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In the UK press today articles reporting that Public Health England (PHE) is recommending people take a supplement of vitamin D. As usual it is completely carp advice. PHE says people should take 10mcg, that’s just 400IU of vitamin D3 per day. That amount of D will take no one out of deficiency and not keep anyone in sufficiency even if they are at sufficient levels to begin with. In addition PHE say if people go out in the sun they should cover up or put on sunscreen - those both stop the skin making vitamin D. PHE also say that vitamin D has nothing to do with immunity. Huge sigh of frustration here.

Hi, My husband who had to have his lungs washed out due to a bad bronchitis infection that was not shifting and that lasted 2 years, was recommended by the Respiratory specialist to take Vit D. She said there is increasing evidence that it's helpful for your immunity. (Not just good for your bones). For 3 years he has not even had a cold.
But does anyone know if there is issue with Vitamin D + Warfarin?
 
I've been taking Vitamin D for many years - not always consistently, but usually every day.

When I was discharged from the hospital a few weeks ago, the cardiologist and electrophysiologist, both fully aware that I take warfarin (and now, also Plavix), directed me to take 5000 units of Vitamin D (in addition to Vitamin C and Magnesium). If there WAS a problem with Vitamin D and Warfarin, they would have at least warned me. I don't think there's any problem taking Vitamin D along with Warfarin.

If you have a meter, you can always test the INR after a few days of Vitamin D.
 
I don't take warfarin, but since vitamin D comes from the sun and it's a necessary substance for human life (vit in vitamin means vital - actually it's a hormone but it's called a vitamin and is vital) I don't see how vitamin D could cause a problem with warfarin - yes I know we're talking about supplemental D but if there was a problem with warfarin and vitamin D there would be warnings to stay out of the sun on the warfarin packaging or not take supplemental D, or there'd be warnings on the packaging of the supplemental D about it and warfarin.

There are warnings with supplemental vitamin K1 because it's the coagulation vitamin so would interfere with warfarin. Everyone can usually get enough K1 from their diet, though if a person increases their consumption of certain green veggies, a rich source of K1, they might have a problem if they don't check their INR. The reason that there are warnings on supplemental vitamin K2 is probably because it is mixed up with K1 - maybe due to the K ?
 
Vitmin = Vit(al) am(i)ne - Vital amine (without the parentheses. When researchers began work on discovering these 'amines' that were essential to life, they broke some into groups and subgroups (like K1, K2; and a lot of the B vitamins).

Vitamin D is essential, and many fluid milks are Vitamin D enriched by passing the milk under powerful ultraviolet light during processing, converting some of the proteins(?) in the milk into Vitamin D.

A good percentage (I have no idea of how many) of people today are deficient in Vitamin D - sheltering in place - being locked at home and rarely going out - the need for supplementation may even be higher.
 
I have a huge Vit. D issue and for some time I take 10,000 IU per day 5x a week to keep my Vit. D levels in range, and how true with all the indoor time lately most people are likely more deficient than not. Although just walking around outside your home for 15-20 minutes a day in sun light should recharge your Vit. D levels.
 
I have been taking Vitamin D supplements for a while as I was deficient (D-3 5,000 IU). With C-19 I have added (in addition to my multi-vitamin Opti-Men) both zinc and Quercetin, both recommended to boost and balance immune system. Even if just a placebo not expensive and my most recent test (today) was reflecting my triglycerides were down. iHerb which ship to Japan out of Hawaii have been great.
 
Me too, as often as i can, i had my D tested at the end of last summer and i was a little under so i have taken D3 over winter.
I have just had another test that came back 168 nmol/L ( 67.2ng/mL )
 
I'll jump on this D train. With my long track record, only in the last year or so was I advised to take 2000 IU of Vitamin D cuz my blood tests showed me a bit low. I don't think I've felt its positive effects, but now I'm in normal range. So there's that.
 
I received this info from my sister who is a physician and it has a better explanation of how the COVID 19 virus works in the body and what the concerns are, she sent it to family. If it's useful to you, great, if not please ignore.

I wanted to repeat/expand on my post of what we know (that will be outdated by tonight), about coronavirus.

