Vitamin D & other nutritional supplements to
protect against severe COVID-19 symptomsRobin Whittle email@example.com 2020-07-06 17:50 UTC
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Disclaimer below: #disclaimer which is followed by contact and copying details. I am not a doctor. Even if I was, I have not examined you.
News and updates
2020-07-02: I have been unable to
disprove my hypothesis that two widely-cited non peer reviewed articles
concerning vitamin D and COVID-19 are invalid
. The authorship of
these articles is attributed to Mark Alipio
et al. Please see my new site
for a detailed account of why I believe these articles are
fabricated. Please do not take my word for it - read the above
account and make up your own mind. I am not an authority.
2020-07-06: Please see the Newcastle upon Tyne (northern England) article #2020-Panagiotou
below. It is the first proper report I have read showing the
correlation between low vitamin D levels in hospital patients and more
severe COVID-19 symptoms. As part of their review of previous
work, these authors cite the bogus - I am sure - Alipio and
Raharusun (now withdrawn) articles, as well as another bogus and also
now withdrawn article whose authorship is ascribed to Glicio.
In the UK, NICE have released their report which, as best I understand
it, finds no good reason to think that low vitamin D levels are causing
severe COVID-19 symptoms: COVID-19 rapid evidence summary: vitamin D for COVID-19, Evidence summary [ES28] 2020-06-29
This is obviously mistaken. I plan to write a response here, but
I have to give priority to paying work after spending a lot of time on
the abovementioned articles which I consider bogus.
I have only briefly looked at this article The major genetic risk factor for severe COVID-19 is inherited from Neandertals https://www.biorxiv.org/content/10.1101/2020.07.03.186296v1
which suggests that a Neanderthal gene haplotype [W
drives an overly inflammatory response which drives severe COVID-19
symptoms, and that this is much more common in some races (though they
do not use this term).
This haplotype is rare in Africans, moderately prevalent in Europeans,
and common in some South Asian populations: "The highest frequency
occurs in Bangladesh, where more than half the population (63%)carries
at least one copy of the Neandertal risk variant and 13% is homozygous
for the variant." This does not relate directly to vitamin
D, but when considering low vitamin D as a cause of severe COVID-19
symptoms, which is very common in people with brown or black skin, who
live far from the equator, we should consider that genetic factors such
as this may also play a role.
Vitamin D basics:
Since 2008, four dozen medical doctors and researchers have been advocating for 40 to 60ng/ml
(100 to 150ng/ml) 25OHD vitamin D levels to be recognised as necessary
for health in general - and particularly regarding the immune
system. This is the Call to D*Action
Also, Barbara A Gilchrist's 2008 article Sun exposure and vitamin D sufficiency
on why sun exposure of artificial ultraviolet light capable of raising
vitamin D always involves DNA damage and so increased risk of
cancer. Exposure to about 1/3 the UVB light required to produce a
little sunburn is all that is required each day to maximise vitamin D
production in the skin. In general, it is best to avoid sun or
other UVB exposure and instead rely on nutritional supplements, since
there is not enough vitamin D in food to achieve vitamin D
She argues for a lower target than 40 to 60ng/ml - but that was before 2012 research
which provides the best estimate we have for the 25OHD levels of our
African ancestors - the level which our immune systems evolved to work
with. The average vitamin D level of traditionally living East
African Maasai herders and Hadzabe hunter gatherers is 46ng/ml
As you will read below, there is a strong relationship between low
vitamin D levels - particularly below 30ng/ml - and severe symptoms,
lasting harm and death among adults with COVID-19. This is
surely a significant reason contributing to the greater toll of harm
and death suffered by people with dark and black skin especially
when they are living far from the equator. The same is true of
children who suffer from Kawasaki disease, which can be triggered by
numerous viral and bacterial infections, including especially
COVID-19. Italian research #2015-Stagi
shows they have very low vitamin D levels: 9.2ng/ml - and 4.9ng/ml for
those with coronary artery artery damage. Most doctors have been
unaware of this important research.
Other pages here
|Doctors! Be sure to see
the sections on this page on the Marik Protocol and Front Line Protocol
for ICU treatment of COVID-19 patients. It results in higher
survival rates than the techniques used in most hospitals today.
This page also has more detailed discussion of COVID-19 endothelial
pathology in the lungs and the importance of good vitamin D levels to
ensure our immune responses are both strong and well regulated.
|(Coming soon.) Links to and
discussion of the most pertinent research on the vexed question of
vitamin D toxicity - in general and for individuals with particular
genetic makeups, particular tumors or granulatomous diseases such as
sarcoidosis. For now, see Vitamin D Is Not as Toxic as Was Once Thought , Vitamin D Toxicity - A Clinical Perspective
and Calcium and Vitamin D in Sarcoidosis: Is Supplementation
Safe? which indicates that vitamin D and calcium supplementation
for sarcoidosis patients is beneficial and does not result in
hypercalcemia. (Sarcoidosis involves extreme immune system
dysregulation in which various types of immune cells attack each other,
mistaking each other for pathogens, and clump together all over the
|(Coming soon.) If demand
for pharmaceutical vitamin D greatly exceeds supply (as I expect it
will once most people recognise they need substantial supplements to
stop their immune system causing harm and death when responding to the
SARS-CoV-2 virus), what are we going to do for people who cannot get
the supplemental D3 they need or good, high-elevation sun exposure most
days? Firstly, access some of the vitamin D3 used for
agricultural feed, which is where about 75% of D3 production
goes. Secondly, use boron - which is worth using anyway for its
anti-inflammatory and other immune-system benefits. Thirdly, find UV
light sources which can drive D3 synthesis in our skin - this is
Finally, build vitamin D3 factories in our own countries -
skunkworks-style as in war-time, since our lives depend upon it.
Regarding this, for now please refer to this excellent description of
industrial production of vitamin D3 cholecalciferol by Arnold L. Hirsch in 2010 : https://sci-hub.tw/10.1016/B978-0-12-381978-9.10006-X .
|About 10 million people
are confined in prisons and jails. They and the
prison staff are at high risk of COVID-19 infection. While (in
the USA, so far) rates of prison harm and death per confirmed case from
generally lower than in the outside world, this is primarily due to few
prisoners being over the age of 60. The number of confirmed cases
is generally higher - which may be partly due to better testing in
The rate of harm and death
for younger prisoners may be higher than in the outside world - in part
because prisoners in general have even lower vitamin D levels than free
There is an urgent need to give all these people
substantial vitamin D supplements - and more generally the full range
of vitamins, minerals and omega-3 fatty acids. The health and
other benefits have already been shown to far exceed the small cost of
providing these - and COVID-19 infection is close to inevitable
in the months to come.
|Decreasing sodium (salt)
consumption and boosting potassium intake - including with supplements
in the form of potassium gluconate solution drinks - reduces the
incidence of high blood pressure and stroke.
| Links to research
articles indicating that in general, with certain exceptions, fever (at
least in the initial stages) should not be lowered because it is an
important part of the body's defense against viral and bacterial
infection. Also links to some research which may indicate there
is little harm and perhaps some benefit of lowering fever with COVID-19
with particular drugs.
Contents of this long page
||Some other sites of interest.
||Recent articles concerning COVID-19 and vitamin D.
|| Severe vitamin D deficiency in Italian children with Kawasaki disease.
||Ending the global vitamin D
deficiency pandemic by aiming for at least 40ng/ml 25OHD. This is
the only way we can ensure that COVID-19 causes far less harm and fewer
||COVID-19 induced Kawasaki disease in children and babies AKA Paediatric multisystem inflammatory syndrome.
||Discussion of the high rate of
harm and death to black, Asian and minority ethnic people in the UK has
generally not mentioned their very high rates of vitamin D deficiency.
||Pep-talk for doctors regarding
the need for robust vitamin D supplementation to protect against severe
COVID-19 symptoms. Written specifically for BAME doctors, but
really to all doctors - and not just because of COVID-19.
||Articles concerning vitamin D
supplementation to protect against harm and death from COVID-19,
including research which shows that 40ng/ml or more 25OHD is required
for proper immune system functioning. Also a list of other
articles of interest I have not read or written about yet.
||Irish doctors debate whether to use low or ridiculously low doses of vitamin D3.
||21 authors advise very low levels of D3 supplementation, aiming for a minimum 25OHD level of only 10ng/ml.
||COVID-19 pathology - weak and dysregulated immune systems. The icu/ page has all the details.
||Weak and dysregulated, over-inflammatory, immune responses are
caused by lack of helminths, individual genetic variation, dietary
excesses and several common nutritional deficiencies
||I am not a doctor etc. About these pages. Contact and copying information.
||Global plan for better nutrition
for immune system health, and for better guidance regarding
fever. Written for people who are fusspots for detail.
||This section is older, and not
so recently updated. It is based on the email I sent out to
doctors, researchers etc. starting on 22 March 2020.
In general, people infected with COVID-19 only suffer serious harm, or are killed,
due to their immune system being weak and/or being dysregulated
- their immune response is overly-aggressive, proinflammatory, generally ineffective against the virus and most importantly, damaging to the self
The same is true of influenza, but COVID-19 is much worse because it is
highly infectious and - when the dysregulated immune
system allows the virus to infect the lungs - the loss of ACE2
receptors there raises angiotensin II, which causes vasoconstriction of
the pulmonary capillaries and a highly coagulative state, which leads
to micro-embolisms and larger blood clots there and in other parts of
the body. Both the vasoconstriction and the clots reduce the
ability of the lungs to exchange oxygen and carbon dioxide.
Without hospital care, including oxygen (though ideally not mechanical
ventilation, which tends to make things worse), the patient will be
seriously injured or killed through lack of oxygen.
Direct viral and/or dysregulated immune responses damage endothelial
cells in the lung - and presumably elsewhere - and the body responds to
this blood vessel damage by making the blood hypercoagulative.
This hypercoagulative state drives most of the harm which results, with
micro-embolisms and/or larger blood clots anywhere in the body,
including the lungs, brain, spinal cord, heart, kidney and liver.
This can lead to death via stroke, heart attack and kidney failure.
There are evolutionary reasons why our immune systems are dysregulated
- as explained below, we (in developed countries) lack the helminths
(intestinal worms) our ancestors had. Our immune system evolved
to counter helminthic downmodulation of many immune responses.
Without helminths, many of our immune responses are overly-inflammatory
and self destructive.
There is also considerable genetic variation between individuals.
Finally, common nutritional deficiencies and excesses both weaken our
immune system, and reduce its ability to regulate its potentially
excessive actions. The focus of this web page, and others which
lead from it, is to correct these nutritional problems - most
importantly by way of vitamin D3 supplements. If all humans do
this, then our general health will improve in many ways, and COVID-19
will cause us little trouble.
This is the only way we can deal with the threat of harm and death from COVID-19
and likewise with the rising incidence of numerous chronic and acute
health problems which result from our generally weakened and
dysregulated immune systems.
We can't stop the spread of the SARS-CoV-2 virus which causes COVID-19
illness. Antivirals have never stopped the spread of any
virus. The common hope or expectation that a vaccine could stop it, by being
proven effective and safe, and administered to most people in the
world, is unlikely in any time frame - and impossible to achieve in
the next few months or year.
It is likely that drugs will be developed which reduce the ability of
the virus to replicate, and so cause serious symptoms. These will
be welcome, but are unlikely to be tested and made available en-masse
any time soon. It makes no sense to be using drugs like this
while it is easier, safer and less expensive to improve our immune
system's strength and ability to regulate itself by correcting
We cannot continue to contain the spread of the virus by lockdowns,
social distancing etc. These measures have unsustainable social,
economic and health costs. For now, we should certainly try to
slow its spread - but only when most people's immune systems are
working properly will it be possible to relax these constraints, and so
let the virus spread without causing much harm or death.
Giving humans their proper operating conditions - at least regarding
nutrition for general health and strong, well-regulated immune systems
- is necessary for numerous other reasons (reducing asthma,
neurodegeneration, inflammatory bowel disease, diabetes etc.) and is
urgently needed so we can cope with COVID-19 without the twin disasters
of widespread harm and death (as is occurring now) and of all the
so-far uncounted costs, harm and death which results from lockdowns.
Even children can be affected, with the coronavirus causing their
dysregulated immune system to attack the self in a pattern similar to
that of Kawasaki disease. In pre-COVID research #2015-Stagi
it was shown all
children with this disease were severely vitamin D deficient. The
children with the lowest vitamin D levels had the worst outcomes -
their vitamin D levels averaged about 1/10th of the levels of African
herders and hunter gatherers.
So when children are now, tragically, harmed and killed by COVID-19 in ways which resemble Kawasaki disease, it
is reasonable to assume that this is only occurring due to their
extremely low vitamin D levels (no-doubt combined with genetic and
other factors) - and (in the absence of evidence to the contrary) that their parents and treating doctors were
unaware of the need to provide them with adequate vitamin D
There is no reason to believe that there ever
a vaccine which is effective against COVID-19. Immunity to coronaviruses after infection -
might be elicited by a vaccine - may only likely to last a few
years. Vaccines can cause much worse symptoms in some or
many people when the antibodies they raise attach to the virus and are
recognised by receptors other than ACE2, which enables the virus to
infect other types of cells. (Contrary to this gloomy outlook,
see the research mentioned in points 1, 2 and 3 of this nymag.com
article: people who test positive a second time are not
infectious; SARS-CoV antibodies seem to be effective up to 17 years
later and a SARS-CoV antibody is effective, in vitro, against
SARS-CoV-2 will continue to mutate. We all have to live
indefinitely with current and/or future strains. Fortunately,
this virus does not cause serious trouble for people with properly
functioning immune systems. Other viral diseases do - for
instance smallpox, or ebola. We will be in serious trouble - no
matter how good our nutrition and strong our immune systems - if a novel virus emerges which is as
deadly as these whilst also being highly infectious.
Unfortunately, for various reasons - most of them spurious - most
(but not all) doctors are excessively wary of nutritional
supplements. This wariness is part of the reason we have such
widespread vitamin D deficiencies. The official vitamin D
guidelines are recognised by many researchers and some doctors as being
woefully inadequate in terms of desired 25OHD levels and regarding
maximum safe dosages of vitamin D3.
This global problem of inadequate nutrition will only be solved by
people choosing to take supplements regularly. Ideally this would
happen as a result of most or all doctors recognising that their
guidance, which lead to the current disastrous situation, was wrong and
that they need to accept and promote the regular use of nutritional
supplements in quantities sufficient to make most people replete -
generally without the need for medical supervision and blood tests,
which are more expensive than the supplements themselves.
For instance, an adult taking 4000IU a day of vitamin D3 needs a gram
every 27 years. The ex-factory, kilogram lot, price of
pharmaceutical D3 is USD$2500. At that rate, the annual cost is
USD$0.09 per year. All that is needed is a capsule or tablet a
week, so 5,200 such capsules, with a total D3 cost of USD$10, and I guess USD$100
manufacturing cost, would be good for one adult for 100 years.
For various reasons - not all of them good -
doctors are extremely resistant to changing their thinking.
In order to avoid a catastrophic continuation of the current harm and
death, they will need to change their minds fast
- since I can't imagine most people, with the support of their
governments (to handle the logistics of obtaining and distributing the
nutrients), achieving this level of supplementation without the support of most doctors.
Even if COVID-19 disappeared, we still need to give all humans their proper operating conditions as a matter of
urgency, since the same nutritional problems, against a background of
genetic variation, drive the growing burden of chronic and acute
disease, including: diabetes, neurodegeneration (Alzheimer's,
Parkinson's diseases etc.), hypertension, stroke, multiple sclerosis,
inflammatory bowel disease (Crohn's disease and others), sepsis,
osteoporosis and so on.
Here is a chart depicting vitamin D blood levels in relation to body
weight and D3 dosage. The Kawasaki disease figures come from
research before COVID-19 elicited a similar, deadly, condition in some
children, especially in the UK. You can read below #2016-Caprio
research which indicates that 40ng/ml
is the minimum 25OHD level for proper immune system functioning. Yet some experts #21authors
advise the public that they should supplement to attain merely 10ng/ml
. This is very close to the 9.2ng/ml average 250HD levels of children with Kawasaki disease #2015-Stagi
This is from:
Here is a world map which depicts some estimates of vitamin D deficiency:
The light grey percentages are for
people with less than 30ng/ml, which is the threshold of vitamin D
sufficiency adopted by the Endocrine Society and some other
organisations. Below you can read research from the Philippines
and Indonesia which indicates that the risk of severe symptoms and
death from COVID-19 is very much greater for people whose levels are
below 30ng/ml than for those with higher levels.
Although these figures are incomplete, and based on research at least 6
years old, it is easy to see what that vitamin D deficiency is a
profound problem in most, if not all countries. Jordanian men are
doing pretty well, but not Jordanian women or any of the other
populations surveyed. Among the most alarming results are women
in Bangladesh (80% below 20ng/ml, the UK with 47% below this in winter,
and 78% of Scots below 20ng/ml - and 35% below 12ng/ml.
So about 1/3 of Scots have about 1/4 of 46mg/ml average vitamin D blood
levels of traditionally living African herders and hunter-gatherers (https://www.ncbi.nlm.nih.gov/pubmed/22264449
). Everyone's immune system evolved to work with these 40 to 60ng/ml
The next chart depicts seasonal
variations in vitamin D levels in the UK. See below for another
chart which separates out White and BAME levels.
Larger version 1868x1616
. This is from:
The graph shows month-by-month average 25OHD levels in white men and
women in the UK, all aged 45. Most of the time the 25OHD levels
of most people fall under the 30ng/ml threshold below which the
Endocrine Society defines vitamin D insufficiency or deficiency.
16% of these people used modest ~200IU supplements which raised their
levels 3ng/ml on average. This contributes only about 0.16ng/ml to
the average - so the graph is very close to the averages of
non-supplementing individuals. Vitamin D from food made only a
slight contribution to these levels.
Scots and the obese had lower levels than average. African and
Asian people who do not supplement would have significantly lower
levels. None of these averages come close to the 40ng/ml
minimum level required for proper immune system functioning - according
to several research articles cited below, including: #2016-Caprio
and to the Scientists' Call to D*Action link
, which was originally made in 2008.
The initial phase of COVID-19 infection, harm and death in the UK
occurred in March to May 2020 - when 25OHD levels were close to their
Here is another graph of seasonal
vitamin D levels in the UK, with separate curves for men and women,
white and BAME (black, Asian, minority ethnic) - which means UK
residents with black or brown skin.
Larger version 1453x1255
. If these graphs don't make you gasp at the tragedy of harm and
death resulting from easily correctable nutritional deficiency, then
are not paying attention. This is from:
The data is from 4,510 people, 1,326 of whom were SARS-CoV-2 RNA
positive. Despite the article's title, I found nothing in
it regarding COVID-19 severity. No-one is seriously suggesting
that robust vitamin D supplements will significantly affect the chance
of being infected with the SARS-CoV-2 virus. The lower vitamin D
levels of BAME men compared to women coming out of winter probably
contributes to their higher incidence of severe symptoms and death
compared to BAME women.
There is no numeric mention of the averages for white and BAME people,
but the dotted lines evidently show these: 48 and 32 nmol/L
respectively. Divide by 2.5 to get ng/ml:
- UK white average vitamin D level: 19.2ng/ml = 42% of the presumed average of our African ancestors.
- UK BAME: Black (Caribbean, African, any other Black background),
Asian (Indian, Pakistani, Bangladeshi, any other Asian background),
Chinese, Mixed (White and Black Caribbean, White and Black African,
White and Asian, any other mixed background) and ‘other’. Average vitamin D level: 12.8ng/ml = 28% of the presumed average of our African ancestors.
