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[CLKD]

Paracetamol is dangerous.  So don't take cold preps along with tablets ;-).

[CLKD]

We could, for those not wanting to wade through all the info., false or otherwise, have a 'room' dedicated to the ongoing virus situation.  Keeping each thread as written so that people don't have to go into those that have no interest on any particular day.  Personally, we can never have enough threads as it is obvious by some responses that others haven't read right the way through some of them 

[CLKD]

? does it work though ?

[CLKD]

'does it work' ..... I've never found it helps symptoms 4 me 

[Sparrow]

You might find this useful.  The diagram would not cut and paste, but you can see it on this link.
https://drmalcolmkendrick.org/2020/03/18/coronavirus-covid-19/#comments



CORONAVIRUS [COVID-19]
42 Replies
18th March 2020

I thought I should say something about the coronavirus for readers of this blog. I need to state that the situation is fast moving, facts are changing, and I am not asking anyone to go against any current medical advice.

Here, I am simply providing advice that I believe, currently, may be of benefit to people out there. I am acutely aware that there is controversy swirling about, but I will not promote anything that can cause any significant harm ? but may cause significant good.

I have tended to look back a few years in time for some evidence, because current, emerging evidence is subject to massive bias and controversy, with various vested interests getting involved. The ?older? evidence has not been done in a rush and is therefore more measured.

1: Anti-inflammatories (NSAIDs)

COVID-19 appears to impact the lungs more than any other organ and COVID-19 can be thought of as a ?viral? community acquired pneumonia. There has been evidence for several years that anti-inflammatory agents e.g. ibuprofen, naproxen (NSAIDs) may worsen community acquired pneumonia. As highlighted in this 2017 paper:

?Non-steroidal Anti-inflammatory Drugs may Worsen the Course of Community-Acquired Pneumonia: A Cohort Study:

CONCLUSIONS:

Our findings suggest that NSAIDs, often taken by young and healthy patients, may worsen the course of CAP with delayed therapy and a higher rate of pleuropulmonary complications.? 1

There is now anecdotal evidence, particularly from France, that patients who take NSAIDs do considerably worse. It has been suggested they may lead to an increased death rate.

ADVICE: Avoid NSAIDs if possible

2: Vitamin C

Vitamins always cause massive controversy, and the mainstream medical community tends to be highly critical of the use of vitamins. However, vitamin C has been found to have many, many, positive impacts on the immune system. It also protects the endothelium lining blood vessels ? thus preventing/delaying passage of pathogens from the bloodstream.

I include the full abstract from the 2017 paper ?Vitamin C and Immune Function.? It contains a great deal of medical jargon, but I have highlighted the most important parts.

?Vitamin C contributes to immune defense by supporting various cellular functions of both the innate and adaptive immune system. Vitamin C supports epithelial barrier function against pathogens and promotes the oxidant scavenging activity of the skin, thereby potentially protecting against environmental oxidative stress.

Vitamin C accumulates in phagocytic cells, such as neutrophils, and can enhance chemotaxis, phagocytosis, generation of reactive oxygen species, and ultimately microbial killing. It is also needed for apoptosis and clearance of the spent neutrophils from sites of infection by macrophages, thereby decreasing necrosis/NETosis and potential tissue damage.

The role of vitamin C in lymphocytes is less clear, but it has been shown to enhance differentiation and proliferation of B- and T-cells, likely due to its gene regulating effects. Vitamin C deficiency results in impaired immunity and higher susceptibility to infections. In turn, infections significantly impact on vitamin C levels due to enhanced inflammation and metabolic requirements.

Furthermore, supplementation with vitamin C appears to be able to both prevent and treat respiratory and systemic infections. Prophylactic prevention of infection requires dietary vitamin C intakes that provide at least adequate, if not saturating plasma levels (i.e., 100?200 mg/day), which optimize cell and tissue levels. In contrast, treatment of established infections requires significantly higher (gram) doses of the vitamin to compensate for the increased inflammatory response and metabolic demand.? 2

In short, Vitamin C can help prevent respiratory infections. It can also help to treat established infections, although much higher doses are required. This seems to fit with emerging Chinese data which appears to be showing considerable success with high dose intravenous Vitamin C in treating coronavirus.

It is unlikely that anyone working in the medical system in the West will agree to using high dose Vitamin C as part of any management plan. However, if your loved one is extremely ill in hospital I would recommend speaking to the doctors and asking if this can be added.

Whilst it is possible that vitamin C may prove ineffective, it also does no harm. Those who are currently attacking the use of Vitamin C and attacking those who believe vitamin C may be beneficial are, I believe, mainly concerned with their personal reputations.

ADVICE: Take at least 2g of Vitamin daily C to ?prevent? infection, probably more like 5g. Increase the dose to at least 10g if you are suffering symptoms.

3: ACE-inhibitors/ARBs

COVID-19 appears to enter the body using the ACE2 receptor (found on the surface of many cells, particularly in the lungs. Also found in high concentrations in the heart and kidneys.

Because of its affinity to ACE2 receptors (and the more widespread Renin Aldosterone Angiotensin System or ?RAAS?) COVID-19 is causing upset with the whole system ? in complex ways. The system itself is complex.

To remind those of a more technical bent, here is the system:



 

I wished to make it clear that if COVID-19 impact on the RAAS system, trying to work out the resultant abnormalities, is not easy.

