Table of contents
- PDFs of the study - in Italian and Google Translated English
- Press Release - March 27
- Response by the authors of the press release March 28 to the questions asked further down this page
- Vitamin D against Coronavirus? Just a guess - March 28
- Coronavirus, study by the University of Turin: taking more vitamin D to reduce the risk of infection - March 26
- COVID-19 news on VitaminDWiki
PDFs of the study - in Italian and Google Translated English
Download the Italian PDF from VitaminDWiki
Download the Translated PDF from VitaminDWiki
thanks to Bruce for processing the translation
Press Release - March 27
Translated from Italian by Google Translate
Hypovitaminosis-De-Coronavirus-225-March-2020
If the world of information were healthy, this press release would have been sent back to the sender to then talk about it in front of the real data, because at a time like this we need less than anything to give voice to any hypothesis that comes up. But the world of information is not healthy and therefore we see things going on the front page that have no basis just because they come from someone affiliated with some institution that knows how to move to end up in the newspapers.
Something interesting in this story, however, is and is the line in which it fits: a dispute over the role of vitamin D that has lasted for a hundred years now. I talked about it extensively in my latest book "The hidden science of cosmetics" (Chiarelettere, 2020) and you can find a summary of it in this video that I published on my Youtube channel (you can get there by clicking on the image below).
Since it was discovered in the 1920s to the present day, vitamin D has reached " special surveillance " status for the Italian Medicines Agency. Consumption of vitamin D supplements has in fact grown dramatically in recent years. In the United States, there has been a nine-fold increase over the previous decade and tests for measuring blood values of vitamin D have increased by 500 percent. In Italy, the market has reached 300 million euros and the advice to be exposed to the sun without protection is also very fashionable, perhaps in the hottest hours to "stock up". There is in fact the belief that sunscreen prevents the synthesis of vitamin D.
All these aspects fall within one of the textbook cases of what is called "disease mongering", that is, the invention of a disease, the more or less deliberate action to raise the threshold of the threshold values transforming people from one day to the next healthy in sick people and creating and growing new markets for drugs and supplements.
The most important moment in this long history dates back to ten years ago, when the US National Academy of Medicine published a report on the state of vitamin D levels in the American population. A thousand pages in which the NAM concluded that there were no reasons for concern and suggested general practitioners to prescribe the test and possible integration to patients who showed serious symptoms and relative serious deficiencies.
There is no unanimous consensus on the physiological quantities of vitamin D in circulation in the scientific literature. What is known for sure is that values below 8-10 nanograms per milliliter (ng / ml) of blood give bone problems. However, values between 20 and 50 ng / ml are considered physiological, that is normal, even if these numbers can be very different depending on who goes to look at them. In fact, the NAM put the stake at 20 ng / ml according to the majority of the published studies.
Michael Holick did not like these numbers, the name that always comes up when it comes to vitamin D. Holick was a great scientist, he made important discoveries and had prestigious collaborations. I say he "had" because over time he has lost much of his credit in the scientific community and has had to resign from the Department of Dermatology at Boston University.
Holick, faced with the report of the National Academy of Medicine that clashed with what he believed, decided to take action and the following year, he came out with a study in the Journal of Clinical Endocrinology & Metabolism, the reference journal for American general practitioners, in which it raised the norm to 30 ng / ml thus demonstrating that almost half of the American population was deficient in vitamin D.
The market for tests and supplements has skyrocketed, as has the listing of Holick who has become one of the main advisors of most companies involved in the vitamin D market.
Michael Holick was also the first to recommend exposure to sun or the use of unprotected sun beds to raise vitamin D levels. A move that brought him funding from the UV Foundation, a trade association of sun bed manufacturers.
In the meantime, studies on the widespread use of vitamin D supplements have led to greatly reducing expectations. The effects would be evident only in patients with very serious deficiencies and only to prevent or treat certain specific conditions. In the face of these poor benefits there arethe risks, which are by no means negligible. If with the production of vitamin D following exposure to ultraviolet rays our body is able to regulate itself, producing only the amount it needs, when we talk about integration it may not be so difficult to exaggerate.
If you take too much, for example after reading articles like those published these days, you run the risk of getting intoxicated with paradoxically damage to your bones.
