Proactive Medicine: Getting Some Sunshine and Vitamin D to Fight COVID-19

 Shining the Light on Getting Enough Vitamin D to Counter COVID-19

Evelyn E. Smith

While up to now public health physicians and task forces have concentrated on self-isolation and quarantine as a means of controlling the COVID-19 virus, increasingly independent sources have started to urge readers to take a proactive approach to combatting COVID-19 by making sure they have a healthy immune system to start with since a healthy immune system as well as a body free from co-morbidities is better equipped to fight all respiratory viruses. Moreover, this spring and summer everyone can immediately start to take three proactive steps to enhance over-all physical health:

1)     Ask for a blood test to check for possible Vitamin D deficiency, and then maintain appropriate Vitamin D levels by getting enough sunlight for one’s skin type; and if necessary, take the appropriate level Vitamin D supplement upon the advice of a physician since it is also most important not to take too much Vitamin D in supplement form.

2)    Follow a regular aerobic exercise routine outdoors for thirty minutes five days per week*.

3)    Maintain a healthy diet, which if adhered to, will bring down high blood pressure and improve cardiovascular health.

Today’s topic, however, shines the light on the easiest  and perhaps most inexpensive step anyone can take—getting enough Vitamin D, which, of course, results when both the liver and the kidneys take the Vitamin D found in sunlight, and to a lesser extent in fatty fish, eggs, and fortified milk and cereals, and convert it into calcium.

Thus, the cure for vitamin D deficiency and a weak immune system is for the most part is a relatively simple one:

a)    Get enough sunshine every day when the sun shines during the spring and summer months.

b)    As necessary (upon the advice of one’s physician) take the appropriate level of a Vitamin D supplement. No peer-reviewed studies or randomized trials as yet exist as to whether spending time in the sun or taking a Vitamin D supplement will decrease the mortality rate of COVID-19, but improving the immune system's health will not hurt anyone. 

Pointing Out Vitamin D Deficiency Might Be Controversial:

Here is where some controversy comes into play since darker skin tones absorb less Vitamin D found in sunlight than lighter skin tones:

As Found on YouTube:

Campbell, John. (2020, April 15). Vitamin D and immunity, lots of evidence. YouTube. https://www.youtube.com/watch?v=GCSXNGc7pfs

British medical practitioner Dr. John Campbell argues that evidence is strong enough that Vitamin D deficiency might increase the severity of viruses that listeners should ask their physician whether they should be taking vitamin D supplements during the COVID-19 pandemic. He also points to Public Health England’s recommendation that everyone in England should take a daily 10 microgram supplement in autumn and winter. Moreover, Campbell also recommends that individuals with darker skin tones take a Vitamin D supplement throughout the year.

Translation: Instead of taking only the Politically-Correct sociological approach adhered to by American academics to explain the discrepancy in the mortality rates between African, Hispanic, and Native Americans and European Americans [living in food deserts, undue stress caused by social inequality, prevalence in service occupations], some British physicians, including John Campbell, are adhering to a natural selection argument for taking Vitamin D during the COVID-19 pandemic: Light-skinned people manufacture more Vitamin D than those individuals with darker skin tones, which protect them from the sun. Additionally, during the winter months, or when everyone is confined to the indoors, a large percentage of the population of all skin tones is likely to be Vitamin D deficient—a condition that correlates--but does not necessarily cause--various comorbidities, or preexisting health conditions.

Then again, food deserts do exist in the United States as does social inequality. However, taking an adult multi-vitamin everyday might be the prudent course of action for all adults to do. 

Moreover, additional research also suggests another explanation for the higher mortality rate among African Americans:

Kiddie, Jason. (2020, April 8).  A possible explanation for the COVID-19 racial disparity.  Medpage Today. https://www.medpagetoday.com/infectiousdisease/covid19/86023

A deficiency of L-arginine and subsequently nitric oxide is another possible explanation for why African American death rates are higher than white American death rates. 

