12 Natural Alternatives to Oral Ivermectin (2023) - Evidence based Review

This practical guide on natural alternatives has more than 200 supporting studies that represent the best of science-backed strategies for nutritional interventions in the prevention and treatment of COVID-19.

Ivermectin

The use of ivermectin for COVID-19 has been controversial. 

Ivermectin is often recognized – 2nd to penicillin – for having the greatest impact on human health. And its discovery won the Nobel Prize in 2015. Ivermectin 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. Several studies reported antiviral effects of ivermectin on RNA viruses such as Zika, dengue, yellow fever, West Nile, Hendra, Newcastle, Venezuelan equine encephalitis, chikungunya, Semliki Forest, Sindbis, Avian influenza A, Porcine Reproductive and Respiratory Syndrome, Human immunodeficiency virus type 1, and COVID 19 virus.

Update: Doctors Can Prescribe Ivermectin for COVID-19: FDA Lawyer (August 2023)

If you are confused about the recommendations made by different professional groups for the COVID-19 pandemic and you don't accept what you read at face value, you've come to the right place. Before you continue to read this long-form article, let's start with the end in mind and begin with the conclusion that you may have been told from various mainstream media channels:

• Most of the studies on ivermectin are small and are of low quality? 
• Ivermectin is for horses and dogs?
• We shall wait for bigger and better quality evidence before we can make formal recommendations? There’s no evidence that IVM works or the effectiveness is yet to be proven? 
• There are no randomized controlled trials of IVM? 

In a nutshell, there are two conflicting recommendations from various professional groups. One for and the other against.

The past two years saw basic health information censored and slapped with "mis/dis/mal/information" labels amid a pandemic. 'Misinformation' is based on inaccurate facts. So, what are accurate and inaccurate facts? That will depend on science and research. However, science and research can be manipulated and is subjected to bias. Therefore, it is wise to do your own research in consultation with your trusted doctor. Unfortunately, some of the references used by many media channels are based on outdated studies, or a biased selection of studies based on the narrative that they would like to support.

According to the The Cochrane Review’s editor-in-chief, Karla Soares-Weiser:

“For each measure, though, lack of evidence of effectiveness is not evidence that the interventions are ineffective. Rather, the details of these reviews show why there may never be strong evidence regarding the effectiveness of individual behavioural measures when deployed, often in combination, in a general population living in the complex, diverse circumstances of individuals’ everyday lives. Waiting for strong evidence is a recipe for paralysis. Public health officials must, instead, take measured gambles, based on circumstantial evidence from the reviewed studies and other sources. When protecting the public from harm is the objective, public health officials must act in a precautionary manner to take action even when evidence is uncertain (or not of the highest quality), particularly when the harms and costs of such action are likely limited." - (source)

Check out the evidence tracker on ivermectin and COVID-19 from c19ivermectin.com (constantly updated), with more than 90 published studies (43 RCTs) by more than 1,000 scientists in 27 countries.

Related: Anti Spike Protein Effect of Ivermectin

Natural Alternatives to Ivermectin

Ivermectin is a useful medication against Covid but we don't think it's a miracle drug. There is more than one way to manage COVID-19. 

In the event that you simply cannot get ivermectin, there are viable natural alternatives. Although ivermectin is a relatively safe drug, it's still a synthetic chemical that can have side effects. Nutrients are natural alternatives that will benefit your body for optimal health. 

 

We know there’s an ocean of information out there to navigate, so we’ve compiled and covered 12 best natural alternatives for ivermectin. 

We have perused hundreds of studies and identified multiple nutritional supplements that can be a  game-changer in the alleviation and prevention of severe COVID-19.

Various dietary supplements can be used in combination with other treatments of COVID-19. All these featured supplements have scientific studies to back up their claims. These natural alternatives can easily be purchased over the counter in most countries.

Nutrients and nutraceuticals tend to be agnostic to the COVID-19 virus i.e. it doesn't matter if the patient is down with the Indian, European, Delta, Omicron or Deltacron variants. The mode of actions tend to be multiple and do not have a specific target like targeting the spike protein alone.

Nutrients and supplements are also 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 that 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 information below 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 as an informed patient.

That said, here are some of the substitutes for ivermectin that, in some parts of the country, will be easier to buy whenever we want them. 

Nutraceutical Therapy by Mode of Action

We have provided the list below as a summary and followed by a summary explanation and references for each option/nutrient:

1. Vitamin D3
2. Quercetin
3. Zinc
4. Nigella Sativa (Black Seed Oil) 
5. Melatonin
6. Vitamin A 
7. Curcumin and Turmeric
8. Vitamin C
9. NAC and Glutathione
10. B Vitamins and NAD+
11. Probiotics
12. Nattokinase

1. Vitamin D3 - Anti-inflammatory and Anti-coagulant

At this point, there is simply no question that vitamin D optimization is a crucial component of COVID-19 prevention and treatment. In addition to the many studies published during 2020 and 2021, since December 2021, four large systematic meta-analyses (R, R, R, R) have been published, looking at either vitamin D levels, supplementation or both.

