Adequate Vitamin D Levels Cuts Risk of Dying from Covid-19 in Half, Study Finds 372 points by cpncrunch 6 months ago | hide | past | favorite | 211 comments

 Giving further evidence to this study that came out in preprint about a month ago or so:https://www.sciencedirect.com/science/article/pii/S096007602...“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”This one was actually about giving some patients calcifediol/vitamin D doses as part of the treatment, and comparing what happened to those who received the vitamin injection and those who didn't.tldr: "of 50 patients treated with calcifediol, one required admission to the ICU (2%), while of 26 untreated patients, 13 required admission (50 %).")Performed at Reina Sofia University Hospital, Córdoba, Spain.
 This study is incredibly significant. If there is not a systematic error or fraud, it just revolutionizes Covid-19 treatment. And the numbers are NOT too small to be statistically relevant: They took 76 patients coming to their hospital, and randomly assigned them into the calcifediol (Vitamin D) group (probability 2/3) or the non-calcifediol group (probability 1/3). 50 ended up in the calcifediol group, 26 in the non-calcifediol group. In the end 14 of these 76 patients were going to the ICU. Only 1(!!) came from the large calcifediol group, but 13 from the non-calcifediol group.Let's just calculate the probability of the event that at most one of the 14 patients, who ended up in the ICU, were randomly assigned into the calcifediol group (despite having a 2/3 chance to be assigned there): It is (1/3)^14 for the probability that ALL of them were assigned to the non-calcifediol group. Then (1/3)^13 * 2/3, for the probability that the first ICU patient was assigned to the calcifediol, but all others to the non-calcifediol group. Then the same for the second ICU patient. We get the total probability 14 * (1/3)^13 * 2/3 + (1/3)^14 that at most one of the ICU patents was randomly assigned to the calcifediol group (and that is what happened). That is a probability of 1 : 160.000 (!!!). So extremely significant. It means that is mathematically almost impossible that calcifediol did not influence the ICU outcome (provided that there was no other problem in study design as study fraud, or a bias to not bring the calcifediol patients to the ICU or whatever). Why isn't this getting the attention it should??? The effect is very significant, numbers are definitely not too low to draw conclusions. If you take these numbers seriously, calcifediol treatment lowers mortality by an amount that Covid-19 really becomes comparable to regular flu in mortality. This is a complete revolution! Why isn't it getting more attention?
 This is great as it isolates vit D from other factors (e.g. balanced diet, spending more time in the sun).
 so vitamin d through the sun is not the same or what?
 More vit D from more sun could be a side effect of better health. Sort of like if you found that using TikTok a lot was strongly correlated to very low covid-19 mortality; it would just be a marker for youth. This study makes it look much more likely that it's an actual effective intervention.
 Vitamin D levels can be increased by either UV light exposure or dietary supplements. It's the same hormone in the end. However, bright sunlight exposure has other effects including changing levels of cortisol and nitric oxide. It's plausible that some of those other effects could also impact COVID-19 outcomes but we don't have any reliable data on that yet.
 From what I’ve read it is the same, but most people don’t get enough due to modern lifestyle of working indoors and wearing clothes. If you’re working outside with your shirt off you’ll probably have good levels in the summer months at least, but sadly many of us are largely trapped inside with clothes on :-(
 It would explain why there was a surge in positive rates in Arizona when summer hit. Everyone was inside where the AC was, not getting sun.
 not op, but I don't think that's what's being implied. Just that there might be other benefits from spending time in the sun - so a study where the only variable is that one group got injections of vitamin D means that the difference is caused by the vitamin D not any of the other things that might be associated with high vitamin D levels (time in the sun, diet, etc).
 The correlation observed for many things associated with vitamin D, is that healthy people spend more time outside than unhealthy people, not that being out in the sun is an inherently healthier activity. E.g. runners/athletes spend more time outside than those who are not, and the increased vitamin D exposure is mostly incidental. People with busier social lives tend to spend more time outside than those who do not. Etc.
 Dr. Fauci says to take vitamin D if you're deficient to boost immune system
 And a large proportion of people are deficient, probably most people actually. I’d rather he advised all people to get outside, do things outside under the sun and let your skin do its work, making all of the things it does, including D3.
 For a lot of people who live in the Northern Hemisphere who are about to go into a period of long, dark nights during winter, your advice of "get outside, do things outside under the sun and let your skin do its work" is not really as helpful as taking vitamin D supplements.
 Harvard Gazette 2017:Study confirms vitamin D protects against colds and flu
 Thanks for that! Dr John :-) has an excellent read-through the main points of the paper at https://www.youtube.com/watch?v=V8Ks9fUh2k8. Yes, the study looks very good. The number of patients (76) is not large, hence "pilot". Other than that - solid evidence, as good as it gets. Fwiw, in England/UK, there is a permanent recommendation to supplement Vitamin D b/c of endemic deficiency, given out by the public health bodies: Public Health England (PHE) (https://www.gov.uk/government/news/phe-publishes-new-advice-...) and NICE (https://www.nice.org.uk/guidance/ph56). This is not strictly Covid-19 related, it predates it. I understand earlier in the year NICE urgent review of available evidence found the evidence wanting: of low quality and insufficient (https://www.gov.uk/government/news/insufficient-evidence-for...). I wonder if they will re-review in light of more evidence put forward recently. Given the balance of likely costs of intervention (Vitamin D is safe, cheap, prior knowledge that good portion of population are deficient, prior knowledge it helps in respiratory illness) versus not (major pandemic) if I were a temporary benevolent dictator, would institute a mass public supplementation programme.
 Why don't we see official recommendations to take more vit D to mitigate the effects of covid?Is there still something these studies miss?
 And to tack onto this question, what IS the amount being used in these studies and is it recommended we take it? I remember that Dr from earlier in the month posting a blog series about Vitamin D and even there is still no answer as to how much. She said she was seeing problems when patients were taking something like 4000 IU/day or more...or something like that.
 Reminder that articles from forbes.com should not be seen as having any better reputation than those posted on blogger.com or medium.com.
 Forbes reporting is mostly factual. They don't employ much fact checkers, but don't do glaring errors. Forbes has some Chinese bias and has been criticized for it. It's owned by HK investor. Forbes also has some columnist's who are not very accurate in their opinions.Those who post in blogger.com or medium.com don't have any responsibility to anyone. I think your opinion spreads the "they are all the same" message that is infantile.
