[HN Gopher] Vit D supplementation to prevent acute resp infectio...
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Vit D supplementation to prevent acute resp infections: review and
meta-analysis
Author : bookofjoe
Score : 55 points
Date : 2025-04-09 17:26 UTC (5 hours ago)
(HTM) web link (www.thelancet.com)
(TXT) w3m dump (www.thelancet.com)
| gnabgib wrote:
| Related
|
| _High-dose Vitamin D reduces disease activity in early multiple
| sclerosis onset_ (91 points, 15 days ago, 52 comments)
| https://news.ycombinator.com/item?id=43469661
|
| _Over 80% of Covid-19 patients in a hospital study have Vitamin
| D deficiency_ (654 points, 4 years ago, 363 comments)
| https://news.ycombinator.com/item?id=24912172
|
| _Adequate Vitamin D Levels Cuts Risk of Dying from Covid-19 in
| Half, Study Finds_ (372 points, 5 years ago, 211 comments)
| https://news.ycombinator.com/item?id=24607645
| rwbt wrote:
| Just curious, other than taking Vitamin D pills - what are some
| natural diets that are rich in Vitamin D?
| daveguy wrote:
| There are a lot of every day foods with a good supply of
| vitamin D.
|
| https://www.dietaryguidelines.gov/resources/2020-2025-dietar...
|
| I recommend saving a copy of .gov website sources in case the
| regime decides it is unacceptable speech.
| gnabgib wrote:
| Sources: Fish (generally fatty: trout, salmon, tuna, herring,
| sardines, tilapia, flounder), Mushrooms (some, large variety
| in quantity).
|
| Note the article is "food sources" so it includes fortified
| (dairy, juice) which _do not_ contain vitamin D naturally.
| daveguy wrote:
| Uh. Okay buddy, thanks for that.
|
| P.S. most milk sold in the US is Vitamin D fortified.
| adrian_b wrote:
| The substance in mushrooms (ergocalciferol) has a structure
| similar to the true vitamin D (cholecalciferol a.k.a.
| vitamin D3).
|
| Nevertheless, it seems that it is not able to substitute
| vitamin D in all its functions. Therefore it is not
| advisable to count on it as a source of vitamin D.
|
| There has been a company that has claimed that they have
| discovered a species of lichen that contains true vitamin
| D. Nevertheless, their advertising has seemed highly
| suspicious and it looked more like a scheme to separate
| naive vegans from their money.
|
| Even if it were true, exploiting wild lichen would be much
| more unethical than eating the normal vitamin D3
| supplements made from sheep wool. The reason is that wild
| lichens grow very slowly and exploiting a species for a
| food supplement would cause a very high risk of extinction
| for that species.
|
| In any vertebrate animal, the liver is the part with the
| greatest content of vitamin D.
| meroes wrote:
| According to my doctor, raising vit D through diet is not
| reasonable. It's sunlight or pills/shots if sunlight won't do
| it (genetics or climate).
|
| In peak summer with being outdoors 2+ hours every day my Vit D
| was 30 (<30 is inadequate) and drank fortified almond milk
| daily. In winter it drops to 20 with similar outdoor time. Been
| on a 50,000 pill once a week since.
|
| Maybe someone will share a well informed diet that contradicts
| my doctor.
|
| I get the sense that you have to eat a lot of fish, which
| introduces heavy metal concerns because of modern fishing,
| which is why my doctor went the route he did. And how do you
| know the one type of mushroom actually gets the right light to
| have natural Vit D---raw ingredients like mushrooms don't
| usually have nutrition labels.
| Aurornis wrote:
| > Been on a 50,000 pill once a week since.
|
| FYI, spiking Vitamin D levels in the blood weekly might not
| be the best idea, though it's not exactly proven. There's a
| theory that spiking Vitamin D like that can promote blood
| vessel calcification. There's some more theory that Vitamin K
| administered at the same time might help.
|
| It could be safer to do 5,000 IU seven days a week than
| spikes of 50K once a week.
|
| Watch out, though. I was on a similar daily dose and ended up
| with Vitamin D levels touching the upper limit. Too much
| Vitamin D is not good for you.
