Vitamin D, COVID, and Losartan

Thought I would add my $.02 on Vitamin D wrt to LAF and COVID. Although LAF hardly qualifies as a comorbidity, it might if you are elderly, whenever that occurs. Plus I'm sharing my personal therapeutic approach to COVID. Support for it can be found at the end of this post. It's technical and in the past such a post would have been called a "brain cramp".

Almost 15 years ago I posted in the Conference Proceedings on the topic of Vitamin D and LAF
[www.afibbers.org]

I went on and on about how an elevated vitamin D level might have contributed to my LAF. Sometimes we overthink things. I certainly plead guilty to that. Sometimes the obvious escapes us. What can I say! It was summer and I was probably dehydrated. It probably wasn’t the sun elevating my Vitamin D but the sun elevating my fluid loss. Jackie was right (surprise, surprise) and maybe Peggy too.

Given all the hoopla about the coronavirus and the need to ensure adequate vitamin D levels, I’ve revisited Vitamin D physiology.

First and foremost you should prepare for the COVID and this excellent website, which you’ve probably seen before, is where you should start
[orthomolecular.org]

Vitamin D is not really a vitamin (something ingested to address a nutritional shortfall). It’s a hormone and a really important one. I recently learned that it inhibits renin, part of the renin-angiotensin-aldosterone-system or RAAS. If you have any hypertension or orthostatic hypotension, you should consider a vitamin D deficiency enabling the action of angiotensin II in the former and aldosterone in the latter.
[www.ncbi.nlm.nih.gov]

I won’t bore you with a ton of links to articles touting the tremendous anti-inflammatory benefits of this hormone. We will all eventually catch the COVID, but the trick is to avoid the pneumonia and "cytokine storm” that targets those with comorbidities, especially if the local healthcare infrastructure is overloaded.

So here’s my personal strategy, since I am elderly. Hopefully a 2005 Bordeaux ablation has relegated my LAF comorbidity to permanent bed rest.

SARS 2 Protocol
Must haves: a digital thermometer, a digital sphygmomanometer, and a pulse oximeter (inexpensive at Costco or online at Amazon).
Fill my prescription for Losartan (see below for why) and Azithromycin (Z pack)
Get a probiotic with Lactobacillus paracasei (reportedly increases circulating ACE2) [ufdcimages.uflib.ufl.edu]
Get some turmeric powder (curcumin) for tea or any cold drink (well known anti inflammatory) [www.ncbi.nlm.nih.gov]
Record baseline oxygen saturation from the pulse oximeter.
Record resting BP from the sphygmomanometer.
The minute I detect any shortness of breath, chills, sore throat, or dry cough immediately (inflammatory cytokines which lead to the cytokine storm can be detected even during the asymptomatic phase):
1) Determine my oxygen saturation with the pulse oximeter. 97-99% is considered normal range but this decreases with age => 95% in someone in his/her 70s is normal
2) If it’s lower than normal, immediately take 25 mg losartan and seriously up my Vitamin C intake [orthomolecular.org]
3) Then monitor BP and oxygen saturation and adjust the losartan dosage accordingly.
4) If oxygen saturation drops below 93%, despite the above actions, follow the Lancet algorithm [www.thelancet.com].
5) Get a hs CRP (hi sensitivity C reactive protein), LDH (lactate dehydrogenase for liver function), and a CBC (complete blood count) from the local lab. [link.springer.com]
6) If lymphocyte count is > 1100/microliter, start the Z pack and avoid the hospital if possible. Clinical Characteristics of Coronavirus Disease 2019 in China. “Lymphocytopenia was present in 83.2% of the patients on admission." [www.nejm.org]
“Baseline CT chest x-ray did not show any abnormalities in 21 patients (23%)” [link.springer.com]

Losartan recall NDMA, a suspected carcinogen, was identified in certain lots of most of the - sartans and they were recalled. No adverse reactions were reported from those lots. Losartan is still widely available and routinely prescribed. I have friends on it now. If the NDMA had been found in subsequent lots, it would not be available.

