Hydroxychloroquine vs Ivermectin vs Quercetin: What's the Difference?

If you are confused about the recommendations made by different professional groups for the COVID-19 pandemic, you've come to the right place. Before you continue to read this rather long article, let's start with the end in mind and begin with the conclusion that you may have been told. There is no early treatment for COVID-19? Most of the studies are small and are of low quality? We shall wait for bigger and better quality evidence before we can make formal recommendations?

The main aim of research is to analyze the facts in order to predict the future. Science requires questioning and testing. The world does not exist in a 'black or white' manner and most of the time, things do fall into the 'gray' area. Medical science is dynamic and evidence development is constantly in a continuous work-in-progress mode. If a treatment has been shown to work in a small study, would you wait for a bigger study or should you just take it after considering the benefit and risk ratio; especially if the treatment is actually an old drug that has been used for more than 20 years? You be the judge!

The number of options for the treatment of COVID-19 has increased drastically in recent months, thus making it complicated when it comes to choosing the right combination. In general, there are 3 broad categories of medical interventions:

  1. Prevention or Prophylaxis e.g. vaccine
  2. Early out-patient treatment
  3. Hospital treatment

McCullough et al. Reviews in Cardiovascular Medicine, 2020


All these treatments come with various technologies and jargons, thus could be overwhelming and confusing for you as a consumer. Generally, multiple treatments and strategies are used in combination to achieve the best possible outcome. 

The medical community themselves are battling over ivermectin and hydroxychloroquine on whether they should be used to treat and prevent COVID-19. On one side are experts telling you that more research is needed before the treatment can be fully authorized and confirmed. On the other, are experts telling you that the potential benefits outweigh the risk and a 'wait and do nothing' position is not acceptable. Confused? 

How do you deal with different expert groups dishing out conflicting guides? A common issue is that certain groups have pre-defined narrative that they would like to support. Therefore, only studies that support that pre-defined narrative are picked and cited as references. This is what we call as 'cherry-picking'. Cherry picking will naturally lead to a 'biased' and 'manipulated' decision. In order to get the truth out, scientific information needs to be analyzed in a comprehensive, updated and non-biased manner.

In this article, we would like to cover 3 popular treatments i.e. Ivermectin, Hydroxychloroquine and Quercetin.

Ivermectin and COVID-19

Ivermectin is an anti-parasitic medication widely used in low- and middle-income countries to treat parasitic worm infections in adults and children. It’s been used for decades for this purpose by over 3.7 billion people, and is considered safe and effective. It has an increasing list of indications due to its antiviral and anti-inflammatory properties, and is included on the WHO’s Model List of Essential Medicines.

Check out the evidence tracker on ivermectin and COVID-19 from c19ivermectin.com (constantly updated), with more than 100 published studies by more than 900 scientists.


Is ivermectin a zinc ionophore? Although there are many articles stating it is but most articles do not provide scientific references to support the claim. We have found studies that showed that ivermectin has a probable ionophore nature: 

Ivermectin and FLCCC I-MASK+ Early Treatment Protocol

The Front Line COVID-19 Critical Care (FLCCC) Alliance was initially formed as a working group during the early COVID-19 pandemic days in response to multiple early reports of COVID patients with an inexplicably high need for prolonged mechanical ventilation and an excessive death rate.

Based on rapidly emerging clinical trials evidence, the FLCCC team has developed the I-MASK+ protocol for prophylaxis and at home treatment of early stage COVID-19.

For updated early outpatient protocol (COVID-19 positive), please check out FLCCC I-MASK+ protocol.

Ivermectin and COVID-19 Updates:

Legal Update (April 2022): Tennessee's legislature made ivermectin essentially an over-the-counter drug in April 2022. The state’s Senate overwhelmingly voted 66-20, and the House voted 22-6 in favor of the bill.  Several states gave healthcare providers an immunity guarantee for the use of ivermectin and hydroxychloroquine for COVID. Kansas’ Senate voted to strengthen religious exemptions and give safe harbor to those prescribing ivermectin.


