How do vitamin C and zinc interact when taken together. What are the potential benefits and risks of combining these supplements. When is it safe to take vitamin C and zinc simultaneously. What dosages are recommended for optimal absorption and effectiveness.

The Importance of Vitamin C and Zinc for Immune Health

Vitamin C and zinc are two essential nutrients that play crucial roles in supporting immune function. During challenging times like the current pandemic, many health experts recommend ensuring adequate intake of these nutrients to help bolster the body’s natural defenses. But while both are important individually, taking them together as supplements requires careful consideration.

Vitamin C, also known as ascorbic acid, is a powerful antioxidant that supports various aspects of immune health. It helps stimulate the production and function of white blood cells, which are key players in fighting off infections. Additionally, vitamin C aids in the production of collagen, a protein essential for skin health and wound healing.

Zinc is a mineral that is vital for numerous bodily functions, including immune system regulation. It helps activate enzymes that break down proteins in viruses and bacteria and is necessary for the development and function of immune cells. Zinc has shown promise in reducing the duration and severity of common colds when taken at the onset of symptoms.

The Debate on Combining Vitamin C and Zinc Supplements

While both vitamin C and zinc are beneficial for immune health, there is ongoing debate about whether they should be taken together as supplements. Some public health experts caution against combining these nutrients in supplement form, citing potential interactions that could reduce their effectiveness.

The main concern revolves around absorption. When taken together, vitamin C and zinc may compete for absorption in the digestive system, potentially leading to decreased bioavailability of both nutrients. This means that even though you’re consuming both supplements, your body may not be able to utilize them as effectively as if they were taken separately.

Expert Opinion on Vitamin C and Zinc Combinations

Public Health Expert and Dietitian Swati Bathwal emphasizes the importance of considering nutrient composition and solubility when making supplement combinations. She explains that unless a nutrient is optimally absorbed, it won’t provide the intended benefits to your body. The timing of supplement intake can also affect absorption in some cases.

Bathwal further elaborates on zinc’s potential benefits, stating, “Zinc is supported by virologists especially in prevention of common cold. It is seen that it prevents the onset of common cold. There is no evidence on its benefits in SARS COV 2 related pneumonia but it has shown benefits in prevention from regular pneumonia.”

Factors Affecting Zinc Absorption

Understanding the factors that influence zinc absorption is crucial for maximizing its benefits. Several compounds can bind to zinc ions, affecting their release and absorption in the body.

• Citric acid
• Mannitol
• Sorbitol

These substances can bind zinc ions in a way that prevents their release, potentially reducing the supplement’s effectiveness. Bathwal advises avoiding citric acid when consuming zinc and checking multivitamin labels for binders like mannitol or sorbitol.

On the other hand, zinc is best absorbed when combined with certain compounds:

• Gluconate
• Acetate

These forms of zinc tend to have higher bioavailability, meaning they are more easily absorbed and utilized by the body.

Potential Risks of Excessive Zinc Intake

While zinc is essential for health, consuming too much can lead to adverse effects. Bathwal cautions that excess zinc intake may result in:

• Bad taste in the mouth
• Nausea
• Abdominal pain
• Dry mouth
• Loss of smell (if used through nasal drops)

It’s important to note that the upper limit for zinc intake is 40 mg per day for adults. When using zinc for common cold prevention, Bathwal suggests, “About 10-15 mg of elemental when consumed every 3-4 waking 1-3 days of common cold it prevents the cold.”

Exceptions to the Rule: Approved Combinations

While taking separate supplements of vitamin C and zinc simultaneously is generally discouraged, there are exceptions to this rule. Some over-the-counter (OTC) medications contain both vitamin C and zinc in their formulation. These products have been clinically approved with specific compositional differences that allow for safe and effective combined use.

For example, some chewable vitamin C tablets include a small amount of zinc, typically in ratios like 100mg of vitamin C (ascorbic acid) to 5mg of zinc salt. These formulations have been designed to minimize potential interactions and optimize absorption.

Is it safe to take these combination products? Yes, but only when used as directed and in the suggested dosage. It’s crucial to follow the instructions on the label or your healthcare provider’s recommendations. These products have undergone testing to ensure their safety and efficacy when used correctly.

The Dangers of Supplement Overdose

Overconsumption of any supplement, including vitamin C and zinc, can lead to adverse health effects. It’s essential to understand that more is not always better when it comes to nutritional supplements. Exceeding the recommended dosage can result in various side effects, some of which may be severe or long-lasting.

Potential side effects of vitamin C and zinc overdose include:

1. Vomiting
2. Acute abdominal pain
3. Bloody diarrhea
4. Severe headache
5. Blood in urine
6. Peeling skin
7. Drowsiness
8. Fluctuating heart rate
9. Weak muscles
10. Changes in menstrual cycle

If you experience any of these symptoms after taking multivitamins or mineral supplements, it’s crucial to consult your healthcare provider immediately. They can assess your condition and recommend appropriate measures to address any potential overdose effects.

Optimizing Vitamin C and Zinc Intake

To maximize the benefits of vitamin C and zinc while minimizing potential interactions, consider the following strategies:

• Separate timing: If taking individual supplements, consume vitamin C and zinc at different times of the day.
• Focus on food sources: Prioritize obtaining these nutrients through a balanced diet rich in fruits, vegetables, and lean proteins.
• Consult a healthcare professional: Seek advice from a doctor or registered dietitian to determine the most appropriate supplementation strategy for your individual needs.
• Choose the right formulations: When selecting zinc supplements, opt for forms that are more easily absorbed, such as zinc gluconate or zinc acetate.
• Be mindful of interactions: Avoid consuming zinc supplements with foods or beverages high in phytates, which can inhibit absorption.

The Role of Vitamin C in Enhancing Iron Absorption

While vitamin C may compete with zinc for absorption, it plays a crucial role in enhancing the absorption of another essential mineral: iron. This is particularly important for individuals following plant-based diets or those at risk of iron deficiency.

Vitamin C aids in the absorption of non-heme iron, which is the form found in plant-based foods. When consumed together, vitamin C helps convert non-heme iron into a more absorbable form, significantly increasing its bioavailability.

Foods Rich in Both Vitamin C and Iron

To optimize iron absorption, consider pairing iron-rich foods with sources of vitamin C. Some examples of foods that contain both nutrients include:

• Spinach
• Kale
• Broccoli
• Brussels sprouts
• Strawberries

By consuming these foods together or combining iron-rich foods with vitamin C sources, you can enhance your body’s ability to absorb and utilize iron effectively.

Zinc’s Role in Protein Synthesis and Wound Healing

Beyond its immune-supporting properties, zinc plays a crucial role in protein synthesis and wound healing. This makes it an essential nutrient for maintaining healthy skin, promoting tissue repair, and supporting overall cellular function.

Zinc is involved in various aspects of wound healing, including:

• Collagen synthesis
• Cell proliferation
• Immune function at the wound site
• Antioxidant activity

Adequate zinc levels are particularly important for individuals recovering from injuries, surgeries, or those with chronic wounds. However, it’s essential to maintain a balance, as excessive zinc intake can interfere with copper absorption and potentially impair wound healing.

Vitamin C and Zinc in Age-Related Eye Diseases

Both vitamin C and zinc have been associated with potential benefits in preventing or slowing the progression of age-related eye diseases. These nutrients play important roles in maintaining eye health and protecting against oxidative stress, which is a key factor in the development of conditions like age-related macular degeneration (AMD) and cataracts.

The AREDS Study

The Age-Related Eye Disease Study (AREDS), a major clinical trial sponsored by the National Eye Institute, investigated the effects of high-dose antioxidant vitamins and zinc on the progression of AMD and cataracts. The study found that a combination of vitamins C and E, beta-carotene, zinc, and copper reduced the risk of advanced AMD by about 25% in people at high risk for the condition.

While these findings are promising, it’s important to note that the study used specific formulations and dosages. Individuals concerned about eye health should consult with an eye care professional before starting any supplementation regimen.

Practical Tips for Supplement Use

To ensure safe and effective use of vitamin C and zinc supplements, consider the following guidelines:

1. Consult a healthcare provider: Before starting any new supplement regimen, discuss your individual needs and potential interactions with a doctor or registered dietitian.
2. Read labels carefully: Pay attention to dosages and ingredients in multivitamin or combination products to avoid excessive intake.
3. Time your supplements wisely: If taking separate vitamin C and zinc supplements, space them out by at least 2 hours to minimize potential interactions.
4. Consider your diet: Evaluate your dietary intake of these nutrients before deciding on supplementation. A balanced diet may provide sufficient amounts for many individuals.
5. Be aware of other medications: Some prescription drugs may interact with vitamin C or zinc. Always inform your healthcare provider about all supplements and medications you’re taking.
6. Monitor for side effects: Pay attention to any unusual symptoms or changes in your health after starting supplements and report them to your healthcare provider.
7. Store supplements properly: Keep your vitamins and minerals in a cool, dry place away from direct sunlight to maintain their potency.

By following these guidelines and maintaining open communication with your healthcare team, you can optimize the benefits of vitamin C and zinc while minimizing potential risks or interactions.

Never Take Vitamin C and Zinc Together, Public Health Expert Explains Why

Vitamin C and zinc are two very important nutrients that one needs to take during this pandemic situation. Doctors recommend that you must consume foods rich in vitamin C and zinc to boost your immune system. If you are unable to get it through your diet, take supplements. But do you know that some supplements shouldn’t be taken together? A lot of you might be taking zinc and vitamin C supplements together but in this article, we will tell you why this is a deadly combination.

Can zinc and vitamin C be taken together?

There are so many people out there who are taking multiple vitamins and minerals together without knowing their pros and cons. They consider supplementation as a task and so, in order to get rid of it, they take everything together. This is not a good thing. Public Health Expert and Dietitian Swati Bathwal explain that the composition and solubility of a nutrient should be taken into consideration when making combinations. Unless a nutrient isn’t optimally absorbed, it won’t provide any benefit to your body. Besides, the time of the day these are taken also affects absorption in some cases.

Absorption is the key factor for any supplement. Mixing two supplements may reduce the absorption that only goes waste. In addition to this, such combinations can cause adverse interactions that can harm your health.

Also Read: Zinc Deficiency Can Be Life-Threatening For COVID-19 Patients

Swati Bathwal, Public Health Expert, Dietitian and Diabetes Educator explains, Zinc is supported by virologists especially in prevention of common cold. It is seen that it prevents the onset of common cold.  There is no evidence on its benefits in SARS COV 2 related pneumonia but it has shown benefits in prevention from regular pneumonia. If commenced  in the first 3 days, it helps in reduction from nasal discharge. Upper level for Zinc is 40 mg a day for an adult. About 10-15 mg of elemental when consumed every 3-4 waking 1-3 days of common cold it prevents the cold . When it is bind with binders like citric acid, mannitol, sorbitol, it binds the zinc ions in such a way that it doesn’t release zinc ions. So, if you are consuming zinc avoid having citric acid and in your multivitamin check if it has mannitol or nay other binders mentioned above. it gets best absorbed with gluconate and acetate. Excess zinc can lead to bad taste, nausea, abdominal pain, dry mouth and loss of smell if used through nasal drops.”

Exceptions

Let us tell you that if you are taking these two vitamins C and Zinc(mineral) separately, never take them at the same time, as explained earlier. However, there are OTC medicines with the composition of ascorbic acid(vitamin C) and zinc. Can you take them? Yes, you can but only in the suggested dosage. This is because these have the clinically-approved compositional difference between the vitamin and mineral. For example, there are chewable vitamin C tablets with a small amount of zinc. Say, 100mg vitamin C or ascorbic acid and 5mg zinc salt. If your doctor has prescribed you these, then only take these in the right dosage.

