The Food and Supplement Guide For The Coronavirus Version 6

The Food and Supplement Guide For
the Coronavirus
Version 6, Updated September 3, 2020
by Chris Masterjohn, PhD
This guide provides my recommendations for nutritional and herbal prevention of the
coronavirus. With the recent exception of vitamin D, these strategies have not been tested in
human trials. Other than vitamin D, these strategies are based on the science we have on how
the new coronavirus causes infections, and how similar or different it is from many viruses that
we know a lot about. I have used that science to carefully analyze which immune support
strategies are likely to protect us, and which carry a risk of hurting us. This protocol represents
the best of science-backed strategies for nutritional and herbal prevention.
Extremely Important Disclaimer

This protocol is not meant to substitute for the public health recommendations around hygiene and social
distancing. These must take first place in prevention. There is no safer way to prevent spreading the
infection than to keep the virus far away from your eyes, nose, and mouth. For examples of how I
personally am implementing hygiene and social distancing, please read my article at
chrismasterjohnphd.com/covid19.
I have a PhD in Nutritional Sciences and my expertise is in performing and evaluating nutritional
research. I am not a medical doctor. This guide is meant for educational purposes only, and does not
constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified
health professional.
In order to make this guide easier to read, I have used a conversational tone in many places with
personal pronouns, such as “I” and “you.” This is meant only to make it more pleasant to read, and is not
meant to imply that the guide constitutes any form of advice, whether personal or general.
Table of Contents
● The Protocol ………………………………………………………. Page 2
● Why I Expect This Protocol to Work, Made Simple………….... Page 10
● A Detailed Scientific Analysis…………………………................ Page 24
● Further Reading, Staying in Touch, and a Final Note…………. Page 43
● References…………………………………………………………. Page 45
Copyright © Chris Masterjohn, 2020. All rights reserved. Not for distribution. Do not store this in the files of a public web site.
This guide is for educational purposes only and does not constitute medical or nutritional advice. Do not use these strategies as a
substitute for hygiene and social distancing recommendations made by public health authorities.
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The Protocol
This protocol, except where otherwise noted, is meant to serve as prevention while the threat of
the new coronavirus remains high or uncertain. This is meant as first-line nutritional and herbal
defense, which is, in the big picture, second-line defense after strict hygiene and social
distancing as being recommended by public health experts.
The amounts listed are for adults. For children whose weight is measured in pounds, divide the
doses by 150 and multiply by the child’s bodyweight. For children whose weight is measured in
kilograms, divide the dose by 70 and multiply by the child’s bodyweight.
First: Assess Risk

In order to manage costs and avoid any long-term nutritional imbalances, the protocol is
implemented differently based on the level of risk to which one is exposed.
The use of the term “low-risk” below refers only to the way in which the protocol is implemented,
and is not meant to suggest you should dismiss any concerns about the virus. Conversely,
“high-risk” is not meant to cause panic or fear and is not meant to suggest you will probably get
sick. It simply refers to the way in which the protocol is implemented. Please follow public health
recommendations for your area and living or work situation regardless of how this protocol
assesses risk status.
● Low-Risk: Someone is in a low-risk environment if all of the following apply. Case loads
are stable and not increasing. The local economy has been at least partially reopened
for four weeks or never shut down in the first place and there is no evidence that cases
have started rising. No sudden changes, such as the start of fully opened public school,
have occurred in the last four weeks. All the person’s work is done remotely. All the
person’s travel is done in a privately owned car and stays within low-risk environments.
All exposure to the public is outdoors. No exposure to people with known or suspected
COVID-19 infections.
● Moderate-Risk: Someone is in a moderate-risk environment if all of the low-risk
conditions apply, except any of the following, alone or in combination: 1) they work or go
to school in an indoors public environment; 2) they otherwise encounter the public
indoors for durations longer than five minutes (e.g. indoor dining or entertainment); 3)
they use public transportation, ride sharing services, or rented vehicles, but not air travel.
● High-Risk: Someone is in a high-risk environment if any of the following apply, alone or
in combination: 1) local case loads are increasing; 2) the local economy or public
schools have reopened within the last four weeks or are about to, and it is not yet known
whether local case loads will increase as a result; 3) work is done in an environment
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where exposure to known or suspected COVID-19 infections is part of the job; 4) one
has otherwise come in close contact with a known or suspected COVID-19 case; 5) one
uses air travel at all, even to a low-risk area.
You may wish to step up your risk level from low to moderate, or from moderate to high, if you
have close regular contact with someone considered at very high risk of a severe or fatal case
were they to become infected, for the sake of providing them with extra protection.
Each component of the protocol (everyday use, before and after potential exposures, if and
when you get sick) is described first for those in the high-risk category, because the high-risk
version is the most complete version; after the high-risk implementation, the moderate- and
low-risk modifications are described.
High-Risk Everyday Use: The Essentials

These are to be taken every day as prevention for those in the high-risk category, but not for
those in the moderate- or low-risk categories.
● Elderberry: 700-1000 milligrams per day of elderberry extract from syrup, capsules, or
lozenges. When using a syrup, check the label or the manufacturer’s description to
make sure the exact amount of elderberry extract is reported. With some syrups, this
could be as little as two teaspoons, and with others, it could require as much as four
tablespoons.
● Nutritional Zinc: Foods or supplements providing 7-15 milligrams of zinc taken four
times per day, spread out as much as possible. Choose one of the following options to
provide each dose of 7-15 milligrams of zinc: one or two oysters; oyster extract
supplements providing the equivalent; any zinc supplement (including zinc methionine,
glycine, gluconate, acetate, citrate, or sulfate) that isn’t oxide or picolinate. Take on an
empty stomach unless that causes nausea. If you take it with food, avoid taking it with
whole grains, nuts, seeds, or legumes. Caution: those at high risk of iron-deficiency
anemia should supplement 18 mg/d iron bisglycinate while using high-dose zinc.
● Ionic Zinc Lozenge or Spray: Choose one of the following options. Option 1 (strongly
preferred): Life Extension Enhanced Zinc Acetate lozenges. Suck on one per day,
allowing it to fully dissolve without chewing it or swallowing any pieces (this takes about
a half hour). Option 2 (as a backup in case the lozenges are unavailable): Transfer a
bottle of liquid ionic zinc (you should be able to calculate from the label that it has
900-1200 milligrams of zinc per ounce) into a fine mist spray bottle. Use two or three
sprays per day, trying to get the tongue, inside the mouth, and the back of the throat.
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● Copper: Aim to get 4-8 milligrams of copper per day. Mix and match from the following.
If you chose oysters for the “nutritional zinc” part, this will provide 2 milligrams of copper.
If you instead chose a zinc supplement that had copper in it at a 15-to-1 ratio (for
example, Jarrow Zinc Balance), this will provide 4 milligrams of copper. For each
additional 2 milligrams you will need, use any one of the following food options: 25
grams of spirulina, 40 grams of shiitake mushrooms, 50 grams of sesame seeds, 50
grams of cocoa powder, 56 grams of 90% dark chocolate, or 70 grams of 70% dark
chocolate. If at this point you still have not hit the target, make up the remainder with
MitoSynergy MitoActivator Extra Strength, which provides 1 milligram for every 2
capsules. If this is not affordable, make up the remainder with a copper sulfate or copper
glycinate supplement.
● Vitamin D: Aim to keep your vitamin D status, measured as 25(OH)D, between 30-40
ng/mL (75-100 nmol/L). Best: Measure your vitamin D status (for example, with a home
kit from Grassroots Health) once every 2-4 weeks and use food and sunshine first, and
supplements only if necessary, to stay within 30-40 ng/mL. Good: If you have measured
your 25(OH)D often in the past and know what combination of food, sunshine, and
supplements keeps you within 30-40 ng/mL, use this same combination. Acceptable: In
the absence of data, supplement with 1700 IU per day. Levels above 40 ng/mL are fine if
there is some other reason to maintain them that high, but are not necessary for
COVID-19 prevention.
High-Risk Everyday Use: Potential Add-Ons

● Garlic or Stabilized Allicin: 180 milligrams per day of stabilized allicin; or one clove of
fresh, raw garlic, crushed, exposed to open air for ten minutes, and eaten without
cooking or mixing with other ingredients; or 4 grams of garlic powder, mixed with water,
exposed to open air for ten minutes, and eaten without cooking or mixing with other
ingredients.
● Vitamin C: 150 milligrams per day, preferably from food. Food options include one
serving (100 grams, or 3-4 ounces) of green chilli peppers, yellow or green bell peppers,
guavas, or currants; two servings of kale, broccoli, kiwifruit, red bell peppers, jalapeno
peppers, red chilli peppers, Tahitian taro, or mustard spinach; or three to five servings of
oranges, strawberries, pineapple, papayas, lemons, peas, cabbage, green cauliflower,
Brussels sprouts, banana pepper, red or cayenne pepper, mustard greens, persimmons,
kohlrabi, pummelo, turnip greens, balsam pear, taro leaves, drumstick leaves, longans,
or litchis.
● Vitamin K: 120 micrograms per day of vitamin K1 (obtainable from food with two
100-gram servings of dark green vegetables, or from a supplement in the form of
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“phylloquinone” or “phytonadione”) and 200 micrograms per day of vitamin K2 as MK-4,
MK-7 (also known as menaquinone-4 and -7) or preferably a combination of the two.
The K2 can be obtained from a supplement or by mixing and matching up on six of any
of the following (or simply multiplying the amount by six for a single choice): 3 grams of
(g) natto, a fermented soy food, 4 g natto made from black beans, 8 g emu oil, 9 g goose
liver, 28 g free-range duck fat, 32 g beef liver (limit all liver to 100 grams per week), 45 g
hard cheese, 2.5 egg yolks, 57 g dark chicken meat, 60 g soft cheese, 97 g ghee from
pasture-raised cows, 110 g goose leg, 160 g butter or lard, 225 g chicken liver or heart
(limit all liver to 100 g per week), or 425 g soured whole milk or light chicken meat. More
details about obtaining vitamin K2 from food or supplements can be found at The
Ultimate Vitamin K2 Resource. Caution: Anyone on oral anticoagulants such as warfarin
or any of its relatives must discuss any changes to their vitamin K intake, whether from
food or supplements, with the doctor prescribing the medication before implementing
these changes. The vitamin K could interfere with the medication or alter the dose
needed.
Low-Risk and Moderate-Risk Everyday Use: The Modifications

Low-risk and moderate-risk users should keep these the same as described above:
● vitamin D
● vitamin C
● vitamin K
Low-risk and moderate-risk users should substitute the following for the “nutritional zinc”
target above:
● Use one of the options for nutritional zinc described above only once a day instead of
four times a day.
● At this dose, it is still ideal to obtain the RDA for copper and iron from food, but it is not
necessary to micromanage their ratios.
Low-risk and moderate-risk users may discontinue the elderberry, garlic, zinc acetate
lozenges, ionized zinc spray, or copper except where noted below in the “Before and After
Every Potential Exposure” section below. The elderberry may be continued at a lower dose of
300 milligrams per day if desired.
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All Risk Levels: Before and After Every Potential Exposure
First: Define “Potential Exposure” According to Risk Level
A “potential exposure” is defined differently according to the risk level one has defined for
themselves. Risk levels below refer to the risk level of the person, as assessed on pages 2-3,
and not the risk levels associated with the exposures.
For a person following the high-risk version of the protocol, the definition of “potential
exposure” is as follows:
● Going into public spaces to perform essential errands.

