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Recent Studies of Vitamin D and Zinc in Pandemic

 

 

This is the second part on 3 supplements and the new studies supporting their use in this pandemic crisis.  I’ve been recommending these for the past 2 months to boost your immune system. The supplements are liposomal glutathione (also N-acetyl cysteine), Vitamin D, and Zinc.   The reason I made these recommendations is that oxidative stress on the cell and mitochondria play a key role in whether COVID-19 progresses to complications and a poor outcome. Glutathione is a key antioxidant and its key role has already been extensively discussed (click here).  Vitamin D and Zinc play a role in decreasing complications and poor outcomes of viral infections including forming excessive blood clots, developing kidney problems, and suffering from heart problems.

Let’s start the discussion with Vitamin D. In The Lancet Diabetes & Endocrinology journal Fiona Mitchell wrote an article "Vitamin D and Covid-19: do deficient risk a poorer outcome?" that was published May 20, 2020.

Mortality from COVID-19 is clearly higher in some countries than in others. There are many factors including the the overal percentage population of those over 65, general health, access to quality healthcare, and socioeconomic status. One measure that has been overlooked is the vitamin D levels in the general population.  It has been noted that the elderly are both at higher risk for having complications and adverse events from COVID-19 and more likely to have vitamin D deficiency.

Vitamin D is well known for how it is needed to maintain calcium and phosphate balance, bone growth, and bone turnover. It is also known that vitamin D deficiency has been seen in depression, and infectious diseases such as upper respiratory tract infections. Supplementation of Vitamin D have helped with depression and protection against respiratory tract infections and that higher blood levels may show a negative asssociation with cancer.

Recent circumstantial evidence as presented in the Lancet article just mentioned, suggests there is a link between vitamin D levels and the outcomes of COVID-19 in people infected with the virus.  Of course, the virus started spreading in the Northern hemisphere in late 2019 during winter when the levels of vitamin D are at its lowest point in these Northern populations. Most of the cases of COVID-19 were in the North and associated with vitamin D deficiencies except for ome Nordic countries which already supplement vitamin D in many of their foods because of the known widespread vitamin D deficiency from years of public health studies. Spain and Italy are surprising exceptions as well until one reviews studies showing that these populations actually suffer from widespread vitamin D deficiencies as well but do not supplement vitamin D in their foods. Also black, and minority ethnic groups who are more likely to have vitamin D deficiency (they have darker skin),  seem to be affected more than lighter or fairer skinned people.

 

Vitamin D may have 2 roles in COVID-19 infections. The first is that vitamin D supports production of antimicrobial peptides in the respiratory epithelium or the lining of our nasal passages, pharynx and lungs; therefore it makes infection with the virus and the progression of COVID-19 symptoms less likely. The second is that vitamin D might help to reduce the inflammatory response to infection with COVID-19 (SARS-CoV-2).  SARS-CoV-2 inhibits angiotensinconverting enzyme 2 (ACE2) to convert angiotensin 2 to angiotensin 1,7 and increases polymorphonuclear neutrophils (PMNs). IF angiotensiin 2 doesn't get converted it obviously acccumulates and along with more active PMNs a reactive oxidative species called Superoxide (o2-) accumulates and can cause damage to the cell, mitochondria and reduces nitric oxide which normal allows blood vessels to relax and be pliable. Blood pressure can go up and endothelial dysfunction can occur which is the first in a chain of events that will lead to a poor outome and poor prognosis.  Vitamin D is known to promote the angiotensinconverting enzyme 2 (ACE2), which can help with the fact that  SARS-CoV-2 suppresses ACE2. SARS-CoV-2 uses the ACE2 as an entry receptor into the cell (it occupies and uses the receptor to get into the cell).

 

Rose Anne Kenny (Trinity College Dublin, University of Dublin, Ireland) led the cross-sectional study into mortality and vitamin D status and is the lead investigator of the Irish Longitudinal Study on Ageing (TILDA). She is adamant that the recommendations from all public health bodies should be for the population to take vitamin D supplements during this pandemic. “The circumstantial evidence is very strong”, she proclaims regarding the potential effect on COVID-19 outcomes.

