Plaquenil and other treatments for COVID 19

Bottom line? It is an excellent idea!

Although the studies have been small, they were well done and the treatment is very safe and effective. And costs ~$10/person

Why the debate on it? Academic medicine defines “proven” as having repeated large placebo-controlled studies that normally take years to run. For new treatments that have high risk and cost, and other alternative treatment options, this is reasonable.

But being trapped by that old mindset here runs the known risk of millions of deaths. Our current situation requires a more reasoned approach.

Instead, as we already have two well done studies, it is reasonable to begin with what we know:

1. Taking the Plaquenil for six days resulted in only 25 percent of the treatment group still being contagious by day six, versus 100 percent of the untreated group.
2. The treated group had milder illness.

So the potential and likely benefit is very very high. The next two things to look at are cost and risk:

1. Cost- Under $10/person versus as much as $1000+ for other much less proven and more toxic treatments.
2. Safety- used for decades in millions of people. Main (uncommon, transient and benign) side effects are nausea, headache, or itching. This medication is VERY safe. The risks of eye and heart problems are only in those using it for over five years. They simply are NOT seen with these shorter courses.

Running this equation shows that it is both good science and common sense to use this medication. Now!

The problem—media misinformation—even from usually reliable sources. I like Dr. Fauci. But I strongly disagree with him here. To say this treatment is “unproven” is misleading. He is using the regulatory definition of “unproven” and not using the scientific combined with common sense approach needed for this situation.

The other problem? Pharmacies are sold out. We need to focus on increased production (easy and low cost) and getting it to the public. Health care workers should be on the medication now, and stay on it till the pandemic passes.

Each person over 20 years of age should have the medication, taking two 200 mg tabs twice a day the first day, then one twice a day for five days. I begin it at first sign of infection. It is best absorbed if taken with food. The medicine then stays in the body, offering protection, for months.

As a physician, this is my perspective on what a substantial body of effectiveness and safety research is showing. Of course, this decision is between you and your physician.

Also important? Optimizing your immune function with Zinc 15–50 mg a day for one to two months. Then 15 mg a day. Also get vitamin C 500 mg a day, and 1000+ units daily of vitamin D*. The zinc is especially crucial.

Hoping this is helpful, as we all weather this storm together.

TotalHealth Note: It is very important to have your vitamin D levels tested in order to establish a health protective level of vitamin D. We are providing you with links to the research performed by or analyzed by GrassrootsHealth. GrassrootsHealth is a nonprofit public health research organization dedicated to moving public health messages regarding vitamin D from research into practice. It has a panel of 48 senior vitamin D researchers from around the world contributing to its operations. GrassrootsHealth is currently running the D*action field trial to solve the vitamin D deficiency epidemic worldwide. Under the D*action umbrella, there are also targeted programs for breast cancer prevention and a ‘Protect Our Children NOW!’ program to stop vitamin D deficiency where it starts, in utero.

Vitamin D Helps Fight COVID-19: Part 1

Vitamin D Helps Fight COVID-19: Part 2

Review Suggests Ensuring Adequate Zinc, Selenium and Vitamin D May Protect Against SARS-CoV-2

Building A Better Immune System With These Essential Nutrients

Never before has there been a focus on preventative health like now. And all it took was a pandemic! In addition to the preventative measures of social distancing, such as hand washing and wearing face coverings, government officials have finally recognized that certain dietary supplements, especially vitamins D and C, are critically important for a healthy immune system and may help to lower the risk of influenza and upper respiratory tract infection such as COVID-19.^{1,2,3,4,5,6,7} Research shows there are also several other supplements including amino acids and certain minerals that are critically important for a healthy immune system. Here are the top immune-supporting supplements you should consider taking.

Vitamins C and D
Vitamins C and D are particularly important for your immune system. Studies show that a deficiency in either of these vitamins causes impaired immunity and higher susceptibility to infection, including the flu and upper respiratory tract infections. Supplementation with vitamin C appears to both help prevent and treat respiratory and systemic infections, including coronavirus-type infections.¹ The recommended dose of vitamin C is 1,000 mg a day. Because vitamin C is water-soluble and does not store in the body, experts recommend 1,000 mg up to three times a day, especially when your immune system is challenged.

