Here’s how you can prevent severe disease and hospitalisation due to COVID-19, for both you and those close to you, using these well-researched nutritional treatment options. Read on to learn more about the key vitamins you need and to get our complimentary eBook for the management of COVID-19.
As a health practitioner who has dedicated her life to the assessment of health and treatment of disease, I am alarmed and horrified by the way that we have approached this global pandemic. From day one, health has been ignored, fear has been incited and a single solution has been offered at the peril of many, many people.
The management and treatment of the infection of those with COVID-19 across the globe haven’t just been appalling, it largely hasn’t really happened. Until someone is in a hospital bed, no early intervention or treatment is offered, despite there being ample evidence of many agents that can help to prevent infection, slow progression of the disease, and reduce hospitalisations and mortality rates.
Let’s be real – for most people, COVID isn’t going to be a long-term problem. The issue is, that for a decent amount of people it will, and what we need to focus on here is:
- How do we keep people from getting a severe form of the disease?
- How do we help your body to deal with this virus in the fastest way with the least impact on your health?
- How do we keep you out of the hospital?
This article is not about whether or not a vaccine works, undoubtedly the various vaccines have saved a lot of lives. The vaccines in their current forms do not however, significantly prevent you from acquiring COVID-19 nor from spreading it, and they don’t eliminate your risk of death completely.
It has been nearly 2 years since this pandemic was brought to our shores, and there are NO early interventions being offered to anyone. There are NO preventive measures being offered or promoted, besides public health measures like masks and social distancing.
A vaccine should never have been the only intervention, especially since we had no way of knowing for sure that it would help with future strains. The medical system is inherently reductionistic by nature, and the management of this pandemic is the biggest example I have ever seen of this. But while the mainstream looked to vaccines as the sole and only solution, many doctors and researchers have explored other options. There are hundreds of studies (many of which I have included here) that show mild to excellent efficacy of both natural and medical products for the early intervention of COVID-19.
Before I share some of the interventions that may help you here, let’s go back to some naturopathic principles so you can understand how my mind works. First of all, I am a Bachelor qualified naturopath (I hold two bachelor of health science degrees) with a sound understanding of human physiology, nutritional biochemistry and disease process and treatment. When I am assessing a person sitting in front of me, I’m wanting to understand the landscape of their entire health – what are all the parts of them that make them and how does this contribute to what is happening right now?
As a naturopath my role is to enhance your innate health and natural ability to heal and to fight disease. Everyone has this ability, but our state of health indicates at what level you’re going to be able to do this. What we know is that people who have robust health and great habits to support this, rarely are afflicted with disease. Those that are in poor health, who are eating poorly, highly stressed or have genetic susceptibilities, are going to be more likely to become unwell. This isn’t a fringe theory, science supports this well.
What I began to look at when COVID-19 began to spread – and the data grew – was what types of people were ending up with severe disease. What was it about someone that made them more susceptible to COVID-19?
What we know is that the majority of deaths from COVID-19 are in those aged 50 and above, and that have comorbidities. Given the fact that 82% of Australians will die of a chronic disease, comorbidities are incredibly common and they increase as we age, as a diagnosis of one chronic disease begets another and so forth. Sure, there are cases of younger people who can get severe COVID-19 or even end up with long COVID, but the data shows that the majority of people impacted severely are in the over 50’s demographic. I don’t want to downplay the dangerousness of this virus, it absolutely demanded a global response.
Here are some facts based on what the data is showing us:
- The older you are, the more dangerous COVID-19 is.
- People over the age of 50 need to be concerned – the chance of death drops below 1 in 100 if you acquire it.
- Children 17 and younger are at extremely low risk of dying.
- People 85 and over are at extremely high risk of dying.
- If you’re over 64 you are 62 times more likely to die of COVID than someone who is under 54 (early strains, Omicron data may be different and vaccines can help).
- COVID-19 can be a serious disease, damaging the neurological system and cardiovascular system.
- It was the 3rd largest cause of death in 2020, behind heart disease and cancer.
