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Report: Vitamin D Insufficiency is Prevalent in Severe COVID-19

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Comments

  • Registered Users, Registered Users 2 Posts: 23,084 ✭✭✭✭Esel
    Not Your Ornery Onager


    maninasia wrote: »
    Low vitamin D is common amongst a broad range of chronic diseases and our levels drop as we age. It's a marker for early mortality. It's more likely a result of disease rather than the cause .
    There are thousands of papers linking vitamin d to everything under the sun.

    Only one surety, low vitamin D is a bad sign. By the way there is no evidence that supplementing with vitamin D will improve health unfortunately.
    :D

    Not your ornery onager



  • Registered Users, Registered Users 2 Posts: 396 ✭✭mille100piedi


    Xertz wrote: »
    I wonder though is this just down to the fact that the majority of those who got very sick were also likely to be quite elderly or infirm and may not have been going outside as much?

    I'm always wary about these early correlation type statements that have no real ability to show causation. You get them a lot in dietary type stuff.

    I mean if you take our climate, we are adapted to it. I wouldn't go out of my way to suggest that Irish people are all low in Vit D.
    That's why many of us tend to fry in even sightly sunnier climes. Relatively little UV and we produce adequate vitamin D in most cases, but obviously it does impact some of us more than others depending on your skin type and ability to produce it in low light.

    One aspect that does concern me though is people plastering themselves in sunblock with notions that it's anti-aging in a region that gets very little sunlight much of the year.

    I know quite a few people who'd wear SPF all year here, and I would say some of that research is more likely to be appropriate in California or the South of France.

    Obviously take care of your skin, and avoid skin cancer, but some of this anti-aging stuff gets a bit ridiculous as you might be getting very little sun exposure anyway.

    To me it looks like the Coronavirus just follows the lines of what you'd expect it to follow - international flight traffic, notably long distance business travel type stuff. So, you've had outbreaks everywhere and particular hotspots in Western Europe, North America, parts of Asia and lighter outbreaks in places that aren't those kinds of nexuses of that kind of traffic.

    Also tourism traffic will have played a huge role - Spain for example being one of the most visited places in the world.

    Irish people have the right skin for Irish climate. Black people come from Africa and white people come from places with less sunshine for a reason. Irish people adapted to the environment but in the past they used to spend more time outdoor. Now many of them spend all day long in office where they can't even open the windows. And when they get out it is too late for vitamin D. Also they spend lots of time indoor at the computer at home. Their sport is in an indoor gym. My american doctor told me they see severe case of deficiency in children in USA for the first time. Children spend too much time indoor and don't play outside. Also there are many immigrants that can't absorb the vitamin D in Ireland because they have too dark skin. Also going to live to Australia when a person have a very white skin can be dangerous because that type of skin is not suitable for strong sunshine.
    If you live in Ireland and you are a farmer or you work in a construction site you probably don't have any problem with vitamin D. But if you are in office all day long you might have some problem and vitamin D deficiency signs are not recognise by doctors so they can give you the wrong treatment.
    To understand if we have deficiency a part the fact that we don't feel well, we always can do a blood test. But doctors here in Ireland and not only in Ireland never prescribe this blood test, you have to do it privately. I know personally two persons that had depression and an autoimmune disorder that after many years got better only because they raised their vitamin D level. For so many years they were sick and no one doctor tested their vitamin D level


  • Registered Users, Registered Users 2 Posts: 28,694 ✭✭✭✭drunkmonkey


    https://www.medrxiv.org/content/10.1101/2020.04.08.20058578v3

    (STUDY FINDS) -- EVANSTON, Ill. — A new study conducted at Northwestern University concludes that vitamin D may be an essential ingredient to protecting oneself from the coronavirus. The research team discovered a strong correlation between vitamin D deficiencies and mortality rates.

    According to the study, the lower the vitamin D levels present in a patient’s body, the more likely that person will develop severe symptoms and complications.

    Don't mind your facemasks, throw on the birthday suits and smother yourself in good old Sunshine.


