Doctors' Research Inc.

02/16/2023

Folic Acid is Hazardous to Your Health. What About Food Folate?

By Robert Thiel, Ph.D., Naturopath and Scientist

Folic acid gets a lot of press coverage. There are many reports that folic acid should be taken by pregnant women and may prevent birth defects. Folic acid has also been claimed to help prevent cardio- and cerebral-vascular diseases. Yet few reports have mentioned that folic acid is unnatural, folic acid is synthetic, and that the body cannot properly convert much folic acid into a usable folate form. Furthermore, concerns about folic acid feeding cancer are now a real concern in the 21st Century—too much folic acid may kill you.

“Folic acid is a synthetic folate form” [1] and was not developed until the 20th Century [2]. Folic acid is chemically known as pteroylglutamic acid (PGA) and is a crystalline substance (no food vitamins are naturally crystalline in structure) [2,3]. Folate, once also known as vitamin B9, exists in foods, yet crystalline folic acid does not [1-4]. Folates also differ from folic acid “in the extent of the reduction state of the pteroyl group, the nature of the substituents on the pteridine ring and the number of glutamyl residues attached to the pteroyl group” [1].

An Irish study found that the body has trouble converting more than 266 mcg of folic acid per day [2]. “(C)onsumption of more than 266 mcg of synthetic folic acid (PGA) results in absorption of unreduced PGA, which may interfere with folate metabolism for a period of years” [2]. A 2004 paper from the British Medical Journal confirmed what many natural health professional have known all along: since folic acid is unnatural and the body cannot fully convert large amounts of it into usable folate, this artificial substance can be absorbed and may have unknown negative consequences in the human body [4]. One of the biggest scientific concerns about folic acid is that even in amounts close to official daily recommendations, some of it is absorbed in unreduced form into the bloodstream with potentially dangerous results [2,4]. Also, “(i)n vitro studies do show that PGA derivatives act to inhibit certain enzymes, including those associated with nucleotide biosynthesis” [4]. In spite of this, the U.S. Food and Drug Administration has required that uncooked cereal grains and flour products be fortified with folic acid [1].

A JAMA study recently concluded that “studies have suggested that folate intake decreases risk of cardiovascular diseases. However…[f]olic acid supplementation has not been shown to reduce risk of cardiovascular diseases” [5]. This is because studies using folate (the natural form) show it works, yet folic acid (the synthetic form) does not. Food folate is clearly superior.

Since food folate is natural and is absorbed through a different pathway than folic acid [2], long-term consumption of folate does not result in an accumulation of a foreign substance in the body, but instead has many benefits.

Initially, food folate was given for people with a pregnancy-related anemia in the form of autolyzed yeast; later the synthetic form, folic acid, was developed [2]. Folic acid, as it exists in most supplements, is not found in foods, folates are [2]. USDA reports show that broccoli and alfalfa sprouts contain food folate [6,7] and they are considered to be the best food supplement source by some. Furthermore, “folates are ubiquitous in nature, being present in nearly all natural foods…50 to 95% of folate in food may be destroyed by protracted cooking or other processing” [2]. Yeast, dark green leafy vegetables, and oranges have the highest folate content [1,2].

Folate is an important nutrient for healthy blood; the absence of any of it can trigger various forms of anemia (especially pernicious anemia) [2,8]. Subclinical deficiencies of folate may impair cognitive function [9]. Folate deficiency is the most important determinant in high homocysteine levels [9], and supplemental folate is effective in reducing homocysteine [10,11]. (Homocysteine is highly implicated in vascular diseases such as cardiovascular and other vascular disorders.) “The major forms of folates found in food are methylTHF and formylTHF” [12].

While insufficient folate can result in fatigue, depression, confusion, anemia, reduced immune function, loss of intestinal villi, and an increase in infections [1,2,8], it is not totally clear what dangers long-term consumption of folic acid will cause [2,4]. Certain scientists believe that excessive consumption of folic acid may actually interfere with folate metabolism [2]—this could be expected to worsen conditions that would have otherwise benefited from real food folate. Furthermore, “(v)ery large amounts of folic acid in its pharmacological oxidized (PGA) form may be noxious to the nervous system…and have provoked seizures in patients otherwise under control on anticonvulsant therapy” [2].

