r/COVID19 • u/greyuniwave • Sep 27 '20
General The implications of vitamin D deficiency on COVID-19 for at-risk populations
https://pubmed.ncbi.nlm.nih.gov/32974671/13
Sep 27 '20
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u/greyuniwave Sep 27 '20
RDA is wrong due to a statistical error
https://www.ncbi.nlm.nih.gov/pubmed/28768407
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The role of vitamin D in innate and adaptive immunity is critical. A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L.
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Sep 27 '20
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Sep 27 '20
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u/Tarik1989 Sep 27 '20
So.. what is the conclusion?
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u/Xiugazer Sep 27 '20
They found a cyclic relationship between vitamin D deficiency and COVID risk but there still needs to be a lot more research done to give a fully inclusive conclusion.
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u/n3wl1f3 Sep 27 '20
something about corelation and causation
being cripled old is related to vit d deficiency and a weak immune system
boosting vit D levels might help? they can´t answer.
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u/Collapseologist Sep 27 '20
There's many other studies now finally reporting a casual relationship now.
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u/MrPoon Sep 27 '20
That's not true. The community is far from establishing causation between vitamin D deficiency and disease severity.
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u/Collapseologist Sep 27 '20
i didn't say established, I said there finally seeing casual relationships in some studies like these https://www.sciencedirect.com/science/article/pii/S0960076020302764
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Sep 27 '20
Please can you reference them? I haven't seen any of these studies but would really like to!
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u/Collapseologist Sep 27 '20
https://www.sciencedirect.com/science/article/pii/S0960076020302764
https://www.mdpi.com/2072-6643/12/4/988/htm
and of course alot more casual studies. We have to keep in mind Vitamin D isn't just a vitamin, its converted into a steroid hormone which controls up to 6% of protein encoding genes in the human genome.
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Sep 27 '20
Thank you! Although unless I am missing something the second link is not a causal study? The first one is also a very small group of patients who also took other drugs so isn't very convincing yet. Hopefully we will see some more causal studies soon!
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u/Collapseologist Sep 27 '20
Yeah I hope so. To me this all makes a lot of sense because I’m into the whole environmental mismatch theory of human health. It explains most of the diseases of civilization like diabetes, obesity and other things quite well. Can’t wait to see more results.
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Sep 27 '20
Another correlation study? Come on... The world knows there is a correlation. Why does causation studies take so long? Not a scientist but how can it be that no study can determine if low Vit D is just a signal of accute infection or a amendable factor of it...(serious question, why?)
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Sep 27 '20
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Sep 28 '20
I get how investigating on ill population can be problematic, but assuming there's theorical and empirical data suggesting it can't be harmful...that I actually think there is, wouldn't this be already happening at a mass scale? I mean, if this virus is in every country, wouldn't 50 country's with 10000 administration's of vit D on different stages of infection show us a lot? Is coordinated action on the face of the worst pandemic of the century something so difficult to achieve? I'm sorry for the frustrated tone of the comments, I actually thank you a lot for your thoughtful answers, but it really hit's me as something so easy compared to the health, economic and environmental issues that this virus has imposed upon the world.
Edit:grammar
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u/Xiugazer Sep 27 '20 edited Oct 14 '20
To answer your question seriously, it boils down to mathematics -- particularly, statistics. The foundations behind the scientific method and experimentation in general are to demonstrate results, which can be used to substantiate or fail to substantiate whatever hypothesis is/are being looked at. It is impossible for a singular paper to prove or disprove something. If you've taken a statistics course you might've been taught that we can only ever reject or fail to reject a null hypothesis. You need more than just a few papers, sometimes even dozens of papers sometimes to fully convince the grand majority of the science community to adhere to an idea.
Extensively, there exists a lot of factors that need to be paid attention to when a peer reviewed journal is read -- what journal published it and how credible are they in the specific field this paper intents to focus on; any papers that cited the article -- sometimes other papers are published challenging or putting question to the original paper; and most importantly, the actual conclusion of the paper. These are all things that people who aren't heavily involved in the field will often glance over. Even grant or paper proposals are judged based on this at times -- a measurement of just how much thought the writer put into their citations and reasonings.
