8 replies to this topic

[Dorian Grey]

I was going to take my TMG (trimethylglycine) today & wondered if it might be better with or without food.  Looking at the label, I saw it said: "Methyl donors such as TMG and folate are required for (edit) and for accurate synthesis of DNA and RNA".  RNA synthesis?  Sounds like what's going on during coronavirus replication!  I've also been taking SAM-e (another powerful methyl donor) & Methyl Folate; & while I expect you wouldn't want to intentionally restrict dietary folate, it may be unwise to to be flooding my body with multiple/potential coronavirus fertilizers.  

 

I've heard acetaminophen (aka Tylenol / paracetamol) can badly deplete glutathione, which may greatly exacerbate the oxidative stress Dr Seheult (MedCram) opined is likely responsible for clotting & endothelial dysfunction in the lungs of COVID patients.  I've often wondered if doctors are still recommending Tylenol for fever reduction in their COVID patients.  Have also read dextromethorphan, a common cough suppressant might exacerbate a coronavirus infection, though I don't recall the mechanism.  

 

In our Supplements & Therapies thread, we've discussed how blood pressure and cardiac meds are known to deplete zinc, & how this might be at least partly responsible for the morbidity associated with these conditions.  For those who must stay on these meds, I should think zinc supplementation would be essential.  In fact, all diuretics: ACEi, ARB's, thiazide meds, coffee, tea, alcohol, & the diuresis of diabetes are known to deplete both zinc and magnesium which is required for Vitamin-D activation.  

 

PPI meds (proton pump inhibitors) are also known to predispose zinc deficiency, & I noticed the other day those on PPI meds have been found to be substantially more susceptible to SARS-CoV-2 infection.  

 

I'm hoping other members will contribute any and all information they might have regarding supplements, medications and perhaps other factors that may exacerbate disease during a SARS-CoV-2 infection, and how unavoidable adverse interactions might be averted.  

[bladedmind]

Vitamin K.  

I'd say an important one is whether or not to continue Vitamin K during the Covid-19 pandemic.   Seheult, in his first Q&A for the Medcram series (not numbered in the series - and which I have been unable to relocate - I found second and later Q&As), said to avoid Vit K because it would support coagulation.   Because of his skills in clinical biochemistry I trust his expertise more than I do most others', but he didn't detail the claim, just a passing remark. 

 

On the other hand, an observational study found a positive association between Covid-19 severity and lower Vitamin K status.

https://nutraceutica...COVID-19/164515

 

As it stands, an important issue, but insufficient evidence to decide. 

 

High Fructose.

Seheult in Medcram 83 posed the same question as the OP here, and answered:  avoid high fructose, high BMI.

 

Proton Pump Inhibitors.

An online self-report survey

We found evidence of an independent, dose-response relationship between the use of anti-secretory medications and COVID-19 positivity; individuals taking PPIs twice daily have higher odds for reporting a positive test when compared to those using PPIs up to once daily, and those taking the less potent H2RAs are not at increased risk. Further studies examining the association between PPIs and COVID-19 are needed.

 

Suggestive, but not decisive.   I must take PPIs, and H2RAs cause me prostate trouble.  

 

 

ACE Inhibitors, ARBs.  The greater weight of findings say to continue these medications.  I haven't collected cites, but that remains the stable advice of the relevant medical associations.  

 

NSAIDS, Tylenol.  I'd like better argumentation and evidence.  It seems that medicine is advising to use as needed, but I'm generally skeptical of the health of their wide appllication.  But I can't cite anything at the moment to support my suspicion, 

[pamojja]

Vitamin K.  

.. Because of his skills in clinical biochemistry I trust his expertise more than I do most others', but he didn't detail the claim, just a passing remark. 

 

On the other hand, an observational study found a positive association between Covid-19 severity and lower Vitamin K status.

https://nutraceutica...COVID-19/164515

 

As it stands, an important issue, but insufficient evidence to decide.

 

More research than one ever could wish for vitamin K and coagulation: https://www.k-vitami...p?page=Clotting
 

[gamesguru]

Unlike Vitamin D and magnesium, vitamin K can be easily gotten from the diet in plentiful amounts.