A meta-analysis of randomized controlled trials, published in Pharmaceuticals (Jan 2023), is titled “Protective Effect of Vitamin D Supplementation on COVID-19-Related Intensive Care Hospitalisation and Mortality: Definitive Evidence from Meta-Analysis and Trial Sequential Analysis”. Vitamin D cuts the risk of death from COVID-19 by 51% and the risk of ICU admission by 72%.

In all cases, the data consistently show that low vitamin D levels raises your risk of COVID while higher baseline levels and/or supplementation lowers all risks by 1.5 to three times.

The TSA (trial sequential analysis) revealed "the protective role of vitamin D and ICU admission showed that, since the pooling of the studies reached a definite sample size, the positive association is conclusive." To put it another way, the results suggest "a definitive association between the protective role of vitamin D and ICU hospitalization." 

Words like "conclusive" and "definitive" aren't typically used lightly in scientific research. So, this finding is indeed impressive — although not altogether surprising, since a wealth of other data also shows vitamin D's protective effect against COVID-19. What does raise eyebrows, however, is why the study, which has major implications for public health, isn't being talked about — and vitamin D isn't being widely recommended for COVID-19?

Vitamin D, as an immuno-modulator, is a perfect candidate for countering the immune dysregulation common with COVID-19. Vitamin D deficiency affects the body’s susceptibility to infection and has been associated with influenza, hepatitis C, human immunodeficiency virus (HIV) and other viral diseases [Source]. Surveys indicate that most people in the United States consume less than recommended amounts of vitamin D. 

Scientists from Harvard reported in 2021 that hospitalized patients with a 'Vitamin D blood serum level' of ≥30ng/mL had a much lower mortality rate than those with <30ng/mL.

Results of a systematic review and meta-analysis (Nutrients 2021) suggested that COVID-19 mortality risk correlates inversely with vitamin D3 status, and a mortality rate close to zero could theoretically be achieved at 50 ng/ml 25(OH)D3.

In a June 2022 review paper titled “The Role of Diet and Supplements in the Prevention and Progression of COVID-19: Current Knowledge and Open Issues”​ published in the journal Preventive Nutrition and Food Science, researchers said:

"The consumption of vitamin C and D supplements, in addition to a healthy diet, could be promoted as a co-adjuvant therapy for COVID-19..."

For more evidence, check out the evidence tracker on vitamin D and COVID-19 from c19vitamind.com (constantly updated), with more than 100 published treatment studies and more than 130 sufficiency studies by more than 1,000 scientists.

Trusted Source

Vitamin D has also been shown to have an anticoagulant effect. A decrease in 25-hydroxyvitamin D [25(OH)D] concentration has also been associated with an increased risk of venous thromboembolism (PubMed).

Safety: Daily intakes of up to 25–100 mcg (1,000 IU–4,000 IU) vitamin D in foods and dietary supplements are safe for children (depending on their age) and up to 100 mcg (4,000 IU) are safe for adults. These values, however, do not apply to individuals receiving vitamin D treatment under the care of a physician. Higher intakes (usually from supplements) can lead to nausea, vomiting, muscle weakness, confusion, pain, loss of appetite, dehydration, excessive urination and thirst, and kidney stones. In extreme cases, vitamin D toxicity causes renal failure, calcification of soft tissues throughout the body (including in coronary vessels and heart valves), cardiac arrhythmias, and even death.

Excessive vitamin D in combination with lack of vitamin K2 may cause over-absorption of calcium, which in turn may result in calcium deposits in your heart and kidneys and why some experience symptoms of vitamin D toxicity. Part of the explanation for these adverse side effects is that vitamin K2 keeps calcium in its appropriate place — in your teeth and bones and out of soft tissues and arteries.

Vitamin D and Omicron variants

Will Vitamin D Work Against Omicron BA4, BA 5 and XBB variants? Vitamin D is not variant specific because it's primary mode of action is to support the body’s immune system which reacts in a variety of ways against viral attack, not just in a specific antibody reaction to a specific spike protein. 

Related: Best Vitamin D3 Supplement

2. Quercetin - Anti-inflammatory, anti-coagulant, zinc ionophore and anti-viral

As of November 2023, there have been 11 published studies of quercetin and COVID-19 (c19quercetin.com). 

Quercetin is also no. 1 in this COVID-19 prevention studies league table:

Quercetin is a pigment that is found in plants, vegetables, and fruits, and serves as an immune nutrient offering many health benefits. Elderberry, red onions, white onions and cranberries are the richest sources of quercetin. It is a flavonoid and antioxidant that may help to reduce inflammatory cytokines, infections, allergies and anti-blood clot property. Research has found that quercetin may be particularly beneficial for viral respiratory infections.

Quercetin as a Zinc Ionophore

Quercetin is a zinc ionophore (J Agric Food Chem. 2014). A 2015 study found that that Quercetin shows inhibitory activity in the early stages of a wide range of influenza viruses, including H1N1 and H5N1 (Viruses 2016). Although influenza is not in the same family of viruses as the coronavirus, it’s plausible that a similar mechanism could apply here. There is actually some evidence that Quercetin has already proven effective at treating Ebola and Zika viruses.

Quercetin 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. 

