health care – Page 6 – TranscendingSquare

June 28, 2021October 15, 2022

NLRP3 Inflammasomes & Spike Protein

NLRP3 Inflammasomes are complex units that are built within cells in response to signals from the innate immune system called cytokines. The inflammasomes release even more cytokines that lead to death of the cell by pyroptosis – since the cell is assumed to be infected and would then be in need of removal from the body. When our cells are in trouble from infection, cancerous changes, or simply aging, they add surface marker proteins that signal to the immune system – ‘trouble here – my time is up, remove me please, for the purpose of the greater good‘. In allergies or autoimmune antibody reactions – the trouble signals are actively calling for the creation of NLRP3 Inflammasomes, but there isn’t really trouble in the cell. If an NLRP3 Inflammasome had been constructed though, the cell will still be killed by pyroptosis – it was signaled for and the chemicals lined up, so to speak, and did their job. (He, et al, 2015)(Iorga and Dara, 2019)(4, 5)

The inflammatory cytokines also cause other symptoms that might help remove a pathogen if sick, but during allergy season, the symptoms may just be emptying the tissue box. NLRP3 Inflammasomes may also be involved in allergies developing – sensitivities being created in the first place. (Xiao, Xu, Su, 2018) (1) The risk of allergy sensitivities or autoimmune antibodies being created would be worse for people with low vitamin D levels or low magnesium. Magnesium is needed in the metabolism of vitamin D.

The SARS-CoV-2 virus spike protein, the E protein section, causes activation of NLRP3 Inflammasome creation, and resulting increase in inflammation can also signal further creation of them:

“The IC activity of E protein [168] as well as those of the other accessory viroporins, 3a and 8a [160], activate the NLRP3 inflammasome by effluxing Ca2+ from the lumen of the ER/ERGIC/Golgi, altering the homeostatic levels of cytosolic Ca2+ [168,180] and resulting in upregulation and secretion of pro-inflammatory TNF-α, IL-1β, IL-6 and IL-18 [160,181]. ER stress [182] and ROS production [183] are also activators of the NLRP3 inflammasome, and due to E protein’s regulation of ER stress they may also activate NLRP3 through an alternative mechanism.” (14)

NLRP3 Inflammasomes are little killing machines that we need when a cell is infected, but which become very damaging if they are being created in response to an allergy or autoimmune type of reaction. Immunomodulating phytonutrients can help the body by rebalancing an over-active or under-active immune response making them generally safe for use. For more information about immunomodulators see: Artemisinin, arteannuin-B, sgp130Fc and COVID-19.

Who is most at risk for an immune reaction? People low in vitamin D, zinc, selenium, B vitamins, and others.

Cells from people who had been sick with COVID-19 reacted to exposure to the SARS-CoV-2 spike protein and inflammasome production occurred. Cells from people who had not been pre-exposed to SARS-CoV-2 did not react to cause inflammasome creation:

“Here we show that the SARS-CoV-2 spike protein (S-protein) primes inflammasome formation and release of mature interleukin-1β (IL-1β) in macrophages derived from COVID-19 patients but not in macrophages from healthy SARS-CoV-2 naïve individuals.” (Theobald, et al, 2021)(2)

Which suggests that an allergy like sensitization to the S-protein occurred.

Inflammasome & Pyroptosis, Definitions from research articles:

“Inflammasome is an intracellular signaling complex of the innate immune system. Activation of inflammasomes promotes the secretion of interleukin 1β (IL-1β) and IL-18 and triggers pyroptosis.” (4)
“NLRP3 (NOD-, LRR- and pyrin domain-containing protein 3) is an intracellular sensor that detects a broad range of microbial motifs, endogenous danger signals and environmental irritants, resulting in the formation and activation of the NLRP3 inflammasome. Assembly of the NLRP3 inflammasome leads to caspase 1-dependent release of the pro-inflammatory cytokines IL-1β and IL-18, as well as to gasdermin D-mediated pyroptotic cell death.” (Swanson, Deng, Ting, 2019) (3)
“In response to allergens or allergen/damage-associated molecular signals, NLRP3 changes its conformation to allow the assembly of the NLRP3 inflammasome complex and activates caspase-1, which is an evolutionarily conserved enzyme that proteolytically cleaves other proteins, such as the precursors of the inflammatory cytokines IL-1β and IL-18. Subsequently, active caspase-1 cleaves pro-IL-1 and pro-IL-18. Recently, accumulating human and mouse experimental evidence has demonstrated that the NLRP3 inflammasome, IL-1β, and IL-18 are critically involved in the development of allergic diseases.” (Xiao, Xu, Su, 2018) (1)
“Pyroptosis (“pyro” Greek for fire and “ptosis,” falling) is a highly inflammatory mode of regulated cell death which has evolved as a way of removing intracellular pathogens and has a distinct morphology which depends on the formation of plasma membrane pores resulting in cell explosion. Thus, pyroptosis is related to innate immunity activation, but is different from other forms of cell death in that it manifests with a very specific molecular signature.” (5)

NLRP3 protein is shown within an assembled NLRP3 Inflammasome in two different types of reactions. Pyroptosis leading to cell death is shown on the righthand side. Figure 1
“A Two-Signal Model for NLRP3 Inflammasome Activation. The priming signal (signal 1, **left**) is provided by microbial components or endogenous cytokines, leading to the activation of the transcription factor NF-κB and subsequent upregulation of NLRP3 and pro-interleukin-1β (pro-IL-1β). Caspase-8 and FAS-mediated death domain protein (FADD), and NOD1/2 are involved in the priming step by regulating the NF-κB pathway. NLRP3 undergoes post-translational modifications that license its activation. **The activation signal (signal 2, right) is provided by a variety of stimuli including extracellular ATP, pore-forming toxins, RNA viruses, and particulate matter.** Multiple molecular or cellular events, including ionic flux, mitochondrial dysfunction and reactive oxygen species (ROS) generation, and lysosomal damage, have been shown to activate the NLRP3 inflammasome. BRCC3, BRCA1/BRCA2-containing complex subunit 3; IL-1R, IL-1β receptor; JNK1, JUN N-terminal kinase 1; PKD, protein kinase D; TLR, toll-like receptor; TNFR, tumor necrosis factor receptor.” (Kelley, et al, 2019) (8) *Many things can cause an inflammatory response that leads to NLRP3 Inflammasome formation – not just the spike protein. Extracellular ATP should not be present outside of cells and might indicate a dead cell that burst open in an uncontrolled way, as would happen if a viral replication cycle was complete and the virus were leaving the infected cell, and the body would need to remove the cellular debris – because some of it can be damaging, like the ATP is when in the wrong place.

Allergies and autoimmune antibodies are more likely to occur during an immune challenge, in any case, especially if vitamin D deficient.

The spike protein seems to trigger allergies (and autoimmune antibodies – different link), however so can other viral infections or vaccines. When the immune system is really busy responding to cytokines and the surface marker signals or pathogen or damage related debris (PAMPs and DAMPs), then it is also more likely to make mistakes.

Surface marker proteins for normal self proteins may be mismarked as foreign and autoimmune antibodies result, and memory cells for them so the sensitivity will remain even if the initial antibody load is reduced. Or bits of normal cellular debris may cause more damage related signals and the responding immune cells create reactive autoimmune antibodies instead of Tolerant ones that would recognize the debris chemical as a ‘self’ protein. Non-Neutralizing antibodies occur when the immune cells react to a foreign protein as if it is an self surface marker protein (ADE reaction after a vaccine or infection) and future exposure to the pathogen will result in no immune response. or bit of cellular debris is one of the pathogen or damage related signals and creates reactive antibodies instead of Tolerant ones that would accept it as a ‘self’ protein.

“To this point, our data suggest that the S-protein functions as a primer antigen selectively initiating cytokine release dependent on previous SARS-CoV-2 exposure. In contrast to an antigen- and pathogen-specific activation of the adaptive immune response, triggers of innate immune signaling are known to be non-specific. The transcriptomic signatures identified in S-protein stimulated and unstimulated COVID-19 patient-derived macrophages described above have also been detected in other infectious disease backgrounds or after exposure to pathogen-specific molecular patterns or vaccines. Upregulation of S100A8, S100A9, and S100A12, for example, has been linked to innate immune memory after vaccination with Mycobacterium bovis-BCG (Cirovic et al, 2020). A range of pathogens and vaccines trigger upregulation of the inflammation-associated microRNAs mir-155, 221, and 222 (Furci et al, 2013; Wang et al, 2014).” (Theobald, et al, 2021) (2)

Addition 2/16/2022: Pomegranate peel extract, or the juice or seeds, can help reduce allergy cytokines and cell destruction (via NET formation which leads to inflammasome formation, see previous post https://transcendingsquare.com/2020/05/14/pomegranate-peel-catechins-inhibition-of-net-formation/, and https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-018-1800-z), by inhibiting mast cell activation which are allergy cells that release cytokines when activated (degranulated). IL-17 is a cytokine that is associated with autoimmune disease which pomegranate peel extract also helps reduce. https://www.researchgate.net/publication/317805345_Pomegranate_peel_extract_ameliorates_autoimmunity_in_animal_models_of_multiple_sclerosis_and_type_1_diabetes

This post is in response to a request for clarification/an explanation that was easier to understand.

I was asked about the following Thread regarding the SARS-CoV-2 spike protein (S-protein or SP) and its effects on macrophages, a type of immune cell. The Spike protein seems to be a significant allergen and the immune cells become sensitized to it the first time the person is exposed, and then are hyper-reactive to any future exposure to it. The over-active immune response would be similar to what occurs to someone who has a life threatening bee allergy and they are stung. Anaphylactic shock might occur and without emergency help given quickly (an EpiPen for example), death is likely to occur.

