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Evidence-Based COVID-19 Prevention and Risk Reduction: A Literature Summary with Clinical Recommendation

Without any doubt, the most evidence-based supplementation protocol for prevention of, and risk reduction from, COVID-19 and FLU, is Vitamin D (with synergistic amounts of Vitamin A), and omega-3 fatty acids.

Space does not allow inclusion of a comprehensive summary of all the evidence of the biological/physiological importance of these essential nutrients (immune cell function, regulation of inflammation). I have provided ample evidence in previous articles (The Essential Role of Omega-3 and Vitamins A and D in Viral Immune Defense; OmegA+D Sufficiency for COVID-19 and FLU Risk Reduction: An Evidence-Based Intervention that MUST become Standard of Care; Immune Function, Immune Defense, and Vitamin D – What Everyone Needs to Know) and highly encourage you to reread these. I will include some basic science citations in this summary, but the main focus here will be on the evidence regarding the clinical effectiveness of sufficient daily supplementation with these nutrients and an evidence-based clinical protocol recommendation.

I want to start with an article I did not review in previous articles but which I believe is the best, and most easily understood review of the evidence regarding both biological plausibility and clinical effectiveness of Vitamin D I have seen to date. If you only read one article on the topic, I recommend the Benskin review below. Dr. Linda Benskin is an independent nurse researcher who writes extremely well and has an admirable ability to simplify the complex and equally admirable willingness and courage to speak evidence-based truth to power. We need more like her in healthcare.

Keep in mind this article was first submitted in May 2020 even though it was not published until September 2020. The amount of clinical evidence for the effectiveness of Vitamin D with respect to prevention and risk and severity reduction of COVID-19 published since this article was written surpasses that which was available to Dr. Benskin for this article.

Benskin, L. (2020) A Basic Review of Preliminary Evidence That COVID-19 Risk and Severity Is Increased in Vitamin D Deficiency. Frontiers in Public Health. Vol 8, Article 513

“Early researchers reported three striking patterns. Firstly, the innate immune system is impaired by vitamin D deficiency, which would predispose sufferers to viral infections such as COVID-19. Vitamin D deficiency also increases the activity of the X-chromosome-linked “Renin-Angiotensin” System, making vitamin D deficient individuals (especially men) more susceptible to COVID-19’s deadly “cytokine storm” (dramatic immune system overreaction).”

This is also true for influenza and influenza-like illnesses. It is a tragedy that this has been, and seems to continue to be, ignored by public health officials and medical practitioners.

“Secondly, the groups who are at highest risk for severe COVID-19 match those who are at highest risk for severe vitamin D deficiency. This includes the elderly, men, ethnic groups whose skin is naturally rich in melanin (if living outside the tropics), those who avoid sun exposure for cultural and health reasons, those who live in institutions, the obese, and/or those who suffer with hypertension, cardiovascular disease, or diabetes.”

“And thirdly, the pattern of geographical spread of COVID-19 reflects higher population vitamin D deficiency. Both within the USA and throughout the world, COVID-19 fatality rates parallel vitamin D deficiency rates.”

This is also true for influenza and influenza-like illnesses. Why do you think there is a “flu season”? Flu season is synonymous with low sun exposure or low vitamin D level season. Low vitamin D levels are synonymous with lowered immune function, greater risk of hyper-inflammatory response, greater risk of cytokine storm, and thus greater risk of severe illness and death. The truth is there is less biological plausibility evidence and less clinical evidence for the flu shot than there is vitamin D. We don’t primarily fight influenza with antibodies, we fight influenza with our innate immune system and the T-cells of our humoral immune system. Immunologists have been arguing this for years. The reason you need to get a new flu shot every year is because there is a different strain of the virus every year, so why would we use antibodies against the flu virus? It makes no biological sense.

Nor is there any valid clinical evidence of effectiveness for the flu shot. Let’s ignore the fact that they often guess wrong about the strain and produce a flu shot with antibodies to a strain of flu that is not even circulating. The truth is that, even when they guess correctly, the antibodies in the flu shot are not the main defense humans use to fight influenza and cold viruses and this is why, according to the Cochrane Database of Systematic Reviews, the flu shot is so clinically ineffective – it does not prevent the flu, prevent deaths from the flu, or reduce severity of flu symptoms.

