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Nutritional Supplementation with COVID-19
 One of the most deadly parts of the CoV-2 virus is the ability to stimulate the innate immune response called the inflammasome.  This can cause an uncontrolled  release of pro inflammatory cytokines, referred to as a cytokine storm.  This storm can cause severe and sometimes irreversible damage to the respiratory epithelium.  A 2016 review article  entitled "Natural compounds as regulators of NLRP3 inflammasome-mediated IL-beta production" notes that resveratrol, curcumin, EGCG, and quercetin are potent inhibitors of NLRP3 inflammasome by acting at more than one element of the involved pathways.  However, polyphenols have an even much broader biological effect, as they influence a variety of pathways.  These polyphenols can counteract the "hyper-inflammation" of COVID-19.  

A preprint released in March 23, 2020 identified the ability of plant bioactive compounds to inhibit the COVID-19 main protease which is necessary for viral replication.  Kaempferol, quercetin, demethoxycurcumin, curcumin, catechin are natural compounds that appear to have the best potential to act as COVID-19.  Although more research is needed , there is enough mechanistic support to justify their use. 

For these reasons we recommend the following compounds at standard dosages, to prevent  activation of the NLRP3 inflammasome, to decrease NF-kB activation, and to potentially inhibit COVID-19 replication.  The recommendation is to use higher dosing and or multiple agents when the patient desires higher doses, pre-existing inflammation, multiple co-morbidities, higher risk etc.  Pre-existing inflammation can be, but is not limited to, insulin resistance, diabetic, high blood pressure, sleep apnea, obesity/overweight,  and poor diet, sedentary lifestyle. 


Supplementation for Viruses 
**Quercitin, has been shown to have antiviral effects against both RNA (influenza and coronavirus) and DNA viruses (herpesvirus).  
Regular: 1000 mg/ 2X daily 
Phytosome: 500 mg/2x daily
**Curcumin, Reduces inflammation and viral activity.  
500 - 1,000 mg/2x daily. 
**Zinc (gluconate preferred) 
30-60 mg/day
**N-Acetylcysteine promotes the production of glutathione a potent antioxidant. 
600-900mg/2x daily
** Vitamin D, reduces viral growth, decreases inflammation.  Testing for deficiency is critical and must be completed
5,000 IU/Daily
**Vitamin C contributes to immune defense by supporting many pathways. 
1 to 3 g/day
**​Melatonin promotes quality sleep and has been shown to reduce inflammation. 
5-20 mg at bedtime.  
**Elderberry PREVENTION ONLY   Has been used extensively to prevent influenza. 
500 mg orally daily
**Palmitoylethanolamide (PEA) Naturally occurring agent which has shown to improve outcomes in acute respiratory disease and influenza. 
300 mg 2x/daily for prevention
600-900 mg/3Xdaily for active infection 
**Green Tea (EGCG)  Reduces inflammation enhances the immune system targets one of the processes in COVID-19 replication. 
4 cups daily or 225 mg orally/daily
**Resveratrol As shown in a lab to attack a relative of COVID-19. 
100-150 mg 2X/daily