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COVID etc. prevented and treated with 50,000 IU Vitamin D capsules - July 2022


Rapidly Increasing Serum 25(OH)D Boosts the Immune System, against Infections—Sepsis and COVID-19

Nutrients 2022, 14, 2997. https:// doi.org/10.3390/nu14142997
Sunil J. Wimalawansa Endocrinology & Nutrition, Department of Medicine, Cardiometabolic & Endocrine Institute, North Brunswick, NJ 08873, USA; suniljw at hotmail.com

PDF Table of Contents

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Most of the figures and tables

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A suitable daily or weekly maintenance dose to be started after completing the loading-dose schedule. The dose should be adjusted for those who are overweight (higher) or underweight (lower). ** To convert ng/mL to nmol/L, multiply the amount in ng by 2.5; One ug = 40 IU. $ Mentioned replacement doses can be taken as single, cumulative doses, two to three times a week spread out over a few weeks. $$ From the day one of week two onwards. # Estimated total vitamin D dose needed to replenish the body stores (i.e., the deficit) is provided in the last column.


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Example of a daily or once-a-week dose range for adults with specific body types (based on BMI for white Caucasians and body weight for other ethnic groups). Appropriate dose reductions are necessary for children. #For those with chronic comorbid conditions, such as hypertension, diabetes, asthma, COPD, CKD, depression, and osteoporosis, and to reduce all-cause mortality, higher doses of vitamin D are needed. For them, one can use the doses that are recommended for persons with obesity (BMI, 30-39: the third row). $ Those with multiple sclerosis, cancer, migraine headaches, and psoriasis, and those routinely taking medications such as anti-epileptic and anti-retroviral agents that significantly increase the catabolism of vitamin D should consider taking age- appropriate doses recommended for those with morbid obesity (BMI > 40; the higher end of the daily doses in the fourth row).


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Calcifediol [partially activated vitamin D3, 25(OH)D]. ** Use the earliest possible in person with COVID-19, sepsis, Kawasaki disease, multisystem inflammatory syndrome, acute respiratory distress syndrome, burns, and vitamin D deficiency in early pregnancy and other clinical emergencies. # Measurement (or the concentration) of serum 25(OH)D is unnecessary. ## If calcifediol is unavailable, the equivalent dose of vitamin D is administered, as illustrated in Table 2, preferably in divided doses over three to five days. Irrespective of the regimen used, daily or weekly follow-up maintenance vitamin D dose is necessary as described in the text.


Abstract

Vitamin D deficiency is a global public health problem, a pandemic that commonly affects the elderly and those with comorbidities such as obesity, diabetes, hypertension, respiratory disorders, recurrent infections, immune deficiency, and malignancies, as well as ethnic minorities living in temperate countries. The same groups were worst affected by COVID-9. Since vitamin D deficiency weakens the immune system, it increases the risk of infections, complications, and deaths, such as from sepsis and COVID-19. Deficiency can be remedied cost-effectively through targeted food fortification, supplementation, and/or daily safe sun exposure. Its endocrine functions are limited to mineral metabolism, musculoskeletal systems, specific cell membrane interactions, and parathyroid gland functions.
Except for the rapid, endocrine, and cell membrane-based non-genomic functions, all other biological and physiological activities of vitamin D depend on the adequate intracellular synthesis of 1,25(OH)2D (calcitriol) in peripheral target cells via the genome.
Calcitriol mediates autocrine (intracrine) and paracrine signalling in immune cells, which provides broader, protective immune functions crucial to overcoming infections. The synthesis of 1,25(OH)2D (calcitriol) in peripheral target cells is dependent on diffusion and endocytosis of D3 and 25(OH)D from the circulation into them, which requires maintenance of serum 25(OH)D concentration above 50 ng/mL.
Therefore, in acute infections such as sepsis and respiratory infections like COVID-19, it is necessary to rapidly provide its precursors, D3 and 25(OH)D, through the circulation to generate adequate intracellular calcitriol. Immune defence is one of the crucial non-hormonal functions of vitamin D.