I invite you to review the Cochrane Reviews by Jefferson or the plethora of other articles written by Jefferson, Simonsen, Jackson, Eurich, Fireman, Osterholm, or Govaert as just a start (Jefferson, T. et al. (2012) Vaccines for Preventing Influenza in Healthy Children. Cochrane Database of Systematic Reviews.; 8: Article #CDOO4879; Jefferson, T. et al. (2010) Vaccines for Preventing Influenza in healthy adults. Cochrane Database of Systematic Reviews. ; 8: Article #CDOO4879; Jefferson, T. et al. (2006) Influenza vaccination: policy vs evidence. BMJ 2006; 333:912-915; Simonsen, et al. (2007) Mortality benefits of influenza vaccination in elderly people: an ongoing controversy. Lancet Infect Dis 7: 658-66; Jackson et al. (2008) Influenza vaccination and risk of community-acquired pneumonia in immunocompetent elderly people: a population - based, nested case-control study. 372 (9636): 398-405; Eurich, D. et al. (2008) Mortality reduction with influenza vaccine in patients with pneumonia outside “flu” season. Am j Respir Crit Care Med 178, 527-533; Fireman, B. et al. (2009) Influenza Vaccination and Mortality: Differentiating Vaccine Effects from Bias. Am J Epidemiol 170: 650-656; Osterolm, M. et al. (2012) Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. Lancet Infect Dis 12: 36-44; Govaert, M.E. et al. (1994) The Efficacy of Influenza Vaccination in Elderly Individuals: A Randomized Double-Blind Placebo-Controlled Trial. J.A.M.A. 272: 1661-1665).

Read the peer-reviewed literature NOT marketing brochures or pamphlets produced from vaccine manufacturers for health care providers (their distributors). Don’t rely on internet posts either – whether pro or anti flu shot. Read the peer-reviewed literature and, if this literature seems too scientific or too complicated to understand, then admit to yourself that you are incapable of determining whether or not the information you are getting via brochure or internet post or healthcare provider is accurate!

If you can’t understand the literature, don’t be embarrassed, most doctors and nurses can’t either, they just blindly trust the information they receive, don’t pretend you are “following science” or “being scientific”. Be honest and admit you are choosing to have faith in what is being labelled or marketed as scientific – whether this is pro or anti flu shot information.

I also invite you to keep in mind that the pharmaceutical companies that design and fund the studies distribute their sales and marketing information via pharmaceutical lobbyists to governments, via pharmaceutical reps to doctors and nurses, are convicted felons – EVERY ONE OF THEM. And, they have been convicted of lying about the benefits of their products, hiding harms, deliberately lying to lawmakers, lobbying and outright bribing lawmakers and health policy makers, lobbying and lying to medical doctors, and, most importantly, for doing all this REPEATEDELY.

Don’t have blind faith in what I say either, go to www.search.justice.gov/search and type in Pharma Fraud in search bar and you will see more than enough evidence that these companies are serial felons. Now, should you blindly trust information coming from these companies, whether it comes directly from them, or via those who they have lobbied, wined and dined, and lied to?

Back to the Benskin paper.

“The 141 author groups writing primarily about biological plausibility detailed how vitamin D deficiency can explain every risk factor and every complication of COVID-19, but agreed that other factors are undoubtedly at work. COVID-19 was compared with dengue fever, for which oral vitamin D supplements of 4,000 IU for 10 days were significantly more effective than 1,000 IU in reducing virus replication and controlling the “cytokine storm” (dramatic immune system over-reaction) responsible for fatalities.”

“Among the 47 original research studies summarized here, chart reviews found that serum vitamin D levels predicted COVID-19 mortality rates (16 studies) and linearly predicted COVID-19 illness severity (8 studies). Two causal modeling studies and several analyses of variance strongly supported the hypothesis that vitamin D deficiency is a causal, rather than a bystander, factor in COVID-19 outcomes. Three of the four studies whose findings opposed the hypothesis relied upon disproven assumptions [bolding by author not me].”

“Two May 2020 Centre for Evidence-Based Medicine rapid reviews concluded, without discussing any of the recent studies, that there is no evidence to support a role for vitamin D in prevention or treatment of COVID-19 or the cytokine storm.”

“The high mortality rates among minorities are providing momentum for various public health program expansions, which could diminish if vitamin D deficiency, rather than access to care and economic disparities, were found to be even a partial explanation.”

“However, most governments, medical organizations, and key opinion leaders give one or more of these four reasons not to recommend vitamin D supplements: past claims for vitamin D benefits were overstated, evidence for a link to COVID-19 is insufficient, overdoses are theoretically possible, and the public might believe that taking vitamin D supplements will make them “immune” to COVID-19.”

Note how hypocritical and biased these excuses (not reasons) for not recommending vitamin D supplementation are. First, what past claims of benefit for vitamin D, published in peer-review, were overstated? Note that examples are rarely if ever provided, and when they are, they include negative study findings from invalid studies as evidence that claims from valid studies which showed benefit were overstated. By the way, such overstated claims regarding drugs are NEVER cited as reasons not to prescribe drugs!

Second, to state that evidence of a link between Vitamin D and COVID is insufficient is not just absurd, it is provably false, and, again, keep in mind that this has NEVER stopped them from recommending or using drugs. The hypocrisy is staggering.

Third, overdoses of Vitamin D, though theoretically possible, are, based on the actual valid science, practically, almost impossible. Even at 10,000 IUs per day for months and months there is no evidence of toxicity. This is nothing more than ignorance and/or an excuse not to recommend Vit D and instead, to recommend drugs with MUCH HIGHER chances of toxicity, which again, is NEVER used as an excuse not to recommend drugs.

