As governments around the world battle the COVID-19 pandemic, public health measures that can reduce the risk of infection and death in addition to lockdowns and social distancing are desperately needed. Here at Altruvita we’re constantly reading about the latest clinical trials and studies looking at the impact of micronutrients, nutrition and vitamin deficiencies on health.
An article published by a team based in the US and Hungary reviewed the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19 and how vitamin D supplementation might be a useful measure to reduce risk.
Vitamin D is already known to reduce risk of infections through several mechanisms. Those mechanisms include lowering viral replication rates and reducing concentrations of pro-inflammatory chemicals that produce the inflammation that injures the lining of the lungs, leading to pneumonia.
Evidence supporting the role of vitamin D blood levels in reducing risk of COVID-19 infection includes that fact that the outbreak occurred in winter, a time when vitamin D concentrations are lowest. Note that the number of cases now in the southern hemisphere near the end of their summer are low (for example in Australia, New Zealand and South Africa). Cases have been higher than in areas which are most likely to have vitamin D deficiency.
Vitamin D deficiency has been found to contribute to acute respiratory distress syndrome (ARDS); and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration.
According to national surveys in the UK, across the population approximately 1 in 5 people are thought to have low vitamin D levels and are deficient (defined as serum levels below 25 nmol/L). Patients with levels 25 nmol/L to 50 nmol/L are classed as insufficient.
The UK has been lucky to enjoy sunny weather since the start of the lockdown, an end to the heavy rain of the winter just gone. Those of us who are lucky enough to be able to get out in our gardens or take a daily walk outside are now getting an opportunity to soak up some sunshine. Between late March/early April and September, the majority of people aged 5 years and above will probably obtain sufficient vitamin D from sunlight when they are outdoors, alongside foods that naturally contain or are fortified with vitamin D.
However, the authors of the review suggest that the goal should be to raise 25(OH)D concentrations above 100-150 nmol/L, which is way higher than just obtaining sufficient levels (anything over 50 nmol/L). The only way to achieve this fast enough during the peak of the this pandemic is to do everything – get out in the sun, eat vitamin D rich foods and take a supplement.
Some studies have reported that vitamin D supplementation reduced the risk of influenza, whereas others studies did not. To reduce the risk of infection, the authors of this paper advised that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomised controlled trials and large population studies should be conducted to evaluate these recommendations.
Vitamin D supports the immune system.* Explore Altruvita’s Vitamin D supplement and the rest of our Immune Support range – just click here. Our Vitamin D is from cholecalciferol and provides around 500% of the adult daily requirement for health.
* EU REGISTERS ON NUTRITION AND HEALTH CLAIMS
Grant WB, Lahore H, McDonnell SL et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020 Apr 2;12(4). pii: E988. doi: 10.3390/nu12040988.
At a time when it’s crucial to have a healthy immune system, both to help prevent infections and support our body in recovering when we do get ill, we wanted to share some facts and important information with you about vitamin D.
How do our bodies get vitamin D?
In humans, around 90% of the vitamin D we need is synthesised in the skin when we are exposed to sunlight and the other 10% is obtained from certain foods. The former is why it is sometimes referred to as the ‘sunshine vitamin’! The amount of vitamin D that we produce is influenced by the latitude we live at, the time of year it is, the time of day we tend to venture outside, whether we are wearing sunscreen and the natural pigmentation of our skin.
For example, during the winter months in the UK (and anywhere else above the northerly latitude of 35 degrees) the UVB rays from the sun don’t penetrate all the way down to our skin, so we can’t make vitamin D. That’s why Public Health England recommends that all adults and children (over the age of 1) should take a vitamin D supplement throughout autumn and winter.
Why is vitamin D so important?
When our bodies get vitamin D (from either the skin’s exposure to sunlight or food) they turn it into a hormone called activated vitamin D or calciferol. This works to help to regulate the amount of calcium and phosphorus in our bodies for healthy bones, muscles and teeth.
