Ivermectin and Cytokine Storm - FLCCC Protocol for COVID-19

It appears one of the differences between those who have a mild illness and severe illness is related to the body's ability to reduce the hyperimmune response that leads to a cytokine storm and the hyper-coagulability (tendency for blood clots) that often accompanies it. The cytokine storm may be one possible way to explain the severe reaction of those in hospitals. This may also explain why younger people and those with a healthy immune system and without pre-existing health conditions tend to have an easier time. Their bodies may release lower levels of cytokines creating just enough inflammation for healing. 

       

McCullough et al. Reviews in Cardiovascular Medicine, 2020

In a review, published on 16 Oct 2020 (Open Heart 2020); the authors looked at in vitro studies that have shown the effectiveness of ivermectin in blocking cytokine production. This prompted the authors to search the research literature on ivermectin for anti-inflammatory actions. The authors argued that it is reasonable to think that, at doses near or slightly above standard dosing, ivermectin, “may have important clinical potential for managing disorders associated with life-threatening respiratory distress and cytokine storm—such as advanced COVID-19."

On 8 Dec 2020, Dr. Pierre Kory's testified before the U.S. Senate Homeland Security and Governmental Affairs Committee. Almost in tears, Dr. Kory, a pulmonologist and ICU specialist, studied exactly how the virus can become deadly in some people and learned that ivermectin perfectly pre-empts and often reverses the process that creates the superinfection, inflammatory response, and cytokine storm that are the hallmarks of most of the deadly cases.

Ivermectin and FLCCC

In October 2020, FLCCC added ivermectin as a core medication in the prevention and treatment of COVID-19. FLCCC regard ivermectin as a core medication in the prevention and treatment of COVID-19. For comprehensive information on ivermectin please refer to their Review of the Emerging Evidence Supporting the Use of Ivermectin in the Prophylaxis and Treatment of COVID-19 and the included references.

Image credit: ClevelandClinic

           

           

Ivermectin is a well-known, FDA-approved anti-parasite drug that has been used successfully for more than four decades to treat onchocerciasis “river blindness” and other parasitic diseases. It is one of the safest drugs known. It is on the WHO’s list of essential medicines, has been given 3.7 billion times around the globe, and has won the Nobel prize for its global and historic impacts in eradicating endemic parasitic infections in many parts of the world. FLCCC medical discovery of a rapidly growing published medical evidence base, demonstrating ivermectin’s unique and highly potent ability to inhibit SARS-CoV-2 replication and to suppress inflammation, prompted FLCCC team to use ivermectin for prevention and treatment in all stages of COVID-19. Ivermectin is not yet FDA-approved for the treatment of COVID-19, but on Jan 14, 2021, the NIH changed their recommendation for the use of ivermectin in COVID-19 from “against” to “neutral”. (see FLCCC press release).

FLCCC (Front Line COVID-19 Critical Care) Protocol

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 prevention, the Front Line COVID-19 Critical Care Working Group (FLCCC) recommends (updated April 26, 2021):

• Vitamin D3: 1000–3000 IU/day. Note RDA (Recommended Daily Allowance) is 800–1000 IU/day. The safe upper-dose daily limit is likely < 4000 IU/day. Vitamin D deficiency has been associated with an increased risk of acquiring COVID-19 and from dying from the disease. Vitamin D supplementation may therefore prove to be an effective and cheap intervention to lessen the impact of this disease, particularly in vulnerable populations, i.e. the elderly and obese. (Amazon)
• Vitamin C: 500 - 1,000 mg BID (twice daily) 
• Quercetin: 250 mg daily. It is likely that vitamin C and quercetin have synergistic prophylactic benefit. Quercetin should be used with caution in patients with hypothyroidism and TSH levels should be monitored. (Amazon)
• Melatonin: 6 mg before bedtime (causes drowsiness). (Amazon)
• Zinc: 30 - 40 mg/day (elemental zinc). Zinc lozenges are preferred. (Amazon)
• Ivermectin for 
• prevention in high-risk individuals (> 60 years with co-morbidities, morbid obesity, long term care facilities, etc): 0.2 mg/kg per dose (take with or after meals) — one dose today, repeat after 48 hours, then one dose weekly. (also see ClinTrials.gov NCT04425850). 
• Post COVID-19 exposure prevention: 0.2 mg/kg per dose (take with or after meals)  — one dose today, repeat after 48 hours.