● Accidentally encountering someone you don’t live with face-to-face within six feet, or
making physical content with such a person.
● Touching any surfaces that someone you don’t live with may have touched in the last
nine days without any personal protective equipment.
● Incorrect use of personal protective equipment (for example, taking gloves off your
hands in any other way than explained here or reusing a mask without following these
guidelines).
● Putting your fingers into your mouth or nose, regardless of whether you washed them
beforehand.
For a person following the moderate-risk version of the protocol, the definition of “potential
● Time spent indoors in a public space for work, school, entertainment, or other purposes,
or using public transportation, for longer than five minutes at a time.
● When spending multiple hours indoors in a public space, each 2-4 hours may be
considered an exposure event.
For the person following the low-risk version of the protocol, the definition of “potential
● Traveling to or attending an event, indoors or outdoors, where there are large crowds
of people and are likely to be people that have traveled from high-risk areas in
attendance.
● Traveling to or attending an event that involves indoors time with people who are likely
to have traveled from a high-risk area, regardless of crowd size.
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All Risk Levels: Before and After Every “Potential Exposure”
After any potential exposure that is accidental, and both before and after any potential exposure
that is deliberate, use the following:
● Povidone-Iodine 0.5% Intranasally and Orally: Using a sterile swab, a nasal spray
bottle, or a nasal irrigation kit, apply a 0.5% povidone-iodine solution inside the nose.
Then use 10 mL of the solution in the mouth, swishing for 30 seconds and then gargling
for 60 seconds, then spitting it out. To make a 0.5% solution, start with a 10% solution
and dilute it one part povidone-iodine to 19 parts water. It is critical to dilute it properly
because concentrations above 1.25% damage nasal cilia function and concentrations
above 2.5% are toxic to the tissues of the nose. Some staining of the teeth may occur
but it is mild and reversible.
Caution: Do not use the povidone-iodine if any of the following apply: pregnancy,
any thyroid disorder, treatment with radioactive iodine, kidney failure, dermatitis
herpetiformis, lithium therapy, or known or suspected allergy to povidone-iodine. See
page 14 for more details about contraindications. Limit the use of children to only the
highest-risk exposures. As alternatives: Option 2 (if povidone-iodine is contraindicated):
Sterimar Stop and Protect Cold and Sinusitis Relief (not any of the other Sterimar nasal
sprays). Spray two sprays into each nostril, gently inhaling each spray, and spray four
sprays into the mouth, aiming to cover the tongue, inside of the mouth, and the throat.
Option 3 (if povidone-iodine is contraindicated and Sterimar spray is unavailable):
Transfer a liquid ionic copper supplement (you should be able to calculate from the label
that it has about 70 milligrams of copper per ounce) to a fine mist spray bottle, and spray
it onto the tongue, inside the mouth, and the back of the throat. Do not spray into the
nose. Warning: option 3 tastes terrible, and may have the potential to damage mucous
membranes if used chronically. Do not continue it if you find it irritating, and do not use it
daily for more than four weeks.
● Ionic Zinc Lozenge or Spray: One zinc acetate lozenge, used as described on page 3.
If unavailable, use the ionic zinc spray described on page 3 as a backup. If on the
high-risk protocol, this is additional to what is used under “everyday use.” If on the low-
or moderate-risk protocol, this is used only before and after potential exposures.
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Low- and Moderate-Risk Additions Before Every “Potential
Exposure”
Since the low- and moderate-risk protocol do not include the “everyday use” of elderberry or
garlic, these should be used as described in the “everyday use” section on days where one
knows a potential exposure will occur.
If and When You Get Sick: The Essentials

If you develop any symptoms of the cold or flu, especially a fever, muscle aches, or a dry cough,
the chances you have the coronavirus are about 5% if there is a low case number in your area,
and potentially much higher if you live in a hotspot. If you have any reason to suspect you have
the coronavirus, please seek medical attention and heed all medical advice.
With that said, upon the first symptoms of cold, flu, or the coronavirus, the high-risk “everyday
use” protocol should be followed if one is not already following it, and should be continued if one
is. In addition:
● Vitamin D
○ If you have been consistently following the everyday advice to maintain vitamin D
status at 30-40 ng/mL, supplement with 7-8,000 IU per day at the first sign of
symptoms until recovered.
○ If you have a reason to believe your vitamin D status may be below 20 ng/mL at
the onset of symptoms, you can start with 100,000 IU on the first day, followed by
18,000 IU per day for the rest of the week, followed by 7-8,000 IU per day until
recovered.
● Ionic Zinc Lozenge or Spray: Upon the first sign of a cold, flu, or the coronavirus,
increase the dosing of the zinc acetate lozenges to one lozenge every two hours until
the illness is gone. In the first day or two of symptoms you may use them up to once an
hour if it appears to provide relief. If using the ionic zinc spray, use the same approach
but substitute 2-3 sprays in place of each lozenge.
● Povidone-Iodine 0.5% Intranasally and Orally: Upon the first sign of a cold, flu, or the
coronavirus, use the iodine solution four times a day. If contraindicated (see page 4), use
the Sterimar solution or copper spray six times a day.
If and When You Get Sick: Potential Add-Ons

● 20-40 grams of whey protein per day.
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If and When You Develop Respiratory Distress
If you develop any signs of severe COVID-19, including respiratory distress, please seek the
help of a medical professional, and please seek their advice about anything in this section
before using it.
● Glutathione: A reduced glutathione supplement, taken 2000 milligrams per day.

● Vitamin K: Increase the dose of vitamin K2 from 200 micrograms (as described in
“everyday use”) per day to 3000 micrograms per day. Caution: Anyone on oral
anticoagulants such as warfarin or any of its relatives must discuss any changes to their
vitamin K intake, whether from food or supplements, with the doctor prescribing the
medication before implementing these changes.
Things to Limit Or Avoid Until the Risk Subsides

Exceptions for necessary medical treatment: If you are successfully treating a condition with
anything listed in this section, do not stop doing so to reduce the risk of COVID-19. However, if
you may be overshooting the dose you need, and it is ok with your doctor, try reducing the dose
to see if you can get the same benefit at a lower dose.
● Limit Calcium and Don’t Use Calcium Supplements That Aren’t Balanced by
Phosphorus: Unless advised otherwise by your doctor for medical treatment, limit your
total calcium intake from foods and supplements to 1000 milligrams per day (the amount
in about three servings of dairy or three servings of canned sardines with the edible
bones). Don’t use any calcium supplement besides bone meal. If you have a reason not
to use bone meal (for example, you are vegan), make sure you balance any calcium
supplement you take by supplementing with an equal amount of phosphorus.
● Don’t Use Monolaurin: This has the risk of hurting our immune system as much as it
hurts the virus.
● Don’t Use High-Dose Vitamin C, Pelargonium Sidoides (Umcka), or Bee Propolis:

These all carry the risk of making the lung damage worse if you get infected.
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Why I Expect This Protocol to Work, Made Simple
If you want a simple explanation for why this protocol is our best strategy to stay healthy in the
midst of the coronavirus crisis (after the first-line defenses of hygiene and social distancing), this
is the section to read.
(If you’d prefer scientific jargon and references, you may wish to skip ahead to “A Detailed
Scientific Analysis.”)
How Do We Know Which Foods and Supplements Will Work?
The current coronavirus epidemic is so new that we don’t have any proof showing which foods
and supplements will help prevent it, or which ones will help lower our risk of dying or
developing serious health problems if we do get sick.
We have to come up with a plan, however. We all have to eat, and many of us will be
supplementing with whatever we think will work. So how do we choose the foods and
supplements that are most likely to protect us?
First let’s look at what we shouldn’t do.
“Supporting the Immune System” Can Backfire

One way to approach this that doesn’t work is to eat foods or take supplements simply because
they support our immune system.
While this seems to make sense, it has a huge potential to backfire. Viruses often hijack things
in our body that ordinarily make us healthy to find their way into our cells. The sneakiest viruses
may then undermine our immune system and stop it from working, or, worse yet, hijack it and
use it against us to make us get even sicker.
For example, the coronavirus gets into our cells by hijacking a substance known as “ACE2”
whose normal role is to keep our blood pressure from getting too high and to keep our lungs
and heart healthy. Vitamins A and D are normally incredibly important to our immune systems.
They help us make antibodies and other virus-busting weaponry. And they support our blood
pressure and the health of our lungs and heart by helping us make more ACE2. Vitamins A and
D are good for our lungs, good for our heart, and they support our immune system. Yet, by
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increasing the amount of ACE2 that the coronavirus can hijack in order to get inside our cells,
supplementing with them may actually make us more vulnerable to infection.
As a second example, vitamin A, vitamin C, and an herbal remedy known as pelargonium

sidoides and marketed as “Umcka,” can all help us destroy viruses by making an
immune-boosting, virus-busting superweapon known as interferon. Unfortunately, when it
comes to interferon, the coronavirus most likely behaves just like its evil twin, SARS, which did
its worst harm back in 2003. SARS stands for “severe acute respiratory syndrome.” The virus
that causes it first poisons our ability to make interferon so that it can rapidly reproduce to
achieve massive levels in our lungs. Then, once it’s taken over, it causes us to make crazy
amounts of interferon that vastly exceed what we would normally make in response to the virus.
The excess interferon causes such a storm of inflammation that it leads to the lung damage and
death that this nasty virus became famous for.
In the early stage of infection, when the virus is poisoning the interferon system, it’s not clear
whether vitamin A, vitamin C, or Umcka would be effective. The virus may well undermine their
interferon-boosting abilities completely. In the later stage of infection, when the virus is hijacking
interferon to cause lung damage and death, interferon-boosting supplements could have the
potential to make things worse.
So, when deciding how to protect ourselves from the coronavirus, “supporting the immune
system,” doesn’t cut it. We need a smarter approach.
Copying What We Do for Colds and Flu Doesn’t Work

As with supporting the immune system, we can’t just copy and paste whatever we usually do for
colds and flu.
Sometimes this will work. For example, certain types of zinc lozenges can stop a cold dead in its
tracks, and everything we know so far suggests that zinc offers strong protection against the
coronavirus too. Elderberry is very effective against the flu, and it’s probably just as effective
against the coronavirus.
Yet, other times this doesn’t work at all. For example, vitamins A and D prevent colds from ever
happening in the first place, but they have a strong chance of making us more likely to get the
coronavirus. Umcka makes colds less severe, but has a good chance of making the lung
damage from the coronavirus more severe.
There’s simply no relationship between whether something works for colds and flu and whether
it is likely to work for the coronavirus.
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The Solution: Tapping Into Our Knowledge of the Coronavirus
So what is the solution?
Fortunately, we can use our understanding of how the virus infects us and how it works its dirty
tricks to generate really great ideas that are likely to help and very unlikely to cause any harm.
Here are a handful of things we know:
● This new coronavirus that we are currently fighting belongs to a much larger group of
coronaviruses. However, the many coronaviruses can be very different from each other.
Some of them are so weak that all they can cause is the common cold. Others are so
strong they can kill people. In terms of their inner biology, this one happens to be over
87% similar to the coronavirus that caused the SARS outbreak in 2003, which is named
“SARS coronavirus.” In fact, this new virus is so similar to that old one that its technical
name is “SARS coronavirus 2.”
● This new coronavirus, the original SARS coronavirus, and only one other known
coronavirus (human coronavirus NL63) find their way into cells by hijacking a substance
known as ACE2. Under ordinary circumstances, ACE2 helps keep our blood pressure
under control and keeps our lungs and heart healthy, but these three coronaviruses use
it as a back door to infiltrate our cells. Virtually all other viruses, including all the other
known coronaviruses, use completely different ways of getting into our cells.
● SARS and another coronavirus known as Middle East Respiratory Syndrome (MERS),
which emerged in 2012, both evade, undermine, and hijack our own natural antiviral
defense, interferon. Given the similarity between the biology of the new coronavirus and
SARS, and given the similarity in the lung diseases caused by all three viruses, it’s very
likely that the new coronavirus has a very similar way of twisting our interferon response
towards its own evil ends.
● Coronaviruses belong to a much larger group of viruses known as lipid-enveloped

