Supplements vs Long Covid
The supplements industry is the wild west. Here is the Good, the Bad and the Ugly.
I have seem plenty people in a lot of long covid groups that are taking lots of supplements, you might be one of them. These are seen as safe and potentially effective. This is important when there is very little on offer from medical doctors, and science hasn’t come up with anything that works against long covid (SIM01 being one exception).
People with long covid are desperate and will try anything, but is this approach to supplements worthwhile? Is it a waste of money, just making expensive wee? Could it actually be putting us at risk.
I wanted to research supplements against long covid and supplements in general. My conclusion is the supplements industry is the wild west, so lets see what is good, bad, and ugly about supplements. Spoiler alert, it is mostly ugly.
“The use of dietary supplements is widespread. Many of these supplements confer no performance or health benefit, and some may actually be detrimental to both performance and health when taken in high doses for prolonged periods. Some supplements contain excessive doses of potentially toxic ingredients, while others do not contain significant amounts of the ingredients listed on the label.”
The Good!
Vitamin D
Vitamin D
“Vitamin D is important for your immune health. It's also important for your bones and teeth and a deficiency means you can't absorb the calcium from food and so can lead to weakened bones, or rickets in children.
It's found in some food such as oily fish, egg yolks, red meat, liver, mushrooms that have been grown in sunlight and fortified breakfast cereals or spreads, but it is hard to get enough from diet alone. Our main source of vitamin D is from sunshine, but in winter months in the UK you can't get enough from sunshine alone”
There is good evidence that vitamin D is effective, most adults should consider a Vitamin D supplement in the winter, due to less hours of sunlight. Since people with long covid might struggle to get outside, vitamin D supplements is almost always a good idea.
“Since it's difficult for people to get enough vitamin D from food alone, everyone (including pregnant and breastfeeding women) should consider taking a daily supplement containing 10 micrograms of vitamin D during the autumn and winter.” -The NHS
SourceMore on Vitamin DVery promising results for the use of synbiotic supplements against long covid. This is the most promising data I have seen so far for anything against long covid.
SIM01 is a synbiotic preparation of three lyophilised Bifidobacteria strains and three prebiotic compounds.
Folic acid
“When you're pregnant your folic acid requirement increases and it's hard to get enough from diet alone. Folic acid can help prevent neural tube defects in babies, such as spina bifida. So if you're pregnant, or trying to get pregnant the government advises you to take 400 micrograms (µg) of folic acid each day from conception until the end of the 12th week of pregnancy.
You don't need to take a multivitamin for pregnancy but if you do, make sure it's a specific pregnancy one as standard multivitamins contain vitamin A, too much of which can be harmful to a foetus. Also avoid cod liver oil supplements for the same reason.”
- Which?
If you have long covid and are pregnant or want to get pregnant, then my heart goes out to you, becasue that is going to be tough. I hope you nurture the support of the family and friends, because will need it.
More InformationBeyond these if you eat a varied diet, you should get every vitamin in the quantity you need.
Top tip for diets, eat mostly plants.
Definitely try to hit your five fruit and veg a day,
as then you will be all good for all your vitamins
The Bad
Routine vitamin supplements or muti vitamins. Here we are mostly in the category of wasted money, and expensive wee, since most of these vitamins just end up being past out of you with other liquids.
Also taking a vitamin supplement can lead people to take short cuts on the there diet, or eat more unhealthy foods. this is definitely counter productive. Vitamin supplements are no substitute for a good diet, as most of supplement doesn’t get into your system.
Research indicates that most of the vitamins you get from the food you eat are better than those contained in pills. Even though vitamins in supplements are synthesised to the exact chemical composition of naturally-occurring vitamins, they still don’t seem to work as well.
Iron. You should be able to get all the iron you need from your diet even if you don't eat red meat.
Vitamin B12. This is mainly found in food of animal origin, including meat, fish, milk, cheese and eggs. So Vegans wouls probably require supplements
Vitamin C, it is pretty easy to get all you need from your diet. - and people often take thisx to fight colds. however, there is no reliable evidence that this works.
The Ugly
In order for a drug to get approval it has been shown to be safe and effective. Even then there are issues with publication and file draw effect (negative studies don’t see the light of day). So it is far from perfect, but a lot better than Supplements.
Supplements have no hoops to jump through, they can go straight to market.
you have to show that they do harm in order to get them removed. However, in the US when a substance gets banned, and recalled, it is still on the shelves.
One analysis found that 67% of brands subject to FDA recalls still on sale contained adulterants. dietary supplements adulterated with banned pharmaceutical ingredients One or more pharmaceutical adulterant was identified in 66.7% of recalled supplements still available for purchase (18/27)
“This case series study analyzed 30 dietary supplement products purchased from Amazon.com with claims related to immune health. Seventeen of 30 products had inaccurate labels; 13 were misbranded, and 9 had additional components detected but not claimed on the label.”
