Bitter taste receptors in the lungs & Hesperidin’s decongestant properties.

How did citrus peel help my symptoms? In several ways it turns out, potentially. Antiviral actions, decongestant ability within the lungs, and by reducing the risk of blood clot formation within the lungs as the viral load increases and more tissue damage has occurred.

The antiviral capabilities were mentioned in previous posts – hesperidin and neohesperidin may act as antivirals in several ways, the vitamin C also, and quercetin can act as a zinc ionophore. Zinc ionophores are like chemical taxi-cabs – carrying zinc into infected cells preferentially where the zinc then disrupts the viral replication. (this post) No viral replication, no cell bursting to release them to infect other cells, and so on, in an exponentially increasing level of viral load and dead cells for the patient. The dead cell contents can also become a health risk when occurring in too great a quantity for white blood cells to collect it all for safe detoxification and removal at lymph nodes and by the kidneys.

Decongestant action is due to the bitterness of the hesperidin, neohesperidin, and probably other bitter tasting phytonutrients in citrus peel, and also quinine & chloroquines (also bitter tasting). (19) Think of taste or other sensory receptors that can do a variety of different things depending on where they are located and what they are connected to. Receptors are like tiny machines, activate the keyhole/puzzle piece opening with the matching chemical agonist, or inhibit with the matching chemical antagonist, and then the machine will do something if activated, or not do something or stop doing something if inhibited.

The chloroquines and quinines were found to help relax the airway in people with asthma, and increase movement of mucus out of the lungs. Activation of the bitter taste receptors on immune cells led to reduced production of inflammatory chemokines and cytokines. (19)

Taste receptors on the tongue would be connected to nerve cells that tell the brain a bitter taste or other flavor type was sensed and that information would be used to eat more if hungry for the taste or to stop eating if satisfied. Taste receptors for sweet carbohydrates are much less sensitive, more of the sweet taste is needed to activate them, than bitter taste receptors, by a magnitude of thousands – one or a few molecules of a bitter substance might activate the taste bud in the mouth, while thousands of sweet molecules might be needed to activate the sweet taste receptor. Sour is somewhere in between in the amount of sour molecules needed to activate sour taste receptors.

In other areas of the body sensory receptors may be attached to other chemical pathways instead of to nerves that go to the brain. Within the lungs there are many bitter taste receptors which when activated signal the mucus lining of the lung cells to make thinner mucus and to increase the motion of the cilia. Cilia are hair like or tail like projections lining the cell walls that can all work together in a wave like motion to move mucus and any dust or virus or other infectious microbes up and out of the lungs. (2)

Stimulation of these receptors by known bitter compounds activates calcium-dependent nitric oxide (NO) production that increases phosphorylation of ciliary proteins through protein kinase G (PKG). This increases ciliary beat frequency to facilitate the movement mucus out of the airway by increasing mucociliary transport rates. The generated NO also diffuses into the airway surface liquid & acts as an antibacterial defense mechanism. NO damages bacterial cell walls & DNA & may also damage fungal pathogens & inactivate viral proteins .” (Freund & Lee, 2)

Non-productive cough, a dry cough, feeling like something is in the lungs but you just can’t cough it out is part of the typical symptoms of COVID19/SARS-CoV2 infections for people who get sick rather than being asymptomatic carriers*. (*see footnote) To be able to have thin mucus that is protective, able to be traveled through easily by our mobile line of defense – the white blood cells, we need to have adequate water, and electrolytes (ions) within the cells: magnesium and potassium, and outside of the cells: sodium and calcium. Providing magnesium as a supplement (300 mg/day) helped thin mucus for patients with the genetic condition Cystic Firbrosis which causes chronic excess lung congestion. (16)

Mucus is more than 95% water, making water and ions just as important for controlling mucus properties .” (1)

If a person also is having nausea and vomiting and/or diarrhea, at the same time or in progressive stages, then dehydration and electrolyte deficiencies may become a significant problem, even life-threatening if severe. See this post (ACE2…) for digestive tips, and this one for a way to bypass malabsorption of magnesium with a topical source that can be absorbed through hair follicles (which is how ancient people would have gotten plenty – fresh water sources uses to be rich in magnesium).

