Optimal Serum 25-Hydroxy Vitamin D Concentrations for Various Health Outcomes

Vitamin D deficiency is endemic across the Middle East, including in Israel, where nearly four in five people are low on the vitamin, according to one study from 2011.^[3] By taking supplements before infection, though, the researchers in the new Israeli study found that patients could avoid the worst effects of the disease:^[4]

“We found it remarkable, and striking, to see the difference in the chances of becoming a severe patient when you are lacking in vitamin D compared to when you’re not,” said Dr. Amiel Dror, a Galilee Medical Center physician and Bar Ilan researcher who was part of the team behind the study.

He noted that his study was conducted pre-Omicron, but said that the coronavirus doesn’t change fundamentally enough between variants to negate vitamin D effectiveness.

“What we’re seeing when vitamin D helps people with COVID infections is a result of its effectiveness in bolstering the immune systems to deal with viral pathogens that attack the respiratory system,” he told The Times of Israel. “This is equally relevant for Omicron as it was for previous variants.”

Table 1.  Optimal 25(OH)D Concentrations for Various Health Outcome (Source: [1])

Health Effects of Sub-optimal 25(OH)D Concentrations

 

A new review study examines the evidence for the major causes of death including cardiovascular disease, hypertension, cancer, type 2 diabetes, and COVID-19 with regard to sub-optimal 25(OH)D concentrations.^[1]  The results are tabulated in Table 1.

References

1. A Narrative Review of the Evidence for Variations in Serum 25-Hydroxyvitamin D Concentration Thresholds for Optimal Health
2. Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness
3. Vitamin D deficiency prevalence and cardiovascular risk in Israel 
4. Israeli study offers strongest proof yet of vitamin D’s power to fight COVID
5. Li, Y.; Tong, C.H.; Rowland, C.M.; Radcliff, J.; Bare, L.A.; McPhaul, M.J.; Devlin, J.J. Association of changes in lipid levels with changes in vitamin D levels in a real-world setting. Sci. Rep. 2021, 11, 21536.
6.  Jayedi, A.; Rashidy-Pour, A.; Shab-Bidar, S. Vitamin D status and risk of dementia and Alzheimer’s disease: A meta-analysis of dose-response (dagger). Nutr. Neurosci. 2019, 22, 750–759.
7. McDonnell, S.L.; Baggerly, C.A.; French, C.B.; Baggerly, L.L.; Garland, C.F.; Gorham, E.D.; Hollis, B.W.; Trump, D.L.; Lappe, J.M. Breast cancer risk markedly lower with serum 25-hydroxyvitamin D concentrations >/=60 vs. <20 ng/mL (150 vs. 50 nmol/L): Pooled analysis of two randomized trials and a prospective cohort. PLoS ONE 2018, 13, e0199265.
8. McCullough, M.L.; Zoltick, E.S.; Weinstein, S.J.; Fedirko, V.; Wang, M.; Cook, N.R.; Eliassen, A.H.; Zeleniuch-Jacquotte, A.; Agnoli, C.; Albanes, D.; et al. Circulating Vitamin D and Colorectal Cancer Risk: An International Pooling Project of 17 Cohorts. J. Natl. Cancer Inst. 2019, 111, 158–169.
9. Dai, L.; Liu, M.; Chen, L. Association of Serum 25-Hydroxyvitamin D Concentrations with All-Cause and Cause-Specific Mortality Among Adult Patients with Existing Cardiovascular Disease. Front. Nutr 2021, 8, 740855.
10. Kaufman, H.W.; Niles, J.K.; Kroll, M.H.; Bi, C.; Holick, M.F. SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels. PLoS ONE 2020, 15, e0239252.
11. Seal, K.H.; Bertenthal, D.; Carey, E.; Grunfeld, C.; Bikle, D.D.; Lu, C.M. Association of Vitamin D Status and COVID-19-Related Hospitalization and Mortality. J. Gen. Intern. Med. 2022.
12. Dawson-Hughes, B.; Staten, M.A.; Knowler, W.C.; Nelson, J.; Vickery, E.M.; LeBlanc, E.S.; Neff, L.M.; Park, J.; Pittas, A.G.; Group, D.d.R. Intratrial Exposure to Vitamin D and New-Onset Diabetes Among Adults with Prediabetes: A Secondary Analysis From the Vitamin D and Type 2 Diabetes (D2d) Study. Diabetes Care 2020, 43, 2916–2922.
13.  Shirvani, A.; Kalajian, T.A.; Song, A.; Holick, M.F. Disassociation of Vitamin D’s Calcemic Activity and Non-calcemic Genomic Activity and Individual Responsiveness: A Randomized Controlled Double-Blind Clinical Trial. Sci. Rep. 2019, 9, 17685.
14. Mirhosseini, N.; Vatanparast, H.; Kimball, S.M. The Association between Serum 25(OH)D Status and Blood Pressure in Participants of a Community-Based Program Taking Vitamin D Supplements. Nutrients 2017, 9, 1244.
15. McDonnell, S.L.; Baggerly, K.A.; Baggerly, C.A.; Aliano, J.L.; French, C.B.; Baggerly, L.L.; Ebeling, M.D.; Rittenberg, C.S.; Goodier, C.G.; Mateus Nino, J.F.; et al. Maternal 25(OH)D concentrations >/=40 ng/mL associated with 60% lower preterm birth risk among general obstetrical patients at an urban medical center. PLoS ONE 2017, 12, e0180483.
16. Thyroid nodules and its association with vitamin D in centenarians
• Nearly 3/4 of centenarians had thyroid nodules
• Vitamin D deficiency was associated with probably malignant thyroid nodules in this population