Concerns and Cautions:
  • Ivermectin has a number of potentially serious drug-drug interactions. Please check for potential drug interaction at Ivermectin Drug Interactions - Drugs.com. The most important drug interactions occur with cyclosporin, tacrolimus, anti-retroviral drugs, and certain anti-fungal drugs. 
  • Quercetin and ivermectin interactions? According to Drugs.com: "No interactions were found between ivermectin and Quercetin. This does not necessarily mean no interactions exist. Always consult your healthcare provider."
  • Ivermectin is also lipophilic and therefore, bioavailability is maximised on a full stomach; or best to be taken with meal.
Ivermectin for COVID-19: Real-time meta analysis

Check out the real time meta-analysis on Ivermectin and COVID-19 from Ivmmeta.com (constantly updated).

Related: 

Hydroxychloroquine

Historically, hydroxychloroquine was discovered during efforts to synthesize alternatives to quinine as anti-malarials. Is quinine similar to hydroxychloroquine? Hydroxychloroquine and quinine are both anti-malarial drugs. However, hydroxychloroquine is not the same as quinine as hydroxychloroquine is a synthetic drug while quinine is a naturally occurring compound found in cinchona bark. 

Quinine, was first recognized as a potent antimalarial agent hundreds of years ago. Since then, the beneficial effects of quinine and its more advanced synthetic forms, chloroquine and hydroxychloroquine, have been increasingly recognized in a myriad of other diseases in addition to malaria.

Is quercetin same as quinine? No. Quercetin is a phytonutrient whereas quinine is a naturally occurring compound found in cinchona bark and was used as an antimalarial agent. However, both quercetin and quinine are known to have zinc ionophore properties i.e. they transport zinc into the cells. 

Hydroxychloroquine, developed in the 1950s from chloroquine, an old anti-malarial drug, is registered in around 60 countries under trade names such as Plaquenil, Quensyl and Plaquinol.
 
Hydroxychloroquine, a less toxic derivative of Chloroquine is a widely used medication by people with lupus or arthritis. 

Hydroxychloroquine and COVID-19

Hydroxychloroquine (HCQ) is not effective when used very late with high dosages over a long period (RECOVERY/SOLIDARITY), effectiveness improves with earlier usage and improved dosing. Early treatment consistently shows positive effects. Negative evaluations typically ignore treatment time, often focusing on a subset of late stage studies.

As of April 2022 there have been more than 30 studies of Hydroxychloroquine for early treatment with an overall average improvement of 64% as compared to the control groups.

Here’s a chart from c19early.com that shows that hydroxychloroquine performs better than ivermectin when given as early treatment in terms of risk reduction of dying from COVID-19:


The overall improvement for hydroxychloroquine is better than ivermectin (for early treatment); 72 % vs 43 % in terms of death rate. Importantly, hydroxychloroquine needs to be given 'early'.

The latest FLCCC I-MASK protocol has also incorporated hydroxychloroquine as part of the prevention and treatment protocols:
I-MASK protocol and hydroxychloroquine

The difference in terms of effectiveness for hydroxychloroquine is distinctly different when given early vs late treatment (75% vs 19%), as shown in the summary chart below:


The evidence tracking on Hydroxychloroquine versus COVID-19 is available at c19hcq.com (constantly updated).

Do you need a prescription for hydroxychloroquine?

Yes, hydroxychloroquine is a prescription drug and you do need it to be prescribed to you by a doctor.

Quercetin and COVID-19

Are there supplements similar to hydroxychloroquine? Quercetin acts as a zinc ionophore (PubMed 2014), the same mechanism of action that hydroxychloroquine has via helping zinc pass the cell wall where it might halt viral replication.

This zinc ionophore activity of quercetin facilitates the transport of zinc across the cell membrane. It is known that zinc will slow down the replication of coronavirus through inhibition of enzyme RNA polymerase (PubMed 2010). The COVID-19 is an RNA (RiboNucleicAcid) virus and requires the RNA polymerase to replicate. Do take note that the study publication was a 2010 publication and is referring to a different coronavirus as compared to the latest coronavirus (COVID-19); though both are from the same family of coronaviruses.

A review published in The Sage Journal (Dec 2020), summarizes the antiviral significance of quercetin and proposes a possible strategy for the effective utilization of natural polyphenols in our daily diet for the prevention of viral infection.

