Yawancin labaran binciken da aka yi bita na ƙwararru sun nuna a ƙarshe cewa ƙaramin matakin 25-hydroxyvitamin D a cikin jini yana ƙaruwa da haɗarin kamuwa da cuta mai tsanani, lalacewa na dogon lokaci, da mutuwa daga COVID-19. Cewa wannan bayanin ya kasance ba a san shi ba shekaru uku bayan barkewar cutar za a iya danganta shi da yanayin cin hanci da rashawa da / ko rashin iya aiki a tsakanin likitoci da yawa, masu ilimin rigakafi, jami'an kiwon lafiyar jama'a, da kuma kafofin watsa labarai na yau da kullun.
A cikin wannan labarin, mun haskaka bincike game da dogaron tsarin rigakafi ga mahaɗan “bitamin D” guda uku: bitamin D3 cholecalciferol, 25-hydroxyvitamin D calcifediol da 1,25-dihydroxyvitamin D calcitriol. Na farko shine bitamin kuma dukkanin kwayoyin halitta guda uku suna da matsayi daban-daban. Calcitriol kawai zai iya aiki azaman hormone, amma tsarin rigakafi baya amfani da siginar hormonal.
Gwajin jini na "Vitamin D" yana auna matakin (matsawa) na 25-hydroxyvitamin D a cikin jini, saboda duka kodan da tsarin garkuwar jiki sun dogara da wannan a matsayin wadata don ayyukan siginar su, wanda ya ƙunshi hydroxylating shi zuwa 1,25-dihydroxyvitamin D. 25-hydroxyvitamin D ana yin shi da farko a cikin hanta, daga cikin bitamin D3 wanda aka samar da shi ta hanyar bitamin DXNUMX. makamashi, ultraviolet B radiation akan fata.
A yawancin yawan jama'a, matsakaicin matakan 25-hydroxyvitamin D shine rabin ko ƙasa da 50 ng/mL (125 nmol/L) da ake buƙata don ingantaccen aikin tsarin rigakafi. Bugu da ƙari, muna yin bayanin tsarin intracrine na tushen 25-hydroxyvitamin D da tsarin siginar siginar paracrine waɗanda yawancin nau'ikan ƙwayoyin rigakafi suka dogara da su don amsa yanayin canjin su. Bugu da ƙari, muna gabatar da ka'idar kariyar bitamin D wacce ta dogara da ta kai aƙalla 50 ng/mL na 25-hydroxyvitamin D a cikin watanni da yawa, tare da hanyoyin cimma wannan matakin a cikin gaggawa na asibiti cikin kusan kwanaki huɗu ko ma sa'o'i huɗu.
Akwai karancin bitamin D3 a cikin abinci. UV-B radiation yana da wuyar samuwa sai dai a ranakun marasa gajimare tare da babban hasken rana - kuma koyaushe yana lalata DNA don haka yana haifar da haɗarin ciwon daji na fata.
Za a iya samun lafiya mai kyau tare da aƙalla 50 ng/mL da ke yawo 25-hydroxyvitamin D. Wannan ita ce hanya ɗaya tilo ta tabbatar da cewa SARS-CoV-2 da mura ba sa yaɗuwa cikin yanayin cutar sankara kuma ba sa cutar da su sosai kuma suna kashe yawancin waɗanda suka kamu da cutar. Sepsis, wanda ke mutuwa a kusa Mutane miliyan 11 a shekara a duk duniya, zai zama da wuya idan kowa yana da aƙalla 50 ng/mL wanda ke yawo 25-hydroxyvitamin D.
Abin farin ciki, ana buƙatar ƙananan adadin bitamin D3 - kuma ba shi da lafiya, mara tsada kuma an yi bincike sosai.
Mun kuma tattauna wuce gona da iri, lalata ƙwayoyin cuta, martanin rigakafin kumburi waɗanda ke haifar da mafi yawan cutarwa da mutuwa daga COVID-19 kuma waɗanda ke haifar da wasu cututtuka masu saurin gaske da na yau da kullun, musamman sepsis. Rashin isassun 25-hydroxyvitamin D yana sa waɗannan martanin sun fi muni, amma ainihin dalilin su shine daidaitawar juyin halitta zuwa helminths (tsutsotsi na hanji) wanda aka fallasa a yanzu da ba a cika mu da waɗannan ƙwayoyin cuta masu yawa ba.
Jama'a masu rauni da Rashin Vitamin D
Tsofaffi, waɗanda ke da fata mai duhu ko baƙar fata suna zaune nesa da ma'aunin ruwa, da mutanen da ke guje wa fallasa hasken ultraviolet B yawanci suna da ƙananan matakan 25-hydroxyvitamin D fiye da waɗanda ke kanana, tare da ƙarancin fata, waɗanda ke zaune kusa da madaidaicin ko waɗanda ke fallasa fata mara kyau zuwa hasken rana kai tsaye.
Ƙananan matakan 25-hydroxyvitamin D a cikin jini shine farkon haɗarin haɗari ga mummunan cutar COVID-19 da mace-mace. Duk da yake an san abubuwan haɗari da tsufa da kiba, waɗannan yanayin suna ba da gudummawa ga ƙananan matakan 25-hydroxyvitamin D idan aka kwatanta da ƙanana da waɗanda ba su da kiba. A cikin 2022, Dror et al. ya gudanar da bincike mai taken "Pre-kamuwa da cuta 25-hydroxyvitamin D3 matakan da haɗin gwiwa tare da tsananin rashin lafiya na COVID-19"Wanda a fili ya nuna alaƙa tsakanin matakan 25-hydroxyvitamin D da tsananin COVID-19. Binciken ya bincika matakan 25-hydroxyvitamin D a cikin jini na 253 COVID-19 marasa lafiya da ke asibiti a arewacin Isra'ila tsakanin Afrilu 7, 2020, da Fabrairu 4, 2021, kafin kamuwa da cuta. wanda aka kwatanta a cikin jadawali na sama.
Dror et al. gano cewa marasa lafiya tare da "rashin bitamin D" (<20 ng / mL 25-hydroxyvitamin D) sun kasance 14 sau da yawa sun fi dacewa su fuskanci ciwo mai tsanani ko mai tsanani fiye da marasa lafiya tare da matakan ≥40 ng / mL (rashin rashin daidaituwa [OR], 14; 95% tazarar amincewa [CI], 4 zuwa 51; p0.001 <XNUMX).
Saboda rashin tabbas na ƙididdiga, ainihin ƙimar da cuta mai tsanani ko mai tsanani ke hade da <20 ng/mL vs. ≥40 ng/mL 25-hydroxyvitamin D matakan a cikin yawan samfurin da aka sani da 95% amincewa ya kasance tsakanin 4 da 51. Ma'anar ƙididdiga na wannan lura shine "p <0.001" . Wannan yana nufin cewa idan babu wata alaƙa tsakanin matakan 25-hydroxyvitamin D kafin kamuwa da cuta da tsananin cutar, zai ɗauki gwaje-gwaje sama da 1000 kamar wannan, a matsakaici, kafin kuskuren samfuri zai haifar da karkacewa mai ƙarfi kamar abubuwan lura na yanzu.
Ya kamata a yi bikin waɗannan sakamakon a duk duniya, saboda suna nuna cewa kiyaye isassun matakan bitamin D3 na aƙalla nanogram 40 a kowace millilita hanya ce mafi sauƙi, mafi aminci, mara tsada kuma mafi inganci don rage girman COVID-19 da mutuwa fiye da alluran rigakafi, kulle-kulle, nisantar da jama'a, da abin rufe fuska.
Abu ne mai sauƙi don fahimtar mahimmancin ingantaccen ƙarin bitamin D3 don lafiyar tsarin rigakafi, kuma saboda haka ga COVID-19, sepsis, mura, da sauran cututtuka da yawa. Dalilan da ya sa yawancin likitoci da masu ilimin rigakafi ke nuna iyakacin sha'awar bitamin D, don haka ba su san muhimmancinsa ba, sun fi rikitarwa da ruɗani.
Vitamin D3, 25-hydroxyvitamin D da 1,25-dihydroxyvitamin D
Anan, mun ɗan yi bayanin mahimmancin mahaɗan bitamin D guda uku na farko ga tsarin rigakafi gabaɗaya, kuma ga COVID-19 musamman, gyara kurakurai da cike giɓi a cikin mafi yawan tsarin (rashin) fahimtar waɗannan mahadi. Ana iya samun ƙarin fa'ida, koyawa mai hoto a: vitamindstopscovid.info/00-evi/.
Akwai iyakataccen adadin bitamin D3 (cholecalciferol) a cikin abinci, ko ƙarfafa ko a'a. Tushen abinci kadai bai isa ga lafiyar ɗan adam ba. Ana iya samar da adadi mai yawa na bitamin D3 a cikin fatarmu lokacin da ~ 297-nanometer raƙuman ruwa ultraviolet B (UV-B) radiation ya karya zoben carbon a cikin 7-dehydrocholesterol, kuma sakamakon kwayar halitta ya sake daidaita kansa ya zama bitamin D3 cholecalciferol. Wannan UV-B yana kan babban mitar, babban ƙarfi, gajeriyar zangon bakan Rana. Yana samuwa ne kawai daga hasken rana mai tsayi a cikin kwanakin da ba a gajimare ba, ba tare da wucewa ta gilashi, tufafi, ko fuskar rana ba. Duk da yake akwai abubuwa da yawa masu lafiya na bayyanar hasken rana, UV-B koyaushe yana lalata DNA kuma don haka yana haifar da haɗarin kansar fata. Wannan ya sa bayyanar fata ta UV-B ba ta da amfani don samar da bitamin D3 da jiki ke buƙata - kuma waɗanda ke da duhu ko baƙar fata za su buƙaci sa'o'i masu ƙarfi a kowace rana don samar da bitamin D3 da suke bukata.
Abin farin ciki, ƙarin bitamin D3 yana da aminci kuma yana da tasiri don kiyaye 50 ng/mL ko mafi girma 25-hydroxyvitamin D matakan tsarin rigakafi yana buƙatar yin aiki yadda ya kamata. Don nauyin jiki 70 (154 lb) ba tare da kiba ba, 0.125 milligrams a rana zai kai wannan matakin bayan wasu watanni. Wannan kuma ana kiransa da "Raka'a 5,000 na Duniya" kowace rana. Wannan ya yi daidai da gram kowane shekara 22 - kuma darajar sinadari na bitamin D3 kusan dalar Amurka $2.50 kowace gram, tsohon masana'anta.
Idan yawancin mutane, ko kowa da kowa, sun sami aƙalla 50 ng/mL 25-hydroxyvitamin D, kamar ta hanyar ƙara bitamin D3 daidai, ba za a sami cutar mura ko COVID-19 ba, saboda yawancin tsarin garkuwar jikin mutum zai yi aiki yadda ya kamata, sabanin ƙarancin aikinsu a yau. Waɗanda suka kamu da cutar ba za su sami mummunar cutarwa ba ko kuma a kashe su. Za a inganta lafiyar ɗan adam ta hanyoyi da yawa a cikin juyin juya hali aƙalla mahimmanci kamar waɗanda suka kawo mana tsafta da maganin rigakafi.
Amsoshin gama gari game da waɗannan da'awar sune cewa bitamin D wani nau'in sinadari ne wanda aka fi so kuma idan bitamin D yana da mahimmanci sosai, yawancin likitoci sun riga sun gane wannan. Binciken a bayyane yake, amma ba a fahimta sosai ba.
Vitamin D2 (ergocalciferol) Kwayar kwatankwacin kwaya ce da bitamin D3 (cholecalciferol). Abubuwan da ake samu na 25-hydroxy da 1,25-dihydroxy suna aiki daidai da na bitamin D3 amma ba su da ɗan tasiri. Anan, mun mai da hankali kan abubuwan da ke faruwa ta halitta:
- Vitamin D3 cholecalciferol: Ciki ko samarwa a cikin fata ta aikin hasken UV-B.
- 25-hydroxyvitamin D calcifediol (wanda kuma aka sani da calcidiol): An samo shi daga bitamin D3, da farko a cikin hanta.
- 1,25-dihydroxyvitamin D calcitriol: Wannan fili yana ɗaure zuwa kuma yana kunna kwayoyin "bitamin D mai karɓa", wanda zai fi saninsa da "mai karɓar calcitriol." Wadannan masu karɓan da aka kunna suna canza halayen tantanin halitta ta hanyar sama-da-ƙasa-tsarar da rubutawa da yawa ko ɗaruruwan kwayoyin halitta zuwa kwayoyin mRNA, wanda hakan ya gaya wa ribosomes na tantanin halitta irin sunadaran da zasu yi. Tsarin da kwayoyin halitta suke sama-da-kasa-tsare su ya bambanta daga nau'in tantanin halitta zuwa wani.
Na ƙarshe mahadi guda biyu sune ƙwayoyin bitamin D3 tare da ƙungiyoyin oxygen-hydrogen hydroxy waɗanda aka haɗa su da carbon ɗin sa na 25 da kuma carbon ɗin sa na 1st da 25, bi da bi. Sunayen da suka dace sun haɗa da "D3" amma sunayen sun daɗe da yawa kuma ana barin "3" sau da yawa.
Vitamin D3 yana yawo a cikin jini kuma yana da, a mafi kyau, ƙananan tasiri kai tsaye kawai akan tsarin rigakafi. Sama da mako guda ko fiye da haka, ana sarrafa shi, galibi ta hanyar hanta, ta yadda kusan 1/4 na shi ana yin hydroxylated zuwa 25-hydroxyvitamin D, wanda ke yawo a cikin jini. Sauran an ƙasƙanta da/ko fitar da su. 25-hydroxyvitamin D yana da tsawon rabin rayuwa: wata ɗaya ko makamancin haka don ƙananan matakan da makonni don lafiya da matakan girma.
Vitamin D3 ko 25-hydroxyvitamin D ba sa aiki a matsayin hormones. Hormone wani kwayar sigina ce mai nisa mai nisa wanda matakin da ke cikin jini ke sarrafa ta wani bangare na jiki. Matsayin (matsawa) na hormone a cikin jini ana gano shi ta hanyar nau'in tantanin halitta ɗaya ko fiye a ko'ina cikin jiki, ciki har da a cikin kwakwalwa da kashin baya, ta hanyoyin da suka shafi halayen sel. Tsarin rigakafi baya amfani da siginar hormonal (endocrine).