Side-Effects of Overdosing Supplements

Never overdose on anything be it a nutritional supplement or medicine. There is always a reason why doctors suggest a certain dosage. If you overdose without consulting your doctor, it may cause side-effects and some of them could even be long-lasting. Here are some side-effects of overdosing on vitamin C and zinc:

• Vomiting
• Acute abdominal pain
• Bloody diarrhoea
• Severe headache
• Blood in urine
• Peeling skin
• Drowsiness
• Fluctuating heart rate
• Weak muscles
• Change in menstrual cycle

If you experience any of these after taking multivitamins and minerals, speak to your doctor and explain your condition. They can suggest a solution to reverse the damage.

Conclusion

Both vitamin C and zinc are essential for the body for protection from covid-19 or coronavirus. One must take these either through food or dietary supplements but keep in mind to not take these together(if you are taking separate tablets of vitamin C and zinc). These would hamper the absorption and your body won’t get the benefits it should be getting from them. It is better to consult a doctor beforehand and follow as they say.

Read More in Miscellaneous

What Are the Benefits of Vitamin C & Zinc? | Healthy Eating

By Jan Sheehan Updated December 17, 2018

Vitamin C and zinc have many health benefiits, including aiding immunity, reducing the risk of age-related eye diseases and helping wounds heal. Vitamin C also helps the absorption of plant-based iron, while zinc is required for the body to make DNA and for cell division. Meat and seafood are the best sources of zinc, while friuts and vegetables are good sources of vitamin C. Zinc is also found in cold lozenges and over-the-counter cold medicines.

Protection Against Colds

Vitamin C may reduce the length and severity of a cold, but it doesn’t appear to prevent colds in most people, according to the National Center of Complementary and Alternative Medicine, part of the National Institutes of Health. The exception is marathon runners and other extreme exercisers, as well as people exposed to very cold weather, such as skiers. For these groups, taking 250 milligrams of vitamin C daily may reduce the chance of catching a cold by 50 percent, reports the NIH’s Office of Dietary Supplements. Studies show that using zinc lozenges within 24 hours of catching a cold can reduce the length and severity of cold symptoms.

Eye Disease Protection

Zinc and vitamin C may prevent vision loss in older people by delaying the progression of age-related macular degeneration, or AMD. In one study reported by the Office of Dietary Supplements, high intakes of zinc and antioxidants, including vitamin C, reduced the risk of AMD in elderly people. In another study, taking zinc alone significantly reduced the risk of developing AMD in high-risk subjects, but not in other people. Additionally, studies show high intakes of vitamin C may protect against cataracts, although the ODS notes this association needs further study.

Wound Healing

Vitamin C is needed for the body to form collagen, part of the skin’s connective tissue that plays a vital role in the healing of wounds, such as cuts. Zinc is needed for the formation and maintenance of the skin and mucous membranes. People with skin ulcers are often deficient in zinc, according to the Office of Dietary Supplements. Additionally, insufficient vitamin C can lead to scurvy, a disease that causes connective tissue weakness and gum bleeding.

Recommendations

Obtaining vitamin C from foods is preferable to taking supplements. The Office of Dietary Supplements notes that whole foods contain not only essential vitamins and minerals but also dietary fiber and other healthful substances not found in supplements. If you choose to take supplements, consult your doctor. Vitamin C and zinc supplements can interfere with a number of medicines. Plus, high doses can cause nausea, vomiting, diarrhea and stomach cramps. Intakes of 150 to 750 milligrams of zinc a day have been associated with copper deficiency, which can reduce immunity. Avoid using zinc nasal sprays to treat a cold. The National Center of Complementary and Alternative Medicine warns that these products can cause loss of smell, which may be permanent.

Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection: The COVID A to Z Randomized Clinical Trial | Complementary and Alternative Medicine | JAMA Network Open

Key Points

Question 
Do high-dose zinc, high-dose ascorbic acid, and/or a combination of the 2 reduce the duration of symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)?

Findings 
In this randomized clinical trial of 214 patients with confirmed SARS-CoV-2 infection receiving outpatient care, there was no significant difference in the duration of symptoms among the 4 groups.

Meaning 
These findings suggest that treatment with zinc, ascorbic acid, or both does not affect SARS-CoV-2 symptoms.

Importance 
There is limited evidence regarding early treatment of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to mitigate symptom progression.

Objective 
To examine whether high-dose zinc and/or high-dose ascorbic acid reduce the severity or duration of symptoms compared with usual care among ambulatory patients with SARS-CoV-2 infection.

Design, Setting, and Participants 
This multicenter, single health system randomized clinical factorial open-label trial enrolled 214 adult patients with a diagnosis of SARS-CoV-2 infection confirmed with a polymerase chain reaction assay who received outpatient care in sites in Ohio and Florida. The trial was conducted from April 27, 2020, to October 14, 2020.

Intervention 
Patients were randomized in a 1:1:1:1 allocation ratio to receive either 10 days of zinc gluconate (50 mg), ascorbic acid (8000 mg), both agents, or standard of care.

Outcomes 
The primary end point was the number of days required to reach a 50% reduction in symptoms, including severity of fever, cough, shortness of breath, and fatigue (rated on a 4-point scale for each symptom). Secondary end points included days required to reach a total symptom severity score of 0, cumulative severity score at day 5, hospitalizations, deaths, adjunctive prescribed medications, and adverse effects of the study supplements.

Results 
A total of 214 patients were randomized, with a mean (SD) age of 45.2 (14.6) years and 132 (61.7%) women. The study was stopped for a low conditional power for benefit with no significant difference among the 4 groups for the primary end point. Patients who received usual care without supplementation achieved a 50% reduction in symptoms at a mean (SD) of 6. 7 (4.4) days compared with 5.5 (3.7) days for the ascorbic acid group, 5.9 (4.9) days for the zinc gluconate group, and 5.5 (3.4) days for the group receiving both (overall P = .45). There was no significant difference in secondary outcomes among the treatment groups.

Conclusions and Relevance 
In this randomized clinical trial of ambulatory patients diagnosed with SARS-CoV-2 infection, treatment with high-dose zinc gluconate, ascorbic acid, or a combination of the 2 supplements did not significantly decrease the duration of symptoms compared with standard of care.

Trial Registration 
ClinicalTrials.gov Identifier: NCT04342728

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel strain of enveloped RNA virus that has emerged as a deadly virus resulting in an international pandemic. Common symptoms at the onset of disease mimic influenza and include fever, nonproductive cough, myalgia, and fatigue. ¹ The US Centers for Disease Control and Prevention (CDC) list of SARS-CoV-2 symptoms includes fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea.² In China, most patients (81%) with a confirmed diagnosis experienced only mild symptoms and did not require hospitalization or further care beyond supportive treatment.³ However, given the latency of the disease and prolonged incubation period, even patients who present with mild symptoms may progress to requiring hospitalization, prescription medication therapy, and mechanical ventilation and/or death.

Zinc gluconate and ascorbic acid are commonly available over-the-counter supplements that patients take for the treatment of viral illnesses. Zinc has been purported to increase polymorphonuclear cells’ ability to fight infection, and ascorbic acid is an antioxidant that may play a role in immune response. ^4,5 Limited evidence suggests that high doses of ascorbic acid and zinc gluconate may reduce duration of common cold symptoms and decrease the severity of symptoms.^6-9 However, the role of zinc gluconate and ascorbic acid in decreasing symptoms and improving recovery in patients diagnosed with SARS-CoV-2 infection is uncertain. The current study sought to determine whether zinc and/or ascorbic acid reduces the severity or duration of symptoms associated with SARS-CoV-2 compared with usual care.

The COVID A to Z study was a prospective randomized clinical open-label trial at multiple hospitals within a single health system, involving sites in Ohio and Florida. This study was approved by the Cleveland Clinic institutional review board and followed the Consolidated Standards of Reporting Trials (CONSORT) reporting guideline. All patients participating in the study provided written informed consent. Enrolled participants remained in their own home settings, and all study visits and/or procedures were conducted virtually, via telephone, email, computer, or laptop. The trial was designed to enroll approximately 520 adult patients diagnosed with SARS-CoV-2 infection with a polymerase chain reaction–based assay as outpatients who would likely remain in the outpatient setting for treatment. The full protocol of the study is available in Supplement 1.

Patients were included in the study if they had a new diagnosis in an outpatient setting and were aged 18 years or older. Women of childbearing potential had to confirm a menstrual period within the past 30 days or previous sterilization, and those who were perimenopausal required a negative pregnancy test. Women of childbearing potential were required to have a confirmed negative pregnancy test to be enrolled. Patients were excluded if they were hospitalized, resided outside of Ohio or Florida, were pregnant, were actively lactating, or had advanced chronic kidney disease, liver disease awaiting transplantation, or a history of calcium oxalate kidney stones. Race/ethnicity were self-reported. The patient flow diagram is shown in Figure 1.

Patients were randomized in a 1:1:1:1 allocation strategy to 1 of 4 treatment strategies with a treatment duration of 10 days after a positive diagnosis. The 4 treatment strategies were as follows: (1) 8000 mg of ascorbic acid (to be divided over 2-3 times per day with meals), (2) 50 mg of zinc gluconate at bedtime, (3) both therapies, or (4) usual care without any study medications. The randomization grid was designed via the REDCap database and based on 25% of anticipated enrolled patients in each of the 4 groups. An automatically created link in REDCap randomized the patient to the supplement group based on the randomization grid.

Patients were asked to track their systemic illness daily based on symptoms. Patients were also asked to complete a questionnaire at the beginning of the study and every week after until day 28 to assess whether they were hospitalized or experienced adverse effects from the supplements. For each symptom, the patients assigned a score of 0 to 3 (with 0 indicating no symptoms; 1, mild symptoms; 2, moderate symptoms; and 3, severe symptoms). In the original analysis plan, patients recorded a questionnaire with only 4 symptoms (ie, fever/chills, shortness of breath, cough, and fatigue) for scores ranging from 0 to 12. However, based on CDC guidelines, the study protocol was amended on July 16, 2020, and the symptom questionnaire was expanded to include a total of 12 symptoms (ie, fevers/chills, shortness of breath, cough, fatigue, muscle or body aches, headache, new loss of taste, new loss of smell, congestion or runny nose, nausea, vomiting, and diarrhea), creating a score ranging from 0 to 36.² The original 4-symptom scale was collected from all patients. The 12-symptom scale was only collected from patients enrolled after the July 16, 2020, amendment.

Patients were contacted by study coordinators weekly via email or daily via telephone to assess scores and hospitalizations, adverse effects, and additional medications. Patients seen in the emergency department (without an inpatient hospitalization) during the course of the study were asked to take study supplement(s) if the emergency department visit occurred within the initial 10 days of the study and to continue daily symptom assessments. Patients admitted to the hospital during the course of study were considered treatment failures and were no longer be required to continue study supplementation or track their daily symptoms.

The primary end point was the number of days required to reach a 50% reduction in symptom severity score from peak symptom score. This end point is reported for both the 4-symptom score available for all patients and the subset of patients for whom the 12-symptom score was available. Additional end points were the number of days required to reach a total symptom severity score of 0, cumulative severity score at day 5, hospitalizations, deaths, adjunctive prescribed medications, and adverse effects of the study supplements.

An operational and safety monitoring board (OSMB) within the Cleveland Clinic was established in April 2020 to provide safety monitoring and evaluate operational performance of all SARS-COV-2–related studies at the Cleveland Clinic. None of the OSMB members were involved in the conduct of the study. Due to slower than expected enrollment, an interim analysis was conducted at approximately 40% of expected enrollment (214 of 520 patients). Stopping for superiority would only be considered if any treatment group achieved P < .001 compared with placebo. Stopping for futility would be considered if the conditional power was less than 30% for any (or all) treatment groups compared with placebo.

We assumed that the usual care group would achieve a 50% reduction in symptom severity in a mean (SD) of 6 (3) days and that at least 1 of the other 3 study groups would achieve a 50% reduction in a mean (SD) of 5 (3) days. Assuming a sample size in each of the 4 groups of 130 patients, a 1-way analysis of variance would have 80% power (2-sided α of .05) to detect a difference in means of 1 day with a common SD of 3 days.

