Are you thinking about taking vitamin D? If so, you’re not alone. Vitamin D has been plastering the news because of its possible relationship with COVID-19. In addition to mask-wearing, social distancing, and other quarantine measures, taking a vitamin D supplement might just be the next best thing you can do to boost your immune system and protect yourself from infection.
To help you understand exactly what vitamin D is and how it’s connected to the coronavirus, our pharmacists have broken down the current research below. We’ve also included recommendations for how to pick a vitamin D supplement if you (and your doctor!) decide that’s the right choice for you.
Let’s start with the basics: What is vitamin D?
Vitamin D plays a variety of important roles in your body. It is an essential ingredient for the absorption of calcium, which keeps your bones strong. More importantly for COVID-19, vitamin D supports your immune system by enhancing the activity of our immune cells, which act to protect our bodies from foreign organisms that can cause infection. It has also been found in the past that higher levels of vitamin D potentially reduces the risk of cold and flu, and thus, may decrease the chance of contracting viral respiratory tract infections.
While adequate levels of vitamin D strengthens your immune system, inadequate levels can weaken it. For example, deficiency can contribute to a process called “cytokine storm.” Cytokines are a protein with both pro-inflammatory and anti-inflammatory effects. However, sometimes these proteins can “storm,” causing an uncontrolled spike in inflammation, which can then lead to severe tissue damage and other health consequences. Cytokine storms have been linked to more severe cases of COVID-19 as well.
What is the relationship between vitamin D and COVID-19?
More and more studies have been recently released that point to a connection between vitamin D and COVID-19. Some research has indicated that hospitalized COVID-19 patients have a lower risk of severe symptoms and death if they have adequate vitamin D levels. Of the 235 patients analyzed, those with sufficient vitamin D were 51% less likely to have serious side effects such as becoming unconscious, dangerously low oxygen levels, and death.
While no studies have shown that vitamin D can prevent COVID-19, the possibility that the vitamin can at least reduce the risk of severe infection makes it a popular option to strengthen your immune system during this time.
What are the signs and symptoms of vitamin D deficiency?
Deficiency in vitamin D is very common. It is estimated that around 35% of U.S. adults have inadequate levels of the vitamin in their body. These rates jump up to 50 to 60% in patients who are elderly, obese, hospitalized, or living in a nursing home. Unfortunately, those are the same population groups who are at higher risk for severe COVID-19 infection.
So, how can you tell if this includes you? Here are some signs that you might be deficient:
- Frequent illness
- Fatigue and tiredness
- Bone and back pain
- Slow wound healing
- Bone loss
- Hair loss
- Muscle pain
Your doctor can also order a blood test to measure your vitamin D levels. It’s important to note that many of these symptoms are common with other illnesses and conditions, so it’s a good idea to rule out other possible underlying health issues with your doctor.
Certain prescription medications, such as anti-seizure medications, cholesterol medications, oral corticosteroids, and weight loss medications, have also been shown to contribute to vitamin D deficiency. Some common examples include:
- Calcium Channel Blockers: amlodipine (Norvasc), felodipine (Plendil), nifedipine (Procardia, Adalat), nimodipine (Nimotop), and nisoldipine (Sular)
- H2 inhibitors: Famotidine (Pepcid) and cimetidine (Tagamet)
- Estrogens and Hormones: Premarin, Prempro, oral contraceptives, Estrace, estradiol, Estriol, and Estrone
- Corticosteroids: Betamethasone (Celestone), hydrocortisone (Cortef), and prednisone (Rayos)
If you take any of these medications, it may be especially important for you to take a vitamin D supplement.
How do I get more vitamin D?
There are three main ways to get vitamin D: sunlight, food, or supplements. Naturally, your body absorbs vitamin D when your skin is exposed to direct sunlight (it doesn’t count if it’s through a window). However, due to factors such as age, skin color, clouds, smog, and time of year, sunlight is often not enough on its own to give you adequate vitamin D.
Another option is through your diet, although very few foods naturally contain vitamin D. Beef liver, cheese, mushrooms, and egg yolks contain small amounts. Fatty fish such as trout, salmon, tuna, and mackerel have some as well. Additionally, U.S. milk and many other packaged foods (including orange juice, yogurt, and others) are artificially fortified with vitamin D. However, like sunlight, diet alone is often not enough to make up for a deficiency.
That leaves a third option: supplements. Taking a supplement can be an excellent way to make sure you have healthy levels of vitamin D as long as you pick a high-quality option. Specifically, look for a supplement that contains D3 because studies have shown it maintains active vitamin D levels for longer (around 87% more potent).
What is the recommended dose?
Generally, 4,000IU is the recommended dose. However, our pharmacists recommend 5,000IU because most people are so deficient in vitamin D. Honeybee Health also sells vitamin D3 50,000 IU, a convenient high dose capsule that only needs to be taken once a week. It provides an immediate boost and is best for anyone who has trouble reaching and maintaining peak vitamin D levels. Generally, this capsule is not recommended for long-term daily use. By contrast, vitamin D3 5,000 IU is a smaller dose that is taken more frequently, typically daily. The dose you choose comes down to personal preference in terms of how often you want to take the supplement.
Is it possible to take too much vitamin D?
Yes, it’s possible, but it’s unlikely. Because most people are so low in vitamin D, it is generally safe as long as you follow dosing directions from your doctor and/or pharmacist. There is the possibility of vitamin D being unsafe during pregnancy or while breastfeeding when taken in high amounts, so if that applies to you, you’ll need to speak with your doctor.
Does vitamin D interact with any prescription medications?
You do need to follow special instructions if you are taking vitamin D alongside certain prescription medications:
- Antacids and aluminum: Aluminum is found in most antacids and can interact with vitamin D. Take vitamin D two hours before or four hours after antacids.
- Calcipotriene (Dovonex): Because this medication works similarly to vitamin D, avoid taking vitamin D supplements if you are taking calcipotriene.
- Digoxin (Lanoxin): Taking vitamin D with digoxin may lead to an irregular heartbeat.
- Diltiazem (Cardizem, Dilacor, Tiazac): Taking vitamin D may decrease the effectiveness of diltiazem.
- Verapamil (Calan, Covera, Verelan): Don’t take large amounts of vitamin D if you are taking verapamil as it can affect the heart.
- Thiazide Diuretics such as hydrochlorothiazide, indapamide, metolazone, chlorthalidone: Because vitamin D helps your body absorb calcium and “water pills” increase calcium in the body, taking large amounts of vitamin D may cause too much calcium in your body and may cause serious effects on your kidneys.
Talk to your doctor if you take any of the above medications before starting vitamin D, especially since there may be others that interact with vitamin D as well.
So, should I supplement with Vitamin D?
For most people, yes, taking a vitamin D supplement is a good idea. Here’s a quick overview:
- In most cases, it’s a good idea to supplement with vitamin D because of the immune system benefits, and it’s difficult to get enough through diet and sunlight alone. As always, consult with your doctor and/or pharmacist first though.
- When picking a vitamin D supplement, look for one that is D3. This is the easiest form for your body to process.
- As far as dosing, our pharmacists recommend 5,000IU taken daily for most patients. However, it’s important to speak with a pharmacist first to find the correct dose for you.
- Vitamin D3 can interact with certain prescription medications and health conditions (such as pregnancy), so this is another reason to check in with your doctor and/or pharmacist before starting a new supplement.