Published on January 24, 2022

The Front Line COVID-19 Critical Care Alliance (FLCCC) emphasizes the extreme importance of optimizing vitamin D levels to >50 ng/ml with a recommended vitamin D treatment schedule

Key Points

  • Vitamin D is listed as the first priority nutritional supplement in the pre-and post-exposure (I-MASK+) protocol for COVID-19
  • It is extremely important to dose vitamin D based on the baseline vitamin D level in order to reach the target vitamin D level, suggested to be a minimum of 50 ng/ml (125 nmol/L) for the greatest protection against COVID-19 disease severity and death
  • Two new tables have been included to help individuals determine a safe and practical vitamin D treatment schedule for increasing vitamin D levels

The Front Line COVID-19 Critical Care Alliance (FLCCC), a non-profit organization formed by leading critical care specialists in March 2020, continually updates their recommended approach to COVID-19 prevention, treatment, and recovery based on findings from the most recent research. Their protocol for treatment is meant as a guideline for physicians, and while they suggest that individuals consult with their health care providers before starting the medical treatments suggested, there are several therapies recommended that can be utilized safely from home for prevention and early treatment – including the newly updated protocol for optimizing vitamin D.

Vitamin D Listed as First Priority Nutritional Supplement

Vitamin D is listed as the first priority nutritional supplement in the pre-and post-exposure (I-MASK+) protocol for COVID-19. According to the FLCCC Alliance – COVID-19 Management Protocol overview document, “Vitamin D has numerous immunological properties that play a vital role in limiting the acquisition and severity of COVID-19.” Many studies have demonstrated the effect of vitamin D supplementation and serum level on COVID-19 outcomes and support the concept of the greatest benefit from vitamin D being among those who are currently deficient or insufficient in vitamin D – making the testing of vitamin D levels of incredible importance.

“The OPTIMAL Target Vitamin D Level is >50 ng/ml”

In their latest guide, the FLCCC recognizes the unique dosing requirements needed for each individual, and that dosing amounts should be based on a person’s baseline vitamin D level. “It is therefore EXTREMELY IMPORTANT to stress that the optimal regimen for vitamin D supplementation for both the prophylaxis and treatment of COVID-19 should be based on the baseline vitamin D level.” The target vitamin D level suggested is a minimum of 50 ng/ml (125 nmol/L) for the greatest protection against COVID-19 disease severity and death.

The table below gives an example of a “safe and practical treatment schedule” to increasing vitamin D levels in non-urgent situations when a baseline vitamin D level is known. Large doses, such as those listed as an Initial Dose, are suggested to be broken down into doses of 50,000 IU per day over several days to help improve bioavailability and conversion. (For example, the 200,000 IU Initial Dose could be taken as 4 daily doses of 50,000 IU at the beginning of the first week of supplementation.)  The Weekly Dose can then begin the first day of the second week of supplementation, taken as indicated (50,000 IU each day for X days each week).  Re-testing vitamin D levels after 2-4 weeks is suggested by the authors when using the following treatment schedules to assure a vitamin D level of at least 50 ng/ml has been achieved.  It is also important to maintain the achieved vitamin D level with a daily maintenance dose of vitamin D, and follow up with vitamin D testing every 6 months to make sure the level remains within target.

Click to Enlarge & Print

The following vitamin D treatment schedule is suggested when the baseline vitamin D level is not known.

Click to Enlarge & Print

In addition, the authors suggest supplementing with vitamin K2 and 250-500 mg per day of magnesium, when taking more than 8000 IU of vitamin D per day.  Also note that several other nutrients, such as vitamin C and zinc, are important to include for the best immune health and protection against COVID-19.

The same treatment schedule is recommended as a first line therapy for those with post-COVID syndrome or long-haul COVID.

For the full, current I-MASK+ protocol (version 19, updated on JANUARY 19, 2022) in multiple languages, click here.

Using the Vitamin D*Calculator

Another personalized vitamin D dose calculation option is to use the GrassrootsHealth Vitamin D*calculator, which calculates customized daily vitamin D doses based on an individual’s current vitamin D level (if available), target vitamin D level, weight, and current vitamin D intake. One difference between the tables provided above and the calculator is that the customized loading dose given by the D*calculator is divided into doses of 25,000 IU spread over a number of days to achieve the initial increase in vitamin D level. The calculated maintenance dose can then be taken on a daily basis to help maintain the achieved level, which is capped at 10,000 IU per day to match the No Observed Adverse Effect Level (NOAEL).

When Might Vitamin D Toxicity be a Concern?

Vitamin D levels above 150 ng/ml (375 nmol/L) begin to raise the concern for vitamin D toxicity, which is most frequently diagnosed when levels are over 200 ng/ml (500 nmol/L), though not everyone who reaches that level experiences toxicity. Vitamin D toxicity occurs when high vitamin D levels cause high calcium levels, called hypercalcemia. Symptoms of hypercalcemia include loss of appetite, feeling very thirsty, weight loss, constipation or diarrhea, abdominal pain, musculoskeletal pain, or feeling sick, confused, or tired.

According to a Mayo Clinic publication, “There is enough evidence that vitamin D toxicity is one of the rarest medical conditions and is typically due to intentional or inadvertent intake of extremely high doses of vitamin D (usually in the range of >50,000 – 100,000 IU/day for months to years) without monitoring for hypercalcemia.” In fact, a meta-analysis of 15 clinical trials found no toxicity below a vitamin D level of 200 ng/ml (500 nmol/L) or below a vitamin D intake of 30,000 IU/day.

Measure Your Vitamin D Level At Home through the GrassrootsHealth Project

Having and maintaining healthy vitamin D levels and other nutrient levels can help improve your health now and for your future. Choose which additional nutrients to measure, such as your omega-3s and essential minerals including magnesium and zinc, by creating your custom home test kit today. Take steps to improve the status of each of these measurements to benefit your overall health. You can also track your own intakes, symptoms and results to see what works best for YOU.

Enroll and test your levels today, learn what steps to take to improve your status of vitamin D (see below) and other nutrients and blood markers, and take action! By enrolling in the GrassrootsHealth projects, you are not only contributing valuable information to everyone, you are also gaining knowledge about how you could improve your own health through measuring and tracking your nutrient status, and educating yourself on how to improve it.

How Can You Use this Information for YOUR Health?

Having and maintaining healthy vitamin D and other nutrient levels can help improve your health now and for your future. Measuring is the only way to make sure you are getting enough!

STEP 1 Order your at-home blood spot test kit to measure vitamin D and other nutrients of concern to you, such as omega-3s, magnesium, essential and toxic elements (zinc, copper, selenium, lead, cadmium, mercury); include hsCRP as a marker of inflammation or HbA1c for blood sugar health

STEP 2 Answer the online questionnaire as part of the GrassrootsHealth study

STEP 3 Using our educational materials and tools (such as our dose calculators), assess your results to determine if you are in your desired target range or if actions should be taken to get there

STEP 4 After 3-6 months of implementing your changes, re-test to see if you have achieved your target level(s)

Enroll in D*action and Build Your Custom Test Kit!