For the technical discussion on “ACE2, Villain or Hero?” and Losartan (angiotensin II receptor blocker or AR see below (skip if uninterested)

There seems to be a raging debate in professional circles on whether ACE2 and ARBs/ACEIs are indicated or not for COVID 19. ACE2 is touted as beneficial, yet ACE2 receptor sites facilitate viral entry into cells.

There are two forms of ACE2 receptors, circulating and cell membrane bound. Perhaps the circulating form soaks up much of the virus before it can attach to the fixed ACE2 receptors and gain entry. See diagram below. It is not clear whether the soluble ACE2 represents shedding from membrane bound receptors or intracellular via mRNA.

More importantly perhaps we should shift our attention from the virus and it’s mode of entry to the role of Angiotensin II in all this.
Angiotensin II is a powerful pro inflammatory hormone integral to this cytokine storm.
[www.thelancet.com]
Angiotensin II revisited: new roles in inflammation, immunology and aging
[www.ncbi.nlm.nih.gov]
Is angiotensin-II an endogenous pro-inflammatory molecule?
[www.researchgate.net]

People usually don’t die of viral overload but of the associated cytokine storm mediated by this hormone. ACE2 has proven its value in this regard, at least in mice.
Angiotensin-converting enzyme 2 protects from lethal avian influenza A H5N1 infections (mice)
[www.nature.com]
Angiotensin II receptor blocker as a novel therapy in acute lung injury induced by avian influenza A H5N1 virus infection in mouse.
[link.springer.com]
Angiotensin-converting enzyme 2 (ACE2) mediates influenza H7N9 virus-induced acute lung injury (mice).
[www.ncbi.nlm.nih.gov]
Angiotensin-converting enzyme 2 protects from severe acute lung failure injury (mice).
[www.ncbi.nlm.nih.gov]
Angiotensin-converting enzyme 2 inhibits lung injury induced by respiratory syncytial virus failure (mice).
[www.ncbi.nlm.nih.gov]

Human recombinant ACE2 is not commercially available but ARBs accomplish this indirectly. By blocking Angiotensin II at their ATR1s (angiotensin II type 1 receptors), ARBs trigger an increase in Ang II (Angiotensin II), which trigger an increase in ACE2. ACE2 converts Ang II to Ang 1-7, which attaches to ATR2s (type 2 receptors), which are anti inflammatory and anti oxidant in direct opposition to ATR1s. This is a win/win – less Ang II and more ACE2
[www.hindawi.com]

Whether this all applies to COVID 19 in humans or not is not clear. But the troops in the trenches (China) seem to have cast their vote in favor of ARBs.
These articles have all appeared within the last 6 weeks.
Inhibitors of RAS Might Be a Good Choice for the Therapy of COVID-19 Pneumonia
[www.ncbi.nlm.nih.gov]
Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury
[link.springer.com]
Use of angiotensin receptor blockers such as Telmisartan, Losartsan in nCoV Wuhan Corona Virus infections – Novel mode of treatment
[www.bmj.com]
Angiotensin receptor blockers as tentative SARS‐CoV‐2 therapeutics
[onlinelibrary.wiley.com]

Also it appears that ARBs may be slightly more efficacious than ACEIs (angiotensin converting enzyme inhibitors), since there are other enzymes that mimic ACE, e.g., chymase.
[www.ncbi.nlm.nih.gov]

Aloha PC,

Thanks for posting this! Yours is the first I've seen that addresses the root cause of the major issues - the cytokine storm {edit} and pneumonia.