 Forbes reporting is factual but these "sites" on forbes.com are not Forbes reporting and it's not made clear on the website. I think that is the point op was making
 > I think your opinion spreads the "they are all the same" message that is infantile.In most cases, Forbes contributors (not staffers) receive the same amount of fact-checking as Medium/Blogger writers: zero. Forbes has tarnished its brand so much with its contributor system that clinging to the Forbes brand as a differentiating factor would be the "infantile" opinion.https://www.poynter.org/reporting-editing/2012/what-the-forb...
 How can one be "accurate" in one's opinions?
 1) is the source reputable? (esp. the journal, magazine, author)2) is the study well-designed and big enough to detect the signal as being reproducible and significant?3) did the study ask the question it now supposedly answers?4) did the study employ methods that discriminate precisely and robustly, like use of random groups and correction for complicating variables? Or is it based mostly on observations? And did it overlook the a priori distributions of variables known to confound the outcome of interest?If the article/study does not pass all these tests, it's unworthy of trust as an accurate test of its hypothesis or its claims of significance.
 By basing opinions on evidence and logical deduction."I think the world is flat", is an opinion. You could say its accurate in so much as the subject of the sentence actually believes it. However, most people would say the "opinion" is wrong.
 They probably mean the opinion pieces themselves have factual inaccuracies and/or dubious sources. They probably don't mean that the opinions expressed in those pieces are themselves inaccurate.
 Vitamin d levels are coorrlated with covid deaths, but that could just be an indicator of some other underlying issue. Supplements may or may not help. There are rcts going on now.
 The fact that other studies also indicate D to be prophylactic against contracting covid implies that there's more than a single stray mis-correlation in evidence here.
 The only study I saw that showed this had a really small sample size (N was ~50). Larger trails are going on now.
 Check the byline: Forbes "contributor" is a blogger, Forbes "staff" is a reporter.
 Yes, Forbes contributors are not fact-checked by editors for the most part. A contributor article on Forbes is like a Medium article.https://www.poynter.org/reporting-editing/2012/what-the-forb...https://www.cjr.org/innovations/newsrooms_boost_traffic.phpMost articles on the Forbes website are by contributors.
 They are pointing to a study. Should we question the pointer or the study?
 Reminder that any Coronavirus treatment, vaccine or mitigation is to be treated as insufficient, unsafe or invalid, unless there is an indefinite timeframe for approval.
 Original paper link (1)From the discussion section: "In acquired immunity pathways, 1,25(OH)2D has more modulating effect. 1,25(OH)2D inhibits activation of B-cells [29] and immunoglobulin synthesis [29]. This hormone also promotes Treg cells, which are responsible for anti-infectious action by inducing IL-10 production. This leads to suppression of Th1, and Th17 cells and IFNγ, IL-17, IL-6, IL-23 and IL-2 production and makes Th2 cells predominant. Th2 cells limits inflammatory processes by inhibiting Th1 cell-mediated cytokines and tumour necrosis factor α (TNFα) [11, 30, 31]."Yes this could all be correlative, but lets assume for a moment that the effect is causal and as significant as this study is finding. It may seem like the effect of Vitamin D on the adaptive immune system doesn't make sense ... decreasing the antibody response and pushing the T-cell population towards a more TH2-type response. So, at least in terms of the adaptive immune system, Vitamin D is actually ~calming~ the immune system down, at least with regard to severe inflammation.One way to make sense of this result would be as another piece of evidence pointing to some people's immune hyper-activation('cytokine storm') as one of the forces behind severe covid19 disease. This tends to be happening in the second and third week of infection and leads to much more devastating results on the body, and in particular, the lungs with ARDS (2).
 There was some discussion that it is a bradykinin storm, not a cytokine storm. https://elemental.medium.com/a-supercomputer-analyzed-covid-...
 Some serious diseases (this was true with the Pandemic of 1918) cause their worst effects, including death, through overreactions of the immune system. Evolution is clever but it's not perfect and regulating biological systems is difficult - even for nature.
 Especially when those biological systems deviate from ancestral behaviors. By being sedentary, avoiding the outdoors, etc. We are well prepared for one type of life on Earth, we just don’t live that life anymore, but it would be smart to try to, as much as possible.
 It might be that Vitamin D helps zinc function more effectively.Vitamin D3 transactivates the zinc and manganese transporter SLC30A10 via the Vitamin D receptor
 Every time there's an article like this I say something like "OK, can we please now have governments giving people vitamin D for free now? What's the worst that can happen?" and every time, someone says it's not worth it, or that people will get a vitamin D overdose. I think people find it really hard to accept that something so basic could actually help and not be some kind of disaster.
 In Sweden, by law, some milk and milk derived products have to be enriched with vitamin D[1]. This targets products that are common in the diet of Swedes.Additionally, vitamin D in oil is literally handed over to parents for children up to 2 years. It is recommended to continue with supplements beyond that.[2] The recommendations are based on age groups, diet habits (including the above mentioned milk products) and sun exposure.It's worth mentioning that this is the case since before COVID was even a thing. Vitamin D deficiency is recognized as a general health issue for its known relation to various sickness.[2] also in Swedish: https://www.livsmedelsverket.se/livsmedel-och-innehall/narin...
 Didn't Sweden also ban fluoridation of their water supply? It was argued that it is forced medication that infringes upon personal liberty.
 That sounds like a great idea. At the same time, I can't help but imagine all the conspiracy theories that would result from the government sending pills to everyone in the country.One approach could be to have the government just start subsidizing vitamin D to \$0 (up to a specific quantity per person per month) at private retailers, or offer a rebate or tax credit for any verifiable purchases of vitamin D.Edit: To help address toxicity concerns, anything like this should also cover vitamin K.
 I don't know about the US, but here in the Netherlands a bottle of 300 x 10mcg pills costs €2.50. I doubt the current costs are holding back usage.
 It’s not just about the cost (though for people most likely to get covid cost could still be important) it’s about educating people and getting the message out. If the government say this is going to be free because it’s so useful, people will notice and do it. Even if they ultimately just buy their own because it’s more convenient.
 Just wait until stores figure out that people are going to be willing to pay many times that if vitamin D becomes a recommended supplement against covid-19.The cost increase of alcohol-based hand sanitizer is just inane, especially now when it seems that production had caught up.
 I don't think the thing stopping people from taking vitamins is that they aren't being handed out for free. If you think the mask 'debate' is anti-intellectial, try talking to people about nutrition.
 In the UK, the government give children free vitamin drops and no-one complains about that.
