Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

William B Grant, Henry Lahore, Sharon L McDonnell, Carole A Baggerly, Christine B French, Jennifer L Aliano, Harjit P Bhattoa, William B Grant, Henry Lahore, Sharon L McDonnell, Carole A Baggerly, Christine B French, Jennifer L Aliano, Harjit P Bhattoa

Abstract

The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.

Keywords: COVID-19; UVB; acute respiratory distress syndrome (ARDS); ascorbic acid; cathelicidin; coronavirus; cytokine storm; influenza; observational; pneumonia; prevention; respiratory tract infection; solar radiation; treatment; vitamin C; vitamin D.

Conflict of interest statement

W.B.G receives funding from Bio-Tech Pharmacal, Inc. (Fayetteville, AR). H.L. sells vitamin D supplements. GrassrootsHealth works with various supplement suppliers to test the efficacy of their products in various custom projects. These suppliers may be listed as sponsors of GrassrootsHealth. H.P.B. has no conflicts of interest to declare.

References

    1. Zhu N., Zhang D., Wang W., Li X., Yang B., Song J., Zhao X., Huang B., Shi W., Lu R., et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N. Engl. J. Med. 2020 doi: 10.1056/NEJMoa2001017.
    1. Zhong N.S., Zheng B.J., Li Y.M., Poon L.L.M., Xie Z.H., Chan K.H., Li P.H., Tan S.Y., Chang Q., Xie J.P., et al. Epidemiology and cause of severe acute respiratory syndrome (SARS) in Guangdong, People’s Republic of China, in February, 2003. Lancet. 2003;362:1353–1358. doi: 10.1016/S0140-6736(03)14630-2.
    1. Assiri A., McGeer A., Perl T.M., Price C.S., Al Rabeeah A.A., Cummings D.A., Alabdullatif Z.N., Assad M., Almulhim A., Makhdoom H., et al. Hospital outbreak of Middle East respiratory syndrome coronavirus. N. Engl. J. Med. 2013;369:407–416. doi: 10.1056/NEJMoa1306742.
    1. Song Z., Xu Y., Bao L., Zhang L., Yu P., Qu Y., Zhu H., Zhao W., Han Y., Qin C. From SARS to MERS, Thrusting Coronaviruses into the Spotlight. Viruses. 2019;11:59. doi: 10.3390/v11010059.
    1. Yin Y., Wunderink R.G. MERS, SARS and other coronaviruses as causes of pneumonia. Respirology. 2018;23:130–137. doi: 10.1111/resp.13196.
    1. Paget J., Spreeuwenberg P., Charu V., Taylor R.J., Iuliano A.D., Bresee J., Simonsen L., Viboud C. Global mortality associated with seasonal influenza epidemics: New burden estimates and predictors from the GLaMOR Project. J. Glob. Health. 2019;9:020421. doi: 10.7189/jogh.09.020421.
    1. Holick M.F. Vitamin D deficiency. N. Engl. J. Med. 2007;357:266–281. doi: 10.1056/NEJMra070553.
    1. Pike J.W., Christakos S. Biology and Mechanisms of Action of the Vitamin D Hormone. Endocrinol. Metab. Clin. 2017;46:815–843. doi: 10.1016/j.ecl.2017.07.001.
    1. Beard J.A., Bearden A., Striker R. Vitamin D and the anti-viral state. J. Clin. Virol. 2011;50:194–200. doi: 10.1016/j.jcv.2010.12.006.
    1. Hewison M. An update on vitamin D and human immunity. Clin. Endocrinol. 2012;76:315–325. doi: 10.1111/j.1365-2265.2011.04261.x.
    1. Greiller C.L., Martineau A.R. Modulation of the immune response to respiratory viruses by vitamin D. Nutrients. 2015;7:4240–4270. doi: 10.3390/nu7064240.
    1. Wei R., Christakos S. Mechanisms Underlying the Regulation of Innate and Adaptive Immunity by Vitamin D. Nutrients. 2015;7:8251–8260. doi: 10.3390/nu7105392.
    1. Coussens A.K. The role of UV radiation and vitamin D in the seasonality and outcomes of infectious disease. Photochem. Photobiol. Sci. 2017;16:314–338. doi: 10.1039/c6pp00355a.
    1. Lang P.O., Aspinall R. Vitamin D Status and the Host Resistance to Infections: What It Is Currently (Not) Understood. Clin. Ther. 2017;39:930–945. doi: 10.1016/j.clinthera.2017.04.004.
    1. Gruber-Bzura B.M. Vitamin D and Influenza-Prevention or Therapy? Int. J. Mol. Sci. 2018;19:2419. doi: 10.3390/ijms19082419.
    1. Rondanelli M., Miccono A., Lamburghini S., Avanzato I., Riva A., Allegrini P., Faliva M.A., Peroni G., Nichetti M., Perna S. Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds-Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds. Evid. Based Complement. Alternat. Med. 2018;2018:5813095. doi: 10.1155/2018/5813095.
    1. Gombart A.F., Pierre A., Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020;12:236. doi: 10.3390/nu12010236.
    1. Schwalfenberg G.K. A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol. Nutr. Food Res. 2011;55:96–108. doi: 10.1002/mnfr.201000174.
    1. Kast J.I., McFarlane A.J., Globinska A., Sokolowska M., Wawrzyniak P., Sanak M., Schwarze J., Akdis C.A., Wanke K. Respiratory syncytial virus infection influences tight junction integrity. Clin. Exp. Immunol. 2017;190:351–359. doi: 10.1111/cei.13042.
    1. Chen Y., Leng K., Lu Y., Wen L., Qi Y., Gao W., Chen H., Bai L., An X., Sun B., et al. Epidemiological features and time-series analysis of influenza incidence in urban and rural areas of Shenyang, China, 2010–2018. Epidemiol. Infect. 2020;148:e29. doi: 10.1017/S0950268820000151.