The primary reason it is so deadly is that it destroys you *relatively* silently, until you are so far gone it’s hard to save. I’ll explain.

Cov-SARS-2 doesn’t put you into rapid ARDS like SARS and MERS did. It slowly and progressively attacks your surfactant production. Surfactant is what our lungs make inside the alveoli (air sacs.). This is like lube inside the lungs; it makes the tissue stretchy, and the more of it you have the easier those little sacs open (the less pressure it takes.). With lower amounts it is harder and harder to inflate each minuscule sac, like trying to inflate a new balloon vs one that has been blown up a bajillion times. Eventually as the surfactant gets low enough, if you are not pushing to keep those air sacs open, they’ll stick/fuse together at the edges and no longer inflate at all. You are slowly developing more and more atelectasis (collapsed air sacs) and your lungs are regressing to be like a premature infant, born without prenatal steroid treatment. You cannot breathe without a vent, eventually.

This is why (it seems) it is hitting newborn infants hard and leaving most children alone; children’s lungs after they adjust to “life on the outside” make a crap ton of surfactant; you have to lubricate lungs VERY well to allow them to grow. Surfactant production starts to drop statistically much more quickly after age 50y. Surfactant is used up faster in some lung diseases like asthma. Diabetes affects surfactant production. It fits. The science is not well enough researched to be sure, but so far what we know for sure has not refuted this model; so far everything fits.

The problem is the EVENTUALLY. What is killing people on vents is only partially their lungs. Most of it is organ failure, a cascade that has always been nearly impossible to reverse. If it were just their lungs we’d have a decent chance.

The trouble is that CO2 diffuses vastly more rapidly across the alveolar matrix than oxygen. This isn’t a problem, it’s great, usually. Our bodies use acid/base pH sensors to monitor our acid status constantly (CO2 is an acid when dissolved in blood) and so we change our breathing to adjust. If we have too much CO2 we breathe faster. If we are making acid (working out, fever, too hot, drank engine cleaner, septic/poor circulation), then the acid monitor tells us to breathe faster. We feel short of breath; we breathe faster/harder and that ramps up our oxygen delivery. Oxygen goes up as a lovely side effect; when oxygen goes up our tissues are happier and make less acid. Solid system. Almost every form of lung disease comes on quickly enough, or affects the TISSUE of the lungs in such a way that BOTH CO2 and O2 levels are affected, so the breathing difficulty is fairly readily apparent. We can tell by talking to you, getting a history, watching how hard it is for you to breathe.

COVID doesn’t do that. As it picks off your alveoli one by one, you lose lung function so slowly that you may not consciously realize it other than feeling fatigued or chest pressure. If your CO2 levels remain stable, and there is *just* enough oxygen to go into organ failure, you may just feel off/tired/flu-like. This allows it to remain silent. Eventually your oxygen will drop. When it drops enough for your tissues and organs to start to starve, they will make acid and you will start to work harder to breathe. By the time it is obvious that you need to risk the ED to be seen, your oxygen levels may be as low as 40% EVEN THOUGH YOU WALKED INTO THE ED UNDER YOUR OWN POWER. The lowest reported so far is 38% in a patient who DROVE to the ED and WALKED in and was TALKING ON HIS CELL PHONE. But he was in multi system organ failure cascade and was dead within 18 hours. Not because they didn’t have a ventilator; because his oxygen had been too low for too long and his inflammatory cascade from organ failure was too severe. As oxygen drops below 80% the blood becomes more viscous and more likely to clot, increasing stroke risk.

So help keep your lungs open. Deep breaths at least a few once an hour while awake. Blow up a balloon once an hour. Dig out that old incentive spirometer plastic thingy they sent home with you from your last surgery that you never threw away. Do it preventively, and especially if you get sick. Report to your doctor if it is getting harder to do by the day. Check your oxygen if you even think you are sick, with a pulse oximeter; preferably one that is not a knock-off piece of crap, but even the knock off ones are more likely to unnecessarily scare you than to miss a real low (though some are misfired so the HR and the Pox show up in reverse fields, but still work; work out a little to raise your HR and see what happens.). If your O2 is consistently dropping less than 95% let your doctor know, and insist on at least a Telehealth appointment if you are below 90%. Early lung exercises, and home oxygen, may be enough when the disease process is caught early; it’s easier to prevent a snowball from rolling downhill than to stop the avalanche.