- It is generally not dangerous in children. Despite worldwide infection rates, it does not make the top 10 causes for childhood mortality.
COVID-19 is new, but our understanding of the immune system, viruses, and disease is not. This is the reason we were able to make a vaccine so rapidly, because virologists, immunologists, and researchers have been working to understand these types of viruses and create these types of vaccines for years.
We didn’t begin from scratch, and this is why quite early on, possible treatments became apparent. From a naturopathic point of view, we don’t necessarily need to know what we are treating in order to be successful. Even though at the beginning of the pandemic we had no studies to investigate the use of interventions against COVID-19, we could follow some basic principles that were likely to help.
Under the naturopathic principle ‘first do no harm’, these were all regarded as safe, and probably helpful based on current science and clinical experience. When the pandemic began, these were the agents that we called upon to help people, in the hope that if they did contract COVID that they may have a better outcome. Note that many of these will end up on my list of research-backed recommendations – this isn’t because I’m a genius, it’s because if you follow general common sense prescribing rules based on research that could be extrapolated (like we know zinc worked on viruses so why not coronavirus?), it’s likely that it will help.
- Vitamin D – Vitamin D deficiency increases the risk of just about everything, and it has a role in immunity.
- Zinc – many studies support the use of zinc against various viruses.
- Vitamin C – a long known immune-supporting nutrient, well studied for respiratory tract infections.
- Bioflavonoids (quercetin, rutin, bromelain) – have anti-inflammatory and immunomodulating properties.
- Immune herbs such as Echinacea root – to help increase NK cells and help with immune readiness.
We can justify using these treatments, even though we’re not sure that they will help. Doctors do this all the time, using medications off-label, in the hope that they may help if the risk outweighs the potential benefits. It’s estimated that 20% of the drugs prescribed in the US are done so off label – that is without ample clinical research to support their use in that area.
Fast forward to now, and the clinical research on what is effective against COVID-19 is mounting. I’ll be talking about natural interventions, both because this is in my wheelhouse and because you can take these medicines and support yourself, without causing harm. I’ve also read a heap of research on conventional medicines that have shown superb results, but I’ll leave that side to the doctors and focus on what I know best.
I’ll start with Vitamin D because it is the cheapest and most readily available vitamin, and probably the most researched. What we know about Vitamin D, is that it acts more like a hormone than a vitamin. It regulates most tissues and organs in the body and is associated with overall disease prevention. Vitamin D deficiency is associated with an increased risk of most diseases – cancer, heart disease, infertility, autoimmune disease and allergies to name a few. But what we knew even before this pandemic was that Vitamin D supplementation could prevent respiratory tract infections.
This systematic review and meta-analysis was published in the British Medical Journal in 2017 and involved over 11,321 people aged 0-95 (this is serious cred peeps). It found that Vitamin D supplementation significantly reduced the risk of respiratory infection amongst all participants. The authors concluded that “Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall.”
OK so what about COVID-19? What is the evidence for using Vitamin D when it comes to this particular virus-based respiratory tract infection?
Of all the research I conducted in this area, Vitamin D has shown to have an overwhelmingly positive impact on COVID-19. These clever humans have created a dynamic meta-analysis (each time new research is published it is added) which now includes over 156 studies. The data shows that statistically significant improvements are seen in treatment studies for mortality, patients requiring ventilation, ICU admission, hospitalisation and number of cases. We’re talking an average reduction in mortality (death) of 81% for early treatment, and 54% for late treatment. There was also a 35% improvement in prophylaxis, that is, the prevention of getting COVID-19 in the first place. Studies that looked at sufficiency (if your baseline levels were high enough) also showed a strong association between levels and your risk of death.
If you’re not savvy on research terms, a meta-analysis is a study on studies – largely one that collates the results from many studies and publishes them as one mega study. Research results are always going to vary based on who they are studying, where it is taking place, the study design and the researchers who are conducting it. It’s incredibly common to have studies that show positive results, then others that show a negative result. A meta-analysis is a great way to look at the average result and if it is overall positive or negative.
Now because I know that some will argue that the meta-analysis above is not peer reviewed, so I’ll share a few of the larger studies that I came across on Vitamin D and COVID-19.
