Amazing the depth. Thank you, as always. I'm struggling with my explanation of why I have chosen to not be vaccinated. I don't have that "pitch" because I get distracted by, 'trumper', non-vaxxer, selfish, ... I believe none of those to be my personal reason yet I'm feeling pigeonholed even in my close group of friends and family. "Well, uh, I am 50ish, fit, eat well, exercise, get enough V-d, wear masks without any disgruntlement, wash my hands, social distance when needed...and uh, I'd rather wait and see what happens...? Because we don't have long term effects yet on these Vax's?" It accords with my understanding. Solo understanding, I guess, in my very polarized circles. Anyway, thanks for all yours and Bret's efforts to keep us all searching, reading and trying to be good humans.

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Fact Check: TRUE

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Heather, thank you for the great read. I have been a proponent of being outside for years. Especially for children. I believe most of what ails our children is due to a lack of simply being outdoors. There's a lot more I could say, but I will leave with just a personal note on how thankful I am for your and Bret's deep dive into such a wide range of important topics. Even though we reside in Michigan, we are at least close enough to a Great Lake beach that we frequent throughout the year, but especially in the summer! So very frustrated that our politicians are so apt to get on the band wagon of vaccines. Just today our governor is paving the way to speed up distribution of the COVID vaccine to children 5-11. My stomach turns. So many parents will hop on this band wagon, because getting the vaccine will be the "cool" and "right" thing to do. They want to so desperately fit in for fear of looking like a "bad" parent, that they will blindly follow this path. My heart aches today for our children.

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Linda Benskin, whose review you cite, asked me to post this on her behalf:

Dear Heather,

I appreciate your kind words about my Basic Review concerning the link between vitamin D levels and Covid-19 outcomes. I'm honored that you cited it several times in this post.

However, at this point, the Basic Review is out of date. I wrote this invited, heavily referenced, Chapter:


only two months ago. I voluntarily put it through a rigorous open review process with well known vitamin D experts and others (see acknowledgements) before submitting it to the publisher, who sent it through the standard blinded peer review process (the latter accepted it without changes). It is listed as a preprint on ResearchGate only because I wanted to post a document I could edit freely if I learned anything needed to be corrected.

In the Chapter, I emphasize the strong evidence of a causal relationship, most of which was not available a year ago. As I was researching for the chapter, I also learned that the target level for serum 25(OH)D should be much higher than I previously thought. The graphs in the chapter show clearly that both surgical site infection rates and Covid-19 infection rates drop as vitamin D levels rise, plateauing at close to zero when 25(OH)D levels reach 50ng/ml. The target level for vitamin D should therefore be a minimum of 50ng/ml. This means I would now recommend higher dosages of D supplements.

The story of the Boston area dairy that accidentally fortified their milk at 575 times the intended amount for several years, included in the chapter, illustrates how incredibly safe vitamin D supplementation is for the general public.



Linda Benskin, PhD, RN, SRN (Ghana), CWCN, CWS, DAPWCA


Improving health care in rural areas of tropical developing countries

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Thank you (again) for this. I will amend the piece to indicate that this newer, better review is now available.

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2/2 Please read the research articles cited at https://vitamindstopscovid.info/05-mds/ , including especially McGregor et al, who show that Th1 regulatory lymphocytes rely on good 25-hydroxyvitamin D levels to run each cell's autocrine signaling system. When this works, the initially pro-inflammatory mix of cytokines they produce at startup only lasts until a high level of a complement protein is detected, whereupon the cell transitions to its anti-inflammatory shutdown program. The Th1 cells they extracted from the lungs of hospitalised COVID-19 patients remained stuck forever in their pro-inflammatory startup program. The complement protein was detected and the autocrine signaling system activated. However, it could not complete its operation due *solely* to the lack of 25-hydroxyvitamin D. This explains why Castillo et al. found that a single oral dose of 0.532mg calcifediol (the pharma name for 25-hydroxyvitamin D) when given to hospitalised COVID-19 patients, reduced ICU admissions from 50% to 2% and deaths from 8% to zero. This treatment fixed up their 25-hydroxyvitamin D levels - to well over 50ng/ml - in four hours. Ordinary healthy D3 intakes would take months to attain this. Bolus D3, such as 10mg 400,000 IU (single dose) is better, but it still takes a few days due to its need to be hydroxylated to 25-hydroxyvitamin D in the liver.