|
| > and drank fortified almond milk daily.
|
| Can't say without seeing the labels, but I wouldn't expect a
| cup of almond milk to have more than 10-20% of your daily
| value.
| johnisgood wrote:
| IIRC supplementing K with D also helps D to be absorbed
| and/or utilized better.
| canucker2016 wrote:
| Are you getting enough Magnesium (and also Vitamin B6)?
| Magnesium is a required cofactor of Vitamin D in many bodily
| processes.
|
| see https://www.qeios.com/read/479KRZ
| adrian_b wrote:
| Cod liver oil is probably the best choice, as it also includes
| DHA, EPA and vitamin A, providing most things that would not be
| provided by vegetable oil (the only essential fatty substance
| that is neither in vegetable oil nor in cod liver oil is
| vitamin K2).
|
| Well made cod liver oil is tasty and you can add it to food
| together with whatever else kind of oil you prefer (after food
| is cooked, not before, as it is heat sensitive). No more than
| 10 mL/day is necessary.
|
| At least at the analysis reports that I have seen in the EU,
| fish oil has never been found with high content of mercury,
| even if the fish from which it has been extracted are likely to
| have been contaminated with mercury. Moreover, cod liver oil is
| sold in the EU as recommended for children and pregnant women.
| I doubt that any company would have the guts to sell such
| products here without taking care to make frequent chemical
| analyses to ensure that the product is never contaminated.
|
| Chicken liver is also rich in vitamin D, but it is not
| advisable to eat great quantities, because it may contain too
| much vitamin A (which is toxic in excessive amounts). The
| amount of vitamin A in chicken liver or turkey liver is pretty
| much unpredictable, because it may vary by more than an order
| of magnitude between various producers, depending on how they
| feed the birds.
|
| Most vitamin D3 pills contain vitamin D3 that is produced from
| sheep wool (i.e. from lanolin).
| moltar wrote:
| Not possible with diet alone.
| moltar wrote:
| Recommend dminder app for an illuminated way to count D intake
| from both sun and supps.
| mrandish wrote:
| Having looked pretty deeply into Vit D studies a while back, my
| takeaway was (in broad strokes):
|
| * Adding more Vit D doesn't appear to meaningfully _prevent_
| upper respiratory infections.
|
| * However, being _deficient_ in Vit D appears to be correlated
| with a meaningful number of D deficient people who do happen to
| get an upper respiratory infection having a more serious impact.
| Basically, a higher percentage of deficient people (but certainly
| far from all) appear to have worse symptoms for longer and have
| more trouble fighting the infection off. Whether that just means
| an extra day of feeling under the weather or that you join the
| very small percentage of those hospitalized for upper respiratory
| infection depends on the other factors you already know (age,
| overall health, etc) _much_ more than on Vit D deficiency. But
| Vit D deficiency is very probably in the top 5 somewhere behind
| the two statistical Godzillas at the top, age and overall health
| (which are overwhelmingly correlated).
|
| This is only worth talking about because a fairly significant
| number of people are Vit D deficient at least some of the time
| (probably more than 20% but less than half). Who and how much
| depends on where they live, lifestyle, age, diet, time of year
| and there is also a genetic propensity for deficiency that's
| primarily based on race.
|
| Bottom line: If you're Vit D deficient then it may be a good idea
| to supplement a little Vit D which is cheap, easy and extremely
| low risk (Note: nothing is ever zero risk across a large enough
| population but supplementing a small amount of Vit D is about as
| safe as these things ever get). It may be especially worth
| considering if you're in a statistically higher risk group,
| location and/or season. So, if you're at elevated risk and can't
| be younger or healthier, at least don't be Vit D deficient too.
| Once you're not deficient, taking even more Vit D won't help more
| (and can be harmful). Mega-dosing can definitely be harmful, so
| please don't. Starting oral supplements once you have symptoms is
| also too late to matter.