Duk likitoci sun fahimci cewa 1,25-dihydroxyvitamin D calcitriol na iya aiki azaman hormone. Glandar parathyroid yana jin matakin alli mai kewayawa kuma yana sigina wannan ga kodan ta hanyar hormone parathyroid. Wannan iko har zuwa abin da kodan hydroxylate 25-hydroxyvitamin D don samar da wani tam sarrafawa, sosai low matakin circulating 1,25-dihydroxyvitamin D. Wannan yana da rabin rayuwa na kasa da yini, da kuma matakin hormonally iko da dama muhimmanci al'amurran da calcium-phosphate-kashi metabolism ta shafi hali na mahara cell iri a cikin hanji, kodan, kodan. Yayin da ake ƙara godiya ga rawar bitamin D a cikin tsarin rigakafi, yawancin likitoci - da masu bincike na bitamin D da yawa - suna kuskuren ɗauka cewa tsarin rigakafi yana "kayyade" hormonally ta hanyar ƙananan ƙwayar koda na 1,25-dihydroxyvitamin D.
Duk da Reinhold Vieth's 2004 gargadi, filin ya kasance yana fama da kurakurai guda biyu har zuwa yau:
- Yayin da "bitamin D" shine kalmar gama gari da ta dace don mahadi guda uku, masu bincike da yawa suna amfani da shi don komawa zuwa fili ɗaya kawai, kamar dai duka ukun sun kasance iri ɗaya ne, lokacin da ya kamata su tantance mahallin da kansa.
- Wannan yana haifar da haɗuwar 1,25-dihydroxyvitamin D calcitriol, wanda zai iya aiki a matsayin hormone, a matsayin kasancewar nau'i ɗaya na bitamin D don haka ya zama daidai da bitamin D3. Wannan yana haifar da ƙaryar gama gari cewa "bitamin D shine hormone." Wannan kuskuren fahimta yana tsoratar da mutane da yawa daga samar da bitamin D3 da kyau, musamman lokacin da aka bayyana adadin yau da kullun da ake buƙata a matsayin dubban sauti mai ban sha'awa. Ƙungiyoyin Ƙasashen Duniya. 1,25-dihydroxyvitamin D calcitriol ba bitamin ba ne, kuma matsayinsa ya bambanta da na bitamin D3 cholecalciferol, kamar yadda aikin 25-hydroxyvitamin D ya bambanta gaba ɗaya da na sauran biyun.
Bayan da aka fayyace dogon kafa, fahimtar koda-centric na mahaɗan bitamin D guda uku, yanzu mun juya zuwa ga abubuwan da aka gano kwanan nan kuma har yanzu da wuya a fahimci mahimmancin 25-hydroxyvitamin D da 1,25-dihydroxyvitamin D ga tsarin rigakafi.
Fahimtar Siginar Kwayoyin rigakafi da Matsayin 25-Hydroxyvitamin D
Yawancin nau'ikan ƙwayoyin rigakafi sun dogara da matakin da ya dace na 25-hydroxyvitamin D a cikin jini don waɗannan ƙwayoyin cuta su bazu cikin cytosol na kowane tantanin halitta (ruwa a cikin babban jikin tantanin halitta) cikin isasshen adadin don tallafawa tsarin siginar intracrine da paracrine.
Siginar intracrine yana faruwa gaba ɗaya a cikin tantanin halitta ɗaya. Tantanin halitta yana gano takamaiman yanayin waje, kamar ta hanyar ƙwayoyin masu karɓa waɗanda ke faɗin membrane nata kuma suna gano kasancewar takamaiman ƙwayoyin cuta a wajen tantanin halitta. Wannan ganowa yana sa tantanin halitta ya samar, a ciki, ƙanƙanta amma mahimmancin adadin kwayoyin sigina, wanda ke aiki azaman wakili na intracrine, ta hanyar kunna kwayoyin mai karɓa cikin tantanin halitta guda. Waɗannan ƙwayoyin ƙwayoyin masu karɓa da aka kunna suna canza rubutun kwayoyin halitta, daga baya suna canza haɗin furotin kuma suna haifar da tantanin halitta don canza halayensa don mayar da martani ga yanayin waje da ya gano.
Sigina ta atomatik iri ɗaya ce, sai dai cewa wakili na autocrine da aka samar a ciki yana kunna masu karɓa a wajen tantanin halitta ɗaya. Kuskure ne na kowa don rikitar da siginar intracrine da autocrine.
Alamar paracrine na iya kasancewa tare da intracrine ko siginar autocrine. Kwayoyin siginar, wanda tantanin halitta ya samar don amsa wasu yanayi, yana yaduwa daga cikin tantanin halitta da aka yi shi, yana haɓaka matakin wannan fili a cikin yanki, inda yake aiki azaman paracrine wakili don canza halayen wasu sel na kusa, yawanci iri daban-daban.
25-hydroxyvitamin D na tushen siginar intracrine yana da mahimmanci don ikon nau'ikan ƙwayoyin rigakafi da yawa don amsa yanayin canjin kowane tantanin halitta. An bayyana wannan a ƙarshen 2000 ta Martin Hewison da abokan aiki a Burtaniya, suna aiki tare da macrophages da ƙwayoyin dendritic.
Nau'in tantanin halitta na uku wanda aka yi nazarin siginar intracrine na tushen 25-hydroxyvitamin D shine Th1 tsarin lymphocytes daga huhun marasa lafiya na COVID-19 na asibiti. Wannan kyakkyawan aikin babban ƙungiyar masu bincike ne, Chauss et al. 2021 a cikin Immunology Nature: Siginar autocrine bitamin D yana kashe shirye-shiryen pro-mai kumburi na ƙwayoyin Th1.
Yawancin sauran nau'ikan kwayoyin halitta, musamman na tsarin garkuwar jiki waɗanda ba su da hannu a cikin metabolism na calcium-phosphate-kashi, an san su don canza yanayin bayyanar su sosai don mayar da martani ga ƙwayoyin masu karɓar bitamin D da ake kunna su ta hanyar ɗaure zuwa 1,25-dihydroxyvitamin D calcitriol. Yana da kyau a ɗauka cewa duk waɗannan nau'ikan tantanin halitta kuma suna amfani da siginar intracrine na tushen 25-hydroxyvitamin D da/ko siginar paracrine.
Matakan 1,25-hydroxyvitamin D na ciki da aka samar lokacin da aka kunna tsarin siginar intracrine sun fi girma sosai fiye da ƙananan ƙananan, matakin hormonal na extracellular 1,25-dihydroxyvitamin D, wanda shine kusan 0.12 ng/mL. Sabili da haka, wannan hormone 1,25-dihydroxyvitamin D ba shi da wani tasiri mai mahimmanci akan ƙwayoyin rigakafi ko dukan tsarin rigakafi.
Waɗannan sel ɗin suna iya amsawa ga yanayin canjin su gabaɗaya da sauri idan isassun 25-hydroxyvitamin D ya bazu cikin cikin su don samarwa da kiyaye jujjuyawar sa zuwa 1,25-hydroxyvitamin D (wanda ke da ɗan gajeren rabin rayuwa) lokacin da tsarin siginar intracrine na tantanin halitta ke kunna ta kowane yanayin waje wanda nau'in tantanin halitta ya gano.
Bukatar aƙalla 50 ng/ml (125 nmol/L) yana zagayawa 25-hydroxyvitamin D
Ba za a iya auna matakan 25-hydroxyvitamin D na cikin salula ba. Babu wani binciken ilimin halitta-kwayoyin halitta har zuwa yau da ya nuna cewa aƙalla 50 ng / ml na watsawar 25-hydroxyvitamin D ana buƙatar don samar da wannan fili - wanda shine albarkatun ƙasa, ba siginar siginar sigina ba - zuwa sel a isasshen adadin kowane tantanin halitta don samun damar sauri da cikakken aiwatar da siginar intracrine zuwa 1,25-dihydroxyvitamin, duk da haka yana iya faruwa a cikin tsarin rigakafi. A gaba matakin 25-hydroxyvitamin D mai watsawa yana ƙasa da 50 ng/mL - wanda shine sashi ɗaya a cikin 20,000,000 ta taro. Wannan dangantakar tana bayyana a cikin cututtuka da yawa, kuma raguwar lafiya tare da ƙananan matakan 25-hydroxyvitamin D yana bayyana a fili a cikin abubuwan Dror et al., wanda aka kwatanta a sama.
Kodan na iya samar da isasshen hormonal 1,25-dihydroxyvitamin D tare da 20 ng/mL ko fiye da zazzage 25-hydroxyvitamin D. A cikin ƙasashe masu tasowa, jagororin kariyar bitamin D na gwamnati suna nufin cimma wannan matakin 20 ng/mL ba tare da la'akari da bukatun tsarin rigakafi ba. (Kimball da Holick 2019.)
A cikin 2008, 48 manyan masu binciken bitamin D kira don ma'auni na bitamin D ya zama 40 zuwa 60 ng / mL na rarraba 25-hydroxyvitamin D. Tun daga farkon 2000s, waɗannan da sauran masu bincike sun yi jayayya tare da kwamitocin jagororin gwamnati game da buƙatar karin bitamin D3 a cikin adadin da suka kai irin wannan matakan.
Ƙungiyar Endocrine ta 2011 shawarwarin yana da manufa na 40 ng/mL don tabbatar da kusan duk mutane suna da matakin sama da 30 ng/mL. Guba, a cikin nau'i na matakan calcium mai yawa da asarar ma'adinai na kashi na iya faruwa amma matakan 25-hydroxyvitamin D "yana buƙatar zama sama da 150 ng / mL kafin a sami damuwa". Daga wannan suna samo, maimakon sabani, "margin aminci" babba iyakar 100 ng/ml.
Wadannan masu binciken '~ 50 ng/mL manufa an tabbatar da su ta hanyar babban binciken bincike, misali daya mai karfi shine bincike na 2014 na likitoci a asibitin Boston akan hadarin kamuwa da cututtuka na asibiti da kuma wuraren tiyata, a matsayin aikin pre-operation 25-hydroxyvitamin D matakan: Ƙungiya Tsakanin Matakan 25-Hydroxyvitamin D na Gaba da Ciwon Cutar da Aka Samu Na Asibiti Bayan Tiyatar Gastric Bypass na Roux-en-Y.
Batun sun kasance marasa lafiya 770 masu fama da rashin lafiya waɗanda aka yi wa tiyata iri ɗaya na asarar nauyi. Kiba yana rage karfin jiki don canza bitamin D3 zuwa 25-hydroxyvitamin D, amma babu wani dalili da za a yi imani da cewa yana canza matakin 25-hydroxyvitamin D wanda kwayoyin rigakafi ke buƙatar gudanar da tsarin siginar intracrine da paracrine yadda ya kamata. Don haka waɗannan abubuwan lura na Boston sun shafi duk mutane.
Abin da suka gano yana da ban mamaki. Hotunan su (a ƙasa a haɗa su zuwa ɗaya) ana iya fahimtar su cikin sauƙi kuma yakamata a nuna su a ofisoshin likitoci da dakunan jira saboda suna da alaƙa da kowane fanni na lafiya.
Ga waɗancan marasa lafiya da ke da 50 ng/mL ko fiye da ke yawo 25-hydroxyvitamin D (wanda za a iya samu gabaɗaya ko gaba ɗaya ta hanyar ingantaccen bitamin D), haɗarin samun asibiti da cututtukan wuraren tiyata, daban, sun kasance kusan 2.5%. 20 ng/mL daidaitaccen matakin talakawa ne ga wanda baya ƙara bitamin D3 da yawa ko kwata-kwata kuma wanda kwanan nan bai sami faɗuwar fata ta UV-B ba (ko wanda ke da, amma akan fata mai duhu ko baki). Binciken asibitin Boston ya nuna cewa irin waɗannan mutane suna da damar 24% na kowane nau'in kamuwa da cuta.
Wannan babban haɓakar cututtuka yana faruwa ne saboda rauni na asali da kuma daidaitawa ga ƙwayoyin cuta waɗanda su ne tushen farko na nau'ikan kamuwa da cuta guda biyu. Wani mataki na ruɗani na iya kasancewa a cikin waɗannan sakamakon asibiti na Boston, kamar mutanen da ke da lafiya gabaɗaya suna faruwa suna ɗaukar ƙarin bitamin D3 ba tare da wannan ya shafi ikonsu na kariya daga cututtukan ƙwayoyin cuta ba. Duk da haka, dangantakar a bayyane take kuma mai karfi kuma hanyoyin siginar intracrine da paracrine yanzu sun fahimci cewa yana da kyau a ɗauka cewa masu haɗin gwiwa suna da alhakin ƙananan ƙananan wannan dangantaka, kuma cewa yawancin yawancin shi shine saboda ƙananan 25-hydroxyvitamin D matakan da ke haifar da rashin lafiya.
Za mu iya gani daga histogram na matakan 25-hydroxyvitamin D a cikin jadawali a farkon wannan labarin (daga Isra'ila et al. 2020) cewa ko da a cikin Isra'ila mai rana, wani muhimmin kashi na yawan jama'a - musamman matan Larabawa - suna da matakan 25-hydroxyvitamin D a cikin 5 zuwa 10 ng / mL kewayon, 1/10th zuwa 1/5th tsarin na rigakafi. A 5 ng/mL, haɗarin asibitin Boston na duka asibitocin da aka samu da kuma cututtukan wuraren tiyata sun haura zuwa 47%.
A cikin histogram na matan Larabawa, mashaya mafi ƙasƙanci, na 4 zuwa 5 ng/mL, ya fi girma fiye da layin da aka yi. Wannan saboda wasu daga cikin waɗannan matan suna da matakan ƙasa da iyakar gano 4 ng/ml. Wadannan ƙananan matakan suna haifar da, a babban ɓangare, daga waɗannan tufafin mata da ke rufe yawancin jikinsu, da kuma salon rayuwarsu na rana.