Did you know that even if you get plenty of calcium in your diet (from sources such as milk and leafy green vegetables), your body can’t absorb it unless you have enough vitamin D? That means that a lack of vitamin D can lead to bone deformities such as rickets in children, and a bone condition called osteomalacia in adults.
Activated vitamin D also contributes to the normal function of the immune system and the process of cell division. If you are keen to support your immune system function at this time, it’s worth considering if you are likely to be getting enough vitamin D.
Who is at risk of vitamin D deficiency?
- People who are unable to go out much during the daytime in those all-important spring and summer months, such as office workers, the housebound, and night shift or factory workers.
- People who cover most of their skin with clothing when they go outside, even during the warmer weather.
- People over 65, because their skin is not as good at making vitamin D.
- Now that self-isolation and social distancing measures are part of our day-to-day life, we all need to keep an eye on the amount of sunlight we get.
Which foods can we get Vitamin D from?
As mentioned above, the best source of vitamin D is when our bodies are exposed to sunlight and make it for us, but we can get a small amount by eating certain foods as well.
The most common food sources of vitamin D include:
- Oily fish such as sardines, salmon, pilchards, trout, herring and kippers.
- Eggs – mainly from the yolk, so be careful if you’re keen on egg white omelette!
- Red meat, though this will vary depending on what kind of meat and the time of year it is produced.
- Milk – again, it can depend on the time of year
- Fortified products such as cereals, some dairy products and soy milk.
Altruvita’s high-strength vitamin D supplement
Along with vitamin C and selenium, vitamin D helps to support a healthy immune system, along with the other important roles it plays in our body. Shop Altruvita’s high-quality cholecalciferol vitamin D supplement here.
There has never been a more important time to be proactive with our nutrition, with the aim of supporting the very best immune system defence.
Our immune systems play a role not only in fighting off infections, but also in promoting tissue repair to recovery. To function properly, our immune system requires plenty of both macro and micronutrients.
To help support your health over the next few months, we’ve put together a few diet and lifestyle pointers to keep you going in this worrying time.
Avoid strenuous exercise
Moderate-intensity exercise can be protective against illness by boosting the immune system, whereas high-intensity sessions actually compromise the immune system. Our immune system takes a hit for up to 72 hours following high-intensity training, making this a key time for susceptibility. This is especially important to note if you exercise in a class with others, where you’re more likely to pick up bacteria and viruses.
Let yourself sleep, rest and recover
Rest and recovery are key to prevent getting ill and further unwanted illness. If you’re always on the go with minimal rest, your immune system can be compromised long term. Poor sleep can affect the immune system and make you more susceptible to infection or illness. Sometimes it’s hard to stop, particularly when the future feels so uncertain, but don’t ever underestimate the importance of rest and relaxation! Run a hot bath, read a book, get a massage or listen to relaxing music every now and again.
Don’t drink excessive amounts of alcohol
Excessive chronic intake of alcohol can decrease the number of a few white blood cells types, which means that your immune system will not be as able to fight off any bugs. Keeping within the alcohol guidelines will help, which in the UK is currently set at 14 units per week. That’s 6 pints of beer or 6 glasses of wine if that’s your preferred tipple. If you do prefer to round off the week with a few drinks you could pick drinks with healthy, vitamin-packed mixers such as orange, tomato or pineapple juice.
It’s not the time to diet
If you are unlucky enough to pick up an infection, you will need plenty of energy to fight it off. That means that it might not be the wisest time to start a calorie reduced diet – unless of course you have a pressing health issue that means you need to lose weight urgently. Low intakes of carbohydrates such as bread, rice and potatoes, which end up as glucose in the blood, can be a contributing factor to impaired immunity.
Keep well hydrated
Unfortunately, being dehydrated can also contribute to a compromised immune system. Still at this time of year when there’s still a bit of a nip on the air, it’s easy to forget to drink. One of the front-line defences in our immune systems are the immune proteins in our saliva. When we’re dehydrated, the levels of these proteins decreases, meaning our initial defence to bugs entering through the mouth is also decreased. Make sure you don’t wait to feel thirsty before you drink up, carry a water bottle with you (everywhere!) and keep sipping throughout the day.
