Should you be taking Vitamin D supplements to help combat the COVID pandemic?

Former Surgeon General had urged physicians to recommend Vitamin D supplementation to combat the COVID pandemic (January 2021)

While the CDC official position is that “There is insufficient evidence to recommend either for or against the use of Vitamin D for the prevention or treatment of COVID-19.”, several prominent physicians continue to advocate the use of Vitamin D in combating the pandemic.

Among them is Vietnam US Veteran and former 17th (2002) Surgeon General, Vice Admiral Richard H. Carmona, MD., M.P.H., F.A.C.S, who, in a statement on January 5, 2021, in MED PAGE TODAY, stated “Don’t let COVID-19 patients died with Vitamin D deficiency”. His concluding remarks was “It is our responsibility as physicians not to wait for perfect evidence when making life-and-death decisions. Given the safety profile of Vitamin D, the 40% prevalence of Vitamin D deficiency in the U.S., and the fact that this season will likely be the deadliest phase of the pandemic to date, we need to act now. Identifying and eradicating Vitamin D deficiency with early and aggressive supplementation in COVID-19 has the potential to save thousands of lives and should be one of our highest public health priorities.” (40). Earlier, some other authors had expressed the same thing (41). In December 2020, over 200 prominent scientist and physician from more than 30 countries, have sent a common united letter to all world governments, urging for the immediate implementation for Vitamin D to combat COVID-19. The letter emphasized that there was Scientific evidence indicates Vitamin D reduces infections & deaths (42).

Unfortunately, the Former Surgeon general’s message as well as those from far too many other prominent physicians and scientists, continue to fall on deaf ears. As a result, the COVID-19 pandemic continues to roar.

Further, merely raising the blood level of 25 hydroxy Vitamin D to 30 or 40 ng/ml, will probably not do an adequate enough job either (46). A larger amount of Vitamin D supplement needs to be taken over a period of up to three months, and ongoing, to develop and maintain a meaningful resistance to COVID-19.

So, for prevention measures and to reduce the risk of COVID-19, you must take Vitamin D (supplement) on a regular basis and maintain a blood level of anywhere between 70 – 100 ng /ml (30 – 100 ng/ml is the normal range). You will get a slow rise in protection until it plateaus at about 12 weeks. This is somewhat variable and depends on genetic and other individual constitutional factors.

However, to treat an active infection, one must take the activated forms of Vitamin D: either 25 Hydroxy Vitamin D (Calcifediol) or 1,25 dihydroxy Vitamin D (Calcitriol). These are not available over-the-counter and must be prescribed by a licensed physician. You may request these medications from your doctor if you or someone you know has COVID-19. The Suggested dosage for calcifediol is: The Calcifediol capsules are 0.266mg; take two immediately and then one on days 3, 7, 14 (47).

How much Vitamin D supplements should you take to achieve the desired protective level?

It is important that your actual blood level of 25 hydroxy Vitamin D, rather than how much Vitamin D supplements you are taking, that determines whether you have an adequate protection against Covid-19. This is because there is a fair amount of variability between the actual amount of Vitamin D supplements you take and the plateau blood level of 25 hydroxy Vitamin D you achieve. There are several reasons for this. One is BMI; that is how much fatty tissue you have in your body. Vitamin D tends to be sequestrated in fatty tissues. Therefore, an obese individual would tend to need more Vitamin D supplements to attain the same blood level of 25 hydroxyvitamin as a leaner individual. There are some probably also genetic factors in the way Vitamin D is metabolized (activated and deactivated).

For this reason, it is crucial to determining your true blood level of 25 hydroxy Vitamin D to ensure that you have adequate protection.

A rough guide is described by Dr. David Grimes (48). It is based on the model of immature mice requiring at least 1 IU per 10 g of body weight, to avoid the rickets (a bone disease caused by Vitamin D deficiency). It is probable that for humans, the requirement would be somewhat higher to optimize immunity.

Another rough guide is provided by Dr. Holick (17, 49). Here, the following is recommended:

To Achieve levels > 40 ng/ml (100 nmol/L)

Normal BMI: Take 6000 IU / day

Overweight BMI: Take 7000 IU / Day (Generally requires X 1.5 the normal amount)

Obese BMI: Take 8000 IU / Day (Generally requires X 2-3 the normal amount)

To determine your BMI, go to: https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html

When taking CO-VIT D+ 10, as a general rule, to attain a blood level of 25 hydroxy Vitamin D of 70-100 ng/ml, the following guideline is suggested:

For individuals 200 lbs., or above, take 10,000 IU / day (2 servings of CO-VIT D+ 10 or four scoops)

For individuals around 150 lbs., take 7,500 IU / day (1 1/2 servings of CO-VIT D+ 10 or three scoops)

For individuals around 100 lbs., take 5,000 IU / day (1 servings of CO-VIT D+ 10 or three scoops)

Take this dosage on a daily basis and check your blood level of 25 hydroxy Vitamin D in 3 months’ time. If you have achieved the desired level of 25 hydroxy Vitamin D (70 to 100 ng/ml), continue this regular regimen on a daily basis. You can either go thru your doctor or order it on line and go directly to a designated nearby laboratory; you do not need a doctor’s prescription for that.

