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Vitamin D Supplementation Improves Cognitive Function: 12-month RCT

414 points| undefined1 | 5 years ago |pubmed.ncbi.nlm.nih.gov

193 comments

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[+] devy|5 years ago|reply
Interestingly, Oxidative stress is considered to the main cause of COVID-19 infection severity, according to Dr. Roger Seheult in his bio-chemistry analysis of SARS-CoV-2 in human body. He also explained why Vitamin D could help reduce the mortality of COVID-19 due to Vitamin's ability to slow down oxidative stress.[2]

Dr. Seheult is the main lecturer of his popular YouTube channel MedCram[3] and is a board certified physician in Internal Medicine, Pulmonary Diseases, Critical Care Medicine and Sleep Medicine.

[1]: https://youtu.be/gzx8LH4Fjic?t=28

[2]: https://www.youtube.com/watch?v=Mdc7T2UTHBI

[3]: https://www.youtube.com/channel/UCG-iSMVtWbbwDDXgXXypARQ

[+] aidenn0|5 years ago|reply
My sister got leukemia while part way through her doctorate. After it went into remission, she was unable to recall new information long enough to read papers and had to put her studies on hold. Eventually a doctor did a blood test that included vitamin d levels, and she was in the single digits (don't remember units but it was supposed to be at least 20). She started supplementing and graduated this spring. Just one data point, but it was pretty clear that remedying a deficiency made a marked improvement in her case.
[+] boyband6666|5 years ago|reply
The interesting analogy Ross Tucker (https://sportsscientists.com/who-are-we/) uses is adding vitamins and mineral is like adding a wheel to a car. If you onyl have 3, then adding the 4th is really going to make a massive difference. If you already have enough however, it's like adding a 5th wheel, which will essentially do nothing, and could be harmful.

It works well as an explanation, as people do seem to try and reduce complex functions to simple rules, and extrapolate from specific populatiosn to create general rules (not helped by studies that are minimally generalisable)

[+] pombrand|5 years ago|reply
Vitamin D is vital for adaptive immune system function too!

When a T-cell encounters a foreign pathogen, it extends a vitamin D receptor. A signaling device allowing it to bind to the active form of vitamin D. Only after this can T-cells perform their intended function. [1]

Which is likely why healthy levels > 40 ng/mL significantly reduce COVID mortality, there's been > 2 dozen obersvational studies and at least one randomized controlled one. [2]

1. von Essen MR, Kongsbak M, Schjerling P, Olgaard K, Odum N, Geisler C (April 2010). "Vitamin D controls T cell antigen receptor signaling and activation of human T cells". Nature Immunology. 11 (4): 344–49. https://doi.org/10.1038/ni.1851

2. Entrenas Castillo, M., Entrenas Costa, L. M., Vaquero Barrios, J. M., Alcalá Díaz, J. F., López Miranda, J., Bouillon, R., & Quesada Gomez, J. M. (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". The Journal of steroid biochemistry and molecular biology, 203, 105751. https://doi.org/10.1016/j.jsbmb.2020.105751

[+] treeman79|5 years ago|reply
Similar story. My mind was in fragments from diseases. Vit D in low teens. Started high level vit D at start of Covid Brain function is approaching my old levels. Now I take a lot of supplements, so it’s always tricky to pin it down. But so far so goods.
[+] ezekiel68|5 years ago|reply
Funny -- I was just digesting a competing study released recently[0] which showed little-to-no benefit from vitamin D, Omega 3 fatty acids, and exercise (either alone or in combinations). That study used 5X the daily vitamin D as this one. So I guess the jury's still out and I may choose to continue to err on the side of supplementing vitamin D.

[0] https://www.upi.com/Health_News/2020/11/10/Study-Little-bene...

[+] amanaplanacanal|5 years ago|reply
> 40.7% of participants had 25(OH)D levels of less than 20 ng/mL at baseline, and according to current guidelines, all were allowed to take 800 IU/d of supplemental vitamin D outside the study medication.