    1. Rossi G.A., Fanous H., Colin A.A. Viral strategies predisposing to respiratory bacterial superinfections. Pediatr. Pulmonol. 2020 doi: 10.1002/ppul.24699.
    1. Liu P.T., Stenger S., Li H., Wenzel L., Tan B.H., Krutzik S.R., Ochoa M.T., Schauber J., Wu K., Meinken C., et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science. 2006;311:1770–1773. doi: 10.1126/science.1123933.
    1. Adams J.S., Ren S., Liu P.T., Chun R.F., Lagishetty V., Gombart A.F., Borregaard N., Modlin R.L., Hewison M. Vitamin d-directed rheostatic regulation of monocyte antibacterial responses. J. Immunol. 2009;182:4289–4295. doi: 10.4049/jimmunol.0803736.
    1. Laaksi I. Vitamin D and respiratory infection in adults. Proc. Nutr. Soc. 2012;71:90–97. doi: 10.1017/S0029665111003351.
    1. Herr C., Shaykhiev R., Bals R. The role of cathelicidin and defensins in pulmonary inflammatory diseases. Expert Opin. Biol. Ther. 2007;7:1449–1461. doi: 10.1517/14712598.7.9.1449.
    1. Agier J., Efenberger M., Brzezinska-Blaszczyk E. Cathelicidin impact on inflammatory cells. Cent. Eur. J. Immunol. 2015;40:225–235. doi: 10.5114/ceji.2015.51359.
    1. Barlow P.G., Svoboda P., Mackellar A., Nash A.A., York I.A., Pohl J., Davidson D.J., Donis R.O. Antiviral activity and increased host defense against influenza infection elicited by the human cathelicidin LL-37. PLoS ONE. 2011;6:e25333. doi: 10.1371/journal.pone.0025333.
    1. Zhao Y., Ran Z., Jiang Q., Hu N., Yu B., Zhu L., Shen L., Zhang S., Chen L., Chen H., et al. Vitamin D Alleviates Rotavirus Infection through a Microrna-155-5p Mediated Regulation of the TBK1/IRF3 Signaling Pathway In Vivo and In Vitro. Int. J. Mol. Sci. 2019;20 doi: 10.3390/ijms20143562.
    1. Martinez-Moreno J., Hernandez J.C., Urcuqui-Inchima S. Effect of high doses of vitamin D supplementation on dengue virus replication, Toll-like receptor expression, and cytokine profiles on dendritic cells. Mol. Cell. Biochem. 2020;464:169–180. doi: 10.1007/s11010-019-03658-w.
    1. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y., Zhang L., Fan G., Xu J., Gu X., et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 doi: 10.1016/S0140-6736(20)30183-5.
    1. Sharifi A., Vahedi H., Nedjat S., Rafiei H., Hosseinzadeh-Attar M.J. Effect of single-dose injection of vitamin D on immune cytokines in ulcerative colitis patients: A randomized placebo-controlled trial. APMIS. 2019;127:681–687. doi: 10.1111/apm.12982.
    1. Cantorna M.T. Mechanisms underlying the effect of vitamin D on the immune system. Proc. Nutr. Soc. 2010;69:286–289. doi: 10.1017/S0029665110001722.
    1. Lemire J.M., Adams J.S., Kermani-Arab V., Bakke A.C., Sakai R., Jordan S.C. 1,25-Dihydroxyvitamin D3 suppresses human T helper/inducer lymphocyte activity in vitro. J. Immunol. 1985;134:3032–3035.
    1. Cantorna M.T., Snyder L., Lin Y.D., Yang L. Vitamin D and 1,25(OH)2D regulation of T cells. Nutrients. 2015;7:3011–3021. doi: 10.3390/nu7043011.
    1. Jeffery L.E., Burke F., Mura M., Zheng Y., Qureshi O.S., Hewison M., Walker L.S., Lammas D.A., Raza K., Sansom D.M. 1,25-Dihydroxyvitamin D3 and IL-2 combine to inhibit T cell production of inflammatory cytokines and promote development of regulatory T cells expressing CTLA-4 and FoxP3. J. Immunol. 2009;183:5458–5467. doi: 10.4049/jimmunol.0803217.
    1. Vasarhelyi B., Satori A., Olajos F., Szabo A., Beko G. Low vitamin D levels among patients at Semmelweis University: Retrospective analysis during a one-year period. Orv. Hetil. 2011;152:1272–1277. doi: 10.1556/OH.2011.29187.
    1. Novel C.P.E.R.E. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41:145–151. doi: 10.3760/cma.j.issn.0254-6450.2020.02.003.
    1. MacLaughlin J., Holick M.F. Aging decreases the capacity of human skin to produce vitamin D3. J. Clin. Invest. 1985;76:1536–1538. doi: 10.1172/JCI112134.
    1. Grober U., Kisters K. Influence of drugs on vitamin D and calcium metabolism. Dermatoendocrinol. 2012;4:158–166. doi: 10.4161/derm.20731.
    1. Lei G.S., Zhang C., Cheng B.H., Lee C.H. Mechanisms of Action of Vitamin D as Supplemental Therapy for Pneumocystis Pneumonia. Antimicrob. Agents Chemother. 2017;61 doi: 10.1128/AAC.01226-17.
    1. Mousavi S., Bereswill S., Heimesaat M.M. Immunomodulatory and Antimicrobial Effects of Vitamin C. Eur. J. Microbiol. Immunol. 2019;9:73–79. doi: 10.1556/1886.2019.00016.
    1. Colunga Biancatelli R.M.L., Berrill M., Marik P.E. The antiviral properties of vitamin C. Expert Rev. Anti Infect. Ther. 2020;18:99–101. doi: 10.1080/14787210.2020.1706483.
    1. Wimalawansa S.J. Global epidemic of coronavirus--COVID-19: What we can do to minimze risksl. Eur. J. Biomed. Pharm. Sci. 2020;7:432–438.
