Vitamin D Metabolism is a Decisive Factor in the Severe Course of Infections

Vitamin D Metabolism is a Decisive Factor in the Severe Course of Infections

As part of the immunological acute phase reaction, the vitamin D level drops for a short time drastically (quote from Prof. Martin Smollich, DAZ 41/2020). When Prof. Smollich coined this sentence in 2020, he was probably not aware of how crucial this statement is for the course of a Covid 19 infection, but also for other infections.

One could conclude from the sentence that the vitamin D level drops only once and after a few days everything is back to normal. The rapid drop in the vitamin D level means that a  process in the body during an infection massively consumes vitamin D. This process is known and was already found in 2010 in a study from Copenhagen. Vitamin D is needed to activate T cells, which are then used to fight viruses. Logical conclusion from the above process: The more viruses occur, the more T cells must be activated, and the more vitamin D is consumed.

How massive this consumption is can be seen in a study from Slovakia, in which a drop in vitamin D levels of 2.5 nanograms per millilitre per day was observed in #Covid 19 patients. That’s actually drastic. To compensate for this drop, a 72 kilograms person would need to supplement 25,000 IU of vitamin D daily during an infection.

Since an infection often lasts longer than a day, this can consume more than 200,000 IU of vitamin D in a short time. Several months usually pass before this deficit is made up if vitamin D is not supplemented. Even if 1,000 IU are supplemented daily, after a 4-day infection (consumption of 100,000 IU), for example, it takes 100 days to return to the old level. 

How the vitamin D level changes depending on the supplemented dose is shown in the graphic of the publication under the following link. The graph of the publication under the following link shows how the vitamin D level changes depending on the supplemented dose.

Gütsel Online, Covid 19: Factor 11 lower risk of infection among bank employees through vitamin D supplementation …

So it is no wonder that all possible consequences of a vitamin D deficiency are observed after an infection and these only disappear very slowly.

Whenever something is consumed, it is only available for a finite amount of time, depending on the initial amount and daily consumption. This also applies to vitamin D.

For example, the average vitamin D level of the population in winter can be used as a starting amount, which is around 22 nanograms per millilitre, of which around 10 nanograms per millilitre can be used if the vitamin D level should not decrease in the severe deficiency range (less than 12 nanograms per millilitre).

In winter, vitamin D is no longer available after (10 through 2.5) 4 days on average, in summer (32 nanograms per millilitre) this is the case from about (22 through 2.5) the 8th day of infection.

It wouldn’t matter if vitamin D could be replaced with something else to activate T cells. But that’s not the case if you follow the study from Copenhagen and know the result of a study from Israel. The study from Copenhagen was funded by the EU, which is why publications were published in all EU languages.

CORDIS Europa, Sun More sun means a better immune system …

≫… Scientists at the University of Copenhagen in Denmark have now discovered that vitamin D is critical to T cell function. Without sufficient sources of this vitamin in the blood, say the researchers, the cells remain dormant and are therefore incapable of ›activating‹ to fight foreign pathogens. When a T cell is exposed to a foreign pathogen, it extends a signalling device or ›antenna‹ known as a vitamin D receptor, with which it searches for vitamin D, said the university’s professor, Carsten Geisler. ›This means that the T cell must have vitamin D or activation of the cell will cease. If the T cells cannot find enough vitamin D in the blood, they won’t even begin to mobilise.‹≪

Two important mechanisms can be derived from this study: T cells extract vitamin D from the blood to fight viruses. The fight against viruses is stopped when there is no more vitamin D in the blood.

Of course, another vital substance or a completely different process could also have a strong influence on the course of an infection. However, the result of an Israeli study from February 2022 speaks against this. In Israel there is a database with more than 400,000 patient data, which is excellently suited for determining the decisive parameters in the course of a pandemic. The database was used to check which parameters, such as previous illnesses and blood values, correlated with the severity of the course of a Covid 19 disease.