Quercetin Dosage

The FLCCC I-MASK+ protocol recommends 250 mg daily for prevention and 250 mg twice daily for early treatment.

Quercetin works best when taken with vitamin C and Bromelain, as vitamin C helps activate it and bromelain helps with the absorption.

Precaution: Quercetin should be used with caution in patients with hypothyroidism (low thyroid hormone) and relevant thyroid hormone levels should be monitored.

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."

Quercetin and COVID-19

For an updated list of studies, check out c19quercetin.com. 

A word about quercetin: Some physicians are recommending this supplement to reduce viral illnesses because quercetin acts as a zinc ionophore to improve zinc uptake into cells. It is much 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 unless you take massive doses (3-5 grams a day), which cause significant GI (gastrointestinal) side effects such as diarrhea.

Editor's Note: Studies typically use advanced formulations for greatly improved bioavailability.

Related: Best Quercetin Zinc Supplement

3. Zinc - Anti-viral 

Zinc is another powerful immune nutrient known for its benefits for providing immune health support and inflammation reduction as well as for improving cold and respiratory symptoms, wound healing, acne reduction, and lowering the risk of age-related diseases. This trace element is essential to to cell function and involved in over 100 enzymes. Research on atherosclerosis and diabetes mellitus suggests that zinc deficiency may contribute to low-grade systemic inflammation.

Aging is associated with compromised immunity, that just means that your immune response to pathogens and infections starts to slow and is less robust, including a reduced vaccine immune response/efficacy. ⁣
⁣
Improving zinc intake/zinc status improves/modulates/enhances immune function. The flip side is, while some aspects of immunity slow, others increase. Uncontrolled immune responses drive excess inflammation. Zinc helps to balance all of this. ⁣

The National Institutes of Health (NIH) states:

“Zinc is involved in numerous aspects of cellular metabolism. It is required for the catalytic activity of approximately 100 enzymes and it plays a role in immune function, protein synthesis, wound healing, DNA synthesis, and cell division. Zinc also supports normal growth and development during pregnancy, childhood, and adolescence and is required for proper sense of taste and smell.”

Foods that are high in zinc include oysters, crab, lobster, mussels, red meat, and poultry. Cereals are often fortified with zinc. Most multivitamin and nutritional supplements contain zinc.

Zinc and COVID-19

The use of zinc for SARS-CoV-2 was a topic routinely flagged by COVID fact checkers as “misinformation,” so word didn’t really get out about its potential as an anti-COVID agent. However, there are more than 35 studies that provided evidence on zinc’s promise for keeping people healthy if they get COVID.

Zinc gluconate (R), zinc acetate (R) and zinc sulphate (R) have all been shown to reduce the severity and duration of viral infections such as the common cold. Zinc also appears to be the key ingredient in treatment protocols using hydroxychloroquine (HCQ).

The reason for this is because HCQ is a zinc ionophore (zinc transport molecule), meaning it’s a drug that improves your cells’ uptake of zinc. Once inside your cells, zinc prevents viral replication. This is also why zinc and zinc ionophores need to be taken very early in the illness, or as a prophylactic.

The problem is that zinc is largely insoluble and cannot easily enter through the fatty wall of your cells. Getting all the way into the cell is crucial, as this is where the viral replication occurs. This is why zinc ionophores are so important.

Aside from hydroxychloroquine, other natural, and safer, zinc ionophores include quercetin and epigallocatechin-gallate (EGCG). If given early, zinc along with a zinc ionophore should, at least theoretically, help lower the viral load and prevent the immune system from becoming overloaded.

Check out the evidence tracker on zinc and COVID-19 from c19zinc.com (constantly updated). 

Safety: 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). Be aware that typical daily doses of zinc provided by zinc lozenges generally exceed tolerable upper limits for zinc, and for this reason, they should not be used for longer than about a week. 

Excessive doses may interfere with copper absorption, which could negatively affect your immune system as it can cause copper deficiencies, blood disorders and potentially permanent nerve damage. Zinc can also impair the absorption of antibiotics, and use of zinc nasal gels or swabs has been linked to temporary or permanent loss of smell.

When it comes to zinc supplementation, more is not necessarily better. In fact, it can frequently backfire is you do not also maintain a healthy zinc-to-copper ratio. As explained by Chris Masterjohn, who has a Ph.D. in nutritional sciences, in an article and series of Twitter posts:

“In one study, 300mg/day of zinc as two divided doses of 150 mg zinc sulfate decreased important markers of immune function, such as the ability of immune cells known as polymorphonuclear leukocytes to migrate toward and consume bacteria.

The most concerning effect in the context of COVID-19 is that it lowered the lymphocyte stimulation index 3 fold. This is a measure of the ability of T cells to increase their numbers in response to a perceived threat. The reason this is so concerning in the context of COVID-19 is that poor outcomes are associated with low lymphocytes …

The negative effect on lymphocyte proliferation found with 300 mg/day and the apparent safety in this regard of 150 mg/d suggests that the potential for hurting the immune system may begin somewhere between 150-300 mg/d …

It is quite possible that the harmful effect of 300 mg/d zinc on the lymphocyte stimulation index is mediated mostly or completely by induction of copper deficiency …

The negative effect of zinc on copper status has been shown with as little as 60 mg/d zinc. This intake lowers the activity of superoxide dismutase, an enzyme important to antioxidant defense and immune function that depends both on zinc and copper …

A study done with relatively low intakes of zinc suggested that acceptable ratios of zinc to copper range from 2:1 to 15:1 in favor of zinc. Copper appears safe to consume up to a maximum of 10 mg/d.

