Low levels of vitamin D linked to long COVID

Vitamin D
Vitamin D

Long COVID risk has been found to increase with low levels of vitamin D, according to research presented at the 25th European Congress of Endocrinology in Istanbul. The findings suggest that individuals should have their vitamin D levels checked after COVID-19.

Also known as post COVID-19 syndrome, long COVID is a new condition in which the effects of COVID-19 last for more than 12 weeks after contracting the initial infection. Studies have shown that it affects 50-70% of patients previously hospitalised for COVID-19, yet very little is known about the condition. One risk factor for worse outcomes for hospitalised COVID-19 patients, such as intubation and mechanical ventilation or death, is low vitamin D levels, but its role in long COVID has not been adequately investigated.

For this study, supported by Abiogen Pharma SpA, researchers from the Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital in Milan examined 100 patients aged 51-70 years, with and without long COVID. They measured their vitamin D levels when first admitted to hospital for COVID-19 and six months after being discharged, and found lower vitamin D levels in patients with long COVID compared to those without. This result was more evident in patients who experienced ‘brain fog’ symptoms, such as confusion, forgetfulness and poor concentration, at the six-month follow-up.

The researchers included patients without any bone conditions and only those who went to hospital for COVID-19, without ending up in the intensive care units (ICUs). They matched the two groups, with and without long COVID, in terms of age, sex, pre-existing chronic diseases and COVID-19 severity. “Previous studies on the role of vitamin D in long COVID were not conclusive mainly due to many confounding factors,” said lead investigator Professor Andrea Giustina. “The highly-controlled nature of our study helps us better understand the role of vitamin D deficiency in long COVID, and establish that there is likely a link between vitamin D deficiency and long COVID.”

While Professor Giustina acknowledges that larger studies are needed to confirm this link, he and his team are now focussed on finding out whether vitamin D supplements can reduce the risk of long COVID. “Our study shows that COVID-19 patients with low vitamin D levels are more likely to develop long COVID but it is not yet known whether vitamin D supplements could improve the symptoms or reduce this risk altogether.”

Study suggests vitamin D benefits and metabolism may depend on body weight

People with higher body mass index had a blunted response to vitamin D supplementation, explaining observed differences in outcomes such as cancer, diabetes, and autoimmune disease


Researchers from Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, have found new evidence that vitamin D may be metabolized differently in people with an elevated body mass index (BMI). The study, appearing in JAMA Network Open, is a new analysis of data from the VITAL trial, a large nationwide clinical trial led by Brigham researchers that investigated whether taking vitamin D or marine omega-3 supplements could reduce the risk of developing cancer, heart disease, or stroke.

“The analysis of the original VITAL data found that vitamin D supplementation correlated with positive effects on several health outcomes, but only among people with a BMI under 25,” said first author Deirdre K. Tobias, ScD, an associate epidemiologist in Brigham’s Division of Preventive Medicine. “There seems to be something different happening with vitamin D metabolism at higher body weights, and this study may help explain diminished outcomes of supplementation for individuals with an elevated BMI.”

Vitamin D is an essential nutrient involved in many biological processes, most notably helping our body absorb minerals, such as calcium and magnesium. While some of the vitamin D we need is made in the body from sunlight, vitamin D deficiencies are often treated with supplementation. Evidence from laboratory studies, epidemiologic research and clinical research has also suggested that vitamin D may play a role in the incidence and progression of cancer and cardiovascular disease, and it was this evidence that prompted the original VITAL trial.

The VITAL trial was a randomized, double-blind, placebo-controlled trial in 25,871 U.S. participants, which included men over the age of 50 and women over the age of 55. All participants were free of cancer and cardiovascular disease at the time of enrollment. While the trial found little benefit of vitamin D supplementation for preventing cancer, heart attack, or stroke in the overall cohort, there was a statistical correlation between BMI and cancer incidence, cancer mortality, and autoimmune disease incidence. Other studies suggest similar results for type 2 diabetes.