“It is not considered possible to achieve toxic levels via the sun alone, and supplementation for prolonged periods brings 25(OH)D to toxic levels only if the dose is consistently extraordinarily high (40,000 IU/day for many months).”

“However, vitamin D toxicity concerns remain heightened, with a reluctance to recommend supplements. Dietary sources provide UK adults with only about 100 IUs of vitamin D per day. During the COVID-19 pandemic, after concluding that vitamin D is likely to reduce acute respiratory tract infection risk, and that 10,000 IU/day is safe, the NHS paradoxically recommended only 400 IU/day “to protect bone and muscle health”.

“Alarmed by the media response to a literature review suggesting a link between COVID-19 and vitamin D, two Brazilian medical associations jointly published a note stating that vitamin D supplements are only approved for bone health.”

These people are not just ignorant, they are unethical, and they have such a pro-drug, anti-nutrient bias that they are anything but trustworthy.

Fourth, the claim that admitting the benefits of Vitamin D might make people believe they are immune to COVID-19 is so stupid that I will not dignify it with a response other than to say that this is NEVER cited as a reason not to recommend a drug therapy or a vaccine!

The real fear is that there is evidence that Vitamin D has MUCH more evidence of benefit, and MUCH less evidence of harm than drugs which means that if this truth gets out, there will be less demand for drugs, fewer drug sales, fewer visits to MDs, and decreased reliance on and belief in the authority and superiority of drug-centric healthcare and healthcare providers.

The irrefutable truth is that there is no such thing as an illness caused by a deficiency of drugs but there are MANY illnesses caused by a deficiency of essential nutrients. As I have been saying for decades, it is an irrefutable FACT that sufficient intake of essential nutrients is REQUIRED to express health and deficient intake of essential nutrients, by definition, results in a state of biological/physiological dysfunction and ill-health. The very definition of an essential nutrient is a nutrient that is essential for human cell function and health which the cells of the body cannot make, so must be sourced via required dietary intake or sun exposure.

The ONLY way to solve a problem caused by deficient intake of essential nutrients is with sufficient intake of essential nutrients – period, no exceptions, no debate. No drug has, is, or will, EVER solve a problem caused by deficient intake of essential nutrients. If your immune cells need Vitamin D, and Omega-3 and Vitamin A by the way, to function properly, and you are deficient in these essential nutrients, your immune cells CANNOT FUNCTION PROPERLY and no drug will ever fix this.

This FACT undermines the entire foundation of drug-centric healthcare and this is why those who make a living from drug-centric care go to great lengths to deny the evidence of benefit from essential nutrients. It is NOT a lack of biological plausibility, or a lack of evidence, it is ignorance of the evidence and/or a fear of lack of profits and cultural authority that is the basis of the excuses given to not recommend essential nutrients - as they hypocritically ignore the very same excuses when recommending drugs. This ignorance, greed, and hypocrisy has cost millions of lives over the past decades and, unless corrected, will cost millions more in the upcoming decades. It also costs trillions of dollars in healthcare expenditures and lost productivity and wages, and, worst of all, costs millions of quality life years because people are unnecessarily sick.

As you read all this information about the role of these essential nutrients with respect to immune function, the prevention of, and reduction of risk of complications from, respiratory illnesses and COVID-19, keep in mind that the EXACT same information can be applied to influenza and influenza-like illnesses. Compare the evidence regarding effectiveness, cost-effectiveness, and safety of Vit D to the evidence of the flu vaccine in the Jefferson et al. Cochrane Reviews and you will be gob smacked. It is heart breaking.

“The literature review also found that prophylactically correcting possible vitamin D deficiency during the COVID-19 pandemic is extremely safe. Widely recommending 2,000 IU of vitamin D daily for all populations with limited ability to manufacture vitamin D from the sun has virtually no potential for harm and is reasonably likely to save many lives.” (You could VERY safely recommend 5000 IU per day!)

“Unlike influenza, children under age 10 are almost completely spared in COVID-19. This unusual risk factor pattern presented a mystery that spawned studies showing that COVID-19 fatalities are especially high in areas with lower levels of sunshine due to latitude or air pollution, except when population vitamin D intake is high. In fact, the risk groups for severe COVID- 19 match the risk groups for vitamin D deficiency exactly, and there is biological plausibility: vitamin D is known to modulate the immune system, helping prevent both under-reaction that allows upper respiratory infections to be contracted, and the over-reaction referred to in COVID-19 as the “cytokine storm”.

THIS IS EXACTLY WHAT I OUTLINED IN MY ‘THE ESSENTIAL ROLE OF OMEGA-3 AND VITAMINS A +D ARTICLE – WHICH I WROTE MONTHS PRIOR TO THIS ARTICLE EVEN BEING SUBMITTED FOR PUBLICATION – THINK OF THE LIVES THAT COULD HAVE BEEN SAVED AND THE SUFFERING THAT COULD HAVE BEEN PREVENTED AND THE MONEY THAT COULD HAVE BEEN SAVED!! Many of my practitioner subscribers did implement this information and many of them did save lives – thank goodness.