  • Administrators, Social & Fun Moderators, Sports Moderators Posts: 78,393 Admin ✭✭✭✭✭Beasty


    Threads merged


  • Registered Users, Registered Users 2 Posts: 16,181 ✭✭✭✭iamwhoiam




  • Registered Users, Registered Users 2 Posts: 54 ✭✭ShareShare


    TLDR; Trinty professors say take Vitamin D and it may reduce covid complications

    According to this article published a few hours ago, there is a strong correlation between vitamin D levels with twice the likely hood of bad covid 19 complications.

    Two trinity professors are suggesting to the government to instruct the population to increase Vitamin D. They recently completed a very large study on aging, and one of the data sets they had was vitamin D levels across large populations.

    Northwestern university from US found similar. England, Scotland and wales health representatives also suggest increasing Vitamin D.

    https://www.irishtimes.com/news/health/coronavirus-adults-should-take-vitamin-d-researchers-say-1.4250588

    I read another from china that showed a correlation between selenium levels too. So i make sure to get my appropriate dosage each day now.

    Maybe its rubbish, or maybe a little change like this will help some people.


  • Registered Users, Registered Users 2 Posts: 18,719 ✭✭✭✭_Brian


    This information has been in the public domain for about 2 months.

    My OH is a Dietician and they have been recommending VitD supplements right from the start.


  • Registered Users, Registered Users 2 Posts: 54 ✭✭ShareShare


    _Brian wrote: »
    This information has been in the public domain for about 2 months.

    My OH is a Dietician and they have been recommending VitD supplements right from the start.

    I had no idea. I've not heard it discussed at all. Was there anything you came across that was worth reading on it?


  • Closed Accounts Posts: 161 ✭✭LeYouth


    Is Vitamin C not the one for viruses?


  • Registered Users, Registered Users 2 Posts: 18,719 ✭✭✭✭_Brian


    ShareShare wrote: »
    I had no idea. I've not heard it discussed at all. Was there anything you came across that was worth reading on it?

    It’s something that was widely discussed among frontline nutrition staff for sure. Having said that we would take VitD supplements over the winter period anyway as it’s just not possible to get enough sunlight.

    It’s a possible reason why Black patients have raised worse outcomes as their Vit D levels would often be lower due to skin pigmentation.


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  • Registered Users, Registered Users 2 Posts: 5,842 ✭✭✭roosterman71


    Selenium is only need in small amounts. Couple of Brazil nuts every couple of days. Will boost the immune system but won't prevent you catching and spreading the virus, but may help you fight it


  • Registered Users, Registered Users 2 Posts: 3,987 ✭✭✭mikeym


    Once the vaccine is brought in the better.

    Vitamins are good for you but its not going to stop the virus getting to someone who has a weak immune system.


  • Registered Users, Registered Users 2 Posts: 6,352 ✭✭✭alias no.9


    mikeym wrote: »
    Once the vaccine is brought in the better.

    Vitamins are good for you but its not going to stop the virus getting to someone who has a weak immune system.

    Vitamin D is fundamental to the function of the immune system


  • Registered Users, Registered Users 2 Posts: 69 ✭✭mc25


    I would encourage everyone to read the actual source material instead of what is essentially a fluff piece in the IT:
    http://imj.ie/irish-medical-journal-may-2020-vol-113-no-5-vitamin-d-debate/

    Also, probably not the place to complain about it but I hate when newspapers report on stuff like this and don't include a link to the journal article (which may be behind a paywall anyway but that's a whole other rant!)


  • Closed Accounts Posts: 1,165 ✭✭✭timmy_mallet


    mikeym wrote: »
    Once the vaccine is brought in the better.

    Vitamins are good for you but its not going to stop the virus getting to someone who has a weak immune system.

    Depends how they achieved a weak immune system. If it is chips and bread for dinner, and Mars and tayto washed down with Ribena for lunch, then there are quicker ways to avoid a poor outcome from a respiratory illness.


  • Registered Users, Registered Users 2 Posts: 18,854 ✭✭✭✭silverharp


    Vitamin D seems to be trending on Twitter in Ireland. An idea floated is that your Vit D status could be a go back to work marker from some people, the cause and effect doesn't matter in this case

    A belief in gender identity involves a level of faith as there is nothing tangible to prove its existence which, as something divorced from the physical body, is similar to the idea of a soul. - Colette Colfer



  • Registered Users, Registered Users 2 Posts: 32,136 ✭✭✭✭is_that_so


    silverharp wrote: »
    Vitamin D seems to be trending on Twitter in Ireland. An idea floated is that your Vit D status could be a go back to work marker from some people, the cause and effect doesn't matter in this case
    An idea floated on Twitter? That's a good plan for sure.