viruses. They have an oily coating that helps protect them from our immune systems, yet
leaves them vulnerable to soap and to certain substances in foods and supplements that
can penetrate or dissolve the oily coating.
When considering whether foods and supplements are likely to be effective against the new
coronavirus, here are the questions we should ask:
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● Is it effective against SARS?
○ Since the biology of the two viruses are 87% similar, things that are effective
against SARS are likely to be effective against the new coronavirus.
○ If it’s not effective against SARS, there’s a good chance it’s not effective against
the new coronavirus either.
● Does it prevent the SARS coronavirus or human coronavirus NL63 from hijacking
ACE2 to get into our cells?
○ If so, it almost certainly prevents the new coronavirus from doing the same thing.
○ On the other hand, if it’s preventing some other virus from getting into cells by
some completely different means, that really tells us nothing about whether it
would stop the new coronavirus from getting in.
● Does it help us kill other viruses mainly by helping us make more interferon?
○ If so, it might not work the same way with the new coronavirus, which likely has a
SARS-style way of evading, undermining, and hijacking the interferon system. It
could be ineffective, or even make things worse.
○ If not, it runs less of a risk of making any potential lung damage worse.
● Does it destroy the lipid envelopes of most or all enveloped viruses?
○ If so, it probably destroys the lipid envelope of the new coronavirus too. In this
case we could learn from any collection of enveloped viruses, even if they have
little else in common with the new coronavirus.
○ If not, we shouldn’t assume too much about things that kill distantly related
viruses. With the exception of envelope-busting powers, we should focus on the
closely related viruses we discussed above.
Allright. With those concerns in mind, let’s take a look at our foods and supplements!
Elderberry
Elderberry is a type of berry usually sold as a syrup, a powdered extract contained in capsules,
or as an ingredient in lozenges.
Elderberry is highly effective against human coronavirus NL63, one of the three known
coronaviruses to enter cells through the ACE2 “back door.” It directly stops the attachment of
the virus to ACE2, so probably does the same for the new coronavirus as well. Since viruses
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need to hijack our cells in order to multiply and spread, and since if they don’t do that they
eventually die, blocking the entry of the virus into the cell destroys its ability to multiply, spread,
and survive.
Elderberry’s effects aren’t limited to blocking the ACE2 back door. It also destroys the lipid
envelope of avian infectious bronchitis virus, a coronavirus that infects chickens and other birds,
and in humans it is effective against the flu, which isn’t a coronavirus at all. None of these
viruses enter cells using ACE2. Still, its ability to directly block the use of ACE2 as an entryway
means it has the potential to nip the new coronavirus in the bud and prevent it from ever
establishing an infection in the first place. As a result, it deserves a place as a preventative and
first line of defense against the new coronavirus.
How much should we take?
Human studies using elderberry to combat the common cold and flu have all used 700-900
milligrams of elderberry extract per day, divided in two to four doses, either as lozenges,
capsules, or syrup. When a syrup was used, it was four tablespoons per day of Sambucol,
which provides a little over 750 milligrams of extract. Some elderberry syrups have as much as
1200 mg of extract per tablespoon, however, so always consult the label of the product before
deciding on a dose.
1000 mg of elderberry extract per day is safe over the course of 12 weeks, but high doses like
this haven’t been studied for longer than that.
So, the best approach for elderberry would be to use lozenges, capsules, or a syrup to yield
anywhere from 700 to 1000 milligrams per day during the period where the coronavirus threat is
high or uncertain, and to stop the supplement or reduce the dose to 300 milligrams per day
when the threat has calmed down.
Zinc
Zinc is a mineral that we get from food and is absolutely essential to life. Zinc directly inhibits at
least two tools that the original SARS coronavirus uses to reproduce. Since zinc directly targets
SARS, it is likely effective against the new coronavirus as well.
Zinc interferes with the virus replicating and causing trouble once it’s made it into a cell, but we
currently have no reason to believe it stops the virus from getting in. Still, if the viruses that
make it into our cells can’t replicate, they won’t be able to establish much of an infection. Since
elderberry blocks the entry of the virus into the cell while zinc blocks its replication, zinc is just
behind elderberry in importance as a preventative.
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Zinc can be obtained from foods, pills, and lozenges. Lozenges are best for releasing zinc in the
mouth, allowing it to travel into our nose and throat. This is why people often take them for
colds, which mostly infect the nose and throat. Foods and pills get digested and allow zinc to
circulate through all the tissues of our entire body, including our lungs. We know for certain that
the new coronavirus primarily infects the lungs, but recent evidence shows that it also infects
the throat, and that the infection may actually begin in the throat. That means we should
simultaneously focus on getting foods or pills to maximize the amount of zinc within our lungs,
and use lozenges alongside this to maximize the amount of zinc within our mouth, nose, and
throat.
The simplest way to get zinc from foods is to eat oysters. We can only absorb a small amount of
zinc per meal, and one or two oysters will easily hit that mark. So, the best way to maximize the
amount of zinc we get into our lungs is to eat one or two oysters three or four times per day.
If that’s too inconvenient or you don’t like oysters, there are oyster extract pills on the market. If
you use one of these supplements, consult the label and take enough capsules to equal one or
two oysters or 7-10 milligrams of zinc, taken four times per day.
If you are allergic to oysters, or you don’t eat them for religious reasons or because you are
vegan, a zinc supplement would be best. Supplements come in a multitude of forms. Good
forms include zinc methionine, glycine, gluconate, sulfate, citrate, and acetate. Avoid using zinc
picolinate or zinc oxide. Zinc supplements usually provide at least 15 milligrams per capsule,
although some have 10 milligrams. Avoid doses higher than this. Take 10-15 milligrams of zinc
four times per day.
Before choosing your zinc supplement, read the copper section below to help you decide
whether to choose a zinc supplement that contains copper or one that does not.
Never take your zinc with whole grains, nuts, seeds, legumes (which include lentils, peas, and
beans), or coffee. These foods can block your ability to absorb the zinc. Instead, take it on an
empty stomach if you can. If that makes you nauseous, take it with some food, but not with any
of the foods listed above.
Keep your zinc intake this high while the threat of the coronavirus is high or uncertain. When the
threat subsides, reduce the amount of zinc you get from food and supplements to about 15
milligrams per day, which is what we need for general health.
In addition to getting zinc from foods and supplements, the right zinc lozenges can help us
maximize the amount of zinc in our nose and throat. The only zinc lozenges on the market that
are designed to do this correctly are Life Extension Enhanced Zinc Acetate lozenges. In order to
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get the zinc into your nose and throat, it is critical that you suck on these slowly until they fully
dissolve rather than chewing or swallowing them. If you can obtain these, I recommend using
one a day preventatively, and one before and after any potential exposure to the virus. At the
first sign of a cold, flu, or the coronavirus, especially fever, muscle aches, or a dry chough, step
this up to sucking on one every two hours (or every one hour for the first couple of days if it
seems to provide relief) until you run out or until the illness has run its course (and if you think
you have the coronavirus, see a doctor!).
If these specific zinc lozenges are unavailable, I recommend buying a bottle of liquid ionic zinc.
Transfer it to a fine-mist spray bottle. Use two to three sprays as the equivalent of one zinc
lozenge, and try to coat your tongue, the inside of your mouth, and the back of your throat.
I recommend using the lozenges or spray preventatively while the threat of the coronavirus
remains high or uncertain, using them intensively during illness, and stopping when the threat
has subsided.
High doses of zinc need to be balanced with copper, and how to do so is described in the next
section. Zinc can also worsen an existing iron deficiency, so those with iron deficiency anemia
or a tendency to develop it should supplement with 18 milligrams per day of iron bisglycinate
when using the high doses of zinc that accompany the high-risk protocol.
Copper
Copper is a mineral that we get from food and is essential to life.
Although coronaviruses can survive for five to nine days on most surfaces, including teflon,
PVC, ceramic, glass, plastic, silicon, rubber, and stainless steel, they die within five to thirty
minutes on surfaces that contain high concentrations of copper, such as brass.
Copper is just straight up toxic to coronaviruses. Unfortunately, that tells us little about whether
we can use copper to make our nose, mouth, throat, and lungs toxic to coronaviruses, and
nothing about how much copper we would need to consume to do that.
However, we do know that copper has to be balanced with zinc and that, for every 10-15
milligrams of zinc we get, we should get at least one milligram of copper. Since I recommend
above 40-60 milligrams of zinc from food or supplements, plus another 20 milligrams from a
lozenge or spray, this should be balanced with 4-8 milligrams of copper per day.
Some supplements add copper in a 15-to-1 ratio. If you use these, you wouldn’t have to add
extra, but you could add as much as 4 milligrams. If you use oysters to get your zinc, this will
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provide about 2 milligrams of copper. You would need 2-6 milligrams more. If you take a zinc
supplement that does not contain any copper, you would need all 4-8 milligrams.
Copper in foods is superior to copper in pills, so I recommend trying to get the balance from
food.
Each of the following contain two milligrams of copper:
● 25 grams of spirulina.
● 40 grams of shiitake mushrooms.
● 50 grams of sesame seeds.
● 50 grams of cocoa powder, 56 grams of 90% dark chocolate, 70 grams of 70% dark
chocolate.
Note: Liver is also an excellent source of copper, but, for reasons described in the “Vitamin A”
section, I recommend limiting your consumption of liver while the threat of the coronavirus
remains high or uncertain.
If getting the remainder of your copper from food is inconvenient, or you have other reasons to
avoid the foods listed, you can take a copper supplement. The only one on the market that has
copper in the same form as found in food is MitoSynergy MitoActivator Extra Strength, which
provides one milligram of copper for every two capsules. If this supplement is too expensive,
copper sulfate or copper glycinate are acceptable alternatives.
Copper sprays are likely to kill the virus when it is outside our cells just like copper surfaces do.
High concentrations of copper can damage mucous membranes, but Sterimar Stop and Protect
Cold and Sinusitis Relief is specifically designed to deliver copper salts to the nose and throat
with other ingredients that coat and protect mucous membranes. As a backup to
povidone-iodine when contraindicated, I recommend using this preventatively before and after
potential exposure events and more intensively while sick. An ionic copper spray is suggested
as a third-level backup to this, but to protect the sensitive mucous membranes, it shouldn’t be
used in the nose, shouldn’t be used more than a few sprays per day, and shouldn’t be continued
for more than four weeks.
Povidone-Iodine
Povidone-iodine has a long track record of safe use as an antiseptic in many contexts, and is
commonly used in by surgeons, dentists, eye doctors, and many others in the medical field.
Recently, it was shown to completely inactivate the coronavirus that causes COVID-19 in 60
seconds, using a 0.5% solution that is known to be safe to mucous membranes. This can be
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used to irrigate the nasal passages and can be swished or gargled for antiseptic activity in the
mouth and throat.
There is a slight risk that one may be allergic to povidone-iodine or may become allergic to it by
using it. This risk was shown to be 0.4% in patients with suspected skin allergies, so is likely to
be much lower than that in the general population. The ability of povidone to bind iodine allows it
to interfere with radioactive iodine therapy. Povidone-iodine can lead to excess iodine intake,
which can be dangerous in the context of any thyroid disorder or pregnancy. Children, and
especially infants, may be more vulnerable to excess iodine due to lower body size and greater
vulnerability to the developmental effects of thyroid abnormalities. Excess iodine is released into
the urine, and kidney failure could impair that process. Iodine has been linked to flareups of
dermatitis herpetiformis, a skin manifestation of celiac disease. Lithium therapy can enhance the
ability of povidone-iodine to interfere with thyroid function. These concerns form the basis for the
contraindications described on page 4, in which case the Sterimar or ionic copper spray can be
used as a substitute.
Garlic and Stabilized Allicin

