Vitamin D “should be like masks. Everybody should know about it. The government agencies should be pushing it that way,” says Congressman Glenn Grothman (R-WI).
Grothman, representing Wisconsin’s 6th congressional district, wants to see vitamin D become part of the nation’s COVID control efforts. Last month, he introduced a resolution urging the federal agencies to “recognize the significant role vitamin D may play.”
“If passed, my resolution will unite the voice of the House of Representatives in the search for additional ways to limit the negative effects of COVID-19 and hopefully encourage our public health establishment to issue much-needed guidance as to truly how effective vitamin D can be in preventing serious symptoms, complications, or death from the coronavirus.”
While vitamin D has gotten considerable media attention in the last decade, Grothman told Holistic Primary Care that in his experience many people still do not realize its importance for maintaining overall health and, potentially, for improving immune system resilience against SARS-CoV-2.
So far, none of the federal health agencies have openly advocated for wider use of vitamin D in the fight against COVID. The Biden administration, like its predecessor, has been silent on this subject.
Challenging the Experts
Grothman is a hard-right heartland conservative who makes no secret of his disdain for highly paid experts and academics who—in his estimation—lack common sense. He believes the government’s unwillingness to advocate vitamin D—a readily available, low cost, safe supplement–has done the public a disservice.
“You can’t turn around without being told to wear a mask or stay six feet away from people. But there are people to this day who don’t know about the benefits of vitamin D, and it’s now 11 months after this pandemic broke. So, it seemed that somebody should be talking about it a little more.”–Rep. Glenn Grothman (R-WI)
He introduced his resolution (H.Res.116) to the House Committee on Energy and Commerce on Feb. 11. It calls on the House to:
(1) recognize the benefits of vitamin D intake against preventing respiratory complications and infection;
(2) recognize the benefits of vitamin D intake for improved immune health and response;
(3) recognize the correlation between vitamin D deficiencies and poor COVID–19 patient outcomes, including hospital stays, ICU admittance, and mortality; and
(4) encourage the Centers for Disease Control and Prevention and the Food and Drug Administration to update existing guidance and issue new guidance on vitamin D intake during the COVID–19 pandemic.
Enthusiasm vs Evidence
The scientific case for vitamin D in the COVID context is not quite as strong as Rep. Grothman’s enthusiasm.
It rests largely on epidemiological correlations between vitamin D deficiency, increased risk of SARS-CoV-2 infection and severe illness; observational studies showing that people with higher vitamin D levels are less likely to have severe COVID; and pre-COVID evidence that vitamin D regulates innate and adaptive immune responses and can mitigate some forms of acute respiratory dysfunction.
There is a placebo-controlled intervention study of 40 people with mild SARS-CoV-2 infection showing that 60,000 IU of cholecalciferol per day improved viral clearance rates, and an open-label study indicating that addition of oral calcifediol on top of azithromycin and hydroxychloroquine reduced ICU admissions in a cohort of 50 hospitalized COVID patients.
But two recent large trials looking at use of high-dose vitamin D as treatment for acute hospitalized COVID patients show no significant benefit in terms of major clinical outcomes.
As many commentators have pointed out, there are methodological holes to be found in nearly all of the published studies, and some question the logic of using vitamin D in a drug-like manner as a late-stage intervention for severely ill patients.
“Evidence to date suggests the possibility that the COVID-19 pandemic sustains itself in large part through infection of those with low vitamin D, and that deaths are concentrated largely in those with deficiency. The mere possibility that this is so should compel urgent gathering of more vitamin D data.”–Vitamin D for All Open Letter to World Leaders
Though the epidemiologic data suggest that supplementation makes sense as a covid prevention strategy, there are not yet any definitive studies showing that regular vitamin D use does, in fact, prevent transmission of the virus or that it will prevent infected people from developing symptoms.
Grothman contends that the available evidence is strong and consistent enough to warrant a more serious governmental consideration of this vitamin in the context of COVID prevention.
A Global Call
In making his case, he cites an open letter signed by more than 200 physicians, researchers, and policymakers around the world, naming vitamin D deficiency as “by far the most easily and quickly modifiable risk factor” in the COVID-19 equation, and urging governments of all nations to “immediately recommend and implement efforts appropriate to their adult populations to increase vitamin D, at least until the end of the pandemic.”
According to the letter’s authors, “Evidence to date suggests the possibility that the COVID-19 pandemic sustains itself in large part through infection of those with low vitamin D, and that deaths are concentrated largely in those with deficiency. The mere possibility that this is so should compel urgent gathering of more vitamin D data.”
They urge world leaders to up the current Vitamin D recommendations to 4,000 IU daily (100 mcg) for adults (possibly more for darker-skinned people), to mandate routine serum vitamin D measurement for all hospitalized COVID-19 patients, and to supplement when warranted by the test results.
“The preponderance of evidence indicates that increased vitamin D would help reduce infections, hospitalizations, ICU admissions, & deaths.
