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How Vitamin D Helps Fight COVID-19 - Grassroots Health Oct 2020

Part 1 Oct 2, 2020


Vitamin D deficiency has now been shown to increase susceptibility to COVID-19 and increase the risk of COVID-19 severity, including ICU admission and death. Conversely, other published studies have also shown those with higher vitamin D levels (over 30 ng/ml or 75 nmol/L) have a reduced risk of severe symptoms and death due to COVID-19. In fact, an analysis of over 190,000 Americans found that having vitamin D levels of at least 50 ng/ml resulted in a 53% lower positivity rate than those whose levels were less than 20 ng/ml! The first-published randomized controlled trial on vitamin D and COVID-19 found that adding vitamin D to the standard treatment nearly eliminated ICU admissions and did eliminate deaths.
 
It sounds almost too good to be true... Yet vitamin D is known to influence the expression of thousands of genes and is involved in regulating over 80 biological pathways in the body. Vitamin D is not a miracle drug, nor does it act alone, but it is an important mediator of immune function, and we can largely control whether or not we get enough vitamin D from our daily habits (sun, diet and supplements). 
 
Today we will explain HOW vitamin D acts to protect you from getting COVID-19, and in an upcoming Part 2, we will discuss how vitamin D helps improve symptoms if you do get COVID-19. 

 


Vitamin D is Known to Help Prevent Upper Respiratory Tract Infections

 


Vitamin D is known to help fight upper respiratory tract infections. As previously discussed, a large meta-analysis including 25 randomized controlled trials with over 11,300 individuals showed that vitamin D supplementation reduced the risk of respiratory tract infections by 70%. GrassrootsHealth participants with vitamin D levels greater than or equal to 40 ng/mL were 41% less likely to have had the flu and 15% less likely to have had a cold in the prior 6 months than participants with levels less than 20 ng/mL.  
 
Acute Respiratory Distress Syndrome (ARDS) is a major complication and cause of death among those with serious COVID-19 infections. When comparing vitamin D levels among those with and at risk of ARDS, one study found that 96% of those at risk of ARDS were deficient in vitamin D.

 


Vitamin D Can Protect Lung Cells from SARS-CoV-2 Attack

 


COVID-19 is caused by a coronavirus (a specific type of virus) called SARS-CoV-2. Infection of COVID-19 begins when the SARS-CoV-2 virus enters the cells of the lung by binding the angiotensin-converting enzyme 2 (ACE-2) receptor and de-activating it, resulting in inflammation. Vitamin D is responsible for increasing ACE-2 expression, which allows it to carry out its anti-inflammatory actions to help protect the lungs and keep inflammation at bay. 
 
During the early incubation stage when the virus is hijacking the cell there are generally no symptoms. Most people who are infected with SARS-CoV-2 experience mild-moderate respiratory symptoms and recover without any need for hospitalization or therapy. In those who do experience more severe symptoms, only a small percentage have severe enough symptoms for the virus to be life threatening. This difference in both susceptibility (whether the virus is able to invade) and recovery (how well the body fights it off if it does invade) is attributed to the individual’s immune response. Vitamin D may help protect against COVID-19 specifically through maintenance of physical barriers (susceptibility) and regulation of innate and adaptive immunity (mounting an effective immune response to the virus). 
 
The graphic below provides a very clear illustration of several ways vitamin D acts to directly protect the lungs, from its effect on the protective barrier of the lungs, to its involvement in the maturation of immune cells, and its role in regulating the inflammatory response and inhibiting the cytokine storm (which will be covered in more detail in Part 2).

 


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Vitamin D Regulates the Immune Response

 


Vitamin D plays a crucial role in regulating immune system activity – both innate and adaptive responses. As previously described, the innate immune system is responsible for the initial defensive front with a central role played by phagocytes. Vitamin D stimulates expansion of these phagocytes (monocytes and macrophages) increasing their ability to fight off the virus by increasing their numbers, as well as increasing their killing capacity through stimulating the production of the anti-viral protein cathelicidin. Vitamin D also acts to regulate the maturation of dendritic cells which are important for activating CD4+ T cells and in turn the rest of the immune response.
 
