Talk:Vitamin D/Archive 10

Use of supplements, Mortality, all-cause
The Mortality, all-cause section implies that vitamin D can be harmful to the African-American population, which is not a quantitative or in any way rational biological statement. Vitamin D is a necessity for all people on Earth, and you need to mention the exact bodily concentration or interval or supplementation dose that is harmful, and necessary, respectively, for each population group. (It is annoying that you deleted those additions of mine that could help illuminate(no pun intented) which doses of the sunny vitamin D supplements and serum concentration could be helpful to the African-American population, and were thereby constructive). Because we emigrated from East Africa to the rest of the world, we started producing more of the protein that binds the inactive 25-hydroxyvitamin D blood that stays in the bloodstream until needed. "blacks have only a quarter to a third as much of the binding protein, Thadhani says" - https://www.npr.org/sections/health-shots/2013/11/20/246393329/how-a-vitamin-d-test-misdiagnosed-african-americans?t=1539628613515 People of African descent might therefore be applying the consumed vitamin D directly and more immediately, because they are storing less in the blood-stream. For this reason, a high supplement might have more negative effects than when production of the vitamin in the skin as a response to UVB rays is allowed. However, it isn't sunny everywhere and always. A solution to this problem is needed, or at least specific quantification, since there are vitamin D deficient African-Americans, and a test is needed to quantify this and offer appropriate supplementation."There is currently no approved test for the bioavailable 1,25-dihydroxyvitamin D, although Thadhani and his colleagues are working on one and have filed for a patent."

Are depot pills the answer?

Concerning the rest of the section, it is irresponsible not to mention the findings of this review from 2016: http://ar.iiarjournals.org/content/36/3/1379.full

"Vitamin D deficiency is a risk factor for increased mortality and meta-analyses of randomized trials suggest that vitamin D3 supplementation may reduce mortality."

It is also not responsible not to include this review from 2018, which reviews around 140 studies: http://ar.iiarjournals.org/content/38/2/1121.full

"Conclusion The UVB–vitamin D–cancer hypothesis has considerable supporting scientific evidence from a variety of study types: geographical ecological, observational, and laboratory studies of mechanisms, as well as several clinical trials. At this time, the general public and individual physicians can spend more reasonable time in the sun and use vitamin D3 to prevent and treat many cancers. Hopefully soon, the clinical evidence will be strong enough that health care systems and agencies will endorse vitamin D3 supplementation as a way to prevent and treat cancer."

"Many other health benefits are associated with higher 25(OH)D concentrations, including reduced risk of autoimmune diseases (133), diabetes mellitus type 2 (134), adverse pregnancy and birth outcomes (135), respiratory tract infections (136), and all-cause mortality rate (137). Whether vitamin D reduces risk of cardiovascular disease is still uncertain based on support from observational studies but not clinical trials (138). Thus, raising 25(OH)D concentrations in an effort to reduce cancer risk will yield additional benefits. The optimal 25(OH)D concentration is certainly above 75 nmol/l and more likely 100-150 nmol/l. Reaching those concentrations could take 1,000-5,000 IU/d of vitamin D3 or a moderate amount of sensible sun exposure. The only way to ensure reaching the desired concentration is to have serum 25(OH)D concentration measured (18, 19). Yes, it is unfortunately the only current way, but developments within testing are being made or are already produced. That is why it sucks that the 1,25-dihydroxyvitamin D test is not mentioned in the section. Historicar33 (talk) 21:33, 15 October 2018 (UTC)

Those vitamin D mortality refs
Let's first get the two mortality refs into proper format:


 * PILZ
 * GRANT

William B. Grant has published extensively on vitamin D status and health. I have a concern that his affiliation is the Sunlight, Nutrition, and Health Research Center, which appears to be him, and that his funding support is from Bio-Tech Pharmacal, Inc., a dietary supplement company. His publications are in reputable peer-reviewed journals, but I suggest his conclusions be examined for pro-vitamin D bias. Stephan Pilz is at the Medical University of Graz, Austria, and has also published extensively on vitamin D. He and Grant are among a large group of co-authors on a 2018 position paper supporting vitamin D fortification (PMID #30065699).


 * The vitamin D article does not cover mortality risk within the Deficiency section (it should).
 * In the Lead: "The effect of vitamin D supplementation on mortality is not clear, with one meta-analysis finding a small decrease in mortality in elderly people,[12] and another concluding no clear justification exists for recommending supplementation for preventing many diseases, and that further research of similar design is unneeded in these areas.[13]" I personally am not happy with the approach of that last reference, which arbitrarily set a reduction in risk of 15% as its criteria for effectiveness. I think the benefits are real but modest.
 * In the Use of supplements section: "Vitamin D3 supplementation has been tentatively found to lead to a reduced risk of death in the elderly, but the effect has not been deemed pronounced or certain enough to make taking supplements recommendable. Other forms (vitamin D2, alfacalcidol, and calcitriol) do not appear to have any beneficial effects with regard to the risk of death. High blood levels appear to be associated with a lower risk of death, but it is unclear if supplementation can result in this benefit. Both an excess and a deficiency in vitamin D appear to cause abnormal functioning and premature aging. The relationship between serum calcifediol level and all-cause mortality is parabolic. Harm from vitamin D appears to occur at a lower vitamin D level in the black population than in the white population."
 * The Cancer and Cardiovascular disease subsections within Use of supplements are inconclusive on benefits.

I believe the article can be improved by adding more referenced content, very likely beyond just Pilz and Grant. A PubMed search on vitamin D mortality, limited to meta-analyses and systematic reviews, yields more than 200 articles., some concluding there is a benefit, some not. David notMD (talk) 11:12, 16 October 2018 (UTC)


 * Part of the problem you identify is that this article is heavily focused on the effects of vitamin D supplements, with less emphasis on epidemiological associations. The lead balances ref 12 and ref 13, which are in Mortality under the Effects of supplementation section.  (Ref 13 is a powerful meta-analysis showing how modest the effects are.  The 15% level is rather arbitrary, but we are here to pass on their conclusions -- discussed well in that paper). Not sure these two papers add much to the balance. Happy to review any new large meta-analyses on treatment and to build on epidemiology. Jrfw51 (talk) 12:31, 16 October 2018 (UTC)
 * Added empty subsections under Deficiency so that content can be added there that does not come from supplementation trials. Will need to cover relative strength of epidemiology versus randomized clinical trials (RCTs). David notMD (talk) 13:53, 16 October 2018 (UTC).

