Vitamin C plus pentoxifylline also significantly increased total antioxidant capacity, but pentoxifylline alone did not. Phytother Res 2021;35:1230-6. However, some reports have linked high blood levels of melatonin with delayed puberty and hypogonadism [124]. However, studies have evaluated the use of oral NAC to treat bronchopulmonary diseases, such as bronchitis and chronic obstructive pulmonary disease (COPD) with some promising results in reducing numbers of episodes and symptom severity [145,146]. Clin Drug Investig 2016;36:169-75. [, DeLuccia R, Clegg D, Sukumar D. The implications of vitamin D deficiency on COVID-19 for at-risk populations. Clinical Significance of Micronutrient Supplementation in Critically Ill COVID-19 Patients with Severe ARDS. There is also no good evidence to support using N-acetyl cysteine for COVID-19. High vitamin C doses might also cause falsely high or low readings on some blood glucose meters that are used to monitor glucose levels in people with diabetes [267-269]. Our findings need to be confirmed by properly designed prospective clinical trials. Findings were similar for 45,757 individuals in the United States and for 27,373 participants in Sweden. Biochimie 2020;179:275-80 [, Thibault R, Seguin P, Tamion F, Pichard C, Singer P. Nutrition of the COVID-19 patient in the intensive care unit (ICU): a practical guidance. [, Zelzer S, Prller F, Curcic P, Sloup Z, Holter M, Herrmann M, et al. Beni-Suef Univ J Basic Appl Scie 2021;10:21. Scientific opinion on the tolerable upper intake level of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA). [, d'Ettorre G, Ceccarelli G, Marazzato M, Campagna G, Pinacchio C, Alessandri F, et al. Quercetin as a potential treatment for COVID-19-induced acute kidney injury: Based on network pharmacology and molecular docking study. Online ahead of print. WebMoreover, high-dose intravenous NAC may be expected to play an adjuvant role in the treatment of severe COVID-19 cases and in the control of its lethal complications, also including pulmonary and cardiovascular adverse events. Nutrients 2021;13:1714. Front Pharmacol 2020;11:556885. [, Murugan NA, Pandian CJ, Jeyakanthan J. Computational investigation on Andrographis paniculata phytochemicals to evaluate their potency against SARS-CoV-2 in comparison to known antiviral compounds in drug trials. Virol J 2020;17:136. In a retrospective study in Singapore among 43 hospitalized patients aged 50 years or older with COVID-19, those who received daily supplementation with 150 mg magnesium, 1,000 IU (25 mcg) vitamin D3, and 500 mcg vitamin B12 for a median of 5 days, starting within the first day of hospitalization for most patients, were less likely to need oxygen therapy, intensive care support, or both than those who did not receive the supplementation [99]. J Transl Med 2020;18:415. Body mass index and risk for COVID-19-related hospitalization, intensive care unit admission, invasive mechanical ventilation, and death - United States, March-December 2020. [, de Alencar JCG, Moreira CL, Mller AD, Chaves CE, Fukuhara MA, da Silva EA, et al. [, Diniz LRL, Souza MTS, Duarte ABS, Sousa DP. Safety: Echinacea appears to be safe. [, Kinoshita E, Hayashi K, Katayama H, Hayashi T, Obata A. Anti-influenza virus effects of elderberry juice and its fractions. Nutrients 2020;12. However, serum or plasma nutrient concentrations might not reflect body stores. Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths. The FDA classifies intravenous forms of vitamin C as drugs; only oral forms can be classified as dietary supplements. Recent analyses suggest that some elderberry supplements have been adulterated because they are highly diluted or contain a cheaper ingredient, such as black rice extract, instead of elderberry [64]. [, Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Nutrients 2018;10: 1614. Medicine (Baltimore) 2021;100:e27586. Postgrad Med J 2020. Several additional clinical trials are underway. Eur J Med Res 2021;26:20. Food Chem Toxicol 2007;45:2179-205. About 10-15 mg of elemental when consumed every 3-4 waking 1-3 days of common cold it prevents the cold . Planta Med 2004;70:293-8. J Endocrinol Invest 2021;44:765-71. [. Findings from some animal studies suggest that andrographis might adversely affect fertility, so experts recommend against its use by pregnant women and by men and women during the preconception period [26,28,29]. In addition, self-reported use of vitamin C supplements (doses not reported) more than three times per week for at least 3 months among 372,720 U.K. residents aged 16 to 90 years, 45,757 individuals in the United States, and 27,373 individuals in Sweden was not associated with higher or lower risk of SARS-CoV-2 infection [160]. In another study, self-reported use of zinc supplements (dose not reported) more than three times per week for at least 3 months among 372,720 U.K. residents aged 16 to 90 years as well as 45,757 individuals in the United States and 27,373 individuals in Sweden was not associated with higher or lower risk of SARS-CoV-2 