Wannan haɗin abubuwan lura da fahimtar injiniyoyi ya bayyana a sarari cewa yawancin mutane, a yawancin ƙasashe, ga mafi yawan ko duk rayuwarsu, basu da isasshen 25-hydroxyvitamin D don tafiyar da abubuwan da suka dace da tsarin rigakafi ga ƙwayoyin cuta. Hakanan tsarin siginar intracrine iri ɗaya da na paracrine shima ana tsammanin zai kasance mai mahimmanci ga ikon tsarin rigakafi don ɗaga ƙarfi na asali da kuma daidaita martani ga ƙwayoyin cutar kansa, fungi, da ƙwayoyin cuta.
Wannan labarin ya nisanta daga tattaunawa na COVID-19 zuwa cikin koyawa ta karo akan 25-hydroxyvitamin D na asali da siginar daidaitawa. Wannan yana da mahimmanci don fahimtar dalilin da yasa lafiyar ɗan adam mai kyau, gami da musamman game da COVID-19, za a iya samu kawai tare da aƙalla 50 ng/mL da ke yawo 25-hydroxyvitamin D. Babu adadin magunguna, alluran rigakafi, kulle-kulle, masks, ƙwayoyin rigakafi na monoclonal, magungunan ƙwayoyin cuta da sauransu, na iya daidaita tsarin rigakafi yana gurgunta, wanda zai zama babban adadin bitamin D. ng/ml.
Yayin da ake ci gaba da wayar da kan jama'a game da mahimmancin bitamin D ga tsarin rigakafi, ƙananan likitoci ko masu bincike sun fahimci 25-hydroxyvitamin D na tushen intracrine da siginar paracrine. Mutane da yawa suna ɗauka cewa tsarin rigakafi ko ta yaya ana daidaita shi ta hanyar hormone 1,25-dihydroxyvitamin D wanda kodan ke amfani da shi don sarrafa halayen sel masu nisa, nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan suna da alaƙa da haɓakar ƙwayoyin calcium-phosphate-kashi. Wannan ya sa wasu likitoci suka yi magani sepsis da COVID-19 ta haɓaka wannan matakin na yawo 1,25-dihydroxyvitamin D, duka ba tare da nasara ba. Kamar yadda aka gani a cikin Front Line COVID-19 Critical Care Alliance (FLCCC) MATH+ ka'idar asibiti, wannan maganin calcitriol yana da ƙarancin tasiri akan ƙwayoyin rigakafi kuma zai iya haifar da guba ta haɓaka matakan calcium na jini da yawa.
Yawancin labaran bincike sun bayyana cewa "bitamin D yana daidaita tsarin rigakafi". Wannan yana haifar da yawancin masu bincike da likitoci suyi zaton cewa tsarin hormonal kuma ya shafi tsarin rigakafi. A zahiri, babu ɗaya daga cikin mahaɗan bitamin D guda uku da ke tsara komai. Parathyroid da kodan suna daidaita metabolism na calcium-phosphate-kashi, tare da kodan ta yin amfani da 1,25-dihydroxyvitamin D a matsayin wakili na endocrin (hormone) don sarrafa halin sel mai nisa don wannan dalili.
Tsarin rigakafi yana sarrafa kansa tare da hanyoyin haɗin gwiwa da yawa. Wani muhimmin sashi na wannan shine ikon kowane sel don amsa yanayin canjin su. Yawancin nau'ikan ƙwayoyin rigakafi, lokacin da suka fahimci takamaiman yanayin nau'in tantanin halitta, suna haifar da 1,25-dihydroxyvitamin D a matsayin wakili na intracrine, gabaɗaya a cikin tantanin halitta, don canza halayen tantanin halitta. Wasu daga cikin wannan suna yaduwa zuwa sel na kusa inda zai iya zama wakili na paracrine don canza halayen su. 1,25-dihydroxyvitamin D shine kwayar sigina. Vitamin D3 da 25-hydroxyvitamin D ba su. Matsayin bitamin D3 shine a canza shi zuwa 25-hydroxyvitamin D mai yawo, wanda kodan ke buƙata, kuma - a matsayi mafi girma - ta nau'ikan ƙwayoyin rigakafi da yawa.
Dysregulated, rashin wariya, martanin kumburin da ke lalata tantanin halitta
Ƙananan matakan 25-hydroxyvitamin D yana raunana haɓakar haɓaka da amsawar rigakafi na daidaitawa yana bayyana yawan rashin lafiyar da mutane da yawa ke fama da su a yau. Duk da haka, akwai wani bangare na tsarin rigakafi wanda ke fama da mummunar tasiri lokacin da ƙwayoyin rigakafi ba za su iya samun isasshen 25-hydroxyvitamin D: kumburi mai yawa. Anan, muna mai da hankali kan kumburi da yawa a cikin manyan cututtukan COVID-19 da sepsis, maimakon kumburin wuce gona da iri wanda ke haifar da cututtukan autoimmune.
Lokacin da COVID-19 ya yi mummunar cutarwa ko ya yi kisa, tsarin rigakafi ne ke haifar da lahani da lalacewa, ba kwayar cutar ba - wacce a lokacin ta daina yin kwafi. MATH+ na FLCCC Yarjejeniya ya bayyana haka:
Lokacin da bayyanar cututtuka suka yi tsanani don ba da garantin asibiti, yaƙin yana adawa da martanin rigakafi na hyper-mai kumburi, ba kwafi na hoto ba. Marasa lafiya sun isa wannan yanayin ne kawai idan abubuwan da suka dace da nasu sun kasa murkushe kamuwa da kwayar cutar kuma kwayar cutar ta fara aiki a cikin huhunsu. Matsalolin kumburi da yawa ga wannan kamuwa da cuta yana haifar da lalata ƙwayoyin endothelial na huhu - waɗanda ke rufe tasoshin jini na huhu. Jiki yana ba da amsa ga wannan lalacewar jijiyoyin jini ta hanyar kauri jini, don haka a shirye yake don toshe ruwan. Hyper-coagulative jini yana samar da micro-embolisms (clots) a cikin kyawawan capillaries na huhu inda ake musayar oxygen da carbon dioxide. Wannan yana toshe wurare dabam-dabam a cikin sassan huhu, yana kara tsananta raguwar iskar iskar oxygen da ta haifar da tarin ruwa (naumonia) a cikin alveoli (kananan jakar iska) inda wannan musayar ke faruwa.
Babban dalilin mutuwa shine hypoxia. Micro-embolisms da manyan ɗigon jini kuma suna toshe wurare dabam dabam kuma suna haifar da lalacewa ta dindindin, mai yuwuwar lalacewa a cikin sauran gabobin, gami da zuciya, ƙwaƙwalwa, kashin baya, da hanta.
Binciken lymphocyte na 2020 Th1 wanda yakamata ya kawo karshen cutar
"T cell dysfunction" an ambaci a cikin MATH+ zane, wanda ya kawo mu zuwa Chauss et al. 2021, an fara buga shi azaman a bita in Yuli 2020, wanda masu binciken suka yi nazarin tsarin lymphocytes na Th1 da aka samo daga huhun marasa lafiya na COVID-19 na asibiti. A karo na farko, sun bayyana irin wannan tantanin halitta dogara ga 25-hydroxyvitamin D na tushen intracrine sigina. Kwayoyin Th1 suna samar da cytokine pro- da anti-mai kumburi (tsarin gajeriyar siginar siginar ƙwayoyin cuta). A cikin shirin su na farawa, lokacin da aka kunna su a cikin huhu na waɗannan marasa lafiya, kowane tantanin halitta Th1 yana da pro-inflammatory: samar da shi na cytokine pro-inflammatory ya fi na mai kumburi.
Wadannan lymphocytes suna gano wani yanayin waje (madaidaicin matakin a dace da furotin), ta hanyar masu karɓa a saman tantanin halitta. Wannan yana haifar da tantanin halitta don kunna tsarin siginar intracrine na tushen 25-hydroxyvitamin D, ta hanyar samar da kwayoyin halittar bitamin D mai karɓa (VDR) a cikin jikin tantanin halitta, da 1-hydroxylase enzyme wanda ke canza 25-hydroxyvitamin D zuwa 1,25-dihydroxyvitamin D (calcitriol). Kowane ɗayan waɗannan ƙwayoyin yana ɗaure zuwa ƙwayar VDR don haka yana samar da hadaddun VDR-1,25-dihydroxyvitamin D mai kunnawa.
Lokacin da wannan tsarin siginar yayi aiki da kyau, ɗakunan da aka kunna suna samun hanyarsu zuwa tsakiya kuma sama- da ƙasa- daidaita tsarin. kundin rubutu na ɗaruruwan kwayoyin halitta, waɗanda ke canza samar da furotin na tantanin halitta don haka yana canza halayensa. Tantanin halitta ya canza zuwa shirin sa na kashe kumburi: mafi girma samar da cytokine mai kumburi fiye da na mai kumburi.
Wannan labarin nazarin halittun tantanin halitta mai yawa yana bayyana madaidaicin matakan kwayoyin halitta wanda duk wannan yakamata ya faru. Hakanan yana bayanin yadda wannan tsarin siginar intracrine ke kasawa a cikin sel Th1 daga huhun marasa lafiya na COVID-19 na asibiti. Wannan yana nufin ƙwayoyin Th1 suna ci gaba da haɓaka martanin kumburi a cikin huhu har abada. Wannan - kuma mai yiwuwa irin wannan gazawar na 25-hydroxyvitamin D intracrine da siginar paracrine a cikin wasu nau'ikan kwayoyin halitta na rigakafi - yana haifar da kumburi mai yawa, lalacewar kwayoyin halitta, da lahani da mutuwa sakamakon ciwon huhu, hypoxia, da lalacewar gabobin.
Iri ɗaya gazawa ko raunana na 25-hydroxyvitamin D tushen siginar intracrine a cikin wasu nau'ikan ƙwayoyin rigakafi waɗanda ke ba da kariya kai tsaye daga kamuwa da ƙwayar cuta tabbas abu ne mai mahimmanci a cikin kamuwa da cuta da ke ci gaba fiye da ƴan kwanaki da ci gaba zuwa huhu.
Chauss et al. ya gano cewa babban dalilin wannan gazawar shi ne rashin isasshen 25-hydroxyvitamin D a cikin wadannan Th1 lymphocytes. Masu binciken ba su da bayanai game da matakan 25-hydroxyvitamin D masu yaduwa na marasa lafiya, amma mun sani daga bincike kamar na Dror et al. cewa marasa lafiya na COVID-19 a cikin kulawa mai zurfi da waɗanda suka mutu yawanci suna da ƙarancin matakan 25-hydroxyvitamin D fiye da yawan jama'a - yawancinsu suna da ɗan ƙaramin abin da tsarin garkuwar jikinsu ke buƙatar yin aiki yadda yakamata.
Domin kowane tsarin siginar intracrine na kwayar halitta ta Th1 ya yi aiki yadda ya kamata, 25-hydroxyvitamin D dole ne ya yadu daga jini kuma a fadin membrane plasma tantanin halitta zuwa cikin cytosol (ruwa na ciki) a cikin adadi mai yawa don tabbatar da cewa lokacin da aka kunna tsarin siginar intracrine ta tantanin halitta, canzawa zuwa 1,25-dihydroxyvitamin D da ake buƙata, ya ci gaba da haɓaka ƙimar D. watsa cikin tantanin halitta don maye gurbin waɗancan ƙwayoyin da aka canza yanzu. Rashin isassun intracellular 25-hydroxyvitamin D yana nufin cewa tsarin siginar intracrine ba zai iya samar da isasshen 25-dihydroxyvitamin D don kunna adadin kwayoyin VDR da ake buƙata don canza halin tantanin halitta da kyau.
Duk bayanan da ke sama suna samuwa a cikin labaran bincike ko preprints tun daga tsakiyar zuwa ƙarshen 2020, kafin a gudanar da duk wani allurar rigakafi na mRNA da adenovirus, kuma kafin kulle-kulle da murkushe maganin da wuri ya zama mai lalacewa. Ba a yi amfani da wannan bayanin ta hanyar waɗanda suka ba da umarnin mayar da martani na cutar ba, kuma har yau, mutane kaɗan - ciki har da likitoci da masu ilimin rigakafi - da alama sun fahimci hakan.
Babban dalilin wannan jahilci shine yawancin masu ilimin rigakafi da likitoci ba su da sha'awar irin wannan binciken.
Likitoci da masu aikin rigakafi suna da aiki sosai. Filayen su sun ƙunshi nauyi mai nauyi da manufa na samun ilimi mai yawa. Mujallu na ilimi suna cike da labarai gabaɗaya, musamman game da COVID-19.
Koyaya, idan masana ilimin rigakafi da likitoci, gabaɗaya, ƙungiyoyin ƙwararrun ƙwararrun ƙwararrun waɗanda ɗan adam suka dogara gabaɗaya, suna nema da wayar da kan mafi mahimmancin bincike, to Chauss et. al. da sauri ya zama sananne, ko da a matsayin preprint. Na farko, kaɗan daga cikin waɗannan ƙwararrun za su karanta shi. Sannan da sun gaya wa takwarorinsu, wadanda su ma za su fahimci muhimmiyar rawar da wannan sabon ilimin zai iya takawa wajen mayar da martani. Da sun gaya wa wasu, labari ya bazu, kafofin watsa labarai na yau da kullun za su yi rubutu game da shi, kuma nan ba da jimawa ba gwamnatoci za su yi hakan don kare jama'a ta hanyar haɓaka mafi yawan matakan 25-hydroxyvitamin D. An ba da fifiko ga marasa lafiya da ke asibiti, ma’aikatan kiwon lafiya, tsofaffi, waɗanda ke tsare da sauran mutane masu rauni.
Wannan martanin da aka yi game da cutar zai iya murƙushe ta a ƙarshen 2020 ko farkon 2021, ba tare da dogaro da alluran rigakafi, abin rufe fuska ko kulle-kulle ba - musamman idan an haɗa ta da adadin lafiya, marasa tsada, ingantaccen jiyya na farko, wanda ivermectin yanzu shine sananne.