These BAME figures are averages for multiple ethnic groups. It is
reasonable to assume the Africans, with the darkest skin, have still
lower average 25OHD levels. Now consider UK African males, coming
out of winter, take the 20% of these with the lowest vitamin D levels
and I guess you would find hundreds of thousands of men with 25OHD
levels 6 to 9ng/ml. Now consider all you read below and on the icu/
page about 40ng/ml being the minimum vitamin D level required for
proper immune system functioning, and how weakened and dysregulated
immune responses (of which low vitamin D is the primary easily
avoidable cause) are the cause of harm and death with COVID-19.
Also consider that some or many COVID-19 sufferers the world over may
have lowered their temperature with drugs in the initial stages of
their illness, so further reducing their body's initial attempts at
fighting the virus. (See fever/
for the pre-COVID-19 research I found which suggests fever should generally not be lowered.)
Then consider that - assuming they made it to hospital, rather than
dying at home - most of the people who suffer harm and death from their
own immune responses to COVID-19 were generally treated by hospital
teams who were not
repleting their missing vitamin C (as is done following the Marik Protocol, with much better survival rates icu/#Marik-protocol
) nor repleting their generally disastrously low vitamin D (except
perhaps by a measly 400IU, when they need at least 10 times this on a
steady basis, and 100 times more as a bolus dose to quickly correct
their deficiency) . . . and wonder why so many BAME men and women have
died in these early months (to June 2020) of the COVID-19 epidemic in
More on COVID-19 severe symptoms of BAME people in the UK below: #uk-bame
Most people the world over are vitamin D deficient. This is
especially so of people who spend most of their time indoors, or
protecting themselves from sunburn (as they should) and all the more so
of people with brown and dark skin who are living far from the equator.
For instance (BMJ response
Somalis make up 0.84% of the population of Stockholm County, but but of
the 15 deaths to 2020-03-24, 6 were Somali. This is a death rate
48 times that of non-Somalis.
Other sites concerning Vitamin D, the immune system and COVID-19
This is a long established vitamin D
advocacy organisation, whose International Scientists Panel includes
many of the most prominent vitamin D research article authors. Since 2008 they have advocated
(the Call for D*action) for 40 to 60ng/ml 25OHD to be regarded as the optimal vitamin D level -
well above most of the standards which persist to this day.
They offer test kits
for vitamin D, omega-3 fatty acids and other nutrients, since there is 25OHD levels vary
greatly between individuals using the same supplementation
amount. (Some of that variation will be due to their weight and
whether or not the supplement is taken with a fatty meal. So I
think the graph there, with its extremes from large samples, depicts
more variation than would be expected if a person scales their D3 dose
to their body weight, and takes it with a fatty meal.)
Karl Pfleger's extensive information.
Rufus Greenbaum has been advocating
better vitamin D nutrition in the UK since at least 2011.
Sometime in the future - a new website
I plan a more extensive and better organised site 5 Neglected Nutrients
concerning five nutrients which most people do not get enough of,
causing not just potentially deadly responses to COVID-19, but lifelong
problems with the
immune system, hypertension, stroke, bone and dental health:
- Vitamin D.
- Omega 3 fatty acids.
- Vitamin C.
Further down this page you will find information on these.
Research in the last few decades shows
that boron has numerous functions regarding proper immune system
regulation and bone health. The mechanisms by which it works in the
body are not well understood and most doctors do not regard it as an
essential nutrient. However, it is inexpensive, safe (below 20mg/day) and in doses such as 6 to 12mg a day helps reduce
arthritis and problems caused by inadequate vitamin D.
Modern diets typically provide only about 1mg boron a day. Like
vitamin D, it improves immune system regulation by reducing the
overly-aggressive, pro-inflammatory response, which drives the cytokine
storm response some people have to COVID-19.
Recent articles concerning COVID-19 and vitamin D
Newcastle upon Tyne (UK) COVID-19 patients are vitamin D deficient - and the ICU patients are more deficient
Here is the first substantial report I
know of regarding low vitamin D levels correlating with COVID-19
severity. (See below for the Alipio and Raharusun articles which
reported this, were widely cited, including in this article, and which
I cited too - but which I now believe are bogus.) However, I have
not yet had time to look carefully at this 2020-06-10 Singaporean
serum 25-hydroxyvitamin D (25[OH]D) levels in patients hospitalised
with COVID-19 are associated with greater disease severity: results of
a local audit of practice.
Panagiotou, Su Ann Tee, Yasir Ihsan, Waseem Athar, Gabriella
Marchitelli, Donna Kelly, Christopher S. Boot, Nadia Stock, Jim
Macfarlane, Adrian R. Martineau, Graham Paul Burns, Richard
Quinton 2020-06-25 (Not peer-reviewed.)
164 primarily Caucasian hospital inpatients with COVID-19 had their
25OHD levels tested on admission, prior to a selective vitamin D
supplementation trial - more on this below.
92 were in the general wards and 42 in the ICU. (I am not sure
how this assessment was made, since patients can be transferred between
these.) The most directly interesting findings were that the general ward
patients averaged 30.6ng/ml
25OHD while those in the ICU
. This looks like a significant difference to me, but, probably
due to the wide range of values in each group, analysis revealed that
the p value was only 0.3, meaning that that with the observed scatter
of values, even if there was no actual link between the ward/ICU
observation and the measured levels, that on average, once in every
3.333 trials we would see a deviation like this.
However, some of the other observations point more strongly to a strong
correlation between low vitamin D levels and COVID-19
severity. No-one is seriously suggesting that the low 25OHD
levels result entirely or largely from the severity of COVID-19, so
most of this relationship presumably reflects low vitamin D levels
causing the increased severity. For this not to be the case, some
more complicated hypothesis would need to be accepted, such as an
unmeasured condition causing both the low 25OHD levels and the
severity. This is not out of the question to some degree, but
when we consider how far these 25OHD levels are below the 40 to 60ng/ml
levels recommended as optimal, it is hard to avoid the conclusion that
low vitamin D levels are a major causative factor of COVID-19 severity.
The first observation is that the general ward group was, on average,
older (76.4 years) than the ICU group (61.1). This is highly
statistically significant: p less than or equal to 0.001.
This means that if there really was no relationship, then such a
deviation would be observed on average only once in 1000 or more trails.
Since greater age is generally associated with worse disease outcomes
(the association is causative from age to outcomes, since the outcomes
can't affect age!) the fact that the ICU patients were younger makes us
think that some common factor, such as low vitamin D, might be having a
stronger ill effect with these people, than if the average ages of both
groups were the same.
Moreover, many comorbid conditions (pre-existing conditions generally associated with worse COVID-19 outcomes) were marginally less
prevalent in the ICU group. The two exceptions were obesity (how
defined?) with ward/ICU percentages 6.3% / 25.7% and hypertension (how
defined) 40.5% / 686.6%, both of which were p <= 0.01, and so highly
significant. However, I am puzzled by the hypertension finding,
since the ICU average blood pressures were lower than the ward average.
C-reactive protein levels were much higher in ICU patients than in the
ward patients. This is expected since this is marker of increased
The researchers defined "normal" 25OHD levels as 20ng/ml or
above. This may be normal in the far north of England, but it is
half the bottom of the 40 to 60ng/ml range recommended by the D*action
MDs and researchers. The ward/ICU percentages of patients with
less than 20ng/ml 25OHD were 61% / 81% (p = 0.02.) This is a very
coarse level of analysis.
Overall, the patients (here the ward and ICU patients are considered all together) had low vitamin D levels:
- 66.4% had less than 20ng/ml.
- 37.3% had less than 10ng/ml.
- 21.6% had less than 6ng/ml. This is described correctly as "very severe deficiency".
Even more horrifying, the researchers mentioned that an unspecified number of patients' 25OHD levels were below the 3.2ng/ml detection limit
! This threshold is 7% of the 46ng/ml average of East African herders and hunter gatherers.
This is a highly preliminary report, as part of a program in which
COVID-19 patients with sufficiently low 25OHD levels recieved
supplemental vitamin D3.
Sidebar: I am just a . . . . If I was a . . . .
I am just an electronic technician, and
I think of low 25OHD levels like a sagging power supply voltage or a
flat battery. I would see patients suffering and dying for lack
of this vital nutrient and I would move fast to fix it. So I
would be supplementing these patients to get their 25OHD levels well
into the 40ng and higher range. I would use oral or perhaps IV
25OHD (calcifideol) itself, since this goes straight into the
bloodstream, while D3 takes days to a week or so to be converted into
25OHD - and that assumes normal liver function, which is unlikely to be
I would also recommend that everyone on Earth supplement to get their
25OHD levels up to 40ng/ml at least. To me, this is just
like telling my musical instrument customers to use fresh alkaline
batteries, not old ones, or ordinary carbon-zinc batteries. The
cost of these batteries and of vitamin D supplements is vastly lower
than the cost of batteries being flat, or 25OHD being low.
These researchers considered 30ng/ml as not needing any vitamin D
supplementation. Patients with levels between 16 and 30ng/ml were
given 800IU D3 orally a day. This is a fraction of the dose most
adults need to attain 40ng/ml or the like, but at least it is something
- and twice the scandalously low 400IU a day the UK government
Patients with 25OHD levels between 10 and 16ng/ml were given 100,000IU
(2.5mg) D3 as a single bolus dose, followed by 800IU a day.
100,000IU is good.
Patients with 25OHD levels between 5.2 and 10ng/ml were given 200,000IU
(5.0mg) D3 as a single bolus dose, followed by 800IU a day. 200,000IU
Patients with 25OHD levels below 5.2ng/ml were given 300,000IU
(5.0mg) D3 as a single bolus dose, followed by 1600IU a day. 300,000IU
is better still.
Now hypercalcemia resulted from any of these bolus doses, which is not surprising.
The authors write that vitamin D levels are so low in the UK in part
due to poor promotion of vitamin D supplements to the public.
They don't mention that this 400IU dose is 10% or less of what most
people need to get to 40ng/ml or so. The note that in
Scandinavia, vitamin D prescription is promoted to the public in
winter, and result in better outcomes.
My overall view of the UK, being hit by COVID-19 as the country came
out of winter, is that almost everyone has dangerously low 25OHD
levels, and that this is in part due to the high latitude and to the
scandalously low standards of dosage and adequate 250HD level
recommended by the UK government. I regard these low levels
as being the biggest single easily avoidable cause of COVID-19
suffering, harm and death in the UK. A similar pattern plays out
in all countries - but the UK government recommendations
are, in my view, just to be very clear, dangerously and irresponsibly low
Majority of Italian COVID-19 patients are vitamin D deficient
It might seem obvious, but unfortunately, nutrition is still widely overlooked in the hospital setting.
Our preliminary analysis clearly shows that the majority of patients admitted with COVID-19 have a vitamin D deficiency.
I hope that COVID-19 and that research, such as my own and the other
studies, are seen and taken as our chance to develop a well-designed
preventive campaign that puts nutrition and tailored vitamin
supplementation at the core of preventative medicine.
Latitude and COVID-19 severity - solar UV exposure and vitamin D
I have not yet had time to read this article, but it looks interesting:
Death rates correlate with high northern latitude. There is too little data at southern high latitudes to be significant.
There is also a critique of RCTs (Randomized Clinical Trials), citing
the work of several other researchers on this topic - regarding some
RCTs not meeting proper requirements and their results incorrectly
being being ascribed greater validity than observational studies.
#veracity #2020-Raharusun #2020-Alipio
Reports of research from Indonesia and the Philippines which I
previously accepted and quoted are, in my opinion now, completely
Please see my new site:
for all the reasons I now believe these two articles
(and one other not cited here) concerning vitamin D and COVID-19 are
fabricated. Please read the material there and make up your
own mind, rather than taking my word for it. I am not an
I apologise for not scrutinising these articles more carefully at
first. I had no idea that anyone would write completely fictional
documents posing as academic articles.
23% of the Indonesian population is
vitamin D "deficient" (25OHD < 20ng/ml). "The examination of Vitamin
D status is not a routine in Indonesian clinical setting." Of 10
COVID-19 patients average age 49.6 in Bethesda Hospital Yogyakarta, 9
were deficient and 1 was "insufficient" (20 to 29ng/ml).
Their levels were (patients sorted by age):
Pt. 25OHD Comorbidities (HT = hypertension.)
Age ng/ml Symptoms (Fever, Fatigue.)
7 14F 8.3 -
3 17M 20.5 -
4 40M 11.9 Fa, Fe, dry cough
1 49F <8.1 Fa
2 51M 10.6 Diabetes Fe, diarrhea
8 54F 10.1 Fa, headache
10 64F <8.1 HT, post stroke Fe, dry cough
5 65F 11.6 HT Fa, Fe, headache
9 69M <8.1 HT Fa, dry cough
6 73M 12.4 HT COPD Fa, Fe, dry cough
All patients received 2000IU oral D3 a day.
Singapore trial of 1000IU vitamin D3, B12 and magnesium
On 2020-06-10 the results of a small trial in Singapore were published:
The patients were all over 50 years
old, not requiring oxygen therapy. The control group of 26 were
admitted before the trial began. The intervention group of 17
patients received, daily, on average for 5 days:
- 1000IU vitamin D3.
- 150mg magnesium (compound not specified).
- 500ug vitamin B12.
The intervention group was younger than the control group (average 58.4
to 64.1) and had a greater number of comorbidities (14 over 17
patients, compared to 49 over 26 control patients). The
intervention group required less oxygen therapy (3 = 17.6% to 16 =
61.5%) and only one of them required ICU treatment, compared to 8 of
the control group. Of the 3 intervention group patients who
required oxygen therapy, 2 had only been treated for one day.
This is a small, non-randomized, non-blinded trial, conducted under
"difficult dynamic circumstances" with modest vitamin D3 and magnesium
doses and with no record of 25OHD levels. The authors claim that
after correcting for age and comorbidities, that the DMB intervention
was associated with significantly better outcomes - and this includes
with the two patients who were only treated for one day.
Research from Belgium, Louisiana, a homeless shelter in Boston . . .
In this Belgian retrospective study, male but not female
COVID-19 hospital patients had lower 25OHD levels than controls whose
levels were sampled at the same time of year. However, the
controls were all "diseased" in that they were attending or admitted to
In males, but
not females, there is a clear correlation between low vitamin D and
COVID-19 disease severity:
There's no record of to what extent any of these patients
or controls were supplementing with vitamin D3. Nor are there
data on 25OHD levels for age matched non-hospitalised controls.
numerous items of interest here, including:
Louisiana, African Americans account for 70% of COVID-19 deaths despite
representing only 32% of the population. In a Boston homeless shelter,
100% of 147 COVID-19 positive subjects were asymptomatic.
hospital patients in ICU, on average, have lower vitamin D
levels than those not in ICU. Of these 19 ICU patients, 17 are
African American. 17 of these patients have 26ng/ml 25OHD or less.
from India, by El James Glicio, reports on 25OHD levels measured
before COVID-19 patients were admitted to hospital. Those with
mild symptoms averaged (Fig 5) 30ng/ml and those with severe symptoms
408 people in a homeless shelter in Boston were PCR tested and 36% were
positive for COVID-19. Their average age was 53.1. They had no
serious symptoms, and a remarkably low incidence of minor symptoms:
7.5% cough, 1.4% shortness of breath and 0.7% fever - and these rates
hardly differed from those who tested negative, average age 50.8.
people are more exposed than average to sun, and therefore
might be expected to have higher than average vitamin D levels, even
without supplements. They also get more exercise - and I suspect few of
them are as old as those in their 70s and 80s who suffer the worst harm
from COVID-19. They are probably less likely to use drugs to
lower fever, though I guess they would often find it harder to keep
warm and so sustain any fever which was helping them fight the
Also, perhaps they smoke more - and there is some evidence of smoking being protective:
. . . . France (nicotine?), Ireland . . .
File this under "COVID-19 curve-ball": 25.4% of
the French population smoke. 4.4% of a COVID-19 inpatient group
smoke and 5.3% of an outpatient group.
A large survey of Irish males 40 to 60 yo revealed they had a median
25OHD level of 18.8ng/ml. 25% of
them had 16.4ng/ml or less!
25% of them had 26ng/ml or more. So, assuming for the moment that
the Indonesian and Philippino reports above are relevant to Irish men
(and ignoring any nicotine use) most of these Irish men are at much
higher risk of serious harm and death from COVID-19 than if they
supplemented with vitamin D3 to bring their 25OHD levels well above
30ng/ml - say to the 40 to 50 range.
The report concerns 33 males 40yo and above with COVID-19 pneumonia and
respiratory failure. None of them suffered from cancer, diabetes,
CVD or had received chronic immunosuppressive therapy. 12 were
placed on mechanical ventilators and four of these men died. The
21 who did not need mechanical ventilation had mean 25OHD 16.4ng/ml, while the 12 who needed
this had mean 25OHD 10.8ng/ml.
All these levels are very low. indeed.
2015: Severe vitamin D deficiency in Italian children with Kawasaki disease
By mid-May 2020 it has become clear that some
children are suffering
severe symptoms from COVID-19 - and some of them are suffering serious
harm or are dying. The
inflammatory symptoms are similar to Kawasaki disease and it is
reasonable to regard such cases as instances of Kawasaki disease
However, due to some specific disease features - presumably due to
particular characteristics of the SARS-CoV-2 infection - and its sudden
wide prevalence, a new diagnostic category has been created for this
condition when triggered by COVID-19:
Paediatric multisystem inflammatory syndrome
]. Here I will use "KD" and "Kawasaki disease" to include both diagnostic categories.
Here is a
2015 article of crucial importance from Italy:
Severe vitamin D deficiency in
patients with Kawasaki disease: a potential role in the risk to develop
heart vascular abnormalities?
Stefano Stagi et al. Clinical Rheumatology volume 35, pages 1865–1872
Google Scholar 13 citations (2020-05-29)
On 2020-05-30, as best I could tell, none of the numerous academic
journal articles concerning Kawasaki disease and COVID-19 cite this
one. See below #kdarticles
below for a link to the list of such articles. I wrote to the corresponding authors
of all these articles pointing them to this Stefano Stagi et al. 2015
Every such article should cite this one, because there is no other way
of understanding the etiology of Kawasaki disease, how to prevent it,
or how to cure it, if the central and surely causative role of vitamin
D deficiency is not fully recognised. This is true whether it is
triggered by COVID-19 or any other condition.
The patients were 21 girls and 58 boys, average age 5.8 years.
Their average 25OHD levels were 9.2ng/ml
, while age-matched controls averaged 23.3ng/ml. In the patients
who developed coronary artery abnormalities, the average 25OHD
level was 4.9ng/ml
These children, due to the decisions made by adults, were
struggling to live with vitamin D 25OHD in their bloodstream 20%
to 11% of what is normal for hunter gatherers in Africa. https://www.ncbi.nlm.nih.gov/pubmed/22264449
These children are severely
vitamin D deficient. What is hard about this? For heaven's
sake give children vitamin D supplements so they never have to suffer
like this! All children before they get ill, and especially these
KD children who have such low levels. Why are so many doctors resistant
to vitamin D
supplementation when most people, without supplements are deficient?
More on Kawasaki disease in sections following the next one.