So, even the controls were given D3 supplements if they were deficient. That kind of throws the whole study into question.

[+] sachdevap|5 years ago|reply
I have not looked at the underlying study, but that article definitely does a terrible job of being clear on the caveats of the study. E.g. this nugget was left for the last paragraph of the article:

"Our exercise intervention was a simple home strength exercise program, which likely was not challenging enough in our unexpectedly active study population, where over 80% already engaged moderate to high intensity exercise," she said.

I would take anything from this study with a pinch of salt. I doubt if it was a well controlled study.

[+] rustamm|5 years ago|reply
One important factor in vitamin studies is the prevalence of vitamin deficiency in a particular population. E.g. vitamin D in the US might not be as effective because it is already added into many food products, e.g. milk, which is not the case for other countries.
[+] dilap|5 years ago|reply
Or just get some sunshine! It's likely there are other benefits, besides just the vitamin D.
[+] msandford|5 years ago|reply
There's a big difference between the amount you need to not get rickets (around 100 IU) and the amounts that seem to move the needle on other outcomes (2000 IU or more). The study used 800 IU which to me, isn't great.
[+] ve55|5 years ago|reply
It's worth noting that vitamin D has a lot of high-confidence but low-effect results going for it, including a lot of strong meta-analysis over many health outcomes. What I mean by this is that it usually seems to conclusively either do something beneficial, but minor, almost nothing in the case of many studies, and in the case of some others, something very beneficial (as we've seen a few of in relation to covid recently).

Although Vitamin D isn't a particularly exciting supplement most of the time, that isn't enough of a reason for us to ignore it, as the proper way to make the decision of taking it or not would be to perform a cost/benefit analysis (as we should with any other supplements, lifestyle changes, etc).

The costs of vitamin D are just about as low as any supplement gets, and can be between $0.01 and $0.05 per day. The non-financial costs such as side effects or potential adverse effects are practically non-existent as well. So I do think that even those that have a healthy bit of skepticism over some results should still consider supplementation - there are a lot of potential benefits even if some are minor, and almost no risks or real costs. The optimal way to supplement is to get a blood test before+after starting supplementation in order to be confident you're taking the correct amount, but this isn't required of course. But I think the cost/benefit analysis is clearly in favor, so I didn't hesitate to add Vitamin D to my list of supplements that I take daily (https://nearcyan.com/supplements/ if curious), along with many others at this point.

[+] batushka3|5 years ago|reply
I've looked up your list and remembered great movie Vitamania. Most striking part was that to people living in space, no suplements are provided except vitamin D. Every other is gained from various food they eat. And the supplement industry is barely regulated and HUUUGE in US.
[+] ip26|5 years ago|reply
almost no risks or real costs

I worry a little about risk compensation, or whatever the equivalent is for diet. That is to say, if I feel like I'm all set on vitamins & minerals via pills, maybe I don't need to try so hard to eat my fruits & vegetables anymore...

[+] wavegeek|5 years ago|reply
As with this study the dose used is often quite low, driven by paranoia about overdoses. Other studies have been very short term, had small numbers of subjects and thus would only find very large effects, or used large irregular "bolus" doses which are very bad and no longer used.

I went through one meta-analysis and found only 3 of about 35 studies that were actually useful. So take a close look at the methods section of the paper. You don't just read the abstract, do you? Do you?

Why 600 IU / day is not enough:

1. Meta-analysis that concluded this was faulty due to back statistical analysis and understated need by a large factor Nutrients 2014, 6, 4472-4475; doi:10.3390/nu6104472 "A Statistical Error in the Estimation of the Recommended Dietary Allowance for Vitamin D" by Paul J. Veugelers and John Paul Ekwaru

2. Lactating women who get only the RDA have vitamin D deficient milk. This makes no sense if the RDA is valid

3. When people go out in the sun their bodies produce up to 10,000 IU per day but not more. Why produce all that Vit D if it is not useful?