There is an excessive increase in inflammatory cytokines – which would be needed in order to defend against an actual infection. The spike protein on the virus acts like an infection and the body responds – and may also set up an allergic like sensitivity. With the spike protein gene injections the protein is being produced within cells and presented on their surface and it may set up a “self” recognition response instead of a protective one – or it may set up the sensitized allergy response. Then the second injection might cause the severe over-reaction of the immune system and the EpiPen and also high dose Intravenous Vitamin C therapy might be life saving (thiamine is given also – the over-reactive response causes an enormous increase in the body’s need for thiamine and other B vitamins in addition to the increased need for vitamin C. Magnesium too, but that isn’t part of the IV-C therapy).

Twitter Thread by Walter M Chestnut, click to view: @parsifaler, (Twitter Threads can be hard to read, I did find it easier when written out in paragraphs):

“A paper published on June 16, 2021 proves my hypothesis that the spike protein therapies are sensitizing recipients to the Spike Protein super-allergen of the SARS-CoV-2 virus.

*Figure 7. In vivo reprogramming of macrophages is required for SARS-CoV-2 S-protein dependent NLRP3 inflammasome formation and IL-1β secretion*. (Theobald, 2021) (2)

The SARS-CoV-2 S-protein, a surface exposed viral receptor binding protein and important as vaccine antigen, triggers NLRP3 inflammasome activation and cytokine secretion selectively in COVID-19 patient-derived macrophages.

SARS-CoV-2 infection leads to reprogramming of human macrophages providing an intracellular landscape that allows for rapid inflammasome [formation]. The findings reveal that SARS-CoV-2 infection causes profound and long-lived reprogramming of macrophages resulting in augmented immunogenicity of the SARS-CoV-2 S-protein, a major vaccine antigen, and potent driver of adaptive and innate immune signaling.

The implications are that when the virus reemerges in the fall (and perhaps even as soon as this summer, with new variants circulating) the host will have a devastating NLRP3 inflammasome activation, resulting, I believe, in the hospitalization and death of millions of individuals throughout the world. I urgently implore that the sensitization of the world population to the S-Protein be stopped immediately.” *I agree – thanks.

The second part is about the sensitization that occurs when first exposed to the spike protein – in some people, particularly those deficient in vitamin D are at greater risk and people who already are prone to allergies and autoimmune conditions. It is likely that not every single person will have a problem. The majority of people did recover from having a Covid infection, although the LongCovid group is also fairly large. Thirty percent or more possibly, may have had lingering symptoms after , but specific data is only just starting to be collected by medical groups, rather than the preliminary research that is based on patient groups doing self surveys. LongCovid is real, Chronic Fatigue Syndrome, Gulf War Syndrome, fibromyalgia – all real people with real symptoms – not faked for attention or to get out of work.

Retinoid Toxicity also causes mast cell overactivity and allergy like and other symptoms.

I was one of those people with chronic fatigue syndrome and fibromyalgia like symptoms during the early days when it was disbelieved. The symptoms started after a case of mononucleosis during high school, and may be due to the infection having caused a change in my liver that causes vitamin A and beta-carotene to be converted into retinoic acid – which then would cause allergy like symptoms in addition to skin rashes and other odd symptoms. See my document which includes several blogposts and a symptom survey: Retinoid Toxicity.

In normal health vitamin A is protective and needed by the immune system, in this theory of retinoid toxicity a challenge to the immune system may leave it in the over activate vitamin A due to an infection stage, and never stopping…. chronic degenerative disease is the long term outlook. I stopped eating many carrots – me a dietitian who loves carrots. Life is odd. Health is complex and seems easy when it works, and kind of impossible when it doesn’t – but keep trying. Retinoid toxicity may be occurring in some LongCovid patients and adding to the complicated question of what’s wrong? Cannabinoid deficiency seems involved in the painful fingers and toes, see: Cannabinoids & blood vessels – and LongCovid. THC may help while CBD might worsen the membrane break down. Increased gentle movement may help by increasing oxygen flow to the tissue. The medication propanalol may help stabilize vascular membranes that have damage with cannabinoid imbalance. (13)

Genetics can leave some people more at risk because they can’t make cannabinoids, or metabolize glycine fully (like me, BHMT double gene allele), or remethylate folate and vitamin B12. Standard supplements would just make a deficiency worse and the person needs the bioactive forms instead, or just good dietary sources. There are many reasons someone might be more at risk for a health problem or infection compared to average – and they may have several odd issues, not just one. I have 11 gene alleles affecting metabolic pathways, 4 of them double, and working through my own symptoms to finally reach better health has been a long and meandering route.

LongCovid and spike protein injection recipients may also be in for a long and meandering route to learn what their own individual quirks are – the advantage in doing so is then you can feel astonishingly better, as the underlying issues are discovered and improved – and maintained. My own health got quite worse again when I started feeling well enough to just try a little taste or serving of a problem food – they were problems for a reason, and an autoimmune sensitivity will remain a risk for the rest of life, avoiding the problem food can help symptoms subside as the active antibodies fade away within about six months. LongCovid seems to involve some autoimmune antibody problems in G-protein coupled receptors – a type that includes the cannabinoid receptors and the niacin receptor, and many other important types with body wide impact on health.

Good health and chronically inflamed are not even a night/day comparison. The flu goes away – chronic inflammation is like having the flu every day, or randomly when you are really busy anyway and need to get stuff done, not rest with the flu like symptoms of your imaginary illness that no one believes in anyway — NO – rest. Your body will get worse because of that busy stress.

Myokines from intense exercise would worsen inflammatory risks, likely including the risk of inflammasome creation – polyphenols are protective.

Our muscles make a type of cytokine too, and more during extreme exercise. “Skeletal muscle is a major source of […] release of IL-6 from muscle can mediate metabolic processes. IL-6 is, therefore, the first identified “myokine” released from muscle that can now be termed an endocrine organ.” (9)

Dr. Samuel Yanuck also discussed myokines in his cogenceimmunology.com video course, Episode M5/V4. (Registration required.)

Top athletic types have seemed more at risk for LongCovid than average. Polyphenols in the diet helps the body with post exercise recovery and reduces IL-6 and a blueberry supplement helped stop inflammasome production. (12) The real magic is in our foods.

Vitamin C and E also were found beneficial for reducing post exercise recovery from the cytokine increase (IL-6, which is one of the ones commonly elevated in severe COVID-19): “Role of vitamin C and E supplementation on IL-6 in response to training … the higher the fitness level, the lower the increase in exercise-induced plasma IL-6.” (10) Dopamine excess may also increase inflammatory IL-6, (11) – so overexcitement, over use of the internet perhaps may be too much EMF, too much blue light in the evening hours, and too much dopamine. Is health complicated – yes. Is an “illness” likely to have only one cause? No. If an unhealthy person gets sick, then to get healthy again, they may need to get healthy in the first place, and that is far more complex than “Eat right and exercise“.

Vitamin C would also help in the fatigue situation of anemia of chronic inflammation which can be unusually severe in COVID-19 patients. Typical ferritin levels are , I have seen a lab report for a LongCovid person whose ferritin level was over 10,000. Another Thread of Walter M Chestnut’s added clarity as to why that might happen.

9) Hepcidin similarity; Spike protein may enter cells at ferroportin and increase iron loss from cells. *Excerpt from S-protein Risks & Aids.

Spike protein may enter cells by mimicking hepcidin and ferroportin – which may also lead to excessive free iron or ferritin levels. *see next section for other ways membrane breakdown may be occurring due to inflammation itself.

Inflammatory membrane breakdown leads to increased risk of blood clots, stroke and heart attack because of changes in iron storage also, (49), called anemia of chronic infection or inflammation, but it seems more excessively than typical in COVID patients. See Thread by Walter M Chestnut, @parsifaler, (50, links, 49, 51, 52, 53) regarding the possibility that the spike protein increases this effect by mimicking a protein called hepcidin that is involved in the natural process. (53) The body does it to protect iron from pathogens, who also need it for growth. The spike protein may be doing it to enter cells at a receptor that hepcidin can interact with – ferroportin.
Iron chelators can help with the excessive ferritin and free iron associated with chronic inflammation or infection, or spike protein mimicking hepcidin – whatever the reason there is too much free iron – the solution is still going to include iron chelators. Giving blood is also used when iron overload is a problem in a person who is healthy, but for someone with symptoms of anemia, more mature blood cells are needed, not fewer. Immature blood cells that can’t carry oxygen tend to be associated with anemia of chronic infection.
Iron chelators: Artemisinin, quercetin, EGCG, resveratrol, turmeric and lactoferrin- an isolate from milk that has not been found to be an allergy concern for people with milk protein sensitivity.
Vitamin C can help. See: Anemia of Inflammation, IL-6, Hepcidin, Iron and Vitamin C.
See: Iron and Anemia of Chronic Infection – for a brief explanation.

So Listen! medical community – patients have odd symptoms, but that doesn’t mean they aren’t suffering real problems.

My own premise as a clinician – start by listening to the person – what are their concerns, what is their story – granted, it doesn’t always make sense – but that doesn’t mean ignore them or think they are lying. Just listen, ask more questions based on a differential diagnostic type structure (mentally), try to figure out what they are talking about, it may take a little time. It may take trying a few strategies and checking back to see if that did or did not make an improvement for them – also useful information for a differential diagnosis. Dietitians do not diagnose, except that we are trained in the same process, and regarding digestive upset and other diet related symptoms we may make specific recommendations to the patient based on what the problem seems like, or may write the person’s health care professional with the nutrition assessment and recommendations.