Ending the global vitamin D deficiency pandemic
Inadequate vitamin D levels - such as
25OHD levels below 40ng/ml (100nmol/L) - are a slippery slope leading
to multiple forms of ill-health, disease and sometimes
death. This is a global pandemic. See the Google
search results for vitamin D deficiency pandemic
We are now living in what I hope will be the last months or year or so of the Vitamin D Dark Ages
Future generations will look back in bewilderment that we had such
sophisticated technology, hospital care and social and scientific
achievements - yet still expected most people to live with inadequate
nutrition, including especially vitamin D. This will be clumped
together with other
health-horrors-now-thankfully-and-firmly-in-the-past: The days
before sewerage systems; hand-washing and basic sanitation;
antibiotics; vaccines; anesthetics; chemical analysis of blood
and tissue samples; X-ray and MRI machines; Internet access to health
information and lively discussions like this one . . . .
The days when many people, including many doctors, smoked
. (They still do in China.)
It is not practical to repeatedly test the 25OHD levels of every person
on Earth. This would be far more trouble and expense than the
vitamin D supplements themselves. There are some concerns about
vitamin D toxicity (link
among a small fraction of the population, which I want to analyse and
write more about later - but in general everyone needs to get their
25OHD to 40ng/ml or more in order that their immune system works
correctly. This goal is at odds with the advice given by
some, such as #21authors
, that we should aim for 25OHD levels merely above 10ng/ml (25nmol/L).
Here are some arguments for robust vitamin D supplementation to ensure
25OHD levels above 40ng/ml which will ensure, in most people, strong
initial immune responses to infections and well-regulated later
responses with good resolution mechanisms - not the overly-aggressive,
pro-inflammatory, self-destructive responses which cause the harm in
Kawasaki disease, COVID-19 and many other conditions.
I am using Kawasaki disease (see the article linked to in the previous
section) in children as an example, but the principles apply to people
of all ages, and for all sorts of conditions - of which COVID-19 is the
one which most urgently demands our attention.
The estimated vitamin D intakes of the KD children did not differ
significantly from those of the control group. The numbers
in brackets are the standard deviation [W
values show the probability that this difference would
occur by chance due to random differences even if there was no actual
relationship between the two variables. NS means the difference
is not statistically significant - in this article, below 0.05.
NS means that there is a greater than 1 in 20 chance the difference in
these observations could occur due to random variation
rather than due to a real cause.
|Vitamin D from diet IU/day
|Vit D supplementation in prior 6 months
|25OHD vit D ng/ml
KD children with heart damage
about 11% of the children had received vitamin D supplements in the
past 6 months. We don't know how much they were given, or how
these children's 25OHD levels differed from those who were not
supplemented. The control group's 23OHD level of 23.3ng/ml is (I
guess) about the same as for many adolescents and adults.
However, older people, and those with darker skins would have generally
A simplistic analysis of this might be that the KD children had the
same (or slightly more) vitamin D intake as the controls (their
sunlight exposure and sunscreen use was about the same too) and that
a viral or bacterial infection trigger caused their 25OHD levels to plummet in the course of
their illness. In this basis, there might be no argument for
greater vitamin D supplementation to prevent illness.
There are, of course, strong arguments for supplementing these children
with vitamin D once they are ill. However I have not found any
reports of doctors doing this. It seems that most doctors are
unaware of these low vitamin D levels, or consider them insignificant
or at least not amenable to change once in hospital. I am not a
doctor, but it seems obvious to me that these children should get oral,
intravenous or intramuscular 25OHD (25 dihyhdroxy vitamin D =
calcifediol = Rayaldee) supplements as a matter of urgency, since this
will directly raise the blood 25OHD their immune system relies upon.
Failing this, they should at least get oral vitamin D3, which will take
some days to be converted by their livers into the circulating 25OHD.
It is possible that the viral infection (and the direct, helpful - even
if weakened - immune response to it) and/or the KD disease process
itself (which is a self-destructive dysregulated immune response)
levels. I am still researching this, but I think there is limited
evidence for substantial declines like this in any illness.
half-life of 25OHD in adults is weeks, but I guess it might be shorter
children. Being ill, they may have been out of the sun for a
or so by the time they were admitted to hospital, and they may have not
been eating well, absorbing vitamin D3 or converting it in their livers
to 25OHD in the bloodstream. So even without direct effects
of the viral or KD illnesses, we might expect these children's 25OHD
levels to drop a few percent to 30% (my guess) over this month or so of
(Whatever small amount of boron they might have had from their normal
food - fruits, vegetables and nuts mainly - would be rapidly depleted
if they stopped eating this due to illness. The half life in
adults is less than a day. Hospital food probably has little or
no boron, since it is not recognised as a nutrient.)
Accepting that some non-trivial fraction of the difference between 25OHD levels of the control and KD children is
caused by the viral illness and the immune system's subsequent attack
(all the KD literature indicates that KD occurs weeks after the peak of
viral replication), here is my attempt
to explain the causative role of vitamin D deficiency in Kawasaki
disease in general, KD or anything like it in children due to COVID-19 and
more generally severe symptoms from COVID-19 in adults
completeness, this explanation also attempts to cover severe outcomes for adolescents whose disease progression
differs significantly from that of KD and of adult COVID-19. Adult
COVID-19 severe symptoms result from viral replication in the lungs
driving endothelial damage and a resulting hypercoagulative
KD does not seem to involve the lungs so much, and most of
the harm is observed in mid-sized arteries - especially those supplying
the heart muscles - though I think stroke is also a cause of harm and
We start with a population of children of suitable age for KD, before
any disease trigger. We assume that the dietary vitamin D
estimates and those for sunlight are valid and that the 23.3ng/ml
25OHD levels of the control group apply to this whole group.
The first thing to note is that although the Endocrine Society
regards levels of 30ng/ml or as being replete, 23.3ng/ml is too low by
a factor of
about 2. It is half the average level of 25OHD in African herders
and hunter gatherers. See #2020-Baker-a
below for why we should aim for 40 to 60ng/ml.
Assuming (for simplicity in this example) a Gaussian distribution [K
the 10.6 standard deviation indicates that 16% of these children have
25OHD levels below 12.7ng/ml, which is very
low. Let's take these
children and call them subset AA
. The reasons for these low levels include some mixture of:
- These children, on average, had lower than average (for the
entire initial set of children) vitamin D3 intake from food and
- Darker skin pigments. (Dark skinned people also have more
melanin and another uncoloured protein in their skin which absorbs the
UVB light before it can reach the lower parts of the skin where vitamin
D3 can be made.)
- Less skin exposure to sunlight with UVB, due to latitude,
clothing, sunscreen, air pollution, lifestyle, living in dense urban
- Poor absorption of D3 in food and supplements due to genetic
differences, nutritional differences (not yet known, but they likely
exist), whether or not the D3 was taken with a fatty meal - which is
best for absorbing this fat-soluble vitamin - and potentially other
- Genetic or other reasons why the D3 is not converted to circulating 25OHD so well in the liver.
- Body size variations and fat storage diluting the D3 in the whole body so there is a lower concentration in the blood.
- Genetic, nutritional and other currently unknown variations
affecting the quantity of vitamin D transporter protein in the
blood. This affects the availability of 25OHD to the immune
- Likewise other variations in the genes which determine the
structure of this transporter protein, and in the proclivity of 25OHD
to bind to any other proteins there (I recall albumin is one of them).
Now, by some magical means, we sort these children AA according to
their genetic proclivity to mount an overly-aggressive pro-inflammatory
immune response to infection even
they were replete in all nutrients including vitamin D and any we
currently know little about (such as boron) which affect immune
This proclivity is due to numerous types of genetic variation
concerning their immune system cells, on top of the general human
tendency for our inflammatory immune response to be overly-aggressive
due to the fact that we have no intestinal worms. (See #helminthsgone
below.) Let's pick the 20% of these AA children with the most
destructively dysregulated immune responses, and call them group BB
BB are 3.2% of the initial group of children whose age made them possibly at risk of KD.
Now I will assume that 5% of these BB children - group CC
- are infected with SARS-CoV-2. This is 0.16% of the initial set of children.
Ignoring, for simplicity, genetic variations in the virus, some
children will get a mild initial dose and others will get a large
initial viral load, which is inherently more difficult to fight.
There could be 100 to 1 variations in the viral load these children get.
Some of these SARS-CoV-2 infected children will develop a fever.
Of these, a fraction will be given drugs to lower that fever. As
far as I know, from all the research fever/
found regarding viral infection fevers in general - not specific
to COVID-19 - this is a bad idea, and is likely to cause a weakened
innate and adaptive antiviral response, and so a greater chance that
the infection will worsen and so increase the likelihood of triggering
Assuming the lack of helminths and genetic variations in
overly-aggressive pro-inflammatory responses are not important in the
initial stages of the infection (in the throat, or perhaps the eyes),
there will be some inherent genetic variation in how strongly the
children can fight the virus, even if they were replete in all
However, all of group AA, BB and CC are very
low in vitamin D (less than or equal to 12.7ng/ml in this example), and
this greatly reduces the ability of their innate (at first [K
]) and later adaptive [K
immune systems to fight the virus directly. So we expect some
fraction of the CC children not to stop the viral infection in the
first few days.
I will assume this is 20%. For these children, group DD
the virus replicates in large numbers in their lungs, blood vessels or
wherever else it is active in a way which tends to stimulate a
self-destructive immune response we later diagnose as Kawasaki
disease. This is group DD - now 0.16 * 0.5 * 0.05 * 0.20 = 0.08%
of the whole initial group of children - one in 1,250.
These children are in trouble - and these are the ones who, in general,
get Kawasaki disease or whatever else their condition might be called -
severe symptoms with possible lasting damage the heart and other
organs, triggered by COVID-19.
The short version of this story is that a SARS-CoV-2 viral infection
has triggered KD in a relatively small subset of all children,
according to the combined effects of various circumstances as just
described. I have assumed a sharp cutoff of 25OHD 12.7ng/ml to
denote the children at risk of KD. In fact, there is no sharp
cutoff. Some children with higher levels will get KD - presumably
due to some bad combination of all the variables just mentioned.
Still, for discussion, this 12.7ng/ml sharp threshold is good enough.
Now lets re-run the situation with one major change. This change
is easier to make than changing lifestyle, urban shadowing, culturally
driven patterns of clothing and sunscreen use, or food choices.
This change is also a hell of a lot easier than coping with the
situation described above, in which some children - thousands to
hundreds of thousands in any one country as COVID-19 affects almost the
entire population - suffer illness, lasting harm and perhaps death,
with all the efforts at treatment etc.
The change is that with the support of most doctors and the government,
the great majority of parents recognise the need to get their
children's 25OHD levels safely at or above 40ng/ml. This means lifelong robust vitamin D supplementation
(except perhaps if, as adults, they spend a lot of time all-year round
in UVB rich sunlight without clothing or sunscreen protection).
It also requires robust vitamin D supplementation for women in
general and especially women of childbearing age, since their baby's
25OHD levels depend entirely on their own before birth, and frequently
after when they rely on breast feeding.
(This will also significantly reduce the incidence of autism and
probably numerous other health conditions. Low vitamin D in-utero
and/or early life seems to be a significant cause of autism: https://www.scientificamerican.com/article/vitamin-d-and-autism/
The whole set of children now average 46ng/ml 25OHD. The proportion of them with dangerously low 25OHD levels is now reduced
So the incidence of KD in general, and in response to COVID-19, will be
correspondingly lower. Likewise adolescents and adults regarding
severe symptoms from COVID-19 and numerous other chronic conditions and
If doubling the average level also doubled the standard deviation, then:
Ave. SD Proportion below
23.3 10.6 15.9% calc
46.6 21.2 5.5% calc
in theory, 65% (1 - (5.5 / 15.9)
the children at risk of KD in the first scenario due to low vitamin D
levels would no longer be at risk. Likewise any other diseases
which strongly depend on low
If everyone supplemented about the same amount, to double the average
levels, the standard deviation would probably increase by less than a
factor of 2, as I have assumed here. The bell curve would be
narrower and the proportion of children with less than 12.7ng/ml 25OHD
would be even less than this. If the SD was 16, only 1.7%
of the children would have 25OHD levels below 12.7ng/ml - a reduction of 89% from 15.9%
In this future era of ubiquitous vitamin D awareness, any children
diagnosed with KD or similar conditions would be quickly treated with
extra vitamin D, ideally 25OHD, and any other nutrients which would
improve their immune system dysregulation. At present, this does
not occur, and hospital treatment relies on transfusions of donated
plasma with antibodies, anti-inflammatory drugs, aspirin and (as far as
I know - and though the doctors may not recognise this) probably a low
level of vitamin D3 which may be in the food or IV drips the children
receive once in hospital.
The same reductions in severe disease should apply for adolescents and
adults with COVID-19, sepsis, severe symptoms from influenza etc.
Come the revolution we will all have generally good levels of
vitamin D supplementation, generally good (40ng/ml) 25OHD levels and so
a great reduction in the incidence of severe disease states, with
prompt repletion as soon as such states are diagnosed.
COVID-19 induced Kawasaki disease in children and babies
Further to the two sections above:
It is reasonable to assume that when children infected with COVID-19
have severe symptoms and sometimes die from a condition closely
resembling Kawasaki disease, that in most cases they too were already struggling with
extremely low 25OHD levels.
According to these newspaper reports, on 2020-04-16, Alexander
Parsons became the youngest person in the UK to die due to
COVID-19. He was 8 months old:
(In mid May 2020, Google reports 6,050 pages
on this child's tragic death.)
In the Daily Mail comments, VV, Cheshire wrote:
My daughter's immunologist told me they had 200 cases in 6 weeks in the
U.K. because of the instance in initially Asymptomatic COVID-19 in
children. There's usually only 300 cases of Kawasaki in an entire
"Only 300 cases" a year? There are numerous bacterial and viral
triggers for Kawasaki disease, with SARS-CoV-2 being a novel, widespread
and potent one. But these extremely low 25OHD levels can at
best be only partly explained as a result of the disease (there are
some suggestions in research that the levels drop due to
It is obvious that most of these 300 children a year would not be suffering
Kawasaki disease if their 25OHD levels were not so extremely low.
While individual levels do vary, for any given body weight and intake,
surely if these children were properly supplemented, most of them would not
have this disease, no matter what triggering condition they have which
might have set it off in children with very low 25OHD levels.
NHS advice https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/
is that babies to 1 year should take 240 to 400IU vitamin D3 a
day. This seems like a reasonable amount considering their small bodies.
mickyfin of Leeds wrote:
also read recently that around 40% of covid patients recovering from
treatment were also diagnosed with dangerous blood clots.
The comments are full of sorrow, grief and people apparently resigned
to all that is happening - both COVID-19 and the decades old pattern of
Kawasaki disease. I saw no mention of vitamin D or any
other preventative measures.
I am an electronic technician and computer programmer. I want
things to work properly - including especially people's bodies! I
wrote this comment to both newspapers, but in neither case did the
moderators approve it:
is reasonable to assume that children suffering severe symptoms from
COVID-19 - especially those with a condition resembling Kawasaki
disease - are struggling with extremely low vitamin D levels:
Severe vitamin D
deficiency in patients with Kawasaki disease: a potential role in the
risk to develop heart vascular abnormalities? Stefano Stagi et al.
Clinical Rheumatology volume 35 (2015)
The patients were 21
girls and 58 boys, average age 5.8 years. Their average 25OHD
(vitamin D) levels were 9.2ng/ml, while age-matched controls averaged
23.3ng/ml. In the children who developed severe coronary artery
abnormalities, the average 25OHD level was 4.9ng/ml. These
children, due to the decisions made by adults, were struggling to live
with vitamin D in their bloodstream about 10% to 20% of what is normal
for hunter gatherers in Africa: 46ng/ml (115nmol/L):
On 2020-05-30 I searched Google Scholar
for articles concerning this disease and COVID-19. I found none
which mentioned the Stefano Stagi et al. 2015 article #2025-Stagi
. I think this article is
the key to understanding, preventing and treating Kawasaki disease, no
matter what triggers it.
This outrigger page:
lists those 15 articles, with a few notes about the contents of
these articles. See also below another 3 articles and the email I sent to the corresponding authors: #more-KD-articles-1
I may have missed one or two, but I think this is
the great majority of the articles written about COVID-19 and Kawasaki
disease. None of them mention:
- The Stefano Stagi et al. 2015 article.
- Vitamin D.
- The word "vitamin".
The general picture presented by all of them is that the etiology is
Kawasaki disease is unknown, except that there is usually a viral
or bacterial infection trigger and that the fact that only some children get it is explained
by currently unknown genetic factors.
This is despite some of the articles observing a disproportionate
number of sufferers being dark skinned (living in Paris, for instance)
and that in Japan, the peak incidence coincides with
The average person would quickly link these observations to the
possibility that vitamin D deficiency was a significant contributing
cause to the disease.
However, these doctors do not think of this. Some studies
included lab tests on numerous compounds associated with general health and inflammation, but 25OHD was never mentioned.
I know there is a problem with the volume of research, but
any academic article concerning Kawasaki disease is affecting matters
of life and death, and so should be based on the best available
knowledge of the cause of the condition, and of measures to prevent and
The Stefano Stagi et al. 2015 article is good research of
Perhaps some contributing reasons to it being only occasionally cited
are that it is behind a paywall and that it is in a rheumatology
journal - and so may not be seen by the heart and vascular
specialists who tend to work on Kawasaki disease.
A 2019 article on Kawasaki disease does mention vitamin D and cites Stagi et al. 2016:
This is a retrospective study of
Kawasaki disease in German children, with a control group made up
largely of children who were in similar families - often friends of the
families of the KD children.
The researchers had no information on vitamin D levels in any of the
children. They drew on medical records of the KD cases, which
included various details of their condition and treatment. This
indicates that in general, the doctors treating these Kawasaki disease children had no interest in their vitamin D status.
The researchers attempted to find a correlation between the incidence
of KD and the length of vitamin D supplementation from birth and of
breastfeeding. Some correlation was found, but I think it is of
little interest, since the median age of KD onset was 30 months and
vitamin D supplementation ended on average after 5 months. Of the
79% of KD patients who were supplemented, 27% were "irregularly"
supplemented, and there is no information on the dosages.
Breastfeeding data was even less precise, with 21% of KD patients being
breastfed for less than 2 weeks and no data on how long the remainder
were breastfed. Nor was there any information on the mothers' 25OHD levels, or those of the milk itself.
By 2.5 years, there would be no effect of that breastfeeding or vitamin
D supplementation on actual 25OHD levels. There might however be
some correlation with the children's general nutrition and/or some
lasting effects of the original breastfeeding and vitamin D
supplementation on the children's immune systems.
In Germany, vitamin D supplementation generally is recommended for the first year of life.
As you will read in these pages, to safely reach or exceed 40ng/ml 25OHD -
which seems to be the minimum required for proper immune system
functioning - all people, from birth, need supplements, with the
possible exception of those who spend so much time in the sun all year
round that they produce enough D3 themselves.
The 1 year recommendation is obviously too short, but it did did result
in more than half of the children being supplemented for 5 or so months
to start with.
2020-06-11 I found two more articles concerning Kawasaki disease and
COVID-19, both with clinical details, plus another two discussing
these. I could probably have found more if I searched assiduously.
The first three are written by 28 medical doctors and one PhD. There is NO mention of vitamin D
It should be obvious to anyone with an understanding of immune
dysregulation and vitamin D, and who is aware of the low 25OHD levels
in child (KD) and adult COVID-19 patients with severe symptoms, that
these symptoms are both, in large part, caused by
inadequate vitamin D.
Of all the things I have ever researched, this is the greatest mystery
Why are so many doctors so ignorant of, so blind to, or whatever, the
importance (generally causative) of inadequate vitamin D and a these
two acute conditions which are affecting hundreds of thousands and soon
millions of adults and children all around the world?
