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Vitamin D is one of the important but still overlooked protective measures to prevent (harmful and often fatal consequences) infections with the new coronavirus. So far, this preventive measure has been "only" recommended, now this recommendation has been unequivocally confirmed - with results Spanish interventional randomized study, which is the first direct evidence that the addition of vitamin D in patients with COVID-19 in need of hospital treatment significantly helps to reduce further complications that would otherwise require treatment in the intensive care unit.
Therefore, Dr. Darko Siuka, who has been warning for months about the importance of vitamin D in limiting the spread of new coronavirus infections and mitigating the effects of COVID-19, called on the government to urgently and immediately prepare a strategy for vitamin D protection. It should be aimed primarily at those groups of the population who are most exposed to the risk of infection and the severe course of COVID, as well as those who are able to prevent further complications. The proposal, which is currently under discussion, was sent to the government by Siuka on 23 September.
The vitamin, which acts as a hormone in the body and has receptors in almost all cells and stimulates the transcription of more than 200 different genes, is formed in the skin under the influence of sunlight (ultraviolet B), which is between April 10 and September. 4pm when sunlight travels vertically through the atmosphere. For a supply of vitamin D during this time, it is sufficient to expose a part of the skin, which should not be coated with a protective cream, to the sun for ten to 15 minutes - this means that a sufficient dose is obtained during normal chores or during a short walk. taking care not to overdo it by exposing the skin to the sun.
How does a lack of "sun vitamin" manifest itself and how to prevent this deficiency
The excess amount of vitamin D produced by sun exposure remains in the body - in the blood and in adipose tissue - but the stores eventually run out. In winter, for example, if you want to get enough vitamin D, you should be in the sun for at least two and a half hours, because the angle of ultraviolet B rays is completely different then and goes through the thicker layers of the atmosphere. The fact is that a person does not get enough vitamin D, especially in the autumn and winter, even if he spends a lot of time in the fresh air and in the sun.
Vitamin D takes care of the metabolism of calcium and phosphate, enables bone mineralization and strengthens the immune system. At all stages of life, it is crucial for development, for bone and tooth regeneration, and for strengthening resilience; lowers blood pressure, improves insulin secretion, reduces the possibility of autoimmune diseases.
Vitamin D deficiency is more pronounced and more common in individuals who stay indoors all day, either because of work or because they are obsessed with the computer or because they cannot get out due to illness or physical disabilities; in the elderly, the skin produces less vitamin D, and in overweight individuals, this vitamin is stored in adipose tissue. Vitamin D deficiency also occurs in individuals with liver, kidney or gastrointestinal disease - as well as in patients taking glucocorticoids or anti-epileptic drugs.
As long as vitamin D deficiency is moderate, it manifests itself as chronic fatigue, poorer resistance to acute (especially viral) respiratory infections, it can also be perceived as uncharacteristic chronic muscle pain, in the elderly there is a decrease in bone mineral density, and falls are more frequent. cancer ...
For a proper supply of the body with vitamin D, it is also crucial to have a proper diet, for which the assistant. Siuka says, “Modern food is delicious, but it is very poor in terms of nutrients. In Scandinavia, for example, they have less problems with vitamin D deficiency because they add it to food, such as dairy products. ”It will be similar in our country in the future.
Otherwise, when it comes to food, there is a lot of vitamin D in fish (salmon, sardines, tuna, trout), eggs, raw butter, cheese, whole milk and yogurt ... The recommended amount of daily intake of vitamin D is sufficient if, on example, we eat 31 grams of salmon.
foods rich in vitamin d
Taking vitamin D can significantly reduce the likelihood of severe complications with COVID-19
An interventional randomized study involving 76 patients at Cordoba University Hospital in Spain who had to be hospitalized after being infected with a new coronavirus is the first to unequivocally confirm that vitamin D supplementation can significantly reduce the likelihood of developing the disease. COVID-19 led to complications that would make treatment in the intensive care unit unavoidable.
According to the assistant. Siuke "would not be right and ethical to remain silent as a doctor, given the exceptionally good results of this study - as I was not silent when we proposed the introduction of protective measures in March." Therefore, he decided to propose that Slovenia (in the coming period, when we can expect not only a significantly higher number of newly infected, but also more and more patients), with an appeal, on which voting is still taking place on the government's website.in which the recovery of COVID disease will lead to a critical phase, so the inevitable treatment in the intensive care unit) will include the intake of vitamin D among the strategic protective measures.
"With autumn and winter, the stocks and levels of vitamin D in the body decrease - but we know that in the case of a deficiency of this vitamin, we can expect a more severe course of COVID-19 disease. However, the Spanish interventional randomized study is the first direct evidence that the addition of vitamin D3 (25-hydroxyvitamin D) in COVID patients greatly reduces the need for hospitalization in the intensive care unit. Of the 50 patients treated according to the hospital protocol who received hydroxychloroquine and azithromycin therapy, as well as vitamin D supplementation, only one had to be assisted in the intensive care unit, none died, and none were hospitalized. no complications occurred during treatment. Of the remaining 26 patients who did not receive vitamin D, as many as 13 needed treatment in the intensive care unit, two died, while the rest had no complications during hospital treatment, "Darko Siuka points out.