Wannan rashin haɗin kai ga mafi mahimmancin bincike, a cikin rikicin duniya, ya zama babban matakin rashin gaskiya wanda ya kasance, kuma har yanzu, yana haɗuwa da cin hanci da rashawa da kuma gwamnatoci da kamfanoni suna aiki tare don murkushe muhawara. Sakamakon haka, dubun dubatar mutane sun mutu lokacin da za a iya kawar da cutar gaba ɗaya a duniya tare da ingantaccen bitamin D3 a ƙarshen 2020. WHO ruwaito kusan mutane miliyan 14.9 cutar ta kashe a cikin 2020 da 2021 - kai tsaye ta rashin lafiya da kuma a kaikaice, kamar ta rashin samun damar samun magani a asibiti don wasu yanayi.
Idan likitoci da masu ilimin rigakafi - ko ma kafofin watsa labarai na yau da kullun - sun kasance suna da sha'awar irin wannan muhimmin bincike, ingantaccen fahimtar bitamin D zai yadu sosai kafin cutar ta COVID-19. Misali, game da cututtukan da aka samu a asibiti, tsinkaya da tabbatar da binciken a cikin binciken asibitin Boston na 2014, Yusuf et al. 2012 da kuma Laviano et al. 2020, wanda ya lura da karuwar 48% a cikin cututtukan cututtuka na baya-bayan nan don kowane raguwa na 10 ng/ml a cikin pre-operation 25-hydroxyvitamin D.
Daya daga cikin mu (RW) rubuta zuwa Kungiyar Bayar da Dabarun Dabaru da Fasaha na WHO don Hatsari masu Yaduwa (STAG-IH) akan 2020-03-22 game da bitamin D da sauran abubuwan gina jiki don magance COVID-19.
Manyan masu binciken bitamin D sun yi gaggawar yin bayanin buƙatar kyawawan matakan 25-hydroxyvitamin D don magance cutar, kodayake ba a cikin mujallolin da aka bita na al'ada ba: Wimalawansa 2020-02-28 da kuma Grant & Baggerly 2020-04-09.
Labari da aka yi bita na ɗan-uwan da aka yi magana sosai Ƙara yawan adadin bitamin D na iya wakiltar kyakkyawan zaɓi don hana ko magance kamuwa da cutar COVID-19 Mansur et al. 2020-05-18 da ya ceci miliyoyin rayuka da likitoci da masu aikin rigakafi sun kula da shi yadda ya kamata.
Samun 50 ng/ml 25-hydroxyvitamin D
Abinci na iya samar da ɗan ƙaramin juzu'i na bitamin D3 da muke buƙata don kula da lafiya mai kyau. Fitarwar fata ta UV-B ba hanya ce mai aminci ko sauƙi mai sauƙi don samar da yawancin ko duk bitamin D3 da jikinmu ke buƙata ba. Cikakken bitamin D3 daidai shine hanya daya tilo ga yawancin mutane don cimma matakan 25-hydroxyvitamin D tsarin garkuwar jikinsu yana buƙatar yin aiki da kyau. Adadin yau da kullun ba su da yawa; don saukakawa da rage farashi, ana iya ɗaukar manyan allurai kowane kwanaki 7 zuwa 10. Vitamin D3 da gwamnati ta amince da shi na yanzu ƙarin jagororin basu isa ba. Suna nufin cimma matakin 25-hydroxyvitamin D mai yaduwa na kawai 20 ng/mL, wanda gabaɗaya ya isa kawai don aikin koda da lafiyar kashi. Waɗannan jagororin yawanci suna ƙididdige ƙarin adadin dangane da rukunin shekaru, galibi tare da matsakaicin yawan yau da kullun na 0.1 zuwa 0.25 MG (4,000 zuwa 10,000 IU).
Don cimma lafiyayyen matakan 25-hydroxyvitamin D ga kowa da kowa, ba za mu iya dogara kaɗai ga waɗannan shawarwarin ba, gwajin jini, ko kulawar likita. Abin farin ciki, akwai nau'in nau'in abinci mai lafiya na bitamin D3 ga kowane mutum, saboda ayyuka masu iyakance kansu na enzymes waɗanda ke lalata 25-hydroxyvitamin D a gwargwadon matakinsa a cikin jiki. A sakamakon haka, ninka yawan shan bitamin D3 yana yiwuwa ya ƙara matakan 25-hydroxyvitamin D da kashi 40 zuwa 50 kawai.
Don samun lafiyayyen matakan 25-hydroxyvitamin D na aƙalla 50 ng/mL, kuma har zuwa 90 ko 100 ng/mL ba tare da kulawar likita ba, duka biyun ya zama dole kuma ya isa a ƙayyade matsakaicin adadin bitamin D3 na yau da kullun a matsayin rabo na nauyin jiki, ko tsakanin kewayon rabo biyu, tare da mafi girma rabo ga waɗanda ke fama da kiba. Da kyau, manyan masu binciken bitamin D sun riga sun rubuta labarin mujallolin yarjejeniya kan wannan tasirin. Ana iya samun shawarwarin da suka yi daidai da wannan hanyar a cikin labarin abubuwan gina jiki na 2022 na Emeritus Farfesa na Medicine Sunil Wimalawansa (Jami'ar Texas Medical Branch a Galveston da Robert Wood Johnson Medical School, New Jersey): "Haɓakawa da sauri Serum 25(OH)D yana haɓaka Tsarin rigakafi, akan cututtuka - Sepsis da COVID-19.” Waɗannan shawarwarin sun haɗa da ma'auni masu zuwa:
- Na al'ada da kiba: 60 zuwa 90 IU a kowace kilogiram na nauyin jiki, kowace rana. Don haka, 0.125 mg (5,000 IU) kowace rana, ko 50,000 IU capsule kowane kwanaki 10, ya dace da daidaikun mutane masu nauyin 56 zuwa 83 kg (122 zuwa 183 lbs).
- Kiba I & II (BMI 30 zuwa 39): 90 zuwa 130 IU kowace kilogiram na nauyin jiki kowace rana.
- Kiba III (BMI 40 ko fiye) - yanayin da ke buƙatar kulawar likita: 140 zuwa 180 IU kowace kilogiram na nauyin jiki kowace rana.
Matsakaicin nauyin jiki ga marasa kiba, na yau da kullun da masu kiba, tare da mafi girman rabo ga waɗanda ke fama da kiba, za a iya samu daga Afshar et al. 2020 wanda ya gano cewa 70 zuwa 100 IU bitamin D3 a rana a kowace kilogiram na nauyin jiki, don fiye da 500 neuro-opthhamology marasa lafiya tun 2010, ya haifar da matakan 25-hydroxyvitamin D na tsawon lokaci tsakanin 40 da 90 ng/mL. Gabaɗaya, waɗanda ke ƙasan ƙarshen wannan kewayon sun kasance suna fama da kiba.
Ekwaru et al. 2014 an bincika matakan 25-hydroxyvitamin D na dogon lokaci bisa ga adadin abubuwan da ake amfani da su na yau da kullun don nau'ikan jikin mutum huɗu da aka kwatanta: ƙarancin nauyi, al'ada, kiba da kiba. Daga wannan yana yiwuwa a kammala cewa don samun 50 ng/mL 25-hydroxyvitamin D, waɗanda ke fama da kiba suna buƙatar kusan 43% ƙarin bitamin D a kowace rana, a matsayin rabo na nauyin jiki, fiye da waɗanda ba su sha wahala ba.
Farfesa Wimalawansa ya daidaita wannan ƙirƙira zuwa jeri na ma'auni da aka ambata, wanda muka taƙaita a cikin sauƙi a cikin tebur mai zuwa:
Ya kuma ba da shawarar 70 IU bitamin D3 / kg BW / rana don shekaru 18 da ƙarami (ba tare da gyara ga kiba ba) da ƙananan ƙimar ga manya marasa nauyi.
Bincike yana nuna cewa hanyoyin guda biyu suna haifar da mutanen da ke fama da kiba don samun ƙananan matakan 25-hydroxyvitamin D fiye da waɗanda ba su da kiba, ga kowane rabo na bitamin D3 ƙarin ci da nauyin jiki: raguwar hydroxylation na bitamin D3 a cikin hanta da ƙara yawan sha na 25-hydroxyvitamin D a cikin ƙwayar adipose. Waɗannan hanyoyin sun keɓance ga kiba. Ba mu san wani makanikai ko shaida na lura don ƙananan rabo ga masu ƙarancin nauyi ba.
Ta bin shawarwarin da suka dogara da nauyin jiki kamar waɗanda Farfesa Wimalawansa ya yi, mutane na kowane zamani, nauyi da yanayin yanayin jiki za su kai aƙalla 50 ng/mL na yawo 25-hydroxyvitamin D a cikin watanni da yawa, tare da matakan da wuya ya wuce 100 ng/mL, ba tare da buƙatar gwajin jini ko kulawar likita ba.
Da sauri haɓaka matakan 25-hydroxyvitamin D a cikin gaggawa na asibiti
Kodayake 5,000 IU na iya zama kamar adadi mai yawa na bitamin D3, wannan ƙaramin 1/8000th na gram yana yin kaɗan a cikin kwana ɗaya don haɓaka matsakaicin matsakaicin 25-hydroxyvitamin D, wanda yawanci kewayo daga 5 zuwa 25 ng/mL. Hanya ta gama gari don haɓaka matakan 25-hydroxyvitamin D cikin sauri shine kashi na bolus (ko “loading”) na bitamin D3. A cewar Ƙungiyar Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararrun Ƙwararru (ESPEN) Jagora akan abinci mai gina jiki na asibiti a cikin sashin kulawa mai zurfi, babban kashi ɗaya na 500,000 IU (12.5 MG) na bitamin D3 ya bayyana lafiya ga marasa lafiya da rashi a cikin makon farko na jiyya. Koyaya, a cikin marasa lafiya marasa lafiya, yuwuwar iyakoki akan sha da aikin hanta, da kwanaki huɗu ko makamancin da ake ɗauka don hydroxylate da bitamin D3 zuwa 25-hydroxyvitamin D, ba za a yarda da shi ba yana jinkirta ci gaban da ake buƙata cikin gaggawa a cikin aikin rigakafi.
Hanya mafi inganci, kamar yadda Farfesa Wimalawansa ya ba da shawarar, ta ƙunshi kashi ɗaya na baki na calcifediol (25-hydroxyvitamin D) na 0.014 MG kowace kilogram nauyin jiki.. Ga matsakaita nauyi babba, wannan shine kusan milligram 1. Calcifediol yana ɗaukar hankali fiye da bitamin D3 kuma kai tsaye yana shiga wurare dabam dabam, yana haɓaka matakan sama da 50 ng/ml cikin sa'o'i 4 kawai. Wannan haɓakar matakin yana raguwa cikin kwanaki zuwa mako guda, don haka ƙarin calcifediol ko na yau da kullun ko bolus bitamin D3 ya zama dole don kiyaye shi. Kashi na 1 MG na calcifediol yayi kusan daidai da matsakaicin 160,000 IU (4 MG) na bitamin D3. Sai dai idan akwai wani dalili na zargin mai haƙuri yana da 25-hydroxyvitamin D mai yawa, gwajin jini ba dole ba ne, saboda wannan cin abinci ba ya haifar da guba.
Maganin da ya dace ga matsalolin kiwon lafiya masu tsanani da na yau da kullum shine ƙarfafawa da tallafi - amma ba tilastawa - kowa da kowa don ƙara bitamin D3 a cikin adadi mai yawa don samun aƙalla 50 ng/mL 25-hydroxyvitamin D. Ga waɗanda ba su yi wannan ba, kuma waɗanda aka gano tare da COVID-19, sepsis, ko duk wata rashin lafiya mai mutuwa. Ka'idar calcifediol da ke sama ita ce mafi mahimmancin saƙon likita da suke buƙata cikin gaggawa, banda numfashi da tallafin hawan jini. Calcifediol ne akwai a wasu ƙasashen Turai a matsayin takardar sayan 0.266 MG mara tsada Hydroferol or Neodidro capsules. kwalabe na 60 kanana d.wuri Allunan 0.01mg sune akwai a Amurka ba tare da takardar sayan magani ba akan $20.
Hotunan da ke ƙasa sun bambanta na al'ada, tsayin watanni a cikin 25-hydroxyvitamin D tare da haɓakar sa'o'i 4 biyo bayan kashi 0.532 na calcifediol a cikin batutuwa masu lafiya:
Waɗannan jadawali sun fito daga McCullough et al. 2019 kuma a 2016 lamban kira don capsules da aka yi amfani da su a cikin gwajin sarrafa bazuwar, an ruwaito a Castillo et al. 2020, wanda zamu tattauna a kasa. Castillo et al. Masu bincike sun san cewa calcifediol na baka zai haɓaka matakan 25-hydroxyvitamin D da sauri fiye da bitamin D3 na bolus amma mai yiwuwa ba su san ikon mallaka ba ko lokacin tashi na awa 4. Daga baya sun gano wani labarin da ba a ambata a 1974 na TCB Stamp (daga baya, Sir Trevor) mai taken "Abun ciki na 25-hydroxycholecalciferol” wanda ke nuna saurin haɓakar amsawa zuwa kashi ɗaya na nauyin jiki na 0.01 mg/kg na calcifediol.
Yawancin fahimtar likitoci game da maganin bitamin D ga cututtuka masu tsanani yana iyakance ta:
- Ba tare da sanin cewa ana buƙatar 50 ng/mL 25-hydroxyvitamin D don ingantaccen aikin tsarin rigakafi.
- Kasancewar rashin sanin cewa ko da bolus allurai na bitamin D3 na baka yana ɗaukar kwanaki don haɓaka matakan 25-hydroxyvitamin D.
- Rashin sanin yadda calcifediol na baka ke samun hakan a cikin sa'o'i 4.
- Ƙarin rashin fahimta mafi mahimmanci cewa bitamin D3 na baka zai haɓaka matakan 1.25-hydroxyvitamin D, wanda ba haka ba ne, tare da waɗannan matakan ko ta yaya "ƙarfafa tsarin rigakafi".