On 2020-06-11 I wrote to the corresponding authors of these articles,
and of the 15 mentioned above, a message you can read here: kd/#msg
. I won't mention details of any correspondence, but will add a
note here if and when I receive any replies. (5 days later . . .
UK discussion about BAME community susceptibility to severe COVID-19 symptoms generally ignores vitamin D
In mid-June 2020, the tide is turning
and more people are seriously considering the low vitamin D levels of
Black, Asian, Minority Ethnic (black and brown skinned) people in the
UK regarding their much greater share of COVID-19 harm and death.
So hopefully the above heading will soon be be a footnote in history,
rather than referring to tragic reality.
Please see the graph
I added on 2020-06-20 above #2020-UK-vit-D-BAME
which shows seriously low vitamin D level for UK White people and disastrously low levels for BAME people.
Here is an article, one of many
concerning the much greater death toll among Black, Asian and Minority
Ethnic people in the UK - especially among doctors and other healthcare
I wrote a response to this.
I wanted to write a similar response to an article in Unherd,
concerning a hypothesis, which I disagree with, that the majority of
people are already immune to the virus without being infected.
However, Unherd's discussion system, like that of the above BMJ page,
is controlled by Disqus, and I am concerned that by writing something
similar, the Disqus system will regard me as a spammer.
My response is on a separate page here: bmj-gopal-response/
On 2020-06-15 I was happy my comment, the first, was accepted for this
Conversation.com article on the BAME COVID-19 tragedy, which does
mention nutrition for immune system:
This 2020-05-26 article http://www.pulsetoday.co.uk/.../20040871.article
* reports on a team of doctors north of Manchester (Dr Mohammed Jiva and colleagues, Rochdale and Bury LMC staff.php
) who developed a Safety Assessment and Decision scorecard (SAAD), which commemorates their colleague, Dr Saad Al-Dubbaisi
, who died of COVID-19. (Article
on hundreds lining the streets for his funeral procession.)
* I was able to access this
article at first, but not a second time. Clearing my browser's
cookies for www.pulsetoday.co.uk enabled me to see it again.
Side note on geography and music:
Bury is 53.6° north of the equator. So is Wigan, where my father Jeff was born - and Wigan gets a mention in the KLF's Its Grim Up North .
This is like living 900km south of the southern tip of the South
Island of New Zealand, with its glaciers and all. Heaven help the
Here's a live performance of Justified & Ancient,
with Tammy Wynette, Maxine Harvey and Ricardo da Force all warming this
world immeasurably - the last two BAME, though I think the term didn't
exist in 1991: https://www.youtube.com/watch?v=f1PNnDagj6s
. This is my absolute favourite.
Here is my adaptation of the SAAD scorecard, with 25OHD levels in both ng/ml and (x 2.5) nmol/L:
Here is a bigger version: SAAD_table--ng-per-ml--1000x620.png
They only consider low vitamin D levels a risk factor for COVID-19
severe symptoms and death if 25OHD is below 20ng/ml. See #2016-Caprio
below for arguments for raising 25OHD levels to at least 40ng/ml.
Low vitamin D levels
thought of as a risk factor along with other conditions like age, but
unlike all the other factors listed in the above table, it can be changed within a week or so
with substantial vitamin D3 supplementation - far more than the paltry
400IU/day recommended by the UK government. If anyone has 25OHD
below 40ng/ml, according to all the research I can find, there is are
very good arguments why they should raise that by robust vitamin D
supplementation as a matter of great urgency - to at least 40ng/ml, to
approximate, to the best of our knowledge, the levels our African
ancestors had when our immune systems evolved.
This would apply to virtually all people in the UK who were not already
taking substantial (4000IU or more) vitamin D3 supplements.
Low vitamin D levels in the UK population in general, and in BAME
communities in particular, have been recognised for years:
This recent article assumes a 20ng/ml threshold for vitamin D deficiency and cites 2013 research:
which found that, of 45 years and older people recruited at medical clinics, with S
sian (India, Pakistan and Bangladesh) and B
aribbean, background, M
ale and F
emale, the following percentages of people had 25OHD levels:
ng/ml = nmol/L SA-M SA-F BAC-M BAC-F
20 > 50 7% 11% 13% 30%
12-20 30-50 17% 13% 34% 33%
6-12 15-30 36% 31% 41% 38%
< 6 < 15 40% 44% 14% 11%
These are "age adjusted" figures which I rounded to the nearest
integer. The article explains that for some conditions, SA and
BAC people seem to be able to cope with lower 25OHD levels than people
of European ancestry. Still, these levels are frighteningly low
for general immune health, and are clearly a significant factor in the
higher rates of harm and death among these people due to COVID-19.
These extremely low vitamin D levels, and their generally causative
association with a plethora of illnesses, have been known for
decades. I don't understand why governments, at the urging of most
doctors have not not implement programs to get everyone's 25OHD levels at least to above 30ng/ml. To this day (#21authors
, below), some in the UK use 10ng/ml (25nmol/L) as the threshold above which they consider 25OHD levels to be sufficient.
The past record of ill-health hasn't prompted this push for adequate
supplementation. Even now (mid-June 2020) with the deaths of so
many UK doctors, nurses and other health workers from their weak and
dysregulated immune system responses to SARS-CoV-2, there are just
murmurings about vitamin D, and lots more fuss about more
difficult-to-correct factors such as crowded homes and
workplaces. These affect the likelihood of contracting the virus,
while vitamin D levels have a profound effect on the incidence of
severe symptoms. Density of housing, use of PPE etc. are not decisive, because within months
most people will be infected anyway. The lockdowns necessary to really
slow transmission are not sustainable for more than a few months.
There are many reasons to believe that a truly safe, effective, vaccine
for SARS-CoV-2 in all its variations will never be possible. Even
if it was, it would take years to develop, test, refine and put into
billion-dose scale production. Individuals and governments
waiting for a vaccine to save the day any month now are completely
Robust population-scale vitamin D supplementation will be safer,
cheaper and vastly more effective than all the current investment in
drugs or vaccines.
The British Medical Association has a page devoted to the threat posed by COVID-19 to BAME medical workers:
It doesn't mention vitamin D.
Dr David Grimes, from Blackburn, north of Bury, wrote on 2020-05-07
that all the doctors in Blackburn had recently begun prescribing
vitamin D and taking it themselves - perhaps in part due to an
impromptu video lecture he did while buying fuel for his chainsaw being
widely circulated on Facebook.
He also writes that the deaths of (mainly BAME) doctors in the UK is
slowing and that this was due in large part to vitamin D awareness
being spread by social media and local newspapers.
A 2020-04-19 article in the BMJ Is ethnicity linked to incidence or outcomes of covid-19?
briefly mentioned vitamin D. Most of the 24 (2020-06-15) responses
concerned vitamin D.
The response from veteran vitamin D researcher William B. Grant
mentions, among many other things, that winter 25OHD levels were
15.2ng/ml for vegans and 25.2 for meat eaters, which he attributed to
meat containing both vitamin D3 and 25OHD. Leslie Lewis
mentions 1999 research
into South Asian ethnicity and polymorphisms in the ACE (not ACE2)
enzyme. Robert A. Brown and numerous colleagues from the McCarrison Society
wrote at length about vitamin D.
Pep-talk for doctors regarding the need for robust vitamin D supplementation to protect against severe COVID-19 symptoms
DOCTORS!!!! What is it about vitamin D deficiency that you just don't see, or accept in some fatalistic manner?
The page you are reading and the icu/
page link to
plenty of research showing the need for proper - 40 to 60ng/ml (100 to
150nmol/L) 25OHD levels to prevent the weakened and dysregulated immune
response which is harming and killing millions of people due to
COVID-19 - and has been doing so for decades at a slower rate with
numerous other acute diseases and chronic conditions.
What is it about vitamin D toxicity (link) which makes you so wary of recommending robust supplementation of 4000IU and more for adults to achieve these levels?
If this catastrophic level of harm and death to your
patients doesn't prompt you do do this, and the harm and death to your
doesn't prompt you to do this, what will?
Doctors are subject to enormous pressures to
conform, not to make wild claims, not to do anything which might cause
harm. Your ability to practice your profession requires you not
to do anything which might make people think of you in terms of the
sound made by ducks.
Non-doctors all around the world are figuring out the need for robust
vitamin D supplementation - sometimes with the help of doctors who
recognise the need for this. I am an electronic technician in
Australia. As far as I know, I have never seen a person infected
was obvious to me that vitamin D deficiency was driving much of the
harm and death from COVID-19. Before I established
these web pages on 2020-03-22 I wrote to numerous doctors and other
responsible people about this. The first version of the email
went to the WHO
Strategic and Technical Advisory Group for Infectious Hazards (STAG-IH)
Since I figured out the urgent need for a global program of vitamin D
supplementation program in March this year, when the Wordometer looked
like this (2020-03-17):
I expect everyone else to have figured it out by now (13.5 weeks later 2020-06-13):
with 120,000 new confirmed cases and 4000 deaths a day.
Remember, the ex-factory cost of pharmaceutical grade vitamin D3, in
1kg lots, is USD$2.50 a gram. At this rate, 4000IU a day costs
USD$0.09 a year. If all adults in the world took this, there would
be little serious harm or death from COVID-19, or influenza and a great
reduction in numerous chronic diseases. Some people, especially
those overweight, need twice this (see the next section).
We don't need blood tests, doctors consultations, double-blind placebo
controlled randomized clinical trials etc. etc. We need a program
to get everyone's vitamin D levels safely above 40ng/ml, ideally within
weeks - but it will take months with all the best efforts and full
support of most doctors and governments. It won't work for
everyone, since it will be voluntary, but it will help most people
escape harm from the COVID-19 infections they are bound to get in the
months to come. Fortunately, for the northern hemisphere, it will
Dr David Grimes, from Blackburn, north of Bury, reports (2020-06-07) http://www.drdavidgrimes.com/2020/06/covid-19-vitamin-d-progress.html
that many BAME doctors are prescribing and taking vitamin D, and that
the death rate among BAME healthcare workers is declining, at least in
Articles concerning vitamin D supplementation to protect against harm and death from COVID-19
You can see the vitamin D supplementation naysayers (who want RCT
trials of COVID-19 patients before they would recommend supplements,
though a few say it would do little harm) debating with doctors and
nurses who recognise how important it is to supplement vitamin D, in
the comments to this article:
Manson, who has lead vitamin D supplementation research, proposes
further work on the value of vitamin D supplementation in anticipation
of COVID-19 infection.
I found two interesting comments: Dr Robert Baker of New Jersey https://robertbakermdhealthnewsletter.blogspot.com
wrote (my boldface), on 2020-05-14:
over 12,000 patients for a vitamin D level since 2004. A number
patients told me when tested that they take 1000 or 2000IU a day of
vitamin D. In spite of that almost all of those people come back
a result in the 20's. Seldom over 30ng/ml.
Most adults need
5000 units a day to reach a level of 40 to 50 ng. Some actually
double that. The only way to tell for sure is to test at 6
yearly. It would be a waste to do a study that is only going to
the level to high 20's or 30's.
someone to fund an RCT to document what so many clinicians have
observed in the field for decades? The correlation of dramatically
reduced incidence and severity of respiratory infections in
thousands of patients who replete
serum vitamin D levels to 50ng/ml or more is
not ‘anecdotal.’ It’s reams of unpublished potential case studies that
could save lives.
Studies on the effects of vitamin D on various forms
of immunity are probably being designed right now with the same
pathetically insufficient doses to support healthy immune system
function. Such a waste. Mostly over misplaced
fear of Hypercalcemia.
Most average weight patients would need to take 10,000 IU daily for a
year to begin to see a rise in serum calcium levels.
Benefit - Risk Assessment of Vitamin D Supplementation
Heike A. Bischoff-Ferrari1 et al. Osteoporosis Int. 2010 July ; 21(7):
Mike Vidler wrote:
80 yr old British born; user for 25 years, southern USA. No degenerative illnesses. NO infections in 20 yr.
Prepared to accept the consequences of my decision whatever they may be!)..
Typical dose 10,000 IU. (10 years)Typical 25(OH)d 70 mg/dL (175 nMol/L)
2400IU D3 raises the 25OHD levels of most, but not all, white women in the USA above 30ng/ml
Here is my adaptation of one of the charts:
Doctors advising vitamin D supplementation in sufficient quantities
to raise 25OHD to 40 to 60ng/ml, which they regard as being vitamin D
Since 2008, with the Scientists' Call to D*Action link
, doctors and researchers have been advocating 40 to 60ng/ml as the healthy standard for vitamin D 25OHD levels.
While they may be in the minority, there are doctors all over
the world, who - like Robert Baker #2020-Baker-a
- recommend high enough D3 intakes
that their patients will be vitamin D replete:
Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza
and COVID-19 Infections and Deaths
William B. Grant
et al. Nutrients 2020, 12(4), 988
recommended that people at risk of influenza and/or COVID-19 consider
taking 10,000 IU/d of vitamin D3 for a few weeks to
rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to
raise 25(OH)D concentrations above 40 to 60 ng/mL (100–150 nmol/L).
I had back surgery in October 2019 and my Dr. recommended to start taking D3 4000IU
every day + vit. E 1000 to help absorbed D3, I had the surgery and I
was walking the same day. I also had COVID-19 in February and I didn’t
know I had it until I recovered and no fever ever I was just very tired for 1 1/2 week. I‘m 76 yrs. Old and doing great!
This article has a good review of "high
dose" (compared to recommendations such as 2000IU a day) vitamin D
supplementation, including with oral and intramuscular 25OHD
(calcifideol). A 6 month trial with relapsing-remitting multiple
sclerosis patients, of 800IU and 10,400IU D3 (cholecalciferol) per day:
. . . achieved 25OHD levels between 40 and 60ng/ml, which was considered the optimal target for patients with MS.
In addition, only in the high-dose group, there was a reduction in the
proportion of IL17+ CD4+ T cells, considered a major contributor to the
immunopathogenesis of MS, with a concomitant increase in the proportion
of central memory CD4+ T cells and naıve CD4+ T cells, concluding that
high-dose cholecalciferol therapy exhibits in vivo pleiotropic
immunomodulatory effects in MS. Adverse events were minor and did not
differ between the two groups, indicating that 10,400 IU
cholecalciferol daily is a safe and well-tolerated therapy in patients
A Brazilian pilot study by Finamor et al. on the efﬁcacy and safety of prolonged high-dose vitamin D3 therapy in patients with psoriasis and vitiligo suggested that an oral daily dose of 35,000 IU
D3 for 6 months, associated with preventive measures (low-calcium diet
and a daily hydration of at least 2.5 L daily), is a safe and effective
therapeutic strategy for reducing disease activity. All nine patients
with psoriasis and 14 out of 16 with vitiligo recruited in the study
received beneﬁt from the treatment, showing a decreased disease
activity with no side effects. Altogether these studies indicate that
25OHD blood levels below 100ng/mL are safe.
Nevertheless, there are groups of individuals in which high doses of
vitamin D over a long period could be detrimental in terms of
developing hypercalcemia and rapid deterioration of kidney function,
such as patients with primitive hyperparathyroidism or those with
chronic granulomatous diseases, which are prone to elevated extrarenal
synthesis of 1,25OHD. Moreover, even healthy subjects with
mutations in CYP24A1 - the mitochondrial enzyme responsible for the
deactivation of 1,25OHD - are susceptible to developing hypercalcemia,
hypercalciuria, and kidney stones when exposed to high vitamin D
Therefore, to avoid toxicity, all patients eligible for a high-dose
treatment should be previously screened for hypercalcemia and
hypercalciuria, while serum and urinary calcium levels should be
monitored during the vitamin D treatment itself.
To date, it can be established that vitamin D dose up to 2000 IU/day, or more recently, 4000 IU/day should be considered safe above the age of 9. This dose should be corrected according to non-pharmacological intake of the vitamin D.
The question of potential vitamin
toxicity for particular groups of people is a frequent argument for
limiting supplement does for all people. I plan to research this
assiduously when writing the forthcoming website, using the best
available research on vitamin D toxicity such as this
. I have an article here somewhere arguing that patients with
granulomatous diseases do better with higher doses of vitamin D.
(These are immune system disorders in which the troops fuss and fight,
mistake each other for the enemy, and bind to each other in numerous
small clumps throughout the body. Some immune cells in these
clumps have been observed to convert 25OHD into 1,25OHD in such
quantities perhaps due to intracellular bacterial infection - that it diffuses into the bloodstream, potentially
disturbing calcium metabolism.)
Massimiliano Caprio and colleagues cite several lines of research
indicating the need for 40ng/ml or more 25OHD to avoid various
Editorial – Vitamin D status: a key modulator of innate immunity and natural defense from acute viral respiratory infections
A. Fabbri, M. Infante, C. Ricordi Eur Rev Med Pharmacol Sci 2020; 24 (7): 4048-4052 2020-04-05
We also believe that maintenance of circulating 25-hydroxyvitamin D levels of 40 - 60ng/ml would be optimal, since it has been suggested that concentrations amounting to 40ng/ml represent the beginning point of the plateau where the synthesis of the active form calcitriol becomes substrate-independent [2011-Hollis err] [2018-Wagner].
Additionally, serum 25-hydroxyvitamin D levels of approximately greater than or equal to 40ng/ml
could provide protection against acute viral respiratory infections, as
demonstrated in a prospective cohort study published in PLoS One and
conducted on 198 healthy adults [2020-Sabetta]. To reach these concentrations in adults, a dietary and/or supplemental intake of vitamin D up to 6000 IU/day
– deemed to be safe – is required. However, elderly subjects,
overweight/obese and diabetic patients, patients with malabsorption
syndromes, and patients on medications affecting vitamin D metabolism may require even higher doses under medical supervision.
Indian Police receive substantial vitamin D supplementation
Here is an example of the action
governments and particular organisations and companies can take in this
time of crisis to make a real difference to people's health through
Fermenta Biotech is one of the biggest producers of vitamin D3
cholecalciferol for both pharmaceutical use and for agricultural
feed. They have cholecalciferol factories in Kullu and Dahej:
Fermenta Biotech and Indchemie Health Specialities have jointly
committed to supplying Maharashtra Police personnel 250,000 strips of DV
60K, each strip containing sufficient dosage for an individual’s
recommended regime of 60,000 IU of Vitamin D3 per week for two months.
The state of Maharashtra includes Mumbai and has a population of 112
million people. Its 250,000 personnel will use these oil-filled
minicaps once a week to provide 8571IU (214ug) vitamin D3 per day.
Other articles not yet mentioned
I don't have time to report in detail
on a number of vitamin D COVID-19 articles. Here are the
URLs. I hope to return to these at a later date, probably on the
new website, since this page is getting very long:
Irish doctors debate whether to use low or ridiculously low doses of vitamin D3
You may be interested to read Irish doctors debating how much supplemental vitamin D3
should be given, with one group (and these are the good guys) arguing
(62.5ug) a day - which, above, Robert Baker wrote was nowhere near
enough - and the other group arguing for 800IU
(20ug) or so a day, which
is 10% to 20% of what people actually need. These are two of
several articles in a Vitamin D Debate section of the May 2020 edition (index
They are concerned about supplements of 2000IU (50ug) being "high".
They were responding to an article by McCartney et al, here
citing the Filipino work (#2020-Alipio
) I now regard as bogus, with suggestions of up
Likewise a doctor who cites the Philippino and Indonesian research
mentioned above, and who for some reason thinks that 600IU/day D3 is
until RCTs demonstrate that more is needed for COVID-19 patients.
