It’s become very clear over the last week that many people are not aware of some of the important accepted scientific evidence surrounding COVID-19.
A quick PubMed search for ‘COVID-19’ yields over 50,000 results and while my intention is not to review each paper, or discuss the entirety of the pandemic, I wanted to provide one place for the evidence that I have been sharing across social media since February 2019.
Let’s take a closer look.
The Role of Vitamin C
The powerful antiviral action of vitamin C has been demonstrated for decades. High-dose intravenous vitamin C has also been successfully used in the treatment of 50 moderate to severe COVID-19 patients in China. High-dose vitamin C has been clinically used for several decades and the regime of 1.5 g/kg body weight is safe and without major adverse events.
Read COVID-19 & Intravenous Vitamin C: https://thenaturalnutritionist.com.au/covid-19-intravenous-vitamin-c/ Note: this was written before the evidence surrounding treatment with HCQ and triple therapy was released.
Cheng RZ. 2020. Can early and high intravenous dose of vitamin C prevent and treat coronavirus disease 2019 (COVID-19)?. Medicine in Drug Discovery, 5, 100028. DOI: 10.1016/j.medidd.2020.100028.
Ruan Q et al., 2020. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Medicine, 46, 5, 846-848. DOI: 10.1007/s00134-020-05991-x.
The Role of Vitamin D
It is also well known that vitamin D has potent anti-viral properties including reduced pro-inflammatory cytokine production, which is protective in diseases that cause a cytokine storm (i.e. COVID-19).
In the study “Effect of Calcifediol Treatment and best Available Therapy versus best Available Therapy on Intensive Care Unit Admission and Mortality Among Patients Hospitalized for COVID-19: A Pilot Randomized Clinical study“, released in August 29th 2020, vitamin D (calcifediol) reduced the severity of the disease and significantly reduced the need for hospitalised patents to require ICU admission. With a sample size of 76, it is still too small to extrapolate at this stage, but it is the first randomised controlled trial (RCT) of its kind, and shows promising future application of this natural, side-effect free intervention.
Recent research has also shown that low vitamin D status is an independent risk factor for COVID-19, where low was defined as vitamin D below 30 ng/mL, or in Australian units, 74.88 nmol/L.
What does our Australian reference range tell us is adequate? 50 nmol/L. What do you think winter +/- lockdown is making us? Vitamin D deficient. Moral of the story: have your levels tested. The optimal level is 100-150 mmol/L (40-60 ng/mL).
Read: COVID-19 & Vitamin D: https://thenaturalnutritionist.com.au/covid-19-vitamin-d/
The Role of Zinc
“Zinc status is a critical factor that can influence antiviral immunity, particularly as zinc-deficient populations are often most at risk of acquiring viral infections”. With reference to SARS-CoV-2, zinc has been shown to directly inhibit replication of the virus, and enhance the efficiency of anti-viral drugs. At the time of writing, clinical trials are still occurring, however the trials we do have show between 50-75mg zinc/day is necessary to exert anti-viral properties.
Food sources of zinc include beef, lamb, oysters and pumpkin seeds. Blood test dependent, supplementation with 50mg/day is the dose we use here at The Natural Nutritionist.
Read SA, Obeid S, Ahlenstiel C, Ahlenstiel G. 2019. The Role of Zinc in Antiviral Immunity. Adv Nutr, 10, 4, 696-710. DOI: 10.1093/advances/nmz013.
Rahman MT., Idid SZ. 2020. Can Zn Be a Critical Element in COVID-19 Treatment?. Biological Trace Element Research. DOI: 10.1007/s12011-020-02194-9.
The Role of Metabolic Syndrome
Insulin resistance, type 2 diabetes, inflammation and the additional co-morbidities increase your risk of COVID-19 by 12 times.
“Metabolic abnormalities are a risk factor for severe and critical conditions, thus demonstrating that metabolic parameters must be managed to control the COVID-19 disease course. Glycaemic management is associated with better outcomes in COVID-19.”
“The most significant factor that determines blood glucose levels is the consumption of dietary carbohydrate, that is, refined carbs, starches and simple sugars.”