  • Registered Users, Registered Users 2 Posts: 18,854 ✭✭✭✭silverharp


    is_that_so wrote: »
    An idea floated on Twitter? That's a good plan for sure.

    I know there is sarcasm in there somewhere but can you unpack?

    A belief in gender identity involves a level of faith as there is nothing tangible to prove its existence which, as something divorced from the physical body, is similar to the idea of a soul. - Colette Colfer



  • Registered Users, Registered Users 2 Posts: 32,136 ✭✭✭✭is_that_so


    silverharp wrote: »
    I know there is sarcasm in there somewhere but can you unpack?
    Twitter tends not to be a barometer of much apart from today's trend. Good ideas is not something I would associate with it but there are a myriad of ideas magnified by it.


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  • Registered Users, Registered Users 2 Posts: 18,854 ✭✭✭✭silverharp


    is_that_so wrote: »
    Twitter tends not to be a barometer of much apart from today's trend. Good ideas is not something I would associate with it but there are a myriad of ideas magnified by it.

    Twitter is turning into a global brain , and like any brain you get some randomness in there too

    A belief in gender identity involves a level of faith as there is nothing tangible to prove its existence which, as something divorced from the physical body, is similar to the idea of a soul. - Colette Colfer



  • Registered Users, Registered Users 2 Posts: 32,136 ✭✭✭✭is_that_so


    silverharp wrote: »
    Twitter is turning into a global brain , and like any brain you get some randomness in there too
    I'd say over 90% of that brain is unusable!


  • Registered Users, Registered Users 2 Posts: 18,854 ✭✭✭✭silverharp


    is_that_so wrote: »
    I'd say over 90% of that brain is unusable!

    it connects a lot of experts in a way that wasnt practical before, I wouldnt knock it...(too much)

    A belief in gender identity involves a level of faith as there is nothing tangible to prove its existence which, as something divorced from the physical body, is similar to the idea of a soul. - Colette Colfer



  • Banned (with Prison Access) Posts: 4,077 ✭✭✭Away With The Fairies


    mikeym wrote: »
    Once the vaccine is brought in the better.

    Vitamins are good for you but its not going to stop the virus getting to someone who has a weak immune system.

    I'd rather take vitamins than a vaccine that has been rushed through.


  • Registered Users, Registered Users 2 Posts: 32,136 ✭✭✭✭is_that_so


    silverharp wrote: »
    it connects a lot of experts in a way that wasnt practical before, I wouldnt knock it...(too much)
    That's happening anyway elsewhere. Format is unsuitable for real communication.


  • Registered Users, Registered Users 2 Posts: 3,987 ✭✭✭mikeym


    Depends how they achieved a weak immune system. If it is chips and bread for dinner, and Mars and tayto washed down with Ribena for lunch, then there are quicker ways to avoid a poor outcome from a respiratory illness.

    I agree that people out there eat chips everyday washed down with a can of coke/glass of ribena.

    But there are people who have cancer and other serious issues that vitamins would cure.


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  • Registered Users, Registered Users 2 Posts: 23,084 ✭✭✭✭Esel
    Not Your Ornery Onager


    mikeym wrote: »
    I agree that people out there eat chips everyday washed down with a can of coke/glass of ribena.

    But there are people who have cancer and other serious issues that vitamins would cure.

    Which vitamins cure cancer?

    Not your ornery onager



  • Registered Users, Registered Users 2 Posts: 18,854 ✭✭✭✭silverharp


    A belief in gender identity involves a level of faith as there is nothing tangible to prove its existence which, as something divorced from the physical body, is similar to the idea of a soul. - Colette Colfer



  • Registered Users, Registered Users 2 Posts: 18,854 ✭✭✭✭silverharp


    Dr. Rhonda Patrick Goes In Depth on the Benefits of Vitamin D

    A belief in gender identity involves a level of faith as there is nothing tangible to prove its existence which, as something divorced from the physical body, is similar to the idea of a soul. - Colette Colfer



  • Banned (with Prison Access) Posts: 4,077 ✭✭✭Away With The Fairies


    A quick Google shows severe vitamin D deficiency in Kawasaki disease (disease affecting kids).


