complete index of all the studies related to vitamin D and COVID-19. Before commenting here I recommend reading through all of the article abstracts as much of what you might want to know has already been addressed.

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

This could also explain the higher Covid death rates for Blacks in the US, while Africa has relatively lower death rates

https://www.nature.com/articles/s41371-020-00398-z

Climate and socioeconomic conditions are probably also factors, but yes, I wouldn't be surprised if vitamin D is one, too.

Age demographics as well.

Considering how relatively safe Vitamin D is, why aren't governments pushing really hard on it?

Same with N95 masks. At this point, if there was a push, we could have had plenty of them, and they're significantly more effective, but there's no push.

It's weird. But the US is botching vaccine distribution, too, so at least it's consistent.

My understanding is that it can take years for measurable benefit from supplements to be realised for this

I have no reason to believe this is true. It can take years to fully remedy a serious backlog of nutritional deficits, but that's a completely different metric from "years for measurable benefit...to be realized."

For seeing an overall mortality benefit in normal times, maybe.

But it's the D-related-compound levels in your body right now (or seasonally) that have a noticeable effect on fighting current viral infections.

It takes about 7 days for ingested Vitamin D to be fully converted into calcifediol, an important active form measured in the blood, and with good results as a treatment preventing ICU admission in serious COVID cases.

So if you'd like a better chance of fighting off a COVID infection over the next few months with only mild effects, ensure you're on a daily regimen of Vitamin D now.

The US also botched testing quite a bit, keep your expectations low and you’ll never be disappointed/surprised

and now they're just over testing, especially with PCR with 40+ amplification cycles. The false positives combined with positives from minor infections are blowing up case numbers out of proportion.

One angle is that since no one owns a patent on Vitamin D, there is no one who lobbies for it.

They should fortify commonly consumed food products with Vitamin D. Like milk.

I know you're joking, because they do, but the amount they fortify it with is very small. If they would 10x it, then maybe it would make a difference.

Not all countries do this.

Milk isn't that commonly consumed. It's not like salt. You also don't want to overdo vitamin D.

https://www.sciencedirect.com/science/article/abs/pii/S00220...

https://www.theguardian.com/food/2020/jan/06/us-dairy-indust...

In Finland drinking milk is quite normal, however the sunlight might be a factor here as well..

The US and some other countries DO set minimum levels for D in milk. Fortification is allowed if it's too low naturally.

The same stuff is required in the US for skim milk and plant "milks" too. Occasionally all-natural believers get into trouble with the FDA for not having enough D in their skimmed milk.

N95 masks are only really effective when people wear them properly.

I wouldn't be surprised if they were less effective than the regular masks when worn improperly, because the higher resistance of the N95 filter material means more air goes through the gaps (whereas the regular masks are breathable enough that air still mostly flows through them). I would also expect acceptance to be much lower due to higher breathing resistance.

> Considering how relatively safe Vitamin D is

Vitamin D (like Vitamin A) accumulates in the body and is dangerous in high doses.

It's pretty mild compared to A, with a large gap between the UL and getting sick.

Healthy adults need a few months on a dose two orders of magnitude higher than the typical recommendation to see overt toxicity. All known cases of toxicity stem from people going ten times the UL.

Still, don't handle this like a water soluble vitamin. Never think about bulk powders, since the IU-to-weight conversion ratio is crazy potent.

What is the meaning of UL?

Tolerable Upper Intake Level, as set by the Institute of Medicine in the US or the European Food Safety Authority. Currently 100 µg/d (4000 IU) for vitamin D.

I ramped up to 60k IU's per day. No issues thus far. It's been a few years to get to this point. I also take a lot of K2 MK-7, Magnesium, C, Zinc. Well, a bit of everything. AMA.

Also include suppressing antibody tests, see below podcast:

https://lexfridman.com/michael-mina/

There is little hard evidence for the benefits of it. The cited paper is very very soft

You should read all of the other papers. The evidence is now quite strong. https://vitamin-d-covid.shotwell.ca/

So like hydroxychloroquine...

Except it's a lot safer already produced in large amounts.

https://en.wikipedia.org/wiki/Hydroxychloroquine#Adverse_eff...

https://en.wikipedia.org/wiki/Vitamin_D#Excess

As long as you aren't pregnant and don't overdo Vitamin D, you'll be fine.

The NHS in the UK now recommends all adults suppliment vitamin D, not because of COVID, but because a large part of the population is deficient due to the low levels of sunlight we get.