Excessive Folic Acid is Becoming a Health Concern

A 2010 report states, “"The more we learn about folic acid, the more it's clear that giving it to everyone has very real risks," says folic acid researcher David Smith, PhD, a professor of pharmacology at the University of Oxford in England…The risk experts worry about most: colon cancer. Last year, health officials in Chile reported that hospitalization rates for colon cancer among men and women age 45 and older more than doubled in their country since fortification was introduced in 2000. In 2007, Joel Mason, MD, director of the Vitamins and Carcinogenesis Laboratory at the Tufts University School of Medicine, described a study of the United States and Canada suggesting that rates of colon cancer rose — following years of steady decline — in the late 1990s (around the time our food was being fortified)” [13].

The same report also states, “Other research links high doses to lung and prostate cancers. In one study conducted in Norway, which doesn't fortify foods, supplementation with 800 mcg of folic acid (plus B12 and B6) daily for more than 3 years raised the risk of developing lung cancer by 21 percent. Another, in which men took either folic acid or a placebo, showed those consuming 1,000 mcg of folic acid daily had more than twice the risk of prostate cancer. And a new worry recently came to light when scientists discovered the liver has limited ability to metabolize folic acid into folate — which means any excess continues circulating in the bloodstream. "Unlike folate, folic acid isn't found in nature, so we don't know the effect of the excess," says Smith. Indeed, many scientists have grown increasingly concerned about mounting research — including a study published last winter in the Journal of the American Medical Association — suggesting that all the extra folic acid might increase your odds of developing cancer” [13].

Even foods “fortified” with folic acid may cause serious neurological problems in patients deficient in vitamin B12 [12]. Furthermore, “no folic acid dose can be considered as truly safe in the presence of untreated cobalamin deficiency” [12].

Laura Bell correctly reported, “We all need the natural folate found in leafy greens, orange juice, and other foods, and diets high in these foods are perfectly healthy; many researchers, though, believe that folic acid may be both friend and foe. When cells in the body are healthy, folate helps shepherd along the normal replication of DNA. But when cells are malignant or in danger of becoming so — and as many as half of adults older than 60 could already have precancerous colon polyps, while most middle-aged men have precancerous cells in their prostates — animal studies suggest excess folate in the form of folic acid may act like gas on the fire… lowering your intake to 400 mcg won't hurt — and might help save your life” [13].

It is clear that since folic acid is unnatural, is synthetic, is chemically different, is structurally different, and is not absorbed in the same pathways as folate, long-term folic acid consumption may be hazardous to human health. Folate in foods is what is safe and is the preferred form of folate for human consumption. Excessive folic acid may make cancer worse. And unlike folic acid, humans have been safely consuming food folate for thousands of years.

I have been warning people against folic acid for many years [3,14]. Now it is becoming clearer and clearer that those warnings should have been heeded by more people. Everyone should be concerned about taking synthetic/isolated USP vitamins like those containing folic acid.

References
[1] Hendler SS, Rorvik D, eds. PDR for Nutritional Supplements. Medical Economics, Montvale (NJ), 2001
[2] Shils ME, Olson JA, Shike M. Modern Nutrition in Health and Disease, 9th ed. Williams & Wilkins, Balt., 1999
[3] Thiel R. Natural vitamins may be superior to synthetic ones. Med Hypo, 2000;55(6):461-469
[4] Lucock M. Is folic acid the ultimate functional food component for disease prevention? BMJ, 2004;328:211-214
[5] Bazzano LA, Reynolds K, Holder KN, He J. Effect of folic acid supplementation on risk of cardiovascular diseases: a meta-analysis of randomized controlled trials. JAMA. 2006;296(22):2720-2726
[6] Broccoli, raw. USDA National Nutrient Database for Standard Reference, Release 18 (2005)
[7] Alfalfa seeds, sprouted raw. USDA National Nutrient Database for Standard Reference, Release 16-1, 2004
[8] Whitney EN, Hamilton EMN. Understanding Nutrition, 4th ed. West Publishing, NY, 1987
[9] Gonzalez-Gross M, Marcos A, Pietrzik K. Nutrition and cognitive impairment in the elderly. Br J Nutr 2001;86:313-321
[10] Verhoef P. Homocysteine metabolism and risk of myocardial infarction: Relation with vitamin B6, B12, and Folate. Am J Epidemiol 1996;143(9):845-859
[11] Brattstrom L. Vitamins as homocysteine-lowering agents: A mini review. Presentation at The Experimental Biology 1995 AIN Colloquium, April 13, 1995, Atlanta Georgia
[12] Carmel R. Folic Acid. In Modern Nutrition in Health and Disease, 10th ed. Lippincott Williams & Wilkins, Baltimore, 2006:470-481
[13] Bell L. Is your breakfast giving you cancer? Research links too much folic acid to certain cancers. Prevention. March. 29, 2010. http://www.msnbc.msn.com/id/35874922/ns/health-diet_and_nutrition//
[14] Thiel R. Is Folic Acid Hazardous to Your Health? The Original Internist, 2004;11(2):39-40

