"Vitamin D" Against Coronavirus

Vitamin D deficiency is among the most common vitamin deficiencies seen in our country and globally. While approximately one billion people worldwide are estimated to have vitamin D deficiency, this deficiency, which occurs at a rate of 60-70 percent in Turkey, is known to seriously affect health. Due to the weakening of the immune system, people with vitamin deficiency have a significantly increased risk of contracting infectious diseases, including flu infections, and of experiencing these diseases more severely.   With the coronavirus pandemic, experts drawing attention to a strong immune system point out that vitamin D strengthens the immune system, reducing the risk of contracting the disease, and if contracted, enabling milder progression.   Deputy Chief Physician at Maltepe University Hospital and Family Medicine Specialist Dr. Associate Professor Şevin Demir explained in detail the importance of vitamin D, how its deficiency is understood, the harm of excess, and through which methods supplementation can be provided. Noting the importance of vitamin D, which regulates calcium and phosphorus levels, for bone and muscle health, Dr. Demir stated, "Vitamin D regulates the heart's healthy contraction and relaxation, reduces the risk of developing hypertension and insulin resistance. By playing a role in our immune system, it enables the prevention of autoimmune diseases and reduction of inflammation, and is effective in our respiratory system's fight against viruses."

WHAT SHOULD VITAMIN D LEVEL BE?

Dr. Demir stated that vitamin D deficiency or excess can be understood through a simple blood test and that supplementation use must be carried out with a doctor's recommendation. Noting that excess vitamin D in the body can lead to poisoning, Dr. Demir said, "Clinical findings emerge according to the degree and duration of vitamin D deficiency. In addition to a decrease in bone mineral density, osteomalacia, meaning a reduction in bone durability, widespread bone-muscle pain, bone sensitivity, muscle weakness, walking difficulty, and fractures may develop."

STRENGTHENS IMMUNE DEFENSE

So what is the importance of vitamin D against coronavirus? Dr. Demir said that vitamin D strengthens immune defense by increasing the release of certain substances that lead to the destruction of viruses, thereby helping to eliminate these viruses. Noting that the ACE2 receptor, which is the receptor through which the Covid-19 virus binds to cells, plays a protective role in the development of the complex symptoms of this viral infection, Dr. Demir stated, "It is thought that vitamin D increases the production of ACE2. There is also evidence that vitamin D may reduce the proliferation of most other respiratory viruses. This is supported by clinical data showing that vitamin D has a preventive role against viral respiratory infections, particularly in patients with very low vitamin D levels."  

DISEASE PROGRESSES MORE MILDLY

Dr. Demir emphasized that there is not yet sufficient evidence regarding the relationship between vitamin D levels and severe progression of Covid-19 or mortality rates, but that there are many ongoing studies. Stating that it is possible to say the disease has positive effects on its course when studies conducted to date are taken into account, Dr. Demir said, "The protective effects of vitamin D support against respiratory infections have been demonstrated. For this reason, during the pandemic period, we want to raise vitamin D levels above 30 ng/ml. At our hospital, we provide supplementation to all patients whose vitamin D levels are inadequate."  

CORRECT DOSAGE IS IMPORTANT

Noting that vitamin D supplementation will not prevent us from contracting the disease but will enable us to be stronger while fighting the disease, Dr. Demir drew attention to the words of Paracelsus, an important scientist of the 16th century and considered one of the founders of modern medicine: "All substances are poison; it is the dose that distinguishes poison from medicine." Emphasizing that even water, which is most necessary for our survival, cannot be consumed in amounts of 20 liters, Dr. Demir gave the following answer to the frequently asked question about how much vitamin D supplementation should be taken: "Taking the daily maintenance doses contained in multivitamins is not a problem, but if high doses are to be taken, a level measurement is absolutely necessary beforehand."  

THE SUN IS THE GREATEST SOURCE OF VITAMIN D

Ten to 20 percent of vitamin D is obtained through food. Eighty to 90 percent is synthesized in the skin through the effects of UVB rays. Noting that vitamin D synthesis occurs between the months of May and November at Turkey's location, Dr. Demir stated: "Since the appropriate ray angle is between 10:00-15:00, we recommend sun exposure during these hours for vitamin D synthesis. In summer, if the entire body is exposed to sunlight during appropriate hours in a way that creates slight pinkness on the skin; vitamin D synthesis occurs in the skin at a level equivalent to approximately 20,000 IU of vitamin D taken orally. If only the hands, arms, and legs are exposed to the sun, it provides approximately 3,000 IU of vitamin D synthesis. In a person with light skin color, slight pinking of the skin can be achieved in 15 minutes, while in a dark-skinned person this period can be 3-4 times longer. The use of sunscreen creams with a factor level of 15 or higher prevents sun rays from reaching the skin. Sunbathing behind glass and curtains also prevents vitamin D synthesis. If the level of vitamin D we secrete from sun exposure is below desired, supplementation is needed."

KEEP YOUR VITAMIN RESERVES FULL

Dr. Demir noted that it should not be forgotten that during the pandemic period, since we have stayed home and been exposed to less sunlight, our vitamin D levels may have decreased further. Noting that during this period less movement has occurred, more junk food has been consumed, and routine checks for chronic diseases such as diabetes and hypertension have been neglected due to concerns about hospital risks, Dr. Demir made the following recommendation: "We know that the stronger and healthier we are while fighting this virus, the more easily we can defeat it. For this reason, our chronic diseases must be under control, and our body's vitamin reserves must be sufficiently full."