Patients were categorized as either meeting the primary end point or failing to meet the primary end point. Patients who died or were hospitalized during the study were counted as treatment failures. The primary end point was defined as the number of days from the time of peak symptom score to a 50% resolution in those achieving a 50% reduction within the study time frame. Patients who were asymptomatic at baseline were classified as missing when calculating the days to a 50% reduction in symptom score. In a sensitivity analysis, the number of days to reach a 50% reduction was set to 28 days for patients considered treatment failures. The original analysis plan was to evaluate all pairwise treatment comparisons with adjustment for multiple comparisons using the Tukey method. Because the study was stopped early for futility, the overall F-test P value from an analysis of variance is reported for all end points, summarizing number of days to 50% reduction. Nominal P values from the χ² statistic are reported for categorical variables. Kaplan-Meier curves were created comparing the primary end point among the 4 treatments. The Kaplan Meier plot and P value from the log-rank test of the null hypothesis of no difference between the 4 survival curves were made using the survminer package in R version 3.6.1 (R Project for Statistical Computing). Statistical significance was set at P < .05, and all tests were 2-tailed.

The OSMB met on October 23, 2020, and recommended stopping the study for futility. The futility criteria was met for the 3 active treatment groups compared with the usual care group. Data on the 214 patients enrolled at the time of study termination are the final data for this study.

A total of 214 patients were enrolled and randomized from April 27, 2020, to October 14, 2020. Of the 214 patients, 50 (23.4%) were randomized to usual care, 48 (22.4%) were randomized to ascorbic acid only, 58 (27.1%) were randomized to zinc gluconate only, and 58 (27.1%) to both supplements. Baseline characteristics of study participants are reported in Table 1. The mean (SD) age of study participants was 45.2 (14.6) years. There were 132 (61.7%) women in the study and 68 people (31.8%) reported currently or formerly smoking. At least one-quarter of participants used vitamins and minerals previously (56 [26.2%]). The mean (SD) symptom composite score (of 12 possible points) at baseline was 4.3 (1.9) points and was similar across treatment groups (Figure 2). In the subset of patients with a 12-symptom score (36 possible points) the mean (SD) was 11.6 (5.6) points.

There was no significant difference in the primary outcome of days required to reach a 50% reduction in symptoms among the 4 study groups. Patients who received usual care without supplementation achieved a 50% reduction in symptoms in a mean (SD) of 6.7 (4.4) days compared with a mean (SD) of 5.5 (3.7) days for patients receiving ascorbic acid, a mean (SD) of 5.9 (4.9) days for patients receiving zinc gluconate, and a mean (SD) of 5.5 (3.4) days for patients receiving both ascorbic acid and zinc gluconate supplementation (overall P value = 0.45; log-rank P = .25) (Figure 3).

There was no significant difference in any of the secondary outcomes, including number of days to reach no presence of fever, cough, shortness of breath, or fatigue. The mean (SD) composite 4-symptom score at day 5 was 3.2 (2.2) points and did not differ among the 4 study groups. A total of 17 patients (7.9%) were hospitalized before the 28-day study period ended, and 3 patients (1.4%) died after enrollment in the study (Table 2). However, both the number of hospitalizations and deaths did not significantly vary among the 4 treatment groups. Less than 3% of the population had medications added to treat coronavirus disease 2019 (COVID-19)–related symptoms, and less than 10% of the population experienced an adverse effect related to the supplement, with slightly more adverse effects, including nausea, diarrhea, and stomach cramps, in the group receiving ascorbic acid only (eTable in Supplement 2).

The data safety monitoring board noted 4 serious adverse events, including 3 patients who died from COVID-19 and another patient who was admitted to the hospital for a chronic obstructive pulmonary disease exacerbation during the study period. The board did not believe that any of the adverse events were caused by individual treatments that patients received as a part of the study.

The COVID A to Z study was designed to examine whether patients treated with zinc gluconate, ascorbic acid, or a combination of both treatments would experience a shortened duration of symptoms associated with SARS-CoV-2 compared with usual care. A significantly faster reduction in symptoms was not observed in any of the active treatment groups vs usual care. Based on an interim analysis, the study was stopped for futility.

The data about oral ascorbic acid and zinc are inconsistent, with some trials suggesting that high doses of ascorbic acid and zinc gluconate may reduce the duration of common cold symptoms and decrease the severity of symptoms, while other studies have shown no benefit.^6-9 The data for intravenous ascorbic acid is also variable, with a meta-analysis review that investigated the role of ascorbic acid in critically ill patients¹⁰ showing no significant association with mortality but variable associations with secondary end points, including duration of ventilator support and hospital length of stay. Ongoing clinical trials in China and the United States are investigating the potential role of intravenous ascorbic acid in reducing respiratory failure requiring mechanical ventilation in patients with SARS-CoV-2. In addition, ascorbic acid, zinc, and vitamin D are being studied for the prevention of SARS-CoV-2 infection. What is unknown is whether ascorbic acid and zinc gluconate can shorten the duration or prevent progression of the disease.

In terms of biologic plausibility, zinc is known to play a role in immune function via antibody and white blood cell production.⁴ Zinc supplementation has been suggested to increase polymorphonuclear cells’ ability to fight infection, while there is evidence that zinc deficiency increases pro-inflammatory cytokines and decreases the production of antibodies. Zinc has also been implicated in coronavirus biology.¹¹ Angiotensin-converting enzyme 2 is a zinc metalloprotease that is important for cellular entry of coronavirus.¹² In addition, studies on SARS, a coronavirus, have shown that zinc can inhibit its ribonucleic acid polymerase.¹¹ However, the biologic activity of zinc against viruses may require ionophores, such as pyrithione, to block viral replication.¹³ Ascorbic acid is known to be an antioxidant, and a variety of studies have suggested that it can affect the immune system.¹⁴ Moreover, in vitro and in vivo studies in avians have shown that ascorbic acid could be protective against coronavirus, and human trials have found that it may decrease susceptibility to viral respiratory infections and pneumonia.¹⁵

However, based on the current study, these supplements cannot be recommended to reduce symptom morbidity in such patients. High-dose zinc gluconate, ascorbic acid, or both supplements did not reduce SARS-CoV-2 symptoms. Most consumers of ascorbic acid and zinc are taking significantly lower doses of these supplements, so demonstrating that even high-dose ascorbic acid and zinc had no benefit suggests clear lack of efficacy. In addition, administering supplements with unproven benefit can be detrimental due to adverse effects. Zinc has been shown to cause a metallic taste, dry mouth, and gastrointestinal intolerance in high doses.¹⁶ Ascorbic acid can cause gastrointestinal intolerance, and in the current study, a significantly higher proportion of patients in the ascorbic acid subgroups reported adverse effects, including nausea, diarrhea, and stomach cramps.

Strengths and Limitations

There are several strengths and limitations that should be acknowledged. A major strength is the pragmatic design of the study and its novel primary end point, which was based on a symptom assessment questionnaire (time to reduction in symptom score by 50%). A major limitation was that there was no placebo control group; the current study was open label, and patients were not masked to which therapy they received. Patients were recruited in a single health system, and therefore, the outcomes in our health system may not represent the outcomes of patients in other health care settings. However, it should be acknowledged that patients were recruited from multiple outpatient facilities in Ohio and Florida. It is possible that certain groups with higher susceptibility (eg, older patients and patients from minority racial/ethnic groups) were underrepresented in the current study and the results may not be broadly generalizable. Also, stratification of symptoms by age, sex, race, or duration of symptoms prior to testing were not taken into consideration in the current analysis. Furthermore, the doses of zinc and ascorbic acid, while well tolerated, could be lower than amounts needed to shorten the duration of symptoms, and patients could have previously taken supplements such as zinc and ascorbic acid before enrolling in the study. Recent studies have also demonstrated that vitamin D deficiency is associated with increased risk of SARS-CoV-2 infection and an increased risk of hospitalization,¹⁷ so the potential role of other supplements in decreasing SARS-CoV-2 symptoms cannot be concluded from our study. Randomized trials are currently being performed to answer whether vitamin D supplementation can benefit patients diagnosed with SARS-CoV-2.

In this randomized clinical trial, ambulatory patients diagnosed with SARS-CoV-2, treatment were treated with high doses of zinc gluconate, ascorbic acid, or a combination of zinc gluconate and ascorbic acid. These interventions did not significantly shorten the duration of symptoms associated with the virus compared with usual care.

Accepted for Publication: January 9, 2021.

Published: February 12, 2021. doi:10.1001/jamanetworkopen.2021.0369

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Thomas S et al. JAMA Network Open.

Corresponding Author: Milind Y. Desai, MD, MBA, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Ave, Desk J1-5, Cleveland, OH 44195 ([email protected]).

Author Contributions: Dr Desai had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Thomas, Patel, Bittel, Kumar, Mehra, McWilliams, Nissen, Desai.

Acquisition, analysis, or interpretation of data: Thomas, Patel, Bittel, Wolski, Wang, Kumar, Il’Giovine, Mehra, Nissen, Desai.

Drafting of the manuscript: Thomas, Patel, Bittel, Kumar, Il’Giovine, Mehra, Desai.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Wolski, Wang, Kumar, Desai.

Obtained funding: Thomas, Kumar, Desai.

Administrative, technical, or material support: Thomas, Bittel, Kumar, Nissen, Desai.

Supervision: Thomas, Bittel, Kumar, Il’Giovine, Nissen, Desai.

Conflict of Interest Disclosures: Dr McWilliams reported receiving consulting fees from Gilead Sciences outside the submitted work. Dr Desai reported receiving grants from Myokardia outside the submitted work and being supported by the Haslam Family Endowed Chair in Cardiovascular Medicine. No other disclosures were reported.

Data Sharing Statement: See Supplement 3.

Additional Contributions: Serpil Erzurum, MD, James Young, MD, Daniel Culver, MD, Joan Booth, RN, Nancy Obuchowski, MPH, and John Petrich, RPh (Cleveland Clinic), were members of the operational and safety monitoring board. They were not compensated for their time. We would like to thank Samantha Xu, BS (Cleveland Clinic), for help with logistics of study set-up and coordination. She was compensated for her time.

3.Wu
 Z, McGoogan
 JM.  Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention.   JAMA. 2020;323(13):1239-1242. doi:10.1001/jama.2020.2648PubMedGoogle ScholarCrossref 9.Hemilä
 H.  Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage.   JRSM Open. 2017;8(5):2054270417694291. doi:10.1177/2054270417694291PubMedGoogle Scholar11.te Velthuis
 AJ, van den Worm
 SH, Sims
 AC, Baric
 RS, Snijder
 EJ, van Hemert
 MJ.  Zn(2+) inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture.   PLoS Pathog. 2010;6(11):e1001176. doi:10.1371/journal.ppat.1001176PubMedGoogle Scholar13.Krenn
 BM, Gaudernak
 E, Holzer
 B, Lanke
 K, Van Kuppeveld
 FJ, Seipelt
 J.  Antiviral activity of the zinc ionophores pyrithione and hinokitiol against picornavirus infections.   J Virol. 2009;83(1):58-64. doi:10.1128/JVI.01543-08PubMedGoogle ScholarCrossref 16.Weismann
 K, Jakobsen
 JP, Weismann
 JE,
 et al.  Zinc gluconate lozenges for common cold: a double-blind clinical trial.   Dan Med Bull. 1990;37(3):279-281.PubMedGoogle Scholar17.Meltzer
 DO, Best
 TJ, Zhang
 H, Vokes
 T, Arora
 V, Solway
 J.  Association of vitamin D status and other clinical characteristics with COVID-19 test results.   JAMA Netw Open. 2020;3(9):e2019722. doi:10.1001/jamanetworkopen.2020.19722PubMedGoogle Scholar

Possible Interactions with: Vitamin C (Ascorbic Acid) | Complementary and Alternative Medicine

If you are being treated with any of the following medications, you should not use vitamin C supplements without first talking to your health care provider.

Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs)
— Both aspirin and NSAIDs can lower the amount of vitamin C in the body because they cause more of the vitamin to be lost in urine. In addition, high doses of vitamin C can cause more of these drugs to stay in the body, raising the levels in your blood. Some very early research suggests that vitamin C might help protect against stomach upset that aspirin and NSAIDs can cause. If you regularly take aspirin or NSAIDs, talk to your doctor before taking more than the recommended daily allowance of vitamin C.

Acetaminophen (Tylenol)
— High doses of vitamin C may lower the amount of acetaminophen passed in urine, which could cause the levels of this drug in your blood to rise.

Aluminum-containing antacids
— Vitamin C can increase the amount of aluminum your body absorbs, which could cause the side effects of these medications to be worse. Aluminum-containing antacids include Maalox and Gaviscon.

Barbiturates
— Barbiturates may decrease the effects of vitamin C. These drugs include phenobarbital (Luminal), pentobarbital (Nembutal), and seconobarbital (Seconal).

Chemotherapy drugs
— As an antioxidant, vitamin C may interfere with the effects of some drugs taken for chemotherapy; however, some researchers speculate that vitamin C might help make chemotherapy more effective. If you are undergoing chemotherapy, do not take vitamin C or any other supplement without talking to your oncologist.

Nitrate medications for heart disease
— The combination of vitamin C with nitroglycerin, isosorbide dinitrate (Isordil), or isosorbide mononitrate (Ismo) reduces the body’s tendency to build up a tolerance to these medications so that they no longer work. If you take nitrate medications, talk to your doctor about whether you should take vitamin C.

Oral contraceptives (birth control pills) and hormone replacement therapy (HRT)
— Vitamin C can cause a rise in estrogen levels when taken with these drugs, particularly if you are deficient in vitamin C to begin with and start taking supplements. Oral estrogens can also decrease the effects of vitamin C in the body.

Protease inhibitors
— Vitamin C appears to slightly lower levels of indinavir (Crixivan), a medication used to treat HIV and AIDS.

Tetracycline —
Some evidence suggests that taking vitamin C with the antibiotic tetracycline may increase the levels of this medication; it may also decrease the effects of vitamin C in the body. Other antibiotics in the same family include minocycline (Minocin) and doxycycline (Vibramycin).

Warfarin (Coumadin)
— There have been rare reports of vitamin C interfering with the effectiveness of this blood thinning medication. In recent follow-up studies, no effect was found with doses of vitamin C up to 1,000 mg per day. However, if you take warfarin or another blood thinner, talk to your doctor before taking vitamin C or any other supplement.

Coronavirus 2019 (COVID-19)- Using Ascorbic Acid and Zinc Supplementation – Full Text View

We aim to see whether ascorbic acid and zinc gluconate which has limited side effect profile and is readily available over the counter can decrease the duration of symptoms seen in patients with new diagnosis of COVID-2019. A secondary purpose is to see whether Zinc and/or Ascorbic acid supplementation can prevent progression of the severe manifestations of the disease including development of dyspnea and acute respiratory distress syndrome which may require hospitalization, mechanical ventilation, and or lead to death.

This is a single-center, prospective, randomized study which plans to enroll 520 patients with a principal diagnosis of COVID-2019, managed in an outpatient setting, who presented after being sent by a healthcare provider to get tested and receive a PCR (Polymerase Chain Reaction) -assay based confirmed diagnosis of the disease. All patients who agree to participate in the study will answer a baseline questionnaire about their symptoms at the time of inclusion. Patients will then be randomized to one of 4 study arms. Patients in Arm A (n=130) will receive vitamin C (to be taken divided over 2-3 times a day with meals), patients in Arm B (n=130) will receive zinc gluconate to be taken at bedtime, patients in Arm C (n=130) will receive both vitamin C (to be taken divided over 2-3 times a day with meals) and zinc gluconate (taken at bedtime). Patients in arms A, B and C will take study supplements daily for 10 days. Patients in Arm D (n=130) will not receive any of the study medications and continue on standard of care. Patients will then track their symptoms daily from day 0 to day 28 answering 12 basic questions on illness severity.They will stop filling out their daily questions once they reach reach the end of the 28 day study period or at time of hospitalization; whichever comes first . Study team members will call patients at days 7, 14, 21, and 28 of the study period to assess need for hospitalization, ER visit, or additional medications prescribed by a healthcare provider, and any side effects from the supplements that the patient could have experienced.

Can You Overdose on Vitamins? Symptoms to Look For

We’ve all heard the saying, “Too much of a good thing is bad for you.” But what about when it comes to vitamins? Can you ever really overdo them?

“Yes, absolutely,” said Dawn Gerber, PharmD, a clinical ambulatory pharmacy specialist with Banner Health. “Basically, there are two types of vitamins: water-soluble and fat-soluble. Although your body can excrete large amounts of water-soluble vitamins, it holds onto fat-soluble vitamins, which can be toxic at high levels.”

Water-soluble vitamins, like vitamin C and B-complex, are carried to the body’s tissues and aren’t stored in your body. Fat-soluble vitamins, like A, D, E and K, are absorbed along with fats in your diet and are stored in your body’s fatty tissue and in the liver.

“These get caught in our fat, the non-muscular parts of our bodies,” Dr. Gerber said. “The more supplements we take at high doses, the more that accumulates and isn’t flushed out.”

While it’s hard to overdose just eating these vitamins naturally with a well-balanced diet, vitamin supplements can have negative ramifications.

Here’s what you need to know to avoid overdoing it in the supplement department.

Watch out for these fat-soluble vitamins: A, E and K

Here are details about vitamins A, E and K and the symptoms of overdose to look out for.

Vitamin A is a fat-soluble nutrient that is naturally present in many foods, like beef, eggs and many fruits and vegetables. An overdose of this vitamin can lead to problems with confusion, hair loss, liver damage and bone loss. It can also cause an increased risk for death and lung-associated issues for those who have a history of smoking—particularly female smokers.

Vitamin E is a fat-soluble nutrient found naturally in foods and added to some fortified foods that can help protect cells from damage caused by free radicals, such as air pollution. But taking too much of this supplement can increase your risk for bleeding and bleeding in the brain.

Vitamin K is a fat-soluble nutrient that’s important for blood clotting, healthy bones and other bodily functions. It’s rare that you’ll overdose on vitamin K by eating things like broccoli. But in supplement form, it can induce blood clots, which can lead to heart attacks and strokes, if you take too much.

What about vitamin D?

You may have noticed we left vitamin D off this fat-soluble list, and there is a good reason (or two for that). “The reason for this is that we don’t typically see overdose with vitamin D as much,” Dr. Gerber said. “The data hasn’t shown detrimental effects of high doses. In addition to this, many Americans are actually deficient in the vitamin as well.”

Don’t overdo vitamin C and zinc either

With cold season, flu season and the COVID-19 pandemic, many people load up on vitamin C and zinc thinking they can fight off—and even prevent illnesses. But the verdict is still out on their potential benefits—especially when it comes to COVID-19.

“Vitamin C is especially hot right now with COVID-19,” Dr. Gerber said. “There’s currently no strong data that shows vitamin C and zinc help with cold viruses. And the verdict is still out on COVID-19, mostly because it hasn’t been around long enough to know.”

Overdose symptoms for vitamin C and zinc

Vitamin C is generally safe, but in large doses (anything over 2,000mg), it can cause diarrhea and nausea. High doses can also result in falsely elevated blood glucose readings, which can be problematic for diabetics. Low blood glucose can cause them to feel shaky, sweaty and can even lead to seizure or a loss of consciousness. “Diabetics use their home glucose monitor and their glucose level looks fine, but the high dose of vitamin C is masking the real low blood glucose reading,” Dr. Gerber said.

Oral zinc can also cause gastrointestinal problems and a host of other problems if taken long-term, especially in high doses (anything over 40mg). High levels of zinc can cause a copper deficiency, taste disturbances, hematologic and neurological effects and may interact with some medications and antibiotics.

“For example, if you’re taking zinc with an antibiotic, you won’t get 100% of the benefit of the antibiotic,” Dr. Gerber said. “That’s because zinc can bind itself to the antibiotic and weaken the medication’s effectiveness. This can be very frustrating for patients who don’t understand why they aren’t getting better.”

Before you pop a vitamin or supplement, contact your doctor

While you might feel like you are low in this or that, don’t go with your gut. You may actually be deficient in something else completely.

Schedule an appointment with your primary care doctor to assess your overall health and if you may be lacking in certain vitamins. As a general tip: It’s important to check in at least once a year with your doctor. Your doctor may recommend certain over-the-counter supplements or suggest simple diet adjustments that can help get you back on track.

You’ll also want to talk to your doctor or a pharmacist to see if any vitamins interact with any medications you are taking.

“When it comes to taking any medications, pharmacists and doctors consider, ‘Is this the right drug for the right patient for the right issue?’ and the same holds true with vitamins,” Dr. Gerber said. “You want to make sure the vitamins you are taking are necessary and right for you.”

To find a Banner Health specialist near you, contact bannerhealth.com.

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HOW VITAMIN C, VITAMIN D, AND ZINC CAN STRENGTHEN YOUR IMMUNE SYSTEM – Doctor’s Nutrition

Research has shown that daily doses of vitamin C, vitamin D-3 and Zinc offer significant boosts to the immune system. Zinc is also an essential mineral to the thymus gland, which orchestrates the immune function in the human body.

This is why Hospitals Are Now Using Mega-Doses Of Vitamin C To Help COVID-19 Patients

We’ve reached a point where the COVID-19 epidemic has become very serious in the United States. The U.S. currently has the most confirmed cases out of any country in the world. And New York has been particularly hard hit.

New York City hospitals are being flooded with very sick people, and they’re having a hard time keeping up. Unfortunately, that means more people are dying.

Of course, New York medical staff is doing everything they can to keep people alive. And that includes one tactic that may surprise a lot of people — they’re giving mega-doses of vitamin C to people who are seriously ill with COVID-19.

You’ve probably heard in the past that vitamin C can support a healthy immune system. It’s why so many people take vitamin C supplements when they feel like they’re coming down with a cold or flu.

But there’s still a lot of conjecture about whether vitamin C works for things like colds and flu, let alone something as serious as COVID-19. So, what’s prompting NYC doctors to use it during this major crisis? Promising reports from China, that’s what.

Here’s what they found.

Vitamin C Helps With Corona-virus-Related Sepsis

Scientists at Zhongnan Hospital in Wuhan, China, have started a clinical trial to see if vitamin C can improve outcomes for people with COVID-19. They believe that when the testing is done, they may be able to prove that vitamin C reduces the lung inflammation caused by the disease.

There are at least two other clinical trials on vitamin C and COVID-19 underway in China too. And the Shanghai Medical Association released official guidelines in early March in which experts endorsed high dose intravenous vitamin C to treat COVID-19.

Promising reports from these efforts have inspired doctors at Northwell Health hospitals in New York to incorporate vitamin C into the treatment regimen for some patients right away.

Dr. Andrew G. Weber, a pulmonologist and critical-care specialist affiliated with two Northwell Health facilities on Long Island, is giving COVID-19 ICU patients under his care 1,500 milligrams of intravenous vitamin C immediately upon being admitted. These patients then continue to receive this same dosage three to four times per day. And he’s not the only doctor in the Northwell Health hospital system using vitamin C for COVID-19 patients.

Northwell Health has 23 hospitals, and a spokesperson for the hospital system said that vitamin C was being “widely used” (although, it’s not used for every COVID-19 patient). Besides vitamin C, doctors are using the anti-malaria drug hydroxychloroquine, the antibiotic azithromycin, Zinc, and a variety of biological drugs to fight COVID-19. But at this point, all the treatments doctors are using are somewhat experimental since we don’t have substantial evidence for what helps with this virus yet.

