Vitamin D and COVID-19 - Chris Masterjohn AHS 2021

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Mito

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mrchibbs

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I remember the studies which started to point this out in April 2020, basically just advocate for more vitamin D testing in the elderly, get the kids outside, don't lock anybody in and nothing else would have needed to be done.

But we live in a sad world.
 

yerrag

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Haidut came out with this thread last April: Nine out of ten COVID-19 deaths may be due to vitamin D deficiency

In his July newsletter that just came out, Ray mentions low vitamin D as a factor in causing low hepcidin production. Hepcidin is a protein that limits the availability of iron from pathogens to keep them from multiplying so readily:

The increase of tissue iron in aging is a factor in the greater susceptibility to infection. Iron not only supports the growth of infective
organisms, but increases the formation of inflammatory cytokines and weakens the barrier function of the intestine, contributing to endotoxemia (Visitchanakun, et al., 2020). These factors are involved in the corona virus sickness, and iron overload is increasingly recognized as a factor in susceptibility to that infection and in its main characteristics, extreme inflammation, the cytokine storm, and hyper-coagulability.


Aside from low vitamin D, high estrogen also decreases production of hepcidin.

I have no doubt that even in our sunlight and vitamin D-aware RPF community, we are not getting as much sunshine and vitamin D during this pandemic. I would have to take an extra effort to just go out and walk in sunshine. Luckily for me, I have a garden and a koi pond that forces me to have to do outside chores, so sunlight exposure comes more naturally to me. Still, I don't get as much sunshine as before.

It would be safe to say that worldwide, the restrictions imposed have the effect of changing our lifestyle towards that of cave-dwellers, and that this shift plays a huge role in the world being caught in the vicious cycle of getting sicker and sicker. Snapping out of this vicious cycle requires a mass awareness, which is impossible given the disinformation campaign brought upon us.

A simple rectification of an error would do. But when has a simple elegant solution been a hallmark of modern civilization?
 
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Overall Conclusions​

Synthesizing all of the data, we can conclude as follows:
  • While the threat of COVID-19 persists, actively maintaining 25(OH)D in the 30-60 ng/mL range is likely to protect against getting infected, with the best protection offered in the 50-60 ng/mL range.
  • Whether a supplement is needed to maintain this and how much depends on one's environment, lifestyle, diet, and other factors, so it is best to measure the blood level. Many people living in temperate regions would require 5,000 IU per day during the coldest half of the year.
  • Maintaining D in this range will also prevent a 5-or-more-day delay in the ability to quickly raise 25(OH)D with vitamin D supplements upon getting sick.
  • If the Entrenas-Castillo protocol is adjusted for the relative bioavailability of 25(OH)D and vitamin D and converted into the equivalent of oral vitamin D3 supplements, it translates to 106,400 IU on day 1, 53,200 IU on days 3 and 7, and 53,200 IU per week thereafter until symptoms resolve. If this is in turn translated into daily dosing, it would be the equivalent of 30,400 IU per day for the first week, followed by a maintenance dose of 7,600 IU per day until symptoms resolve. This could be simplified to a loading dose of 200,000 IU once, followed by a 10,000 IU per day maintenance dose until symptoms resolve.
  • This protocol should be started at the first sign of any possible symptom and should not be delayed until COVID-19 is confirmed. This is needed to raise biological vitamin D activity at the beginning of the infection, rather than waiting until it is a) too late and b) too difficult to raise 25(OH)D in an environment of excessive inflammation.
  • For someone who is maintaining 25(OH)D in the 50-60 ng/mL range, the loading dose might be unnecessary. However, for anyone with 25(OH)D lower than this, the loading dose is critical. For someone who is likely deficient at the time of infection and waits until diagnosed or hospitalized before starting vitamin D, it is imperative for a physician to prescribe calcifediol (that is, oral 25(OH)D) at a dose of 0.532 miligrams on day 1, followed by 0.266 milligrams on days 3 and 7, and weekly thereafter until symptoms resolve.
  • Although concrete evidence for this is lacking, my personal opinion is that each 10,000 IU of vitamin D (the loading dose can be excepted from this) should be matched with 5-10,000 IU of vitamin A (as retinol), 200 micrograms of vitamin K2 (preferably as a mix of MK-4 and MK-7), and 20 IU of alpha-tocopherol in a background of naturally occurring mixed tocopherols and tocotrienols. The diet should be analyzed (for example, as described here) to make sure that no nutrients are deficient and zinc dosing as described here should be considered.
 