Your customizable and curated collection of the best in trusted news plus coverage of sports, entertainment, money, weather, travel, health and lifestyle, combined with Outlook/Hotmail, Facebook, Twitter, Bing, Skype and more.

02/02/2023

An established and growing nutritional supplement company is looking for someone who wants to learn and work Monday through Friday.

Duties include taking orders over the telephone, in-person, and from the internet; learning about effective clinical nutrition; entering orders into the computer, pulling products for orders; checking orders; shipping orders; restocking; and answering the telephone.

Responsibilities also include assisting with inventory, the production of certain literature, helping keep the office clean, as well as mailings and other duties. Self-motivated person will find opportunities for advancement.

Computer experience required and interest in graphics a plus. If you are good on the telephone, want to be able to use your brain and develop your talents, want to be able to help people attain better health.

Please apply in person or send a resume.

01/04/2023

An established nutritional supplement company is looking for someone to work 30 hours per week--6 hours per day, Monday through Friday. Duties include taking orders over the telephone, in-person, and from the internet; learning about effective clinical nutrition; entering orders into the computer, pulling products for orders; checking orders; shipping orders; restocking; and answering the telephone.

Responsibilities also include assisting with inventory, the production of certain literature, helping keep the office clean, as well as mailings and other duties. Computer experience required and interest in graphics a plus.

Apply in person or send resume.

08/03/2022

Forbes author against vitamin D in a one-sided article. But what about it supporting the immune system?

Forbes ran the following article:

"Stop Taking Vitamin D Already!

"Way back in 2014, I wrote a column about vitamin D supplements, explaining that they don’t work. I added vitamin D to my previous list, the Top 5 Vitamins That You Should Not Take, to create a list of 6 useless vitamin supplements.

"Together, these two columns had well over 1,000,000 views. And yet it seems the message didn’t get through. Well, now a massive new study published in the New England Journal of Medicine reports that I was right all along: taking vitamin D pills isn’t good for you. Let’s review the findings, shall we? …

"In 2014, I wrote about two studies, both published in The Lancet. The first paper, a massive review of 462 other studies, concluded that taking supplemental vitamin D did not help to prevent heart disease, weight gain, mood disorders, multiple sclerosis, and metabolic disorders, all of which had been linked to lower vitamin D. …

"In other words, vitamin D supplements are a complete waste of money. https://www.forbes.com/sites/stevensalzberg/2022/08/01/stop-taking-vitamin-d-already/?sh=74f4ec656617 "

Just because the above author got a million views of something, does not mean he is right.

As far as the study he cited in the New England Journal of Medicine, notice what it actually states, as opposed to the Forbes author’s take on it:

"Vitamin D supplements are widely recommended for bone health in the general population, but data on whether they prevent fractures have been inconsistent. …

"Participants were not recruited on the basis of vitamin D deficiency, low bone mass, or osteoporosis. …

"Supplemental vitamin D3, as compared with placebo, did not have a significant effect on total fractures (which occurred in 769 of 12,927 participants in the vitamin D group and in 782 of 12,944 participants in the placebo group; hazard ratio, 0.98; 95% confidence interval [CI], 0.89 to 1.08; P=0.70), nonvertebral fractures (hazard ratio, 0.97; 95% CI, 0.87 to 1.07; P=0.50), or hip fractures (hazard ratio, 1.01; 95% CI, 0.70 to 1.47; P=0.96). https://www.nejm.org/doi/full/10.1056/NEJMoa2202106 "

Basically, the study says that it ignored whether or not anyone needed vitamin D and that people were given what had to be a USP synthesized vitamin D isolate compared to a placebo (it did NOT use food vitamin D), the reduction of fractures was not much higher for the vitamin D group. The study should have been better designed in order to improve the value of any conclusions.

The fact is that people who get enough sunlight, which converts cholesterol into vitamin D, probably get no benefit from USP vitamin D (which is not the same as food vitamin D).