A single oral (bolus) dose or divided upfront loading doses between 100,000 and 500,000 IU, using 50,000 IU vitamin D3 increase the serum 25(OH)D concentrations to a therapeutic level of above 50 ng/mL that lasts between two to three months.
This takes three to five days to raise serum 25(OH)D. In contrast, a single oral dose of calcifediol (0.014 mg/kg body weight) can generate the needed 25(OH)D concentration within four hours.
Considering both D3 and 25(OH)D enter immune cells for generating calcitriol, using the combination of D3 (medium-term) and calcifediol (immediate) is cost-effective and leads to the best clinical outcome.

To maximise protection against infections, particularly to reduce COVID-19-associated complications and deaths, healthcare workers should advise patients on safe sun exposure, adequate vitamin D supplementation and balanced diets containing zinc, magnesium, and other micronutrients to support the immune system.
Meanwhile, governments, the World Health Organisation, the Centers for Disease Control, and governments should consider similar recommendations to physicians and the public, change the outdated vitamin D and other micronutrient recommendations directed to their population, and organise targetted food fortification programs for the vulnerable groups.
This article discusses a rational approach to maintaining a sustained serum 25(OH)D concentration above 50 ng/mL, necessary to attain a robust immune system for overcoming infections. Such would cost-effectively improve the population's health and reduce healthcare costs. It also describes three cost-effective, straightforward protocols for achieving and sustaining therapeutic serum 25(OH)D concentrations above 50 ng/mL (>125 nmol/L) to keep the population healthy, reduce absenteeism, improve productivity, and lower healthcare costs.
 Download the PDF from VitaminDWiki


Conclusions

A robust immune system is essential to overcome infections without complications. It depends on the adequate entry of vitamin D3 and 25(OH)D into immune cells for generating calcitriol. The latter required maintaining a serum 25(OH)D concentration of over 50 ng/mL. Therefore, to successfully manage and overcome an infectious epidemic or a pandemic, it is crucial to maintain the population's serum 25(OH)D concentration above the mentioned therapeutic level.

In acutely ill persons, especially those with vitamin D deficiency having infections, raising serum D3 and 25(OH)D concentrations quickly is paramount and life-saving. In these urgent situations, 0.5 to 1.0 mg of calcifediol can raise serum 25(OH)D concentrations above the minimum therapeutic levels of 50 ng/mL in four hours and boosts the immune system within a day that facilitates to overcome infections.

While calcifediol raises serum 25(OH)D within hours, the oral administration of even high doses of vitamin D takes three to five days to raise serum 25(OH)D concentrations. This delay is due to its less efficient absorption than calcifediol and the need for vitamin D to undergo 25-hydroxylation in the liver, a rate-limiting step. In acutely ill patients, as in those in the ICU, administering even high doses of oral D3 may take a week to increase serum 25(OH)D concentration. Therefore, it is unhelpful in emergencies like SARS-CoV-2 infections.

With a weight-based, single dose of calcifediol, as described in Table 3, circulatory 25(OH)D concentrations are maintained for approximately 8 to 14 days. In contrast, parental high dose vitamin D3, administered as loading or bolus, will maintain serum 25(OH)D concentrations between two to three months. Although the circulatory half-life of D3 is short, due to the larger initial doses, it maintains a higher circulatory concentration of both D3 and 25(OH)D for several weeks—partly because of the release from the storage in fat and muscle tissues.

Therefore, with calcifediol, one should administer a suitable higher dose of vitamin D3. This can be done using 50,000 IU vitamin D capsules in outpatients' setups and emergencies, as illustrated in Table 3. Nevertheless, considering the non-genomic beneficial actions of vitamin D3 and its longer duration of physiological actions described above, the combination of D3 and calcifediol provides better clinical outcomes than either alone. Therefore, administering the proper doses of D3 and calcifediol is recommended for patients with infections as an adjunct therapy at the first outpatient or inpatient encounter.

