Determination of Optimal Active Vitamin D Levels to Decrease COVID-19 Viral Replication and to Mitigate Its Secondary Inflammation

Abstract

Measurement of plasma (serum) 25(OH)D3, levels, (the precursor of active vitamin D) is the current method of evaluating vitamin D status. This paper will present evidence to support the hypotheses that the measurements of serum 25(OH)D3 or serum 1,25(OH)2D3 do not often reflect the actual synthesis and levels of active vitamin D in the body and that they do not reflect the sometime dramatic changing demand for active vitamin D by the body. Because there appears to be an association between low vitamin D status and COVID-19 morbidity and mortality, a new method for determining vitamin D status and demand is needed. Unlike other vitamins, active vitamin D is a hormone acting on many receptor sites in the body and it is an essential modulator of the immune system. The vitamin D hormone plays an active role in the initial suppression of invading microbials including new viruses and in subduing the body’s inflammatory response to acute viral infections and latent viruses. In this paper, a molar balance approach involving vitamin D end metabolites is used to estimate fluctuating active vitamin D levels (synthesis) and demand. The ability to estimate active vitamin D levels (synthesis) and demand may allow the establishment of actual active vitamin D levels in the body needed to suppress COVID-19 virus replication and to decrease COVID-19 virus stimulation of an immune system inflammatory response. Determining actual active vitamin D levels and demand may prove vital in the treatment and monitoring of individuals with acute and sometimes life-threatening COVID-19 infections. This new information may allow clinicians to quickly adjust intervention with calcitriol, active vitamin D, 1,25(OH)2D3, to achieve rapid suppression of the COVID-19 virus and improvement in immune system function.