Health bosses scrap scheme offering vulnerable Britons free vitamin D… but experts say decision is ‘short-sighted’ because the nutrient could have benefits beyond Covid
Vitamin D supplements won’t be dished out to millions of vulnerable Britons for free this year.
Last winter nearly 3million clinically extremely vulnerable people — including cancer and severe kidney disease patients — were offered a four-month course of the ‘sunshine vitamin’.
Health officials were concerned the group had low levels of the nutrient because of how long they’d been stuck inside under the shielding guidance.
They also hoped vitamin D could protect them against Covid after a series of studies suggested people with a deficiency were more likely to catch the virus and become seriously unwell.
But the same scheme has been scrapped this winter because shielding guidance was ditched earlier in 2021 — meaning those vulnerable did not have to be stuck inside.
And studies haven’t provided strong enough evidence that the nutrient can protect against Covid.
However, experts told MailOnline the vitamin — which capsules of can cost less than 3p — should be dished out again, arguing the Government’s decision not to offer it this winter was ‘short-sighted’ because it is cheap and safe.
One scientist said vitamin D could have health benefits beyond Covid.
During the winter months, Britons cannot get their required intake — 10 micrograms per day for everyone aged one and older — from being outdoors, so are advised to take a supplement
The graph from the Scientific Advisory Committee on Nutrition (SACN), No10’s advisors, shows the amount of vitamin D Britons get from sunlight drops during the winter months
From early April to the end of September, most people in the UK get all the vitamin D needed from sunlight.
During the autumn and winter, however, Britons can’t get their required intake — 10 micrograms per day — from being outdoors, so are advised to take a supplement.
The vitamin, also abundant in oily fish, red meat, liver and egg yolks, boosts general health and fortifies bones and muscles.
Department of Health bosses announced in November 2020 that 2.7million people in England could opt-in to get vitamin D supplements. The scheme ran until last April.
Clinically extremely vulnerable (CEV) people were likely to have been indoors more than usual this spring and summer, the agency said.
WHAT DOES VITAMIN D DO?
Vitamin D helps regulate the amount of calcium and phosphate in the body.
These nutrients are needed to keep bones, teeth and muscles healthy.
A lack of vitamin D can lead to bone deformities such as rickets in children, and bone pain caused by a condition called osteomalacia in adults.
Government advice is that everyone should consider taking a daily vitamin D supplement during the autumn and winter.
People at high risk of not getting enough vitamin D, all children aged 1 to 4, and all babies (unless they’re having more than 500ml of infant formula a day) should take a daily supplement throughout the year.
There have been some reports about vitamin D reducing the risk of coronavirus (COVID-19). But there is currently not enough evidence to support taking vitamin D solely to prevent or treat COVID-19.
This meant they ‘may not have been able to obtain enough vitamin D from sunlight’.
And it was reviewing evidence on the link between the supplement and Covid ‘to ensure we explore every potential opportunity to beat this virus’.
But shielding guidance was paused this April and officially ended in September due to the success of the vaccine rollout.
As a result, health bosses scrapped the scheme for the coming winter.
But data from the Office for National Statistics shows a fifth of people in the group were still shielding at the end of last year.
Experts told MailOnline that rolling out the vitamin despite a lack of strong evidence that it works could boost protection against the virus over the winter.
Professor David Armstrong, an expert in medicine and sociology from King’s College London, admitted studies on Covid and vitamin D have been ‘mixed’, so there is ‘no clear mandate for wide adoption of supplementation’.
But he added: ‘Is there an argument for supplementary vitamin D, just in case? Yes, this position can be argued as it is a relatively safe (and cheap) intervention.’
Professor Armstrong also said that too much vitamin D can harm health, so it is not ‘completely safe’ to rollout across the country.
And if people perceived they were at less risk from Covid because they were taking vitamin D, it could make them less cautious with other measures, he said.
‘When you reduce one risk people tend to increase other, such as faster driving when wearing a seat belt,’ Professor Armstrong said.
Professor Adrian Martineau, an expert in respiratory infection and immunity based at Queen Mary University London, told MailOnline that ‘the jury is still out’ on whether vitamin D protects against the virus.
It ‘has a small protective effect against other acute respiratory infections’, which has been acknowledged by Government scientists, he said.
But last year’s offer of free vitamin D was hampered by low uptake, added Professor Martineau, who led the CORONAVIT study examining the effects of the nutrient on Covid.
This was especially noted among those living in the most deprived areas and older people, which are the groups that stand to benefit most from the offer.
Professor Martin Hewison, an expert in molecular endocrinology at the University of Birmingham, told MailOnline the Government decision to cease the free vitamin D programme is disregarding a precaution that could boost Covid protection.
‘Perhaps there is a fear vitamin D supplementation is a distraction from vaccination,’ he said.