Since 2/3 of Australia adults are overweight or obese, the extent to which metabolic health contributes to the severity of COVID-19 infection is likely to be significant.
CDC statistics now show that 94% of deaths were in people with 2-3 existing co-morbidities, so one does have to wonder – how many lives would have been saved if SARS-CoV-2 didn’t intersect with our “diabesity” epidemic in the west?
Listen to: COVID-19 & Metabolic Syndrome – How Can Keto Help Our Global Pandemic? with Dr David Harper here.
Ayres, J.S. 2020. A metabolic handbook for the COVID-19 pandemic. Nature Metabolism, 2, 572–585. DOI: 10.1038/s42255-020-0237-2.
Demasi M. 2020. COVID-19 and metabolic syndrome: could diet be the key? [published online ahead of print, 2020 Jul 10]. BMJ Evidence Based Medicine, bmjebm-2020-111451. DOI: 10.1136/bmjebm-2020-111451.
The Role of Ketones
Ketones play a powerful the cell signalling role and beta-hydroxybutyrate (BHB) has been shown to exert a positive impact to associated cytokine storm. How does one achieve the optimal level of ketones? A lower carbohydrate, healthy fat diet. Research examining the role of exogenous ketones is also seeming to be positive, however there is a vested interest that needs to be considered. (P.s there’s vested interested in almost all research, and Stubbs et al have disclosed theirs).
Stubbs BJ, Koutnik AP, Goldberg EL, et al. 2020. Investigating Ketone Bodies as Immunometabolic Countermeasures against Respiratory Viral Infections [published online ahead of print, 2020 Jul 15]. Med (N Y). DOI: 10.1016/j.medj.2020.06.008.
More discussed in the podcast with Dr David Harper above.
And in case you’ve missed the successful pharmaceutical interventions, here are some further areas to explore:
Hydroxychloroquine (HCQ)
This anti-malaria drug has been a significant topic of conversation across the COVID-19 landscape. To be clear, I’m not suddenly supporting Big Pharma, but I do think it’s important that we examine the evidence surrounding this intervention, especially when the safety data and 65-year history is far more than what we can say for our hypothetical vaccine. My ideal scenario is that the population is robust enough to withstand a virus and has no need for pharmaceutical intervention at all, but we all know that’s just a pipe dream. I digress.
What the research now clearly shows is that HCQ contributes to the suppression of the “cytokine storm” responsible for the disease progression to acute respiratory distress syndrome. While there has been significant criticism of this drug, three things are now well accepted. Previous studies:
- Used excessive, sometimes lethal, doses of HCQ;
- Prescribed HCQ alone, when it is most successful co-prescribed with zinc, and proving to be most successful in triple therapy with azithromycin;
- Prescribed the intervention too late, when it is designed for early treatment and prophylaxis.
Just a question at this stage, but why do you think Uganda (population 45.9 million) where HCQ is prescribed like candy for malaria, only recorded 19 COVID-19 deaths?
There are many doctors speaking out about the use of HCQ for COVID-19, including French doctor and virologist Didier Raoult, who has treated more than 3,700 patients with HCQ, with 0.5% mortality and no cardiac toxicity. Dr Mark McDonald believes that “if all Americans had access to hydroxychloroquine the pandemic would essentially be over in 30 days’’. It is statistically highly likely that the same could be said for Australia.
You might also be interested to know that the All India Institute of Medical Sciences advises hydroxychloroquine as prophylaxis for health care workers and high-risk contacts. The case fatality rate for COVID-19 infection rates in India is current 1.8% compared to 3% in Victoria.
I do agree that specific SARS-CoV-2 clinical trials are required, but the question I ask is why would HCQ suddenly be banned in many states and countries? It has been used safely for decades in lupus and rheumatoid arthritis on a daily basis, and given to pregnant women, nursing women and elderly adults. Did you also know that 15 years ago, Dr Anthony Fauci (director of the National Institute of Allergy and Infectious Diseases) said that HCQ was a potent inhibitor or coronaviruses, and now he is leading the charge to discredit the application of HCQ and censor the online discussion. You can’t not ask questions.