The same UV-B light, around 297nm, which converts 7-dehydro cholesterol to D3 also damages DNA and so raises the risks of skin cancer. This is not some vague theoretical possibility. It harms and kills a lot of people: https://www.canceraustralia.gov.au/cancer-types/melanoma/statistics . Relying on this to attain 50ng/ml all year round is asking for trouble. 25-hydroxyvitamn D has a half life of weeks to a month or two at these healthy levels. It is impossible to load up on D3 in summer and ride out winter at 50ng/ml or more. Our ancestors who moved to Northern Europe lost their melanin for good reason, but there's no reason to believe they had healthy D3 levels at any time, especially in winter. They survived. They did not necessarily thrive.

Fortunately, evolution has given us the brains and social skills to get highly coordinated and make D3 in factories. There are only a handful in the world. None are owned by multinational pharmaceutical companies. They involve extremely specialised UV-B radiation of 7-dehydrocholesterol, which is difficult to prepare from lanolin. It is dissolved in hydrocarbons and the UV-B breaks a carbon-carbon bond to open up one of the carbon rings and make D3. This requires a lot of UV-B - and so a lot of electricity - to make 1kg of D3, and they use extremely specialised, multi-kilowatt, water cooled mercury vapour lamps, which are doped with iron (I think) to make them emit at the necessary wavelength, since mercury's emission lines are all at different wavelengths.

Most of this D3 is made for agricultural animals who are kept indoors all their lives - primarily poultry and pigs. Some of it is refined to pharmaceutical standards for humans. This costs USD$2500 / kg ex-factory. This is USD$2.50 a gram, and the above-mentioned 0.125mg 5000IU / day is a gram every 22 years. So the ex-factory cost of the D3 an average weight person needs to be fully vitamin D replete is about one US cent a month.

To replete all humans on Earth to ~50ng/ml 25-hydroxyvitamin D, we need about 1 tonne of D3 a day. This would cost about USD$1B a year at current prices. It just needs to be split into once-a-week tablets or capsules. The health benefits would go far beyond suppressing COVID-19 transmission and severity to the point of ending the pandemic and almost all of the current toll of suffering, harm and death.

My article https://nutritionmatters.substack.com/p/government-vitamin-d3-supplementation tells how the Institute of Medicine chose 20ng/ml as its standard of repletion in 2010, despite researchers and MDs calling for 40 to 60ng/ml to be the standard, since 2008: https://www.grassrootshealth.net/project/our-scientists/ . Then the IOM miscalculated that only 0.01mg 400IU D3 a day would be sufficient to attain this, when the real value is over 12 times higher. Many doctors and all governments still follow these two completely faulty recommendations, as does Pearce and Cheetham 2010 https://www.grassrootshealth.net/project/our-scientists/ who you cite.

There's no such thing as vitamin D rich food, unless perhaps you think that 0.01mg 400IU / day D3 is sufficient. The real need is for 0.125mg = 125ug a day for 70kg bodyweight. According to Lamberg-Allardt, who you cite, https://www.sciencedirect.com/science/article/pii/S0079610706000071 this is 1.7kg of salmon, 1kg of salmon (wild or farmed? - farmed has much less D3) or 4.5kg of eggs.

The "Raharusun" article which Rita Rubin spent so long writing about is 100% fake and has nothing to do with real vitamin D research. All the sordid details of this effort by two young men in the Philippines is here: https://researchveracity.info/alra/ .

These numerous, supposedly expert, vitamin D and ivermectin naysayers always pick on some nth rate articles and portray them as representative of the field. They never address the strongest research.

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Fascinating, all, and thank you. I did not get into what felt like the weeds, to me, of what qualified as deficient or insufficient or sufficient levels of vitamin D. I did not know most of what you wrote here; note that I steered clear of particular recommendations as to levels. As always, I prefer a holistic to a reductionist approach. People in the northern climes were thriving, even in Winter, before there were supplements, but that doesn't mean that moderns could, with all that we have changed. Again, thank you.

