Vitamins C + D

The world is aching right now. Life as we know it is changing and our well-being is of the utmost importance, which means it’s time to take even better care of ourselves and control what we can; whether it is improving your diet or incorporating more exercise into your routine on a daily basis. One way we are improving our daily health regime at O2 is adding more Vitamin C and Vitamin D into our diets. This is a small, but effective, way to improve the body’s immune system. We turned to Nurse Practitioner, and Doctoral Student in Nursing, Nicole Eloff for an education on two vitamins so important to our everyday lives.

What is Vitamin C, and how can it help with Covid-19?

Vitamin C (ascorbic acid) is an important antioxidant vitamin that has many essential functions in the body. This super vitamin is responsible for helping to generate collagen and enhance wound healing, while helping to promote skin, bone and dental health. Vitamin C is an essential immune-boosting vitamin evidenced by it’s properties that enhance immune cell integrity and function. Vitamin C is not produced by the body and needs to be consumed in our diet through the food we eat or through supplements.

While data to support the efficacy of Vitamin C in the prevention and treatment of other viral illnesses is not conclusive, we are seeing beneficial outcomes in the treatment of Covid-19 patients with high dose intravenous Vitamin C.  Current studies are underway in the United States and China examining the association between Vitamin C infusion and Covid-19 complications. While it is too soon to extrapolate from the 2020 Covid-19-Vitamin C data, the decision to treat hospitalized Covid-19 patients with high dose IV Vitamin C is supported by the CITRIS-ALI Clinical trial, a randomized-controlled trial study published in 2019.  The study found that patients with sepsis and Acute Respiratory Distress Syndrome (ARDS) treated with IV Vitamin C had similar 4-day rates of organ dysfunction as the placebo group, BUT had a significantly lower death rate at 28 days post-infection. In context of the similarities between ARDS and severe Covid-19 complications, this gives us reason to utilize this long-heralded antioxidant vitamin in the prevention and treatment of Covid-19.

What is Vitamin D, and how can it help with Covid-19?

Vitamin D is an important fat-soluble antioxidant that plays essential roles in regulating skeletal bone metabolism and electrolyte balance; Vitamin D is also active in maintenance of bowel health, mitigation of inflammation, and promotion of adaptive and innate immune functions in the body. We believe Vitamin D supports the immune system by stimulating production of an innate substance called cathelicidin, an antimicrobial protein that assists our bodies in fighting infection.  Vitamin D also supports specific immune cells called macrophages and T-cells in signaling pathogenic presence in the body. Vitamin D can be consumed in the diet as ergocalciferol or cholecalciferol (Vitamin D3).

In addition to general immune system support, there is research to suggest that Vitamin D supplementation to normal or above-normal levels, decreases an individual’s risk of developing an acute viral or bacterial respiratory infection (ARI) such as tuberculosis, ARDS, and Chronic Obstructive Pulmonary Disease (COPD) by 12% (Martineau et al., 2017).

What kind of dosing are we talking here?

For the next few weeks of the Covid-19 upswing in the “curve,” you should focus on consuming 2,000-5000 mg of Vitamin C daily, and 2,000-5,000 iµ of Vitamin D daily to prevent Covid-19, and to augment supportive care once infection has been established.

Should I consult a healthcare provider BEFORE starting vitamin supplementation?

You should consult with your healthcare provider before starting a Vitamin D supplement if you have a history of kidney stones, high blood calcium (hypercalcemia), low blood calcium (hypocalcemia), or irregular heart rhythm.

There is no reason to consult a healthcare provider before starting a Vitamin C supplement. Be aware Vitamin C can cause gastrointestinal upset in the form of nausea, diarrhea or constipation but is generally well tolerated.

For more information please refer to the following resources:

CITRIS-ALI Study:

https://jamanetwork.com/journals/jama/article-abstract/2752063

https://www.uclahealth.org/ortho/vitamind

https://www.bmj.com/content/356/bmj.i6583