Can Supplements Lower Your Risk of Coronavirus Infection?

There is a lot of news and information being churned out when it comes to the latest Coronavirus or COVID-19 pandemic.

When it comes to supplements, there is also a lot of confusion due to the overwhelming mixing of credible scientific information and marketing hypes available on the internet. Information is all over the place and we have tried to compile the major ones into one place.

There are several supplements that might help and we have arranged them in order of importance based on available scientific evidence.

supplements and immune system


1. Vitamin C

Most people turn to vitamin C after they've caught a cold. 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.

Vitamin C appears to be able to both prevent and treat respiratory and systemic infections by enhancing various immune cell functions. Prophylactic prevention of infection requires dietary vitamin C intakes that provide at least adequate, if not saturating plasma levels (i.e., 100–200 mg/day), which optimize cell and tissue levels. In contrast, treatment of established infections requires significantly higher (gram) doses of the vitamin to compensate for the increased metabolic demand. (PubMed).

A large review of 29 studies in 11,306 people demonstrated that regularly supplementing with vitamin C at an average dose of 1–2 grams per day reduced the duration of colds by 8% in adults and 14% in children (PubMed).

Interestingly, the review also demonstrated that regularly taking vitamin C supplements reduced common cold occurrence in individuals under high physical stress, including marathon runners and soldiers, by up to 50% (PubMedPubMed).

Additionally, high dose intravenous vitamin C treatment has been shown to significantly improve symptoms in people with severe infections, including sepsis and acute respiratory distress syndrome (ARDS) resulting from viral infections (PubMedPubMed).

However, note that 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.

On Feb 11, 2020, a study on "Vitamin C Infusion for the Treatment of Severe 2019-nCoV Infected Pneumonia” was posted to ClinicalTrials.gov by Chinese researchers.

As of Mar 28, 2020, there were 2 new studies related to Vitamin C for COVID-19 on clinicaltrials.gov. One in Italy and the other in Saudi Arabia.

On the Chinese Clinical Trial Registry, there is another new trial registered on Vitamin C and COVID-19: A randomized, open, controlled trial for diammonium glycyrrhizinate enteric-coated capsules combined with vitamin C tablets in the treatment of common novel coronavirus pneumonia (COVID-19).

Time will tell what the outcome will be.


2. Vitamin D

In a 2019 review of randomized control studies in 11,321 people from 14 countries, supplementing with vitamin D significantly decreased the risk of respiratory infections in people deficient in this vitamin and lowered infection risk in those with adequate vitamin D levels (PubMed).

Other studies note that vitamin D supplements may improve response to antiviral treatments in people with certain infections, including hepatitis C and HIV (PubMedPubMedPubMed).

A study that was published in the Journal of the American Geriatrics Society in 2016, revealed that
elderly patients who had high doses of the Vitamin D3 were 40 per cent less likely to develop lung infections. Pneumonia, bronchitis and influenza are known to have higher death rates among older people because of their weakened immune system. Experts believe vitamin D helps to reinforce the first line of defense as people age, to prevent acute respiratory infections.

As for the dosage, anywhere between 1,000 and 4,000 IU of supplemental vitamin D per day is sufficient for most people, though those with more serious deficiencies often require much higher doses (PubMed).


3. Zinc

Numerous studies reveal that zinc supplements may protect against respiratory tract infections like the common cold (PubMedPubMed).

What’s more, supplementing with zinc may be beneficial for those who are already sick.

In a 2019 study in 64 hospitalized children with acute lower respiratory tract infections (ALRTIs), taking 30 mg of zinc per day decreased the total duration of infection and the duration of the hospital stay by an average of 2 days, compared with a placebo group (PubMed).

Supplemental zinc may also help reduce the duration of the common cold (PubMed).

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.


4. Thiamine (Vitamin B1)

In a Journal of Thoracic Disease article with the evocative title, “Do Not Forget to Give Thiamine to Your Septic Shock Patient!” the authors stress that:

“[Thiamine] is a water-soluble vitamin that is an indispensable constituent of cellular metabolism. A lack of this vitamin can, therefore, be potentially life-threatening ... Thiamine diphosphate, also known as thiamine pyrophosphate (TPP) … is the most important and active form of this vitamin …"
Considering the safety of thiamine, even at high doses, the authors stress that “septic shock patients should be given thiamine … without waiting for the results of thiamine level.”

The European Society for Clinical Nutrition and Metabolism guidelines for patients in intensive care situations are 100 to 300 mg of thiamine per day “during the first three days in the ICU for all patients with suspected thiamine deficiency.”

In cases of septic shock, however, dosages of 500 mg may be required. According to “Do Not Forget to Give Thiamine to Your Septic Shock Patient!”:

“Because anaphylaxis has been reported in rare instances, guidelines in the United Kingdom have recommended that thiamine should be administered over 15- to 30-minute interval in a mixture of saline solution or dextrose, with the intention of averting potential adverse reactions.”


5. Quercetin

study published in 2020 by the University of Tennessee and Oak Ridge National Labs used the most powerful IBM supercomputer to model which FDA approved compounds or supplements might interfere with the coronavirus binding to cells. To review, the coronavirus uses the ACE 2 (Angiotensin Converting Enzyme) receptor to enter cells. Once in a cell, the coronavirus virus empties its RNA contents and hijacks the cell to start producing more viruses. So preventing the coronavirus from binding to the ACE 2 receptor is a good thing as it means the virus can’t get into your cells. The study modeled various compounds and at number 5 on the list as those that has the potential to block the virus was Quercetin.