  • Registered Users, Registered Users 2 Posts: 18,854 ✭✭✭✭silverharp


    A belief in gender identity involves a level of faith as there is nothing tangible to prove its existence which, as something divorced from the physical body, is similar to the idea of a soul. - Colette Colfer



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  • Closed Accounts Posts: 4,550 ✭✭✭ShineOn7


    silverharp wrote: »
    Dr. Rhonda Patrick Goes In Depth on the Benefits of Vitamin D



    That whole recent Podcast with her is a worthy listen. She's great


  • Registered Users, Registered Users 2 Posts: 15,297 ✭✭✭✭cj maxx


    I have MS and vit D is recommended. From various sites 5000 iu is what my daily intake should be.
    Since covid19 all the vitD is sold out. Good job it's coming into summer :)


  • Registered Users, Registered Users 2 Posts: 4,633 ✭✭✭maninasia


    https://www.medrxiv.org/content/10.1101/2020.04.08.20058578v3

    (STUDY FINDS) -- EVANSTON, Ill. — A new study conducted at Northwestern University concludes that vitamin D may be an essential ingredient to protecting oneself from the coronavirus. The research team discovered a strong correlation between vitamin D deficiencies and mortality rates.

    According to the study, the lower the vitamin D levels present in a patient’s body, the more likely that person will develop severe symptoms and complications.

    Don't mind your facemasks, throw on the birthday suits and smother yourself in good old Sunshine.

    That's well known from existing clinical research. Low vitamin D levels indicate you will usually die younger. Unfortunately taking vitamin D supplements doesn't seem to make any difference. Low vitamin D levels are mostly an indicator of poor health not caused by low vitamin D levels. Symptom not cause. Researching 'vitamin D' and 'disease of choice'...pop out a paper. Easy peasy. 99% of those papers cannot be reproduced.

    That said it may be beneficial to try and maintain them above low levels by exposing yourself to some sunshine regularly.


  • Registered Users, Registered Users 2 Posts: 26,209 ✭✭✭✭Strumms


    cj maxx wrote: »
    I have MS and vit D is recommended. From various sites 5000 iu is what my daily intake should be.
    Since covid19 all the vitD is sold out. Good job it's coming into summer :)

    I take vitamin D for an unrelated health issue but as of Saturday no problem getting any.


  • Registered Users, Registered Users 2 Posts: 4,633 ✭✭✭maninasia


    A quick Google shows severe vitamin D deficiency in Kawasaki disease (disease affecting kids).

    A quick google of 'insert any disease' and 'vitamin D' will show correlation.

    Try it.


  • Posts: 0 [Deleted User]


    maninasia wrote: »
    That's well known from existing clinical research. Low vitamin D levels indicate you will usually die younger. Unfortunately taking vitamin D supplements doesn't seem to make any difference. Low vitamin D levels are mostly an indicator of poor health not caused by low vitamin D levels. Symptom not cause. Researching 'vitamin D' and 'disease of choice'...pop out a paper. Easy peasy. 99% of those papers cannot be reproduced.

    That said it may be beneficial to try and maintain them above low levels by exposing yourself to some sunshine regularly.

    Lots of assertions there. I suppose you can provide evidence.
    I've no health issues that would lead to a deficiency but I had one due to an indoor job and lifestyle.

    We don't get enough sun in Ireland due to our latitude, we need a supplement but not all vit d i good quality and not all carriers are effective for a person.


  • Registered Users, Registered Users 2 Posts: 4,633 ✭✭✭maninasia


    w
    Lots of assertions there. I suppose you can provide evidence.
    I've no health issues that would lead to a deficiency but I had one due to an indoor job and lifestyle.

    We don't get enough sun in Ireland due to our latitude, we need a supplement but not all vit d i good quality and not all carriers are effective for a person.

    Well it's kind of my job to follow the research on vitamin D and supplementation....so yeah I can back it up. Multiple large scale trials across the world have failed to support supplementation being an effective treatment (either D2, D3 or both).

    https://www.pharmaceutical-journal.com/news-and-analysis/news/no-evidence-vitamin-d-supplements-improve-bone-health-major-analysis-finds/20205553.article

    Our meta-analysis finds that vitamin D does not prevent fractures, falls or improve bone mineral density, whether at high or low dose. Clinical guidelines should be changed to reflect these findings,” said Bolland.