 

A serving of Kale or Chard can be delicately steamed or stir fried as part of a rice or potato dish and it provides ~200 µg of Vitamin K. It's around 150-200% of the RDA.

 

Less is more with these potent ones.  I take just a 125mcg vitamin D supplement every other day.  A lot of people take 500mcg a day, but it's dangerous IMHO.

 

Effect of low-dose supplements of menaquinone-7 (vitamin K2 ) on the stability of oral anticoagulant treatment: dose-response relationship in healthy volunteers

Abstract

Background and objective: Despite the worldwide use of vitamin K antagonists (VKAs), there is limited knowledge of the influence of dietary vitamin K on anticoagulation control. In view of the increasing nutraceutical availability of menaquinone-7 (MK-7; vitamin K2 ) and its promotion for bone and cardiovascular health, it is important to determine the posology for the interference of supplemental MK-7 with VKA therapy.

 

Patients: Eighteen healthy men and women were anticoagulated for 4 weeks with acenocoumarol, and 15 of them attained a target International Normalized Ratio (INR) of 2.0. In the six subsequent weeks, subjects were given increasing doses of MK-7 (10, 20 and 45 μg day(-1) ) while continuing acenocoumarol treatment at established individual doses.

 

Results: Apart from the INR, acenocoumarol treatment significantly increased the levels of uncarboxylated factor II (ucFII), uncarboxylated osteocalcin (ucOC), and desphospho-uncarboxylated matrix Gla-protein (dp-ucMGP), and decreased endogenous thrombin generation (ETP). A daily intake of 45 μg of MK-7 significantly decreased the group mean values of both the INR and ucFII by ~ 40%. Daily intakes of 10 and 20 μg of MK-7 were independently judged by two hematologists to cause a clinically relevant lowering of the INR in at least 40% and 60% of subjects, respectively, and to significantly increase ETP by ~ 20% and ~ 30%, respectively. Circulating ucOC and dp-ucMGP were not affected by MK-7 intake.

 

Conclusions: MK-7 supplementation at doses as low as 10 μg (lower than the usual retail dose of 45 μg) significantly influenced anticoagulation sensitivity in some individuals. Hence, the use of MK-7 supplements needs to be avoided in patients receiving VKA therapy.

[Dorian Grey]

Thanks for the contributions guys.  I'm not terribly frightened of dying, but I really don't want to have to try and live with a stroke or cardiomyopathy (heart damaged trying to pump blood through clotted lungs).  I've heard clots can start forming very early in the disease process, so I'd be a bit spooked about supplemental K.  I know green tea contains a lot of K, so I'm getting some from diet.  EGCG in green tea is supposed to be a zinc ionophore, but don't know if I'd go to heavy with this while symptomatic.  Good prophylaxis though.  

 

Good point about the fructose.  I avoid that like the plague anyway.  I wonder if doctors advise their COVID outpatients to avoid sodas?  

 

Regarding the NSAIDs / Tylenol, if I had to take anything for pain or fever it would be Aleve / naproxen, as some believe this might be a potential COVID therapeutic.  

 

https://clinicaltria...how/NCT04325633

 

Dr. John Campbell had a great youtube on how lowering fever inhibits the immune system & response (sorry, can't find it now).  Covid fevers are often low grade anyway, so probably best not to treat unless you get up near 104F.  

 

I assume the PPI / COVID issue pertains primarily to GI infections, which are probably the easiest to avoid.  Wash hands before eating is a no-brainer.  

 

 

Edited by Dorian Grey, 20 July 2020 - 07:49 PM.

[lancebr]

On the other hand, an observational study found a positive association between Covid-19 severity and lower Vitamin K status.

https://nutraceutica...COVID-19/164515

 

 

Based upon that study it looks like you would want to take vitamin K since lower levels are associated with more severe Covid

Edited by lancebr, 26 July 2020 - 05:47 AM.