Scientists usually stick to one subject and use 20-30 years researching and publishing within that subject. The publications are reviews quoting original research done by others, that also include the few cases where vitamin D should be avoided. They are pretty objective according to my review, and apparently according to the peer reviews that allowed them to become published. Historicar33 (talk) 20:20, 16 October 2018 (UTC)

I think that the supplement part does nothing to advice people about the cause and effect of vitamin D deficiency, and how to solve it, a deficiency different from deficiencies of other vitamins that are not so much dependent upon being out in the sunlight. The highly sheltered and sedentary livestyles are a relatively new phenomenon, and vitamin D is actually a pro-hormon we produce because of sunlight, like we produce the hormon melatonin without light reacting to receptors in our eyes. Both are beneficial and have clear biological reasons to exist, even thought our lifestyles changed in the last few centuries. The article says that, I quote, vitamin D does more harm to the African-American population than others, assuming that vitamin D does damage in the first place. Too high doses of anything can do harm, but without the addition I added as to why African-American doses should be adjusted and a different form monitored, that poor formulation without addition could make people believe something as natural as insulin, glucagon and melatonin is harmful. We produce the first two on our own, while vitamin D and melatonin can only be produced in the presence or absence of sunlight (melatonin in the absence or almost all wavelengths of the light spectrum, such as those projected from monitors). My additions were deleted, keeping people unaware of the development of a new test designed specifically for Africans and African-Americans. Some people should know they need lower instant supplement doses of vitamin D, but that they still need the vitamin, and that they should have the concentrations monitored if living in northern climate or in not sunny seasons, sedimentary lifestyle, etc. Taking people out of a natural habitat and putting them in areas with less sunlight might have done some damage that can be corrected with the correct tests (1,25-dihydroxyvitamin D) and correct dose of supplement. Historicar33 (talk) 20:37, 16 October 2018 (UTC)
 * On your first point, not discounting those two publications (well, maybe, Grant), only suggesting that the existing text and referencing are weak and can benefit by reviewing all of the systematic review and meta-analysis literature. I agree that the deficiency part of the article needs more content, hence the creation of empty subsections.


 * For the consideration of adding a description of African-Americans having different blood vit D and binding proteins, I recommend the journal ref be used rather than the NPR interview of Dr. R. Thadhani. David notMD (talk) 11:54, 17 October 2018 (UTC)

My COI
Currently I am self-employed as a science consultant to companies in the dietary supplement, performance nutrition and functional food industries. I am not receiving payments from clients for making changes to Wikipedia entries (and have not, and will not). NO PAID EDITING. None of my clients are aware of my Wikipedia activities, and none have ever asked me to create or edit Wikipedia entries. My intentions are to avoid conflict of interest (COI) and maintain a neutral point of view (NPOV). For articles with more of a potential for COI I identify that information on my Talk page and on the Talk page of the articles in question. As in here. David notMD (talk) 14:29, 16 October 2018 (UTC)
 * Retired as of 1/1/19. David notMD (talk) 17:03, 11 January 2019 (UTC)

Deficiency section
I BOLDly removed a sentence from the beginning of that section here, and was reverted. My rationale is that exactly the same information is already in that paragraph, and after a description of its effect at the cellular level. It makes no sense to repeat exactly the same information (and with almost identical wording, no less) twice. The Blade of the Northern Lights ( 話して下さい ) 15:27, 22 August 2019 (UTC)
 * A more clear edit summary might help if you try it again. Dicklyon (talk) 15:30, 22 August 2019 (UTC)
 * Fair enough. I can sometimes be a bit too oblique. I've tried again, but tweaked it some; think this game out better. The Blade of the Northern Lights ( 話して下さい ) 15:38, 22 August 2019 (UTC)

Research
I added a section under research pertaining to Vitamin D deficiency in the United States and in athletes. This is a hot topic in sports nutrition research with likely more evidence to emerge. Mtt72 (talk 01:04, 1 December 2019 (UTC)
 * Prevalence already covered elsewhere in the article, and the ref did not appear to be addressing vitamin D and athletic performance. Consider instead:


 * Farrokhyar F, Sivakumar G, Savage K, Koziarz A, Jamshidi S, Ayeni OR, Peterson D, Bhandari M. Effects of Vitamin D Supplementation on Serum 25-Hydroxyvitamin D Concentrations and Physical Performance in Athletes: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Sports Med. 2017 Nov;47(11):2323-2339. doi: 10.1007/s40279-017-0749-4. Review. PubMed PMID: 28577257.
 * Han Q, Li X, Tan Q, Shao J, Yi M. Effects of vitamin D3 supplementation on serum 25(OH)D concentration and strength in athletes: a systematic review and meta-analysis of randomized controlled trials. J Int Soc Sports Nutr. 2019 Nov 26;16(1):55. doi: 10.1186/s12970-019-0323-6. Review. PubMed PMID: 31771586. David notMD (talk) 03:55, 1 December 2019 (UTC)

respiratory infections and lack of vitamin d
https://www.who.int/elena/titles/vitamind_pneumonia_children/en/

There is a connection between a lack of vitamin d and respiratory infections. This should be mention.
 * Needs reference(s) that are reviews of multiple clinical trials. David notMD (talk) 11:25, 16 April 2020 (UTC)


 * These are already there in Immune System | Infectious disease. Jrfw51 (talk) 16:35, 17 April 2020 (UTC)
 * So it does. David notMD (talk) 19:56, 17 April 2020 (UTC)

Covid-19
I have added the last three words to the following sentence (which is under the "Immunity" subheading): "Deficiency has been linked to increased risk or severity of viral infections, including HIV[82][83] and possibly Covid-19."

I'm not an experienced Wiki editor, so don't know the correct process or standards for my change (e.g. is "Covid-19" the correct name, and how to make it linkable). Perhaps someone can do it properly for me.

My source for my edit is mainly Dr. John Campbell. I am watching his YouTube channel during the Covid-19 pandemic, and he often strongly suggests that Vitamin D deficiency is very important to how badly people suffer from this virus. (I also don't know how to insert sources in the main article).