Unlike vitamin C, vitamin D is fat-soluble and can store in the body. A chemical reaction occurs between the ultraviolet rays of the sun and the human skin that manufactures vitamin D3. Unfortunately, most Americans do not get enough sun exposure throughout the year to create enough vitamin D3. In fact, studies show 80–90 percent of Americans are deficient in this vitamin. The health consequences of being deficient in vitamin D3 are much greater than you might imagine. The risk of a wide variety of diseases, ranging from neurological problems to cancers, increase dramatically. For those whose levels are in the ideal range (40–60 ng/ml), the risk of those diseases is minimal. This appears to also be true for COVID-19. A recent study conducted by Northwestern University found that COVID-19 patients who are severely deficient in vitamin D are twice as likely to experience severe complications, including death.^3,6,7

The only way to know how much vitamin D you should be taking is to test your levels. Right now, it may be difficult to schedule with your doctor, but you can still get your vitamin D level checked by ordering an at-home vitamin D test kit from www.nutrientpower.org.

The kit arrives at your home with instructions. Shortly after you send your sample back, you will receive an email with your results. If your levels are very low, you will want to take the higher doses of vitamin D determined by a vitamin D calculator and re-check your levels in a few months.

Amino Acids
According to the British Journal of Nutrition¹¹, a deficiency of dietary protein or amino acids impairs immune function and increases the risk of infectious disease. Amino acids play a major role in protein synthesis and the formation of white blood cell and antibodies, which your body’s immune system uses to help fight off foreign invaders like bacteria and viruses.¹⁰ With limited exercise options during lockdowns, quarantines and social distancing, muscle loss can play a bigger role than most realize—it can impair your immune system and increase your susceptibility to sickness. Lean muscle loss is a particular issue in those who are aged 60 and older because as we age, we lose lean muscle every year.

Studies show that if you take a specific combination of amino acids as a supplement, it not only supplies your immune system with the nutrients it needs, but it also helps to prevent muscle loss. An amino acid supplement called Rejuvenate consists of the exact combination of essential amino acids—including higher concentrations of leucine, valine and isoleucine—shown in the studies to be most effective.^{8,12,13,14,15} As the subject of more than 25 clinical peer-reviewed published studies, Rejuvenate has been shown to be extremely effective, including increasing the body’s ability to rebuild and repair muscle by 57 percent with noticeable muscle mass improvement within just 30 days.

In one study published by The Journal of Clinical Endocrinology & Metabolism¹⁴, patients on bed rest gained muscle mass with Rejuvenate compared to those who experienced muscle loss who were not taking the supplement. Developed by one of the world’s leading researchers in protein and amino acid nutrition, Rejuvenate is affordable and easy to take. It comes in individual powder pouches and can be easily mixed with water.

Minerals
Your immune system cannot function well without adequate amounts of the minerals zinc, copper and selenium. Zinc not only helps immune function, but it has also been shown to prevent the replication of viruses inside cells and can decrease the duration of colds.^16,18,19 Zinc lozenges are especially effective as reported in a study published in the Annals of Internal Medicine.¹⁶ Although there is no direct evidence at this time that zinc lozenges can prevent or treat COVID-19, Dr. James Robb, a retired virologist at University of California San Diego believes it may be helpful because zinc was shown in a lab study in 2010 to inhibit the replication of coronavirus in cells.¹⁸ Zinc lozenges should not be taken for more than five to seven days because it may cause a copper deficiency, which can dangerously impair immune function.

The link between copper and innate immune function has been recognized for decades. The immune system requires copper to perform several functions, of which little is known about the direct mechanism of action.²⁰ Mild copper deficiency in humans and animals are characterized by neutropenia or a low white blood cell count.²¹ The recommended daily allowance is around 900 micrograms (mcg) a day for adolescents and adults.

Selenium is an essential micronutrient found in the soil that plays a crucial role in a wide variety of physiological processes including effective immune responses. Viral and bacterial infections are often associated with deficiencies of selenium ^22,23,24 as well as an increased incidence of influenza viruses mutating to highly pathogenic strains.²³ Recommended daily amounts are 200 mcg.

A Healthy Foundation
Supplements, as their name implies, are meant to be used in addition to a healthy diet and lifestyle. For immune-boosting supplements to work well, you must provide your body with high-quality nutrition and engage in health-promoting daily habits, including regular exercise, adequate sleep, meditation or other stress-reducing techniques such as yoga. If you eat a lot of processed foods, refined carbohydrates and sugar; stay up too late at night; drink excessive alcohol; smoke cigarettes; and are inactive, your immune system will be so severely weakened that no supplements will be able to counteract that damage. One of the big takeaways of the COVID-19 pandemic is the importance of immune system strength. You should be working on your immune system daily, not just when we are getting older or feeling run down and sick. By making sure your diet and lifestyle is as healthy as possible, and supplementing with key vitamins (C and D), minerals (zinc, copper, and selenium) and the amino acids (the combination found in Rejuvenate), you’ll be much better prepared to face any future infectious disease challenges.