I've been taking Vitamin D supplements for the last year, and most recently I had my doctor run tests. They were very surprised that the test came back and I was under the minimum range, even with the supplements.

They had not expected that at all. So instead they asked me to up my dosage. Ever since then I've felt mentally better than before, it really helped my mood and improved my ability to think.

What body weight are you? What dosage were you at before? What dosage are you at now?

I'm a big guy. 300 lbs. Was at 2,500 IU, now at 5,000 IU.

I’m also interested. What’s your latitude and do you get sun often?

I live in San Francisco. There's plenty of sun, I don't spend an awful lot of time outside though, and especially not uncovered or without adequate sun screen to protect my tattoos and my skin (skin cancer sadly runs in the family)

Warning for others: HN seems to be pro-armchair diagnosis on vitamin D supplements, which makes sense given the demographic and stereotypical lifestyle factors. Vitamin D is fat soluble. It can build up in your system over time. Normal levels are 30-50 ng/ml, and you can get your levels tested by asking for the test whenever you get a blood draw or your physical. Taking vitamin D supplements at high levels indefinitely without medical testing is dangerous (albeit a slowly building danger over months that is relatively easily reversed).

Anecdata: I was taking 5000 IU daily for a year, and my levels went up to 79 ng/ml. I stopped taking it for 6 months, and my levels went down to 47 ng/ml.

I've been going 60K IU's for a long time, no issues thus far. I had to ramp up to that. Doing that all at once can cause headaches or blurry vision.

Appreciate the warning, but I started taking supplements due to a previous doctor recommending me to take them.

Then that doctor retired and I got a new doc who didn't read that in my previous charts, so they were surprised when the results came back, evenjhough I was taken supplements.

I got my blood tested and everything came back in normal ranges except Vitamin D, which was HALF of the normal range!

I and the doctor both knew that the link to COVID susceptibility was inconclusive, but that its such low hanging fruit that might as well take a supplement. Its honestly just not even worth debating "but maaaaybe low Vitamin D is linked to other things and those people were already sick!" okay, typical useless internet discussion. Now back to getting it into normal ranges. The doctor gave me 50,000 IU weekly doses. Available by prescription only.

50,000 IU dosages aren’t really available by prescription only when 5,000 IU pills are OTC.

hahaha I see what you mean. so it really comes down to the concentration, specific instructions, and how a single pill is digested, as the pill is the same size as the others but the delivery method relies on the slow destruction of the outer layer, with explicit warnings not to chew them.

lower dose pills don't have the same warning.

I wonder why you’d do this over 7,000 IU daily.

It is a weekly dose. A single weekly dose.

Right. You’re taking a fancy, slow release, 50k IU once a week. Why not take a not fancy, regular release, 7k IU pill every day? I’m not saying once a week is bad, but there seems to be a cost to it. And assuming everyone involved is a rational actor, something justifies that cost. What is it? Is there some effect that heavy infrequent dosages has? More convenient? Higher patient compliance?

The pill's outer coating is different which contributes to the release schedule. This can be important based on how the body is expected to metabolize it. By default, the body will waste many extra servings of vitamins. There is also the chance of overdosing on it and not getting the desired effect or damaging other organs.

Also, this whole conversation about cost is a red herring. I looked at the sister thread and I have no idea what they are talking about.

This set of pills was cheaper for me to pay for, with the doctor's prescription, than the lower dosage pills on Amazon. Which I also had purchased upon seeing my blood results, before my doctor had chimed in on the results themselves.

It'd be ridiculously expensive compared to the prescription option, though. And potentially rather dangerous. If you're willing to invest that much in dubious self-medication, use that money to get better insurance (edit: if possible), which should in turn pay for a PCP visit and some basic blood tests. And a prescription--if you need it. Edit: If you don't have that option, you probably shouldn't be dropping money on supplements, and you're probably not going to appreciate someone on HN telling you to prioritize such matters in the first place.

Edit: People who are in difficult situations financially shouldn't be focusing their energy on self-medication with random supplements. Those resources are better spent elsewhere. It may be the case that no, they cannot get insurance or blood work for the cost of self-medication--but that doesn't mean they should go ahead and do it anyway.