Regards, 122.62.138.18 (talk) 06:24, 8 May 2020 (UTC)Martyn


 * Added link and two medical reviews. Jrfw51 (talk) 08:17, 8 May 2020 (UTC)

Doses in COVID-19 clinical trials
This reverted edit was not a recommendation for the general public, but is in the section on Infectious diseases and COVID-19, and pertains to establshing semi-normal vitamin D blood levels in people deficient of the vitamin and who have severe COVID-19 disease. The Bergman review discussed high bolus (then weekly) doses of 10,000 IU per day or as much as 100,000 IU per month for some disease conditions where severe vitamin D deficiency is seen. The Ebadi review addresses using such high doses for vitamin D deficient people hospitalized with COVID-19 infections. This is new territory with ongoing clinical studies, so there are no reviews of completed trials to state firm conclusions, but there is evidence from the clinicaltrials.gov studies that large bolus amounts are being used to adjust vitamin D levels in the people with deficiency and severe COVID infection. As examples, this study is using a 25,000 IU bolus, this uses a bolus of 200,000 IU as "high" and 50,000 IU as "standard" (for correction), and this uses 5,000 IU per day for 2 weeks (70,000 IU total). Citing the Ebadi review is not Wikipedia's recommendation, but sources a reputable Nature review on a plan of action for adjusting toward normal the vitamin D deficiency that may be a risk factor for severity of COVID-19 infection, especially for hospitalized people in a clinical trial. Zefr (talk) 20:14, 21 May 2020 (UTC)
 * There are many protocols for treating vitamin D deficiency, but describing details in the context of COVID-19 (Ebadi) implies that this is the right amount, when it is not yet known if any amount prevents COVID-19 or reduces severity of symptoms of COVID-19. David notMD (talk) 21:25, 21 May 2020 (UTC)
 * The Ebadi article puts into words what the protocol details of the trials shown on clinicaltrials.gov state. As an ongoing event which editors are choosing to write into the encyclopedia, WP:NOW, if we're going to point to clinicaltrials.gov as evidence of how vitamin D is being used in COVID-19 studies, then there can be no legitimate objection to citing doses discussed by Ebadi and other clinical experts. The discussion requires context: bolus mega-doses are the choice of clinical trial designers and physicians, and they're only for hospitalized people with vitamin D deficiency and severe infection being studied in a clinical trial. Zefr (talk) 21:53, 21 May 2020 (UTC)

Exposure to sunlight
added the following text: but it was reverted by  as Unnecessary detail for this article.

I understand the argument that it may be WP:UNDUE, but I'm not sure I agree. The statement is well-sourced, relevant, and doesn't seem to be covered elsewhere that I can find. Can I ask Spaully to reconsider, please? --RexxS (talk) 12:22, 5 October 2020 (UTC)
 * I would argue that 2 paragraphs on this pandemic is unduly long, particularly where there the synthesis is that there is "no evidence for or against taking vitamin D supplements specifically to prevent or treat COVID-19". I agree the above statement is well sourced, though is essentially speculation, but that the relevance of the current pandemic to this overarching article on the vitamin itself is probably worth 2 sentences total rather than expansion. The nuance probably ought to go in the COVID-19 treatment/research articles. |→ Spaully ~talk~ 12:44, 5 October 2020 (UTC)
 * when I made my original edit, I included the text as well as consider supplementation to correct for the lower vitamin D naturally produced from lack of sun exposure. to try and account for this part of it (i.e. potential increased need for supplementation due to pandemic) - if my wording is not clear I think we should fix that rather than have a whole separate sentence about it. I agree it merits mentioning, but I think my current sentence was sufficient - even if it (almost certainly) could be worded better. -bɜ:ʳkənhɪmez (User/say hi!) 13:04, 5 October 2020 (UTC)
 * thanks both, for your thoughts on this. There is a lot of pressure to include information on COVID-19 in articles that it may be relevant to, and I'm grateful for your measured contributions to keeping that in perspective. Cheers --RexxS (talk) 13:10, 5 October 2020 (UTC)
 * , no problem at all - I think many articles will, for at least a year or two, merit specific sub-sections regarding COVID-19 simply because it's due weight at this time because of the extreme amount of weight the news has been giving it for months. That doesn't mean that they merit more than a paragraph or so (5-6 sentences most) imo in any article unless there's something more to say. I agree that there's a lot of pressure to include irrelevant COVID-19 information in articles it shouldn't be in - but we need to balance fighting that pressure with actually including the encyclopedic and due information that "it is being studied for COVID" or "it's not recommended for COVID"... that doesn't mean we include the entire genome of the COVID spike protein in an article about some failed treatment to explain why they thought it would work in the first place, for example :P - TLDR: basic information yes good include, but we must fight the pressure to include tons of other info beyond the basics. I also agree that (sub)sectioning should be evaluated on a case by case basis. -bɜ:ʳkənhɪmez (User/say hi!) 13:16, 5 October 2020 (UTC)


 * I've expressed my views on this at the MED talk page, here (see ) in the context of a broader discussion of what constitutes appropriate coverage/weight in cases like this (including guidance not confined to a binary conclusion on existence/absense of evidence). I absolutely understand that there are weight considerations within the page. But, fwiw, I believe that our responsibility to provide clear and appropriate information to readers who turn to Wikipedia as a go-to source of valid (and generally reliable :) information in the current crisis may outweigh that consideration, and also provide a real-world rationale for giving somewhat greater weight - for the time being - to COVID-19 content. But I acknowledge I don't have any specific WP guidance at hand to support (or contest) that view. For the sake of clarity, I should perhaps add that my considerations are absolutely *not* intended to undermine, or fail to recognize, the very hard work done here by highly competent contributors. Thank you, 86.190.128.126 (talk) 14:06, 5 October 2020 (UTC)
 * @IP - I agree that we do need to consider somewhat greater weight to COVID-19 related content - hence why I support the current state of this article - with a subsection of approximately 1 paragraph regarding the COVID-19 research and evidence (or lack thereof) for this. I do not think that further information is necessary in this article specifically. I'll note that I don't think anyone has a problem with the sentence you added - it simply duplicated something that was already in there (see: as well as consider supplementation to correct for the lower vitamin D naturally produced from lack of sun exposure). If you think that wording that's already there can be improved please feel free to improve that - but I don't think it needs restating in its own sentence. -bɜ:ʳkənhɪmez (User/say hi!) 14:15, 5 October 2020 (UTC)