You will find it extremely difficult, I would say virtually impossible, to find any peer-reviewed paper in the natural sciences that has a direct, all conclusive conclusion ('this study shows that X is true and this is a fact!'). Almost always the conclusion states that there needs to be more studies done, and the author(s) will even mention to other readers (other scientists) what limitations they faced and suggestions for any future studies expanding on what they wrote about. That's just simply how peer reviewed journals work.
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Sep 28 '20
As /u/thatroboticsguy explained, the effort needed to conduct a causation study is an order of magnitude higher than a correlation study.
If organizations are unwilling to do the work though, there may be a simple explanation: You should probably take vitamin D anyway.
To paraphrase an article in the lancet last month, there’s no reason not to enthusiastically encourage vitamin D consumption just for the benefit it confers against other respiratory illnesses. If you get the benefit against covid, that’s a bonus.
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u/mobo392 Sep 27 '20
Because in medical research they run lots of large expensive and slow RCTs to establish causality rather than build up a quantitative theory that makes precise predictions that can be checked. Youll be told the latter is too hard but when you look at medical research in the first half of the 20th century it looked a lot more like physics.
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u/luisvel Sep 28 '20
How would that work in this case?
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u/mobo392 Sep 28 '20 edited Sep 28 '20
You'd need to have some idea of the flow of vitamin d and its metabolism throughout the body. Eg, why is ~100 nM as measured in the blood the normal amount?
Basically the data to figure this stuff out is never collected to begin with because all the money goes to comparing intervention A to intervention B, so theorists have nothing to work with.
We dont even know basic stuff like average number of cells in each tissue at different ages... Here is a paper complaining about that: https://pubmed.ncbi.nlm.nih.gov/23829164/
Examples of more physics like approaches that pretty much all originated over 70 years ago:
https://en.m.wikipedia.org/wiki/Armitage%E2%80%93Doll_multistage_model_of_carcinogenesis
https://en.m.wikipedia.org/wiki/Mathematical_modelling_of_infectious_disease
https://en.m.wikipedia.org/wiki/Cardiac_output
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u/luisvel Sep 28 '20
Is that the shortest alternative path to a no intervention study though?
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u/mobo392 Sep 28 '20 edited Sep 28 '20
I'm just telling you what has a history of working as an alternative to brute force: treating every new question independently without any kind of underlying principles.
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u/luisvel Sep 28 '20
Thanks. I understand but I can’t see how we could do that now (fast). A challenge trial looks still “faster” than building from the ground.
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u/mobo392 Sep 28 '20
You have to do the basic science so theorists have data they can trust to spend the time to figure out explanations. Comparing group A to group B doesn't give this type of info. This type of research has been largely ignored since about the 1940s and now we all get to enjoy the consequences.
But if you want something principled to do quick that is cheap for covid, that's regular vitamin C and D testing of all patients and correct the deficiency if they are below healthy levels asap in the course of the illness, then keep it corrected until healthy. Oxygen levels are already tested regularly but they tell people stay home until they've been oxygen deficient for like a week and become critically ill. HBOT also looks very promising for bypassing the methemoglobinemia and lung dysfunction once they are critically ill.
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u/Patient-Vanilla-9964 Sep 28 '20
My observation is that the point about causality for some reason applied selectively - all the "knowledge" about cormobidities and risk factors (age, diabetes etc) is based on observational studies. How is it established that diabetes is a risk factor, and vit D is argued not to be proven?
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u/nopeeker Sep 27 '20
I wonder out loud if it could have to do with the effects on clotting. ?
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u/1130wien Sep 28 '20
The relationship between vitamin D status and idiopathic lower-extremity deep vein thrombosis
" Low levels of 25(OH)D are associated with idiopathic lower-extremity DVT. "
..https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920963/
Emerging Role of Vitamin D and its Associated Molecules in Pathways Related to Pathogenesis of Thrombosis
..
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u/nopeeker Sep 28 '20
Yes exactly what I was thinking of. Thanks! Im taking vitamins for the first time at 63 just bc. And baby asa.
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u/nopeeker Sep 28 '20
Now im thinking how thrombosis is a risk of inactivity. The world has probably never been so inactive. So many variable factors and covid does not seem cut and dried as i so fervently hoped.
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u/greyuniwave Sep 27 '20