“Most studies of vitamin D for influenza prevention were conducted on healthy populations with high baseline levels, rather than on the deficient populations who would benefit most. Despite this, some found that higher 25(OH)D linearly enhance the innate immune response to acute winter respiratory infections, halving the incidence and significantly reducing the duration of illness.”

“In 2017, 25 international researchers from 23 institutions performed a meta-analysis of individual participant data from 25 high-quality randomized controlled trials of vitamin D supplementation to prevent acute respiratory tract infections to determine why the results were inconsistent.”

*This is the Martineau et al. study I reviewed in my ‘Immune Function, Immune Defense, and Vitamin D – What Everyone Needs to Know Article LAST YEAR and this is EXACTLY what I emphasized.

“They found that bolus doses [large one-time doses often used in research studies] were not consistently protective, even in severely vitamin D deficient populations. Removing bolus-dose data led to consistent findings of benefit, regardless of initial vitamin D status. Daily or weekly vitamin D supplementation was most beneficial for participants with baseline 25(OH)D less than 10 ng/ml (severe deficiency), providing more statistically significant protection than the protection vitamin D provided less deficient participants.”

“The authors found that response to vitamin D supplementation is so variable that studies should base findings on changes in 25(OH)D levels, rather than relying upon the vitamin D dose given to each participant. They also found that vitamin D supplementation is extremely safe: even large doses did not increase risk of serious adverse events, such as renal stones.”

CONCLUSION

“The 141 articles presenting primarily biological plausibility evidence overwhelmingly support the assertions that vitamin D sufficiency increases resistance to viral infections and helps prevent every symptom of severe COVID-19 that results in fatalities. They show that vitamin D deficiency can also explain every major risk factor, including the mystery of why children seem relatively protected and why males, the elderly, and people with naturally melanin-rich skin are especially vulnerable.”

“The 47 studies summarized here demonstrate that vitamin D deficiency explains the geographical differences in COVID-19 case and fatality rates. They provide overwhelming correlational evidence for the hypothesis, and causal evidence as well. COVID-19 mortality was predicted by vitamin D in 16 studies and vitamin D levels or sunlight predicted contracting COVID-19 in 17. Both causal modeling studies and eight chart reviews demonstrated that lower 25(OH)D was linearly associated with more severe COVID-19 outcomes.”

“None of the four objections to recommending universal vitamin D supplements are supported by the evidence. The exhaustive literature search found no vitamin D proponent who suggested that COVID-19 could be completely eliminated with supplementation. Rather than overstating the case, they present compelling evidence that vitamin D deficiency is one factor which increases risk for COVID-19 infection and progression.”

“Although overdoses are theoretically possible, they are highly improbable. The recommended dose by consensus, 2,000 IU/day for adults, is 1/20th the amount that must be taken for many months to risk toxicity.”

In other words, you would need to take 40,000 IUs per day for months to even risk toxicity! Again something I have been stating based on the evidence for years. The most frustrating thing is that the RDI or RDAs are still 400 IUs! I fought with Health Canada for over a year about this for my OmegA+D Sufficiency label recommendations and my Vitamin D-Sufficiency label recommendations. Regardless of how much EVIDENCE I submitted, they just would not accept the facts, despite a complete inability to provide evidence for their daily recommended amounts!

Even worse, many Vitamin D studies only include a few hundred IUs of Vitamin D per day and then claim Vitamin D has no benefit, or, they include huge injected bolus doses, which have been shown to be ineffective, and claim Vitamin D has no benefit. They deliberately stack the deck against nutrients so they can continue to sell drugs or the flu shot! It is not only scientifically unethical; it is dishonest and immoral and it costs lives.

This is not to suggest that every non-drug or non-medical intervention is effective and/or safe - far from it. Nor is it to suggest that every drug or medical intervention is ineffective and/or unsafe. My argument is not for or against any profession or intervention per se, my argument is for interventions that have valid evidence of safety and effectiveness and cost-effectiveness and against interventions that lack such evidence. I’m an advocate for evidence-based care, and a critic of care which lacks evidence – period. Who provides the care is irrelevant to me and it should be irrelevant to scientists, practitioners, legislators, third-party payors, patients, and public consumers.

There is a reason Big Pharma has two full time lobbyists for every member of congress, why Big Pharma spends more than any other industry on lobbying – by FAR, why Big Pharma is the major funder of medical education, research, and journals, why drug therapy is synonymous with medical care, and why medical education includes only a few hours of nutrition, exercise, or any other lifestyle science. The entire system is designed to prescribe and sell drugs and to undermine the authority of any other alternative.

“The evidence strongly suggests that vitamin D deficiency is an easily modifiable risk factor and correcting it is potentially life-saving. Suppressing this evidence out of fear that the public might believe supplements will make them “immune” to COVID-19 is not only elitist, but it is inconsistent with existing public policy approaches. Many mitigation strategies are publicized. None are seen as conferring immunity.”