This study, as the interlocutor points out, “confirms that vitamin D can greatly reduce the chance of a risky course of COVID-19 disease. On the other hand, this vitamin, in the doses recommended in terms of prevention and therapy, has a negligible chance of side effects - except for parathyroid diseases, hypercalcemia or kidney stones. "General vitamin D deficiency, especially in the elderly
In this context, the results of the national Nutrihealth survey are very telling, with which the researchers gained insight into the supply of the adult population of Slovenia with some vitamins and other micronutrients important for health. The research is, as prof. dr. Marija Pfeifer, on a representative sample of healthy Slovenes aged 18 to 74, showed that “vitamin D deficiency is really very, very high - especially in winter. The limit below which, according to strict criteria, we can say that there is a lack of vitamin D is 50 nanomoles per liter, determining 25-hydroxyvitamin D, which is a really good indicator of vitamin D supply - and in the survey the majority (80 percent) Slovenians had a moderate deficiency (level below 50), while more than 20 percent had a severe deficiency of this vitamin. If this deficiency lasts for a long time, rickets can develop (even in children), osteomalacia occurs in adults, soft bone diseases (bones become sensitive, they like to bend and break), muscle pain, poor resistance ...
So what are the key reasons why he advises adults to take vitamin D? "According to the doctrine, vitamin D must be taken by small children, and it is given to them preventively in the first year of age so that rickets does not develop. According to the new recommendation, this recommendation is valid until the age of 3, and recently studies show a lack of vitamin D in teenagers as well. It is essential that vitamin D be taken by pregnant women - and it is absolutely essential that it should be taken by the elderly, who mostly stay indoors. In the first place, these are people cared for in nursing homes, because researchers in this group (in more than 80 percent) find a severe deficiency of this vitamin (below 30 nanomoles), which means a greater risk of falls, fractures and osteomalacia, "warns prof. Pfeifer's.
The positive effect of vitamin D on the (minor) incidence of viral infections in winter has been confirmed by numerous meta-analyzes, so the interviewee explains: became ill, the course of the disease was milder. Based on this, we concluded that - given that the majority or at least 80 percent of the Slovenian population is deficient in vitamin D in winter - it would be advisable to replace vitamin D in this period. Also in terms of protection against the serious consequences of new coronavirus infections. "
More than 80 percent of residents in nursing homes have been diagnosed with severe vitamin D deficiency, which (among other things) increases the risk of falls, fractures, and osteomalacia. On the other hand, preventive intake of this vitamin is known to contribute to less frequent flu and colds - and in this sense, this kind of protection against the serious consequences of new coronavirus infections is also essential.
Vitamin D enables white blood cells to produce an endogenous antibiotic that kills viruses, bacteria, fungi ...
Vitamin D has two mechanisms important for preventive action, says Dr. Maria Pfeifer. On the one hand, it increases man's natural resilience. “We need it so that our cells, the white blood cells - these are on the mucous membranes where the virus enters the body - can make an endogenous antibiotic, a substance that kills viruses, that kills bacteria, that kills fungi. To be able to do this, however, a person must have enough vitamin D in their blood; if it does not, macrophages cannot form the active form of vitamin D and cannot form endogenous antibiotics. Therefore, the recommendation is to give, maintain or establish optimal concentrations of vitamin D and thus ensure that the mechanism of natural resistance can work in humans. "
On the other hand, vitamin D is supposed to alleviate the worst course of COVID disease, when patients with severe pneumonia need intensive therapy, when lung failure can occur and when it is necessary to connect the patient to a respirator, even for a long period of time. (if he survives at all) in a coma ...
“In such cases, vitamin D is supposed to calm the body’s severe inflammatory response, the so-called cytokine storm. Therefore, in my opinion, and in the opinion of many experts involved in studying the positive effects of vitamin D, especially in the current period, it is essential that the population has a normal and optimal level of this vitamin. This can be ensured by taking cholecalciferol (vitamin D3 derived from lanolin), which is an inactive form of vitamin D with an extremely wide therapeutic window, in which there is no danger of overdose or the occurrence of side effects, "she said.
Prof. dr. Marija Pfeifer emphasizes that vitamin D must be taken by the most at risk - the elderly and individuals with diseases in which the immune system is weakened, so they are at higher risk of developing a severe form of COVID. "In my opinion, it is unheard of if in such cases we do not start giving vitamin D for preventive purposes. However, if they do get sick, they should be given higher doses of this vitamin; with the optimal and safe concentrations achieved in this way, the chance that they will be able to survive this disease better will be significantly higher. "
Will the findings dictate a new strategy in the fight against the pandemic?
As the assistant told the health portal. Darko Siuka and a group of fellow doctors have been working since March to implement key protective measures, among which vitamin D should play an important role. At the time, they had the results of past studies for other respiratory viral infections that confirmed the benefits of adding this vitamin - and this was followed by the logical conclusion that the same was true for the new COVID-19 disease.
The results of observational studies for patients with COVID-19 have been published internationally since March, but, as Darko Siuka points out, “these studies have not been interventional, vitamin D has not yet been added as a medicine. However, a new, randomized study has only reinforced the current knowledge about this kind of connection - and we simply cannot go beyond these results, which are really good. "