1. Hemilä H. Vitamin C and SARS coronavirus. J Antimicrob Chemother. 2003;52(6):1049–1050. doi:10.1093/jac/dkh002.
2. Carr AC, Maggini S. Vitamin C and Immune Function. Nutrients. 2017;9(11):1211. Published 2017 Nov 3. doi:10.3390/nu9111211.
3. Grant WB, Lahore H, McDonnell SL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4):E988. Published 2020 Apr 2. doi:10.3390/nu12040988.
4. Cannell JJ, Vieth R, Umhau JC, et al. Epidemic influenza and vitamin D. Epidemiol Infect. 2006;134(6):1129–1140. doi:10.1017/S0950268806007175.
5. Prietl, Barbara et al. “Vitamin D and immune function.” Nutrients vol. 5,7 2502-21. 5 Jul. 2013, doi:10.3390/nu5072502 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3738984/.
6. Vitamin D levels appear to play role in COVID-19 mortality rates.
7. The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patients. Healthy Vitamin D Levels Could Be Linked to COVID-19 Survival
8. English KL, Paddon-Jones D. Protecting muscle mass and function in older adults during bed rest. Curr Opin Clin Nutr Metab Care. 2010;13(1):34–39. doi:10.1097/MCO.0b013e328333aa66.
9. Knight J et al (2019) Effects of bedrest 5: the muscles, joints and mobility. Nursing Times [online]; 115: 4, 54–57. https://cdn.ps.emap.com/wp-content/uploads/sites/3/2019/03/190320-Effects-of-bedrest-5-the-muscles-joints-and-mobility.pdf.
10. Phillip C. Calder, Branched-Chain Amino Acids and Immunity, The Journal of Nutrition, Volume 136, Issue 1, January 2006, Pages 288S–293S, https://doi.org/10.1093/jn/136.1.288Shttps://academic.oup.com/jn/article/136/1/288S/4664141.
11. Li, P., Yin, Y., Li, D., Woo Kim, S., & Wu, G. (2007). Amino acids and immune function. British Journal of Nutrition, 98(2), 237-252. doi:10.1017/S000711450769936X.
12. Katsanos CS, Kobayashi H, Sheffield-Moore M, Aarsland A, Wolfe RR. A high proportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly. Am J Physiol Endocrinol Metab. 2006;291(2):E381–E387. doi:10.1152/ajpendo.00488.2005.
13. Børsheim E, Bui QU, Tissier S, Kobayashi H, Ferrando AA, Wolfe RR. Effect of amino acid supplementation on muscle mass, strength and physical function in elderly. Clin Nutr. 2008;27(2):189–195. doi:10.1016/j.clnu.2008.01.001.
14. Paddon-Jones D, Sheffield-Moore M, Urban RJ, et al. Essential amino acid and carbohydrate supplementation ameliorates muscle protein loss in humans during 28 days bedrest. J Clin Endocrinol Metab. 2004;89(9):4351–4358. doi:10.1210/jc.2003–032159.
15. Ferrando AA, Paddon-Jones D, Hays NP, et al. EAA supplementation to increase nitrogen intake improves muscle function during bed rest in the elderly. Clin Nutr. 2010;29(1):18–23. doi:10.1016/j.clnu.2009.03.009.
16. Prasad AS, Fitzgerald JT, Bao B, Beck FW, Chandrasekar PH. Duration of symptoms and plasma cytokine levels in patients with the common cold treated with zinc acetate. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2000;133(4):245–252. doi:10.7326/0003-4819-133-4-200008150-00006.
17. Shankar AH, Prasad AS. Zinc and immune function: the biological basis of altered resistance to infection. Am J Clin Nutr. 1998;68(2 Suppl):447S–463S. doi:10.1093/ajcn/68.2.447S .
18. te Velthuis AJW, van den Worm SHE, Sims AC, Baric RS, Snijder EJ, van Hemert MJ (2010) Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture. PLoS Pathog 2010 Nov; 6(11): e1001176. https://doi.org/10.1371/journal.ppat.1001176 https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1001176.
19. Rao, Goutham, and Kate Rowland. “PURLs: Zinc for the common cold—not if, but when.” The Journal of family practice vol. 60,11 (2011): 669-71.
20. Percival SS.Copper and immunity. Am J Clin Nutr. 1998;67(5 Suppl):1064S–1068S. doi:10.1093/ajcn/67.5.1064S .
21. Karrera Y. Djoko,1 Cheryl-lynn Y. Ong,1 Mark J. Walker, and Alastair G. McEwan The Role of Copper and Zinc Toxicity in Innate Immune Defense against Bacterial Pathogens* J BiolChem. 2015 Jul 31; 290(31): 18954–18961.
22. Avery JC, Hoffmann PR. Selenium, Selenoproteins, and Immunity. Nutrients. 2018;10(9):1203. Published 2018 Sep 1. doi:10.3390/nu10091203.
23. Steinbrenner H, Al-Quraishy S, Dkhil MA, Wunderlich F, Sies H. Dietary selenium in adjuvant therapy of viral and bacterial infections. Adv Nutr. 2015;6(1):73–82. Published 2015 Jan 15. doi:10.3945/an.114.007575.
24. Hoffmann, Peter R, and Marla J Berry. “The influence of selenium on immune responses.” Molecular nutrition & food research vol. 52,11 (2008): 1273-80. doi:10.1002/mnfr.200700330.