Asking someone in a financially difficult situation to spend $15-30/mo on Vitamin D is silly. That's a lot of money. It would be better spent getting more or healthier food (the latter of which comes at a premium in the US), or perhaps setting it aside for the inevitable medical costs that life always brings. If you can afford to drop $15-30/mo on vitamins, you can afford to visit a PCP once every year or two--even out-of-pocket, the PCP visit is going to cost less.

Could you get the vitamins online for a fraction of the cost? Sure, but there are people who often can't pay with anything but cash or food stamps. Suggesting that they're in a position to order products online is rather dismissive of the reality that many of these people live.

Most with insurance have little to no choice. It’s 1 or two of the same PPO with different deductibles or an HMO, if you’re lucky.

This is entirely anecdotal, but I was recently prescribed 50,000 IU/wk by my doctor after blood tests. Even if I had paid for the doctor, blood tests, and prescription entirely out-of-pocket, it would've been cheaper than self-medicating at a dose like that. Most of it was out-of-pocket for me anyway because I hadn't met my deductible, and the whole ordeal set me back less than $100. If I didn't have in-network pricing, it still would've been less than the cost of one month of health insurance.

Obviously, there are plenty of regions and situations in which things don't work out that way. Asking someone to self-medicate with Vitamin D still has the potential to be expensive, and there may be better uses for that money, especially for someone in that sort of financial position.

You went to a doctor, got blood tests, and didn't hit your deductible..... and paid $100. Where exactly did you cross international borders?

That or your doctor visit had no out of pocket costs for being preventative (most insurance plans don't)

A bottle of 360 5,000 IU Vitamin D pills is $16 on Amazon. Each pill is 4.5 cents, so you’re looking at 45 cents a week for 50k IU. I don’t think you can get better insurance for $2/month.

I suppose if you're buying it online instead of locally, that's an option. If I were to buy it from a local store, though, it's a lot more expensive than that--$16 will get you 14-30 doses, even with a cheap brand. And that's assuming you can find the cheap brands in stock, which is often difficult.

I don't think it's reasonable to expect that people in financially difficult situations are able to order online. These are often people who can only pay with cash, food stamps, or other methods that Amazon won't accept. If you're shopping on Amazon, you're probably in a position whereby you have a bit more flexibility in your life.

I know that in Massachusetts (United States), you can see a PCP, get blood work, and get a Vitamin D prescription for free if you don't have sufficient income or insurance. I have friends and neighbors who don't have jobs right now; that's how they get their healthcare. Of course, they're lucky: from what I hear, it's certainly not like that in most of the US, let alone the rest of the world.

Regardless, I don't think it's constructive to insist that self-medicating with Vitamin D should be a priority for people in such a financial position. There are other priorities. If your life is comfortable enough that you can worry about supplements, you probably have enough money to get better insurance or get proper blood tests.

Edit: I don't understand the downvotes. There are an awful lot of people for whom buying medications on Amazon just isn't an option. They don't have and can't get credit cards or bank accounts. They don't have a stable place to live or a way to receive packages. "I don't understand why these people can't afford X; I can order it online for just Y cents" is entitled and dismissive: that's not the reality for many people, especially in the US.

Meanwhile, a not-insignificant percentage of these people live in places where they can, in fact, see a doctor, get blood tests, and get basic prescriptions for free (money). They often can't take advantage of these benefits--not because of the costs, but because of the time (taking a day off from work? Not an option.), bureaucratic red tape (paperwork, call random people and wait on hold for hours), and lack of awareness (how do you know these services exist, especially if you don't speak English or even know to look for them?).

I hear you.

Gentle reminder: every CVS and Walgreens I've ever gone into has Amazon gift cards someone can buy with cash and use them to pay for stuff on Amazon.

I can only speak for people I know, but I think the logistics of that are right up there with "take advantage of free healthcare that's available at your income level." They have to:

1. Know that the option is available

2. Have a stable home--Amazon doesn't work well if you're homeless or couch-surfing

3. Speak English, assuming you're in the US (this is a big one)

4. Have consistent access to a computer or a cell phone

5. Have consistent access to the internet--not a given when you keep defaulting on your cell phone payments

6. Have the time, energy, and intelligence to figure out how to get an Amazon account working via non-traditional methods--it sounds silly, but this is a real problem if you're juggling just as many jobs as kids.

#1, #2, #3 are really difficult for a lot of people. Even in places where people would be eligible for some minimal level of free healthcare, they're still significant hurdles.

I ordered off Amazon while homeless and sleeping in a tent.