Bincike da ƙarin fahimtar mahimmancin kiyaye 50 ng / mL da ke yaduwa matakan 25-hydroxyvitamin D sun ci gaba da sannu a hankali fiye da yadda za su kasance idan duk mahalarta - musamman masu ilimin rigakafi da likitoci - sun ba da hankali ga wannan filin.
Mutanen da ke da asali a aikin injiniya, waɗanda suka saba da saurin ci gaba a fannoni kamar semiconductor da microprocessors, na iya samun jinkirin ci gaba a wannan fagen. Hakanan suna iya lura da ƙarancin sha'awar da likitocin da yawa ke nunawa game da bincike wanda ya saba wa ra'ayin ijma'i a tsakanin takwarorinsu.
A cikin duniyar da duk likitoci da yawancin mutane suka fahimci wajibcin ingantaccen ƙarin bitamin D3 don lafiyar tsarin rigakafi, da wataƙila an hana yaduwar cutar ta SARS-CoV-2. Bugu da ƙari, mura da cututtukan sepsis ba za su kasance da wuya ba, kuma gabaɗaya kiwon lafiya zai ga gagarumin ci gaba.
Vitamin D3 da calcifediol azaman magani na farko don COVID-19, sepsis da sauransu.
Ba a san ko'ina ba cewa wannan ka'idar calcifediol gabaɗaya za ta haifar da haɓaka cikin sauri a mafi yawan lokuta na COVID-19, sepsis, da sauran cututtuka masu saurin gaske inda raunata na asali da kuma daidaitawa - da martanin kumburi mara kyau - cutarwa da kashe mutane da yawa.
Likitoci da masu ilimin rigakafi yakamata su kasance masu sha'awar samar da tsarin rigakafi da sauran jikin da yanayin da suke buƙatar yin aiki yadda ya kamata. Koyaya, saboda dalilai daban-daban masu wahala, yawancin ba haka bane. Biyu manyan litattafan ilmin rigakafi, Janeway's 9th Edition da Abbas'' 10th Edition, jimlar shafuka 1500, kar a ambaci bitamin D a cikin maƙasudin su.
Vitamin D - a matsayin bolus bitamin D3 ko mafi kyau har yanzu, 0.014 mg/kg na nauyin jiki calcifediol - yakamata a gane shi a matsayin mafi inganci maganin farko don COVID-19. Duk da haka, a kullum sabunta meta-analysis site c19early.org, An ƙididdige Vitamin D a matsayin ƙarancin tasiri, a cikin binciken da aka yi a farkon jiyya, fiye da ivermectin, antibody monoclonal mara amfani, quercetin, povidone-iodine, melatonin, fluvoxamine, da motsa jiki.
Wannan yana sa likitoci da yawa su ɗauki bitamin D a matsayin wani magani kawai a cikin babban kayan aikin su. Rashin fahimtar da aka ambata a sama, suna ba da magunguna ɗaya ko fiye ba tare da takamaiman maganin calcifediol ba wanda zai ba da damar yawancin tsarin garkuwar jikin marasa lafiyar su yi aiki yadda ya kamata cikin sa'o'i - mai yiwuwa a karon farko a rayuwarsu.
Vitamin D COVID-19 Gwaje-gwajen da aka sarrafa bazuwar jiyya (RCTs) sun bambanta sosai dangane da tsananin cutar yayin shan, sharuɗɗan nasara, da ka'idojin magani. Mutane da yawa sun yi amfani da adadin bitamin D3 marasa amfani a cikin kwanaki biyar na farko. Duk waɗanda suka yi amfani da 7.5 MG (300,000 IU) ko fiye da bitamin D3 sun samar da sakamako mai kyau, kamar yadda wasu waɗanda suka yi amfani da ƙasa ba su yi ba - amma waɗannan ƙananan gwaji ne kuma don haka ba a ba da mahimmanci ba.
Mafi mahimmancin waɗannan RCTs shine Castillo et al. , wanda aka buga a watan Agusta 2020. Idan waɗanda ke da alhakin mayar da martani na cutar sun yi cikakken lissafin wannan bincike kuma sun sadaukar da kai don dakile yaduwar COVID-19 da tsananin - maimakon mayar da hankali kan mahimmancin da ake tsammani na alluran rigakafi - da sun hau kamfen na samar da bitamin D3 na duniya da rarrabawa, tare da calcifediol don jiyya da wuri, a ƙarshen wannan shekarar. Wannan hanyar, musamman tare da jiyya na farko da suka shafi tutiya da magunguna masu tsada, da sun kawo ƙarshen cutar ba tare da kulle-kulle ba, alluran rigakafi, ko abin rufe fuska kuma da ɗan ƙaramin adadin masu mutuwa na yanzu.
Masu binciken sun yi aiki tare da marasa lafiya 76 COVID-19 da aka kwantar a asibiti a Cordoba, Spain, waɗanda dukkansu an yi musu magani da hydroxychloroquine da azithromycin na rigakafi. Marasa lafiya 50 a cikin rukunin jiyya sun sami kashi ɗaya na baka na 0.532 MG calcifediol akan shigar da su, sannan kuma 0.266 MG na allurai a ranakun 3, 7, 14, 21, da sauransu.
Sakamakon sakamako mai kyau ya kasance wani ɓangare saboda rashin daidaituwa na rashin daidaituwa, wanda ya haifar da ƙungiyar kulawa da ke dauke da adadi mai yawa na marasa lafiya tare da cututtuka. Koyaya, masana ilimin lissafin MIT guda biyu sun bincika sakamakon a cikin a bita kuma ya kammala cewa raguwar shigar da ICU yana da alaƙa da shiga tsakani na calcifediol, yana ba da garantin nan da nan, ingantattun gwaje-gwaje na asibiti don ƙara kimanta tasirin wannan jiyya.
Sakamakon, har ma da waɗannan fa'idodin, sun kasance masu ban mamaki: shigar da ICU ya ragu daga 50% zuwa 2%, kuma mutuwar daga 8% zuwa sifili. Maganin farko na 0.532 MG na calcifediol ya kusan rabin wanda aka ba da shawarar a cikin ka'idar 0.014 mg / kg BW da aka ambata a sama, wanda zai kasance 1 MG ga mai haƙuri mai nauyin kilogiram 70.
A ƙarshen 2020, tare da duniya a cikin firgita game da COVID-19, tare da aiwatar da kulle-kulle da ƙarancin gwajin mRNA da adenovirus vector quasi-vaccines da za a gabatar da shi, yakamata a tattauna wannan muhimmin bincike kuma a yi bikin. Duk da haka, har yau, kaɗan ne suka ji labarin. (Daga baya binciken da ƙungiyar guda ɗaya tare da calcifediol ya haifar da sakamako mai ban mamaki, amma a lokacin ana amfani da calcifediol sosai a cikin yawan jama'a, ka'idar jiyya ta fi rikitarwa, ba za a iya tabbatar da yarda ba kuma waɗannan gwaji na baya ba su da wata ƙungiya mai kulawa.)
A ƙarshe, yuwuwar ƙa'idar calcifediol a cikin kula da COVID-19, sepsis, da sauran cututtuka masu saurin kisa ba a ƙima da ƙima saboda ƙarancin ilimi da fahimta tsakanin kwararrun likitocin. Babban sani da kuma yarda da rawar bitamin D a cikin jiyya, tare da saurin tasirin calcifediol akan tsarin rigakafi na marasa lafiya, zai canza yanayin yanayin kiwon lafiya yayin fuskantar annoba da sauran cututtuka masu mahimmanci. Yana da mahimmanci don wayar da kan jama'a game da mahimmancin bitamin D3 da ka'idar calcifediol a cikin ilimin likitanci da aikin asibiti.
Sepsis, kumburi da rashin helminths
Wannan mummunan rashin fahimta game da mahaɗan bitamin D guda uku da rawar da suke takawa a cikin tsarin rigakafi, wanda ya hana hukumomin kiwon lafiya dakatar da cutar ta COVID-19, yayi kama da irin wannan yanayin rashin fahimtar sauran cututtuka. Cin hanci da rashawa daga kamfanonin harhada magunguna na kasa da kasa na taka muhimmiyar rawa wajen dakile sanin mahimmancin mahadin bitamin D fiye da aikinsu a cikin metabolism na calcium-phosphate-kashi. Babban mai binciken bitamin D Bill Grant ya ba da rahoto game da wannan a cikin labarinsa na 2018: “Babban Pharma ya jinkirta karɓar Vitamin D yana bin littafin Playbook Disinformation.” Duk da haka, wannan ba zai iya zama cikakken bayani ba, kamar yadda irin wannan tsari ke wanzuwa a kasar Sin, wanda ya fi karfin kasashen yammacin duniya kai tsaye.
Sepsis wani yanayi ne mai ban tsoro wanda ba a kula da shi ba, ƙwayar cuta, ƙwayar cuta, ko fungal kamuwa da cuta yana haifar da matsananciyar amsawar kumburi mai lalata kai, lalata gabobin kuma sau da yawa yana tabbatar da mutuwa. Gaggawa da sauri yana da mahimmanci amma yana da ƙalubale, saboda marasa lafiya na iya gabatar da ɗimbin alamun alamun da ba na musamman kuma yanayin su na iya yin tabarbarewa cikin sauri.
Google Scholar ya sami labaran 54,000 akan sepsis da bitamin D, da yawa suna nuna cewa marasa lafiya na sepsis suna da ƙananan matakan 25-hydroxyvitamin D fiye da yawan jama'a. Yayin da kamuwa da cuta da kumburi na iya rage wannan matakin, ƙananan matakan kamuwa da cuta suna ba da gudummawa sosai ga haɗarin. Koyaya, bitamin kawai da aka ambata akan shafin Wikipedia don sepsis shine bitamin C.
Idan aka ba da wannan ilimin, a bayyane yake cewa matakin 50 ng/mL 25-hydroxyvitamin D zai rage haɗarin kamuwa da cututtukan da ke haifar da sepsis, da kuma rage yiwuwar amsawar kumburi mai yawa.
A cikin ilimin rigakafi, kalmar "ƙumburi" yana da ma'ana mai faɗi. Ya haɗa da ɗaukar sel na rigakafi zuwa wuraren kamuwa da cuta da wasu martanin cytotoxic (lalacewar sel mara gaira), kamar na eosinophils – ‘yan kunar bakin wake na garkuwar jiki. Wadannan martani na cytotoxic sun samo asali ne da farko don magance ƙwayoyin cuta masu yawa, kamar helminths (tsutsotsi na hanji), tun da ƙwayoyin rigakafi da macrophages waɗanda ke aiki yadda ya kamata a kan ƙwayoyin cutar kansa, ƙwayoyin cuta, fungi, da ƙwayoyin cuta ba su da tasiri kan ƙwayoyin cuta da suka haɗa da biliyoyin sel.
Ƙananan sanannun, amma tabbatacce kuma an yi bincike ne kawai, dalilin da ya wuce kima, ƙonewa na lalata kwayoyin halitta shine rashin helminths a cikin mutane - kuma a cikin abokanmu da dabbobin noma - a cikin karni na karshe ko makamancin haka. Helminths da dadewa sun samo asali ne na mahadi waɗanda ke daidaita martanin kumburin rundunoninsu. Kakannin kakanninmu suna da alama sun mamaye ko'ina tare da nau'in helminth guda ɗaya ko fiye, kuma mun gaji daidaitawar juyin halitta zuwa wannan: amsawar kumburi mai ƙarfi wanda wataƙila za a daidaita lokacin da mahaɗan helminthic suka rushe.
Yanzu da muka cire tsutsotsi, muna da saurin kamuwa da kumburi da yawa. Wasu daga cikin mu, saboda bambancin kwayoyin halitta, suna da martani mai karfi musamman wanda ke haifar da cututtuka masu kumburi da yawa kamar su sclerosis, rheumatoid arthritis, psoriasis, asma, ciwon kai, da migraine. Da fatan za a gani vitamindstopscovid.info/06-adv/ da kuma helminthictherapywiki.org don haɗin kai da tattaunawa game da maganin helminthic - wanda za'a iya kawar da waɗannan cututtuka ta hanyar kamuwa da cutar helminth da gangan. Shafin farko ya kuma tattauna manyan ka'idojin 25-hydroxyvitamin D na Cicero Coimbra da sauransu, wanda kuma zai iya murkushe waɗannan yanayi, tare da kulawar likita don kiyaye yawan matakan calcium da asarar kashi.
Nasarar duka waɗannan tsarin kulawa suna nuna cewa rashin helminths shine babban matsala mai mahimmanci da ke haifar da rashin lafiya mai tsanani da na kullum, tare da ƙananan 25-hydroxyvitamin D matakan da ke daɗaɗa ƙarfin amsawar kumburi. Filayen binciken bitamin D da helminth kamar jiragen ruwa ne da ke wucewa cikin dare - ba su san juna ba. Coimbra yarjejeniya likitoci bayyana nasarar da suka samu ta hanyar hasashe, ta yin amfani da kalmar "juriya na bitamin D", ba tare da magana ga helminths ba. Masu bincike na Helminthic ba su ambaci bitamin D ba.
Helminthic modulatory mahadi, irin su tuftsin-phosphorylcholine, an gano da kuma hada da kuma a halin yanzu ana bincike. Koyaya, har yanzu babu ko ɗaya don amfanin warkewa. Yana da sauƙi a yi tunanin ana amfani da waɗannan mahadi cikin adalci, tare da ingantaccen bitamin D3. boron, Magnesium, Zinc, da omega-3 fatty acid ci, da kuma guje wa wuce kima na omega-6 fatty acids, don samun nasarar dakile yawancin cututtuka masu kumburi, ciki har da wadanda ke taimakawa wajen kiba, damuwa da neurodegeneration.
Cutar Kawasaki, MIS-C, PIMS da COVID-19
Cutar Kawasaki cuta ce mai saurin kisa kuma mai yuwuwar cutar kumburin vasculitis wacce ke shafar jarirai da farko kanana yara. Ana lura da abin faɗakarwa makonni ko watanni kafin farawa. Lamurra masu tsanani sun haɗa da aneurysms na jijiyoyin jini, wanda zai iya zama mai mutuwa daga baya a rayuwa.
