Main Page

Information about Vitamin-D3 (Cholecalciferol).

When Vitamin-D is mentioned it is going to refer to Vitamin-D3 unless it is clear from context that it is referring to both Vitamin-D2 and Vitamin-D3.

Where ever possible both sets of alternate units to indicate serum concentrations and dose amounts will be used to make the text easier to parse for readers from all regions.

Other editors are welcome to contribute if they want to help with the general theme of promoting national Vitamin-D3 education or self sufficiency.

Vitamin-D Info (Cholecalciferol)

This is to be a collection of information relating to Vitamin-D3, this has the chemical name of Cholecalciferol and is considered a sterol pro-hormone. It was categorised as a vitamin initially before the UVB mediated synthesis in skin was established, this designation has firmly persisted and has good and bad implications. A lot of information is available on the web and a good starting place is Wikipedia. This site is intended to provide information that is available somewhere but many or even most people will not know that the information even exists. The goal is to have a answers to questions that you did not know to ask.

The main reason for my interest in Vitamin-D is the huge potential that proper management of population wide supplementation could have on human health and health care costs due to the global Vitamin-D deficiency pandemic. Because there is money involved in health care this issue will be considered here from a few angles, some of the ideas will be controversial but this is because the amount of money involved is so massive.

I make a note here to indicate that this site is still in its infancy and the layout is sure to change and evolve. I will be doing much of the editing myself but will welcome other editors who have similar goals. I hope to leave this in a state that will provide suitable information to assist advocates and activists to promote the rational discussion about Vitamin-D and putting false myths to rest. A lot of medical research will be quoted from and global programs will be mentioned.

Many of these topics will open onto more detailed pages.    

Forms

The Biosynthesis of Vitamin-D3 is a multi stage process in the body. Commercially produced Vitamin-D3 uses the precursor traditionally extracted from Lanolin and performs the first two steps followed by extraction and purification processes. The next two steps occur in our cells. The bulk of Vitamin-D3 is promptly hydrolysed in the liver into the longer lasting so called storage form. This is used as substrate for the Parathyroid hormone controlled endocrine function of calcium metabolism to modulate the concentration of the further hydrolysed active hormone form, this process occurs in the kidneys. This has been the early understanding of how Vitamin-D3 prevents Rickets by increasing calcium absorption from the gut. Vast amounts of research have now shown that the effects of Vitamin-D3 are much more diverse. It plays a part in immune function, gene expression and much more. Deficiency is implicated in over 80 diseases and conditions that respond to treatment or prophylaxis. The endothelium is directly and preferentially supported by the vitamin form and receptors in almost all cells enable use in autocrine and paracrine signalling.

Biosynthesis of Vitamin-D3

• precursor/7-dehydrocholesterol/7-DHC + UVB =
• pre-Vitamin-D3/pre-cholecalciferol + heat (spontaneous isomerisation) =
• Vitamin-D3/VD3/cholecalciferol + 25-hydroxylase enzyme mostly in liver =
• storage form/calcifediol/calcidiol/25(OH)D3 + 1-alpha-hydroxylase enzyme mostly in the kidneys =
• hormone/active form/calcitriol/1,25(OH)2D3

There is a chart that covers this pretty well on Wikipedia on the page at

Cholecalciferol#Biosynthesis

7-Dehydrocholesterol

There has been speculation that some cholesterol lowering medication may reduce the amount of 7-DHC thus aggravating the deficiency even with sun exposure.

Cholecalciferol

The traditional form referred to as Vitamin-D3. While most animals are able to synthesise Vitamin-D3 in the presence of sunlight modern day urban humans generally do not make enough with over 50% markedly deficient if not supplementing.

Calcidiol

25(OH)D₃
Calcidiol/Calcifediol

Calcitriol

1,25(OH)₂D₃

This component is considered the hormone form because it is generated in the kidneys (source is a tissue or organ) and circulates everywhere and the amount in our blood stream is determined mostly by way of a feedback loop that uses the Para-thyroid hormone (PTH) to adjust the amount we need. The serum calcium concentration and calcium:magnesium ratios are the big drivers and this hormone is understood to be the driver in bone calcium metabolism and a frank deficiency in the substrate for this hormone will result in Rickets in children or the equivalent condition of Osteomalacia in adults.