    1. Kalil A.C., Thomas P.G. Influenza virus-related critical illness: Pathophysiology and epidemiology. Crit. Care. 2019;23:258. doi: 10.1186/s13054-019-2539-x.
    1. Hope-Simpson R.E. The role of season in the epidemiology of influenza. J. Hyg. 1981;86:35–47. doi: 10.1017/S0022172400068728.
    1. Cannell J.J., Vieth R., Umhau J.C., Holick M.F., Grant W.B., Madronich S., Garland C.F., Giovannucci E. Epidemic influenza and vitamin D. Epidemiol. Infect. 2006;134:1129–1140. doi: 10.1017/S0950268806007175.
    1. Cannell J.J., Zasloff M., Garland C.F., Scragg R., Giovannucci E. On the epidemiology of influenza. Virol. J. 2008;5:29. doi: 10.1186/1743-422X-5-29.
    1. Kroll M.H., Bi C., Garber C.C., Kaufman H.W., Liu D., Caston-Balderrama A., Zhang K., Clarke N., Xie M., Reitz R.E., et al. Temporal relationship between vitamin D status and parathyroid hormone in the United States. PLoS ONE. 2015;10:e0118108. doi: 10.1371/journal.pone.0118108.
    1. Lowen A.C., Mubareka S., Steel J., Palese P. Influenza virus transmission is dependent on relative humidity and temperature. PLoS Pathog. 2007;3:1470–1476. doi: 10.1371/journal.ppat.0030151.
    1. Shaman J., Kohn M. Absolute humidity modulates influenza survival, transmission, and seasonality. Proc. Natl. Acad. Sci. USA. 2009;106:3243–3248. doi: 10.1073/pnas.0806852106.
    1. Shaman J., Pitzer V.E., Viboud C., Grenfell B.T., Lipsitch M. Absolute humidity and the seasonal onset of influenza in the continental United States. PLoS Biol. 2010;8:e1000316. doi: 10.1371/annotation/35686514-b7a9-4f65-9663-7baefc0d63c0.
    1. Urashima M., Segawa T., Okazaki M., Kurihara M., Wada Y., Ida H. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am. J. Clin. Nutr. 2010;91:1255–1260. doi: 10.3945/ajcn.2009.29094.
    1. Zhou J., Du J., Huang L., Wang Y., Shi Y., Lin H. Preventive Effects of Vitamin D on Seasonal Influenza A in Infants: A Multicenter, Randomized, Open, Controlled Clinical Trial. Pediatr. Infect. Dis. J. 2018;37:749–754. doi: 10.1097/INF.0000000000001890.
    1. Urashima M., Mezawa H., Noya M., Camargo C.A., Jr. Effects of vitamin D supplements on influenza A illness during the 2009 H1N1 pandemic: A randomized controlled trial. Food Funct. 2014;5:2365–2370. doi: 10.1039/C4FO00371C.
    1. Arihiro S., Nakashima A., Matsuoka M., Suto S., Uchiyama K., Kato T., Mitobe J., Komoike N., Itagaki M., Miyakawa Y., et al. Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Upper Respiratory Infection in Patients With Inflammatory Bowel Disease. Inflamm. Bowel Dis. 2019;25:1088–1095. doi: 10.1093/ibd/izy346.
    1. Loeb M., Dang A.D., Thiem V.D., Thanabalan V., Wang B., Nguyen N.B., Tran H.T.M., Luong T.M., Singh P., Smieja M., et al. Effect of Vitamin D supplementation to reduce respiratory infections in children and adolescents in Vietnam: A randomized controlled trial. Influenza Other Respir. Viruses. 2019;13:176–183. doi: 10.1111/irv.12615.
    1. Sabetta J.R., DePetrillo P., Cipriani R.J., Smardin J., Burns L.A., Landry M.L. Serum 25-hydroxyvitamin d and the incidence of acute viral respiratory tract infections in healthy adults. PLoS ONE. 2010;5:e11088. doi: 10.1371/journal.pone.0011088.
    1. Wang D., Hu B., Hu C., Zhu F., Liu X., Zhang J., Wang B., Xiang H., Cheng Z., Xiong Y., et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 doi: 10.1001/jama.2020.1585.
    1. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z., Xiang J., Wang Y., Song B., Gu X., et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020 doi: 10.1016/S0140-6736(20)30566-3.
    1. He Q., Gu Y., Zhang M. Spatiotemporal trends of PM2.5 concentrations in central China from 2003 to 2018 based on MAIAC-derived high-resolution data. Environ. Int. 2020;137:105536. doi: 10.1016/j.envint.2020.105536.
    1. Longhin E., Holme J.A., Gualtieri M., Camatini M., Ovrevik J. Milan winter fine particulate matter (wPM2.5) induces IL-6 and IL-8 synthesis in human bronchial BEAS-2B cells, but specifically impairs IL-8 release. Toxicol. In Vitro. 2018;52:365–373. doi: 10.1016/j.tiv.2018.07.016.
    1. Autier P., Mullie P., Macacu A., Dragomir M., Boniol M., Coppens K., Pizot C., Boniol M. Effect of vitamin D supplementation on non-skeletal disorders: A systematic review of meta-analyses and randomised trials. Lancet Diabetes Endocrinol. 2017;5:986–1004. doi: 10.1016/S2213-8587(17)30357-1.
    1. Rejnmark L., Bislev L.S., Cashman K.D., Eiriksdottir G., Gaksch M., Grubler M., Grimnes G., Gudnason V., Lips P., Pilz S., et al. Non-skeletal health effects of vitamin D supplementation: A systematic review on findings from meta-analyses summarizing trial data. PLoS ONE. 2017;12:e0180512. doi: 10.1371/journal.pone.0180512.
    1. Heaney R.P. Guidelines for optimizing design and analysis of clinical studies of nutrient effects. Nutr. Rev. 2014;72:48–54. doi: 10.1111/nure.12090.