To activate the bitter taste receptors that help with forming healthy thin mucus and help activate the wave like motion of the cilia we would need to have some bitter chemicals that match the bitter taste receptors found in great quantity within lung tissue. Hesperidin is a tasteless chemical found in citrus peel, with a bitter tasting chemical side chain, (3), and neohesperidin, a similar flavonoid, likely is obviously bitter in taste. (26)

Hesperidin, a flavonoid present in many citrus fruits, provides an example of a multi-domain compound. This molecule was found to contain eight of the substructures that form the nodes of the tree, and a selection of these are given in Figure 6. Of the eight node substructures contained within hesperidin, only one contains a significant proportion of known bitter molecules.” (3)

Anticoagulant action: The vitamin C and flavonoids in citrus peel can also help prevent blood clot formation which in more severely ill patients with COVID19 infections has been found to be part of the mortality risk. (4) Prevention is important – strengthen capillary walls to prevent microvascular damage that can lead to blood collecting and forming clots which then may block larger blood vessels and cause stroke like damage to larger areas of tissue.

More detail about this problem is available in a document with a revised Marik Protocol for treatment of ARDS with Vitamin C Infusion (and contains thiamine, vitamin B1 which may also be needed in greater quantity during a severe infection response, see this document 14, and 15). The revision recommendations are based on COVID19 treatment in China and elsewhere – the lung problems are not typical of ARDS and patients likely need more oxygen than pressure from the ventilator support or worse lung damage may result. (evms.edu/EVMS_Critical_Care_COVID-19_Protocol.pdf) (8)

Important Recommendation for Earlier Treatment for patients suspected of having a COVID19 infection – for homecare/outpatient prescriptions:

The evms.edu pdf includes a recommendation for nutrients to be used as a prevention before infection, and at home for early treatment (see the pdf for that list). Here is their recommendation for prevention dosing:

  • Vitamin C 500 mg BID and Quercetin 250-500 mg BID
  • Zinc 75-100 mg/day (acetate, gluconate or picolinate). Zinc lozenges are preferred. After 1-2 months, reduce the dose to 30-50 mg/day.
  • Melatonin (slow release): Begin with 0.3mg and increase as tolerated to 1-2 mg at night
  • Vitamin D3 1000-4000 u/day (optimal dose unknown). Likely that those with baseline low 25- OH vitamin D levels and those > living at 40o latitude will benefit the most.
  • (evms.edu/EVMS_Critical_Care_COVID-19_Protocol.pdf) (8)
  • Food sources of Quercetin include dock, sorrel, cilantro/coriander leaves, radicchio, kale, watercress, asparagus, onions, and okra: (graphic, via @HiperacusiaCAT), in addition to being found in citrus peel. (23)
  • Quercetin and EGCG are both are zinc ionophores that can carry zinc into infected cells preferentially where the zinc disrupts viral replication, and they may also have direct antiviral effects by inhibiting proteins that are important to the virus. The two phytonutrients may be even more effective at inhibiting the SARS-CoV2/COVID19 proteins than hydroxychloroquine and remsdivar medications based on computer modeling of the molecular shapes of the viral proteins, medications, and phytonutrients. (24)

Early treatment is critical due to the SARS-CoV-2 virus causing loss of iron from hemoglobin within red blood cells. In later stages of viral replication the lack of functioning hemoglobin alone causes lung damage due to the lack of oxygen. (20) Simply providing extra oxygen can’t help if there is too little functional hemoglobin. Providing blood transfusions with healthy red blood cells might be helpful – preventing the virus from replicating to that point would be better. *This theory was based on computer modeling and has not been verified. (25) The symptom of red blood cell’s having hemoglobin that is unable to transport oxygen is present in symptomatic Covid-19 illness, the theory about why iron is shifted out of hemoglobin was flawed.

Anemia of inflammation (post) could be the reason: the cytokine IL-6 causes an increase in hepcidin, which causes an increased movement of iron out of molecules of hemoglobin in red blood cells, or available for the growing red blood cells still within bone marrow, and into intracellular storage where it can overload the ability to keep it from oxidizing other chemicals and can lead to cell death. Pathogens also need iron so the strategy is a defense mechanism of the body that can become dangerous if the response becomes excessive. See the post Anemia of Chronic Inflammation, IL-6, Hepcidin, Iron, and Vitamin C, for more information.

A different group is recommending to the FDA to fast track approval for preventive, early treatment with zinc and an anti-malarial and an antibiotic that are fairly available and have a long history of use, so risks and dosing have been studied. “It’s important to note that HCQ, zinc, and azithromycin are very well understood drugs with clear safety profiles; they are widely available, generic, inexpensive, and can be scaled rapidly, including to the developing world, which would be expedited by US leadership in recommendations.” More is included in the second half of this post about the zinc and anti-malarial medication and other food/phytonutrient zinc ionophores which include quercetin. See this document for the recommendation to the FDA: (Immediate Treatment for Early Stage SARS-CoV-2 Infections). via (13)