Ordering a ‘Dietary consult’ – means asking the nutrition specialist to review the patient’s chart and provide a summary of findings based on lab tests, medical and social history, weight changes, interview with the patient or caregiver, and any other information from the chart. Recommendations may be made for changing a patient’s supplements, medications, (negative interactions can be a risk factor), adding or removing food supplements (high protein drinks are used or other enriched snack foods to promote nutrient intake when there are bedsores or other causes for increased calorie needs), and doing more frequent weight checks for patients who seem to be doing poorly.

We can listen to veterans about their struggle with Gulf War Syndrome symptoms: Gulf War Syndrome | The Mysterious Illness Suffered by Gulf War Veterans, (Youtube) Veterans have gained some recognition and help from the US government: 5 Questions about Presumptions [qualifying] for Gulf War [diagnosis] and Undiagnosed Illnesses: (Youtube)

Magnesium is needed to help reduce inflammation and an over-active inflammatory response. Vitamin C, niacin, thiamine, and other nutrients also help.

We need magnesium to prevent inflammation and protect the mitochondria’s use of the Citric Acid Cycle for energy production. When mitochondria have to switch to fermentation of glucose or glutamate for energy – it is a early warning sign for cancerous changes in the cell or prion damage – protein tangles seen in Alzheimer’s dementia and other neurodegenerative conditions.

Magnesium is needed to reduce the cytokine response that leads to NLRP3 inflammasome production within a cell. To give you a bigger world visual – think of the inflammasome as SWAT team high tech van with all of its armor and weapons – dangerous and for defense/offense – a killing machine for dangerous pathogens. Sounds great – we want our body to be defended right? Yes, right – if there is a pathogen in the cell. But what if it is an allergic reaction and there is no pathogen to kill? The cell dies anyway, the Inflammasome would need to kill an infected cell.

“[Magnesium Sulfate], MgSO₄ inhibits NLRP3 inflammasome, IL-1β upregulation, and pyroptosis. The mechanism is consistent with decreased intracellular calcium levels.” (7)

Why do I take Epsom salt baths or footsoaks? because I don’t want my cells to be killed by NLRP3 Inflammasomes due to a chronic inflammatory condition. Magnesium helps block excess calcium entry from entering cells – which is an increased risk when there is excessive free glutamates and aspartic acid artificial sweeteners in the diet – or a chronic inflammatory condition.

Tight Junctions and passive magnesium absorption.

Tight Junctions and Magnesium channels within the intestinal lining are two ways magnesium may be absorbed from our diet. TRPM6 and 7 ion channels allow magnesium entry – however genetically some people may have dysfunctional or fewer of the TRPM channels and a topical source may be needed, allowing hydrated magnesium ions to diffuse through the Tight Junctions between cells. Excess can be absorbed through the passive route as there are no controls on it other than the concentration of ions. Passive diffusion is the process by which ions from a more concentrated solution will gradually shift over to the less concentrated solution when there is some opening for the ions to pass through – such as the thin crevice between cells.

Our extracellular matrix is a gelatin like fluid that surrounds our cells and coats membranes in a protective layer. Adequate glycine and other nutrients helps it be more protective rather than too thin or so thick that function is reduced. It helps prevent Tight Junctions from allowing too much or too large of particles from the intestines to enter our body. This helps prevent autoimmune antibodies from being created, or other allergic reactions to dietary proteins. See: Glycine – good for our extracellular matrix & for immune protection against viral infection.

**Magnesium enters cells in two ways:** **Active Transcellular > TRPM 6 & 7 ion channels, & Passive Paracellular > Tight Junctions between cells.** “Figure 4. Magnesium absorption in the intestine. Magnesium is absorbed through either a saturable transcellular pathway (left) in which TRPM6 and TRPM7 actively transport magnesium into the GI epithelial cells, which is effluxed through a Na+/Mg2+ exchanger and/or a paracellular pathway (right) where magnesium transverses the tight junctions of the intestinal epithelium, assisted by magnesium associated claudin proteins.” (Workinger, et al, 2018) (6)

Personally I think the miracle of life deserves understanding and protection – not an expectation that it just happens or simply can be purchased with a prescription pad. The Epsom salt doesn’t soak my feet for me – I have to do that – and I am blessed that I can just go buy some magnesium sulfate salt crystals.

From April 7, 2020 post: Bitter taste receptors in the lungs & Hesperidin’s decongestant properties.

Anti-inflammatory Phytonutrients/nutrients from a previous post; promote p53 or inhibit NLRP3:

Other phytonutrients including quercetin which is found in citrus peel, also can help inhibit production or activity of the inflammatory NLRP3 inflammasome which has been found to be elevated during more severe COVID19 illness. Sulfarophane (broccoli, etc), resveratrol (grape skins, etc), EGCG (green tea, pomegranate peel), curcumin (turmeric/curry powder), gensenoside (ginseng), emodin (aloe vera gel), mangiferin (mango) and genipin (from a fruit used as a Traditional Chinese Medicinal) are also phytonutrients that may reduce activity or production of NLRP3 inflammasomes. (17*) **

Increasing activity of a protein called p53 seems to help inhibit the production or activity of the NLRP3 inflammasome. Phytonutrients and nutrients that may promote p53 activity also include zinc, artemisinin (wormwood herb), goldenseal (berberine, also found in a few other herbs), Black seed oil (Nigella sativa), ginger (6-gingerol), feverfew, chamomile, and cordyceps mushrooms. (18*)** Replication of human coronaviruses and the SARS-CoV-1,(2003 strain) virus has been found to be inhibited by p53 and have also been found to cause the production of an additional protein that leads to breakdown of the p53 protein which may help explain the dysfunction of immune function in more severe infections. (21*, 22*)**

For more about p53 and how it may help against aging see: Intermittent fasting, magnesium, cancer prevention, and elephants – “Elephants never forget” – it may be because of their p53 gene.

Inactivating the NLRP3 inflammasome seems to have anti-inflammatory benefits (17*) that may help prevent age related changes. It is an area of research being pursued for pharmaceutical development. (11*)** Sleep masks/pitch blackness during sleep, with the alarm clock and light leaking in the window covered, could help your body inactivate the NLRP3 inflammasome on a nightly basis with no ongoing copay (by increased melatonin production, see: Sleep and health, for tips for improving sleep habits for better melatonin production). **( Excerpt from: Bitter Taste Receptors… see for references 11*, 17*, 18*, 21*, 22*) *The excerpt was included in: Phytonutrients that may help against SARS-CoV-2 & jenniferdepew.com/Phytonutrients.

Black seed oil has been helping me with what seems like a chickenpox/shingles problem. I take a spoonful am and pm and use it topically on the spots. Within a day or two the stinging fluid filled bumps flattened out. I have gotten more since but with continued use of the black seed oil the pain and itching has not been a problem and only a couple are fluid filled. I had a severe case as a child so I remember, they can get finger-tip size and pop, scab over, and are very itchy, take a long time to heal and leave scars. Fun times. Black seed oil is better in my personal experience.

From a January 13, 2021 post, COVID19, summary of nutrients that might help prevent, treat, recover.:

Magnesium helps white blood cells kill infected cells & protects the brain from inflammation risks.

Epsom salt, magnesium sulfate, can be absorbed through skin pores (any studies about magnesium chloride not being that well absorbed have little to nothing to do with the absorbability of a hydrated magnesium sulfate molecule). The sulfate is bioactive and patients would also be helped by the magnesium. Magnesium is nature’s calcium channel blocker and so would help protect against cell damage from excess calcium being allowed into cells. Magnesium is also essential for white blood cells to be able to perform apoptosis, killing infected cells and removing them safely. Poor intestinal absorption is not uncommon and topical magnesium or intravenous may help, especially if muscle cramps are a symptom. Lab tests showing hypokalemia can also suggest low magnesium is a problem. (Mechanism of Hypokalemia in Magnesium Deficiency – JASN)

Magnesium also is needed as a calcium channel blocker to protect against stimulation by EMF energy which can also open the calcium channels. (Klinghardt pdf) See post: EMFs and Intracellular Calcium – Magnesium is nature’s calcium channel blocker. For the long hours of sleep in particular it can help reduce inflammation risk to remove or turn off WiFi devices from the sleeping area or nearby rooms. Various products are available that block EMF such as cell phone cases and modem covers which help reduce excess energy release, (educateemf.com/WiFi Router Guards) turning it off while sleeping would be ideal if possible.

The SARS-CoV-2 virus can add viroporins to the infected cell’s membrane which allows calcium to enter. The excess calcium within a cell causes the creation of NLRP-3 inflammasomes which produce cytokines that increase inflammatory changes in other cells, (“pro-inflammatory IL-1β cytokines“). (Klinghardt/3/19/2020,pdf) The viroporin channels vary somewhat for different virus and one type is blocked/inhibited by the anti-viral medications “amantadine and rimantadine.” (viroporins) Adequate magnesium would help protect other cells if/when an infected cell burst open to release the newly replicated virus from the infected cell. Phytonutrients that may help inhibit NLRP-3 inflammasome assembly are listed towards the end of this post: Phytonutrients that may help against SARS-CoV-2.

Avoiding EMF exposure would help by not adding more activation of our own calcium channels and promoting even more entry of excess calcium into all of our cells (our whole body being exposed to the EMF somewhat equally depending on the source, or more to our ear/hand if holding a smartphone). (Klinghardt/3/19/2020,pdf)

Blackout curtains or an eye mask for sleeping or napping can help with eye sensitivity and may help the body make more melatonin which has protective effects against viral infection and inflammasome production. Vitamin C also reduces inflammasome production and can reduce over negative effects on blood vessels. (Klinghardt/3/19/2020,pdf)

Scope of Practice

In health care some practice general services for any type of patient and refers to specialists as those needs become more complex. Others specialize in one fairly narrow area of practice. My clinical experience, my 15 years of experience listening to people and helping them individually, was spent focused on prenatal, postpartum, lactation, and early childhood health. That is narrow compared to all disease, all health, all ages, which is the general training I received in college and my supervised apprenticeship. I have also worked in residential facilities and home based care for elderly and disabled patients, however I was checking my textbooks and references and feeling like that college student again.