Multiple observational and RCTs have demonstrated that serum 25(OH)D concentrations (pre-infection or on admission) inversely correlated with the incidence, severity, and rates of death from COVID-19 [45,55,56,153. Meanwhile, vitamin D supplementation significantly reduces complications and deaths [33,44,45,150,154]. Irrespective of the regimen, initial bolus or loading doses of vitamin D and/or calcifediol should follow a daily or weekly, longer-term maintenance regimen [11,118,155].

The described schedules in the three tables are highly cost-effective ways to raise serum 25(OH)D concentrations and maintain it to keep the immune system on high alert. Consequently, it prevents and/or reduces infections and complications from COVID-19 and other infections. For non-obese 70 kg adults, the recommended longer-term vitamin D3 maintenance dose is 5000 IU/(0.125 gg) day or 50,000 IU (1.25 mg)/week (or every ten days). Nevertheless, this regimen takes a few months to reach the desired serum 25(OH)D concentration above 50 ng/mL. It can be expedited by ingesting vitamin D, 10,000 IU/day (250 gg/day) for 8 to 10 weeks and reverting to the daily dose of 5000 IU.

Rectifying vitamin D deficiency costs less than 0.1% of the costs related to evaluating and treating comorbidities and complications associated with vitamin D deficiency [156]. For example, in western countries, vitamin D supplementation to maintain serum 25(OH)D costs approximately $8 per person/year, versus an average cost of $5000 to $15,000/year per person to manage vitamin D deficiency-associated diseases and related complications [156]. Despite a favourable cost-benefit ratio, availability as a non-prescription over-the-counter nutrient, and exemplary safety profile, millions of people become ill due to vitamin D deficiency requiring medical attention, markedly increasing the cost of healthcare. Vitamin D deficiency increases healthcare costs, absenteeism and opportunity costs and reduces productivity.

Considering the described significant benefits associated with disease prevention, reduced illness severity, reduced absenteeism, complications and deaths, improved wellbeing and higher productivity, the calculated overall cost-benefit ratio for administered vitamin D3 supplements exceeds 1 in 20,000. Despite these data, no country is yet to recommend vitamin D (or has published proper guidelines with the right doses) for disease prevention or recommended it as an adjunct therapy to prevent complications and deaths from infections or other diseases. This report provides rationale, justifications, straightforward guidance, and practical tables that provide regimens for use in clinical practice for achieving and maintaining the serum 25(OH)D concentrations needed to ensure a robust immune system that helps to overcome infections, including SARS-CoV-2.


VitaminDWiki – COVID-19 treated by Vitamin D - studies, reports, videos

As of Nov 25, 2022, the VitaminDWiki COVID page had:  19 trial results,   37 meta-analyses and reviews,   Mortality studies   see related:   Governments,   HealthProblems,   Hospitals,  Dark Skins,   26 risk factors are ALL associated with low Vit D,   Recent Virus pages   Fight COVID-19 with 50K Vit D weekly   Vaccines   Take lots of Vitamin D at first signs of COVID   116 COVID Clinical Trials using Vitamin D (08/2022)
5 most-recently changed Virus entries


A few publications on 50 ng of Vitamin D to fight COVID


40-150 ng of Vitamin D need to treat various health problems

Vitamin D Treats
150 ng Multiple Sclerosis *
80 ng Cluster Headache *
Reduced office visits by 4X *
70 ngSleep *
60 ngPreeclampsia RCT
50 ng COVID-19
Fertility
Psoriasis
Infections Review
Infection after surgery
40 ng Depression
ACL recovery
Hypertension
Asthma?
30 ng Rickets

* Evolution of experiments with patients, often also need co-factors


See also VitaminDWiki

Wimalawansa

Nomograms of 50K dosing to get to 50 ng

Suggested dosing to get 50 ng of Vitamin D (if healthy) - July 2022 - based on Wimalawansa
Horizonal axes: body weight Black = kilograms, Red = pounds
Vertical dose axis: Black = milligrams or IU
Vertical dose axis: Blue= IU per week;
Vertical dose axis:Purple = days between 50,000 IU capsules

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Comments by readers on this publication