Vitamin D should be taken anyway for musculoskeletal health and especially those with osteopenia and osteoporosis. It should be given to especially to those in nursing homes unless there is an extremely good reason not to do so.  In those people who do not need to have their blood thin due to coronary stents or previous strokes (among other things), Vitamin K2 should also be taken with vitamin D especially over the age of 40 as Calcium may tend to accumulate more in the arteries (can cause arteriosclerosis with calcifications) and kidneys (causing kidney stones). The Vitamin K2 helps the calcium allocated more appropriately to the bones and teeth.

In regards to Zinc, there is a very interesting pre-published copy of a retrospective study written by Dr. Phillip Carlucci: Hydroxycholorquine and azithromycin plus zinc vs hydroxychloroquine and azithromycin alone: outcomes in hospitalized COVID-19 patients. The preprint of this study was recently posted o May 8,2020.  This retrospective study looked at 932 hospitalized patients with COVID-19 at New York University Langone Medical Center. Some of the patients that there were treated with their standard hydroxychloroquine and azithromycin regimen (there were 521) were compared to 411 patients who also received zinc sulfate on top of the standard regimen. Statistical analysis were made between the two groups and the conclusions were as follows:

"Zinc sulfate added to hydroxychloroquine and azithromycin associates with a decrease in mortality or transfer to hospice among patients who do not require ICU level of care and an increased likelihood to be discharged directly home from the hospital. In light of study limitations, this study alone is not sufficient to guide clinical practice. Rather, these findings suggest a potential role for zinc sulfate in COVID-19 patients and support the initiation of future randomized clinical trials investigating zinc sulfate against COVID-19."

 

It should be noted that studies that are more recent have shown an increase mortality or death from the use of Hydroxychloroquine which can cause a deadly heart arrhythmia resulting from prolonged Q-T interval as seen on EKGs. Ongoing studies are just underway to study hydroxychloroquine. It has been proposed that hydroxychloroquine by acting as a zinc inophore allows zinc to get into the cells. Zinc then acts to inhibit viral RNA synthesis so the viral replication is impaired and thus spread of the virus to other cells is limited. Zinc normally does not get in the cell from the blood stream or tissues with any significant concentrations. Another zinc ionophore readily available is the supplement Quercetin.

Therefore, from the discussion of the recent articles, we just went through and going back to our discussion from 2 months about immune boosting supplements, we can see that there is now more evidence to support the use of glutathione and N-acetyl cysteine, Vitamin D, Zinc, and Quercetin. I believe that these key supplements which help boost the immune system are among the best supplements we have at the current time to stay healthy in this global crisis.

For more information on AFH pharmaceutical grade glutathione, Vitamin D&K, Zinc Active, Natural Allergy Support (with Quercetin) food intolerances, MitoMax, or other immune boosting tips please see the blogs on https://www.allfunctionalhealth.com/blog

If you have comments, questions, or want to learn how functional medicine can help with improving your brain and immune function call our office or email info@jeffreymarkmd.com. Stay healthy and take care.

So, if you'd like to take advantage of the time you have sheltered at home to do the GI Reset Program please call our office to schedule a telephone or telemedicine video chat consultation.

We now offer online functional medicine assessment, HIPPA compliant video or phone telehealth visits, and in home functional lab kits that you can mail back directly to the laboratories. We can work together to address your health challenges in the comfort and safety of your home during COVID-19 shelter in place and beyond.

Author
Jeffrey Mark, M.D. Helping clients with compassionate and comprehensive medical care for over 25 years with 4 board certifications in functional medicine, gastroenterology, internal medicine, and anti-aging/ regenerative medicine . IFMCP, ABIM Gastroenterology, NPAS Internal Medicine, ABAARM.

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