Vitamin D is needed before many surgeries – many studies and RCTs

Summary of 20+ studies

1. Loading doses of 300,000 IU Vitamin D have been frequently used for adults
   • More than 300,000 IU is sometimes needed for adults
   • infants-Children might only need 10,000 IU per kg
2. Loading dose for the ICU should be given in a single day
   • An oral dose does not result in a full response for 3+ days
   • An injection does not result in a full response for several weeks
3. A gut-friendly form of Vitamin D should be used if patient has poor digestion
   • Nanoemulsion sublingual or topical are fast acting (hours)
   •    Any form of vitamin D given just before/after surgery is better than none
4. All of the above also applies to ICU (Intensive Care Unit)
   • 4.8 X more likely to die within 28 days of ICU if low Vitamin D - Jan 2024

5. Vitamin D3, not Vitamin D2 should be used

6. Note: Some Chemotherapies are amplified so much by Vitamin D as to result in death if dose size is not decreased

DON'T GET SURGERY Unless You Do This First - Dr. Berg video March 2025

YouTube 5 minutes

Free summary by GLASP AI

• The video emphasizes the importance of having sufficient vitamin D levels before any surgery to reduce complications and improve outcomes.

• Surgical procedures themselves can lower vitamin D levels (from an average of 42.7 to 28 in one study mentioned).

• Sufficient vitamin D before surgery helps reduce infection risk, supports immune function, decreases inflammation, lowers cardiovascular complications, and enhances wound healing.

• Low vitamin D is associated with 200% higher post-operative inflammatory markers and up to 8x higher risk of cognitive dysfunction after surgery.

• Some studies have used very high doses of vitamin D before surgery (100,000-600,000 IU) to saturate the body's cells, though these are short-term protocols, not long-term recommendations.

• Vitamin D supports adrenal function during the stress of surgery, helping to regulate the cortisol spike that can increase 4x following surgical procedures.

• The video recommends taking additional vitamin D approximately 3 days before surgery to allow time for cellular absorption.

• Vitamin D influences over 2,000 genes, with about 200 related specifically to adrenal function.

23+ studies: Much better outcome if add Vitamin D before/after surgery

• Orthopaedic surgeries need Vitamin D – many studies

• Large dose Vitamin D before surgery was found to help by 35 studies

• Surgery complications cut in half by 300,000 IU of vitamin D 2 weeks before (hip and knee) – RCT May 2024

• Rotator Cuff repair using Vitamin D lowers medical cost by 46 dollars – June 2023

• Better Surgical outcomes if preceded by Vitamin D loading dose – Oct 2018

• Little risk of infection after surgery if have more than 50 ng of vitamin D - 2014

• Children in Intensive Care need Vitamin D loading dose of 10000 IU per kg (nearing a consensus) - Oct 2016

• Esophageal Cancer surgery helped by 300,000 IU of Vitamin D – RCT Sept 2018

• Surgeries more successful if high vitamin D (tympanic membrane in this case) – Nov 2022

Heart

• Taking Vitamin D just before and after surgery helps (open-heart in this case) – RCT Feb 2021

• Half as much AFIB after bypass if 600,000 IU of vitamin D before surgery – RCT April 2022

• Getting Vitamin D before heart surgery prevented Afib in those who had been deficient – July 2018

Bone

• Foot and Ankle Surgeries should benefit from Vitamin D – Feb 2019

• Spinal Fusion complications 2.2 X more likely if low Vitamin D – Dec 2020

Brain

• Surgeries to re-establish blood in brain, heart, etc. are far more successful with high Vitamin D levels – March 2022

• Fewer days in hospital if 300,000 IU of vitamin D before brain surgery - RCT Feb 2021

• Traumatic Brain Injury – 120,000 IU of Vitamin D resulted in 3 fewer days on ventilators – RCT March 2020

Sepsis

• Sepsis (with mechanical ventilation) treated by 5days of 50,000 IU of Vitamin D – RCT May 2024

• Sepsis mortality greater in Black than White children (low vitamin D) - Dec 2023

• Sepsis is fought by Vitamin D in 9 ways – Feb 2023

• 3X less Septic Shock in children with sepsis getting 150,000 IU of Vitamin D - RCT June 2020

• Severe sepsis may be prevented by 400,000 IU of vitamin D – RCT 2023

• Urinary sepsis – a single Vitamin D injection reduced hospital days by 40 percent – RCT April 2018

Cancer

• Restore your Vitamin D levels before surgery (Gastric Cancer in this case) - Jan 2023

• Esophageal Cancer surgery helped by 300,000 IU of Vitamin D – RCT Sept 2018

TB

• Spinal TB surgery now includes Vitamin D as the standard of care (5,000 IU daily) – Sept 2024