In addition to the fact that promising reports are coming from China, Dr. Weber says he’s using vitamin C because it may be able to help patients get through sepsis, an inflammatory response that happens when your body overreacts to an infection. Sepsis is what’s killing many COVID-19 patients.

According to Weber, when COVID-19 patients develop sepsis, their vitamin C levels plummet. And he believes maintaining high vitamin C levels may be able to help them.

Previous studies on sepsis and vitamin C show that Weber may be right. One 2019 study found that intravenous vitamin C reduced the risk of death in sepsis patients by 16 percent within 28 days. It also helped people get out of the Intensive Care Unit three days earlier and go home from the hospital a week earlier.

However, vitamin C is just one piece of a larger puzzle that supports a healthy immune system. When talking about strengthening your immune system, we also have to consider including both Vitamin D and Zinc.

Your body needs Zinc to create infection-fighting white blood cells known as T-cells (t-lymphocytes). That may be why research shows that children and older adults who are deficient in Zinc are more at risk for pneumonia and other infections.

But what about viruses? And most importantly, what about the novel corona-viruses?

There is scientific evidence that Zinc can stop the spread of viruses. A 2010 study found that increasing the amount of Zinc available in cells can prevent viruses, including corona-virus, from replicating and multiplying in your throat and nasopharynx.

There’s also evidence that Zinc can help with the common cold. In some cases, the common cold is caused by a corona-virus, in other cases, a rhinovirus. Zinc can shorten the length of colds caused by rhinovirus and can improve cold symptoms like congestion, nasal drainage, sore throats, and coughs.

Here are some essential thoughts on the zinc dosage.

In the case of colds, research shows taking 75 mg of Zinc within the first 24 hours of cold symptoms does reduce symptoms. But be warned, taking too much Zinc could make your immunity worse rather than better. Taking more than 150 mg of Zinc per day can cause zinc toxicity. And do you know one of the side effects of zinc toxicity? Reduced immune function. So, it’s a fine antiviral line you’re walking with Zinc.

And last but not least, Vitamin D. Vitamin D3 is a hormone. Long suppressed by the medical establishment, it is now reluctantly embraced. More and more studies by mainstream medical publications are showing vitamin D3’s benefits in suppressing a host of infections. A study published by the National Institutes of Health in PubMed in 2012 stated, “vitamin D is a key factor linking innate and adaptive immunity, and both of these functions may be compromised under conditions of vitamin D insufficiency.”

One of the best ways to boost your vitamin D levels naturally is with sunshine. Foods like beef liver, cheese, egg yolks, and fatty fish also add vitamin D to your diet. Cod liver oil is a time-honored source as well.

To get Vitamin C, Vitamin D3, and Zinc you need to strengthen your immune system, call Doctor’s Nutrition today at 228-897-0070.

1. New York hospitals treating coronavirus patients with vitamin C — New York Post
2. Hospitals turn to high-dose vitamin C to fight coronavirus — Nutraingredients
3. New York Hospitals are Using Vitamin C to Treat Some Coronavirus Patients — Newsweek
4. New study links vitamin C therapy to better survival rates after sepsis — MedicaXpress
5. Can Zinc Lozenges Ward Off Coronavirus? What Doctors Say — MedicineNet

90,000 🧬 To drink or not to drink: how to choose vitamins correctly?

Why is “sunny” vitamin D needed not only in winter, is it worth trusting multivitamins, how to choose omega-3, what threatens the lack of iodine in the body and how to support a “losing weight” body on a diet? GMS Clinic endocrinologist Olga Ignatova gave an interview for Posta Magazine.

The important effect of vitamins on our body is discussed everywhere. Often, data on miracle effects are either far-fetched, or taken from small studies or from interesting clinical cases.There is a lot of talk now about the role of vitamins C and D in cancer treatment, for example. But a competent doctor in his recommendations usually focuses on the principles of evidence-based medicine, on international recommendations in this area, and this position, of course, is distinguished by a more relaxed attitude towards the benefits of vitamins. Benefits – and proven ones – are undoubtedly there. But, firstly, no sensations, and secondly, vitamins must be taken wisely and regularly. At present, people eat quite well and regularly eat, therefore, vitamin deficiencies and polyavitaminosis are practically not found, but hypovitaminosis – a lack of a certain vitamin – is quite common.It is for this reason that, in my opinion, you should not use multivitamins: not all 15-30 vitamins from this jar really need us, there is no exact understanding of which of them and in what volumes are absorbed by your body. An ordinary person, if he does not suffer from severe gastroenterological diseases and does not have, for example, malabsorption syndrome or underwent stomach surgery, simply does not need such a complex of vitamins.

Russians tend to be deficient in certain vitamins and minerals: for example, people on strict diets and vegetarians are prone to deficiencies in iron, B12, magnesium, essential amino acids and often suffer from hair loss, weakness, anemia, and leg muscle cramps.

Men are more often characterized by a deficiency of B vitamins (insufficient intake of whole grains, cereals, alcohol abuse). Since they prefer meat and hardly eat fruits and vegetables, vegetable fats, nuts and fish, they lack polyunsaturated fatty acids (omega-3), which is useful for fiber digestion. Plus, due to insufficient consumption of dairy products, the diet is poor in calcium and prebiotics. Many people suffer from a lack of polyunsaturated fatty acids, since there is no good quality fish in our area – both because of its high cost and because of low-quality products: fish grown on farms does not eat as it should.Well, few of us constantly eat, for example, olive oil or nuts.

Well, for sure everyone suffers from seasonal vitamin D deficiency.

What to drink: iodine

First of all, as an endocrinologist, I must say about iodine deficiency. Our country belongs to a region with an average and moderate deficiency of iodine in the soil. In many other countries, with the same peculiarity, mandatory iodization of salt in production has been introduced once and for all, and the inhabitants of the country, buying, for example, bread, receive with it the iodine necessary for the body.In our country, compulsory iodization was mistakenly canceled back in the 80s, and until now, despite the efforts of the country’s leading endocrinologists, this problem has not been resolved.

What is iodine for? It is important in the development of the fetus in the womb, for the development of the nervous system and the formation of the capabilities of the child’s brain.

According to a study conducted in the 2000s, the IQ level of schoolchildren at that time was already 20% lower than in the 80s and 90s.

How to drink

Children under 3 years old – preparations of potassium iodide in tablets of 100 micrograms per day, you can dissolve in water, you can buy baby lozenges with iodine, absorbable in the mouth.Also, iodine should be drunk by pregnant women and adolescents from the age of 15, when the thyroid gland is actively growing. However, thoughtlessly “eating iodine” is not worth it: just drinking it in adulthood is useless, and after 45 it is also risky because of the wide spread of nodular goiter in the category of people 45+.

What to drink: vitamin D

In Russia, due to its geographical location, there is a total shortage of vitamin D among the population. Moreover, from Vladivostok to Sochi. Even the Sochi kids, all summer “bathing” in the sun, need nourishment by October.Vitamin D deficiency even in Spain is experienced by office workers living in the “office-car-home” mode! So for our country, vitamin D is definitely a year-round history. Last December, the sun shone brightly for a total of only 6 minutes! Remember this.

Moreover, the deficit is observed in people of all ages. There is a real “boom” on vitamin D, there is a lot of research, but we will only talk about the proven effects. There are three of them:

• Influence on the formation of bones in a child.Prevention of osteoporosis in adults.
• Enhancing immunity by acting on the cells of the immune system – that is why it is used in the complex treatment of fungal and viral diseases.
• Vitamin D does not increase the risk of cancer, unlike group B, and there is quite authoritative research showing that it even reduces the risk of cancer.

In addition, vitamin D has a positive effect on reproductive function in men, helping to increase the male hormone testosterone, and in women, including stimulating the renewal of hair follicles and improving the composition of the stratum corneum and softening it.Therefore, it is used in the complex treatment of atopic dermatitis and psoriasis.

How to drink

Vitamin D does not have to be taken every day. For example, if you sprayed your throat with lugol (this is the annual rate of iodine), the body will take only the daily rate, and remove the rest. But for vitamin D, we have a depot, as, for example, for iron. Can be taken once a week, once a month, or even once every six months – in reserve. The easiest way to determine the required dose is to take a blood test for vitamin D content (now the cost of analysis is becoming more affordable).If this is not possible, then focus on the average safe rate: children – 500 IU per day, adults – 800-1000 IU, women in menopause – 1000-1500. The effect is visible immediately: you feel cheerfulness, children get sick half as much, it is easier to get up in the morning. The main thing is to understand that you can only prescribe this inactive vitamin colecalceferrol D3 to yourself, which the body will store and will “activate” as needed. The active form of the vitamin alfacalcidol is prescribed by doctors and only for certain indications, for example, for kidney problems.In this case, the entire dose that has entered the body will “work” immediately.

Vitamin D: a look into the future

Research continues, the results are favorable: Presumably, in obese people, vitamin D regulates fat metabolism and helps to lose weight. According to many reports, it can also help lower blood sugar levels in diabetics. Another line of research is the effects of vitamin D on nerve tissue, which may help us advance in the treatment of neuropathic pain.There is interesting research on preventing depression. Plus, if proven to be effective, vitamin D can make life easier for the elderly, who, due to muscle weakness and dizziness, often have falls and fractures, and it is in the elderly that they often end in death. A person broke his leg, went to bed and does not get up anymore, because a lot of problems appear from a lying lifestyle at this age, for example, stagnation in the lungs and pneumonia. All of these points have not yet been included in serious “guidelines for action” for doctors, but these studies have definitely gone beyond the student framework.

What to drink: omega-3

Omega-3 is an anti-aging godsend, but, as with vitamin D, it should be taken not only by those who care about extra wrinkles. We are not inhabitants of a happy Mediterranean, we do not have the necessary quality of fish, and prevention of cardiovascular diseases is important to all of us. Omega-3 contains docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which the body uses to regulate fat metabolism, but does not produce itself.It is a strong defense against atherosclerosis, which turns our blood vessels into rusty tubes clogged with cholesterol plaques. Omega-3 is important in the prevention of dementia, as it helps to regulate the plasticity of brain tissue. There is no medical evidence yet, but omega-3 is also credited with the ability to restore telomeres in DNA molecules, which become shorter with age, leading to the aging of the body itself: presumably, omega-3 completes the DNA strands and thereby raises immunity.

How to drink

An important note: you need to drink exactly omega-3, and not omega-6 and -9, as they tend to cause inflammation in the body. The content of DHA and EPA should be at least 200-300 mg. Children drink 1000 mg per day, adults – 2000. More is needed only if, for example, a couple is preparing for IVF. But here, of course, a doctor’s consultation is required.

What to drink: vitamin C

There is a lot of data about vitamin C, but they are all contradictory.For a long time it was believed that it is indispensable in the fight against influenza, that it fights viruses, restores cells, and is able to fight cancer. But today, major meta-analyzes are challenging all of these claims. Much has not been proven, use in oncology is important if we are not talking about vitamins, but about intravenous administration of large doses of the drug, about 100-200 times higher than usual. Perhaps the only industry where the effect of vitamin C has been proven is cosmetology: it improves collagen synthesis.But in the fight against influenza, according to the latest scientific data, it is much more effective to use vitamin D. And this is not limited to its benefits.

How to drink

Drink 200 mg for anti-aging effect. For the same purpose, you can drink alpha lipoic acid – this is the most powerful antioxidant with a proven effect.

What to drink: calcium

It is recommended to drink calcium for the elderly, especially if a person does not regularly eat dairy products.

How to drink

Irina Miroshnichenko in advertising informed us that it is important to take calcium, but she did not warn that it is not absorbed without a sufficient dose of vitamin D. If vitamin D is enough, then 3 regular servings of dairy products per day – for example, a glass of milk in porridge, 30 g cheese or a jar of yogurt for an afternoon snack and kefir for the night – they will easily replenish the norm of calcium without vitamins, but if there is a deficiency, then calcium will not be absorbed, and the body will begin to destroy bones in order to get calcium from there – this is how calcium deposits appear in the body : this is our internal calcium.