Thanks Henry - this is one of the best, accurate papers I've read. I believe differently concerning the calcifediol than the authors - of course, giving 25-OH D (calcifediol) is going to have a higher measured 25-OH D level - but that does not necessarily mean that the amount of fully activated D (1,25) is any less than required by the body. I believe that since D can be fully activated ih the periphery, as well as deactivated, that this is a push-through phenomenon. Provided that enough D3 is given such that the liver capacity to 25-OHylate is saturated (about 15-20,000 IU/day D3) that the body will push-through activate what is needed, where it is needed, in the amount needed and deactivated when no longer needed. This is likened to the function of the common light switch on the wall.
If you look at this site listed below - you'll see why I don't want to implant the idea that docs should be instructing patients to take or hospitals to have calcifediol on the formulary. Dave M

https://clincalc.com/DrugStats/Drugs/Calcifediol
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Thank you Sunil,

This is most comprehensive. I think it helps that it is very repetitive on certain points. There's nothing like repetition to make sure a point is made! The 50 ng/mL minimal ideal level may have been mentioned 50 times and the importance of the half-iife almost as often, but this is the point of the article, to not allow anyone to be able to ignore these finding. I like the allowance for, and even recommendation for bolus dosing, but with guidelines on maximum days between doses.

I also appreciate the particulars, early in the document, on some of the exact ways immune system integrity is maintained:

"As described in the next section, 25(OH)D and 1,25(OH)2D also mediate rapid non-genomic actions that are vital for some physiological actions, including endocytotic cellular entry of precursors, the integrity of tight junctions in epithelial and endothelial cells, and immune responses."

It seems endothelial cell boundaries in both vascular and intestinal tissue will be compromised significantly without significant levels of vitamin D:

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803557/
  • https://pubmed.ncbi.nlm.nih.gov/17962355/
  • https://pubmed.ncbi.nlm.nih.gov/21115878/

I'm guessing Henry has references to these vitamin D insufficiency situations, but I did not bother to search his site. I'm just happy to see some specifics on some of the immune system impairments possible if one is low in 25(OH)D.