Lagier JC, Million M, Gautret P, et al. 2020. Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis [published online ahead of print, 2020 Jun 25]. Travel Medicine and Infectious Disease, 36, 101791. DOI: 10.1016/j.tmaid.2020.101791.
Li, X., Wang, Y., Agostinis, P. et al. 2020. Is hydroxychloroquine beneficial for COVID-19 patients? Cell Death and Disease, 11, 512. DOI: 10.1038/s41419-020-2721-8.
Yu B, Li C, Chen P, et al. 2020. Low dose of hydroxychloroquine reduces fatality of critically ill patients with COVID-19. Science China Life Sciences, 1-7. DOI: 10.1007/s11427-020-1732-2.
Pre-print: Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial.
Ivermectin
The anti-parasitc drug, ivermectin has been shown to have broad-spectrum anti-viral activity and in vitro, is an inhibitor of SARS-CoV-2. While I very much appreciate the difference between in vitro and in vivo and I don’t believe it can be considered a miracle cure for COVID-19, it does warrant further testing and adequate allocation of resources.
According to Prof Thomas Borody, when combined with zinc and the antibiotic doxycycline, the treatment is proving to be very safe and effective. The clinical trials will tell the full picture in time.
With suppression of this information also occurring, more questions need to be asked.
Researchers are also looking at synergists effects of HCQ and ivermectin.
Caly L, Druce JD, Catton MG, Jans DA, Wagstaff KM. 2020. The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antiviral Research, 178, 104787. DOI: 10.1016/j.antiviral.2020.104787.
Sharun, K., Dhama, K., Patel, S.K. et al. 2020. Ivermectin, a new candidate therapeutic against SARS-CoV-2/COVID-19. Annals of Clinical Microbiology and Antimicrobials, 19, 23. DOI: 10.1186/s12941-020-00368-w.
Patrì A, Fabbrocini G. 2020. Hydroxychloroquine and ivermectin: A synergistic combination for COVID-19 chemoprophylaxis and treatment?. Journal of the American Academy of Dermatology, 82, 6, e221. DOI:10.1016/j.jaad.2020.04.017.
With many natural preventative measures and many safe existing treatments, the questions need to be asked:
Is the vaccine really necessary? Scott Morrison has already spent $333m of our tax payer dollars on the deal with Oxford University/AstraZeneca, for a vaccine that will require a 95% uptake to be effective. With rushed clinical trials, including a phase 3 clinical trial lasting only 6 months, many are already questioning the safety and efficacy of this vaccine. Many vaccines take two years to develop and some take up to 10 years. With unknown long term effects, do you think the risks will outweigh the benefits?
Sorry Steph, I really appreciate your excellent knowledge on nutrition and both follow your general principles and pass them on to my patients and recommend they look at your books and consider seeing you (minus a few small elements)… But I think your analysis of the science on Covid 19 is superficial and simplistic at best. You are cherry picking and misterpreting data, I hope not intentionally. Perhaps it would be better for you to remain focussed on the nutritional part of this discussion where your passion and expertise lies? By the way, the reason for hydroxy chloroquine being restricted was that many people with terribly severe diseases such as rheumatoid arthritis and ulcerative colitis need it to maintain function and prevent any disease progression. Even in the few weeks before it was restricted, stockpiling and prescribing (after trump’s interview) had started and people were starting to have a lot trouble accessing it. Imagine if there was widespread uptake! For a drug with barely a thread of decent evidence.
With billions of dollars already made available for a vaccine, there is clearly enough money and resources to make HCQ available for everyone who needs it. The question you may consider asking yourself is, why are you ignoring the fact that HCQ is saving hundreds if not thousands of lives already, as both a prophylaxis and early stage treatment? I may have ignored the studies where toxic levels of HCQ was used, as everyone who has examined the issue closely is, but your cherry picking is actually perpetuating continual unnecessary deaths. You may be able to live with that, but myself and many of your colleagues and experts in their field can not.