Earlier studies have shown that in SARS and influenza the adaptive immune cells, T cells and B cells, are vital in defending the body against the virus. Many studies have found this to be the case in COVID-19 as well, with both antibody and cellular defenses being recruited to the fight. Vitamin D is a potent regulator of adaptive immunity, including both cell-mediated (T cell) and humoral (B cell) immunity

 


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Cox R and Brokstad K, Nature Reviews, 2020.
Click to Download & Print

 


Once SARS-CoV-2 has been successful at replicating itself and spreading to surrounding cells, mild to moderate symptoms progress (e.g. sore throat, cough, fever and muscle aches) that result from localized and appropriate inflammation, associated tissue damage and antiviral activity of B cells and T cells. CD4+ and CD8+ T cells secrete cytokines (chemical signals that instruct other cells what to do) and are central to the successful elimination of COVID-19, as happens in most people. Unfortunately, more serious symptoms and death can result with an over-reactive or ineffective immune response, as can happen when there is not enough vitamin D for use. The role of vitamin D at this stage will be covered in Part 2.
 
Thus, vitamin D is important to help fend off an attack by SARS-CoV-2. Ensuring optimal levels of vitamin D is an easy way to help support your immune system response.

 


Better Results when Taken Together

 


Nutrients work synergistically in order to carry out specific functions within the body. For example, we have recently discussed how different immune cells rely on a variety of nutrients, including vitamins D, C, B6, B12, zinc, and magnesium, in order to carry out their actions in an immune response. Without these necessary nutrients, immune function may be hindered.
 
Could a nutrient deficiency be putting a damper on your immune response? Find out by testing your vitamin D, omega-3s, magnesium and other essential elements (including selenium), as well as your inflammation levels, with the new Immune Boost home test kit offered by GrassrootsHealth. Measuring levels is the only way to know if you are supporting your immune system and whether additional changes should be made, with supplementation, dietary changes, or both.


Part 2 Oct 9, 2020


 
 
 
 
 
 
 
 

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Vitamin D is used by every cell of the body, influences the expression of thousands of genes, and is involved in regulating over 80 biological pathways – importantly, vitamin D is a potent regulator of immune function. However, it may still be surprising how much one vitamin can influence the body’s response to a COVID-19 infection. Vitamin D deficiency has now been shown to increase susceptibility to COVID-19 and increase the risk that if you do have COVID-19, it will be severe enough to require hospitalization in the ICU and lead to death. Conversely, published studies have also shown reduced risk of severe symptoms and death due to COVID-19 with higher vitamin D levels (over 30 ng/mL). In fact, an analysis of over 190,000 Americans found that having a vitamin D level of at least 50 ng/ml resulted in a 53% lower positivity rate for SARS-CoV-2 infection than those with levels less than 20 ng/ml! The first-published randomized controlled trial on vitamin D and COVID-19 found that adding vitamin D to the standard treatment nearly eliminated ICU admissions and did eliminate deaths

In Part 1 we reviewed how vitamin D acts to protect against COVID-19. Today we will describe how vitamin D influences the immune system in ways that are beneficial, such as preventing the hyper-inflammatory response characteristic of severe COVID-19 infection. 


Vitamin D Regulates the Immune Response

Vitamin D plays a crucial role in regulating immune system activity – both innate and adaptive responses. As described in Part 1, vitamin D increases the innate immune response and may help reduce entry of SARS-CoV-2 into cells in the lung and reinforce the physical barriers, or junctions, between cells, which in turn may help prevent the spread of the virus between cells. Vitamin D also stimulates expansion of phagocytes (monocytes and macrophages) increasing their ability to fight off the virus by numbers. In addition, vitamin D directly stimulates phagocytes and lung cells to produce anti-viral proteins, cathelicidin and defensins, that kill the virus. However, an appropriate adaptive immune response is a vital part of the body’s defense against SARS-CoV-2. Vitamin D is a potent regulator of adaptive immunity, including both cell-mediated (T cell) and humoral (B cell) immunity. Vitamin D is needed by these white blood cells to help them recognize, bind to, and destroy SARS-CoV-2.

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Click to Enlarge & Print

What Causes A Severe SARS-CoV-2 Infection?