A couple of thoughts on SpO2 monitoring from someone who lives in a cold climate and at altitude. I live at moderate altitude (5,500') and spend a lot of time at elevations up to 13,000'. SpO2 will drop with altitude and can be significantly variable. Here is one reference:

SpO2 vs Altitude (meters)

My basement temperature is commonly in the 50's (deg F). If my hands are cold, an SpO2 reading can be erroneous. When I warm my hand, I get a normal reading. I have a pulse wave velocity monitor, that measures SpO2. This morning it initially read 77% before I warmed my hand, then it was in the 90's, including 99% readings after I'd done breathing with a Russian Frolov rebreathing device (to increase CO2 tolerance). Point is don't use absolute cutoffs, but get a good baseline and if you see a material drop, then act per PC's instructions.

Mahalo,

George



Edited 1 time(s). Last edit at 03/17/2020 12:34PM by GeorgeN.

PC said; There are two forms of ACE2 receptors, circulating and cell membrane bound. Perhaps the circulating form soaks up much of the virus before it can attach to the fixed ACE2 receptors and gain entry. See diagram below. It is not clear whether the soluble ACE2 represents shedding from membrane bound receptors or intracellular via mRNA.



As for ACE up- or down- regulation with ACE inhibitors–the research is not clear yet but COVID-19 is hitting the elderly particularly hard and I would assume they have a much higher rate of taking these drugs. I find it very hard to believe taking an ACE or ARB medication will help this illness but again, the research is not fully established yet.
DrB

www.drbrownstein.com



Edited 1 time(s). Last edit at 03/17/2020 04:48PM by Elizabeth.

Thank you George for the good point.

The tide in favor of ARBs against COVID 19 is beginning to surge.
[portlandpress.com]
[resources.rndsystems.com]
[m.youtube.com]

This is especially important for LAFers in particular.
Many of those with SARS2 (COVID 19) in the ICU develop hypertension from the increased angiotensin II and hypokalemia from the increased aldosterone (RAAS) not surprisingly. You can bet they become hypoagnesemic too.

As Dr. Ryan of the WHO (not the musical group), an Ebola expert, said in a recent video, “if you’re not fast, you lose, if you wait to be correct, you lose". So don't wait for the clinical studies or the vaccine or ....

My 70 y/o MD neighbor (no other comorbidities) just returned from a trip to Colorado and immediately developed fever and flu-like symptoms. He had very painful muscle and joint pain for 10 days and is now in recovery mode. Turns out he was positive for COVID and the family has been self quarantining.

So don't take this lightly.

Thank you for the post Elizabeth.

Dr. Brown and many others are behind the eight ball on this.

[www.healio.com]

See my latest post with the linked diagrams.

Perhaps, but he has a point, the elderly are the ones that are probably taking losartan and yet they are the most in danger of contracting the virus.

liz

The article in Cardiologytoday that you cite has to do with not unduly discontinuing ACEI's or ARB's for hypertension because of the lack of evidence. Indeed it says "there are no experimental or clinical data demonstrating beneficial or adverse outcomes among COVID-19 patients using ACE inhibitor or angiotensin receptor blocker medications” . I also didn't find any evidence that ARBs are the drug of choice in the trenches in China. In fact, it seems that the drug of choice based on clinical trials is chloroquine Bioscie Trends 2020 . Perhaps you can comment on these points.

Well, Hello PC ! - Thank you for sharing your experience and wisdom on this very important topic. Your valuable input has been missed. I appreciate all of the relevant info and references you’ve provided and I’m reading with interest.

One topic of particular interest to me has always been the importance of periodic testing for Vitamin D levels .. since that omission by my physicians back then undoubtedly contributed to Afib onset as well as my profound muscle weakness and fatigue - well-known symptoms of a very low 25 - hydroxy vitamin D levels which more accurately reflect vitamin D status since it is not influenced by PTH and other hormones. My experience was that optimizing the OHD levels was a slow process and also that regular test monitoring (for me) was an important, preventive guideline.

As I reflect back on the muscle fatigue…and the heart is a muscle, a connection to arrhythmia would seem to make sense. However, it could also have been from the health mandate at the time that everyone should be using the newly-offered statin medication. After using, it didn’t take long for my profound muscle weakness to present. I’ve always felt there was a connection.