To try to make order in the chaos of the threshold values and test prescriptions, on 22 October 2019 the «Official Gazette» published the AIFA Note 96"Relating to the prescription of the drugs indicated for the prevention and treatment of vitamin D deficiency in adults", in which the bar is actually brought back to where it should be: 20 nanograms per milliliter. Only those with lower values and at the same time presenting symptoms of hypovitaminosis will be able to access the repayment of the so-called mutual. Similarly, prescriptions for pregnant or breastfeeding women and for people with diagnosed diseases related to a reduction or malabsorption of vitamin D will be reimbursed. Furthermore, in the Note it is recommended that "the dosage should be performed in a limited number of patients with persistent symptoms of deep asthenia, myalgias, diffuse or localized bone pain suspected of osteomalacia or with high Pth or predisposition to unmotivated falls or in particular risk conditions ". If this measure indicates the end of the carpet tests and of the measures "just to do a check" we will find out later. Certainly it is a clear and courageous step that cannot be ignored by doctors.
Unfortunately, the whole supplement sector remains the most open and decidedly unregulated.
In times like the one we are experiencing, we need clear indications from the institutions on what to do to reduce the infection, but we would also need a greater sense of responsibility both from the scientists who, however in love with their idea, should learn to release the results only after having produced and verified them, both by the media and in the face of scientific news, they seem totally unprepared and at the mercy of the wild release, ready to publish anything with a semblance of scientificity.
It does not work like that. It shouldn't work that way.
--
Response by the authors of the press release March 28 to the questions asked further down this page
Dear Dr. Mautino,
In reference to what you expressed on the blog "The waxing of Occam" regarding our document "Possible preventive and therapeutic role of vitamin D in the management of the pandemic from COVID-19", and the type of emphasis given to this by the means of communication, there is an obligation to send you some considerations that we hope will better clarify the meaning and spirit of our work.
- 1) Our document stems from the question, for now unanswered, about the presence of the anomalous virulence that has been recorded in Italy and Spain, and even earlier in China, of the pandemic: in an effort to find some peculiarities that differentiate our Country and that could promote the spread of virosis, we focused our attention on the lack of Vitamin D, to transmit to the scientific community a reflection, perhaps banal but not superficial, to give a constructive contribution in this sad story and to trigger a scientific reflection which could be very useful.
- 2) You may notice that in no part of the press release on the University website, which should be considered the official source, we speak of "study": https: //www.unitonews.it/index.php/it/ne ... . In any case, a literature study has been done, and in depth. It is a scientific custom to report not only new data, but also published data. They are "given" to each other.
- 3) The "data" that we have not disclosed in detail are preliminary, as explicitly stated, and their disclosure will follow the classic channels of scientific communication, therefore with longer times. Being the document based on literature analysis, it seemed useful to report a preliminary verification on the field.
- 4) The bibliographical references reported in the document were not chosen by us with an "arbitrary" criterion, but on the basis of precise criteria of importance and scientific weight: everything was summarized in a draft that was initially submitted to the Members of the Academy of Medicine of Turin, some of whom confirmed that they had checked the references or even carried out an individual bibliographic research before publicly exposing the name of the Academy on this topic. Overall, the reported data were defined as "very interesting", with typical scientific prudence.
- 5) You will have noticed that the document is studded with references with hyperlinks to published articles, most of which are original studies that report the results of clinical and preclinical studies, which can be immediately opened and checked. In addition to countless original works and published reviews we have mentioned a preprint, which does not present original data but is in turn a very recent review on the subject, to make available to readers the one hundred and seventy references contained therein, some of which we have also entered directly as links in the text after careful screening.
- 6) As regards the observations on the prescriptive inadequacy to which Vitamin D would have been subjected, we prefer not to express ourselves as this problem, which is certainly present, is beyond the scope of our initiative. In any case, in our document we clearly indicate the reference value of 20 ng / ml as that on which there is the widest consensus.
- 7) We also agree on the opportunity to underline that incorrect descriptions of the document that give the idea of a clinical study must be avoided, which is not and does not want to be. However, the fact that the document is not a published study does not render the countless studies cited there less valid and relevant. We praise the spirit that animated the drafting of the text in the blog, aimed at promoting correct scientific dissemination.
We really hope to have provided you, with the necessary transparency in a scientific debate, a more exhaustive picture than what is reported in the meager press release, and thanking you for your attention, we take this opportunity to send you our best regards.