Shekaru da yawa na labarin bincike na cutar Kawasaki da rahotanni na asibiti suna nuna yanayin cutar a matsayin abin asiri. Bayan koyon sanannun halayen cututtukan cututtukan, kamar kamuwa da cuta a Japan a cikin hunturu ko kuma galibi yana shafar yara masu duhu a cikin Paris, da yawa waɗanda ba ƙwararru ba za su yi zargin rashin isasshen bitamin D a matsayin babban abin da ke haifar da cutar. Duk da haka, irin waɗannan ra'ayoyin ba su faruwa ga yawancin likitocin yara.
A cikin 2015, masu bincike na Italiya Stagi et al. buga wani Labari wanda yakamata ya canza fahimta, rigakafi, da maganin cutar Kawasaki. Duk da haka, a watan Mayu 2020, an ambaci shi sau 13 kawai. Alhamdu lillahi, a cikin shekaru uku masu zuwa, an yi tafsiri 39, amma wannan kadan ne daga tasirin da ya kamata ya yi.
Binciken ya shafi 'yan mata 21 da maza 58, masu matsakaicin shekaru 5.8. Matsakaicin matakan su na 25-hydroxyvitamin D sun kasance 9.2 ng/mL, yayin da matakan da suka dace da shekaru sun kai 23.3 ng/mL. Matsakaicin matsakaicin matakin yaran da suka haɓaka rashin lafiyar jijiyoyin jini ya ma ƙasa da ƙasa: kawai 4.9 ng/mL. Aƙalla, kaɗan ne kawai na wannan bambance-bambancen za a iya bayyana ta ta hanyar cutar da ke rage matakan 25-hydroxyvitamin D. Sauran wannan bambance-bambancen mai ƙarfi a fili yana haifar da haɗari, tare da tsinkayen kwayoyin halitta da kuma haifar da cututtuka.
Tun da waɗannan ƙananan matakan 25-hydroxyvitamin D masu haɗari suna da sauƙi don haɓakawa kuma ya kamata a tashe su don wasu dalilai masu yawa, wanda zai iya tunanin cewa wannan binciken zai zama lokacin eureka ga masu bincike na cutar Kawasaki da likitoci, wanda aka kwatanta a cikin kafofin watsa labaru na yau da kullum a matsayin ci gaba mai canza wasa. Duk da haka, an yi watsi da shi sosai.
Cutar Kawasaki yanzu ita ma cutar na iya haifar da ita ta COVID-19, gami da waɗanda ba su da asymptomatic, kamar yadda galibi ke faruwa ga yara. Bincike guda biyu da ke da alaƙa da cutar Kawasaki sun fito a cikin 2020: MIS-C (Multisystem Inflammatory Syndrome a Yara) da PIMS (Pediatric Inflammatory Multisystem Syndrome). Kwayoyin cuta na COVID-19 ne ke haifar da waɗannan ko, lokaci-lokaci, COVID-19 maganin alurar riga kafi.
Cutar Kawasaki da ke fitowa daga COVID-19 wani ɓangare ne na ci gaba da alamun bayyanar cututtuka tare da MIS-C/PIMS, kamar yadda aka bayyana ta Tsoukas dan Yeung a shekarar 2022. Jarirai da kanana sun fi kamuwa da cutar Kawasaki, yayin da matasa da matasa za su iya kamuwa da wasu yanayi guda biyu, wadanda suka hada da karancin vasculitis da kuma lalata gabobin jiki.
Ɗaya daga cikinmu (RW) ya rubuta wa ɗimbin marubutan cutar Kawasaki/MIS-C a cikin 2020 don wayar da kan su game da binciken Stagi et al. da kuma bayyanannen abubuwan da ke tattare da bitamin D3 a matsayin ma'aunin rigakafi da calcifediol azaman magani. Daya ne kawai ya amsa, yana bayyana ba tare da takamaiman gardama ba cewa ba za su iya tunanin matsalar rashin bitamin D. Binciken 2022 na cutar Kawasaki / MIS-C guda 50 a jere a cikin Google Scholar ya gano cewa daya ne kawai aka ambata bitamin D sannan kawai a wucewa. Wataƙila lamarin ya ɗan gyaru tun daga lokacin. Wani saƙon imel ga wasu daga cikin waɗannan likitocin yara ya haifar da amsa guda ɗaya, wannan lokacin ya fi godiya, daga likitan da bai yi la'akari da bitamin D a baya ba.
A ƙarshe, rashin fahimta da rashin amfani da bitamin D wajen yin rigakafi da magance cututtuka daban-daban, irin su sepsis da cutar Kawasaki, sun haifar da karɓar nau'i mai yawa na wahala, cutarwa da mutuwa a matsayin al'ada kuma ba makawa, lokacin da mafi yawansa za a iya hana shi tare da ingantaccen abinci mai gina jiki. Sepsis kadai kamar dodo ne da ke taunawa ta bil'adama a adadin yakin duniya na biyu ko COVID-19, duk yini, kowace rana - mutuwa daya a kowane sakan 3.
Haɗuwa da binciken bitamin D tare da bincike na helminth zai iya buɗe sababbin hanyoyi don ƙarin jiyya mai mahimmanci, mai yiwuwa ceton rayuka da inganta yanayin rayuwa ga waɗanda ke fama da waɗannan yanayi.
Bayan cin hanci da rashawa, ko matakan rashin iya aiki na yau da kullun
Cin hanci da rashawa ya haifar da wani ɓangare na matsanancin rashin sanin yakamata a cikin ma'aikatan kiwon lafiya game da mahimmancin kiyaye isasshen matakan 25-hydroxyvitamin D don ingantaccen tsarin rigakafi. Shaidar da aka bayar a cikin bincike da sake dubawa da aka ambata a sama suna nuna cewa ƙananan matakan 25-hydroxyvitamin D sune muhimmiyar mahimmancin da ke ba da gudummawa ga watsawa da/ko tsananin COVID-19, mura, sepsis, KD, MIS-C, PIMS, da yawancin cututtukan kumburi na autoimmune. Duk da haka, jama'a sun ci gaba da dogara ga yawancin likitoci da masu ilimin rigakafi waɗanda ba su san wannan ba.
Waɗannan ƙwararrun likitocin ba ƙwalƙwal ba ne, marasa ƙwarewa, ko marasa hali. Kamar kowa, ikonsu na gane gazawar tsarin da ke cikin nasu da kuma fahimtar sana'arsu game da duniya yana takure da tunanin rukuni. Wasu likitocin suna samun 'yantar da kansu daga wannan tunanin, kawai suna fuskantar babbar matsala wajen samun abokan aikinsu suyi la'akari da wannan mahimman bayanai. Irin waɗannan likitocin za a iya ɓata su kuma takwarorinsu za su yi magana da su. Hakazalika, waɗanda ke sukar allurar rigakafi da hana ivermectin da sauran amintattun jiyya, masu inganci, da marasa tsada don COVID-19 suna fuskantar azaba, gami da soke rajista.
Waɗannan ɓangarorin ɓarna a cikin likitanci, waɗanda ke hana ƙirƙira da kuma kama mafi yawan masu aiki a cikin sake zagayowar gurɓataccen tunani na rukuni da rashin fahimta, da alama suna yin niyya ga ƙananan maɓalli, mafita mara kyau ga matsananciyar matsalolin likita a halin yanzu ana magance su ta hanyar tsada, ƙwararru. Manufar riba a bayyane take a nan. Wani abu mai yiwuwa shi ne, yawancin likitocin ba su jure shekaru goma ko fiye da buƙata ba, horarwa mai tsada kawai don ciyar da ayyukansu akai-akai suna ba marasa lafiya shawarar shan bitamin, guje wa wuce kima na omega-6 fatty acids, sugar, da gishiri, da kuma motsa jiki da yawa. Wani ɓangare na wannan juriya na iya fitowa daga yawancin marasa lafiya suna tsammanin ƙarin ƙunƙuntaccen jiyya da nagartattun jiyya, la'akari da farashin sabis na likita.
Masana'antun da ke bikin ƙirƙira - irin su fasahar kere-kere, lantarki, da software - da wuya su fuskanci yawancin ƙwararrun ƙwararrunsu da ke cikin ruɗani na rashin amfani na shekaru, kamar yadda ke faruwa a cikin magani. Akwai bidi'a a cikin magani, wanda aka tabbatar ta hanyar tiyatar ido na yau da kullun, hip, da gwiwa waɗanda zasu zama abin al'ajabi 'yan shekarun da suka gabata. Kulawar hakori kuma ya sami ci gaba na ban mamaki.
Gabaɗayan fagagen magunguna sun faɗi cikin ɓarna ga ɓataccen sha'awar hadaddun, nagartaccen, da karkatar da jama'a daga abin da majiyyata da jama'a ke buƙata da gaske. Hanyoyi masu sauƙi, waɗanda suke daidai abin da suke buƙata, galibi ana yin watsi da su, a guje su, ko kuma ba'a kamar yadda ba su cancanci kulawar likitoci ba.
Rashin gaskiya, wani lokacin m-addini, bege da tsammanin da ke kewaye da alluran rigakafin sun kasance mafi mahimmancin murdiya tunani da aiki yayin bala'in COVID-19. Idan babu irin wannan rigakafin da zai yiwu ko kuma da an yi watsi da su cikin sauri da kuma daidai da cewa suna da iyaka ko ƙima, da an tilasta wa likitoci da sauran ƙwararrun dogaro ga jiyya da abinci mai gina jiki da wuri. Waɗannan da sun fi tasiri fiye da jiyya da ake magana da su a matsayin allurar COVID-19, amma ba za su gamsar da wasu ƙwararrun sha'awar tada tsoro da kuma sarrafa dukkan al'umma yayin rikicin da aka kera ba.
Rukunin bitamin D na wuraren kiwon lafiya ba zai iya rugujewa ba idan ko da wani bangare ne aka gyara. Misali, idan duk likitocin yara sun fahimci mahimmancin ingantaccen ƙarin bitamin D3, ciki da waje, don rage haɗarin cutar Kawasaki, MIS-C, PIMS, pre-eclampsia, Autism, schizophrenia, da haihuwa kafin lokaci, sannan sauran wuraren da ba za a tafi ba za su ruguje - sepsis, COVID-19, mura, kuma a ƙarshe neurodegeneration. Likitoci kaɗan ne ke sha'awar, ko sanin, gaskiyar cewa mutanen da ke da cutar Parkinson ke nunawa ko da ƙananan 25-hydroxyvitamin D matakan fiye da waɗanda ba tare da cutar ba, tun kafin bayyanar cututtuka.
Ƙarin misalan nisantar bayanan likita na dagewa wanda zai haifar da mafi sauƙi, mafi inganci, ƙarancin kyan gani, da rashin fa'ida ga manyan matsalolin kiwon lafiya sun haɗa da:
- Peer ya sake nazarin bincike a cikin 2011 ta M.R Naghii et al. ya nuna cewa karin sinadarin boron na MG 10 a kowace rana yana haifar da rarrabuwar kawuna wanda aka tabbatar da dusar ƙanƙara, yana ba da damar wucewa cikin sauƙi, sau da yawa a cikin kwanaki da fara magani. Naghii ya ba da shawarar cewa L-arginine yana taimakawa wannan tsari sosai. Saboda haka, yawancin masana'antar jiyya na dutsen koda na biliyoyin daloli na iya zama duka marasa buƙata kuma masu cutarwa, idan aka yi la'akari da kuɗin kuɗi da haɗarin likita idan aka kwatanta da cinye rabin amintaccen iyakar boron kowace rana.
- Boron ya kamata a gane shi azaman mahimmin abinci mai gina jiki tare da lafiyayyen abinci na yau da kullun a kusa da 10 MG, maimakon na al'ada ~ 1 MG, galibi daga 'ya'yan itace da kayan marmari da ake girma a cikin ƙasa mai ƙarancin boron. Fa'idodin sun haɗa da rage rheumatoid amosanin gabbai da haɓaka lafiyar haƙori da ƙashi (Babu Komai Game da Boron, 2015 PMC4712861 da kuma aminotheory.com/cv19/#08-boron).
- Ciwon Ƙafafun Ƙafa / Rigakafin motsi na lokaci-lokaci da bambance-bambancen da za a iya gano su da ke haifar da rashin barci na iya zama an bayyana shi cikin sauri ta zaɓin abinci na gama gari da zaɓin salon rayuwa, da yawa waɗanda za a iya kaucewa ba tare da sa hannun likita ba. Waɗannan suna rage inhibitory dopaminergic da/ko kunnawa mai karɓa na opioid a cikin da'irar reflex na kashin baya da ke da alhakin ɗan adam na musamman, mai laushi-kunna, kariya ta kafa, amsawar amsawa. Duk da sanar da RLS.org da manyan masu binciken RLS game da wannan a cikin 2011, ba a sami amsa ba, kuma har yanzu ba a san ilimin etiology a hukumance ba. Miliyoyin masu fama da cutar suna ci gaba da jinyar su tare da masu adawa da dopamin masu canza hali kuma, lokacin da waɗannan suka gaza, opioids.
Cutar ta COVID-19, sepsis, da sauran batutuwa masu alaƙa za a kawar da su ne kawai da zarar yawancin likitocin sun fahimci buƙatar tsarin rigakafi na 50 ng/mL 25-hydroxyvitamin D. Wannan zai fi dogara ga masana ilimin rigakafi, waɗanda a halin yanzu sun mamaye cikin rikice-rikice na cytokines, bambance-bambancen kwayoyin halitta, kuma ba za su iya fahimtar tsarin aikinsu gaba ɗaya ba. wanda kwayoyin rigakafi guda ɗaya ke amsawa ga canjin yanayin su.
Zamanin mura da COVID-19
Matakan 25-hydroxyvitamin D masu lafiya na 50 ng/mL ko sama da haka kadan kadan suna rage yuwuwar kamuwa da cutar COVID-19 daga duk wani bayyanar kwayar cuta. Wadannan matakan suna ba da kariya mai karfi daga cututtuka mai tsanani. Har ma mafi mahimmanci ga dukan jama'a, irin waɗannan matakan suna ba da cikakken ƙarfin amsawar rigakafi wanda ke hanzarta murkushe cututtukan ƙwayar cuta da rage matsakaicin matakan zubar da hoto. Wannan tsarin, fiye da kowane, yana rage watsawa kuma, saboda haka, jimillar adadin waɗanda suka kamu da cutar. Har ila yau, ingantaccen amsawar rigakafi yana haifar da mafi kyawu, rigakafi mai dorewa daga ƙwayoyin cuta iri ɗaya ko makamancin haka.