The value though in having a clinical background in prenatal and early childhood health is that my scope of practice was focused on growth – how to grow healthy cells with just what you can put in a grocery bag – my clients were within or near the poverty line economically and supplements and ‘fancy’ foods were not available or of interest to them for the most part.

No matter what your age, illness, or genetic differences – you, dear reader, and everyone else – are not going to be able to grow healthy cells or repair them or remove toxins safely – without adequate nutrients and whole foods that have many other helpful phytonutrients and non-digestible fiber that supports a healthy microbiome. The severe illness of COVID-19 seems related to having an unhealthy microbiome and a resulting lack of butyrate: Resistant Starch/Butyrate.

Butyrate is a short chain fatty acid that can activate the niacin receptor which can help the body remove inflammation as heat – or generate heat from glucose during cold weather. High dose niacin supplements and butyrate supplements could be protective in addition to improving your own diet, for the sake of your healthy microbiome species at least. Low fiber, low zinc diets lead to the beneficial species dying off and without them to keep pathogenic types in check, less helpful or harmful species are more likely to grow. Harmful species may cause inflammatory cytokines, and that may lead to production of NLRP3 Inflammasomes -and potentially leading to the death of some of your cells. And you wouldn’t have needed any novel SARS-CoV-2 virus or spike protein to be involved. Leaky Tight Junctions allow allergenic or autoimmune inducing proteins to enter the body – adequate fiber in the diet also helps the cells maintain extracellular fluid in a stable, not too liquid or too thick, gelatinous texture – our jelly lining.

See this post for more about the protective effects of the extracellular matrix: Glycine – good for our extracellular matrix & for immune protection against viral infection.
Also: Microbiome.

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

Reference List

(Xiao, Xu, Su, 2018) Xiao Y, Xu W, Su W. NLRP3 inflammasome: A likely target for the treatment of allergic diseases. Clin Exp Allergy. 2018 Sep;48(9):1080-1091. doi: 10.1111/cea.13190. Epub 2018 Jul 3. PMID: 29900602. https://pubmed.ncbi.nlm.nih.gov/29900602/
(Theobald, et al, 2021) Theobald SJ, Alexander Simonis A, Theodoros Georgomanolis T, et al., Long-lived macrophage reprogramming drives spike protein-mediated inflammasome activation in COVID-19, EMBO Mol Med (2021) e14150. https://doi.org/10.15252/emmm.202114150 https://www.embopress.org/doi/full/10.15252/emmm.202114150
Swanson, K.V., Deng, M. & Ting, J.PY. The NLRP3 inflammasome: molecular activation and regulation to therapeutics. Nat Rev Immunol 19, 477–489 (2019). https://doi.org/10.1038/s41577-019-0165-0 https://www.nature.com/articles/s41577-019-0165-0
(He, et al, 2015) He, Wt., Wan, H., Hu, L. et al. Gasdermin D is an executor of pyroptosis and required for interleukin-1β secretion. Cell Res 25, 1285–1298 (2015). https://doi.org/10.1038/cr.2015.139 https://www.nature.com/articles/cr2015139
(Iorga and Dara, 2019) Andrea Iorga, Lily Dara, Chapter Two – Cell death in drug-induced liver injury, Editor(s): Anup Ramachandran, Hartmut Jaeschke, Advances in Pharmacology, Academic Press, Volume 85, 2019, Pages 31-74, ISSN 1054-3589, ISBN 9780128167595, https://doi.org/10.1016/bs.apha.2019.01.006. https://www.sciencedirect.com/science/article/abs/pii/S1054358919300067 Excerpt viewable here: https://www.sciencedirect.com/topics/neuroscience/pyroptosis
Workinger JL, Doyle RP, Bortz J. Challenges in the Diagnosis of Magnesium Status, Nutrients 2018, 10(9), 1202; https://doi.org/10.3390/nu10091202 https://www.mdpi.com/2072-6643/10/9/1202/htm
Chang YY, Kao MC, Lin JA, Chen TY, Cheng CF, Wong CS, Tzeng IS, Huang CJ. Effects of MgSO₄ on inhibiting Nod-like receptor protein 3 inflammasome involve decreasing intracellular calcium. J Surg Res. 2018 Jan;221:257-265. doi: 10.1016/j.jss.2017.09.005. Epub 2017 Sep 30. https://pubmed.ncbi.nlm.nih.gov/29229137/
Kelley N, Jeltema D, Duan Y, He Y. The NLRP3 Inflammasome: An Overview of Mechanisms of Activation and Regulation. Int J Mol Sci. 2019;20(13):3328. Published 2019 Jul 6. doi:10.3390/ijms20133328 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6651423/
Febbraio MA, Pedersen BK. Contraction-induced myokine production and release: is skeletal muscle an endocrine organ? Exerc Sport Sci Rev. 2005 Jul;33(3):114-9. doi: 10.1097/00003677-200507000-00003. PMID: 16006818. https://pubmed.ncbi.nlm.nih.gov/16006818/
Christina Yfanti, Christian P. Fischer, Søren Nielsen, et al., Role of vitamin C and E supplementation on IL-6 in response to training. J Applied Physiology 2012 112:6, 990-1000 https://journals.physiology.org/doi/full/10.1152/japplphysiol.01027.2010
Kazuhisa Nakano, Kunihiro Yamaoka, Kentaro Hanami, et al., Dopamine Induces IL-6–Dependent IL-17 Production via D1-Like Receptor on CD4 Naive T Cells and D1-Like Receptor Antagonist SCH-23390 Inhibits Cartilage Destruction in a Human Rheumatoid Arthritis/SCID Mouse Chimera Model. J Immunol March 15, 2011, 186 (6) 3745-3752; DOI: https://doi.org/10.4049/jimmunol.1002475 https://www.jimmunol.org/content/186/6/3745
Professor David Nieman, A Multi-Omics Approach to Interpreting the Influence of Polyphenols in Countering Exercise-Induced Physiological Stress, video presentation, International Electronic Conference on Nutrients – Nutritional and Microbiota Effects on Chronic Disease SciForum.net https://youtu.be/aFnalWJ2Fgk
Anderson R, Ramafi G, Theron AJ. Membrane stabilizing, anti-oxidative interactions of propranolol and dexpropranolol with neutrophils. Biochem Pharmacol. 1996 Jul 26;52(2):341-9. doi: 10.1016/0006-2952(96)00212-2. PMID: 8694859. https://pubmed.ncbi.nlm.nih.gov/8694859/
(Wong and Saier, 2021) Wong, N.A. and Saier, Jr., M. H., The SARS-Coronavirus Infection Cycle: A Survey of Viral Membrane Proteins, Their Functional Interactions and Pathogenesis. Int. J. Mol. Sci. 2021, 22, 1308. https://doi.org/10.3390/ijms22031308 https://www.dropbox.com/s/kfnfxn99h5k6hxq/ijms-22-01308-v3%20%281%29.pdf?dl=0 *Quote from page 20

January 22, 2021September 2, 2021

Niacin, & early treatment in general for SARS-CoV-2 is sensible, reduces hospitalization and mortality rate.

The longer a viral infection is allowed to progress the more cells are killed or damaged, either by the viral replication, or by the damaged cells contents harming the surrounding tissue . See for more information: Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection. (1)

*post updated 8/1/2021, & 8/24/2021, & 9/2/2021.

See my recent post for a variety of nutrients or other strategies which may help prevent or provide early treatment for a viral infection: COVID19, summary of nutrients that might help prevent, treat, recover. Or more recent: Spike Protein Risks & Aids – summary list.

The post Niacin may help prevent or treat migraines also includes a graphic by Dmitry Katz, PhD about the cofactors used in the Citric Acid Cycle by mitochondria when they are performing aerobic glycolysis – metabolizing sugar with the use of oxygen. Mitochondrial dysfunction and a shift to anaerobic metabolism of sugar or glutamate, fermentation, is associated with cancer cells and other chronic degenerative disease. The cause may be limited nutrients – the list of cofactors needed is long and includes niacin.

Cofactors needed in the Citric Acid Cycle include niacin:

B vitamins: B1 (Thiamin) (3) , B2 (Riboflavin) (4), B3 (Niacin) (8, 10), B5 (Pantothenic acid) (5), B6 (Pyridoxine) (6, 7), B7 (Biotin), B9 (Folate) (9),
Minerals (17): Mg++ (Magnesium) (11, 12, 13), Mn++ (Manganese), K+ (Potassium) (13), Zinc (14, 15), Iron (16), Copper, Sulfate,
Amino acids: Carnitine (derived from lysine), Cysteine,
Antioxidants: CoQ10, Glutathione, Alpha-Lipoic Acid (ALA).

Niacin in a large dose may help with treatment of an active COVID19 illness or the symptoms of LongCovid. Specifically the niacin/nicotinic acid form, not niacinamide. The “niacin flush” that occurs is warm – and is removing inflammation along with the increased sensation of warmth on the skin. Feeling a little chilled as the niacin flush continues is also normal, internally the body is cooling somewhat as the inflammation is being removed as heat on the skin.