Yes, there are people who absolutely cannot readily make their lives work. I still struggle to make ends meet, though it's better than it used to be and I'm at least no longer homeless.

But you seem to be pointlessly beating a dead horse here. There may be a good argument for "We should just give away help for the most vulnerable during the pandemic because protecting them protects others." but beyond that I don't know what your point is.

> but beyond that I don't know what your point is.

The ancestor to which I'm responding was suggesting that self-medicating at prescription-level doses was a viable option. It's not:

1. If you can get the tests to show that you actually need prescription-level dosing (rather than OTC dosing), then you can get the prescription far cheaper than the OTC medication anyway.

2. If you can't get the tests, then you shouldn't be taking a higher-than-OTC dose without a damn good reason, and we sure as heck shouldn't be encouraging that here or treating it as a priority--although I think the ancestor was half-joking.

This particular branch of the discussion isn't about OTC dosing. If you want to just take normal supplements at normal doses, go right ahead. Don't think you need to allocate money to go higher than that, especially when there isn't really a guarantee that it will even be safe, much less necessary.

All I'm seeing is this statement which is factually correct: 50,000 IU dosages aren’t really available by prescription only when 5,000 IU pills are OTC.

A lot of people on this forum are very comfortably well off. I'm not one of them and I do what I can to educate people, both here and elsewhere, about the reality of what a lot of poor people live with. But that seems to mostly be irrelevant to the points people here are making today.

I'm not sure why you seem to feel so compelled to argue so strenuously that everyone here is missing some important details about how the poorest of the poor live in the US. I really don't think they are. I think that's just mostly got nothing to do with this discussion at the moment.

I also think HN is fairly well informed these days overall on such topics because they put up with me being openly homeless for nearly six years and I still sometimes write about that and sometimes hit the front page on such topics. So the crowd here isn't generally all "la la la, not listening." This just seems honestly not relevant to the discussion, at least not in the way it is being approached.

Yeah, you seem to have gotten my original point and I’m super surprised where this discussion turned. It was just a normal hacker spirit response to “You can only get X from Y” with “I can get Z and make X easily”.

Indeed, I apologize--I certainly did get carried away with a hypothetical. The mere thought of someone actually going out and doing that triggered all kinds of panic.

> All I'm seeing is this statement which is factually correct: 50,000 IU dosages aren’t really available by prescription only when 5,000 IU pills are OTC.

I think it was probably intended to be somewhat humorous, and yes, it's technically correct. However, it makes little sense if taken as factual rather than humorous: you shouldn't be exceeding the OTC dosage unless you know you need to; you can't know you need to exceed the OTC dosage unless you are tested; if you're tested, you're eligible for a prescription to get it cheaper anyway.

> I'm not sure why you seem to feel so compelled to argue so strenuously that everyone here is missing some important details about how the poorest of the poor live in the US.

Money is only one factor, and I think that's something people on HN tend to forget.

> I'm not sure why you seem to feel so compelled to argue so strenuously that everyone here is missing some important details about how the poorest of the poor live in the US.

I should clarify that this is largely anecdotal. I only know a handful of people who have been in these situations. I wouldn't even say they're the poorest of the poor: there are often other factors at play, be it mental disorders, language barriers, or a combination thereof.

> I also think HN is fairly well informed these days overall on such topics because they put up with me being openly homeless for nearly six years and I still sometimes write about that and sometimes hit the front page on such topics. So the crowd here isn't generally all "la la la, not listening."

I would agree; it's certainly one of the better communities in that regard.

> This just seems honestly not relevant to the discussion, at least not in the way it is being approached.

Quite possibly, especially considering that the ancestor was probably joking. Still, I can't help but cringe at the thought of someone I care about hearing that the solution to their COVID troubles is to waltz into the nearest pharmacy, spend their food money on a bottle of vitamin D, and down 10 of them at once.

The original commenter was not joking and not recommending anything: https://news.ycombinator.com/item?id=25620199

I think you are just reading in something that wasn't intended. That's not at all uncommon. HN is somewhat prone to being more literal than a lot of people expect other people to be.

Anyway, in the interest of not putting more focus on this, I don't intend to reply further.

> I think you are just reading in something that wasn't intended.

Almost certainly, as I'm wont to do. I appreciate you humoring me and taking the time to explain regardless.

