Newest RCT D vs Covid, plus C

Sorry, some if that text is small, not sure why or how to correct it.

Somewhere in an earlier thread, I had posted something about the UK was going to be giving out free D to high risk groups for Covid. Though I thought their doses were ridiculously low, this at lest seemed like a good step forward from those in authority in the UK. Well, it seems I celebrated too early.

https://archive.is/msqfb
"
There is currently insufficient evidence to support taking vitamin D solely to prevent or treat COVID-19, according to new guidance.
However, experts confirmed current advice for everyone to take a vitamin D supplement throughout the autumn and winter. ( BB adds: ?????? ).........................
Evidence Is 'Inconsistent'
The scientists agreed that low vitamin D status was associated with more severe outcomes from COVID-19. However, they said it was not possible to confirm causality because many of the risk factors for severe COVID-19 outcomes are the same as the risk factors for low vitamin D status.
Other problems with the available evidence were cited as inconsistencies between studies, and differences between supplementation doses, settings, populations, durations of trials, and definitions of outcomes.
Prof Ian Young, chair of SACN, said: "This evidence review confirms that currently there is not enough available evidence to determine that there is a causal relationship between vitamin D and COVID-19."
The guidance recommended that more research be conducted.......".

Or, in my case, call me crazy, I will just continue to take Vitamin D and other possible helpers, and encourage every one I care about to do the same, after researching this for themselves. I'm not waiting for the never ending recommendation "that more research be conducted", though I do hope they actually do so. Besides, they apparently are not considering the RCTs which have already been done.

"Dr Paul Chrisp, director of the Centre for Guidelines at NICE, said: “As research continues on the impact of vitamin D on COVID-19, we are continuing to monitor evidence as it is published and will review and update the guidance if necessary."". Well, no need to rush.

"One recent study, published in the journal Nutrients, suggested that a high-dose booster therapy of vitamin D in its 'parent' form, cholecalciferol, regardless of baseline serum 25(OH)D levels, appeared to be associated with a reduced risk of mortality in acute inpatients admitted with COVID-19.
The observational study involved 444 participants with a median age of 74 from Tameside General Hospital in Ashton-under-Lyne.
The authors call for further work...........". LOL! Or, some of us might choose to not wait for further work, and go ahead and make certain we are not deficient or even insufficient on D. Like me.

"They point out that if beneficial, high dose therapy with vitamin D would be inexpensive and widely available.". Well, we agree on that! And considering the RCT in the OP of this thread, a few other RCTs with the same results, and about a bazillion observational studies all pointing in the same direction, I do start to wonder if there is actually any amount of evidence that would be enough for these people? Besides, I'm willing to bet money that almost every one of those advisors are supplementing at least with a couple of thousand IU of D.

"The panel was concerned that not everyone was aware, or were following, UK Government recommendations to take a supplement between October and early March when people in the UK do not make enough vitamin D from sunlight.
They stressed that everyone should consider taking a supplement containing 10 micrograms (400 international units) of vitamin D daily.
The panel also stressed that this was particularly important during the COVID-19 pandemic, when people may be indoors more than usual.
'Alarming' Vitamin D Deficiency in UK Ethnic Groups
New research found that 57.2% of people with Asian backgrounds living in the UK are deficient in vitamin D (levels below 25 nmol/L) during the winter and spring..............".

Well, may I suggest if "not everyone was aware, or were following, UK Government recommendations to take a supplement between October and early March...." it might be because of articles like this that seem to be saying "we can not recommend vitamin D supplementation to improve your odds against- among other illnesses- Covid-19"?

"The study used data from 440,581 UK Biobank participants.
"The rate of severe deficiency was much higher in most population groups than we would have expected, so these results are really very alarming," commented Prof Elina Hypponen from the University of South Australia, who led the study.
The authors said the results strengthened calls for a mandatory vitamin D fortification programme in the UK."
Well, which is it? Should they supplement or not? After all, the title/headline is: "'Not Enough Evidence' to Recommend Vitamin D for COVID-19 Treatment
Peter Russell
December 17, 2020
There is currently insufficient evidence to support taking vitamin D solely to prevent or treat COVID-19, according to new guidance." And I seriously doubt the recommended tiny dose of 400 IU, or food fortification, is going to do much to get levels for most folks up above 30 ng/ml, considering that nature will supply > 10,000 IUs from exposing a lot of skin to sunshine for 30 minutes.

Post Edited (BillyBob@388) : 1/9/2021 8:52:39 AM (GMT-7)

F8 said...
more than 300k new cases yesterday which means more than 5k deaths a day soon.

