Vitamin D for Covid-19 in Down syndrome



I get it. The Covid19 crisis has been going on for a while now and many are fatigued, frustrated, and downright fearful, especially if you are a parent of a child with Down syndrome. Back in October 2020, CNN released an article detailing a study that concluded that people with Down syndrome are more likely to die from a Covid-19 infection.


Unfortunately, this finding wasn't unexpected, at least for those of us who work closely with individuals with Down syndrome. People with DS are more likely to die from cardiovascular and respiratory illnesses like influenza, pneumonia, and respiratory failure in general [1] due to the effects DS has on the body.


Trisomy 21 has a unique effect on lung tissue, often impairing it's function. This is due, in part, to how Down syndrome affects the formation of certain lungs cells called cilia. Cilia are the tiny hair like cells that move foreign objects out of the lungs and into the nose and mouth for removal from the body (via coughs and sneezes).



Cilia remove foreign objects from the lungs through an upward beating motion.

These cells are essential in keeping foreign invaders like bacteria and viruses from getting deeper into the lungs and causing serious infections.


With Trisomy 21, the formation and function of cilia is often impaired because of the extra amount of a protein called pericentrin that's encoded for on the 21st chromosome. Typical individuals only have two copies of chromosome 21 and therefore only 2 copies of the gene that produces pericentrin. People with DS have 3.


Pericentrin acts as an anchoring protein and is essential for cell cycle regulation. The problem comes when there's too much of this protein. When there is too much pericentrin, as in DS, this protein almost acts like a glue, preventing the cilia from moving freely [2]. This decreases the cilia's ability to beat effectively which allows for the entry of more foreign invaders deeper into the lungs.


This obviously causes diseases like pneumonia and respiratory illness.

There are other reasons why people with DS are more likely to die from Covid-19 and other respiratory illnesses. These range from smaller nasal passages to increased autoinflammation which is common in DS[3].



Autoinflammation occurs when the innate immune system response doesn't work properly. There are two distinct parts to the human immune system, the innate or general immune system and the adaptive or specialized immune system.


While these two systems work closely with one another, they do play different roles in keeping the body safe from foreign invaders. For example, the innate immune system is the first line of defense when it comes to protecting the outside body against invaders. This part of the immune system protects the skin and mucus membranes (like inside the mouth) and responds exactly the same to all foreign invaders.


The adaptive immune system is more specialized in its approach to protecting the body by attacking the specific germ that is causing the infection [4].


In fact, both innate and adaptive immune system dysfunction are hallmarks of DS [5] and one of the biggest factors causing such susceptibility to Covid-19.


Since there appears to be greater virulence of the delta variant of Covid-19, the increased need for protection against Covid-19 for individuals with DS is more crucial now than ever.


What should you do to better protect your child?



With the talk of breakthrough infections in the vaccinated, is there anything else that can help support the immune system? While measures like handwashing and practicing good hygiene are essential, there is a powerhouse vitamin that can offer more give your child's immune system a boost.


Vitamin D is one of the best ways to give your child's immune system a huge boost. Vitamin D isn't just a vitamin. It would be more accurately classified as a sterioid hormone and it actually has some pretty amazing effects on the immune system.


For example, vitamin D helps to produce beta-defensins, a compound produced by the innate immune system that can cut the membrane of a virus in two. Vitamin D also stimulates the production of cathelecidins which improves the immune defense against viral infections [6].


Vitamin D also plays a role in regulating the adaptive or specific immune response. Vitamin D acts as a powerful adaptive immune system regulator which inhibits the production of pro-inflammatory cytokines like the deadly cytokine storm seen in Covid-19 [7].


Cytokines are small secreted proteins that are released by cells. These proteins have an affect on the way cells interact and communicate with each other. Pro-inflammatory cytokines create inflammation in the body as part of the immune response.


A cytokine storm occurs when the immune system becomes unregulated leading to body wide inflammation, high fever, difficulty breathing, and often multiple organ failure which can be fatal if left untreated [8]. Vitamin D helps to prevent a cytokine storm from ever occurring through preventing the release of too many inflammatory cytokines [9].



With all of the immune boosting (and regulating) benefits of vitamin D, you'd think that most people would have adequate levels in their bodies to protect themselves. Unfortunately, this isn't the case.


A study from 2006 estimated that up to 42% of the adult population of the United States was vitamin D deficient with vitamin D levels at or below 20ng/mL. There's no doubt that the number of people who are vitamin D deficient may be even higher due to lockdowns last year which may possibly happen again with the surge of the delta variant[10].


Vitamin D is synthesized by the skin when the skin is exposed to sunlight. Avoiding the outdoors due to covid could very well have weakened many immune systems.


But all isn't lost!


To bring vitamin D levels back up to optimal level which will provide the greatest benefit to the immune system, there's supplementation, dietary changes, and UV light exposure.



Supplementation

With supplementation, there's good reason to start if you haven't already. Vitamin D supplementation has been linked to a lower all cause mortality and lower cancer death rates [11]. Vitamin D supplementation has also been found to reduce the risk of acute respiratory infections and was found to be the most protective in people taking daily or weekly vitamin D supplements [12].


While the NIH recommends between 400-800IU per day of vitamin D depending on age, research is generally varied with anywhere from 200-2000IU/day recommended or more. This wide range takes into account age, vitamin D status, pre-existing conditions, and diet.


When it comes to supplementation, I like the both capsules and drops because of their ease of use. There's even vitamin D gummies that your child might love. You can pick up vitamin D and any other supplements you'd like in my online dispensary where you can create a free account and purchase any supplements you'd like. (Make sure to pick them up before the start of fall to avoid shortages like last year!)


You should always talk to your naturopathic doctor before starting on any new supplement.



Diet

In fact, adding more vitamin D rich foods into your child's diet can boost their immune system. There are very few foods that are naturally high in vitamin D so a dietary approach may not be the fastest way to raise your child's vitamin D levels.


Foods that contain vitamin D include the flesh of fatty fish like trout, salmon, tuna, and mackeral, beef liver, cheese, and egg yolks. Some mushrooms also have vitamin D in the form of D2, a less effective form of vitamin D for raising blood levels, if they are grown in UV light.



UV light

Since your skin produces vitamin D when it is exposed to sunlight, getting outdoors is a great way to boost your child's vitamin D levels. While this may not be feasible or if you still have reservations, then you can always opt for a UV lamp.


UV lamps are lamps that shine ultraviolet light onto the skin simulating sunlight to bring out vitamin D production among other things. Research has found that UV lamps are effective in maintaining vitamin D levels throughout the winter when there is less sunlight and more people are prone to stay indoors[13].


When it comes to giving your child an immune boost in this concerning covid era, vitamin D is an amazing choice.






References

  1. https://pubmed.ncbi.nlm.nih.gov/32680774/

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557141/

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252041/

  4. https://www.ncbi.nlm.nih.gov/books/NBK279396/

  5. https://pubmed.ncbi.nlm.nih.gov/21352207/

  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500624/

  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266123/

  8. https://www.nejm.org/doi/full/10.1056/NEJMra2026131

  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080872/

  10. https://pubmed.ncbi.nlm.nih.gov/21310306/

  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689821/

  12. https://pubmed.ncbi.nlm.nih.gov/30675873/

  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846322/

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