“This succinct but comprehensive review of the evidence found that despite almost complete absence of official government guidelines favoring vitamin D supplements to potentially decrease COVID-19 risk and severity, support among clinicians and other researchers for correcting and preventing vitamin D deficiency with modest daily vitamin D supplementation during the COVID-19 pandemic is very strong, worldwide.”

Here are some citations from other studies – the level of evidence for Vitamin D (and Omega-3) is overwhelming!

Rastogi, A. et al. (2020) Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomized, placebo-controlled, study (SHADE study). Postgrad Med J doi:10.1136/ postgradmedj-2020-139065

The immunomodulatory effect of vitamin D has been previously studied in bacterial as well as viral infections, but not in SARSCoV- 2 infection.

“Vitamin D influences the expression of various genes involved in the immune system (innate immunity, adaptive immunity) and the downstream inflammatory cascade, thus affecting the susceptibility to and severity of bacterial and viral infections.

Vitamin D can induce anti-microbial peptide cathelicidin in neutrophils, NK cells and monocytes to cause reduction of Herpes-Simplex virus titre.

“In a recent meta-analysis of intervention trials, vitamin D supplementation was observed to reduce the incidence of acute respiratory tract infections. Similarly in SARS-CoV-2 infection vitamin D deficiency may lead to a proinflammatory cytokine milieu, thus augmenting the disease severity.

“It has been observed that vitamin D-deficient individuals have increased COVID-19 risk and mortality.”

“Therefore, we hypothesise that high-dose cholecalciferol supplementation in patients with SARS-CoV-2 infection and vitamin D deficiency may lead to SARS-CoV-2 negativity in greater proportions of patients with a decrease in serological markers of inflammation.’

“It is noticed that those receiving vitamin D supplementation have fewer respiratory tract infections. However, the immune-modulatory effect of vitamin D is likely to be observed at 25(OH)D levels, which are considered higher than that required for its skeletal effects.”

“Patients with vitamin D deficiency defined as 25 (OH)D level<20 ng/ml were randomised to receive daily 60000 IU of cholecalciferol (5 ml oral solution in nano droplet form)for 7 days in the ‘intervention arm’ with the aim to achieve 25 (OH)D level>50 ng/ml or placebo (5 ml distilled water) for 7 days (control group).”

“The 25(OH)D levels at day-14 were 51.7 (48.9 to 59.5) ng/ml and 15.2 (12.7 to 19.5) ng/ml, p<0.001 with a median increase of 42.4 (39 to 48.8) ng/ml and 5.1 (0 to 12.3) ng/ml (p<0.01) in the intervention and control group, respectively.”

“10 out of 16 (62.5%) participants in the intervention group achieved SARS-CoV-2 negativity compared to 5 out of 24 (20.8%) participants in the control arm.”

“In conclusion, a high dose, oral vitamin D supplementation to augment 25(OH)D >50 ng/ml helped to achieve SARS-CoV-2 RNA negativity in greater proportion of asymptomatic vitamin D-deficient individuals with SARS-CoV-2 infection along with a significant decrease in inflammatory marker. SARS-CoV-2 RNA negativity by cholecalciferol supplementation may help in reducing transmission rates of the highly contagious SARS-CoV-2 infection.”

“A reassurance for public health workers regarding greater likelihood of SARS CoV-2 RNA negativity in individuals receiving therapeutic cholecalciferol supplementation will be encouraging.”

Yilmaz, K. & Sen, V. (2020) Is vitamin D deficiency a risk factor for COVID-19 in children? Pediatric Pulmonology 55:3595-3601.

“Vitamin D is a pluripotent hormone modulating the adaptive and innate immune response. The risk of infection by several mechanisms can be reduced by vitamin D. Vitamin D induces cathelicidins and defensins that can reduce the viral replication rate. In addition, it increases the concentrations of anti‐inflammatory cytokines and decreases the concentration of proinflammatory cytokines that cause pneumonia and lung damage. ‘

“In previous studies, vitamin D deficiency has been shown to increase respiratory infections risk including respiratory syncytial virus, tuberculosis and flu, and is a risk factor for acute respiratory distress syndrome (ARDS).”

“A randomized trial from China reported the beneficial effects of vitamin D is appropriate for the prevention of seasonal influenza as proved by rapid relief from symptoms, fast reduce, in viral loads and disease recovery. Another randomized trial of daily high dose versus standard dose of vitamin D in Canadian children showed that the incidence of influenza infections in the high‐dose group was reduced by 50%.”

Conclusion: This is the first to evaluate vitamin D levels and its relationship with clinical findings in pediatric patients with COVID‐19. Our results suggest that vitamin D values may be associated with the occurrence and management of the COVID‐19 disease by modulating the immunological mechanism to the virus in the pediatric population.

