Can a Multivitamin lessen the Severity of COVID-19 among Older People?

study among older men and women in Singapore with COVID-19 found that those who were started on a combination of vitamin D, magnesium and vitamin B12 supplements within one day of hospitalization were much less likely to require oxygen therapy and other intensive care support than those not given the supplements.

Update: Now published in Nutrition doi: 10.1016/j.nut.2020.111017

Researchers with the Singapore General Hospital and Duke-NUS Medical School, who set out to determine if a combination of vitamin D, magnesium and vitamin B12 would improve outcomes among COVID-19 patients aged 50 and older. Their basis was to attack the inflammatory component of the infection, noting:

“A broad theme of immune hyper-inflammation has emerged as a key determinant of patient outcome with uncontrolled immune response postulated as a pathophysiologic factor in disease severity. Intuitively, immunomodulation becomes an attractive potential treatment strategy.”

Vitamin D, Magnesium, B12 Combo Improves COVID Outcomes

The cohort study involved 43 COVID-19 patents who were admitted to the Singapore General Hospital between January 15, 2020, and April 15, 2020. Seventeen of the patients received oral vitamin D3 (1,000 IU), magnesium (150 milligrams (mg)) and vitamin B12 (500 mcg) — together known as DMB — upon admission for a median of five days while 26 patients who did not receive DMB served as the control group.9

Significant benefits were seen among the DMB group (vitamin D, Magnesium and vitamin B12), with only 17.6% requiring initiation of oxygen therapy during their hospitalization, compared to 61.5% of those in the control group. The requirement for oxygen is associated with an increased risk of needing intensive care, and the DMB group also benefited in this area.

Among those in the DMB group who required supplemental oxygen (three out of the 17 patients), two required ICU admission while one did not. Among the control group, all of those who needed supplemental oxygen required further ICU support. Nine of the DMB patients were given the combination within the first week of the onset of symptoms, and only one among them required oxygen therapy.

Overall, only three of the DMB patients deteriorated, two of whom deteriorated within 24 hours and may not have had enough time for the combo to work. The third case was started on DMB after seven days from onset of symptoms, and the researchers believe starting earlier in the course of the infection may be important.

Further, DMB was protective even after accounting for other risk factors, including age and high blood pressure:

“On univariate analysis, increasing age and hypertension demonstrated significantly higher odds ratio for oxygen therapy, while exposure to DMB therapy was associated with a significantly improved odds ratio. Multivariate analysis showed that DMB remained a significant protective factor against clinical deterioration after adjusting for age or hypertension separately.”

Combo Targets the Inflammatory Response

The researchers noted that many current therapeutics are focused on viral elimination instead of modulating the hyper-inflammation often seen in the disease. In fact, uncontrolled immune response has been suggested as a factor in disease severing, making immunomodulation “an attractive potential treatment strategy.”

For example, cytokines are a group of proteins that your body uses to control inflammation. If you have an infection, your body will release cytokines to help combat inflammation, but sometimes it releases more than it should.

If the cytokine release spirals out of control, the resulting “cytokine storm” becomes dangerous and is closely tied to sepsis, which may be an important contributor to the death of COVID-19 patients.

“COVID-19 is therefore a multi-organ phenomenon and it is becoming evident that appropriate systemic inflammatory control is necessary for overall survival benefit,” the researchers explained, writing how vitamin D, magnesium and vitamin B12 present a unique three-pronged approach for tackling COVID-19:

“Vitamin D, through its effect on NFkB and other pathways, can attenuate various proinflammatory cytokine mediating the uncontrolled cytokine storm seen in severe COVID-19 with deficiency associated with severe COVID-19.

Magnesium is critical in the synthesis and activation of vitamin D, acting as a cofactor in many of the enzymes involved in vitamin D metabolism. Vitamin B12 is essential in supporting a healthy gut microbiome which has an important role in the development and function of both innate and adaptive immune systems.

This could be pivotal in preventing excessive immune reaction especially in COVID-19 patients with microbiota dysbiosis which were associated with severe disease.”

No side effects or adverse events occurred after DMB administration, which also provides an inexpensive, readily available solution that could be easily administered in doctor’s offices at the first onset of symptoms or even taken prophylactically among high-risk populations during outbreaks. There may even be benefit against other viral infections:

“As all agents in this combination are readily available, safe and inexpensive, DMB can benefit a large swath of the world population especially in economically-challenged countries with limited or late access to vaccines and other therapies. DMB may also exhibit a generic efficacy against other viral infections with similar pathological mechanism.”

Magnesium Works in Concert With Vitamin D

Magnesium, which is required for the conversion of vitamin D into its active form, is important to ensure you’re properly utilizing the vitamin D you’re taking.

Research by GrassrootsHealth, based on data from nearly 3,000 individuals, reveals you need 244% more oral vitamin D if you’re not also taking magnesium and vitamin K2, which also works synergistically with vitamin D and helps prevent complications associated with excessive calcification in your arteries.

What this means in practical terms is that if you take all three supplements in combination, you need far less oral vitamin D in order to achieve a healthy vitamin D level. This is also part of the success of the featured study’s DMB combination, which combines vitamin D with magnesium.

Dark green leafy vegetables are a good source of magnesium, and juicing your greens is an excellent way to boost your intake, although supplementation may also be necessary for some people.
    As for vitamin B12, the third component of DMB, increasing B12-rich foods, such as grass fed beef liver, wild rainbow trout and wild sockeye salmon, in your diet can help.

    It’s encouraging, however, that simple and readily available nutrients such as these are showing such significant promise against COVID-19, and highlights the importance of optimizing your nutrient intake year-round to stay healthy and help ward off infectious disease.

    Editor's Note: The current treatment strategies of COVID-19 are among the most commonly debated topic with a lot of confusion among doctors let alone the public.

    In order to reduce the confusion, you need to know that the treatment strategies are slightly different as there are two distinct though overlapping phases in COVID-19:

    1) the inital viral replication phase (that's when treatments are targeted towards reducing the viral load (ramdesivir, hydroxychloroquine, zinc etc.)

    2) the second phase characterised by hyper-inflammation or uncontrolled immune response and cytokine storm etc. Treatments are targeted towards modulating the immune response in order to control the unnecessary damage to major end organs like the lungs, kidneys and the heart. Some of the treatments use include IV steroid, tocilizumab (interleukin 6 inhibitor), vitamin D and even mesenchymal stem cells.

    Disclaimer: This article is not medical advice. It should not replace professional advice from a trusted and competent medical doctor.


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