Taste the Rainbow
Fruit and vegetables contain a wide range of different micronutrients with varying roles within the body. Many of these nutrients are involved in immune function such as iron, vitamins C and D, selenium and zinc. Anyone with even mild deficiencies in any of these micronutrients can have an altered immune response.
The easiest way to ensure you’re getting enough micronutrients and other phytochemicals is to consume a wide variety of different fruit and vegetables. Taste the rainbow- choose different coloured and textured fruit and veg every single day!
Vitamin C, vitamin D and selenium all help to support a healthy immune system. Not everyone can eat enough to get these micronutrients (or get enough sun in a UK winter), so consider taking a food supplement if you are lacking some antioxidant or immune protection. Contrary to popular belief, huge doses of vitamin C are not required in winter. At doses of say 400-500mg a day, the excess vitamin C is simply excreted in urine, making it literally money down the toilet!
In summary: consume enough antioxidants to support your immune system, sleep well, drink plenty (but not too many drinks of the alcoholic kind), avoid strenuous activity and wash your hands before eating to stay well.
Do you feel a little gloomy and run down in the winter? It might interest you to know that the lack of sunshine during those colder months of the year doesn’t just impact our mood, it actually can impact on our physical health too. Direct sunlight acting on the skin provides the majority of our vitamin D requirement, so when there’s less sun, we make less of this essential nutrient.
The link between certain health problems and a Vitamin D deficiency has been noted through comparisons between regions with relatively low levels of sunlight, and those that enjoy more hours of sunshine. Incidence of various cancers, irritable bowel syndrome and inflammatory bowel disease have all been linked to low exposure to sunlight and a reduction in the potential of vitamin D production.
You might be deficient in vitamin D if you cover your skin, or if you spend the daylight hours indoors. For individuals living above the north latitude of 35 degrees (which is all of the United Kingdom!), the sun cannot not reach the necessary angle for UVB penetration for all of the winter months. That means that for UK residents there is no opportunity for winter vitamin D production, unless you head to warmer climes for a holiday!
Vitamin D levels are also strongly linked to mental illness, with a Swedish study showing 58 percent of people who had attempted suicide were vitamin D deficient. They concluded that testing vitamin D levels in mental health care is of vital importance.
Thankfully, vitamin D can also be consumed through dietary sources! There are certain foods that are very rich in vitamin D. Oily fish such as mackerel, salmon and tuna are not only excellent sources of vitamin D, they also contain omega-3 fats that deliver benefits to the cardiovascular system. Among the other foods that can boost your daily vitamin D intake are fortified milk, mushrooms, egg yolks, liver and fortified breakfast cereals.
Sunlight is our main provider of vitamin D, so over the winter months especially, vitamin D supplementation is recommended for adults and children in the UK.
Over the past few years there has been a renewed interest in vitamin D as it has been found to be strongly associated with many diseases. For example intestinal inflammation, ulcerative colitis, Crohn’s disease and some cancers cancer have strong associations with vitamin D deficiency.
Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal system affecting a large number of people worldwide. Although it doesn’t directly kill people, flatulence, bloating, distention, pain, diarrhoea and constipation have a substantial impact on patients’ quality of life. Appointments for IBS symptoms also put a large financial burden on healthcare services and patients are often forced to trialling unsafe dietary restrictions alone without professional support.
Although the role of vitamin D deficiency in irritable bowel syndrome (IBS) has not yet been established one new study tried to establish the role of vitamin D deficiency in IBS patients compared to a healthy control group.
Sixty patients with IBS and 100 healthy individuals were included as test and control groups, respectively, in the study. The average blood level (nmol/L) of IBS patients was compared to the control group levels.
Although vitamin D is common in various parts of the world, there was a statistically significant difference in the mean vitamin D level between healthy and IBS patients. Vitamin D deficiency was detected in 49 patients (82%) in the IBS group and 31 patients (31%) in the control group.