    “On the strength of existing evidence, we believe there is little justification for more trials of vitamin D supplements looking at musculoskeletal outcomes.”

    And this one.

    https://www.ncbi.nlm.nih.gov/pubmed/30415629?dopt=Abstract

    We conducted a nationwide, randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D3 (cholecalciferol) at a dose of 2000 IU per day and marine n-3 (also called omega-3) fatty acids at a dose of 1 g per day for the prevention of cancer and cardiovascular disease among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were invasive cancer of any type and major cardiovascular events (a composite of myocardial infarction, stroke, or death from cardiovascular causes). Secondary end points included site-specific cancers, death from cancer, and additional cardiovascular events. This article reports the results of the comparison of vitamin D with placebo.

    CONCLUSIONS:
    Supplementation with vitamin D did not result in a lower incidence of invasive cancer or cardiovascular events than placebo. (Funded by the National Institutes of Health and others; VITAL ClinicalTrials.gov number, NCT01169259 .).


    My advice is get out in the sun , expose your skin to the sun for 20 mins a day...


  • Closed Accounts Posts: 4,550 ✭✭✭ShineOn7


    There's a reply somewhere in this thread (can't find it) that overuse of Vitamin D leads to kidney stones. As someone who's passed one before and it was excruciating this is something I'm keeping in mind with dosage

    Ideally I'd go to my GP for a blood test to see where my D levels actually are, but there's no way I'm going to sit in a GP's waiting room in these times for something that's non essential. Both GP waiting rooms and hospitals will be high risk for Covid

    So that said, as much as I want to up to 5,000 dosage daily, I think I'll have to stick to my current one of 1,000

    When it feels a bit safer I'm definitely getting a Vitamin D blood test to see where my natural levels of it actually are


  • Registered Users, Registered Users 2 Posts: 396 ✭✭mille100piedi


    maninasia wrote: »
    w

    Well it's kind of my job to follow the research on vitamin D and supplementation....so yeah I can back it up. Multiple large scale trials across the world have failed to support supplementation being an effective treatment (either D2, D3 or both).

    https://www.pharmaceutical-journal.com/news-and-analysis/news/no-evidence-vitamin-d-supplements-improve-bone-health-major-analysis-finds/20205553.article

    Our meta-analysis finds that vitamin D does not prevent fractures, falls or improve bone mineral density, whether at high or low dose. Clinical guidelines should be changed to reflect these findings,” said Bolland.

    “On the strength of existing evidence, we believe there is little justification for more trials of vitamin D supplements looking at musculoskeletal outcomes.”

    And this one.

    https://www.ncbi.nlm.nih.gov/pubmed/30415629?dopt=Abstract

    We conducted a nationwide, randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D3 (cholecalciferol) at a dose of 2000 IU per day and marine n-3 (also called omega-3) fatty acids at a dose of 1 g per day for the prevention of cancer and cardiovascular disease among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were invasive cancer of any type and major cardiovascular events (a composite of myocardial infarction, stroke, or death from cardiovascular causes). Secondary end points included site-specific cancers, death from cancer, and additional cardiovascular events. This article reports the results of the comparison of vitamin D with placebo.

    CONCLUSIONS:
    Supplementation with vitamin D did not result in a lower incidence of invasive cancer or cardiovascular events than placebo. (Funded by the National Institutes of Health and others; VITAL ClinicalTrials.gov number, NCT01169259 .).


    My advice is get out in the sun , expose your skin to the sun for 20 mins a day...

    I don't know anything about research but my vitamin D was very low and after taking the supplement my vitamin D increased and I feel much better. When you have a very low vitamin D level you feel like dying. Do you have a low vitamin D level?How did you increase it during the winter?


