Who knew? BillyBob knew!

BillyBob, If you search on "billybob vitamin d" there are over 200 results which you can order by date or relevance. Or maybe you did that and couldn't get to the beginning of the 4508 posts.

BillyBob@388 said...
So over all, close to 1/2 the population was WAY below the suggested MINIMUM of 30, IOW they were below 20. If 42% were below 20, that means most likely that a much larger % was below 30.

I guess I wasn't very explicit with my post. What I was actually interested in was the vitamin D deficiency rate of the population that this hospital in Spain serves. The study reports 80% of the Covid-19 patients had Vitamin D deficiency. If 80% of the feeder population also had a deficiency, then this report tells us nothing. If it's 50% as your reference (for the USA) suggests, then there appears to be a lesser correlation than the headline of that report seems to suggest. If the general population had only 5%, then WOW!

Now, there's also lots of other things that have to be statistically accounted for... age, co-morbidities, mask wearing, etc. Maybe they did that in the full report but I can only read the abstract.

I don't mean to throw a wet blanket here, however, as I am a believer in Vitamin D (unless science tells me differently).

...Jerry

GreenBeans said...
BillyBob, If you search on "billybob vitamin d" there are over 200 results which you can order by date or relevance. Or maybe you did that and couldn't get to the beginning of the 4508 posts.

Thanks, GreenBeans. I have done that, and like you said, so many posts that it is not easy finding. What I need is just a listing of threads I have started, then I could maybe tell by the titles when I first mentioned specifically D and CV-19. Now, for the more general topic of acute respiratory infections( which includes CV-19), no problem. I see those going back to at least 2017. Here is one:
https://www.healingwell.com/community/default.aspx?r=q&f=35&m=4223138#gsc.tab=0
"...........But while that is the headline, and even though both groups are well supplemented, there is a little detail that seems to not be highlighted: When it comes to the much more important flu (and I bet all these kids had flu shots) "Incidence of influenza was 50% lower in the high-dose D group (IRR, 0.50; 95% CI, 0.28-0.89), but only 16 cases (4.4% of all infections) occurred in that group, and only 31 (8.5% of all infections) occurred in the standard-dose group.". 50% lower? Good grief, I bet it is not that much lower with flu shots! And if higher dose( of D ) compared to just high dose was 50% lower, wouldn't you love to see the flu incidence for zero supplementation, especially since they say "supplementation is not indicated to prevent such infections."? Why wasn't "flu reduced 50%" the headline?........."

But I'm not going to going to spend much more time trying to prove something that doesn't need proving anyway. Because it does not matter at all. All that matters is how tickled I am that someone besides my wacko self is bringing the subject up. Like I said, I saw it twice in one day on local TV news, where they mentioned two of the what must be close to by now 2 dozen studies. Yay! Maybe I just missed it previously. But I watch a lot of TV news. And except for a few weeks ago when they were discussing that part of Trumps treatment in the hospital included D, zinc and melatonin, two or three nights ago was the first I've ever heard of it. So that is something. Word is getting out, and that will probably save lives.

Of course, word should be getting out, because I've mentioned before that I have been posting every one of these studies to FB. And I have had people contacting me, including at least one retired MD I worked with for years, asking about doses. And I can't be the only crazy person in this country who has been bugging people and trying to spread the word about D and such.

Now, where is some word, yay or nay, on IV vitamin C? I mean, other than the 1/2 dozen or so critical care docs I know of who have been using it from the beginning, where are some of the studies, and mention on the news? Those docs won't do placebo controlled trials, because it is unethical, after they had seen such dramatic results, to let patients die. By not giving them IV vitamin C and giving them placebo instead. But I know a couple of trials have been complete by now, and I am waiting for the results. D has at last been proven solidly enough to justify minimal risk and cost. The new frontier is IV C, if the studies finally prove it.

https://covid19criticalcare.com/


As a group of colleagues with over 200 years of combined experience in Critical Care and Emergency Medicine, as well as long-standing shared interests in developing effective treatments for critical illnesses including sepsis, we formed a working group devoted to creating a treatment protocol against COVID-19. The protocol we devised, called “MATH+” is intended for use in the hospitalized patient, with an emphasis on early initiation — as soon as the patient develops a need for supplemental oxygen.

In the hospitals that have adopted the protocol and initiated it early in the treatment of patients, both state and medical center data reporting the mortality of COVID-19 patients treated in these hospitals compares strongly with COVID-19 mortality rates published in studies from around the world. Although these data are in evolution, the MATH+ hospitals have been reporting hospital mortality between 4% and 10% (as of July 2020) while the hospital mortality from published reports in the US, Italy, and China average approximately 23%..............................
The two main therapies that can reverse and/or mitigate the extreme inflammation causing ARDS are the combination of the corticosteroid Methylprednisolone and the antioxidant Ascorbic acid, which is given intravenously and in high doses..............".