Safety considerations of nutrient/phytonutrient Zinc Ionophore: Quercetin in very large doses may affect kidney health negatively (I can’t find a dose for that) however in an animal based study quercetin was protective of kidney health at a dose that would be about 360-720 milligrams per day for an adult weighing about 160 pounds (5-10 mg/Kg was provided to the experimental animals). (6) The amount of quercetin used as a zinc ionophore by a Canadian team may be 500 mg taken three times per day during or prior to suspected viral infection – but I can’t find the specific dosing. Zinc can be taken in larger amounts (~15-30 mg) for a few weeks but can collect in the body to excessive levels over time. Symptoms of chronic excess might include a decrease in immune function and copper deficiency may occur as the two trace minerals can affect each other (an excess of copper can cause a zinc deficiency). (Symptoms of excess Zinc, 7)

Bonus – Circadian cycles affect immune function – because bonuses are nice – another way phytonutrients, including hesperidin (9), may be helping immune function is by tipping the body towards the anti-inflammatory night-time chemistry and away from the daytime, stress response, inflammatory pathways.

And the bigger picture take-home-point from that is sleep is important for immune function and the sleep needs to have a complete blackout level of lighting for the body to be able to switch over to the anti-inflammatory action of an ancient dark night. We make more melatonin if we get some full spectrum daylight during daytime/wake hours and have complete darkness at nighttime – so a sleep eyemask or folded piece of soft clothing like a Tshirt draped over the eyes may help health. During my untested CoV-19 like illness I did have light sensitivity headaches and found sleeping or resting with a cloth over my eyes to be helpful.

Melatonin is a hormone that helps reduce inflammatory pathways that result in increased cytokines, and inflammasomes such as NLRP3 (10) which has been associated with worse prognosis for patients with COVID19. the role of NLRP3 activity in SARS-CoV (2003 strain) has been a subject of research. (12)

An animal study on oxidative damage from a type of cancer treatment: “Oral treatment with melatonin gel had a protective effect in the small intestine, which was associated with mitochondrial protection and, consequently, with a reduced inflammatory response, blunting the NF-κB/NLRP3 inflammasome signaling activation.” (10)

Phytonutrients that might inhibit NLRP3 and/or increase p53 activity.

Other phytonutrients including quercetin which is found in citrus peel, also can help inhibit production or activity of the inflammatory NLRP3 inflammasome. 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)

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. Options exist and are worth trying in an order of least toxicity risk to greater toxicity risk.

*Asymptomatic carriers: In some people the virus replicates somewhat but not to the point of much cell damage – not growing exponentially to the point of the patient’s life being threatened. Instead the virus seems to just become dormant within some cells and the person isn’t even aware they are sick – a symbiotic host/parasite relationship assures the parasite goes on living – in a living host – which is not abnormal, we typically have virus in us that can even provide some health benefits possibly – symbiotic means benefits both the host and the parasite, but not enough is known about this area of study – called our virome, (5), instead of microbiome.

Disclaimer: This information is provided for educational purposes within the guidelines of Fair Use. It is not intended to provide individual guidance. Please seek a health care provider for individualized health care guidance.

