Effectiveness of Vitamin-D to lower the risk of Covid-19

Posted on : December 24, 2020 by Clinic One on COVID-19

Recent studies suggest that sufficient levels of vitamin D in our body can also negate any adverse effects of Covid-19 such as its mortality.

Vitamin D, a fat-soluble vitamin, has long been known to improve our immune system and protect us against various respiratory illnesses.

Similarly, vitamin D is also known to aid in calcium absorption, mineralization of the bones aiding growth.

In this regard, this article attempts to shed some light on the effectiveness of vitamin D to curb the risk associated with Covid-19.


Historical background of Vitamin D

Investigations on the effects of vitamin D on various respiratory infections can be dated back to the 1930s where industrial workers who were frequently absent from their work due to common cold were being used to be treated with cold-liver oil rich in vitamin D.

Vitamin D deficiency in nepal

Similarly, various randomized trials from 2007-2020 using vitamin D against various acute respiratory infections have proven to have positive effects.

Hence there are good reasons to investigate the promises of vitamin D on Covid-19 patients, at the helm of a current time of crisis where effective treatment is out of hand.


Importance of Vitamin D in lowering the risk of Covid-19

Vitamin D has long been known to support and thereby activate innate antiviral effector mechanisms. These include both antimicrobial peptides and autophagy (consumption of the body’s own tissue).

Similarly, vitamin D is very essential in regulating and improving our immune health.

In other words, its anti-inflammatory and immuno-regulatory properties are noted to be crucial to activate the defense mechanisms associated with our immune system.

These defense mechanisms are first in line in our body to protect us from diseases and infections.

Thus, on the contrary, low levels of vitamin-D are associated with various diseases, infections, and immune-related disorders.

For example, lower levels of vitamin-D are often explicitly associated with various respiratory diseases such as tuberculosis, asthma, and COPD (Chronic Obstructive Pulmonary Disease).

Thus these facts make it very clear that healthy levels of vitamin-D are essential to help our body fight against various respiratory illnesses hence igniting the idea that it could very well have a significant role in curbing down the fatal consequences of Covid-19.


What do recent studies say?

Even though there is scarce and limited knowledge on the effects of vitamin D on Covid-19 patients. But one recent study of vitamin D metabolite namely 25 dihydroxy vitamin D, abbreviated as 25(OH)D (steroid hormone or biologically active vitamin D metabolite) on nasal epithelial cells infected with Sars-Cov-2 (Covid-19) seems to have an inhibitory effect.

Moreover, vitamin D is also shown to regulate immune-pathological inflammatory response against various respiratory infections. 

Similarly, another study suggested that appropriate levels of vitamin-D in the patient’s blood seem to assist in lowering the adverse effect and fatal consequences of Covid-19.

These appropriate levels are determined to be 30ng/ml of 25(OH)D. Furthermore, the study suggests that patients older than 40, with adequate levels of vitamin D, are less likely to have severe outcomes which may include becoming unconscious, hypoxia, and death. 

Similar studies in many European countries elucidating the link between 25(OH)D, a biomarker for vitamin D, and Covid-19 has found the inverse correlation between national estimates of 25(OH)D and susceptibility, severity and mortality associated with Covid-19 cases. 

Moreover, a recent study comprising 11,321 people from across 14 countries demonstrated that supplementing people with appropriate levels of vitamin D decreased the likelihood of Acute Respiratory Infections abbreviated as (ARI).

This could ultimately be a boon in decreasing the fatal consequences of Covid-19. As respiratory illness such as pneumonia is the major cause of mortality in the case of current pandemic Covid-19. 


What are the challenges to use Vitamin D supplements?

vitamin D to lower the risk of Covid -19

The first challenge to elucidate the appropriate levels of vitamin D supplements on severe covid-19 patients is that patients generally tend to seek medical attention only in the case of the hyper-inflammatory stage.

Secondly, it might be hard to show the efficiency and thereby use micro-nutrient such as vitamin D over macro-nutrient such as dexamethasone (standard anti-inflammatory) that is used in various health care providers against severe diseases.


Cytokine storm and Covid-19

Similarly, deficiency in vitamin D is thought to enhance “cytokine storm” which may be critical in patients suffering from severe Covid-19 symptoms.

In short, cytokines are proteins that have either pro or anti-inflammatory properties, thus in turn, regulating our immune systems.

But, “cytokine storm” refers to the uncontrolled, dysfunctional, and excessive release of pro-inflammatory cytokines that can cause tissue damage and enhance disease progression and severity. 

This “cytokine storm” is associated to be one of the results of deficiency of vitamin D and this may have an adverse effect during an infection.

For instance, blood samples of patients suffering from Covid-19 are observed to release high levels of cytokines, particularly Interleukin-1 (IL-1) and Interleukin-6 (IL-6).

Thus, it’s quite safe to postulate that deficiency of vitamin D is instrumental in enhancing “cytokine storm” as well as reduced immune function which may be detrimental to people suffering from Covid-19.

And on the contrary, supplementation of vitamin D could negate severe consequences and lower the risk associated with Covid-19.


So what are the healthy levels of Vitamin D?

There seems to be uniform agreement that the optimal value of vitamin D in our blood lies between 30-60 ng/ml. Or in other measuring units it’s considered optimal at the levels of 75-150 nmol/L.

Thus, supplementation of 1000-4000 IU of vitamin D on a daily basis is considered to be enough for most vitamin D deficient peoples.

But of course, highly deficient peoples with very low levels of vitamin D may need some extra volumes to level up to that optimal level.

Similarly, national health guidelines to achieve optimal vitamin D for bone and muscle health in healthy peoples in the UK ranges from 400 IU/day while in the USA it is 600-800 IU/day.


How to get Vitamin D?

The cheapest and easiest way to get vitamin D on a daily basis is to get exposed to sunshine as it is famously called “Sunshine vitamin”.

As the sun is the best source of nutrients one can get. The mechanism behind this is that our skin harbors a kind of cholesterol that is a precursor to vitamin D, which when exposed to sunlight (UV-B) converts itself into vitamin D.

Moreover, vitamin D generated from sunlight tends to circulate into our blood twice as much time as compared to those ingested with the supplements and foods.

Similarly, your skin tone also affects the amount of vitamin D that it produces.

People with darker skin tone may need to spend more time in the sun to produce the same amount of vitamin as compared to people with lighter skin.

This is because people with dark skin constitutes of melanin pigment in their skin that inhibits vitamin d production.


Summary

Thus, it may be wrong to say that supplementation of vitamin D, alone could prevent someone from contracting with Covid-19 but wise to assume that people with healthy levels of vitamin D could mitigate its adverse effects if infected and lower the risk of Covid-19.

Hence, quantification of vitamin D in your blood is vital in knowing if you are deficient or not with this essential nutrient that may help you immensely during this pandemic.

So get some suntan or supplements if needed.


References: 
Adrian R. Martineau, Nita G. Forouhi (3rd August 2020), Vitamin D for Covid-19: a case to answer?
Ansley Hill (17th March 2019), Health line magazine, 7 Effective Ways to Increase your Vitamin D Levels, 
Jilian Kubala and Katherine Marengo (October 12, 2020), Health line magazine, Can Vitamin D lower the risk of Covid-19, 



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