Long COVID Treatment – Vitamin B12, Vitamin D and other vital nutrients

Long COVID and COVID Long Haulers

COVID has gripped many lives for more than a year now and in some countries, people with Long COVID are lucky enough to be treated with essential nutrients which the virus appears to deplete or to exacerbate a latent deficiency. 

So many are writing about this and I wanted to collect together some of these texts for those unaware of a potential way back to full health.

 

The UK

Unfortunately many people in the UK with Long COVID may only be accessing the following treatments: aspirin, steroids, antivirals, antibiotics, and anti inflammatories as detailed on the Patient info website.

This BBC news clip on the effects of #longCOVID (and the following two) feature: Dr Nathalie Mac Dermott, Louise Buxton and Sarah Wakefield, who may benefit from the information within this blog, so if you know them, please share.

You will see that the symptoms of B12 deficiency (and other nutrient deficiencies) and Long COVID very much overlap:

Long-term COVID-19 Symptoms in a Large Un-selected Population.

“The long-term symptoms most enriched in those with COVID-19 are anosmia, ageusia, difficulty concentrating, dyspnea, memory loss, confusion, headache, heart palpitations, chest pain, pain with deep breaths, dizziness, and tachycardia.” 

In my April blog it was also highlighted that B12 could be of help in treating COVID and since then more information has been gathered.

I hope the following offers an added pathway back to health for those experiencing the debilitating effects of Long COVID.

New to Vitamin B12 Deficiency?

If you read the following documents and feel that B12 deficiency could be affecting you, then if possible, please try not to supplement with B12 before testing. Then please see this crash course for more info on how to diagnose and treat B12 deficiency.

You may need B12 injections if you cannot absorb B12 from food and even very low dose B12 tablets can raise serum B12 levels to be ‘within range’ which may skew results and stop you accessing the treatment you need. Some countries allow purchase of injectable B12 from pharmacies but for those in countries like the UK that currently don’t allow this (which we want to change) then you may need a doctor to diagnose and then treat you with injections.

If you have already tried oral B12 supplements but your symptoms haven’t improved, make sure you ask for testing and let the doctor know to make sure the lab note that you have been taking B12. Do not wait to be clear of supplements for 4 months, there is absolutely no point in wasting time!

It’s key that your doctor understands that a within range result, coupled with symptoms should not be ignored as the clinical picture is of utmost importance. Make sure you get to see a copy of your results – you are legally entitled to them.

 

In the UK the NHS stated that Long COVID sufferers would be offered help at specialist centres:

Respiratory consultants, physiotherapists, other specialists and GPs will all help assess, diagnose and treat thousands of sufferers who have reported symptoms ranging from breathlessness, chronic fatigue, “brain fog”, anxiety and stress.

Perhaps NHS England and Professor Chris Brightling would benefit from the information in this blog?


Hypotheses and articles on Long COVID treatment 

 

Sally Pacholok

Undiagnosed Cobalamin Deficiency in the Face of COVID-19:  An unrecognized Comorbidity and Silent killer.

“People with undiagnosed vitamin B12 deficiency may be at a higher risk of dying from COVID-19. Not only does low B12 suppress one’s immune system making it harder to fend off infection and produce antibodies, but B12 deficiency also causes hyperhomocysteinemia, which in turn can cause dangerous blood clots (i.e. deep vein thrombosis, pulmonary embolism, stroke, and myocardial infarction).”

Dr Albert Mir

Please see Dr Albert Mir’s Hypothesis Jan 2021 version –
COVID-19 and vitamin B12. An important warning for the population.                          

COVID-19’s toll on the elderly and those with diabetes mellitus – Is vitamin B12 deficiency an accomplice?

“…The question on hand thus lies on whether managing B12 deficiencies will impact COVID-19 fatality outcome or recovery rates. Herein, we review the latest evidence that shows that B12 deficiency associates in multiple areas very similar to where COVID-19 exerts its damaging effects: immunologically; microbiologically; haematologically; and through endothelial cell signalling—supporting the hypothesis that B12 deficiency is a potential modifiable risk factor in our fight against COVID-19.”

