Do Supplements like Quercetin, Zinc, Vitamin C and Vitamin D help with the Coronavirus (COVID-19)?

As of November 2020, there are more than 70 types of supplements that are being tested for COVID-19. You can review the details of these trials on clinicaltrials.gov. There are more than 120 trials testing the various nutrients and dietary supplements including vitamin D, vitamin C, zinc and melatonin. Vitamin D remains the most tested vitamin followed by vitamin C, for COVID-19.

The lung injury in COVID-19 patients is associated with ROS (reactive oxygen species) released by phagocytes, and thus the use of antioxidants is necessary for the management of COVID-19.

Do take note that for optimal effectiveness, each supplement should not be considered as a single intervention as most of the supplements are given as part of a combination protocol. Further, each nutrient will also have influence on another nutrient. For example, vitamin C and zinc need to be given together with copper. Also, vitamin D3 needs to be given with vitamin K2.

Quercetin and COVID-19

Quercetin was initially found to provide broad-spectrum protection against SARS coronavirus in the aftermath of the SARS epidemic that broke out across 26 countries in 2003 (1,2,3). Now, some doctors are advocating its use against SARS-CoV-2, in combination with vitamin C, noting that the two have synergistic effects.
Quercetin

Incidentally, ascorbic acid (vitamin C) and the bioflavonoid quercetin (originally labeled vitamin P) were both discovered by the same scientist — Nobel prize winner Albert Szent-Györgyi (4,5). Quercetin’s antiviral capacity has been attributed to five main mechanisms of action:
  1. Inhibiting the virus’ ability to infect cells by transporting zinc across cellular membranes
  2. Inhibiting replication of already infected cells
  3. Reducing infected cells’ resistance to treatment with antiviral medication
  4. Inhibiting platelet aggregation — and many COVID-19 patients suffer abnormal blood clotting
  5. Promoting SIRT2, thereby inhibiting the NLRP3 inflammasome assembly involved with COVID-19 infection
Similarly, vitamin C at extremely high doses also acts as an antiviral drug, effectively inactivating viruses. 

Quercetin and Vitamin C

The initial MATH+ protocol was released in April 2020. In early July and August, it was updated to include quercetin and a number of optional nutrients and drugs, not only for critical care but also for prophylaxis and mild disease being treated at home.

There is evidence that vitamin C and quercetin co-administration exerts a synergistic antiviral action due to overlapping antiviral and immunomodulatory properties and the capacity of ascorbate to recycle quercetin, increasing its efficacy.

For prophylaxis, the Front Line COVID-19 Critical Care Working Group, FLCCC recommends:
  • Vitamin C — 500 mg
  • Quercetin — 250 mg to 500 mg
  • Zinc — 75-100 mg/day (acetate, gluconate or picolinate). Zinc lozenges are preferred. After one month, reduce the dose to 30 mg to 50 mg per day
  • Melatonin (slow release) — Begin with 0.3 mg and increase as tolerated to 2 mg at night
  • Vitamin D3 — 1,000 to 4,000 IUs per day
The at-home treatment for mildly symptomatic patients is very similar, but adds several optional drugs, including aspirin (ASA), famotidine (an antacid), ivermectin (a heartworm medication that has been shown to inhibit SARS-CoV-2 replication in vitro). (For dosages, see the Critical Care Management Protocol summary, available on the Easter Virginia Medical School’s site.)

They also recommend monitoring your oxygen saturation with a pulse oximeter and to go to the hospital if you get below 94%. The medical evidence to support each drug and nutrient can be found under “Medical Evidence” on the FLCCC’s website.

June 19, 2020, Marik published the paper (25) “Quercetin and Vitamin C: An Experimental, Synergistic Therapy for the Prevention and Treatment of SARS-CoV-2 Related Disease (COVID-19)” in the journal Frontiers in Immunology, which notes:

“Ascorbic acid is a crucial vitamin necessary for the correct functioning of the immune system. It plays a role in stress response and has shown promising results when administered to the critically ill. Quercetin is a well-known flavonoid whose antiviral properties have been investigated in numerous studies.

There is evidence that vitamin C and quercetin co-administration exerts a synergistic antiviral action due to overlapping antiviral and immunomodulatory properties and the capacity of ascorbate to recycle quercetin, increasing its efficacy.

Safe, cheap interventions which have a sound biological rationale should be prioritized for experimental use in the current context of a global health pandemic.”


The paper presents evidence for the use of vitamin C and quercetin — based on their biological actions and pharmacokinetics profiles — both as prophylaxis in high-risk populations, and as an adjunct to drugs such as Remdesivir or convalescent plasma in the treatment of hospitalized COVID-19 patients.

You can purchase Quercetin as a dietary supplement online at Lazada Malaysia.

Vitamin D and COVID-19

Several publications and studies have suggested that maintaining adequate levels of vitamin D would seem potentially beneficial in fighting the COVID-19 infection.