Once SARS-CoV-2 has been successful at replicating itself and spreading to surrounding cells, mild to moderate symptoms progress (e.g. sore throat, cough, fever and muscle aches) as part of a normal immune response to the virus. CD4+ and CD8+ T cell responses including secreted inflammatory cytokines are central to the successful elimination of COVID-19, as happens in most people.
 
However, in some people the immune response goes awry at this point and generates a hyper-inflammatory state referred to as the “cytokine storm” as depicted in the diagram below. The cytokine storm is the leading theory that explains why some people have a severe reaction to coronaviruses while others only experience mild symptoms. Moderate levels of inflammation are associated with mild-moderate symptoms of COVID-19, whereas the cytokine storm generates a hyper-inflammatory state associated with severe COVID-19 symptoms.

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Click to Enlarge & Print

The cytokine storm results from a sudden acute increase in circulating levels of different pro-inflammatory cytokines including IL-6, IL-1, TNF- a, and interferon produced mostly by T cells. These inflammatory cytokines, in addition to the ongoing replication and spread of the virus, trigger more immune cell involvement and tissue damage that leads to acute respiratory distress, multiple organ failure and possibly death. By dampening the cytokine storm, we can reduce the severity of symptoms and the risk of death.

Vitamin D Helps Control the Cytokine Storm and Reduce Symptom Severity

Vitamin D acts in many ways to regulate the adaptive immune response. Vitamin D stimulates CD4+ T cell proliferation and cytokine production, and antibody activity (B cells). Vitamin D acts to regulate T cell response through initiating dendritic cell tolerance. These dendritic cells in turn stimulate the increased production of T regulatory (Treg) cells and their production of anti-inflammatory interleukin (IL)-10, switching the response from being Th1-driven and pro-inflammatory to a Th2-driven anti-inflammatory response.
 
Vitamin D acts to suppress the production of inflammatory cytokines (such as IL-1, IL-6 and IFN which are predominant in the cytokine storm characteristic of severe COVID-19). Vitamin D also has an effect on the actions of B-cells and inhibits the production of antibodies. Overall, the immunomodulatory actions of vitamin D play a very important role in preventing the activation of an inappropriate hyper-inflammatory immune response.
 
Because the virus also binds ACE-2 receptors it interrupts the renin-angiotensin system, responsible for regulating blood volume, a pathway that is also regulated by vitamin D. Ensuring sufficient vitamin D may improve response to the virus in the lungs and lessen the impact of SARS-CoV-2 infection on reduced levels of surfactant (a liquid secretion that allows the lungs to open and fill with air) which may then reduce the impact of SARS-CoV-2 infection on the ability to breathe.
 
Thus, vitamin D is important to help regulate the immune response to a SARS-CoV-2 infection. Ensuring optimal levels of vitamin D is a safe and easy way to help support your immune response.

Do you know your vitamin D level?

Measure your vitamin D level today! When you know what your level is, you can determine next steps to take and how much supplementation may be needed if you are below your target level. A panel of 48 International Vitamin D scientists recommend a level between 40-60 ng/ml (100-150 nmol/L) - where are you?

See also in VitaminDWiki

COVID-19 news
COVID-19 and Dark Skins
COVID-19 treated by Vitamin D - studies, reports, videos
As of Jan 24 had:  34 trials4 trial results,  12 meta-analyses and reviews,   46 observations,   25 recommendations,   42 associations,  83 speculations,  37 videos   see also COVID-19 and Vitamin D:   Governments.   Health problems.   Hospitals
and has the following recent updates

