In a
June 22, 2020, Orthomolecular Medicine News Service press release,1 Damien
Downing, president of the British Society for Ecological Medicine, outlines how
we could resolve the COVID-19 pandemic in 30 days for about $2 per person,
simply by taking affirmative action to raise vitamin D levels. The downside or
risk of doing this is basically nil, while the potential gain could be avoiding
another COVID-19 spike altogether.
“If
we could arrange to give everyone vitamin D, and it failed to protect them, so
what? The risk from not acting is much greater than the risk from
acting,” Downing says, adding: “If you caught the COVID19
virus right now, having a good vitamin D status (from already having taken a
supplement) would
- Reduce your risk of the disease becoming severe by 90%
- Reduce your risk of dying by 96%
This
is not ‘proven’ or ‘evidence-based’ until we have done controlled trials
comparing it to placebo … But the data, already strong, has been pouring in
since the start of the pandemic.”
Soram
KhalsaBest Price: $1.25Buy New $10.69(as
of 08:00 EST - Details)Although the required prospective randomized controlled trials
using vitamin D have not yet been completed, they are indeed underway and
results from many will be in before year’s end. You can visit the clinical
trials registry to review the current state of these trials.2,3 As
of June 2020, there were over 20 studies in progress on the use of vitamin D in
COVID-19.
Vitamin
D and COVID-19
Downing
goes on to cite research and supporting data. Among them is a study4 from
the Philippines, which found that for each standard deviation increase in serum
vitamin D, the odds of experiencing only mild disease rather than severe
illness was 7.94 times greater, and the odds of having a mild clinical outcome
rather than a critical outcome was 19.61 times greater. According to the
author:
“The
results suggest that an increase in serum 25(OH)D level in the body could
either improve clinical outcomes or mitigate worst (severe to critical)
outcomes, while a decrease in serum 25(OH)D level in the body could worsen
clinical outcomes of COVID-2019 patients.”
Another
study5 from Indonesia, which looked at data from 780 COVID-19
patients, found those with a vitamin D level between 20 ng/mL (50 nmol/L) and
30 ng/mL (75 nmol/L) had a sevenfold higher risk of death than those with a
level above 30 ng/mL. Having a level below 20 ng/mL was associated with a 12
times higher risk of death. As noted by Downing:6
“With
a deficient vitamin D status (<50nmol/L) the mortality rate from COVID-19
was 98.8% against 4.1% with adequate vitamin D (>75nmol/L). The Hazard Ratio
is 24.1 … A Hazard Ratio of 4 means that in one condition, for instance vitamin
D deficiency, you are 4 times more likely to suffer the ‘hazard’ than in
another condition, say vitamin D adequacy.“
A
third paper,7 which provides data from 20 European countries, also found
that “the probability of developing COVID-19, and of dying from it, is
negatively correlated with mean population vitamin D status, with both
probabilities reaching zero above about 75 nmol/L,” (30 ng/mL) Downing notes.8
A
vitamin D3 blood level of at least 75 nmol/L (30 ng/ml) is needed for
protection against COVID-19.
In
their preprint submission of this paper,9 the authors
concluded, “We believe that we can advise vitamin D supplementation to protect
against SARS-CoV2 infection.” Downing created the following graph10 to
illustrate the data in that paper.
Vitamin
D Level Above 30 ng/mL Protects You Against COVID-19
Downing
also addresses the issue of dosage and safety, highlighting how warnings about
“excessive vitamin D intakes” being dangerous are very misleading and
unwarranted, as toxicity has not been demonstrated until you hit blood levels above
200 ng/mL (500 nmol/L).Ellison, ShaneBest Price: $5.81Buy New $9.56(as
of 03:17 EDT - Details)
The recommended blood level
for optimal health is currently between 60 ng/mL (150 nmol/L) and 80 ng/mL (200
nmol/L). In other words, there’s a significant margin of safety, even if you
manage to exceed the optimal range.
“The
three papers11,12,13 mentioned
above show that a vitamin D3 blood level of at least 75 nmol/L (30 ng/ml) is
needed for protection against COVID-19,” Downing
writes.14
“Government
recommendations for vitamin D intake — 400 IU/day for the UK and 600 IU/day for
the USA (800 IU for >70 years) and the EU — are based primarily on bone
health. This is woefully inadequate in the pandemic context.
An
adult will need to take 4,000 IU/day of vitamin D3 for three months to reliably
achieve a 75 nmol/L level.15 Persons
of color may need twice as much.16 These
doses can reduce the risk of infection, but are not for treatment of an acute
viral infection.