The central mystery for me, in all this, is not what is happening in
COVID-19 patients, or in people who are suffering from a wide range of
diseases, nor in how these tragic, disastrous, patterns of ill-health
can be largely resolved by supplementation. The
central mystery, which I am slowly coming to elucidate, is why many
doctors (at least in the West - and I haven't seen such a trend in
nurses) are so ignorant and/or unreasonably wary of nutritional
supplements in general and of vitamin D in particular.
I will write up my thoughts some other time, but for now, I regard many doctors'
extreme reluctance to advise robust, safe, doses of vitamin D3 is
to the immense toll of harm and death due to immune system dysfunction.
21 authors advise very low levels of D3 supplementation, aiming for a minimum 25OHD level of only 10ng/ml
Meanwhile 21 authors, in an article
finalised on 2020-04-29, support the official UK guidance on vitamin D
intakes, cautioning strongly against exceeding 4000IU/day on account of
unspecified dangers (though kidney disease was mentioned in passing):
They advocate daily, midday sunshine as an important part of
maintaining vitamin D levels - despite the sun not always shining and
not being at a high enough angle in the sky to be useful, even if
direct sunlight can be found in dense urban environments in which many
people are confined due to shelter at home laws. There's no
mention of skin area to be exposed, but their "season appropriate
clothing" description implies scarves and gloves, with little skin to
be exposed, in winter.
They explicitly support the official recommendations for 400IU/day D3
(UK) and 600IU/day (USA and for >70 yo Europeans). They note
that the UK standards are intended to ensure the majority of the
population have 25OHD levels above 10ng/ml
(UK) or 12
(USA). There is no reference to hunter-gatherer levels of
), or to the severe vitamin D deficiency observed in, and
obviously causing (in combination with some infectious insult) Kawasaki
above) were sufferers averaged 9.2ng/ml.
Historical note: I initially complained here "Nor is there any mention of the work of #2020-Alipio (3 weeks before their final version) and #2020-Raharusun (a day after) showing much greater risk of serious COVID-19 symptoms and death with 25OHD levels below 30ng/ml." but in late June I recognised these to be bogus, so these Susan Lanham-New et al, were right not to cite these.
21 highly qualified people went to some trouble to write an article
which gave people completely false assurances about the desirability of
such low levels of vitamin D supplementation and 25OHD levels, whilst
warning strongly against dosages which are actually, as mentioned
above, at the low end of what is necessary to achieve vitamin D
repleteness regarding immune system functioning.
work such as this as a fundamental part of the problem we are trying to
solve - and that it directly contributes to the suffering, harm and
death caused by dysregulated immune system responses to SARS-CoV-2.
I wrote a comment to this article on 2020-05-20.
Despite assurances via email that the were attending to this, no
comments have been published. Meanwhile, the article has been
widely reported in the press along the lines of experts advising that
there is no reason to believe that vitamin D supplementation will help
with COVID-19 symptoms - while suggesting that their low doses should
be taken anyway, with an absolute upper limit of 4000IU/day.
COVID-19 pathology - weak and dysregulated immune systems
On the ICU page icu/
please see these items:
Firstly, Farid Jalali's beautiful detective work icu/#2020-Jalali-b
- an etiological hypothesis of COVID-19 lung injury, which explains may
observations which are unique to this disease. One of is diagrams:
Secondly a link icu/#2020-Kim
to a recent article Vitamin D and Endothelial Function which shows how
important vitamin D is for enabling endothelial cells to vasodilate
(and COVID-19 makes them vasoconstrict) and to resist inflammation.
If you are are a researcher or doctor - or if you still doubt how
essential it is to make everyone vitamin D replete - please see the icu/ page for more detailed descriptions of COVID-19 lung and pathology and the role vitamin D deficiency plays in this.
Please see the ICU page icu/#2020-Tay
for a link to an article which makes it clear how much severe COVID-19
symptoms are a result of weakened and dysregulated, overly-aggressive,
proinflammatory immune responses. A diagram from the article:
Weak and dysregulated, over-inflammatory, immune responses are
caused by lack of helminths, individual genetic variation, dietary
excesses and several common nutritional deficiencies
is my account of this important question. I haven't read it like
this in any one academic article, but I cite such articles which
support the various parts of my explanation.
The primary reason
for the immune dysregulation which makes COVID-19 potentially harmful
and deadly is that our immune systems evolved to be overly-aggressive
due to the presence of intestinal worm (helminth) infestations which
downregulated many aspects of our immune response. Now - in
developed countries - without such helminths, our immune system is
overly-aggressive in several important ways, which contributes
enormously to a plethora of acute and chronic inflammatory and
autoimmune diseases, including asthma, MS (multiple sclerosis),
inflammatory bowel disease, osteoporosis etc. etc.
(The Inkscape .svg file of the above chart his here
Some information on helminth infection prevalence by country and within countries is available at http://www.thiswormyworld.org/maps/find-a-map
It would not be surprising if people with such infections
had less trouble with COVID-19 than those in developed nations where we
got rid of helminths decades ago. However, many of these people
suffer numerous health problems and have little access to hospital
care. They may also be deficient in vitamin D, boron and other
nutrients, so this is not a cause for complacency or even much
hope. As far as I know, COVID-19 will spread inexorably through
all countries and will cause a great deal of harm and death unless and
until most people take supplements to fix their most pressing
That said, please consider these two items concerning Ethiopia:
51% prevalence of helminths. I haven't scrutinised the article,
but it is clear from many other articles that helminths are more
prevalent in Ethiopia than in most other countries. Also, this advice for travelers (iamat.org
) states Risk is present in urban and rural areas of Ethiopia.
et al. state that since school age children are the most likely hosts,
and that infection in childhood may provide protection from MS for
life, that relatively low (such as for most children being infected at
some stage, rather than the whole population) levels of helminth
infection may provide good protection for most of the population.
Numerous factors are discussed which
might explain the low rate of spread and severity in Ethiopia.
Vitamin D is mentioned briefly, but not helminths.
We cannot easily fix the overly-aggressive immune systems we inherited. Helminthic therapy https://helminthictherapywiki.org
is sometimes used for severe asthma, Crohn's disease etc. There
is a lot of research into compounds which replicate of mimic the
downregulating chemicals helminths exude.
There is, of course, considerable genetic variation
between individuals. For instance, sensitivity to Crohn's disease
has a strong genetic component. Yet pig whipworm infection causes
many Crohn's sufferers to go into remission.
The second set of reasons
this immune system dysregulation is nutritional deficiencies
, such of salt and some fats. These weaken
many initial immune responses and are an additional cause of
dysregulation which drives overly-aggressive inflammatory responses,
which harm the self while failing to destroy the virus, bacteria or
whatever it is which is causing the infection.
These nutritional deficiencies can be fixed - and fixing them for most humans is the only way we
can coexist with COVID-19 without further disastrous harm and death and
without the need for the disastrously harmful and deadly lockdowns.
However difficult it may seem, fixing these deficiencies will be vastly
easier, less expensive and better for everyone's health than the
current approach of trying to hold back the tide of infection, while
accepting a terrible toll of harm and death on a significant subset of
the population as they contract COVID-19.
not a doctor. I have no medical training.
I have not even done a first aid course, though I think everyone
should learn this in high school. My positive view of the
research and ideas you read here should not affect your own decisions
about healthcare for
yourself and your loved ones . You
should read and consult very
By all means ask your doctor, nurse or naturopath to read this material.
Through their training and day-to-day work, medical professionals
develop a vast knowledge of interrelated considerations about human
health, and use this for your benefit after individually assessing your
Their knowledge may be incomplete. The medical conventions they
rely upon may be out of step with current research. They may be
excessively wary of supplements and more confident about using drugs,
due to the constant schmoozing of drug companies. Their patients
may be generally tired of dietary advice, and expect quick drug fixes
for whatever ails them. For reasons of professional liability
insurance, and to protect their reputation, doctors may be reluctant to do
anything different from what the main body of medical professionals
seem to be doing - so many of them are bound by a strong herd mentality.
I provide information by way of linking to and quoting from research
articles and - in some instances which I intend to make very clear -
with my own interpretations and hypotheses. But even if I knew
all there was to know about your individual condition, I do not have
the knowledge and experience to do what medical professionals normally
do so well: give reliable guidance tailored to your particular
situation - because I lack their training and experience.
Furthermore, I don't want that sort of responsibility.
If your decisions are influenced by what you read below, it should be
because you have evaluated the arguments, read
the research articles I cite and because you take responsibility for your own health
understand what you read here, please rely on the judgment of someone
who does - someone with a broad knowledge of science in general,
biology, nutrition and human health to evaluate the
observations and arguments in the broadest possible context.
I have expanded on a few acronyms with
fuller text and/or [WP
(Panadol) is the
same as acetaminophen
etc.) It reduces fever and is generally not regarded as an NSAID https://en.wikipedia.org/wiki/Nonsteroidal_anti-inflammatory_drug
- a class of drugs which includes aspirin
I am an electronic technician working with electronic musical instruments http://www.firstpr.com.au/rwi/dfish/
I also work in computer programming: C++ for mine schedule
optimisation, continuing the work of my father Jeff Whittle. My
wife Tina and I live in Daylesford, north west of Melbourne, Victoria,
this website http://aminotheory.com
primarily for my new observations and
etiological theory of Restless Legs Syndrome / Periodic Limb Movement Disorder, which I suggest should be known as Restless Limbs Sensorimotor Disorder
This is not a commercial site. It generates no revenue. I
am not selling anything. I never got around to getting the
certificates etc. for encrypted https. These web pages set no cookies in your browser.
I update this material according to new information and any feedback I receive from
clinicians, researchers, or anyone at all.
Please email constructive critiques to firstname.lastname@example.org
Please quote selected passages in your social media feeds, discussion
forums etc. - always with a link to this page's URL:
Please do not copy the entire page,
or substantial parts of it, to other sites
, since I may update
the text at any time, and I don't want out-of-date versions of this
text floating around the Web.
Plan for better nutrition and guidance regarding fever
(This section was written 2020-05-26 and revised a little on 2020-06-15.)
We insist on proper operating conditions (fuel, oil, water, tyre
pressure, ignition timing etc.) for our cars. We insist on
feeding our cats a diet which makes them replete in all known nutrients
(though boron is not yet recognised as one of them). We insist
the AA batteries which run our devices are 1.5 volts, not 1.3.
Yet only a small fraction of 7.79 billion humans get their proper
operating conditions, which begin with adequate quantities of dozens of
Primary problems concerning immunity, health in general and COVID-19 in particular
COVID-19 spreads quickly unless unsustainable - and ultimately harmful
and deadly - lockdown measures are enforced. If the disease only
caused a week or two of suffering and inability to function properly,
this would not be such a serious matter.
I have broken P2
sub-types. All these are strongly associated with very low levels
of vitamin D and of other nutrients. However, there is much more
to the interrelated set of health problems we are trying to solve than
lack of vitamin D.
Coagulation. With current (generally inadequate) approaches to
nutrition and hospital care, a significant number of people who
contract COVID-19 die
(0.5 to 5%) or suffer serious harm
to 20%). (2020-06-15: The UK death rate is 14% of the confirmed
cases! While the latter is surely an underestimate, the death
rate will rise even if new infections stopped today.) Most of these are
elderly people with known health
problems, but there are lots of people in middle age, in their 20s and
30s - and some children - who are suffering lasting harm and
The main reason for all this harm is
the SARS-CoV-2 virus' ability, once it is replicating in the lungs
(which would not occur if the immune system successfully fought it in
the throat), to elicit a dysregulated immune response which damages the
epithelium (inner lining of blood vessels and capillaries) in the
lung. The fragments of epithelial cells cause the blood to become
hypercoagulative - the natural, evolved, response to these signs of
broken blood vessels.
This hypercoagulopathy causes blood clots (including thousands or
millions of micro-embolisms) to form in the lungs. These, plus
the viral and immune system damage, reduces oxygen and CO2
exchange progressively over a week or so. Beyond a certain point,
unless their breathing is assisted in hospital (with oxygen via nasal
canula, trying as much as possible to avoid mechanical ventilation,
with its sedation, invasive plumbing and lung damage) the person will
Even without significant breathing difficulties, the hypercoagulative
state causes blood clots all over the body, resulting in permanent harm
Inflammation. Many people, particularly as we age, suffer serious harm or are killed by a long list of chronic and acute illnesses caused by excessive inflammation
These include diabetes (type 2 and type 1 which strikes in childhood),
asthma, inflammatory bowel disease, neurodegeneration (dementia), some
forms of cancer and the mechanisms by which it metastasizes, multiple
sclerosis, coeliac disease etc.
Sepsis. Many bacterial and viral diseases - and some injuries such as
near-drowning and burns - if severe enough, can prompt the immune
system to respond in an overly-aggressive, pro-inflammatory way known
. This develops
rapidly and even with ICU hospital care, often leads to permanent
disability and death. (Though see the Marik Protocol in icu/
for techniques which achieve better outcomes, in part by fixing the
extreme vitamin C deficiency which afflicts sepsis and most other
patients who need critical care.)
Most deaths caused by influenza are due
to sepsis, in the form of Acute Respiratory Distress Syndrome (ARDS),
in which the lungs are flooded (pneumonia) due to
over-inflammation. This fluid reduces the ability to breathe,
potentially killing the person. Even if this inflammation does
not kill, it may lead to later bacterial infection - bacterial
pneumonia - which again can flood the lungs, damage other organs and
(Initially, it was assumed that COVID-19 produced a similar form of
sepsis and ARDS. We now know that the virus's direct harm to the
epithelium of the lung, together with the overly-inflammatory response
there, drives an extremely destructive hypercoagulative state, which is
not found in traditional sepsis or ARDS.)
are caused to some extent by existing illness and injuries, such as to the lungs, but are primarily caused by P3w
: The immune system has one or more of its many antiviral, antibacterial, antifungal or antiparasite mechanisms weakened
. This causes no direct harm to the self.
: The immune system has one or more of these mechanisms dysregulated
. Overly aggressive, overly inflammatory, immune responses ensue, often taking place at the wrong time or the wrong place
These responses are typically ineffective at combating the
pathogen, but the most important result of this immune system
dysregulation is inappropriate inflammation, including destruction of cells of the body which do not really need to be destroyed in order to stop viral or bacterial replication
is caused primarily by:
- P3d on its own.
- P4 (wheat, below).
- By P3d exacerbating the problems caused by P4:
The noxious properties of gluten proteins in wheat
and related grains. Rice and oats are fine.
These grains evolved sulphur
cross-links in the protein of the wheat grain to make them difficult to
digest by birds, animals and insects which would otherwise eat the
grain. These links give rise to wheat's dough's unique stretchy
nature which is essential to bread-making. The linked
sections of protein cannot be broken into separate amino acids by our
digestive enzymes. The resulting protein fragments (the most
notorious one is called 33-mer
with 33 amino acids) disturb the lining of the intestine and trigger an
immune response there. The whole intestinal lining is in a
constant state of inflamed preparedness, to accept food and defend
against pathogens. This opens gaps in the tight junctions between
the brush-border cells [W
allowing lumen (digestive juices, food fragments and bacteria) to enter
the bloodstream, so causing inflammation and other problems throughout
the body. For instance, in some people, wheat causes neurological
problems, such as gluten ataxia [W
] even though the problems in their digestive tract to not result in any noticeable symptoms.
While the sourdough processes used for all bread until the early 20th century reduces this
disturbance by breaking down the noxious protein fragments, our taste
for wheat condemns many of us to a lifelong struggle against the
ill-effects of these indigestible fragments.
Other plants we eat contain noxious
substances too. Wheat gluten would still cause us some harm even
if our immune system was working perfectly. Today, due to human
genetic variation and unknown triggers, some people suffer intense harm
with coeliac disease, while most of us other wheat-eaters suffer more
subtle forms of harm over a lifetime of eating non-sourdough wheat
There are several contributing causes to P3w
(weak immune responses) and P3d
(dysregulated, overly-aggressive, proinflammatory responses):
- Generally poor nutrition
(including the separately listed problems of inadequate intake of macronutrients omega-3 fatty acids P15
and potassium P16
and of multiple micronutrients, such as vitamin D and boron P14
lack of exercise and lack of other essentials for health and happiness
including clean air and water, sunshine, close friends and loving
relationships, social contact, good medical support when needed etc.
- Prior injuries
- Nutritional excesses, such as salt
, omega-6, saturated and trans fatty acids.
- Use of recreational drugs
which harm health in general and immunity in particular, including alcohol and
no-doubt tobacco, cannabis, cocaine etc. (Though there are
suggestions that nicotine has anti-inflammatory effects which protect
against severe problems with COVID-19: #nicotine
- The use of prescription drugs which weaken immune responses
(immunosuppresants are helpful in some medical conditions, often due to
our lack of helminths) or which cause particular problems with
COVID-19. There has been discussion about particular
hypertension drugs making things worse for COVID-19 patients.
Some drugs such as hyroxychloroquine (for lupus) or others which dampen
down excessive immune responses, such as for asthma or Crohn's disease,
may be protective against severe COVID-19 symptoms. (Mehra et al. 2020-05-22
report (hydroxy)chloroquine apparently causing heart arrhythmia and being associated with higher death rates and an earlier RCT
showed no antiviral or other benefits.)
Prescription drugs should be continued unless advised by your doctor.
- Some people seriously curtail their body's initial attempts to fight the virus by lowering their temperature when they have a fever
. See the fever/
- Individual immune responses differing from from the norm due to genetic variations
. These variations are primarily in the codons of our DNA, but there is also an epigenetic
component, in which long lasting (and impossible to change, as far as
we know) methylation and other additions to the DNA occur due to life
experience - including especially in-utero - affect how our bodies
interpret the genes we inherited from our parents.
- Assuming that the person does not have any helminth infections
(intestinal worms, as described in the previous section), some aspects of their immune system, due to evolution, being set up for overly-aggressive actions
which are not being downmodulated by the helminths our ancestors had. See above: #helminthsgone
. This is the condition of essentially all people in developed
countries - our immune systems, in general, are primed to respond in
damaging, overly-aggressive, proinflammatory ways to many stimuli,
including especially SARS-CoV-2 infection of the lungs.
- People with helminth infections
in general, but to some extent these P3d
excesses will be moderated by the chemicals their helminths
exude. These people may have weak responses to the virus due to
helminthic downmodulation of normally effective immune responses.
Their (without helminths) overly-aggressive responses may persist, may
be downmodulated to being about optimal, with a good balance between
fighting infection and harming the self. These responses may also
be downregulated below the point of optimality - being ineffective
against the virus, and hopefully being still less harmful to the
- Deficiencies in nutrients which cause significant weakening and/or
dysregulation of the immune system. Of course all nutrition
affects general health and so the immune system, but there are a number
of micronutrients which are important here: vitamin D
, vitamin C
and probably quite a few others.
There are also two macronutrients of
interest in this regard - macro because we need grams of them per day,
not milligrams or micrograms: omega-3 fatty acids and potassium.
Most of what follows on this page, and in the forthcoming 5 Neglected
Nutrients website, concerns vitamin D, boron, vitamin C, omega-3 fatty
acids and potassium. These are all of widely neglected, but are
vital to immune system functioning and to avoiding hypertension and
This article is highly relevant, but I haven't read it yet. It
mentions vitamins A, D, C, E, B6, and B12, folate, zinc, iron, copper,
A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection
Adrian F. Gombart, Adeline Pierre and Silvia Maggini Nutrients 2020, 12(1), 236 2020-01-16
- We generally don't eat enough omega-3 fatty acids
These are synthesized by algae and
eaten by fish - so with oily fish, fish-oil capsules and/or algae oil
capsules, we can obtain decent amounts of omega-3 fatty acids.