    1. Grant W.B., Boucher B.J., Bhattoa H.P., Lahore H. Why vitamin D clinical trials should be based on 25-hydroxyvitamin D concentrations. J. Steroid Biochem. Mol. Biol. 2018;177:266–269. doi: 10.1016/j.jsbmb.2017.08.009.
    1. Manson J.E., Cook N.R., Lee I.M., Christen W., Bassuk S.S., Mora S., Gibson H., Gordon D., Copeland T., D’Agostino D., et al. Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease. N. Engl. J. Med. 2019;380:33–44. doi: 10.1056/NEJMoa1809944.
    1. Pittas A.G., Dawson-Hughes B., Sheehan P., Ware J.H., Knowler W.C., Aroda V.R., Brodsky I., Ceglia L., Chadha C., Chatterjee R., et al. Vitamin D Supplementation and Prevention of Type 2 Diabetes. N. Engl. J. Med. 2019;381:520–530. doi: 10.1056/NEJMoa1900906.
    1. Lu D., Zhang J., Ma C., Yue Y., Zou Z., Yu C., Yin F. Link between community-acquired pneumonia and vitamin D levels in older patients. Z. Gerontol. Geriatr. 2018;51:435–439. doi: 10.1007/s00391-017-1237-z.
    1. Zhou Y.F., Luo B.A., Qin L.L. The association between vitamin D deficiency and community-acquired pneumonia: A meta-analysis of observational studies. Medicine. 2019;98:e17252. doi: 10.1097/MD.0000000000017252.
    1. Manion M., Hullsiek K.H., Wilson E.M.P., Rhame F., Kojic E., Gibson D., Hammer J., Patel P., Brooks J.T., Baker J.V., et al. Vitamin D deficiency is associated with IL-6 levels and monocyte activation in HIV-infected persons. PLoS ONE. 2017;12:e0175517. doi: 10.1371/journal.pone.0175517.
    1. Dalvi S.M., Ramraje N.N., Patil V.W., Hegde R., Yeram N. Study of IL-6 and vitamin D3 in patients of pulmonary tuberculosis. Indian J. Tuberc. 2019;66:337–345. doi: 10.1016/j.ijtb.2018.05.018.
    1. Poudel-Tandukar K., Poudel K.C., Jimba M., Kobayashi J., Johnson C.A., Palmer P.H. Serum 25-hydroxyvitamin d levels and C-reactive protein in persons with human immunodeficiency virus infection. AIDS Res. Hum. Retrovir. 2013;29:528–534. doi: 10.1089/aid.2012.0120.
    1. Zhang M., Gao Y., Tian L., Zheng L., Wang X., Liu W., Zhang Y., Huang G. Association of serum 25-hydroxyvitamin D3 with adipokines and inflammatory marker in persons with prediabetes mellitus. Clin. Chim. Acta. 2017;468:152–158. doi: 10.1016/j.cca.2017.02.022.
    1. Zhou W., Mao S., Wu L., Yu J. Association Between Vitamin D Status and Sepsis. Clin. Lab. 2018;64:451–460. doi: 10.7754/Clin.Lab.2017.170919.
    1. Li Y., Ding S. Serum 25-Hydroxyvitamin D and the risk of mortality in adult patients with Sepsis: A meta-analysis. BMC Infect. Dis. 2020;20:189. doi: 10.1186/s12879-020-4879-1.
    1. Thickett D.R., Moromizato T., Litonjua A.A., Amrein K., Quraishi S.A., Lee-Sarwar K.A., Mogensen K.M., Purtle S.W., Gibbons F.K., Camargo C.A., Jr., et al. Association between prehospital vitamin D status and incident acute respiratory failure in critically ill patients: A retrospective cohort study. BMJ Open Respir. Res. 2015;2:e000074. doi: 10.1136/bmjresp-2014-000074.
    1. Dancer R.C., Parekh D., Lax S., D’Souza V., Zheng S., Bassford C.R., Park D., Bartis D.G., Mahida R., Turner A.M., et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS) Thorax. 2015;70:617–624. doi: 10.1136/thoraxjnl-2014-206680.
    1. Hou Y.M., Zhao J.Y., Liu H.Y. Impact of serum 25-hydroxyvitamin D on cardiac prognosis in Chinese patients with heart failure. Br. J. Nutr. 2019;122:162–171. doi: 10.1017/S0007114519000795.
    1. Aparicio-Ugarriza R., Salguero D., Mohammed Y.N., Ferri-Guerra J., Baskaran D.J., Mirabbasi S.A., Rodriguez A., Ruiz J.G. Is vitamin D deficiency related to a higher risk of hospitalization and mortality in veterans with heart failure? Maturitas. 2020;132:30–34. doi: 10.1016/j.maturitas.2019.11.005.
    1. McDonnell S.L., Baggerly L.L., French C.B., Heaney R.P., Gorham E.D., Holick M.F., Scragg R., Garland C.F. Incidence rate of type 2 diabetes is >50% lower in GrassrootsHealth cohort with median serum 25-hydroxyvitamin D of 41 ng/mL than in NHANES cohort with median of 22 ng/mL. J. Steroid Biochem. Mol. Biol. 2016;155:239–244. doi: 10.1016/j.jsbmb.2015.06.013.
    1. Xie Z., Xia W., Zhang Z., Wu W., Lu C., Tao S., Wu L., Gu J., Chandler J., Peter S., et al. Prevalence of Vitamin D Inadequacy Among Chinese Postmenopausal Women: A Nationwide, Multicenter, Cross-Sectional Study. Front. Endocrinol. 2019;9:782. doi: 10.3389/fendo.2018.00782.
    1. Brot C., Jorgensen N.R., Sorensen O.H. The influence of smoking on vitamin D status and calcium metabolism. Eur. J. Clin. Nutr. 1999;53:920–926. doi: 10.1038/sj.ejcn.1600870.