And
since vitamin D is fat-soluble and its level in the body rises slowly, for
those with a deficiency, taking an initial dose of 5-fold the normal dose
(20,000 IU/day) for two weeks can help to raise the level up to an adequate
level to lower infection risk.”
Become
Metabolically Flexible and Insulin Sensitive
As
discussed in my interview with Dave Asprey, featured in “How Ketones May Be Useful Against COVID-19,”
being metabolically flexible is another important lifestyle component. The
reason for this is because insulin resistance makes you more susceptible to
cytokine storm, a primary cause of death among COVID-19 patients.
The
single most important step you can take to attain metabolic flexibility is to
cut down the hours during which you eat. More than 90% of people eat for more
than 12 hours a day, and more than half eat for more than 16 hours a day. The
key is to reduce your eating window to six to eight hours, making sure the last
food you eat is at least three hours before you go to bed.Judson
Somerville MDBest Price: $9.96Buy New $9.98(as
of 06:05 EST - Details)When you restrict your eating window you will decrease insulin
resistance, become more metabolically flexible and able to seamlessly switch
back and forth between burning fat or carbs as your primary fuel. I wrote an
entire book on how to become metabolically flexible, “Fat for Fuel,” but a
simple summary is as follows:
- Time-restrict
your eating window to six to eight hours
- Eliminate
all industrially processed vegetable oils
- Limit
carbs to 50 grams a day until metabolically flexible and then increase to
150 grams of healthy carbs twice a week
This
strategy is absolutely vital in light of the prevalence of insulin resistance.
Over 90% of the U.S. is vitamin D deficient; 90% of the population is also
insulin resistant. Research17 published in Metabolic
Syndrome and Related Disorders in February 2019 concluded that 87.8% of the
U.S. adults sampled were metabolically inflexible, which means they cannot
efficiently burn fat for fuel.
Ketones
May Also Be Useful Against COVID-19
When you are insulin
sensitive, metabolically flexible and eating a cyclical low-carb diet, you will
be able to generate healthy ketone levels. Remember that constant ketosis and
low-carb is an unhealthy strategy. It is fine to go low-carb for a few months,
but for optimal health you need to cycle healthy carbs back in once or twice a
week, ideally when you are doing your hardest exercise or resistance training
of the week.
When you burn sugar for fuel,
you need to break glucose down to two molecules of 3 carbon pyruvate. Pyruvate
is then used by your mitochondria after it is converted to acetyl CoA. Insulin
resistance, in turn, can impair the enzyme that converts a breakdown product of
glucose into pyruvate so it can be shuttled and burned as energy in your
mitochondria.
The problem with COVID-19 is
that the cytokine storm inhibits the enzyme converting pyruvate to acetyl CoA,
which radically limits your mitochondrial ATP production. An additional consequence
of this is that it also reduces NADPH.
NADPH is the battery of your
cell, the reservoir of electrons that actually cause endogenous antioxidants
like glutathione, vitamin E and C to be recharged so they can continue to work
and mitigate against the free radical damage resulting from all this oxidative
stress. One way to compensate is to make sure you have enough NADPH, and
ketones radically upregulate NADPH.
NADPH also turns off NLRP3
inflammasome that produces cytokines like TNF alpha, NF Kappa B, IL1B, IL6 and
IL18 (interleukins) that are causing all the damage.
All of that said, it’s
important to realize that ketone esters will not treat the primary cause of the
disease, which is an impaired immune system, typically due to insulin
resistance. Ketone esters can, however, be used acutely, as they’ve been shown
to provide rapid improvement in some patients with COVID-19. For an
illustration of this, see the video above.
To
address insulin resistance and metabolic inflexibility in the long term, your
best bet is to implement a cyclical ketogenic diet, described in my book “Fat for Fuel,”
as well as many previous articles that you can find by
using the search bar on my site.
Molecular
Hydrogen
Molecular
hydrogen (H2 gas) has powerful antioxidant and anti-inflammatory
effects,18 making it useful for COVID-19 by reducing inflammatory
cytokines, as explained in this video by Tyler W. LeBaron, founder of the
science-based nonprofit Molecular Hydrogen Institute.Michael
F. HolickBest Price: $2.01Buy New $9.08(as
of 10:55 EST - Details)
In
his video, LeBaron reviews the pathophysiology of COVID-19 and explains why H2 is
being clinically investigated by discussing the proposed mechanisms of how
molecular hydrogen might ameliorate this particular disease.
Molecular
hydrogen or H2 has the ability to activate the Nrf2/keap1 pathway,
thereby replenishing your endogenous antioxidants. In so doing, H2 helps
regulate and maintain homeostasis in the whole system, preventing the infection
from getting out of control and causing cell death.
