Vitamin D shown to decrease many of the risks associated with COVID including hospitalization time and mortality!

Vitamin D is well known for its role in regulating calcium, but it has a lesser-known role supporting the immune system. It’s role in the immune system has been associated with multiple chronic conditions such as depression, diabetes, high blood pressure and autoimmune disease. Beyond these chronic conditions new studies have shown a significant correlation between vitamin D deficiency and Covid-19. It is theorized this is due to vitamin D’s ability to signal an early immune response. These studies have shown decreased vitamin D levels increase Covid infections, hospitalizations, and risk for mortality. Further studies showed Vitamin D supplementation can decrease many of these risks including hospitalization time and mortality. These studies concluded vitamin D supplementation is a reasonable, safe low-cost way to lower the risk of complications and negative outcomes of Covid-19 infections.

Vitamin D is a fat soluble nutrient vital to maintain proper function of biological needs and overall health. Unlike most other vitamins, vitamin D is produced by the body using precursor elements. Modern lifestyles decrease the ability for the body to produce Vitamin D. This leaves a significant percentage of the population without adequate stores of the nutrient to meet the demands of the body. Decreased levels of vitamin D have been associated with diabetes, hypertension, osteoporosis, and autoimmune disorders, this has been well documented for many decades. Recently research has shown a significant correlation between Vitamin D and Covid-19. This research may provide insight into future treatments or prevention of the Covid-19 infections.

Vitamin D is produced through a multi-step process using two forms of calciferol, D2 and D3. The process begins in the skin with exposure to sunlight, transitions through the liver and is finally converted to its active form by the kidneys. This process from precursors D2/ D3 to the active form of Vitamin D depends on an adequate amount of magnesium in the body. So if magnesium is low Vitamin D will not be able to carry out its’ functions effectively, (low magnesium may be up 20% of the population, rates of subclinical hypomagnesemia may be much higher). The combination of decreased Vitamin D and magnesium increases the probability of deficiency in the general population.  

Vitamin D’s primary function is to help balance the body’s calcium stores. It acts as a hormone, signaling to the body to increase or decrease absorption from the intestines, reabsorption from the bones and excretion in the kidneys. It has many other roles in the body, including its’ role signaling the innate immune system (the portion of immune system that starts our defense against a new pathogen). Cells from the innate immune system have receptors for Vitamin D. So, if there is an inadequate amount of Vitamin D then not as many cells of the innate immune system will be signaled, creating a slower immune response. This is problematic when the pathogen is new or unknown to the body, such as Covid-19.

Low Vitamin D levels are separated into two classifications, below 50 nmol/ L is labeled as Vitamin D deficient whereas 50-70 nmol/ L is considered Vitamin D insufficiency. The lower the levels the greater the dysfunction in the body. It is estimated that approximately 40% of the U.S. population is either deficient or insufficient in Vitamin D. The percentage goes up significantly in certain populations including people with darker skin tones, African Americans, and the elderly. Other risk factors include smoking, obesity, diabetes, and low education level. Modern lifestyles which include many hours indoors and using high SPF sunscreen have also been shown to decrease Vitamin D levels.

Vitamin D is easily supplemented in a variety of forms and routes. Individuals can use both the D2 and D3 form to supplement, though multiple studies have shown that D3 is nearly twice as effective at raising serum levels. Both oral and intramuscular have been shown effective in raising serum levels. Intramuscular supplementation has been shown to have a longer duration, creating a sustained increase in blood levels. In one study, intramuscular injections raised serum Vitamin D levels have been shown to break the 50 nmol/ L level in just seven days, though oral had a higher level of 83 nmol/L at 30 days (this study was evaluating a one-time intramuscular dose versus daily oral supplementation). Monthly or bimonthly doses of 50,000 units intramuscular have been shown effective in maintaining an optimal Vitamin D level.

A recent meta-analysis (a review of multiple studies on the same subject) concludes there is a significant correlation between Covid-19 infections and low Vitamin D levels. This article showed that patients with serum Vitamin D levels below 50 nmol/ L had a 2.5 time increase in Covid-19 infections. This meta-analysis showed the link between a Vitamin D levels severity of illness and hospitalization rates. This has been corroborated by another study, that showed not only the correlation between Vitamin D and covid but also showed normalizing Vitamin D levels, decreased hospitalization days and mortality. It is also important to note that populations with higher rates of Vitamin D deficiency are also at an increased risk for Covid-19, including people with darker skin tones, African Americans, and the elderly, other risk factors include smoking, obesity, diabetes, and low education level. One of the distinguishing traits of Covid that make it both communicable and deadly is that it suppresses the innate immune system. As stated earlier one of Vitamin Ds’ roles is to signal the innate immune system, if the body is deficient in vitamin D it takes longer to initiate a adequate response from the immune system. Multiple studies have concluded that Vitamin D supplementation is a low-risk way to boost the immune system and potentially decrease negative outcomes associated with Covid infections.

Note to reader:

As this is not an academic article resources included primary, secondary and common sources. Sources were not directly quoted, nor proper citation was included. Sources are listed below. For any questions about the article and the format please contact the author Alex Stiebling at alexs@clubrecover.com.

Kaya, M. O., Pamukçu, E., & Yakar, B. (2021). The role of vitamin D deficiency on the Covid-19: A systematic review and meta-analysis of observational studies. Epidemiology and health, e2021074. Advance online publication. https://doi.org/10.4178/epih.e2021074

Gönen, M. S., Alaylıoğlu, M., Durcan, E., Özdemir, Y., Şahin, S., Konukoğlu, D., Nohut, O. K., Ürkmez, S., Küçükece, B., Balkan, İ. İ., Kara, H. V., Börekçi, Ş., Özkaya, H., Kutlubay, Z., Dikmen, Y., Keskindemirci, Y., Karras, S. N., Annweiler, C., Gezen-Ak, D., & Dursun, E. (2021). Rapid and Effective Vitamin D Supplementation May Present Better Clinical Outcomes in COVID-19 (SARS-CoV-2) Patients by Altering Serum INOS1, IL1B, IFNg, Cathelicidin-LL37, and ICAM1. Nutrients, 13(11), 4047. https://doi.org/10.3390/nu13114047

Parva, N. R., Tadepalli, S., Singh, P., Qian, A., Joshi, R., Kandala, H., Nookala, V. K., & Cheriyath, P. (2018). Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012). Cureus, 10(6), e2741. https://doi-org.uc.idm.oclc.org/10.7759/cureus.2741

Roger Seheult Could Vitamin D’s role in the ACE2 renin-angiotensin system help protect from severe COVID-19?  https://www.foundmyfitness.com/episodes/vitamin-d-ace2-covid-19

Vitamin D Deficiency Also called: Hypovitaminosis D, Low Vitamin D  https://medlineplus.gov/vitaminddeficiency.html