Enzo Medico and Giancarlo Isaia
Vitamin D against Coronavirus? Just a guess - March 28
Translated from Italian by Google Translate
There are no ongoing studies that have tested the effectiveness of this hormone in contagion or against complications from covid-19. Bronte, immunologist at the University of Verona: "In this moment of emergency we must be careful with information"
by TIZIANA MORICONI
For some days now the news has been circulating that vitamin D may be useful to people most at risk of contagion from Covid-19 or complications. The basic idea is that a deficiency of it can be a risk factor. Two teachers from the University of Turin - from Geriatria, Giancarlo Isaia, and from Histology, Enzo Medico - have in fact written a reportat the Academy of Medicine of Turin where it is suggested "to doctors, in association with well-known general prevention measures, to ensure adequate levels of Vitamin D in the population, but especially in those already infected, in their relatives, in the staff health care, in frail elderly people, in guests of welfare residences, in people in a cloistered regime and in all those who for various reasons do not expose themselves adequately to sunlight ". Furthermore - reads the report - " Intravenous administration of calcitriol (the active form of vitamin D, ed. ) Could be considered in patients with Covid-19 with particularly impaired respiratory function".
No clinical studies
It should be said immediately that the reflection - that the two professors are not the only ones to do on the international scene - is based on some literature data on the general deficiency of vitamin D and its possible role in respiratory tract infections. Among the sources cited, the one that assumes a role against the coronavirus refers to a review of "narrative" of several studies presented on an open platform, Preprints ( By Grant, Lahore, etc. on VitaminDWiki ) , and not in a scientific journal with peer review.
In short, as the scientific popularizer Beatrice Mautino has pointed out on her blog La cerca di Occam on Le Scienze, there is no study from the University of Turin (and still not from other centers) that has demonstrated the effectiveness of a vitamin supplementation D against complications fromcoronavirus , such as interstitial pneumonia .
The rules for using medications don't change
"As never before, we are witnessing a multiplication of theories on the possible usefulness of various drugs, not only vitamin D, with and without scientific rationale," says Vincenzo Bronte, Professor of Immunology at the University of Verona, Airc researcher and coordinator of a study on the characteristic immunological aspects of Covid-19 - “Know him to defeat him. Alliance against COVID-19 (ENACT) ”of the University of Verona, funded by the Cariverona Foundation and co-funded by the TIM Foundation. “This great interest is certainly important - continues Bronte - but the rules of the scientific community for using a drug remain the same, even in this circumstance. Before saying that a substance is useful for complications from Coronavirus, it must be proven in a clinical study. At the time of these studies there are none ”.
The focus, now, is in fact on the use of drugs such as anti-inflammatory, antiviral and an old anti-malaria drug, chloroquine, and several randomized studies are underway to establish efficacy, dosages, indications. Applications of other support drugs remain hypotheses for now.
The age-old question of vitamin D
The question of the effectiveness of vitamin D for uses other than bone health is long-standing and controversial. So much so that the Medicines Agency last autumn restricted the pathologies and categories of people for which it can be reimbursed by the health system. Until then, it was instead prescribed to anyone and also for the prevention of cardiovascular diseases, strokes or tumors, although there is no clear scientific evidence that it is really useful for all this. Aifa put it black on white: it is ineffective and inappropriate for such indications. The problem is that the data are contradictory: if it is true that a deficiency of vitamin D has been associated with a greater risk of various pathologies, it is also true that clinical studies (in the USA the Vitamin D and the immune system
"We know some of the effects of vitamin D on the immune system and we know for example that it certainly has an action in the skin, where it is produced," explains Bronte: "In this district it helps to maintain the functions of the immune system. Like hormone, it can then affect several lymphocyte populations, but studies that have proven the effect of vitamin D on immunity are few, and in fact there is no indication to date to use this drug as an immunomodulator. In patients, we are seeing changes in many blood parameters, not only of vitamin D, but it is also difficult to determine whether they were present before the general decline in function or if they are a consequence. It is true - he continues - that it is often said that since vitamin D does not hurt, we might as well give it.
In short, as the scientific popularizer Beatrice Mautino has pointed out on her blog La cerca di Occam on Le Scienze, there is no study from the University of Turin (and still not from other centers) that has demonstrated the effectiveness of a vitamin supplementation D against complications fromcoronavirus , such as interstitial pneumonia .