The countries with robust in-home state care programs instead of hospital based focus, that stored up on Pox and on PEP flutter (home lung therapy devices a little more advanced than balloons and incentive spirometry) are finding if they catch the low oxygen before it causes shortness of breath and use home oxygen that the mortality rate plummets. Still preliminary, but the science is good.

Stay safe, stay well, as we slowly take more risks out of necessity. Please feel free to share the information above with friends and family, but if it’s not our immediate relatives then try to copy and paste to keep my name out of it; I don’t want to go viral. Information accurate insofar as I know as of May 2, 2020.


She bought my parents and all sibs pulse oximeters and is having them shipped.

I am *NOT* a physician nor do I play on one TV, so I can't really answer questions or engage in debates, I merely offer this to fellow valve patients for whatever it's worth or not to you.
 
That is probably the best explanation of this phenomenon I have seen (and I've read a few). Your sister has a gift for explaining a very complex situation clearly and simply. If only more docs had the ability, or desire, to explain things so well to their patients. Brilliant.
 
Just some thoughts ....

I think that if we ever get real numbers, that close to 50% of people who died from covid-19 became infected in a medical facility such as a nursing home, assisted living home, other elder care facilities, VA homes, hospitals, doctor's offices, clinics, etc. My reasoning - most people that die from covid-19 are sick and elderly and this is where you find them. Asymptomatic health care workers could easily infect these patients.

Use of ventilators, while standard of care, seems to be the wrong treatment according to several papers. Other treatments for low blood oxygen have had much more success. In the majority of cases where patients were put on a ventilator, they died.

Stay at home for all, does not make medical sense. Healthy people under 55 have a minimal chance of dying from Covid-19, unless they have co-morbidities. Under 45, I think it approaches 0. That doesn't mean that no one under 45 dies, but that the rate approaches 0. I have also seen reports that children don't get covid-19 and are not infectious.

Many deaths (about 25%) were of patients in elder care facilities. States have regulatory authority over these homes, so states should be held responsible. State assemblies should be holding hearings to find out why state health administration and governors failed to protect senior citizens.

Why did people die? While there are research papers written in medicaleze, why hasn't the government in their briefings, explained this in language the public can understand? It would be very helpful to know more than old with co-morbidities. A few times they mentioned hypertension, diabetes, lung disease, but how sick are the people who die? Is their blood pressure 150/90 or is it 200/110? Do they have a bmi of 30 or 40? Are they bedridden or active?

Who is responsible for medical best practices for covid-19? Many hospitals experimented, when one treatment didn't work they tried something else. There are many studies going on, many research papers being written. Who is collecting all this research and formulating new best practices? How do I know that my local hospital has access to the newest best practices for covid-19? How do I know the doctors who would treat me have this information?
 
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....I think that if we ever get real numbers, that close to 50% of people who died from covid-19 became infected in a medical facility such as a nursing home, assisted living home, other elder care facilities, VA homes, hospitals, doctor's offices, clinics, etc. My reasoning - most people that die from covid-19 are sick and elderly and this is where you find them. Asymptomatic health care workers could easily infect these patients...

The cluster outbreaks of Covid in places like church socials, conferences, prisons, families, etc. would indicate that it is not related medical facilities but instead related to groups of people with at least on infected person coughing away.
 
Rich01 - while it's true that COVID-19 iis probably much worse for the elderly, weak, and other vulnerable people, it's also true that death and terrible symptoms can also affect people of any age. Some young chlldren are getting the rare Kawasaki disease - a terrible set of symptoms that can be fatal. People of all ages are getting it.

I'm worried about reopening stores, restaurants, beaches, etc. too soon. We'll see how well these reopenings do in a few weeks. Will the number of cases climb again?

Finally -- I don't know if 'asympomatic' health care workers won't at least have a fever. At local hospitals - and I suspect ALL health facilities, employee temperatures are taken before they're allowed into the facility. If asymptomatic workers still show fever, they won't be allowed in. This could limit transmission within these facilities.

