Coronavirus Nutrition

The world is under the threat of the recent outbreak of COVID-19 coronavirus.  While the best way to treat this virus is to avoid contracting it, there is no guarantee that you can avoid it.

Supplements and nutritional products are available that may help minimize negative effects of the virus.  In discussing these supplements and products, it must be noted that as COVID-19 is a new novel coronavirus, currently, there is no strong research regarding any aspect of the virus and recommendations are made on the best currently available evidence.  Much of the currently available evidence is based on anecdotal reports from providers in the field, case studies, and non-peer reviewed research papers, and under normal circumstances would be considered weak evidence.  Ideally, medical evidence is gained by stronger sources such as blinded randomized controlled trials and meta-analysis, however, these are unavailable at this time.  Therefore, we will only fully understand which treatments are beneficial after the situation has been resolved and proper studies performed.  Some of the supplements and nutritional products suggested in this article will not stand the test of time, but the best current evidence suggests they may be helpful while minimizing risk of reactions and complications. 

Vitamin C in megadoses has shown promise as a good treatment option.  When used in the hospital setting for treatment of COVID-19, it is typically used intravenously as Vitamin C absorption through the digestive system is not as effective.  Dr. Andrew Weber, a Long Island based pulmonologist and critical-care specialist with Northwell Health has been providing his patient with 1500mg IV Vitamin C 3-4 times per day.  Dr. Richard Cheng, Chinese Edition Editor of the Orthomolecular Medicine News Service, advocates for higher doses. 

IV Vitamin C is not practical in the home setting, however, megadoses of Vitamin C can be taken by mouth.  Research has shown that Vitamin C in megadoses may prevent progression of COVID-19 infection to more severe pneumonia.  Vitamin C has also been shown to decrease chances of acute respiratory distress syndrome (ARDS).  ARDS onset significantly increases chance of death and is a major factor in many COVID-19 related deaths.  Higher doses of vitamin C should not be taken all at once, and should be divided throughout the day. 

Vitamin C is generally safe for short periods even in megadoses, however, it does have side effects.  The most common side effect of high Vitamin C doses is stomach upset and diarrhea.  When more Vitamin C is taken than can be absorbed by the body, no more is absorbed from the digestive tract, and it can produce a laxative effect.  When laxative effect occurs, this is called bowel tolerance, and is indication that enough supplemental Vitamin C has been taken. Some studies have suggested that antioxidants such as Vitamin C in high doses over prolonged periods can increase chances of cancer. Vitamin C is water soluble and does not build up in the body.  As Vitamin C is water soluble, it is excreted in the urine.  However, it is excreted as oxalate, which can contribute to the formation of kidney stones, and should not be taken in high doses by those with a history of kidney stones or history of kidney problems. 

Vitamin D is a fat-soluble Vitamin that helps with immune system function and provides benefit against general respiratory infections.  Vitamin D is produced in the body when skin is exposed to UV-B light.  Sunlight is a good way to get UV-B light and produce Vitamin D.  However, often it is not so easy to get enough or correct sunlight.  Glass generally filters out UV-B light, and therefore sunlight from a closed window is not effective at producing Vitamin D in the body. Supplements can be used to get Vitamin D; however, caution must be used when taking additional Vitamin D though supplements or diet.  Unlike Vitamin C, which is water soluble and does not accumulate in the body, Vitamin D is fat soluble and can accumulate and build up in the body, which may lead to health problems associated with excess Vitamin D.  Vitamin D produced in the skin does not accumulate excessively, as excess Vitamin D produced in the skin breaks down, whereas Vitamin D from diet does not.  The upper limit when supplementing Vitamin D is 4,000 IU per day for adults.  Vitamin D dose of 2000 IU per day is within the adult limits and safe for most healthy adults. 

Zinc is a mineral that is known for supporting immune function.  Zinc can also inhibit and slow replication for a variety of viruses, including the original SARS virus, which has similarities to the current COVID-19 coronavirus.  Definitive studies are not yet available as to the benefits of zinc in regards to COVID-19, however, zinc is generally low risk and there is a good chance it will be beneficial. 

N-Acetyl Cysteine (NAC) is a chemical that has shown to provide a variety of benefits.  Relevant to COVID-19, NAC can help thin and loosen mucus, thereby easing breathing and decreasing coughing.  NAC provides the amino acid cysteine and is relatively safe.  NAC is used in the body to produce glutathione, which is a major antioxidant in the body.  As an antioxidant, glutathione helps limit oxidative damage. 

NAC itself is not available in food, but is available as a supplement.  Typical dosages are 500mg per day.  Taking more than 1200mg of NAC per day can produce side effects in some people such as headache, nausea, abdominal pain, vomiting, constipation, or diarrhea.  People taking glutathione should not use NAC without doctor supervision as they can interact and produce dangerously low blood pressure. 

Research continues on treatments and supplements that may be helpful for COVID-19.

At Accident & Wellness Chiropractic in SE Portland and Aloha, OR, our chiropractors provide nutrition counseling as part of treatment for personal injuries.

Vitamin C Kidney stones

https://www.healthline.com/nutrition/side-effects-of-too-much-vitamin-c#kidney-stones

Vitamin C Studies

https://clinicaltrials.gov/ct2/show/NCT04264533

Vitamin C & ARDS

https://consultqd.clevelandclinic.org/study-suggests-benefits-of-vitamin-c-for-severe-sepsis/
https://pulmccm.org/critical-care-review/vitamin-c-reduces-mortality-from-sepsis-with-ards-in-first-randomized-trial/

Hospital Vitamin C Treatment

https://nypost.com/2020/03/24/new-york-hospitals-treating-coronavirus-patients-with-vitamin-c/
http://orthomolecular.org/resources/omns/v16n11.shtml
https://www.dailymail.co.uk/news/article-8149191/amp/New-York-hospitals-treating-corona-patients-6000-milligrams-VITAMIN-C.html?__twitter_impression=true

Can early and high intravenous dose of vitamin C prevent and treat coronavirus disease 2019 (COVID-19)?

https://www.sciencedirect.com/science/article/pii/S2590098620300154

Vitamin D Upper Limit

https://ods.od.nih.gov/factsheets/VitaminD-Consumer/

Zn(2+) Inhibits Coronavirus and Arterivirus RNA Polymerase Activity in Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture

https://pubmed.ncbi.nlm.nih.gov/21079686/