Why the Silence?
Rep. Grothman, now in his 3rd term, has generally not been involved in healthcare policy over the course of his congressional tenure. He says he became interested in the vitamin D question last Fall after he became aware of research by David Meltzer at the University of Chicago showing strong inverse associations between vitamin D status and risk of COVID infection. Studies from all over the world indicated similar patterns.
“We started running across these articles more and more, and we wondered why this wasn’t being pushed by the professionals.
“You can’t turn around without being told to wear a mask or stay six feet away from people. But there are people to this day who don’t know about the benefits of vitamin D, and it’s now 11 months after this pandemic broke. So, it seemed that somebody should be talking about it a little more, and it’s been very frustrating that the people we pay the big bucks to at the CDC have been largely mute,” Grothman told Holistic Primary Care in an interview.
He said the impulse to raise the issue in Congress is entirely independent of financial interests. The initiative is not being funded by any supplement company or industry representatives.
“This is new stuff for me,” he acknowledged. “I’m taking it now, but I wasn’t taking it before.”
Asked why public health officials have been so reluctant to mention vitamin D or, for that matter, any other supplements in the COVID guidelines, Grothman chose his words carefully:
“Cynical people would say—and I hate to become cynical—that they (the agencies) push stuff that people can make a lot of money on. But when it comes to alternative treatments, or prevention in the first place….you know, a bottle of vitamin D is pretty cheap…the interest seems to wane. Whereas if something more expensive, like a new drug, comes along a little more attention is paid to it.”
So, the basic profit motive?
“People tell me that, and I don’t like to believe it. But why else would they be sitting on this?” Grothman says.
Though his resolution is focused exclusively on vitamin D, Grothman also has axes to grind about fenofibrate, hydroxychloroquine and other low-cost generic drugs that he believes are being ignored, under-utilized, or used too late.
Seeking Bipartisan Support
Whether the vitamin D resolution gains traction in the House will depend on whether Grothman can muster support from across the political divide. About this he is confident.
“No question there will be bipartisan support,” he said, citing Rep. Salud Carbajal, from California’s 24th district as a potential ally from among the Democrats. Carbajal is, himself, a COVID survivor.
Grothman says his primary objective for the resolution is simply to “wake them up a little bit,” referring to Congress and the public health establishment. Even if it does not pass, it will have done its job if it can spark interest among legislators from both parties, and generate some meaningful dialog.
The bill has gotten the attention of medical professionals, and several of the organizations representing holistic, functional, and naturopathic medicine have indicated tacit support.
In early March, the American Association of Naturopathic Physicians issued a statement commending Rep. Grothman, “for introducing a resolution before Congress that raises public awareness of vitamin D and calls for the FDA and other government agencies to study and recognize the connection between vitamin D deficiencies and COVID-19. As experts in natural medicine, licensed naturopathic doctors have long recognized and utilized the power of key vitamins, especially vitamin D, to help support the immune system.”
While AANP “enthusiastically joins the call for our government’s top public health agencies to issue guidance” on vitamin D and COVID, the organization is not taking any direct action to promote it. The California Naturopathic Doctors Association has urged members to contact their representatives and voice their support.
Patrick Hanaway, MD, coordinator of the Institute for Functional Medicine’s COVID-19 Task Force, told Holistic Primary Care that from the perspective of biological plausibility and in alignment with the precautionary principle, it makes sense to incorporate vitamin D into public health policy around COVID.
Most functional medicine practitioners believe it is a good thing to use with their patients, and IFM’s “Recommended Interventions” for COVID-19 suggest that adults take 5,000 IU orally per day.
But Hanaway points out that “the conventional scientific community has not agreed that having normal values of vitamin D is associated with helping to support the IS. This is something that continues to be discussed.”
IFM as an educational organization does not take official positions on political matters, and will not be issuing an official statement on the Grothman resolution, though the group supports it in principle.
“From my perspective I look at the science. This is a low-cost, low-risk intervention. We work with practitioners to try and educate them about that,” Hanaway says.
Not surprisingly, the bill has generated considerable enthusiasm from within the dietary supplement industry. The Natural Products Association—one of the industry’s largest trade organization—has been spearheading an effort to rally supplement companies and their consumer base.
Kyle Turk, NPA’s deputy director of governmental affairs, says its members have already generated roughly 500 letters urging members of congress to support the resolution.
Though he stressed that NPA cautions its member companies against making COVID-related product claims—which are considered to be unlawful drug claims by the FDA—Turk says his organization is whole-heartedly behind the idea that things like vitamin C, vitamin D, zinc, and many botanicals have a role to play in bolstering immune system resilence.
He is hopeful about the prospects for the vitamin D resolution.
As polarizing as HC can be, something like this should be a two-foot putt for Congress. We can all agree that the use of vitamins and minerals to support healthy immune system is important. This could be a great way to start building bipartisanship.”