This article summarizes the value of a variety of B vitamins against viral infections and/or inflammation and goes into more detail about niacin use for prevention or treatment of infections and inflammation: Is Niacin a Missing Piece of the COVID Puzzle?. (2) Niacin helps our body cope with increased inflammation and without niacin the inflammation continues to become more severe. For more detail see: Sufficient niacin supply: the missing puzzle piece to COVID-19, and beyond? by Dmitry Kats, PhD (3); and Be Well: A Potential Role for Vitamin B in COVID-19, a team project including scientists from several nations. (4)

Niacin (nicotinic acid) Protocol against COVID-19,
shared with permission of the author, Dmitry Kats, PhD. *His website: niacincurescovid.com.
*The apples and antihistamines can decrease the flush effect if it seems like too much and should be fine at other times of the day, than taken with or shortly after the niacin dose.

Adequate niacin may also help the body have a stable thyroid hormone level. (5)

Low levels of niacin and a metabolite NAD+ may be involved in mitochondrial myopathy which leads to tiredness and weak muscles. Providing 500-1000 milligrams of niacin per day was found to improve muscle strength, increase NAD+ levels to the level seen in the healthy control group, and liver fat decreased by 50% in the experimental group. (6)

Potential short term symptoms – may include serotonin increase.

People who were previously low in serotonin, a neurotransmitter that affects mood and intestinal health, may experience temporary symptoms from an increase in the messenger chemical. Once the body adjusts to the new level of serotonin the symptoms should no longer occur. Symptoms of a sudden increase, or excess of serotonin may include: Agitation or restlessness, Confusion, Rapid heart rate and high blood pressure, Dilated pupils, Loss of muscle coordination or twitching muscles, Muscle rigidity, Heavy sweating, Diarrhea, Headache, Shivering, Goose bumps. (13) People experiencing Serotonin Syndrome for other reasons would likely have more severe symptoms than the short term change due to the increase in niacin. Tryptophan is an amino acid precursor for serotonin and it is depleted when there is inadequate niacin available to make NAD+.

Addition 8/1/21: St. John’s Wort herbal supplements, 5-HTP, and other medications including SSRI antidepressants may increase risk of serotonin toxicity. The problem usually is seen with SSRI use, and treatment generally is to wean off the amount of whatever is being taken, without a sudden stop in case of adverse reaction to that, and the symptoms should lessen. See: St. John’s Wort Drug Interactions with Antidepressants (17)

During acute infection the risk of serotonin toxicity becoming severe is more of a concern to medical professionals I’ve been in communication with. The gradual increase over time may help when it is being used preventatively. Caution is advised with high dose niacin use. Serotonin inhibitor treatment would be needed if the problem of serotonin excess was severe.

Addition 8/24/2021: The FLCCC protocol for CoV may include SSRI medications and trying the niacin protocol and the I-MASK+ FLCCC protocol in combination may increase risk of the serotonin excess. Sudden increase of the niacin dosing to the 1000 mg amounts may also increase the risk of the adverse symptoms of serotonin excess. Try to remain calm, it is temporary though can be dangerous. Seek medical help and cut back on the niacin or SSRIs but suddenly stopping may also be risky. The FLCCC protocol uses fluvoxamine an SSRI.

Saffron taken as a medicinal herbal supplement (88 mg day per Dr. Grouf) may also help by preventing a serotonin excess which may also be a risk of a severe infection condition. “Saffron will restore breathing, heart rate and clear the lungs, it will also prevent serotonin induced injury to brain, lungs and heart and fix co–d diarrhoea” (@DGrouf)

“Saffron extract may inhibit serotonin reuptake in synapses (Sophia Esalatmanesh et al., 2017). Serotonergic mechanisms have been influenced by crocin by showing antagonistic action at the 5-HT2c receptor site (Lopresti et al., 2014).”
*Saffron: The Age-Old Panacea in a New Light*, by Maryam Sarwat · 2020, page 125, *Chapter 10: Saffron in Brain Diseases*, (Google Books) via (@DGrouf)

Another caution against taking saffron at the same time as curcumin/turmeric, as the phytonutrients have opposing mechanisms of action. https://twitter.com/MirrorManDan/status/1430203127257608192?s=19

Dizziness – niacin, nicotinamide and nicotine in combination, can have an adverse effect.

Dizziness may result from a combination of niacin, nicotinamide, and use of a nicotine patch. Niacin/(rxlist.18) Solution – stop taking the niacinamide.

Niacin is converted into niacinamide during metabolic use of the nutrient, so taking both is not really necessary.

“Chemically, niacin is one of the simplest vitamins, having the empirical formula C6H3O2N (Illus. 13-1). Nicotinic acid and nicotinamide correspond to 3-pyridine carboxylic acid and its amide, respectively.” […] “Nicotinic acid is converted to the amide form in the tissues, and Erickson et al. (1991) suggests this occurs in the rumen. [article about supplements for lactating cows > is helpful] Nicotinamide functions as a component of two coenzymes: nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP).” […] (16)

“Although niacin coenzymes are widely distributed in the body, no true storage occurs. The liver is the site of greatest niacin concentration in the body, but the amount stored is minimal.” […] (16)

Niacin can be made from tryptophan, an amino acid, as long as there is also adequate protein, energy, vitamin B6, riboflavin and necessary hormones available. Iron is also needed. Synthesis may take place in the gut as well as throughout the body. See longer excerpt in the Reference List. (16)

Glyphosate may be reducing average tryptophan levels in our diet, and in our bodies.

Glyphosate residue in our food supply may be reducing our levels of tryptophan and other amino acids (14) and trace minerals such as manganese. (15) Glyphosate is a mineral chelator and antibiotic affecting a chemical pathway that affects tryptophan. That may disrupt bacterial health, and was thought to not risk human health too, however it may affect us due to our need for the amino acids., in addition to other effects that have been less studied then the shikimate pathway mechanism of action.

“The herbicide glyphosate inhibits the shikimate pathway of the synthesis of amino acids such as phenylalanine, tyrosine, and tryptophan.” (Vivankos et al., 2011) (14)

Potential long term risks – may affect liver health and gout – uric acid; quercetin may help reduce risk of uric acid build up.

People with liver damage or gout may need to avoid taking large doses of niacin long term (more than 2000-6000 mg/day). Taking it along with alcohol use may increase the risk of liver damage and worsen the symptoms of the niacin flush with itching. Long term use of large doses may lead to gout, excess uric acid. (7) Symptoms of gout can occur abruptly even waking up at night with severe joint pain, most frequently occurring in the joint at the base of the large toes. Other joint tissue can also be affected. Pain, swelling and redness in the affected toe or other joints are typical symptoms. (8)

Use of large doses of niacin/nicotinic acid for treatment of patients with symptoms of schizophrenia were studied extensively in the 1950s-70s. Use of nicotinamide was not found to help similarly and the treatment was most immediately beneficial for patients with acute onset of the schizophrenia symptoms. People with chronic schizophrenia took longer to respond to use of niacin and needed larger doses to achieve symptom relief. Regarding risk of toxicity, liver concerns, gout, and increases in blood uric acid were observed but were not too severe of a problem, compared to the adverse side effects seen with standard psychiatric medications, and some patients could use a different form or a smaller dose. “The vitamin has been given to patients suffering from gout whose symptoms were not aggravated and it did not interfere with their specific treatment for gout.” (9)

Uric acid/urate levels in gout can be reduces with use of xanthine oxidase inhibitors (10) which include the phytonutrient quercetin. (11) For more information about quercetin’s other benefits as a zinc ionophore and bioflavonoid see the recent post: COVID19, summary of nutrients that might help prevent, treat, recover.

Quercetin is found in many plant foods in small amounts, and rich in some foods like capers (Alcaparras) and cilantro. It is also found in citrus and pomegranate peel. “The researchers note that pickling promotes conversion of rutin (flavonoid compound also called rutoside in capers) to quercetin, the ingredient that they found to be an efficacious KCNQ channel activator. This makes pickled capers as the richest known “natural” source of quercetin, with a maximum reported concentration of 520 mg/100 g for canned capers, compared to a maximum of 323 mg/100 g quercetin for raw capers.” (12) People with Mast Cell overactivity (seasonal allergy & other symptoms might be present) may need to avoid pickled or other fermented foods as that can worsen mast cell symptoms, for more information see: MCAS/Histamine.

Other nutrients that may help as cofactors recommended by Dimitry Kat’s, Ph.D. include vitamin C, a B complex, vitamin D3, zinc, magnesium, and Black seed oil, quercetin, and N-acetyl cysteine could provide additional antioxidant support.

Dr. Kats’ All Natural Daily Protocol for COVID19 (*may help preventively, during viral or other infections, and during recovery. The nutrients help the body remove inflammation as heat loss, the skin reddening ‘niacin flush’. The nutrients also are used by mitochondria to provide us energy and reduce risk of cancer. Niacin and magnesium help cells engulf damaged cells, pathogens, and chemical debris, or tangled proteins for reuse as nutrients. )

Dr. Kats’ Niatonin Protocol (update 9/2/21)

Melatonin and niacin are recommended in the most recent version of the Kats’ protocol, available in this post: Spike summary spreadsheet; telomerase, Circadian cycle & Nrf2, Aug. 22, 2021. Caution: Melatonin is a hormone normally present and active in very tiny amounts, not a milligram, micrograms, and too much may disrupt sleep cycle. Too much regularly, may suppress our own production of melatonin.

Simply focusing on improving sleep habits and getting full spectrum light during the day can help all of the genes and hormones effected by our circadian cycle. Hundreds of genes are activated or de-activated during the day/night transitions – during normal health. Modern life tends to keep us in the inflammatory day time mode – all of the time. That is really what Metabolic Syndrome is – constant low level inflammation instead of cycling between anti-inflammatory night-time growth and repair mode, and the active get busy and do stuff, inflammatory day-time mode.

Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

Reference List

Peter A. McCullough, MD, MPH. et al., Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection. August 06, 2020 American Journal of Medicine, VOL 134, ISSUE 1, P16-22, JANUARY 01, 2021 DOI:https://doi.org/10.1016/j.amjmed.2020.07.003 https://www.amjmed.com/article/S0002-9343(20)30673-2/fulltext
Mercol J, Is Niacin a Missing Piece of the COVID Puzzle?, Jan 20, 2021, mercola.com, https://articles.mercola.com/sites/articles/archive/2021/01/20/what-are-the-benefits-of-niacin.aspx
Kats D, Sufficient niacin supply: the missing puzzle piece to COVID-19, and beyond?, preprint, https://osf.io/uec3r/
Be Well: A Potential Role for Vitamin B in COVID-19, Maturitas, Shakoor H, Feehan J, Mikkelsen K, et al. Be well: A potential role for vitamin B in COVID-19. Maturitas. 2021;144:108-111. doi:10.1016/j.maturitas.2020.08.007 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428453/
Shakir KM, Kroll S, Aprill BS, Drake AJ 3rd, Eisold JF. Nicotinic acid decreases serum thyroid hormone levels while maintaining a euthyroid state. Mayo Clin Proc. 1995 Jun;70(6):556-8. doi: 10.4065/70.6.556. PMID: 7776715. https://pubmed.ncbi.nlm.nih.gov/7776715/
Pirinen E, Auranen M, Khan NA, Brilhante V, Urho N, Pessia A, Hakkarainen A, Kuula J, Heinonen U, Schmidt MS, Haimilahti K, Piirilä P, Lundbom N, Taskinen MR, Brenner C, Velagapudi V, Pietiläinen KH, Suomalainen A. Niacin Cures Systemic NAD⁺ Deficiency and Improves Muscle Performance in Adult-Onset Mitochondrial Myopathy. Cell Metab. 2020 Jun 2;31(6):1078-1090.e5. doi: 10.1016/j.cmet.2020.04.008. Epub 2020 May 7. Erratum in: Cell Metab. 2020 Jul 7;32(1):144. PMID: 32386566. https://pubmed.ncbi.nlm.nih.gov/32386566/
Niacin, mayoclinic.org, https://www.mayoclinic.org/drugs-supplements-niacin/art-20364984
Gout – Symptoms & Causes, mayoclinic.org, https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897
Hoffer A, Megavitamin B-3 Therapy for Schizophrenia, Canad. Psychiat. Ass. J. Vol. 16 (1971) https://journals.sagepub.com/doi/pdf/10.1177/070674377101600605
White WB, Gout, Xanthine Oxidase Inhibition, and Cardiovascular Outcomes. Circulation. 2018;138:1127–1129 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.036148
Zhang C, Wang R, Zhang G, Gong D. Mechanistic insights into the inhibition of quercetin on xanthine oxidase. Int J Biol Macromol. 2018 Jun;112:405-412. doi: 10.1016/j.ijbiomac.2018.01.190. Epub 2018 Jan 31. PMID: 29410028. https://pubmed.ncbi.nlm.nih.gov/29410028/
Kim Stewart, Discovery: Caper Berry’s Quercetin Activates KCNQ Potassium Channel. July 16, 2020, todayspractitioner.com https://todayspractitioner.com/botanical-medicine/discovery-caper-berrys-quercetin-activates-kcnq-potassium-channel/
Serotonin Syndrome: Symptoms & Causes, mayoclinic.org https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
Vivancos PD, Driscoll SP, Bulman CA, et al. Perturbations of amino acid metabolism associated with glyphosate-dependent inhibition of shikimic acid metabolism affect cellular redox homeostasis and alter the abundance of proteins involved in photosynthesis and photorespiration. Plant Physiol. 2011;157(1):256-268. doi:10.1104/pp.111.181024 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165874/
Samsel A, Seneff S. Glyphosate, pathways to modern diseases III: Manganese, neurological diseases, and associated pathologies. Surg Neurol Int. 2015;6:45. Published 2015 Mar 24. doi:10.4103/2152-7806.153876 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4392553/
Niacin, DSM.com, https://www.dsm.com/anh/en_US/products/vitamins/vitamin-nutrition-compendium/companion-animals/niacin.html “The amino acid tryptophan is a precursor for the synthesis of niacin in the body. There is considerable evidence that synthesis can occur in the intestine. There is also evidence that synthesis can take place elsewhere within the body. The extent to which the metabolic requirement for niacin can be met from tryptophan will depend first on the amount of tryptophan in the diet and second on the efficiency of conversion of tryptophan to niacin. The pathway of tryptophan conversion to nicotinic acid mononucleotide in the body is shown in Figure 13-1. Protein, energy, vitamin B6 and riboflavin nutritional status as well as hormones, affect one or more steps in the conversion sequence shown in Figure 13-1. Therefore, they can influence the yield of niacin from tryptophan. Iron is required by two enzymes for the conversion of tryptophan to niacin with a deficiency reducing tryptophan utilization.” (16)
St. John’s Wort Drug Interactions with Antidepressants, verywellmind.com, https://www.verywellmind.com/st-johns-wort-drug-interactions-with-antidepressants-1066686
Niacin, RxList.com https://www.rxlist.com/niacin/supplements.htm

January 20, 2021January 20, 2021

Strategic Mindset & Grit – try, try, try again, but a little bit better each time.

Strategic Mindset – thinking critically about goals and outcomes, and whether methods are working or need to be modified. (1)

Grit – sticking with a tough problem or a long complex job. (1)

Having grit without a strategic mindset might leave you eventually all tired out but not at the goal you might have hoped for. Keep trying, but check the progress and redirect the craft as needed to get you to where you want to go. Trying to row a boat across a rapid river requires rowing slightly upstream against the current or you will just be pushed downstream. (1)

Our choices can make us healthier, wealthier, wiser, more productive, and feeling better about ourselves. Or they may lead to chronic illness and feeling unproductive, tired and listless, and it might seem difficult to go to work or look for a job, or to study for that important test or new job skill.

Support can help us stick with the difficult choices and tasks, or or negative, lack of support, may make us give up or feel like we can’t accomplish our goal. If someone is consistently negative to you, let it go, that is them, your choices are you. This also may mean letting go of well meaning advice that was intended positively, yet doesn’t match your goals, or you already had learned the suggestion didn’t work for you.

“Don’t try to win over those who ridicule, mock or hate. You’re not called to be the jackass whisperer.” -Scott Stratten

Health or lifestyle habits can be generally helpful for most, but we are individuals and health habits may not all be as helpful for each of us in the same way. Tuning into our own needs can help us learn what seems to lead to feeling energetic and happy and what tends to add to the tired and listless, or headachy and irritable.

“Our self-respect tracks our choices. Every time we act in harmony with our authentic self and our heart, we earn our respect. It is that simple. Every choice matters.” – Dan Coppersmith

Sometimes the grit might be needed to wade through the deluge of information available to us in our modern virtually connected world, to find the nuggets that will be of most value for our own needs. The information in a book can help you plan a strategy that might get you to your goal, it won’t get you there while it stays in the book though. You have to try the techniques, and practice and modify the strategy, refining it as needed until it is effectively helping you to reach your desired goal.

“Information is not knowledge. The only source of knowledge is experience. You need experience to gain wisdom.” ~ Albert Einstein
“We are drowning in information but starved for knowledge.” – John Naisbitt
“There seems to be an inherent eagerness of this next-gen workforce to avoid starting from scratch, but to seek out the best of what exists and build upon it. This may be a condition of pressure put on them earlier in their career to produce results and solutions at a more rapid pace than has ever been expected before. Companies would be wise to harness this energy and, through technology, give them better and more instant access to those building blocks. ” – KeySafety (thinkkeysafety.com)

Nutrition science – we need all the building blocks to build health, enough of each in balance with the others to support a stable structure.

Experience knows how to create a stable structure from the rudimentary knowledge.
(Image found online, original source unknown, via @ProfFeynman .)

Practice makes perfect it is said, but not if what you are practicing is not a good technique for you, or in general.

“In theory there is no difference between theory and practice. In practice there is.“ -Yogi Berra (via @nonludic)

Knowledge is collected from Experience that is shared by others or that you had learned first hand by trying something, whether once or with ongoing practice until the skill was mastered. Creativity can take that information and imagine new ways to look at it, and Wisdom may see connections that others didn’t see.

**Knowledge** is collected from **Experience** shared by others or learned first hand.
**Creativity** can take that information and imagine new ways to look at it,
and **Wisdom** may see connections that others didn’t see.
(Graphic found online, original source unknown, via @ThinkingWiseman.)

What creativity and collective wisdom did it take the ancient people who created Stonehenge as a giant astronomical calendar to get the circle of stones in alignment with the passing stars? That is hard to imagine, or how the giant stone blocks were cut and moved by hand.

“*Sunrise at Stonehenge today (17th January) was at 8.02am, sunset is at 4.32pm*, “
Image by Stonehenge, U.K., @STONEHENGE.

In building anything we need perseverance, grit, to stick with the hard work that might take years or decades to accomplish. To build effectively we need to have a strategic mindset with a plan that may be adapted along the way as methods are tested and analyzed for whether the goal is being achieved. Did the planets and stars move across the skies at the time the stone circle indicated or was modification in their placement needed? Stonehenge was initially likely a circle of smaller bluestones before all the large stones were moved from much farther away and put in place. It would have been arduous work. You wouldn’t want to have to move one of those building blocks again if you goofed.