Hydrogen
can also downregulate NOX and NOS enzymes, thus lowering superoxide and nitric
oxide production respectively. This is good, as when these two molecules are
increased too much they instantly combine to create the pernicious
peroxynitrite molecule. H2 also supports your
mitochondrial function. Importantly, H2 selectively
reduces peroxynitrites and hydroxyl radicals.
H2 also
steps in to prevent a cytokine storm from occurring. For a written summary of
LeBaron’s video lecture, see “How Molecular Hydrogen Can Help Against COVID-19.”
H2 will also help improve NADPH, and works synergistically
with time-restricted eating and cyclical ketosis.
Quercetin
Plus Zinc May Lower COVID-19 Risk Further
In
addition to vitamin D optimization, quercetin — which acts similarly to the
drug hydroxychloroquine — and zinc19 may
further lower your risk of COVID-19. Compelling evidence suggests the reason
hydroxychloroquine appears so useful in the treatment of COVID-19 is a zinc
ionophore, meaning it improves zinc uptake into the cell.
Quercetin
has the same effect. In fact, one study20 has
suggested the biological actions — which include antiviral effects — of
quercetin may in fact be related to its ability to increase cellular zinc
uptake.Best Price: nullBuy New $9.92 ($0.04 / Count)(as
of 04:43 EDT - Details)
Zinc
is vital for healthy immune function21 and
a combination of zinc with a zinc ionophore (zinc transport molecule) was in
2010 shown to inhibit SARS coronavirus in vitro. In cell culture, it also
blocked viral replication within minutes.22 Conversely,
zinc deficiency has been shown to impair immune function.23 As
noted in a 2013 paper on zinc deficiency:24
“Zinc
is a second messenger of immune cells, and intracellular free zinc in these
cells participate in signaling events. Zinc … is very effective in decreasing
the incidence of infection in the elderly. Zinc not only modulates
cell-mediated immunity but is also an antioxidant and anti-inflammatory agent.”
The problem is that zinc is
largely insoluble and cannot easily enter through the fatty wall of your cells.
Getting all the way into the cell is crucial, as this is where the viral
replication occurs. This is where zinc ionophores such as quercetin come in.
Quercetin is also a potent antiviral in
its own right, and has the added advantage of inhibiting the 3CL protease25 —
an enzyme used by SARS coronaviruses to infect healthy cells.26 According
to one 2020 study,27 the ability of quercetin to inhibit SARS coronaviruses “is
presumed to be directly linked to suppress the activity of SARS-CoV 3CLpro in
some cases.”
To
this you could also add niacin (vitamin B6) and selenium, as both play a role in the
absorption and bioavailability of zinc in the body. For example, a study28 published
in 1991 demonstrated that when young women were on a vitamin B6-deficient diet,
their serum zinc declined, suggesting B6 deficiency affected zinc metabolism
such that “absorbed zinc was not available for utilization.”
A
more in-depth exploration and explanation of both niacin and selenium’s
relationship to zinc is provided in the 2008 paper, “Zinc, Metallothioneins and
Longevity: Interrelationships With Niacin and Selenium.”29
The
MATH Protocol
If
you are hospitalized with COVID-19, early treatment becomes paramount. While
there’s a great deal of controversy over which treatment is best, clinical
evidence clearly suggests mechanical ventilation should be avoided at all
costs. I discussed the reasons for this in “Ventilators May Increase Risk of Death From COVID-19.”
Furthermore,
while hydroxychloroquine combined with zinc appears effective, I believe one of
the best treatments suggested so far is the MATH+ Protocol. The protocol was developed by
the Front Line COVID-19 Critical Care Working Group,30 which
includes Dr. Paul Marik, chief of the Division of Pulmonary & Critical Care
Medicine at Eastern Virginia Medical School Norfolk, and boasts a near-100%
effectiveness rate.
The
MATH+ Protocol is designed to treat the second phase of COVID-19 infection —
the stage when the hyperinflammatory immune response sets in. For best results,
it must be administered early enough, though. The MATH+ protocol31 calls
for the use of the following three medicines, all of which need to be started
within six hours of hospital admission:
- Intravenous methylprednisolone, to suppress the immune system and prevent organ
damage from cytokine storms — For mild hypoxia, 40 milligrams (mg) daily
until off oxygen; moderate to severe illness, 80 mg bolus followed by 20
mg per day for seven days. On Day 8, switch to oral prednisone and taper
down over the next six days.
- Intravenous ascorbic acid (vitamin C), to control inflammation and prevent the
development of leaky blood vessels in the lungs — 3 grams/100 ml every six
hours for up to seven days.
- Subcutaneous heparin (enoxaparin), to thin the blood and prevent blood clots — For mild
to moderate illness, 40 mg to 60 mg daily until discharged.