Garlic possesses a number of antimicrobial effects, and the most important antiviral chemical
that garlic can yield is called “allicin.” Allicin forms when garlic is crushed or diced and left in the
open air at room temperature for at least ten minutes before being eaten.
Garlic supplements do not provide reliable amounts of allicin, but “stabilized allicin”
supplements, such as Allimax, do. 180 milligrams of stabilized allicin per day reduces the
incidence of the common cold by 60-70%.
Neither garlic nor allicin have ever been tested against any of the coronaviruses. However,
allicin combats at least six different viruses, including the causes of herpes, many cases of the
common cold, and most cases of childhood bronchitis and pneumonia. It does so mainly by
destroying the lipid envelope, so it may well destroy the lipid envelope of the new coronavirus as
well. Allicin also shares some chemical properties with zinc that make it possible that it would
work side by side with zinc to inhibit some of the key tools used by the new coronavirus to
reproduce.
Since garlic and stabilized allicin don’t have any coronavirus-specific science behind them,
garlic deserves a lower place in the protocol than elderberry, zinc, and copper. Since it seems
like it should help, though, it is included as an optional add-on for prevention.
If you choose to use it, I recommend using the dose of stabilized allicin shown to be effective
against colds, 180 milligrams per day. You can also obtain this by crushing one clove of raw
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garlic, or adding water to 4 grams of garlic powder, and letting it sit for ten minutes before eating
it.
You shouldn’t expect a fancy dinner with garlic in the recipe to provide these benefits, however,
because the heat from cooking and the acids included in many sauces may destroy the allicin.
Garlic cloves vary in size, and they will vary in how much allicin they yield. Therefore, stabilized
allicin provides the most reliable dose, garlic powder is next most reliable, and fresh garlic is the
most variable.
If using the optional garlic or allicin, maintain the dose while the threat of the coronavirus is high
or uncertain, then stop.
Vitamin C
Vitamin C is a vitamin that we get from food, and is essential to life. In the small amounts found
in fresh foods, vitamin C is absolutely essential to our immune system. For most of us, vitamin C
supplements help us get better from a cold about one day earlier. This is a small but helpful
effect.
Vitamin C can also be helpful in dire situations. For example, one study examined the effect of
injecting patients with high doses of vitamin C when their lung function was in crisis. The vitamin
C doubled their chances of survival.
However, there aren’t any studies testing vitamin C against any of the coronaviruses. No one in
the study of vitamin C injections was suffering from SARS, the new coronavirus’s evil twin.
Studies show conflicting effects of vitamin C on interferon: in some cases it increases it; in
others, it decreases it. Therefore, it is difficult to predict whether vitamin C would make things
better or worse during the inflammatory destruction of the lungs that happens with SARS and
the new coronavirus.
I therefore recommend eating a diet that provides enough vitamin C to support our immune
system, which is about 150 milligrams per day, but avoiding adding any supplemental vitamin C
on top of this.
You can obtain 150 milligrams of vitamin C from one serving (100 grams, or 3-4 ounces) of any
of the following foods: green chilli peppers, yellow or green bell peppers, guavas, or currants.
You can obtain the same amount from two servings of any of the following: kale, broccoli,
kiwifruit, red bell peppers, jalapeno peppers, red chilli peppers, Tahitian taro, or mustard
spinach.
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Or, you can obtain the same amount from three to five servings of any of the following: oranges,
strawberries, pineapple, papayas, lemons, peas, cabbage, green cauliflower, Brussels sprouts,
banana pepper, red or cayenne pepper, mustard greens, persimmons, kohlrabi, pummelo, turnip
greens, balsam pear, taro leaves, drumstick leaves, longans, or litchis.
If mixing and matching these foods to obtain 150 milligrams of vitamin C is too inconvenient or if
you have reasons to avoid all of these foods, you can supplement with 150 milligrams per day of
vitamin C.
Vitamin K
Vitamin K comes in two forms: vitamin K1 and vitamin K2. Vitamin K2 itself actually refers to a
collection of different subforms, with names such as MK-4 and MK-7. Vitamin K protects soft
tissues such as the blood vessels and lungs from developing calcium deposits, and helps
shuttle calcium to where it belongs, in the hard tissues of the bones and teeth. Vitamin K2 is
more effective at supporting this function than vitamin K1. Coronavirus patients have poor
vitamin K status in their lungs and blood vessels, and those that require ventilation or die have
even worse vitamin K status than those that get better without the need for ventilation. It is
possible that poor vitamin K status in the lungs is one of the reasons the lungs get damaged.
Although it has not yet been proven, vitamin K, especially vitamin K2, may have a role in
protecting against the lung damage that occurs in severe cases of the coronavirus.
Vitamin K also supports blood clotting. Although blood clotting also plays a role in the
coronavirus illness, vitamin K will not cause blood clots except in people who are being treated
with anticoagulants. If you are prescribed anticoagulants, it is critical to tell your doctor about
any change to your vitamin K intake before you implement it, and get approval for the change,
because it might alter the effectiveness or the required dose of the medication.
Glutathione
Glutathione is something we make from the protein we eat that protects our tissues from wear
and tear, helps remove toxins from our body, inhibits the growth of viruses, and helps open the
airways to allow us to breathe freely. Glutathione was used to help reverse respiratory distress
in two patients with the coronavirus.
Whey Protein
Milk is antiviral towards the coronavirus in a test tube, and whey protein accounts for 75% of the
antiviral effect of the milk. One component of whey protein, lactoferrin, accounts for part of that
effect, and 200 milligrams per day of lactoferrin has also been shown to lower IL-6, which might
help prevent the risk of respiratory distress and death. 20-40 grams of whey protein would
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provide 200 milligrams of lactoferrin in its most natural form (which is superior to most lactoferrin
supplements on the market) and would also provide the other antiviral whey proteins. Whey
protein also boosts the body’s own production of glutathione, which has antiviral properties and
helps prevent respiratory distress, as described above. Milk only contains 1.6-2.3 grams of
whey protein per cup, so whey protein is also a more efficient way of providing lactoferrin than
milk.
Vitamin D
Vitamin D is a vitamin that we can obtain from food, or by exposing our skin to sunshine, and is
essential to life. Vitamin D is not as critical to the immune system as vitamin A, but it does help
us make virus-busting weapons and it does seem to reduce the risk of the flu (although during
the swine flu pandemic of 2009, all it did was delay catching the flu by a month). Vitamins A and
D both increase the amount of ACE2 on our cells, and this could theoretically increase our risk
of getting infected with the new coronavirus. However, so far there are no studies published on
the relation between vitamin A status and coronavirus risk, while there are multiple studies
suggesting that infection risk is higher in people with low vitamin D status.
No randomized controlled trials have been done testing the effect of vitamin D supplementation
with infection risk. However, one trial has been published showing that in people hospitalized for
the coronavirus, vitamin D reduces their odds of being admitted to the ICU by 98% and may
even eliminate their risk of dying.
This might be because maintaining vitamin D status at 30-40 ng/mL 25(OH)D prevents
interleukin-6 (IL-6) from rising to the extremely high levels that appear to increase the severity of
the disease and the risk of death.
I recommend using a combination of food, sunshine, and supplements to keep vitamin D status
at 30-40 ng/mL. If supplements are necessary, 900 IU is likely to be sufficient for the average
person, and 1700 IU will be sufficient for most people.
If maintaining 30-40 ng/mL proactively, 7,600 IU per day during illness will be the equivalent of
what was used to nearly abolish the risk of needing ICU treatment in the one human trial
published.
However, the patients in that trial most likely had vitamin D status close to 16 ng/mL, and were
treated with the equivalent of 106,400 IU on the first day and and 53,200 IU on two other days
within the first week, and then 53,200 IU weekly thereafter. They were given califediol, which is
a partially activated form of vitamin D made by the liver when regular vitamin D is consumed.
This is the equivalent of taking just over 100,000 IU vitamin D the first day and taking just under
18,000 IU the other six days of the first week, then reverting to 7,600 IU per day thereafter.
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Calcium and Phosphorus
Calcium and phosphorus are minerals that are found in food and essential to life. Most of us
consume too much phosphorus, because it is used in many hidden food additives. Most of us
don’t consume enough calcium, since it is mostly found in milk, edible bones, and dark green
vegetables. Osteopenia and osteoporosis, conditions of weak bones, are common because of
these imbalances.
For most health issues, we want more calcium and less phosphorus. However, a high ratio of
calcium to phosphorus increases the amount of ACE2 on the surfaces of our cells, so could
increase our risk of getting infected with the new coronavirus.
If you’re being treated for osteoporosis or kidney disease and have been instructed by your
doctor to supplement with calcium or to eat a low-phosphorus diet, stick to the doctor’s orders.
In all other cases, I recommend aiming to limit calcium to 1000 milligrams per day (the amount
in three glasses of milk, or three servings of canned sardines with the edible bones inside), and
to avoid calcium supplements that aren’t balanced with phosphorus. Dairy products and bone
meal are balanced with phosphorus, but all other calcium supplements are not. If you are a
vegan and need to supplement with a vegan source of calcium, supplement with an equal
amount of phosphorus.
Pelargonium Sidoides (Umcka)

Pelargonium sidoides, marketed as “Umcka,” is a medicinal herb from Africa. It is used to treat
infectious bronchitis. It also helps combat human coronavirus 229E, which causes anything
ranging from a common cold to severe pneumonia. However, this coronavirus does not enter
cells using ACE2 and is not very closely related to SARS or to the new coronavirus. Umcka
increases interferon, so it might not be effective against SARS or the new coronavirus, and it
might worsen damage to the lungs once the infection is established. I therefore recommend
against the use of Umcka while the threat of the coronavirus remains high or uncertain.
Honeybee Propolis
Propolis is a substance made by honeybees that offers support to the immune system.
However, it does not have any antiviral activity against any of the coronaviruses that have been
tested, and it has neer been tested against SARS or the new coronavirus. Propolis supports the
immune system in part by boosting interferon, running the risk of making the lung damage from
the new coronavirus worse once infected. I therefore recommend against the use of propolis
while the threat of the coronavirus remains high or uncertain.
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Monolaurin
Monolaurin is a supplement derived from coconut that has a wide spectrum of antimicrobial
effects. When we eat coconut, some of its fat is digested into monolaurin, and milk naturally
contains small amounts. Since coconut is a major traditional food in some parts of the world,
and since monolaurin is found in mother’s milk, it is probably healthy to have some of it in our
diet, especially for a baby, whose immune system is not fully developed. However, monolaurin
seems to carry out its antimicrobial effects mainly by disrupting the oily coating of cells, known
as a lipid membrane, and of viruses, known as a lipid envelope. It destroys any bacteria that
doesn’t have a cell wall, a hard structure that covers and protects the membrane. Some of these
bacteria are bad for us, but some of them are good “probiotic” bacteria. It destroys lipid
enveloped viruses, so it would probably destroy the new coronavirus. However, it also hurts the
membrane of our immune system cells and could decrease immune function. Because it could
mess with the balance of bacteria within our body and could potentially decrease immunity, I
recommend against the use of monolaurin while the threat of the coronavirus remains high or
uncertain.
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A Detailed Scientific Analysis With References
Coronaviruses are a group of related viruses that are enclosed in a lipid envelope and are
covered in club-shaped “spike proteins” that are used to enter cells. In a two-dimensional
electron micrograph, the spike proteins look like a corona, the aura of plasma that surrounds the
sun and other stars, derived from the Latin word for “crown.” Some coronaviruses are mild: they
account for about 15% of cases of the common cold.1 Others are life-threatening: severe acute
respiratory syndrome (SARS) emerged in 2002 and had a 10% fatality rate, while Middle East
Respiratory Syndrome (MERS) emerged in 2012 and had a 35% fatality rate.1
Similarities with SARS
The current coronavirus emerged in December of 2019 and was first named the “2019 novel
coronavirus (2019-nCoV) but in February of 2020 it was renamed the SARS coronavirus-2
(SARS-CoV-2) and the disease it causes was named “coronavirus disease 2019 (COVID-19).”2
Its genome is 96% identical to another coronavirus found in bats, suggesting it transferred from
bats to humans.3 Its genome is 80% identical to that of the coronavirus that causes SARS
(SARS-CoV),3 and the majority of its proteins are 85-100% homologous, with an average
homology of 87%.2 Together with a large overlap in the clinical presentation, this similarity led to
it being renamed SARS-CoV-2, and the similarities mean that treatments that were effective for
SARS are very likely to be effective against COVD-19 as well.
The Importance of ACE2

One of the important similarities between the two viruses is the way they enter cells. Viruses
must enter host cells to replicate, and do so first by attaching or “docking” to a substance on the
outside of the cell that has some completely unrelated function in host physiology. Most
coronaviruses whose entry method is well established dock to aminopeptidase N, which
normally plays a role in breaking down protein during digestion or to regulate circulating
proteins.4 SARS-CoV and SARS-CoV-2, by contrast, dock to angiotensin-converting enzyme-2
(ACE2).5,6 Only one other coronavirus is known to dock to ACE2, the human coronavirus NL63
(HCoV-NL63).7
The role of ACE2 in normal physiology is as part of the renin-angiotensin system.8 In this
system, low blood pressure or low blood volume cause a decreased flow of blood through the
kidneys, and the kidneys respond by making renin. Baroreceptors in the aorta and carotid artery
also sense the low blood pressure and respond by increasing sympathetic tone, which also
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increases renal production of renin. Renin is an enzyme that converts angiotensin, released by
the liver, into angiotensin I. Angiotensin-converting enzyme (ACE, not to be confused with
ACE2) in the vascular endothelium of the lung and kidney then convert angiotensin I to
angiotensin II. Angiotensin II acts on angiotensin receptors to cause vasoconstriction, and
causes the adrenals to release aldosterone, which causes the retention of sodium and the
urinary loss of potassium. Together, vasoconstriction and sodium retention both increase blood
pressure, restoring homeostasis. Chronic elevation of angiotensin II also causes cellular
proliferation and fibrosis.
ACE2 functions as a counterbalance to ACE, leading to the conversion of angiotensin II to

angiotensin1-7 or, in conjunction with other enzymes, the conversion of angiotensin I to
angiotensin1-7 instead of its conversion to angiotensin II. Angiotensin1-7 opposes the effects of
angiotensin II on blood pressure, cellular proliferation, and fibrosis. In other words, ACE2 is a
counterbalance to ACE, and angiotensin1-7, the product of ACE2, is a counterbalance to
angiotensin II, the product of ACE. ACE2 and angiotensin1-7 support healthy blood pressure and
cardiovascular function.
ACE2 is most highly expressed in the lung and small intestine,9 which would explain why SARS
and COVID-19 are primarily lung diseases, and why SARS was associated with diarrhea. The
binding of SARS-CoV to ACE2 is thought to downregulate ACE2 expression, leading to a loss of
the anti-proliferative and anti-fibrotic actions of ACE2 in the lung, thereby contributing to the lung
damage that occurs in SARS.2
ACE inhibitors and angiotensin receptor blockers used to lower blood pressure both increase
ACE2 expression and may increase the susceptibility to COVID-19.10 When evaluating the
potential of nutrients or herbal remedies to help prevent COVID-19, a central concern must be
whether they may impact ACE2 expression as well.
The Importance of Interferon