Arbitrary break
Since the NICE guidance at least does, in effect, encourage following *regular* guidance on supplementation during the pandemic (and both NICE and NIH have thought it appropriate to issue some official guidance), might there perhaps be a case for splitting the COVID-19 content between == Use of supplements == and == Research == ? It seems to me that some of our current 'Research' content actually regards public-health guidance. And (at the risk of possibly annoying RexxS ;-), I think it's altogether reasonable to suppose that a subset of people consulting this page will primarily be interested in gleaning reliable information about the potential relevance of Vitamin D supplementation during this pandemic. 86.190.128.126 (talk) 14:31, 5 October 2020 (UTC)

SARS-CoV-2 and COVID-19 distinction refinements
In the "COVID-19" paragraphs I changed "... in patients with COVID-19." to '...for COVID-19 patients.' and "...treatment of COVID-19 infections." to 'treatment of SARS-CoV-2 infections.' Another option for the first instance is "...for patients with SARS-CoV-2 infections." These changes respect that COVID-19 is the name of the pandemic event, not the virus, which is named SARS-CoV-2. Please chime in if my changes seem flawed. Cheers! -- H Bruce Campbell (talk) 00:13, 19 October 2020 (UTC)

Vis-a-vis COVID-19: more reviews than trials
Still looking forward to results from the clinical trials. As of 19 September 2020, fifty (!!!) clinical trials of vitamin D for COVID19 are listed at clinicaltrials.gov. Until then, there is far more smoke than fire. I personally am not opposed to the evolving research section in the article, but consider it premature to mention treatment amounts until some of these trials reach publication. David notMD (talk) 16:53, 19 September 2020 (UTC)


 * We now have many reports of analyses of associations of 25(OH)D with incidence and severity, with multivariate analyses to address the confounding issues of ethnicity and other factors. Some are reviews. Regarding effects of treatment, I have tried to include the RCT from Castillo and have had it reverted on two occasions, once because it has "pilot" in the title. It has 76 patients, is prospective, double-masked, randomized 2:1 with calcifediol vs. best available therapy, and has clear highly significant differences in severity, measured as ICU admission.  Yes there is a bigger study on the way.  This study has been quoted in the mainstream media .  I would like to see this trial included in the Research section on RCT but will not add unless that is the consensus here. Jrfw51 (talk) 19:16, 19 September 2020 (UTC)
 * I am against including the Castillo trial in the article. In addition to being small (yes, I consider that small), vitamin D status was not determined, and furthermore, all patients were treated with hydroxychloroquine and azithromycin. For all we know, the vitamin D reduced the drug adverse effects. Unlikely, but still. David notMD (talk) 21:27, 19 September 2020 (UTC)
 * Hmm. Your theory is not discussed in this otherwise good paper.  Very unlikely in my opinion based on what we now know.  Included a multivariate analysis. ICU admission: Calcifediol 1 in 50 vs. 13 in 26 on standard care.  Have you seen this is in WP here: COVID-19 drug repurposing research?  Would you like to include that? Jrfw51 (talk) 18:38, 22 September 2020 (UTC)
 * It looks like there are some reviews available, but most are either primarily about something else (e.g., sleep apnea) or extend prior, non-COVID-19-specific work to COVID, e.g., "Level 1 and 2 evidence supports the use of thiamine, vitamin C, and vitamin D in COVID-like respiratory diseases, ARDS, and sepsis." WhatamIdoing (talk) 16:02, 2 October 2020 (UTC)
 * Without a good-quality review supporting the use of vitamin D in COVID-19 itself, attempting to extrapolate its effect on similar respiratory diseases is classic WP:SYNTH. --RexxS (talk) 16:37, 2 October 2020 (UTC)


 * Vitamin D is not a novel drug or vaccine being evaluated for safety and efficacy. It is an essential nutrient that every human has in their body. The questions that needs to be understood is "what is the optimal level, what level is sufficient, and what level is considered deficient", as well as "is there a causal relationship between vitamin D levels and COVID-19 outcomes", and "does supplementation help a population" and "is Vitamin D useful as part of a COVID-19 treatment regimen"? The data is overwhelmingly strong showing that there is not just a correlation between Vitamin D levels and COVID outcomes (rate of positive tests, showing symptoms, requiring hospitalization, requiring ICU care, requiring mechanical ventilation, mortality), but a causal relationship. It's to the point where withholding Vitamin D supplements, and withholding Vitamin D treatment from COVID patients would be as unethical as withholding a parachute from those jumping out of airplanes at high altitude. We don't need a randomized controlled trial to determine whether parachutes result in improved outcomes for high altitude jumps any more than we need another RCT for Vitamin D supplementation to correct deficiency. Observational studies are valid and more ethical than waiting for another RCT. Supporters of Vitamin D to combat COVID have no more burden of proof than those who would withhold Vitamin D from a population that is deficient, or from COVID patients. This blog post by Dr. David Grimes, critiquing the UK's NICE and their analysis of the available data, explains these points better than I could. It is required reading for anyone who wishes to update the COVID-19 section of this article. Tvaughan1 (talk) 22:36, 22 October 2020 (UTC)