Optional additions include
thiamine, zinc and vitamin D. In addition to these medications, the protocol
calls for high-flow nasal oxygen to avoid mechanical ventilation that can
damage the lungs.
Together,
this approach addresses the three core pathological processes seen in COVID-19,
namely hyperinflammation, hypercoagulability of the blood, and hypoxia
(shortness of breath due to low oxygenation).
COVID-19
Doesn’t Have to Remain a Crisis
Health experts are warning
we’re likely to see a second wave of COVID-19 this fall. I believe the
strategies reviewed in this article can go a long way toward minimizing fatalities.
The first thing I recommend
everyone do is to optimize your vitamin D this summer. Again, the optimal blood
level for health and disease prevention is between 60 ng/mL and 80 ng/mL. (In
Europe, the measurements you’re looking for are 150 to 200 nmol/L and 100
nmol/L respectively.)
However,
simply getting above 30 ng/mL (75 nmol/L) may dramatically reduce your risk of
serious infection and death, and doing so is both easy and inexpensive. As
stated by Downing, we could fix the COVID-19 pandemic in as little as 30 days
simply by making sure everyone is taking vitamin D in sufficiently large doses.Henriques,
TiagoBest Price: $18.23Buy New $17.97(as
of 08:00 EST - Details)
More
detailed information about how vitamin D works and why it’s so important
against COVID-19 can be found in my Vitamin D Report. Download and share! You
can also find a summary of the key steps you need to take to optimize your
level in this previous vitamin D article. Here is the link to my
comprehensive science report.
I want to thank those of you
who read the above report and provided constructive feedback. I want you to
know that I did read those suggestions. I had already planned on writing a
short summary, but the responses were nearly universal in support of that.
So, when you click the button
below, you will get the condensed report that you can send to your friends and
family and get them on board with the Vitamin D Campaign, which not only can
save many lives, but can help prevent the country from shutting down again and
worsening our already damaged economy.
Taking quercetin and zinc is
another preventive strategy worth remembering, as is the advice to implement
cyclical nutritional ketosis to make sure you’re metabolically flexible and not
insulin resistant. Again, you can do this by following three powerful
strategies:
- Time-restricted
eating window of six to eight hours
- Eliminating
all industrially processed vegetable oils
- Limiting
carbs to 50 grams a day until metabolically flexible and then increasing
to 150 grams of healthy carbs twice a week
More acutely, ketone esters
may offer rapid relief of COVID-19-related symptoms such as shortness of
breath, and the MATH+ Protocol, administered within six hours of
hospitalization, could be a life saver.
While the Front Line COVID-19
Critical Care Working Group has been struggling to get the word out to doctors
and hospitals, you could (at bare minimum) request your doctor contact them and
urge them to implement the protocol should you or someone you love get ill and
need hospitalization.
Sources
and References
- 1, 6, 8, 10, 14 Orthomolecular Medicine News
Service June 22, 2020
- 2 ClinicalTrials.gov, Vitamin D
for COVID-19
- 3 Chinese Clinical Trials Registry. The relationship
between vitamin D and novel coronavirus pneumonia (COVID-19), 2020
- 4, 11 SSRN April 9, 2020
- 5, 12 Emerginnova.com June 4, 2020
- 7, 9, 13 Infectious Diseases April 8, 2020 DOI: 10.21203/rs.3.rs-21211/v1
- 15 Am J Clin Nutr, 73:288-294.
- 16 Eur J Nutr. 58:2281-2291.
- 17 Metabolic Syndrome and Related Disorders February 8,
2019 DOI: 10.1089/met.2018.0105
- 18 Molecules 2019 Jun; 24(11):
2076
- 19 Chrismasterjohnphd.com Best
Dose of Zinc for COVID-19 Prevention
- 20 Journal of Agricultural Food Chemistry August 13,
2014; 62(32): 8085-8093
- 21 NIH Zinc Fact Sheet
- 22 PLOS Pathogens November 4,
2010 DOI: 10.1371/journal.ppat.1001176
- 23 NIH Zinc Fact Sheet, Zinc
Deficiency
- 24 Advances in Nutrition 2013
Mar; 4(2): 176–190
- 25, 27 Journal of Enzyme Inhibition
and Medicinal Chemistry 2020; 35(1): 145–151
- 26 Science March 20, 2020;
eabb3405
- 28 American Journal of Clinical Nutrition December
1991; 54(6): 1059-1064
- 29 Curr. Pharm. Des. 2008; 14(26): 2719-2732
- 30 covid19criticalcare.com
- 31 MATH+ Protocol (PDF)
Copyright
© Dr. Joseph Mercola