This protocol will include ideas on the many ways to support your immune system. We hope this will help you reduce the risk of acquiring the coronavirus or reduce the severity or duration of an infection. We will focus on the value of healthy lifestyle—including sleep, stress management, dietary approaches, and supplements.
Using available evidence, an understanding of the virulence of COVID-19, as well as data from similar, but different, viruses, we offer the following strategies to consider. AMC recommendations are based on expertise of AMC group specialists, protocols of Cleveland Clinic Institute for Functional Medicine, The University of Arizona Andrew Weil Center for Integrative Medicine.
Adequate sleep: Shorter sleep duration increases the risk of infectious illness. Adequate sleep also ensures the secretion of melatonin, a molecule which may play a role in reducing coronavirus virulence.
Stress management: Psychological stress disrupts immune regulation and is specifically associated with increased pro-inflammatory agents in the body. Various mindfulness techniques such as meditation, breathing exercises, guided imagery helps to reduce stress.
We would like to recommend breathing exercises for people with asthma and COPD, it can have additional benefits in the prevention of respiratory infections.
Vegetables and fruits plus flavonoids supplements:
- Glycyrrhiza glabra (licorice)
- Quercetin (found in apples and onions)
- Myricetin found in tomatoes, oranges, nuts, and berries
- Apigenin found in chamomile, parsley and celery
- Curcumin (found in turmeric root)
- Epigallocatechine gallate (EGCG) from green tea.
At least 5–7 servings of vegetables and 2–3 servings of fruit daily provide a repository of flavonoids and are considered a cornerstone of an anti-inflammatory diet.
Vitamin and Microelement Supplements:
Vitamin C: Like flavonoids, ascorbic acid is a potent antioxidant. Clinical trials have found that vitamin C shortens the frequency, duration and severity of the common cold and the incidence of pneumonia. The ongoing trial in China is investigating the potential benefit of high dosages of vit C (100-200mg/kg per day) in treatment of acute respiratory distress syndrome caused by novel coronavirus.
Typical daily dosing of vitamin C ranges from 500 mg to 3000 mg daily with even higher doses utilized during times of acute infection.
Vitamin D: A recent review regarding the role of vitamin D in reducing the risk of the common cold shows it role in enhancing of cellular and innate immunity. One research claims that Vitamin D supplementation can help reduce hospital-associated infections. So during the COVID-19 epidemic, all people in the hospital, including patients and staff, should take vitamin D supplements to raise 25(OH)D concentrations as an important step in preventing infection and spread.
The peak season for acute respiratory infections is generally when vit D concentrations are lowest. Thus, vitamin D3 supplementation should be started or increased during this time. To achieve optimal ranges approximately half the population could take at least 2000–5000 IU/d of vitamin D3. In case of vit D deficiency it is reasonable to suggest taking 10,000 IU/day for a month and then decrease to 5000 IU/day. These doses are individual and depend on current level of vit D in the blood.
Please visit your local AMC to check your vit D and calcium level to establish your individual vit D dose.
Vitamin A: vitamin A and related retinoids play a major role in immunity. Recent clinical trials suggest that vitamin A supplementation reduces morbidity and mortality in different infectious diseases, such as measles-related pneumonia, human immunodeficiency virus infection and malaria.
The suggested dose is up 10.000 – 25.000 IU/day.
Please contact your doctor before taking Vit A since it’s important to monitor liver function while taking it.
Zinc: Coronavirus appear to be susceptible to the viral inhibitory actions of zinc. Zinc may prevent coronavirus entry into cells and appears to reduce coronavirus virulence.
Typical daily dosing of zinc is 15 mg–30 mg daily with lozenges potentially providing direct protective effects in the upper respiratory tract.
Zinc serum level test is available at all AMC clinics.
Sambucus nigra (Elderberry): Elderberry inhibits replication and viral attachment of flu viruses and other type of coronaviruses. An evidence-based systematic review of elderberry conducted by the Natural Standard Research Collaboration concluded that there is level B evidence to support the use of elderberry for influenza.
Of note, Sambucus significantly increases inflammatory cytokines, so should be discontinued with symptoms of Covid infection (or positive test).
Typical dosing of 2:1 elderberry extract is 10 mL–60 mL daily for adults and 5mL–30 mL daily for children.
Pelargonium sidoides is a root from which a herbal supplement is prepared. This root has been shown to have immune system modulatory capabilities. this supplement proved to have benefit in treating the common cold, with decreased symptom severity and shorter symptom duration.
Recommended dose is 10-20 drops of 80% Pelargonium extract 3 times a day for prevention, 30 drops 3 times a day for treatment.
Echinacea purpurea can be effective in decreasing the severity and duration of cold symptoms. A plethora of Echinacea preparations made from a variety of species and methods is available. The dose varies on the manufacturer suggested usage.
Recombinant α-2b interferon spray/ or suppositories.
Interferon response represents one of the first lines of defense against viral infections.
Study from China shows preventive effect of recombinant human interferon alpha-2b for nasal spray against SARS and other common respiratory viral infections. In some countries it’s also included in home management of mild Covid 2019 infections.
The recommended doses are:
Nasal interferon spray 3 drops in each nostril – 5 times a day for 5 days (the one-time dose is 3 000 IU, the daily dose is 15 000 – 18 000 IU per day).
Other possible supplements:
Probiotics are live microorganisms that may be found and consumed in dietary supplements and fermented foods, such as yogurt. Although the mechanism is unclear, probiotics are able to provide potential health benefits through modulation of the immune system. Probiotic use has been found to have several potential benefits in lung-related conditions. Probiotics may help reduce lung infections in healthy and hospitalized children, as well as a shorten the length of time a person suffers from the common cold. Probiotics can also strengthen an important part of the immune system that helps a person who has COPD and smokes fight off viral lung infections.