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Fight infections such as COVID with 50 ng of Vitamin D – Sunil Dec 2022


Overcoming Infections Including COVID-19, by Maintaining Circulating 25(OH)D Concentrations Above 50 ng/mL

Pathology and Laboratory Medicine Int. Vol 14 Pages 37—60, DOI https://doi.org/10.2147/PLMI.S373617
Sunil J Wimalawansa suniljw at hotmail.com
Department of Medicine, CardioMetabolic and Endocrine Institute, North Brunswick, NJ, USA

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Half of the people get to 50 ng with 5,000 IU daily
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Note: Virtually all get to 40 ng with 7,000 IU daily (50,000 IU weekly)

The elderly and those with underlying chronic diseases (i.e., comorbidities) such as pulmonary, cardiovascular, metabolic, and renal diseases, increase their susceptibility to sepsis, including COVID-19. The SARS-CoV-2 virus damages pulmonary cells, causing acute respiratory distress syndrome (ARDS) and hypoxia. It further damages endothelial cells, altering clotting mechanisums causing intravascular hemolysis, microvascular thrombosis, and micro-embolization, contributing to the risk of death.
Approximately 75% of the immune system functions of humans depend on vitamin D and the availability of sufficient amounts of vitamin D metabolites [vitamin D and 25(OH)D] concentrations to enter immune cells from the bloodstream. Such concentrations are achievable through sun exposure, targeted food fortification programs, and adequate daily or weekly vitamin D supplements. That would allow for generating 1,25(OH)2D (non-hormonal form of calcitriol) intracellularly in peripheral target cells like immune cells. This enables immune cells’ physiological functions, including intracrine/autocrine and paracrine signaling processes. This initiates and maintains robust immune functions, such as forming antibodies and antimicrobial peptides, suppressing inflammation, and increasing the expression of anti-inflammatory and antioxidant genes, thus, strengthening immune functions. The opposite occurs in hypovitaminosis D, increasing vulnerability to infections and dying from it. Therefore, governments should make the population sufficient with immunoceuticals—micronutrients, especially vitamin D, and other micronutrients: the most cost-effective intervention to keep the population healthy. The cost of such interventions are minuscule compared to the expenses related to increased hospitalizations and premature deaths. Supposed such a program was implemented in mid-2020 as the author proposed, we estimated that 50% of hospitalizations (and the associated healthcare costs) and a third of deaths from COVID could have been prevented. Described herein are cost-effective strategies using vitamin D to achieve and sustain serum D3 and 25(OH)D concentrations crucial for maintaining a robust immune system, improving general health, minimizing disease severities and deaths, and reducing healthcare costs.

Why is It Necessary to Target Serum 25(OH)D Concentration Above 50 ng/mL?

Good public health policies aim to minimize diseases, their complications, and the spread, cost-effectively. However, during the COVID pandemic, some of these principles were ignored by leading health authorities and governments, which led to chaos. Those who develop symptomatic disease and complications and die from infections have feeble immune systems. Therefore, maintaining a robust immune system is not only essential to protect the population during infectious pandemics like SARS-CoV-2 but also the most cost-effective way to control it.
Convincing evidence has been published that rapidly raising and maintaining vitamin D and/or serum 25(OH)D concentrations above the minimum required level of 50 ng/mL (125 nmol/L) would minimize infections-related adverse clinical outcomes.46-48 Therefore, in such situations, in addition to preventing disease spread (eg, wearing effective face masks and social distancing), a broader goal should be to maintain mentioned circulatory 25(OH)D concentration in the population that would significantly improve clinical outcomes, including fewer hospitalizations and deaths, while mimizing healthcare costs.50
If the goal is to achieve a population minimum serum 25(OH)D concentration of “40” ng/mL, 60% of people will be below the required serum 25(OH)D concentration of 50 ng/mL. Whereas, if the targeted minimum concentration is set for 30 ng/mL, more than 80% of the population will have serum 25(OH)D concentration below 50 ng/mL, due to the scatter of representation in the community. Consequently, such approaches are ineffective and unwise especially during infectious epidemics and pandemics. It would fail to maintain a robust immunity in the population that needs to overcome infections. This is a crucial reason for the community spread of SARS-CoV-2, its, severe complications and deaths from the current COVID pandemic.
Therefore, keeping individuals or the populations’ serum 25(OH)D concentration below 50 ng/mL as recommended by some as the lower limit, is unwise and undesirable.48 During infectious epidemics or pandemics, there is no scientific justification for maintaining minimum serum 25(OH)D concentrations at 20, 30, or even 40 ng/mL, suggested as precautionary (and theoretical) principles by some. It would lead to serum 25(OH)D concentration of over two thirds of the population under the minimum necessary level of 50 ng/mL—disadvantage them by contracting infectious pathogens—both bacteria and viruses—therefore, it is counterproductive. Such a policy would enhance the spread of the viral illness, increase complications, hospitalizations, deaths, and associated costs.
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