 Official government advice to pregnant women and new parents in the UK is not a great example of effective communication. As someone in the UK and of an age where my close circle includes several young children and a few more current pregnancies, I wouldn't be surprised if many parents had never even heard of that scheme or who qualifies for it, nor the accompanying advice on vitamins for young children for that matter. As I understand it, right now you don't even get a lot of the usual face-to-face check-ups during pregnancy or early life where such things might be discussed. So as you mentioned in another comment, the first problem here is getting useful information to those who would benefit from it to begin with.
 We just got given it whenever we took our daughter to get weighed and checked over during the first year of her life. You only need a few drops so the couple of bottles we got given lasted ages. Maybe that’s specific to London? Was that not your experience?
 I've asked around a little this morning, and so far 0% of the parents of young children I know were aware of this. :-(Plenty of them had been going to those weigh-in sessions before they stopped because of the virus, so apparently it isn't a universal thing.Several were not aware of the advice about vitamin supplements either, so this discussion has had at least one benefit because now everyone is looking that up!
 Sadly, I think a lot of the reason for this is that a lot of people, in much of the English-speaking world, haven't heard of a successful government program in their lifetimes.Much of this is media bias (Murdoch-style media will only report on sensationalist failures) but the past decades of withering of state capacity and the growth of elite self-dealing means that successful government interventions are increasingly rare.The idea that government can actually help people seems to be a dead letter in the United States (less so in other English-speaking countries) and this is killing people now we are faced with a pandemic that can only be mitigated through collective (governmental) action.
 It did already help against Rickets in exactly this way. It's why it's in milk.
 In England/UK, there is a permanent recommendation to supplement Vitamin D b/c of endemic deficiency, given out by the public health bodies: Public Health England (PHE) (https://www.gov.uk/government/news/phe-publishes-new-advice-...) and NICE (https://www.nice.org.uk/guidance/ph56). It is not strictly Covid-19 related, it predates it. It is just not publicized enough, and not acted on sufficiently. Imho you are right. Given the balance of risks/costs of intervention (Vitamin D safe, cheap, prior knowledge population deficient & helps respiratory illness) versus not (pandemic) it is a no-brainer: to increase the uptake (via better publicity and more). As to "why is it not done", I think: the default is "no intervention", and it has not found its champion to push for intervention. As simple as that.
 In US it's already in practically every milk and in many cereals. Shipping it to everybody would be a giant waste. It'd likely end up in trash. It's already fairly cheap so subsidizing it won't help much with the demand.
 Clearly that isn’t enough for \$reasons because vitamin d deficiency is endemic in a lot of the population groups in the USA.
 Price isn't the problem with vitamin D. It's very cheap.
 My logic:Q: How many people take vitamin d supplements now?A: Not manyQ: How many would take it if it was given to them free?A: A lotQ: how much does it cost to give someone life saving ICU support?A: a lotQ: how much does it cost to give people some vitamin d?A: not much
 I doubt having the world’s largest bureaucracy create a plan to source and ship Vitamin D to every American would cost “not much”. On the contrary, each American would most likely be taking the most expensive Vitamin D ever sourced.Yes, theoretically, without fraud, waste, and abuse, it would be cost efficient. But that isn’t even remotely a possibility.
 When you put it like that I see your point. I was thinking of my own country, the UK. I think places without the insanity of US medical insurance prices may be able to do this sensibly. As other have pointed out some counties are doing this already for kids.
 My logic:Q: how many people take vitamin D?A: not manyQ: how many would take it if they knew they need it?A: a lotQ: what can we do about it?A: spend X on "marketing" so they know they should take it, or spend 1000*x on giving people stuff they can buy themselves
 I’m not a biologist or nutritionist but is there any reason to believe that the body is capable of absorbing Vitamin D supplements at the necessary efficiency levels to make a significant impact? Compared to, say, sunshine?My questioned is motivated by the common knowledge that vitamins tend To be flushed through out of the body during urination.
 Vitamin D supplements can raise your serum levels well beyond what you can get from sunshine. You really need to get your blood tested to figure out your dose.> My questioned is motivated by the common knowledge that vitamins tend To be flushed through out of the body during urination.That's true for Vitamin C but probably not for most vitamins, they are all quite different. Vitamin A for instance can accumulate to hazardous levels and take a long time to go back to normal.
 It's one of the ones that's stored through fat, so you get a nice stream of it while you are sick and losing weight.The question of dose is a big one, but I personally don't go over 1500 IU of supplements a day (try the 1000 IU gummies IMO). I also only take it from November to February. The recommended daily dose is way less, and you can easily sit down and pop 20,000 IU of the stuff. Be careful! It is technically a hormone.
 What do you make of the whispers that the recommended daily dose is way under? I've seen it pop in recent comments so I found a couple of the papers:[2] https://pubmed.ncbi.nlm.nih.gov/28768407/ (two years later)
 There can't be a recommended daily dose for everyone, every body is different. I quote:"... in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L."That just means there are some people who need a very high dose. For comparison, 4000IU/d gets me well over 50nmol/L, this is also the "generally considered safe" upper limit. There was a case reported on HN where 5000IU/daily caused issues with calcium levels. You gotta get your bloodwork done.
 50 nmol/l (20 ng/ml) is right in the middle of the 'insufficient' range. Did you mean ng/ml? The upper limit for most labs is between 175 and 200 nmol/l.In my personal example, taking about 6000 UI (plus 300 mcg K2) for a year put me just under 200 nmol/l. I did an experiment and stopped taking it for 2 months (but kept taking K2). After testing again I had dropped to 70 nmol/l (top of the insufficient range) and had mild symptoms of muscle ache and fatigue. Needless to say, I've started taking it again (and will aim for 175 nmol/l).
 My levels were more than sufficient, definitely in the high range, but I don't know them off the top of my head.
 In general I agree and these studies are what got me looking into it in the first place. But there's a ceiling too. Dr. Deva Boone has talked about it here on HN [1].
 This. I was taking 5000IU as I thought it was mostly harmless. But I also noticed some of the symptoms mentioned in that thread such as crazy heart rhythm even when resting. I’ve dropped that supplement and am just accepting the more nominal amount from diet, multivitamins, and mild sunlight exposure. Since then I haven’t had the heart rhythm issues.
 It's funny, most people doesn't consider bioavailability of what they are eating. This is even more important with vitamins. Bioavailability can vary from 55 to a 100% [1]. You can without worries take 4000 IU of vitamin D daily.
 Personally I wouldn't go that high without talking to a doctor. There are just a whole bunch of confounding factors with Vitamin D: It takes six weeks of continuous supplementation to really see the effects. It's fat-soluble so whether you're losing or gaining weight matters. And now this!There's just a whole lot of variables. If you're going really high-dose, check with your doctor. Even if you do need a high dose to catch up and level out, how would you know when to stop?Search the string "devaboone" here on HN for more about the potential drawbacks of really high doses.