    1. Pilz S., Marz W., Cashman K.D., Kiely M.E., Whiting S.J., Holick M.F., Grant W.B., Pludowski P., Hiligsmann M., Trummer C., et al. Rationale and Plan for Vitamin D Food Fortification: A Review and Guidance Paper. Front. Endocrinol. 2018;9:373. doi: 10.3389/fendo.2018.00373.
    1. Chen X., Wu W., Wang L., Shi Y., Shen F., Gu X., Jia Z. Association Between 25-Hydroxyvitamin D and Epicardial Adipose Tissue in Chinese Non-Obese Patients with Type 2 Diabetes. Med. Sci. Monit. 2017;23:4304–4311. doi: 10.12659/MSM.904755.
    1. Lucato P., Solmi M., Maggi S., Bertocco A., Bano G., Trevisan C., Manzato E., Sergi G., Schofield P., Kouidrat Y., et al. Low vitamin D levels increase the risk of type 2 diabetes in older adults: A systematic review and meta-analysis. Maturitas. 2017;100:8–15. doi: 10.1016/j.maturitas.2017.02.016.
    1. Qi D., Nie X.L., Wu S., Cai J. Vitamin D and hypertension: Prospective study and meta-analysis. PLoS ONE. 2017;12:e0174298. doi: 10.1371/journal.pone.0174298.
    1. Gholami F., Moradi G., Zareei B., Rasouli M.A., Nikkhoo B., Roshani D., Ghaderi E. The association between circulating 25-hydroxyvitamin D and cardiovascular diseases: A meta-analysis of prospective cohort studies. BMC Cardiovasc. Disord. 2019;19:248. doi: 10.1186/s12872-019-1236-7.
    1. Zhu M., Wang T., Wang C., Ji Y. The association between vitamin D and COPD risk, severity, and exacerbation: An updated systematic review and meta-analysis. Int. J. Chron. Obstruct. Pulmon. Dis. 2016;11:2597–2607. doi: 10.2147/COPD.S101382.
    1. Hoseinzadeh E., Taha P., Wei C., Godini H., Ashraf G.M., Taghavi M., Miri M. The impact of air pollutants, UV exposure and geographic location on vitamin D deficiency. Food Chem. Toxicol. 2018;113:241–254. doi: 10.1016/j.fct.2018.01.052.
    1. Slow S., Epton M., Storer M., Thiessen R., Lim S., Wong J., Chin P., Tovaranonte P., Pearson J., Chambers S.T., et al. Effect of adjunctive single high-dose vitamin D3 on outcome of community-acquired pneumonia in hospitalised adults: The VIDCAPS randomised controlled trial. Sci. Rep. 2018;8:13829. doi: 10.1038/s41598-018-32162-2.
    1. Mirzavandi F., Talenezhad N., Razmpoosh E., Nadjarzadeh A., Mozaffari-Khosravi H. The effect of intramuscular megadose of vitamin D injections on E-selectin, CRP and biochemical parameters in vitamin D-deficient patients with type-2 diabetes mellitus: A randomized controlled trial. Complement. Ther. Med. 2020;49:102346. doi: 10.1016/j.ctim.2020.102346.
    1. Amrein K., Papinutti A., Mathew E., Vila G., Parekh D. Vitamin D and critical illness: What endocrinology can learn from intensive care and vice versa. Endocr. Connect. 2018;7:R304–R315. doi: 10.1530/EC-18-0184.
    1. Han J.E., Jones J.L., Tangpricha V., Brown M.A., Brown L.A.S., Hao L., Hebbar G., Lee M.J., Liu S., Ziegler T.R., et al. High Dose Vitamin D Administration in Ventilated Intensive Care Unit Patients: A Pilot Double Blind Randomized Controlled Trial. J. Clin. Transl. Endocrinol. 2016;4:59–65. doi: 10.1016/j.jcte.2016.04.004.
    1. Cho N.H., Shaw J.E., Karuranga S., Huang Y., da Rocha Fernandes J.D., Ohlrogge A.W., Malanda B. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res. Clin. Pract. 2018;138:271–281. doi: 10.1016/j.diabres.2018.02.023.
    1. Henley S.J., Gallaway S., Singh S.D., O’Neil M.E., Buchanan Lunsford N., Momin B., Richards T.B. Lung Cancer Among Women in the United States. J. Womens Health. 2018;27:1307–1316. doi: 10.1089/jwh.2018.7397.
    1. Malinovschi A., Masoero M., Bellocchia M., Ciuffreda A., Solidoro P., Mattei A., Mercante L., Heffler E., Rolla G., Bucca C. Severe vitamin D deficiency is associated with frequent exacerbations and hospitalization in COPD patients. Respir. Res. 2014;15:131. doi: 10.1186/s12931-014-0131-0.
    1. Kim H.J., Jang J.G., Hong K.S., Park J.K., Choi E.Y. Relationship between serum vitamin D concentrations and clinical outcome of community-acquired pneumonia. Int. J. Tuberc. Lung Dis. 2015;19:729–734. doi: 10.5588/ijtld.14.0696.
    1. Naghshtabrizi B., Borzouei S., Bigvand P., Seifrabiei M.A. Evaluation of the Relationship between Serum 25-Hydroxy Vitamin D and Hypertension in Hamadan, Iran-A Case Control Study. J. Clin. Diagn. Res. 2017;11:LC01–LC03. doi: 10.7860/JCDR/2017/25522.10187.
    1. Valcour A., Blocki F., Hawkins D.M., Rao S.D. Effects of age and serum 25-OH-vitamin D on serum parathyroid hormone levels. J. Clin. Endocrinol. Metab. 2012;97:3989–3995. doi: 10.1210/jc.2012-2276.
    1. Christensen M.H., Lien E.A., Hustad S., Almas B. Seasonal and age-related differences in serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and parathyroid hormone in patients from Western Norway. Scand. J. Clin. Lab. Invest. 2010;70:281–286. doi: 10.3109/00365511003797172.