The rules for using medications don't change
"As never before, we are witnessing a multiplication of theories on the possible usefulness of various drugs, not only vitamin D, with and without scientific rationale," says Vincenzo Bronte, Professor of Immunology at the University of Verona, Airc researcher and coordinator of a study on the characteristic immunological aspects of Covid-19 - “Know him to defeat him. Alliance against COVID-19 (ENACT) ”of the University of Verona, funded by the Cariverona Foundation and co-funded by the TIM Foundation. “This great interest is certainly important - continues Bronte - but the rules of the scientific community for using a drug remain the same, even in this circumstance. Before saying that a substance is useful for complications from Coronavirus, it must be proven in a clinical study. At the time of these studies there are none ”.
The focus, now, is in fact on the use of drugs such as anti-inflammatory, antiviral and an old anti-malaria drug, chloroquine, and several randomized studies are underway to establish efficacy, dosages, indications. Applications of other support drugs remain hypotheses for now.
On Futura News , the head of the Master in Journalism Giorgio Bocca of the University of Turin, Prof. Medico reiterated that theirs is not a clinical study, but an analysis to focus on the topic: "Over the past few weeks, some colleagues from the Turin Hospital have reported a widespread vitamin D deficiency in patients admitted to be positive to Covid-19. We therefore decided to collect a series of clinical studies to try to give a more organic picture of the issue. In the sources we cited, over 12 thousand cases are taken into consideration and the publications are both for and against the beneficial thesis. of vitamin D. We did everything in an extremely delicate and balanced way, without unbalancing ourselves, but reporting evidence that the scientific community had been aware of for some time. Many colleagues - he added - although they are often working in really precarious conditions,they took an interest in our work and a discussion has started which we hope will be constant and lasting ".By Grant, Lahore, etc. on VitaminDWiki) , and not in a scientific journal with peer review.
In short, as the scientific popularizer Beatrice Mautino has pointed out on her blog La cerca di Occam on Le Scienze, there is no study from the University of Turin (and still not from other centers) that has demonstrated the effectiveness of a vitamin supplementation D against complications fromcoronavirus , such as interstitial pneumonia .
Coronavirus, study by the University of Turin: taking more vitamin D to reduce the risk of infection - March 26
Translated from Italian by Google Translate
The first data collected in these days indicate that hospitalized patients have a very high prevalence of Hypovitaminosis D
by JACOPO RICCA, March 26, 2020
Coronavirus, study by the University of Turin: taking more vitamin D to reduce the risk of infection
Scientists from the University of Turin recommend taking vitamin D to combat the coronavirus pandemic . The study of the professors of Geriatria, Giancarlo Isaia , and Histology, Enzo Medico , was submitted to the members of the Turin Academy of Medicine who considered the first results to be "very interesting". The document analyzes possible causes for the contagion from Covid-19 and proposes vitamin D certainly not as a cure, but as a tool to reduce risk factors.
The first preliminary data collected in these days in Turin indicate that patients hospitalized for Covid-19 have a very high prevalence of Hypovitaminosis D. "The compensation for this widespread vitamin deficiency can be achieved primarily by exposing it to sunlight as far as possible, even on balconies and terraces, feeding on foods rich in vitamin D and, under medical supervision, taking specific pharmaceutical preparations "say the researchers.
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The analysis, also carried out following the recent recommendations of the British Dietetic Association, investigated the role that the lack of Vitamin D could play, which in Italy affects a large portion of the population, especially the elderly, in this pandemic. In the document, the authors suggest to doctors, in association with the well-known general prevention measures, to ensure adequate levels of Vitamin D in the population, "but above all in those already infected, in their relatives, in healthcare personnel, in frail elderly people, in the guests of the welfare residences, in people in a cloistered regime and in all those who for various reasons do not expose themselves adequately to sunlight ". In addition, administration of the active form of Vitamin D could also be considered,
"These indications derive from numerous scientific evidences - the professors write - Who have shown an active role of Vitamin D on the modulation of the immune system, the frequent association of Hypovitaminosis D with numerous chronic pathologies that can reduce life expectancy in elderly people , even more in the case of Covid-19 infection, an effect of Vitamin D in reducing the risk of respiratory infections of viral origin, including those caused by coronaviruses and the ability of vitamin D to counteract lung damage caused by hyperinflammation ".