Reference List

  1. Hansson GC. Mucus and mucins in diseases of the intestinal and respiratory tracts. J Intern Med. 2019;285(5):479–490. doi:10.1111/joim.12910 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6497544/
  2. Jenna R. Freund, Robert J.Lee, Taste receptors in the upper airway. World Journal of Otorhinolaryngology – Head and Neck Surgery, 4;1, March 2018, pp 67-76 https://www.sciencedirect.com/science/article/pii/S2095881118300167
  3. Sarah Rodgers, Johanneke Busch, Hans Peters, Elly Christ-Hazelhof, Building a Tree of Knowledge: Analysis of Bitter Molecules. https://academic.oup.com/chemse/article/30/7/547/360693
  4. Here’s the Damage Coronavirus (COVID-19) Can Do to Your Lungs. March 20, 2020, health.clevelandclinic.org, https://health.clevelandclinic.org/heres-the-damage-coronavirus-covid-19-can-do-to-your-lungs/
  5. Virgin HW. The virome in mammalian physiology and disease. Cell. 2014;157(1):142–150. doi:10.1016/j.cell.2014.02.032 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3977141/
  6. Yang H, Song Y, Liang YN, Li R. Quercetin Treatment Improves Renal Function and Protects the Kidney in a Rat Model of Adenine-Induced Chronic Kidney Disease. Med Sci Monit. 2018;24:4760–4766. Published 2018 Jul 10. doi:10.12659/MSM.909259 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6069490/
  7. Too much Zinc: Symptoms, Causes, and Treatments, MedicalNewsToday.com, https://www.medicalnewstoday.com/articles/326760#symptoms
  8. EVMS Critical Care COVID-19 Management Protocol, *Marik protocol revised, evms.edu https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf
  9. A. Manjula, R. Subashini, R. Punitha & P. Subramanian (2017) Modulating effects of hesperidin on circadian pattern indices of rotenone induced redox homeostasis in clock mutant (cryb) of Drosophila melanogaster, Biological Rhythm Research, 48:6, 897-906, DOI: 10.1080/09291016.2017.1319641 https://www.tandfonline.com/doi/abs/10.1080/09291016.2017.1319641?journalCode=nbrr20
  10. Beatriz Fernández-Gil, Ahmed EA Moneim, Francisco Ortiz, et al, Melatonin protects rats from radiotherapy-induced small intestine toxicity. PLOS One, April 12, 2017 https://doi.org/10.1371/journal.pone.0174474 https://dx.plos.org/10.1371/journal.pone.0174474
  11. Hannah Balfour, NLRP3 inflammasome ‘off switch’ reverses effects of chronic inflammation. Feb 6, 2020, drugtargetreview.com, https://www.drugtargetreview.com/news/55776/nlrp3-inflammasome-off-switch-reverses-effects-of-chronic-inflammation/
  12. I-Yin Chen, Miyu Moriyama, Ming-Fu Chang and Takeshi Ichinohe, Severe Acute Respiratory Syndrome Coronavirus Viroporin 3a Activates the NLRP3 Inflammasome. https://www.frontiersin.org/articles/10.3389/fmicb.2019.00050/full
  13. Immediate Treatment for Early Stage SARS-CoV-2 Infections. via Avery J. Knapp, Jr. MD (https://twitter.com/aknappjr/status/1247497984431943680?s=20) https://docs.google.com/document/d/1ka76CL50hR_a0b5oIhEAVY4gfyqkJcBxXBcP0r2nrz0/edit?fbclid=IwAR0ss1p0lsPhLkSFhO6_8vJK19BUispAREVcn0oi09iajG-Pq4HDCMFTQdg
  14. James Ludell, Operation CAI-Reducing Peak Load on Hospitals from COVD-19, April 5, 2020, last updat April 10, 2020, (father of a child with a rare condition for which high dose thiamine helps – making him a very well-informed patient advocate sharing information that typically would not be used/studied for standard patient care – but can be helpful for critically ill and/or malnourished patients, see 15), https://docs.google.com/document/d/1vnYosVsgChnGVecOXp96T5i2UibTsnHVaDUVF6Us2uM/edit?usp=sharing
  15. Manzanares W, Hardy G. Thiamine supplementation in the critically ill. Curr Opin Clin Nutr Metab Care. 2011;14(6):610–617. doi:10.1097/MCO.0b013e32834b8911 https://pubmed.ncbi.nlm.nih.gov/21912244/
  16. Magnesium Clears up Mucus and Improves Breathing in Cystic Fibrosis Patients. Feb 10, 2014, Natural Health Research Institute, naturalhealthresearch.org, https://www.naturalhealthresearch.org/magnesium-mucus-cystic-fibrosis/
  17. József Tőzsér and Szilvia Benkő, Natural Compounds as Regulators of NLRP3 Inflammasome-Mediated IL-1β Production. Mediators of Inflammation, 2016, Article ID 5460302, 16 pages, https://doi.org/10.1155/2016/5460302 https://www.hindawi.com/journals/mi/2016/5460302/
  18. Pack GL, Natural Promotion of p53 Protein Activity. Dr. Pack’s Summary #763, Rainbow Grocery, San Francisco, CA, USA. https://www.rainbow.coop/library/natural-promotion-of-p53-protein-activity/
  19. (Nayak, Shah, Deshpande, 2019) Nayak AP, Shah SD, Michael JV, Deshpande DA. Bitter Taste Receptors for Asthma Therapeutics. Front Physiol. 2019;10:884. Published 2019 Jul 16. doi:10.3389/fphys.2019.00884 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6647873/
  20. *This paper has been found to have flaws in the interpretation. (25) Wenzhong Liu, Hualan Li, COVID-19: Attacks the 1Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism. covid19-2020004-9-EN.pdf ChemRxiv, https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173
  21. LMU Press Release, contact person Dr. Albrecht von Brunn, How a Tumor Suppressor Indirectly Inhibits Coronaviruses. Aug 12, 2016, DZIF German Center for Infection Research, https://www.dzif.de/en/how-tumor-suppressor-indirectly-inhibits-coronaviruses
  22. Yue Ma-Lauer, Javier Carbajo-Lozoya, Marco Y. Hein, et al., p53 down-regulates SARS coronavirus replication and is targeted by the SARS-unique domain and PLpro via E3 ubiquitin ligase RCHY1. Proceedings of the National Academy of Sciences Aug 2016, 201603435; DOI: 10.1073/pnas.1603435113 https://www.pnas.org/content/early/2016/08/11/1603435113.abstract
  23. Shafiya Rafiqa, Rajkumari Kaula, S.A.Sofi, et al., Citrus Peel as a Source of Functional Ingredient: A Review, J Saudi Society of Ag Sci, 17;4, Oct 2018, pp 351-358, https://www.sciencedirect.com/science/article/pii/S1658077X16300960
  24. Michael Lustgarten, Coronavirus – Can Diet Help?, April 11, 2020, michaellustgarten.com, https://michaellustgarten.com/2020/04/11/sars-cov-2-can-diet-help-in-the-fight/
  25. Randy J Read, Flawed methods in“COVID-19: Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism” ChemRxiv.org, https://chemrxiv.org/articles/Flawed_methods_in_COVID-19_Attacks_the_1-Beta_Chain_of_Hemoglobin_and_Captures_the_Porphyrin_to_Inhibit_Human_Heme_Metabolism_/12120912
  26. Adam Drewnowski, Carmen Gomez-Carneros, Bitter taste, phytonutrients, and the consumer: a review, Amer J of Clinical Nutrition, 72;6, December 2000, Pages 1424–1435, https://doi.org/10.1093/ajcn/72.6.1424 https://academic.oup.com/ajcn/article/72/6/1424/4729430 Addition – “neohesperidoside, and neohesperidin are very bitter, whereas hesperidin is tasteless