“The oldest part of the Stonehenge monument was built during the period from 3000 to 2935 bce. … Although it once was believed that the Aubrey Holes served as pits for wooden posts, excavation and archival research by the Stonehenge Riverside Project revealed that they probably held Welsh bluestones.” – Stonehenge- First stage: 3000–2935 BCE (Britannica)

The first stage of building Stonehenge took the ancient people about 65 years, the second stage about 160 years, third, about 190 years, and the fourth, fifth, and sixth stages of building are estimated to have been completed over another 760 years. That is quite a dedicated community project. (Britannica)

The reason why Stonehenge was built is not known, however having a calendar, even a really, really large one, may have helped with determining when to plant crops to maximize yield. There was a change in climate conditions for about 700 years during the time Stonehenge was built which made growing crops more difficult and herd animals became more predominant until the cold weather improved. (sciencenewsforstudents)

To build health we need all of the nutrient building blocks and it can be helpful to have phytonutrients and other complex molecules in our diet too. Nucleotides are needed to make the RNA that is needed for us to make each protein molecule such as bitter taste receptors. We may be able to make nucleotides but there would also be some in animal product foods. It saves us energy to use ready made molecules that are small enough to be absorbed whole. Colorful plants and vegetables have many phytonutrients and phospho-nutrients that can help us directly or may be used as building blocks to help us build other molecules.

Studies on cognitive health, our mental fitness as we age, have found that the modern Western diet has adverse effects while a more Mediterranean style diet was more protective. People whose diet was estimated to be the most like the Mediterranean diet, had cognitive health equivalent to being 5.8 years younger than those with the least Mediterranean style diet.

“Western diets may adversely affect cognitive health,” Agarwal said. “Individuals who had a high Mediterranean diet score compared to those who had the lowest score were equivalent to being 5.8 years younger in age cognitively.” – Unhealthy Foods May Diminish Diet’s Positive Effects, January 8, 2021, Rush.edu, (rush.edu)

The Mediterranean Diet has anti-inflammatory benefits from the olive oil, which is rich in monounsaturated fats, and the diet tends to include a generous amount of fish and other seafoods regularly which would be a good source of omega 3 fatty acids. The Western diet uses a lot of plant/seed oils which are high in polyunsaturated fats and omega 6 fatty acids both of which can increase inflammation when eaten in excess. The ratio of omega 3 to omega 6 fatty acids is too low in the modern diet due to the use of refined plant oils like canola seed, corn or soy oil.

The Mediterranean diet also tends to have more beans, with smaller servings or less use of meats, than the Western diet. The phytonutrient rich herbs like oregano and basil might be used in far greater quantity along with other healthy vegetables and fruits than in the standard Western diet.

Another study looked at the effects of different diet patterns on the muscle mass of a group of Australian women. Interestingly The ‘plant focused‘ diet was not associated with skeletal muscle size while a traditional diet based on the Australian Recommended Food pattern was linked to muscle mass and an overall use of fewer inflammatory food and beverage choices was also. People on the ‘plant focused‘ diet may not have been getting enough protein or other nutrients involved in our production of muscle tissue.

“Three a posteriori dietary patterns were identified from the PCA and named: i) plant-focused, ii) western, and iii) traditional. The plant-focused pattern was characterised by positive factor loadings on fruits, vegetables, legumes, fish, nuts, rice, tofu, yogurt, red wine, and eggs, and negative loadings on white bread. The western pattern included positive factor loadings on pizza, potato chips, processed meats (sausage, meat pies, salami, bacon), tomato sauce and pasta, and negative loadings on fruits. The traditional pattern was characterised by positive loadings on vegetables, jam, tinned fruit, red meat (beef and lamb), biscuits, ice cream, fish, and high-fibre cereals, with no negative loadings (Jacka et al., 2010).” – Diet quality and a traditional dietary pattern predict lean mass in Australian women: Longitudinal data from the Geelong Osteoporosis Study (Davis et al, 2021)

It takes knowledge to know which foods are more beneficial or less inflammatory, and it takes experience to try them and find out if they are also not inflammatory for your personal metabolism and health. It takes creativity to prepare interesting meals from a wide range of healthy foods, and wisdom to see the long term value in going to the effort to do so, most days. It also takes wisdom or strategic mindset to watch for patterns in your symptoms and health and modify your choices as you age or your health changes.

Every decade our metabolism slows down a little so we need about 10% less calories than we did in the previous decade – this would vary somewhat with the amount of physical and mental effort we expend and our personal thyroid hormone level and other factors.

Reference List

The Mindset You Need to Succeed at Every Goal. bbc.com, https://www.bbc.com/worklife/article/20200722-the-mindset-you-need-to-succeed-at-every-goal?ocid=ww.social.link.twitter
Unhealthy Foods May Diminish Diet’s Positive Effects, January 8, 2021, Rush.edu, (rush.edu) https://www.rush.edu/news/unhealthy-foods-may-diminish-diets-positive-effects
Jessica A. Davis, Mohammadreza Mohebbi. Fiona Collier, et al., Diet quality and a traditional dietary pattern predict lean mass in Australian women: Longitudinal data from the Geelong Osteoporosis Study. Preventive Medicine Reports, Vol 21, March 2021, 101316, https://www.sciencedirect.com/science/article/pii/S2211335521000073

January 13, 2021April 23, 2021

COVID19, summary of nutrients that might help prevent, treat, recover.

I had untested Covid19 like illness Feb/March prior to when testing was available. Antibody testing wasn’t available until 3 months later and it was negative at that time. My symptoms and timeline matched the description of the still novel illness. Due to my autoimmune illness history I already was familiar with and using daily, many phytonutrients, in addition to other nutrients.

I managed to get better on my own but the symptoms got into breathless asthma like problems with non-productive cough before I started recovering and my history of colitis-like/inflammatory bowel symptoms also flared up but I was also familiar with what foods could help get that back under control instead of worsening. Severe diarrhea can be deadly too and a percentage of Covid patients did have bowel symptoms too, see the pomegranate peel section below for a link. (More specifics on my illness: Treatment vs a ‘Cure’.

Twenty two other nations besides the United States are distributing medications, nutrients, and/or therapeutics, for early at home treatment for their citizens. (rcm.imrpress.com)

Citrus Peel and Bioflavonoids

Patients could be helped with some non-toxic, inexpensive, readily available nutrients and phytonutrient foods. Bioflavonoids – citrus peel – was what I added to my routine as the non-productive cough got worse – within 10-20 minutes the mucus had loosened and my airways opened and I could cough it out. Vitamin C, chewable 100 mg (what I had), also soothed my sore throat and helped with breathing. The serving of citrus peel to open the airway (lots of research on bioflavonoids for asthma exists) that I found helpful was about 2 teaspoons of orange zest every few hours or one navel orange peeled with a sharp knife so the white pith was left on the orange instead of being removed. (citrus peel posts)

Powdered bioflavonoid is readily available for purchase in bulk and the inner pith is mild – it could simply be added to foods for patients still able to eat. Bitter taste receptors in the lungs are activated and cause thinning of the mucus, opening of airways, and increase in cilia moving the mucus up and out of the lungs. Bioflavonoids are also a source of some vitamin C, quercetin, and a variety of flavonoids that may also be available as single nutrients such as hesperidin and that might help patients who could only be given nutrients intravenously (Evaluation of the Intravenous and Topical Routes for Ocular Delivery of Hesperidin and Hesperetin). Like vitamin C, hesperidin and other flavonoids can help reduce risk of vascular problems.

Zinc Ionophores, anti-viral, anti-microbial.

Quercetin and EGCG, found in green tea and pomegranate peel, have similar anti-viral mechanism of action as Hydroxychloroquine & Ivermectin, though those medications have other anti-viral action also. Pomegranate peel also has other mechanisms of action as an anti-viral. The inner peel is milder than the outer rind and both are sources of potent phytonutrients. The inner peel can be chopped fresh or dried and powdered to add to soup or salads in small amounts, about one to two tablespoons for a recipe. The outer peel is more bitter and can be used to make a tea/extract, simmer gently for about 20-30 minutes. Overheating too long deactivates some of the medicinal nutrients.

See: Pomegranate peel – anti-COVID19, may block ACE2 receptor access to the SARS-CoV-2 virus.
Pomegranate Peel/extract may help increase NAD+ (involves niacin, see next section).
Pomegranate peel catechins – inhibition of NET formation – helps prevent the clotting risk seen with more severe COVID19.
Pomegranate, neuroinflammation, antimicrobial, metal chelator. – protects the brain from risks of excessive inflammation, and has even helped promote regrowth of hippocampal brain cells, the type damaged in Alzheimer’s dementia. Just 4-8 ounces of pomegranate juice per day helped improve behavior symptoms for patients with dementia.
G13. Pomegranate – an overview of the many health benefits of pomegranate and pomegranate peel and tips for preparation and recipes.

Niacin and other B vitamins have anti-viral power, and are needed to help with energy level and reducing inflammation.

Adequate B vitamins are also important for preventing vascular and other symptoms. Thiamin (needed in higher amounts during an infection, Operation Thiamine – Reducing the Need for Hospitalization of Patients with COVID-19.), riboflavin, and niacin also have anti-viral action. The niacin can be very effective at higher doses, given in the ‘flush’ form, building up to 1000 mg day. (Sufficient Niacin Supply: The Missing Puzzle Piece to COVID-19, and beyond?.)

Symptoms of low niacin/B3 include dermatitis, skin rash or dryness, the lower legs in particular may show the skin symptoms; diarrhea; and worsening deficiency can cause dementia, and ultimately death if left untreated. See: Pellagra: dermatitis, dementia, and diarrhea.

Niacin (nicotinic acid) Protocol against COVID-19,
shared with permission of the author, Dmitry Kats, PhD.
*The apples and antihistamines can decrease the flush effect if it seems like too much and should be fine at other times of the day, than taken with or shortly after the niacin dose.

For more about the benefits and possible risks for a few types of people, which might be reduced by the additional use of quercetin, see the post: Niacin, & early treatment in general for SARS-CoV-2 is sensible, reduces hospitalization and mortality rate.

