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Vitamin D: Will It Save You From Coronavirus?
Which tactic is better: to continue to "self-isolate" so as not to face the virus, or vice versa - to run towards the sun in order to be nourished with vitamin D? It is said to contribute to an easier course of COVID-19.
Photo: Joanna Malinowska 7474
We are discussing this difficult issue with the therapist of the Rassvet clinic, a full member of the Russian Scientific Society of Physicians, Anna Rameeva.
Vitamin D and immunity
Vitamin D has received increased attention in the past few years. Ultimately, this allowed us to come closer to understanding its biological role. Including - in maintaining the stability of the immune system. Doctors have suggested that the peak of respiratory illness in the winter is associated with low vitamin D levels due to lack of sun. More than 25 randomized clinical trials (RCTs) have been conducted on the relationship between vitamin D and ARI. And on their basis, one could conclude that the number of cases of acute respiratory infections among patients receiving the recommended daily dose of vitamin D is lower than among the rest. However, even the term "ARI" itself is interpreted differently in different countries: from a mild runny nose to a severe flu-like condition.And the initial own level of vitamin in the blood of all the subjects was different - so that even for common colds there is no complete understanding. For COVID-19 - even more so!
Vitamin D and COVID-19
No matter how much we would like it, there are still no RCTs to confirm or deny the relationship between the severity of the course of the new coronavirus infection and the initial level of vitamin D in the body: too little time has passed, too few patients have been examined. Hasty conclusions based on preprints with beautiful graphs led to the hysterical prescription of colossal doses of cholecalciferol in drops and capsules. The fact that the studies did not take into account concomitant pathologies, enthusiasts and propagandists did not want to pay attention. At the same time, for example, chronic kidney disease (CKD) and liver failure, on the one hand, lead to vitamin D deficiency, and on the other, they are in themselves risk factors for severe complications of any (!) Infection. That is, vitamin D deficiency and COVID-19 complications could have a common cause, but that does not meanthat low vitamin levels were themselves the cause of the complications.
Murderer or Witness?
Vitamin D deficiency can develop due to insufficient sun exposure and malnutrition in the elderly, office workaholics, adolescents who change the walls of the school to the walls of a room with a computer … Well, and everyone who strictly adhered to the norms of self-isolation and missed the whole spring.
We also find a deficiency of this vitamin in patients suffering from severe skin diseases, autoimmune diseases accompanied by photosensitivity (for example, systemic lupus erythematosus).
In addition, low levels of vitamin D can be caused by malabsorption in the intestines, which prevents nutrients from entering the bloodstream from fish, for example, or from dairy products where it is found.
Now look at whom we talked about in the previous three paragraphs: about people who lead a sedentary lifestyle; about people with severe autoimmune diseases; and those who simply do not get enough nutrition for various reasons … All these factors in themselves can lead to complications of coronavirus infection.
In other words, at the current level of data, we still cannot tell if low vitamin D levels are a "killer" or a "bystander."
This is a purely psychological trick: since in recent years in the scientific world they were interested in its properties and effects, then in connection with COVID-19, special attention is paid to it. Protein-energy malnutrition in general, anemia (iron and B12-deficiency), and folic acid deficiency are not studied as meticulously. Although, in all fairness, they should.
If the scientific world rushed just as zealously to study the severity of COVID-19 in vegetarians, we would certainly have received a number of interesting hypotheses … But he did not rush - it is politically incorrect.
How much vitamin do you need
The biggest problem with all vitamin D research is that there is no consensus among scientists as to which level is considered a deficiency. In 2010, the National Academy of Medicine published a 1,132-page report stating that nearly 98% of the US population has vitamin D levels below 20 ng / ml, and the so-called EAR (Estimated Average Nutritional Requirement) is 16 ng / ml. In 2016, several leading epidemiologists and endocrinologists who were on the original committee of the Academy published an article entitled "Vitamin D Deficiency: Is There Really a Pandemic?" It said that you should not take the level of 20 ng / ml as a target, in fact, it is at the upper limit of needs. It is possible that we are trying to fill the "deficit" in people who are completely healthy.
Staying in the sun during the daytime in a swimsuit for 15-25 minutes would provide us with a daily need for vitamin. However, now, when the walking schedule is strict, and outside the window is not summer weather, the recommended sufficient dose of vitamin D3 (cholecalciferol) is 400 IU. Well, and make sure that foods containing vitamin D are present in the diet: fatty fish, egg yolk, butter, fortified milk, fortified breakfast cereals. This is not to prevent complications of covid-19, but generally to feel good.