Top Vitamin D and COVID-19 recent updates


Many clinical trials are underway which are testing Vitamin D to fight COVID-19

COVID-19 RCTs


50 most-recently changed items in Virus Category in VitaminDWiki

Id Page Hits Last modification Creator Categories
11728 COVID-19 treated by Vitamin D - studies, reports, videos 26135
25 Jan, 2021 03:01
admin Top news
Virus
12255 COVID-19 2.7 X more likely to be severe if less than 30 ng of vitamin D (China) – Jan 2021 75
24 Jan, 2021 19:45
admin Orient
Virus
12254 2.7 fewer COVID-19 hospital deaths in those having more than 30 ng of vitamin D – Mayo Jan 9, 2021 121
24 Jan, 2021 19:44
admin Mortality and D
Virus
12235 Iranians with COVID-19 were 2.3 X more likely to die if low vitamin D – Jan 2021 216
24 Jan, 2021 19:43
admin Mortality and D
Virus
12250 Vitamin D Help Us Fight Infections - interview of Dr. Thakkar (transcript) Jan 20, 2021 95
24 Jan, 2021 03:39
admin Virus
9072 Flu 12601
23 Jan, 2021 17:00
admin Immunity
Virus
12253 COVID-19 onset strongly associated with latitude in Europe (Vitamin D)– Jan 21, 2021 149
23 Jan, 2021 16:17
admin UV and Vitamin D
Virus
12232 400,000 COVID deaths, 400,000 IUs of Vitamin D needed to prevent COVID death - Jan 2021 166
22 Jan, 2021 15:08
admin Virus
11919 Acute viral respiratory infections reduced by Vitamin D - overview of 20 reviews - Aug 2020 425
22 Jan, 2021 14:37
admin Breathing
Meta-analysis of Vitamin D
Virus
12245 1170 vaccinations to prevent 1 severe COVID-19 case , vs 1.2 vaccinations to prevent 1 case of Measles 90
22 Jan, 2021 00:33
admin Virus
12238 Vitamin D, COVID - Campbell and Davis (UK with transcript) - Jan 18, 2021 278
20 Jan, 2021 20:07
admin Books, videos on Vitamin D
Virus
12161 Take 50,000 IU of Vitamin D weekly before and after COVID-19 vaccination 557
20 Jan, 2021 18:38
admin Virus
12223 Herd immunity occurs only via vaccination - W.H.O. Oct 2020 71
20 Jan, 2021 13:50
admin Virus
12229 Many COVID-19 risks are associated with low vitamin D (7 studies) – Systematic Review Jan 2021 132
20 Jan, 2021 13:50
admin Virus
12239 War increases risks of COVID-19 (social distance, mask, less sun, poor food, stress) - Jan 2021 56
20 Jan, 2021 13:48
admin Virus
12242 1 in 8 Recovered COVID-19 Patients Die Within 5 Months - Jan 18, 2021 62
20 Jan, 2021 12:56
admin Virus
11925 Long term fatigue, etc. common after viral infections (SARS1,2, MERS, Swine, 1918,...) 580
20 Jan, 2021 12:52
admin Virus
12067 Governments are starting to use vitamin D to fight COVID-19 906
20 Jan, 2021 12:31
admin Virus
12240 Elderly COVID-19 patients getting 400,000 IU of vitamin D had better survival (Italy, April)– Jan 14, 2021 291
19 Jan, 2021 23:59
admin Mortality and D
Virus
12234 .Iranians with COVID-19 were 2.3 X more likely to die if low vitamin D – Jan 2021 13
18 Jan, 2021 03:22
admin Mortality and D
Virus
12233 Vitamin D to prevent COVID- strange trial recommendations from the UK – Jan 2021 94
18 Jan, 2021 03:11
admin Virus
12227 40 ng of Vitamin D to fight COVID 15K to 50K weekly or 100K monthly – Spanish Jan 2021 135
16 Jan, 2021 11:23
admin Virus
12213 30 x fewer COVID-19 deaths in those getting 400,000 IU of Vitamin D - Jan 2021 519
15 Jan, 2021 16:23
admin Mortality and D
Virus
11959 Admission to COVID-19 ICU 1.7X more likely to have less than 20 ng of vitamin D – Sept 2020 236
15 Jan, 2021 14:07
admin Virus
12043 COVID-19 survivors can have poor health for a long time 199
14 Jan, 2021 20:40
admin Virus
