Strengthening the immune system: Vitamin D
A few years ago, as part of an aid project, I was with a team in Albania in a remote village without a car.
A man injured himself while building and developed blood poisoning. We cleaned the wound. I told the woman who had our medicine box underneath her that she should definitely give him antibiotics.
When I asked her two days later if she had done it, she replied: "No. You can develop resistance to antibiotics, and I wanted to avoid that." I was stunned: "He could die and you're not giving him antibiotics for fear of resistance?"
Everything went well back then. But the experience reminds me of the discussion about vitamin D. Some praise it as a miracle cure that saves lives and can do everything else. Others warn of side effects.
What is vitamin D
Vitamin D refers to a group of fat-soluble vitamins, the best known and most important of which is vitamin D3.
Vitamin D is produced in the skin with the help of UV-B radiation. However, it is also present in some Food such as eggs, offal, fatty fish, cod liver oil and some mushrooms.
In order for the body to produce vitamin D itself, you need UV-B radiation with a wavelength of 290 nm to 315 nm. This is only available all year round below 35 degrees latitude. Germany lies between 47 and 55 degrees latitude. In this country, you can only produce vitamin D outdoors between March and October and, if you take in enough, you can also build up vitamin D reserves in fat and muscle tissue.
In the winter months, it is not possible to absorb vitamin D from sunlight in Central Europe. According to a survey by the German Nutrition Society, to which the RKI refers, 25% of the German population therefore have a severe vitamin D deficiency (around 30nmol/l) in the months of November to April. In February and March, the figure is as high as 50% (Wikipedia).
Obese people in particular suffer from vitamin D deficiency and have a far higher risk of a severe course. It seems to be the case that Obesity leads to vitamin D deficiencybut vitamin D deficiency does not automatically make you fat.
To compensate for vitamin D deficiency, you need to soak up plenty of sun in summer Vitamin D-rich food or to draw on reserves if you have any. The alternative is to take vitamin D as medication or as a dietary supplement.
A ARD report summarises this well.
What do you need vitamin D for?
In the body, vitamin D primarily regulates the Calcium levelsl and is very important for Bone augmentation. A lack of vitamin D can lead to rickets and osteoporosis. To prevent this, babies and sometimes breastfeeding mothers in Germany are given vitamin D supplements.
Vitamin D is also involved in many metabolic processesinvolved in the formation of proteins and the control of a large number of genes.
It also has an effect on the production of messenger substances such as dopamine, noradrenaline and adrenaline that stimulate our Mood influence. There is also evidence that there is a link between low vitamin D levels and depression.
A number of studies also show correlations between vitamin D deficiency and a higher Mortality risk and a higher probability, Cardiovascular diseases to get.
One English studywhich analysed patient data from over 180,000 patients, comes to this conclusion: Low vitamin D levels correlate with the highest risk of cardiovascular disease and mortality. The results are consistent with increasing evidence that these diseases occur primarily in people with vitamin D deficiency.
Vitamin D deficiency?
The vitamin D level - officially 25(OH)D - is measured in the blood. 25(OH)D is a Precursor of the active vitamin D, it can be specified in the units nmol/l or ng/ml. To convert nmol/l to ng/ml, divide the value by 2.5, i.e. 2.5 nmol is 1 ng.
The RKI defines it like this with regard to bone health:
- Serum values of less than 30 nmol/l (less than 12 ng/ml) constitute a Inadequate vitamin D supply with an increased risk of diseases such as osteomalacia and osteoporosis,
- serum values of 30 to less than 50 nmol/l (12 to less than 20 ng/ml) are a suboptimal supply with possible consequences for bone health.
- With 25(OH)D serum concentrations from 50 nmol/l (from 20 ng/ml), it is assumed that a adequate supply to maintain bone health.
In medicine, we speak of deficiency when clinical symptoms appear, i.e. when the deficiency already leads to symptoms of illness - such as nutritional deficiency, which leads to the breakdown of fat and muscle tissue and has a negative effect on organs.
In this sense, those who say: There is no vitamin D deficiency here that has been proven to cause diseases such as rickets.