Thyroid

• Half as many problems if take Vitamin D (300,000 IU) before thyroidectomy – RCT Jan 2021

• Pre-operative Vitamin D often helps (thyroidectomy in this case) – June 2021

• Vitamin D before surgery often helps (Thyroidectomy in this case) – Sept 2019

14+ studies: improved ICU outcomes

• 5,000 ICU patients have benefited from Vitamin D – need more data – Aug 2024

• 4.8 X more likely to die within 28 days of ICU if low Vitamin D - Jan 2024

• ICU - need Vitamin D ASAP - interview and transcript, Matthews Aug 2024

• 18 fewer hospital days if given 500,000 IU of vitamin D while ventilated in ICU – RCT June 2016

• Fewer days in ICU after 300,000 IU of vitamin D, but not 540,000 – meta-analysis Aug 2020

• Heart attack ICU costs cut in half by Vitamin D – Oct 2018

• Hospital ICU added high dose vitamin D - malpractice lawsuit costs dropped from 26 million dollars to ZERO - Oct 2016

• ICU adults getting 540,000 IU of Vitamin D were 2X more likely to be alive 30 days later – RCT June 2019

• ICU cost reduced by at least 27,000 dollars if get high dose vitamin D in first week - April 2017

• ICU mortality reduced by non-oral vitamin D – meta-analysis May 2021

• ICU patients greatly helped by Vitamin D loading doses – if gut-friendly – Oct 2020

• ICU survival increased with vitamin D single 540K IU loading dose - JAMA Sept 2014

• Those getting an injection of 300,000 IU Vitamin D got out of the ICU a week sooner – RCT Dec 2020

• Vitamin D loading doses reduce ICU mortality by 30 percent – meta-analysis April 2017

15+ studies: Poor surgery outcomes if low vitamin D

• Surgery outcome worse if low vitamin D (lumbar spine surgery this time) – Nov 2019

• Postoperative cognitive dysfunction 8 X more likely if low vitamin D – March 2018

• 3 additional hospital days after emergency neurosurgery if low vitamin D – Nov 2019

• Surgical Site Infection 4X more likely if low vitamin D – Aug 2019

• 40% less likely to recover from TBI with Intracranial Injury if low vitamin D – June 2022

• Crohn's Disease 4X less likely to reoccur after surgery if good level of vitamin D – Feb 2021

• Delirium or cognitive problems after surgery 1.5X more likely if low vitamin D –meta-analysis Aug 2022

• Kidney transplant rejection 1.8X more likely if low vitamin D – May 2021

• Low vitamin D at ICU admission is associated with cancer, infections, acute respiratory insufficiency and liver failure – Oct 2018

• More post-operative pain if low vitamin D before ( 2.4 X for Thoracoscopic) – Oct 2022

• Spinal Fusion complications 2.2 X more likely if low Vitamin D – Dec 2020

• Spinal Surgery patients – almost all have low vitamin D – Nov 2016

• Surgery outcome worse if low vitamin D (lumbar spine surgery this time) – Nov 2019

• Trauma with fracture – 2 weeks longer hospital stay if less than 10 ng vitamin D – Jan 2018

• Vitamin D deficiency with severe sepsis increased risk of dying by 7.7 X – Nov 2017

5 studies: Surgeries reduce vitamin D Levels

• Critical illness – Vitamin D levels start low and then drop for several days – Feb 2018

• Vitamin D levels crash after various surgeries (cardiac in this case) – Nov 2021

• After hip surgery Vitamin D levels dropped by 32 percent – Sept 2018

• Surgeries often deplete Vitamin D - 300,000 IU resulted in little response – Nov 2018

• Pro-inflammatory cytokines cause the 74 percent drop in vitamin D after knee arthroplasty – Feb 2014

6 suggestions for Vitamin D before/after surgery

• 400,000 IU of Vitamin D before surgery should cost-effectively reduce infection after knee replacement – May 2020

• Vitamin D appears essential to survive many critical illnesses - review Oct 2018

• Give Vitamin D before all spinal surgeries – no testing needed – June 2020

• Vitamin D needed after most spinal surgeries (and before as well) – 2013

• Foot and Ankle Surgeries should benefit from Vitamin D – Feb 2019

• Use of Vitamin D in a trauma surgery - Dr. Matthews on Facebook – Jan 2020

20X fewer problems after surgery (noncardiac) if a high level of Vitamin D

The Association of Serum Vitamin D Concentration with Serious Complications After Noncardiac Surgery- 2014

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Vitamin D Life - studies in both categories Surgery and Loading Dose

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