This component is also synthesised in many if not most other cells as a paracrine and/or autocrine signaling molecule. It has effects relating to at least immune function and gene expression.

Other

There are many other metabolites that occur naturally in the body that are derived from Vitamin-D3 but their direct function has not been well studied. Some are understood to be inactive forms that are formed to reduce the amount of the active form, some are unneeded side products. Various enzymes are used to scavenge these products out of the way.

Prescription

The primary vitamin is generally available over the counter in all countries. Some countries have higher dosages as prescription only. The hydrolysed forms are generally prescription medication and need to be more carefully dosed as the natural feed back loops are bypassed. Calcitriol is produced in the body on demand and dosing it in excess can cause genuine intoxication which is hard with Calcidiol and almost impossible with Cholecalciferol and in healthy individuals impossible from sunlight exposure due to active control mechanisms and controlled substrate production speeds. Some countries have easier access to the Vitamin-D2 in prescription forms that is a cause for concern.

D2

Ergocalciferol is produced mostly in fungi and yeasts in response to UVB radiation of the precursor ergosterol in a similar way to how Cholecalciferol is produced in animals from the precursor 7-Deoxyhydrocholesterol.

The effects in animals is similar though not identical, Vitamin-D3 is considered superior for humans and should be used in preference. Farmed fowl/poultry gain no benefit from Vitamin-D2 and must receive Vitamin-D3 feed supplement if denied sun and/or UVB exposure in indoor cages.

Deficiency

Many causes for deficiency

Genetic

Protective

• Lighter skin
• Rare mutations

Aggravating

• Darker Skin
• Rare Mutations

Disease

• Gall bladder removal

   Vitamin-D3 is a fat soluble pro-hormone and is very often sold disolved into a edible oil.  As with the absorption of other oils we use the bile from the gall bladder to promote absorption of the fats and oils in our diet.  For this reason those without functioning bile secretion may have reduced absorption of Vitamin-D3.

• Diabetes

   The incidence of type 1 Diabetes is known to increase in populations that do not supplement with Vitamin-D3.

• Liver diseases

   May cause limitation in enzyme mediated hyrdoxylation from Vitamin-D3 (Cholecalciferol) to the storage form (Calcidiol, calcifediol, 25(OH)D3)

• Kidney disease

   May cause limitation in the enzyme mediated hydroxylation from the storage form (Calcidiol, calcifediol, 25(OH)D3) to the hormone form (calcitriol, 1,25(OH)2D3)

• Cystic Fibrosis sufferers

   CF patients have inefficient vitamin D absorption due to pancreatic exocrine insufficiency resulting in malabsorption of fat-soluble vitamins, including vitamin D. CF subjects absorb approximately 50% less vitamin D compared with what normal subjects absorb, depending on the degree of exocrine insufficiency
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846322/

• Short bowel syndrome (SBS)

   SBS patients have been given high-dose oral vitamin D supplementation without an improvement in vitamin D status due to poor intestinal absorption of vitamin D.
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846322/

• Sarcodosis

   Some forms of sarcodosis can result in an excess of Vitamin-D3 building up in the body and they should supplement or take on UVB radiation with caution.

• Genetic errors

   There are a number of known total and partial errors in the various hormones that are involved with the synthesis and metabolism of Vitamin-D3.

For those with absorption issue UVB radiation treatment may be a practical solution.
For those with Kidney issues supplementation with the hydrolysed forms has been used.

Global

• Solar cycles
• Air Pollution
• Urbanisation
• Polar migration / Latitude

Mean Vitamin D levels in 19 European Countries & COVID-19 Mortality over 10 months

Seasonal

Serum variability as well as serum deficiency may both be risk factors.

  https://www.youtube.com/watch?v=MIDWA9-cGdY

Seasonal fluctuation can best be mitigated by regular physiological level supplementation.

Winter

• UVB inadequacy low sun angle and daylight hours
• Dressing for cold
• Less holidays

Summer

• Avoiding sun
• Dressing for modesty
• Mid day siesta
• Monsoon weather

Work place

Space Arctic Submariner Shift worker , Institutionalised ====

Sources

Th source is Vitamin-D3 unless Vitamin-D2 is mentioned.

Skin

We synthesize The vitamin in the epidermis from a common precursor 7-Dhydrocholesterol that is used to make all our secosteroidal hormones.

Sun

Tropospheric Emission Monitoring, Internet Service database may provide solar UVB data

Ambient UVB Dose and Sun Enjoyment Are Important Predictors of Vitamin D Status in an Older Population1–3

Fiona OSullivan, Eamon Laird, Dervla Kelly, Jos van Geffen, Michiel van Weele, Helene McNulty, Leane Hoey, Martin Healy, Kevin McCarroll, Conal Cunningham, Miriam Casey, Mary Ward, JJ Strain, Anne M Molloy, and Lina Zgaga

doi:10.3945/jn.116.244079

https://fastrt.nilu.no/VitD.html

UVB therapy

Used already in second world war.

Used by submariners.

Tested by military personel in USA recently.

Heliotherapy

Solariums used to have open sun decks. They were situated in high mountains (like the Alps) to gain altitude and freedom from airborne pollution and be south facing all to maximise the production of Vitamin-D3 (before they knew what it was). Their benefits were reduced when the balconies were enclosed by glass to allow patients to enjoy the sun in colder weather but without the UVB rays so no more Vitamin-D3.

Diet

Mostly from marine oily fish livers and flesh. A report that farmed salmon had lower levels than free range has been made as they are often fed processed food.

Livers of carnivores are said to concentrate and be a rich source they have sometimes been blamed for Vitamin-D3 intoxication but more likely symptoms have been due to high Vitamin-A levels in bear or seal livers.

Some Vitamin-D2 can be had from sun dried mushrooms.

Industrial

The production is many stages of extraction and purification of the precursor, followed by a UVB irradiation at a preferred wavelength of ultraviolet light at a preferred temperature for a preferred time, followed by thermal isomerization and then further extraction and purification steps followed by dilution or compounding before shipping to customers either in a pure crystalline form of 40 million International Units per gramme (40MIU/g) or at various dilutions in oil (500kIU/g) or starch bases usually packed under inert gas free of metallic impurities that will degrade the product. Humidity, light and oxygen also degrade the product in shipment or final product storage.

"Vitamin D3 can be produced by irradiating the 7DHC ... with ultraviolet light, such as with a mercury lamp, followed by heating. The heating temperature is preferably 50 to 100° C., most preferably 80° C. to 100° C. The heating time is preferably 5 to 300 minutes, more preferably 10 to 100 minutes. The obtained vitamin D3 may be concentrated by using techniques such as high-performance liquid chromatography, and supercritical chromatography, and collected to obtain highly concentrated purified vitamin D3." - US20170204056A1

Back in 1946 alternate mechanisms for producing the 7-Dehydrocholesterol precursor were proposed. A New Route to 7-Dehydrocholesterol, Provitamin D3 with a direct link to the scanned page

Lanolin

This is the most common form available to commerce. Those with a wool or lanolin allergy could avoid this form.

"methods used to extract cholesterol from wool. In particular, a skilled person may refer to the methods described in U.S. Pat. No. 2,688,623, or U.S. Pat. No. 2,650,929, or British Patent No. GB690879, GB646227, or GB613778." - US20170204056A1

Lichen

A vegan alternative. A form of Vitamin-D3 prepared from a few species of Nordic Lichen

Seaweed

A vegan alternative. A form of Vitamin-D3 prepared from a species of Australian sea weed

    https://patents.google.com/patent/US20110207952A1/en

Mushrooms

Vitamin-D2: Still found in USA fortified foods and larger supplement doses. Suitable for animal feed, not poultry

Yeast

Vitamin-D2: Still found in USA fortified foods and larger supplement doses. Suitable for animal feed, not poultry

Bacteria

Patent describing how to produce the 7-dehydrocholesterol precursor using a reduced SMT activity Labyrinthulea slime bacteria.

"The method for extracting 7DHC and other sterols from the cells of microorganisms is described in L. Parks et al. [Methods in Enzymology 111 Edited (1985) by L Ming, L. Parks, C. Bottema, R. Rodriguez and Thomas Lewis, p. 333-339]."

"The crude 7DHC thus obtained may be further purified by using a method known to a skilled person, in particular, the method described in Boselli E, Velazco V, Caboni Mf and Lercker G J, Chromatogr A. 2001 May 11;917 (1-2): 239-44."

   https://patents.google.com/patent/US20170204056A1/en

Patents

• Preparation of vitamin d3 US2707710A (expired)
• Process for the production of vitamin d3 US3661939A (expired)
• Technological method for preparing vitamin D3 CN102276510A (pending)
• Phototherapeutic apparatus for focused UVB radiation and vitamin D synthesis and associated systems and methods AU2018200369B2 (granted)
• Photochemical process for the preparation of a previtamin d WO2008128782A2 ()
• Photolysis of 7-dehydrocholesterol EP0967202A1 (expired) (eximer lamp)
• Method of production of vitamin-D US4388242A (expired) (laser)
• Vitamin d3 EP0055999B1 (expired) (poor rats)
• Photochemical process for the production of previtamin D3 US6180805B1 (expired)
• Method for improved production of vitamins d2 and d3 JP2021059577A (pending)
• A kind of vitamin D3Production technology CN106478479B (active)
• Technology for preparing vitamin D3 CN102850248A (pending)
• Vitamin D3Purification method of (2) CN110527700B (active) (enzymatic acylation method)
• Irradiation process of pro vitamin d CA3137162A1 (pending)
• Method for synthesizing vitamin D3 by segmenting and determining spectral bands CN112110841A (pending)
• Process for the production of vitamin d3 US3661939A (expired)
• Method for synthesizing pre-vitamin D3 by using LED ultraviolet lamp CN111960980A (pending)
• Photochemical process for the preparation of a previtamin d CN101668739A (pending) (LED)
• Phototherapy unit for creation of focused uv radiation and vitamin d synthesis and corresponding systems and methods RU2644752C2 (granted) (booth)
• Wearable Ultraviolet Light Phototherapy Device US20190099613A1 (pending) (I also had this idea KMP)
• Implant modified with non-hydroxylated vitamin D precursors US8821568B2 (active) (coated dental implants)
• The method for detecting vitamin A and 25-hydroxy-vitamin D in blood simultaneously CN106442761B (active)
• A cosmetic composition for blocking ultra violet comprising pro vitamin D3 KR101975387B1 (granted)
• 7-dehydrocholesterol-contained cosmetic composition KR100322208B1 (granted) (stabilised for skin application)
• Development of healthy and nutritional LED (Light Emitting Diode) light source apparatus CN105276518A (active)
• Manufacturing method of 7-dehydrocholesterol and vitamin D3 ES2772259T3 (active)

Testing

Michael Hollick made advances in metabolite testing

Serum

VitaminD

Measurement of the primary dietary or synthesised substance Cholecalciferol is rare, partly due to the short half-life. It is also discussed as unbound or free and the bound amount that is associated with the Vitamin-D binding protein that transports it and the other metabolites which compete for the binding protein. The sulphate ion is also supposed to assist with transport and lipids have been proposed as a delivery vehicle and a transport mechanism.

25(OH)D3

• Mail in tests

Vitamin D 25-oh total (Testing Vitamin D2 & D3) £119.00

• Thin-film chroma assay, finger tip blood drop Point-of-Care test, puremed is one provider
• Antibody
• HPLC-MS/MS
• UV fluorescence photometry (Zivak)

Some comparative information. August 2018 Product Focus: Vitamin D

1,25(OH)₂D3

Rare

Other

Combined, 25(OH)D, 24,25(OH)₂D, 1,25(OH)₂D measurement technique has been used. Simultaneous measurement of 1.25-dihydroxy-vitamin D, 24.25-dihydroxy-vitamin D and 25-hydroxy-vitamin D from a single two milliliters serum specimen. Preliminary clinical application

Saliva

Mail in tests

Supplements

Foodstuffs - Determination of vitamin D by high performance liquid chromatography - Measurement of cholecalciferol (D3) or ergocalciferol (D2)
BS EN ISO 12821:2009

Benefits

Please go to Vitamin D Wiki for the research on all the diseases that are better managed with Vitamin-D. This focuses on the regular benefits to health from natural levels with some obvious easy to demonstrate reversible conditions that can be used to advocate.

Immune system

Congregate Living

Does vitamin D supplementation prevent SARS-CoV-2 infection in military personnel? Review of the evidence

Cancer

Dingli Song 2019 Vitamin D intake, blood vitamin D levels, and the risk of breast cancer: a dose-response meta-analysis of observational studies

Pregnancy

Reduce Preeclampsia

Dental

• Reduce mouth bacteria
• Promote implant ossification

Safety

Acute toxicity

Cholecalciferol is still used as a rodent poison, the idea is that because it is more toxic to rodents than other beneficial animals it has some value. The doses required to LD₅₀ are so much greater than physiological or therapeutic doses it is not to be compared with supplement dosing dangers.

Bolus

100'000

Metabolites

Faster absorbtion Prompt action Lack of fat buffering

Food

Carnivore livers, excessive fish liver oil.

Sun

Practically not possible, self regulating. Sunburn and skin ageing more of a concern from excessive sun

Resources

Journals

• Ilkka Laaksi 2010 Vitamin D Supplementation for the Prevention of Acute Respiratory Tract Infection: A Randomized, Double-Blinded Trial among Young Finnish Men
• Sara R Zwart 2011 Response to vitamin D supplementation during Antarctic winter is related to BMI, and supplementation can mitigate Epstein-Barr Virus Reactivation
• Scott M Smith 2008 Vitamin D supplementation during Antarctic winter

DOI For journal papers

Facebook

Protect with Vitamin D against Covid-19! IMPORTANT!

Web

Vitamin D Health

Vitamin D Council/

The Vitamin D Society

Vitamin D Wiki

VDMETA: Vitamin D is effective for COVID-19: real-time meta analysis of 71 studies
VDMETA: Vitamin-D for CoViD-19

Shotwell: Vitamin D and Covid-19

Larry Brilliant: TED Prize wish: Help stop the next pandemic

Repository

This will be stuff that I have not added here yet.

Repository

Other sources

Quick links for the record

Other

Advocates

There are many advocates who promote Vitamin-D, their reasons vary a lot and they may share other goals and beliefs that are opposing or orthogonal to other advocates, this does not detract from the many sound and important reasons for advocating the correct use of Vitamin-D. Here is a list of advocates who hopefully agree to list their names here and some have edited these pages.

It does not take much to be a Vitamin-D advocate, you have six (6) main pathways, you may promote:

• physiological serum targets,
• physiological supplement doses,
• nature identical forms (D3 as opposed to D2),
• regular daily dosing
• the need to address co-factors
• debunk the myths of great harm

If you bring this important information to the notice of others you can call yourself a Vitamin-D advocate, that is all it takes to make the world a better place. You may appreciate all the main reasons or just one, you may have many other issues that are also relevant and you will see many of them described here.

Some of the advocates here will be prepared to respond to reasonable questions and try to assist you with understanding how things work. Some have busy schedules and do not have time to respond personally but you may find they have published relevant information on social media, medical journals, mass media or published books. There are a LOT of other advocates that do not appear here and some other lists will be linked here as they become available.

Each of these advocates will have their own reasons and strengths for advocating, some are from the medical field while others are simple citizen researchers.

Europe

• Finland This directs to a page with mostly native Finnish advocates who write in Finnish text.
• Finland, Kalle Pihlajasaari, Facebook, LinkedIn Recomendation, citizen researcher, wiki editor.
• Greece, Hippocrates of Kos, Whoever wishes to investigate medicine properly should proceed thus: in the first place to consider the seasons of the year., 400B.C.
• UK, Dr David Grimes, Covid-19 & Vitamin D – Haredi, BAME, Obese, Elderly at risk, Vitamin D and Cholesterol : Book details consultant physician and gastroenterologist

Americas

• R. Edgar Hope-Simpson, The Transmission of Epidemic Influenza. New York: Plenum Press, 1992
• John J. Cannell, The difference between a prophet and a madman, founder and principal of the educational organisation, the Vitamin D Council.
• John J. Cannell, R. Vieth, J.C. Unhaus, Michael F. Holick, William B. Grant Epidemic influenza and vitamin D Epidemic influenza and vitamin D
• Dakota Smith, Facebook, Citizen researcher
• Dr. Alex Vasquez, Telegram Facebook Long term researcher and book publisher on nutrients and Vitmain-D
• Alan Lewis, Quora Veteran wrote an interesting answer on 2010
• Henry Lahore, Electronic Engineer, passionate Vitamin-D advocate, founder of Vitamin-D-Wiki
• Michael F. Holick, Pioneer researcher and widely published. Wisdom we have lost Sunlight and Vitamin D - A global perspective for health, other published works can be searched for using "Holick and vitamin" at PubMed

Other

• Australia, Robin Whittle, What every MD should know about vitamin D and the immune system

Controversy

Historical errors

The IoM has a lot to answer for. They proposed reference values for those that fortify food products with Vitamin-D. They made assumptions based on physiological minimum needs that were required to hold off Rickets. Then they were cautious and determined incorrectly the dose that would maintain 95% of the population above this minimum level. These errors have been shown but there has never been a official correction to their papers. These errors were propagated into other heath bodies and used to drive clinical practice and treatment for deficiencies. They linger in all corners of the world still today even though they are based on shown mathematical errors.

Research negligence

Much of the nutrition research is left in the hands of University research centres and small observational trials by interested individuals. Funding is much less than what is received for drug trials in general. There are simple reasons for this that are not really controversial, Private companies have little reason to fund research that will reduce their profits, in simple terms we can say that it would be NEGLIGENT for a drug company COO or CEO or director whoever to authorise research into nutrition or supplements as there is NO resulting income from positive results. They do occasionally seem to be involved in research that has poor results but these studies and papers are often of such a calibre that they should be withdrawn in shame or at least the conclusions should be neutral.

Measurement variability

The enduring failure in Vitamin-D research is the misguided belief in a inverse "J" or "U" shaped curve in the benefits of dosing and the turning point has been assumed to be at a level much below natural levels which is physiologically unbelievable. This belief is a result of just a few published papers that have since been shown to have errors in data collection due to less than linear measurement systems for determining the 25(OH)D concentrations.

Ergocalciferol / Vitamin-D2

At various points in history the wholesale cost of Ergocalciferol has been below that of Cholecalciferol and it has been proposed and implemented as an alternative, these days the costs are similar. It has very similar chemical structure and also has similar function in humans. However the differences are not insignificant. Firstly the life time of Vitamin-D2 and the metabolites differ from those of Vitamin-D3. The effect is less than the same mass of Vitamin-D3 by a factor of 2 to 3 in various trials. For maternal expression in breast milk it did not provide the function that Vitamin-D3 did for the lactating infant. Some say it is less toxic than Vitamin-D3 but this hardly matters, you need to take more and you should not be near any toxic doses when seeking physiological doses or serum levels. Another added concern is that current measurement techniques do not give accurate results if you have both metabolites in your serum as the sensing peaks overlap. There is one company (Zivak) that makes a dedicated high speed blood analyser that seems to be up to the task but it is a substantial investment if you do not have enough use for it.