The Study"Extracts of the evergreen tree yohimbe, Pausinystalia johimbe, though banned in many countries, are sold in hundreds of dietary supplements in the USA."
“Of the 49 yohimbine supplement brands sold at seven major retail chains in the USA, only 4.1% (2/49) provided consumers with both accurate information about the quantity of yohimbine as well as information about yohimbine's known adverse effects”
Pharmaceutical quantities of yohimbine found in dietary supplements“Twenty-three of the 57 products (40%) did not contain any detectable amount of the labeled ingredient. Among the other products, the actual content ranged from 0.02% to 334% of the label’s stated quantity. Only six products (11%) contained ingredients within 10% of the stated labelled standard. Seven of the 57 products were found to contain at least one FDA-prohibited ingredient, an unapproved drug available legally only in Russia (omberacetam), three drugs formerly available in Europe (ioctodrine, oxilofrine, and deterenol), and incredibly, one drug that has never been approved in any country (1,4-dimethylamylamine). “
More Information“In 2008, when a poorly manufactured multivitamin was responsible for more than 200 cases of selenium poisoning — with symptoms including diarrhea, fatigue, hair loss, and joint pain — local health departments cracked the case linking the illness to the multivitamin;”
More Information“Only 10% of the calcium supplements analyzed met the criteria of acceptable Pb[lead] levels (1.5 μg/daily dose) in supplements/consumer products set by the United States.”
More InformationINSANE bee pollen and EDGE Amplified Weight Loss, both of which have been spiked with the antidepressant drug fluoxetine (Prozac).
More Information“Although the majority of the fungi that were found in the supplements are generally not hazardous to human health, many of them could be problematic to sensitive groups, such as immunocompromised individuals.“
More InformationThis is just scratching the surface, a short literate review showed me there are lots of cases of unreliable doses, contamination is rife, and often herbal supplements are spiked with drugs.
None of this is transparent, and the manufactures are barely accountable, and not at all regulated. Banned substances prevail, and it seems you can do whatever you like. This really is the wild west.
Even if you are getting what it says on the packet, there is another problem, mega doses.
Mega Doses
“If taken incorrectly or in excess, these vitamins may be a potential health hazard….When vitamins are taken in excess of the Recommended Dietary Allowances or the individual's needs, the vitamins no longer function as vitamins but instead act as drugs, with such pharmacological effects as clinical toxicities and the abnormal utilization of vitamins.”
More Information“Of particular concern is that several products provided more than or close to the Tolerable Upper Intake Levels (ULs) of some vitamins and minerals, above which there is increasing risk of toxicity with regular use: A prenatal exceeded the UL for magnesium; nine multis exceeded the UL for niacin; and a men's multi was right at the UL for vitamin B-6.”
More Information“Every vitamin has a toxic dose. Further, there is likely a ceiling effect, meaning that there is a level of intake that is sufficient and anything beyond that is of no further benefit. In this view, maximal nutritional benefit comes from taking the appropriate amount of each vitamin, rather than simply taking more. Most vitamins do have a very large range over which they are essentially harmless, which creates the false impression that all vitamins are completely harmless. Some vitamins have a narrower range, and it is possible to experience toxic effects from routine supplementation, or even from an extreme diet. Vitamins A and B6 toxicity are not rare. I have diagnosed B6 toxicity myself, which can cause nerve damage. There is also good reason to conclude that large doses of antioxidants can be harmful, supported further by the current study.” - Steven Novella
“Large-scale studies have consistently shown little benefit in taking mega-doses of supplements. In fact, there is some evidence that taking high-dose supplements to prevent or cure major chronic diseases, such as heart disease and cancer, may be harmful to your health.”
I did a little research of my own into this phenomena. I found the upper safe levels from this paper, and compared this to the level found in supplements. To find the level in supplements, I just looked for the highest dose on the front page of a google search for that vitamin supplement..
The square diagram shows the typical supplement dose compare to the recommended daily allowance (grey), as you can see these doses are massive compared the amount you actually want every day.
The circular diagram shows how these doses compare to the safe upper limit. This is only the dose from one dietary supplement, once you add in you intake from food it is clear that routine supplements would take you over safe levels.
Conclusion
"There is essentially no benefit to routine supplementation, and there may be some risks. You are far better off saving your money, and spending it on fresh produce. Have a varied diet with plenty of fruits and vegetables and you are overwhelmingly likely to get all the nutrition you need.
For those with special needs or if you have any questions, simply consult your physician. Targeted supplementation based on specific needs and measured blood levels is the way to go. You probably should be taking prenatal vitamins if you are trying to get pregnant, and should be under the care of an OB. If you are trying to reduce your stroke and vascular risk, again you should be doing this under the supervision of an appropriate physician. This may include folic acid supplementation.
Also, while we are at it – do not believe supplement hype (antioxidant or otherwise), do not believe nutrition gurus, do not take megadoses, and there is no such thing as a “superfood.”
- Steven Novella