Most people contract one or more colds every year. A cold is caused by viruses that infect cells of the upper respiratory tract. Since there are over 200 different species and strains of these viruses, a cold caused by one virus does not protect a person from catching a cold cause by a different one. This explains why colds can occur one after another or several times a year. An acute sore throat, on the other hand can be caused by a viral or bacterial infection. If your sore throat gets worse no matter what you do, it’s probably bacterial and may require a trip to the doctor for an antibiotic. The well-known symptoms of a cold include stuffy nose, watery eyes, low fever, aching, and possibly a sore throat.

Conventional medical treatment for a cold generally involves rest, aspirin, decongestants, and drinking a lot of fluids. Conventional medical treatment for a sore throat also involves rest, aspirin, lots of fluids, and sometimes antibiotics. An integrative approach may also include supplementation with vitamin C, zinc lozenges, Echinacea, vitamin A, and a homeopathic remedy for colds.

Vitamin C
Since the late, great Nobel Laureate, Linus Pauling first discussed that megadoses of vitamin C might be an effective treatment for the common cold, the medical world has published study after study attempting to prove or disprove Pauling’s claim. In some cases, the studies were flawed since the amounts of vitamin C used were hardly megadoses, and were not sufficient to elicit a response.

Placebo-controlled studies have shown that vitamin C supplementation decreases the duration and severity of common cold infections. However, the magnitude of the benefit has substantially varied, hampering conclusions about the clinical significance of the vitamin. In one published review, 23 studies with regular vitamin C supplementation were analyzed to find out factors that may explain some part of the variation in the results. It was found that on an average, vitamin C produces greater benefit for children than for adults. Perhaps of greatest significance, the dose also affects the magnitude of the benefit, there being on average greater benefit from at least 2000 mg daily compared to 1000 mg daily. For example, in five studies with adults administered 1000 mg daily of vitamin C, the median decrease in cold duration was only six percent, whereas in two studies with children administered 2000 mg daily, the median decrease was four times higher, 26 percent. The studies analyzed in this review used regular vitamin C supplementation. The authors of the review, however, noted that, “it is conceivable that therapeutic supplementation starting early at the onset of the cold episode could produce comparable benefits.”¹

In fact, this is exactly what took place in a recent study involving 252 adult subjects with a cold or flu who were treated with hourly doses of 1000 mg of vitamin C for the first six hours, and then three times daily thereafter. A control group of 463 subjects were treated with pain relievers and decongestants. The results were that overall reported flu and cold symptoms in the vitamin C group decreased 85 percent compared with the control group after the administration of megadose Vitamin C. The researchers in this study concluded: “Vitamin C in megadoses administered before or after the appearance of cold and flu symptoms relieved and prevented the symptoms in the test population compared with the control group.”²

I’ve also found effective results with the common cold when supplementing with higher doses of vitamin C. I recommend 1000–2000 mg every two hours (reduce dose if experiencing loose bowels).