As you observe about optimizing vitamin D levels in light of the COVID virus, we must ensure that we have optimal immune system functionality by supporting with Vitamin D3 along with the excellent tips provided in the Orthomolecular News link. I’ve been circulating the data about the lipospheric form of vitamin C as outlined by Thomas E. Levy, MD JD - a Board Certified Cardiologist and a crusader for the high efficacy/success rate of this particular form of vitamin C. The “lipo C” efficacy is more than impressive and has a wealth of supportive studies. I’ve used it for a number of years and would never want to be without several boxes on hand “just in case.”

In the General Health section, this link goes into more detail on the Lipospheric C topic. [www.afibbers.org]

Again, PC, thank you so much for your guidance. I hope you will continue.

Be well,
Jackie

PS, of course, I should have mentioned that optimizing the 25 OHD, should also include the balancing nutrient, K2 MK7 to keep our arteries flexible and free from calcium deposits.

Hi Jackie,

Thank you for the Vitamin C tip. But I just received my 1 kg container of vitamin C powder from Amazon and it stands at the ready should it be needed over and above my daily dose.

Hi Satin,

My goal is to inform, not to convince. I present the dots and connect them in a certain way. You can deny the dots or connect them in a different way. The ultimate decision rests with the reader, as it should.

I have read good things about chloroquine mainly from Japan. Years ago I took it for malarial prophylaxis while working in Thailand. I had no complaints about coverage or tolerance. But I do plead ignorance about its mode of action.

I consider peer reviewed articles on therapy based on the Chinese experience especially credible. And I understand how it works and why many MDs are loathe to prescribe it.
They don’t understand that there are two forms of ACE2, circulating and membrane bound. They also don’t understand that it’s not about antiviral therapy but about anti-inflammatory therapy. Why are children apparently less affected? Why are prepubescent mice similarly less affected wrt influenza? They have the same viral load as their elders that die. Why are ARBs also good for Ebola and other pandemics?
[www.ncbi.nlm.nih.gov]
[www.researchgate.net]

to repeat from my first post:
These articles have all appeared within the last 6 weeks.
Inhibitors of RAS Might Be a Good Choice for the Therapy of COVID-19 Pneumonia
[www.ncbi.nlm.nih.gov]
Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury
[link.springer.com]
Use of angiotensin receptor blockers such as Telmisartan, Losartsan in nCoV Wuhan Corona Virus infections – Novel mode of treatment
[www.bmj.com]
Angiotensin receptor blockers as tentative SARS‐CoV‐2 therapeutics
[onlinelibrary.wiley.com]

Also it appears that ARBs may be slightly more efficacious than ACEIs (angiotensin converting enzyme inhibitors), since there are other enzymes that mimic ACE, e.g., chymase.
[www.ncbi.nlm.nih.gov]

Hi Safib (sorry for the previous faux pas),

Here is another article that addresses the chloroquine v COVID 19 question from May 2020 (? the future)
[www.sciencedirect.com]
It's positive but with some concerns.
I'm just more comfortable with the ARBs.
Here's another older article addressing an RAS approach to SARS 1 therapy that suggests that increased ACE2 Is a good thing even though it is the target for cellular viral entry.
[www.sciencedirect.com]
Again this gets at the notion of the importance of anti-inflammation trumping the importance of anti-viral action.

Quote
PC, MD
Again this gets at the notion of the importance of anti-inflammation trumping the importance of anti-viral action.