Another unique aspect of SARS-CoV that most likely applies to SARS-CoV-2 is the way the
virus evades the normal interferon response, undermines it, and then hijacks it and uses it
against the host, a trait it shares with the coronavirus that causes MERS (MERS-CoV).11 Most
viruses cause the host’s immune system to release interferon, which has potent antiviral effects.
By contrast, both SARS-CoV and MERS-CoV evoke little if any interferon response.
One of the key signals of viral invasion that ordinarily stimulates an interferon response is the
presence of double-stranded RNA. This is because host cells make single-stranded RNA
transcripts from DNA, and then use the transcript to make proteins. Viruses, however, have to
copy their own RNA to replicate, leading to the unique presence of double-stranded RNA in the
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host cell. SARS-CoV and MERS-CoV hide their double-stranded RNA in double-membrane
vesicles, which evades detection by the cell.
One of the sensors of double-stranded RNA is retinoic acid-inducible gene I (RIG-I), which, as
its name suggests, is made in response to the activated form of vitamin A, retinoic acid. This is
one of the mechanisms by which vitamin A is important to the antiviral defense. However,
SARS-CoV and MERS-CoV possess an enzyme known as papain-like protease that directly
blocks the activation of RIG-I and thereby prevents the induction of interferon, and undermines
one of vitamin A’s key roles in the antiviral response.12 This is just one example: SARS-CoV and
MERS-CoV together have at least 15 different mechanisms of blocking the production of
interferon.11 They also block the cellular response to interferon, causing interferon resistance, so
that what little interferon is made has even less of an effect than would be expected.11
This initial evasion and undermining of interferon induction allows the viruses to replicate very
quickly, unopposed, and achieve very high degrees of infection in the lungs. During the
replication of the virus, macrophages are recruited to the lung, and when the infection is well
established, the macrophages generate an excessive amount of interferon that initiates a
“cytokine storm.”13 In one experiment, mice had the genes for the main interferon receptor
deleted. A dose of SARS-CoV-2 that killed 85% of the normal mice didn’t kill a single mouse
with the deleted interferon receptor. The genetically altered mice also had less damage to their
lung tissue. In contrast, when the mice were exposed to mouse hepatitis virus or influenza A,
the exact opposite happened: a dose of either virus that only killed 10-20% of normal mice killed
100% of the genetically altered mice.14
The mouse study shows two very important principles:
● Interferon contributes to the lung pathology and death that results from infection with
SARS-CoV.
● The unique ways that SARS-CoV and its closely related viruses evade, undermine, and
hijack the normal antiviral interferon response makes interferon have completely
opposite effects on SARS as it has on most other viral diseases. In most viral diseases,
interferon prevents death; in SARS, interferon promotes death.
In 2006, in response to a request by the World Health Organization, the Centers for Disease
Control and Prevention (CDC) conducted a systematic review of clinical treatments for SARS.15
They identified 12 studies in cell culture that all consistently showed interferon destroyed the
SARS virus. They identified three studies in human SARS patients and considered all three
“inconclusive.”
When taking into account how SARS initially delays the interferon response to achieve a greater
degree of infection but later causes an interferon-mediated cytokine storm that contributes to
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lung pathology and death, it is probably the case that interferon could be helpful at an early
stage of infection, but could be harmful when the immune system is primed to respond with a
“cytokine storm.”
Given this, how should we think about nutrients or herbal remedies that support the immune
system by increasing interferon? Without studying them specifically in the context of SARS-CoV,
MERS-CoV, or SARS-CoV-2, we cannot know whether they could overcome the interferon
evasion of early infection. We also cannot know whether they could worsen a cytokine storm
later on in the course of infection. We do know from the mouse study that interferon can save
the lives of mice in the context of typical viruses, but can kill mice in the case of SARS, so
intentionally boosting interferon with nutrients or herbs strikes me as playing with fire.
Why Colds and Flu Are a Poor Model for COVID-19

Most nutrients and herbal remedies people use for immune support have been tested in the
context of colds and flu. Is it safe to generalize from these studies?
Not at all.
Half of colds are caused by rhinoviruses1, and 90% of them dock to intercellular adhesion
molecule-1 (ICAM-1).16 Flu viruses dock to sialic acid.17 Even the coronaviruses that cause 15%
of colds do not dock to ACE2. They use aminopeptidase N18 or sialic acid.19 Preventing the virus
from docking to host cells is a key strategy for preventing infection, but SARS-CoV-2, the cause
of COVID-19, shares its docking mechanism not with cold or flu viruses, but with SARS-CoV,
the cause of SARS.
Interferon administered to human volunteers reduced the incidence and severity of colds20 and,
as discussed above, interferon protects mice from otherwise lethal doses of influenza A.14
Nutrients and herbal remedies that increase the antiviral interferon response should, therefore,
protect against colds and flu. However, just as interferon leads to lung damage and death in
SARS-infected mice,14 and apparently to a cytokine storm in human SARS patients,13 these
same nutrients and herbal remedies might actually cause harm in SARS, and, by extension, in
COVID-19.
Evaluating Nutrients and Herbal Remedies for COVID-19

Currently, SARS-CoV-2 is too new for us to have a body of literature on how specific nutrients or
herbal remedies affect clinical outcomes in COVID-19. We therefore need to predict the
likelihood of risk and benefit based on an understanding of the mechanisms involved and the
similarities between SARS-CoV-2 and its most closely related viruses.
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In this protocol, I considered the following for each nutrient or remedy:
● Does it impact ACE2 expression?

● Has it been shown to prevent docking to ACE2 by SARS-CoV or HCoV-NL63?
● Does it have antiviral activity against SARS-CoV?
● Does it substantially increase interferon, and if so is that a major mechanism of its
antiviral activity?
● Since all coronaviruses have lipid envelopes, does it work by generally destroying lipid
envelopes?
● Has it been tested in humans, at least for more distantly related effects, such as
prevention or treatment of colds and flu?
The ideal candidates downregulate or are neutral toward ACE2, do not have interferon
modulation as a major effect, and have some specific effect against a closely related
coronavirus (such as inhibition of ACE2 docking or of SARS-specific replication proteins) or at
least have a general effect toward lipid envelopes that is likely to generalize to SARS-CoV-2.
Candidates that have been tested in humans, even for something less closely related such as
the cold or flu, give us a best guess for the proper antiviral dose and provide information about
the safety of that dose.
The following nutrients and herbal remedies were screened for inclusion in the protocol based
on their common use for immune support during cold and flu season, or popular suggestions on
the internet that they could be helpful for COVID-19 prevention.
Elderberry
In rhesus monkey kidney cell culture, elderberry has virucidal, anti-plaque, anti-replication and
anti-attachment activity toward HCoV-NL63.21 Caffeic, chlorogenic, coumaric, ferulic, and gallic
acids were the key constituents with antiviral properties, but caffeic acid had had an IC50 (the
concentration that achieves 50% inhibition of the virus) more than ten-fold lower than any other
constituent. Caffeic acid directly binds to ACE2 to prevent viral docking, offering strong support
that elderberry would have similar antiviral effects against SARS-CoV and SARS-CoV-2.
Elderberry also has antiviral properties toward avian infectious bronchitis virus (IBV), which
infects chickens and other birds, and appears to compromise the lipid envelope.22 Although IBV
is not known to dock to ACE2,4 all coronaviruses have lipid envelopes, so this might be an
additional antiviral mechanism that generalizes to SARS-CoV-2.
Although caffeic acid is present in large amounts in black chokeberries, a number of herbs and
spices, sunflower seeds, ligonberries, prune juice, and dates,23 elderberry extract provides
3.6-12 milligrams (mg) of caffeic acid for every 1000 mg extract. Only black chokeberry has
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comparable amounts (predicting from the fresh weight content and assuming 70% water in the
fresh berry, as published elsewhere24), at 4.7 mg/g extract. Obtaining this amount of caffeic acid
from any other foods would require impossibly high amounts of spices (50-100 grams), or at
least 100 grams of sunflower seed meal, ligonberries, or prune juice, and at least 150 grams of
dates. Although it seems reasonable that the caffeic acid in these foods would have the same
antiviral properties as it has in elderberry, foods are complex mixtures of many compounds with
potentially conflicting effects, so it is possible that the generalization would not hold. Since
elderberry is more convenient to supplement and since it is elderberry that has directly been
tested for antiviral activity, it is elderberry that is included in the protocol.
Trials using elderberry for the flu25 or the common cold26 used 175 mg extract in a lozenge 4
times per day (x/d), 1 tablespoon syrup 4x/d, or a 300 mg extract in a capsule 3 x/d. In a
separate study on cardiovascular disease, elderberry was safely used at 1000 mg extract per
day for 12 weeks.25 These trials are used for the dosing in the protocol.
Zinc
Ionic zinc inhibits at least two proteins required for SARS-CoV replication, papain-like
protease-227 and 3CL protease.28 That zinc targets multiple proteins specific to SARS-CoV
makes it likely that it inhibits the homologous proteins in SARS-CoV-2.
Zinc has been studied extensively in the treatment of the common cold, and the evidence
strongly favors zinc acetate lozenges.29–31 The critical factor is that the zinc ions are released
into the nasal and adenoid lymph tissue. This requires zinc acetate or gluconate, with zinc
acetate ionizing twice as effectively as zinc gluconate, the absence of other ionizable acids such
as citrate or tartrate, the absence of ionizable magnesium, and that the lozenge not be candied.
One of the key mechanisms of action is that zinc ions interfere with the docking of rhinoviruses
to intercellular adhesion molecule 1 (ICAM-1),16 which occurs mostly in the lymph tissue of the
nose and throat.
There is currently no evidence that zinc ions inhibit ACE2 docking. There are also no strong
similarities between the docking mechanisms of rhinoviruses with ICAM-1 and of the three
coronaviruses that dock to ACE2. In rhinovirus docking,16,32 the positive charges of ICAM-1
lysine residues bind to negatively charged carboxylate ions within the viral capsid. Zinc ions
carry a +2 charge, and displace ICAM-1 by binding to the same carboxylate ions. By contrast,
ACE2 docking by SARS-CoV6 and SARS-CoV-25 is mediated mainly by hydrogen bonds, polar
bonds, and van der Waals force, and the known docking inhibition by caffeic acid is mediated by
hydrogen bonding.21 None of this shows that zinc does not inhibit docking, but the docking
mechanisms are not similar enough to predict that it does.
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Our tentative presumption, then, should be that zinc ions inhibit SARS-CoV-2 replication once
the virus has successfully entered the cell.
The use of zinc acetate lozenges for the common cold emphasizes the provision of ionic zinc to
the nose and throat tissue. This is important because less zinc will migrate throughout the nose
and throat if the zinc does not ionize in the mouth and because other tissues will outcompete
the nose and throat if the zinc is swallowed. It is also important because it is specifically ionized
zinc that inhibits rhinovirus docking, just as it is specifically ionized zinc that inhibits the
SARS-CoV replication proteins. However, since rhinovirus docking occurs on the outside of the
cell, most ionic zinc moving through the nose and throat tissue will remain in ionized form by the
time it reaches the site of rhinovirus docking. By contrast, once zinc enters a cell, the cell will
prioritize how much remains ionized and how much is incorporated into various proteins or other
bound locations. Therefore, the aim of zinc for COVID-19 differs from the aim of zinc for the
common cold in that we primarily care about maximizing the zinc available to the most relevant
tissues, rather than ensuring that it reaches the outside of the relevant cells in ionic form.
This then raises the question of what the relevant tissues are.
Since the virus docks to ACE2, primarily infects the lungs, and is spread primarily by droplets
released during coughing, the infection must begin wherever it would first encounter ACE2 after
entering the nose or throat en route to the lungs. A 2004 paper,9 published when SARS was the
major concern, used immunohistochemistry to determine the expression of the ACE2 protein in
human tissues. This is a technique that uses a specific antibody to the ACE2 protein that can
then be stained and visualized under a microscope. They found high expression in the
endothelial cells that line the insides of blood vessels, in the epithelial cells of the lung alveoli, in
the muscular layer of the gastrointestinal tract, and in the enterocytes of the small intestine, but
not the colon. Although they found ACE2 expressed in the oral and nasal mucosa, it was in the
basal membrane, rather than the environment-facing surface of the apical membrane. This
suggests that the oral and nasal mucosa would not act as a site of infection for SARS-CoV or
SARS-CoV-2. Instead, the virus would have to pass through the nose or mouth to get to the
lungs.
On the other hand, a recent paper published in Nature33 as the concerns over COVID-19
emerged argued that ACE2 is highly expressed through the surface epithelium of the mouth,
with the highest expression on the surface of the tongue. This paper measured RNA expression
resolved down to the single-cell level, and dismissed the results of the previous study as lacking
single-cell resolution.
However, these criticisms are dubious for two reasons.
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First, proteins are made from RNA transcripts and it is proteins that carry out physiological
effects. The virus docks to the ACE2 protein located on the cell surface, not to an ACE2 RNA
transcript inside the cell. Although there is a general tendency overall for RNA expression to
correlate with protein expression, the correlations are strong for some proteins and extremely
weak for others.34 If the protein expression is unknown, the RNA expression cannot be used to
show that the protein is indeed expressed.
Second, the staining techniques used in the 2004 paper were able to determine where the
protein is expressed within the cells. Understanding whether the virus can infect the nose and
throat does not require resolution between single cells, which the 2020 paper had. Instead, it
requires resolution of which side of the cell layer the protein is expressed on, which the 2004
paper had. The fact that the 2004 paper found ACE2 in the nasal and oral mucosa located on
the basal side and not the environment-facing apical side suggests that ACE2-docking viruses
do not infect the oral or nasal mucosa. This is perfectly consistent with the symptoms, wherein a
dry cough is prominent and a runny nose or other cold-like symptoms are rare.2
All this may be moot, however. A recent paper published as a preprint that has not yet been
peer-reviewed found direct evidence that the virus infects the throat and independently
replicates in the throat.35 This included the isolation of live virus from oropharyngeal and
nasopharyngeal swabs, the isolation of subgenomic messneger RNAs that are only found in
cells with live infections from the same swabs, and one patient whose swabs showed a viral
mutation that had not occured in the sputum coughed up from her lungs. Furthermore, the viral
load of the swabs seemed to already be in decline on the first day of symptoms, and declined
much more rapidly than the viral load of the sputum. This seems to suggest the infection
actually starts in the throat. There was no difference in viral load between oropharyngeal (mouth
and throat) and nasopharyngeal (nose and throat) swabs, so if the infection starts in the throat it
may well also start in the mouth and nose.
Since the infection is primarily in the lung but appears to start in the mouth, nose, or throat, I
recommend using oral zinc to maximize the amount delivered to the lungs and also using zinc
acetate lozenges to maximize the amount delivered to the mouth, nose, and throat.
The lozenge protocol follows what would be used for colds upon the first sign of illness, and
uses one lozenge per day preventatively, as well as one additional lozenge before and after
each potential exposure.
For the oral zinc, it is generally thought that we can only absorb 5-7 milligrams of zinc per day,36
limited by the saturation of intestinal zinc transporters. However, the relevant studies have been
limited to less than 20 mg/d. Supplementation with 100 mg/d zinc sulfate has been shown to
more than double total zinc absorbed from 4.5 to 10.5 mg/d, while decreasing the fraction
absorbed from 43% to 9%.37 Zinc absorption can be increased further by keeping it away from
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sources of phytate (whole grains, nuts, seeds, and legumes) and coffee, and spreading it out
across the day.36,38
Zinc at 50 mg/d has been shown to lower superoxide dismutase,39 and at 85 mg/d increased
self-reported anemia.40 Both of these could probably have been averted by proper balancing
with copper, which is addressed in the section below. However, the increased need for copper at
high zinc intakes reflects increased expression of metallothionein,41 which can bind to many
positively charged metals besides copper.
In an attempt to maximize the total amount of zinc absorbed without going high enough to cause
major imbalances with other nutrients, the protocol recommends small doses of 7-15 mg of zinc
taken away from phytate four times a day, and balances this with an appropriate amount of
copper.
As a hedge against the possibility that SARS-CoV-2 can infect the mouth or throat, the protocol
also includes one zinc acetate lozenge per day, with a contingency plan to increase the amount
of lozenges used if cold symptoms or potential COVID-19 symptoms are experienced, in line
with the protocols described in the papers cited earlier on using zinc lozenges to fight the
common cold. Since zinc lozenges are likely to be back ordered, the protocol also uses an ionic
zinc spray as an alternative.
When New York City physicians added 50 mg/d zinc as zinc sulfate to their existing
hydroxychloroquine and azithromycin protocol, the use of zinc was associated with a 49% lower
risk of either being transferred to hospice or dying, a 44% decreased chance of requiring
invasive ventilation, and a 56% increased likelihood of being discharged from the hospital and
released to home care.42 In a different report, four cases of COVID-19 were treated with
between 115 and 184 mg/d of zinc from zinc lozenges, either zinc citrate, zinc citrate and
gluconate, or zinc acetate.43 Only one patient was also treated with hydroxychloroquine, and all
seemed to improve as a result of the zinc. One of the patients got worse while using 46 mg/d
but improved while using 115 mg/d, suggesting that the higher dose was needed.
Copper
Ionic copper has been shown to inhibit papain-like protease 2 of SARS-CoV, but with an IC50
roughly ten times higher than that of zinc.27
Better evidence for an effect of copper comes from the survival of coronaviruses on copper
surfaces. For most surfaces, such as teflon, PVC, ceramic, glass, plastic, silicon, rubber, and
stainless steel, coronaviruses can last 5-9 days.44,45 However, SARS-CoV only survives for less
than five minutes on surfaces made from alloys of aluminum oxide and either copper or silver.46
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Human coronavirus 229E has been studied more extensively.45 It will die in less than 30 minutes
on brass (which is an alloy of zinc and copper) or on any surface that has at least 70% copper.
The greater the copper concentration, the quicker the virus dies. While copper alloys with zinc
inactivate the virus more quickly than copper alloys without zinc, zinc without copper has very
little effect. The effect of copper appears to be the generation of oxidative stress beyond the
toleration of the virus.
So, while zinc ions may be much stronger than copper ions at inhibiting enzymes involved in
viral replication, copper ions seem to be far more directly toxic to the virus.
Copper is mainly included in the protocol to keep the zinc-to-copper ratio within the acceptable
range of 2:1 to 15:147 while staying within the upper limit of 10 mg/d.48 Sterimar Stop and Protect
Cold and Sinusitis Relief spray is also recommended for a virucidal effect before and after
potential exposure and during illness because it has been formulated to protect mucous
membranes and has shown to be safe toward an in vitro model of the nasal epithelium.49
Povidone-Iodine
Povidone-iodine was recently shown to completely inactivate SARS-CoV-2 in vitro within 60
seconds, comparable to 70% ethanol.50
Inhalation of 1% povidone-iodine using a jet nebulizer eliminated potentially pathogenic bacteria

