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Prophylaxis is simple. There is a toxicity risk, and there are effects relating to bone density, (oral Vitamin D does not always do what people want who suffer osteoporosis, the bodies tendency to homeostasis can be an issue I believe)

But, in the current context some thousands of IUD should be something easy to do.

Like the thyroid risk and iodine for kids: you dont want to have to but you know you can.

Second upside: D is now indicated in depression. And its always be suspected in MS (higher prevelance in women, and in northern hemisphere dark winter economies)

> Like the thyroid risk and iodine for kids: you dont want to have to but you know you can.

I'm not familiar with these. Can you explain?

I was actually thinking Chernobyl, and selective uptake of radioactive iodine. Deposited on grass, eaten by cows, milk drunk by children. If you give people iodine pills, the body rejects surplus dietary iodine (homeostasis?) and so the risk is reduced.
I seem to remember it is associated with type 1 diabetes as well.
Lots of studies link inflammation and diabetes generally. To whatever degree vitamin D deficiency plays a role in inflammation, that would generally link it to diabetes (all forms of it, as best I understand it).
To be fair, inflammation is literally (or perhaps figuratively) correlated with almost every bad outcome.
And given that inflammation is part of the body's immune response (and response to trauma or other damage) it makes sense that it would be correlated with all sorts of bad things.

Showing that inflammation is causative tends to be the hard part, since it's often a consequence of the underlying damage.

Right about depression. Bright lights help me a lot in every autumn.
The most effective way to get Vitamin D in your system is a Vitamin D lamp. Taking D3 is a limited substitute. Switching to a lamp had an immense and immediate effect on my insomnia.
Doesn’t this depend on age and other factors?

I thought that as you age your body slowly loses the ability to synthesize it, hence the need for supplements.

Please consult a doctor before taking lamp form. You could easily reach toxic levels.
Should they also consult a doctor before going outside?

There are a lot of risks to being in UVB light too much, but excess endogenous Vitamin D production isn't one of them.

There's a risk to get a skin cancer, so its very serious.

Better to eat oranges and go outside as much you can: balcony/roof/near private home etc.

So is spending time in the sun without sunscreen.
Make sure to double-check on Twitter before following medical advice from a Hacker News thread
Yes, I'd just like to add that moms on Facebook may seem invaluable but they are often a misguided version of the information you can read on the subreddit.

Don't be gullible, check your facts!

What about just getting some sun?

Not effective?

A lamp is a minute or two and you're done. Sun requires 15+ mins and if you spend too much time you get sunburn. Using sunscreen works against you.
Getting enough sun at some places or latitudes is almost impossible during the summer unless you work outside during the breaf period of time there actually is light outside. It's also cold.
You need the sun at > 40 degrees angle if IRC.

In the north this happens only during brief periods of time. It’s also usually during office hours...

Use this calculator to figure out how much sun time you need given your latitude/longitude, cloud cover, elevation, etc. https://fastrt.nilu.no/VitD.html
And keep in mind that using your skin to generate Vitamin D from the sun is a complex process that takes time. Exposure during the day typically results in Vitamin D being made available in the evening, and thorough washing can reduce yield.
One thing I don't understand about these lamps, does the narrowband UVB radiation from these lamps create skin damage like normal sun radiation?

To rephrase would overdosing something like this actually create skin burning/tanning similar to tanning beds?

No tanning or burning. You are also done in a min or two so no time for one either.
Ok thanks, one more question, for the curious.. whenever I've seen people use these lamps, they are pointing them to their face (maybe because of winter mood/blues etc.).

Would these lamps be more effective if they pointed the lamps towards exposed arms/legs (greater surface area)?

I point it at my torso, wear glasses (they came with the device) and have closed eyes for the duration. I have no idea why anyone would point it at their face.
Can you explain how that works? As I understand it, UVB is responsible for both vitamin D synthesis and skin damage. So how is it then possible that 1 minute of sun-lamp radiation is equivalent to 15 minutes of natural/sun radiation in terms of vitamin D, but not in terms of skin damage?
I was talking about tanning and burning. That is UVA. Vitamin D lamps limit the light to a single wavelength at least mine does. As for damage, the wavelengths that are suppose to cause the most damage are different to the wavelength that it uses for vitamin d.
Which lamp/model do you use?
Androv medical Dermfix 3000 UV-B. It seems it is discontinued now, but their other model has the same light wavelength so it produces the same effect.
Thank you. The only other model I found is out of stock from the German store as well and can’t find it elsewhere.