In this meta-analysis and systematic review that analysed the outcomes of 2311 people, the authors concluded that “prescribing Vitamin D supplementation to patients with COVID-19 infection seems to decrease the mortality rate, the severity of the disease, and serum levels of the inflammatory markers.”
This systematic review and meta-analysis analysed the data of 14 studies with 999,179 (that’s almost a million folks) participants, looking at how serum Vitamin D levels correlated with susceptibility to COVID-19, severity and mortality. Low serum vitamin D was associated with an increased risk of contracting COVID-19, and an increased risk of severe disease and an increased risk of death.
This meta-analysis collated the data from 13 studies involving 2933 COVID-19 patients found that supplementation significantly reduced ICU admission and mortality.
I could go on, but you get the point. Results from well over a million participants have shown that Vitamin D will help if you contract COVID-19. It has no adverse effects when dosed correctly.
VITAMIN D SUPPLEMENTATION RECOMMENDATIONS
In clinical practice, we’re going to use different doses depending on your unique situation, but without knowing this, here is my recommendation for Vitamin D supplementation. Based on the research I feel called to share this and empower you to take immediate action on this. There is no evidence that these treatments can cause harm when used as advised below.
As a disclaimer, please see this as general advice and seek medical approval from your naturopath or doctor before taking these treatments.
- If you’re deficient: diagnosed at under 100/nmol per litre.
Please note that the Australian guidelines put a minimum of 50nmol/L, this is far too low and we’d consider anything below 100 on the low end and worthy of supplementation in these times.
My dosage recommendation: 5000IU daily until levels are replete (usually 6-8 weeks).
- If your Vitamin D is replete: (or you don’t know) – serum levels over 100nmol/L. If you don’t get much sun, you can probably assume you’re on the lower side, but I’d be cautious to use too high levels so stick to this (or get tested).
My dosage recommendation: 2000IU daily.
- If you contract COVID-19: there is research that backs early intervention so the sooner you begin the better.
My dosage recommendation: 10,000IU twice per day until symptoms subside.
* IMPORTANT – this is a short term dose, please don’t persist past your active infective period.
Note that these dosages are for cholecalciferol, the most widely available Vitamin D3 supplement on the market.
Since we are in this for the long haul it’s worth mentioning some lifestyle factors that can help keep your vitamin D replete. I’d still supplement, but every bit counts.
- Sun exposure: Sun exposure helps to convert inactive Vitamin D into the active form used in your body. This happens primarily on the soft parts of your body – tummy, inner thighs, inner forearms. Getting 15-20min of unprotected sunlight a day in the middle of the day, can help increase serum Vitamin D.
- Organic Butter: All dairy has Vitamin D but if you’re a follower of myself and The Shift Podcast, you’ll know it is not the best to have when it comes to your health. Butter has next to no lactose or casein (the big culprits of dairy issues) but is a very good source of Vitamin D. Use liberally.
- Oily Fish: These are also excellent sources of Vitamin D, keep to smaller fish (like anchovies and sardines) to avoid excessive toxin exposure.
Next up I’m going to examine Zinc and the research on COVID-19. Zinc is a critical mineral in your body with key roles in immune function, metabolism, mood regulation and tissue healing. Zinc deficiency is incredibly common because our diets are often low in the foods that contain this mineral. Low stomach acid, which is also incredibly common, can make it difficult for us to replete zinc, so our poor diet paired with our digestive insufficiency means many of us will have low levels of zinc.
This review looks at zinc as a potential beneficial intervention for COVID-19 outlines the robust research that shows zincs role in immune function, the health of our respiratory epithelium (the mucous membranes of your airways) and its direct antiviral properties. It makes logical sense that given zincs function, it will probably be helpful in some way.
Unlike Vitamin D which is mostly available as cholecalciferol (Vitamin D3), zinc is available in many different forms. These vary in quality, bioavailability and their ability to actually increase your zinc levels can be quite different. With this in mind, you can’t really compare research papers or do a proper meta analysis on zinc because the data will not correlate well.
