[HN Gopher] Vitamin D supplementation reduces autoimmune disease...
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Vitamin D supplementation reduces autoimmune disease risk in trial
findings
Author : sizzle
Score : 102 points
Date : 2022-01-28 19:38 UTC (3 hours ago)
(HTM) web link (www.bmj.com)
(TXT) w3m dump (www.bmj.com)
| pknomad wrote:
| I'm 10 years removed from life science research at this point...
| but aren't these vitamin studies a dime a dozen at this point? I
| don't think I see a comparison of outcomes between groups that
| were vitamin D deficient/insufficient vs vitamin D sufficient,
| which I think could be a bit more useful?
| d883kd8 wrote:
| I'm actually getting submarine vibes from the amount of
| positive Vitamin D coverage I've seen recently
| themikesanto wrote:
| What does that mean?
| lkbm wrote:
| PR/astroturfing. It's a reference to Paul Graham's essay
| "The Submarine: http://www.paulgraham.com/submarine.html
| ozim wrote:
| That someone is pumping vitamin D supplementation
| promotion.
|
| I have also my own example of N(1) where supplementing
| vit-D made me healthier and I am nerd sitting most of the
| time hidden from the sun.
|
| Pre-Covid after start of supplementation I noticed less
| infections, easier hangovers overall better health.
|
| That said I mostly sit inside by the screen and live in
| countries where is not that much sun so it is easy for me
| to get positive outcome of supplementation.
|
| I think there is a lot of people like that and that is why
| there is so much positive reaction for D supplementation.
| nradov wrote:
| Yes most studies on micronutrient supplementation are badly
| flawed in that way. They typically give a supplement to the
| study group and a placebo to the control group, but since
| vitamins also come from other sources the supplements are only
| loosely correlated with actual levels.
|
| A better approach is to pick at least two different target
| levels for separate study groups. Then use periodic blood tests
| to precisely titrate those levels using varying amounts of
| supplements as needed. If the results show a clear relationship
| between the different blood levels and the study goal then it's
| likely a real causal relationship exists.
| _qua wrote:
| Vitamin D is one of the most overstudied topics in medicine.
| Yes, there are probably aspects of vitamin D function that we
| do not understand well, but if there were a large signal for
| benefit, it should have been discovered by now.
| wheelerof4te wrote:
| Or, I don't know...go outside if you need vitamin D.
| clajiness wrote:
| Some of us live at higher latitudes and work during the day.
| It's not as simple or easy as just going outside.
| hangonhn wrote:
| Above or below a certain latitude, sunlight cannot give you
| enough vitamin D during certain parts of the year.
| newsbinator wrote:
| No, this doesn't work. You'd have to be outside in summer
| sunlight with your shirt off to get enough.
|
| In the Northern Hemisphere about half the year it's impossible
| to get enough Vitamin D by going outside.
| wheelerof4te wrote:
| If Russians can do it, so can you!
|
| Don't be a small cat!
| jmnicolas wrote:
| OK you go first big cat! :)
| themaninthedark wrote:
| There are many photos of Russian children in a circle
| around a sunlamp with only bottom underwear on.
| danShumway wrote:
| A quick search online suggests that Russians also tend to
| be at higher risk for vitamin D deficiency and that the
| local climate/weather is a large contributing factor. I
| feel pretty comfortable saying that people who live in
| northern climates like Russia should be getting their
| Vitamin D levels checked, and potentially taking
| supplements or using sun lamps.
|
| Big cats especially need proper nutritional intake, or
| they'll turn into small malnourished ones :)
| sizzle wrote:
| Rather decrease my risk of Melanoma from UV skin damage and
| just supplement Vitamin D by popping a few pills everyday
| sb057 wrote:
| It's significantly below freezing in much of the northern U.S.
| and virtually all population centers of Canada.
| wheelerof4te wrote:
| Aha, didn't know you guys have it so rough _up_ there.
| Jtsummers wrote:
| Indeed, I had no problems with vitamin D levels when living
| in Georgia (the state), especially since I regularly ran or
| otherwise exercised outdoors after work and most weekends
| year round (even when it got cold, it didn't get _that_ cold,
| and there was no ice to speak of south of Atlanta). But
| during my first winter in Colorado, hah! Good luck getting
| sunlight during the week when the sun sets by 4:40pm and the
| sidewalks and trails you run on are covered with ice even if
| you do get outside before then.
| odiroot wrote:
| Well, gee, thanks. I'm in Central Europe and it's middle of
| winter.
| edejong wrote:
| There are many reasons why it's not that simple.
|
| 1. We need to dress up to go outside, exposing only minimal
| amounts of skin.