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Thank you for this one, Heather! Who ever would have thought an essay with 39 footnotes would be an enjoyable read instead of a slog!

This is so valuable to me; I use your hard work to be able to show others the facts, data, and observations that support our arguments instead of their un-documented press clippings and anecdotal evidence. Also, for the links that have special significance or information, we can store them in safe places, so when the memory hole swallows them up, still, we know.

I hope you're proud of yourself, young lady.

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Here is an argument of inexorable logic, from Bret Weinstein, later in the vitamin D segment of the DarkHorse podcast 102, 2021-10-31: https://www.youtube.com/watch?v=fSVYU5evaDA&t=1235s

- - - -

The likelihood that you are D deficient is incredibly high.

The number of things which D seems to be protective of is incredibly large.

The harm to you if you raise your D levels and it somehow turned out that D was a third correlate and not causal is so low.

The cost of the stuff is very cheap.

The danger of taking too much of it is very low . . .

. . . and the potential benefit of it is sky high.

So the point is, you might as well . . . (Pascal's wager: https://en.wikipedia.org/wiki/Pascal%27s_wager .)

But the real import of that is that, to the extent that our public health authorities are not recommending this, and have not been recommending it throughout the pandemic, you know that they are either incompetent at a level which strains credulity, or not interested in health . . .

and until they change their tune on this, I think one has to look on everything they say with a kind of skepticism: How do I know this person is actually interested in my health they way they claim to be if they are not picking the lowest hanging fruit on the tree which is vitamin D.

That's a jaw-dropping thing to say - public health officials who aren't interested in health, public or otherwise - that's a remarkable claim. On the other hand, how else to explain their total silence on vitamin D?

- - - -

Medical professionals, researchers and advocates (some are both or all three) have been struggling with the general avoidance and ignorance of vitamin D for decades. It is an enormous, very old, problem which goes beyond just vitamin D and involves a general avoidance of simplicity in favour of complex hypotheses and treatments.

Prof Sunil Wimalawansa, who I collaborate with, has been on the case for two decades. The most common objection he encounters is incredulity: "How could something so simple be so significant?" - "Its too simple".

Please see this article from long-time vitamin D researcher Bill Grant:

Vitamin D acceptance delayed by Big Pharma following the Disinformation Playbook

Othormolecular Medicine News Service William B. Grant 2018-10-01


Regarding the gross neglect of elderly people - and staff - in aged care homes:

Responsibility for vitamin D supplementation of elderly care home residents in England: falling through the gap between medicine and food

Joseph Williams and Carol Williams

BMJ Nutrition, Prevention and Health 2020-08-17


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Linda Benskin's 2020-09-10 review: "A Basic Review of the Preliminary Evidence That COVID-19 Risk and Severity Is Increased in Vitamin D Deficiency" https://www.frontiersin.org/articles/10.3389/fpubh.2020.00513/full cites three fake articles, (Alipio, "Raharusun" and "Glicio") all from the same series: https://researchveracity.info/alra/ .

These are refs 3, 4 and 5 on pages 13 and 14. Fig 5 on page 14 is based on 100% bogus data from the Alipio fake article.

Page 2 of the PDF carries a note to the effect that refs 3, 4 and 5 "may have relied upon data from unofficial sources". These articles were 100% fake, and not done by professional researchers. My best guess is that the two or so people who created them were competing with their friends to amass Google citations. This blatant and amateur fakery was not expected by anyone, so some of us took the articles on face value, for a while at least. They are no reflection on the real importance of vitamin D to the immune system and to tackling COVID-19.

Joseph Mercola still cites the bogus "Raharusen" data, by way of a graph Figure 12 graph in his full report and Figure 3 in his condensed report https://www.stopcovidcold.com/covid-research.html. Despite me and at least one vitamin D researcher writing to him about this over the past year, and me commenting on this in a recent article of his (the comment was deleted), Dr Mercola still seems to believe that COVID-19 deaths drop off suddenly above 30ng/ml. While higher vitamin D levels certainly do reduce severity, viral shedding (and so transmission) and deaths, there is no magic safety level. People with serious health problems will still have bad outcomes even if their 25-hydroxyvitamin D is 50ng/ml or more.