2004 study showed that Quercetin blocked the entry of another SARS coronavirus into cells. A 2012 study basically concluded the same thing (PubMed). This coronavirus is called SARS-CoV-2 and is different from the others in its family. So has Quercetin been shown to do anything that prevents this novel virus from entering cells? A lab study in 2020 that has yet to be peer-reviewed, demonstrated that Quercetin and other compounds showed promise in blocking the SARS-CoV-2 novel coronavirus from entering cells.


6. Luteolin

Luteolin is a common flavonoid abundantly present in several plant products, including broccoli, pepper, thyme, and celery. Studies have shown that luteolin possesses beneficial neuroprotective effects both in vitro and in vivo. It also has antioxidant and immunomodulatory properties.

The IBM Modelling Study as mentioned above also studied other compounds and at number 3 on the list as those that has the potential to block the virus was Luteolin.


7. Curcumin

Turmeric and especially its most active compound curcumin have many scientifically-proven health benefits, such as the potential to prevent heart disease, Alzheimer's and cancer. It has powerful anti-inflammatory properties, and animal studies indicate that it may help improve immune function (PubMed).

lab study in 2020 that has yet to be peer-reviewed, demonstrated that Curcumin and other compounds showed promise in blocking the SARS-CoV-2 novel coronavirus from entering cells.


8. Probiotics


Probiotics can promote a healthy gut, enhance your immune system and reduce your risk of infection (PubMedPubMed).

On the Chinese Clinical Trial Registry,  a study on probiotics for the treatment of COVID-19 was posted on Feb 18, 2020.


9. Alpha Lipoic Acid

Lipoic Acid (often called Alpha-lipoic acid) is an organic compound found in all human cells.

It’s made inside the mitochondrion — also known as the powerhouse of cells — where it helps enzymes turn nutrients into energy (PubMed).

Alpha-lipoic acid is both water- and fat-soluble, which allows it to work in every cell or tissue in the body. Meanwhile, most other antioxidants are either water- or fat-soluble (PubMed).

As of Mar 28, 2020, there were 2 new studies related to Alpha Lipoic Acid for COVID-19 on the Chinese Clinical Trial Registry. One on Mar 8, 2020 and another on Feb 15, 2020.


10. Molecular Hydrogen

Molecular hydrogen has been shown to have anti-oxidant and anti-inflammatory properties. Yes, we are referring to the hydrogen gas (H2) and not some fancy new chemical entity. 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.

Published in 2017, a group of researchers in China suggested that hydrogen-rich solution therapy may be a safe, reliable, and effective treatment for Multiple Organ Dysfunction Syndrome (MODS) induced by influenza and other viral infectious diseases (Ref).

A review in 2019 that included 113 references, has also focused on the potential mechanisms of molecular hydrogen against sepsis to provide a theoretical basis for clinical treatment (PubMed).


11. Magnesium

What's the role of Magnesium in critical illness?

Magnesium is required for the activation of both Thiamine (PubMed) and vitamin D:

12. Garlic

Garlic has shown promise as a treatment for preventing colds and the flu.

Studies have shown that garlic reduces the risk of becoming sick in the first place, as well as how long you stay sick. It can also reduce the severity of symptoms (PubMedPubMed).

One study gave 146 healthy volunteers either garlic supplements or a placebo for three months. The garlic group had a 63% lower risk of getting a cold, and their colds were also 70% shorter (PubMed).

Another study found that colds were on average 61% shorter for subjects who ate 2.56 grams of aged garlic extract per day, compared to a placebo group. Their colds were also less severe (PubMed).


Conclusion

There it is, the list of supplements that you can consider. If you are a minimalist and if you were to ask me to recommend only one, the obvious choice is Vitamin C, as per the ranking of this list.

That being said, the supplements do have synergistic effects with each other and preferably, you should consider taking a combination strategy. That's the reason why the most ideal source is to get them from 5 servings of fruits and vegetables on a daily basis.

Please take note that the dosages for micronutrients are higher for treatment as opposed to maintenance. This is probably due to higher demand or the deficiency of the micronutrients are worse during a complicated viral infection. However, for prevention or maintenance, the dosages for most of the micronutrients are much lower. I know this is complicated. Please discuss with your doctor on what's best for you.

Aside from supplements, there are other ways that may help improve immune response and to prevent you from catching the coronavirus.
  • Wear protective face mask. This is to protect not only yourself but others.
  • Abundant evidence suggests that eating whole in fruits, vegetables and whole grains—all rich in networks of naturally occurring antioxidants and their helper molecules—provides protection against free radicals.
  • Getting Enough Sleep
  • Avoid Sugar
  • Don't smoke.
  • Take steps to avoid infection, such as washing your hands frequently and cooking meats thoroughly.
  • Try to minimize stress.
  • Drink enough water to keep your body hydrated.
  • Avoid excess alcohol.
  • Regular physical activity (outdoor activities may not be allowed in countries with 'lock-down').

Alert

For those with a weakened immune system, existing heart or lung problem and the elderly, please see your doctor immediately if you suspect that you have been infected by the Coronavirus. If you have high blood pressure, please make sure that your blood pressure is well controlled, as the fever will likely to increase the blood pressure, raising your probability of getting a heart attack or a stroke.

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