from the pharynx in 44% of 16 people and in 86% of the subset of 7 people who did not have
chronic respiratory problems.51 No adverse effects were noted. Multiple studies suggest nasal
application with a sterile swab and at least ten seconds of “vigorous stirring” is a safe way to
reduce or eliminate the bacterium S. aureus.52 Gargling povidone-iodine dramatically reduced
bacterial counts, and recommending the practice to middle schoolers appeared to reduce the
rate of cold and flu, although there is no clinical trial evidence supporting any antiviral
activities.53
It is not clear that it would be as effective against viruses as it is against bacteria, given that
viruses spend much of their life inside human cells, whereas most bacteria live outside human
cells where the povidone-iodine has greater access to them. Nevertheless, it should be effective
against the extracellular virus particles, which should at least reduce peak viral load, and might
help reduce the risk of a meaningful infection when used immediately before and after high-risk
exposure events.
It is not clear whether other iodine solutions, such as Lugol’s, would be as effective as
povidone-iodine. In the original patent for the discovery of povidone-iodine,54 Lugol’s was
effective against S. aureus only down to a 4% dilution, whereas povidone-iodine was effective
as low as 0.33%. Other iodine solutions need to be tested against SARS-CoV-2 to determine
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what concentrations are required. Furthermore, povidone limits the amount of iodine that can
cause toxicity to cell and that reaches the circulation. It therefore likely delivers equal or better
antiseptic activity with less risk of iodine excess. Everything else in this section below refers
specifically to povidone-iodine.
The American Dental Association recommends using a 0.2% solution as a pre-procedure

mouthrinse for patients.55 Physicians from the otolaryngology departments of Johns Hopkins
and University of Pittsburgh School of Medicine released a protocol using nasal irrigation with
240 mL 0.4% and oropharyngeal wash with 10 mL 0.5% every 2-3 hours up to four times per
day for high-risk health care workers or for COVID-19 patients.56 Physicians from the Royal
Surrey County Hospital and King’s College London recommended two sprays of 0.5% into each
nostril, in each case sniffing while holding the opposite nostril blocked, then swishing with 9 mL
for 30 seconds, gargling for 30 seconds, and spitting the solution out, repeating every 2-6 hours
up to four times per day. This was recommended for all patients having procedures in and
around the nose and mouth, all patients with presumed or confirmed COVID-19, and all health
care workers with COVID-19 exposure.57
There is a risk of becoming allergic to povidone-iodine while using it, or already being allergic to
it, but it is very unlikely. In a series of 500 consecutive patients with suspected skin allergy, 0.4%
had contact sensitivity to it.58 Just under 41% of the patients had used povidone-iodine on the
skin or mucous membranes, but there was no information about how it was applied or at what
concentration. Given that these patients may have used concentrations much higher than 0.5%
and without proper guidance, and given that all of them had a suspected skin allergy, the rate of
allergy in the general population is probably much lower than 0.4%, as is the risk of developing
one while using it according to the protocol discussed herein.
Povidone-iodine is contraindicated in the following conditions: A history of allergy to

povidone-iodine, alkyl phenol ether sulphate ammonium salt, disodium hydrogen phosphate
dodecahydrate, any thyroid disease, current radioactive iodine treatment, lithium therapy,
pregnancy, renal failure, and dermatitis herpetiformis.57 It is safe to use in limited high-risk
exposures with children but shouldn’t be used regularly in a sustained manner, due to greater
vulnerability to iodine excess.
Outside of these conditions and the rare allergy, risk is mainly associated with concentrations
significantly higher than 0.5%, or with accidental inhalation of the solution during general
anesthesia. 1.25% povidone-iodine has been shown to decrease the ciliary beat frequency,
representing functional damage to respiratory tissue, and 2.5% is toxic to the nasal mucosa.50
Pneumonitis has been reported in four cases of inhalation of povidone-iodine-containing fluid
during general anesthesia.59 One person developed hypothyroidism after 3-5 gargles per day for
10 years with 5%, and this reversed upon stopping the practice.60 One person developed
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cardiovascular collapse, metabolic acidosis, renal failure, and seizures after a 3-hour-long sinus
irrigation using 300 mL of a 10% solution, and recovered with medical treatment.61
Povidone-iodine has decades of routine use supporting its safety as an antiseptic, and reports
of harm are rare and associated with much higher concentrations, volumes, or durations of use
than discussed herein. With the exception of a minor risk of allergy and the list of
contraindications, these other concerns are unlikely to apply to this protocol.
Garlic and Stabilized Allicin