 It’s pretty inexpensive already, free actually, from sunshine.
 We are not living through a pandemic, we are living through a syndemic.IMHO, the variability of outcomes is largely nutritional and a bit genetic. But fixing these would mean admitting there are deeper problems in our society. So vaccines it is!
 I find it bizarre and horrifying that most governments continue to focus exclusively on wearing masks and social distancing for pandemic control. Those measures may help in temporarily slowing down viral transmission but won't eradicate the virus. Many of us are still going to be exposed before a safe vaccine is widely available, and even then any vaccine won't be 100% effective. There should be more focus on preventing and treating co-morbid conditions that increase COVID-19 risk, particularly vitamin D deficiency and obesity.
 Why not both though? Before we find treatments and cures, masks save lives and this is a fact. And it’s the only thing we know works for sure so far.Otherwise this is like a gunshot victim with diabetes coming into the ER and the doctors focus on the diabetes.
 We have treatments. The survival rate is high for all but the frailest patients. We can push the survival rate even higher by reducing obesity and eliminating vitamin D deficiency.Cures are unlikely any time soon. We only have effective cures for a tiny number of viral diseases. Waiting for a cure is unreasonable.
 And by wearing masks. Again, it’s the only thing that has been shown to be effective with 100% certainty unlike the other things. I mean how would your 70 year old 105 lb grandma feel about you saying that waiting for a cure is unreasonable as you cough directly on her face?
 I mean, obesity is not going anywhere in a hurry, it’s at least a generational problem. But, yes, vitamin d deficiency - once enough studies are signaling as they are now beginning to snowball - does seem like particularly low-hanging fruit.
 I agree there should be more focus on that, but not at the expense of masks and social distancing. We just need to do all these things.
 Masks and social distancing are temporary measures only and obviously not sustainable indefinitely. SARS-CoV-2 is going to be a risk essentially forever, just like the 4 other endemic human coronaviruses. If we really want to save lives over the long term then the primary focus should be on improving the infection fatality rate.
 Assaying vitamin D levels doesn’t necessarily mean that Vitamin D levels are the primary effector, though. Maybe I’m missing some details from the actual study, but showing that mortality risk is higher with a deficiency could support either of these:1) Vitamin D deficiency causes increased mortality2) Whatever causes increased mortality also changes or is correlated with Vitamin D levels
 While you’re not wrong. I often see comments like this when new studies come out.I think most people here know that correlation doesn’t mean causality. However in the case of Vitamin D, there’s a lot of studies pointing towards Vitamin D actually helping fight bad outcomes. Such as the clinical trial from Spain where they gave supplement Vitamin D to one group and compared the outcomes [0] That does seem to indicate that the Vitamin D really is helping.
 If you look at the other comments on this thread, you'll quickly see why people like myself write comments clearly explaining what studies actually show. There is nothing wrong with understanding that the knowledge we have today is limited to a set of possible states - further study, such as the link, help collapse those states. Honestly, it makes the narrative more compelling too as showing direct action is easier than disproving all unseen movers.
 Only read the article, which could be very different from the actual study, the Forbes article is referring to people already hospitalized so we are talking about a pretty low bar of health already (low but probably common, make note of that reality), and of those people they are "getting" Vitamin D, which kind of suggests after they are hospitalized.This is new data then, because earlier studies were saying that Vitamin D supplements weren't improving circumstances, which would reinforce your perspective that people with inadequate Vitamin D levels had other issues.This article doesn't specify what "getting" Vitamin D means, maybe the study does.Let me know!
 >This is new data then, because earlier studies were saying that Vitamin D supplements weren't improving circumstancesThis is the previous Spanish study that found supplementing vitamin D on hospitalisation cut ICU admission drastically. A difference of 2% vs 50%.
 > After adjusting for confounding factors, there was a significant association between vitamin D sufficiency and reduction in clinical severity, inpatient mortality serum levels of C-reactive protein (CRP) and an increase in lymphocyte percentageHere's the key sentence from the study results. They are claiming a significant association [0] between Vitamin D above and below a threshold [1] and clinical severity [2]. The word "getting" is a bit deceptive, because "getting enough" tends to be in reference to their base behavior. Eating fruit helps me get enough vitamin C, so a doctor might recommend adjusting my behavior if tests show I have vitamin C deficiency. Adjusting my behavior would hopefully result in me "getting enough".This is pretty different when compared to the study showing treatment results from Spain (Per another commenter) [3]. Here's the key conclusions from that study:> Our pilot study demonstrated that administration of a high dose of Calcifediol or 25-hydroxyvitamin D, a main metabolite of vitamin D endocrine system, significantly reduced the need for ICU treatment of patients requiring hospitalization due to proven COVID-19. Calcifediol seems to be able to reduce severity of the disease, but larger trials with groups properly matched will be required to show a definitive answer.Treatment (Administration) with a chemical known to modulate the Vitamin D system now shows a clinical effect (ICU treatment reduction, albeit they have some reservations about study size). There's a whole set of further study that would need to be done to directly prove that the mechanism of action is exactly what they think it is, but it provides another good checkpoint (And is at the right abstraction layer to start considering it as a treatment more generally).[0] Correlated, with the implication it could be worth studying as a causative driver[1] "Sufficiency" is just a way of saying the assayed value is at least a value determined to be healthy[2] They've got a long list of different clinical conditions they saw in the two cohorts
 > ...serum levels of C-reactive protein (CRP)....This is interesting to me. I know C-reactive protein is an important biomarker of inflammation, but I've never seen anything that indicates lowering CRP actually does anything. What I have seen is that interventions like exercise and statins lower CRP, and improve other markets of cardiovascular health.One other interesting tidbit is this study [0], which suggests that vitamin D levels are inversely correlated with CRP levels, independently of COVID-19. This suggests to me that maybe the observed lower CRP levels in the COVID-19 patients might be a red herring.---
 #1 is technically right and how the story is usually presented.#2 is also right! Measuring Vitamin D is kinda like measuring how many bullets someone has while fighting a war. Of course it's going to be low. But the soldier starting off with fewer bullets is still at a huge disadvantage.
 This misses the point of the post, it isn't about presentation but what research was actually done. If the story had presented either of those as a summary of the study, it would have been wrong as the study did not interrogate whether either of those were correct. The study saw a relation, it did not discern how that relation was constructed or if clinical intervention along those lines would be useful.