12221 Poor COVID-19 prognosis was 6 X more likely if low vitamin D – Jan 21, 2021 256
13 Jan, 2021 21:04
admin Mortality and D
Virus
12220 4X fewer COVID-19 deaths in those having high Omega-3 index – Jan 6, 2021 107
13 Jan, 2021 20:38
admin Vitamin D and Omega-3
Virus
11703 Coronavirus might hitch a ride on air pollution - March 2020 817
13 Jan, 2021 01:01
admin Virus
12219 COVID-19 cases in Delhi increased 7 days after pollution (less UV and Vitamin D, indoors more) Jan 12, 2021 81
13 Jan, 2021 00:51
admin Virus
12195 Vitamin D reduces COVID-19 by 80 percent - anonymous meta-analysis - Jan 5, 2021 543
13 Jan, 2021 00:20
admin Meta-analysis of Vitamin D
Virus
12216 Many increased risks for dying of COVID-19 in nursing home (Vitamin D not even mentioned) - Jan 6 2021 50
11 Jan, 2021 23:36
admin Virus
12217 Active vitamin D (calcitriol) might fight COVID-19 – Jan 5, 2021 100
11 Jan, 2021 23:28
admin Calcitriol
Virus
12215 Vitamin D sales up 40 percent in Dec (2020 vs 2019) 122
11 Jan, 2021 20:03
admin Virus
12210 2.8 X fewer COVID-19 nursing home deaths if add 10,000 IU Vitamin D daily for a week (small observation)- Jan 2021 239
10 Jan, 2021 21:04
admin Mortality and D
Virus
12197 Don’t Let COVID-19 Patients Die With Vitamin D Deficiency - Jan 5, 2021 452
10 Jan, 2021 20:14
admin Virus
12035 COVID-19 lung death 4X more likely in Iran if less than 25 ng of vitamin D – Oct 30, 2020 582
10 Jan, 2021 04:29
admin Breathing
Mortality and D
Virus
11945 14.7 X more likely to die of COVID-19 if less than 12 ng of Vitamin D (185 Germans) – Sept 10, 2020 942
10 Jan, 2021 04:28
admin Mortality and D
Virus
11901 COVID ARDS deaths 2X more likely if less than 10 ng of Vitamin D – Aug 8, 2020 563
10 Jan, 2021 04:28
admin Breathing
Mortality and D
Virus
12010 9X COVID-19 survival in nursing home if had 80,000 IU dose of vitamin D in previous month – Oct 2020 1628
10 Jan, 2021 04:25
admin Mortality and D
Virus
12073 Hospital COVID-19 observation: 7X more likely to live if more than 20 ng of vitamin D– Nov 19, 2020 783
10 Jan, 2021 04:22
admin Mortality and D
Middle East
Virus
12090 COVID-19 male mortality increased 3.9 X if low vitamin D – observation Nov 25, 2020 191
10 Jan, 2021 04:21
admin Mortality and D
Virus
12145 7X less likely to die of COVID-19 if taking Vitamin D loading dose – Dec 11, 2020 815
10 Jan, 2021 04:20
admin Mortality and D
Loading dose for Vitamin D
Virus
12190 Italian nursing home COVID-19 – 4X less likely to die if taking Vitamin D– Dec 22, 2020 252
10 Jan, 2021 04:19
admin Mortality and D
Virus
12207 COVID-19 Disease and Vitamin D: A Mini-Review – Dec 15, 2020 129
09 Jan, 2021 10:40
admin Virus
12206 6 months after COVID-19 hospitalization 76 percent still had at least one symptom – Jan 8, 2021 111
09 Jan, 2021 03:26
admin Virus
12162 600,000 IU of Vitamin D (total) allowed previously weak immune systems to fight off a virus antigen - Nov 2020 261
08 Jan, 2021 16:24
admin Seniors
Immunity
Virus
12202 Small study found Vitamin D did not fight COVID-19 (probably mostly less than 30 ng) – Jan 2020 130
07 Jan, 2021 17:05
admin Virus
12198 COVID-19 test positive 4.5 X more likely if had low vitamin D test within 4 years – Jan 6, 2021 189
06 Jan, 2021 20:51
admin Virus
12196 Less likely to test positive for COVID-19 if higher Vitamin D – meta-analysis Jan 6, 2021 272
06 Jan, 2021 12:05
admin Meta-analysis of Vitamin D
Virus
11865 Health problems at high risk of COVID-19 684
05 Jan, 2021 21:33
admin Virus

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