Also, older people are advised to drink potassium and magnesium – a lack of them causes cramps and heart problems.

Source: posta-magazine.ru

Doctors warned about the dangers of vitamin C and zinc in COVID-19

Vitamin C and zinc are useless in COVID-19 despite the popularity of these supplements, American doctors warn. Moreover, long-term use of them in high doses only leads to additional health problems – nausea, diarrhea and heartburn.

Vitamin C and zinc supplements are popular as a means to alleviate symptoms of respiratory diseases, including COVID-19. Vitamin C, as an antioxidant, is thought to play a role in the immune response, while zinc helps white blood cells fight infection. However, as doctors at the Cleveland Clinic in the United States have found out, this opinion is erroneous. Their research was published in JAMA Network Open journal .

It was attended by 214 adults treated for COVID-19 at home.Scientists divided them into four groups, one of which received daily high doses of vitamin C (8,000 mg per day), the second – zinc gluconate (50 mg before bed), the third – both supplements. The fourth group did not use supplements at all. For a month, patients monitored their condition, noting the symptoms and their severity.

It turned out that neither zinc, nor vitamin C, nor their combined intake in any way improves the condition of patients and does not contribute to the relief of symptoms.

Also, there was no difference in the number of hospitalizations and deaths in the groups.Moreover, in the supplement groups, some of the participants additionally suffered from the side effects of high dosage supplements – nausea, diarrhea, heartburn, dry mouth, stomach pain, etc.

“Unfortunately, these supplements did not live up to the hype around them,” says Dr. Erin Mikos. from Johns Hopkins University.

“Based on the results of the current study, these supplements cannot be recommended to combat the symptoms of COVID-19,” the researchers conclude.-

Most people take these supplements at significantly lower dosages, so the demonstration that even high dosages of ascorbic acid and zinc do not provide any benefit indicates a clear lack of effectiveness.

Vitamin C and zinc supplementation appears to be undesirable for other respiratory conditions. Although zinc deficiency results in increased cytokine levels and decreased antibody production, taking it in high doses during a cold can 90,089 shorten 90,090 by just a day.Vitamin C, although considered a powerful preventive measure, does not appear to reduce the 90,090 risk of colds at 90,089 (some studies, however, show an 8% reduction in risk in adults and 14% in children). If a person has already become infected, vitamin C will not help him in any way.

At the same time, an excess of vitamin C inhibits the activity of the pancreas, promotes thrombus formation and the formation of kidney stones, as well as tumor growth. Too much zinc concentration over a long period of time leads to a drop in copper levels in the body, a decrease in the level of “good” cholesterol and a deterioration in immunity.

However, research groups do not give up hope – in China and the United States, experts are studying the role of ascorbic acid, administered intravenously, in the fight against respiratory failure. The role of vitamin C, vitamin D and zinc as prophylactic agents against COVID-19 is also being explored. But the existing evidence so far suggests that relying on such supplements for the treatment of diseases is not worth it.

However, a lack of vitamin D in the body during COVID-19 can indeed be dangerous, warn doctors from Imperial College London.

They found a strong correlation between the severity of COVID-19 and latitude – in the Northern Hemisphere, where seasonal vitamin D deficiency is common, more severe cases have been observed.

Vitamin D plays a role in the functioning of the immune system, promoting its activation in response to bacteria and viruses entering the body. When vitamin D levels are normal, immunity works more efficiently, the researchers explained.

The virus targets a protein spike on the surface of cells called ACE2, which is part of the renin-angiotensin system (RAS).Among other things, the RAS regulates blood pressure and the inflammatory response. During replication, the virus can deplete ACE2, which causes a cytokine storm – uncontrolled inflammation that damages the body’s own tissues. Vitamin D deficiency, in turn, prevents it from being prevented. Given the prevalence of vitamin D deficiency, the authors of the work recommend its prophylactic intake in high doses – up to 4000 IU.

How to take vitamins correctly: a cheat sheet from the Siberian State Medical University

TOMSK, November 10 – RIA
Tomsk. Taking vitamins that strengthen immunity is especially popular in the midst of an epidemic. Project Manager
“Tomsk region – health laboratory” Yulia Samoilova told
residents of Tomsk, how to take vitamins correctly and whether it is possible to replace natural vitamins with synthetic ones. Details – in
review by RIA Tomsk.

Earlier it was reported that the Siberian
State Medical University (SSMU) in 2017 launched a large-scale
the program “Tomsk Region – Health Laboratory”, which includes
in several directions:
information site, open webinars on nutrition, sports and medicine, and others
activity.RIA Tomsk is the information partner of the project.

Overdose
vitamins

“Lack of vitamins, also
like excess, can lead to various disruptions in the body and
serious diseases, “says the head of the Center for Clinical
Research, Head of the Department of Childhood Diseases, Professor of the Department
Faculty therapy with a course in clinical pharmacology at the Siberian State Medical University
Ministry of Health, chief freelance specialist in medical prevention of the Department of Health Yulia Samoilova.

© RIA Tomsk. Taisiya Vorontsova

The expert explains that vitamins
are necessary as an integral part of food and are divided into two groups –
fat-soluble and water-soluble. The first includes vitamins A, D, E, K, which
the second – B1, B2, PP, B5, B6, H, B9, B12, C, R.

Lack of vitamins
characterized by the following symptoms: increased fatigue or
excitability, irritability, decreased appetite of varying degrees
severity (up to anorexia), sleep disturbance, pathological changes
condition of the skin and mucous membranes.

These are also violations of the normal
the functioning of the organs of the gastrointestinal (gastrointestinal) tract and
changes in the blood count.

“Hypervitaminosis is less common than deficiency.
Water-soluble vitamins are usually successfully excreted in the urine if they are in excess.
However, long-term consumption of fat-soluble vitamins in quantities that
exceeding the daily requirement, can lead to the development of intoxication
(hypervitaminosis) “, the doctor warns.

So the real danger
for health is an overdose of fat-soluble vitamins D, A and K.
Particular attention should be paid to the use of high doses of vitamin D, which has recently
began to acquire a very serious scale, as many people independently
prescribing vitamin D supplements for themselves.

“Although we should be aware, some patient groups may be more sensitive to vitamin D supplementation.
These are, first of all, patients with granulomatous diseases (including
sarcoidosis, tuberculosis, chronic fungal infections, lymphomas and others).Have
in these patients, correction of 25 (OH) D levels should be done with caution in
type of enhanced PTH-independent activation of vitamin D and potentially increased
the risk of hypercalcemia and hypercalciuria “, – says Samoilova.

According to her, such patients should be corrected for vitamin D deficiency with
caution, under the control of indicators of calcium-phosphorus blood metabolism.

Compatibility
vitamins

“At the moment in the scientific community there is no unambiguous
opinions on the compatibility of various vitamins, “says Samoilova.

Modern research shows that the use of
vitamin and mineral complexes are not always effective due to the interaction between micronutrients. For example, phosphorus can lower
efficiency of absorption of magnesium, and vitamin B12 can lose up to 30% of its
activity in the presence of iron.

© RIA Tomsk. Yakov Andreev

On the other hand, there is no proven scientific evidence of antagonistic interactions between individual vitamins and minerals.

Synthetic
vitamins

“Synthetic vitamins are also a controversial issue,” the expert is sure. “There are groups of scientists who oppose the use of
synthetic vitamins. Disputes about their bioavailability for the body do not subside. “

According to her, some experts argue that synthetic vitamins are not at all
absorbed by the body, and their intake leads to additional diseases. Others write that synthetic vitamins are similar to natural and
chemical structure, and biological activity.

Yet it is known that some natural and synthetic
vitamins have a non-identical composition. For example, ascorbic acid is only
isolate, a fragment of natural vitamin C. In addition to ascorbic acid,
natural vitamin C includes other substances – rutin, bioflavonoids, tyrosinase
etc.

However, the use of vitamins in tablets is permissible and
leads to a positive result with vitamin deficiencies.

Vitamin D

Suffers from its deficiency to varying degrees from 50%
up to 75% of the world’s population.The risk group for developing vitamin D deficiency is
babies, the elderly, dark-skinned people, people with limited sun exposure
(less than two hours a day), obese, population of countries located to the north
35th parallel in the northern hemisphere (almost the entire territory).

Vitamin D
promotes intestinal absorption of calcium and maintains the required levels
calcium and phosphate in the blood to ensure bone mineralization and prevent
hypocalcemic tetany.

It is also necessary for bone growth and the process
bone remodeling, that is, the work of bone cells. Enough level
vitamin D prevents the development of rickets in children and osteomalacia in adults.
Together with calcium, vitamin D is used for prophylaxis and in the composition
complex treatment of osteoporosis.

According to a number of researchers, the functions
vitamin D is not limited only to the control of calcium-phosphorus metabolism, it is also
affects other physiological processes in the body, including modulation
cell growth, neuromuscular conduction, immunity and inflammation.

Vitamin D deficiency is recommended
determine laboratory as a concentration of 25 (OH) D <20 ng / ml (50 nmol / l), insufficiency - concentration of 25 (OH) D from 20 to 30 ng / ml (from 50 to 75 nmol / l), adequate levels as 30-100 ng / ml (75-250 nmol / L).

Physiological need for
vitamin D for children and adults in Russia is 10 micrograms per day
(mcg / day), for people over 60 years old – 15 mcg / day. Natural sources of vitamin D: fish oil, oily fish (salmon, tuna, mackerel), beef
liver, cheese, egg yolk, butter.

© RIA Tomsk. Pavel Stefansky

Vitamin called
“solar”: our body is able to produce it itself – with the help
melanocytes, special skin cells. For the vitamin to be produced for us
you need to stay in the sun for about 20 minutes a day, but unfortunately this
not always possible. Physical activity is no less important – since
the vitamin synthesized in the skin enters the bloodstream better and is carried throughout
the body.

For persons aged 18-50 for
prevention of vitamin D deficiency, it is recommended to receive at least 600-800 IU
vitamin D per day.Those over 50 years old – at least 800-1000 IU
vitamin D per day.

Pregnant and lactating women
for prevention, it is recommended to receive at least 800-1200
IU of vitamin D per day.

For children under 4 months of age, a daily intake of 500 IU / day is recommended (for premature babies – 800-1000 IU / day),
from 4 months to 4 years – 1000 IU / day, 4-10 years – 1500 IU / day, 10-16 years – 2000
IU / day of vitamin for a year.

Vitamin A (retinol)

It plays an important role in the processes of growth and reproduction,
differentiation of epithelial and bone tissues, maintenance of immunity and vision.

Physiological requirement for adults – 900 mcg / day,
for children – from 400. Plants do not contain retinol, it comes in pure form
only with animal products: butter, cream,
chicken egg yolks, kidneys, fermented milk products, fish liver.

B vitamins

A group of water-soluble vitamins that play an important role in cellular metabolism.
Some substances used to belong to B vitamins, but later it was
it has been shown that they are only vitamin-like substances or are synthesized
in the human body.

Vitamin B2 participates in
redox reactions, improves susceptibility
color visual analyzer and dark adaptation. Physiological level
needs – 1.1-2.8 mg / day.

Physiological role vitamin B6
consists in participating in the exchange of tryptophan (converting it into nicotinic
acid), methionine, cysteine, glutamic and other amino acids, histamine.

It is required for regulation
fat metabolism, participates in maintaining the immune response, inhibition processes
and excitation in the central nervous system, contributes to the normal
the formation of red blood cells, maintenance of normal levels of homocysteine ​​in the blood.

© RIA Tomsk. Pavel Stefansky

Physiological
the need for adults is 2.0 mg / day, for children – from 0.4 to 2.0 mg / day.
Partially vitamin B6 is synthesized by the intestinal microflora. A large number of
this vitamin contains yeast.