Now, the Forbes author also cited two studies published in The Lancet that did not find vitamin D helpful for several conditions.

Yet, that does not mean that vitamin D is not helpful.

Vitamin D is an essential nutrient. It is involved in bone formation, immune system support, and many other things.

Now are there any ‘modern’ reasons to take food or non-food vitamin D supplements?

Yes.

Notice the following from last week:

"Study: Vitamin D deficiency raises risk of death from COVID by 50%
Israeli, Russian researchers affirm benefits of supplements
July 25, 2022 at 5:33 pm"

"Patients with a Vitamin D deficiency have as much as a 50% higher probability of death from COVID-19, according to a study by researchers in Israel and Russia.

"The boost to the immune system from Vitamin D can be found in supplements as well as foods such as egg yolks, fatty salmon, sardines, herring, canned tuna, beef liver, fortified milk, cereals, yogurt and orange juice. …

"The study, published in the Israel Medical Association Journal, analyzed published clinical trials showing patients with low vitamin D levels are more prone to infection from COVID-19, and severe illness and death from the disease, the Jerusalem Post reported. …

"The researchers published preliminary findings in June 2021 that showed 26% of coronavirus patients died if they were vitamin D deficient soon before hospitalization. That compared to 3% who had normal levels of vitamin D. https://www.wnd.com/2022/07/study-vitamin-d-deficiency-raises-risk-death-covid-50/ "

This is something that public health officials, Big Tech, and the media should have been telling people about for a long time.

Why?

Because the positive benefits of vitamin D related to COVID has been known for at least 2 years.

As far as food vs. non-food vitamin D, I wrote about that decades ago (see Thiel R, Natural Vitamins May Be Superior to Synthetic Ones. Medical Hypotheses, 2000; 55(6):461-469). Here is something from that paper:

"Vitamin D “Vitamin D is inherently biologically inactive…1,25-dihydroxyvitamin D” is “the biologically active form of vitamin D”. Vitamin D is not an isolate, it “is a combination of substances” [25]; USP vitamin D forms are normally isolates. Foods contain complexed, not isolated, vitamin D. “The first vitamin isolated was a photoproduct from the irradiation of the fungal sterol ergosterol. This vitamin was known as D1…vitamin D obtained from irradiation of ergosterol had little antirachitic activity” [36]–in other words, the first synthetic vitamin D did not act the same as natural vitamin D.

“At the time of its identification, it was assumed that the vitamin D made in the skin during exposure to sunlight was vitamin D2”, but it was later learned that human skin produced something called vitamin D3 [36]. It was first believed that provitamin D3 was directly converted to vitamin D3, but that was incorrect. The skin actually contains a substance commonly called provitamin D3; after exposure to sunlight previtamin D3 is produced and it begins to isomerize into vitamin D2 in a process which is temperature dependent, with isomerized vitamin D3 being jettisoned from the plasma membrane into extracellular space. Vitamin D2 was used to fortify milk in the US and Canada for about forty years until it was learned that D3 was the substance which had better antirachitic activity, so D3 has been used for the past twenty years [36]. But vitamin D has many benefits which are unrelated to rickets: B and T lymphocytes have been shown to have receptors for vitamin D similar to those found in the intestines, vitamin D seems to affect phagocytes, and may even have some antiproliferation effect for tumor cells [36]. It has not been proven that any single USP isolated form of vitamin D has all the benefits as natural occurring forms of vitamin D. (Also, since the vitamin D was not particularly stable, manufacturers used to put in 1.5 to 2 times as much of synthetic vitamin D as they claimed. This led to neonatal problems and hypercalcemia. [36].) New vitamin D analogues are still being developed: some which may have greater affects on calcium utilization [71], some even may be helpful for breast cancer [72]–but these really may be pharmacological applications since these analogues are not food. In view of the historical errors in the supplementation with forms of vitamin D, it is reasonable to conclude that additional benefits of natural source vitamin D may be discovered, further distinguishing it from synthetic isolates. http://www.healthresearch.com/vitamins.htm "

As far as vitamin D and COVID goes, nearly two years ago, I wrote and posted the following:

"First, yes, vitamin D can be quite helpful. Notice the following:

"Vitamin D deficiency increases a person’s risk for catching COVID-19 by 77% compared to those with sufficient levels of the nutrient, a study published Thursday by JAMA Network Open found. https://www.upi.com/Health_News/2020/09/03/Vitamin-D-deficiency-raises-COVID-19-infection-risk-by-77-study-finds/7001599139929/

"The human body, with the aid of sunlight, converts cholesterol into vitamin D. And vitamin D can help the immune system. It also looks to reduce the severity of COVID-19 symptoms in some (see COVID-19: Ghana pushing exercise, Germany reports about Vitamin D). Isolated vitamin D, such as what Dr. Fauci presumably takes, is not as natural as food source vitamin D, but normally does assist in elevating vitamin D levels. …

"While government actions have been focused on masks, social distancing, and quarantining those not known to have COVID, a personally helpful approach would be encouraging people to:

"Avoid biblically unclean meats,
Eat more fruits and vegetables high in vitamin C,
Fast regularly for those who can,
Consume foods high in zinc like pumpkin seeds or 100% food nutrient supplements which provide Zinc,
Get proper sunlight exposure for vitamin D,
Exercise regularly, and
Lose weight for those who are overweight.

"All the above help support one’s innate immune system, which helps the body fight many types of pathogens–not just one. (Thiel B. COVID interview: Dr. Fauci takes isolated vitamin D and synthetic vitamin C. COGwriter, September 13, 2020)"

I also posted that at Facebook, along with other material and 31 references. Facebook censored and removed it. Then last year, YouTube censored me for telling the truth and providing accurate and potentially lifesaving information related to nutrition and COVID. Here is a link to the YouTube censored video from a different platform: COVID-19: Eat what is good! https://www.bitchute.com/video/g5OUFHZBotgc/

Notice something related to variants and vaccines:

"August 2, 2022

"An Indian big pharma director of Bharat Biotech (BB) International Limited says that a new COVID variant that evades “vaccines” is coming no later than November of this year. But we’ve already seen literally everything evade the four COVID shots being injected in whoever is naive enough to take them.

"Dr. Krishna Ella, who is the director of Bharat Biotech in India has advocated nasal vaccines as the next step for the protection of the upper respiratory system as injectable vaccines can protect “only the lower part”. Surely they will work as well as the injections …

"Dr. Ella claims that a new variant capable of escaping “vaccine protection” (which is hilarious considering the fully vaccinated and boosted are by and large the ones getting sick and dying of everything right now) will surface by November. This vaccine escapable variant will be stopped by…you guessed it…a vaccine!

"It’s becoming laughable what the ruling classes insist we believe. https://www.sgtreport.com/2022/08/big-pharma-director-predicts-a-new-covid-variant-that-will-evade-vaccines-by-november/ "

There are things other than vaccines that people can and should do.

Notice something I wrote and posted elsewhere back in April of 2020:

"Governments around the world, including the USA, have been loath to tell the public that they can do more than hide and wash to help themselves with COVID-19–that is a disgrace that should shame most public health officials (there are a few that have had the integrity to tell some scientific facts about nutrients that can help, like zinc, vitamin C, vitamin D, etc.). …

"Now, getting back to the CDC’s list to protect oneself, it is astounding that the CDC still refuses to tell people to watch their diets, to try to follow the official US government dietary guidelines to consume two or more servings of fruit and three or more servings of vegetables each day, and will not tell people to consider real food nutrient supplements if they may be at risk of being deficient in zinc (like many diabetics are) or other nutrients. (Thiel B. ‘CDC Triples Number of Possible CCP Virus Symptoms;’ Don’t swallow Lysol to fight COVID-19! What about Zinc? Bloodclots? COGwriter, April 24, 2020)"

Here is something I posted a couple of years ago on this page related to vitamin D:

"‘Vitamin D Determines Severity in COVID-19: Researchers Urge Government to Change Advice"

"Saw the above headline today. I have been urging the government to change its advice related to nutrition and the novel coronavirus for some time.

"Facebook posts here have covered vitamin C and zinc. Plus, because of the involvement in blood clots and COVID-19 deaths, nattokinase is something that many who get COVID-19 should consider taking.

"Anyway, the vitamin D article (https://scitechdaily.com/vitamin-d-determines-severity-in-…/) had the following:

“Researchers from Trinity College Dublin are calling on the government in Ireland to change recommendations for vitamin D supplements.

“A new publication from Dr. Eamon Laird and Professor Rose Anne Kenny, School of Medicine, and the Irish Longitudinal Study on Ageing (TILDA), in collaboration with Professor Jon Rhodes at University of Liverpool, highlights the association between vitamin D levels and mortality from COVID-19.