There are many many smaller studies on Zinc showing benefit, but no huge ones like we have for Vitamin D. There are a few meta-analyses looking at a small number of studies, and none of these seem to show significant benefit as far as I have found so far. I do think however that zinc has merit based on it’s known mechanism of action, and that there is enough evidence to add it to your treatment protocol (but not to use alone).
This paper analysed the data from 4 studies and included 1474 people. It found no benefit to zinc supplementation and in fact an association between zinc use and longer ICU stays, but on reviewing the data I wouldn’t put too much weight on this, as even the authors point out that the study design was not great and that the 4 studies included had different measures and also different zinc supplements used.
This study showed that patients with COVID-19 had significantly lower zinc levels compared to healthy controls. Zinc deficient patients develop significantly more complications (70.4% vs 30% for those who were zinc replete) and had a prolonged hospital stay (7.9 days vs 5.7 days).
Here’s another study that looked at 254 COVID-19 patients in ICU. They found that low serum zinc levels were correlated with worse clinical presentation, longer time to reach stability, and higher mortality rates.
While I couldn’t find any decent studies showing that supplementing zinc was of benefit when you get COVID-19, there were plenty of studies like this showing that zinc deficiency impacts outcomes in a significant way. For this reason (and knowing what we know about the function of zinc in the body), I think it is imperative that we supplement with zinc before exposure and I don’t think there is any detriment to taking it on onset either (and if you use the right dose and forms it will probably help).
ZINC SUPPLEMENTATION RECOMMENDATIONS
A few things to know about zinc supplementation. Firstly, there are only a few forms that are easily absorbed by the body. I’d recommend looking for:
- Zinc citrate
- Zinc picolinate
- Zinc carnosine (harder to come by).
And if you can’t find any of these then a zinc amino acid chelate is the next best thing (although if your gut function is not great you’re not going to absorb it as well).
The next thing is that to absorb zinc the best, an empty stomach is best BUT for some people (especially if you’re low in zinc) taking zinc on an empty stomach can make you feel a little unwell.
Zinc dosages vary depending on form, but you want to look for ‘elemental’ zinc on the bottle. This is the dosage that the recommendations below are based on.
Lastly, you don’t really want to take too high of doses of zinc for a long time, because you don’t want your levels to become too high. Using the doses below there is a low risk of this since we are all so zinc depleted but keep this in mind that you might want to check in with a naturopath or nutritionist if you’re considering zinc longer term.
These little specificities are the reason why you don’t really see me recommending herbs and supplements to the general public without a consultation from our naturopaths BUT in these times, I really believe that the masses need to get on to evidence based protocols in order to help decrease your risk.
- For general prevention: and to keep you zinc levels replete. Preferably zinc citrate, zinc picolinate or if you can’t get these zinc amino acid chelate.
My dosage recommendation: 50mg taken before bed at night (away from other supps and medications).
If you feel nauseous take it with food instead.
- If you contract COVID-19: these dosages are based on what I would prescribe for a respiratory tract infection. Please ensure you follow the general recommendations above.
My dosage recommendation: 50mg twice per day until symptoms subside.
*IMPORTANT – this is a short term dose, please don’t persist past your active infective period.
Vitamin C has always been a go to when it comes to immune issues, and there are dozens of smaller studies looking at mostly intravenous Vitamin C in the treatment of COVID-19. Most of these studies are very small and show varying results, with some showing benefits in areas like kidney function, oxygenation rates and mortality, and others not showing any difference. This could be due to dosages used and when the intervention began, but let’s take a look at a few studies that showed positive results.
Like Vitamin D, some clever humans have collated this data into a real-time meta-analysis that shows a statistically significant, but small improvement, particularly with high dose IV use.
This study found that patients given IV Vitamin C in conjunction with the standard protocol showed marked improvements in kidney function
This study of 150 COVID-19 positive ICU patients gave half intravenous vitamin C and half placebo. Patients that received IV Vitamin C became symptom free earlier and spent fewer days in hospital, however there was no statistical significance in the need for ventilators or mortality.