Zinc

Currently, due to the pandemic situation, a large number of publications have appeared on the role of zinc in the prevention of COVID. This has indeed appeared scientifically proven data. Adequate levels of zinc in the body can reduce the likelihood of respiratory infections, pneumonia and its complications, the scientists said.Zinc plays an important role in the regulation of immunity and maintains resistance to inflammation, therefore its effect on the body is considered in many studies from the point of view of prevention of COVID-19.

Zinc is present in over 300 enzymes. It participates in the processes of synthesis and breakdown of carbohydrates, proteins, fats, nucleic acids and in the regulation of the expression of a number of genes. Insufficient consumption leads to anemia, secondary immunodeficiency, liver cirrhosis, sexual dysfunction, and fetal malformations.

Physiological requirement for zinc for adults – 12 mg / day, for children – from 3 to 12 mg / day.

I would like to draw the attention of readers: the use of one microelement, unfortunately, will not prevent the development of the disease even in high dosages, so we must not forget about other preventive measures.

Folic acid

The biological role of folic acid is associated with its participation in
the exchange of nucleic acids and proteins, especially hematopoietic cells. She
directly regulates the synthesis of methionine, purine compounds (and indirectly – pyrimidine compounds), the transformation of a number of amino acids.Physiological need for
adults – 400 mcg / day, for children – from 50 to 400 mcg / day.

Phosphorus

Phosphorus takes part in many physical processes,
including energy metabolism, regulation of acid-base balance. Included in
composition of phospholipids, nucleotides and nucleic acids, participates in cellular
regulation, necessary for bone mineralization
and teeth.

Deficiency of phosphorus in the body leads to anorexia, anemia,
rickets.Physiological need for adults – 800 mg / day, for children – from
300 to 1200 mg / day.

Calcium

This is an essential element
the mineral matrix (intercellular substance of bone tissue) of the bone, which
acts as a regulator of the nervous system, participates in muscle contraction. Deficit
calcium leads to demineralization of the spine, pelvic bones and lower
limbs, increases the risk of osteoporosis.

Physiological need for
adults – 1000 mg / day, for people over 60 years old – 1200 mg / day, for children – from 400
up to 1200 mg / day.

Phosphorus deficiency in the body
leads to anorexia, anemia, rickets. Physiological need for adults
– 800 mg / day, for children – from 300 to 1200 mg / day.

Potassium and sodium

© Valery Doronin

Potassium is essential
intracellular ion, which takes part in the regulation of water, acid and
electrolyte balance, participates in the processes of conducting nerve impulses,
pressure regulation. Physiological requirement for adults – 2500 mg / day, for
children – from 400 to 2500 mg / day.

Sodium – main extracellular
an ion that takes part in the transfer of water, blood glucose, generation and transmission
electrical nerve signals, muscle contraction. Physiological
the need for adults is 1300 mg / day, for children – from 200 to 1300 mg / day.

Iron

In the body of an adult
contains 3-4 grams of iron, while its daily rate in the diet
is 0.018 grams for women and 0.008 grams for men. But there is one
the detail is important – only 10% of the consumed iron is absorbed by the body, you need
increase the daily rate by 10.Lack of iron can be the reason not only
chronic fatigue, dry skin and decreased performance, but also the development
such a dangerous disease as anemia.

Iron is part of various
by its function of proteins. Participates in the transport of electrons, oxygen,
provides redox reactions and activation
peroxidation.

Products containing the greatest
the amount of iron is beef, as well as beef liver, kidney and heart.100 grams of product accounts for 36% of the daily
mineral norms. At the same time, beef contains heme iron, which is absorbed five times better,
than non-heme.

Physiological need for
adults – 10 mg / day for men and 18 mg / day for women, for children – from 4 to 18
mg / day

Selenium and chromium

Selenium – an antioxidant element
defense systems of the human body, has an immunomodulatory effect,
participates in the regulation of the action of thyroid hormones.Deficiency Leads to Illness
Kashin-Beck (osteoarthritis with multiple deformities of the joints, spine and
extremities), Keshan disease (endemic myocardiopathy), hereditary
thrombasthenia.

Physiological need for
adults – 55 mcg / day for women, 70 mcg / day for men, for children – from 10 to
50 mcg / day

Chromium participates in the regulation of the level
blood glucose, enhancing the action of insulin. Deficiency leads to a decrease
glucose tolerance.Physiological requirement for adults – 50 mcg / day,
for children – from 11 to 35 mcg / day.

Iodine

The main biological role of iodine in
the human body is participation in the synthesis of thyroid hormones of the thyroid
glands that determine mental development. It is especially important for the intrauterine development of a child and young children

Daily physiological
the need for iodine is: for children – 90 mcg / day, adolescents – 120
mcg / day, adults – 150 mcg / day, elderly – 100 mcg / day.For pregnant women and
nursing daily intake of iodine should be at least 200 mcg / day. Real
the same consumption of iodine in Russia does not exceed 40-80 mcg / day.

Products fortified with iodine:
iodized salt, iodized bread, lactic acid products adapted
infant formula for children.

Snezhana Kavrigo: Vitamin prophylaxis in conditions of COVID-19: what doctors advise

Vitamin deficiency among Belarusians is not uncommon.But if before the people themselves did not pay enough serious attention to this problem (think avitaminosis!), Then with the advent of coronavirus infection in our life, the word “vitamin prophylaxis” acquired a new meaning. Trying to protect themselves from the disease, people buy both individual drops and tablets, and whole complexes. Not always carefully studying the issue, but simply believing in the miraculous power of an antiviral cocktail of three components – zinc, selenium and vitamin D. I talked with the head of the Minsk City Health Center Snezhana Kavrigo.

Vitamin prophylaxis is used in certain physiological conditions (pregnancy, increased physical activity, etc.), as well as in certain diseases – to prevent the development of vitamin deficiency.

The resources of our body are not unlimited. And to increase efficiency, prevent various non-infectious, alimentary-dependent conditions, the diet must contain the main components of food, some of which are vitamins.

Vitamins are involved in the regulation of metabolism; they are biological catalysts or reagents for photochemical processes in the body. They are also actively involved in the formation of enzymes, determine their normal function and activity. Vitamins affect the absorption of nutrients, contribute to the normal growth of cells and the development of the whole organism.

Lack, and even more so the absence of any vitamin in the body leads to metabolic disorders. With a lack of them in food, a person’s working capacity decreases, the body’s resistance to diseases, the action of unfavorable environmental factors.

Vitamin reserves of the body are depleted faster when a person’s physical activity is higher than usual, when he is under stress or in unusual conditions. The period of spread of COVID-19 just creates such conditions for our body. And no matter what phase a person is in (pre-illness, illness or recovery) – it is advisable to pay attention to the vitamin composition.

For example, in the fight against acute respiratory infections, the emphasis should be on supplements such as B2 (riboflavin). Thanks to him, the cells of the body actively produce energy, and it becomes easier for him to fight viruses.During illness, the body also needs vitamin A (retinol), the main sources of which are fish oil and liver. Retinol is actively involved in the functioning of the immune system.

The most important substances for supporting the immune system in COVID-19 are vitamins D and C, zinc, and omega-3-unsaturated acids.

But this is a general recommendation. When, to whom and what vitamins should be taken?

Vitamin D. Vitamin D is good for people who are in self-isolation.The lack of beneficial effects of sunlight on the body can be compensated for with vitamin D. In addition, this vitamin is recommended for elderly people who are more at risk of developing an infection. In old age, the likelihood of a more severe course of the disease is also high. And vitamin D is the most immunomodulating vitamin.

Vitamin C is vital for the immune system as it is a powerful antioxidant that protects the body from free radicals that damage and destroy healthy cells.

Zinc plays an important role in the formation of leukocytes – the main defenders of the body against infectious agents. Zinc clears the mucous membrane of viruses, restores tissue barriers and the integrity of the epithelium, which makes it difficult for pathogens to enter the bloodstream, and also inhibits viral replication.

Omega-3 fatty acids are found in cell membranes and blood vessels. They are also important for the proper functioning of the immune system. For the normal functioning of the body, 1-7 g of omega-3 fatty acids are needed per day.

However, do not forget that all the conclusions of scientists about the effectiveness of vitamins are still preliminary. This is by no means a call to action. Any medications, including vitamins, should be taken only after a doctor’s prescription. You should not “prescribe” vitamins to yourself on the advice of “well-wishers” or simply on the basis of your own feelings.

Rational nutrition – special attention

Especially in conditions of an increased risk of an infectious disease COVID-19 and a long stay of people at home in self-isolation.

Rational nutrition – nutrition of people, taking into account their age, sex, nature of work and climatic conditions. In the daily diet, the presence of 6 main food groups is desirable: dairy, meat, low-fat fish (2-3 times a week), cereals, vegetables, fruits. In the summer – chicken broth and vegetable soups – everything that is well absorbed by our body. We refuse fatty, spicy food, mushroom dishes – such food is very difficult to digest, especially in hot weather, since the activity of the body’s enzymatic system is reduced, and with it the appetite is reduced.

To keep the body in good shape, it is necessary to introduce additional protein into the diet – cottage cheese, eggs, fish, meat, poultry and seafood.

Compliance with some recommendations in everyday life will help to some extent resist infection.

First, the drinking regimen. Moisturized mucous membranes are the first barrier to the virus. It is believed that a person needs at least 25 ml / kg per day. However, this figure can go up to 60 ml / kg.

Second, fiber.90,090 80% of our immunity depends on the intestines. And the use of foods rich in fiber helps to maintain the normal microflora of our intestines. WHO recommends consuming at least 400 g of different vegetables and fruits daily.

Third, products containing pro- and prebiotics. They also contribute to the maintenance of normal intestinal microflora. Fermented milk products are an excellent source of calcium, vitamins and minerals; they have a positive effect on the natural intestinal flora due to the content of lactobacilli.

Fourth, “edible” vitamins – vitamin D, omega-3 fatty acids. Fish (halibut, mackerel, cod, herring, tuna and the liver of these fish) will be a complete source of vitamin D. And also eggs, offal, forest mushrooms, dairy products. You can drink it in preparations or supplements to get at least 400-800 IU per day.

Marine fish such as halibut, salmon, herring, tuna, mackerel and sardines, as well as flaxseed oil, are high in omega-3 acids, which provide the building blocks for the production of the anti-inflammatory hormones eicosanoids.The diet should contain fatty fish 2-3 times a week. Vegetable oils contain omega-6 and omega-9 fatty acids, which are also essential for our body. It is recommended to consume 20-25 g of vegetable oils per day.

Fifth, “fat” care for the lungs. This is a very fat-dependent organ, without a full intake of fat in the body with food, the work of the lungs is disrupted. A low-fat diet harms them as much as smoking. Lack of fat in the diet leads to the fact that any infection, including COVID-19 infection, penetrates much more easily into weakened bronchi and lungs.An adult needs 70-80 g of fat per day, up to 30% of which must be provided with animal fats.

Sixth, protein. Meat, poultry, fish, dairy products, eggs are a source of animal protein, which is necessary for the creation of tissues and the synthesis of hormones, as well as immune proteins – antibodies that play an important role in protecting the body from bacteria, viruses and parasites. Vegetable proteins are considered less valuable in terms of amino acid composition, but should be included in the diet.The richest in protein are legumes (beans, peas, lentils, chickpeas), nuts, seeds (quinoa, sesame, pumpkin seeds) and, of course, soybeans and their products. An adult needs to get 0.8-1.2 g / kg of body weight of proteins per day, more than half of them should be of animal origin.

It is important that all these products have a nonspecific beneficial effect on the human body, i.e. useful for any infections.

Snezhana Kavrigo also warned: food can harm the immune system.High-calorie foods, smoked meats, canned food and marinades, refined foods with a predominance of saturated fats or trans fats, fast food, sugar and salt reduce the body’s natural defenses.