 * An expert panel in Switzerland has published a white paper, advising the population to take 2000 iu/day of Vitamin D. We now see the UK government waking up to the realization that supplementation is necessary and helpful for a population in a northern latitude which doesn't produce enough Vitamin D from sunshine.  Canada's Yukon government has public service messaging (however awkward) advising Vitamin D supplementation. Tvaughan1 (talk) 15:53, 23 October 2020 (UTC)
 * The Swiss panel "white paper" is not in a peer-reviewed journal. The authors acknowledge that many trials are ongoing, but results not yet available. In addition to their recommendation for vitamin D, they also recommend vitamin C at 200 mg/day, omega-e fatty acids at 500 mg/day, selenium at 50-100 micrograms per day and zinc at 10 mg/day. All of these nutrients have some evidence for impacting immunity, but in my opinion the critical connection between supplementing vitamin D in placebo-controlled clinical trials of either people who are not infected (prevention concept, requires very large trial), or people who have been diagnosed as infected (treatment concept, smaller trial) is still lacking, and until that evidence is available, any wording implies or is a recommendation is not yet warranted. David notMD (talk) 02:25, 24 October 2020 (UTC)
 * As of October 23, 2020 there is one published clinical trial (Castillo). Until the myriad ongoing trials are published, I am steadfast in my opinion that the COVID-19 section in Vitamin D should remain in a Research section with the existing citations, which all conclude that clinical trial results are crucial. I've had a long career in clinical nutrition (PhD MIT 1981) and have seen repeated examples of correlative evidence refuted by subsequent clinical trials (beta-carotene and lung cancer, selenium and prostate cancer...). David notMD (talk) 02:35, 24 October 2020 (UTC)
 * The causal relationship between pre-infection serum Vitamin D levels and COVID outcomes can't be determined in a randomized controlled trial (at least, not ethically, and not in any reasonable time frame). It can only be determined in observational studies, which are valid if done right. These findings should be shared in the research section. In terms of interventional treatments, most Vitamin D researchers would conclude at this point that withholding Vitamin D treatment from a control group would be unethical, given the overwhelmingly positive statistically significant effects observed thusfar (despite a smaller sample size in the Castillo study, the strength of the outcome makes the effect undeniable from a statistical perspective). Here is a another study (not peer-reviewed yet) showing the positive effects of Vitamin D treatment for COVID patients... Ling, Stephanie Fenxi and Broad, Eleanor and Murphy, Rebecca and Pappachan, Joseph Mundattuchundayil and Pardesi-Newton, Satveer and Kong, Marie-France and Jude, Edward Bernard, Vitamin D Treatment Is Associated with Reduced Risk of Mortality in Patients with COVID-19: A Cross-Sectional Multi-Centre Observational Study. http://dx.doi.org/10.2139/ssrn.3690902 Tvaughan1 (talk) 15:51, 24 October 2020 (UTC)
 * As is evident from what has gone before (and then deleted), I would be in favour of citing large, primary, high impact, observational studies showing the evidence and relationships of the associations of vitamin D with Covid incidence (or severity) such as here, but others want to wait until someone has incorporated these into their secondary reviews. However, I do think we have to wait for studies such as the ones you quote to be peer-reviewed and then published.  This is a critical and exciting time and thankfully, the clinicians and scientists aren't just waiting for WP to get it right! Jrfw51 (talk) 17:35, 24 October 2020 (UTC)
 * The Lancet posted the following as a preface to that clinical trial report. "Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These papers should not be used for clinical decision making or reporting of research to a lay audience without indicating that this is preliminary research that has not been peer-reviewed." I agree. David notMD (talk) 18:41, 24 October 2020 (UTC)


 * As has previously been discussed at WT:MED, is is critically important we follow the WP:PAGs - in this case. in particular, WP:MEDRS - for any biomedical material related to COVID-19. That makes the decision easy. Alexbrn (talk) 19:12, 24 October 2020 (UTC)

Natural levels.
In the last 6 months the only credible research about desired blood concentrations I have seen with rational basis and detectable endpoints have ALL suggested a MINIMUM level of 75nmol/l (30ng/ml) with MOST of them favouring levels over 100nmol/l (40ng/ml) and extending to 150 to 250nmol/l (60 to 100ng/ml) (changed 80 to 100 typo fix). Yet this page only references old recommendations that have been shown to be ill founded and based on strange historical fear limits before any actual trials were ever done on danger levels.

This article needs to bring to front and centre what the NATURAL level of this pro-hormone is that we need to function optimally. The fact that all but a few papers indicate benefits of increasing serum levels up to around 75 to 125nmol/l (30 to 50ng/ml) as required to achieve physiological saturation and substrate repletion is indicative of a real physiological use for the substance. This article is wrong and costing human society thousands of lost lives per day from a long list of ailments that can be reduced by changing a simple number. There are dozens of research papers that are more up-to-date and more credible that propose higher serum levels yet here we have an encyclopaedia that caves in and quotes the research with the lowest figures and then throws in a bit of unfounded fear as we approach the lower end of the healthy scale.

Fixing this ONE THING will do so much more than trying to guess about doses and waiting for CoViD-19 research to verify the action on yet another corona virus as has been seen previously. Right now I put on record here that Wikipedia is party to a massive crime against humanity if it only shows one side (the wrong side) of an argument about how much Vitamin-D metabolite we should have in our blood.

Here is a random sample paper that is just one of MANY that conclusively show that we were designed to operate with higher than advertised levels of 25(OH)D.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1868557/

P.S. The smoking gun for me is that you need over 110nmol/l (44ng/ml) (or was it 114nmol/l) in a lactating mothers blood before her breast-milk will start to express Vitamin-D for the infant. It is simple, if we get rickets our hips do not form correctly for childbirth, until the mother has enough Vitamin-D (= sunshine) the society cannot survive. Therefore we KNOW that PRE-URBAN woman had natural levels from the fact that WE ARE HERE. This cannot be explained away with U or J shaped curves and heath risks from mega-doses or Vitamin-A poisoning when eating Bear livers on Arctic trips that were blamed on Vitamin-D or trials and treatments with fast acting metabolites and analogues or null effects from micro doses or ignoring of skin synthesis when calculating winter doses. This Wikipedia page is wrong on the optimal blood level and there is lots of research to prove it so.

Once this single point of failure error is corrected the rest of the speculation will collapse into determining how much we should take, winter and summer and latitude dependant or tested against out blood levels.

Idyllic press (talk) 12:17, 22 September 2020 (UTC)


 * Per the article section on recommended serum levels, the U.S. Institute of Medicine concluded in 2011 that a serum 25(OH)D level of 20 ng/mL (50 nmol/L) is needed for bone and overall health. The Institute found serum 25(OH)D concentrations above 30 ng/mL (75 nmol/L) are "not consistently associated with increased benefit", and that serum 25(OH)D levels above 50 ng/mL (125 nmol/L) may be cause for concern. The serum levels can be achieved when vitamin intake is at the RDAs (or equiv for other countries). Please keep in mind that Wikipedia is an encyclopedia rather than a worldwide medical authority that dictates medical practice. If enough evidence accrues that serum levels should be higher to achieve optimal health, then that will be summarized is reliable sources and changes to government recommendations - and Wikipedia will report that. David notMD (talk) 14:18, 1 October 2020 (UTC)


 * The "J" shaped curve that IoM relies on to promote lower levels of supplementation and serum targets is old and has been superseded, they were aware of the safe ranges but wanted to be cautious when setting recommendations. Wikipedia should not follow cautious recommendations set by committees based on outdated information they should follow science.
 * * 6 Tolerable Upper Intake Levels: Calcium and Vitamin D 2011


 * The benefits of higher serum levels are shown to extend beyond 40ng/ml (100nmol/l) consistently.
 * * Meta-analysis of All-Cause Mortality According to Serum 25-Hydroxyvitamin D 2014
 * * Vitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium 2017