But there is still a ‘strong case’ for rolling out the tablets because it is ‘not expensive and what have we got to lose?’.
Professor Hewison added: ‘Every winter people in the UK are at risk of vitamin D deficiency.
‘Over the last year there have been many published studies showing that vitamin D deficiency is common in people with Covid infection or more severe Covid disease.
‘Does this mean that vitamin D deficiency leads to worse Covid outcomes? The simple answer is that we do not know.’
Supplementation of those with higher risk of vitamin D deficiency ‘is cheap, safe and may have general health effects beyond Covid’, Professor Hewison said.
He added: ‘We have a successful vaccination programme in the UK but there is still concern over infection and hospitalisation.
‘We are encouraged to take every precaution to help promote our best health and protect family, friends, and our health service – masks and testing are good examples.
‘It therefore seems very short-sighted that DHSC are prepared to ignore something as simple, cheap, and safe as supplementation with vitamin D – at least during the winter when we will all be a risk of vitamin D deficiency.’
But Professor Vimal, an expert in nutrigenetics and nutrigenomics at the University of Reading, told MailOnline respiratory tract infections are just one Covid symptom ‘and there is no convincing evidence to support’ whether vitamin D will prevent or treat the infection.
He said vitamin D ‘cannot be considered as a silver bullet against Covid’, but given the ongoing risk of infection and long-term effects of Covid, vulnerable people should continue to have access to the free NHS service supplying the vitamin.
Professor Naveed Sattar, an expert in metabolic medicine at the University of Glasgow, told MailOnline he is ‘not surprised’ by the Government’s decision, because there is a lack of evidence that the vitamin works against Covid.
He said: ‘Their provision could even be harmful by providing people with false reassurance.
‘Rather, it would be far better if people are encouraged to walk a little more and eat better (or drink less alcohol) over the winter months to help prevent weight gain or lose weight since the link between excess weight and more severe Covid is solid.’
One study of 550 people in Barcelona found a vitamin D treatment reduces Covid deaths by 60 per cent. And a study of 4,600 Americans found people with higher vitamin D levels were seven per cent less likely to catch the virus.
The findings from the study in Spain led former Brexit Secretary David Davis to call for the treatment to be rolled out to every hospitalised Covid patient.
But experts poked holes in the research and subsequent a study by researchers in Canada of 1.2million people found the nutrient does not affect the risk of catching or being hospitalised from Covid.
What have studies into vitamin D and Covid-19 shown?
When? June 2021.
By who? McGill University in Canada.
What did scientists study? Genetic variants strongly associated with increased vitamin D levels in more than 4,000 people who were diagnosed with Covid and more than 1.2million uninfected people from 11 countries.
What did they find? There was no evidence linking high vitamin D levels and a lower risk of contracting Covid. And among those who tested positive, there was no association between higher vitamin D and a lower likelihood of being hospitalised or becoming severely ill.
What were the study’s limitations? The study did not include individuals with vitamin D deficiency, so does not cover whether deficient patients could benefit.
When? March 2021.
By who? The University of Chicago.
What did scientists study? The vitamin D levels for more than 3,000 people in Chicago and whether this increased their risk of catching Covid.
What did they find? 30 ng/ml of vitamin D in the blood is usually considered sufficient. But Black people who had less than 40 ng/ml were 2.64 times more likely to test positive compared to those with levels more than 40 ng/ml. No statistically significant link was found between vitamin D levels and infection risk in white people.
What were the study’s limitations? It is unclear how vitamin D supports immune function and is only observational, so cannot determine that low vitamin D causes the increased risk of infection.
When? December 2020.
By who? King’s College London.
What did scientists study? 372,720 users of the Covid Symptom Study app in the UK, who had reported what supplements they were taking at the start of the pandemic.
What did they find? Women taking vitamin D, multi-vitamins, omega-3 or probiotics appeared to be between nine and 14 per cent less likely to get Covid-19. This means that, if the average risk of getting Covid was one in 10, those taking supplements could see their risk fall to around one in 12.
What were the study’s limitations? Scientists were very unsure of the results and said the study did not prove that the pills actually protected women, but may have been a sign of generally healthier lifestyles. The expert who led the study said people shouldn’t start trying to protect themselves with vitamins.
When? October 2020.
By who? University of Cantabria in Spain.
What did the scientists study? 116 Covid patients at the Valdecilla Hospital
What did they find? Eighty-two per cent were deficient in vitamin D, whereas just 18 per cent had adequate levels of the nutrient – a fourfold difference. This was compared to the 47 per cent of people who were deficient in a control group who did not have the infection.
What were the study’s limitations? The research does not prove that deficiency led to them falling ill enough to need hospital care.
When? September 2020.
By who? Cordoba University in Spain.
What did scientists study? 50 Covid-19 hospital patients with
Covid-19 were given vitamin D. Their health outcomes were compared with 26 volunteers in a control group who were not given the tablets.