Be well: A potential role for Vitamin B in COVID-19

“There is a need to highlight the importance of vitamin B because it plays a pivotal role in cell functioning, energy metabolism, and proper immune function []. Vitamin B assists in proper activation of both the innate and adaptive immune responses, reduces pro-inflammatory cytokine levels, improves respiratory function, maintains endothelial integrity, prevents hypercoagulability and can reduce the length of stay in hospital [,]. Therefore, vitamin B status should be assessed in COVID-19 patients and vitamin B could be used as a non-pharmaceutical adjunct to current treatments.”

Vitamin b12 Deficiency in Covid-19 Recovered Patients: Case Report.

“The link between immunity and nourishment is clearly known and special attention is being given to its role in the COVID-19 disease Vitamin B12 is one of the dietary requirements necessary in the treatment of coronavirus patients Coronavirus patients often show clinical symptoms, such as fever, cough, respiratory distress syndrome, gastrointestinal infection, and fatigue It is sensible to suppose that COVID-19 affects cobalamin metabolism, impairs intestinal microbial proliferation, and contributes to symptoms of cobalamin deficiency Such an assumption is based on the fact that there are signs and symptoms of vitamin B12 deficiency that are similar to those of a coronavirus infection Based on these observations, it can be inferred that treatment with vitamin B12 can be useful in the recovery of COVID-19 patient.”       

A potential Role for Vitamin B in COVID-19.

“However, SARS-CoV-2 could interfere with vitamin B12 metabolism, thus impairing intestinal microbial proliferation. Given that, it is plausible that symptoms of vitamin B12 deficiency are close to COVID-19 infection such as elevated oxidative stress and lactate dehydrogenase, hyperhomocysteinemia, coagulation cascade activation, vasoconstriction and renal and pulmonary vasculopathy. In addition, B12 deficiency can result in disorders of the respiratory, gastrointestinal and central nervous systems. Surprisingly, a recent study showed that methylcobalamin supplements have the potential to reduce COVID-19-related organ damage and symptoms.”                                                                                                                                                      

ERYTHROCYTES AS A TARGET OF SARS COV-2 IN PATHOGENESIS OF COVID-19

“Hemolytic anemia in COVID-19, which develops at the first stage as a reaction to the SARS COV-2 viral microorganisms, causes cascading reactions to toxic erythropoietin and hemoglobin released from erythrocytes in the bloodstream, and then to hemosiderin released due to the death of erythrocytes in the tissue. The process ends with a decrease in the synthesis of erythropoietin in the decaying liver and kidneys, in the absence of the necessary vitamin B12 due to the pathology of its secretion in the gastrointestinal tract. The characteristic signs of damage to red blood cells in conditions of infection with COVID-19 indicate disruption of erythropoiesis, with developing iron deficiency and B12 anemia.”   

Homocysteine as a Potential Predictor of Cardiovascular Risk in Patients with COVID-19.

“Since the beginning of the novel coronavirus pandemic, the scientific community is in urgent need for reliable biomarkers related to disease progression, in order to early identify high risk patients. In fact, the rapid disease spread makes it necessary to divide patients in risk categories immediately after diagnosis, to ensure an optimal resource allocation. The identification of new biomarkers is strictly related to the understanding of viral pathogenetic mechanisms, as well as cellular and organ damage. Trustworthy biomarkers would be helpful for screening, clinical management and prevention of serious complications.” 

Can Vitamin B12 be an Adjuvant to COVID-19 treatment? 

“COVID-19 has  become an international pandemic and is causing a  worldwide public health emergency; therefore, an effective treatment is urgently needed. The hypothesis is that Covid virus interferes with the cobalamin metabolism, causing  symptoms  of cobalamin deficiency.  This is  plausible to  infer,  because there  are symptoms  of vitamin  B12 deficiency  that  are similar  to  those of  COVID-19. These symptoms  include increase oxidative  stress, homocysteine concentration, activation of the  coagulation  cascade, thrombocytopenia, elevated lactate  dehydrogenase  (LDH), low reticulocyte count, intravascular coagulation thrombosis, vasoconstriction, renal and pulmonary vasculopathies, which can result in respiratory, gastrointestinal and central nervous system  disorders.  Research  shows  that  high doses of methylcobalamin  is the  treatment for  symptoms  of vitamin  B12 deficiency.  Thus, an  additional hypothesis  is that treatment with vitamin B12, especially methylcobalamin, would reduce Covid’s damage to infected patients. Hence, in this  review  article  it  is  suggested  that  methylcobalamin  (vitamin  B12)  may  serve  as  an  attenuator  to  COVID-19symptoms. Clinical studies are required to confirm this hypothesis.”                                                                                              