Updates/ Vitamin C Infusion is helping CoV-19 patients in New York.

Addition – Food sources of vitamin C, quercetin, and zinc are at the top of this document, which includes this blog post and a few others on the topic of COVID-19 (Antivirals in Foods) Eating good sources several times a day may help the body prevent infection or have a less severe case.

Virus enter a cell and are replicated to the cell’s capacity to produce them, at that point the cell bursts releasing the newly formed virus which go and infect other cells and force those cells to make even more virus to the cell’s capacity, and they all burst, releasing yet more virus – in an exponentially increasing number. Each time a cell bursts and releases the viral load, the cell dies. So the sooner you can help your body stop the viral replication the sooner you are protecting your cells from being killed by the process.

Megadoses of the nutrients that help stop viral replication may not be needed. Moderate amounts of good food sources may help the body fight the infection before it has spread to numerous cells and caused significant cell damage. Reducing infection load may also help prevent an over-reaction of the immune system to the infection. An over-reaction of the immune system can be deadly as the inflammatory chemicals can attack healthy cells and lead to organ failure and eventually death. The next section is about a nontoxic treatment that might help if an over-reaction of the immune system leads to a Cytokine Storm/sepsis reaction.

Foods contain antivirals that work in a similar manner to the chloroquine medications that we have been hearing about in the news. More production is needed before they are available for widespread use, and they are somewhat expensive and can be dangerous. Quercetin is a phytonutrient that is readily available in vegetables and fruits and as a bulk or individual supplement.

Nursing homes and hospitals could be adding the bulk supplement powder to a food at each meal and including zinc food sources. The zinc is carried into infected cells by the quercetin (or chloroquine) and the zinc disrupts viral replication. The chloroquine, quercetin, or zinc are not killing virus. White blood cells are the body’s patrol for killing and removing infected cells.

Health takes work and work takes nutrients.

  • Vitamin C helps the immune system fight infection. Good sources include: cabbage, tomatoes, green peppers, broccoli, asparagus, peas, kale, & citrus, strawberries, kiwi, papayas, cantaloupe. (Vit C Fact Sheet)
  • Good food sources of quercetin include: red onion, onion, garlic, kale, tomatoes, asparagus, broccoli, capers, nuts and seeds, red grapes, cherries, olive oil. Herbal supplements also containing quercetin include St John’s Wort, Gingko biloba, and American Elder. (WebMd
  • Good food sources of zinc include oysters, meats, poultry, dairy, cashews, pumpkin seeds. Other beans, nuts and seeds would also have some as vegan sources. Meats have more than the vegan sources, while oysters have so much zinc that it might risk excess if eaten regularly in large servings.  (Zinc Fact Sheet).

There are no guarantees in life, but trying a nontoxic strategy is at least safe. Medications may have risks of side effects – always see a medical professional for individualized health care guidance.

Vitamin C Infusion for Cytokine Storm immune overreactions.