Amazon results for vitamin D lights seem dubious to me... the only thing I found was some reptile uvb lamps but not sure I want to risk those on myself :-/

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So, a couple of thoughts:

First, correlation does not prove causation. This kind of study is fairly common for medical stuff and it's not some double-blind study, so it's rather hard to draw firm conclusions.

Second, I have no doubt Vitamin D plays an important role in immune function. It is one of the vitamins people with cystic fibrosis are typically deficient in and this is a population very prone to respiratory infections, among other things.

Pretty thin. Even ignoring the accuracy of the source data, there are plenty of outliers on that graph. Before I'd assume vitamin D has any effect at all on COVID-19 death rate, I'd compare Sweden and Scotland.
Just listened to a podcast on this [1]

a) 95% of severe covid cases in Indonesia had vitamin D deficiency (n=780)

b) Darker skin in high latitudes is strongly correlated with vitamin D deficiency

c) In Sweden, Somali immigrants make up 40% of the covid hospitalizations despite being .8% of the population.

d) Vitamin D is also a hormone that regulates up to 5% of all gene expression while your immune system cells have vitamin D receptors

e) 70% of Americans have insufficient (a step above deficient) Vitamin D levels

[1] https://www.youtube.com/watch?v=45rlZGRz6Qo&feature=youtu.be,

[Also] https://www.youtube.com/watch?v=4_ZJ8YDOX6g

While that may be true, I'd really like a better source than a channel which otherwise deals with "supplements that lengthen telomeres" or the age-old sauna-detox myth.
Yeah, YouTube is an anti-source for health information; far too many people selling something.
If you actually watch the video, they are not uncritical regarding the idea of lengthening telomeres due to a hypothetical cancer risk.

Then they point to two studies that show that Omega 3 and Vitamin D lenghtened or maintained telomere length against control groups.

The benefits of sauna are supported in a similar fashion.

You can argue that the studies are of poor quality, but that is true for most studies regarding medicine and especially nutrition. You gotta take a chance either way.

There are at least 3 randomized studies on D and its affects on respiratory diseases.
I was surprised to learn a few years ago that saunas might actually have significant health benefits.

See the references below from The Journal of the American Medical Association (JAMA), The New England Journal of Medicine (NEJM), and Dr. Patrick who has interviewed the original researcher.

[1] https://media.jamanetwork.com/news-item/sauna-use-associated...

[2] https://www.jwatch.org/fw109897/2015/02/24/sauna-use-linked-...

[3] https://www.foundmyfitness.com/episodes/sauna-heart-presenta...

I explicitly said "sauna-detox myth", i.e., the myth that you can "detoxify" your body through sweating.
I've seen at least 6 or 7 research studies coming to the same conclusion that vitamin D deficiency leads to more severe outcome. It's not just from a random channel.
Here's the paper mentioned in (a) above that's the source of the claim: [1] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3585561

Here is another paper with similarly stark data: [2] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3571484

Table 1 in each of those papers show Vitamin D status vs Outcomes. The correlation between Vitamin D status, where Normal is >30 ng/ml (or 75 nmol/L), and death rates is stark.

From [1] (which had n=780 cases) here is the punchline: "98.9% of Vitamin D deficient cases died while only 1.1% of them were active cases. 87.8% of Vitamin D insufficient cases died while only 12.2% of them were active cases. Only 4.1% of cases with normal Vitamin D levels died while 95.9% of them were active cases."

From [2] (which had n=212 cases) here is the punchline: "Of the 212 (100.0%) cases of Covid-2019, 49 (23.1%) were identified mild, 59 (27.8%) were ordinary, 56 (26.4%) were severe, and 48 (22.6%) were critical (Table 1). Mean serum 25(OH)D level was 23.8 ng/ml. Serum 25(OH)D level of cases with mild outcome was 31.2 ng/ml, 27.4 ng/ml for ordinary, 21.2 ng/ml for severe, and 17.1 ng/ml for critical."