Notably, the maximum amount of zinc one could consume while staying in the acceptable range of zinc-to-copper ratios and also staying within the upper limit for copper is 150 mg/d.”

Another factor to keep in mind is that certain additives can inhibit zinc absorption, which is the complete opposite of what you’re looking for. For instance, research has shown citric acid, glycine, mannitol and sorbitol can reduce zinc absorption,48 so zinc lozenges containing these ingredients may be less useful.

Zinc Form and Dosage

There are several types of zinc supplements. Supplements contain several forms of zinc, including zinc gluconate, zinc citrate and zinc picolinate. The percentage of elemental zinc varies by form. To find out the percentage of elemental zinc in each form, check out elemental zinc percentage.

Chelated zinc is a general form of supplementary zinc in which the zinc is chelated — or bound — to a compound to make it easier for the body to absorb. Zinc picolinate or zinc gluconate are formed when zinc is chelated to picolinic acid or gluconic acid, so the main difference between zinc gluconate and picolinate is what compound it is bound to.

To find out which zinc supplement to consider, check out best zinc supplement.

Most people do not lack an intake of zinc, but in disease state, there might be an increase in demand by the body. The FLCCC I-Prevent protocol recommends 20 - 50 mg a day for prevention and the FLCCC I-Care protocol recommends 75 - 100 mg a day for early treatment of COVID-19. This should not be taken long term without evaluation of your zinc/copper ratios.

The ideal zinc form should come 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.

Do take note that you should keep the dosage back to within 40 mg/d once the exposure risk is back to normal.

4. Nigella Sativa (Black Seed Oil) and Cytokine Storm - Anti-inflammatory

Nigella sativa (N. sativa) is a small flowering plant that grows in Southwest Asia, the Middle East, and Southern Europe (Source). This shrub produces fruit with tiny black seeds. Commonly referred to as black seed, N. sativa seeds go by many other names, such as black cumin, black caraway, nigella, fennel flower, and Roman coriander (Source).

Black seed oil is extracted from N. sativa seeds and has been used in traditional medicine for over 2,000 years due to its many therapeutic benefits.

Thymoquinone which is the active ingredient in N. sativa seeds has demonstrated effects in significantly reducing the cytokine storm chances and consequent mortalities (Source).

Summary results of more than 10 published clinical studies are available on this dedicated webpage: c19ns.com. 

5. Melatonin- Anti-inflammatory and anti-viral

Melatonin is a hormone produced by the pineal gland in the brain, mainly during the night, that helps regulate circadian rhythms [Source]. Its levels decrease with aging. Most melatonin supplementation studies have evaluated its ability to control sleep and wake cycles, promote sleep, and reduce jet lag.

The potential utility of melatonin in treating COVID patients has not gone unnoticed, with a PubMed search combining melatonin and COVID producing more than 50 citations.

Check out the evidence tracker on melatonin and COVID-19 from c19melatonin.com (constantly updated). As of January 2023, there are more than 15 published clinical studies of melatonin for treatment and prevention in COVID-19 and the results are promising even when it's given as a late treatment.

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 (Antioxidants, 2020) 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.

Production of melatonin diminishes with age, contributing to immune dysfunction and increasing oxidative stress, inflammation, and infection susceptibility (Ref). In addition, infectious viruses can suppress melatonin production, disrupting circadian controls and impairing immune function (Ref).

According to a review (Cardinali et al. 2020), melatonin might counteract the consequences of COVID-19 via salutary effects on the sleep/wake cycle and more generally on chronobiology, as well as through its antioxidant and anti-inflammatory effects.

Based on melatonin’s therapeutic potential and well-established safety profile, it has been suggested those at higher risk for severe illness and complications from viral respiratory infection, including the elderly and those with chronic medical conditions, may benefit most from regular use of 3–10 mg melatonin at bedtime (Ref). 

Fluvoxamine (Selective Serotonin Reuptake Inhibitor) might also exert beneficial effects in COVID patients through its well-characterized ability to substantially increase (~ 2–3-fold) night-time plasma levels of melatonin. This increase appears to result from fluvoxamine’s inhibition of the melatonin-metabolizing liver enzymes (von Bahr et al. 2000).

An Iranian randomised controlled trial (Arch Med Res 2021), studied 74 mild to moderate hospitalized patients. The study showed that adjuvant use of melatonin has a potential to improve clinical symptoms of COVID-19 patients and contribute to a faster return of patients to baseline health.

Some researchers have suggested high doses of melatonin, ranging from 50 to 200 mg twice daily, might help treat patients hospitalized for severe acute respiratory illness (Ref).

In a small Philippine case series study of 10 hospitalised COVID-19 patients, high dose melatonin (hdM) was given in addition (adjuvant) to standard therapy. According to the authors:

"High dose melatonin may have a beneficial role in patients treated for COVID19 pneumonia, in terms of shorter time to clinical improvement, less need for MV, shorter hospital stay, and possibly lower mortality."

