We encounter many things in life that we have no control over. There are others, however, that we actively participate in creating and make happen.
In both scenarios we can for the most part control how we react to the encounters. If there are any lessons to be learned from the year 2020, one of them should be the boundaries around control.
So can we control contracting the COVID-19 infection? Can we control how our bodies react if we get COVID-19? In short, yes and no.
We are all aware of the CDC recommendations, and it makes intuitive sense that avoiding the virus to begin with is the best “cure.” Unfortunately, we live in a dynamic world, and it is next to impossible to bury our heads in the sand so to speak or avoid all human contact.
We not only enjoy human contact but rely on others for our daily needs, even if it is delivered directly to our homes. Therefore we have instituted measures to help limit the amount of exposure to the virus, in particular staying six feet or more apart, proper handwashing, nasal lavage, and wearing a mask to decrease exposure of our nasal passages to the water droplets that the viruses are often suspended in.
You may have heard in the news that certain blood types, namely type O, seem to have fewer respiratory complications from the COVID-19 as compared to blood type A. Unfortunately, our blood type is a permanent fixture.
We see increased risk of complications from COVID in the elderly, persons above their ideal body weight, and in persons with coexisting comorbidities or other medical problems such as hypertension, diabetes, COPD. It stands to reason that if we improve our comorbidities then we also improve our ability to defend our cells from the COVID-19 infection.
What else can we do to improve our immune system to fight illness, including the COVID-19 virus?
1. Quercetin: 250-1000 mg per day
Quercetin is a natural plant flavonol found in many fruits and vegetables such as berries, seeds, red onion, kale and broccoli and is used in many dietary supplements as well as in beverages and in food. In fact, the proportion of flavonoids in foods is directly related to its strength as an antioxidant.
Quercetin as an antioxidant is known to protect cells by switching on cell repair in response to cell damage by bacterial viruses and, as well, switching off to decrease inflammation in the body. In particular for its antiviral abilities, it is known to block the enzyme replicase, which viruses use to multiply in human cells.
By blocking the enzyme, while the virus might get into a cell it is not able to replicate as freely, which improves the body’s ability to defend itself against a smaller viral load.
2. Vitamin D3 (cholecalciferol): 1000-5000 IU daily
Adequate levels of vitamin D is essential to the functioning of the immune system and protection against many infections. One literature review published in the British medical journal involving over 11,000 participants of all ages showed that vitamin D supplementation reduced the frequency of respiratory infection by 70% in those starting off with an inadequate vitamin D level, and by 25% in those with adequate vitamin D levels.
More recently in 2020, studies have shown that deficiency in vitamin D increases the risk of contracting COVID-19 as well as experiencing more serious illness from it. While many foods such as fish, eggs, milk and other dairy products have vitamin D within them, dietary levels are not adequate to meet our needs.
Direct exposure to sunlight helps to activate our natural production of vitamin D, but it is fairly variable, and time spent in the sun is reduced by many persons rightfully fearing the risk for skin cancers. The best way to make sure you are getting adequate amounts of vitamin D is to take a supplement daily and to have your levels checked every few years during your annual exam.
3. Vitamin C: 500 mg a day up to 1000 mg twice daily
Vitamin C or ascorbic acid has been one of the most widely researched vitamins in the past 50 years. It is known to help promote a strong immune system as well as skin, cardiovascular and brain health.
It occurs naturally, and its highest concentration is in the brain and adrenal glands. While many mammals make vitamin C, humans, monkeys and guinea pigs do not. It is found in foods, in particular citrus fruits and vegetables. It is an important antioxidant and is needed as a coenzyme in many other cellular reactions.
In the lab, vitamin C has been shown to kill various cancer cells; however, in clinical studies the benefits have not been as strong. Large-scale viral studies with thousands of participants have shown that vitamin C reduces the risk of contracting colds/corona viruses with other studies showing that vitamin C reduces the symptoms by about 25% when a person does have a corona virus.
4. Zinc: 50-100 mg a day
Zinc is a mineral ingested as lozenges or pills. Although it comes in an intranasal form, this should be avoided to decrease the risk of possible loss of smell. A typical zinc lozenge or pill has 13.3 mg with recommendation for taking one every 2-4 hours until symptoms subside for a maximum of six lozenges in a day in adults and four4 tabs in children 12 and older.
Zinc is found in foods such as oysters, red meat, poultry, beans, nuts, whole grains and dairy products. It is involved in cellular metabolism, wound healing, growth, and immune function, as well as cell division and for proper sense of smell and taste.
Human studies in the past assessing the ability of zinc to reduce symptoms of respiratory infections have produced mixed results, but it is used in many over-the-counter cold remedies. Moreover, there are ongoing randomized, controlled clinical trials with COVID-19, so in the future we will know more about the possible benefits of using zinc in COVID-19 patients.
5. Melatonin: up to 6 mg each night
Melatonin is best known as a sleep aid, but it can block inflammation, especially in the lungs, which reduces the risk of fibrosis, one of the most serious COVID complications.
Recommendation is to take 0.5-6 mg each evening. For sleep maintenance I would recommend taking it 1½-2 hours prior to desired bedtime, which should also help decrease any morning drowsiness.
Interestingly, bats, which are the natural reservoir of the corona virus, have exceptionally high levels of melatonin that may protect them from developing symptomatic disease. It is a nighttime hormone and is made naturally in our bodies during sleep, emphasizing the importance of sleep for a healthy immune system.
Please note that to date the FDA has not approved any vitamin or mineral for the direct cure of diseases. It is also important to always check with your physician before starting any supplements as to possible interactions with your current medications and your particular health conditions. Also check the source of where you buy any supplements to see that they have some type of independent quality measure in place.
Dr. Inell Rosario is a board-certified ENT and sleep physician practicing at Andros ENT & Sleep Center in Inver Grove Heights, Minnesota. She has many times been recognized as a Top Doctor and Best Doctor in various Minnesota magazines and can be reached at drrosario@androsent-sleep.com or 651-888-7800.
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