Vitamin D and COVID, Is There a Link?
The conversation often starts like this, “What’s my vitamin D level, Doc?” or “I’d like to check my vitamin D level?”
A big part of my job is interpreting lab results for patients and almost irrespective of the condition, the journey usually begins at the interpretation of the complete blood count or CBC for short, and typically culminates at the vitamin D test. Less by design, and more by default -it’s just how labs are typically reported.
Working through this interpretation is a nuanced discussion, requiring a significant amount of compelling education on my part and concentration on the patient’s part.
Even the best of them can sometimes get “glassy-eyed”, through some of the deeper dives.
“...and finally, your vitamin D levels”
Everyone seems to perk up at this point of the show. I’m not sure whether I intentionally dramatize this portion, but it somehow inevitably ends up that way.
For most living at northern latitudes, vitamin D levels are going to be absolutely abysmal.
FYI -Vitamin D status is assessed by measuring 25-hydroxyvitamin D (25OHD). The score is reported in nmol/L in Canada and ng/mL in the US. Reference range is 75-250 nmol/L. The US equivalent would be 30-100 ng/mL. But because of its enormous impact on general health, immunity, and hormone health, most functional medicine practitioners generally like to keep vitamin D levels above 125 nmol/L or 50 ng/mL.
“How bad is that?” asked one gentleman this past week when told of his 39 nmol/L reading.
“It’s pretty sh*t,” I replied. (I find that a gentle cuss word occasionally thrown into the conversation helps tap into the limbic (emotional) part of the brain, which facilitates long-term learning.
“But, that being said, I actually see a lot worse,” I added, somewhat consolingly.
Case in point. A patient the very following day had a reading of 20 nmol/L, a decent level for a human cadaver or a vampire.
My patients are not alone. Vitamin D deficiency affects over 1 billion people by some estimates (1) and up to half of the global population by others. (2)
Vitamin D deficiency is part of a group of overlooked healthcare pandemics that actually underlie the pandemic.
“We cannot ignore evidence in a recent ‘individual patient data’ meta-analysis that vitamin D supplementation protects against acute respiratory infections (ARIs)” urged researchers in a recently published article in the Journal of Global Antimicrobial Resistance (3).
The truth is, our healthcare policy makers have ignored the evidence. Our politicians and media have become so fixated on the roadkill that they’ve taken their eyes off the proverbial road.
People get sick for a multitude of reasons and most of the reasons are related to modifiable disease factors, not just viral exposure. Until we begin to direct our resources on these underlying causative factors, we’re cooked.
Vitamin D status is one of these modifiable factors.
People that are vitamin D deficient are more likely to get respiratory infections, more likely to test positive for COVID-19, and are more likely to suffer severe pneumonia from COVID-19. (4)
82.2% of hospitalized patients in a small but recently popularized study in Spain, were Vitamin D deficient. (5)
Being vitamin D deficient quadruples your death rate from COVID 19. (4)
My patients are constantly asking me, my thoughts on the various COVID-19 vaccines. I’m not sure I can answer these questions intelligibly. I know that the Canadian College of Naturopathic Medicine issued a position paper in October of this year proposing an expanded scope of practice for Ontario NDs to include vaccinations, partially in an effort to help overcome vaccine hesitancy. (6) Whether this comes to fruition or not, we’ll see.
Here’s the point.
Underlying most deaths associated with this pandemic is poor health. Period. The corollary of poor health is decreased immune system integrity. Nutrient deficiencies are critical to both and the modifiable factors associated with poor health can no longer be ignored.
This is true for antioxidant status which includes nutrients such as vitamin C, glutathione, selenium and zinc (see previous blog for latter).
This is true of protein and macronutrient status.
And this is especially true for vitamin D status.
So while you may have to wait to have your ND administer a vaccine in the province of Ontario, you don't have to wait to have them test and boost your vitamin D levels.
(1) Hilger J, Friedel A, Herr R, et al. A systematic review of vitamin D status in populations worldwide. Br J Nutr. 2014;111:23-45.
(2) Holick M. F. (2007). Vitamin D deficiency. N. Engl. J. Med. 357 266–281.
(3) Zemb, Patrick et al. “Vitamin D deficiency and the COVID-19 pandemic.” Journal of global antimicrobial resistance vol. 22 (2020): 133-134. doi:10.1016/j.jgar.2020.05.006
(4) Dieter De Smet, MD, Kristof De Smet, MD, Pauline Herroelen, MSc, Stefaan Gryspeerdt, MD, Geert A Martens, MD, PhD, Serum 25(OH)D Level on Hospital Admission Associated With COVID-19 Stage and Mortality, American Journal of Clinical Pathology, , aqaa252, https://doi.org/10.1093/ajcp/aqaa252
(5) José L Hernández, Daniel Nan, Marta Fernandez-Ayala, Mayte García-Unzueta, Miguel A Hernández-Hernández, Marcos López-Hoyos, Pedro Muñoz-Cacho, José M Olmos, Manuel Gutiérrez-Cuadra, Juan J Ruiz-Cubillán, Javier Crespo, Víctor M Martínez-Taboada, Vitamin D Status in Hospitalized Patients with SARS-CoV-2 Infection, The Journal of Clinical Endocrinology & Metabolism, , dgaa733, https://doi.org/10.1210/clinem/dgaa733