We are offering clarification with regard to the message we sent to all our patients on 21.4.20. We have based our suggestion to take daily vitamin D on the following:
- NHS guidance which already advises that all adults living in the UK, including those at high risk should take year round vitamin D at a strength of 400 iu. We are aware it is more commonly available in pharmacies and supermarkets at strengths of 1000 iu and we felt daily doses up to this are safe. See link: https://cks.nice.org.uk/vitamin-d-deficiency-in-adults-treatment-and-prevention#!scenario:1
- Evidence that vitamin D enhances the function of the immune system. See link: https://www.bmj.com/content/356/bmj.i6583
- Evidence that high levels of vitamin D reduce the risk of severe respiratory illness. See links: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6121423/and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835877/
- Evidence that vitamin D affects the expression of Angiotensin Converting Enzyme 2, which is the receptor for SARS-CoV-2. See link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999581/and https://www.sciencedirect.com/science/article/pii/S0092867420302622
Our clinical team had a discussion around the safety of suggesting this to all our patients, and concluded that the benefits outweighed the risks for our patient population. We trust that it will be received by our patients in the spirit it was sent: in public health interest, with kindness and hope that we were serving the best interests of our community.
We would like to remind patients that the best way to obtain vitamin D is safe sun exposure however this must be balanced carefully against avoiding the risk of burning. Please follow the guidance as issued by the NHS here: https://www.nhs.uk/live-well/healthy-body/how-to-get-vitamin-d-from-sunlight/
Kind Regards, Abbey Lane and Totley Rise Clinical Team.
UPDATE 24 April 2020
Our practice team in discussion with NHS Sheffield CCG together wish to make the following clear:
- NHS England have produced advice for the public about Vitamin D including a statement in relation to Covid 19 and keeping your bones and muscles healthy which can be found here.
- NHS Sheffield CCG has guidance for prescribers for vitamin D, also available for the public, which can be found here and updates in relation to medicines and Covid19 that can be found here.
- NHS Sheffield CCG wish to make clear that in relation to points 2, 3 and 4 at this time they have not reviewed nor validated this evidence and as such cannot support it. These points of evidence are raised only by our team.
We will continue to update this advice as and when necessary.
Abbey Lane and Totley Rise Clinical Team and NHS Sheffield CCG