|
| In terms of confidence levels, my sense was there's pretty
| clearly a meaningful correlation here but causation and relative
| effect are fuzzy. The correlation mostly comes from looking
| retrospectively at the Vit D levels of those who have infections
| serious enough to get hospitalized. However, the Vit D
| correlation is far less than age or overall health (which are
| overwhelmingly large). The challenge is looking at it the other
| way, from the front end, where it gets pretty fuzzy trying to
| tease out high confidence causal data, narrow other factor's
| contributions or derive a degree of impact specific to Vit D.
| There are a lot of potentially confounding factors and Vit D is
| not usually checked in many blood work panels unless there's a
| reason to. Worse, long-term diary studies of diet are
| _notoriously_ inexact. So much so that as an armchair amateur
| scientist just trying to objectively assess data, I have to
| attach error bars to longitudinal diary diet studies so large
| they usually swamp any signal. For example, the question: "Does
| being Vit D deficient meaningfully increase _susceptibility_ to
| infection? " I don't think there's sufficiently clear data to
| make any judgement.
| timrichard wrote:
| > you'll just pee out the extra Vit D.
|
| It's fat soluble, rather than water soluble
| adrian_b wrote:
| True.
|
| I have not checked this, but I assume that most excess
| vitamin D, which is stored in the liver, is excreted by the
| liver together with cholesterol and other cholesterol
| derivatives, in the biliary secretion, reaching thus the
| intestine, and not by the kidneys in urine.
| mrandish wrote:
| Thanks! I removed that line.
| slibhb wrote:
| > Bottom line: If you're Vit D deficient then it may be a good
| idea to supplement a little Vit D which is cheap, easy and
| extremely low risk (Note: nothing is ever zero risk across a
| large enough population but supplementing a small amount of Vit
| D is about as safe as these things ever get).
|
| Too much vitamin D can cause pretty serious symptoms, including
| neurological symptoms. This condition has been getting more
| common since so many people are supplementing.
| p0w3n3d wrote:
| I read somewhere that additionally supplied vitamin K
| decreases these side effects. However I'd like to see a
| scientific paper instead of an article
|
| https://www.health.com/vitamin-d-and-k-8427006
| kstrauser wrote:
| Very true. That said, I've been taking 5000IU daily for the
| last couple years after a blood test showed my levels were a
| bit low. As of last week, my 25-Hydroxy D level is 76, near
| the middle of the 30-100 normal range.
|
| Everyone's different: what's right for me isn't right for
| you. I just mean that to demonstrate that it's possible for
| some healthy adults to take a pretty significant amount every
| single day and have perfectly reasonable blood levels.
| Aurornis wrote:
| Vitamin D has a very long half-life in the body once stored.
| On the order of a month or two.
|
| This leads a lot of people into slowly overdosing over
| several years. They start with low levels, get up to mid-
| range on their next blood test, and think they're on the
| right track. Continuing the same dose for years can easily
| put you over the top if you're not careful.
| AStonesThrow wrote:
| If we're deficient then it may well mean that our bodies aren't
| being accorded the _usual natural_ opportunities to manufacture
| it!
|
| Therefore a deficiency here is an indicator of sedentary,
| indoor, face-in-a-screen lifestyles that risk all sorts of poor
| health conditions.
|
| The solution to D deficiency is to manufacture it by touching
| grass, enjoying sunlight (unprotected!!!) and exercising--not
| in a gym--but in that extremely large room, lit by a bright,
| warm lamp that's 93 million miles away.
| SoftTalker wrote:
| Just taper into the sunlight exposure so you don't get burnt.
| Skin cancer is not really a price you want to pay for
| adequate Vitamin D levels.
| AStonesThrow wrote:
| Skin cancer is not something I anticipate, since I
| scrupulously avoid slathering carcinogens onto it. I
| protect with clothing, umbrellas, and old-fashioned hanging
| out in the shade [my skin tone is porcelain, minimal
| freckling, 100% Celtic edition]. 26 years in Phoenix metro
| with literally no burns and no cancer: homelessness and
| public transit benches notwithstanding.
| jerf wrote:
| We don't need to hypothesize about our bodies not getting the
| natural opportunities to manufacture it. We know we don't.