Sorry I am away from my paper trove so I do not have the cites for 2 and 3.

[+] bsder|5 years ago|reply
> and almost no risks

This isn't true--especially for Vitamin D. We have several doctors at this point who deal with cases where too much Vitamin D causes Calcium uptake issues and affects cognition and heart function.

Vitamin D is NOT something like Vitamin C. Your body easily dumps excessive Vitamin C so you can take fairly massive doses with no real ill effects.

Your body has a much tougher time excreting Vitamin D--so large doses of Vitamin D can cause issues and accumulate.

[+] cassepipe|5 years ago|reply
"The non-financial costs such as side effects or potential adverse effects are practically non-existent as well."

This not accurate. I remember that there was an article on the front page of Hacker News an article that explain that Vitamin D is actually a hormone and telling the story of woman that had been prescribed high level of supplementation that could not talk anymore. It had something to do with her calcium intake regulated by that hormone. Luckily she was so distressed she stopped taking the supplementation but still it took her six months to get back to to talking normally and a normal hormone concentration level.

EDIT : I found the article : https://news.ycombinator.com/item?id=24261948

[+] jimrandomh|5 years ago|reply
This sounds like an important study, but unfortunately it is effectively unpublished; neither Google Scholar nor Sci-Hub is able to find the full text. I'm not willing to trust it without reading the methodology section, and I'm not willing to pay $32 to read it.

If any of the study authors happen to read this: pay close attention to how you publish, the journals will destroy all the value of your study in exchange for a few bucks, if you let them.

[+] JohnJamesRambo|5 years ago|reply
>2020 Nov 4. doi: 10.3233/JAD-200926. Online ahead of print.

Give it time.

[+] jzer0cool|5 years ago|reply
Anyone have experience using any nootropics or something else that helped with cognitive function? Some friends I know have tried adderall during school and I was curious your experience with any of these.
[+] maliker|5 years ago|reply
Effect size... around 5% improvement in the FSIQ score. Not very big.

Although the dose of 800 IU/day was small.

[+] kstrauser|5 years ago|reply
Thanks for the summary! On the other hand, I'd take a 5% bump basically for free.
[+] ineedasername|5 years ago|reply
That's interesting, but they claim the effect was "substantial" and it was statistically significant, but they do not provide the magnitude of the difference. They do not provide the experimental group's baseline metric for cognitive function and the increase.

It also doesn't mention anything about how it controlled for patients' initial levels of vitamin D, or what those levels were. There could be a threshold effect, for example, where raising levels to X produce the result observed, or a linear relationship between D levels & cognitive function...

Certainly the full extent of things like this would require additional research, but the basics would be known just from the data collection on the patients and their results.

I'm not saying I doubt the research: I know vitamin D has some interesting and diverse impacts on the body, so this result would not surprise me if it's true. But the abstract was lacking in important details. (And unfortunately the university library to which I have access does not have this journal in its databases)

[+] stjohnswarts|5 years ago|reply
You know I use a vitamin d supplement because I'm not a big outdoors guy and I livein the northern USA and I was deficient at my last annual inspection. That said why does HN seem to have a vitamin D story everyday? It's not a magic pill. If you have deficient levels you should do something about it, but it's not a cure all.
[+] lopis|5 years ago|reply
Lately it does effectively sounds like a magic pill.
[+] InterMilan|5 years ago|reply
HN seem to love three health subjects:

1 - Vitamin D

2 - Fasting

3 - Did I mention fasting?

[+] iambateman|5 years ago|reply
This is specifically for older adults, not a general result.

Still seems promising, though.

[+] cyrusmg|5 years ago|reply
This study was done in China. It is important to know the locals behaviour with regards to natural Vitamin D source (the Sun). Locals do not like to have "too dark skin" and as such are using sun screen with factor 50 and try avoid sunshine altogether.