 Yes, low vitamin D is an indicator of frailty, so surely not all of the observed difference is causal. OTOH, giving people vitamin D in a RCT does seem to improve outcomes, so it looks like there's something real here.
 As a person with darker skin living in Europe, I’m told I have vitamin D deficiency and take supplements. Could the higher rate of COVID illness in black and minorities be related to this?
 For sure. We used to live in a basement flat in the UK, and when my partner and kid were diagnosed with Vit D deficiency (white skin) I knew I had it too (dark skin). Two weeks of dosing myself cured my knee pains. And I’m a highly-clued up HN reader.Start hoovering those tablets, fellow darker-skinned technocrats!
 :) I'm told the under tongue sprays work best...
 I would like to see a study that tests whether a large dose of vitamin D improves outcomes when administered during the early stage of COVID-19. Dr. Gerry Schwalfenberg reported positive results with giving 50000 IU as an influenza treatment but that's just anecdotal. We desperately need more research in this area.
 A couple great posts about vitamin D posted to HN:-And her part 3 (which links to tons of studies and is quite informative): https://www.devaboone.com/post/vitamin-d-part-3-the-evidenceMy TLDR from reading those posts: Vitamin D overdosing is possible, can have some pretty severe consequences.Vitamin D deficiency is correlated with tons of conditions. But this seems likely to be a correlation and not a causation. Simply because unhealthy people spend more time indoors than healthy people.The relevant statement in her post from part 3:"Vitamin D seems to reduce asthma attacks in adults with mild to moderate disease, and daily or weekly Vitamin D seems to prevent acute respiratory infection in those with Vitamin D less than 10 ng/ml (25 nmol/l). There is considerable excitement around Vitamin D's potential role in Covid treatment, though we do not yet have enough evidence to make a definitive conclusion"
 No one dies of Vitamin D overdose. Hundreds of thousands of people are dying of COVID-19. So dosing everyone with Vitamin D is extremely low risk for a very high reward...
 Could this be a factor in near zero morbidity rates for young children? They clearly drink more milk and spend more time in the sun than the average adult.
 Background to this comment: Vitamin D is commonly artifically added to milk.
 I'd imagine this varies by country, and that should give relatively easy statistical comparisons?
 After spending the past 7 months as an amateur statistician I have found that nothing is easy when you want compare different countries.
 Comparing within the EU is fairly OK.Testing a hypothesis like the above could be easier if you remember that the US can be divided up like the EU too - that way you have fairly geographically sparse but hopefully methodologically similarly recorded data.
 > Comparing within the EU is fairly OK.The company I work at do data analysis on COVID-19. We cannot compare within EU as of now; only within the country. Even then, data (e.g. from hospitals) needs to be "standardized".
 One of the reasons (plausibly there are multiple reasons) for that may have to do with children having fewer ACE2 enzymes lining the nasal cavity:"The authors evaluated gene expression in nasal epithelial samples collected as part of a study involving patients with asthma from 2015 to 2018. The nasal epithelium is one of the first sites of infection with SARS-CoV-2, and the investigators probed for the expression of the cell surface enzyme angiotensin-converting enzyme 2 (ACE2), which has been proven to bind to SARS-CoV-2 spike protein and promote internalization of the virus into human cells. Among a cohort of 305 patients aged 4 to 60 years, older children (10-17 years old; n = 185), young adults (18-24 years old; n = 46), and adults (≥25 years old; n = 29) all had higher expression of ACE2 in the nasal epithelium compared with younger children (4-9 years old; n = 45), and ACE2 expression was higher with each subsequent age group after adjusting for sex and asthma."
 There are a number of other corroborating scenarios. Homeless populations having much higher rates of infections but much higher rates of being asymptotic. Much lower mortality rates in Central African countries.
 Great question for hn: why is infection rate, not death rate, the metric de jur...
 Two different problems for two different groups of people.Policy makers and individuals want to focus on infection rate. Lower infection rate = less spreading = less trips to the hospital = the society is "winning"Hospitals and doctors want to focus on death rate. At the point they get a patient, they are already infected. They want the lowest % of people possible to die, to show that their care is working.Neither effort is in conflict with each other, and can be near perfectly parallelized. I.e. the hospitals trying a new medicine to lower death rate has no impact on a region trying to lower infection.
 This would explain "flu season" just as well as anything related to distancing or indoor air filtration : the lack of sunlight at high latitudes results in poor vitamin d production
 I don't have the references handy, but IIRC "flu season" and winter diseases in general were essentially resolved by a model that takes absolute (not relative) humidity and gives the probability that aerosols (e.g., a sneeze or breath) will remain in air for a while, or fall to the ground.IIRC, same computations correctly predict flu season (and other viral diseases) for the last 10 years or so, but fail to predict covid-19 dispersion (and in particular, predicted a drop during the summer of the northern hemisphere, which did not happen) - which may indicate either that the model is borked, or that the primary dispersion vector is NOT, as commonly assumed, aerosolized -- in fact, there are quite a few pieces of evidence pointing in that direction. (Not that it's impossible, just that it's not the primary one).
 Given we know aerosolization is a vector I'd take humidity to be confounded with something else. Even then, unless experiment reveals it you can't take simulations as anything except hypothesis generators.Serum vitamin d concentration vs virus damage would be an interesting trial.
 We do not know that it is the primary vector, though. We know that the fecal-oral route is also a vector, one that’s historically a big problem in nursing homes, and plays a nontrivial part in spread through food preparation (unlike e.g. with flu which is essentially all aerosol with short life).The spread data is not properly reflected in recommendations IMHO and likely for political and politically correct reasons.
 Excellent medcram video on D re covid
 At the moment I'm checking this, the title of the article is much less sure than what's on HN."Study Suggests Reduced Mortality Risk For Covid-19 May Be Associated With Adequate Vitamin D Levels"Whereas the current HN title claims that "study finds" that "Vitamin D Levels Cuts Risk" which is much stronger claim, which doesn't have to be true -- i.e. an editorialized title, not what HN typically prefers.
 The headlines on Vitamin D and Covid far surpass the actual data. Here is my summary on the latest research: https://www.devaboone.com/post/vitamin-d-and-covid
 Worth repeating that people in the UK are unable to get enough vitamin D from the sun from next month until the spring.
 Unable or unlikely?There are still a fair few hours of sun...
 Unable to get enough. The sun is too low.
 They need to disambiguate whether the effect holds for people who are getting vitamin d from sunlight vs people who get it from supplements. It could be that sunlight/fresh air/exercise/being healthy enough for the above is the real explanation.