Garlic’s main antiviral constituent is allicin. Garlic does not contain allicin itself. Rather, it
contains alliin, which is converted to allicin within ten minutes when raw garlic is crushed, or
when garlic powder is mixed with water, and either are allowed to sit at room temperature in the
open air for ten minutes.62 Allicin is not stable to heat or pH,63 so if fresh garlic or garlic powder
are used as a source, they need to be eaten without cooking them or mixing them with
ingredients that might alter the pH. In supplements, garlic extract with “potential” allicin is not
reliable. Only “stabilized allicin” is reliable.64
180 milligrams per day of allicin reduces the incidence of the common cold by 60-70% in
humans.65 This equates to one clove of crushed raw garlic or 4 grams of garlic powder.66 Since
garlic varies in the concentration of its chemical constituents and since garlic cloves vary in size,
the stabilized allicin supplements offer the most control over the dose and crushed raw garlic
offers the least control.
In vitro, allicin has antiviral effects toward herpes simples virus type 1, herpes simplex virus type
2, parainfluenza virus type 3, vaccinia virus, vesicular stomatitis virus, and human rhinovirus
type 2.67 These effects appear to result from damage to the lipid envelope and only work while
the virus is outside of the cell. Since coronaviruses are enveloped, this might generalize to
SARS-CoV-2.
Allicin’s antibacterial effects toward Staphylococcus aureus, however, are from the intracellular
binding to sulfhydryl groups, resulting in the S-allylation of many enzymes, bacillithiol (BSH, a
bacterial analog of glutathione or GSH), cysteine, and coenzyme A.68 The binding to sulfhydryl
groups is also the mechanism by which zinc and copper inhibit SARS-CoV enzymes, so it is
possible that allicin inhibits those enzymes as well. Allicin inhibits papain, so, as the name
suggests, perhaps it also inhibits the papain-like proteases of the SARS-related coronaviruses.
Garlic has never been tested against coronaviruses directly, but since it is plausible and
appears perfectly safe, 180 milligrams of stabilized allicin or its equivalent is included as an
optional add-on in the protocol.
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Vitamin C
Doses of vitamin C between 200 and 2000 mg/d have been used to prevent or treat the
common cold.69 Prophylactic use reduces the duration of cold symptoms in children by 14% and
in adults by 8%. Beginning use at the onset of a cold generally does nothing, although one
study found a benefit of using 8 grams on the first day of the cold. The evidence is strongest in
athletes, where 2 g/d used preventatively cut the incidence of colds in half. In a double-blind
randomized controlled trial of the use of intravenous vitamin C during acute respiratory distress
syndrome (ARDS), vitamin C cut the mortality rate in half.70 However, none of these patients
had SARS. Vitamin C has not been tested against any specific coronavirus. Several studies
using cell culture or mouse models have shown conflicting effects of vitamin C on interferon,
either increasing it or decreasing it.71 With the likelihood of causing unexpected effects on
interferon, high-dose vitamin C for COVID-19 prevention seems potentially dangerous.
Therefore, I recommend getting enough vitamin C, preferably from food, to support normal
immune function, the upper bound of which appears to be 150 mg/d.72,73
Vitamin K
Vitamin K status was recently measured in COVID-19 patients using a biomarker known as
desphospho-uncarboxylated matrix gla protein or dp-ucMGP.74 MGP protects soft tissues such
as the blood vessels, cartilage, and lungs, from calcification, and dp-ucMGP circulates in the
blood when there is insufficient vitamin K to activate the protein by carboxylating it.75 Many
pulmonary diseases, including emphysema, chronic obstructive pulmonary disease (COPD),
idiopathic pulmonary fibrosis, and alpha-1 anti-trypsin deficiency, involve breakdown of elastin, a
protein that makes up the fibers. Vitamin K prevents elastin from calcifying, and since calcified
elastin is more likely to be degraded, vitamin K may thereby help prevent the excessive elastin
degradation that occurs in these diseases.76 In the COVID-19 study, dp-ucMGP was three times
higher in patients than controls, and 72% higher in patients that needed ventilation or died than
in patients that were released without the need for ventilation. Breakdown products of elastin
were also elevated in these groups and correlated with dp-ucMGP. This is consistent with the
possibility that vitamin K would help prevent elastin from calcifying, and thereby prevent it from
breaking down, helping to preserve the lungs from severe damage.
Vitamin K2, which comes in a number of subforms denoted MK-n, such as MK-4 and MK-7,
more effectively reaches tissues outside the liver than vitamin K1. We would therefore expect
vitamin K2 to be more effective than K1 for this purpose.
Anticoagulants often target vitamin K recycling, to prevent it from activating clotting factors. The
international normalized ratio (INR) represents the degree of blood thinning caused by these
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drugs and is used to calibrate the dose. A Kings College London anticoagulant clinic recently
reported a nine-fold increase (from 0.1% to 0.9%) in INRs above the therapeutic level during the
COVID-19 lockdown.77 They noted that this could be caused by antibiotics, liver impairment,
alcohol, acetaminophen, viral infection of the gut decreasing the absorption of vitamin K, or
poorer access to green vegetables due to panic buying and stockpiling food.
It isn’t clear whether dp-ucMGP was elevated in the first study due to an increased production of
MGP, and therefore an increased demand for vitamin K, or poorer supply of vitamin K resulting
from poor absorption or decreased intake. It could have been a combination of both. I suspect
the increased demand occurs as follows: the high neutrophils associated with COVID-19
increase elastase, which degrades the elastin; destruction of the extracellular matrix, where
elastin is found, leads to calcification; MGP production increases to protect against that
calcification. It is not clear whether vitamin K supplementation would fully activate the MGP, but
it might, and doing so would presumably help protect the lungs from severe damage.
In the absence of a randomized controlled trial in this context, we can generalize from previous
results in hemodialysis patients to estimate what dose might be effective for COVID-19. The
dp-ucMGP levels were 1998 pmol/L in poor-outcome COVID-19 patients, three times greater
than healthy controls but one-third lower than in hemodialysis patients. In hemodialysis patients,
360, 720 or 1080 µg of MK-7 three times per week were tested for 8 weeks, and these doses
served to bring the dp-ucMGP down by 17, 33 and 46%, respectively.78 This suggests both that
1080 µg every other day is inadequate and that the dose response decays with increasing
dosage. Extrapolating from these values, the maximum effect of vitamin K in the hemodialysis
patients could require almost 4200 micrograms. Since the poor-outcome COVID-19 patients
had one-third lower levels of dp-ucMGP, this figure was multiplied by 0.67 and rounded up to the
nearest 1000 micrograms, selecting 3000 micrograms for the protocol during times of illness.
This number should be seen as an educated guess rather than a firmly data-driven conclusion.
Glutathione
Previously, one case had been described in a short letter where 100 mg/kg bodyweight
N-acetyl-cysteine (NAC), a precursor to glutathione, was administered as continuous infusion,
transitioned after 3 days to 600 mg twice a day orally. This helped mitigate H1N1 flu-mediated
pneumonia.79 More recently, a report of two cases was published where 2000 mg/d of oral
glutathione was used for COVID-19 respiratory distress in the context of a multi-faceted protocol
and seemed to ameliorate the respiratory distress.80 Glutathione is found in high concentrations
in the extracellular fluid of the lung, where it protects against oxidative stress, maintains mucous
fluidity, and combines with nitric oxide to produce nitrosoglutathione, an endogenous
bronchodilator.81 These mechanisms may explain why it would relieve respiratory distress.
Additionally, glutathione has multiple antiviral effects,82 and it’s ability to break disulfide bonds
could play a role in preventing SARS-CoV-2 from docking to ACE2.83
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Whey Protein
Milk, whey protein, and lactoferrin are all antiviral toward SARS-CoV-2 in vitro.84,85 Whey protein
accounts for 75% of the effect of milk, and the lactoferrin component of whey protein accounts
for 19% of the effect of milk. Apart from lactoferrin, it is unclear what the exact components are,
whether they survive digestion, and what their pharmacokinetics are, so it is difficult to predict
what dose of whey protein or milk, if any, would prove antiviral in humans. Whether lactoferrin
can be absorbed in humans is controversial,86–88 but in rats it is cleared from circulation within an
hour,89 suggesting that in vitro studies incubating cells for one or more days with it cannot be
used to model its antiviral effects in humans.
However, lactoferrin has been shown to lower IL-6,90 which may help prevent respiratory
distress and death in humans with COVID-19. Specifically, 90 pregnant women in a
non-randomized intervention trial were given the choice of bovine lactoferrin or iron as ferrous
sulfate. The lactoferrin was taken 100 mg twice a day before meals, yielding a daily dose of 200
mg. The lactoferrin, but not the ferrous sulfate, lowered IL-6:
● In pregnant women with minor beta-thalassemia, serum IL-6 dropped 76% from 25 to 6
pg/mL.
● In pregnant women with hereditary thrombophilia, serum IL-6 dropped 35% from 89 to
58 pg/mL.
● In non-pregnant women with minor beta-thalassemia, serum IL-6 was almost cut in half,
dropping from 24 to 13 pg/mL.
● In non-pregnant women with hereditary thrombophilia, serum IL-6 dropped five-fold, from
45 to 9 pg/mL.
In patients with COVID-19 pneumonia and hypoxemia, blocking IL-6 with tocilizumab was
recently shown to reduce the chance of the hypoxemia from getting worse 8-fold, and to
increase the rate of the recovery of hypoxemia over the course of two weeks from 60% to
80%,91 suggesting that lactoferrin’s ability to lower IL-6 may have similar potential.
200 mg of lactoferrin can be obtained from 10-57 grams of whey protein,92 which usually comes
in roughly 20-gram scoops, so could be approximated with one to two scoops, providing 20-40
grams. Most commercial products are apolactoferrin, which is iron-depleted. The lactoferrin
used to lower IL-6 was 20-30% iron-saturated, and the specific product, Lattoglobina, is only
available from Italy. Natural lactoferrin in milk and whey protein is 15-20% iron-saturated,
making whey protein a source of lactoferrin much closer to that used to lower IL-6 than what is
available in most supplements. Milk only contains 1.6-2.3 grams of whey protein per cup, so
whey protein is also a more efficient way of providing lactoferrin than milk.
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20-40 grams of whey protein would also be expected to increase glutathione levels.93,94
Vitamin A
Vitamin A is absolutely critical to the immune system, supporting the production of everything
from mucus to antibodies. It’s role in the immune system gave it its reputation as “the
anti-infective vitamin” in the early half of the twentieth century.95 Nevertheless, it’s active
metabolite, all-trans retinoic acid, has been shown to upregulate ACE2 in the heart of rats
whose blood pressure was raised by constricting their aortas,96 in the heart and kidney of
spontaneously hypertensive rats,97 in the kidney of rats with glomerular sclerosis (to much
higher levels than even healthy control rats),98 and in rat tubular epithelial cells subject to
hypoxia-repurfusion.99 Due to the consistent ability of retinoic acid to upregulate ACE2 across
multiple models, including the ability to raise it to much higher levels than found in healthy
controls, vitamin A may be risky to use at high doses for the prevention of COVID-19.
However, vitamin D also upregulates ACE2, and, as described below, the evidence that has
accumulated has so far failed to show any clear increase in infection risk at high levels, but has,
by contrast, shown that infection risk is elevated at low levels and that high doses can nearly
abolish the risk of requiring ICU treatment in those hospitalized. While no such research has
been done on vitamin A, the research done on vitamin D suggests that increasing ACE2 in
animal models is not a good predictor of whether an otherwise antiviral fat-soluble vitamin might
increase risk in any context. Therefore, the suggestion to limit vitamin A intake in earlier editions
of this guide has been removed. Nevertheless, it still seems prudent to limit vitamin A to what
occurs in natural vitamin A-rich foods and, in supplements, to values close to the RDA, rather
than megadosing.
Vitamin D
Vitamin D is needed for the production of antimicrobial peptides such as cathelicidin, and
numerous trials have investigated its ability to prevent the flu. 1200 IU/d was effective at
preventing and shortening the flu in infants and school children,100,101 although during the H1N1
pandemic, it only served to delay contracting the flu by a month in high school students.102
As with vitamin A, vitamin D runs the risk of increasing ACE2. Calcitriol, the active metabolite of
vitamin D, increases ACE2 mRNA and protein in rat pulmonary microvascular endothelial cells
treated with lipopolysaccharide,103 synergizes with diabetes to increase ACE2 protein in the
renal tubules of rats,104 and in the brains of both hypertensive and healthy rats.105
There are three studies that don’t line up perfectly with the three just discussed. In double
transgenic rats overexpressing human angiotensin and renin genes, vitamin D depletion had no
effect on serum ACE2.106 Notably, serum ACE2 would be ACE2 that has been shed from cells
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and might block viral entry into cells, not cell surface ACE2 that would enable viral entry. Soluble
ACE2 in serum may not be reflective of cell surface ACE2 in other tissues, and vitamin D
deficiency might not necessarily yield the opposite of high-dose supplemental vitamin D.
Calcidiol, the partially activated metabolite of vitamin D, mitigated the elevation of ACE2 that
otherwise occurred in rat kidney in response to ischemia-repurfusion.107 The authors attributed
this to a reduction in the level of injury to the kidney that led to less overproduction of
angiotensin-II and less of a compensatory elevation of ACE2. Thus, this appears to reflect a
beneficial effect of vitamin D on the resilience of the kidneys to the model of injury being
studied, and not a direct suppressive effect on ACE2. In an observational study in humans,108
people who supplemented with vitamin D had lower circulating ACE2 than those who didn’t
when they had stage 5 kidney disease, but this was not statistically significant if they had less
severe kidney disease, and there was no difference in healthy controls. As with the rat study,
circulating ACE2 is likely to be protective or irrelevant.
Of the four studies that looked at the effect of vitamin D on non-circulating ACE2, three support
an increase, and one supports an indirect decrease that resulted from a protection against the
experimental model of kidney injury. On the balance, vitamin D is likely to increase ACE2
expression, which could increase the risk of infection and possibly worsen the severity of an
existing infection.
On the other hand, the major predictors of severity and/or death in human COVID-19 patients
are low lymphocytes,109–113 a high ratio of neutrophils to CD8+ T cells,4 and high interleukin-6
(IL-6).109–115 Vitamin D may affect some of these markers.
In the context of HIV, vitamin D deficiency is associated with lower CD4 T cell counts in some116
but not all117 studies. However, vitamin D supplementation does not raise the CD4 T cell
counts.118,119 Similarly, in postmenopausal women, vitamin D does not alter lymphocyte
counts.120 However, in the context of tuberculosis, vitamin D supplementation increases
lymphocyte counts,121 and in adolescent girls, vitamin D decreases the ratio of neutrophils to
lymphocytes.122 This suggests that vitamin D may favorably alter these markers in some but not
all contexts, and that might translate to COVID-19 in a beneficial way.
A meta-analysis of four trials in middle-age and older-adults123 found no effect of vitamin D on

