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)

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.

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.
*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+.

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.

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

  1. 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
  2. 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
  3. Kats D, Sufficient niacin supply: the missing puzzle piece to COVID-19, and beyond?, preprint, https://osf.io/uec3r/
  4. 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/
  5. 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/
  6. 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/
  7. Niacin, mayoclinic.org, https://www.mayoclinic.org/drugs-supplements-niacin/art-20364984
  8. Gout – Symptoms & Causes, mayoclinic.org, https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897
  9. Hoffer A, Megavitamin B-3 Therapy for Schizophrenia, Canad. Psychiat. Ass. J. Vol. 16 (1971) https://journals.sagepub.com/doi/pdf/10.1177/070674377101600605
  10. White WB, Gout, Xanthine Oxidase Inhibition, and Cardiovascular Outcomes. Circulation. 2018;138:1127–1129 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.036148
  11. 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/
  12. 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/
  13. Serotonin Syndrome: Symptoms & Causes, mayoclinic.org https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758

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.

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

  1. 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
  2. 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
  3. 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

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.

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.

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.

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)

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).

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.