Excerpt from study

»While VitD and age were consistently found to be risk factors for increased Covid 19 disease severity, one multivariate analysis found pre-existing COPD to be associated with Covid 19 disease severity, while another multivariate analysis found an association with diabetes.«

Study, Pre-infection 25-hydroxyvitamin D3 levels and association with severity of Covid 19 illness …

The complete database was therefore searched with all the parameters recorded there and nothing was found other than the main factors of age and vitamin D deficiency and the secondary factors of diabetes and an existing lung disease. Since the severity of the course of a Covid 19 infection in 253 patients in a clinic could then be calculated with great accuracy using these factors, it is unlikely that there are other major factors that influence the course of an infection. If these unknown factors were present, they would have reduced the significance of the prediction.

You can read here in which parameters the risk factors for a severe course named here by our doctors are hidden. Israeli study on Covid 19: The main factors in the course of the disease are vitamin D status and age. The probability is therefore very high that the course of a supposedly mild infection suddenly worsens on the day when the vitamin D supply in the blood runs out.

But why has this not been noticed in the 100 years since vitamin D has been known? The answer to that is simple. It was very rare before Covid 19 that the viral load of an infection was so high that the vitamin D supply in the blood was not sufficient to fight all viruses.

Since many people consider the vitamin D level to be constant rather than rapidly changing, it is also not common to measure the vitamin D level several times in a short period of time. As a result, it cannot be noticed that the course of an infection is getting worse at the point at which the vitamin D supply is running low.

There is now a study in which the vitamin D level of Covid 19 patients was recorded several times during an infection, this comes from the Ruzinovska University Hospital in Slovakia: (June 7th, 2022): Serum 25-hydroxyvitamin D Concentration Significantly Decreases in Patients with Covid 19 Pneumonia during the First 48 Hours after Hospital Admission

There, the above-mentioned decrease in the 25(OH)D value of 2.5 nanograms per millilitre per day was observed. The study includes a graph that shows how each patient’s 25(OH)D level changes over a 4-day period. This graphic is shown in the cover of this publication.

Some conclusions can be drawn from the graph

In patients with 25(OH)D values below 7 nanograms per millilitre, the 25(OH)D value hardly drops, so only very little vitamin D can be taken from the blood. Below a 25(OH)D value of around 7 nanograms per millilitre, effective virus control is no longer possible.

Even with higher vitamin D levels, the curves do not fall faster than 2.5 nanograms per millilitre per day, from which one can conclude that the amount of virus that can be destroyed daily is limited. This suggests that the magnitude of the viral load determines the duration of the acute phase of infection. The higher the viral load, the longer the acute phase of infection. Higher vitamin D levels, on the other hand, shorten the acute phase of an infection only slightly. This explains why there are only slight differences in the course of infection when vitamin D levels are very different but sufficiently high. So as long as there is no deficiency during an infection, the course is almost independent of the 25(OH)D value before the infection.

How little is known that vitamin D is used to activate T cells can be seen in the discussion part of the study by the Ruzinovska University Hospital. In this study, various assumptions are made as to why the 25(OH)D value has dropped. There, for example, the administration of glucocorticoids (cortisone) is mentioned as a possible reason, or the falling of the 25(OH)D value is also referred to as a possible laboratory phenomenon, but the study from Copenhagen (vitamin D for T cells) is not listed.

Unfortunately, many other scientists also do not consider the consumption of vitamin D in their studies. Thus they do not look for a difference between »there is no more vitamin D available« and »there is still some available«, but they still try to find out why e. g. a 25(OH)D value of 40 nanograms per millilitre is better than one of 20 nanograms per millilitre. In doing so, one rightly does not see a big difference between 20 nanograms per millilitre and 40 nanograms per millilitre in effect, but does not think that the 20 nanograms per millilitre is simply used up by the 4th day of infection, and  the 40 nanograms per millilitre would last until the 12th day of infection, and that makes the big difference.