Note: the classification for outcomes was "(1) mild – mild clinical features without pneumonia diagnosis, (2) ordinary – confirmed pneumonia in chest computer tomography with fever and other respiratory symptoms, (3) severe – hypoxia (at most 93% oxygen saturation) and respiratory distress or abnormal blood gas analysis results (PaCO2 >50 mm Hg or PaO2 < 0 mm Hg), and (4) critical – respiratory failure requiring intensive case monitoring."

I want to see a dozen more studies like [1] and [2] to see if this holds up to replication.

The show notes for the parent video are quite comprehensive with links to references. The summary above leaves out the detailed discussion of the interplay between Vitamin D, the renin-angiotensin-system, the ACE2 receptor, and SARS-CoV-2: [3] https://www.foundmyfitness.com/episodes/vitamin-d-covid-19

Thanks for the links!

Interestingly, these papers together are much stronger evidence than either apart. This is because they use different methods. The OP is a population level study, while the second link you shared is a retrospective individual level study.

While I have some concerns with the stats in both papers (I'm always suspicious of p-values close to the magic number of 0.05), this does seem like interesting research, and potentially very helpful to dealing with Covid-19.

The irony of course, is that I suspect many of the Northern latitude people with high levels of Vit-D may be getting it through tourism to Southern Europe, which is very unlikely to happen this year.

A brief vacation to southern Europe won't give a Scandanavian enough stored Vitamin D to last the rest of the year. Supplement use is common, and they tend to eat a lot of Vitamin D rich foods.
Furthermore, vitamin D is added to some product types. At least in Finland there is a requirement for all fat free milk to contain additional vitamin D.
If you live in a country with little daylight for part of the year your going to consider supplements of Vitamin d.

Also pickled herring is a delicacy in the many countries which have fared well in Europe in the fight against covid 19.

Also oily fish like salmon and mackerel are good for vitamin D.

Yet for many Brits it's a fish we rarely consider but is one of the biggest Concerns about the UK denying access to EU nation's to certain waters I believe with Brexit.

https://en.m.wikipedia.org/wiki/Herring_as_food

https://en.m.wikipedia.org/wiki/Pickled_herring

> c) In Sweden, Somali immigrants make up 40% of the covid hospitalizations

This number seems high, but may be accurate for northen Stockholm (hard to check as only confirmed infections and deaths are tracked in available statistics). Certainly not for the whole of Sweden. Anyway, while the vitamin D deficency may be a part of it, many Somali immigrants live in apartments with a lot of family, often multiple generations.

So, social class is the main factor.

Also, one medical doctor of Somali decent in Stockholm said that it was hard to reach the Somalis with information on good prevention, as health info was at first only available in Swedish and the official minority languages plus English and Arabic. Information in Somali is available now.

Plus a highly contagious virus transmitting quickly through a close knit immigrant community should be unsurprising to anyone with any idea about epidemiology.

This article (about the Assyrian-Syriac immigrants, who aren't as dark skinned as Somali, but are also hard hit) explains how they come into contact with a lot more sick people and thus transmit it:

Earlier this month, the country’s public health agency reported that people in Sweden with foreign backgrounds are disproportionately represented among those who need hospitalization.

That squares with the experience of Terez Kino, a resident of the city of Södertälje and member of its large population of Assyrian-Syriacs, an ethnic minority scattered across Turkey, Syria, and Iraq. She used to have five carers, all of immigrant background as well, who would come to her home and tend to her needs. Four are now sick at home with virus symptoms. Her elderly sister has also contracted the virus from her carers, and her brother recently died of the virus. Her son is now taking care of her.

https://www.csmonitor.com/World/Europe/2020/0427/With-scienc...

Where did get that figure of 40% from?

Lack of information in Swedish had very little to do with why Somalis contracted the virus. Tegnell even pointed this out.

I don't know but on the 24'th of march 15 people had died of COVID19 in Stockholm. 6 of those where Somali. This is from a SVT article and one of the first where this is reported. 6/15=0.4 so maybe this is where the 40% figure comes from.
The Somalis in the Järva area in Stockholm contracted the virus in early march. Thats why we saw those deaths at the end of march.
> a) 95% of severe covid cases in Indonesia had vitamin D deficiency (n=780)

Indonesia is a developing nation, with most people still laboring as rice farmers and making $1 - $2 per day.