A study published in November 2020 from Singapore (CW Tan, Nutrition 2020), found that those who were started on a daily oral dose of vitamin D3 (1,000 IU), magnesium (150 mg) and vitamin B12 (500 mcg) within the first day of hospitalisation and continued up to 14 days were significantly less likely to require oxygen therapy and further intensive care.

The statement released on 2 October by the U.S. president’s physician said that in addition to the antibodies, Trump “has been taking zinc, vitamin D, famotidine, melatonin and a daily aspirin.”

Several publications and studies have suggested that maintaining adequate levels of vitamin D would seem potentially beneficial in fighting the COVID-19 infection.

A recent study, published in JAMA (JAMA Netw Open. 2020) found that persons who are likely to have deficient vitamin D levels at the time of COVID-19 testing were at substantially higher risk of testing positive for COVID-19 than were persons who were likely to have sufficient levels.

The same team above, has also published a preprint article: A study at the University of Chicago of over 4,000 patients that found that untreated vitamin D deficiency was associated with an increased risk for COVID-19 infection.

Do take note that you can also get good amounts of vitamins C and D, zinc, and other essential vitamins and minerals from a basic multivitamin.

Buy Vitamin D supplement in Malaysia: Vitamin D3 supplements appear to be more effective at raising vitamin D levels than D2 supplements. One can also take vitamin K2 together with D3 as vitamin K2 works synergistically with vitamin D3. D3 capsules are available in most supermarkets and health food stores such as Guardian and Watsons, as well as online.


Vitamin C and COVID-19 

Most people turn to vitamin C after they've caught a cold. That’s because it helps build up your immune system. Vitamin C is thought to increase the production of white blood cells. These are key to fighting infections. Some of the most vitamin C-rich foods include citrus fruits, from tangerines to limes, along with leafy greens, bell peppers and broccoli. Berries are another great source, and they all provide this and other potent antioxidants, which support your immune response and help to rebuild collagen. Because your body doesn't produce or store it, you need daily vitamin C for continued health. Almost all citrus fruits are high in vitamin C.

While large controlled studies demonstrating vitamin C's effectiveness in COVID-19 are still lacking, there are many such studies underway. You can review the status of these trials on clinicaltrials.gov. As of November 2020, more than 40 studies have been launched to investigate the benefits of vitamin C against COVID-19.

Word of Caution - Taking large doses of vitamin C (ascorbic acid) on a regular basis lowers your level of copper, so if you are already deficient in copper and take high doses of vitamin C, you can compromise your immune system.

So, whereas temporarily taking megadoses of vitamin C supplements to combat a case of the cold or flu is likely not going to cause a problem. For long-term, daily use, your best bet is to eat a diet that is full of high quality organic vegetables and fruits that are minimally processed. Not only will you get vitamin C, but you will get all the other accessory nutrients and micronutrients that are needed to optimize it.

Related: 10 Best Vitamin C Supplements in Malaysia


Zinc and COVID-19

Foods that are high in zinc include oysters, crab, lobster and mussels.

Zinc has been shown in a lab study to inhibit regular coronavirus (not the current SARS-CoV-2) in a 2010 publication.

As of November 2020, there are 40 studies that have been launched to investigate the benefits of Zinc against COVID-19. You can review the status of these trials on clinicaltrials.gov.

Taking zinc long term is typically safe for healthy adults, as long as the daily dose is under the set upper limit of 40 mg of elemental zinc (PubMed).

Excessive doses may interfere with copper absorption, which could compromise your immune system. 

However, too much zinc can also negatively affect your immune system as it can offset your zinc and copper balance

The ideal dose for prevention while the COVID-19 risk is high is 40-100 mg/d, a portion of which comes from zinc lozenges to spread the zinc through the tissues of the nose, mouth and throat. It should be accompanied by at least 1 mg copper from food and supplements for every 15 mg zinc.

Zinc Sulphate is also part of Dr. Vladimir Zelenko anti-coronavirus experimental protocol. Please take note that the protocol is experimental and has not been 100% proven. Do discuss with your doctor before taking the medication as per the protocol. You can check out his publication in the International Journal of Antimicrobial Agents

Based on the statement released on 2 October by the U.S. president’s physician, zinc is also part of the treatment given to the US President. According to the president's physician, "Trump has been taking zinc, vitamin D, famotidine, melatonin and a daily aspirin.”

Editor's note: Hydroxychloroquine is a zinc ionophore. If increased intracellular Zn ion concentration is required to disrupt viral replication, perhaps using multiple zinc ionophores would increase that concentration thus decreasing viral replication further. Other OTC (over the counter) zinc ionophores include quercetin (QCT) and epigallocatechin-gallate (EGCG – green tea extract).

You can purchase Zinc (+copper) as a dietary supplement online and from local health stores in Malaysia i.e. Guardian and Watsons.

Melatonin and COVID-19

You may know about melatonin as a supplement that can support your healthy sleep cycle. Assisting sleep and rest is already an immune system-supporting benefit, but melatonin has more to offer. It is a powerful antioxidant that supports your immune health, brain, eyes, digestion, and more.