This study might have different results in other parts of the world.

[+] AntiImperialist|5 years ago|reply
Why does it have to be supplementation?

Nutrition science is mostly unreliable because it is difficult to study, is very limited and progress is slow. The supplementation industry capitalizes on this ill-reported junk science.

For many years, vitamin D2 was sold as supplementation. Now it is well-known that D2 is not bioavailable to humans. Similarly, it is well-known now that even D3 is mostly useless without K2. Now, some D3 supplements come with K2. Who knows what we'll find in the future?

Even more ridiculous is iron. The iron in spinach is basically rust. It is not bioavailable to humans. Not only that, it induces oxidative stress in humans. Ever heard you need anti-oxidants? You do, if you've been eating spinach or cereal fortified with rust or supplements with such iron. Our body needs a specific organic compound of iron: heme. You can't just swallow a nail and get iron from it.

Vitamin A, D, E, K are all available in animal fat, in exactly the forms we can readily absorb. Animal fat has been a crucial part of diet for every human culture forever. There has never been a single exception... until recently when junk science and industry PR started selling seed oil as a "healthy" replacement. As a result, a large portion of population is deficient in these vital nutrients.

Seed oil is highly problematic because... it's seed. Not only does it have no nutrients, plants don't want you to eat their seed. That is the one thing plants don't want you to eat, more than anything else. That is why they pack it with the most dangerous toxins they can come up with.

Nutrition science is hard but nutrition is easy. Just eat what humans have been eating for thousands of years.

[+] shajznnckfke|5 years ago|reply
I read that there is 15 UI of vitamin D in a steak. You need 25 or 100 times that per day. It’s more likely that humans evolved to get their vitamin D from sunlight (although we also know that introduces cancer risk) than eating a whole cow every day. It seems like you’re trying to make the facts fit your preferred narrative re. meat consumption.
[+] jdkee|5 years ago|reply
My wife has noticed that her severe COVID patients all have vitamin-D levels in the single digits. YMMV.
[+] LimitedInfo|5 years ago|reply
There was a thread on here the other month about a chronically ill person who was accidentally overdosing on Vitamin D. I believe the conclusion of the piece was don't take copious amounts of Vitamin D and assume no side effects.
[+] wlll|5 years ago|reply
Check the amounts. ISTR the person that you mentioned was taking a substantially higher dosage than was tried in this study.
[+] oksurewhynot|5 years ago|reply
what is the deal with hn and vitamin d
[+] dageshi|5 years ago|reply
As a group of people who spend large amounts of time infront of a computer and not outdoors we're all particularly vulnerable to deficits in vitamin D.
[+] 1996|5 years ago|reply
It's hacking the body!
[+] dkural|5 years ago|reply
FWIW It seems to published in a journal with a company that also publishes studies showing how music can help Alzheimer's etc. Not a particularly reputable source.
[+] MattGaiser|5 years ago|reply
Is music helping Alzheimer's patients considered implausible?
[+] intricatedetail|5 years ago|reply
I had been taking D for almost a year every day. (4000 dose) and wasn't feeling well at all. Once I stopped D and take it occassionaly I feel much better.
[+] partyboat1586|5 years ago|reply
Did you take a soft-gel or hard tablet?
[+] amai|5 years ago|reply
...in Older Adults with Mild Cognitive Impairment
[+] kobayashimaru|5 years ago|reply
Milk and sunshine probably cheaper
[+] reducesuffering|5 years ago|reply
Vit. D supplementation is dirt cheap. Like $15 for a years worth. That’s a lot cheaper than milk.
[+] aantix|5 years ago|reply
You're not walking around naked like our ancestors? Do you use sunscreen in the summer? Work indoors?

We're shielded from most of our potential Vitamin-D intake.

[+] kevinmchugh|5 years ago|reply
Milk contains 100 IU vitamin D per cup in the US. A typical supplement dose is 2000 IU.