There are two main drugs that are designed to lower blood pressure by ?interfering? with the RAAS system. ACE-inhibitors (angiotensin converting enzyme inhibitors), and ARBs (angiotensin II receptor blockers). They are very widely prescribed.

Some people have suggested that these drugs should be stopped. Others have suggested that they should be continued. You may be able to see why the advice is contradictory, given all the possible interactions.

However, it does seem the COVID-19 creates hypokalaemia (a low blood potassium level). A rising potassium level indicates recovery from the virus. This is probably due to interference with the hormone Aldosterone due to degradation of many ACE-receptors in the body.

ADVICE ? currently not enough information to provide any advice on ACE-inhibitors and ARBs. However, increased consumption of potassium, if symptomatic, can be advised. Dose?

?People who eat large amounts of fruits and vegetables tend to have a high potassium intake of approximately 8000 to 11,000 mg/d,? 3

So, up to Ig a day appears perfectly safe, and if more is being lost through the kidneys with COVD-19, there appears to be little danger of overdosage.

4: Chloroquine and Hydroxychloroquine

These drugs normally used to treat/prevent malaria (and are also used to treat various ?immune? disease). However, they have been found to be effective in treating other viruses and seem to have been highly effective against COVID-19 4. These drugs will only be available as part of medical management. They cannot be bought over the counter (in any country, as far as I know).

If you, or a loved one, is seriously ill, I would urge you to ask for ? one or the other ? to be used. Hydroxychloroquine has fewer side effects (drug related adverse effects)

ADVICE ? Ask for one of these drugs if you, or a loved one, is seriously ill with COVID-19.

5: Vitamin D

This one is simple. Vitamin D has important effects on the immune system 5. A low vitamin D level in the winter is almost certainly why flu epidemics occur in the winter months. [Vitamin D is synthesized in the sun by the action of sunlight].

ADVICE ? take at least 2000iu vitamin (preferably D3) daily.

I hope some people have found this useful. If anything I have written here proves to be wrong, or dangerous, I will change it. However, I am working on the basis here of ?first, do no harm.? The worse thing that any of this advice can do, I believe, is to NOT work.

1: https://www.ncbi.nlm.nih.gov/pubmed/28005149

2: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707683/

3: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485434

4: https://www.connexionfrance.com/French-news/French-researcher-in-Marseille-posts-successful-Covid-19-coronavirus-drug-trial-results

5: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3756814/

[CLKD]

Tnx but far too long 

VitC has to be taken in HUGE amounts and anything over what the body needs is discharged via urine.  There was a study many years ago (1960s) which was eventually discredited, somewhere we have a copy   . 

Also I believe it is too early for any tests to have been done and what came out of France this week has no prove behind it re nurofen.  So the UK government has advised not to use it for this particular virus. 

[Sparrow]

Interesting CLKD, but Dr.Kendrick is a GP and he does a lot of research.  I think I will go with what he says.

[Jari]

Very interesting Shadyglade.

I am eating more vit c fruits plus supplements. Also D3. 👍

[CLKD]

Could you copy and paste for a new thread and split the topics with references - it would be easier to read and not be lost in the main thread?

There was a whole article on the BBC this morning about fake news and I think that the French reference was stated there.  After all, the virus doesn't last many days so it is possible that patients recovered B4 the medication trial rather than due to it ;-).

[Yorkshire Girl]

This virus is causing everyone so many problems, I know you can get bogged down with what are minor issues surrounding this, especially with people dying but it's hitting us hard: Hubby has a lost a third of his pension, if it doesn't recover he won't be able to retire in 3 yrs like he wanted to, on the plus side at least his company has seen sense and closed the office, everyone working from home, may even work out to be more productive! Teenager's important A level exams have been cancelled, if they go with mock exam results that'll be ok he did well but I can see some students being very disappointed. Worried about my nearly 98 yr old grandmother, mind you she is in very good health but....this among other things, but unfortunately all out of our hands.

[pants46]

Phoned my local pet shop at 4pm today to see if my order of puppy milk had come in. Poor girl was in tears. Her 2 staff hadn't come in. She was literally raided when she opened this morning. Shelves emptied. She shut up shop at 2pm. Nothing left on the shelves.
People are going completely bonkers.
I met her at about 6pm, to collect my puppy milk, which had just been delivered. And she said that when she opened up this morning there was already 30 cars waiting outside. They blocked the road !!
Bless her heart, she stayed there to give me the milk. So I said that if she opens up tomorrow to call me and I will go and help a bit. I can leave my puppy for an hour to help.

[pants46]

Well, we've got to help keep local businesses going for as long as we can. I rely on my local shops and have done for about a year, since I've struggled to drive.

[pants46]

I hope so.
My brother is a consultant anaethatist in a NHS hospital, so very much on the front lines. His hospital has 1 CV patient in intensive care and 8 others receiving less intensive treatment.
He's having to take on additional duties. It's all hands to the pump.
And he's scared. He doesn't get scared.
That makes me scared.

[jillydoll]

Oh Pants   
Wish more people were like you.
xx

[rolercoasterhell]

Sorry if this is obvious but should we or shouldn't we be taking paracetamol to lower our body temperature/fever? Is it best to allow the fever to work its way through our bodies without drugs or to lower the fever?

If I know that it is less dangerous to allow the fever to take hold then I will abstain from paracetamol...if possible.

I know that ibuprofen is not recommended.

I'm worried that a lot of old people do not realise that they should not be taking ibuprofen or cant get hold of any paracetamol.