Most of the fat we eat in food other than fish contains mainly, or
exclusively omega-6 and saturated fatty acids. Fats are
controversial, but as far as I can tell, we generally eat too much
omega-6 and saturated fat and too little omega-3 fatty acids.
Omega-3 fatty acids [W
perform at least two crucial functions. Firstly, they are used to
make some of the prostaglandins (others are made from omega-6s) and
other compounds, which are necessary for proper immune system
Secondly, the two-fatty-tail phospholipids [W
- which make up (with cholesterol) the lipid bilayer cell membrane of
all our cells - have their fatty tails composed of oily tails from the
fats we eat. So the ratio of omega-3 tails to other types of
tails in our cell membranes reflects what we have been eating in the
last few months or year or so. These tails' mechanical properties
vary, and the exact mechanical properties of the lipid bilayer affect
the operation of the complex transmembrane proteins through which many
molecules and ions enter and leave the cell and which form many types
of receptor. These effects are directly mechanical on these major
transmembrane proteins and by way of altering other transmembrane
proteins which, ideally, sit alongside the major ones.
So the exact, mechanical, electrical and chemical behaviour of all our
cells' membrane-bound receptors, calcium channels etc. depend, in some
on the ratio of omega-3
to other fatty acids in our diet. This is especially true of our
neurons. So the ratio of the various types of fat in our diet
affects every aspect of our emotions mood and cognition. Most
people in the West would benefit from less omega-6s [W
], saturated fatty acids [W
] and especially trans-fats [W
]and more omega-3s in our diet.
This article describes the importance of dietary omega-3 fatty acids
for improving immune system regulation, including by decreasing
excessive inflammation, by way of these fatty acids forming part of
lipid rafts which support the transmembrane proteins of CD4+ T-helper
], which play an important role in regulating inflammation, by their secretion of anti-inflammatory cytokines:
- Except for hunter gatherers, some vegetarians and perhaps some people
with modern diets who eat lots of yams, sweet potatoes etc. none of us
get enough potassium
in our diet. This is exacerbated by the fact that we generally consume excessive amounts of salt.
The following account is written from memory after partially reading a
large box full of research articles on salt and potassium metabolism,
hypertension, stroke etc. and especially this excellent book from 2001:
The High Blood Pressure Solution: A Scientifically Proven Program for Preventing Strokes and Heart Disease
Richard D. Moore MD Healing Arts Press; 2nd edition 2001-06-15
Our ancestors found it very hard to
obtain enough sodium (and so chloride) through salt, so their tastes
(now ours) evolved to included a strong liking for salt - and our body
has evolved to conserve it.
Potassium was plentiful in the ancestral diet (going back to common
ancestors with chimps etc.), with a potassium to sodium ratio
(by mass) of 20 to 40. We have no taste for potassium and our
bodies do not
Every cell in our body relies on pumping potassium ions into the cells
and sodium ions out for its trans-membrane voltage, and ionic
This voltage and the two opposing ionic concentration gradients powers
the operations of many
trans-membrane proteins. So the exact voltage and concentrations
the two ions on either side of the membrane constitute some of the most
important operating conditions for each cell. Some cells, such as
neurons, devote 70% or so of their entire energy budget to pumping
these ions, with various transmembrane proteins powering their
operation by letting sodium ions back in and the potassium ions out
Now salt is easy to obtain (actually almost impossible to avoid,
since it is needed in bread-making, and is in most manufactured foods),
we eat lots of it.
Potassium is primarily found in vegetables and fruits. There is little in grains, eggs, dairy, fish, poultry or meat.
Consequently, many people ingest 2 to 4 grams of sodium a day, and only
2 grams or so of potassium. Ideally we would have 1 to 2 grams of
sodium and 5 or more grams of potassium.
The very low - below 1.0 for many people - potassium to sodium ratio in
our diet directly drives ill health in general and hypertension and
stroke in particular. For more information on this, with research
references, and for the little known option we have for supplementing
potassium via potassium gluconate solution, please see the kna/
COVID-19 is causing stroke in many people, including younger people who
do not get particularly severe symptoms. A contributing factor to this
is surely excessive sodium and insufficient potassium. I advocate
reducing salt, but not, in the short term, supplementing potassium.
While it is surely better to supplement potassium, and so avoid
hypertension and so hypertension drugs, and to reduce reduce the risk of stroke, there are some tricky
aspects to it and I an not suggesting people rush into this without
their doctor's supervision.
Unfortunately, I think most doctors are
unaware this ability to supplement with 2 or 3 grams of potassium a day
- and quite a few would find the prospect alarming. Richard
D. More explains that in medical school, it is impressed upon all the
trainee doctors, how careful they must be with intravenous potassium -
because excessive input (faster than the cells can absorb it) will
raise blood levels and so cause potentially deadly heart disturbances.
We can't stop the virus spreading, or change the genes which evolved in our ancestors
We can't stop the virus from spreading to most people, in all countries, since:
- It is highly infectious and (with possible partial exceptions due
to previous SARS or other infections - and perhaps BCG vaccinations) we have no immunity to it.
- There is no prospect of an antiviral drug preventing infection.
- It is unlikely that a safe, effective vaccine will be deployed to
most of the population of all countries any time soon, or at all,
because it is very difficult to devise such a vaccine (especially with
viral mutation) and to prove beyond reasonable doubt that it is
effective for most people and is highly unlikely to cause any harm,
including by making future infections more severe.
- The only effective measures against spread are intolerably costly
and deadly for more than a month or so: lockdown and other economically
and socially crippling restrictions.
We can't change people's DNA or its epigenetic attachments.
We can't stop the virus from causing a substantial proportion of the
population to suffer fever, cough and other moderate symptoms for a few
Nor can we coexist with COVID-19 by using vaccines, antivirals or lockdowns
Even if there were drugs with powerful antiviral or
inflammation-dampening properties, we can't manufacture or distribute
them in sufficient quantities, with sufficient medical oversight, to
most people in the world in a few months - or probably over years.
We can - and must - improve nutrition to correct many of the
failings which cause people's immune systems to be weak and/or
: The public should be advised
, in general (with whatever exclusions properly apply) that they should not lower their fever
, with drugs or other means. This is potentially a complete solution to P10
However, since it is impossible and
generally undesirable to advise people to do this against the wishes of
most doctors in general, and their doctor in particular, and since many
doctors (I don't know the proportion - I guess 20% to 80%) still
support the use of anti-pyretic drugs in general, and so I guess with
COVID-19, this could only be fully achieved if we somehow solve another
: How to convince the great majority of doctors of the need for this advice, in the next few weeks
so their united position will cause health authorities to promptly
issue the required advice to the public, with the backing of almost all
doctors. There is an urgent need for this, since the next
wave of COVID-19 infections are coming, with lockdowns impossible to
extend. (At least in the northern hemisphere, I hope people will
get some sunlight on their skin over their summer and so boost their
vitamin D levels a little.)
In principle this could be done by having them all read the research, such as that which I found and link to at the fever/
page. However, there are challenges regarding doctors changing
their minds, rapidly, about a matter on which they have long held a contrary
position. Arguments against lowering fever with antipyretics have
been controversial for decades, and some doctors recognise the
essential role fever plays in fighting infections. There is a
long way to go, and here we run into numerous reasons - not all of them
good - for the great resistance to change and new information which for
many or most members of the medical profession constitutes a profound
Ideally there wouldn't be any urgency, and the doctors who still
advocate lowering fever could be gently cajoled and convinced of the
need to (generally) let fever do its work, over decades. This
would be the polite thing to do, and would respect doctors' dignity and
The trouble is, that with COVID-19 inducing protective fever in a large
fraction of the population in the months to come, waiting and hoping
for doctors to change their mind would vastly increase suffering, harm
I think P20
. Therefore, any improvement on the currently parlous situation - (P10
of people lowering their fever and so frequently suffering a more
prolonged illness with more harmful and deadly hypercoagulation - will
result from partial or full solutions to P21
: How to convince health authorities to issue good advice against lowering fever
for COVID-19 and perhaps other diseases, with suitable exceptions) despite a lack of consensus on this among doctors.
I regard P21 this as insoluble,
since authorities generally would only advise according to broad
consensus among doctors, and since many people would not accept such
advice even if it was contrary to their understanding of doctors' consensus views.
: How to convince most people to ignore the opinion of many doctors
, including perhaps their own AND the absence of suitable guidance by health authorities, with them placing more trust in the advice of particular doctors
they know to be respected, and who advise (with suitable exceptions) against lowering fever
for COVID-19 and/or in general.
This can probably be achieved to some limited extent, with Internet communications. It
would be a pretty dodgy for this to be done by people like me who lack
medical training, so I hope that the solution will be along the lines
: Directly to P22
, indirectly to P21
and so towards fully achieving S1
doctors and nurses communicate their advice on letting fever (in
general, with suitable exceptions) do its work - primarily to the
public, and secondarily to other doctors and nurses
On paper, the Ivory Tower Academics [who want RCTs before introducing any new treatment]
will always look better. Their arguments are technically
impeccable. It’s easy for them to paint themselves as the paragon
of scientific virtue, while shaming others as irresponsible
dilettantes. However, the closer one gets to the bedside struggle
against COVID-19, the less compelling these intellectual arguments
become. Thus, I daresay that among frontline providers actually
caring for patients with COVID-19, the rogue cowboy mentality [who use RCT-unproven therapies which seem safe and effective] often has greater appeal.
I think emcrit.org
articles and discussions I have read are the very heights of erudition, thoughtfulness and pertinence.
However, see Dr Roger Seheult's Update 74
in which he cites a CNN interview with YouTube CEO Susan Wojcicki, who
states that videos which contradict the WHO's COVID-19 advice
contravene YouTube's Terms of Service - so raising the spectre of academic censorship in the middle of a crisis.
: Directly to P7
, and so in part to P3w
- Everyone should be advised not to drink alcohol
(or at least not to drink it regularly or to the point of intoxication) or use excessive salt
- and of course not to harm their immune systems with other recreational drugs.
This is basic, uncontroversial, medical
advise which can safely be given to everyone. So there should be
no problems with changing doctor's thinking, or any controversy.
Again, it is unseemly for non-medicos such as me to be leading the
charge here. So doctors and nurses should communicate directly
and urgently with the public, and with their patients, as well as
advocating health authorities to issue suitable directives.
Only a subset of people will take any notice, but it will help.
(There is a suggestion
that some cannabis compounds might reduce COVID-19 severity. Maybe so,
but this is of no interest to me since there's no way of deploying such
compounds or any other drugs to the population in general in any time
frame, let alone the months we have to cope with the second
wave of COVID-19 infections.)
can and should urgently reduce the toll of harm and death for
hospitalised patients, even within the currently poor nutritional
arrangements by which most people live. See the Marik Protocol icu/
However, this would only relevant for the general population if all the
people who start to develop the hypercoagulative state are able to be
treated in hospital very promptly. People at home with symptoms
continuing beyond a week or so, beyond the throat infection stage, with
the virus replicating in their lungs, develop this hypercoagulative
state and so are at high and ever-increasing risk of serious harm or
death from blood clots forming in their lungs, brain, spinal cord,
heart, liver, kidneys etc. People at home are suffering permanent
neurological damage, stroke, heart attack etc. Children and babies are
suffering and dying from a form of Kawasaki disease.
Generally (New Zealand potentially excepted) national governments can't
slow the spread of the disease sufficiently to ensure that the 20% or
so of their people who do get lung infections can all go
immediately to hospital. If they could, then in principle it
would be possible to fully achieving S4, which would have huge benefits and largely solve P2c.
In order to achieve S4 (ignoring for the moment that we can't generally slow the infection rate as just mentioned) we
face problems regarding conservatism, herd mentality and getting
changes made to departmental guidelines in a hurry similar to those
mentioned above regarding fever (S2). As with S2 and S3
it would be unseemly for non-medicos like me to be advocating change,
so it is vital that doctors and nurses work within their professions,
and by communicating to the public in general, about the need for
hospital treatment protocols such as those pioneered by Dr Marik, which
result in far less harm and death than is the norm in most hospitals so
far (to May 2020 at least).
However, even if S4 was fully achieved, this is only relevant for the general population to the extent that all the people who start to develop the hypercoagulative state are able to be treated in hospital very promptly.
People at home with symptoms continuing beyond a week or so, beyond the
throat infection stage, with the virus replicating in their lungs,
develop hypercoagulopathy and so are at high and ever-increasing risk
of serious harm or death from blood clots forming in their lungs,
brain, spinal cord, heart, liver, kidneys etc. People at home are
suffering permanent neurological damage, stroke, heart attack
etc. Children and babies are suffering and dying from a form of
The Marik protocol works, in part, by solving a severe nutritional
deficiency, of vitamin C, by way of intravenous vitamin C (ascorbic
acid) around 10 grams per day.
I believe these techniques could be improved by repleting patients'
deficiencies of vitamin D, boron and other nutrients as well.
However, the earlier all these nutritional deficiencies are fixed, the
better - so that the people don't get seriously ill and never need to
go near a hospital.
Other solutions having been highlighted, we now focus on nutrition
to improve the function of the immune system, general health and to
reduce hypertension and the risk of stroke
So the remaining solutions to the problem of COVID 19 - beyond sustainable
hand-washing, social distancing etc. - all concern improving the
nutrition of adults and children so that their immune systems are
strong and well-regulated, to solving, to the greatest extent possible:
- the central problem P2c/i/s (Coagulation, Inflammation and Sepsis) - COVID-19 causing serious harm and death - by solving, to the greatest extent possible:
- P3w/d - weak and dysregulated immune systems - by solving, to the greatest extent possible:
- P14 and so P3a and P3b
- Deficiencies in nutrients which cause significant weakening and/or
dysregulation of the immune system.
Unfortunately, we can't fix the fact that human immune systems are
bound to be dysregulated in the absence of helminths. I believe
that for most people, a great deal of currently lacking immune system
regulation can be restored by repletion of micronutrients, especially
vitamin D and boron, even though are genes predispose us to
overly-aggressive inflammatory responses.
There are several levels on which this can be achieved:
- As individuals and families, deciding to take the relevant
supplements, being able to do so (the supplements being available and
affordable) - either due to personal decisions or in accordance with
advice from doctors or health authorities. Initially, this
will need to be in accordance with the subset of doctors who advocate
such supplementation, since I have no idea how long it will take for
most doctors and authorities to overcome their long-established pattern
of avoidance and ignorance of nutritional supplements.
The extent to which doctors' caution about supplementation is valid (is) will be
the subject of a section below. There are reasons to be
concerned, but overall, I believe these concerns are blown out of all
proportion, especially given the urgent need to deal with COVID-19
triggering a billion or so people's dysregulated immune system into
harming and killing them.
- At the level of individual doctors, clinics or hospitals and so
their their patients, including especially those at home who need to
prepare for COVID-19 infection in the weeks and months to come.
- At the level of countries, where governments act decisively to
facilitate the practical, educational and other aspects (medical
guidance, identification of individuals with unusual nutritional needs
etc.) of a campaign to get all their citizens replete in the nutrients
they need to protect them from COVID-19 harm and death.
I am not advocating mandatory
supplementation - just clear advice and logistical and economic support
for the entire population to become replete in these nutrients, in the
hope that most people will follow this advice.
is the project which these web pages are intended to facilitate: Getting
people - individuals, families, countries and ideally all humans -
replete in the nutrients which are essential for proper health, in
particular immune health.
This will largely protect them against the worst symptoms of COVID-19, so we can let the virus run
and do away with unsustainable measures which attempt to slow the
spread of the virus. This will also greatly reduce the death toll
from influenza - so reducing the need for vaccinations. This will
also greatly reduce the prevalence of chronic illnesses due to immune
system dysregulation. This is a far bigger problem, in the long
run, than COVID-19.
In order to achieve this, there are a number of problems to solve:
Identify which nutrients are required, and in what quantities in
general - and for particular individuals and people with particular
: Entwined with P30
get enough doctors to agree on this, since - except for a few
individuals and families who trust either their own judgment or that of
remote (via the Internet) doctors who advocate proper supplementation -
most people and all governments will take the required actions only when
there is broad consensus to do so among doctors.
: Entwined with P30
review all available research and arguments and come to the right
conclusions regarding what the nutritional advice should be, despite
this differing significantly from the consensus view of the medical
profession in recent decades.
For instance, the dosages of vitamin D3
we need for COVID-19 survival (and for general health, avoiding to the
greatest extent possible, without helminths, the plethora of
inflammatory disorders) exceed not just the recommended dosages many
doctors and government health authorities recommend, but their maximum
tolerable doses too.
Likewise the desired 25OHD levels. Some doctors are happy to aim
for getting most people above 12ng/ml (30nmol/L). This might be
enough to avoid rickets, but to make people safe from COVID-19, we need
to get everyone safely over 40ng/ml. So we should be aiming for 40
to 80ng/ml. Toxicity may
occur, for most people, above 150ng/ml, which can only be achieved by
long-term usage of much higher doses of D3 than are required to get
most people to > 40ng/ml. There may
also be problems with the subset of people with unusual genetics for
vitamin D enzymes, with granulomatous diseases or tumors.
In the case of boron, only some researchers and a few doctors recognise
it as nutrient - though it has long been recognised as safe in daily
doses up to 20mg. As far as I know, we probably need 6 to 12mg a day to be boron
replete. (Tina and I take 12mg.)
In trying to solve these problems, the material at this website (below,
I will work on completely revised versions for vitamin D and boron) is
biological reality, as best we can understand it from all research and
observations AND the beliefs of most doctors - not least because their
general wariness about nutritional supplementation has some basis in
reality, at least for some subsets of the population.
Recent updates are above this point.
Below is what I will work on next, when I get time. All that follows will soon be greatly revised and reorganised:
Updated version of the message I wrote to clinicians and researchers in late March
Poor survival rate once people need breathing assistance
Most people's battle against the virus will be lost or won at home,
not in hospitals or doctors' clinics. Zhou et al. (below) report
that of 34 patients receiving invasive mechanical ventilation or ECMO [WP], only 1 survived. The
survival rate for non-invasive ventilation was 2/26 and for nasal
breathing support, 8/41. Antivirals and antibiotics help, but we
will soon run out of these.
Coronavirus home remedies as suggested here - nutritional supplements
to enhance immune system function, especially by reducing the
overly-aggressive pro-inflammatory responses which cause sepsis -
can make a substantial contribution to public health in this
disastrous situation, given doubling times of half a week, and the
impossibility of retaining sufficient social distancing for 6 months or
Clear guidance regarding paracetamol, ibuprofen, aspirin and NSAIDs
Please see the separate page on this: http://aminotheory.com/cv19/fever/
Reducing the cytokine storm of sepsis
The cytokine storm, lead by
IL-6, TNF-alpha and other
pro-inflammatory cytokines is the primary or sole cause of death - and
probably of pneumonia and so most hospital admissions. The graphs
in Fei Zhou et al. Clinical course
and risk factors for mortality of adult inpatients with COVID-19 in
Wuhan, China: a retrospective cohort study
show that those who survived usually did so without radically
elevated IL-6 levels, and that those whose IL-6 levels kept on rising
died. Thrombosis (D-dimer) increased progressively in those who
died, but not in survivors. These averages are extremely
divergent. Serum ferritin kept rising in those who died,
indicating not iron overload, but (www.bmj.com/content/351/bmj.h3692.full)
The real enemy with COVID-19 is not the virus itself, but the
excessive and inappropriate inflammatory response to it - the
same thing which drives sepsis, neurodegeneration (Alzheimers,
Parkinsons), osteoporosis, diabetes etc. One probable cause of
this is that some aspects of our immune system are far more aggressive
than they should be, due to them evolving in the presence of ubiquitous
infection with intestinal parasites and/or H. pylori, both which
attenuate these mechanisms. However, now is not the time for
helminthic therapy. (Google
search for helminthic therapy.)