 We need a quick, cheap way of regularly testing all of this stuff at home. Vitamin D levels take a while to change, I guess people will want to know before they have a deficiency. Maybe the Series 7 watch will feature blood testing.
 You can get a blood test from DirectLabs in most of the US for vitamin D for \$50. Don't know if you think that's cheap.
 People in the Northern hemisphere could have solved their vitamin D problems by going outside for twenty minutes a few times a week over the last several months. Unfortunately sunscreen marketing has clouded our judgment.
 I (Scottish-level white) spend an hour or longer outside every day, all year, in London. Yet my vitamin D levels were almost zero. Unless I take around 50,000 IU per week, they drop to insufficient.Not everyone seems to generate enough vitamin D from sun exposure.
 UVB is what causes vitamin D production, and UVB doesn’t penetrate the atmosphere when the sun angle is below about 50deg, so if you are not out when the sun is high enough, it doesn’t help with vitamin D
 It looks like in London, the sun doesn't go above 50deg except between late April and late Aug, and on the solstice it's only above 50deg between 10:30 and 15:30. Which means for the most part, it that condition only occurs while people are inside the office, and only for half of the year.
 Exactly that. Hence a permanent recommendation by PHE and NICE, that for public health reason, most of UK residents need a supplement. Alas - it is all but forgotten. Mostly acted on for newborns, where the GP surgery, probably reminds the parents or even distribute small bottles of Vitamin D drops. (administered orally) For everyone else, the widespread Vitamin D deficiency, goes virtually unnoticed. It is the default, with no-one pushing for a change. It is a low hanging fruit, wrt Covid-19 and also seasonal flus.
 Sounds unusual. I thought the paler you were the easier you generated it tbh. Also 50k IU sounds a lot too. I’m pale as fuck an 400iu a day and a quick walk put me in the healthy range.
 > a quick walk put me in the healthy range.Could this be due to where you live?The winter in the UK can be very low light for quite long periods. The weeks-long ‘rain’ or whatever you call that semi drizzle is very dreary.There is about 3x the rainfall per year where I live now but it’s short and sharp in comparison.
 It is essentially overcast from October until March. It barely rains, but it nearly always looks like it's about to rain!That being said, even in the summer, when I regularly go outside enough to get a pinkish hue to my skin, I still don't generate enough Vitamin D. In an ideal world maybe I'd have an explanation for it, but I just take a supplement and don't worry about it any more. Some research suggests that there is a high degree of variability in how much Vitamin D individuals generate from sunlight.
 You're probably right. London is over 51° N latitude. Most people in the hemisphere are well south of that. Most people in Canada live south of that.
 Europe in general is fairly far north. According to Citymetric, half of Canada's population lives further south than Milan, and the most populated latitude in Europe is 52° N.
 The Gulf Stream distorts a lot of perceptions as does the fact that a lot of the Canadian population lives pretty close to the US border. A lot of people in the US are pretty surprised that London, Amsterdam, and even Paris are at the same latitude as northern Newfoundland and Quebec way north of Montreal.
 It's pretty standard amount tho. My doctor suggested that, but I opted for a steadier amount when my D levels were low and have been using it ever since. 2 months after he suggested I had been taking 2000IU per day and my levels were back in what he called excellent range. No idea what level that is :) . I am an indoor dweller and in general don't like the sunlight and enjoy night time activities much better.
 From early March until mid-June, we were told by government to “stay home”. There were even few events where police tackled to the ground and arrested people who were taking a walk outside, away from any crowd, in a group of two. Now people do go outside, and even though we have more detected cases of Covid-19 as compared to spring, the cases are milder and mortality rates are lower. Country: Croatia
 Seems like these articles never clarify if they're talking about clothed or partially unclothed exposure. Hard to imagine much vit d being generated in the little bit of face and hand skin area exposed to sunlight by a normal clothed configuration.
 And they often skip over skin colour as a significant factor.
 From the link given above:These seem like benefits everyone should be able to take advantage of. But not all people process sunlight the same way. And the current U.S. sun-exposure guidelines were written for the whitest people on earth.Every year, Richard Weller spends time working in a skin hospital in Addis Ababa, Ethiopia. Not only is Addis Ababa near the equator, it also sits above 7,500 feet, so it receives massive UV radiation. Despite that, says Weller, “I have not seen a skin cancer. And yet Africans in Britain and America are told to avoid the sun.”...People of color rarely get melanoma. The rate is 26 per 100,000 in Caucasians, 5 per 100,000 in Hispanics, and 1 per 100,000 in African Americans....How did we get through the Neolithic Era without sunscreen? Actually, perfectly well. What’s counterintuitive is that dermatologists run around saying, ‘Don’t go outside, you might die.’At the same time, African Americans suffer high rates of diabetes, heart disease, stroke, internal cancers, and other diseases that seem to improve in the presence of sunlight, of which they may well not be getting enough. Because of their genetically higher levels of melanin, they require more sun exposure to produce compounds like vitamin D, and they are less able to store that vitamin for darker days. They have much to gain from the sun and little to fear.
 If you check, you'll often find they assume shorts and t-shirt.
 A bunch of us have that kind of white skin that in adult years doesn't tan.. it burns in clearly unhealthy ways.
 Try https://fastrt.nilu.no/VitD-ez_quartMEDandMED_v2.html and err on the low side if you're worried. Regular self-examination is always a good idea for everybody and essential for very pale skins.Vitamin D productive begins immediately when the skin is exposed.
 In the northern states, you burn long before you get enough vitamin D around the winter solstice. Assuming the sky is even clear.With vitamin d it’s about building up reserves while you can, and supplementing with food or vitamins.
 I'm in Sweden, which is about the same latitude as Alaska.My sister and mom tan, I burn. Weird thing though, when I was a kid I spent so much time outdoors. Like, all of the time.That was before I got hold of a decent computer at like age 12 in 1989, and I started spending so much time indoors.After 30 years or so of mostly staying indoors, I burn when UV rays hit my skin.I'm willing to concede that my behavior is at least a part of the issue.
 Swedes tend to get a good amount of vitamin D from the herring and salmon in their diet.
 Well, I was eating the sorta usual amount of herring and salmon for a Swede, and was still diagnosed with a severe lack of Vitamin D, a few years ago. I got a recipe for 3200 IU/day based on my test.
 My son says he doesn't tan - he pinks.
 In some Northern hemisphere countries we are not allowed outside.
 Example of country where you are not allowed to go outside at all (except during temporary quarantine of a couple of weeks)?I now that even during France's confinement (which is over now), people were still allowed to leave their house for solitary outdoor exercise and walks.