    1. Nam H.H., Ison M.G. Respiratory syncytial virus infection in adults. BMJ. 2019;366:l5021. doi: 10.1136/bmj.l5021.
    1. Paynter S., Ware R.S., Sly P.D., Weinstein P., Williams G. Respiratory syncytial virus seasonality in tropical Australia. Aust. N. Z. J. Public Health. 2015;39:8–10. doi: 10.1111/1753-6405.12347.
    1. Feng X., Guo T., Wang Y., Kang D., Che X., Zhang H., Cao W., Wang P. The vitamin D status and its effects on life quality among the elderly in Jinan, China. Arch. Gerontol. Geriatr. 2016;62:26–29. doi: 10.1016/j.archger.2015.09.002.
    1. Nassar M.S., Bakhrebah M.A., Meo S.A., Alsuabeyl M.S., Zaher W.A. Global seasonal occurrence of middle east respiratory syndrome coronavirus (MERS-CoV) infection. Eur. Rev. Med. Pharmacol. Sci. 2018;22:3913–3918. doi: 10.26355/eurrev_201806_15276.
    1. Grant W.B., Fakhoury H.M.A., Karras S.N., Al Anouti F., Bhattoa H.P. Variations in 25-Hydroxyvitamin D in Countries from the Middle East and Europe: The Roles of UVB Exposure and Diet. Nutrients. 2019;11:2065. doi: 10.3390/nu11092065.
    1. Moura F.E., Perdigao A.C., Siqueira M.M. Seasonality of influenza in the tropics: A distinct pattern in northeastern Brazil. Am. J. Trop. Med. Hyg. 2009;81:180–183. doi: 10.4269/ajtmh.2009.81.180.
    1. Arboleda J.F., Urcuqui-Inchima S. Vitamin D-Regulated MicroRNAs: Are They Protective Factors against Dengue Virus Infection? Adv. Virol. 2016;2016:1016840. doi: 10.1155/2016/1016840.
    1. Villamor E., Villar L.A., Lozano A., Herrera V.M., Herran O.F. Vitamin D serostatus and dengue fever progression to dengue hemorrhagic fever/dengue shock syndrome. Epidemiol. Infect. 2017;145:2961–2970. doi: 10.1017/S0950268817002059.
    1. Fan H.Z., Zhang R., Tian T., Zhong Y.L., Wu M.P., Xie C.N., Yang J.J., Huang P., Yu R.B., Zhang Y., et al. CYP24A1 genetic variants in the vitamin D metabolic pathway are involved in the outcomes of hepatitis C virus infection among high-risk Chinese population. Int. J. Infect. Dis. 2019;84:80–88. doi: 10.1016/j.ijid.2019.04.032.
    1. Hu Y.C., Wang W.W., Jiang W.Y., Li C.Q., Guo J.C., Xun Y.H. Low vitamin D levels are associated with high viral loads in patients with chronic hepatitis B: A systematic review and meta-analysis. BMC Gastroenterol. 2019;19:84. doi: 10.1186/s12876-019-1004-2.
    1. Brice D.C., Toth Z., Diamond G. LL-37 disrupts the Kaposi’s sarcoma-associated herpesvirus envelope and inhibits infection in oral epithelial cells. Antivir. Res. 2018;158:25–33. doi: 10.1016/j.antiviral.2018.07.025.
    1. Alvarez N., Aguilar-Jimenez W., Rugeles M.T. The Potential Protective Role of Vitamin D Supplementation on HIV-1 Infection. Front. Immunol. 2019;10:2291. doi: 10.3389/fimmu.2019.02291.
    1. Gui B., Chen Q., Hu C., Zhu C., He G. Effects of calcitriol (1, 25-dihydroxy-vitamin D3) on the inflammatory response induced by H9N2 influenza virus infection in human lung A549 epithelial cells and in mice. Virol. J. 2017;14:10. doi: 10.1186/s12985-017-0683-y.
    1. Currie S.M., Findlay E.G., McHugh B.J., Mackellar A., Man T., Macmillan D., Wang H., Fitch P.M., Schwarze J., Davidson D.J. The human cathelicidin LL-37 has antiviral activity against respiratory syncytial virus. PLoS ONE. 2013;8:e73659. doi: 10.1371/journal.pone.0073659.
    1. Laplana M., Royo J.L., Fibla J. Vitamin D Receptor polymorphisms and risk of enveloped virus infection: A meta-analysis. Gene. 2018;678:384–394. doi: 10.1016/j.gene.2018.08.017.
    1. Bucak I.H., Ozturk A.B., Almis H., Cevik M.O., Tekin M., Konca C., Turgut M., Bulbul M. Is there a relationship between low vitamin D and rotaviral diarrhea? Pediatr. Int. 2016;58:270–273. doi: 10.1111/ped.12809.
    1. Theron M., Huang K.J., Chen Y.W., Liu C.C., Lei H.Y. A probable role for IFN-gamma in the development of a lung immunopathology in SARS. Cytokine. 2005;32:30–38. doi: 10.1016/j.cyto.2005.07.007.
    1. Wong C.K., Lam C.W., Wu A.K., Ip W.K., Lee N.L., Chan I.H., Lit L.C., Hui D.S., Chan M.H., Chung S.S., et al. Plasma inflammatory cytokines and chemokines in severe acute respiratory syndrome. Clin. Exp. Immunol. 2004;136:95–103. doi: 10.1111/j.1365-2249.2004.02415.x.
    1. Mahallawi W.H., Khabour O.F., Zhang Q., Makhdoum H.M., Suliman B.A. MERS-CoV infection in humans is associated with a pro-inflammatory Th1 and Th17 cytokine profile. Cytokine. 2018;104:8–13. doi: 10.1016/j.cyto.2018.01.025.
