A 43% don’t get enough Calcium 44% don’t get enough Magnesium 52% don’t get enough vitamin K 67% don’t get enough vitamin E 89% don’t get enough Choline 92% don’t get enough vitamin D 94% don’t get enough Potassium 100% Source: Drake, Micronutrient Inadequacies in the US Population: an Overview, Oregon State University 2018-2021 Linus Pauling Institute.
Mol. Sci. 2018, 19(8), 2419. Bergman et. al. Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, PLoS One 2013 Jun 19;8(6):e65835. doi: 10.1371/journal.pone.0065835. Print 2013. Surman et. al. Vitamin Supplementation at the Time of Immunization with a Cold-Adapted Influenza Virus Vaccine Corrects Poor Mucosal Antibody Responses in Mice Deficient for Vitamins A and D, Clin Vaccine Immunol. 2016 Jan 6;23(3):219-27. doi: 10.1128/CVI.00739-15.
Plausibility Coherence Experiment Analogy Alternate explanations (not included in Hill’s original criteria, but some include now) 1 2 3 4 5 6 7 8 9 10 Image Source: Unknown author, CC BY 4.0, Wikipedia
deficiency associated with C19 mortality with 7.6 OR (P < 0.001) Dose-response Large decrease in SARS-CoV-2 seropositivity as 25D increases from <20 to 50 ng/mL Consistency 13 of 16 observational studies (more now) found inverse relationship Plausibility Several established immunological mechanisms proposed Coherence Experimental and obs. evidence has shown that vitamin D reduces risk of many diseases Experiments Limited evidence to date, but what does exist largely supports causality Analogy Vitamin D supplementation reduces the risk of acute RTIs Alternate explanations Reverse causation unlikely based on current evidence; association still present after adjusting for confounding factors Source: Annweiler et. al., Point of view: Should COVID-19 patients be supplemented with vitamin D?, Maturitas. 2020 Oct;140:24-26. doi: 10.1016/j.maturitas.2020.06.003. Epub 2020 Jun 8.
ICU admissions in the treatment group were due to imperfect blinding, uneven distribution of prognostic risk factors, or a combination of the two.” https://www.medrxiv.org/content/10.1101/2020.11.08.20222638v2
was given too late in the course of the disease The form of vitamin D given did not increase serum levels of D fast enough The trial was underpowered The trial only included moderately ill patients Most patients in the treatment group were obese (BMI >30)
D Activation and Function, J Am Osteopath Assoc. 2018 Mar 1;118(3):181-189. doi: 10.7556/jaoa.2018.037. DiNicolantonio, et. al., Magnesium and Vitamin D Deficiency as a Potential Cause of Immune Dysfunction, Cytokine Storm and Disseminated Intravascular Coagulation in covid-19 patients, Mo Med. 2021 Jan-Feb; 118(1): 68–73.
et. al., Magnesium in Infectious Diseases in Older People, Nutrients. 2021 Jan 8;13(1):180. doi: 10.3390/nu13010180. Dominguez et. al., Magnesium and Hypertension in Old Age, Nutrients. Nutrients. 2021 Jan; 13(1): 139.
10,000 IU/d Form D3 (cholecalciferol) for prevention, calciferol in hospital (if available) Typical dose 5,000 IU/d Source: Brighthope et. al., Vitamin-D and COVID-19: time for the profession to take a stand, Adv Integr Med. 2021 Jan 21. doi: 10.1016/j.aimed.2021.01.003. Online ahead of print.
IU/d Initial bolus dose 50-200,000 IU Sources: Gröber et. al., The coronavirus disease (COVID-19) - A supportive approach with selected micronutrients, Nutrition, 24 Jan 2021, :1-22 doi: 10.1024/0300-9831/a000693. Kimball et. al., Evaluation of vitamin D3 intakes up to 15,000 international units/day and serum 25-hydroxyvitamin D concentrations up to 300 nmol/L on calcium metabolism in a community setting, Dermatoendocrinol. 2017; 9(1): e1300213. Bacon et. al., High-dose oral vitamin D3 supplementation in the elderly, Osteoporos Int. 2009 Aug;20(8):1407-15. doi: 10.1007/s00198-008-0814-9. Epub 2008 Dec 20.