Online Nutrition Sources

Espostio, Lisa and Kotz, Deborah. (2018, July 18). How much time in the sun do you need for vitamin D.  U.S. News & World Report. https://health.usnews.com/wellness/articles/2018-07-18/how-much-time-in-the-sun-do-you-need-for-vitamin-d

In the winter, everyone living in the Northern Hemisphere 37 degrees North of the equator (or anywhere North of Atlanta, Georgia) does not get enough sun in the winter months to absorb enough Vitamin D from sunlight. Although over sun exposure increases the risk of melanoma and skin cancers, Northern Europeans should allow for 10 to 15 minutes of unprotected sun exposure between 10 a.m. to 3 p.m. However, Hispanic, Native, and African Americans as well as Europeans who tan easily may need 15 to 20 or more minutes of sun exposure mid-day to achieve this dosage. Since individuals deficient in Vitamin D double their risk of dying from heart disease, most studies now recommend achieving a balance between getting in a little midday unprotected sun exposure most days of the week and the habitual use of sunscreen.

Grant, William B, Lahore, Henry, et al. (2020, April 12). Evidence that Vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths. Nutrients. https://www.mdpi.com/2072-6643/12/4/988

Even though some studies and clinical trials report that adequate intake of Vitamin D reduces the risk of influenza, others do not report these findings. Grant and his fellow researchers, however, point to the lower number of COVID-19 cases in the Southern Hemisphere during the first three months of 2020 as well as to findings that vitamin D deficiency contributes to acute respiratory distress syndrome (ARDS), and that case fatality rates increase with age and with chronic disease comorbidity as circumstantial proof that relates low levels of Vitamin D with increased mortality rates associated with COVID-19. The researchers thus recommend that those most at risk for COVID-19; for example, the elderly and those diagnosed with comorbidities, take 10,000 I.U. of Vitamin D supplements to rapidly raise their levels of Vitamin D. Even so, the researchers nevertheless caution that controlled trials and larger population studies will need to prove this hypothesis.

Bottom Line:  Consult a physician before taking the appropriate-level Vitamin D supplement.  Remember more Vitamin D, however, is not necessarily better, for it may damage the liver and kidneys.

Public Health England Asks Brits to Take Vitamin D

Hancocks, Nikki. (2020, April 23). Public Health England extends vitamin D supplement advice during lockdown. Nutraingredients. https://www.nutraingredients.com/Article/2020/04/23/Public-Health-England-extends-Vitamin-D-supplement-advice-during-lockdown

England’s National Health Service is advising its entire population to take a daily supplement of 10 micrograms of Vitamin D to avoid Vitamin D deficiency since they might not be getting enough sunlight during the quarantine. This advisory particularly applies to high-risk individuals and the elderly. New research findings are not the reason for this advisory, however.

Mayor, Susan. (2016, July 21). Public health England recommends vitamin D supplements in autumn and winter. The BMJ [British Medical Journal]. https://www.bmj.com/content/354/bmj.i4061

Since diet alone will not allow the English to achieve their recommended daily dose of Vitamin D during the autumn and winter months, Public Health England recommends that both children and adults should take a daily vitamin D supplement during that part of the year.

Medical Sources for General Audiences

Hensrod, Donald. (2017, April 25). Mayo Clinic Q. and A. How much vitamin D do I need? Mayo Clinic. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-how-much-vitamin-d-do-i-need/

Vitamin D. deficiency is associated with osteoporosis, multiple sclerosis, rheumatoid arthritis, chronic pain, and such comorbidities as diabetes, high blood pressure, cardiovascular disease, and some cancers, although correlation does not mean that vitamin D deficiency causes these conditions. The skin absorbs most Vitamin D from the sun, although individuals wearing a sunscreen with an SPF factor of 8 or greater and dark-skinned individuals may not be absorbing enough Vitamin D from sunlight. Foods with vitamin D include egg yolks, cheese, cod-liver oil, beef liver, and fatty fish, such as tuna, salmon, sardines, herring, and mackerel. U.S. markets also fortify milk with Vitamin D.

Kubala, Jillian. (2020). Can Vitamin D lower your risk of COVID-19? Healthline. https://www.healthline.com/nutrition/vitamin-d-coronavirus

Currently, no known preventive measures apart from social distancing and maintaining proper hygiene practices can keep anyone from coming down with the Sars-COVID-19 virus; however, some research shows that maintaining a healthy level of vitamin D generally guards against respiratory diseases since Vitamin D enhances the function of immune cells.  Conversely, studies associate low levels of Vitamin D with an increased susceptibility to infectious diseases and immune-related disorders, including tuberculosis, asthma, COPD, and viral and respiratory infections. Taking a Vitamin D supplement also reduces the morality rate in older adults. Typically, the prescribed supplement dosage is between 1,000 and 4,000 I.U. daily.

