In Oktober vorig jaar verscheen op dit blog een artikel over de positieve invloed van Vitamine D op de ernst van het verloop van een COVID-19 infectie en eventueel als preventie.
Er werden nog twee updates toegevoegd op 28 Oktober en 2 November waarin de toepassing van Vitamine D werd genoemd in de pers. Nu is er een artikel verschenen in het Engelse blad van de Royal Society Open Science met als titel: “Vitamin D and COVID-19: evidence and recommendations for supplementation“.
Daarin wordt op grond van de huidge kennis het gebruik van Vitamine D sterk aanbevolen in hoeveelheden van 800 IU per dag, dat is 25 µg per dag, ongeveer twee tabletjes van de gebruikelijke Vitamine D tabletjes. En dat is een veilige dosis. Hieronder de tekst van de conclusie van het artikel:
Conclusion
— Evidence linking vitamin D deficiency with COVID-19 severity is circumstantial but considerable links with ethnicity, obesity, age and institutionalization; latitude association; evidence from experimental models of respiratory pathogens; preliminary reports of associations with COVID-19
severity in hospitalized patients; basic biology studies showing extensive vitamin D impacts on the immune system underlying various anti-viral and anti-inflammatory responses; vitamin D responsive genes altered in lung lymphocytes from COVID-19 patients.
— Vitamin D deficiency is common; particularly, but not solely, in people living well away from the equator and can persist throughout the year in individuals who have little sunlight exposure.
— Vitamin D deficiency is readily preventable by supplementation that is very safe and cheap.
— The current UK definition of vitamin D deficiency (less than 25 nmol l−1) is low by international standards and evidence from parathyroid hormone status (which rises with vitamin D deficiency) as well as large population studies of all-cause mortality suggests that a target blood level of at least 50 nmol l−1, as indicated by the American Institute of Medicine and by the European Food Safety Authority, is more appropriate. This would require supplementation with 800 IU/day (not 400 IU/day as currently recommended in UK) to bring most individuals up to the normal range.
Growing evidence suggests that regular daily supplementation is more effective than intermittent high-dose bolus.
— Vitamin D supplementation at levels needed to avoid deficiency—e.g. 800–1000 international units(25 μg) vitamin D3/day—is extremely safe and typically costs no more than 10p per day.
— Randomized placebo-controlled trials of vitamin D in the community in vitamin D-deficient individuals will be difficult to conduct and will not complete until spring 2021 at earliest although we note the positive results from Cordoba, Spain of an open-labelled randomized trial of 25(OH)D3 (calcifediol) in hospitalized patients.
Key recommendations:
— There seems nothing to lose and potentially much to gain by recommending vitamin D supplementation for all, e.g. at 800–1000 IU/day, making it clear that this is to help ensure immune health and not solely for bone and muscle health.
— This should be mandated for prescription in care homes, prisons and other institutions where people are likely to have been indoors for much of the time during the summer.
— People likely to be currently deficient should consider taking a higher dose, e.g. 4000 IU/day for the first four weeks before reducing to 800 IU–1000 IU/day
— People admitted to hospital with COVID-19 should have their vitamin D status checked and/or supplemented and consideration should be given to testing high-dose calcifediol in the RECOVERY trial.
We feel this matter should be pursued with great urgency. Vitamin D levels in the UK will be falling from October onwards as we head into winter.