Safety: If you take a melatonin supplement, be careful: Too much can cause daytime sleepiness. There is no federal RDA nor any formal advice on supplement dose ranges. Based on an on-going Spanish study, a 2 mg daily dose protocol is being investigated for prevention of COVID-19. Do take note that the dosage for 'prevention' and 'treatment' is different, For prevention or maintenance, a lower dosage is normally recommended whereas a 'treatment' or 'therapeutic' dosage is normally higher.

Typical doses of 1–10 mg/day melatonin appear to be safe for short-term use (Source). Reported side effects, which are usually minor, include dizziness, headache, nausea, upset stomach, rash, and sleepiness. However, some reports have linked high blood levels of melatonin with delayed puberty and hypogonadism.

Studies have not evaluated melatonin supplementation during pregnancy and breastfeeding, but some research suggests that these supplements might inhibit ovarian function (Source). Therefore, some experts recommend that women who are pregnant or breastfeeding avoid taking melatonin.

6. Vitamin A

Summary results of 10 vitamin A and COVID-19 studies are available on this dedicated webpage: c19early.com/va. 

Based on this early treatment mortality studies drug league table below, vitamin A might even out-perform vitamin D, ivermectin and hydroxychloroquine:

That said, most clinicians will use the multi-drug or combination approach to get the best outcome. Further, the sorting of the table above is based on only 1 vitamin A study.

7. Curcumin and Turmeric - Anti-inflammatory and anti-viral

Curcumin, a yellow carotenoid from turmeric, is a nutritional therapeutic recommended as part of the FLCCC I-CARE early treatment protocol, and has antiviral, anti-inflammatory, antioxidant and immune modulating properties.

There are more than 20 completed studies of curcumin in COVID-19 that suggest that it improves clinical outcome of patients.

Curcumin also acts as natural zinc ionophores and can promote the cellular uptake of zinc and can be used with zinc to increase the effectiveness of these compounds in the inhibition of the virus (Ref).

Curcumin has been demonstrated (Ref) to suppress several inflammatory cytokines and mediators of their release such as tumor necrosis factor-alpha (TNF-alpha), IL-1, IL-8 and nitric oxide synthase.

8. Vitamin C - Anti-inflammatory

Vitamin C, which most of us reach for with any cold or flu, was used in high doses to great effect by COVID-19 early treatment doctors.

Vitamin C may be one of the most well-known immune nutrients that protect against immune deficiencies and which supports the prevention and recovery from the common cold and upper-respiratory issues, and also protects your cardiovascular system, eyes, skin, and other parts of your body. Research has found that vitamin C may help to optimize the immune system.

Do take note that the vitamin C dosages given in the hospitals intravenously are different from those over the counter vitamin C supplements. Therefore, when you come across studies on vitamin C, you need to differentiate those that are given intravenously vs oral vitamin C.

Vitamin C and COVID-19

 

Check out the evidence tracker on vitamin C and COVID-19 from c19vitaminc.com (constantly updated).

Safety: The U.S. Recommended Dietary Allowance (RDA) for vitamin C is 75 to 120 milligrams per day. 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.

While generally considered safe even in high doses, way too much vitamin C — anything above 2,000 milligrams daily—can cause headaches, insomnia, diarrhea, heartburn, and other issues.

Be aware that there are side effects and risks associated with taking high doses of vitamin C. People sometimes assume there is no harm in taking large doses because vitamin C is water-soluble (i.e. excess vitamin C is excreted from the body), but this is not the case. In addition to causing gastric distress and diarrhea, high doses of vitamin C (over 500 mg per day) over the long-term may increase the risk of cataracts. High-dose vitamin C can also reduce the effectiveness of certain medications and interfere with certain blood tests. Furthermore, very high-dose vitamin C (typically 2,000 mg per day or more) can increase the risk of oxalate nephropathy — a condition in which oxalate crystals are deposited in the kidney, leading to kidney damage and/or kidney failure. Cases of this were shown to rise during the first two years of the COVID-19 pandemic, likely due to increased use of very high dose vitamin C (Fong, Kidney Int Rep 2022).

That said, temporarily taking megadoses of vitamin C supplements to combat a case of the cold or flu is likely not going to cause a problem.

Many vitamin C supplements that are above the US RDA are sold in the market. It’s important to seek a physician’s advice if you intend to take high dose vitamin C on a long term basis. To be on the safe side, you may also request for your kidney functions to be monitored.

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. 

Vitamin C, Omicron and Deltacron

Will Vitamin C Work Against Omicron or Deltracron? Vitamin C is not variant specific because it's primary mode of action is to support the body’s immune system which reacts in a variety of ways against viral attack, not just in a specific antibody reaction to a specific spike protein. 

Related: Best Vitamin C Supplement

9. NAC, Glutathione and COVID-19 - Anti-inflammatory and anti-coagulant

N-acetylcysteine (NAC) is a precursor to glutathione. It is an antioxidant and increases glutathione levels in the body (Source). NAC has mucolytic activity, so it helps reduce respiratory mucus levels. Laboratory research suggests that NAC might boost immune system function and suppress viral replication. NAC also decreases levels of interleukin-6 and has other anti-inflammatory effects.