Note:  Everyone should consult a physician before taking Vitamin D supplements, so as not to overdose oneself.

Sunlight destroys coronavirus quickly, say US scientists. (2020, April 24).  https://medicalxpress.com/news/2020-04-sunlight-coronavirus-quickly-scientists.html?utm_source=join1440&utm_medium=email&utm_placement=itkst

Medical science has long understood that radiation damages any virus’s ability to reproduce, but now researchers have determined the exact amount of time it takes.

COVID-19’s half-life, or the time it takes for it to reduce to half its amount on hard surfaces is 18 hours with a room temperature of between 79 to 75 degrees Fahrenheit, or 21 to 24 degrees Celsius, but this time span reduces to just six hours when the humidity rises to 80 percent and to just two minutes when the virus is in the presence of direct sunlight.  As for an aerosol (suspended in air) COVID-19 virus, while its half-life is one hour when the temperature is between 70 to 75 degrees Fahrenheit  with 20 percent humidity, in the presence of sunlight, the time it takes to destroy the virus drops to one and a half minutes.

PubMed, National Library of Medicine Sources

It is a little too soon for a peer-reviewed, randomized clinical trial on whether Vitamin D works, but rest assured one is in the works.

Parva, Nareen R., Tadepalli, Satish, et al. Prevalence of Vitamin D deficiency and associated risk factors in the U.S. population. Cureus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6075634

Parva et al note that 82.1 percent of African Americans are Vitamin D deficient, and 62.9 percent of Hispanic Americans are Vitamin D deficient. Additional risk factors for Vitamin D deficiency include obesity, not enough regular milk consumption, and a formal education that does not go past secondary school. The primary source of Vitamin D is sunlight while fatty fish, such as salmon and tuna, is another natural source of Vitamin D.

In other words, researchers urge that everyone who lives at a Northern latitude, all dark-skinned people, and those with pre-existing conditions should take Vitamin D supplements while light-skinned people, who are likely to sunburn, should limit their mid-day sun exposure during the summer months while at the same time getting enough Vitamin D.

Editorial Note: Of course, a Mediterranean diet that features the consumption of fatty fish  at least twice a week would probably decrease the cholesterol levels of all concerned**; and scheduling a brisk 30-minute mid-day walk outdoors might lower everyone’s risk of cardio-vascular disease, hypertension, and diabetes.

Teymoon-Rad, M., Shokri, F., et al. (2019, March). The interplay between vitamin D and viral infections. Reviews in Medical Virology. doi. 10 1002/my2032. https://www.ncbi.nlm.nih.gov/pubmed/30614127

Regularly monitoring Vitamin D levels is necessary, even though post-modern medicine has yet to fully understand the affect Vitamin D has on viral infections.

Vitamin D on prevention and treatment of COVID-19 z9COVITD-19). (Updated: 2020, April 17). ClinicalTrials.gov. U. S. National Library of Medicine. https://www.clinicaltrials.gov/ct2/show/NCT04334005

In a currently ongoing, 200 participant, randomized clinical trial, “The Effect of Vitamin D Administration on Prevention and Treatment of Mild Forms of Suspected Covid-19”, researchers have hypothesized that the administration of Vitamin D supplements will produce significant improvement in the heath status for those patients diagnosed with non-severe, symptomatic COVID-19.  Similar research relates reduced levels of Vitamin D with the cause of bovine coronavirus in the past. The targeted completion data for this trial is 30 June 2020.

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*Laskowski, Edward R (2016).  How much should the average adult exercise every day.  Health-lifestyle/ Fitness. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/fitness/expert-answers/exercise/faq-20057916

The United States Department of Health and Human Services recommends taking 150 minutes of moderate aerobic exercise, or 75 minutes of strenuous aerobic exercise, during a week as well as the strength training of all major muscle groups twice weekly.  This might mean taking a brisk walk for thirty minutes five days a week.

***Fish and Omega-3 fatty acids. (2017, March 23).  American Heart Association. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/fish-and-omega-3-fatty-acids

The American Heart Association recommends eating two servings a week of fatty fish (salmon, mackerel, herring, trout, sardines, albacore tuna), although the public should avoid eating fish with the highest potential or mercury contamination.

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