[Dorian Grey]

The problem with so many supplements, is that they all too often contain remarkably high doses.  I'm sure a deficiency in K can be problematic and may well contribute to COVID morbidity, but personally, I'd want to err on the side of moderation.  Yes, correct any deficiency, but perhaps unwise to mega-dose.  

 

Green tea is already one of my coronavirus prophylactics, due to the combination EGCG anti-inflammatory, zinc ionophore and Vitamin-K content, which may be wise when supplementing with fairly high doses of Vitamin-D.  

 

Make darn sure you're getting enough, but if you are already getting enough, more isn't always better!  

Edited by Dorian Grey, 26 July 2020 - 06:24 AM.

[bladedmind]

Associations of severe COVID-19 with polypharmacy in the REACT-SCOT case-control study

 

Here's plenty of things to AVOID.  I'm reducing my PPI.  

 

Results -- Severe COVID-19 was strongly associated with the number of non-cardiovascular drug classes dispensed. This association was strongest in those not resident in care homes, in whom the rate ratio (95% CI) associated with dispensing of 12 or more drug classes versus none was 10.8 (8.7, 13.2), and was not accounted for by treatment of conditions designated as conferring increased risk. Of 17 drug classes postulated at the start of the epidemic to be "medications compromising COVID", all were associated with increased risk of severe COVID-19. The largest effect was for antipsychotic agents: rate ratio 4.14 (3.39, 5.07). Other drug classes with large effects included proton pump inhibitors (rate rato 2.19 (1.70, 2.80) for >= 2 defined daily doses/day), opioids (3.62 (2.65, 4.94) for >= 50 mg morphine equivalent/day) and gabapentinoids. These associations persisted after adjusting for covariates, and were stronger with recent than with non-recent exposure. Conclusions -- Severe COVID-19 is associated with polypharmacy and with drugs that cause sedation, respiratory depression or dyskinesia, have anticholinergic effects or affect the gastrointestinal system. These associations are not easily explained by co-morbidity. Although the evidence for causality is not conclusive, these results support existing guidance on reducing overprescribing of these drug classes and limiting inappropriate polypharmacy as a potential means of reducing COVID-19 risk. 

 

 

[Dorian Grey]

More evidence supplemental folate may be unwise...  

 

https://www.dailymai...e-Covid-19.html

 

Drug used for more than a decade to treat cancer could cure Covid-19 – outperforming remdesivir in lab tests

 

"Pralatrexate is a chemotherapy medication but has promise as a Covid treatment"

 

https://en.wikipedia...ki/Pralatrexate

 

Pralatrexate is a dihydrofolate reductase inhibitor

 

https://en.wikipedia...ctase_inhibitor

 

"A dihydrofolate reductase inhibitor (DHFR inhibitor) is a molecule that inhibits the function of dihydrofolate reductase, and is a type of antifolate."

 

--------------------------

 

While this may not prove supplemental folate / methyl folate / folic acid might be a miracle grow coronavirus fertilizer, I'm taking no chances. 

 

My little jar of methyl folate I've been taking daily (to lower homocysteine) just went into the trash.  

 

Note: A lot of B-Complex & multis contain substantial amounts of folic acid.  I've found a Rite-Aid brand B-Complex (with B-12) that has no folate/folic acid. 

 

https://www.amazon.c...s/dp/B00F0SK2DM

 

Will be taking this from now on.  

 

Folic acid fortification of food was mandated in 1996 in the US, so our folic acid consumption is already higher than most.  

 

https://academic.oup.../9/2792/4687815

 

Is this part of the reason why the US is having such a dreadful time with COVID?  

 

Interestingly, excess folic acid has also been associated with increased risk for colon cancer:

 

https://www.ncbi.nlm...les/PMC1856406/

 

"exceptionally high supplemental folate levels and folate intervention after microscopic neoplastic foci are established in the colorectal mucosa promote rather than suppress colorectal carcinogenesis."

 

And colon cancer rates have been skyrocketing in younger populations since folic acid fortification was mandated: 

 

https://www.cancer.o...ger-adults.html

 

Avoid this (excess folic acid) if you can!  

 

Edited by Dorian Grey, 02 January 2021 - 06:21 AM.