The unfairly maligned Maghbooli et al. 2020 article: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0239799 has a graph which is unique in all the articles I have seen: hospital cases and deaths by age (X) and 25-hydroxyvitamin D level (Y) - Fig 1. There were 3 deaths with 40ng/ml and two with about 48 and about 53ng/ml, for patients aged about 79 and about 84.

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Thank you for this.

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1/2 Please see the research articles cited in my page "What every MD, immunologist, virologist and epidemiologist should know about vitamin D and the immune system": https://vitamindstopscovid.info/05-mds/ . Without proper vitamin D supplementation (0.125mg 5000IU/day for 70kg 154lb bodyweight) or recent UV-B skin exposure, most people have 25-hydroxyvitamin D levels of only 5 to 25ng/ml, when the immune system needs 50ng/ml at least to work properly.

If everyone has good levels like this, COVID-19 would cause few serious symptoms and so much less viral shedding that the pandemic would die out.

Most physicians and immunologists clueless about how immune cells rely on 25-hydroxyvitamin D as in input to their autocrine (within each cell, also known as "intracrine") and paracrine (to nearby cells) signaling systems, which are the main way individual cells respond to their changing circumstances.

Part of the reason for this lack of knowledge is that much of the vitamin D research literature is written by people who think that the very low level of hormonal 1,25-hydroxyvitamin D - which the kidneys produce and maintain the level of, to regulate calcium-bone metabolism - is important to immune cells. For instance the Lordan article you cite. He states (page 6) that 25 to 50ng/ml is "normal". Actually, most people without proper D3 supplementation and who have not had a lot of UV-B skin exposure in the last month or two have 5 to 25ng/ml.

Vitamin D3 is not a hormone (though many articles state this). Hormones are for long-distance signaling in the blood. D3 signals nothing. Reinhold Vieth in 2004: https://sci-hub.se/10.1016/j.jsbmb.2004.03.037 . 25-hydroxyvitamin D is not a hormone. It does not signal anything, or modulate anything. It is a required input for the kidneys and for numerous types of cell which use it for their autocrine and paracrine signaling, by converting it intracellularly to 1,25-dihydroxyvitamin D. In all such cases - which includes all the use made by immune cells of 25-hydroxyitamin D, this 1.25-hydroxyvitamin D functions as an autocrine agent or a paracrine agent. The levels of these are very much higher than the low, stable, level of hormonal 1,25-dihydroxyvitamin D, produced and maintained by the kidney.

Some researchers and doctors assume that it is the hormonal 1,25-hydroxyvitamin D which affects immune cells, so they try to boost it with oral 1,25-hydroxyvitamin D (calcitriol). This doesn't work and might upset calcium-bone metabolism. It does nothing to raise the typically low 25-hydroxyvitamin D levels to the 50ng/ml or more the immune cells need. Unfortunately the FLCCC doctors have made this mistake in recent months - recommending oral calcitriol in their MATH+ and I-MASK+ protocols. It is not surprising they think this, because a lot of the vitamin D research literature is confused and confusing.

When you have viewed the Quraishi et al. graph (see my page, or the two graphs on page 116 of the article https://jamanetwork.com/journals/jamasurgery/fullarticle/1782085) you can see that 25-hydroxyvitamin D levels below 50ng/ml 115nmol/L cause weakened innate and adaptive immune responses to the bacterial pathogens which cause hospital acquired and surgical site infections. This is due to multiple types of immune cells not being able to work properly because they do not have enough 25-hydroxyvitamin D for their autocrine and paracrine signaling systems.

The innate and adaptive responses to viruses would be weakened in the same way. Above 50ng/ml, the risk of either type of post-operative infection is about 2.5%. Below this level, the risks rise rapidly. For instance, at 18ng/ml, which is a typical level for people who do no supplement D3 and have not recently had substantial UV-B exposure, the risks rise to 25%.

This 18ng/ml - and down to 5ng/ml for some people, such as Muslim women, even in sunny Israel - is the terrible state most people are in trying to live, in general, and when trying to tackle COVID-19.

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Thank you for this great article, Heather. Can anyone point me to any literature/guidance dosage for Vit. D3 supplement for children (esp. under 10), please?

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