    1. Britten R. The incidence of epidemic influenza, 1918-19. Public Health Rep. 1932;47:303–339. doi: 10.2307/4580340.
    1. Grant W.B., Giovannucci E. The possible roles of solar ultraviolet-B radiation and vitamin D in reducing case-fatality rates from the 1918–1919 influenza pandemic in the United States. Dermatoendocrinol. 2009;1:215–219. doi: 10.4161/derm.1.4.9063.
    1. Feigenbaum J.J., Muller C., Wrigley-Field E. Regional and Racial Inequality in Infectious Disease Mortality in U.S. Cities, 1900–1948. Demography. 2019;56:1371–1388. doi: 10.1007/s13524-019-00789-z.
    1. Aloia J.F., Li-Ng M. Re: Epidemic influenza and vitamin D. Epidemiol. Infect. 2007;135:1095–1096. doi: 10.1017/S0950268807008308. author reply 1097–1098.
    1. Ginde A.A., Liu M.C., Camargo C.A., Jr. Demographic differences and trends of vitamin D insufficiency in the US population, 1988–2004. Arch. Intern. Med. 2009;169:626–632. doi: 10.1001/archinternmed.2008.604.
    1. Clay K., Lewis J., Severnini E. What explains cross-city variation in mortality during the 1918 influenza pandemic? Evidence from 438 U.S. cities. Econ. Hum. Biol. 2019;35:42–50. doi: 10.1016/j.ehb.2019.03.010.
    1. Liu X.X., Li Y., Qin G., Zhu Y., Li X., Zhang J., Zhao K., Hu M., Wang X.L., Zheng X. Effects of air pollutants on occurrences of influenza-like illness and laboratory-confirmed influenza in Hefei, China. Int. J. Biometeorol. 2019;63:51–60. doi: 10.1007/s00484-018-1633-0.
    1. Croft D.P., Zhang W., Lin S., Thurston S.W., Hopke P.K., van Wijngaarden E., Squizzato S., Masiol M., Utell M.J., Rich D.Q. Associations between Source-Specific Particulate Matter and Respiratory Infections in New York State Adults. Environ. Sci. Technol. 2020;54:975–984. doi: 10.1021/acs.est.9b04295.
    1. Smith E.M., Jones J.L., Han J.E., Alvarez J.A., Sloan J.H., Konrad R.J., Zughaier S.M., Martin G.S., Ziegler T.R., Tangpricha V. High-Dose Vitamin D3 Administration Is Associated With Increases in Hemoglobin Concentrations in Mechanically Ventilated Critically Ill Adults: A Pilot Double-Blind, Randomized, Placebo-Controlled Trial. JPEN J. Parenter. Enter. Nutr. 2018;42:87–94. doi: 10.1177/0148607116678197.
    1. Centers for Disease Control and Prevention Update: Severe acute respiratory syndrome--Toronto, Canada, 2003. MMWR Morb. Mortal. Wkly. Rep. 2003;52:547–550.
    1. Hagel S., Ludewig K., Moeser A., Baier M., Loffler B., Schleenvoigt B., Forstner C., Pletz M.W. Characteristics and management of patients with influenza in a German hospital during the 2014/2015 influenza season. Infection. 2016;44:667–672. doi: 10.1007/s15010-016-0920-0.
    1. Youssef D.A., Ranasinghe T., Grant W.B., Peiris A.N. Vitamin D’s potential to reduce the risk of hospital-acquired infections. Derm. Endocrinol. 2012;4:167–175. doi: 10.4161/derm.20789.
    1. Quraishi S.A., Bittner E.A., Blum L., Hutter M.M., Camargo C.A., Jr. Association between preoperative 25-hydroxyvitamin D level and hospital-acquired infections following Roux-en-Y gastric bypass surgery. JAMA Surg. 2014;149:112–118. doi: 10.1001/jamasurg.2013.3176.
    1. Laviano E., Sanchez Rubio M., Gonzalez-Nicolas M.T., Palacian M.P., Lopez J., Gilaberte Y., Calmarza P., Rezusta A., Serrablo A. Association between preoperative levels of 25-hydroxyvitamin D and hospital-acquired infections after hepatobiliary surgery: A prospective study in a third-level hospital. PLoS ONE. 2020;15:e0230336. doi: 10.1371/journal.pone.0230336.
    1. Martineau A.R., Jolliffe D.A., Hooper R.L., Greenberg L., Aloia J.F., Bergman P., Dubnov-Raz G., Esposito S., Ganmaa D., Ginde A.A., et al. Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583. doi: 10.1136/bmj.i6583.
    1. Heaney R.P., Davies K.M., Chen T.C., Holick M.F., Barger-Lux M.J. Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am. J. Clin. Nutr. 2003;77:204–210. doi: 10.1093/ajcn/77.1.204.
    1. van Groningen L., Opdenoordt S., van Sorge A., Telting D., Giesen A., de Boer H. Cholecalciferol loading dose guideline for vitamin D-deficient adults. Eur. J. Endocrinol. 2010;162:805–811. doi: 10.1530/EJE-09-0932.
    1. Amir E., Simmons C.E., Freedman O.C., Dranitsaris G., Cole D.E., Vieth R., Ooi W.S., Clemons M. A phase 2 trial exploring the effects of high-dose (10,000 IU/day) vitamin D(3) in breast cancer patients with bone metastases. Cancer. 2010;116:284–291. doi: 10.1002/cncr.24749.
    1. Charoenngam N., Shirvani A., Kalajian T.A., Song A., Holick M.F. The Effect of Various Doses of Oral Vitamin D3 Supplementation on Gut Microbiota in Healthy Adults: A Randomized, Double-blinded, Dose-response Study. Anticancer Res. 2020;40:551–556. doi: 10.21873/anticanres.13984.
    1. Ekwaru J.P., Zwicker J.D., Holick M.F., Giovannucci E., Veugelers P.J. The importance of body weight for the dose response relationship of oral vitamin D supplementation and serum 25-hydroxyvitamin D in healthy volunteers. PLoS ONE. 2014;9:e111265. doi: 10.1371/journal.pone.0111265.