It has been promoted as a vegetarian alternative being usually prepared from fungal or yeast sources and is an option though vegan sources of Vitamin-D3(precursors) have been isolated and prepared from lichen and seaweed in recent years.

The Vitamin-D debate seminar came to the conclusion that it should be avoided due to the many negative points and no additional benefits even when the negative points are compensated for.

In spite of this it is in common use in the USA for humans as a supplement and also to be found many of the high potency forms used in treatment and medical trials which can have poor results for this reason as well. "In 2018, it was the 61st most commonly prescribed medication in the United States, with more than 12 million prescriptions."

"in France, China and the USA, where vitamin D2-containing supplements are frequently used" [LC–MS/MS based 25(OH)D status in a large Southern European outpatient cohort: gender- and age-specific differences]

"Vitamin D2 potency is less than one third that of vitamin D3. Physicians resorting to use of vitamin D2 should be aware of its markedly lower potency and shorter duration of action relative to vitamin D3.", "Another barrier is the lack of a high-potency therapeutic vitamin D3 preparation in the United States. In Europe, several high-potency preparations are available, some used for “stoss” therapy in clinical trials" Vitamin D2 Is Much Less Effective than Vitamin D3 in Humans

It is important to remember that Vitamin-D2 does not work at all in farmed fowls, they develop rickets and fail to thrive if the only source of Vitamin-D is Vitamin-D2 from feed. While Vitamin-D2 has been used for other animal feeds it is not favoured due to the extra management of two supplements and need to ensure that chicken feed does not get the wrong supplement.

• DOI: 10.1093/ajcn/68.4.854
• DOI: 10.1093/ajcn/84.4.694
• DOI: 10.1210/jc.2010-2230
• DOI: 10.1111/nbu.12293
• DOI: 10.4158/EP-2018-0415

A long list starting from here. DOI#DOI:_10.1093/ajcn/68.4.854

CoViD-19

Clinical trials

The Vitamin-D Meta collection seems comprehensive.

Interventions

Europe

• UK, Scotland, from late 2020 providing a small dose 20ug (800IU) of Vitamin-D to all care home residents and the vulnerable who have been shielding at home.
• UK, England, from the start of 2021 in a response to the Scotland initiative for an initial 4 months a rollout of providing a small dose 20ug (800IU) of Vitamin-D to all care home residents and the vulnerable who have been shielding at home.
• UK, Slough - recommendation?
• Ireland, The Joint Committee on Health puts in place plan to sort out Vitamin-D deficiecny. Report on addressing Vitamin D deficiency as a public health measure in Ireland.
• Andalusia, after Spanish research published decided to add Vitamin-D to treatment program. Recommendation for institutionalised, calcidiol
• Italy, Piedmont region, Piedmont introduces Vitamin-D to treat patients at home Document signed by 156 Italian doctors and researchers. Vitamina D nella prevenzione e nel trattamento del COVID-19: nuove evidenze

Americas

• USA, Roma, Starr County, Texas - good serum level goals of 100-250nmol/l (40-100ng/ml) Testing was promoted by ICD but very little official mention left to be found on the web other than page 9 of this advertising paper.
• USA, Nebraska - good dose recommendations 125-150ug/day (5000-6000IU/day)
• USA, Central NY, New York State - 250ug (10'000IU) to those at food bank
• Brazil, Figueirão, Mato Grosso do Sul (MS) - Dose 250ug/day (10'000IU/day) with co-factors
• Brazil, Cristal, Rio Grande do Sul (RS) - Dose 250ug/day (10'000IU/day)
• Brazil, Porto Seguro, Bahia (BA) - Dose 250ug/day (10'000IU/day)
• Brazil, Juiz de Fora, Minas Gerais (MG) - supplement symptomatic and healthcare workers
• Brazil, Nova Petrópolis, Rio Grande do Sul (RS) - Not sure only saw passing mention
• Brazil, São Paulo, São Paulo (SP) ? - Not sure if this city should be on the list, I only saw a vague mention
• Real-World Evidence: The Case of Peru