 I don’t know if you heard but over here on the west coast, shit’s on fire, yo.
 Really?? I just met a friend who spent last week there taking surfing classes with a company - didn't seem like there were anything like that going on there. Haven't seen anything in the news, either.
 The air is currently clear as a bell in the Bay Area.
 Where is this? I feel like I should have seen something about this on the news... If this is Covid-related, you should know that time spent outside in the sun away from crowds is better for your health than time spent in any situation inside.
 Has there been any research into the vitamin d levels of patients after periods in hospital? Do vit d levels fall quickly enough for being admitted to hospital (and so being indoors) to become an issue in treatment?
 How many people actually have inadequate vitamin D levels? They chose a fairly arbitrary amount (30 ng/ml) as their measure for an inadequate level.
 It’s pretty frequent
 Yes, AFAIK all diabetics have diminished D levels, as do many vegans.
 I somehow did not ferret out from the Forbes article: Is this correlated or causal?
 Nobody's done the kind of study that would establish that yet.
 I’d say that the Spanish clinical trial does point towards causality. They gave a randomized group of patients Vitamin D and compared the outcomes. Correct me if I’m wrong but that seems like the best way to test for causality.
 Friendly reminder that vitamin D is not harmless, either. Overdoing it can have permanent consequences for your health. If you think you may be deficient (you probably are), have a medical professional assist you with blood work and safe dosage.
 Overdosing is a real danger, but you have to eat a lot.Do talk to your doctor if you have one easily accessible, but if not, 1000-2000 units a day should not be a problem for anyone.
 A lot of people will read this and immediately put themselves on huge doses of vit D thinking they'll be immune - rather than an deficiency increases mortality
 Worth noting that a lot of people are vitamin D deficient. Particularly pronounced with those with a lot of melanin in the northern hemisphere, e.g. see https://www.scientificamerican.com/article/vitamin-d-deficie...So to a first approximation, taking 1000 IU of vit D might be a good default recommendation for anyone if you can’t afford to get your blood work done.I am not aware of any evidence supporting megadosing though.
 Over the last month or so I've seen comments by HNers that they've taken pretty large doses and that it's helped with depression. I've been trying a double daily dose every day that I'm not able to go outside for an hour - after two weeks (and remember this is anecdotal, the causative nature in this is hidden) I had my first day in years where I was just happy; it was weird, I was like, huh, I feel happy today. My mood has been up in general.I'm hoping this helps long-term; perhaps VitD deficiency is a contributor to rising levels of depression too?
 Great that you feel better! There are several potential explanations for this, for example: * It could be pure chance and selection bias, for you it seems unlikely, but consider how many took the same advice and saw not effect, they wouldn't post about it. This is why we need larger sample sizes and a control group to compare to. * It could be placebo, maybe your expectations made you notice and appreciate the happiness, maybe also strengthening it. This is why we need to make studies blind by using a placebo group. * There was indeed an effect because you were vitamin D deficient.Recently a large study was published where they gave a large group vit D to look for depression incidence and they could not find any effect. There's a lot of parameters that could affects the results so it doesn't mean there is none, but probably that it's not as simple as "give everyone vit D and we get rid of depression".
 Oh for sure, placebo is a strong possibility for me (the sense of taking action perhaps provides the mood improvement which is not quite placebo but a related effect); also on HN we're perhaps a lot more likely to be "shut-ins" (or approaching that) and so we're starting from a non-representative pool.For me, I just noticed a few comments saying it helped their depression, was considering VitD already for Covid19 reasons, and figured the possible level of harm was almost zero so I'd give it a shot.Not sure I'd expect a large randomised group to have a noticeable effect (can you link the study you mention, please) but perhaps "people who have reported depression, have been tested and found to be low in VitD" as a starting group and then see if it does better than placebo.Thanks for your comment.
 For people with vitamin D deficiency I would not be surprised if there's a connection to depression and I guess standard advice applies: If you think you might be at risk, get yourself tested. If nothing else, you can avoid experiencing the bone related issues that a vit D deficiency might cause.This was the study I was thinking of (they did not target people with depression) https://jamanetwork.com/journals/jama/article-abstract/27689...Weirdly I couldn't find any studies on the effects of supplementing with vitamin D for depression, even though there's plenty of studies on the correlation, and even one study where they used it for treatment, without any control group...
 Thanks, appreciate your useful response.I guess the lack of studies comes down to the morality of in vivo testing of treatments; the chances of someone untreated going off the rails is considered too great a risk.
 Every time I think of those Somali refugees they settled in Wisconsin and Washington State, I get a little bit angry. That’s just cruel. Even balancing for potential racism, Iowa, central Illinois/Indiana, Northern California would be loads better temperature and vitamin D-wise.
 Actually, the most common destination is Minnesota, even further north than Wisconsin! Today though, Somalis prefer to be sent to the Twin Cities because of the network effect.
 >I am not aware of any evidence supporting megadosing though.The main consequence of vitamin D toxicity is a buildup of calcium in your blood (hypercalcemia), which can cause nausea and vomiting, weakness, and frequent urination. Vitamin D toxicity might progress to bone pain and kidney problems, such as the formation of calcium stones.It's not good to have too much either.
 > It's not good to have too much either.You can say that about water too. You can literally die if you drink too much water because the electrolytes get diluted too much⁰.
 Yeah, but too much is really quite a lot. Let's not scare people away from taking a reasonable amount.
 I'm not scaring anyone away, but your drama is.After researching the proper dosage of Vitamin D, I purchased the correct dosage, and not one that would lead to overdosing, and those dosages are absolutely available and people often just buy whatever the maximum is even if they don't understand the implications of using it.
 Blood work?
 By way of explanation:Your body accumulates a store of vitamin D in the liver, which it rations out into your bloodstream over time. When you ingest or produce vitamin D, your liver buffers the amount that ends up in your blood, which does two things. 1) saves for a rainy day (literally and figuratively) 2) protects you from vitamin d toxicity over the short term. Which I’m told is quite nasty.With a doctor’s supervision you can take large doses of vitamin d for a short time and your liver will soak it up. How fast your blood levels rise tells the doctor about how much more you need in the tank and/or if you are having absorption problems. They taper you off quickly as you approach a healthy blood level.
 Panel of various tests using your blood.
 Blood tests of serum levels etc.
 It's very hard to take toxic amounts of vitamin D:> "Taking 60,000 international units (IU) a day of vitamin D for several months has been shown to cause toxicity. This level is many times higher than the U.S. Recommended Dietary Allowance (RDA) for most adults of 600 IU of vitamin D a day.Not saying it's impossible, but that's the equivalent of buying the top result on amazon (https://www.amazon.com/Nature-Made-Vitamin-Strength-Softgels...) and taking 12 polls a day for several months. It's not actually impossible to get to toxic levels... but that's a serious commitment.