However, according to Wikipedia, the RKI says that in the winter months from November to April at least 25% and in February and March even 50% of the German population is below the range below 30 nmol/l recognised by all sides as severe vitamin D deficiency. In Nursing homes even - all year round - 96% of the residents!
Others - such as the Solar Alliancewhich strongly recommends vitamin D - even set the necessary value for an optimal supply much higher. Among other things, they refer to studies that say that
- Bone augmentation is only possible from 30ng/l (75 nmol/l)
- the lowest mortality rate is reached at 40 - 50 ng/l (100 - 125 nmol/l)
- Breastfeeding mothers can only pass on vitamin D to their children from 48 ng/l (120 nmol/l).
They therefore recommend aiming for a serum value of 150 nmol/l or more. My doctor told me the same thing.
Vitamin D and Covid 19
A number of studies have focussed on Vitamin D and Covid 19 busy.
After a Study with 7807 Israeli employees in the health service the group with vitamin D deficiency, i.e. less than 30 ng/ml vitamin D in the blood, twice as often infected like those with more vitamin D.
A study in a French nursing home took place at 89% reduced Mortality in residents who have had a treatment shortly before or during Covid-19 High dose of vitamin D received. In other words, with additional vitamin D, you are about 10 times more likely to survive.
In Indonesia only 4.1 per cent of 388 Covid patients with a vitamin D level above 30 ng/ml died, compared to 87 and 98.8 per cent of the approximately equally large group of patients with 20 to 30 and below 20 ng/ml vitamin D respectively. The mortality rate with low vitamin D levels was therefore more than 20 times higher. With extremely low vitamin D levels (below 20ng/ml), the mortality rate was as high as 98.8%.
The result a study from CordobaOf the patients without sufficient vitamin D, 50 per cent had to be transferred to the intensive care unit and two (7.5 per cent) died. Of the group with vitamin D 3, only one (two per cent) had to be admitted to intensive care, and all those with sufficiently high vitamin D levels survived without permanent damage. The probability of becoming seriously ill was therefore 25 times higher with low vitamin D levels.
The study was randomised and double-blinded according to all rules of the art, and the result (concerning the intensive care unit) was statistically highly significant.
In the forum of the German Medical Journal stands: It is undisputed that a good vitamin D level helps people to survive COVID-19 better. This has not only been shown in foreign studies, but also in a Study by Heidelberg University Hospital from 10 September 2020
"Vitamin D Deficiency and Outcome of COVID-19 Patients."
The most important sentence in the study is: "Our patients had a Vitamin D deficiency – adjusted for age, gender and comorbidities - with a 6 times higher risk of severe disease progression and ~ 15 times higher risk of death" (Translated into German with Google Translate). (Emphasis mine).
In English Youtube Lecture Vitamin D and COVID 19: The Evidence for Prevention and Treatment of Coronavirus (SARS CoV 2) Professor of Medicine Roger Seheult summarises dozens of studies and meta-studies that have investigated the effectiveness of vitamin D against respiratory diseases in general and Covid-19 in particular.
Also Vitamin B6 appears to be important for Covid prevention and treatment.
Side effects of vitamin D overdose
Naturally - i.e. through the sun - you cannot overdose on vitamin D. This is only possible if you take it once or over a longer period of time. extreme takes much more high-dose vitamin D than the body needs.
One speaks of toxicity when a vitamin D level in the blood exceeds 125 ng/ml (i.e. 375 mol/l), i.e. a multiple of the recommended value of 40 - 60 nmol/l.
Although this is extremely rare, when it happens it can lead to nausea, vomiting, loss of appetite, extreme thirst, increased urination, weakness, headaches, nervousness, kidney stones and kidney failure.
As far as I know, kidney stones can be prevented by vitamin D in combination with vitamin K2.
To put it simply: vitamin D transports calcium and vitamin K2 tells the body where the calcium should go. If vitamin K2 is missing, the body deposits calcium somewhere - for example in the blood vessels (calcification), joints (deposits), kidneys (kidney stones). Just where you don't need it!
A sufficiently high vitamin K level also reduces the risk of arteriosclerosis and therefore, of course, heart attacks and strokes.