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Overall Conclusions​

Synthesizing all of the data, we can conclude as follows:
  • While the threat of COVID-19 persists, actively maintaining 25(OH)D in the 30-60 ng/mL range is likely to protect against getting infected, with the best protection offered in the 50-60 ng/mL range.
  • Whether a supplement is needed to maintain this and how much depends on one's environment, lifestyle, diet, and other factors, so it is best to measure the blood level. Many people living in temperate regions would require 5,000 IU per day during the coldest half of the year.
  • Maintaining D in this range will also prevent a 5-or-more-day delay in the ability to quickly raise 25(OH)D with vitamin D supplements upon getting sick.
  • If the Entrenas-Castillo protocol is adjusted for the relative bioavailability of 25(OH)D and vitamin D and converted into the equivalent of oral vitamin D3 supplements, it translates to 106,400 IU on day 1, 53,200 IU on days 3 and 7, and 53,200 IU per week thereafter until symptoms resolve. If this is in turn translated into daily dosing, it would be the equivalent of 30,400 IU per day for the first week, followed by a maintenance dose of 7,600 IU per day until symptoms resolve. This could be simplified to a loading dose of 200,000 IU once, followed by a 10,000 IU per day maintenance dose until symptoms resolve.
  • This protocol should be started at the first sign of any possible symptom and should not be delayed until COVID-19 is confirmed. This is needed to raise biological vitamin D activity at the beginning of the infection, rather than waiting until it is a) too late and b) too difficult to raise 25(OH)D in an environment of excessive inflammation.
  • For someone who is maintaining 25(OH)D in the 50-60 ng/mL range, the loading dose might be unnecessary. However, for anyone with 25(OH)D lower than this, the loading dose is critical. For someone who is likely deficient at the time of infection and waits until diagnosed or hospitalized before starting vitamin D, it is imperative for a physician to prescribe calcifediol (that is, oral 25(OH)D) at a dose of 0.532 miligrams on day 1, followed by 0.266 milligrams on days 3 and 7, and weekly thereafter until symptoms resolve.
  • Although concrete evidence for this is lacking, my personal opinion is that each 10,000 IU of vitamin D (the loading dose can be excepted from this) should be matched with 5-10,000 IU of vitamin A (as retinol), 200 micrograms of vitamin K2 (preferably as a mix of MK-4 and MK-7), and 20 IU of alpha-tocopherol in a background of naturally occurring mixed tocopherols and tocotrienols. The diet should be analyzed (for example, as described here) to make sure that no nutrients are deficient and zinc dosing as described here should be considered.
This is a helpful summary. Thank you
 

mrchibbs

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I concur, the loading dose is really crucial info.

I would also think finding an olive oil based supplement (as opposed to MCT) would be the way to go.

Ray talked about this in a recent interview with Danny and Georgi, olive oil probably solves much of the allergenic reaction with MCT.

Adding 200000UI in olive oil, along with a fatty meal can be a quick way to start supplementing. The meal should help absorption and reduce potential irritation.
 
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Peater Piper

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Ray talked about this in a recent interview with Danny and Georgi, olive oil probably solves much of the allergenic reaction with MCT.
Is this only an issue for those who notice bad effects from MCT? I've been using an MCT-based D3 supplement and haven't noticed any adverse reactions. I'm always skeptical that olive oil is really olive oil, though the capsules are so small that it probably doesn't matter.
 

RealNeat

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Rays always ahead of the game. I remember when Masterjohn was warning about D for increasing ACE2 receptors and Ray was saying how it's protective. This is why I love Rays cohesive view of biochemistry and biology, it's not circumstantial.
 

Jam

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Not sure I'd follow his protocol, he got COVID twice, so far.
 
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About mct allergy, Last year I tried an elimination diet. For frying food coconut oil, virgin coconut oil worsen my thyroid and makes the side of my lips cracked inflamed. I have been using it more than 15years and did not expect this. I tried the elimination diet based on the advise of a naturopathic doctor. When she said thyroid problems stop eating coconut milk. That is were I got the idea to stop taking coconut and its byproduct. All liquid supplements i bought has mct that i have not use again. I might try again i hope its miniscule to be symptomatic or do it transdermally.
 

Jam

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Not sure what he had. But he survived, twice
But, someone his age, unless with serious underlying conditions, shouldn't have to follow any "protocol" to survive. Of all the people his age I personally know that got it, not a single one had to take anything more than aspirin, for what was basically a moderate cold.
 
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But, someone his age, unless with serious underlying conditions, shouldn't have to follow any "protocol" to survive. Of all the people his age I personally know that got it, not a single one had to take anything more than aspirin, for what was basically a moderate cold.
From what I recall he had some sort of environmental toxin/mold issue, I suspect that’s left his immune system compromised. Being exposed to mold is no small thing.
 
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