 Acute toxicity is not the only risk. E.g. risks of bone fractures increase at a few thousand IU a day.
 Is that with or without vitamin K2 co-supplementation?
 The toxic dose is 4,000 IU per day though, so you would normally want to be taking well below that except maybe on a short-term basis.
 That seems low, considering that 5000iu softgels are very readily available (eg the vit D supplements at Costco).Edit: acute toxic dose not established, chronic toxic dose >50k iu/day. https://www.medscape.com/answers/819426-102369/at-what-dose-...Edit2: this article lists 4000 IU/day as the generally recognized as safe level https://www.healthline.com/nutrition/vitamin-d-side-effects#...
 Costco's vitamin D softgels are 2000 IU, not 5000.
 5000 IU softgels are definitely sold OTC though: https://www.naturewise.com/products/vitamin-d3-5000-iu-360-c...
 Nature's Bounty D3 125mcg (5000IU), Costco item #1106007So not Kirkland Signature, but sold there.
 As far as I'm aware Vit D toxicity has been observed in much higher doses than 4000 IU/day. Do you have a quote for the 4000 IU/day figure?The skin produces up to 10,000 IU/day after exposure to UV light⁰. The same study I'm quoting shows toxicity levels at over 20000 IU/day for adults. One person in the study has taken 156,000–2,604,000 IU/day for 2 years!
 The production in the body is self-regulating though, so you can't overdose from sun exposure. Supplements can bring you over the limit, because you absorb what you're given.
 You are arguing a point I didn't make. My point was to his statement that 4000 IUs/day were toxic (without stating any basis for that number), while the study I quote claims that the body produces up to 10000 IUs/day – so clearly the toxicity limit is not an unqualified 4000 IUs/day. Perhaps in some people toxicity appears at lower doses while in other people at higher doses.
 I'm not really disputing the 4k not being toxic. Just the way I understand it, even though you can produce up to 10kUI through the skin should have no relation to the toxicity level being below or above 10kUI.
 4000 IU is the tolerable UL (upper limit).
 Most people should just go to a doctor every 6 months. Guessing is not a great idea imo.
 There are not enough primary care physicians in the USA to allow otherwise healthy people to go to the doctor every 6 months. It just isn't possible.
 That’s pretty frequent for a healthy adult. How do the appointments go? I can’t imagine going without something to discuss.
 I mean specifically if you're planning on making significant changes to how you supplement/ diet/ generally maintain health, it's a good idea to get tests done so you can actually measure the impact and understand if you're actually addressing an issue.
 I don't think 6 months is super frequent, even for a healthy person. I go at least once a year, whether I need to or not. I'd go up to every 6 months without hesitation, if my doctor recommended it.
 In the US, annual physical is what insurance typically covers for "free" but you may visit more frequently for follow-ups about something in particular (in which case you have co-pays). Which seems reasonable in general. Same thing with eye exams.
 We don't know the source of the vitamin D: For example it's entirely possible that the type of person who has higher vitamin D levels is the type of person who takes care of themselves through things like vitamin supplements, and people who take care of themselves are less likely to have preventable underlying conditions.So, as always, it's important to remember that this study was retrospective, not experimental in nature.
 Here's an experimental study
 Thanks, that is much more significant than this study, even if it had fewer people.
 You could replace vitamin supplements with going for a walk.
 Yeah but how are you going to do that while quarantining? Going outside and having fun is verboten.
 Is there a country which actually forbids going outside right now?Even Melbourne in heavy lockdown was allowing/recommending limited time exercise outside.
 They allowed an hour. I think it is two hours now.
 Calcifediol doesn't seem readily available for consumer purchase.Because of that, this sort of feels like "Vitamin D could save people[1] from the worst of Covid![1]Healthcare Wealthy Only"Corrections welcome.
 Calcifediol is just a way to rapidly increase the blood levels of Vitamin D in an obvious crisis situation. Going outside, and/or supplementing Vitamin D from exogenous sources takes many days to have an effect.Talk to your doctor, but start now. Your downside risk is fairly minimal. It is estimated that 40% of more of the US population is deficient in Vitamin D.
 Why is specifically availability of Calcifediol relevant, which as far as I understand is a step in the middle of the bodys reaction chain while processing Vitamin D3 (which is easily available)?
 As I understand it, calcifediol is a metabolite of standard cholecalciferol, which is available extremely cheaply over the counter.
 Want to end this mess quick and easy?The government should send every citizen \$300 worth of vitamin D3 and remove all lifestyle restrictions.PS: Early on people like Musk and Ford jump in to help by donating ventilators. Why aren't we seeing other organizations and individuals creating huge pushes to things like manufacture D3 and create widespread publicity for plasma donation? You listening Bill G?
 Given that people are drinking bleach I don’t think sending a large amount of vit D is a clever plan. Way to many idiots out there that will take more than recommended “just to be sure”
 Not sure about the costs in the US, but here in the Netherlands, \$300 worth of vitamin D would be about 30000 10mcg pills...edit: Some googling shows that they costs around 3 to 5 cents per pill in the US, so you're suggesting to send everyone 6000 - 10000 pills?
 You can buy a year's supply of 5000 IU/125 mcg D3 (which may be a bit too much as a daily dose according to current NIH guidelines) for ~\$15 in the US.
 So, I cannot read the article without disabling adblocker, which I won't do, but here is their source anyway: https://www.bumc.bu.edu/busm/2020/09/25/adequate-levels-of-v... This is the nth study to talk about this. It's pretty well demonstrated by now that there is a correlation between vitD levels and covid-19 mortality. What is not clear is:- given that a deficiency is bad, does it matter if you have more than just the normal amount? In other words, does this only matter if you have a deficiency?- given that sunlight increases natural vitamin D production, could it be, not the vit D per se, but rather the sunlight exposure, that has the beneficial effect?- could this even just be a case of healthy people getting out more, hence getting more sunlight and thus vitamin D, and healthy people also dying less from covid-19 (or almost anything else)?What I would like to see is a study where they increase vit D levels, sunlight levels, both, or neither, and compare the mortality rates. If you don't feel it's ethical to do the neither option, you could compare to previous averages when neither was done. So far I have seen no evidence that this is being done, but hopefully soon?
 Well just as i post this another person posts an answer for me: https://www.sciencedirect.com/science/article/pii/S096007602...

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