But, based on the article above from the UK(and is it much different yet in the USA? I hope so), we should not recommend supplementing with D as a possible help against Covid, and for any reasons do not recommend anything above 400 IU. Plus this:
https://www.nice.org.uk/guidance/ng187/resources/covid19-rapid-guideline-vitamin-d-pdf-66142026720709
"Adults, young people and children over 4years should consider taking a daily supplement containing 10micrograms (400units) of vitamin D throughout the year: －if they have little or no sunshine exposure including because they.........................Do not offer a vitamin D supplement to people solely to prevent COVID-19, except as part of a clinical trial. ....".

All of this seems confusing compared to this info from the UK on 11/28:
More than 2.5 million vulnerable people in England will be offered free Vitamin D supplements this winter........................People who are able to buy a Vitamin D supplement and start taking them now, ahead of a free delivery, are advised to do so............". https://www.bbc.com/news/health-55108613

Post Edited (BillyBob@388) : 1/9/2021 9:07:02 AM (GMT-7)

Here is the study I long to see: of the hundreds of thousands who have died from or with Covid-19, how many had high blood levels of vitamins D and/or C before they became ill and throughout their treatment in ICU? I'm betting either zero or exceeding few. Admittedly, if you are 95 years old and near death in a nursing home, with a bunch of comorbidities, and then you get Covid-19 or even the regular flu, you are not likely to make it with or without high levels of vitamin in your blood. But I also wonder how many 95 year olds near death in nursing homes have high levels of D and C in their blood? Again, I'm betting very few.

I have seen several RCTs were vitamin D has been added for people already seriously ill with Covid, as in the OP of this thread, and the people have done much better than the group that was not given D. But I would like to see that looked at in reverse. How many people of the hundreds of thousands in the USA alone, who have died from or with Covid, and high levels of vitamin D or C before they got seriously ill with Covid, and these levels were maintained in there stay in ICU?

Since there have been several studies where people were aggressively treated with vitamin D (sometimes with other nutrients) once admitted to the hospital, and the treated group did much better than the group that only got the usual treatment for COVID-19, one can't help but wonder how much better even this group would have done if they had had high levels – or at least adequate - levels before they even got seriously ill or infected in the first place.

In addition to the OP, here is an earlier study where those treated with a rapid acting form of vitamin D did much better than the group they got everything but the vitamin D. They gave them this form of D by mouth feeling there was no time to wait for the body to convert oral supplements of D3 into the calcifidiol. But of course, if I already making sure your blood levels of D are adequate before you ever even get sick, there is plenty of time for the body to be converting the supplemental D into calcifidiol.


https://www.sciencedirect.com/science/article/pii/s0960076020302764?_hsenc=p2anqtz-8amceoheev0ckpylgn1gbs3kxjbqcycwkiqfyobee***iwjlrjkq_xhq-jofpr1q0aqivicldblfng4xxtvee9-rhi-w_6atfhgwnmeu0arfnq4nu&_hsmi=94616504&utm_campaign=chris%20kresser%20general%20news&utm_content=94616504&utm_medium=email&utm_source=hs_email&via%3Dihub
“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”
"Highlights

•

The vitamin D endocrine system have a variety of actions on cells and tissues involved in COVID-19 progression.
•

Early calcifediol (25-hydroxyvitamin D) treatment to hospitalized COVID-19 patients significantly reduced intensive care unit admissions-Calcifediol seems to be able to reduce severity of the COVID-19.
•

Calcifediol seems to be able to reduce severity of the disease.......

Participants

76 consecutive patients hospitalized with COVID-19 infection, clinical picture of acute respiratory infection, confirmed by a radiographic pattern of viral pneumonia and by a positive SARS-CoV-2 PCR.......................

Procedures

All hospitalized patients received as best available therapy the same standard care, (per hospital protocol), of a combination of hydroxychloroquine (400 mg every 12 h on the first day, and 200 mg every 12 h for the following 5 days), azithromycin (500 mg orally for 5 days. Eligible patients were allocated at a 2 calcifediol:1 no calcifediol ratio through electronic randomization on the day of admission to take oral calcifediol (0.532 mg), or not. Patients in the calcifediol treatment group continued with oral calcifediol (0.266 mg) on day 3 and 7, and then weekly until discharge or ICU admission. Outcomes of effectiveness included rate of ICU admission and deaths.
Results

Of 50 patients treated with calcifediol, one required admission to the ICU (2%), [while of 26 untreated patients, 13 required admission (50 %) p value X2 Fischer test p < 0.001. Univariate Risk Estimate Odds Ratio for ICU in patients with Calcifediol treatment versus without Calcifediol treatment: 0.02 (95 %CI 0.002−0.17). Multivariate Risk Estimate Odds Ratio for ICU in patients with Calcifediol treatment vs Without Calcifediol treatment ICU (adjusting by Hypertension and T2DM): 0.03 (95 %CI: 0.003-0.25). Of the patients treated with calcifediol, none died, and all were discharged, without complications. The 13 patients not treated with calcifediol, who were not admitted to the ICU, were discharged. Of the 13 patients admitted to the ICU, two died and the remaining 11 were discharged.
Conclusion

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............"