“The authors of the article, just published in the Irish Medical Journal, analyzed all European adult population studies, completed since 1999, which measured vitamin D and compared vitamin D and death rates from COVID-19.

“The correlation between low vitamin D levels and death from COVID-19 is statistically significant.

“The authors propose that, whereas optimizing vitamin D levels will certainly benefit bone and muscle health, the data suggests that it is also likely to reduce serious COVID-19 complications. This may be because vitamin D is important in regulation and suppression of the inflammatory cytokine response, which causes the severe consequences of COVID-19 and ‘acute respiratory distress syndrome’ associated with ventilation and death.”

"Instead of mainly using fear and fear tactics, governments should encourage people to boost their innate immunity. This can be done by encouraging people to increase their consumption of fruits and vegetables high in vitamin C, foods high in zinc, and getting, when appropriate, sunlight exposure to increase vitamin D levels.

In my case, in addition to all of the preceding, I also take 100% food nutrient supplements high in vitamin C, Zinc, Vitamin D, selenium, and other nutrients. (Thiel B. ‘Ghanaians Look to Herbal Remedies for COVID-19’ ‘Enti wobԑdi Onyankopↄn Nna Kronkron anaa Ahonhommↄnee Ahomegyeԑ Nna?’ COGwriter, June 2, 2020)"

In those posts vitamin D was mentioned.

The German press ran an article about Vitamin D and COVID on July 8, 2020:

"It is undisputed that vitamin D plays a role everywhere in the body and performs important functions. A severe vitamin D deficiency, which can occur at a level of 12 nanograms per milliliter of blood or less, leads to severe and painful bone deformations known as rickets in infants and young children and osteomalacia in adults. …

"Vitamin D levels in the body rise and fall according to sun exposure. If sufficient UV rays reach the skin, the body is able to produce the vitamin itself. However, the human body only derives an estimated 10 to 20 percent of its daily requirement from food. …

"A research study carried out at the University of Hohenheim has now established a link between vitamin D deficiency, certain previous diseases, and severe cases of COVID-19.

"According to the study, “there is a lot of evidence that several non-communicable diseases (high blood pressure, diabetes, cardiovascular diseases, metabolic syndrome) are associated with low vitamin D plasma levels. These comorbidities, together with the often accompanying vitamin D deficiency, increase the risk of severe COVID-19 events.”

“This statement is completely correct,” said Martin Fassnacht, head of endocrinology at the University Hospital of Würzburg. However, he qualifies that it is a pure association, “i.e. a mere observation that these events occur together. …

"Many studies on the vitamin are association or observational studies. “By definition, these studies cannot prove the causal relationship, but only point to mere correlations,” said Fassnacht. The physician tries to illustrate this with an example:

“Imagine two groups of 80-year-olds. One group is spry, active and does sports. If you compare them with another group living in nursing homes, the difference in vitamin D levels will be dramatic. Life expectancy would also be extremely different.” …

“If a corona virus infection is suspected, it is therefore absolutely necessary to check the vitamin D status and quickly correct any possible deficit,” said the recommendation of the paper published by the University of Hohenheim. https://www.dw.com/en/vitamin-d-against-covid-19-more-help-or-hype/a-54089415 "

So, we see that exercise and having adequate vitamin D levels are associated with better health. Although precisely how each works is not totally understood by the medical profession, there are observational benefits.

Notice another study that the Forbes author seems to have overlooked from last year:

"Abstract

"Background: COVID-19 is a major health problem because of acute respiratory distress syndrome, saturation of intensive care units (ICU) and mortality.

"Methods: Our study aims to elucidate the effect of calcifediol [25(OH)D3] treatment on ICU admission and mortality, in patients admitted to COVID-19 wards of Hospital del Mar, Barcelona, Spain. A total of 930 participants were included. Participants (n=551) were randomly assigned to calcifediol treatment (532 ug on day one and 266 ug on day 3, 7, 15, and 30) at the time of hospital admission or as controls (n=379).

"Findings: ICU assistance was required by 110 (11.8%) participants. Out of 551 patients treated with calcifediol at admission, 30 (5.4%) required ICU, compared to 80 out of 379 controls (21.1%; p

Dear Preprints with the Lancet Readers, We removed this preprint due to concerns about the description of the research in this paper