Improper isolation, inadequate (or no) personal protective equipment at jails, nursing homes and other places, and the ease at which the virus can be spread, account for large numbers of cases in these closed facilities. At places like jails, where the population's age ranges from, probably, 18 years up into the 80s, we'll probably see cases at all ages, with the worst outcomes happening to people at risk.
 
Rich01 - while it's true that COVID-19 iis probably much worse for the elderly, weak, and other vulnerable people, it's also true that death and terrible symptoms can also affect people of any age. Some young chlldren are getting the rare Kawasaki disease - a terrible set of symptoms that can be fatal. People of all ages are getting it.

I'm worried about reopening stores, restaurants, beaches, etc. too soon. We'll see how well these reopenings do in a few weeks. Will the number of cases climb again?

Finally -- I don't know if 'asympomatic' health care workers won't at least have a fever. At local hospitals - and I suspect ALL health facilities, employee temperatures are taken before they're allowed into the facility. If asymptomatic workers still show fever, they won't be allowed in. This could limit transmission within these facilities.

Improper isolation, inadequate (or no) personal protective equipment at jails, nursing homes and other places, and the ease at which the virus can be spread, account for large numbers of cases in these closed facilities. At places like jails, where the population's age ranges from, probably, 18 years up into the 80s, we'll probably see cases at all ages, with the worst outcomes happening to people at risk.
Stay at home was only intended to prevent overrunning hospital capabilities, to spread the rate of infection over a longer period of time, not to stop the spread of the virus. Having the number of cases tick up is expected, and hopefully through tracing can be tamped down before it gets out of control. People will continue to become infected and some will die, even if we stay home. According to NY and Gov Cuomo, staying at home may be the cause of some new infections.

I was primarily referring to deaths. And I was talking statistically. Yes there are deaths in younger people, but at a very low rate.
UNITED NATIONS (AP) — U.N. Secretary-General Antonio Guterres said Friday that the COVID-19 pandemic is causing “untold fear and suffering” for older people around the world who are dying at a higher rate, and especially for those over age 80, whose fatality rate is five times the global average.
According to the report, over 95% of fatalities due to COVID-19 in Europe have been people 60 and older. In the United States, 80% of deaths are among adults 65 and over, it said, and in China, approximately 80% of deaths occurred among adults aged 60 or older.

https://www.usnews.com/news/world/a...deaths-for-people-over-80-are-5-times-average
My thinking was the easiest way to reduce deaths, would be to focus on the age groups most likely to die. I heard a strategy for opening businesses that made a lot of sense, but won't happen. First let younger people, under 35 return to work. There would probably need to be an exception for older supervisors to return as well. After a period of time, let people up to 55 return to work. Older people might be encouraged to stay isolated until there is a vaccine, a treatment, or we reach herd immunity.

By definition, asymptomatic means they have no symptoms, so they wouldn't have a fever. Testing is the only way to know, and that's not 100%.

From what I have read, the case rate in prisons is high, but the death rate is very low. The average age in US of an inmate is under 40.

Both the federal and state governments really dropped the ball when it came to nursing homes and other care facilities. And they still don't have a handle on it as new outbreaks are still occurring in nursing homes.
 
The cluster outbreaks of Covid in places like church socials, conferences, prisons, families, etc. would indicate that it is not related medical facilities but instead related to groups of people with at least on infected person coughing away.
That's true for infections, but not necessarily deaths. It is mainly older people who are dying, so where are you likely to find old people with comorbidities?
 
One question I asked in my earlier post is where are best practices for Covid-19? I just came across this article which you might want to look at if you are interested in best treatment options. This article was developed by EVMS (Eastern Virginia Medical School) - EVMS CRITICAL CARECOVID-19 MANAGEMENT PROTOCOL.

https://www.evms.edu/media/evms_pub...cine/EVMS_Critical_Care_COVID-19_Protocol.pdf
This is our recommended approach to COVID-19 based on the best (and most recent) literature. We should not re-invent the wheel but learn from the experience of others. This is a very dynamic situation; therefore, we will be updating the guideline as new information emerges. Please check on the EVMS website for updated versions of this protocol.

https://www.evms.edu/covid-19/medical_information_resources/
 

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