 * EDIT In David's comment above we see the seeds of Wikipedia's destruction (somewhat joking) with the use of the words U.S. and government being central to the problem that Wikipedia is fighting against. This is a global encyclopaedia and it is duty bound to promote global knowledge.  Using the vagaries of the US or UK or Finnish health departments committees results as science is not right, yes I do understand that is how most of us are programmed but the weight of evidence is not improved simply because it comes from a government body, one could speculate that the quality of the data is reduced and should be avoided where possible.  This page is not and nor are any of the other pages marketing pages for national or language specific government programs, they are intended to collate facts.  I also appreciate as mentioned neatly in a section above that Wikipedia is not intended to be a trendsetter, however it must also not be simply a publisher of government policy, so let us try and put more weight into NON-GOVERNMENT sources where they are available, we do not HAVE to wait for them to catch up so we can catch up, Wikipedia does not have to be LAST and WRONG to boot.


 * Idyllic press (talk) 18:04, 26 October 2020 (UTC)

my 2 cents
where are the health benefits in this page?(the main)

Wikidrift (talk) 02:54, 30 October 2020 (UTC)

ok, i just read 'talk guidlines' and now i can't figure out how 2 delete this entry. — Preceding unsigned comment added by Wikidrift (talk • contribs) 02:57, 30 October 2020 (UTC)
 * No harm, no foul. David notMD (talk) 22:21, 30 October 2020 (UTC)

Cancer
For this source: We have:

removed the work "weak" considering it to be editorializing. However, I think we need some way to account for the extensive discussion in the paper of the limitations in the evidence, e.g.

Thoughts? Alexbrn (talk) 16:12, 16 November 2020 (UTC)


 * That is only part of one paragraph from a 6 paragraph discussion. That paragraph concludes by saying:


 * This seems to me to suggest the analysis is limited by the design of the trials, and not the overall evidence or the conclusion, which is as stated in the Abstract. Here is the first paragraph of the Discussion:


 * This seems pretty strong evidence, or at least not weak, to me! Jrfw51 (talk) 16:39, 16 November 2020 (UTC)
 * The trials being small and underpowered (along with the other caveats the paper mentions) means the evidence they produce is weak or limited (which word I would prefer to weak, except it's already in the sentence). We need to try and make a good summary of the whole paper, and not be overly guided by the abstract. You see there that the evidence is "pretty strong" - I think we need to resist this implication, as it doesn't capture the meaning of the source well enough. Alexbrn (talk) 16:53, 16 November 2020 (UTC)
 * A further problem indicating "weakness" is that the studies reviewed had a 10-fold difference in vitamin D doses (400-4000 IU/day), rendering the source uninterpretable and barely usable. Zefr (talk) 17:00, 16 November 2020 (UTC)
 * This is a meta-analysis, which takes into account the size and power of individual studies, and the authors do not use "weak" or "limited" in reference to the overall conclusions. Note also the sentence Nonetheless, our summary findings (i.e. direction and magnitude of effect size) remain largely unchanged when the analysis was limited according to trial methodology or outcome.  The first paragraph of the Discussion was given here to show wording differently to the Abstract.  However ... aren't we on dangerous ground if we try to review, summarise, or synthesise too much from the details in what is a high-quality MEDRS source? Jrfw51 (talk) 17:19, 16 November 2020 (UTC)
 * Summarizing is exactly what we are meant to do. The question here is what is a good summary. Alexbrn (talk) 17:23, 16 November 2020 (UTC)
 * Agreed. We should summarize their findings.  Words like "weak" and "limiting" should not come from us, from only from quotes of what they found. Dicklyon (talk) 02:08, 18 January 2021 (UTC)

Holick refs?
Holick is not considered a neutral point of view person when it comes to vitamin D. Refs for which he is an author should be reviewed for text supported by ref, and ref represents NPOV. As of this date, Holick first author on 16 refs. David notMD (talk) 22:19, 30 October 2020 (UTC)
 * I too was thinking about the need to review the sources here. There is little reference to the latest NIH update in 2020 https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#en1 which is a strong balanced source and I think should be a major source now.  I will make a start in replacing older sources with this.  Holick has probably done more research on vitamin D than anyone still publishing.  He has led the work on photobiology on the effects of UV light and vitamin D synthesis, and the resulting blood levels.  It would be impossible and unjust to replace appropriate sources simply because he is an advocate for higher vitamin D levels. We need a balance of different viewpoints (from secondary sources of course) to end up with WP:NPOV. Jrfw51 (talk) 10:14, 31 October 2020 (UTC)
 * Not 'cancel' per se, but some value in reviewing for bias, or just for a newer, more review-like ref. For example, #176 (PMID 2825606) is a 1987 ref with some general content but veers into treatment of psoriasis even though its use as a ref is only for basic science. David notMD (talk) 12:09, 31 October 2020 (UTC)
 * Yes this will take a long time to update. The NIH ODS is a good general source on synthesis, levels and effects but we need others too. I have done some work on the skin section. Here is an updated recent (Sept 2020) Holick review PMID 32918212 on skin effects which can replace what you highlighted.
 * I added Present Knowledge in Nutrition (2020) as a ref (currently #15: Fleet JC, Shapses SA). Very good content. However, not available on line. I intend to use it to replace some of the older or flimsy refs. David notMD (talk) 19:14, 31 October 2020 (UTC)
 * I'm sure that is a good secondary source for well-established background content and current views -- but, it is not available online for others to check and learn more. I try to cite open sources so people can expand on what we can write concisely here.  But yes, let's continue to replace some of the older and flimsier refs with better sources.  Good luck!  Jrfw51 (talk) 19:39, 31 October 2020 (UTC)
 * What basis do you have for accusing Dr. Holick of being biased in his work? Certainly his work has focused on Vitamin D. He is "widely recognized as one of the leading vitamin D experts in the world".Tvaughan1 (talk) 18:18, 26 January 2021 (UTC)
 * FFS, you linked to mercola.com to try and show something isn't dodgy!?! Alexbrn (talk) 18:23, 26 January 2021 (UTC)
 * If there is a bell curve for consensus, in my opinion Holick is a couple of standard deviations to the it-cures-everything and more-is-better side. David notMD (talk) 21:17, 5 February 2021 (UTC)
 * It's more that vitamin D intake well below the natural intake from the Sun of between 5,000 to 10,000 IU/day is putting people at risk to a whole host of problems, while conventional medical science has approached this problem from the other end. They started with the null hypothesis that we need zero, and then let the evidence disprove the null hypothesis. They then formulated a new null hypothesis that we need a dose of X where X is the lowest dose for which the corresponding null hypothesis is not falsified at the 95% level. It's likely that the value of X will slowly converge to around 5000 IU/day on a time scale of a century, but I'm not going to wait for that. Count Iblis (talk) 00:29, 6 February 2021 (UTC)
 * Ref 156 is a good summary of the changes in UL recommendations from 1997 to 2011: for adults, was 2,000 IU, became 4,000 IU. Reasons for a UL are identified as non-skeletal conditions that demonstrate or suggest a U-shaped curve, with higher risk of disease at both the lower and higher ends of blood concentration. Adverse effects were documented at above 10,000 IU/day, and an uncertainty factor of 2.5 was used to land at 4,000. However, this Talk section is not about RDA or UL, but about Holick being an outlier rather than a prophet, so my intent is too review content that cites him, to see if current consensus reaches different conclusions. David notMD (talk) 12:38, 6 February 2021 (UTC)