Zinc Lozenges
Zinc’s role in immune function is well established.³ The use of zinc in a lozenge form for the treatment of the common cold is also gaining validity. In one randomized, double-blind, placebo-controlled clinical trial, the treatment of the common cold with zinc lozenges resulted in a significant reduction in duration of symptoms of the cold. The zinc group had significantly fewer days with coughing, headache, hoarseness, nasal congestion, nasal drainage, and sore throat. Cold symptoms were over in 4.4 days in the zinc group compared with 7.6 days in the placebo group.⁴

Echinacea
Echinacea is an immune stimulant/supporter, and is excellent in the prevention and treatment of colds and influenza. Research suggests that Echinacea supports the immune system by activating white blood cells (lymphocytes and macrophages).⁵ In addition, Echinacea appears to increase the production of interferon, which is important to the immune response of viral infections.⁶ In any case, a number of double-blind, clinical studies have confirmed Echinacea's effectiveness in treating colds and flu.^7,8,9,10,11 However, some research suggests that Echinacea may be more effective if used at the onset of these conditions.^12,13

In addition, the results of a published study involving 238 subjects confirmed that Echinacea was safe and effective in producing a rapid improvement of cold symptoms. In the subgroup of patients who started therapy at an early phase of their cold, the effectiveness of Echinacea was most prominent.¹⁴ In a similar study, 246 subjects with a cold were treated with Echinacea preparations or a placebo. Those treated with the Echinacea preparations experienced a reduction of symptoms, significantly more effective than the placebo. The researchers concluded that the Echinacea preparations, "represent a low-risk and effective alternative to the standard symptomatic medicines in the acute treatment of common cold." ¹⁵

Homeopathic Remedy For Colds
In one clinical study, 170 soldiers suffering from the common cold were treated with either a combination homeopathic preparation, or aspirin. On the 4th and 10th treatment days, both the homeopathic remedy and the aspirin were found to possess comparative effectiveness in the treatment of the common cold.¹⁶ Another study involving 53 outpatients suffering from common cold found similar results.¹⁷

Vitamin A
Vitamin A's role in maintaining healthy epithelial tissue helps to fight infection by preventing the invasion of bacteria or viruses. In addition, children with even mild vitamin A deficiency develop respiratory infections and diarrhea at two and three times the rate of children with normal vitamin A status.¹⁸

References

1. Hemila H, Med Hypotheses (1999) 52(2):171–8.
2. Gorton HC, Jarvis K, J Manipulative Physiol Ther (1999) 22(8):530–3.
3. Whitney E, Cataldo C, Rolfes S, "Understanding Normal and Clinical Nutrition," Fifth Edition (1998) West/Wadsworth, Belmont, California, p.463–4.
4. Mossad SB, et al, Ann Intern Med (1996) 125(2):81–8.
5. See DM, Broumand N, Sahl L, Tilles JG. In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients. Immunpharmacol 1997;35:229–35.
6. Leuttig B, Steinmuller C, Gifford GE, et al. Macrophage activation by the polysaccharide arabinogalactan isolated from plant cell cultures of Echinacea purpurea. J Natl Cancer Inst 1989;81:669–75.
7. Melchart D, Linde K, Worku F, et al. Immunomodulation with Echinacea—a systematic review of controlled clinical trials. Phytomedicine 1994;1:245–54.
8. Dorn M, Knick E, Lewith G. Placebo-controlled, double-blind study of Echinacea pallida redix in upper respiratory tract infections. Comp Ther Med 1997;5:40–2.
9. Hoheisel O, Sandberg M, Bertram S, et al. Echinacea shortens the course of the common cold: a double-blind, placebo-controlled clinical trial. Eur J Clin Res 1997;9:261–8.
10. Braunig B, Dorn M, Knick E. Echinacea purpurea root for strengthening the immune response to flu-like infections. Zeitschrift Phytotherapie1992;13:7–13.
11. Brikenborn RM, Shah DV, Degenring FH. Echinaforce® and other Echinacea fresh plant preparations in the treatment of the common cold. A randomized, placebo-controlled, double-blind clinical trial. Phytomedicine 1999;6:1–5.
12. Melchart D, Walther E, Linde K, et al. Echinacea root extracts for the prevention of upper respiratory tract infections: A double-blind, placebocontrolled randomized trial. Arch Fam Med 1998;7:541–5.
13. Grimm W, Müller HH. A randomized controlled trial of the effect of fluid extract of Echinacea purpurea on the incidence and severity of colds and respiratory tract infections. Am J Med 1999;106:138–43.
14. Henneicke-von Zepelin H, et al, Curr Med Res Opin(1999) 15(3):214–27.
15. Brinkeborn RM, Shah DV, Degenring FH, Phytomedicine (1999) 6(1):1–6.
16. Maiwald VL, et al, Arzneimittelforschung (1988) 38(4):578-82.
17. Gassinger CA, Wunstel G, Netter P, Arzneimittelforschung (1981) 31(4):732–6.
18. Whitney E, Cataldo C, Rolfes S, "Understanding Normal and Clinical Nutrition," Fifth Edition (1998) West/Wadsworth, Belmont, California, p.