What did they find? Only one of the 50 patients needed intensive care and none died. Half of 26 virus sufferers who did not take vitamin D were later admitted to intensive care and two died.
What were the study’s limitations? Small pool of volunteers. Patients’ vitamin D levels were not checked before admission. Comorbidities were not taken into consideration.
When? September 2020.
By Who? University of Chicago.
What did scientists study? 500 Americans’ vitamin D levels were tested. Researchers then compared volunteers’ levels with how many caught coronavirus.
What did they find? 60 per cent higher rates of Covid-19 among people with low levels of the ‘sunshine vitamin’.
What were the study’s limitations?
Researchers did not check for other compounding factors. Unclear whether or not volunteers were vitamin D deficient at the time of their coronavirus tests. People’s age, job and where they lived – factors which greatly increase the chance of contracting the virus – were not considered.
When? September 2020.
By Who? Tehran University, in Iran, and Boston University.
What did scientists study? Analysed data from 235 hospitalized patients with Covid-19.
What did they find? Patients who had sufficient vitamin D – of at least 30 ng/mL— were 51.5 per cent less likely to die from the disease. They also had a significantly lower risk of falling seriously ill or needing ventilation. Patients who had plenty of the nutrient also had less inflammation – often a deadly side effect of Covid-19.
What were the study’s limitations? Confounding factors, such as smoking, and social economic status were not recorded for all patients and could have an impact on illness severity.
When? July 2020.
By Who? Tel Aviv University, Israel.
What did scientists study? 782 people who tested positive for coronavirus had their vitamin d levels prior to infection assessed retrospectively and compared to healthy people.
What did they find? People with vitamin D levels below 30 ng/ml – optimal – were 45 per cent more likely to test positive and 95 per cent more likely to be hospitalised.
What were the study’s limitations? Did not look at underlying health conditions and did not check vitamin D levels at the time of infection.
When? June 2020.
By Who? Brussels Free University.
What did scientists study? Compared vitamin D levels in almost 200 Covid-19 hospital patients with a control group of more than 2,000 healthy people.
What did they find? Men who were hospitalised with the infection were significantly more likely to have a vitamin D deficiency than healthy men of the same age. Deficiency rates were 67 per cent in the COVID-19 patient group, and 49 per cent in the control group. The same was not found for women.
What were the study’s limitations? Independent scientists say blood vitamin D levels go down when people develop serious illness, which the study did not take into consideration. This suggests that it is the illness that is leading to lower blood vitamin D levels in this study, and not the other way around.
When? June 2020.
By who? Inha University in Incheon, South Korea.
What did scientists study? 50 hospital patients with Covid-19 were checked for levels of all vital vitamins and compared to a control group.
What did they find? 76 per cent of them were deficient in vitamin D, and a severe vitamin D deficiency (<10 ng/dl) was found in 24 per cent of Covid-19 patients and just 7 per cent in the control group.
What were the study’s limitations?
Small sample size and researchers never accounted for vitamin levels dropping when they fall ill.
When? June 2020.
By Who? Independent scientists in Indonesia.
What did scientists study? Checked vitamin D levels in 780 Covid-19 hospital patients.
What did they find? Almost 99% of patients who died had vitamin D deficiency. Of patients with vitamin D levels higher than 30 ng/ml – considered optimal – only per cent died.
What were the study’s limitations? It was not peer-reviewed by fellow scientists, a process that often uncovers flaws in studies.
When? May 2020.
By Who? University of Glasgow.
What did scientists study? Vitamin D levels in 449 people from the UK Biobank who had confirmed Covid-19 infection.
What did they find? Vitamin D deficiency was associated with an increased risk in infection – but not after adjustment for con-founders such as ethnicity. It led to the team to conclude their ‘findings do not support a potential link between vitamin D concentrations and risk of Covid-19 infection.’
What were the study’s limitations? Vitamin D levels were taken 10 to 14 years beforehand.
When? May 2020.
By Who? University of East Anglia.
What did scientists study? Average levels of vitamin D in populations of 20 European countries were compared with Covid-19 infection and death rates at the time.
What did they find? The mean level of vitamin D in each country was ‘strongly associated’ with higher levels of Covid-19 cases and deaths. The authors said at the time: ‘The most vulnerable group of population for Covid-19 is also the one that has the most deficit in vitamin D.’
What were the study’s limitations? The number of cases in each country was affected by the number of tests performed, as well as the different measures taken by each country to prevent the spread of infection. And it only looked at correlation, not causation.
When? May 2020.
By Who? Northwestern University.
What did scientists study? Crunched data from dozens of studies around the world that included vitamin D levels among Covid-19 patients.
What did they find? Patients with a severe deficiency are twice as likely to experience major complications and die.
What were the study’s limitations? Cases and deaths in each country was affected by the number of tests performed.