An animal study published in the Nature (Aug 2012), concluded that quercetin has anti-oxidant, anti-inflammatory and anti-fibrotic (anti-scarring) properties. Another study (JCI May 2012) on rutin (quercetin molecule bound to a sugar molecule called rutinose), commonly found in fruits and vegetables and sold over the counter as a dietary supplement, has been shown to inhibit the formation of blood clots in an animal model of thrombosis.

As of April 2022, there have been 8 published studies of quercetin against COVID-19. For the list of studies, check out c19quercetin.com.

Quercetin, Zinc and Vitamin C

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. Quercetin and vitamin C also act as an antiviral drug, effectively inactivating viruses. 

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

Quercetin is also part of the FLCCC I-MASK+ protocol and Zelenko protocol for COVID-19.
For updated prevention protocol (COVID-19 positive), please check out FLCCC I-MASK+ protocol.
Quercetin works best when taken with vitamin C and Bromelain, as vitamin C helps activate it and bromelain helps with the absorption. In this study (PubMed), Bromelain also has anti-viral property against COVID-19 virus and anti-clotting property, and therefore may be useful against COVID-19.

Caution: Quercetin has one moderate drug interaction with warfarin. Do not take quercetin without medical advice if you are using warfarin.

Ivermectin vs Hydroxychloroquine vs Quercetin

Clinical evidence to date has reported promising results (see above) for Ivermectin in prevention, early treatment as well as late treatment for COVID-19. While both Ivermectin and Hydroxychloroquine might be useful for early treatment, Ivermectin has a broader potential benefit i.e. prevention, early treatment as well as late treatment / hospital treatment. An important to note is that both ivermectin and hydroxychloroquine perform better when given early (within first 3 - 5 days of symptoms) as opposed to late treatment.

study from India (2021), studied ivermectin in combination with hydroxychloroquine, antibiotics and other drugs. Hydroxychloroquine and antibiotics were given as part of the standard protocol for both groups. The results for risk of death:
  • Ivermectin + Hydroxychloroquine + antibiotics = 0/55 (0%)
  • Hydroxychloroquine + antibiotics = 4/57 (7%)
Hydroxychloroquine and Quercetin are both zinc ionophores i.e. they transport zinc into the cells. 

However, quercetin is less potent than HCQ (hydroxychloroquine) as a zinc transporter, and it does not reach high concentrations in lung cells that HCQ does. Quercetin may help reduce risk of viral illness if you are basically healthy. But it is not potent enough to replace HCQ for treatment of COVID once you have symptoms, and it does not adequately get into lung tissue.

That said, if you simply cannot get hydroxychloroquine or ivermectin, quercetin is a viable stand-in. Quercetin works best when taken with vitamin C and Bromelain, as vitamin C helps activate it and bromelain helps with the absorption. Do not forget to combine it with zinc.

Although ivermectin and hydroxychloroquine are relatively safe drugs, they are still synthetic chemicals that can have side effects. Quercetin and Vitamin D, C, Zinc are nutrients that your body require for optimal health. Nutrients are safer alternatives especially if your risk is low e.g. age below 50 and no other chronic illness. 

Other alternatives such as Betadine mouthwash and Betadine nasal spray are over the counter products that you could get easily from your nearest pharmacy. Importantly, you need to start the treatment early. There's a big difference in terms of outcome depending on how early your treatment is. 

Discuss with your doctor on the benefit vs risk for each treatment. If you are on multiple medications, be aware of supplement-drug interactions that might enhance the possibilities of adverse effects.

Ivermectin, Hydroxychloroquine, Quercetin and FLCCC I-MASK+ Protocol

Ivermectin, hydroxychloroquine and quercetin are all part of the latest FLCCC I-MASK+ preventive and early treatment protocols.

For updated prevention and early outpatient protocol  for COVID-19 positive, please check out FLCCC I-MASK+ protocol.


Other Early Treatment Options

For an up-to-date overview of all published studies on early treatment and prevention of COVID-19, we recommend visiting C19Early


Summary

Although ivermectin and hydroxychloroquine are relatively safe drugs, they are still synthetic chemicals that can have side effects. Quercetin is a phytonutrient that will benefit your body for optimal health. 

For a list of proven benefits of quercetin (by category), check out benefits of quercetin.