Simple carbohydrates (sugars) are the cause of systemic inflammation. The starch found in potatoes, corn, rutabagas and some other vegetables, grains and refined white cereals is the same sugar. It is sugar that creates glycated hemoglobin, which “scratches” our blood vessels, causing inflammation of the vascular wall.Sugar is very fond of pathogenic bacteria and intestinal fungi, suppressing the growth of our friendly microflora and reducing our immunity. Thus, 90,089 it is better to refuse sweets, pastries and confectionery, sweet drinks.

Improper nutrition can lead to obesity, which in turn can lead to various problems: from diabetes and cardiovascular diseases to the development of oncological processes. Such conditions definitely affect the severity of the course of coronavirus infection, since any chronic diseases are risk factors for the development of complications.

How bad habits affect the course of COVID-19

Any type of smoking negatively affects lung function and the immune system. Smoking is an additional risk factor in terms of the severity of any viral infection. Scientists have found that in the lungs of a smoker, the expression of the ACE2 protein is increased by about a third when compared with nonsmokers. Smokers are automatically at risk because they are more likely to suffer from lung diseases. Most people who smoke have reduced immunity: their body produces additional mucus that clogs the lungs.Against the background of smoking, mutation of immune cells occurs, and it becomes much easier for a smoker to become infected with viruses than a non-smoker. The risks increase up to the need to connect to a ventilator.

Alcohol in the case of infections is only good for hand disinfection. Alcohol does not contribute to the destruction of viral particles in the inhaled air, does not provide disinfection of the oral cavity and pharynx, and in no way is a way of protecting against the virus. Excessive consumption of alcoholic beverages weakens the immune system, destroys the liver and brain cells.It is also a risk factor for the development of acute respiratory distress syndrome (ARDS), one of the most severe complications of COVID-19. Finally, alcohol changes thoughts, judgments, decisions and consumer behavior.

People who use soft drugs are also at risk. Long-term self-isolation can lead to breakdown in those who have resisted their addiction well enough. In people who are addicted to psychoactive substances, immunity is usually severely weakened, and the frequent presence of HIV infection in them increases the likelihood of death from viral infections.Hepatitis B and C, which often occur in drug addicts, complicate the course of coronavirus infection.

People who use drugs are more susceptible to contracting coronavirus infection, because with drug addiction, mental disorders are even more pronounced than with alcohol abuse, the lifestyle is even more disorganized and desocialized, and the immune system is weakened. For example, opiates (morphine, heroin) inhibit the respiratory and cough centers of the brain. As a result, due to a violation of the cough reflex, the risk of lung infections, primarily pneumonia, increases sharply.The cardiovascular system of drug addicts is especially affected. When taking opiates, inhibition of the centers of regulation of the activity of the heart and blood vessels occurs. As a result, blood pressure decreases, the body begins to receive less oxygen.

Heat also makes adjustments

Abnormal heat may contribute to an increase in the incidence of COVID-19. In hot weather, people are more likely to congregate indoors, where the virus spreads much faster than outdoors. According to expert opinion, a heat of 30 degrees is not enough to instantly vaporize the virus.To neutralize it in a minute, a temperature above 50-60 degrees is required. If at normal temperatures thermoregulation is turned on only to fight the virus, then in such weather it still works to fight the heat. Dehydration, intoxication of the body occurs. In such weather, it is much more difficult to endure the symptoms of the disease.

Ekaterina KNYAZEVA,

BELTA.-0-

90,000 Don’t do this: 4 Dangerous Mistakes You Make When Taking Vitamins | MogilevNews

One pill or capsule with a standard list of nutrients in the composition of a person is not enough.For vitamins to be effective, you need to take them correctly. Let’s talk about the mistakes we make when we start drinking vitamins and tell you how to get the most out of them.

Mistake # 1: You Prescribe Yourself

What’s wrong

Often we start taking vitamins, focusing only on the first external signs of deficiency and simply following the directions on the package. We think that to fill the deficiency, you need to drink more vitamins and more often, but in fact this can lead to unpleasant consequences.

For example, scientists found that women who received the maximum allowable dosage of vitamins B6 and B12 each day had a 47% higher risk of hip fracture after menopause than those who took the lower dosage.

And if you exceed the recommended dose of vitamin C (recall, for an adult it is 100 mg per day, like in two oranges), in the long term, problems with pressure, urination, irritability, headaches and heartburn may appear.

What to do

Before taking certain vitamin complexes, get tested for their level in the blood. Different clinics offer both complex tests for the level of vitamins A, D, E, K, C, B1, B5 and B6, as well as separate tests for the level of vitamins A, D, C, B vitamins, folic acid and omega-3.

So you will find out if you really have a deficiency or, perhaps, you have mistaken for it another ailment, with which you need to see a specialist.It is recommended to be checked every six months. But first, you should do it at least before and after the course of vitamins. Better to get tested a couple of times than risk your health!

Mistake # 2: you combine the incongruous

What’s wrong

Suppose you were tested and found to be deficient in vitamins B12 and B6. You are looking for a suitable complex and come across a drug that contains B12, B6, B3, B2, and B1. Why not buy it – it will probably be useful to supplement the necessary substances with “neighbors”, you think.This is actually a mistake.

Despite the fact that vitamins belong to the same group, they can interfere with each other.

Vitamin B1 will not be beneficial if taken together with B2 and B3, because they will not allow it to be absorbed.

This also applies to other vitamins: for example, B12 will not work together with vitamin C, and iron is less absorbed with vitamin E, B12, B2.

What to do

Choose high-quality complexes, in consultation with a specialist who knows exactly what vitamins can be taken together.As a last resort, carefully study the composition of the complexes and check the compatibility of the ingredients using information from reliable sources.

Mistake number 3: you eat vitamins with the “wrong” food

What’s wrong

We often take vitamins in the morning, because it is not always convenient to take them with us to work. But if for breakfast you eat, for example, milk with cereals or cottage cheese casserole and drink iron, then there is little sense in such a course of vitamins. Calcium, which is found in dairy products, interferes with the absorption of iron, just like calcium in tablets.It also interferes with the absorption of magnesium, phosphorus, zinc and manganese.

Nevertheless, many vitamins are recommended to be taken in the morning, because in the evening they can have an unpleasant side effect on the body. For example, taking vitamin D from your last meal can impair sleep quality.

What to do

Do not eat iron with dairy products. Fat-soluble vitamins (A, D, E, K) should be consumed with eggs, a little cheese, sour cream or vegetable oil.

Water-soluble vitamins (C, B vitamins, folic acid), on the contrary, do not eat fatty foods.

Vitamins with polyunsaturated fatty acids such as omega-3 should not be consumed with cereals, cereals, bran and cereals. The fiber they contain can interfere with the absorption of fats. And in any case, do not take vitamins on an empty stomach.

Mistake # 4: you forget about omega-3

What’s wrong

Omega-3 is rarely included in the standard vitamin complexes that are advertised to us from screens.Meanwhile, our cell membranes, which in a healthy state help cells retain moisture and nutrients, are composed mainly of fatty acids.

Omega-3 helps to maintain elasticity and softness of the skin, hair and nails, supports the immune system. But in our daily diet, meat and poultry are more common than saltwater fish, which are rich in this fatty acid.

What to do

The main thing is not to confuse omega-3 with omega-6, which is contained in vegetable oils, in particular in sunflower oil (and we already use it almost every day).

An overabundance of omega-6 contributes to the development of cardiovascular diseases.

So, for a start, it is worth taking an analysis for the level of omega-3 in the body, and then, if necessary, choose a quality supplement with it and more often include mackerel, sardines, herring and salmon in the diet.

Compatibility of vitamins and microelements

The latter destroy.

Course for vitamin: B12 blocks the multiplication of a new coronavirus | Articles

Vitamin B12 can stop the multiplication of coronavirus.Indian scientists using computer simulations have shown that it suppresses a special enzyme in the SARS-Cov-2 genome, which is responsible for copying the pathogen. This leads to a decrease in viral load and the severity of the course of COVID-19. Russian experts have confirmed that B12 is anti-inflammatory, but more research is needed to confirm its effectiveness in COVID-19.

Tie the virus “hand in hand”

Scientists around the world are looking for means for the prevention and treatment of COVID-19.People are advised to take vitamins D and C, which slightly enhances immunity, but does not have a dramatic effect on the course of the disease.

The more curious is the study of scientists from the Manipal Academy of Higher Education and the Regional Center for Biotechnology (India), who have found a substance that can block the reproduction of coronavirus. This is vitamin B12, the mechanism of influence of which on the pathogen was substantiated by researchers using computer modeling.

The genome of SARS-Cov-2 contains a protein called nsp12.It assembles “genetic letters” into new viral genomes, that is, it is responsible for the multiplication of the virus. Researchers have performed computer simulations to find out which molecules in natural foods and medicines can inhibit nsp12 activity.

Photo: Global Look Press / Ajith Perera

They created a model of the nsp12 molecule from SARS-CoV-2 and tested its “binding” to more than 8 thousand different compounds, which included molecules from food and various drugs.

“The ability of methylcobalamin (a special form of vitamin B12 that is absorbed by the body best of all. – Izvestia) to suppress viral replication should be urgently tested using in vitro and in vivo assays. In addition, given the urgency of the situation and the fact that B12 is already part of the drug regimen, clinicians may consider adding or increasing methylcobalamin dosage to their current patient care protocols. In addition, this substance can be prescribed as a prophylactic agent for groups such as medical personnel, the elderly or those with underlying medical conditions, to reduce the likelihood of infection and provide emergency care in the hospital, ”the scientists said in the article.

Only with caution

Russian experts were wary of the idea of ​​Indian scientists.

“This is a very preliminary study based on computer modeling,” said Oleg Batishchev, associate professor of the Department of Biophysics and the Department of Physics of Living Systems at MIPT. – That is, so far only a hypothesis, not confirmed by the necessary research.

I agree with my colleague and the head of the Department of Immunology and Allergology of the Sechenov University (the university is a participant in the project to improve the competitiveness of education “5-100”) Alexander Karaulov.

– The authors of the work are famous Indian scientists, talented biologists engaged in modeling. But from the point of view of immunology, the effectiveness of B12 has not been confirmed by anything, so we cannot recommend it as an antiviral drug, ”the expert told Izvestia. – Yes, methylcobalamin is anti-inflammatory and could potentially be used in patients with COVID-19. True, most likely indirectly. B12 enhances the release of melatonin, one of the antioxidant molecules.It affects the mechanisms of innate immunity through the intestinal microbiota and has an anti-inflammatory effect.

Photo: Depositphotos

True, while the performance of B12 has been confirmed only in mice, and not in relation to COVID-19. In general, the potential for its use suggests further research.

– It is necessary to prove the consistency of the idea proposed in the article experimentally , – added Sergey Netesov, Head of the Laboratory of Biotechnology and Virology at the Faculty of Natural Sciences of NSU, Corresponding Member of the Russian Academy of Sciences.- Then check it on animals infected with coronavirus. And only after that – on volunteers.

However, there is another study of the effectiveness of B12, conducted by Singaporean scientists. In an experiment, they combined vitamins B12, D3 and magnesium, resulting in relief from COVID-19. Patients who took vitamins needed additional oxygen to a much lesser extent, did not move to the group of severe patients. Doses of vitamin B12 were small – 500 micrograms per day.

B12 is known to be essential for many important hormonal and metabolic functions in the body. For example, for the production of energy by cells, the normal functioning of the nervous system, DNA / RNA synthesis. However, an overdose of this vitamin is extremely dangerous.

As Sergei Netesov said, an increased number of red blood cells and leukocytes is formed from her in the blood, which leads to the formation of clots in the bloodstream and subsequent thrombosis. The work of the gastrointestinal tract is disrupted, visual acuity decreases, the risk of heart failure increases, serious neurological disorders appear, up to the appearance of hallucinations.