Canje-canje masu sauƙi amma manyan canje-canje a matsakaicin yawan jama'a matakan 25-hydroxyvitamin D suna aiki azaman babban direban mura da yanayin COVID-19: nutritionmatters.substack.com/p/covid-19-seasonality-is-primarily. Kamar yadda aka nuna a cikin wannan labarin, adadin masu cutar COVID-19 da ke asibiti a Burtaniya ya ragu sosai daga 19,617 a tsakiyar Afrilu 2020 zuwa 795 a ƙarshen Agusta. Wannan raguwar kowane wata ya kasance da farko saboda kololuwar lokacin rani a matsakaicin matakan 25-hydroxyvitamin D ga mutanen da ba su da isasshen bitamin D3: a kusa da 25 ng/mL don fata da kusan 15 ng/mL ga waɗanda ke da duhu ko baƙar fata. Babu kulle-kulle, alluran rigakafi, ko yaɗuwar abin rufe fuska da matakan nisantar da jama'a a wannan lokacin. Adadin kamuwa da cuta da asibiti ya karu a cikin Satumba da watanni masu zuwa yayin da matakan 25-hydroxyvitamin D suka ragu kuma sabon bambance-bambancen mai iya yaduwa ya fito.
Dror et al. da sauran rahotanni
Jadawalin da ke farkon wannan labarin yana nuna tarihin rarraba yawan jama'a na matakan 25-hydroxyvitamin D. Na farko, a cikin launin toka, ana ƙididdige matakan daga Luxwolda et al. 2012, wanda shine kawai binciken da aka yi a yau wanda ya auna matakan 25-hydroxyvitamin D a cikin al'adun gargajiya na Afirka - makiyaya Maasai 35 da 25 masu farauta na Hadzabe a Tanzaniya, tare da matsakaicin shekaru 35. Matsakaicin matakin shine 46 ng/mL (125 nmol/L). Yana da kyau a ɗauka cewa tsarin rigakafi na dukan mutane a yau ya bambanta kaɗan da na kakanninmu na Afirka shekaru 50,000 da suka wuce. Duk da haka, gyare-gyare sun samo asali tun daga lokacin, musamman ma asarar UV-B da ke shayar da melanin a tsakanin waɗanda suka yi nisa daga equator, wanda ya inganta ikon yawancin al'umma don samar da bitamin D3 lokacin da aka fallasa shi ga hasken UV-B.
Sauran bayanan tarihi guda hudu sun fito ne daga bugu na Satumba 2020 ta Isra'ila et al., "Alaka tsakanin rashi bitamin D da Covid-19 a cikin yawan jama'a.” Waɗannan sun dogara ne akan ma'auni da aka yi tsakanin 2010 da 2019 kuma an yi rikodin su a cikin bayanan marasa lafiya na Isra'ila miliyan 4.6 duk sun yi ƙasa da 50 ng/mL Duk da cewa suna zaune a cikin Isra'ila mai rana, a 32 ° arewa - matakin tare da San Diego da Savannah, Georgia - matakan matan Larabawa suna da ban tsoro ga matansu da yanayin lafiyar su. Ci gaban jijiyoyi na yara - dole ne ya zama mara kyau.
Labarun bincike da yawa na Burtaniya nuna cewa matsakaicin matakan Asiya (Pakistan, Indiya, da Bangladesh) maza da mata a Burtaniya sun kai 10 ng/mL ko ƙasa da hakan - kuma yana da kyau a ɗauka cewa matsakaicin matsakaicin mata zai yi ƙasa da wannan sosai.
Isra'ila et al. An gano mafi girman adadin kamuwa da cutar SARS-CoV-2 a tsakanin waɗanda ke da ƙarancin matakan 25-hydroxyvitamin D, musamman a tsakanin mata, waɗanda matakansu ya yi ƙasa kaɗan ko kaɗan fiye da na maza na kabila ɗaya. Bugu da ƙari ga ƙananan matakan ƙila suna haɓaka damar kamuwa da cuta, mafi mahimmancin tsarin da ke tattare da wannan alaƙar na iya kasancewa mafi yawan mutane a cikin ƙungiyoyin ƙabilu uku, tare da ci gaba da rage ma'anar 25-hydroxyvitamin D matakan - Janar, Ultra-Orthodox, da Larabawa - suna ciyar da mafi yawan lokutan su a tsakanin sauran membobin ƙungiyar su. Waɗannan ƙananan matakan za su haifar da rashin ƙarfi na martani na rigakafi da sannu a hankali, sabili da haka, mafi girman matakan zubar da ƙwayar cuta da watsawa a cikin waɗannan ƙabilun. Girman dangi da ayyukan aiki - kamar ikon yin aiki daga gida da manyan ayyukan tuntuɓar jama'a - wataƙila suma suna taka rawa a cikin waɗannan ƙimar kamuwa da cuta daban-daban.
Yanzu mun koma ga binciken Dror et al. da na sauran masu binciken waɗanda ke ba da rahoton irin wannan daidaito da ƙarfi tsakanin ƙungiyoyi masu ƙarfi tsakanin ƙarancin 25-hydroxvitamin D da COVID-19 cewa tsohon dole ne ya zama babban abin haifar da ƙarshen, tare da bayyanannun abubuwan da ke tattare da yadda yakamata a magance cututtukan mutum da duka cutar.
Bayanan marasa lafiya 1,176 masu shekaru 18 zuwa sama, tare da gwaje-gwaje masu zaman kansu na PCR guda biyu, waɗanda aka kwantar da su a wani babban asibiti a arewacin Isra'ila tsakanin 2020-04-07 da 2021-02-04, an bincika sakamakon gwajin jini na 25-hydroxyvitamin D wanda aka auna kwanaki 14 zuwa 730 kafin ganewar asali. Matsakaicin tsananin cutar yayin asibiti na marasa lafiya 253 da irin wannan sakamakon gwajin an haɗa su a cikin wannan binciken bincike mai zuwa, wanda aka keɓe cikin sassauƙa, matsakaici, mai tsanani, da mahimmanci.
Masu binciken sun haɓaka algorithm don daidaita waɗannan matakan don rama bambancin yanayi. Koyaya, matakan da ke cikin jadawali na sama suna wakiltar matakan da ba a gyara ba, na baya-bayan nan, ainihin matakan aunawa.
Matsakaicin shekaru a tsakanin sassa masu sauƙi zuwa nau'i mai mahimmanci sune 53, 64, 72, da 76. A cikin waɗannan nau'ikan, ma'anar BMI sune 27.5, 27.6, 29.2, da 32.0, bi da bi; Adadin mutuwar sun kasance 0%, 1.2%, 35%, da 85%; kuma ma'anar 25-hydroxyvitamin D matakan sune 36, 19, 13, da 12 ng/mL. Yayin da matakan 25-hydroxyvitamin D suka bambanta da shekaru, kuma shekarun sun kasance suna da alaƙa da tsanani, lokacin da aka ƙaddamar da batutuwa a cikin shekaru uku, matakan 25-hydroxyvitamin D sun kasance da karfi da mahimmanci (p <0.001) da rashin daidaituwa tare da rashin lafiya (Fig. 3).
Kashi 61% na marasa lafiya Larabawa ne. Daga cikin waɗannan, 64.3% suna da matakan 25-hydroxyvitamin D da ke ƙasa da 20 ng/mL, idan aka kwatanta da 36% na waɗanda ba Larabawa ba. Abubuwan da za su iya haifar da karancin bitamin D a tsakanin Larabawa sun hada da launin fata mai duhu, wanda ke rage ƙwayar bitamin D na fata, da kuma fifiko ga tufafi masu ra'ayin mazan jiya a wasu al'adu da al'ummomin addini, musamman a tsakanin mata, wanda ke daɗa rage bayyanar fata ga hasken rana kuma don haka rage matakan bitamin D. Duk da mahimmancin p = 0.006 na rashin daidaituwa tsakanin Larabawa da wadanda ba Larabawa ba a cikin matakan 25-hydroxyvitamin D, dangantakar ƙabilanci na Larabawa game da rashin lafiya ya kasance ƙasa kuma ba ta da mahimmanci: p = 0.3.
Babu bayanai da aka samu akan karin bitamin D3. Koyaya, yana da kyau a ɗauka cewa yawancin mutanen da ke da matakan sama da 40 ng/mL suna haɓakawa da / ko kwanan nan, faɗuwar fata ta UV-B a lokacin da aka zana jininsu. A cikin ƙarin bayanan, manyan matakan 25-hydroxyvitamin D guda uku mafi girma a cikin nau'i mai tsanani sun kasance daga 56 zuwa 67 ng/mL. Wadannan marasa lafiya uku duk sun kasance shekaru 65 ko fiye kuma suna da COPD da hauhawar jini. Biyu daga cikinsu sun mutu. Waɗannan matakan lafiya, fiye da sau biyu na yawan jama'a da matsakaicin haƙuri, suna rage haɗari amma ba za su iya ba da garantin lafiya ko rayuwa a kowane yanayi ba. Daga cikin marasa lafiya 38 da suka mutu, ɗayan yana ƙasa da 50 kuma na biyu yana tsakanin 50 zuwa 64, tare da matakan 25-hydroxyvitamin D na 16 da 26 ng/mL, bi da bi. Daga cikin sauran 36 da suka mutu, duk shekaru 65 da haihuwa, matakan 25-hydroxyvitamin D sun kasance 67, 56, da 35 ng/mL, tare da dukan marasa lafiya uku da ke fama da COPD da hauhawar jini. Daga cikin sauran marasa lafiya 33 da suka mutu, matakan 25-hydroxyvitamin D sun kasance 21 da 18 ng/mL, tare da sauran marasa lafiya 32 suna da matakan tsakanin 6 da 14 ng/mL, tare da ma'anar 9.9 ng/mL.
Hatsarin asibiti da mummunan cutarwa sakamakon ƙananan matakan 25-hydroxyvitamin D sun fi girma fiye da yadda aka kwatanta a cikin jadawali na sama, kamar yadda waɗanda ke asibiti gabaɗaya suna da ƙananan matakan fiye da waɗanda ba su da.
A Fabrairu 2020 Labari da Tuncay et al. sun binciki matakan 25-hydroxyvitamin D na 596 PCR-tabbatacce COVID-19 marasa lafiya da 59 lafiyayyu a Asibitin Ankara, Turkiyya, daga Maris zuwa Yuni 2020.
A cikin Maris 2021 bita nazarin marasa lafiya 551 a Mexico City daga Maris zuwa Mayu 2020, Vanegas-Cedillo et al. ya ba da rahoton cewa ƙarin haɗarin mutuwar COVID-19 da ƙananan matakan bitamin D ke bayarwa ya kasance mai zaman kansa daga BMI da kitsen epicardial. Bayan daidaitawa don shekaru, jima'i, BMI, C-reactive protein, epicardial fat, D-dimer, oxygen jikewa, nau'in ciwon sukari na 2, da cututtukan koda na yau da kullum, sun samar da wannan samfurin da aka kwatanta na hadarin mutuwa a matsayin aikin 25-hydroxyvitamin D, tare da 1 daidaitaccen haɗari a 20 ng / mL, wanda ke kusa da tsaka-tsakin don samfurin su.
Hakanan a cikin Maris 2021, Bayramoğlu et al. ruwaito matsakaicin matakan 25-hydroxyvitamin D na yara 103, tare da matsakaicin shekaru 12, waɗanda aka gano suna da COVID-19 a asibitin Istanbul tsakanin Maris da Mayu 2020. Wadanda ke ƙasa da shekara 1 da waɗanda ke da cututtukan cututtuka (ciwon sukari, fuka, tarin fuka, gazawar koda, da sauransu) an cire su daga binciken. Bambancin matakan ma'ana ya kasance mai mahimmanci a ƙididdiga (p <0.001):
- 16 ng/ml ga yara asymptomatic.
- 14 ng/mL ga yara masu laushi.
- 10 ng/mL ga yara masu matsakaici zuwa matsananciyar bayyanar cututtuka.
Har ila yau, sun ba da rahoton alaƙa mai mahimmanci tsakanin ƙananan matakan 25-hydroxyvitamin D da ƙananan ƙwayoyin lymphocyte, da kuma manyan matakan alamun kumburi: furotin C-reactive da fibrinogen. A ciki manya masu ciwon zuciya, matakan waɗannan mahadi guda biyu suna da alaƙa da alaƙa da bugun zuciya da mutuwa.
a cikin watan Mayu 2021 BMJ Labari, Derren et al. An gano yara 18 masu shekaru tsakanin watanni 4 zuwa 15, wadanda aka gano suna da PIMS-TS (cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan cututtukan Karororona biyu da kuma 2 ga watan Yuni 12 a wani asibitin yara dake Birmingham a kasar Burtaniya. Wanda yake tsakiyar tsibiran Burtaniya, layinsa na 25° arewa zai sanya wannan birni mai nisan mil 2020 daga arewacin iyakar Amurka idan yana cikin Yammacin Kanada.
Waɗannan yaran sun kasance cikin koshin lafiya a baya, ba tare da kamuwa da cuta ba. Babu ɗayansu da ya mutu, amma huɗu suna buƙatar iskar injuna mai ɓarna, kuma ɗayan yana buƙatar hemofiltration don gazawar koda. Goma sha shida daga cikin yaran Bakar fata ne, Asiyawa, Kabilanci marasa rinjaye (BAME), sauran biyun kuma 'yan kabilar farar fata ne. Matsakaicin matakin 25-hydroxyvitamin D akan shigar da yaran BAME shine 7.6 ng/mL, kuma ga Farin yara, 24 ng/mL. Binciken Birtaniya na 2016 na yara masu shekaru 4 zuwa 10 sun sami ma'anar 25-hydroxyvitamin D matakin 21.6 ng/mL. Muhimmancin bambanci tsakanin wannan da matakin ma'anar rukuni na 9.6 ng/mL shine p <0.001. Yara 12 da aka shigar da su cikin kulawa mai zurfi na yara suna da ƙarancin ma'ana 25-hydroxyvitamin D fiye da waɗanda ba su da. Duk waɗannan 12 suna da ƙanƙara (< 55%) hagu na ɓarnawar fitar da hanta.