I'm sure they're deficient with any vitamin not found in rice, which they eat 3 times per day. (Rice is packed with calories, not vitamins.)

Also, due to corona, there is starvation in the cities. In the West, we use automation to ship groceries, but in Indonesia they unload trucks using manual labor. So the lockdown means they can't unload food trucks, or it gets delayed.

Additionally, many people have no income, or 50% of their former low office salary, and Indonesia is not a welfare state, so people cannot afford food at this time. Very tragic example of lower-income group receiving the worst treatment during this pandemic, basically famine.

It's totally unrealistic to expect them to hang on until 2022.

> I'm sure they're deficient with any vitamin not found in rice

Vitamin D generally comes from sun exposure, and people laboring outdoors are extremely unlikely to be suffering of this particular deficiency.

It's more likely to be older people who spend all their time indoors.

It'd be interesting to see this controlled for age of deaths.

Many people in hot countries tend to cover up however hot it is.
They do, but it's still extremely unlikely that outdoor labourers are getting insufficient vitamin D.

The problem occurs when people in the same ethnic groups (with the same dark skin) start working indoors and actively avoiding sunlight (often because light-colored skin is seen as high class or aesthetically pleasing).

This is what I was told by two different people in Jakarta last week.

Not sure what the downvotes are about in this case.

I wonder if kids have higher vitamin D than adults?
They probably go outside more often, at the very least.
(comment deleted)
Generally yes, both because they get out more and because they synthesize/absorb it more efficiently.
Aside from the other comments, kids tend to drink milk, which is vitamin D fortified (at least in the US).
I don't know how you can take this data seriously. It's comparing population Vitamin D levels vs. population COVID mortality for n = 12 countries.

Are studies like this done to justify an actual Vitamin D study? They need to take a sample of confirmed COVID patients and test their Vitamin D levels individually.

You don’t always need a big n to make causal conclusions. Do you know the story about the king who gets served a soup? Because he’s frightened that the soup might be poisoned, he gives it to his food tester first because the king reasons like this: „If my food tester (n=1) doesn’t die, then I probably won’t die, too, when I eat the soup“. Many great philosophers have argued, that people should use their common sense instead of requesting big tests. Therefore no big n‘s are needed. Start thinking.
??? The Kong’s conclusion wasn’t causal with any statistical certainty (which is what the above is arguing). It was anecdotal.

Maybe the poison doesn’t work for carriers of certain genes. Maybe it’s temperature reactive. Maybe it’ll take weeks to kill.

Just because the King observes something do not make his causal conclusions from that observation valid. Adequate sample-sized statistics aim to bridge that gap.

> The Kong’s conclusion wasn’t causal with any statistical certainty (which is what the above is arguing). It was anecdotal.

There ain't no such thing as statistical certainty my friend.

it must suck to be the king, waiting a couple hours to a day to make sure the food tester doesn't die of a slow acting poison before eating oneself.

Just thinking.

This King story is apropos of... nothing.
I wish people would stop posting studies like this.

It's a junk correlation study, done at a particular time when Southern Europe was hit the worst. If they did it now, with Britain surpassing all those countries they'd get a different result.

Maybe they should do a correlation study of "Vitamin D vs Estimated number of Covid cases in country at date of lockdown" and see what they get.

(Also I'd note they conveniently fail to point out that Northen Italy was hit much more badly than Southern Italy).

They mention Northern Italy right off the bat
> They mention Northern Italy right off the bat

They do.. without pointing out that's where the outbreak first originated, or comparing with Southern Italy by offsetting infection dates.

With epidemics the originating location (and the dynamics around it) is the key factor, and their failure to note that is what I'm calling out.

Correlation studies which focus on one thing also conveniently ignore other variables, such as population density. People comparing Sweden to Britain are comparing apples and oranges. Also, in the case of Italy, there is the issue of increased air pollution in the north, which may play a contributing role.

But this is also why any advice from government and WHO "experts" must be taken with a pinch of salt. They're as clueless as anybody else and all of their policies not evidence based, but are based on panic and power grabs.

I suspect there is some correlation the case of Vitamin D though. It has long been known of D's role in immune function and people not getting enough sunlight are often inflicted with various ailments. Fresh air has also been suggested for common colds.