| Plenty of people live in places where the sunlight is
| insufficient for significant portions of the year to generate
| any vitamin D. Many others live in places where they may
| nominally be getting enough ultraviolet to make enough
| vitamin D, but have too much melanin in their skin for the
| ultraviolet conditions where they live.
|
| This isn't all about "oooh sooo much indoors too much screen
| time stop sitting so much lol lol lol". You can go outside
| all day in the middle of winter at the 45 degree latitude,
| where a lot of people live, and you will generate zero
| vitamin D, no matter what you do, because it isn't the
| visible spectrum you need. You need something that isn't in
| the winter sunlight at all. AIUI, it's technically not the
| same part of the UV spectrum that causes sun burns, but
| you're at least on the right track if you think of it as if
| you can't burn (modulo melanin), you can't generate vitamin D
| at all.
| niemandhier wrote:
| To much words for truth:
|
| More does not help by to little will harm.
|
| I live where the sun does not shine, so I take some.
| brokegrammer wrote:
| The title is wrong. The study concluded that Vitamin D
| supplementation doesn't help prevent acute respiratory
| infections.
| noselasd wrote:
| The title doesn't contain any conclusion.
| brokegrammer wrote:
| Right, my bad. Misleading would be the correct word.
| bookofjoe wrote:
| Full title as published in Lancet:
|
| >Vitamin D supplementation to prevent acute respiratory
| infections: systematic review and meta-analysis of
| stratified aggregate data
|
| What with HN's 80 character limit something had to go!
|
| I apologize for making it "misleading" but what would you
| have done?
| tweetle_beetle wrote:
| No need to apologise. It's not misleading at all.
| zerr wrote:
| It's lacking. A good title should save a click for those
| who are not interested in details but just the
| conclusion.
| bookofjoe wrote:
| I ask again: what do you believe the title should be?
| seizethecheese wrote:
| > For the primary comparison of any vitamin D versus placebo, the
| intervention did not statistically significantly affect overall
| ARI risk (OR 0*94 [95% CI 0*88-1*00], p=0*057; 40 studies; 61 589
| participants; I2=26*4%).
|
| Okay, so the 95% confidence interval is reduction from 0% to 12%,
| but since this barely is on the other side of p=0.05 the
| conclusion is fully that the claim is not supported.
| Aurornis wrote:
| The more interesting finding is that people with low baseline
| Vitamin D levels (<25 nmol/L) did not show any improvement.
| Odds ratio of 0.98 (0.80-1.20).
|
| A lot of previous Vitamin D research was dismissed with the
| claim that Vitamin D would be more effective if you only looked
| at people with low baseline Vitamin D status. This paper does
| not show that to be true.
| johnisgood wrote:
| For what it's worth, it is good to know:
|
| - Low Vitamin D Status despite Abundant Sun Exposure
| (https://academic.oup.com/jcem/article/92/6/2130/2597445)
|
| - Vitamin D deficiency can still occur despite supplementation
| (https://emedicine.medscape.com/article/128762-overview?form=...,
| https://www.ccjm.org/content/89/3/154,
| https://www.health.harvard.edu/healthbeat/9-things-that-can-...)
|
| Thus, you can be deficient despite sun exposure and/or
| supplementation.
|
| You should probably get tests done to be sure.
|
| I have MS, I take daily 10k IU. I should probably get some tests
| done myself.
| normalaccess wrote:
| For anyone who is familiar with the Security Now podcast there is
| an excellent write-up from Steve Gibson on the topic for nerds as
| we all work in man made caves and don't get sun. _Highly
| recommended._
|
| I would also recommend Dr. John Campbell's videos on the topic as
| he is quite thorough when reviewing the medical research.
|
| One interesting point John makes is that if you are already sick
| Vit D is to slow as it needs to metabolize and calcifediol
| (25-hydroxyvitamin D3, the active form) is what patents need
| after infection.
|
| Links:
|
| https://www.grc.com/health/vitamin-d.htm
|
| https://www.youtube.com/@Campbellteaching/search?query=vitam...
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