Annweiler, G. et al. (Nov 2020) Vitamin D supplementation associated to better survival in hospitalized frail elderly COVID-19 patients: The GERIA-COVID Quasi-Experimental Study. Nutrients 12, 3377

“Importantly, a recent unbiased genomics-guided tracing of the SARS-CoV-2 targets in human cells identified vitamin D among the three top-scoring molecules manifesting potential infection mitigation patterns through their effects on gene expression.”

“In particular, by activating or repressing several genes in the promoter region of which it binds to the vitamin D response element, vitamin D may theoretically prevent or improve COVID-19 adverse outcomes by regulating i) the renin–angiotensin system (RAS), ii) the innate and adaptive cellular immunity, iii) the physical barriers, and iv) the host frailty and comorbidities.”

“Consistently, epidemiology shows that hypovitaminosis D is more common from October to March at northern latitudes above 20 degrees, which corresponds to the latitudes with the highest lethality rates of COVID-19 during the first months of winter 2020.”

This is exactly the same scenario for influenza and influenza-like illnesses – this is why they call it “seasonal flu” – it should be called low sunlight or low Vit D flu! Vitamin D supplementation can have the same benefits for prevention and risk reduction from flu as is does for COVID-19!!!!!!

“The objective of this quasi-experimental study was to determine whether bolus vitamin D supplementation taken either regularly over the preceding year or after the diagnosis of COVID-19 was effective in improving survival among hospitalized frail elderly COVID-19 patients.”

They used BOLUS dosing which, as you have just read above, is least effective. However, as you will see, BOLUS doses still had significant benefit. Had they used daily doses of 5-10,000 IUs the benefits would have certainly been even greater!

“Intervention groups were participants regularly supplemented with vitamin D over the preceding year (Group 1), and those supplemented with vitamin D after COVID-19 diagnosis (Group2). The comparator group involved participants having received no vitamin D supplements (Group 3).”

“At the end of the study, the proportion of participants experiencing severe COVID-19 was lower in Group 1 (10.3%) compared to Group 3 (31.3%, p = 0.047), just like the 14-day mortality (6.9% in Group 1 versus 31.3% in Group 3, p = 0.02).”

Conclusions. Regular bolus vitamin D supplementation was associated with less severe COVID-19 and better survival in frail elderly.”

Castillo, M.E. et al. (August 2020) Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study. Journal of Biochemistry and Molecular Biology. 203 105751

“The vitamin D endocrine system may have a variety of actions on cells and tissues involved in COVID- 19 progression especially by decreasing the Acute Respiratory Distress Syndrome.”

“We therefore evaluated the effect of calcifediol treatment, on Intensive Care Unit Admission and Mortality rate among Spanish patients hospitalized for COVID-19.”

“Of 50 patients treated with calcifediol [Vit D], one required admission to the ICU (2%), while of 26 untreated patients, 13 required admission (50 %).”

“Of the patients treated with calcifediol, none died, and all were discharged, without complications.”

2% of the patients treated with Vitamin D required ICU treatment and ZERO percent of these ICU patients died.

“The 13 patients not treated with calcifediol, who were not admitted to the ICU, were discharged. Of the 13 patients admitted to the ICU, two died and the remaining 11 were discharged.”

50% of the patients NOT treated with Vitamin D required ICU treatment and 15% of these patients died.

Conclusion: Our pilot study demonstrated that administration of a high dose of Calcifediol or 25-hydroxyvitamin D, a main metabolite of vitamin D endocrine system, significantly reduced the need for ICU treatment of patients requiring hospitalization due to proven COVID-19.”

Panigraphy et al. (2020) Inflammation Resolution: a dual prolonged approach to averting cytokine storms in COVID-19? Cancer and Metastasis Reviews 39: 337-340.

“Severe coronavirus disease (COVID-19) is characterized by pulmonary hyper-inflammation and potentially life-threatening “cytokine storms”. Controlling the local and systemic inflammatory response in COVID-19 may be as important as anti-viral therapies.”

“Endogenous lipid autacoid mediators, referred to as eicosanoids, play a critical role in the induction of inflammation and pro-inflammatory cytokine production.”

Omega-3 fatty acids (eicosanoids), are essential for the production of lipid mediators called resolvins that play a significant role in what is known as the resolving phase of inflammation – hence the term resolvins.

Chronic inflammation is the result of a lack of resolving inflammation more than it is hyper-inflammation. Deficiencies of Omega-3 and Vitamins D and A cause dysfunction in the resolving phase of inflammation. Inflammation, even a high degree of inflammation, is often both normal and necessary in response to acute injury. It is not the acute inflammation that is at the root of cytokine storm or all the chronic inflammatory diseases such as heart-disease, cancer, diabetes, obesity, arthritis, etc etc. It is the lack of inflammation resolving that is the root cause of chronic inflammation.

Deficiency of Omega-3 fatty acids causes deficiencies of resolvins that control and regulate (resolve) the inflammatory response and deficiency of Vitamin D causes deficient activation of Treg cells (T-Regulatory Cells) which control and regulate (resolve) inflammation.