Good news updates – a hospital chain in New York has found the use of high dose intravenous Vitamin C Infusions helpful for patients infected with the SARS-CoV-2 (COVID-19) novel coranovirus. “Dr. Andrew G. Weber, a pulmonologist and critical-care specialist affiliated with two Northwell Health” is providing his patients who have sepsis/cytokine storm symptoms an intravenous drip with 1500 mg of vitamin C three or four times per day. (1) Patients getting the Vitamin C treatment have been helped more than patients who did not according to Dr. Weber. A spokesperson for the Northwell Health system said that vitamin C is being “widely used” at their hospitals where 700 patients approximately are being treated for SARS-CoV2, however it varied by patient need and the clinician’s plan of care. (1, 2)

The patients who received vitamin C did significantly better than those who did not get vitamin C,” Weber said. (1)

The protocol for the treatment also includes vitamin B1 generally but that news article doesn’t mention that ingredient of the IV mixture. The treatment is a much larger amount of vitamin C than the daily recommendation for a normal diet, however a patient with an overactive immune response is not in normal health. The treatment is used for patients who have had an overactive immune response to the infection and their own immune cytokines become produced in excessive amounts. The cytokines can then start damaging the patient’s own organs which can lead to organ failure and result in death.

The damaging immune chemicals in a normal response to infection would only attack the infected cells. The excessive amounts however use up all supplies of vitamin C in the patient’s body, and supplying vitamin C in high doses is then very helpful for protecting the patient from harm by the excess.

Quercetin plus zinc is a zinc ionophore, and is being tested as an anti-viral in human clinical trials for the treatment of SARS-CoV2 (COVID-19).

Good news update regarding quercetin and zinc as a zinc ionophore – the combination had already made it through animal trials for use against Ebola, and SARS-CoV(1) and was approved by the FDA for human clinical trials. Plans were underway for it to be trialed in China for patients with SARS-CoV2 (COVID-19). I haven’t found results yet.

  • CBC News Interview with “Dr. Michel Chrétien’s team at the Clinical Research Institute of Montreal” : Canadian team invited to do clinical trials in China for antiviral drug. Feb 28, 2020, (youtube).

UK What to do if at home with a Potential Infection, Guidance:

Stay at home: guidance for households with possible coronavirus (COVID-19) infection. Updated 24 March 2020, (gov.uk).

*The UK guidance recommends isolating for seven days after symptom onset, – it might be wise to use caution longer than, especially if trying to protect people in your home who are in a high risk group, which includes: Senior Citizens, people with asthma or other lung conditions, smokers, people with hypertension, and immune-compromised people.

While the infectious stage seems to start prior to symptom onset and to have the most risk of spreading the infection during the early days of symptoms, when a fever is also often a symptom, that might not be consistently true and not everyone infected with SARS-CoV-2 gets a fever. The longest a patient has been found to be infectious was 37 days and the shortest was eight days. The average for patients with severe symptoms being treated in a hospital to be infectious was 19 days and for patients with critical symptoms the average was 24 days to remain infectious. (4)

Sensible precautions if sharing a home with infected and non-infected people include:

  • Cover your coughs or wear a mask or bandana to catch respiratory droplets from your breath, coughs or sneezes. Try to avoid being in the same room with non-infected people if possible, at least during the highest risk days during the early onset of symptoms, or positive test result.
  • Wash hands often and sanitize or wash with soap any commonly used surfaces such as door knobs, kitchen and bathroom areas.
  • Don’t prepare raw foods for non-infected people if you can avoid it. Otherwise wash hands thoroughly or wear food preparation gloves if possible after the initial week or two of more severe feverish symptoms has passed.
  • US CDC guidance for home care of a person infected with SARS-CoV2 https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-spread.html

This is doable – the quercetin rich foods mentioned in the last post plus sinc supplements or foods may provide a protective effect against getting a viral infection. Stay calm and eat sauteed onions or citrus with a little of the peel left on, plus pumpkin seeds or meats. Best wishes for everyone’s health!

Request for plasma donations from people recently recovered from SARS-CoV2, Mount Sinai

There is a request for people who have recently recovered from SARS-CoV2 (COVID-19) and who would be willing to donate plasma if they have antibodies against the infection to contact Mount Sinai’s medical team. Antibody rich plasma can be given to severely ill patients with the infection to help them fight the virus. They can check for the presence of antibodies. Contact: COVIDSerumTesting@mountsinai.org, see (Statement from Mount Sinai Chief Medical Officer, (via @MikeDelMoro/via @joshchafetz).