The IOM interpretation of the studies which led to the RDA has been shown to have a major statistical error, as described here PMID 25333201. This was also addressed here PMID 25763527. These data suggest that higher doses than those that were recommended in 2011 are necessary to meet the RDA requirements. None of these authors is Dr Holick. WP:MEDRS will find it hard to incorporate this argument while there are national guidelines that say otherwise, but criticism of Dr Holick as an outlier is not needed -- many other leading scientists accept these figures. Jrfw51 (talk) 23:23, 6 February 2021 (UTC)
 * Yes, yes, a big error, problem is that if that was true, the amounts for supplementation would be so high, that those "cutoff levels cannot be physiologically met by diet or sun exposure alone". And that is why neither the IOM nor NIH did not change anything. So stop spreading this nonsense about "major statistical error". --Julius Senegal (talk) 10:31, 7 February 2021 (UTC)
 * Please explain your use of "nonsense" in relation to the statistical error. There are better words if you wish to add to the debate.  They use the non-controversial serum value -- assessing the amount of vitamin D supplementation needed for 97.5% of individuals to achieve serum 25(OH)D values of 50 nmol/L.  We need balance in this discussion.  Much of the problem is that on a population level adjustment of supplement dosage is not being made for different individual responses.  However, my contribution here was aimed at showing that others share concerns raised by Mike Holick. Jrfw51 (talk) 12:55, 7 February 2021 (UTC)
 * It is nonsense if you propose cutoff levels which are impossible to meet without supplmenetation. It is also nonsense as IOM or NIH or other organisations did not change anything. So this paper about the "statistical error" is not reliable for this discussion. --Julius Senegal (talk) 08:21, 15 February 2021 (UTC)
 * The entire reasoning in the article makes no sense at all, let's look at the entire paragraph, with me making bold the relevant statements: "The higher cutoffs recommended in some of these guidelines are also based on the plateauing effect on the levels of parathyroid hormone (PTH) with increasing levels of serum 25(OH)D. The functional significance of these higher cutoffs is unknown, and these cutoffs are likely to overestimate the burden of vitamin D deficiency in large populations leading to unwarranted use of vitamin D supplements. In fact, some individuals or agencies have recommended such a high level that almost every human being on the earth will be classified as having insufficient vitamin D nutriture.(18) These high cutoff levels cannot be physiologically met by diet or sun exposure alone, and will require a substantial dose of vitamin D supplements throughout life. On the other hand, the IOM (2010) committee has still based its recommendations (deficiency <30 nmol/L, insufficiency 30–50 nmol/L, and sufficiency 50–75 nmol/L) on the indicators of bone health as a review of plethora of the literature did not suggest any additional evidence of benefit beyond the recommended levels.(13) The committee recommended that “given the concern about high serum 25(OH)D levels as well as the desirability of avoiding misclassification of vitamin D deficiency, there is a critical public health and clinical practice need for consensus cut points for serum 25(OH)D.”(13) It is apparent that raising the level of vitamin D beyond the cutoffs of deficiency/sufficiency (30–50 nmol/L) is inappropriate unless there is a clear benefit (without any risk) of this strategy."
 * So, they leap from some individuals or organizations making recommendations that may lead to people taking supplements at dosages that could be too high to then arguing that we should stick to the very low levels the IOM recommends because we don't know what the benefits are beyond the very low amounts needed for bone health, the argument being that there may be risks.
 * This reasoning then ignores that the natural levels of vitamin D are way higher than what the IOM recommends and that the possible adverse effects come from studies on very old people who were given extremely large bolus dosages. Count Iblis (talk) 09:29, 15 February 2021 (UTC)
 * Which article are you referring to there? Jrfw51 (talk) 14:26, 15 February 2021 (UTC)

VitD supplementation unlikely to have a clinically relevant effect on acute respiratory tract infections
The effect of vitamin D supplementation on ART infections for eldery: Well, a monthly 60,000 IE vitamin D supplementation was not convincing: .--Julius Senegal (talk) 08:59, 12 March 2021 (UTC)
 * Interesting to consider this piece of primary research which of course is only suitable for the talk page as it is not high WP:MEDRS quality. They had a population which is predominantly vitamin D replete with mean levels on placebo of 77nmol/L.  There was a small reduction in duration and severe symptoms with supplements.  Also they gave monthly bolus doses which have different pharmacokinetics from daily supplements.Jrfw51 (talk) 09:58, 12 March 2021 (UTC)

Studies showing benefits of Vitamin D in prevention and treatment of Covid

 * All of the information below is from this excellent YouTube video - Vitamin D and COVID 19: The Evidence for Prevention and Treatment of Coronavirus (SARS CoV 2). Tvaughan1 (talk) 00:06, 15 December 2020 (UTC)

Professor Roger Seheult, MD explains the important role Vitamin D may have in the prevention and treatment of COVID-19. Dr. Seheult illustrates how Vitamin D works, summarizes the best available data and clinical trials on vitamin D, and discusses vitamin D dosage recommendations.

REFERENCES:

The National Human Activity Pattern Survey (NHAPS)... (J. of Exposure Analysis and Environmental Epidemiology) | https://www.researchgate.net/publicat...