What I do myself
The evidence from a large number of studies that vitamin D is important for the body and can also protect against Covid 19 is convincing to me. That's why I make sure my vitamin D levels are sufficiently high.
- mirror can be determined: I have the vitamin D level in my blood analysed regularly - about once a year.
- Vitamin D3 + K2 food supplement: If the vitamin D level is too low, I take vitamin D supplements prescribed by my doctor from the pharmacy or freely available on the market Vitamin D oil in combination with vitamin K2 (re-commissioned advertising)
- Fish and sun: I try to eat fish regularly - at least once a week. In summer, I make sure I get enough sun on my skin (but not too much, of course!). Rule of thumb: if the shade is longer than you are, the skin no longer produces vitamin D.
What you can do
- Have your vitamin D level determined: It's best to see a doctor. If he thinks it makes therapeutic sense, you pay nothing. If he thinks it is unnecessary, you pay 20 euros for the test. But there are also Tests you can take online cost approx. 39 euros (uncommissioned advertising).
- If necessary, vitamin D as a dietary supplement or medication: Here too: preferably after a test and in consultation with a doctor.
To maintain vitamin D levels, you need around 5000 IU a day - from the sun, food or supplements. People who work in an office don't manage this even in the summer - not even in Africa. In the case of acute vitamin D deficiency, you first need more to compensate for the deficiency. The doctor can then prescribe vitamin D supplements.
In comparison: a day in the sun can result in an intake of up to 20,000 IU. In the case of acute vitamin D deficiency, doctors sometimes give their patients 20,000 to 60,000 IU or even up to 100,000 IU per day in the treatment of MS! But that's what doctors do!!! As a private individual, you should not experiment here - and certainly not without having tested your vitamin D level.
The Swiss Society for Nutrition currently recommends 2000 IE Vitamin D per day plus 200 mg vitamin C.
The American Endocrine Society considers an intake of up to 250 µg vitamin D3 per day (= 10000 IU ) to be safe for healthy adults.
The European Food Safety Authority (EFSA) has issued a recommendation for adults Tolerable total daily intake derived from 100 µg (4000 IU ). Make sure you read the pack instructions. It is often recommended to drink enough. - Vitamin D + K2 product in the appropriate quantity - ideally in consultation with a doctor who is well versed in this area.
By the way: Vitamin D is fat-soluble, which is why the body absorbs it best as oil or in capsules containing oil.
Although tablets are practical, they often contain binders and additives that the body doesn't really need. There are combination preparations that offer vitamin D + K2 together, but you should take a close look at how much each contains.
A very detailed Summary of various relevant and very interesting studies on Covid, vitamin D and related topics can be found here
These are my thoughts on a hotly debated topic. I look forward to hearing your thoughts and experiences. If I have misrepresented anything technically, please correct and explain.
Arguments for and against vitamin D are often repeated. I found it interesting in an article about the Successful use of vitamin D in a retirement home in Switzerland and another SSwiss article, which contains several interesting studies the same arguments in favour and against as elsewhere.
To the "Shorten lockdown" series
Many people are in lockdown - tired. They are suffering emotionally, healthily and / or economically. When Coach I know that it is harmful when people feel that they can do nothing and are at the mercy of others.
But it is not the case that we are helplessly at the mercy of the virus. There are things we can do.
- Protection through distance: With AHA and distance, we try to prevent the virus from getting to us
- Protection through the immune system: a Strong immune system which includes vitamin D levels, helps to fight the virus effectively.
There is little talk in the press and politics about how to strengthen your immune system. That's why I'm presenting tips in this series that anyone and everyone can do.
Clearly: None of these tips alone will be able to fight the virus completely. But they could help you and your immune defences to become perhaps 1% or more stronger. These could be the crucial 1%s that decide whether or not a virus catches you and possibly others as a result.
When many of us improve their defences by 1% or 5% or 10%, this could lead to an improvement in the incidence of infection and an earlier end to the lockdown. That is my hope.
You can find a collection of tips for strengthening the immune system in my free e-book Strengthen the immune system.
