Vitamin D, Immune Health and COVID-19 Risk
Beyond cautionary measures like proper hand washing, masks and social distancing, your best defense against COVID-19 and influenza is a well-supported immune system. Learn how to keep it in fighting shape this season with my ongoing immune health series.
A recent comment on the national news got me so revved up it has brought me back into the blogosphere to set the record straight. Admittedly, I don’t watch much news lately, but my ears perked up when a national reporter asked a prominent MD:
“Other than following the CDC guidelines for diligent handwashing, wearing a mask, staying hydrated, and eating our veggies, is there anything else the American public can do to support their immune system?”
This was it … a great question! I was on the edge of my seat hoping this MD would come through and provide solid recent research and empowering strategies for an American public trying to weather a major pandemic.
But the MD’s response was a major missed opportunity. I was beyond disappointed by her answer, which I must respectfully call uninformed. She stated that eating a well-balanced diet and getting enough sleep was important … which I wholeheartedly endorse. But she followed by saying there was little research at this time that supplements or other interventions are helpful to support the immune system. She added there is some inconclusive evidence about vitamin D and that medical professionals don’t recommend people necessarily supplement.
My jaw was on the floor. This interview took place just last week, after over a dozen studies on vitamin D have been released in the past 6 months examining its possible preventive role against COVID-19. These studies are, of course, limited by the challenge of gathering data in the middle of an emerging and evolving pandemic. But several of these studies demonstrate a clear connection between low vitamin-D levels and the risk of COVID-19 infection. Further, the authors of these initial studies also connect their findings with solid prior evidence on vitamin D’s function in preventing and reducing the severity of influenza and other respiratory illnesses, as well as its ability to enhance and modulate the immune system in general.
Here are a couple of examples:
- Role of vitamin D in preventing of COVID-19 infection, progression and severity
This study examined vitamin D levels and the number of COVID-19 cases in 20 European countries. It found that lower vitamin D levels were associated with an increased number of COVID-19 cases.
- The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality
The authors of this study found a similar correlation between lower vitamin D levels and the number of COVID-19 cases this spring in Europe.
- Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study
In an analysis of 14000 Israeli patients tested for COVID-19, low vitamin D levels were found to increase the risk of both infection and hospitalization.
- 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 study randomly assigned 76 patients admitted to the hospital for COVID-19 to receive standard care alone or standard care plus high dose vitamin D. Only 2% of patients who received vitamin D went on to be admitted to the ICU, compared to 50% of those who did not receive vitamin D.
I continue to struggle with understanding why ALL medical doctors are not checking vitamin D levels on their patients and why research-based supplementation guidelines are not being offered to help people have greater control over their health. Individualized and monitored supplementation is necessary to promote the most favorable outcomes.
A robust immune system is the heart of both preventing COVID and minimizing its impact should you catch it. Since we know vitamin D and other supplements can support the immune system, it seems irresponsible to me not to recommend their use in the face of a deadly global infection.
And the same is true for other interventions. Research is clear that lifestyle, environmental factors, and the health of your gut are vital to optimal immune health. That is why over the coming months I will be reporting on solid evidence-based research and strategies that I have been providing to my own clients and followers. I want you to find freedom from the paralysis of fear and give you effective tools that can support your immune system in the fall and winter months, and beyond.
So, keep your eye on this blog as I dive into your many options for optimizing your immunity: including diet, supplements, lifestyle practices, and how to support your immune system’s key regulator — your gut.
Before I sign off for today, let’s get back to the question of vitamin D.
Making the Vitamin D Decision
Are you getting enough vitamin D? Should you supplement?
Your skin produces vitamin D when exposed to the sun, and you need between 10-20 minutes of exposure on your arms and legs a few days per week, typically between the hours of 12-3pm to provide a baseline level. But this is greatly affected by cloud cover, skin color, elevation, use of sunscreen and, especially latitude. I live in Florida, where the sun is strong enough all year to trigger vitamin D production. However, most people in the US live above the 37th parallel, and this means they can’t make vitamin D from the sun November through March each year, and they must rely on whatever stores they’ve built up in the summer months. This is one reason why vitamin D levels plummet in the winter and seasonal infections like the flu rise at the same time.
You can get a small amount of vitamin D from foods, especially fatty fish like tuna and salmon, and some from liver, egg yolks, mushrooms and fortified foods like dairy, dairy substitutes and cereals. The recommended amount for an adult daily is 600 – 800 IU. Three oz of cooked salmon has 450 IU; an egg yolk has 37 IU, and a serving of milk offers 2 IU. As you can see, supplementing in the winter in northern states may be your only easy option to ensure adequate vitamin D levels unless you really, really like sardines.
If you choose to supplement, it’s important to use high quality products from professional supplement lines and know that proper dosing can be affected by supplement quality, concentration of active ingredients and other factors. For the highest safety and greatest benefit, it’s best to consult a qualified clinician for testing and recommendations. The typical recommended dose is 800-2000 IU/day of Vitamin D3. Those with certain genetic variations or other conditions can require up to 5000 IU/day and in some cases 10,000 IU/day may be indicated for a short time span. Supplementation should always be done in conjunction with a licensed qualified practitioner.
With the correct supplement and dosing schedule, it’s possible to restore inadequate vitamin D to a healthy level, often in a few weeks to a few months. If you have low vitamin D levels and you supplement, it is important to recheck your levels in 3-4 months.
2020 has taught us that our health can easily be taken for granted … But I feel it may offer a needed wake-up call! There is so much we can do. Instead of just hunkering down and surviving this pandemic, let’s all commit to emerging stronger and wiser than ever. It is my hope that, individually and collectively, we learn to take steps to prioritize our health. It is not selfish or indulgent, it is necessary. Optimal health not only helps us to thrive, but it gives us the power to care for our loved ones, our communities, and the world.