I think both are important. As I've noted before (and gotten flak from some here), I'm a patient of Steven Gundry's and followed his low inflammation diet plan since 2014. He tests us for many cytokines and other inflammatory markers. In our case, we always test very low (except for the markers like IL 10 for which it is good to be elevated). I don't actually see a conflict between using an anti-viral or your ideas, PC. In fact, my wife & I have a phone consult with a doc friend in the morning to get scripts for chloroquine (if we can find it in stock), Losartan and Z Packs. I think the chloroquine could be used prophylactically at a modest dose. I've also posted I keep my D level (25OHD) high (per Gundry). Last tested in Nov at 150 ng/mL. If ever feel anything unusual, illness wise, I up my intake to 3x50,000 iu's for 3 days (again per Gundry). This seems to cut any of my very infrequent illness very short with a very muted intensity. For this virus, if I felt something coming on, I'd probably start an extended water fast (something that may be risky for an un-keto adapted afibber because of the electrolyte shifts - and something I've been criticized for here). I've read old literature with case studies going back nearly two hundred years. These report resolution of pneumonia, Scarlet fever and measles with extended fasts. My bias is that most of the problem comorbidities with COVID-19 are associated with hyperinsulinemia. Something I assiduously avoid.

The following is a report from an Aussie acquaintance who also follows Gundry's approach and his and his wife's experience with COVID-19.

I had the CoronaVirus and recovered in under 14 days!

My wife and I have the CV COVID-19 virus, untested because govt policy here is only to test those who have returned from overseas travel or been in contact with a case confirmed by testing. We are 100% sure we have it. In Australia when symptoms appear we have to self-isolate 2 weeks. Reading case histories from around the world there is a lot of variation in symptoms but we are exactly the same as the largest sub-group with mild symptoms. She has had it 2+ weeks. She teaches piano in a school with a lot of international students and others who travel a lot internationally. Lots of her students are coming to school with flu symptoms. We believe she got it from an Aussie student who was in China for the Chinese New Year and came to lessons for a while before authorities asked her to self-isolate. Even then she tried to come to lessons, at our home studio, whilst in self-isolation and we wouldn't let her. Since she returned, after two weeks isolation, she has ongoing flu symptoms. We were suspicious but the reality is my wife is in a CV hotbed at the school and we knew we would get it sooner or later. I caught it from her and have had it 11+ days. We didn't know we had it. Just figured it out recently. Not exactly sure when it started as we have to look back at mild symptoms. My wife is high risk because she has hypertension and she is pre-diabetes but doesn't know that (I know a pre-diabetic when i see one). She worried me a couple of times but I think she will be OK. I am fine. I have been on Gundry's low inflammatory immune system boosting diet for approx 3+ yrs. My wife didn't follow me on the diet. I tried to talk to her about her diet but she wouldn't listen. She doesn't eat SAD and compared to the average her diet is good but I know better. In Australia lots of people are walking around infected who aren't tested and the real numbers are way above the official numbers. A lot don't know they have it because of the mild symptoms. Others don't want to know they have it and bluff their way through. They send the kids to school with a "flu" i.e. COVID because if they don't work they have no money to live. They have to send the kids to school so they can go to work. Symptoms vary but for me and my wife it is just like any other flu except milder. It was on her lungs a little bit and she is coughing a bit too (mild cough). She has a minor running nose but it isn't a head cold. For both of us it is mainly like a stomach bug, mild nausea headache and sore throat... no vomiting no diarrhea. It comes and goes in waves. No temperature to speak off. Nothing on my lungs. I'm doing a little bit of sniffing. I had 1-2 days felt tired and went back to bed for a 1 hr lie down but all other 9 days I felt fine except for my tummy. Kept working hard physically in my yard the whole time except for 2-3 days. Weakest flu I ever had or the virus doesn't like Gundry's protocol one little bit. The experts have it wrong in the main. Symptoms are definitely correlated to immune system health. I am very lucky that it turns out my diet is correct, give or take a little bit, and has been for a long time plus I had the good advice on supplements and I already had the required supplements on hand, in bulk, from prior use. Probably saved my wife's life, or at least serious hospital time, because I knew what to do and had the supps. 2 - 3 nights ago it looked like she was going down. She was scared of the vitD at those levels and when I told her to take it she just started with 1000 slowly working up to 4000 only. I pulled out the bazooka and gave her a 10000 VitD to hit it with. She took it before bed and when she got up the next morning she was reasonable again and the crisis over. I used the supps as per Gundry's recommendation search [ Gundry YouTube coronavirus ]. Vit D up to 10000 day ... can start at 5000 and up it if needed in an emergency take 150000 iu (3x50000) per day for 3 days. VitC 4x500mg day ... my wife takes chewables and I take sodium ascorbate powder 1.5 g per day in plain water in a sip bottle to spread it out (don't take the lot in one gulp) + I chew on a couple of hers here and there. In addition I take garlic oil up to 9 per day 3x3 with meals ... this time I only took 2x3 cos I didn't eat 3 meals...each capsule is 1mg equiv to 3g fresh bulb Allium Sativum (not cooked). Fresh garlic and lemon juice are better than tabs but hard to get the amount down. I have a lemon bush loaded with fruit at the moment and I gave them to my wife. She is drinking juice of 1 lemon neat per day. She swears by it now. From experience I know the flu ends up on the lungs and turns into a bacterial infection there and the garlic helps break it down being a natural antibiotic so that is why I added garlic. Feed it don't starve it. I'm just eating normally ... low carb up to 100g a day no inflammatory foods per Phase 2 level (I am strict Phase 2 so no dairy, no red meat whilst infected) and in and around ketosis 1 or 2 meal a day. Not sure if there is any benefit in preventative measures. It might be better to wait until symptoms start then hit it with shock and awe but I was taking a bit of VitD for maintenance and non acidic vit C just before it hit (taking the vitC in Sodium format for the Sodium instead of extreme table salt) . Don't pull the trigger too soon with the big gun i.e. 150k day for 3 days. Wait til you see the whites of it's eyes. Save the 150000 D x 3 for emergency only ... if getting signs of short breath starting and possibly heading for a hospital visit. If in dire straights try to find a Dr who will give intravenous high does C infusion. After symptoms abate keep up the supps for 2 more weeks. Good luck and good health my friends. We are all going to be exposed ... most of us will be fine. Don't panic. Store enough essential supplies in case you have to isolate 2 weeks. The above is just my opinion. Refer to Dr G's advice protocols. if you are eating a bit dirty go strict now until this is all over (3-6 months?) Always consult with your Dr especially if you have flu symptoms.