Other cofactor nutrients besides quercetin that may be helpful in addition to niacin are included in this graphic by Dr. Kats:

Dr. Kats’ All Natural Daily Protocol for COVID19 (* these nutrients might help with any inflammatory condition or viral infection.)

People with a methylation gene difference may be at more risk because the methylated folate and B12 are essential for homocysteine metabolism. Excess homocysteine is a cause of atherosclerosis. Sulfate and vitamin C are also needed for preventing excess homocysteine (Review: Chemical Pathology of Homocysteine. V. Thioretinamide, Thioretinaco, and Cystathionine Synthase Function in Degenerative Diseases)

An overview paper describes the role the various B vitamins have in reducing inflammation and/or helping us fight a viral infection: Be well: A potential role for vitamin B in COVID-19.

Magnesium helps white blood cells kill infected cells & protects the brain from inflammation risks.

Zinc helps us make antibodies and immune cells, and has antiviral power when given with a zinc ionophore.

Zinc is needed to make mature T-cells and for the thymus gland to make antibodies. Zinc is needed for the gene transcription of bitter (and other) taste receptors. Patients who have lost their sense of taste and smell may be experiencing zinc deficiency. Zinc is involved in protein replication and zinc ionophores are antimicrobial because of the ionophore carries the zinc to cells with excess iron (sign of infection or cancer) and help the zinc enter the cell where the zinc then disrupts protein replication – so no virus will be made. The current nutrient guidelines for zinc are likely half what an elderly person needs to promote thymus gland function. During an acute infection more can be given safely but high dose zinc can accumulate so is not for long term use. (jenniferdepew.com/zinc) (other nutrients that may promote T-cells)

Zinc ionophores that have been found effective in many other nations of the world include hydroxychloroquine and ivermectin. Hydroxychloroquine has been safe and effective if given within the first few days to week of symptom onset and ivermectin has been found helpful in preventive, early treatment, and later stage treatment. Phytonutrient zinc ionophores that I was using anyway include quercetin and EGCG from pomegranate peel (my primary source – it is a main research interest of mine) or green tea. (effectivecare.info/pomegranate)(Pomegranate peel – anti-COVID19, may block ACE2 receptor access to the SARS-CoV-2 virus)

Ivermectin, a zinc ionophore, has helped in South America and elsewhere, review.
Hydroxychloroquine is also a zinc ionophore and has also been found effective given early with zinc and azithromycin: study .
Quercetin and EGCG are phytonutrient zinc ionophores that also have shown some benefit as antivirals against SARS-CoV2 and are available in foods and as herbal supplements.

Zinc is also needed for beneficial intestine microbes. Poor gut health has been linked to severe COVID19.

Zinc is also critically important for having a healthy microbiome – intestinal bacteria that help us instead of harming us. Beneficial species use as much as 30% of the zinc from our diet and if our daily diet is consistently low in zinc then more harmful species that don’t need zinc will grow instead. (Chronic Dietary Zinc Deficiency Alters Gut Microbiota Composition and Function, ) Poor gut health has been linked to more severe COVID19. (New Research Shows Poor Gut Health Connected to Severe COVID-19 – Probiotics May Help Patients)

Vitamin D deficiency has been found in as many as 80% of patients with severe COVID19 – it is needed for immune function & reducing risk of an over reaction that is inflammatory & can lead to long term autoimmune disease.

Vitamin D has been clearly shown to be a factor in severe COVID19 (an early study, April 2020) and it is unclear to me why the population as a whole is not being encouraged to take vitamin D and zinc right away – both are needed before an infection ideally. The vitamin D helps reduce risk of an autoimmune type cytokine over-reaction and the zinc is needed to make antibodies and help T-cells to change from immature to functional.

“Studies … show an increased risk of infection in those with low vitamin D levels and a 25 to 30-fold reduced risk of ICU admission and a substantial reduction risk of death in older COVID-19 patients supplemented with vitamin D.” ~ Dr. Dan McCartney
Vitamin D and SARS-CoV-2 infection—evolution of evidence supporting clinical practice and policy development, McCartney et al, 2020. (quote via @mercola)

Low vitamin D levels has been associated with a greatly increased risk of death from severe COVID-19. Levels of vitamin D above 33 ng/ml seems most protective and the greatest risk seen with levels below 27 ng/ml according to one study. (Raharusun et al, an early study, 4/2020)

Low vitamin D levels were significantly associated with increased risk of death from severe COVID19 illness. Levels above 33 ng/ml seem most protective against mortality risk.
“*Results of the age-adjusted clinical study by the working group of Dr. Prabowo Raharusun*,” Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study, an early study, 4/2020.

Standard nutrient guideline dosing of vitamin D may be adequate for protection but it needs to be prior to exposure to the infectious pathogen. Defense doesn’t help as much after an allergic/autoimmune over-reaction already developed. A review found that moderate dose supplements in advance helped reduce risk of respiratory infection by as much as 50%, while mega dose supplements of vitamin D taken after the respiratory infection had already begun were not significantly helpful. (Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data) The vitamin D3 form is more bioactive than the vitamin D2 form that is more typically available in one-a-day type supplements, if you have a choice about what to buy.

Pomegranate peel has anti-viral effects, a zinc ionophore and other phytonutrients that have brain protecting effects, and it can help intestinal health.

Pomegranate peel is a good source of hydrolysable tannins which can be healing to mucus membranes/GI tract) in smaller amounts and an irritant in larger amounts, also a diuretic, so dosing does matter – but I had colitis like flare-up with my CoV-like illness and my bean soup with a little pomegranate peel and Gumbo file was very soothing. The second half of this post has a list of hydrolysable tannin sources and mucilaginous foods or seasonings, which include Gumbo file: ACE2, Diarrhea, & COVID19 – it gets complicated.

Selenium deficiency is also more common in patients with severe COVID19.

Selenium deficiency has also been associated with more severe COVID19. Iodine is needed for immune function but I haven’t seen a direct finding of deficiency associated with severe CoV19. Vitamin A deficiency causes lack of immune function but excess conversion to active retinoic acid within the liver may be a factor in LongCovid – I have improved my health post CoV by reducing beta-carotene foods and I already had cut out all animal products during a previous autoimmune flare-up which helped. At the time I suspected I had developed an albumin autoimmune problem but maybe vitamin A was involved. I am still reading on this topic, very complex (Retinoid Toxicity)

Omega 3 fatty acids are anti-inflammatory and may help protect against death from COVID19.

Omega 3 fatty acids are the type found in fish oil, known also as EPA and DHA, and precursor, ALA, found in plant sources such as walnuts, flax seed meal and Black Currant Oil. Patients with severe COVID19 who had higher levels of omega 3 fatty acids had lower risk of dying of the infection than people with lower levels. (nutraingredients-usa.com) Omega 2 fatty acids EPA and DHA have been found to be made into a endogenous cannabinoid form that has anti-inflammatory benefits. (Emerging Class of Omega-3 Fatty Acid Endocannabinoids & Their Derivatives)

Post recovery may have fatigue from anemia of chronic inflammation and worse symptoms may involve overproduction of the active form of vitamin A – retinoid toxicity.

The liver changes that lead to overproduction of active vitamin A can occur with Epstein Barr viral infection. I had mononucleosis in high school and chronic fatigue type symptoms since then, off and on. Post recovery this March I was still extremely fatigued and it felt like anemia of chronic inflammation/infection to me and I added artemisinin twice a day as an iron chelator and it helped within just a day or two, I was able to start going on short walks outside instead of feeling like the bedroom to the kitchen was too much exercise. (Artemisinin, arteannuin-B, sgp130Fc and COVID-19)

Pain hurts. Health is better. We need all of the nutrients for health and in much greater amounts for some during illness. During health we make the antioxidant equivalent of 300 oranges – during illness we may no longer be able to do so, but we can’t eat 300 oranges, two teaspoons of citrus peel would have more antioxidants than one orange.

Resources with dosing recommendations for early or preventive self care by medical groups or professionals.

Regarding dosing for supplements – see an individual health care provider for individual guidance and here are some recommendations by medical groups or medical professionals:

Immediate Treatment for Early Stage SARS-CoV-2 Infections Recommended To Be Supported Nationally Starting Now, Authored by Ben Kaplan Singer, M.D.; Daniel Stickler, M.D.; Avery J. Knapp Jr., M.D.; with many contributing doctors. (googledoc)
TCM Treatment of COVID-19, based on extensive experience in Chinese hospitals, by Adam Tate, March 20, 2020, updated March 25, 2020. (medicinetraditions.com) — This document includes a description of the progressive or varying stages of COVID19 illness. It includes examples of symptoms that occur in the different stages, and herbal recipes recommended for the specific stage and symptom set. The Chinese medical professionals have found that a combination of the traditional medicinal herb mixtures and modern medicines to be more effective than either alone for treating patients with more severe COVID19 infections.
EVMS Critical Care COVID-19 Management Protocol, Developed and updated by Paul Marik, MD (17)
The Zelenko Protocol with over-the-counter self care and clinician guidance for the medication dosing is available here: Zelenko Protocol. For prevention: Zelenko COVID-19 Prophylaxis Protocol.
Dr Klinghardt’s COVID-19 Prevention & Treatment Guidance Summary, (website/to download pdf) (pdf) (summary pdf)
Physician Secrets Revealed: Outpatient Treatment For Covid-19, By Peter A. McCullough, MD, MPH (physicianoutlook.com)

A graphic summary of care guidance said to be used in Australia was shared on a social media site (harley_carter1). The protocol recommends Ivermectin, zinc, doxycyline, Montek-LC, Paracetamol for fever (better known as acetaminophen in the US). However I am unsure of the specific origin other than the site on the screen shot: (thecompleteguidetohealth.com/ivermectin.html#AUSTRALIA).