Another set of causes, which can be fixed - and must be fixed in the
next few weeks in order to prevent millions of deaths - are nutritional
deficiencies, particularly in vitamin D, boron, omega 3 PUFAs and
probably other nutrients such as vitamin C. For brevity I state
the following arguments as if they were facts.
inflammatory response which drives sepsis is supposedly not
. However, a Google scholar search for inflammation
and helminths makes it clear that our lack of intestinal parasites
now plays a major role in the excessive,
inappropriate, inflammatory response which drives asthma,
disease (and other forms of neurodegeneration),
It is also clear, as you will read below, that common nutritional
deficiencies also drive this inflammation.
given all this research, do so many disease support groups, clinicians
and some researchers fail to recognise that inadequate nutrition (and
with salt, inappropriate nutrition) drives our overly-aggressive
technicians make sure power supply voltages are correct before
attempting serious fault-finding. Motor mechanics don't work on
poorly performing engines without checking the fuel. Farmers fix
problems with their animals by feeding them correctly. For
instance lameness in pigs is routinely fixed with borax: 2005 article Boron
Supplementation Prevents Osteochondrosis in Growing Swine.
Why do doctors put so much
effort into drugs and acute interventions and so little into nutrition
to ensure the body works well in the first place?
A possible answer is that highly
skilled clinicians, researchers and disease support group people
dedicate their lives to helping people with complex, devastating
can't believe that the primary or sole cause of the disease is several
well-researched nutritional deficiencies and excesses which can be fixed.
I have no problem believing this. Electronic devices can
misbehave in all sorts of complex and perplexing ways due to simple
causes such as electrical leakage on the circuit board, temperature
sensitive intermittent failure inside an integrated circuit etc.
Many fault symptoms are complex, and there is usually one or sometimes
two simple (once you find
them) underlying problems which explain it all. Electronics is
complex, but it is child's play compared to cell biology, multicellular
life forms, genetics, immunology, neuroscience etc.
It makes perfect sense to me that human health is terribly impacted due
to one or more nutritional conditions not being met for most people in
our normal lifestyle. We have hundreds of operating conditions
and if only one of them is outside of a proper range, bad things will
happen. There's probably dozens of inputs not being adequately
met. I believe boron is the nutrient most people are most
deficient in. Then vitamin D, potassium, omega 3 fatty acids.
After that are the better known deficiencies such as iron.
It is so much easier to fix these things than live with the
consequences. The fix can't be achieved entirely with food - we
Most people wouldn't tolerate such ill-care for their car. It
would be unethical for a mechanic to be changing valves and pistons on
the engine, adding additives to the oil etc. in an attempt to solve the
problems caused by a fuel or air blockage, or contaminated fuel or
There can be enormous inertia in
some areas of medicine. See the section #ssc
below for 22 pulmonologists
raising 6,267 signatures in a petition to change what they argue is
damaging guidance on treating sepsis from a major international sepsis
Starting in March 2020 and peaking in May, June and beyond, billions
of people will contract COVID-19 and a substantial fraction of them
will be pushed into sepsis-induced pneumonia, respiratory distress and
organ failure - with a high risk of lasting disability and death.
Doctors, nurses and health
organisations have an urgent responsibility to read the research and
connections so they can advise
everyone on readily available nutritional supplements which will reduce
the incidence of sepsis in the months to come. These
levels of nutrition are known to be safe. There is no need, or
time, for RCTs.
Please see the section below #03-vit-d-dose
which lists doctor's vitamin D3 recommended doses for prophylaxis and
for those with COVID-19 infection. Dr Paul Marik recommends
5000IU in both cases.
deficiency is a major causative factor for Acute
Respiratory Distress Syndrome, which is what kills most people with
boldly titled open access article makes it abundantly clear that very
low levels of vitamin D3 are an essential precondition for most cases
of ARDS. This is cited by 62 other articles.
D deficiency contributes directly to the acute respiratory distress
with and at risk of ARDS are highly likely to be deficient, and
severity of vitamin D deficiency relates to increased epithelial
damage, the development of ARDS and survival.
Following adjustment for gender, age, diagnosis, staging data, and
pack-years [smoking], patients with
vitamin D3 less than 20 nmol/L
had a 4.2-fold higher odds of ARDS
than patients with vitamin D3 greater
than 20 nmol/L (p=0.032).
20nmol/L = 8 ng/ml. This is a very low vitamin D level.
Many of these people are dying due to an easily correctable, extreme,
nutritional deficiency! Every supermarket has vitamin D3
capsules. If they took one or two of these a day they probably
wouldn't be in hospital at all.
kills most of its victims due to ARDS (WP).
This results from the same overly-aggressive
pro-inflammatory sepsis which kills people with heart, kidney or liver
failure even if their lungs fail and they are on a ventilator or ECMO.
is just another triggering condition, one of many, for ARDS.
it may have unique characteristics which make it a particularly severe
trigger. One such mechanism, which it shares with SARS, is that
virus attaches to ACE2 (WP)
transmembrane proteins in particular types of
cells in the lungs, liver and other organs. When it attaches it
the ACE2 molecule to be pulled into the cell, with the virus still
COVID-19 sufferers surely have significantly fewer active ACE2
molecules available to play their role as an enzyme in the
renin-angiotensin system, where moderates processes which increase
blood pressure and have numerous other local effects in particular
A 2008 explanation of this system is: journals.physiology.org/doi/pdf/10.1152/physrev.00036.2005
The extremely low vitamin D level of ARDS sufferers might, in part, be
explained as an effect of ARDS or of other processes which accompany or
drive it. A much more important explanation for this relationship
is that vitamin D deficiency directly causes
or at least significantly
the sepsis - the overly-aggressive pro-inflammatory response - which in
this scenario manifests as the condition we know as ARDS.
A Google Scholar search
for ARDS and vitamin D turns up plenty of
articles, but none yet on an RCT involving vitamin D supplementation.
Another perplexed sidebar 2020-03-31 - this time really perplexed:
its current rate of spread, and the health and vitamin D status of the
population as it is now, this disease can be expected to kill millions
of people in these ways in the next few months.
shows that ARDS sufferers - due to a variety of causes other
than COVID-19 - are highly deficient in vitamin D3.
reason to think that the subset of people who COVID-19 kills in this
way are not also, on average, highly vitamin D3 deficient.
We are now 3
months into this global pandemic.
Why hasn't the
WHO told everyone to supplement vitamin D3?
If they had
issued such advice, it would have been followed very widely by now, and
would probably save millions of people's lives in the next few months.
role of vitamin D in ARDS is no secret. See below for articles
which confirm it.
Vitamin D is not
controversial, obscure, expensive or dangerous.
It is not a drug with side-effects. It is safe and very well
researched nutrient. So there's no need for an RCT to prove
beyond reasonable doubt that supplementation would reduce the incidence
of ARDS deaths and disability due to COVID-19.
ARDS isn't the only lung problem caused by vitamin D deficiency.
D deficiency (VDD) is closely associated with lung diseases, including
asthma, cystic fibrosis, interstitial lung disease, chronic obstructive
pulmonary disease (COPD) and respiratory infections.
Here is a trial giving ICU patients high doses of vitamin D3. Of
course it would have been better still if they had taken vitamin D
supplements all their lives. Then they probably would not be in
ICU at all.
There is a
high prevalence of vitamin D deficiency in the critically ill patient
population. Several intensive care unit studies have demonstrated an
association between vitamin D deficiency = less than 20 ng/mL (see
above and below, this is a very low level) and increased
hospital length of stay, readmission rate, sepsis and mortality.
Subjects were administered either placebo, 50,000 IU vitamin D3 or 100,000 IU
vitamin D3 daily for 5
a significant decrease in hospital
length of stay over time in the 250,000 IU
and the 500,000 IU
vitamin D3 group, compared to
the placebo group:
25 ± 14
and 18 ± 11
days compared to 36 ± 19
(p = 0.03). (This means that an outcome would only have
occurred by chance once in 33 such trials.)
With the knowledge from this trial, how is it ethical to admit
people to hospital like this and not
give them 500,000IU (12.5mg) vitamin D3 in the first 5 days?
Its not expensive, or risky.
Tina and I take two of these 50,000IU capsules a month. We also
get some vitamin D in multivitamins.
They are made by Bio-Tech
in the USA. The cost is USD$30 for 100 capsules. The cost
of giving ICU patients 500,000 IU
vitamin D (12.5mg) is USD$3.00. To save:
- 18 =
18 days in hospital
So the cost of avoiding one day in
hospital, with vitamin D supplementation = USD$0.17.
If the drug companies found a patentable compound with this
effectiveness and safety profile, they would be selling it for $100 per
capsule AND they would be advertising it to doctors and the public AND
everyone would think it was a modern marvel and be very happy to pay
good money for it.
Instead, because it is a cheap nutrient, which no-one makes much money
from, hardly anyone sings its praises - and year after year, people
suffer grave illness and death, with billions of dollars of hospital
and drug costs, since only a subset of the population use it.
Doctors do, at times, advise their patients to take vitamin D3, omega 3
fatty acids and other nutrients. However, it is my impression
that the dosage can be rather low, such as 2000IU or less, when
research (below) indicates that about twice this would better protect
against numerous diseases.
Vitamin D3 is exceedingly inexpensive. At PureBulk a powder
up of 0.2549% vitamin D3 sells for USD$93 per kilogram. This
contains 2.549 grams of vitamin D3, at a cost of USD$36.48 per
gram. At 4000IU a day, this would last for 69 years. At
this rate, the 5 million IU (125mg) in the above bottle would cost
At this price, the cost of saving 18 days in hospital would be USD$0.46.
In bulk, a kilogram of pharmaceutical grade vitamin D3 (colecalciferol
USP) costs USD$13,553 from a US supplier (link),
or USD$2500 from a Chinese
100 years supply at 4000IU a day is 3.7 grams, which is USD$9.25 at the
Chinese wholesale price. So, not counting the cost and effort of
splitting it into 5,200 weekly capsules (there's no need to take it
every day), a vast array of diseases and chronic conditions could be
largely or entirely avoided, for 9
cents a year.
It is clear that vitamin D deficiency plays a crucial, causative, role
in many lung diseases. It is reasonable to assume that it plays a
crucial role in most of the suffering and death caused by
COVID-19. The same would be true of the most serious consequences
If everyone in the world took a decent amount of vitamin D, such as
4000IU, it would be reasonable to expect that COVID-19 wouldn't be such
a big deal. It would be a new virus, which makes some people ill
for a while, and it would cause few if any deaths worldwide.
So the entire human world is being
disrupted, and hundreds of thousands or millions of people are going to
die because they didn't take an adequate vitamin D supplement?
As far as I can see, this is true.
So why are our health authorities not urging everyone to take vitamin
D? Now? Or years ago? Hopefully they will.
There would be far less work for doctors and hospitals, and billions of
dollars less spent on drugs. One can imagine a conspiracy of drug
companies suppressing vitamin D, boron etc. but I don't think they are
It is as if the medical profession is focussed on sick people, the
complexities of their illnesses, and the costly, difficult and
sophisticated acute interventions they have learned to help these
people get well again.
Yet it is easy and inexpensive to fix these nutritional deficiencies
such as for vitamin D - which would save so much suffering. It is
a easier than supplementing with potassium, (see kna/
) but that is easier and better than using blood pressure drugs.
It is a lot easier than getting people to give up smoking. And
that is easier than having to cope with the damage smoking causes.
A 2014 article PMC4220998
relates blood levels to vitamin D3
supplement quantities for underweight, normal, overweight and obese
people. For normal weight people, 4000 IU/d provides 117 nmol/L,
which is 47 ng/ml. Toxicity (PMC6158375)
occurs with blood levels more than three times this.
If all adults (who wisely have little UVB exposure) took 4000IU
vitamin D3 a day (a gram every 27 years) then they would avoid most of
the diseases caused by vitamin D deficiency. This
chart from Garland et al. 2014 PMC4103214
shows the importance of achieving at least 40ng/ml.
A chart from one of the co-authors, (vitamindwiki.com/Chart%20of%20Vitamin%20D%20levels%20vs%20disease%20-%20Grassroots%20Health%20June%202013)
labels the various conditions:
(Right click the image to see it at full size.)
Numerous peer-reviewed journal articles showing adequate vitamin D reduces inflammation AKA sepsis
can be found at:
(Vitamin D and inflammatory diseases, 2014. Google reports 227
COVID-19 Vitamin D dose recommendations from doctors
Please let me know any published recommendations not listed here, from
doctors or health authorities - for the public in general, and
especially for the public preparing for COVID-19 infection. These
are implicitly for adults, since children seem not to have much trouble
The nutritional requirements are the
same, except for more melatonin for hospitalised patients.
The prophylaxis recommendations are, implicitly, for all adults in the
current (early April) state of expecting to be infected with COVID-19
in the weeks or months to come. The intention is to either
prevent infection (I think this is unlikely to be achieved) or to
reduce the severity of the infection when it occurs, by preparing the
body with nutritional and other items. I believe these are a very good thing
- Vitamin C (ascorbic acid) 500 mg twice a day.
- Zinc 75 to 100 mg/day (sulphate or gluconate is fine).
- Quercetin 500 to 1000 mg/day.
- Melatonin (slow release): Begin with 0.3mg and increase as
tolerated to 1-2 mg at night
- Vitamin D3 5000IU per day.
Please see #marik
below for a link to the latest version of the document, and for some
quotes from the document which explain the purpose of some of the items
listed above. For instance, melatonin is believed to have
- A 2020-03-25 article by John C. Umhau MD (ex-NIH) discusses
studies of vitamin D's ability to protect against respiratory
infections. It includes a link to very widely cited 2007 article
he co-wrote Epidemic Influenza and
Vitamin D - in which up to
5000IU was recommended for adults to achieve the 50ng/ml blood
levels which appear to protect against viral respiratory infection.
Both the article and the comments are
interesting - however, I think vitamin D will at best slow down the
progression of the infection, rather than prevent it, and that its real
value will be in reducing or eliminating the overly-aggressive
pro-inflammatory immune response which causes the sepsis.
In the comments, Donna Hurlock MD recommends 4000IU to 5000IU.
There is discussion of magnesium, calcium, vitamin K2 and other
- Version 2 (2020-03-30) of an extensive review article:
Evidence That Vitamin D Supplementation
Could Reduce Risk of Influenza and COVID-19 Infections and Deaths
William B. Grant et al.
reduce risk of infection, it is recommended that people at risk of
influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few
weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to
raise 25(OH)D concentrations above 40–60
ng/ml (100–150 nmol/l). For treatment of people who become
infected with COVID-19, higher
vitamin D3 doses might be useful.
The highest recommendation is 10ug,
which is only 400IU.
- Helga M Rhein GP (retired) of Edinburgh wrote comment at the BMJ
that one third of the Scottish population is severely vitamin D
deficient. She recommends up to
100ug = 4000IU vitamin D a day and cites a 2011 survey
which reports an average of 37.5 nmol/L. This is an alarmingly
low average of 15ng/ml. They regarded anything above 10ng/ml as
"optimal" and one third of the population had levels below this:
< 15nmol/L ( 6ng/ml) 12%
Looking at the chart above regarding ARDS, these levels place a
significant proportion of the population at high risk of ARDS when they
contract COVID-19. Likewise looking at the all cause mortality
and burden of disease charts above - only a subset of the population
would have a level which offers them significant protection from a
variety of diseases.
Omega 3 PUFAs
The same is true of omega 3 fatty acids.
I believe that if the WHO et al. recommended adults take 2 grams of
fish oil a day and 4000IU vitamin D3, that this - to the extent that
people were willing and able to comply - would significantly reduce
disease severity and death for hundreds of millions of people,
especially those with a Western, indoor, lifestyle.
Importance of maintaining a low
omega–6/omega–3 ratio for reducing inflammation (2018)
systematic review of 26 randomised controlled trials (RCTs) concluded,
‘Dietary omega-3 fatty acids are associated with plasma biomarker
levels, reflecting lower levels of inflammation and endothelial
activation in cardiovascular disease and other chronic and acute
diseases, including chronic renal disease, sepsis and acute
Indeed, supplementing with fish oil is known to inhibit inflammatory
cytokines such as TNF-alpha and IL-1 beta and
proinflammatory/proaggregatory eicosanoids such as thromboxane-2 and
(2017) N-3 PUFAs induce inflammatory
tolerance by formation of KEAP1-containing SQSTM1/p62-bodies and
activation of NFE2L2
It may be best to recommend zinc
supplements, since Zn++ in the cytoplasm inhibits viral RNA synthesis -
lozenges to slow the initial infection in the throat, before it gets
into the lungs. Zinc is needed for hundreds of enzymes. Please
see what Google scholar returns for zinc
Another potential reason for advising people take, for instance, 25mg
zinc per day as chelate is that oral zinc 225mg a day (as best I
understand it) is recommended for patients who do not yet need
breathing support. Paul Marik's
COVID-19 Treatment Strategy - see below #marik .
I suggest you recommend a substantial but safe level of vitamin C
oral supplementation, since it is known to reduce respiratory
infections and to reduce sepsis when used intravenously. A vet
reports IV vitamin C is routinely used for saving animals from sepsis (medium.com/@anmldoc/i-really-do-not-know-d657e669e749).
She cites Paul Marik MD (www.pilotonline.com/news/health/article_7a3063e5-24cf-56c1-b25c-142731604196.html)
who uses IV vitamin C and hyrdocortisone with success against sepsis in
Paul Marik's COVID-19 Treatment
Strategy - see below #marik
- recommends 500mg oral vitamin C 2 or 3 times a day for patients who
do not require breathing support, and for those in ICU, intravenous
vitamin C 3 grams every 6 hours. From (2017) Vitamin C and Immune Function :
C deficiency results in impaired immunity and higher susceptibility to
infections. In turn, infections significantly impact on vitamin C
levels due to enhanced inflammation and metabolic requirements.
Furthermore, supplementation with vitamin C appears to be able to both
prevent and treat respiratory and systemic infections.
prevention of infection requires dietary vitamin C intakes that provide
at least adequate, if not saturating plasma levels (i.e., 100–200
mg/day), which optimize cell and tissue levels.
contrast, treatment of established infections requires significantly
higher (gram) doses of the vitamin to compensate for the increased
inflammatory response and metabolic demand.
Soon, hundreds of millions of people with COVID-19 breathing
difficulties will be at home, unable to access care in hospitals or
doctors' clinics. Should uninfected people be advised to take
250mg vitamin C a day, and those with fever, sore throats and/or
breathing difficulties (sepsis induced pneumonia) be advised to take
1000mg or more, subject to concerns about diarrhea? (I assume
that for the duration of the illness kidney stones are not a
significant concern: www.ncbi.nlm.nih.gov/pmc/articles/PMC4769668/
Intravenous vitamin C 1500mg 3 or 4 times a day (with
hydroxychloroquine, azithromycin and other drugs) is helping COVID-19
patients in New York: nypost.com/2020/03/24/new-york-hospitals-treating-coronavirus-patients-with-vitamin-c/
Dr Andrew G. Weber said:
patients who received vitamin C did significantly better than those who
did not get vitamin C. “It helps a tremendous amount, but it is
not highlighted because it’s not a sexy drug.