These results suggest that vitamin D should be tested in IBS patients and vitamin D supplementation could play a therapeutic role in the control of IBS.
Khayyat Y, Attar S. Vitamin D Deficiency in Patients with Irritable Bowel Syndrome: Does it Exist? Oman Medical Journal. 2015;30(2):115-118. doi:10.5001/omj.2015.25.
Fecal Microbiota transplant (FMT) is making the news this week. It is where faeces are transplanted from a healthy person  into another bowel to help change the bacterial make-up; the microbiota. Yes, you read this correctly!
Why would you want to do this? It acts in the same way as a probiotic and although it sounds disgusting, it has been used very successfully in treating clostridium difficile (C. diff) infection. It also looks to be one way of treating inflammatory bowel diseases; Crohn’s disease and ulcerative colitis, since the causes of these may be from bacterial imbalance.
You may be wondering how the new microbiota get there? It is performed using nasogastric tubes, endoscopy, enema or colonoscopy. There are also ongoing trials on using carefully sealed capsules for oral administration. If the disease is in the small intestine, access through the mouth is favoured and if in the large bowel, access through the rectum is preferred.
There are some websites that show how you can try it yourself, although this could be very risky business. Faeces should be pre-screened for infectious diseases, or there is a risk of picking up more than you bargained for.
An excellent review published a few years ago, explaining the topic in more depth .
Have you tried diet and supplements first?
 Bakken J S et al (2011) “Treating Clostridium difficile Infection With Fecal Microbiota Transplantation”. Clinical Gastroenterology and Hepatology; 9(12):1044–1049.
 Kelly CR, Kahn S, Kashyap P, et al. Update on Fecal Microbiota Transplantation 2015: Indications, Methodologies, Mechanisms, and Outlook. Gastroenterology. 2015;149(1):223–237. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755303/
Official estimates suggest one in five adults and one in six children in England may have vitamin D3 deficiency.
Vitamin D is an essential fat soluble vitamin that contributes to the maintenance of normal bones, teeth and muscles*. It is used to support the normal function of the immune system and the process of cell division.* Vitamin D also is required for the normal absorption and utilisation of calcium and phosphorous, and normal blood calcium levels.*
For most people, the bulk of their required vitamin D3 is made from the action of sunlight on their skin. Sunlight contains ultraviolet B radiation. During and after the European summer, levels of vitamin D3 in the blood are a bit higher and sometimes scientifically ‘normal’. A healthy, balanced diet is always recommended and with exposure to summer sunshine, many people may get enough of the vitamin D they need.
However, during autumn and winter, sunlight is in short supply, particularly in the northern European countries.
People are also at risk of vitamin D deficiency and need extra help with reaching those vitamin D targets because they have dark skin, are elderly living in care homes, or wear clothing that cover most the skin, which effects conversion of sunlight to vitamin D.
Unfortunately having more sunshine until you burn is not a safe option of getting more vitamin D made in the body. You must wear sunscreen in the UK.
Government report on vitamin D supplements:
- Everyone over the age of four should take 10 micrograms of vitamin D every day, particularly in Autumn and Winter.
- Pregnant and breastfeeding women and at-risk groups should take 10 micrograms of vitamin D per day all year round
- Children between the age of one and four should take 10 micrograms of vitamin D supplements every day, all year round
- All babies from birth up to one year of age should take 8.5 to 10 micrograms of vitamin D per day (particularly those being breastfed).
Treating vitamin D deficiency requires far higher doses.
In addition of course, limited amounts of the vitamin are found in foods such as oily fish, liver, eggs, milk, fortified cereals and fat spreads with added vitamin D. Unfortunately however, it would be near impossible for us to obtain high enough levels of vitamin D through diet without supplementation.
Altruvita vitamin D contains 25 micrograms in 1 vegetarian capsule.
* EU REGISTERS ON NUTRITION AND HEALTH CLAIMS
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