Some resources for Brazil. Mapa do coronavírus por cidades no Brasil, ESPECIAL COVID-19 - Dados por Município

Other

• Iraq eye hospital, give Vitamin-D on admission to all CoVID-19 patients.
• University of Health Sciences (UHS), Lahore, Pakistan
  Established a Vitamin-D academy in Lahore and plans to extend the program to all provinces.
• Russia, supplement (even) after vaccine, recommendation
• Israel, recommendation from early on, vaccine side effects may be less
• Ivermectin crushes Delhi cases
• 1 in 4 COVID patients hospitalized while vitamin D deficient die – Israeli study

Community

Vitamin-D for All

Over 200 Scientists & Doctors Call For Increased Vitamin D Use To Combat COVID-19

France doctors and learned bodies

73 experts and 6 learned societies call for population wide supplementation. Covid-19 : 73 experts lancent un appel pour qu'on donne de la vitamine D à la population française

Supplementation

Treatment regimes

The Functional Medicine Approach to COVID-19: Virus-Specific Nutraceutical and Botanical Agents

Info

Unit conversions

Doses of Vitamin-D3

• 1ug of Cholecalciferol = 40 International Units (IU) of Anti-Rachitic effect
  
• 100ug = 4000IU
• 125ug = 5000IU
• 250ug = 10'000IU
• 375ug = 15'000IU safe limit for adults long term
• 500ug = 20'000IU
• 750ug = 30'000IU

Serum levels 25(OH)D

• 1ng/ml = 2.5nmol/l
• 10ng/ml = 25nmol/l
• 20ng/ml = 50nmol/l
• 30ng/ml = 75nmol/l
• 40ng/ml = 100nmol/l
• 50ng/ml = 125nmol/l Target level
• 60ng/ml = 150nmol/l
• 70ng/ml = 175nmol/l
• 100ng/ml = 250nmol/l
• 150ng/ml = 375nmol/l no harm detected

Glossary

25(OH)D : 25 Hydroxy Vitamin-D
25(OH)D₂ : 25 Hydroxy Vitamin-D₂, 25-hydroxyergocalciferol
25(OH)D₃ : 25 Hydroxy Vitamin-D₃, calcifediol, 25-hydroxycholecalciferol
1,25(OH)₂D₃ : 1,25 Dihydroxy Vitamin-D₃, calcitriol, 1,25-dihydroxycholecalciferol
ug : μg, mcg, microgram
mg : milligram
IU : International Units
nmol/l : nano-mole per litre
ng/ml : nanogram per millilitre

Public Health bodies

Endocrine Society

USA, Sets guidelines for targets and supplementation for good health and clinical treatment.

IoM

America, Institute of Medicine, sets guidelines for conservative daily allowances to guide food fortification.

THL

Finland, Department of Health and Welfare (THL, Terveyden ja Hyvinvoinnin laitos), sets guidelines for daily vitamin and mineral allowances and safe limits.
Is subservient to Food Agency (Ruokavirasto).
Which is subservient to the State Nutrition Advisory Board (VRN, Valtion Ravitsemusneuvottelukunta)

The current serious controversy in Finland on the prohibition on publishing medical research by businesses that trade in food products Elintarvikkeiden markkinoiminen koronaviruksen ehkäisyyn tai hoitoon tulee lopettaa välittömästi, Ruokavirasto kieltää yrityksiltä vitamiinitutkimuksien jakamisen kuluttajille ja ammattilaisille Oikeuskanslerinvirasto ei näe moitittavaa Ruokaviraston tulkinnassa kieltää tieteellisten tutkimusten jakaminen elintarvikevalvonnan piirissä olevilta toimijoilta There is a good explanation of the abysmal judgement in a comment by Mika Rönkkö in a FaceBook thread in Finnish.

The benefits of Vitamin-D for bone, muscle and immune function are accepted in Finland and Europe.

References

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