Vitamin C levels in coronavirus patients drop dramatically when they
suffer sepsis, an inflammatory response that occurs when their bodies
overreact to the infection. It makes all the sense in the world
to try and maintain this level of vitamin C.
Since mid March, our supermarket has been sold out of vitamin C.
Vitamin B1 thiamine
(Not to be confused with theanine, as found
in green tea.)
I have not studied thiamine (WP), but a Google
for thiamine inflammation
turns up plenty of articles, such as:
(2014) The effect of thiamine deficiency on
inflammation, oxidative stress and cellular migration in an
experimental model of sepsis
This begins with numerous references regarding thiamine deficiency and
critically ill patients, neurodegeneration etc.
My reason for including it here is that vitamin B1 is a component of
Paul Marik's COVID-19 Treatment
Strategy - see below #marik,
though not for patients with mild symptoms. Those with breathing
difficulties, in ICU, are given 200mg thiamine every 12 hours, orally
or intravenously. This seems a lot, considering the RDA is 1.0 to
1.2mg. This search
turns up various relevant articles.
acid, corticosteroids, and thiamine in sepsis: a review of the biologic
rationale and the present state of clinical evaluation
The ordinary retail B complex tablet my wife Tina and I take every day
has 15mg of vitamin B1. Our multivitamin has 2.2mg. Given the
correlation between low vitamin B1 and sepsis, it seems prudent to take
ordinary vitamin B1 supplements, especially since it is "relatively
2020-06-15: I have a box of boron research papers and am keen to
write them up as an annotated bibliography. I don't know when I
will have the time for this. I will do it on the new website.
For now, please start by reading this excellent review article from
2018, which has a lot of links to research on boron's role in the
immune system, especially regarding inflammation.
In this section I want to raise your awareness of boron as an essential nutrient which
could save hundred of millions of people from sepsis-induced illness
and death with COVID-19. Please take a look at a recent review
Nothing Boring about Boron
the work of long-time US Department of Agriculture boron researcher,
Forrest Nielsen, such as:
and the research cited at: ods.od.nih.gov/factsheets/Boron-HealthProfessional/
(2011, cited by 60.)
advantage of boron over the other micronutrients mentioned here is that
while supplies of the others could easily be snapped up if everyone
wanted them, there is plenty of boron for the whole population sitting
on supermarket shelves, in the form of laundry borax.
It is a scandal that boron is not officially recognised as an
essential nutrient. Most people turn their noses up at the
thought. The word sounds like "boring" and rhymes with "moron".
They know borax is used in laundry, as a welding flux, as an ant and
cockroach poison and in children's slime. Many people recoil at
the idea of ingesting boron, because they see borax is the active
ingredient of Ant Rid (8.5%
borax). But boron is in many foods, and vitamin D3 is a
widely used rat and mouse poison. (See my second comment at quillette.com/2020/03/22/covid-19-statistical-and-science-update-for-march-22/
The naturally pure mineral borax - sodium tetraborate - is
mined at large scale in Turkey and California, and then refined into
the bright crystals sold in supermarkets. USP boron is used in
nutritional supplements and medication, but it is difficult to obtain
at a retail level.
If a drug company found a patentable compound with boron's health
benefits and safety profile - including especially its ability to
restrain the body's overactive, sepsis-causing, inflammatory response -
then we would all be singing its praises and paying top dollar for it.
Borax, 100mg a day, in water solution, provides 11.36mg boron a day,
and I believe this will significantly reduce the inflammation which is
killing COVID-19 patients. (I have a box of journal
articles on boron, and no time now to write up an annotated
bibliography of boron nutrition.)
Side note on borax regulation in the EU, including the UK:
I have not yet fully researched this,
but as best I can tell, the EU banned borates, including borax for many
purposes including laundry, around 2010. A laundry borax
substitute sodium sesquicarbonate is sold in its place.
Yet according to http://www.caviarfactory.ro/en/caviar-preservative-borax/
borax is authorised as a food additive E285 for preserving caviar in the EU, but not in the USA. An extensive 2013 report
Laundry borax is available by the kilogram in most
supermarkets in Australia and the USA. My wife Tina and I use this - plain laundry borax
is plenty pure enough. (The Eti mine in Turkey, which produces 47% of
the world's borax,
specifies its technical grade borax to have no more than 15ppm
We use: www.blants.com.au/product/natural-pure-borax-900g/
Our 12mg boron a day greatly improves on the typical 1mg a day in
the average American diet (ods.od.nih.gov/factsheets/Boron-Consumer/
and is well within the tolerable maximum of 20mg a day (nap.edu/10026/):
From Nothing Boring about Boron:
number of papers have indicated that boron reduces levels of
inflammatory biomarkers. In a recent human trial involving healthy male
volunteers (n = 8), a significant increase in concentrations of plasma
boron occurred 6 hours after supplementation with 11.6 mg of boron,
coupled with significant decreases in
levels of hs-CRP and TNF-α. One week of boron supplementation 10
mg/d resulted in a 20% decrease in the plasma concentration of TNF-α
[tumor necrosis factor alpha], from 12.32 to 9.97 pg/mL, and in
remarkable decreases (approximately 50%) in plasma concentration of hs-CRP [high-sensitivity C-reactive
protein], from 1460 to 795 ng/mL, and of
IL-6, from 1.55 to 0.87
Is boron adequacy important? Consider that elevated hs-CRP is
associated with an increased risk for breast cancer, obesity and
metabolic syndrome (MetS) in children, atherosclerosis, unstable
angina, insulin resistance, type 2 diabetes, nonalcoholic fatty liver
disease (NAFLD), metastatic prostate cancer, lung cancer, adult
depression, depression in childhood and psychosis in young adult life,
coronary heart disease, and stroke.
An assessment of high hs-CRP levels in www.ahajournals.org/doi/10.1161/JAHA.119.012638
patients with myocardical infarction [heart attack] exhibit elevated
hsCRP levels. Besides identifying populations at high-inflammatory
risk, this study extends the prognostic validity of this biomarker from
trial evidence to real-world healthcare settings.
Please take a look at vitamindwiki.com/Vitamin+D+and+Boron
which links to articles such as M R Naghii et al. 2011:
far as I know, 12mg / day boron is safe for most people, but it is
probably best to start with 3mg and increase from there. The two
possible adverse reactions I am aware of are:
Comparative effects of daily and weekly boron supplementation on
plasma steroid hormones and pro-inflammatory cytokines
10mg boron per day raised Vitamin D levels and reduced
inflammatory cytokine levels.
- I have read of arthritis and candida sufferers initially having a
Herxheimer reaction (en.wikipedia.org/wiki/Jarisch%E2%80%93Herxheimer_reaction)
due to the death of harmful micro-organisms.
- Several peer-reviewed journal articles by M R Naghii et al. in
Iran report that 10mg or so boron a day causes ultrasound-confirmed
kidney stones to disintegrate and leave the body. This is an
important finding since it implies that some or all classes of kidney
stone only exist due to the boron deficient state of most of the
Preliminary Evidence Hints at a
Protective Role for Boron in Urolithiasis (2012)
The full article via SciHub: sci-hub.tw/10.1089/acm.2011.0865
Getting rid of kidney stones without surgery or drugs is a good
outcome, but the fragments can be painful and disturb the urethra,
which can cause a UTI (Urinary Tract Infection).
3mg boron capsules are readily available, but in the current
emergency, I think it would be good to instruct people to get a heaped
teaspoon of borax (about 8 grams), divide it by 4, and dissolve each
quarter in 2 litres of water. Two 50ml drinks a day provides
11.36 mg boron.
500 grams of borax is enough for 5,000 days at this rate, so a
single borax purchase would help a dozen or so households through the
Everyone knows that most people consume too much salt. See some
journal article links below #salt concerning
excessive salt consumption driving pro-inflammatory immune responses -
and so sepsis.
Faced with the threat of imminent sepsis, I think many people could be
convinced by consistent medical advice to go easy on salt.
This should go along with the obligatory warnings to reduce or
eliminate smoking and alcohol.
Regular moderate exercise helps build a robust and well-regulated
(against sepsis) immune system. This 2018 article argues against
the view that intense exercise decreases immune competency: pubmed/29713319.
evidence indicates that regular physical activity and/or frequent
structured exercise reduces the incidence of many chronic diseases in
older age, including communicable diseases such as viral and bacterial
infections, as well as non-communicable diseases such as cancer and
chronic inflammatory disorders.
The challenge is to maintain or increase regular exercise in a time of
social distancing and shelter-in-place.
Potassium supplementation with potassium gluconate solution is
superior to blood pressure medication
Please see the separate page on this: http://aminotheory.com/cv19/kna/
Overcoming Western Medicine's blind spots in the next week or two
Conventional Western medicine excels at surgery and other acute
interventions, but has blind-spots regarding nutrition and chronic
Since there is no money to be made from the nutrients mentioned
above, their full benefits are known only to some clinicians and
researchers. In the developed world, most people are deficient in
potassium, vitamin D and especially boron. This leads to illness
with aging, diabetes, stroke, CVD, sepsis etc.
As best we know, SARS-CoV-2 will induce debilitating and potentially
deadly sepsis in 5 to 20% of the population in April, May and
June. The terrible toll which is likely to come from this is due,
in large part, to easily corrected nutritional inadequacies.
These they can be solved, since the necessary nutrients are widely
It is not right for me to be making such recommendations to the public
at large, since I have no medical training. I am an electronic
technician, computer programmer and amateur neuroscientist: aminotheory.com/rlsd/briefsumm/
. To the extent that
advice such as the above is valid, it needs to come from clinicians and
health authorities, in the
first week or so of April.
(On 2020-03-31, Paul Marik's protocol recommends 5000IU vitamin D a day
for adults, before infection and after, for mild symptoms. I
think this is an excellent development. I hope that intakes such
as this will soon be recommended by national health authorities and/or
COVID-19 and sepsis resources for healthcare professionals
Some aspects of the medical establishment are overly-resistant to new
. This 2020-02-04 article, by Josh Farkas MD (associate professor of
Pulmonary and Critical Care Medicine at the University of Vermont) is
also critical of some aspects of the current WHO COVID-19
guidelines. It starts with a picture of someone drowning.
Surviving Sepsis Campaign is a blight on modern, evidence-based
It's been clear for some years that its fundamentals were
flawed (centering around rapid, large-volume fluid
Rather than adapt guidelines to modern evidence, the campaign recently
doubled down on immediate administration of fluid and antibiotics
within one hour. This provoked widespread protest, including a
petition to retire the Surviving Sepsis Campaign that garnered over
Whether or not to retire the campaign was openly
debated in the journal CHEST.
Change takes time, meanwhile the Surviving Sepsis Campaign continues to
lumber forward. One consequence of this is that recommendations
one-hour sepsis bundle have started to creep into other
30 cc/kg fluid and antibiotics are good for septic shock, then perhaps
they're beneficial for other patients? One example of collateral
damage from these guidelines is their mis-application to viral
"Marik Protocol" is an informal
name for a series of recommendations regarding critical care patients,
including IV vitamin C and vitamin B1.
The latest version of this PDF document can be found at the link EVMS Critical Care COVID-19 Management
Protocol at: www.evms.edu/covid-19/medical_information_resources/
This may be referred to by other sites, such as in the FOAMed on COVID-19 section of emcrit.org/ibcc/covid19/ ,
which links to their own, possibly no longer up-to-date, version of the
See above #03-vit-d-dose for dietary
arrangements it recommends. Here are some of
the notes, which relate to dietary items, listed above, from the
2020-03-31 version of the document. (Clinicians should refer
directly to the latest PDF, since what follows may not be up-to-date.)
We are all inhabitants of the same planet and we are all in this
together. The medical community needs to get off their "high pedestal"
and act decisively and right now; there is no time to
is likely that 40-80% of the population across the world will become
infected with this virus.
It is therefore unrealistic for us to expect this will just go away.
Our goal should therefore to reduce the mortality in those who are at
greatest risk of dying. This requires that those at risk to "socially"
isolate themselves. Once they become infected, we should treat
aggressively to prevent disease progression.
The course of the disease is quite predictable. Acute
respiratory failure occurs on day 6-8 (due to cytokine storm). In those
patients requiring supplemental oxygen, we need to be very aggressive
to prevent progression to ARDS. Once ARDS develops the mortality is
This is not your "typical" ARDS. Chest CT shows bilateral,
discreet, irregular, multi-lobar infiltrates and not the typical
dependent air-space consolidation (“sponge lung”) characteristic of the
usual ARDS. Physiologically "COVID-19 ARDS" is different; our
preliminary data suggests that lung water (EVLWI) is only marginally
increased. Furthermore, lung compliance is quite good yet severe
hypoxia (due to shunting). Cause unclear?? Microvascular
7. Zinc (Zn++ ) inhibits
viral RNA dependent RNA polymerase (replicase). Chloroquine and
hydroxychloroquine are potent Zn ionophores that increase intracellular
Ascorbic acid (vitamin
has numerous proven biological properties (anti-inflammatory,
anti-oxidant, immune enhancing, antiviral) that are likely to be of
benefit in patients with COVID-19 disease.
Very recent data suggests that in addition to being a potent
may have direct antiviral effects against COVID-19. In healthy people,
melatonin levels plummet after the age of 40 years. This may partly
explain the increased risk of death in patients with COVID-19 who are
over the age of 40. Melatonin may therefore have a role in both the
prevention and treatment of COVID-19.
immune enhancing effects. Much of the population, especially the
elderly have sub-optimal vitamin C levels, particularly during the
winter months. Low vitamin D levels have been shown to increase the
risk of developing viral upper respiratory tract infections. Therefore,
prophylactic vitamin D should be considered especially in the
11. Quercetin is a plant
phytochemical. Experimental and early clinical data suggests that this
compound has broad antiviral properties (including against coronavirus)
and acting at various steps in the viral life cycle. Quercetin is a
potent inhibitor of heat shock proteins (HSP 40 and 70) which are
required for viral assembly. This readily available and cheap plant
derived compound may play a role in the prophylaxis of COVID-19 in high
A 2018 article about this by Paul Marik and colleagues: Ascorbic
acid, corticosteroids, and thiamine in sepsis: a review of the biologic
rationale and the present state of clinical evaluation www.ncbi.nlm.nih.gov/pmc/articles/PMC6206928/
contains a big diagram and explanation.
anthropoid apes) have lost the ability to synthesize vitamin C and
therefore have an impaired stress response. The inability to produce
vitamin C has serious implications in septic humans. Treatment with
vitamin C appears to restore the stress response and improve the
survival of stressed humans
(2017) Dr. Paul E. Marik,
MD, FCCP (Norfolk, Virginia, U.S.A) is Professor of Medicine and Chief
of Pulmonary and Critical Care Medicine, Eastern Virginia Medical
School (US) and a world-renowned expert in sepsis and critical care
medicine. Dr Paul Marik has written over 400 peer-reviewed journal
articles, 50 book chapters and authored 4 critical care books.
colleagues, when I told them what was going on, thought it was the
biggest load of nonsense they had ever seen. But then they
actually saw that none of our patients were dying. And then our
CEO saw that none of the patients were dying. So this has become
instituted through the whole healthcare system.
"We were going to do a randomised clinical trial, but we couldn't -
because it would have been unethical."
- Kristina E. Rudd et al. 2020: Global,
regional, and national sepsis incidence and mortality, 1990–2017:
analysis for the Global Burden of Disease Study www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32989-7/fulltext
report that in 2017 there were about 48.9 million deaths from sepsis, representing about 19.7% of
- A 2019 article reporting that rats fed the equivalent of a
Western diet, high in sugar
and saturated fats
(omega 3 fatty acids found in fish and algae are unsaturated) had much
higher levels (estimated from gene expression) of the pro-inflammatory
(tumor necrosis factor) and IL-6 (interleukin-6) than rats fed
fiber-rich chow, when injected with a bacterial endotoxin
lipopolysaccharide (LPS) elsewhere described as "the most potent
microbial mediator implicated in the pathogenesis of sepsis and septic
shock". Western diet regulates
immune status and the response to LPS-driven sepsis independent of
diet-associated microbiome www.pnas.org/content/116/9/3688
High salt (NaCl) and low potassium intakes are common - but
perhaps, in a crisis such as this, some people might be persuaded to moderate their salt intake,
and eat more vegetables and fruits high in potassium. There are
no doubt multiple negative outcomes from this high salt regime.
Researchers with more expertise than I have might be able to construct
an salt lowering strategy for COVID-19 along the following lines:
- (2013) Sodium Chloride
Drives Autoimmune Disease by the Induction of Pathogenic Th17 Cells
T helper cells 17, which produce interleukin 17. "The Th17 cells
generated under high-salt display a highly pathogenic and stable
phenotype characterized by the up-regulation of the pro-inflammatory
cytokines GM-CSF, TNFα and IL-2."
- (2017) Th17/Regulatory
T Cell Imbalance in Sepsis Patients with Multiple Organ Dysfunction
Syndrome: Attenuated by High-volume Hemofiltration journals.sagepub.com/doi/10.5301/ijao.5000625
"The level of Th17/Treg imbalance in sepsis is related to the
occurrence and prognosis of multiple organ dysfunction."
- (2019) Where there is sodium
there may be sepsis www.ncbi.nlm.nih.gov/pmc/articles/PMC6735289/
"Although sepsis patients with hypernatremia face a greater mortality
rate, there is a lack of studies examining a potential association
between hypernatremia and sepsis."
COVID-19 and sepsis links:
- Dr Roger Seheult's
extraordinary Coronavirus Pandemic
video updates on YouTube: www.youtube.com/user/MEDCRAMvideos/videos
These are for clinicians, researchers and well-informed lay
people. References are in the text under the video. I
learned a lot from these videos, including about the
deadly use of aspirin in the Spanish Flu.
- Update 42:
Early and late antibodies (immunoglobulins). Rhesus monkey research
showing viral shedding peaked 3 days after infection, where the virus
was in the body, the development of immunity (antibodies) and how this
prevented the monkeys from being re-infected
second time. 28 days after infection, no viruses could be
detected and chest X-rays were normal. Progress on antibody
tests. RT-PCR tests are only about 60 to 70% sensitivity, at
least in some countries - for instance, in South Korean the tests may
be better. (13:24 he pronounces his surname like "shwelt" - his great
a physician too.)
- Dr Emily Landon
(University of Chicago) speaking of the necessity of extreme Shelter in Place arrangements to
quell the spread of the virus: www.youtube.com/watch?v=kHUuWq6y8F0
- 2020-02-21 report from an ICU
doctor in New Orleans
on the large numbers of patients with extremely serious symptoms,
including those who are in their 40s and have no known pre-existing
These symptoms leading to respiratory distress and death are due to
excessive inflammatory response. To what extent are these people
taking aspirin, ibuprofen or whatever in the early stages of their
disease? To what extent are they deficient in vitamin D, omega 3
fatty acids, boron, vitamin C? Most people are deficient in all
these nutrients and more.
of temporarily overreacting, people are hesitating,
preparing less and taking fewer
precautions than the knots in their stomachs say they should – beset by self-doubt that maybe they’re
wrong and fear of embarrassment that maybe others will mock them.
Perhaps the most challenging job public health officials face right now
is helping us bear these feelings and ambivalences – and, of course,
bearing their own.
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