Precautionary Note: 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. 

Due to the possible drug interaction between quercetin and ivermectin (may increase ivermectin levels), these drugs should not be taken simultaneously (i.e. should be staggered morning and night). 

Ivermectin is also lipophilic and therefore, bioavailability is maximised on a full stomach; or best to be taken with meal.

Related: List of Doctors that will prescribe Ivermectin

For early outpatient protocol (COVID-19 positive), the Front Line COVID-19 Critical Care Working Group, FLCCC recommends (updated Apr 26, 2021):

• Vitamin D3 — 4000 IU/day. (Amazon)
• Vitamin C: 500 - 1,000 mg BID (twice daily) (Amazon)
• Quercetin: 250 mg twice a day. (Amazon)
• Melatonin: 10 mg before bedtime (causes drowsiness). (Amazon)
• Zinc: 100 mg/day. Zinc lozenges are preferred. (Amazon)
• Ivermectin: 0.2–0.4 mg/kg per dose (take with or after meals) — one dose daily, take for 5 days or until recovered. (Find a Doctor)
• Fluvoxamine: 50 mg twice daily for 10–14 days. Add to ivermectin if: 1) minimal response after 2 days of ivermectin; 2) in regions with more aggressive variants; 3) treatment started on or after day 5 of symptoms or in pulmonary phase; or 4) numerous co-morbidities/risk factors. Avoid if patient is already on an SSRI (selective serotonin reuptake inhibitor).
• Nasopharyngeal Sanitation: Steamed essential oil inhalation 3 times a day (i.e. vapo-rub) and/or chlorhexidine/benzydamine mouthwash gargles and Betadine nasal spray 2–3 times a day.
• Aspirin: 325 m/day unless contraindicated.
• Pulse Oximeter: FLCCC 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.

Check out the summary of evidence on Ivermectin versus COVID-19 from Ivmmeta.com (constantly updated).

Recent studies and clinical trials on ivermectin

For an up-to-date overview of all published studies on ivermectin in the treatment and prevention of COVID-19 we recommend visiting c19ivermectin.com; in addition, a meta-analysis of all studies can be found at ivmeta.com (constantly updated).

Related: 

• Find a Doctor who will prescribe Ivermectin

• Here’s How Fluvoxamine Might Help Prevent COVID-19 Infections From Getting Worse

• Quercetin and Zinc Benefits

• Best Vitamin D3 Supplement 2021

• Quercetin and Hydroxychloroquine

• Benefits of Quercetin Bromelain Supplements

• Best Zinc Supplement 2021

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

 

Be aware that most supplements have two categories of dosages: i.e. 

1. treatment (therapeutic) dosages are normally higher than the RDA dosages and 
2. 'maintenance' or 'preventive' dosages that are based on the recommended daily value.

You should ideally supplement your micro-nutrients from healthy and wholesome foods, fruits and vegetables.

Disclaimer: Always see your doctor before taking these supplements. Be aware that most of the 'treatment' dosages are above the recommended dietary allowance (RDA) and therefore such dosages should not be maintained on a long term basis. 

Our aim here isn't to replace your doctors' advice. It is intended as a sharing of knowledge and information. Do take note that supplements are not 100% protective or curative against COVID-19. 

Although ivermectin and hydroxychloroquine are relatively safe drugs, they are still synthetic chemicals that can have side effects. Vitamin D, C, Zinc and Quercetin 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. 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.

Nutritional supplements are meant to tip the scales in favour of you in terms of your immune system and to improve your probability of a smooth recovery, if at all you do get COVID-19. 

You still need to follow the advice given by CDC, WHO and your local authority in terms of local guidelines such as mask wearing, social distancing and avoiding crowds. It's better to combine multiple strategies in order to defend yourself against this virus.