So far I have only mentioned that in the area of ​​severe shortages, the fight against viruses will be stopped. However, since vitamin D is also required to moderate the immune system, a deficiency results in incorrect programming of the immune system, which can lead to autoimmune diseases or the body self-destructing (cytokine storm, sepsis).

This was impressively described by the molecular geneticist Michael Nehls on September 8th, 2021.

ngum.de, Dr. med Michael Nehls  (The page is in German language, if you open it with Chrome or Edge you get normally the offer to translate the page).

Interview: Corona – effective protection with vital substances?

»To understand this, you should know that our immune system regulates itself by so-called cytokines, which are hormone-like messenger substances. Some of these activate immune cells during an infection and thus trigger an inflammation, while others stop the inflammatory reaction as soon as the infection is over. If there is a micronutrient deficiency, such as vitamin D, there is an excessive production of pro-inflammatory messenger substances. On the other hand, anti-inflammatory messenger substances are formed to a lesser extent. The result is a serious imbalance in cytokines and their effects. Due to vitamin D deficiency, we are in a state of chronic inflammation that promotes many lifestyle diseases. If you become infected in this already tense inflammatory situation, be it by flu or corona viruses, this triggers a real cytokine storm in the worst case: Mass and completely unbalanced pro-inflammatory cytokines are released, which cause a lot of harm. The lung tissue is not destroyed by the virus, but by the cytokine storm and thus by the body’s own immune system, as are vital organs far away from the actual focus of infection.«

The mechanisms described above lead to the following quintessence

You can only live well with a low vitamin D level until an infection occurs with such a high viral load that the vitamin D resource is no longer sufficient to completely combat the virus. Depending on the level of vitamin D before an infection, after just a few days it can drop to the level of severe deficiency, which promotes autoimmune diseases and sepsis and in which it is then no longer possible to fight the virus. This must be prevented, either by a sufficiently high vitamin D level before an infection, and/or by massive vitamin D supplementation during an infection.

Which vitamin D level is sufficient to survive almost any infection?

Assumption: infection lasts no longer than 15 days. Specification: Vitamin D level must not fall into the range of severe deficiency => at least 12 nanograms per millilitre Daily consumption: 2.5 nanograms per millilitre. Calculation of safe vitamin D levels = 12 nanograms per millilitre + 15 * 2.5mg/ml = 49.5 nanograms per millilitre ≈ 50 nanograms per millilitre.

The value of 50 nanograms per millilitre calculated here fits very well with the recommendations of many scientists who have researched the topic and consider this value to be good based on their experience. Here is an excerpt from a publication from India in which doctors have gained a lot of experience with vitamin D supplementation in Covid 19 patients and have also recorded many vitamin D values.

thehindu.com, High Vitamin D Levels Reduce COVID Infection: NIMS Study …

»Interestingly, 90% of Indians suffer from a lack of sufficient vitamin D in their bodies with an average presence of 13 to 15 nanograms per millilitre. In addition, it is not sufficiently present in most foods and the only source is sunlight between 10am and 2pm, and that too with limitations in absorption such as pollution and people’s age. Dr. Maheshwar also observed that less than 5% of people contracted Covid 19 when vitamin U levels were more than 55 nanograms per millilitre. The mortality of COVID patients is almost zero when the vitamin D level is 60 nanograms per millilitre and is very high when the level is less than 30 nanograms per millilitre.«

The vitamin D value of 30 nanograms per millilitre recommended by the German RKI as good is therefore not sufficient to survive a Covid 19 infection well. The reason for this is easy to understand, because at the time a good vitamin D level was defined, it was not known that it drops very quickly during an infection, and it was also not known that a deficiency is so noticeable. As a result, the RKI did not take into account a safety reserve, as is usual with all technical constructions, for example, so that they do not collapse in the event of a brief overload. One can only hope that the RKI will reconsider its own recommendation as quickly as possible.