Mount Sinai medical system has developed a test for checking for CoV-19 antibodies within hospitals and are sharing the technique: BREAKING: The First U.S. Test to Detect If a Person Has Potential Immunity to COVID-19 Was Just Developed (leapsmag.com)

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. Lorena Mongelli and Bruce Golding, New York hospitals treating coronavirus patients with vitamin C. March 24, 2020, NYPost.com, https://nypost.com/2020/03/24/new-york-hospitals-treating-coronavirus-patients-with-vitamin-c/?utm_campaign=SocialFlow&utm_medium=SocialFlow&utm_source=NYPTwitter
  2. Dan Lyman, Coronavirus Patients Being Treated With Vitamin C at New York Hospitals. March 25, 2020, https://www.newswars.com/coronavirus-patients-being-treated-with-vitamin-c-at-new-york-hospitals/
  3. CBC News Interview with “Dr. Michel Chrétien’s team at the Clinical Research Institute of Montreal” : Canadian team invited to do clinical trials in China for antiviral drug. Feb 28, 2020, (youtube).
  4. Fei Zhou, Ting Yu, Ronghui Du, et al., Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet, March 11, 2020, DOI:https://doi.org/10.1016/S0140-6736(20)30566-3 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext#back-bib33
  5. Kira Peikoff, BREAKING: The First U.S. Test to Detect If a Person Has Potential Immunity to COVID-19 Was Just Developed. March 22, 2020 leapsmag.com, https://leapsmag.com/breaking-the-first-u-s-test-to-detect-if-a-person-has-potential-immunity-to-covid-19-was-just-developed/?fbclid=IwAR2z_hl9VZfsrjz2JL03Sze2cPscdqGTFD0VyBrSbUvx-bOP8f5lmz9BgdU

Eat Food – Antivirals are found in common foods.

Chloroquine medications are dangerous, many medications are dangerous especially if taken in too large a dose. Chloroquines are typically used to treat malaria, a condition caused by a parasite. The mechanism of action is that the chemical can hold onto the mineral zinc and carry it into an infected cell where the zinc disrupts the replication of proteins, causing less virus replication. (6) It has been mentioned as a medication that potentially may be helpful for treating patients with the novel coronavirus that is currently causing a pandemic.

The chloroquine medications are also used by autoimmune patients and supplies of the drug are limited. Increasing production is a goal but will likely take some time. (7) There are other safer alternatives available in foods or phytonutrient extracts (1, 8, 9) that have an immune modulating effect – promoting removal of infected or damaged cells while also inhibiting an overactive immune response.

People with a heart condition may also be at more risk of dangerous side effects if taking chloroquines. The medication also needs to be given with zinc to be as effective as possible. The food or phytonutrient alternatives would also need to be used with zinc in the diet or added as a supplement. (1, 8, 9)

***** ONLY TAKE PRESCRIPTION MEDICATIONS THAT ARE PRESCRIBED FOR YOU BY YOUR OWN MEDICAL PROFESSIONAL *****

***** ONLY EAT FOOD *****

Someone is dead because they consumed a household product containing chloroquine because they thought it might protect them from coronavirus infection, (10), – dead is not infectable by a virus, but dead is also dead.

Quercetin plus zinc is also an antiviral that works as a zinc ionophore, (1), however it is readily available in some common foods or as a supplement and is nontoxic to cells. (1, 2) The zinc is disrupting protein replication within the infected cell so the virus can not be replicated to spread to other cells, for more replication, more infecting other cells, more replication, etcetera.

Onions are the richest source of quercetin (4) and citrus peel is also a very rich source. (3) Pumpkin seeds are the richest source of zinc in a vegetarian diet and is commonly available in meats in a non-vegetarian diet.

Pomegranate peel extract or the inner white membrane of a pomegranate is also a source of quercetin and another phytonutrient that acts as a zinc ionophore (epigallichatechin-gallate). (1) It also would be nontoxic to healthy cells and low risk compared to the chloroquine medications. (2) However it can have some side effects, acting as a diuretic and has COX2 inhibition activity. (recent post, older post) A tablespoon or two of the liquid extract or inner white membrane can be enough to provide some health benefits for an adult. (G13: Preparation & Benefits of Pomegranate)

Onions, citrus peel, pomegranate peel – we have choices, safe choices, to help our body’s own defense system stop the coronavirus. Chloroquines do not kill coronavirus – it helps our own defense system do its job – but with more risk to healthy cells, and normal function than onions, citrus peel or pomegranate peel or quercetin supplements. Zinc is a trace mineral which we need in small amounts, a larger dose taken for a week or two would be unlikely to build up to toxic amounts but please be aware that in large doses a zinc supplement could become toxic.

Eat food – that is what our body is designed for. If the GI tract is inflamed and the idea of eating food is no longer appealing due to pain or constant diarrhea than please see the recent post: ACE2, Diarrhea, & COVID19 – it gets complicated. and try to eat small servings of something that might help heal and stop the inflammatory reaction in the intestinal tract.