Glenn Atkisson, Saint Clouid, FL, USA


VitaminDWiki videos with TRANSCRIPT in title

This list is automatically updated

Items found: 41
Title Modified
COVID deaths: 3rd as many if any dose, half as many if 50K IU Vitamin D – Campbell transcript Nov 2022 21 Nov, 2022
Moving Vitamin D Research into Practice - Video and transcript - Baggerly - Oct 2021 12 Oct, 2022
COVID infection might prevent infection better than vaccinations - transcript and many studies 11 Oct, 2022
Debunking Misinformation About Vitamin D - Grant podcast and transcript - Sept 2022 21 Sep, 2022
Vitamin D and COVID - satirical comedy (with transcript) by Jimmy Dore - Aug 2022 08 Aug, 2022
4 X fewer visits to Dr. after getting high level of vitamin D (Interview with transcript) - Jan 3, 2022 17 Jul, 2022
Interview with transcript of Dr. Grant on Vitamin D and Cancer by Dr. Moss - June 2022 23 Jun, 2022
Boost Your Immune System, Fight Viruses - Medcram with transcript - Oct 29, 2021 22 Jun, 2022
Transcripts in VitaminDWiki 22 Jun, 2022
Vitamin D reduces autoimmune disease - Dr. Campbell video and transcript - May 2022 30 May, 2022
Wonders of Vitamin D - Renu Mahtani video and transcription - Feb 2022 12 Mar, 2022
VitaminDWiki interview and transcript - Jan 2022 01 Mar, 2022
Cluster Headaches treated by high-dose Vitamin D, etc. (interview and transcript) - Feb 2022 23 Feb, 2022
Vitamin D and COVID - Davies, Benskin (Dark Horse video with transcript) - Dec 27, 2021 29 Dec, 2021
PhD working at VAERS on problems with vacc system - Masterjohn interview and transcript- Dec 27, 2021 27 Dec, 2021
Dr. McCullough on COVID-19: vaccine problems, home treatment – video, slides, transcript – Oct and Dec 2021 22 Dec, 2021
Vitamin D and a Dr. in Israel - Campbell video and transcript - Dec 11, 2021 13 Dec, 2021
Omega-3 decreases heart disease and COVID: Harris and Patrick, video and transcript - Dec 2021 07 Dec, 2021
Vitamin D probably has a Role in Cancer, CVD, and COVID - video and transcript Dec 1, 2021 02 Dec, 2021
Discussion of COVID and 50 ng of Vitamin D (video and transcript)– Dr. Campbell Nov 17, 2021 19 Nov, 2021
End of Alzheimer's video and transcript - Oct 2021 09 Nov, 2021
Vitamin D and Health video with transcript - Dr. Grant Sept 2021 11 Sep, 2021
In-home testing of viral load, etc. Dr. Topol interview with transcript – Aug 11, 2021 14 Aug, 2021
Your Brain on Covid-19 Long-Haul, Dr. Galland video and transcript - Aug 1, 2021 07 Aug, 2021
COVID-19 doctors not allowed to use treatments that work - Dr McCullough Video and transcript May 2021 11 Jul, 2021
Problems with vaccine use during a pandemic - Dr. Bossche interview with transcript - April 22, 2021 28 May, 2021
Vitamin D fights many health symptoms, including COVID-19: Dr. Mahtani video and transcript - April 2021 23 Apr, 2021
Vitamin D, COVID - Campbell and Davis (Video with transcript) - Jan 18, 2021 21 Apr, 2021
Autoimmune and high-dose vitamin D (Dr. Coimbra) - Dr. Mahtani video and transcript - Nov 2020 11 Apr, 2021
The Health Benefits of Vitamin D and Solar UVB (video and transcript) - March 2021 27 Mar, 2021
COVID public health messages 1, 2, and 3 should be - vitamin d vitamin d, vitamin d (video and transcript) - Mar 5, 2021 16 Mar, 2021
Vitamin D Help Us Fight Infections - interview of Dr. Thakkar (transcript) Jan 20, 2021 24 Jan, 2021
COVID-19 Vitamin D: Overview by Dr. in Sri Lanka (Video and transcript) - Dec 8, 2020 26 Dec, 2020
COVID-19 Vitamin D: Overview of Evidence by Dr. Seheult (Video and transcript) - Dec 10, 2020 14 Dec, 2020
Vitamin D Toxicity - an unmerited fear - Renu Mahtani video and transcription - Oct 2020 10 Oct, 2020
Dr. Coimbra on Coronavirus and Vitamin D (English transcript) - Jan 2020 31 Jan, 2020
Dr. Sears podcast with Carole Baggerly about Vitamin D (with transcript) - July 2019 05 Jul, 2019
Vitamin D, trauma, and blacks - Dr. Matthews interview with transcript - Jan 2019 15 May, 2019
Sleep, Vitamin D, B Vitamins, jaw, etc. Dr. Gominak transcript - 2016 31 Jan, 2019
History of Dr. Cannell and Vitamin D Council - Podcast with transcript - Dec 2014 05 Dec, 2014
Vitamin D and bone health - Univ of Maryland video and transcript May 2010 02 Jul, 2010

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18156 S-T3.jpg admin 21 Jul, 2022 22:51 98.18 Kb 209
18155 S-T2.jpg admin 21 Jul, 2022 22:50 117.94 Kb 205
18154 S-table.jpg admin 21 Jul, 2022 22:49 90.98 Kb 189
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18151 S-F5 Outcomes.jpg admin 21 Jul, 2022 22:48 77.04 Kb 205
18150 S= F4 Calcitriol.jpg admin 21 Jul, 2022 22:48 101.13 Kb 203
18149 S-F2 Deaths.jpg admin 21 Jul, 2022 22:48 43.85 Kb 212
18148 S- F2.jpg admin 21 Jul, 2022 22:47 49.76 Kb 211
18147 ToC Sunil.jpg admin 21 Jul, 2022 19:45 123.34 Kb 244
18146 Sunil July 2022_CompressPdf.pdf PDF 2022 admin 21 Jul, 2022 19:45 812.37 Kb 51
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