If you remain at the lower level of 25 hydroxy Vitamin D, you may consider increasing the dosage by no more than one scoop a day at the time (but to no more than 4 scoops / day). Continue for 3 months and then recheck your 25 hydroxy Vitamin D level.

If your blood level of 25 hydroxy Vitamin D exceeds 100 ng/ml, YOU MUST SCALE BACK by 1-2 scoops per day at the time. Check again in 3 months’ time and adjust or maintain accordingly.

If you are over 250 pounds or so, you may need more than 10,000 IU a day to achieve the desired blood level of 25 hydroxy Vitamin D. In that instance, you should not take more than 4 scoops of CO-VIT D+ 10, per day to reach the desired blood level of 25 hydroxy Vitamin D. This is because increasing the amount of CO-VIT D+ 10 to more than 4 scoops a day, also increases the amount of the other vitamins and minerals. This is not desired. Instead, if for example it is decided that you need 15,000 IU of Vitamin D a day, you should take 4 scoops of CO-VIT D+ 10 a day, +5000 IU of over-the-counter Vitamin D3 (or D2) per day.

In addition to monitoring your 25 hydroxy Vitamin D, you must also measure your serum calcium. On NO account, should you allow your calcium level to go outside the normal range. A rise in your blood calcium level is the first sign of Vitamin D toxicity (which also extremely rare, can happen and must be closely monitored). If your blood calcium starts to rise outside the normal limits, stop taking CO-VIT D + 10. Go to see your doctor and contact Sublime USA LLC at 1-888-891-2505 or support@sublimeusa.com, immediately.

This regimen assumes that you’re not taking any Vitamin D supplements. If you are, discontinued and supplements before taking CO-VIT D+ 10 or make the necessary adjustment. If you are taking prescription calcifediol and calcitriol, talking to your physician before taking CO-VIT D+ 10. If you have any disease condition, where your calcium tends to be elevated (such as sarcoidosis and cancer), talk to your doctor before taking CO-VIT D+ 10. If you are pregnant, you MUST talk to your doctor before taking CO-VIT D+ 10.

In any event, it is best to always solicit the help of your doctor when you start taking CO-VIT D+ 10, especially if you are needing more than 10,000 IU of Vitamin D per day.

Vitamin D toxicity can, does and will occur; but it is very rare. Overall, it is generally accepted in the medical and scientific community that taking 10,000 IU of Vitamin D a day, is generally SAFE. Some studies have shown no toxicity with even 30,000 IU of Vitamin D per day (14, 15, 16, 17, 50). But you should not take more than you need and just enough to attain the desired blood level of 25 hydroxy Vitamin D of between 70-100 ng/ml.

Vitamin D toxicity first manifests as an elevated blood calcium, outside the normal range (8.5-10.2 mg/dl). The symptoms are somewhat nonspecific and include nausea and vomiting, weakness, frequent urination dehydration and increased thirst, as well as constipation, disorientation, dizziness, fatigue, high blood pressure, irritability and tinnitus (ringing in your ears). This is followed by abnormal various organs including the kidneys (leading to kidney stones), bones, brain, heart and blood vessels).

However, Vitamin D toxicity is very rare and it seems like you really have to intentionally try very hard and take about 50,000 IU of Vitamin D per for several months day for this to happen (14, 15, 16, 17, 50). Vitamin D toxicity typically happens by accidental overdose or manufacturer’s error. In any event, this appears to be easily reversible, by immediate cessation of all the Vitamin D supplements, without long-term sequelae (6)

Vitamin D toxicity only extremely rarely happens at blood levels of 25 hydroxy Vitamin D of less than 150 ng per ml. The normal range of Vitamin D is 30-100 ng/ml. A blood level of 25 hydroxy Vitamin D of up to 100 ng per/ml, is generally regarded as safe; and will probably significantly reduce your risks of Covid-19 infections (6, 14, 15, 16, 17, 50).

So, although taking 10,000 IU of Vitamin D a day is safe, it is recommended that when you take CO-VIT D+ 10, you monitor your blood level of 25 hydroxy Vitamin D and calcium on a regular basis. Initially every 3 months for the first year. Then after you have found the stable dosage and blood level of 25 hydroxy Vitamin D, then you can monitor it once a year.

Remember to always monitor your blood calcium level as well.