Melatonin is a hormone synthesized in your pineal gland and many other organs. While it is most well-known as a natural sleep regulator, it also has many other important functions. For example, melatonin is a potent antioxidant with the rare ability to enter your mitochondria, where it helps “prevent mitochondrial impairment, energy failure and apoptosis of mitochondria damaged by oxidation.” It also helps recharge glutathione and glutathione deficiency has been linked to COVID-19 severity.

Data from Cleveland Clinic supports the use of melatonin. Here, the researchers analyzed patient data from the Cleveland Clinic’s COVID-19 registry using an artificial intelligence platform designed to identify drugs that may be repurposed.

"Patients who used melatonin as a supplement had, on average, a 28% lower risk of testing positive for SARS-CoV-2. Blacks who used melatonin were 52% less likely to test positive for the virus."

As of November 2020, 8 studies have been launched to investigate the benefits of melatonin against COVID-19. Ultimately, the results of the above trials will offer more definitive evidence.

Molecular Hydrogen and COVID-19

Molecular hydrogen has been shown to have anti-oxidant and anti-inflammatory properties. It is 'the one and only' antioxidant that can both penetrate the mitochondria and neutralize the reactive oxygen species (ROS) (Med Gas Res. 2020).

Published in June 2020 (Reactive Oxygen Species), the aim is to review the current research into COVID-19 and to better understand how treatment with molecular hydrogen is likely to affect cellular responses during COVID-19 infection.

Application of H2, may provide an effective adjunctive medicament to O2 inhalation in the treatment of COVID-19 for the critically ill. Although this method is recommended and practiced in the People’s Republic of China with oxygen/hydrogen mixed gas noted to significantly reduce dyspnea, it is not widely used elsewhere. To date, only one clinical trial using oxyhydrogen for the treatment of COVID-19 infection has been registered with the US National Library of Medicine, with a further four clinical trials registered with The Centre for Evidence-Based Medicine (CEBM). 

It is the authors’ opinion that inhalation of H2 would be a more effective delivery mechanism for patients with moderate/severe symptoms of COVID19. Also worthy of notation is that currently, most, but not all clinical trials have been based on inhalation of H2, with this also being the preferred delivery method as recommended by The National Health Commission of the People's Republic of China.

Published in June 2020 (Journal of Thoracic Disease. 2020), this China study is the first multicenter randomized clinical trial that verifies the efficacy and safety of H2-O2 (mixed hydrogen gas and oxygen gas) inhalation in patients (n=90) with COVID-19.

Patients with COVID-19 frequently presented with dyspnea, coughing, chest pain and distress, and oxygen desaturation which cannot be rapidly relieved with other existing therapies (including oxygen therapy). The therapeutic effects of H2-O2 became significant as early as days 2 and 3 and the reduction of most respiratory symptoms persisted till the end-of-treatment.

The authors also concluded that the safety profiles of H2-O2 have rendered H2-O2 inhalation particularly suitable for relieving difficulty in breathing and other breathing symptoms in patients with COVID-19, regardless of the disease severity.

It was discovered and reported in Nature in 2007 by a team in Japan, that inhaled hydrogen gas could act as an antioxidant and protect the brain from free radicals. This sparked the interest in its potential health benefits worldwide and led to many published and on-going clinical research.

As of November 2020, 18 studies have been launched to investigate the benefits of molecular hydrogen against COVID-19. Ultimately, the results of the trials will offer more definitive evidence.

You can purchase Izumio (hydrogen infused water) from an authorised distributor in Malaysia. For more information, please feel free to WhatsApp: +60 12-749 2112.

B Vitamins

B vitamins may constitute a long list, but each one is important for different reasons. B vitamins are especially effective in boosting your immunity when you combine the foods containing them so they can all work together for maximum effect. These include vitamin B1 (thiamin), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid) and B7 (biotin).

B12, also known as cobalamin, is a powerful cold- and flu-fighting nutrient in your system, as is vitamin B6, another important, germ-combating vitamin that naturally benefits and strengthens your immune system and even protects against the damaging effects of air pollution.

Vitamin B9 and folic acid help repair tissues and aid in cell metabolism and immune support. They’re found in dark leafy greens, wild-caught, cold water fish like herring, mackerel, sardines, anchovies and wild-caught Alaskan salmon, and pastured, organic chicken.

Niacin or vitamin B3 is another precursor to nicotinamide adenine dinucleotide (NAD+). There are three main forms of niacin, which are dietary precursors to nicotinamide adenine dinucleotide (NAD). These are nicotinamide riboside, nicotinic acid and nicotinamide.

Nicotinamide adenine dinucleotide (NAD+) is an essential cofactor in all living cells that is involved in fundamental biological processes. Emerging evidence implicates that elevation of NAD+ levels may slow or even reverse the aspects of aging and also delay the progression of age-related diseases.

NMN (Nicotinamide MonoNucleotide), is also another precursor to NAD. A case series (published in September 2020) of 9 elderly COVID-19 patients treated with a combination of NMN, zinc, betaine and sodium chloride resulted in rapid improvement.

You can find B-vitamin supplements on Lazada Malaysia.


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