IL-6. Another meta-analysis124 reported four studies that all found no effect of vitamin D on IL-6
in hemodialysis patients. Another125 pooled the results of eight studies and reported no effect in
obese and overweight subjects. In diabetes,126 three out of five studies found that IL-6 was lower
in vitamin D supplementation groups than in controls, but statistical significance was only
achieved in one study, and when the results of the five studies were pooled together, they were
not statistically significant. However, in heart failure,127 vitamin D supplementation reduced IL-6
in one trial but not another. In diabetic kidney disease,128 vitamin D supplementation reduced
IL-6 in all three trials. Intramuscular injection of 300,000 IU vitamin D reduced IL-6 in patients
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with ventilator-associated pneumonia.129 Since COVID-19 causes pneumonia, this is arguably
the context that is most relevant to COVID-19. A reasonable interpretation of these studies is
that vitamin D does not affect IL-6 under conditions of chronic low-grade inflammation, but does
lower IL-6 during acute and highly inflammatory conditions.
Over the last few months, numerous observational studies associating poor vitamin D status
with greater COVID-19 infection risk or with worse and more fatal outcomes have been
published.130–140 Overall, these suggest that there is a greater risk of becoming infected, having
a worse outcome, and having a more fatal outcome under 30 ng/mL in some studies, and under
20 ng/mL in others. Genes that impact 25(OH)D do not seem to impact COVID-19 risk, but
genes only explain a very small proportion of the variation in 25(OH)D and many of the most
relevant genes are very non-specifically related to 25(OH)D.141 The prevalence of people with
25(OH)D under 10 ng/mL explains 58% of the variation in the per capita COVID-19 mortality
rate among European countries. The data on levels above 35 ng/mL in these studies is too few
and far between, and too conflicting across studies, to make it clear whether there is a 25(OH)D
concentration above which COVID-19 risk increases, forming a U-shaped curve.
Up until the first randomized controlled trial, published on August 29, 2020, it was not clear
whether the association between vitamin D and COVID-19 represented cause or effect, since
vitamin D is needed for immune function, while inflammation also depletes it.142
However, the first randomized controlled trial has shown that vitamin D supplementation given
to hospitalized patients with COVID-19 pneumonia reduces the odds of ICU admission by
98%.143 Although there were only two deaths in the control group, there were zero in the vitamin
D group, and given that most patients would be admitted to ICU before dying, the dramatic
reduction in ICU admission suggests that vitamin D may also abolish the risk of death.
All patients in the treatment and control groups of this study received the then-standard of care,
which included hydroxychloroquine and azithromycin, now no longer used in that hospital. The
vitamin D was administered as oral calcifediol, which is 25(OH)D, the form made by the liver
from vitamin D, and it is 5 times more potent than vitamin D. 5 micrograms of calcifediol are
equivalent to 1000 IU of vitamin D.144 The treatment was 532 mcg on the first day, 266 mcg on
days 3 and 7, and 266 mcg weekly thereafter. This is 106,400 IU on the first day, and 53,200 IU
on days 3 and 7, and weekly thereafter. This maintenance dose after the first week, if taken
daily, would be 7,600 IU per day.
The 25(OH)D levels of the patients were not measured, but average vitamin D levels in the
region of Spain where the study took place at the time of year in which it was conducted are 16
ng/mL. A single bolus of 100,000 IU of vitamin D typically raises levels around 10 ng/mL to
20-30 ng/mL.145 Most likely the 25(OH)D levels reached 30-40 ng/mL by the end of the first
week and were in the area of 40 ng/mL while the bulk of the recovery took place.
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I believe the strongest interpretation of these studies at present is that maintaining vitamin D
status close to 30 ng/mL restricts IL-6 from rising to the very high levels associated with severe
disease and death. Although this suggests vitamin D is more important after one is infected than
in the time leading up to the infection, 30-40 ng/mL is also associated with the lowest all-cause
mortality in most studies146,147 except a single outlier that was only published as a conference
abstract.148 Therefore, maintaining vitamin D close to this level makes sense even if one has not
been infected.
The average person needs 900 IU/d to maintain 25(OH)D above 30 ng/mL, and 1700 IU/d will
be sufficient for 97.5% of people.149 If 25(OH)D is maintained between 30-40 ng/mL leading up
to infection, then the maintenance dose of calcifediol used in the RCT, converted to vitamin D3,
would be 7,600 IU per day, and this would probably be sufficient to achieve the effects observed
in the study.
Calcium and Phosphorus

Calcium and phosphorus are important constituents of bone and have a complex hormonal
system that keeps them in the appropriate balance within the blood. As such, they tend to have
opposite effects on certain hormones, such as parathyroid hormone, calcitonin, and fibroblast
growth factor-23 (FGF23). A high calcium-to-phosphorus ratio suppresses FGF23, while a low
calcium-to-phosphorus ratio increases it.150–152 FGF23 suppresses ACE2,152 suggesting that a
high calcium-to-phosphorus ratio might increase ACE2. As a result, I recommend keeping
calcium supplements limited to 1000 mg/d unless otherwise directed by a physician and making
sure any supplemental calcium is matched with supplemental phosphorus in an approximately
1:1 ratio.
Pelargonium Sidoides (Umcka)

Pelargonium sidoides, marketed in one product as “Umcka,” is rich in many of the same
phenolic compounds as elderberry, but gallic acid is dominant and caffeic and ferulic acids are
only present in low amounts.153 Since caffeic acid is so dominant an antiviral in elderberry when
tested against HCoV-NL63,21 Umcka is likely inferior to elderberry for COVID-19 prevention.
Umcka has some activity against human coronavirus 229E, but the mechanisms are unclear.154
It appears to mainly target enveloped viruses, but not consistently. It increases both interferon
155
and iNOS156 in cell culture. If it does the same in infected humans, it could have conflicting
effects on lung pathology. It increases neutrophil activity,157 although high neutrophil counts are
associated with poorer SARS prognosis.158
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Since elderberry offers more direct antiviral activity and echinacea offers safer immune support
with a more nitric oxide-dominant pattern and less stimulus to interferon, adding Umcka to the
protocol would have too much risk and too little potential for benefit. The protocol therefore
includes a recommendation to avoid Umcka when focusing on COVID-19 prevention.
Honeybee Propolis
Propolis flavonoids do not have significant direct antiviral activity against any viruses, including
coronaviruses, tested.159 Brazilian propolis augments the interferon response in mice infected
with herpes simplex virus type 1159 and in chickens vaccinated against Newcastle disease.160
While these data suggest that propolis is useful immune support against some viruses, the
increase in interferon is too risky for COVID-19 prevention, so the protocol recommends against
propolis for this purpose.
Monolaurin
Monolaurin appears to disrupt lipid dynamics in viral envelopes and in the cell membrane of any
organism that doesn’t have a protective cell well. It is effective against lipid-enveloped
viruses,161,162 and it has been argued to only hurt pathogenic organisms because it is effective
against yeast and the bacteria that cause bacterial vaginosis, but not against lactobacillus.163
However, it is far more likely that lactobacilli aren’t affected by monolaurin because they are
gram positive bacteria with a cell wall that protects their membrane from the harmful effects of it
has on lipid dynamics. Although probiotic bacteria are mostly gram positive, there are probiotic
gram negative bacteria and probiotic yeasts that do not have cell walls,164 and these are
probably vulnerable to monolaurin. In fact, monolaurin impairs human T cell signaling by
disrupting the lipid dynamics of the cell membrane.165 As an enveloped virus, SARS-CoV-2 is
probably vulnerable to monolaurin. However, the possibility that monolaurin could impair T cell
functioning seems too high to risk while the COVID-19 threat remains high or uncertain.
Further Reading, Staying in Touch, and a Final Note

For more on how I’m dealing with the coronavirus beyond this protocol, particularly for hygiene
and social distancing, see my article at chrismasterjohnphd.com/covid19.
To receive my free almost-daily newsletter, COVID-19 Research Updates, sign up at

chrismasterjohnphd.com/covid19-updates
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Because you purchased this guide, that means you have access to The Coronavirus Forum,
where you can ask me questions about it or discuss it with other people who have purchased it.
Sign in at https://themasterpass.chrismasterjohnphd.com/login and if you don’t remember your
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https://themasterpass.chrismasterjohnphd.com/password/new. If you are unable to log in, email
support@chrismasterjohnphd.com Inside your dashboard, you will find The Coronavirus Forum.
Come join the discussion!
This guide focuses on nutrition and herbal remedies, but besides the critical hygiene and social
distancing measures, we also need to get good sleep, stay active without being too hard on our
bodies, manage stress well, stay connected to our families and friends, and maintain a positive
outlook. All of these things help support a healthy immune system. They are so hard right now!
Understanding how to deal with this situation is stressful and for many of us it’s a source of
panic. I just want to say that I am grateful to you for having purchased this guide, which helps
support my work and my ability to get the word out, and I hope the effort that I’ve put into this
guide brings calm and clarity your way.
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The Food and Supplement Guide For

by Chris Masterjohn, PhD

Extremely Important Disclaimer

First: Assess Risk

High-Risk Everyday Use: The Essentials

High-Risk Everyday Use: Potential Add-Ons

Low-Risk and Moderate-Risk Everyday Use: The Modifications

First: Define “Potential Exposure” According to Risk Level

● Going into public spaces to perform essential errands.

If and When You Get Sick: The Essentials

If and When You Get Sick: Potential Add-Ons

● Glutathione: A reduced glutathione supplement, taken 2000 milligrams per day.

Things to Limit Or Avoid Until the Risk Subsides

● Don’t Use High-Dose Vitamin C, Pelargonium Sidoides (Umcka), or Bee Propolis:

How Do We Know Which Foods and Supplements Will Work?

First let’s look at what we shouldn’t do.

“Supporting the Immune System” Can Backfire

As a second example, vitamin A, vitamin C, and an herbal remedy known as pelargonium

Copying What We Do for Colds and Flu Doesn’t Work

Here are a handful of things we know:

● Coronaviruses belong to a much larger group of viruses known as lipid-enveloped

● Does it destroy the lipid envelopes of most or all enveloped viruses?

How much should we take?

Each of the following contain two milligrams of copper:

Garlic and Stabilized Allicin

Pelargonium Sidoides (Umcka)

Similarities with SARS

The Importance of ACE2

ACE2 functions as a counterbalance to ACE, leading to the conversion of angiotensin II to

The Importance of Interferon

The mouse study shows two very important principles:

Why Colds and Flu Are a Poor Model for COVID-19

Evaluating Nutrients and Herbal Remedies for COVID-19

● Does it impact ACE2 expression?

However, these criticisms are dubious for two reasons.

Inhalation of 1% povidone-iodine using a jet nebulizer eliminated potentially pathogenic bacteria

The American Dental Association recommends using a 0.2% solution as a pre-procedure

Povidone-iodine is contraindicated in the following conditions: A history of allergy to

Garlic and Stabilized Allicin

A meta-analysis of four trials in middle-age and older-adults123 found no effect of vitamin D on

Calcium and Phosphorus

Pelargonium Sidoides (Umcka)

Further Reading, Staying in Touch, and a Final Note

To receive my free almost-daily newsletter, COVID-19 Research Updates, sign up at

1. Greenberg, S. B. Update on Human Rhinovirus and Coronavirus Infections. Semin. Respir.

Crit. Care Med. 37, 555–571 (2016).

2. Xu, J. et al. Systematic Comparison of Two Animal-to-Human Transmitted Human

Coronaviruses: SARS-CoV-2 and SARS-CoV. Viruses 12, (2020).

origin. Nature 579, 270–273 (2020).

bronchitis virus. Virol. J. 4, 20 (2007).

ACE2. Science (2020) doi:10.1126/science.abb2762.

receptor-binding domain complexed with receptor. Science 309, 1864–1868 (2005).

7. Fehr, A. R. & Perlman, S. Coronaviruses: an overview of their replication and pathogenesis.

Methods Mol. Biol. 1282, 1–23 (2015).

receptor. Trends Pharmacol. Sci. 25, 291–294 (2004).

coronavirus. A first step in understanding SARS pathogenesis. J. Pathol. 203, 631–637

Antiviral Interferon Response. Adv. Virus Res. 96, 219–243 (2016).

Type I Interferon Production by Interfering with TRIM25-Mediated RIG-I Ubiquitination. J.

Virol. 91, (2017).

Virol. 75, 185–194 (2005).

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Monocyte-Macrophage Responses Cause Lethal Pneumonia in SARS-CoV-Infected Mice.

Cell Host Microbe 19, 181–193 (2016).