infection [160]. The popularity of the biologically-based therapies during coronavirus pandemic among the Google users in the USA, UK, Germany, Italy and France. [, Doaei S, Gholami S, Rastgoo S, Gholamalizadeh M, Bourbour F, et al. Another trial in Mexico aims to determine whether 350 mg magnesium and 4,000 IU (100 mcg) vitamin D per day for four months improves signs and symptoms of long COVID in about 200 adults with this condition. Omega-3 fatty acids in the psychological and physiological resilience against COVID-19. Acetyl Cysteine Cytokine storm syndrome in coronavirus disease 2019: A narrative review. Much of the research on NAC has used an inhaled, liquid form of this compound. However, self-reported use of omega-3 supplements (dose not reported) more than three times per week for at least 3 months among 372,720 U.K. residents aged 16 to 90 years was associated with a 12% lower risk of SARS-CoV-2 infection after adjustment for potential confounders [160]. Safety: Probiotics, such as strains of Lactobacillus, Bifidobacterium, and Propionibacterium, have a long history of use in food and are often present in the normal gastrointestinal microbiota, indicating that probiotic supplements are safe for most people [179]. Nutritional status of patients with COVID-19. Zinc is necessary for the catalytic activity of approximately 100 enzymes, and it plays a role in many body processes, including both the innate and adaptive immune systems [15,350-353]. As a result, some scientists concluded that ginseng has estrogenic effects [85-88]. However, antibiotic and antifungal medications might decrease the effectiveness of some probiotics [203,204]. Another trial is evaluating whether daily supplementation with 1,000 mg ascorbic acid plus 10 mg melatonin for 14 days affects the symptoms and outcomes of COVID-19 in about 150 adults aged 50 years and older who are not hospitalized [134]. These upper limits, however, do not apply to individuals receiving vitamin D treatment under the care of a physician. In addition, the prevalence of vitamin D deficiency [defined as serum 25(OH)D less than 30 nmol/L (12 ng/mL)] was significantly higher in patients with COVID-19 than healthy participants, and vitamin D deficiency was associated with more severe COVID-19. Drug-vitamin D interactions: a systematic review of the literature. J Immunol Res 2020;2020:9207279. Another trial in the United Kingdom is assessing whether an elderberry supplement (Sambucol; 15 mL 4 times per day) for 14 days reduces symptom severity and rates of hospital admission in 204 adults with mild or moderate COVID-19. Common initial signs and symptoms include cough, fever, fatigue, headache, muscle aches and pain, and diarrhea [2]. National Institute for Health and Care Excellence. In clinical trials among children, zinc supplementation to treat diarrhea increased the risk of vomiting more than placebo [380,381]. Frank vitamin E deficiency is rare, except in individuals with intestinal malabsorption disorders [224,272]. JAMA Netw Open2020;3:e2019722. Several additional clinical trials are underway. However, the United Kingdom does not fortify milk with vitamin D [325]. Omega-3 fatty acids and inflammatory bowel diseases - a systematic review. Nutrients 2021;13:1760. Some research suggests that supplemental vitamin C enhances immune function [251], but its effects might vary depending on an individuals vitamin C status [252]. (which I had once in Nov 2020) To avoid it, I declined infection-promoting COVID vaccines. In addition, vitamin C supplementation might benefit people with pneumonia who have low vitamin C levels [258], as well as people with viral infections, including Epstein-Barr and herpes zoster [251]. Selenium helps support both the innate and adaptive immune systems through its role in T-cell maturation and function and in natural killer cell activity. Nutrients 2020;12. Online ahead of print. Indirectly, immune function can be assessed by examining a person's risk of infectious diseases and severity of symptoms. BMC Complement Med Ther 2021;21:112. The mean baseline 25(OH)D level among participants was 52.3 nmol/L (20.9 ng/mL). Melatonin is a hormone produced by the pineal gland in the brain, mainly during the night, that helps regulate circadian rhythms [123,124]. Nutrients 2020;12. Front Pharmacol 2022;13:856410. Although the genus Echinacea has many species, extracts of E. purpurea, E. angustifolia, and E. pallida are the most frequently used in dietary supplements. Nutr Rev 2020. Efficacy: Currently, data are insufficient to support recommendations for or against the use of zinc to prevent or treat COVID-19. [, Lazzerini M, Wanzira H. Oral zinc for treating diarrhoea in children. Story MJ. Biol Trace Elem Res 2020:1-9. In addition, eleuthero was often referred to, incorrectly, as ginseng at that time because it was called "Siberian ginseng." [, Jayawardena R, Sooriyaarachchi P, Chourdakis M, Jeewandara C, Ranasinghe P. Enhancing immunity in viral infections, with special emphasis on COVID-19: A review. [, Florez ID, Veroniki