2023-04-18 18:52:51
Whether there is a connection between corona and vitamin D is controversial – now there is a new study that shows effects – with a flaw
About every tenth corona patient develops a long Covid syndrome weeks after infection. The symptoms range from weakness and lack of concentration to shortness of breath and cardiovascular problems. Pneumologists from the Medical Clinic Emden presented a study at the annual congress of their specialist society, according to which low vitamin D levels could be a reason for long-Covid. Stephanie Wesely summarizes.
What results did the study of the pulmonologists show?
The researchers measured the vitamin D concentration in the blood of 75 long-Covid patients and compared it with a group of healthy people. The patients had an average of 17.4 nanograms per milliliter (ng/ml) of vitamin D in their blood. According to the Robert Koch Institute (RKI), values below 20 ng/ml indicate an undersupply. It’s not just bone damage. “In the meantime, we have increasing evidence that vitamin D supplementation could also be beneficial for corona patients, especially with regard to the development of long Covid syndrome,” says Dr. Jens Bräunlich, Chief Physician in the Department of Internal Medicine and Pneumology at the Medical Clinic in Emden.
What is the experience with vitamin D in practice?
“We regularly examine our patients’ vitamin D levels during the long-Covid consultation hours. We often find that there is an undersupply,” says Dr. Christian Gogoll, pneumologist and head of a long-Covid practice in Berlin. “Even in the summer months, when most people don’t show any shortages due to spending more time outdoors.” According to him, patients with chronic exhaustion, the so-called fatigue syndrome, often also have a vitamin B deficiency. “The administration of vitamin supplements brought people a rapid improvement in their symptoms,” he says. In this respect, the study from Emden corresponds to the observations from medical practice, although it is not representative given the small number of test subjects. But the pneumologist doubts that there is any economic interest in a larger study. Because these studies are very expensive. In addition, it is now becoming increasingly difficult to find suitable subjects and, above all, comparison groups without corona infection for such a study. That’s why he sees vitamin D supplementation as a simple treatment method with few side effects. “When the patient’s symptoms subside, the treatment has its place,” he says.
Why was the vitamin D so low in Long-Covid?
The authors of the study see two possible causes. On the one hand, the disease itself could have depleted the vitamin D levels. On the other hand, the lack of sunlight due to inactivity during the illness could also be the cause of the deficiency. The decrease in outdoor sports activities caused by the pandemic may also have had a negative impact on vitamin D levels.
Is there also evidence that vitamin D protects against severe flu courses?
“No, that hasn’t been investigated yet,” says pneumologist Christian Gogoll. In practice, however, it is assumed that vitamin D controls recovery processes and strengthens the body’s defenses. “But these are assumptions for which the scientific evidence is lacking.”
Is the vitamin D level determination covered by health insurance?
“Not always,” says Gogoll. The health insurance only pays for the blood test if the doctor believes that there is a vitamin D deficiency. If this is the case, the costs for the vitamin preparations would also be covered, for example in the case of osteoporosis sufferers. Otherwise it is an individual health service (IGeL) at your own expense. The IGeL-Monitor, an institution that evaluates self-payer services on behalf of the statutory health insurance companies in terms of their benefit, classified the vitamin D level determination as unclear because it shows neither health benefits nor harm. The laboratory test costs between 20 and 30 euros.
What are the guidelines for vitamin D in the blood?
According to the RKI, values below 20ng/ml are considered undersupply. Vitamin D levels between 30 and 50ng/ml are optimal. The RKI speaks of an oversupply of more than 50ng/ml, which could result in hypercalcemia, a disease of the kidneys and metabolism. “But the risk of a permanent overdose is very low with a dietary supplement,” says Christian Gogoll. The German Society for Nutrition also recommends dietary supplements for values below 20ng/ml – even if there are no health problems.
For whom is a dietary supplement with vitamin D useful?
Older people or people who are no longer so mobile can usually no longer cover their vitamin D requirements by spending time outdoors. According to the Federal Office for Radiation Protection, even in the winter months there is not enough sunlight to produce vitamin D. Since the body cannot get it from food, it needs a dietary supplement, according to the German Society for Nutrition.
How much vitamin D supplementation is appropriate?
The German Society for Nutrition recommends that children from the age of 15 and adults up to old age take a dietary supplement of 20 micrograms or 800 international units per day if vitamin D formation through sunlight is not possible. But in the case of a vitamin D deficiency, higher doses are usually required: “In practice, there are different options for dietary supplements,” says Christian Gogoll. A preparation (e.g. Dekristol) with 20,000 international units is recommended most frequently once a week. But a daily intake of low-dose preparations makes sense. “The combination of vitamin D with magnesium is important in order to achieve good absorption in the body.” There is little risk of overdosing. The Federal Office for Risk Assessment also sees it this way. “Only if long-term and daily high doses of vitamin D are taken could damage to health occur because vitamin D, as a fat-soluble vitamin, cannot simply be excreted in the urine, but is stored in the fatty tissue,” says the agency.
book tip Vitamin D also plays a role in the book of dr Michaela Moosburner. It shows how Long-Covid can be treated (Graefe and Unzer publishing house, 19.90 euros).
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