“While most COVID-19 clinical trials focus on “anti-viral” and “anti-inflammatory” strategies, stimulating inflammation resolution is a novel host-centric therapeutic avenue.”

“Here, we discuss using pro-resolution mediators as a potential complement to current anti-viral strategies for COVID-19.”

“A paradigm shift is emerging in our understanding of the resolution of inflammation as an active biochemical process with the discovery of novel endogenous specialized pro-resolving lipid autacoid mediators (SPMs), such as resolvins.” – And Treg Cells!

“Resolvins and other SPMs stimulate macrophage mediated clearance of debris and counter pro-inflammatory cytokine production, a process called inflammation resolution.”

“In contrast to classic anti-inflammatory agents, endogenous pro-resolution lipids [omega-3 fatty acids] can terminate the inflammatory response by promoting the clearance of cellular debris.”

“Specialized proresolving mediators (SPMs), including resolvins, lipoxins, and protectins, are bioactive lipid autacoids that mediate endogenous resolution by stimulating macrophage phagocytosis of cellular debris and countering the release of proinflammatory cytokines/chemokines.”

“Importantly, loss of inflammation resolution mechanisms plays a role in sustaining pathologic inflammation.”

“Endogenous resolution processes have been identified in the termination of infectious diseases, including influenza, and could thus be harnessed for averting dysregulated inflammation and associated mortality in COVID-19.”

“SPMs (specialized pro-resolving mediators) from omega-3 fatty acids”:

1. stimulate macrophage phagocytosis and efferocytosis
2. decrease pro-inflammatory cytokine production
3. inhibit leukocytosis and thereby decrease the inflammatory infiltrate, and
4. may stimulate the adaptive immune response and the production of anti-SARS-CoV-2 antibodies.”

“Targeting individual pro-inflammatory cytokines may not be sufficient to prevent COVID-19 progression.”

“Importantly, SPMs [specialized pro-resolving mediators from Omega-3 fatty acids] terminate self-sustaining inflammatory processes, such as those induced by COVID-19, by broadly inhibiting proinflammatory cytokine production and promoting a return to tissue homeostasis.”

“Moreover, conventional anti-inflammatory agents such as NSAIDs and COX-2 inhibitors, while limiting the eicosanoid storm, may be “resolution toxic” as they indiscriminately inhibit eicosanoid pathways that produce resolution mediators and thereby prevent active resolution.”

This is why NSAIDS don’t work for chronic back pain or other chronic pain and why they only work for acute pain for a VERY SHORT period of time. NSAIDS “indiscriminately inhibit eicosanoid pathways that produce resolution mediators and thereby prevent active resolution”. NSAIDS inhibit the body’s innate ability to resolve inflammation!!

“Inhibiting resolution mediator production may potentially facilitate COVID-19-induced tissue injury and progression of infection.”

“As demonstrated in many inflammatory disease models, selectively promoting endogenous inflammation resolution mechanisms clears inflammatory exudates more effectively and promotes a return to tissue homeostasis compared with classic anti-inflammatory agents.” OF COURSE!!

Szabo, Z et al. (2020) The Potential Beneficial Effect of EPA and DHA Supplementation Managing Cytokine Storm in Coronavirus Disease. Frontiers in Physiology 11: Article 752

“In the recent COVID-19 (caused by SARS-Cov-2 virus) pandemic a subgroup of patient death is attributed to the so-called “cytokine storm” phenomenon (also called cytokine release syndrome or macrophage overactivation syndrome).”

“LC-PUFAs (long chain polyunsaturated fatty acids) such as EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are noteworthy because of their direct influence in the immunological response to viral infections.”

“Evidence suggests that n-3 LC-PUFAs can modulate the immune response and function in many ways. Among these complex immunomodulatory effects, interleukin-6 (IL-6) and interleukin-1ß (IL-1b) - because of the suspected central regulatory role in the “cytokine storm” - should be highlighted. These cytokines can be affected by dietary EPA and DHA intake.”

“Both EPA and DHA can decrease the secretion of inflammatory cytokines in vitro and animal studies.”

“Pre-supplementation with DHA (400mM) significantly decreased the release of IL-6 and IP-10 by Calu-3 cells infected with Rhinovirus RV-43 and RV-1B.”

“Based on the results of a randomized, controlled study published in 2018, high-dose (1.5 g/day EPA and 1.0 g/day DHA) n-3 supplementation can reduce plasma levels of both IL-6 and IL-1B.”

“The anti-inflammatory effect of EPA and DHA supplementation seems consistent with most of the previous clinical findings.”

“Summary: Based on the available data, the supplementation of EPA and DHA in COVID-19 patients appears to have potential beneficial effect in managing the “cytokine storm.””

“Therefore, the use of EPA and DHA supplementation should be considered as both a supportive therapy and a prevention strategy in SARS-Cov-2 infection.”

