• Barbara Johnson, MD

Low Vitamin D Increases Risk of All-Cause Mortality




With schools starting back in August, most everyone will potentially be more exposed to the SARS CoV-2 virus. While public health officials and the media are encouraging everyone to slow down the transmission of the virus – which is necessary, there has been little input about what we can do to improve our odds of progressing to complications or surviving the virus if we get infected.

So, take a moment and remember that we’re not helpless in its path. This is a great time to take stock of your health and make changes now to optimize your well-being in the face of this pandemic.

A Review: How SARS CoV-2 Infects

While there are still unknown factors about SARS CoV-2, the path causing respiratory failure and organ damage has been determined. The hypothesis outlined below by Dr. Seheult, who is a Critical Care Specialist, provides a focused outline.

  1. Sars CoV-2 infects the cells and takes out the ACE2 receptor.

  2. ACE2 can no longer convert Angiotensin II (AT II) to Angiotensin1,7 (AT 1,7). This is important because AT II promotes the production of superoxide which is a very damaging free radical. And AT1,7 inhibits the production of superoxide.

  3. Superoxide is now increased in those infected with SARS CoV-2. Elevated levels of superoxide cause increased amounts of oxidative stress and tissue damage.

  4. Oxidative stress increases endothelial damage. Endothelial cells cover the blood vessels.

  5. Damage to the endothelial cells increases the release of Von Willebrand Factor (part of the clotting cascade) which leads to blood clots or thrombosis.

  6. Thrombosis prevents adequate oxygenation leading to respiratory failure.


The key is oxidative stress. SARS CoV-2 significantly increases oxidative stress and those who don’t have a lot of oxidative stress to begin with are going to be able to tolerate the infection better.

In looking at the patients in the hospital with COVID-19, the majority are not those with COPD and lung disease but those with metabolic disease: increased weight, kidney disease, cardiovascular disease, diabetes and elevated blood sugar.

Recent studies have shown that those who have elevated blood sugar were 10x more likely to have complications from SARS CoV-2. Elevated blood sugar along with all of the metabolic diseases mentioned cause an increase in oxidative stress.

Prevention

I’ve discussed in previous blogs about prevention with hand washing and social distancing. I’ve also covered lifestyle factors, nutrition, zinc and vitamin C supplementation. With this post, I want to focus on the importance of Vitamin D and two recently published papers.

Several papers newly published highlighted the need to keep vitamin D levels between 40 and 60 ng/ml.

The July 4th publication in the Journal of Clinical Endocrinology and Metabolism is a very large study including 365,530 participants over a span of nine years. This study revealed that low vitamin D increases all-cause mortality and keeping levels between 45-60ng/ml can reduce premature death.

Another published study, published July 12, 2020, that assessed Vitamin D and the Immune system concluded the following:

Vitamin D directly exhibits antiviral activities against many respiratory viruses, including SARS CoV-2.

Vitamin D directly modulates endothelial function and vascular permeability. The authors of the paper stated that Vitamin D is protective against vascular dysfunction and tissue injury from local and systemic inflammation.

Stabilizing the endothelium is very important with SARS CoV-2 and this may explain why Vitamin D levels are associated with lower mortality in patients with COVID-19. As outlined above, free radicals cause endothelial damage which increases clot formation in the vessels. Vitamin D prevents this from occurring.

The findings also showed that higher levels of vitamin D have protective effects against respiratory viral infections. Vitamin D directly protects against the development of acute respiratory tract infection and suppresses over expression of proinflammatory cytokines. It is this over expression that can lead to a cytokine storm, tissue damage and organ failure.

The paper proposed that supplementation with Vitamin D can reduce the risk and severity of COVID-19 infection. Although ongoing clinical trials are still pending, the advice is to maintain Vitamin D levels between 40-60 ng/ml.

It is well-known and documented that 40% of children and adults have circulating Vitamin D levels less than 20ng/ml and 60% have levels less than 30ng/ml.

It has been shown in many studies that Black individuals, as well as obese individuals are especially prone to vitamin D deficiency. This strong correlation may explain why both Black individuals and obese individuals have an out-of-proportion rate of symptomatic infection, morbidity and mortality of COVID-19.

What these papers do not discuss are the potential genomic variations that individuals may have which affects absorption of Vitamin D, carrier proteins and receptors. Knowing your DNA blueprint relating to vitamin D would better determine if you need to maintain levels closer to 60 or 70. This is a very important topic that I will discuss in my next post.

It is also important to note the vitamin A is necessary to sensitize the vitamin D receptor to promote proper absorption. Therefore, it is best to take vitamin D with vitamin A and K.


Click below to purchase the Vitamin D with A and K. Email Kelsey at jcenterhealth@gmail.com to receive 10% off your order and be added to our newsletter.


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