This study of 176 patients admitted to ICU using oral Vitamin C found that it was associated with lower mortality and increased extubation rate (taking you off the ventilator).
I think given the availability of Vitamin C and the low cost, that it is a worthy inclusion in a treatment protocol. Vitamin C is a water soluble vitamin meaning that we absorb it easily but it also leaves the body quickly. You cannot achieve the doses you would get with IV Vitamin C therapy with oral Vitamin C, although using a liposomal Vitamin C that has enhanced absorbability will help to get higher doses in.
The type of Vitamin C used is not as important here (although liposomal is definitely preferred if you can get your hands on it), as long as you’re reaching the doses needed. The worst thing that can happen if you take too much Vitamin C is that you’ll reach bowel tolerance, meaning it will give you a healthy bout of diarrhoea which is temporary – knock your dose back if this occurs.
Please note: you can only absorb around 250mg of vitamin C at a time, so if you take 500, 1000mg you’ll still get the same amount as if you took 250mg. It’s OK if your supplement has 1000mg (it’s a common dosage) but be aware there isn’t an additional benefit to going higher (and this is why I’ve put dosage ranges below).
VITAMIN C SUPPLEMENTATION RECOMMENDATION
- For general prevention: and to keep you Vitamin C levels replete. Use any form – ascorbic acid, calcium ascorbate, sodium ascorbate, magnesium ascorbate etc. The mineral ascorbates are gentler on the gut.
My dosage recommendation: 250-1000mg three times a day OR 1000mg liposomal Vitamin C once a day.
- If you contract COVID-19: as noted above, Vitamin C does not retain in the body as it is water soluble. This is the dosage I’d recommend to patients with respiratory tract infections and is more based on clinical experience than specific dosages used in research. Because we can’t replicate IV Vitamin C, we want to get as high of levels as possible.
My dosage recommendation: 250-1000mg every 1-2 hours until symptoms subside OR 1000mg liposomal Vitamin C four times per day.
*If you reach bowel tolerance (loose stools) with this frequent dose then space out your doses.V
Quercetin is a bioflavonoid that is naturally found in citrus fruit, apples, onions, parsley and sage. Bioflavonoids have long been proven to have potent anti-inflammatory and immune modulating effects. Quercetin has positive research to support its use in COVID-19, which makes sense given what we know about the way it works in the body. There aren’t any massive studies on quercetin yet, but there are lots of promising smaller ones. Let’s take a look at some of the research.
Again, our friends are collating data on quercetin and they show from their meta-analysis that so far quercetin has a statistically significant improvement in hospitalisation, recovery and ICU admissions.
This study shows that quercetin can inhibit the SARS2 Cov-2 Spike protein, ACE2 and neuropilin, which can help to prevent cell entry by the virus and therefore reduce infection rates.
This study used 1000mg a day of quercetin phytosome, a highly absorbable form of quercetin, on half of 152 participants. Patients taking quercetin have a reduction in the frequency and length of hospitalisation, less need for oxygen therapy and a reduced chance of ICU admission and death.
Vitamin C can recycle quercetin, leading to high blood levels so if you can take these nutrients together for the best results.
QUERCETIN SUPPLEMENTATION RECOMMENDATION
Quercetin is not highly bioavailable so we need to use higher doses of standard supplements. If you can get quercetin phytosome that is great, but if you can’t then higher doses of the standard forms will suffice.
- For general prevention: take with Vitamin C if possible.
My dosage recommendation: 500mg a day quercetin dihydrate OR 250mg of quercetin phytosome.
- If you contract COVID-19: if you have active COVID-19 you want to go for higher doses, again with Vitamin C.
My dosage recommendation: 250mg quercetin dihydrate four times a day OR 250mg twice a day of quercetin phytosome.
Everything I have recommended so far is easily available to most of you, however these next few may be harder to come by. If you’re low risk (young, healthy, no comorbidities) then the list above should suffice. If you’re at high risk, I’d recommend seeing a naturopath or integrative health practitioner if you can for a more comprehensive plan with higher dosages. These are some of the other natural medicines that have evidence of helping with COVID-19.