I think you’re very in touch with reality of people who are unbanked and have access to free healthcare, and very out of touch with people outside of that group. There are a lot of Americans who could swing $2/month and can order on Amazon (which accepts gift cards you can buy for cash) but wouldn’t be able to upgrade insurance plans (upgrade often meaning “get insurance”).

While that does include a significant percentage of America, I would argue that, for the time being, that $2 is better spent elsewhere. Unfortunately, this part of the argument is fairly subjective. Is $2/mo/person on vitamin D worth it? ...maybe, but do we really know that yet? Would that $2 be better spent on something else that would have more definitive long-term benefits?

Ultimately, I don't see the logic in encouraging people to prioritize self-medication with vitamin D. Of all the issues about which we could raise awareness, that seems like one of the most misguided and short-sighted: it's focused on the pandemic of today, not the healthcare of tomorrow. Of course, it's possible to raise awareness about multiple issues, but to me this feels like one of the most out-of-touch with reality. As a concrete, one-step-up example, what about vitamin C? I would assume you're more likely to get scurvy than rickets as a working-class Westerner, though I haven't checked the numbers.

Uh, the pandemic of today is pretty important. I’m not sure I would characterize trying to slow it down as “shortsighted”.

And, the point of vitamin D supplementation isn’t to avoid rickets. That’s what the RDA is based on and there’s increasing evidence that while that’s an easy threshold to cross, it’s way too low. People don’t get enough sun and low vitamin D levels seem to have a serious negative impact on health.

Perhaps, and taking a normal OTC dose of vitamin D might be prudent. My argument here is exclusively with regards to encouraging people to self-medicate at higher-than-OTC doses when they don't even know that they need such a dose in the first place. Encouraging people to pop 10x 5,000 IU pills seems like a recipe for disaster.

One a day is fine, as it recommends on the label.

Have you considered the risk of receiving counterfeit goods in this suggestion? There are numerous threads on this board, and numerous articles on the internet, detailing the dubious quality of goods coming out of Amazon these days. With co-mingling of stock, it’s not even possible to pick a “reputable” seller to avoid this risk.

How does an ordinary person test that we’ve actually received the supplement that was ordered, and not something else entirely? Amazon is the Wild West compared to a drug store.

At least personally, I don’t worry about it. Fraud seems more common with supplements with high material cost and low manufacturing, like a bulk powder of something exotic.

If I were on a tight budget and didn't have a prescription, I'd definitely get mine from Amazon. It's a relatively cheap, generic product. I'd be a little worried about other unexpected chemicals being mixed in, but food is probably even more of a concern in that regard. On the scale of things to fret over if you're short on cash, vitamin D sourcing is probably pretty low.

Besides, what are the chances that a local store's vitamin D is actually higher-quality? It wouldn't surprise me in the slightest if they both ended up coming from the same place.

It's $5 a season at Trader Joe's.

As far as I can tell, that’s for 1,000 IU. You’d have to take 50 pills per week to achieve the dose described here. That would be more like $3/wk.

As others have pointed out, Vitamin D is extremely cheap regardless of where you get it if you buy the higher strength pills. You also don't want to overdo it over the long term.

If you're deficient, many doctors will prescribe some large loading doses, but from the studies I've seen, going above 10,000 IU/day over the long term has the potential for hypervitaminosis. Also from the studies I've seen, 2,000 IU/day long-term is enough to prevent deficiency.

Lots of people don't like Amazon, but you can get a bottle of 250 or so 5000 IU tablets for about $20. This is enough to last a couple of years at 2000 IU/day. There are few people in the U.S. that cannot afford something that costs $1/month.

A lot of places gouge on the prices. Trader Joe’s and Walmart are two that don’t.

Nope, they have a 5k for the last two to three years and the higher dose has largely taken over the shelf. I know because I have bought about a dozen of them this season at $4.99 and given them out as holiday presents.

https://www.traderjoesreviews.com/product/trader-joes-vitami...

Forgot, Walmart is another place with good prices on vitamins.