Much of the research on NAC has used an inhaled, liquid form of this compound. This form—which is classified as a drug, not a dietary supplement—is approved by the U.S. Food and Drug Administration (FDA) as a mucolytic agent and for decreasing respiratory secretion viscosity (Source). Products containing NAC are also sold as dietary supplements.

NAC and COVID-19

Considering many COVID-19 cases involve blood clots in addition to excessive oxidative stress, and NAC effectively addresses both, NAC should be seriously included in standard of care for COVID-19.

 

For a compilation of more than 10 studies of NAC and COVID-19, check out the list of studies here (constantly updated).

However, in terms of early treatment, the improvement rate is not as impressive as the other natural alternatives i.e. quercetin, black seed oil and vitamin A.

That said, NAC is a natural alternative for aspirin and an over-the-counter supplement that both prevents blood clots and breaks up existing ones i.e. anticoagulant effects. 

Studies have shown that NAC may protect against coagulation problems associated with COVID-19, as it has both anticoagulant (source) and thrombolytic effects (source), meaning it may both prevent clots and break up clots that have already formed.

A 2017 paper found NAC has potent thrombolytic effects, meaning it breaks down blood clots once they've formed.

Many COVID-19 patients experience serious blood clots, and NAC counteracts hypercoagulation, as it has both anticoagulant and platelet-inhibiting properties.

Consider taking around 500 milligrams/day of NAC, as it helps prevent blood clots and is a precursor for your body to produce the important antioxidant glutathione.

Foods that have a positive impact on glutathione production include cruciferous vegetables such as broccoli, green tea, curcumin, rosemary and milk thistle. Getting quality sleep may also help.

Different types of exercise can influence your levels as well. In one study, researchers enrolled 80 healthy but sedentary volunteers to measure the type of exercise that may have the greatest effect. They found that aerobic training in combination with circuit weight training showed the greatest benefit.

NAC and Bromelain was shown to degrade spike protein

In a lab study published in March 2021, the combination of Bromelain and Acetylcysteine (BromAc) present a synergistic effect on COVID-19 virus spike protein destabilization.

NAC (N-Acetyl Cysteine) vs Glutathione

N-acetyl L-cysteine (NAC), as a precursor of glutathione, helps to replenish intracellular glutathione, a vital cellular antioxidant. NAC has a low molecular weight and is well absorbed via oral administration as compared to glutathione.

NAC may also protect against coagulation problems associated with COVID-19, as it counteracts hypercoagulation and breaks down blood clots.

Glutathione and Zinc

To improve your glutathione, you need zinc, and zinc in combination with hydroxychloroquine (a zinc ionophore or zinc transporter) has been shown effective in the treatment of COVID-19.

Glutathione and Molecular Hydrogen 

One of the best ways to increase glutathione, though, is molecular hydrogen. Molecular hydrogen does so selectively and will not increase glutathione unnecessarily if you don’t need it. You can view Tyler LeBaron’s lecture on the details of how it does this in “How Molecular Hydrogen Can Help Your Immune System.”

Glutathione and Selenium

Selenium is also important, as some of the enzymes involved in glutathione production are selenium-dependent.

Safety: As an FDA-approved drug, the safety profile of NAC has been evaluated (Source). Reported side effects of oral NAC include nausea, vomiting, abdominal pain, diarrhea, indigestion, and epigastric discomfort. No safety concerns have been reported for products labeled as dietary supplements that contain NAC. (Source)

For NAC contra-indications, check out here.

Update: NAC supplements are now available on Amazon US. 

10. Probiotics and COVID-19 - Anti-inflammatory

Probiotics are living non-pathogenic microorganisms that, when administered in adequate amounts, can have a positive impact on health. Bacteria in the Lactobacillus and Bifidobacterium genera, as well as Streptococcus thermophiles and Saccharomyces boulardii, are examples of common probiotics (Ref).

You can find a list of more than 20 published clinical studies on probiotics and COVID-19 from c19probiotics.com (constantly updated). However, with an overall improvement of 25% for all studies, the improvement rate is not as impressive as the other natural alternatives i.e. quercetin, black seed oil and vitamin A, based on the aggregated analysis on C19early.org. However, the improvement rate of 61% (based on 8 studies) has made probiotics ranked No. 6 in the COVID-19 all mortality (death rate) studies league table, better than ivermectin and quercetin.

11. B Vitamins and COVID-19 - Anti-inflammatory

'B vitamins' as a topic is a complicated subject and that's probably why they are called 'B Complex'. 

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), B7 (biotin), B9 and B12.

B vitamins can be found in a variety of foods including red meat, beans, milk, cheese, broccoli, spinach, avocados and brown rice. Despite the availability of vitamin B-rich foods, many Americans may be deficient in this nutrient — and not even know it. According to a blog post from Harvard University, using the National Health and Nutrition Examination Survey, “3.2 percent of adults over age 50 have a seriously low B12 level” and “up to 20 percent may have a borderline vitamin B12 deficiency.”