So vitamin D is milk soluble...another thing I dont quite understand...soul be...that pesky quantum theory ok ok I will quit while I am behind

Pratoman said...
So while,we are talking about Vitamin D and how important it is, I take 5000iuS and like to keep an eye on my levels, which last time I tested came back at 39. So since I was going fir routine bloodwork at LabCorp in advance if my 6 month checkup next week with my PCP (no PSA, I crossed it off the lab order), and I get to LabCorp this morning, they tell me that both Vit D test and A1c are not covered by Medicare. ***. I TOLD THEM TO DO THE A1c, it was only $65, but they were gonna charge me $266 for the Vit D rest, so I passed.
Never had this problem before. I’m guessing it was The way the Dr wrote the scrip

$265? Bloody heck! Not covered(along with A1C) by MC? Why am I not surprised?

Links, charts, etc. at the url linked at the bottom.

==========================================

Vitamin D for COVID? We've Been Burned Before

Welcome to Impact Factor, your weekly dose of commentary on a new medical study. I'm Dr F. Perry Wilson from the Yale School of Medicine.

I have a bit of a love-hate relationship with vitamin D.

A brief search of my blog will show how I have questioned the links between vitamin D and multiple sclerosis, kidney disease, schizophrenia, falls, and childhood educational attainment.

So it's no surprise, in the COVID era, that vitamin D comes up again. I was intrigued when Dr Anthony Fauci, a sober and responsible voice if ever there was one during this pandemic, reported his personal use of vitamin D. Vitamin D was also part of the presidential cocktail that Trump received during his stay at Walter Reed.

I decided to dig into the data here. But before we do, I want to tell you why I am inherently skeptical of vitamin D studies. There are two main issues:

1. Low vitamin D levels have been linked to so many things. Vitamin C deficiency causes scurvy — fine. But low vitamin D has been linked to everything from Alzheimer's to whooping cough. It's either the most important vitamin in the world or it's a stand-in for some other important thing.

2. When we've tested all of these intriguing links via randomized trials, giving some people vitamin D and some placebo, they almost always showed no effect.

I feel a bit like Charlie Brown with the football here. Vitamin D has burned us before. A couple of examples:

Multiple observational studies found that people with low levels of vitamin D were more likely to develop cancer and cardiovascular disease. These were good studies, adjusting for appropriate confounders — the whole deal.

Then we got a 26,000-patient randomized clinical trial. No effect on either outcome.

Observational studies suggested that low vitamin D levels were linked to the development of diabetes. Then we got a trial of 2400 patients with prediabetes. Vitamin D supplementation had no effect.

Observational studies have found that low vitamin D levels are linked to falls. The randomized trial found no such effect. (Exercise did prevent falls, though.)

Does vitamin D save lives in general? Not really. The Women's Health Initiative Trial randomized 36,000 postmenopausal women to vitamin D vs placebo and saw no survival benefit.

Look, I'm not saying that vitamin D doesn't have its uses or that it may have some limited benefit. Randomized trials are rarely as dramatic as observational data promise. But I can't think of another exposure that has such a wide disconnect between observational and randomized data.

Why is that?

Because your vitamin D level is a marker of the type of life you live, and it's really, really hard to adjust for that. Sure, you can ask people how much sun and exercise they get, how varied their diet is, how much money they make — but these are pretty blunt tools.

Okay. Keeping all of that in mind, what do we know about vitamin D in COVID?

Just this week, in the Journal of Clinical Endocrinology & Metabolism, we got this study out of Spain that found that of 216 hospitalized patients with COVID-19, 80% were vitamin D deficient. Only 40% of controls were deficient. Of course, the controls weren't hospitalized. Or sick, actually.

But okay, better study. Back in September, which as of this recording was like 10 years ago, we got this study out of Chicago showing that of 489 patients with prior vitamin D testing, those who were vitamin D deficient had a 1.77 times higher risk of contracting COVID-19.

This study in PLOS One found that among 235 hospitalized patients, those with vitamin D levels less than 30 ng/mL had a 20% death rate compared with 9.7% in those with higher levels. I should point out that this article was flagged with an "expression of concern" for some data weirdness.

Okay, so we have multiple observational studies — and Anthony Fauci, for crying out loud — saying we should consider vitamin D.

And why not, really? It's cheap. It's got a pretty benign side-effect profile (though the nephrologist in me worries about kidney stones).

But when it comes to COVID, multiple factors associated with low vitamin D levels are also associated with COVID-19 infection and severity: older age, BMI, Black race, poverty, comorbidities. It's just really hard to appropriately account for all of this stuff statistically.

So I'm gun shy on vitamin D. I'd love a randomized trial. Right now, we have one. Two, if you squint.

The one randomized trial is this one, out of Spain.

A small study, 76 patients hospitalized with COVID-19, were randomized in a 2:1 ratio to vitamin D + azithromycin + hydroxychloroquine (don't get me started) vs azithromycin + hydroxychloroquine alone. Of the 50 people in the vitamin D group, just one went to the ICU. Compare that with 13 of the 26 in the non-vitamin D group.

There were zero deaths in the vitamin D group and two in the non–vitamin D group. I should note that the non–vitamin D group was a bit higher-risk at baseline, with more individuals with diabetes and hypertension. But honestly, it's the effect size that surprises me here. I mean, reducing the risk for ICU admission from 50% to 2%? That's just a staggering amount. So we're in the space of: Is this a miracle drug or is there a problem with the study we don't know about? And miracles are in short supply these days.