What I found interesting is

``` Correlation analysis showed no substantial relationship between the mean vitamin D levels and the risk of infection in the younger population (r = −0.16, p = 0.42) or the rate of mortality in the older age group (r = −0.24, p = 0.23). ```

Together with the rest of the issues pointed out here in the comments, I'm sceptical about the value of this study. That said, given that most people should be taking supplements in winter anyways, and that I've seen ZERO warnings about dangers of low-dose supplementation (600 IU/day, not the 3000-6000 some are mentioning here)...

I’ve been taking vitamin D daily for the past year. I came across the study below recently that suggests that Coenzyme Q10 could also reduce hospitalization rates for COVID. This is another low cost over the counter nutritional supplement. It’s also called ubiquinone.

https://www.medrxiv.org/content/10.1101/2020.10.13.20211953v...

How much Vitamin D do you take daily?

Also look into zinc gluconate 15mg, quercetin 200mg, and selenium. A few times a week is safe while helping against colds and flus. This post has links to various studies: https://knowledgeofhealth.com/modern-day-zinc-deficiency-epi... For selenium: Google: selenium virus mutation

For the past couple of months I have been taking 5000IU daily of Vitamin D. Will get my levels checked here in a week or so with my annual physical and will know how my body is handling this dosing. In addition to Vitamin D, my daily regimen includes Vitamin C (ascorbic acid), zinc gluconate and magnesium glycinate.

Aren't most other vitamins readily available in foods? That seems like a lot of supplements to worry about.

I've self-administered vitamin D for decades, 2,000 IU daily for the last few years. When my GP heard about it, they ordered a test. Even with that intake + a reasonably healthy diet I was in the lower 1/3 of the healthy range, so I've upped to 3,000 IU. (Obviously I'm not saying this applies to anybody else.)

To add to the anecdata, I take 5000 IU daily during the winter and about every other day in the summer and my blood tests in the winter showed I had 54 ng/ml, the healthy range is 30-100. I'm not super diligent about it though and take it more often during times I feel tired since I think it helps. Depending on if I go outside in the summer sometimes I don't take it for weeks. However when I got the blood tests I had been taking it regularly, which is why I requested it since I think vitamin D is not measured in the default blood test

What form do you take Vitamin D in? I've read it needs to be taken with fat to be absorbed properly, and Vitamin K is good to take with it as well. I've recently (too early to tell) switched from plain Vitamin D tablets to gell tablets with Vitamin D + K, filled with Omega 3.

I take the pills that have liquid inside, I think they're referred to as softgels. I asked my doctor about Vitamin K and they told me that it's not really necessary so I don't take it. I agree that taking it with Omega 3 is a good idea if that's already part of your routine. I personally dislike taking pills so I only take Vitamin D because it's one very tiny pill. I would also recommend getting a blood test to make sure you're getting what you need and not taking things you don't need.

I've taken these Vitamin D capsules in the past. I believe all of these to be quality products that I feel comfortable taking myself, giving to my children as well as recommending to friends/family/strangers.

* [Bulksupplements Vitamin D3 (Cholcalciferol) Softgels (300 softgels)](https://www.amazon.com/gp/product/B01ERXX7PA/ref=ppx_yo_dt_b...)

* [NOW Supplements, Vitamin D-3 1,000 IU, High Potency, Structural Support, 360 Softgels](https://www.amazon.com/gp/product/B0025P0ZEY/ref=ppx_yo_dt_b...)

[Nutrigold Food-Sourced Vitamin D3 5000 IU, 120 Capsules (Natural Vitamin D from Lichen, Certified Vegan, Kosher, Non-GMO)](https://www.amazon.com/gp/product/B004N8TTBQ/ref=ppx_yo_dt_b...)

Adding another data point. Live in Ireland. Sun doesn't provide any benefit in the winter as the sun's rays get blocked by atmo. I consume no food with supplements. I'm 100kg/220lb moderately athletic, nearly 50 y/o. 1000IU is not enough to keep the SAD (Seasonal affective disorder) away. Its like my batteries are running low. I consume 2000IU daily. If I miss two days in a week, I can feel the difference. With covid-19, I've had no colds or flu so can rule out the occasional virus for same effect. Self treating for 12+ years. Try to consume the minimum to feel "awake"

I like the idea of the Vitamin D link, and it seems well established. But the idea of this paper I find too crude. There can easily big cofactor if you look at the average vitamin D levels per state. Like when the is less Vitamin D might be more people have office jobs leading to higher obesity (for the mortality rate). For infection rate could also be meeting people in offices/indors. Also areas with less sunlight have people indoors more often.

Anecdotal - In my country, doctors advice newborns to be given a certain dosage of Vit-D for the first year, in addition to trying to get them out in the open in the morning sun. We seem to be fairing slightly better with respect to COVID mortality numbers.