Dr. Uma Naidoo, a nutrition expert at Harvard Medical School, explains that:

"In a poorly regulated immune system, the body's cytokine storm induced by COVID cause lots of inflammation in the body, just as if little grenades were being tossed around. This is what causes the worst outcomes and death in COVID.

It follows that anything that improves immune system function and decreases the chances that an infected person will have a catastrophic cytokine storm may improve the outcome of COVID-19 cases and decrease the overall death rate. Therefore, it’s quite feasible that B-vitamin supplementation could contribute to preventing the worst COVID outcomes.”

Thiamine (vitamin B1), a water-soluble B-complex vitamin, is rapidly depleted during times of metabolic stress, including severe illness. Thiamine deficiency is common in hospitalized patients, especially those with critical illness (Ref). Thiamine is needed for cellular energy production and helps regulate reduction-oxidation balance, immune function, nervous system function, and vascular function (Ref).

Thiamine, at 200 mg twice daily, reduced mortality in patients with septic shock and thiamine deficiency, and laboratory research suggests it may inhibit the hyper-inflammatory immune response that accompanies cytokine storm (Ref). It is a key therapeutic in the MATH+ protocol (methylprednisolone, ascorbic acid [vitamin C], thiamine, and heparin, plus other supportive nutrients and medications), a treatment strategy proposed for managing advanced stages of severe acute viral respiratory illness (Ref). Although high-quality clinical evidence is lacking, two US hospitals implementing the MATH+ protocol in patients with a severe acute viral respiratory illness reported mortality rates that were approximately one-quarter of those reported from other US hospitals using standard care (Ref).

In a study in Saudi Arabia (Al Sulaiman et al. Crit Care 2021), 738 critically ill COVID-19 patients from two centers were included in the study. The in-hospital death rate and 30-day death rate were significantly lower in the group that received thiamine as an adjunctive treatment (a therapy given in addition to standard therapy). In addition, the thiamine group also were less likely to have blood clot during ICU stay.

Another study of COVID-19 patients with severe symptoms found 26.3% among diabetics with COVID-19 were vitamin B1 deficient.

Niacin or vitamin B3 is a 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 (NR), nicotinic acid and nicotinamide mono nucleotide (NMN).

Nicotinamide adenine dinucleotide (NAD+) is an essential cofactor in all living cells that is involved in fundamental biological processes. 

Structurally, the closest molecule to NAD+ is NMN, requiring only one enzymatic step to be converted to NAD+. NR, which is two enzymatic steps away from NAD+, is also being studied clinically (David Sinclair. Trends Immunol. 2022).

A Phase 3 study published in Advanced Science (June 2021), demonstrated that 229 patients with mild-to-moderate COVID-19 receiving standard of care experienced a 3.5 day reduction in recovery time when receiving an added nutritional protocol. Aimed at improving mitochondrial function, the protocol included nicotinamide riboside (NR), L-serine, N-acetyl-L-cysteine (NAC), and L-carnitine tartrate. The results of the study, which took place in conjunction with the ChromaDex External Research Program (CERP) and ScandiBio Therapeutics, build on findings from Phase 2 clinical data published in October 2020. The addition of the nutritional protocol, or combined metabolic activators (CMA), to the Turkish standard of care not only reduced recovery time but improved liver health and decreased levels of inflammatory markers.
 

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.

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.

Adequate amounts of folate, vitamin B6 and vitamin B12 are also needed for your body to make the amino acid cysteine. N-acetyl cysteine (NAC) is a supplement form of cysteine. Consuming adequate cysteine and NAC is important for a variety of health reasons — including replenishing the most powerful antioxidant in your body, glutathione. 

12. Nattokinase - Anti Coagulant

Nattokinase (NK) is an enzyme derived from a traditional Japanese food called natto, and it is thought to help lower cholesterol, reduce inflammation, and improve circulation. 

Nattokinase for Blood Clots

Nattokinase dissolves blood clots by directly hydrolyzing fibrin and plasmin substrate. It converts endogenous prourokinase to urokinase (uPA). It also degrades plasminogen activator inhibitor (PAI-1) and increases the level of tissue plasminogen activator (t-PA). (Source)

Tanikawa et al. (2022) examined the effect of nattokinase on the COVID-19 spike protein. In the first experiment, they demonstrated that spike was degraded in a time and dose-dependent manner in a cell lysate preparation that could be similar to a vaccine recipient. The second experiment demonstrated that nattokinase degraded the spike protein in SARS-CoV-2 infected cells. This was reproduced in a similar study done by Oba and colleagues in 2021.

Nattokinase dissolves blood clots by directly hydrolyzing fibrin and plasmin substrate. It converts endogenous prourokinase to urokinase (uPA). It also degrades plasminogen activator inhibitor (PAI-1) and increases the level of tissue plasminogen activator (t-PA). (Source)

Human trials have demonstrated that NattoKinase (NK) provides support to the circulatory system by thinning the blood and dissolving blood clots. (Source, Source)

In a randomized controlled trial (2015), a single-dose of 2,000 FU NK (NSK-SD, Japan Bio Science Laboratory Co., Ltd) appears to potentiate thrombolysis and anti-coagulation profiles.