So, 1 of 50 in the D group ended up in ICU, vs 13 of 26 in the no D group ended up in ICU. Of the one in 50 the D group admitted to ICU, none died. Of the 13 of 26 admitted in the NO D group admitted to ICU, 2 died. What will it take for people to pay attention? The UK is still cautioning that there is no good evidence for D vs Covid. Considering that fine result, I am willing the bet a population that had very sufficient levels of D in their blood before even being exposed to the Covid-19 virus would have way, way lower death rates. But, maybe that's just me. Certainly, some governments (like UK) seem to think there is not much evidence.But I want to see how many had high levels of D and/or C before they got infected and died. I may be waiting a long time for that one.

I had covid before Xmas - I supplemented as suggested by Patrick Holford - 1 gram of powdered vitamin c and zinc every hour for the first 2 days and continued less frequently into the third day as well. It did cause loose bowels but I didnt have covid badly. I will never know if it helped or not but it didnt do any harm. I also had high levels of vitamin d.

OK guys, after all of these studies pointing to benefits for Vit D,, here is one that goes against the grain. Hey, I want readily available stuff(D, C, zinc, etc) to help, but it is all about the science. What ever the numbers show is what they show, So there have been several clinical trials and must be about 20 observational studies all in favor of D vs covid. But this not only shows zero help for D, but apparently even some possible harm against Covid patients. I see that they looked at monthly doses totaling a minimum of 25,000 IU, averaging 800IU/day. But that was the minimom, it was actually a higher dose. If that included any large monthly doses rather than steady daily doses, previous studies have shown that does not work as well as smaller daily doses. So maybe that is a factor, but I don't know for sure :
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7657015/
"Information on supplementation with 25OHD (defined as at least 25,000 IU/mo in the last 3 mo, ~800 IU/d), weight status, comorbidities, serum 25OHD, COVID-19 diagnosis, and related hospitalization and in-hospital mortality were gathered by direct interview and validated through the consultation of institutional electronic charts and linkage to the regional register of health care data.........................

The use of 25OHD supplements (mean intake, 58.846 IU/mo) was reported by 38 (11.7%) participants out of 324. Clinical and demographic features of supplement users and non-users were comparable. Serum 25OHD levels of supplemented inpatients (n = 11) were about 3-fold higher than those of non-users. However, among these participants, two had insufficient levels (20–30 ng/mL; range, 24.7–29.4 ng/mL) and three presented a deficiency status (<20 ng/mL; range, 18.0–19.7 ng/mL). Forty-three (21.8%) out of 197 participants with COVID-19 identified through the phone survey required hospitalization, and 47 (27.6%) of hospitalized patients (n = 170) died. The use of 25OHD supplements was not associated with either hospitalization or in-hospital mortality, although a trend toward a 2-fold higher risk of death was found for supplement users, particularly after adjusting for potential confounders (Table 2 ).............".

Oh, wait, I think I see some questionable stuff that could lead to higher mortality- though all of this is supposed to be adjusted for? In the D supplemented group, 15% had cancer vs 7%. And 32% of the supplemented group had Parkinsons, vs slightly more than the other group. But, the non supplemented group had a bit more diabetes and COPD, so maybe that is all a wash? However, do see a BIG mismatch in over all numbers- 286 in the non supplemented group vs only 38 supplemented. Could that mess things up? Regardless, hospitalization was 26% in the D group and 21% in the non D group, mortality 38% for D vs 26% in the non supplemented. So, D losses.

"We recognize the following limitations. First, a larger study population, along with multicenter participation, would have resulted in increased statistical power and bias reduction. However, we were not able to perform a valid calculation of the sample size, due to the emergency crisis and the heterogeneity in published data on outcomes and use of supplements. Indeed, we recognize that the emergency crisis was a source of bias itself, as it is likely that only individuals with the worst cases were hospitalized in our outbreak area. Finally, in agreement with Italian recommended dietary allowances [14], we decided to define supplementation as an intake of at least 25 000 IU/mo (~800 IU/d) in the previous 3 mo. It is not at all clear that supplements of <1000 IU/d are likely to make much difference compared with larger ones. However, the mean intake for participants taking supplements was >54000 IU/mo (>1800 IU/d), resulting in adequate circulating levels in most participants assessed.

In conclusion, 25OHD supplementation was not associated with hospitalization but appeared to be a risk factor for higher in-hospital mortality in COVID-19. Further studies are needed to clarify the role of vitamin D supplementation and status in modulating the severity of COVID-19, as well as preventing it.".

Post Edited (BillyBob@388) : 1/10/2021 7:34:07 PM (GMT-7)