AA, Al Khalifah R, Yepes-Nuez JJ, Sierra JM, Vernooij RWM, et al. Modern Nutrition in Health and Disease Baltimore, Maryland: Lippincott Williams & Wilkins; 2012. Omega-3s play important roles as components of the phospholipids that form the structures of cell membranes [154]. [, Di Renzo L, Merra G, Esposito E, De Lorenzo A. NAC has mucolytic activity, so it helps reduce respiratory mucus levels [140,142]. No clinical trials of selenium supplementation in patients with COVID-19 have been published, but several trials are underway. BMJ 2017;356:i6583. None of the supplements shortened symptom duration. J Am Coll Nutr 2021;40:104-10. For this reason, research on the ability of vitamin E to improve immune function tends to use supplemental vitamin E rather than simply ensuring that study participants achieve adequate vitamin E status [336]. In addition, a non-randomized retrospective study in Spain of 537 patients hospitalized with COVID-19 (median age 70 years) found that the 79 patients who received calcifediol (25-OHD3, 532 mcg on the first day and 266 mcg on days 3, 7, 14, 21, and 28) combined with medications had a lower mortality rate during the first 30 days of hospitalization than those who received medications without calcifediol [314]. Data are insufficient to support recommendations for or against the use of any vitamin, mineral, herb or other botanical, fatty acid, or other dietary supplement ingredient to prevent or treat COVID-19. [, Buckley LM, Leib ES, Cartularo KS, Vacek PM, Cooper SM. This fact sheet by the National Institutes of Health (NIH) Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. Part II: electrolyte and acid-base disorders complicating diuretic therapy. Nutrients 2021;13. 25-Hydroxyvitamin D concentrations are lower in patients with positive PCR for SARS-CoV-2. Infect Chemother 2020;52:478-95. [, Padayatty SJ, Riordan HD, Hewitt SM, Katz A, Hoffer LJ, Levine M. Intravenously administered vitamin C as cancer therapy: three cases. Baltimore, MD: Lippincott Williams & Wilkins; 2014. Probiotics are live microorganisms that confer a health benefit on the host when administered in adequate amounts [177]. TJ Nutr 2007;137:2405-11. @Kelly04405562. The RDA for selenium ranges from 15 to 70 mcg for infants and children, depending on age, and from 55 to 70 mcg for adults [224]. Allergic reactions might also occur [29,34]. [, Wirtz PH, Spillmann M, Brtschi C, Ehlert U, von Knel R. Oral melatonin reduces blood coagulation activity: a placebo-controlled study in healthy young men. [, Edwards RL, Lyon T, Litwin SE, Rabovsky A, Symons JD, Jalili T. Quercetin reduces blood pressure in hypertensive subjects. : A randomized, multicenter trial. For example, one trial is examining the effects of 50 mg/day zinc (as zinc sulfate) in adults aged 60 years or older or aged 30 to 59 years with an underlying health condition with COVID-19 who are not hospitalized but have a high risk of complications due to their age or underlying health conditions [377]. [, Jawad M, Schoop R, Suter A, Klein P, Eccles R. Safety and efficacy profile of Echinacea purpurea to prevent common cold episodes: a randomized, double-blind, placebo-controlled trial. PLoS Med 2021;18:e1003605. [, Tang Z, Du X, Louie RF, Kost GJ. Vernie LN, de Goeij JJ, Zegers C, de Vries M, Baldew GS, McVie JG. Mechanistic aspects and therapeutic potential of quercetin against COVID-19-associated acute kidney injury. Diabetes Metab Syndr 2020;14:367-82. J Biomol Struct Dyn 2020:1-12. Heart Lung 2017;46:120-8. Ryu M, Aydemir TB. Selenium In: Marriott BP, Birt DF, Stallings VA, Yates AA, eds. A systematic review on the effects of Echinacea supplementation on cytokine levels: Is there a role in COVID-19? Quercetin Phytosome as a potential candidate for managing COVID-19. [, Reider CA, Chung RY, Devarshi PP, Grant RW, Hazels Mitmesser S. Inadequacy of immune health nutrients: Intakes in US adults, the 2005-2016 NHANES. Natural Medicines Comprehensive Database. Some evidence suggests that vitamin D supplementation might reduce COVID-19 severity. WebIf you test positive to COVID-19 using either a PCR test or rapid antigen test (RAT), book a telehealth appointment with your doctor. Phytother Res: PTR 2020. Adv Nutr 2019;10:696-710. Hathaway D, Pandav K, Patel M, Riva-Moscoso A, Singh BM, Patel A, et al. The key role of zinc in elderly immunity: A possible approach in the COVID-19 crisis. Diabetes Metab Syndr 2020;14:561-5. Nutr Bull 2020;45:115-22 [, Murai IH, Fernandes AL, Sales LP, Pinto AJ, Goessler KF, Duran CSC, et al. PLoS Biol 2020;18:e3000970. [. Because of their antiplatelet effects at high doses, omega-3s might interact with anticoagulants [172]. Pharmacotherapy 2010;30:797-805. Having had success in using them and others to treat two dozen cases so far, he thinks they should be put toward preventing COVID. Nutrients 2022;14:4604. All patients were treated with hydroxychloroquine and azithromycin, and 411 also received 50 mg zinc (as zinc sulfate) twice daily for 5 days; the other 521 patients did not receive the zinc supplements.