Nutrients are safer alternatives especially if your risk is low e.g. age below 50 and no other chronic illness. Discuss with your doctor on the benefit vs risk for each treatment. If you are on multiple medications, be aware of supplement-drug interactions that might enhance the possibilities of adverse effects.

The important key takeaway is 'early' treatment. That said you should never attempt to self medicate without the guidance of a licensed medical provider. If you are not a medical doctor, you are likely to find the above information overwhelming. The aim of this article is to empower you with a better understanding of the options available and to discuss the options with your medical doctor.

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Be aware that most supplements have two categories of doses: i.e. 
  1. treatment (therapeutic) doses are normally higher than the RDA doses and 
  2. 'maintenance' or 'preventive' doses that are normally based on the recommended daily value.
You should ideally supplement your micro-nutrients from healthy and wholesome foods, fruits and vegetables. Be aware that most of the 'treatment' or 'therapeutic' doses are above the recommended dietary allowance (RDA) and therefore such doses should not be maintained on a long term basis. You should keep the dose back to within the RDA range once the exposure risk is back to normal.

Disclaimer: Always see or talk to your doctor before taking these supplements. 

Supplements you can purchase from Amazon for COVID-19 prevention. Inspired by the FLCCC prevention protocol >

 

Comments

  1. Excellent article, jam-packed with useful information and sources. Thank you.

    ReplyDelete
  2. Thanks for putting this together.

    ReplyDelete
  3. This is one of the most informational and helpful articles I’ve read to date about how these drugs and vitamins work against Covid and how they protect out bodies. Thank you so much for putting this together. I’m going to share this with all of my groups! I am so curious as to why the anti-parasitic drugs all seem to be the most effective in early treatment of Covid??

    ReplyDelete
  4. You've answered so many questions running through my mind. Thank you. Fantastic article

    ReplyDelete
  5. Gaz
    This is an excellent in-depth look into the efficacy of 3 therapeutics, one of which was very political and controversial.
    Why did the US and UK MSM report very strongly that HCQ was ineffective and indeed a dangerous drug that caused heart arrhythmia and even death. Some media outlets even stated that HCQ was banned.
    I know when the WHO and the Oxford Centre for disease did their study the used huge doses over 5 days resulting in administering close to 3 times the recommended dose. On the 1st day of treatment the gave over 3 times the recommended dose. Recommended dose of HCQ is 400mg morning, 200mg evening for 5 days.
    The WHO & Oxford trials gave 800mg morning, 800mg lunchtime and 400 mg evening. All 3 doses on that 1st day were given within 12hrs. They the continued for 5 days with 800mg morning 400mg evening.
    As you can see the dose over the 5 days was nearly 3 times the recommended dose. It’s no wonder any side effects, which if give the correct dose is minimal and the drug is ver safe, we’re greatly amplified and they were well aware they were not following the drug guidelines and correct dose so the trial was bogus.
    I think it’s a crime that the use of HCQ was vilified by the US democrat government and the UK conservative government. The amount of disinformation and outright lies denied access of HCQ to people that is a helpful and possibly life saving drug.
    If you as much as mentioned HCQ on any of the social media’s ie, Facebook, Twitter and YouTube your account was shut down sighting dangerous disinformation.
    The only reason I can come up with is that they new the big pharmaceutical companies were working on new drug that they could make huge profits on because the HCQ patent run out years ago so anyone can make it and as a result the cost per dose was way less than a dollar were some of the new drugs cost $20 and upwards.
    I think I should leave it there.
    The WHO & Oxford Centre for Disease trials are freely available on there websites and shows everything I’ve mentioned here.

    ReplyDelete
  6. Quercetin is more than Ionophore, actually in this paper Targeting SARS-CoV-2 spike protein of COVID-19 with naturally occurring phytochemicals: an in silico study for drug developmenthttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7441770/#!po=10.7143 they did in silico study (docking) where they simulated how some natural occurring chemicals bind to spike protein S2 docking site binding affinity can be checked in table2! Antibodies do the same thing! And Quercetin has best Binding Affinity (-8.5 kcal/mol) result! In study they also compare HCQ that is not as potent but exhibits some affinity (i think that is main mode of action)...

    ReplyDelete

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