The new study aimed to investigate this correlation. The researchers analyzed data from 16,515 participants from the original trial who provided blood samples at baseline (before randomization to vitamin D), as well as 2,742 with a follow-up blood sample taken after two years. The researchers measured the levels of total and free vitamin D, as well as many other novel biomarkers for vitamin D, such as its metabolites, calcium, and parathyroid hormone, which helps the body utilize vitamin D.

“Most studies like this focus on the total vitamin D blood level,” said senior author JoAnn E. Manson, MD, DrPH, chief of the Division of Preventive Medicine at the Brigham and principal investigator of VITAL. “The fact that we were able to look at this expanded profile of vitamin D metabolites and novel biomarkers gave us unique insights into vitamin D availability and activity, and whether vitamin D metabolism might be disrupted in some people but not in others.”

The researchers found that vitamin D supplementation increased most of the biomarkers associated with vitamin D metabolism in people, regardless of their weight. However, these increases were significantly smaller in people with elevated BMIs.

“We observed striking differences after two years, indicating a blunted response to vitamin D supplementation with higher BMI,” Tobias said. “This may have implications clinically and potentially explain some of the observed differences in the effectiveness of vitamin D supplementation by obesity status.”

“This study sheds light on why we’re seeing 30-40 percent reductions in cancer deaths, autoimmune diseases, and other outcomes with vitamin D supplementation among those with lower BMIs but minimal benefit in those with higher BMIs, suggesting it may be possible to achieve benefits across the population with more personalized dosing of vitamin D,” said Manson. “These nuances make it clear that there’s more to the vitamin D story.”

The authors conclude that the VITAL findings are a call to action for the research community to continue exploring the potential benefits of vitamin D supplementation for preventing cancer and other diseases and to take BMI into account when evaluating the supplement’s health impacts.

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Down on Vitamin D? It could be the cause of chronic inflammation

Sunset


There’s a direct link between low levels of vitamin D and high levels of inflammation. CREDIT Rebecca Wood

Inflammation is an essential part of the body’s healing process. But when it persists, it can contribute to a wide range of complex diseases including type 2 diabetes, heart disease, and autoimmune diseases.

Now, world-first genetic research from the University of South Australia shows a direct link between low levels of vitamin D and high levels of inflammation, providing an important biomarker to identify people at higher risk of or severity of chronic illnesses with an inflammatory component.

The study examined the genetic data of 294 ,970 participants in the UK Biobank, using Mendelian randomization to show the association between vitamin D and C-reactive protein levels, an indicator of inflammation.

Lead researcher, UniSA’s Dr Ang Zhou, says the findings suggest that boosting vitamin D in people with a deficiency may reduce chronic inflammation.

“Inflammation is your body’s way of protecting your tissues if you’ve been injured or have an infection,” Dr Zhou says.

“High levels of C-reactive protein are generated by the liver in response to inflammation, so when your body is experiencing chronic inflammation, it also shows higher levels of C-reactive protein.

“This study examined vitamin D and C-reactive proteins and found a one-way relationship between low levels of vitamin D and high levels of C-reactive protein, expressed as inflammation.

“Boosting vitamin D in people with deficiencies may reduce chronic inflammation, helping them avoid a number of related diseases.”

Supported by the National Health and Medical Research Council and published in the International Journal of Epidemiology the study also raises the possibility that having adequate vitamin D concentrations may mitigate complications arising from obesity and reduce the risk or severity of chronic illnesses with an inflammatory component, such as CVDs, diabetes, and autoimmune diseases.

Senior investigator and Director of UniSA’s Australian Centre for Precision HealthProfessor Elina Hyppönen, says these results are important and provide an explanation for some of the controversies in reported associations with vitamin D.

“We have repeatedly seen evidence for health benefits for increasing vitamin D concentrations in individuals with very low levels, while for others, there appears to be little to no benefit.” Prof Hyppönen says. 

“These findings highlight the importance of avoiding clinical vitamin D deficiency, and provide further evidence for the wide-ranging effects of hormonal vitamin D.”