Aging decreases the capacity of human skin to produce vitamin D3 (The J. of Clinical Investigation) | https://pubmed.ncbi.nlm.nih.gov/2997282/

Racial differences in the relationship between vitamin D... (Osteoporosis Int.) | https://www.ncbi.nlm.nih.gov/pmc/arti...

Decreased bioavailability of vitamin D in obesity (The American J of Clinical Nutrition) | https://academic.oup.com/ajcn/article...

Vitamin D Insufficiency and Deficiency and Mortality from Respiratory Diseases ... (Nutrients) | https://www.mdpi.com/2072-6643/12/8/2488

Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis... (BMJ) | https://www.bmj.com/content/356/bmj.i...

Randomized trial of vitamin D supplementation to prevent seasonal influenza A... (The American J.of Clinical Nutrition) | https://pubmed.ncbi.nlm.nih.gov/20219...

Vitamin D and SARS-CoV-2 infection... (Irish J. of Medical Science) | https://link.springer.com/article/10....

Factors associated with COVID-19-related death... (Nature) | https://www.nature.com/articles/s4158...

Editorial: low population mortality from COVID-19 ... (Alimentary Pharm. & Therap.) | https://pubmed.ncbi.nlm.nih.gov/32311...

The role of vitamin D in the prevention of coronavirus ... (Aging Clinical & Experimental Research) | https://www.ncbi.nlm.nih.gov/pmc/arti...

25-Hydroxyvitamin D Concentrations Are Lower in Patients with ... SARS-CoV-2 (Nutrients) | https://www.mdpi.com/2072-6643/12/5/1359

Vitamin D deficiency in COVID-19: Mixing up cause and consequence (Metabolism) | https://www.ncbi.nlm.nih.gov/pmc/arti...

Low plasma 25(OH) vitamin D level... increased risk of COVID-19... (The FEBS J.) | https://pubmed.ncbi.nlm.nih.gov/32700...

The link between vitamin D deficiency and Covid-19... | https://www.medrxiv.org/content/10.11...

SARS-CoV-2 positivity rates... with circulating 25-hydroxyvitamin D levels (PLOS One) | https://journals.plos.org/plosone/art...

Vitamin D status and outcomes for... COVID-19 (Postgrad Medical J.) | https://www.ncbi.nlm.nih.gov/pmc/arti...

Vitamin D Deficiency and Outcome of COVID-19... (Nutrients) | https://www.mdpi.com/2072-6643/12/9/2757

“Effect of calcifediol treatment...” (The J. of Steroid Bio. and Molec. Bio.) | https://www.ncbi.nlm.nih.gov/pmc/arti...

Vitamin D and survival in COVID-19 patients... (The J. of Steroid Bio. and Molec. Bio.) | https://www.ncbi.nlm.nih.gov/pmc/arti...

Effect of Vitamin D3 ... vs Placebo on Hospital Length of Stay...: A Multicenter, Double-blind, Randomized Controlled Trial | https://www.medrxiv.org/content/10.11...

Short term, high-dose vitamin D... for COVID-19 disease: a randomized, placebo-controlled, study [SHADE study] (Postgraduate Medical Journal) | https://pmj.bmj.com/content/early/202...

Association of Vitamin D Status... With COVID-19 Test Results (JAMA Network Open) | https://jamanetwork.com/journals/jama...

Vitamin D Fortification of Fluid Milk ... A Review (Nutrients) | https://www.ncbi.nlm.nih.gov/pmc/arti...

Analysis of vitamin D level among asymptomatic and critically ill COVID-19 patients... (Scientific Reports from the Journal Nature) | https://www.nature.com/articles/s4159... Ocdctx (talk) — Preceding undated comment added 00:33, 14 December 2020 (UTC)

BBC report of 'cover-up' conspiracy theory, based on a paper that was widely reported and then withdrawn - without matching reporting of its withdrawal
My addition of this text "A paper from the University of Barcelona "suggested vitamin D had staggering success, with an 80% reduction in intensive care admissions and a 60% reduction in Covid deaths". But "the paper has since been withdrawn over 'concerns about the description of the research, and The Lancet journal is now launching an investigation into the paper"."

has been reverted per wp:MEDRS. This would seem to suggest that it is my summary (of the BBC report) that is inadequate rather than the report itself, since I had no intention of making a medico-scientific contribution. As the report itself mentions, and the original topic of this section (above) confirms, the belief is widespread that Vitamin D is the magic bullet for COVID. Of course this is nonsense but it seems to me that if the article fails to address this urban myth head on, we leave a vacuum for the fantasists to fill. "It must be true because Wikipedia is avoiding the issue."

So, per wp:BRD, the discussion I would like to open is this: how can we best put a visible stake through the heart of this nonsense? "I see no ships" is not a sensible position to take, as the article seems to do now. --John Maynard Friedman (talk) 18:12, 5 April 2021 (UTC)
 * The reason I had reverted the addition was because as written, it specified the purported/disputed benefits from vitamin D supplementation as percentage reductions in deaths and intensive care hospitalizations (per Univ Barcelona). This gave undue exposure/weight to results later challenged. A casual reader could have a take-away that vitamin D is hugely beneficial and those results are being suppressed. In my opinion, anti-vacc people will latch on to whatever they wish (including, apparently, that the vaccine is the "mark of the Beast"), but Wikipedia is better for reporting what meta-analyses are reporting, not any individual trial, either accepted or retracted. David notMD (talk) 19:38, 5 April 2021 (UTC)


 * There have been many medical, scientific and lay press articles (such as this BBC report) during the pandemic on whether there are significant associations (or not) of vitamin D deficiency with the risk of getting COVID-19, its severity and/or mortality. Several studies have looked at the effects of giving vitamin D supplements.  Systematic reviews and meta-analyses of these trials are high quality sources (as per WP:MEDRS), as are recommendations by national bodies, and we have a summary of these differing sources.  The Barcelona preprint quoted is a primary source which has not undergone peer-review and not been published, with strengths and weaknesses at several levels.
 * We need to wait until there are secondary sources that have assessed whether this is a "magic bullet" or "nonsense". We all inevitably have our own POVs but that is why we need to stick to WP:MEDRS for the sources to be acceptable. Jrfw51 (talk) 19:42, 5 April 2021 (UTC)
 * Ok, good argument. Accepted. --John Maynard Friedman (talk) 22:33, 5 April 2021 (UTC)