COVID19, COBALAMIN / B12 AND SEPSIS: A LEFT OF FIELD SOLUTION

“High dose parenteral Cobalamin as prophylaxis and treatment for Covid19 and Sepsis/ARDS.”                                                                                                                                        

Homocysteine and the SARS-CoV-2 Coronavirus – The X Factor of Severe Disease and Death.

“Homocysteine (Hcy) is a natural, non-essential amino acid formed by the de-methylation of methionine. Pathologic elevations occur in many chronic conditions, particularly the cardiovascular conditions common with aging, and in SARS-Cov2. The most common co-existing morbidities, hypertension, cardiovascular disease, and diabetes are all strongly associated with elevated levels of Homocysteine.”
    

Vitamin C, D, Folate (B9), magnesium, zinc etc.

Jerome Burne’s blog 12 Dec 2020  Pressure rises for Vitamin supplements to protect against the virus.

“For almost a year now the government and the NHS have been studiously ignoring the possibility that a highly plausible way of effectively combating the virus would be to ensure that everyone, especially those most exposed to it, had adequate levels of the nutrients vital for a well-functioning immune system, such as Vitamin D, Vitamin C, zinc and selenium. Now suddenly three things that might just make a difference, have all happened at once…”

And the following papers:

Possible Treatments for Covid-19 or LongCovid.

Topic: Which vitamins, minerals, and health supplements might help people who have suffered from Covid-19 and its aftermath for too long?                       

SARS-Cov-2/Covid/19 ADULT RESPIRATORY DISTRESS SYNDROME /ARDS: HIGH DOSE IV METHYLCOBALAMIN IS A SAFE & COST EFFECTIVE RESCUE TREATMENT for ARDS

“Abstract -A SAFE AND EFFICACIOUS PROPHYLACTIC /TREATMENT FOR COVID19, TO PREVENT AND TREAT ACUTE RESPIRATORY DISTRESS SYNDROME, ALREADY EXISTS: RESPECTIVELY using HIGH DOSE IM AND IV METHYLCOBALAMIN FORM OF VITAMIN B12. The hydroxocobalamin form of B12 has been used in ICUs in France, Italy and China for nearly 70 years, as the anti-CN antidote of choice. It is safe, licensed and available. Methylcobalamin would be preferable, for a number of research based reasons. But both could be life savers in the current health crisis.”                                                           

The Role of Folic Acid in the Management of Respiratory Disease Caused by COVID-19.

“Entrance of coronavirus into cells happens through the spike proteins on the virus surface, for which the spike protein should be cleaved into S1 and S2 domains. This cleavage is mediated by furin, which can specifically cleave Arg-X-X-Arg sites of the substrates. Furin, a member of proprotein convertases family, is moved from the trans-Golgi network to the cell membrane and activates many precursor proteins. A number of pathological conditions such as atherosclerosis, cancer, and viral infectious diseases, are linked with the impaired activity of this enzyme. Despite the urgent need to control COVID-19, no approved treatment is currently known. Here, folic acid (folate), a water-soluble B vitamin, is introduced for the first time for the inhibition of furin activity. As such, folic acid, as a safe drug, may help to prevent or alleviate the respiratory involvement associated with COVID-19.”

Virtual Screening and Repurposing of FDA Approved Drugs Against COVID-19 Main Protease.

“The present study provided a comprehensive targeting of the first resolved COVID+19 structure of Mpro and found a suitable save drugs for repurposing against the viral Mpro. Ribavirin, telbivudine, vitamin B12 and nicotinamide can be combined and used for COVID treatment. This initiative relocates already marketed and approved safe drugs for potential use in COVID-treatment.”                                                                                                                                   

Clinical Trials are Proving that Vitamin D fights COVID-19 in Hospitals.    