There is also scant evidence that COVID is a serious transmission risk between people in open spaces. Infection appears to be more prevalent when large numbers of people are condensed in closed spaces, such as public transport, clubs etc.

The other elephant in the living room is obesity, which the media don't want to talk about for fear of upsetting or "fat shaming" unhealthy people.

If it does turn out to be the case, then all government advice to "stay at home" so far will have been iatrogenic and the government witchdoctors and henchmen are really contributing to iatrocide in those who are vulnerable when they're forcing lockdown rules through violence or fines.

The position of lockdowns should be completely reversed and official government advice should be to get out, get sunlight, fresh air and exercise in open spaces. This doesn't need to exclude social distancing rules, although it will probably be difficult to achieve in densely packed cities. Fortunately we have plenty of open space in national parks. Trips out are good for mental well-being and can be educational for kids. More picnics now!

The issue with businesses which operate in closed spaces, the restaurants etc, I'm not entirely decided on, but since I believe in personal liberty, it should be ones own decision whether or not they're going to enter these closed spaces and take the risk. Leave it up to the owners and the market to decide their fate. Lockdown is far more damaging than COVID.

Can someone explain something to me? What's this Vitamin D craze about that a lot of people in the Hackernews crowd seem to follow?

Multiple times in the past days weak studies indicating some beneficial effect of Vitamin D have been posted here. None of them looked like anything even remotely conclusive. This one just cries "confounder!".

But in the comments below a large number of people seem convinced that this is definitive evidence and that they always knew their Vitamin D pills are some kind of magic.

We evolved to be outside in daytime. Nerds spend lots of daytime inside. Skin in sunlight makes Vitamin D. In the absence of other information, it'd be surprising if Vitamin D supplements weren't beneficial.
I have a bunch of chronic health issues and have been recommended to take Vitamin D for about 15 years or more - my brother has MS and requires it as well. We both feel like direct sun works better than the supplement but our doctors both insist we use a supplement. I do, because I listen to my doctor, but I also make sure I get outside every day. I don't "tan", I just hang out outside every day (this is easy because my son is always interested in a bike ride or whatever). In the Winter it is more difficult as I live in a more northern city in Canada but I make it work.
I'm in Edmonton, and was advised to take 2000 IU a day by my doc.

I don't tan either. Sun up here can still give you cancer, and the days are looooooong during the summer.

I've also found that the direct light-on-my-eyeballs has a big difference in waking me up and making me active.

Vitamin D has long been staple in the "anti-aging" business, and this is something I guess many people around here are very interested in, to put it mildly.
I doubt anyone here thinks it's some kind of magic, but if you've been following the pandemic from the beginning, you've probably seen these two doctors who both recommend vitamin D:

- Dr. Seheult's: https://www.youtube.com/watch?v=NM2A2xNLWR4&t=821s - Dr John Campbell: https://www.youtube.com/watch?v=GCSXNGc7pfs&t=29s

It's cheap and has minimal downside. Pre-covid it was already known to "reduce symptoms of colds or influenza"[0].

[0] Benefits of Vitamin D Supplementation - Journal of American Physicians and Surgeons https://www.grc.com/health/pdf/Benefits_of_Vitamin_D_Supplem...

I feel like we're just repeating the exact same arguments seen for Vitamin C. Which went through the same arguments (cure for colds, cure for cancer, recommended by doctors etc) and ended up generally being inconclusive as to whether or not it actually helped.

At this point I'm convinced vitamin supplements are a scam in 99% of situations. The only time they're useful is when you have an actual deficiency as prescribed by your primary doctor.

Vitamin supplements are mostly a scam, but you can increase your Vitamin D level for free.
For those that don’t know, Vitamin d is created when sunlight hits skin.

“The major natural source of the vitamin is synthesis of cholecalciferol in the lower layers of skin epidermis through a chemical reaction that is dependent on sun exposure (specifically UVB radiation)”

https://en.m.wikipedia.org/wiki/Vitamin_D

Which unfortunately doesn’t work well in the winter depending on how far you are from the equator.

It’s fat soluble so levels can be tested.

>For those that don’t know, Vitamin d is created when sunlight hits skin.

Actually it's when UVB rays hit the skin, and only during certain times of the day, and north of 37 degrees only during part of the year.

