COVID-19 Treatment Update for Adults: An Integrative Medicine perspective*
By Gina Serraiocco MD, IFMCP
*note: this is educational material and should not be construed as medical advice. Please consult with a physician who knows your history before making changes to your treatment plan, especially if you have a history of GI bleed, renal/liver disease, or are on blood thinners.
Welcome Friends! The following information is based on a review of over 200 Covid research papers, my experience treating over 1000 Covid and Long-Covid patients in the past 3 years, and my combined training in internal medicine, integrative medicine, and functional medicine. It represents an attempt to encapsulate a large amount of evolving information into educational material that you can use to take practical action for the present surge. This is a fact and science-based update – please click on the underlined hyperlinks for direct connection to supportive research articles.
Top recommendations for management of active COVID-19 infection
Why is it important to be proactive about treating all cases of Covid-19?
Decrease the chance of Long Covid, which can result from even a mild case of Covid.
Decrease the possibility of long-term chronic disease (cardiovascular, autoimmune, cancer, diabetes) being triggered by sequelae of inflammation from a Covid infection.
It’s important to seek medical care immediately at the onset of symptoms. Inquire about the appropriateness of these two prescriptions, as they are time-sensitive:
Paxlovid: decreases risk of Long Covid when started within 5 days of symptom onset.
Metformin: This very well done Lancet study indicates a 41% decreased risk of Long Covid when a Metformin prescription is started within 3 days of symptoms, for overweight individuals. I would extend this recommendation to anyone with a high fasting sugar level in their recent history. This is how Metformin was used in the study: 500 mg on day 1, 500 mg twice daily on days 2–5, then 500 mg in the morning and 1000 mg in the evening up to day 14.
The following over-the-counter support could also be considered during active infection (for 14 days). These are the items that I have at home, ready to go. Even though acute symptoms may dissipate within a week, the body generally needs extra support for at least one additional week. Note that supplements approved by USP, NSF or ConsumerLab.com are the most reliable for purity and quality.
I’ve done my best to list the tips below in order, with consideration of priority, accessibility, tolerance, and value.
Nasal sinus rinse: Twice daily sinus rinses drastically decrease symptoms and severity of Covid-19 infection, as shown in this study. Start immediately at onset of symptoms. I will also use a sinus rinse after any public exposure as a preventive measure using this method.
Vitamin C: Very important for supporting the white blood cells (immune system), managing oxidative stress from infection, and supporting tissue recovery. Decreases mortality as shown in this meta-analysis and this review article. Consider Vitamin C 1000mg, twice a day for 14 days. Note: if you have a history of kidney stones, high dose Vitamin C can theoretically increase your risk of stones. If so, while supplementing with Vitamin C, be sure to stay very well hydrated, and consider a temporary low oxalate diet.
Zinc: Plays a huge role in the anti-viral immune system and healing. Improves outcomes as shown in this trial, for these 11+ reasons. Consider Zinc picolinate 25mg with food, twice a day for 14 days.
Vitamin D: Supports macrophages (immune system) against viruses. Improves outcomes as shown in these studies, for these reasons. Consider Vitamin D 5000IU with food for 14 days.
Omega-3: Supports complete healing from viral infections as explained here; helps to “mop up” the final stages of an infection. Consider Omega-3 fish or algae oil 2000mg daily for 14 days.
Aspirin: Decreases the inflammation and blood clotting cascade which is seen in Covid. Has been shown to decrease mortality in Covid for these reasons. Consider Aspirin 325mg daily with food for 14 days.
Probiotics: Support faster healing in Covid infection as shown here and here.
Cetirizine (Zyrtec, or any other antihistamine): Rationale explained here. Consider cetirizine 10mg nightly for 14 nights. This is also one of the most successful medications used in Long Covid management.
Famotidine (Pepcid AC): Rationale explained here. Consider famotidine 10mg, twice a day for 14 days. This is also one of the most successful medications used in Long Covid management.
Liposomal Glutathione: May help with recovery from oxidative stress, as explained here. Consider liposomal glutathione 250mg twice a day. A more accessible alternative at health food stores is N-acetylcysteine (NAC), which is a precursor to glutathione, taken 600mg twice a day, for 14 days.
Best tips for prevention through nutrition and lifestyle
Discuss the appropriateness of a booster with your PCP. And if you’re really trying to avoid getting sick, wearing a KN95 or N95 mask while out in public is still quite protective.
People with adequate baseline Zinc and Vitamin C levels are less likely to develop Covid and common cold symptoms, according to this study. The common available supplement dosages appropriate for prevention are Zinc 15mg and Vitamin C 250mg daily.
Having an adequate (non-deficient) level of Vitamin D is essential for optimal immune function. This study on healthcare workers taking 4000IU daily resulted in significantly decreased risk of contracting Covid-19 infection. Consider checking a blood test 8 weeks after regular supplementation to achieve a target Vitamin D level of 30ng/ml (same as 75 nmol/L) based on this study. In my practice, Vitamin D 2000IU daily is a good starting point for normal weight individuals, while overweight individuals commonly need doses of 4000IU or higher to achieve target levels.
A healthy gut is important as explained here, here and here. Consider a daily prebiotic fiber supplement (ex. acacia fiber), increasing fermented food intake (such as sauerkraut), and adding vegetable diversity. A probiotic supplement may also be helpful.
Intermittent fasting may be helpful for many reasons as outlined here and here, and shown to reduce Covid severity in this research study. Please work with your physician to discuss whether starting an overnight 14 hour fasting regimen is appropriate for you. Regardless of fasting interval, an anti-inflammatory lifestyle and diet are recommended.
Closing thoughts
Please remember that in addition to pills, the internal and external environment of your body is extremely important for healing. It’s time to turn up the meditation, mantra, prayer, and calming music to manage stress — these are medicine too. Rest more than you think you need, and nourish healthfully. These foundational measures build a strong immune system, and are essential complements to any pills that you might choose to take.
Wishing you empowered health, peace, joy, and abundance. 💙
With love, Dr. Gina