Same here in the UK (and baby formula even has to have Vit D (among a big list of other things) in it) with advice to leave babies by windows and go for walks to avoid jaundice etc, but we're still seeing terrible rates of infection.

so I got high calcium by using 2000-3000 IU a day which impacted my brain function (very cloudy) and body feeling weak. I had to stop the pills.be careful not to take too much as it also stores in the body.

It seems Magnesium regulates Calcium. To fix Calcium it is being suggested to take care of Magnesium first.

(Source: I'm not a doctor)

Did you take vitamin K together with D3? If not you should. And potentially supplement calcium and magnesium also.

Man this board is really obsessed with vitamin d usage. Y’all even got me taking a 5000 iu pill with the K vitamin in it. Hope you’re all happy now.

Make sure what you're using goes through an FDA certification process.

What certification process?

Certain brands like Nature Made are certified by the FDA as having exactly the number of IUs advertised.

https://www.fda.gov/food/dietary-supplements

> Man this board is really obsessed with things that might make you less likely to die from a COVID infection

If you rewrite your first sentence this way, does it better highlight why this board is interested in this information?

I remember vit-d coming up in articles before covid.

Colds and flu can linger for weeks in the winter with low D levels.

Other things in that category are not as prevalent here.

Can you provide an example? I haven't seen anything as easy/cheap to address? Most of what I've seen is related to comorbidities and general health factors (weight). Nothing as easy as "Go sit in the sun for an hour and/or take this supplement".

No beyond covid the commentators here are really obsessed with vitamin d I feel, it’s just covid made the posts come more. Now I don’t mind, but the vitamin D and other threads which are just comments on scientific research kinda turn into typical Reddit /r/all threads which I can’t stand. I much prefer people’s perspective here on technology not vitamin d

I live in Finland, where winters are short on sunlight.

Taking a vitamin D tablet once per day is a common occurence here for a lot of the population.

Malnourished people are more susceptible to disease? Shocking.

I'm taking 800IU a day with calcium. I don't know why some folks here are taking 3000-5000. That seems obscenely high.

Yeah you can overdose [1]. It's not just what these people are getting in supplements, but also about what they are getting naturally.

[1] https://en.wikipedia.org/wiki/Hypervitaminosis_D

Do they actually make 5000IU pills?

I've been taking 1 pill of 1000IU whenever I stay inside an entire day without even 5 minutes outdoors, but I really don't know for sure what the recommended doses are.

I asked this before and apparently in the US you can find 5000IU pills. Here in Canada all I could find was 1000IU and I take 5x of the pills instead.

It still does the job, I presume.

Are you (or any of the parent comments) noticing anything after supplementing? As arguably a hormone I'm curious if there's any experientially observable effects from high doses.

No I personally have not felt anything taking it at 5000. Or you know, not taking it after a period.

It's just like taking a vitamin. It's also a low enough dose to be safe for my adult body size/weight.

There is no recommended dose without knowing your current blood levels.

Get yourself tested - if you're severely deficient start taking large doses (3000IU - 5000IU or more) for a few weeks, get yourself tested again and then adjust.

If you're not deficient just keep doing what you're doing.

In USA 5000 IU is pretty easy to find at any store that sells vitamins. This is what I buy all the time.

Yes, costco sells 10000 IU ones.

Vitamin D is fat-soluble, so dosing daily isn't required (the excess is stored and not excreted in urine). The 5k and 10k IU pills are useful because you can pop a few on weekends (or whenever you remember) and don't need to build a daily habit.

Oh that's good to know. Thanks!

Because it's really hard for your body to absorb, unless taken sublingually (or maybe with a fatty meal, given it's fat soluble).

All that matters is your serum level. 800IU may work for you, but you may need several times that. Best to just get it checked. People feel better at different levels, e.g., I seem to feel best around 35-40 ng/mL.

Check out Dr. Rhonda Patrick (@foundmyfitness) on the topic: https://www.youtube.com/watch?v=uc815fQn8iY.

There is evidence to say that the recommended dose is much much lower than what is beneficial.

Plus if you actually do OD, the symptoms are very apparent and treatment readily available.

Also to OD I think you need a LOT more than 5000 IU a day.

It's not though. That is to say... people really ought to check their blood results and act appropriately.

The truth is that in northern latitudes, anyone with dark skin is simply unable to meet their vitamin D intake from sun exposure alone. In certain parts of America, and a lot of Europe, a dark skinned person spending the entire lit part of the day outside buck naked is still not enough to synthesize enough vitamin D to be sufficient. Supplementation or dietary ingestion is necessary.