Just to throw some cold water on that study, we have this one, still in preprint, which used Mendelian randomization to look at whether vitamin D might have a causal link with COVID severity in over 400,000 individuals.

In this study design, you compare people who are genetically predisposed to lower vitamin D levels with those who are not. That takes lifestyle stuff out of the equation. Interestingly, people genetically destined to have low vitamin D levels were less likely to be hospitalized with COVID-19 or to develop severe disease. Not peer-reviewed yet, grain of salt, etc.

Bottom line? We know that people with low vitamin D levels are at higher risk for bad outcomes in COVID-19. We still don't know whether vitamin D supplementation will change that risk. There is some promise here, but the lifestyle vitamin has burned us before, so proceed with 400 international units of caution.

F. Perry Wilson, MD, MSCE, is an associate professor of medicine and director of Yale's Program of Applied Translational Research. His science communication work can be found in the Huffington Post, on NPR, and here on Medscape. He tweets @methodsmanmd and hosts a repository of his communication work at www.methodsman.com.

https://www.medscape.com/viewarticle/939759

Prato - My A1c is covered by Medicare + BCBS supplement when done at GP's clinic for screening purposes. Medicare statement said $41 billed, Medicare paid $9.71. Could not find any BCBS corresponding claim though for that date. Don't know how it works exactly but I have never paid for any lab tests since being on Medicare + Supplement. I know it is possible but none to date and I have had a lot of blood tests and shots over last couple of years. Heck, my annual eye checkups are covered fully in some manner and I know that Medicare does not cover the vision test part. I think BCBS picks up some things to a certain amount but it is hard to spend a lot of time figuring it out when you never owe anything.

Again: Prat, you, me, and everyone else here has PCa, and perhaps other comorbidities i.e. high blood pressure, diabetes, heart issues etc. Therefore, if, God forbid, any of us contracted Covid-19, and expired, there is no way to know whether a deficiency in vitamin D, aided our demise. Therefore, when you say vitamin D does this, or does that, you've no real proof of that. It is your opinion. That is fine. That is your right. God bless you.

BTW I'm not claiming to be the first. I am the first. Just go back and reread the fake news thread. But, as I said, I was joking above when I said you believed vitamin D cures baldness, gives you an erection, etc. You can wear the D crown. I want, nor deserve, a ticker tape parade. I merely posted Dr. John Campbell's theories. As you say, he might be right, he might be wrong.

One last thing on Dr. Perry Wilson's cautions against taking D because he has been burned with D and the previous RCTs. I have had some threads here in the past about questionable studies. So often it is the case that they do a study and when you dig nto the details you have to say "why in the heck did they that" Many examples like not preventing the so called placebos from taking their own D, or both controls and interventions median baseline D levels show that many had obviously been supplementing. Or using a lower dose of D as the "placebo". Or using a tiny dose of D, way less than sunshine would generate. Etc, ad infinitum. So maybe not all, but I know that some studies that have burned us were either stupid or biased studies. Regardless, we have some pretty good controlled trials now, one of which he mentioned.

On a related note: I can only assume the forum was "dead" and Tupdock wanted to get some action going in starting this thread (which has a lot of views, more than any other recent thread). Bravo Jim. I salute you. Everyone loves action.

There is so much here, I could not read all of it.to your point buddy, I like to keep things simple. All I know and care about is normal range Vit D is better than low Vit d.so I like to get checked at least once a year.

I’ll,just tell my Doctor to test in his office and use whatever code he needs to use to get it covered. Failing that, I’ll wait till I get to Florida in December and do it on my own for dirt cheap.
What a system🙄

Exhibit A

Buddy Blank said...
Again: Prat, you, me, and everyone else here has PCa, and perhaps other comorbidities i.e. high blood pressure, diabetes, heart issues etc. Therefore, if, God forbid, any of us contracted Covid-19, and expired, there is no way to know whether a deficiency in vitamin D, aided our demise. Therefore, when you say vitamin D does this, or does that, you've no real proof of that. It is your opinion. That is fine. That is your right. God bless you.

BTW I'm not claiming to be the first. I am the first. Just go back and reread the fake news thread. But, as I said, I was joking above when I said you believed vitamin D cures baldness, gives you an erection, etc. You can wear the D crown. I want, nor deserve, a ticker tape parade. I merely posted Dr. John Campbell's theories. As you say, he might be right, he might be wrong.

Exhibit B

Buddy Blank said...
Heavy is the head that wears the crown.

In your zeal to promote a magic bullet, in this case a vitamin, you misread Wilson.

You desperately want vitamin D to have properties it hasn't been proven to have. There's no proof - zero - that vitamin D helps anyone with Covid-19, or anything else.

https://twitter.com/methodsmanmd/status/1321857578348019713

As I said, and will keep saying: those deficient in vitamin D re: Covid, and died, had comorbidities. There is zero proof that the lack of vitamin D was a cause of their demise.