  • Closed Accounts Posts: 379 ✭✭Mike3287


    ShineOn7 wrote: »
    There's a reply somewhere in this thread (can't find it) that overuse of Vitamin D leads to kidney stones. As someone who's passed one before and it was excruciating this is something I'm keeping in mind with dosage

    Ideally I'd go to my GP for a blood test to see where my D levels actually are, but there's no way I'm going to sit in a GP's waiting room in these times for something that's non essential. Both GP waiting rooms and hospitals will be high risk for Covid

    So that said, as much as I want to up to 5,000 dosage daily, I think I'll have to stick to my current one of 1,000

    When it feels a bit safer I'm definitely getting a Vitamin D blood test to see where my natural levels of it actually are

    Use my clinic or similar

    https://www.myclinic.ie/blood-testing/energy-profile


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  • Closed Accounts Posts: 4,550 ✭✭✭ShineOn7


    Has anyone got links to good 2,000 strength capsules? I'm sticking to 1,000 but I'm going to get the parents 2,000

    No Ebay links. Thanks


  • Registered Users, Registered Users 2 Posts: 318 ✭✭lainycool


    ShineOn7 wrote: »
    Has anyone got links to good 2,000 strength capsules? I'm sticking to 1,000 but I'm going to get the parents 2,000

    No Ebay links. Thanks

    This Vitamin D is great, No fillers or binders in the capsules and when you buy the Vitamin D you get a vitamin c free.

    https://healthmatters.ie/product/viridian-vitamin-d3-2000iu-60-capsules-with-free-ester-c-550mg-30-capsules/


  • Closed Accounts Posts: 4,550 ✭✭✭ShineOn7


    For the week that's in it weather wise: Is sunshine on your face/body after 1pm really useless for Vitamin D?

    Surely some sunshine for this is better than none


  • Banned (with Prison Access) Posts: 4,077 ✭✭✭Away With The Fairies


    ShineOn7 wrote: »
    For the week that's in it weather wise: Is sunshine on your face/body after 1pm really useless for Vitamin D?

    Surely some sunshine for this is better than none

    check out dminder app. I was outside after 1pm today, entered the time I was out, the cloud coverage and how much skin exposed and according to the app, I got some vitamin D from being outside.


  • Registered Users, Registered Users 2 Posts: 18,854 ✭✭✭✭silverharp


    ShineOn7 wrote: »
    For the week that's in it weather wise: Is sunshine on your face/body after 1pm really useless for Vitamin D?

    Surely some sunshine for this is better than none

    whats significant about 1PM? currently 11:15-3.30PM is the time of day when the Sun at the right height to make Vit D, 10 to 20 minutes a few times a week is plenty

    A belief in gender identity involves a level of faith as there is nothing tangible to prove its existence which, as something divorced from the physical body, is similar to the idea of a soul. - Colette Colfer



  • Closed Accounts Posts: 4,550 ✭✭✭ShineOn7


    check out dminder app


    I installed it but finding it a bit finicky

    I'll keep at it, thanks


  • Registered Users, Registered Users 2 Posts: 1,636 ✭✭✭the.red.baron


    have people started smoking yet to stave off infection or has that also died a death


  • Registered Users, Registered Users 2 Posts: 8,203 ✭✭✭partyguinness


    Midday is when the earth is closest to the sun but that is not the time when the sun hitting the earth is at its hottest.

    That is 3-4 hours later as it takes that long for the sun to hit the earth. Hence it is warmer at 4-5pm than 12pm.

    Ok you do not need the hottest time to benefit from sun exposure.


  • Registered Users, Registered Users 2 Posts: 18,854 ✭✭✭✭silverharp


    Midday is when the earth is closest to the sun but that is not the time when the sun hitting the earth is at its hottest.

    That is 3-4 hours later as it takes that long for the sun to hit the earth. Hence it is warmer at 4-5pm than 12pm.

    Ok you do not need the hottest time to benefit from sun exposure.

    That would be better expressed as the angle of the Earth to the Sun, to make Vit D the Sun needs to be at an angle of 50 degrees or more which today in Ireland is 11.14AM to 3.30PM

    A belief in gender identity involves a level of faith as there is nothing tangible to prove its existence which, as something divorced from the physical body, is similar to the idea of a soul. - Colette Colfer



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  • Registered Users, Registered Users 2 Posts: 8,203 ✭✭✭partyguinness


    silverharp wrote: »
    That would be better expressed as the angle of the Earth to the Sun, to make Vit D the Sun needs to be at an angle of 50 degrees or more which today in Ireland is 11.14AM to 3.30PM


    Reallly? So not all sunshine is equal when it comes to the body's ability to make Vit D?


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