However, individual doctors and scientists were already aware at the beginning of the pandemic that the vitamin D level falls sharply during an infection. This can be seen, for example, in a recommendation that a doctor from Bamberg published in February 2020 at the beginning of the #pandemic. In this recommendation, a short-term supplementation of 40,000 IU daily is recommended to quickly increase the vitamin D level and in the case of a Covid 19 infection a daily supplemental amount of 80,000 IU vitamin D is mentioned.

Dr. Kersten, Covid 19 You can do that!  (The page is in German language, if you open it with Chrome or Edge you get the offer to translate the page. This also applies to the other links below). If everyone had followed this guidance, or the guidance of international scientists who recommended preventative vitamin D supplementation of 200,000 IU within 10 days (20,000 IU per day), then there would have been far fewer Covid 19 deaths.

This can now be published as a recent study from the USA has proven the benefits of vitamin D supplementation. This study by the American »Veterans Administration« found a 33% lower Covid 19 mortality in the group that supplemented with vitamin D3 based on the medical records of 408,000 veterans.

Gütsel Online, Finally, taking vitamin D helps …

This study was also evaluated by the German Society for Endocrinology (DGE), and it can be expected that a corresponding statement will be made in the near future. DGE blog: Vitamin D deficiency and Covid 19: What is the current evidence?#comment-110657">

#comment-110657">Commentary by Prof Helmut Schatz of November 19th, 2022

In the guidance of Dr. Kersten does not have a recommendation for the daily dosage. There are good reasons for this, because it is easier to calculate this with a vitamin D calculator because it depends on your weight.

Vitamin D Info, Vitamin D Calculator …

Enter a starting value of 20 nanograms per millilitre and a target value of 50 nanograms per millilitre, plus your own weight, and it will display how much vitamin D you should supplement daily to reach the target value. If you take this dose, the target value is reached after about 120 days.

If this is to be achieved more quickly, you can take the dose calculated for quick refilling in the first 10 days. Since about 300,000 IU (weight dependent) must be supplemented to go from 20 to 50 nanograms per millilitre, a daily dosage of about 30,000 IU is calculated for the first 10 days.

The vitamin D calculator can also be used to calculate how much vitamin D needs to be supplemented during an infection so that the 25(OH)D value does not drop. 2.5 nanograms per millilitre per day must be compensated. Parameterization: Enter a 2.5 nanograms per millilitre higher 25(OH)D value as the target value compared to the starting value (e.g. 32.5 nanograms per millilitre; 30 nanograms per millilitre). Period to supplement is 1 day.  Specify weight. With a weight of 72 kilograms, a daily dosage of around 25,000 IU is calculated to quickly reach the target value.

The vitamin D calculator under the link also calculates the dosage of the cofactors for a vitamin D intake. The first cofactor magnesium is required for the conversion of vitamin D into the form Calcitriol that can be used by the immune system. By taking vitamin D, the body absorbs calcium better, which can increase the calcium level in the blood and calcify vessels. This is prevented by the second co-factor, vitamin K2, which stores calcium in cells and bones. If the dosage is right, bone density increases and the vessel walls can even become more elastic again because calcifications are broken down.

Here are some  consequences of a Covid infection, which are also observed with a vitamin D deficiency: hair loss (3 months after infection), periodontal disease, fatigue, muscle weakness, muscle pain, body aches, depression, increased blood pressure. If you notice this in yourself, keep in mind that the reason could be a severe vitamin D deficiency after an infection.

A vitamin D deficiency promotes these consequences

• Autoimmune diseases (incorrect programming of the immune system)

• Diabetes (about 3 months after infection, only noticed when about 80% of the insulin-producing cells have been destroyed)

• Increased susceptibility to infection (many Covid diseases in the last six months => more widespread vitamin D deficiency than usual => promotes any infections)

• Sepsis or cytokine storm (immune system destroys own body cells)

Much of this can be avoided simply by making sure that vitamin D levels don’t fall into the deficient range during an infection.

More information about Covid 19 and Long #Covid #online.

Christian Wiechering, Kiel, Germany