N ACETYL CYSTEINE (NAC)
There is limited evidence for the use of NAC but some promising data does exist. This review paper discusses NACs ability to increase antioxidant capacity, interfere with virus replication and to reduce inflammation producing cells. In mice studies, it has also reduced the mortality rate in influenza infected animals.
NAC increases your intracellular glutathione, one of your body’s major antioxidants. For those with higher risk profiles I think it is worth considering NAC once you have the above nutrients covered.
Carnitine, which is an amino acid, has a few early but promising studies.
This study found that those with genetically higher levels of carnitine reduces your susceptibility and severity of COVID-19, which means that supplemental use could do the same.
This study found that carnitine supplementation in both humans and mice lead to a dose-dependent reduction in infection rates, and a reduction of ACE2 which is responsible for viral attachment.
Selenium is an important mineral in the body and a powerful antioxidant.
In this systematic review, the authors analysed 11 studies looking at selenium levels and COVID-19 outcomes. 9 out of the 11 studies showed that low selenium levels were associated with worse outcomes for patients with COVID-19.
Selenium is found in high levels in Brazil nuts, I’d suggest eating 4 Brazil nuts every day to up your levels.
At our clinic, herbal medicines are always going to be a part of the treatment protocol. I have not included information on herbs here because:
- Herbal medicine quality is a problem, it is rife with adulteration (the wrong herb being substituted) and varying levels of active constituents.
- Herbal medicines have a much-increased risk of interactions with medications or contraindications with certain issues, compared to the above.
- You should seek advice before taking herbal medicines, especially if you have complex health issues.
SYNERGY IN TREATMENT
In the naturopathic prevention and treatment of any viral infection we would use a comprehensive treatment and not something on its own. This study for example shows such an approach, using zinc, quercetin, Vitamin D, Vitamin E and L-Lysine. They found that only 4% of people taking this regime developed flu-like symptoms compared to 20% that developed symptoms without taking it. Three quarters of participants with symptoms were COVID-19 positive.
To summarise, here’s what I’d suggest (based on the evidence) that you take daily to protect you against severe COVID-19.
|Nutrient||Preventative Dose||COVID-19 Positive Dose||Notes|
|Vitamin D||2000IU/day||10,000IU twice a day||If your levels are low, take 5000IU/day until replete|
|Zinc||50mg/day||50mg twice a day||These doses are elemental zinc|
250-1000mg three times a day
1000mg liposomal once a day
250-1000mg every 1-2 hours
1000mg liposomal four times a day
|Liposomal is superior if you can get it|
500mg a day quercetin dihydrate
250mg of quercetin phytosome
250mg quercetin dihydrate four times a day
250mg twice a day of quercetin phytosome
|Take quercetin dihydrate with Vitamin C for best results|
WORKING ON YOUR INNATE HEALTH TO FIGHT DISEASE
Earlier I talked about the death rates in COVID-19 and the association with other health conditions and your risk of hospitalisation from these. It’s very important, now more than ever, that we work on our whole health picture. If you need to eat better, lose weight or eat a better diet now is the time to do it.
When you look at the population as a whole, we live on diets with suboptimal nutrition and excesses of sugar which we know impairs your immune function. While eating well might not prevent you from getting COVID-19, it’s clear from the research that if you’re deficient in zinc, Vitamin D, selenium and Vitamin C at the very least, you will have a worse outcome than someone who is not.
It is time to come back to the foundations of health – good food, lots of veggies, lots of living foods, adequate sleep, great water intake, and keeping stress levels at bay. Get some support to reduce inflammation in your body and keep chronic disease at bay. Look after your body so it can look after you.
I hope that from reading this you can see that there is ample evidence for many agents to combat the high hospitalisation and death rates that have occurred as a result of this global pandemic. If you need specific help or are at high risk, I’d recommend booking an appointment with one of our Shift Clinic naturopaths, or another integrative healthcare provider.
Please share this information widely – the more people that have early treatments, the less the mortality rates from COVID-19 will be.
As always, yours in good health.
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