Open Access Review Evidence Regarding Vitamin D and Risk of COVID-19 and Its Severity.

“Vitamin D deficiency co-exists in patients with COVID-19. At this time, dark skin color, increased age, the presence of pre-existing illnesses and vitamin D deficiency are features of severe COVID disease. Of these, only vitamin D deficiency is modifiable. Through its interactions with a multitude of cells, vitamin D may have several ways to reduce the risk of acute respiratory tract infections and COVID-19: reducing the survival and replication of viruses, reducing risk of inflammatory cytokine production, increasing angiotensin-converting enzyme 2 concentrations, and maintaining endothelial integrity. Fourteen observational studies offer evidence that serum 25-hydroxyvitamin D concentrations are inversely correlated with the incidence or severity of COVID-19. The evidence to date generally satisfies Hill’s criteria for causality in a biological system, namely, strength of association, consistency, temporality, biological gradient, plausibility (e.g., mechanisms), and coherence, although experimental verification is lacking. Thus, the evidence seems strong enough that people and physicians can use or recommend vitamin D supplements to prevent or treat COVID-19 in light of their safety and wide therapeutic window. In view of public health policy, however, results of large-scale vitamin D randomized controlled trials are required and are currently in progress.”                                                                  

Casting Sunlight on an Epidemic   Is vitamin D a critical host factor to prevent COVID-19?

“Some people will experience minimal effects from COVID-19 because their immune system can efficiently fight off the infection. The “host” factors that promote such a strong immune system were extensively studied before the age of antibiotics, and without an effective vaccine, they should be an important part of today’s response to the epidemic. Host factors that are often considered include vitamins (e.g., A and C), minerals (e.g., zinc and magnesium), and the omega-3 fatty acids. Of these, perhaps the most studied and most important host factor impacting survival from COVID-19 is vitamin D, created in skin from exposure to ultraviolet B radiation in sunlight.”                                                                              https://www.medpagetoday.com/infectiousdisease/covid19/85596

Vitamin D is the Solution to the Covid-19 Second Wave.

“What is causing the Second Wave? Vitamin D blood levels are seasonal; they rise and fall from one season to another. In summer, vitamin D levels are higher because people are out in the sunshine. When sunshine (specifically UV-B) strikes the skin, the body makes vitamin D. But as people spend more time indoors, in autumn and winter, vitamin D blood levels fall. The levels decrease from late September to October to November, and they reach their lowest extent in December through March.”                                                                               

Role of Vitamin D in Preventing of COVID-19 Infection, Progression and Severity.

“The outbreak of COVID-19 has created a global public health crisis. Little is known about the protective factors of this infection. Therefore, preventive health measures that can reduce the risk of infection, progression and severity are desperately needed. This review discussed the possible roles of  vitamin D in reducing the risk of COVID-19 and other acute respiratory tract infections and severity.”                                                                                    

Immune-boosting Role of Vitamins D, C, E, Zinc, Selenium and Omega-3 Fatty Acids: Could they Help Against COVID-19?

“Recent evidence has highlighted that nutritional supplementation could play a supportive role in COVID-19 patients. Administration of higher than recommended daily doses of nutrients such as vitamins D, C, E, Zinc and omega-3 fatty acids might have a beneficial effect, potentially reducing SARS-CoV-2 viral load and length of hospitalization . These nutrients are well-known for their antioxidant properties and immunomodulatory effects. Deficiencies in these nutrients can result in immune dysfunction, and increase susceptibility to pathological infection. In fact, dietary insufficiency of vitamins and minerals has been observed in high-risk groups of COVID-19 patients, such as the elderly, increasing the morbidity and risk of mortality  It is well known that the elderly are more likely to be nutrient deficient and to have compromised immunity via immuno-senescence, significantly increasing their risk of poor outcomes from COVID-19, and making adequate nutrition doubly important. The role of vitamins D, C, E, Zinc, selenium and omega-3 fatty acids in immunity, their status in patient infected by SARS-CoV-2 and their potential therapeutic role are discussed.”                                                                                                      

Nutrition, immunity and COVID-19.

