COVID-19 and Vitamin D

In early September, a study published in JAMA Network raised the stakes on the importance of adequate Vitamin D levels – there may be an association between lower Vitamin D levels and CoVID-19. ​ In this study, researchers from the University of Chicago Medical School (one of the best in the country) looked at over 4000 cases of CoVID-19 and did a retrospective analysis. In the end they recruited 489 patients who had a measured Vitamin D level within a year but more than 14 days before CoVID diagnosis. Interestingly, the vast majority of these patients were non-white women. ​ Those with deficient Vitamin D levels had a 19% incidence of CoVID-19 vs 12% in those with sufficient Vitamin D levels. This finding corroborates what we have long known about Vitamin D: it is important for optimal functioning of the innate immune system. ​ There are many things about this study that make it quite powerful but, as usual, there are also many unanswered questions. I am happy to dive into the gritty details of confounding variables, etc. but for now, I want to leave you all with this take home point: timing is everything. We all could use adequate Vitamin D levels, and now is the optimal time. ​ Seventy percent of Americans will, at some point in their lifetime, be Vitamin D deficient. This deficiency can be attributed to many things: Celiac disease, obesity, diabetes, age, sheltering at home, living in the God-forsaken Northeast Corridor, and other things. While very high doses of Vitamin D can be harmful, modest doses of supplemental Vitamin D may provide some protection against the risk of developing COVID-19. More importantly, low doses of Vitamin D most certainly carry very little harm. ​ Ideally, we would know your Vitamin D level before you begin a supplement. However, insurance coverage for Vitamin D testing is spotty without a known deficiency. We have seen labs charge $300-400 for the test. ​ In the aforementioned study, inadequate levels were defined as a 25-hydroxycholecalciferol level less than 20 pg/ml, or a 1,25 dihydroxycholecalciferol less than 18 pg/ml. These are really low levels. Even pre-CoVID-19, most clinicians would say that any 25-hydroxycholecalciferol under 30 pg/ml warranted supplementation given Vitamin D’s role in calcium absorption and innate immunity. So, my recommendation to OUR practice patients (please consult with your own doctor), is to get levels checked IF you have had vitamin D deficiency in the past (the testing is covered in this setting). ​ If you are not sure of your level, and currently do NOT take a Vitamin D supplement, adding 800-1000 IU per day of Vitamin D3 MAY be beneficial and is most likely NOT harmful. This is especially true as we see our gloriously long summer days dwindling. Less sun exposure means less skin conversion to active Vitamin D levels. Basically, now is as good a time as any. ​ Remember, there really is such a thing as TOO much. More is not necessarily better, and may be harmful. ​ In my house, we have spent a lot of our two decades of parenting talking about risk-reward in terms of behavior; the risk of getting caught driving your mom’s car vs. the very temporary reward of impressing a lovely young lady, for example. Nowhere has this concept of low risk vs. possible benefit been more important than in medical interventions in the era of CoVID-19. Should we take supplements? Should we get our blood types checked? Should we gargle with peroxide? Deciphering the pros and cons of these scenarios is hard but it really does boil down to a simple series of questions. Does the proposed intervention show possible benefit? What is the risk? Is the relative risk low compared to the benefit? ​ Give us a call or send us a portal message if you have further questions. We're here to help.

MMR Booster Series Immunizations

In June, we began following news that a relatively low-risk action may decrease our risk of serious illness or death if infected with SARs-CoV-2, the virus that causes the disease known as CoVID-19. In a paper submitted to Dr. Fauci and NIAID in March, and updated in May, several researchers from world.org describe powerful evidence that the MMR vaccine confers protection against severe disease and death from CoVID-19. This is correlative data, based on well-established, published epidemiological data.

What does this data mean for us? Well first, MMR immunity does NOT protect you from getting CoVID-19 (read that aloud if you need to) – it changes nothing about the urgent need to social distance, mask, hand-wash, and quarantine. But beyond that, understanding what MMR immunity CAN do for you requires some background. And some action. FAST FACTS: Are you a skimmer? Here are the essentials:

• New and emerging research suggests that MMR (Measles, Mumps, Rubella) immune status appears to correlate with a patient's ability to recover from CoVID-19. Higher MMR vaccine use has reduced some countries' rates of death (but not rate of infection).

Antibody Testing Consultations

Our office now consults with patients about the SARS-CoV-2 Antibody (IgG) test. This is not a test for active infection, but the test is great news because:

• We need to know who has antibodies to SARS-CoV 2 so that we can understand what level and duration of immunity these antibodies provide. If immunity is conferred, we can choose our first-line workers with this in mind.