|
| 2. People of color produce less vitamin D (most likely due to
| skin pigmentation).
|
| 3. Pollution and shadows significantly reduce UV light within
| cities.
| matsemann wrote:
| Sun goes up at 09:34 and down at 15:16, most of us are at work.
| And that doesn't include the mountains blocking the sun, some
| weeks it barely goes above them. So there's light, but no
| direct sun light. And when it's -10C, only a few square
| centimeters of my skin is exposed to the elements, not really
| producing any vit D.
| salberts wrote:
| Interesting, however statistical significance seems borderline at
| best
| kmonad wrote:
| While the vitamin D result was significant, this is not a slam
| dunk result. 123 (treatment) vs 155 (placebo) had a confirmed
| autoimmune disease. Low incidence rate with a small effect size
| hamper the power here. This is somewhat expected given the
| complexity of autoimmune diseases; I would have been highly
| suspicious of a slam dunk, silver bullet result.
| belter wrote:
| Don't exaggerate your daily dose. Its difficult to overdose,
| requires multiple exaggerated daily intakes for several months,
| but some individuals have managed to achieve dangerous levels.
|
| "Vitamin D toxicity"
| https://en.wikipedia.org/wiki/Vitamin_D_toxicity
| pyotr55 wrote:
| i was once accidentally taking 25.000 IU daily for a few months
| instead of 5.000 (400-600 IU being official recommended
| dosages, although many sources claim that that's way to little,
| hence the 5.000). went to an endocrinologist for really weird
| bouts of whole body weakness and exhaustion after even light
| activity. nothing like i had ever experienced. lab results came
| back with a vitamin d level of the maximum measurement level
| (so probably more, maybe a lot more). that's when i realized i
| was taking 5 times more than i had planned. i looked up vitamin
| d toxicity and found fatigue and muscle weakness as symptoms
| and had the answer to my condition. i don't want to know what
| would have happened if i hadn't looked it up myself, because
| the doctor didn't even want to see me again, claiming by letter
| that my blood work was just fine. so yeah, pay attention to
| your supplement regime.
| vanusa wrote:
| Yeah, but you have to be basically gobbling these pills to get
| anywhere near the dangerous levels. People dumb enough to do
| that are probably making all sorts of other poor decisions
| about their health and life.
| goostavos wrote:
| Really, best course of action is not to guess and just get
| blood work done regularly.
|
| It builds up slowly enough that your doc may suggest mega-
| dosing for a few weeks to bring things back in line.
|
| Pure anectdata on the auto-immmune thing: since getting my
| vitamin D levels up, my alopecia barbae has completely
| disappeared. It's pretty crazy cause it's something I've had my
| entire life (and very severe at times). My doc mentioned a link
| between auto-immune and vitamin D, and after bringing my levels
| back in line, all the patches filled back in. Pretty wild, tbh.
| EvanAnderson wrote:
| There was a good discussion a ~16 months ago (and the author
| even showed-up to comment) on an MD's article re: vitamin D
| that discusses toxicity:
| https://news.ycombinator.com/item?id=24138590
| edejong wrote:
| Talking about Vitamin D and calcifediol: why are we not informed
| that Calcifediol treatment (and as such Vitamin D
| supplementation) significantly reduces the chance of ICU
| admission and mortality in COVID-19 based on RCTs [1,2]?
|
| [1] https://pubmed.ncbi.nlm.nih.gov/34097036/
|
| [2]
| https://www.sciencedirect.com/science/article/pii/S096007602...
| lkbm wrote:
| Because at least for Vitamin D in general, there are a bunch of
| studies, and overall it looks like it _probably_ doesn 't
| work[0].
|
| I'd recommend taking it anyway, but there are more than two
| studies and the results are not solidly on the side of "it
| works".
|
| [0] https://astralcodexten.substack.com/p/covidvitamin-d-much-
| mo...
| edejong wrote:
| I would like to take time to debunk that whole article, but
| let's just focus on the article [1] I shared and to debunk
| his argumentation for the preprint article [2].
|
| To begin with, you have to understand that the vitamin D3
| supplement we take is usually cholecalciferol, which is
| metabolised by our body over a period of weeks into
| calcifediol. The key takeaway is that the usual supplement
| takes weeks to be effective.
|
| The RCT in article [1] is so strong because it supplements
| calcifediol at hospital intake, meaning the supplementation
| is immediately effective. So you can see that as a proxy for
| having supplemented with normal vitamin D for a couple of
| weeks prior.
|
| In article [2], the one he is promoting, cholecalciferol
| (normal vitamin D) is supplemented. This means it is unlikely
| that it will have a significant effect during the first weeks
| of admission.
