Vitamin D

BANT recommends ‘extraordinary measure’ of Vitamin C and Vitamin D supplementation

BANT recommends ‘extraordinary measure’ of Vitamin C and Vitamin D supplementation for all adults as part of a wider prevention strategy for COVID-19.

With the apparent second wave of COVID-19 worsening, BANT recommends all adults supplement 1000mg of Vitamin C and a minimum of 600-800 IU/d vitamin D3 daily, increasing to a higher therapeutic dose of 5000 IU/d should symptoms develop (1). An adequate intake of Vitamins C and D is vital for immune resilience. Food sources of both are imperative for maintenance but unlikely to provide adequate quantities in case of infection. Supplementation of both nutrients at the given levels is safe, effective, and an inexpensive way to encourage individuals to take preventative measures to support their immune system. Vitamin D insufficiency is especially common in northern hemisphere countries where limited exposure to sunlight reduces our ability to naturally synthesise it through skin. For this reason, Public Health England recommend 10 micrograms of Vitamin D daily throughout the winter months.

Vitamin D is a potent immune modifying micronutrient and deficiency has been shown to correspond to a greater risk of respiratory tract infections, and acute respiratory distress in SARS-CoV-2 infections (1). A recent large meta-analysis (looking at 10,933 people in 25 trials), showed that vitamin D supplementation reduced the risk of cold and flu patients developing acute respiratory infections (ARIs) from 60% to 32% (2). Similarly, hospital data on early intervention with Vitamin D supplementation in SARS-CoV-2 infections reduced severity of the infection and lowered ICU admissions (3). The most abundant food sources of Vitamin D are oily fish, mushrooms and egg yolks. Three foods which are often absent in the nation’s regular dietary intake, and which alone cannot provide adequate levels, reinforcing the possible need for supplementation. In some individuals, testing and supplementation via their general practitioner may be best advised.

Evidence on Vitamin C is equally compelling. A potent antioxidant, Vitamin C plays an immuno-protective role to protect against oxidative damage to the cells, helping moderate inflammatory cytokines and reduce both the severity and longevity of infection (4). Whilst Vitamin C is readily available in foods such as citrus fruits and leafy greens, low storage capacity means a regular intake of it is necessary for adequate plasma levels.

BANT urges the government to make clear recommendations as part of a wider prevention strategy for COVID-19 to empower individuals to make informed decisions about their food choices and need for additional supplementation.

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