Binciken Echocardiagram na arteries na jijiyoyin jini ya nuna cewa biyar suna da "fitattun", ma'ana dilated, arteries da daya yana da fusiform dilation, wanda ganuwar arterial ya raunana da balloons na jirgin zuwa fiye da 150% na diamita na yau da kullum. Yara biyu da ke da abin da masu binciken suka yi la'akari da su "sun isa" matakan 25-hydroxyvitamin D (20 ng / mL ko fiye) ba su da irin wannan lalacewar zuciya.
Page: A cikin Afrilu da Mayu 2020, an karanta kuma an kawo wasu buƙatu guda uku waɗanda ke ikirarin cewa labaran bincike ne na gaske game da bitamin D da COVID-19. Sunayen marubutansu na farko su ne Alipio, Raharusun(a), da Glicio. Sunan farko na ɗaya daga cikin ƴan damfara ne, wanda ya ƙaddamar da waɗannan a zaman wani sashe na ƙirƙira gabaɗaya na 23 ko makamancin haka. Sauran sunaye biyu na tatsuniyoyi ne. Cikakken bayanin wannan yakin yana a researchveracity.info/alra/. Biyu daga cikin dupe ɗin ƴan damfara, waɗanda suka tara musu kuɗi, an ba su bayanan ƙagaggen da suka rikide zuwa jadawali da ke nuna alaƙar da ba za ta yiwu ba tsakanin matakan 25-hydroxyvitamin D da mace-mace. Ba a yi wani yunƙuri da ya dace ba don cire ambaton wannan jadawali na karya, kuma kwafinsa ya rage har yau kuma ana tattaunawa a cikin wani bidiyo a www.powerofd.org.
Maganganun da aka kafa, masu ƙarfi na zamantakewa da na ci gaba, matsaloli
Masu bincike da likitocin da suka gane mahimmancin matakan 25-hydroxyvitamin D mafi kyau ga al'amuran kiwon lafiya da yawa, bayan calcium-phosphate-kashi metabolism, sun sadaukar da shekaru ko ma shekarun da suka gabata don wayar da kan abokan aiki. Matsaloli da yawa da suka haɗa kai da alama suna hana sha'awar dabi'a da ƙwararrun waɗannan abokan aikin yakamata su kasance cikin wani abu mai mahimmanci ga lafiyar ɗan adam. Waɗannan shingen sun haɗa da:
- Yin amfani da Ƙungiyar Ƙasa ta Duniya don ƙarin adadin bitamin D3 (amfani da kalmar "kashi" yana nufin magani, yayin da muke magana da farko game da abinci na yau da kullum). An daidaita shi zuwa 1/40,000,000 na gram a farkon karni na 20, wannan ma'auni yana kimanta adadin yau da kullun na bitamin D da bera ke buƙata don guje wa kamuwa da cutar rickets. Wannan yana haifar da adadi mai yawa don ƙarin adadin lafiya, wanda zai iya haifar da duka likitocin da jama'a su yi taka tsantsan game da kari mai dacewa.
- Maimaituwa akai-akai na bayanin yaudarar cewa "bitamin D hormone ne", ko da ta hanyar jagorancin masu binciken bitamin D. Wannan da alama ƙoƙari ne na ba cholecalciferol gravitas wanda suka yi imanin cewa ba shi da shi a matsayin bitamin kawai. Ana iya amfani da kalmar "hormone na secosteroid" don ƙarin girmamawa.
- Jagororin hukuma don ƙarin ci na bitamin D3 ba sa lissafin nauyin jiki da kiba, yana ba da kusan kashi 15% na abin da matsakaitan nauyi manya ke buƙata don cimma abin da muka sani yanzu suna da lafiyayyen matakan 25-hydroxyvitamin D.
- Rashin fahimta irin su “abinci mai wadatar bitamin D” da iƙirarin da aka yi game da ƙaƙƙarfan abinci na iya ba wa wasu mutane rashin tsaro game da matsayinsu na bitamin D. Abinci mai ƙarfi kaɗai ba zai iya cimma ko'ina kusa da 50 ng/mL yana zagayawa 25-hydroxyvitamin D. Ɗayan mu (RW) yayi jayayya cewa duk ƙoƙarin da za a iya yi don haɓaka katangar abinci na D3 zai fi kyau a karkata zuwa goyan bayan ingantaccen kari na son rai.
- A cikin ƙasashe irin su Ostiraliya, matsakaicin adadin bitamin D3 a cikin kayan abinci mai kayatarwa shine 1000 IUs mai ban sha'awa, daidai da 0.025 MG. Wannan shine kawai kashi 20% na abin da matsakaicin nauyi manya ke buƙata kowace rana. Kudin da rashin jin daɗi na cinye biyar daga cikin waɗannan a rana yana haifar da cikas ga ingantaccen abinci mai gina jiki. A cikin Amurka, 1.25 mg 50,000 IU capsules sun fi samuwa kuma suna ba da mafi dacewa da araha madadin.
- Ana samun Vitamin D galibi akan manyan kantunan kantuna tsakanin bitamin C da E, duka biyun sun yi yawa.
- Yawancin samar da bitamin D3 yana faruwa a kasar Sin don dabbobin noma kamar alade, shanu, da kaji da ake kiwon su a cikin gida. Tsire-tsire kaɗan ne kawai, waɗanda ke cikin Indiya da Turai, yi da kuma tace shi zuwa matakin magunguna. Babban gasa USD$2.5k a kowace kilogiram farashin yana nuna hadaddun tsari na ƙirƙirar 7-dehydrocholesterol daga kitsen ulu, karya ɗaya daga cikin zoben carbon ɗin sa tare da hasken UV-B daga kilowatt mai yawa, musamman doped, fitilu tururin mercury mai sanyaya ruwa, da kuma tace samfurin daga maganin benzene. Waɗannan masana'antu - babu ɗaya mallakar manyan kamfanonin harhada magunguna - suna da ƙarancin ribar riba don saka hannun jari don haɓakawa, musamman tunda farashin samfuransu na kowane babba ya kai kusan kashi ɗaya a wata.
- Kamun tsari ta masana'antar harhada magunguna ta fi son haɓakawa, amincewa, da kuma tallata magunguna, alluran rigakafi, da ƙwayoyin rigakafi na monoclonal akan tallafin abinci mai gina jiki da yawancin mutane ke buƙata don kula da lafiya mai kyau.
- Faɗin, masana'antar binciken likitanci na duniya da nazarin halittu galibi suna yin watsi da bitamin D, saboda galibi ana ba da kuɗi zuwa ga ƙarin ayyuka masu ban mamaki.
- Babu labarin jarida da aka bita da takwarorinsu da ke ba da bayanin gabatarwar 25-hydroxyvitamin D intracrine da siginar paracrine. A cikin rashi, yawancin masu bincike da likitoci sun ɗauka samfurin hormonal na calcium-phosphate-kashi metabolism kuma ya shafi "bitamin D" - 1,25-dihydroxyvitamin D a kaikaice - ko ta yaya "daidaita" tsarin rigakafi. Wannan yana haifar da yawancin sababbin shiga cikin filin da ke dawwama matsalar ta hanyar rubuta ƙarin labaran da ba su da kyau kuma masu yuwuwar yaudara.
- Duk da yake goyon baya mai ƙarfi ya wanzu tsakanin manyan masu bincike tun daga ƙarshen 2000s don kusan 50 ng/mL yana zagayawa 25-hydroxyvitamin D, ba a buga shawarar yarjejeniya don ƙarin adadin bitamin D3 ba, a matsayin ƙimar nauyin jiki, tare da mafi girma ga waɗanda ke fama da kiba, wanda zai dogara da wannan ga mutanen kowane shekaru daban-daban ba tare da kula da lafiyar jiki ba.
Muddin yawancin matakan 25-hydroxyvitamin D na mutane sun kasance a cikin ƙananan matakan da suke da shi a halin yanzu, babu wani ƙoƙari tare da alluran rigakafi, ƙwayoyin rigakafi na monoclonal, magungunan rigakafi, kulle-kulle, ko abin rufe fuska da zai murkushe SARS-CoV-2 ko kare duk waɗanda suka kamu da wannan ko makamancinsu daga cutarwa ko mutuwa. Sauran abubuwan gina jiki da magunguna masu araha suna da rawar da zasu taka, amma babu wanda zai iya ramawa ga raunana, sau da yawa gurguwa, da ɓarnawar martanin rigakafi a cikin yawan jama'a wanda ya haifar kai tsaye ta hanyar rashin isasshen 25-hydroxyvitamin D.
Maganin COVID-19, sepsis, da mura yana da yawan jama'a, tallafin gwamnati amma ba a tilasta shi ba, ƙarin bitamin D3 don cimma matakan lafiya na 25-hydroxyvitamin D. Babu wata mafita. Duk sauran ƙoƙarce-ƙoƙarce idan babu wannan cikon zai kasance kawai tauye ne a gefe.
Duk da yake dole ne a tattauna da kuma magance batutuwa irin su cin hanci da rashawa, sa ido, kai wa gwamnati hari, rashin tasirin allurar rigakafi da rauni, da sauran abubuwan da za a iya jayayya da su game da cutar da cutar, waɗannan sun shagaltu da wayar da kan jama'a da haɓaka fahimtar tsarin rigakafi na buƙatar 50 ng/mL yana yawo 25-hydroxyvitamin D.
Rashin isassun 25-hydroxyvitamin D ya kasance matsala ga raguwar ɗan adam mai girma tun lokacin da mutanen zamani suka yi nisa daga equator kusan shekaru 40,000 da suka wuce. Hanyoyi na ilimin halitta da masana'antu don haɗa bitamin D3 duk sun ƙunshi kusan 297 nm hasken UV-B, wanda kuma yana karya alaƙa a cikin DNA kuma yana haɓaka haɗarin kansar fata. Pigmentation don rage wannan lalacewa yana haifar da raguwar samar da bitamin D3, musamman a lokacin lokutan ƙarancin UV-B.
Gidaje, ababen hawa, tufafi, da kuma hasken rana duk sun rage samar da bitamin D3 na fata a yawancin ƙasashe. Magance matsalar COVID-19 ya dogara da warware matsalar 25-hydroxyvitamin D, wanda wani bangare ne na rashin jin daɗi na dogon lokaci tsakanin yawancin waɗanda ke da alhakin wannan yanayin na ingantaccen abinci mai gina jiki - likitoci da masu ilimin rigakafi - don ɗaukar sha'awar bayanin da ke nuna cewa sun yi kuskure shekaru da yawa game da wajibcin samun ingantaccen ƙarin bitamin D3.
Babban shamaki na farko don magance wannan matsala shine tunanin rukuni - dabi'ar dabi'ar da muke da ita don yin la'akari da bayanin da ke da alama ya saba wa ra'ayin ijma'i na waɗanda muka fi amincewa da su ba su cancanci kulawar mu ba.
Babban ƙalubalen sake cika 25-hydroxyvitamin D na kowa na iya zama cewa sa baki ya ƙunshi tsarin aiki mai sauƙin fahimta na ingantaccen kayan abinci mai gina jiki wanda yawancin mutane sun saba da shi. Wannan gaskiya ne musamman a lokacin rikici, tare da ƙwararrun sana'o'i suna aiki tuƙuru tare da biliyoyin daloli don samar da kudade don samar da mafita waɗanda aka yi imanin cewa ya zama takamaiman takamaiman cututtuka, irin na mashi, da kuma ƙunƙun da aka yi niyya.
Farfesa Wimalawansa, wanda ya yi bincike cikin kuzari tare da haɓaka wayar da kan bitamin D tun tsakiyar shekarun 1990, ya gaya wa ɗaya daga cikinmu (RW) cewa mafi yawan martanin da likitocin ke yi game da ƙoƙarinsa shine: “Ta yaya zai zama gaskiya? Yana da sauƙi.”
Magance rashi mai yaɗuwa a cikin matakan 25-hydroxyvitamin D yana da mahimmanci don yaƙar ba kawai COVID-19 ba har ma da sauran cututtuka masu alaƙa da aikin tsarin rigakafi. Yana da mahimmanci cewa likitoci, likitocin rigakafi, da jami'an kiwon lafiyar jama'a sun fahimci mahimmancin ingantaccen karin bitamin D3 kuma suyi aiki don aiwatar da ingantattun dabaru don tabbatar da isassun matakan 25-hydroxyvitamin D a cikin yawan jama'a.
Ta hanyar shawo kan tsarin tunanin rukuni na yanzu da kuma rungumar sauƙi na wannan mafita, za a iya samun gagarumin ci gaba a yaƙin COVID-19 da sauran cututtuka masu yaduwa. Tare da ƙoƙari na haɗe-haɗe don wayar da kan jama'a game da mahimmancin kiyaye matakan lafiya na 25-hydroxyvitamin D, akwai bege don ingantacciyar hanyar kula da lafiyar jama'a da rigakafin cututtuka.
Wannan labarin yana bayyana a Substacks na marubuta https://www.drgoddek.com da kuma https://nutritionmatters.substack.com, duka biyun suna ba da damar yin sharhi da ƙarin tattaunawa.
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Dokta Simon Goddek masanin kimiyyar halittu ne, marubuci, mai bincike, ɗan kasuwa, kuma ɗan jarida ɗan jarida mai sadaukar da kai don haɓaka lafiya da wadatar kai. Shi ne Shugaba na Sunfluencer.
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Robin Whittle mai tsara shirye-shiryen kwamfuta ne kuma masani na lantarki da ke zaune a Daylesford, Victoria, Australia. Tun daga Maris 2020 yana wayar da kan jama'a game da buƙatar ingantaccen ƙarin bitamin D3 don samar da tsarin rigakafi tare da 25-hydroxyvitamin D yana buƙatar yin aiki yadda ya kamata.
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