|
| [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456194/
|
| [2] https://www.medrxiv.org/content/10.1101/2020.11.16.202323
| 97v...
| nradov wrote:
| That article is badly outdated and incomplete. I recommend
| reading through this more comprehensive list of studies.
|
| https://vitamin-d-covid.shotwell.ca/
|
| Maintaining adequate vitamin D levels probably does "work" in
| the sense of reducing the risk of severe symptoms. It is not
| a magic cure and shouldn't be relied upon as an alternative
| to vaccines or other therapies.
| wahern wrote:
| Most of these studies suck. For example, as mentioned in this
| response,
| https://academic.oup.com/jcem/article/106/12/e5271/6348963, to
| that first linked study (which may apply equally to the second,
| as it was just a trial for the subsequent study):
|
| > However, the authors did not provide information on 25OHD
| serum levels after the supplementation, limiting the evidence
| of a causal link between vitamin D supplementation and the
| observed clinical outcomes.
|
| IIRC, there was a similar study to the above that was
| retracted, in fact. Possibly even #2 above?
| PragmaticPulp wrote:
| > why are we not informed
|
| What do you mean? I've been bombarded with Vitamin D
| recommendations since COVID started, from my doctor through
| countless podcasts. It also comes up frequently in any online
| discussion about COVID. And before anyone suggests otherwise,
| yes, Dr. Fauci has also spoken about Vitamin D.
|
| But Vitamin D isn't a magic bullet. It helps, but it's not a
| miracle cure like some of the internet articles or early ad-hoc
| studies would imply.
| edejong wrote:
| Podcasts, Twitter, Youtube, Fauci (informally): yes. Official
| medical recommendations: none that I am aware of.
| nradov wrote:
| The official NIH treatment guidelines contain no
| recommendation for vitamin D testing or supplementation. They
| were last updated in April 2021 and appear to not incorporate
| the latest research. At a minimum we ought to be testing
| vitamin D levels for many COVID-19 patients in order to
| identify those at greater risk of developing severe symptoms.
|
| https://www.covid19treatmentguidelines.nih.gov/therapies/sup.
| ..
|
| https://vitamin-d-covid.shotwell.ca/
| [deleted]
| _nothing wrote:
| Yeah, people have been talking about the decreased Vitamin D
| levels in COVID patients and suggesting supplementation since
| almost the very beginning of the pandemic. Maybe they just
| don't want to draw attention away from the fact that
| vaccination and masking are still by far the best means of
| avoiding hospitalization.
| [deleted]
| fumar wrote:
| We need to understand the impact of increased vitamin D on
| vitamin D average vs vitamin D deficient people. I was vitamin D
| deficient, lowest part of the spectrum, and since taking daily
| supplements I noticed less health issues overall. I believe it
| also helps with my sleep cycle. YMMV I am regularly tested for
| vitamin D and its consistently above average, but you must
| monitor to not exceed the threshold.
| serverholic wrote:
| Do you just swallow a pill?
| jeff303 wrote:
| Yep, it's the most insanely underappreciated public health
| intervention in history.
| thinkcontext wrote:
| Many public health people say that iodized salt takes those
| laurels. Or maybe its the most bang for the buck, at an
| estimated $.05/person/year to prevent intellectual and
| developmental problems. Guess it depends on exactly what
| you mean.
|
| https://en.wikipedia.org/wiki/Iodised_salt
| andy_ppp wrote:
| Vitamin D is a fat soluble vitamin isn't it, so maybe we need
| more than just swallowing a pill. We have very bad data from
| most Vitamin D studies suggesting it does almost nothing. The
| people with high natural Vitamin D who spend 1-2h per day
| (exercising?) outside might just imply a proxy for a healthy
| lifestyle.
|
| Alternatively Vitamin D might need to be a) taken in higher
| quantities than the studies have done b) taken with fat c)
| taken with other supplements K2, NAC, Magnesium (which people
| are also deficient in) etc.
|
| We could probably come up with other theories why the trials
| and results don't add up. Nice to see an actually positive
| result from supplimentation.
| sandworm101 wrote:
| >> who spend 1-2h per day (exercising?) outside might just
| imply a proxy for a healthy lifestyle.
|
| Try living in the north. Being outside, exercising, and
| sunlight exposure are three unrelated activities for at
| least six months of the year. Vitamin D supplements are the
| only way short of tanning lamps.
| radicaldreamer wrote:
| Also make sure you're getting your calcium levels tested as too
| much Vitamin D can lead to hypercalcemia.
| sizzle wrote:
| thanks for sharing, never knew this. Got a good source to
| read more up on it?
| pstuart wrote:
| Vitamin K2 can address that:
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566462/
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