In another 8-week randomized controlled trial (2016), subjects were given 8 weeks supply of either a placebo or a nattokinase. Nattokinase NSK-SD® (subtilisin NAT) was encapsulated in veggie caps with 100 mg/capsule and standardized to at least 2,000 fibrinolytic units (FU) per each 100 mg daily oral dose.  Subjects were instructed to take one capsule daily in the morning and to return the bottles with any remaining capsules at the 8-week visit.

The average level of vWF (Von Willebrand Factor) was reduced by 15% in the nattokinase group, whereas no consistent change was seen for the subjects consuming placebo for 8 weeks. The difference in vWF levels at 8 weeks between the two groups showed a statistical trend (P<0.09). This decrease in vWF levels was sex specific, as it was seen for the group of females consuming nattokinase (26% reduction, P<0.09) but not in the male group consuming nattokinase.

Dosage: Nattokinase 100 mg/day (equivalent to 2,000 fibrinolytic units [FU]), typically for a duration of 8 weeks, has been used in some studies evaluating thrombolytic/fibrinolytic and blood pressure effects.

Quercetin, Vitamin C, D, Zinc, Melatonin and the FLCCC Protocol

So how do we combine multiple nutrients together? Quercetin, Vitamin C, D, Zinc, Melatonin and Black Seed Oil are part of the FLCCC I-PREVENT and I-CARE protocols. For updated prevention and early outpatient protocol for COVID-19 positive, check out FLCCC I-MASK+ protocol.

 

Quercetin, zinc, vitamin D and C are also part of the Zelenko Protocol. In an effort to make it easier for patients, Dr Zelenko has developed an oral supplement that contains all four key ingredients: vitamin C, quercetin, vitamin D3 and zinc. It’s referred to as 'Z-Stack Supplement'.

Related: Best Pulse Oximeter

Eliminate Seed Oils

Eliminate vegetable (seed) oils in your diet, which involves eliminating nearly all processed foods and most meals in restaurants unless you convince the chef to only cook with butter. Avoid any sauces or salad dressings in restaurants as they are loaded with seed oils. Also avoid chicken and pork as they are very high in linoleic acid, the omega-6 fat that is far too high in nearly everyone and contributes to oxidative stress that causes heart disease.

Metabolic Health

The ability to eliminate insulin resistance is a strategy that addresses the majority of illnesses that you will ever encounter in your lifetime.

This is why time-restricted eating, eliminating industrially processed seed oils like soy, corn and canola oils, eating a cyclical ketogenic diet, exercising and sleeping well can improve, if not eliminate, most conditions that you would need to take medications for.

Ivermectin for COVID-19: Real-time meta analysis

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

Related: List of Doctors that will prescribe Ivermectin

Notes: 

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

Other Potential Treatments

There are over two dozen compounds that have shown effectiveness in treating COVID-19. For a list of COVID-19 early treatment studies, check out c19early.com (constantly updated).

Please check this page regularly for updates – new natural alternatives may be added and/or dose changes to existing alternatives may be made as further scientific studies emerge.

As you can see from the treatment league table above, some of the 'natural alternatives' (including diet (R) and exercise (R)) might even perform better than synthetic drugs.

Summary

The combination of quercetin, zinc, vitamin D, vitamin C and melatonin offer a high virus inhibiting and anti-inflammatory potential with a valuable degree of safety at a time of great uncertainty.

That said, based on the above evidence, a combination of vitamin D, quercetin, black seed oil, vitamin A and melatonin might even offer a greater probability of improvement if given as early treatment.

 

Quercetin, zinc, vitamin D and C are part of the FLCCC's I-CARE protocol and Zelenko Protocol.

Nutrients and supplements 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.

However, if your risk is high e.g. age above 60, hypertensive, diabetic and obese; you might wish to consult a doctor and discuss more potent alternatives in the FLCCC's I-CARE protocol.

If you review most of the above studies, you will find a very common theme among most of the studies. A key highlight is that 'early treatment' results tend to be better than 'late treatment' results. Therefore, the most important takeaway is to get '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 information above overwhelming. 

Please also follow other precautions and measures (as advised by your local health authorities and doctors) in order to minimize your risk.

Treatments do not replace vaccines and other measures. All practical, effective, and safe means should be used. Elimination is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all variants.

Z-Stack Supplement

In an effort to make it easier for patients, Dr Vladimir Zelenko has developed an oral supplement that contains all four key ingredients: vitamin C, quercetin, vitamin D3 and zinc. It’s referred to as 'Z-Stack Supplement'. 

Z-Stack Vitamin cocktail provides key ingredients needed in order to help your body fight off this deadly invader. The Z-Stack Vitamins are Kosher certified, GMP certified and made in the USA.

The cost of the Z-STACK vitamin cocktail is $55 per bottle for a one month supply. 

Where to buy Z-Stack: Z-stack is available on Dr Zelenko's website. Here is the link: Z Stack Supplement 

Note: To get 5% OFF, please use this coupon code: drfrancis

Disclaimer: Please do not consider these information as personal medical advice, but as a recommendation for use in consultation with professional providers. Consult with your doctor, share the information on this website and discuss with her/him.