An Evidence-Based COVID-19/Influenza Prevention and Risk Reduction Supplementation Protocol


Szabo, Z et al. (2020) The Potential Beneficial Effect of EPA and DHA Supplementation Managing Cytokine Storm in Coronavirus Disease. Frontiers in Physiology 11: Article 752

“Summary: Based on the available data, the supplementation of EPA and DHA in COVID-19 patients appears to have potential beneficial effect in managing the “cytokine storm.””

Therefore, the use of EPA and DHA supplementation should be considered as both a supportive therapy and a prevention strategy in SARS-Cov-2 infection.”

Grant et al. (April 2020) Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths Nutrients 12, 988; doi:10.3390/nu12040988

To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d.”

“The goal should be to raise 25(OH)D concentrations above 40–60 ng/mL (100–150 nmol/L).”

“For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful.”

Bettoun Burris, et al. Retinoid X Receptor Is a Nonsilent Major Contributor to Vitamin D Receptor-Mediated Transcriptional Activation. Molecular Endocrinology 17: 2320–2328, 2003

“In summary, we describe a unique and unexpected facet of intermolecular cross-talk between VDR and RXR and demonstrate that RXR actively participates in RXR-VDR-mediated gene transcription by directly recruiting coactivators in response to 1,25-(OH)2D3.”

In layperson terms vitamin A (retinoid) is required to activate the expression of vitamin D controlled genes. In other words, without sufficient amounts of vitamin A, the actions of vitamin D can be impaired or even blocked. Vitamin A and Vitamin D work synergistically.

Mawson, A. (2013) Role of Fat-Soluble Vitamins A and D in Pathogenesis of Influenza: A New Perspective. Infectious Diseases http://dx.doi.org/10.5402/2013/246737.

“This paper presents a new model of the etiopathogenesis of influenza, suggesting that host resistance and susceptibility depend importantly on the ratio of vitamin D to vitamin A activity.”

“Retinoid [Vit A] concentrations within normal physiological limits appear to inhibit influenza pathogenesis whereas higher background concentrations [i.e., very low vitamin D:A ratios] increase the risk of severe complications of the disease.”

Prietl, B. et al. (2013) Vitamin D and Immune Function. Nutrients, 5, 2502-2521; doi: 10.3390/nu5072502

“Besides enhancing chemotaxis and phagocytic capabilities of innate immune cells, the complex of calcitriol [Vit D], VDR [Vit D Receptor], and retinoid X [Vit A] receptor directly activates the transcription of antimicrobial peptides such as defensin β2 and cathelicidin antimicrobial peptides.”

Vitamin A and D TOGETHER activate the transcription (production/epigenetic expression) of AMPs (anti-microbial proteins) by innate immune cells (macrophages and neutrophils) which KILL VIRUSES.

Levine, SA. The importance of a balanced approach to vitamin D supplementation. Journal of Orthomolecular Medicine. 2011;26(1):15-20.

“Vitamin A and vitamin D balance, enhance, and contain each other through the retinoid X receptor (RXR).”

Because they share a receptor, if we supplement either vitamin D or vitamin A in an unbalanced fashion, we create a functional deficiency of the one not supplemented.”

The Scientific Evidence is Clear that:

1. sufficient intake of omega-3 fatty acids and Vitamins A + D is essential for immune function, especially immune defense against Influenza (flu), Rhino (cold) , and Corona (covid) viruses,
2. deficiencies in these essential nutrients leads to reduced baseline immune defense against these viruses and/or to increased hyper-inflammatory responses to these viruses leading to cytokine storm and Acute Respiratory Distress Syndrome (ARDS)
3. supplementation with sufficient daily amounts (not mega or bolus doses) of these essential nutrients has been clinically shown to decrease inflammation and thus the risk of cytokine storm and/or ARDS and/or to decrease the risk of infection and/or reduce severity of infection from these viruses
4. the Vitamin A and Vitamin D receptors on immune cells (phagocytes and T-cells) require proper synergistic amounts of both Vitamins A and Vitamin D to properly up-regulate these receptors to allow sufficient intake of these vitamins into the immune cells to express proper immune function
5. Innate Choice OmegA+D Sufficiency is the only supplement in the world that combines fish oil, cod liver oil (with naturally occurring pre-formed Vitamins A and D), and extra vitamin D in order to provide sufficient amounts of Omega-3 and Vitamins A and D, AND, provide the proper synergistic amounts of Vitamins A and D

Thus, I have developed the following evidence-based COVID-19/Influenza prevention and risk reduction supplementation protocol and adamantly state that this should become standard of care.

Regular Price = $155; SPECIAL PRICE = $120 + FREE Shipping! 

 

DIRECTIONS FOR USE:

First month4 gelcaps of OmegA+D Sufficiency™ and 12 drops of Vitamin D Sufficiency DAILY.

This provides 10,000 IU/day of Vit D and sufficient and synergistic amounts of Omega-3 and Vit A.


Ongoing4 gelcaps of OmegA+D Sufficiency™ and 2 drops of Vitamin D Sufficiency DAILY.

This provides 5,000 IU/day of Vit D and sufficient and synergistic amounts of Omega-3 and Vit A.


 

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