For me, as a dark skinned person in a northern latitude, my levels were very low. Taking 2000 IU a day did nothing. I had to take 10000 IU a day in order to appreciably raise my Vit D levels. That is what we found after checking with a doctor. I would recommend anyone else do the same. 5000 IU + is typical for people with vitamin D deficiencies. Some doctors even recommend extremely high megadoses to reset your vitamin D intake.

Thanks for sharing your experience. I am not used to seeing 10K IU so it's useful to see the real numbers backed by doctors.

It would probably be wise to not post your opinion on things like vitamin dosages unless you're a medical doctor.

My doctor prescribed 1 week of 15000 IU a day, then a week of 10000 IU, then a running dose of 5000 IU a day. I've seen measurements of 50k IU from a day in the sun. 3000-5000 is not too much or "obscenely high" for many people, but as with literally everything like this, its best to consult a doctor about an individual's needs.

Why? The younger doctor is likely just reading wikipedia too.

And the older ones are probably just telling you what was the conventional wisdom when they did their education 20 years ago.

You're asking "Why" as in "Why shouldn't we listen to untrained professionals' opinions on supplement dosages" ?

Also this person did not wikipedia what they posted, as wikipedia also lists tolerable upperbounds for adults as 4000 IU / day.

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

It's technically a steroid, not a nutrient. We can manufacture it in the body. "Essential nutrients" are things we cannot manufacture.

It's essential to bone health and bone marrow is where the body makes white blood cells. It's generally understood to be important to normal immune function.

If you have reason to believe you are Vitamin D deficient, it is always a good idea to address that. If you are not deficient, there is no reason to believe that taking "extra" will protect you from anything. In fact, it may be quite harmful, in part because it is a steroid and in part because it is fat soluble so you can end up storing the excess to the point of hitting "toxic" levels.

> If you are not deficient, there is no reason to believe that taking "extra" will protect you from anything.

You’re right. Buuut, a lot of people are walking around deficient. And even though it’s fat soluble, there’s a pretty big window where you can supplement and not worry about overdoing it.

If they are deficient: it is always a good idea to address that.

Some reasons to suspect you are deficient: You don't get much exposure to sunlight for some reason (which would be a lot of people this year, what with lock down), you have a genetic disorder where you misprocess fats/fat soluble vitamins, you have known symptoms of deficiency.

If you are concerned at all, I highly recommend you look up known symptoms of deficiency. Look for a source you trust. .gov and .edu sites are typically deemed to be more trustworthy for info of that sort.

Considering that humans evolved having most of their skin exposed to sunlight, and typically people have their hands and face only exposed (or arms if summer and wearing short sleeves), And combined with most people having indoor jobs -- wouldn't that cause most people to be at least somewhat deficient?

I suspect there may be a bad meme involved here too. People have been told “just fifteen minutes per day outside in the sun is enough for your body to produce all the vitamin d it needs.” But I’ve heard it’s more like you need to basically be running around naked in the sun all day - like how we evolved. Not sure how they’d measure that though.

> We can manufacture it in the body. "Essential nutrients" are things we cannot manufacture.

Entirely anecdotal, but there are definitely people out there who have to take supplements to achieve normal levels. My most recent blood tests showed that I had a vitamin D deficiency, so my PCP prescribed vitamin D. At the time, I was getting outside plenty and was exposed to the sun more than most people with desk jobs, but it wasn't enough. I wouldn't be surprised if being stuck inside due to the pandemic has made it worse.

Did the prescription change anything? Dunno. I haven't died yet, and it costs nothing since it's prescribed by my PCP, so I'm not complaining, but otherwise I feel exactly the same. Would I go around taking random supplements without the oversight of my doctor? Nope.

I mentioned this in the thread above, but it's now an NHS recommendation for all adults to suppliment vitamin D because the majority of people in the UK are at least a little deficient in it (because of the low levels of sunlight).

Yes, living far enough north is a good reason to suspect you may be deficient -- something folks seem to not like hearing when I say it.

There are quite a lot of people who have good reason to believe they may be deficient. But there seem to never be enough qualifiers to make anyone on the internet happy.

My above statement is as accurate as I know how to make it and I can't readily think of anything I would change about it, in spite of how poorly it seems to have gone over with folks here.

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