“Vitamins B6 and B12 and folate all support the activity of natural killer cells and CD8+ cytotoxic T lymphocytes, effects which would be important in antiviral defence. Patients with vitamin B12 deficiency had low blood numbers of CD8+ T lymphocytes and low natural killer cell activity.”                                                                                                                                

Nutritional Status of Patients with COVID-19.

“Nutrients play a vital role in the defense against infectious diseases and the regulation of inflammation; however, little is known with regards to COVID-19.

We measured concentrations of vitamins B1, B6, B12, folate, vitamin D (25-hydroxyvitamin D), selenium, and zinc in 50 patients with COVID-19. Vitamin D deficiency was shown in 76% of patients and selenium deficiency in 42%. There was a significant difference compared to a control group of 150 people (vitamin D deficiency 43.3%). Among 12 patients with respiratory distress, 11 (91.7%) had one or more nutrient deficiency.”                                                                                                                                    

Combating COVID-19 and Building Immune Resilience: A Potential Role for Magnesium Nutrition? 

“In December 2019, the viral pandemic of respiratory illness caused by COVID-19 began sweeping its way across the globe. Several aspects of this infectious disease mimic metabolic events shown to occur during latent subclinical magnesium deficiency. Hypomagnesemia is a relatively common clinical occurrence that often goes unrecognized since magnesium levels are rarely monitored in the clinical setting. Magnesium is the second most abundant intracellular cation after potassium. It is involved in >600 enzymatic reactions in the body, including those contributing to the exaggerated immune and inflammatory responses exhibited by COVID-19 patients.”                          

A Cohort Study to Evaluate the Effect of Combination Vitamin D, Magnesium and Vitamin B12 (DMB) on Progression to Severe Outcome in Older COVID-19 Patients.

“Objective: To determine the clinical outcomes of older COVID-19 patients who received DMB compared to those who did not. We hypothesized that fewer patients administered 2DMB would require oxygen therapy and/or intensive care support than those who did not.”

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There are many more documents, papers and articles on nutrient deficiencies and COVID treatment and I hope this blog helps with your personal research and pathway to recovery.

I you wish to add any other articles to the comments please do, I would love to hear from you.

Kindness always

Tracey x

www.b12deficiency.info

Do you want to help make B12 injections available OTC from Pharmacies in the UK?

 

 

B12 deficiency at the heart of the matter

This little fella spent a long lime in hospital as a child following a diagnosis of Perthes disease (Legg-Calvé-Perthes disease).  Perthes is a childhood hip disorder caused by a disruption of blood flow to the ball of the hip joint.

By the time he was 30 years old he had suffered his first heart attack.

He died aged 37 following his third.

Born 1937 - Died 1973

Born 1937 – Died 1973

 

Just prior to his first heart attack he experienced intense jaw pain whilst digging the garden and his face drained of colour. In between the 2nd and 3rd attacks he experienced flu-like symptoms but no chest pain and none of the other classic symptoms associated with heart attack. These details were a surprise to me and may be to you too.

This handsome young man was my dad and I inherited many things from him including his hair, a love of woolly jumpers and furniture making skills. (I don’t make a habit of keeping model aeroplanes under my bed though).

Amongst those interesting traits, I also inherited a clotting disorder; Factor V Leiden (FVL) and a myriad of genetic polymorphisms many of which are connected to B12 and folate methylation. (MTHFR, MTRR, MTR,CBS, and BHMT, to name a few).

No one knew why my dad had heart attacks and died so young and it has long remained a mystery, apart from his limp left over from Perthes disease, he appeared to be a fit and healthy young man.

I learned that I had FVL when I was trying to conceive and found that Perthes’ disease also has a connection to FVL. (see refs below).

With the help of genetic testing and the unravelling of my own medical history since being diagnosed as B12 deficient, there are now clear indications of  my dad’s underlying B12 and folate methylation problems.

These coupled with an undiagnosed clotting disorder could have contributed to – or could perhaps be the cause of his death? I wouldn’t mind betting that he had a sky-high homocysteine level but it’s doubtful that testing for this would have been on any radar and even today it’s tricky (if not impossible) to persuade a GP to test.

