Can Vitamin D Protect Against COVID-19?

Scientists don’t yet know why COVID-19 is fatal for some people and not others, but ongoing research is rapidly adding to their understanding of the disease. In a recent development, a study published last month found an apparent link between COVID-19 and vitamin D deficiency.

It is important to note that there is no cure or recommended treatment for COVID-19. However, vitamin D deficiency is thought to play a role in respiratory diseases, including tuberculosis, asthma, and chronic obstructive pulmonary disease (COPD). It has also been linked to autoimmune illnesses such as psoriasis, rheumatoid arthritis, multiple sclerosis, and Graves’ disease.

It now appears that vitamin D deficiency may also play a role in COVID-19 fatalities. Researchers made several observations that led them to investigate a link between vitamin D and COVID-19:

• The COVID-19 outbreak began in December, a time when vitamin D levels are lowest in the northern hemisphere. This is significant because our bodies produce vitamin D naturally from sunlight.
• In the southern hemisphere, where it was summer at the time of the outbreak, the number of COVID-19 cases was low.
• Vitamin D deficiency is known to contribute to adult respiratory distress syndrome (ARDS).
• Older patients and those with a chronic disease (such as heart or lung disease or diabetes) have higher fatality rates than others. Vitamin D deficiency is associated with advanced age and many chronic diseases.

Vitamin D plays a vital role in the body’s immune system, which has two parts. One is the innate immune system — the one we’re born with — and the other is called the adaptive immune system. The adaptive system is the one that’s activated to fight off an infection or injury. Vitamin D helps both systems to function properly. While it strengthens the innate immune system, it also prevents the adaptive immune system from overreacting to an infection or injury.

When the body recognizes an infection, it triggers an inflammatory response (the area becomes red and swollen) and releases chemicals called “cytokines,” which then try to fight the infection.

In some cases, however, this reaction produces too strong an inflammatory response, called a “cytokine storm.” The cytokine storm results in excess inflammation, which can injure the lungs and lead to pneumonia and COVID-19.

According to the new study, vitamin D in the form of vitamin D3 may reduce the risk of this overactive immune response in people at high risk for COVID-19 or influenza. Researchers suspect that vitamin D supplementation may also reduce the risk of flu, though the research is not yet conclusive on this.

The study notes that not everyone should take supplemental vitamin D. (Many people get all they need from sunshine and diet.)

However, for those at high risk of influenza or COVID-19, the study recommends vitamin D supplementation to reduce the risk of infection. They recommend the following dosages:

• For a few weeks, vitamin D3 at 10,000 International Units per day (10,000 IU/d) to quickly raise the vitamin D3 level.
• Then reduce dosage to 5000 IU/d.
• Aim for a vitamin D level — also called 25(OH)D — of 40–60 ng/ml. Vitamin D level can be checked with routine testing by your primary healthcare provider.

People who are not already taking vitamin D should discuss these recommendations with their healthcare provider before starting supplementation.

NOTE OF CAUTION: Very high doses of vitamin D can increase fall risk in older adults. Be sure your healthcare provider knows if you are already taking any form of vitamin D.

REFERENCES

Aranow C. Vitamin D and the immune system. J Investig Med. 2011;59(6):881‐886. doi:10.2310/JIM.0b013e31821b8755

Grant WB, Lahore H, McDonnell SL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4):E988. Published 2020 Apr 2. doi:10.3390/nu12040988.

Sanders KM, Stuart AL, Williamson EJ, et al. Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial [published correction appears in JAMA. 2010 Jun 16;303(23):2357]. JAMA. 2010;303(18):1815‐1822. doi:10.1001/jama.2010.594

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