If nausea and vomiting are also symptoms, hold off on the food and just sip water that has a dash of lemon or lime juice or apple cider vinegar. Those all have a type of acid that is similar to stomach acid. In cases of severe nausea even plain water can be unsettling and larger amounts of anything can be a problem. Start gradually with small sips of the lemon water, or a lime or lemon popsicle may be soothing and not cause more vomiting.

Once feeling better some of the mucilaginous or hydrolyzable tannin foods mentioned in the recent post (ACE2, Diarrhea…) can help replace the mucous lining that coats the intestinal tract during times of health. It also serves as a defense system, helping to prevent entry of virus or other pathogens into the body between intestinal cells. And white blood cells patrol the area and actively defend against pathogens.

Pomegranate peel also provides hydrolyzable tannins if the white membrane is used in prepared foods like a bean soup (G8: Cookies & Bean Soup/recipes) or sweet potato dish. Pomegranate peel and citrus peel and onions (less so) are also sources of vitamin C which also helps our body’s natural anti-viral defenses. (5)

Addition: Table of drugs and phytonutrients that are being investigated for use as a COVID19 treatment, (@rubbersoul23,Eric/table) based on A SARS-CoV-2-Human Protein-Protein Interaction Map Reveals Drug Targets and Potential Drug-Repurposing, March 23, 2020, (biorxiv.org)

Disclaimer: This information is provided for educational purposes within the guidelines of Fair Use. It is not intended to provide individual guidance. Please seek a health care provider for individualized health care guidance.

Reference List

  1. Husam Dabbagh-Bazarbachi , Gael Clergeaud, Isabel M Quesada, et al., Zinc Ionophore Activity of Quercetin and Epigallocatechin-Gallate: From Hepa 1-6 Cells to a Liposome Model. J Agric Food Chem, 62 (32), 8085-93 2014 Aug 13. https://pubmed.ncbi.nlm.nih.gov/25050823/
  2. Houston DMJ, Bugert JJ, Denyer SP, Heard CM. Potentiated virucidal activity of pomegranate rind extract (PRE) and punicalagin against Herpes simplex virus (HSV) when co-administered with zinc (II) ions, and antiviral activity of PRE against HSV and aciclovir-resistant HSV [published correction appears in PLoS One. 2017 Nov 20;12 (11):e0188609]. PLoS One. 2017;12(6):e0179291. Published 2017 Jun 30. doi:10.1371/journal.pone.0179291 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5493292/
  3. Shafiya Rafiqa, Rajkumari Kaula, S.A. Sofia, et al., Citrus peel as a source of functional ingredient: A review. J of the Saudi Society of Ag Sci, 17;4, Oct. 2018, pp 351-358 https://www.sciencedirect.com/science/article/pii/S1658077X16300960
  4. Quercetin, Pharmacology, Toxicology and Pharmaceutical Science/Quercetin, ScienceDirect.com, https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/quercetin
  5. Kim Y, Kim H, Bae S, et al. Vitamin C Is an Essential Factor on the Anti-viral Immune Responses through the Production of Interferon-α/β at the Initial Stage of Influenza A Virus (H3N2) Infection. Immune Netw. 2013;13(2):70–74. doi:10.4110/in.2013.13.2.70 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659258/
  6. Xue J, Moyer A, Peng B, Wu J, Hannafon BN, Ding W-Q (2014) Chloroquine Is a Zinc Ionophore. PLoS ONE 9(10): e109180. https://doi.org/10.1371/journal.pone.0109180 https://journals.plos.org/plosone/articleid=10.1371/journal.pone.0109180
  7. Eva Schrezenmeier, Thomas Dörner, Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology. Nat Rev Rheumatol 16, 155–166 (2020). https://doi.org/10.1038/s41584-020-0372-x https://www.nature.com/articles/s41584-020-0372-x
  8. Wang T1, Men R1, Hu M, et al., Protective effects of Punica granatum (pomegranate) peel extract on concanavalin A-induced autoimmune hepatitis in mice. Biomed Pharmacother. 2018 Apr;100:213-220. doi: 10.1016/j.biopha.2017.12.110. Epub 2018 Feb 9. https://www.ncbi.nlm.nih.gov/pubmed/29428670
  9. Hou L, Huang H. Immune suppressive properties of artemisinin family drugs. Pharmacol Ther. 2016;166:123–127. doi:10.1016/j.pharmthera.2016.07.002 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035609/
  10. Anne Flaherty, Sophie Tatum, Man dies after ingesting aquarium product containing chloroquine: Hospital network. March 23, 2020, abcnews.go.com, https://abcnews.go.com/Politics/man-dies-ingesting-chloroquine-prevent-coronavirus-banner-health/story?id=69759570