High homocysteine is known to be strong risk factor for cardiovascular disease, it is a an amino acid which rises to a toxic level in patients with low, B12, B6 and B9 (folate).  If a high homocysteine level is present and the patient also has FVL then research shows there is an even greater risk of Cardiovascular problems.

I was thankful that the GP I saw upon diagnosis of my B12 deficiency seemed to understand the problems associated with FVL and low B12 and I was reassuringly told -‘We’ll have to look after you’. Sadly this statement was quickly forgotten and the silly games regarding strict rationing of life giving B12 injections began.

I contacted many cardiologists to invite them to the conference we held in May but there was a total lack of interest. They receive millions of pounds in research grants but they don’t appear to want to look at the basics. It is a crying shame they didn’t hear Sally Pacholok and Malcolm Kendrick speak, but when their research money comes from pharmaceutical companies I expect they feel their hands are tied.

On health questionnaires we are often asked if we have a history of certain conditions, it seems that with a shrug of the GP’s shoulders, you must understand that you may succumb to heart attack, Alzheimer’s, or bipolar if they are prevalent conditions in your family (they are in mine). That you just have to take it on the chin and await what comes your way.

Many of us who read and research B12 deficiency, join up the dots early. We know that these conditions and many more can all be related to low B12 and that if we are given vital B12 injections at the frequency we need then we can live healthily and happily. We may also feel that the outcome for many of our loved ones might have been different had the full knowledge of B12 deficiency been available to the clinicians in charge of their care.

We want our doctors to discover and understand this too so we send them journals, advise them to read ‘Could it be B12?’ We lay the facts out in black and white, but we are often ignored, ridiculed and neglected. We understand that this action of trying to educate is irritating to doctors but what else can we do?

We are fighting for our lives whilst we wait for the medical community to catch up.

To see who is at risk of B12 deficiency, please click here http://www.b12deficiency.info/who-is-at-risk/ 

Raising awareness; http://www.b12deficiency.info/how-you-can-help/

Please sign and share this petition, let’s get it over 10,000 signatures; https://www.change.org/p/ian-hudson-please-make-our-life-saving-injectable-vitamin-b12-hydroxocobalamin-available-over-the-counter?

Best wishes, Tracey

www.b12deficiency.info

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J Orthop Res. 2014 Jan;32(1):1-7. doi: 10.1002/jor.22473. Epub 2013 Aug 27.
Meta-analysis of hypercoagulability genetic polymorphisms in Perthes disease.
Woratanarat P1, Thaveeratitharm C, Woratanarat T, Angsanuntsukh C, Attia J, Thakkinstian A.
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Legg-Calve-Perthes disease and thrombophilia.
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Thrombophilia and Legg-Calvé-Perthes disease: is it a causative factor and does it affect the severity of the disease?
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Legg-Calve-Perthes disease, venous and arterial thrombi, and the factor V Leiden mutation in a four-generation kindred.
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Thromb J. 2014 Dec 16;12(1):30. doi: 10.1186/s12959-014-0030-0. eCollection 2014.
Severe hyperhomocysteinemia due to cystathionine β-synthase deficiency, and Factor V Leiden mutation in a patient with recurrent venous thrombosis.
Awan Z1, Aljenedil S2, Rosenblatt DS3, Cusson J4, Gilfix BM2, Genest J5.
http://www.ncbi.nlm.nih.gov/pubmed/25516723
Clin Chem Lab Med. 2003 Oct;41(10):1357-62.
The risk of venous thromboembolism associated with the factor V Leiden mutation and low B-vitamin status.
Obeid R1, Hakki T, Jouma M, Herrmann W.
http://www.ncbi.nlm.nih.gov/pubmed/14580166
J Med Assoc Thai. 2000 May;83(5):536-42.
Association between serum homocysteine, vitamin B12, folate and Thai coronary artery disease patients.
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http://www.ncbi.nlm.nih.gov/pubmed/10863900
Mini Rev Med Chem. 2012 Sep 1;12(10):997-1006.
Role of polymorphisms in factor V (FV Leiden), prothrombin, plasminogen activator inhibitor type-1 (PAI-1), methylenetetrahydrofolate reductase (MTHFR) and cystathionine β-synthase (CBS) genes as risk factors for thrombophilias.
Miranda-Vilela AL1.
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