In order to get enough UVB rays to make Vitamin D you need sunlight from around noon, during spring summer and fall

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257661/

Yes and no:

“Except during the summer months, the skin makes little if any vitamin D from the sun at latitudes above 37 degrees north”[1].

Also everybody’s production of vitamin D is different. There are plenty of people who work outside all day and still have insufficient levels.

[1] https://www.health.harvard.edu/staying-healthy/time-for-more...

Vit C was thought to be helpful essentially based on the testimony of one biologist. All of the research shows that it has a minimal / marginal impact on wellness if you're getting a modest amount already.

All of the research on Vit D suggests it has a much stronger impact on wellness than most supplements. I remember a list of "supplements proven to improve performance by studies" and it was basically steroids, creatine, and vitamin D; everything else was marginal or not backed by research.

You can not get conclusive evidence for most health topics within a reasonable timeframe. This is not physics, you cannot just repeat experiments dozens of times to make sure. Most studies, even those done to actually get medicine approved, are relatively poor.

If there is a pandemic unfolding and low Vitamin D is very strongly correlated with severe disease outcome, I do not wait for some study to conclusively prove that Vitamin D is a causal factor. I pop those 4000 IU pills and hope for the best, because the potential upside is far greater than the downside.

Well said. And the thing with vitamin D is:

1) A whole lot of people are deficient so could benefit from supplementation anyway, and

2) Supplementation is safe and inexpensive.

As far as potential treatments go, sure, it could turn out to be nothing. But the risk/reward ratio is favorable.

Widespread Vitamin D deficiency has been known about for a decade or two, but I think the American public is only just recently starting to pick up on the research the past few years. I read about this a couple years ago and asked my doctor for a blood test, and it turns out I'm severely deficient. For what it's worth, I'm Hispanic, and anecdotally, after starting to take supplements I've actually felt better emotionally.

It's probably safe to assume that our not-too-distant ancestors spent a lot more time outside, probably with less clothes, and more skin exposed to the sun.

http://www.efsa.europa.eu/ don't appear to agree with you. They might be wrong of course.

"EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to vitamin D and contribution to the normal function of the immune system. The Panel considers that vitamin D is sufficiently characterised. Contribution to the normal function of the immune system is a beneficial physiological effect for children. The Panel had previously assessed a claim on vitamin D and contribution to the normal function of the immune system with a favourable outcome. The target population was the general population. The Panel considered that vitamin D plays a regulatory role in the functioning of the immune system. The Panel considers that the role of vitamin D in the functioning of the immune system applies to all ages, including children."

https://www.efsa.europa.eu/sites/default/files/consultation/...

No magic involved as can be determined from a reading of the massive peer-reviewed literature regarding vitamin D.

Get out and sunbath, enough about supplements:)
Wow, thanks, I am cured. You know that currently a lot of people all over the World who cannot go out, right?
What does that have to do anything? A lot of people are unable to exercise, that doesn't mean that you shouldn't be exercising if you can.
Just a few days ago there was an article which claimed that Vitamin D supplements were useless (also referring to scientific research). Seriously, at some point, one starts not believing anything related to vitamins, since they seem to contradict one another all the time.
Supplemental vitamin D is not as effective as that naturally produced by exposing skin to the sun.

This is perhaps what you read, and doesn't invalidate thre findings here.

I am getting an SSL error for this page. This website serves a self-signed certificate for/by "odin.com" in Russia.
The rational calculation here is very clear.

Taking 1000 IU of Vitamin D a day has pretty much zero risk.

Going outside in the sun around noon, without too much clothing (or sunblock, of course!), for about 15 minutes a day also has pretty much zero risk. (In fact, it likely has benefits other than vitamin D, such as nitric oxide production, which lowers blood pressure.)

There is substantial evidence that these measures would reduce severity of infections such as influenza and covid-19, at very small to zero monetary cost. It's not a certainty, of course, but it is highly unlikely that Vitamin D deficiency is actually protective against covid-19.

Therefore, all public health organizations should be strongly recommending that everyone take 1000 IU of Vitamin D and get some sunlight, and heavily publicizing this recommendation.

The fact that they are not doing this is sadly an indication that the people in charge of these organizations do not actually have a mental orientation of solving the problem. (As you probably know, there are many other indications of this as well.)