    1. Shirvani A., Kalajian T.A., Song A., Holick M.F. Disassociation of Vitamin D’s Calcemic Activity and Non-calcemic Genomic Activity and Individual Responsiveness: A Randomized Controlled Double-Blind Clinical Trial. Sci. Rep. 2019;9:17685. doi: 10.1038/s41598-019-53864-1.
    1. McCullough P.J., Lehrer D.S., Amend J. Daily oral dosing of vitamin D3 using 5000 TO 50,000 international units a day in long-term hospitalized patients: Insights from a seven year experience. J. Steroid Biochem. Mol. Biol. 2019;189:228–239. doi: 10.1016/j.jsbmb.2018.12.010.
    1. Holick M.F. Environmental factors that influence the cutaneous production of vitamin D. Am. J. Clin. Nutr. 1995;61:638S–645S. doi: 10.1093/ajcn/61.3.638S.
    1. Howard J.E., Meyer R.J. Intoxication with vitamin D. J. Clin. Endocrinol. Metab. 1948;8:895–910. doi: 10.1210/jcem-8-11-895.
    1. Malihi Z., Lawes C.M.M., Wu Z., Huang Y., Waayer D., Toop L., Khaw K.T., Camargo C.A., Scragg R. Monthly high-dose vitamin D supplementation does not increase kidney stone risk or serum calcium: Results from a randomized controlled trial. Am. J. Clin. Nutr. 2019;109:1578–1587. doi: 10.1093/ajcn/nqy378.
    1. Cianferotti L., Bertoldo F., Bischoff-Ferrari H.A., Bruyere O., Cooper C., Cutolo M., Kanis J.A., Kaufman J.M., Reginster J.Y., Rizzoli R., et al. Vitamin D supplementation in the prevention and management of major chronic diseases not related to mineral homeostasis in adults: Research for evidence and a scientific statement from the European society for clinical and economic aspects of osteoporosis and osteoarthritis (ESCEO) Endocrine. 2017;56:245–261. doi: 10.1007/s12020-017-1290-9.
    1. Lappe J., Watson P., Travers-Gustafson D., Recker R., Garland C., Gorham E., Baggerly K., McDonnell S.L. Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women: A Randomized Clinical Trial. JAMA. 2017;317:1234–1243. doi: 10.1001/jama.2017.2115.
    1. Amrein K., Scherkl M., Hoffmann M., Neuwersch-Sommeregger S., Kostenberger M., Tmava Berisha A., Martucci G., Pilz S., Malle O. Vitamin D deficiency 2.0: An update on the current status worldwide. Eur. J. Clin. Nutr. 2020 doi: 10.1038/s41430-020-0558-y.
    1. Grant W.B., Al Anouti F., Moukayed M. Targeted 25-hydroxyvitamin D concentration measurements and vitamin D3 supplementation can have important patient and public health benefits. Eur. J. Clin. Nutr. 2020 doi: 10.1038/s41430-020-0564-0.
    1. Garland C.F., Gorham E.D., Mohr S.B., Garland F.C. Vitamin D for cancer prevention: Global perspective. Ann. Epidemiol. 2009;19:468–483. doi: 10.1016/j.annepidem.2009.03.021.
    1. Ross A.C., Manson J.E., Abrams S.A., Aloia J.F., Brannon P.M., Clinton S.K., Durazo-Arvizu R.A., Gallagher J.C., Gallo R.L., Jones G., et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: What clinicians need to know. J. Clin. Endocrinol. Metab. 2011;96:53–58. doi: 10.1210/jc.2010-2704.
    1. Grant W.B., Karras S.N., Bischoff-Ferrari H.A., Annweiler C., Boucher B.J., Juzeniene A., Garland C.F., Holick M.F. Do studies reporting ‘U’-shaped serum 25-hydroxyvitamin D-health outcome relationships reflect adverse effects? Derm. Endocrinol. 2016;8:e1187349. doi: 10.1080/19381980.2016.1187349.
    1. Holick M.F., Binkley N.C., Bischoff-Ferrari H.A., Gordon C.M., Hanley D.A., Heaney R.P., Murad M.H., Weaver C.M., Endocrine S. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 2011;96:1911–1930. doi: 10.1210/jc.2011-0385.
    1. Veugelers P.J., Pham T.M., Ekwaru J.P. Optimal Vitamin D Supplementation Doses that Minimize the Risk for Both Low and High Serum 25-Hydroxyvitamin D Concentrations in the General Population. Nutrients. 2015;7:10189–10208. doi: 10.3390/nu7125527.
    1. Pludowski P., Holick M.F., Grant W.B., Konstantynowicz J., Mascarenhas M.R., Haq A., Povoroznyuk V., Balatska N., Barbosa A.P., Karonova T., et al. Vitamin D supplementation guidelines. J. Steroid Biochem. Mol. Biol. 2018;175:125–135. doi: 10.1016/j.jsbmb.2017.01.021.
    1. Grant W.B., Boucher B.J. A Review of the Potential Benefits of Increasing Vitamin D Status in Mongolian Adults through Food Fortification and Vitamin D Supplementation. Nutrients. 2019;11:2452. doi: 10.3390/nu11102452.
    1. Camargo C.A., Jr., Ganmaa D., Frazier A.L., Kirchberg F.F., Stuart J.J., Kleinman K., Sumberzul N., Rich-Edwards J.W. Randomized trial of vitamin D supplementation and risk of acute respiratory infection in Mongolia. Pediatrics. 2012;130:e561–e567. doi: 10.1542/peds.2011-3029.
    1. Uwitonze A.M., Razzaque M.S. Role of Magnesium in Vitamin D Activation and Function. J. Am. Osteopath Assoc. 2018;118:181–189. doi: 10.7556/jaoa.2018.037.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe