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Karl Pfleger, PhD Profile picture
@KarlPfleger
Jun 8, 2020 • 5 tweets • 3 min read • Read on X
#COVID19 cases mostly have low #VitaminD. Fixing low D might reduce deaths 5-10x. There’s no reason not to fix low D & much evidence it might help a lot. Until the data suggests otherwise, fixing low D while getting more data must be prioritized. 1pager: agingbiotech.info/vitamindcovid1…
@mattwridley
@VitaminD_Holick
@FatEmperor
@foundmyfitness @PeterAttiaMD @nutrition_facts @joerogan

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More from @KarlPfleger

Karl Pfleger, PhD Profile picture
Dec 6, 2023
Data from the new TargetD trial suggests that prior vitamin D trials were flawed:

Many people, even professionals, still think vitamin D was a false profit that was disproven by big RCTs. This view is very flawed, for several reasons. A brief history:news-medical.net/news/20231113/…
For decades, thousands of studies have shown reliable correlation of low vitamin D levels & bad health outcomes. Scientifically, the proper way to test the hypothesis that this correlation is causal is RCTs that meaningfully alter the low vitamin D status & then measure outcomes.
Heaney in 2014 published trial design guidelines for nutrients saying essentially the above.

Rule 4 was "The hypothesis to be tested must be that a change in nutrient status (not just a change in diet) produces the sought-for effect."academic.oup.com/nutritionrevie…
Read 15 tweets
Karl Pfleger, PhD Profile picture
Aug 30, 2022
Highly recommend the most recent good review of mechanisms of action of vitamin D affecting Covid risk pubmed.ncbi.nlm.nih.gov/35308241/
by notable Irish researchers who've published in the area throughout the pandemic.

Notable: Directly addresses satisfying Hill's Criteria for causation.
Image is Fig 2: "Molecular pathways in the pathology of Covid-19 thought to be affected by vitamin D"

That's a lot of diff Covid related biology affected by vitamin D!

Great job @RoseAnnekenny1 & co

Some direct quotes f/ the main text of the paper are worth repeating here:

🧵
"Applying the Bradford-Hill criteria [..] the collective literature supports a causal association between low vitamin D status, SARS-CoV-2 infection, and severe COVID-19 [..] A biologically plausible rationale exists for these findings"
Read 19 tweets
Karl Pfleger, PhD Profile picture
Aug 12, 2022
The most basic implication of the uncontroversial strong association between vitamin D levels & health outcomes:

Vitamin D level should be tested in clinical trials for many conditions, including Covid.

Why isn't this routine? Why isn't this discussed more?

Short 🧵 1/5
Vitamin D's causal influence on many health conditions is controversial, mostly for not enough big positive RCTs. But vitD's correlation w/ outcomes in many important conditions (CVD, cancer, diabetes, Covid, etc) is uncontroversial.

See mdpi.com/2072-6643/14/3… for a review.
2/5
Baseline risk is important in clinical trials eg to check risk imbalance, power calcs, & assessing effect size. Google it for a lit sample.

Trials should assess all easy-to-measure significant risk factors. Risks factors are determined mostly by observational data not RCTs.
3/5
Read 5 tweets
Karl Pfleger, PhD Profile picture
Aug 11, 2022
There are now (at min) 4 big systematic meta-analyses of vitamin D & Covid since Dec'21.
3 study D levels & 2 supplementation. Newest both.
Strong, consistent, & highly statistically significant results:
Low D raises & supplementation lowers all stages of Covid risk by ~1.5-3x
🧵
This 🧵 is an update & elaboration of a prior thread:
since 2 more MAs are now available & since they cover supplementation, not just D levels.
You might want to glance over that thread too.
I've put the links & full titles of all 4 papers & the results into this spreadsheet: docs.google.com/spreadsheets/d…
Screenshot of paper list here.
Results are in a subsheet. (On desktop use tabs at bottom.)
I've lined up the results for as direct comparison as possible. Let's dig in...
Read 25 tweets
Karl Pfleger, PhD Profile picture
Aug 9, 2022
In nutrition, when RCTs & observational studies disagree, there are good reasons to trust the observational studies even though tendency is to defer to RCTs, say Harvard researchers, inc Willett (one of the most cited researchers in all clinical med):academic.oup.com/advances/artic…
Quote:
when RCTs contradict the findings of observational studies, there is a tendency for the academic community to believe that RCTs conclusively refute the hypotheses generated by such observational studies.
...
Quote cont:
Although this is a possibility, an equally, and sometimes more likely, possibility is that the RCT and observational studies are answering very different questions. For example, an observational study might answer the question...
Read 4 tweets
Karl Pfleger, PhD Profile picture
May 11, 2022
@CharlesMBrenner @aubreydegrey @LauraMinquini
Didn't see place yet for Qs for Thu live event. Here are my Qs + high level comment:

Was a mistake to simul-debate general Q of LEV feasibility by any means vs SENS prog specifically. Should be separate discussions in that order.🧵
Qs for anyone skeptical of general feasibility of Longevity Escape Velocity:

On car analogy:
Generally agreed an old car can be kept in youthful functioning order indefinitely. Humans more complex. ADG & CB agreed.
Living (& having DNA) vs not alive is another binary difference.
Not-alive complexity continuum: watch/clock, car, space shuttle, death star, Dyson sphere.
Presumably most agree all could get classic car treatment w/ enough resources/technology.
Living continuum: single cell, simple multi-cell organism, worm/fly, mouse, dog, human.
Read 11 tweets

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