The ongoing Coronavirus (COVIOD-19) pandemic is still affecting many nations, including SriLanka. The rapid vaccination shows some progress in a few countries, but there is a growing fear that there will be a new virus variant due to fast mutations. Currently, there are six variants in circulation in Sri Lanka. 

It is a known fact that there is no cure for viral infections other than prevention, and the medical treatments are aimed at supporting organs and systems if you get infected. It is true that the potency of the virus strains kept changing to become highly infectious and causing server inflammatory responses but could humans handle the infection better if the human immunity was more robust?While we are adhering to the social distancing and preventing contacts, what can we do to improve our immunity? There are many available in nature that may help you boost the immune function to fight against the virus. Following research of many available scientific publications, these are naturally available vitamins, minerals, and enzymes that may help improve immunity.

Importance of Vitamin D
One of the most important hormones that help to improve human immunity and health is Vitamin D. The benefits of the Sun on humans and the protection against infections are known before it is linked to Vitamin D metabolism. 
Vitamin D’s benefits on viral infections are vast; therefore, we can assume that it may have the same beneficial effects on COVID-19. 

The sunshine is free for everyone; therefore, exceedingly difficult to control the exposure. 

To achieve the benefits of vitamin D, we should start taking Vitamin D before we are infected and maintain the levels at a high-normal level.  The best way to do this is exposure to direct sunshine. Therefore, we should take the maximum physiological dose to reach the high normal levels. 

This is regarded as 10000 IU (250mcg) to 20000IU (500mcg) a day for one or two weeks if you are not able to expose to sunshine. Normal levels of vitamin D range from 75 nmol (30ng) to 220 nmol/L (88ng). However, the upper level may not be mentioned in many reports as there are no international agreed upper limits of vitamin D. Once the normal levels have been achieved. You need to go down to the normal maintenance dose of 4000 IU (100mcg) to 5000 IU (125mcg) a day to maintain the serum vitamin D levels if you are around 70 Kg.

Vitamin C
The next essential vitamin against viral infections is Vitamin C. Vitamin C’s beneficial effects have been known for generations, and regular supplementation of higher doses has been efficacious in reducing the duration of the common cold. 

Under normal conditions, everyone should eat fresh fruits & vegetables to acquire enough vitamin C. I would recommend taking a chewable vitamin c daily during this infection period and increase the dose up to 2 gr a day if you get infected.  You can take 500mg every six hours for two weeks to avoid gastric disturbances.   Only people who have G6PD hormone deficiency should take a lower vitamin C dose. Still, there are no records of any complications from taking the oral form of vitamin C at these doses.

Magnesium
One of the essential minerals that help vitamin D efficiency is Magnesium. Magnesium is an alkaline metal and the second most important mineral found in all tissues. However, 99% of Magnesium is intercellular. Magnesium is contained in green vegetables, nuts, avocados, dark chocolate, all of which are advised to consume daily. The recommendations are between 310-360 mg for women and 400-420mg for men. There are no recorded side effects due to magnesium intake at higher levels other than loose bowels.  If you get infected, get a higher dose of Magnesium,and I would recommend taking up to 500 mg of Magnesium a day for two weeks. 

Zinc

Another especially important mineral that improves immunity and helps fight against viruses is Zinc, an essential micronutrient to all living organisms and participates in numerous biochemical activities. Most seafood, meat, milk products, and nuts contain an abundance of Zinc. The requirement of Zinc is about 25mg a day for regular intake. You can achieve this if you regularly take a balanced diet or otherwise advice takinga higher amount of Zinc a day. If you feel that you get any symptoms of COVID19, I recommend taking 25 mg twice a day for two weeks. Intake of Zinc at these doses for two weeks does not cause any severe side effects. 

Water
We should not forget to keep the body well hydrated. During an infection, the body will produce more waste products than usual. Hydration is necessary to maintain adequate urinary volume to eliminate waste products and acids. It is also essential to avoid the consumption of sugar and carbonated drinks during the infection as many are acidic and potentially cause the urine to become more acidic. The usual advice is to take 6 to 8 mugs or at least one and a half litres of water a day. As all of us are different in body size and shape a good measure is to check urine colour. Urine should be pale and should not irritate while peeing. 

Bromelain
In the event of infection, you may be able to reduce the effect of the inflammatory response by using Bromelain. A natural anti-inflammatory substance such as Bromelain may help control inflammation tissue healing and improve the pain associated with swelling. Bromelain isa combination of enzymescontained in the pineapple stem and the core. In Sri Lanka, you may not have Bromelain as a tablet, but fresh fruitsarein abundance. While it is unknown how much exactly each fruit contains Bromelain,the advisable dose for a day is 200 mg to 2000mg a day.

Hydration is necessary to maintain adequate urinary volume to eliminate waste products and acids

Ubiquinone
Another reason for the failure of the organs& systems in the vent of Covid19 may be due to reducing cellular energy production. The cellular energy production during severe inflammatory conditions can fail due to mitochondrial (the powerhouse of the cell) dysfunction. One of the important enzymes thatare producedin mitochondria that support energy production is Coenzyme Q-10, also known as Ubiquinone. Covid19 causes a severe inflammatory response, and the patients with high inflammatory markers found to be low in CoQ-10.Therefore, it is wise to combine CoQ-10. Suppose you get infected with Coronavirus until symptoms get better I do recommend taking CoQ-10up to 300 mg once a day for two weeks or until symptoms get easier. It is a very safe supplement, and the toxicity has not been reported in high oral intake.

There are no significant side effects to CoQ-10 other than minor diarrhoea, nausea and heartburn at these dosages.

Dr. Thanthulage has been a consultant in anaesthesiology and pain medicine at Broomfield hospital, 
Chelmsford, UK.