Is loasartan bring used off-label for COVID-19? I ask because my wife takes it for hypertension but we can’t seem to get it refilled right now. All the pharmacies are out. We are in central North Carolina.

Hi George,

You must have gotten writers cramp with that long post. And I thought I was bad. The only reason you don’t have Alzheimer’s disease is due to your plentiful vitamin D intake, which inhibits renin.
[alzres.biomedcentral.com]

Hi Wolfpack,
Your speculation is probably correct about off label use of Losartan. Alternatively it may just be in short supply, as most of these meds come from China. You might consider asking your MD for prescription to another -sartan, e.g., valsartan, irbesartan, ..

Appreciate your N2 post above, glad you don't have writers cramp.
It is really difficult to get tested for CV here in Australia with mild symptoms unless one is a politician/celebrity/footballer/or the like.

Hello George,

My name is Johan, I am new to this forum, am 53, live in Belgium and have had episodes of LAF since 2009. I was prescribed amiodarone for 11 years. Fortunately I only took it during the AF episodes, not all the time. I could never convert back to SR without it, it typically took 5 days to convert back. Recently the episodes got a lot more frequent and I was being pushed to have an ablation. Side note, they are doing the Heartlight X3 ablation here in Hasselt, looks promising. Heartlight X3

Anyway, before deciding on the ablation, I thought I would do a search myself to see if there wasn't anything better than amiodarone by now. It was at that point that I found out that I really shouldn't have been taking amiodarone for so long. I had another AF episode and decided I wouldn't take amio anymore no matter what. I had my blood tested for thyroid abnormalities and sure enough the numbers were way too high. An ultrasound revealed a big nodule on my thyroid, so they did a biopsy. Fortunately it's not malignant, thank God.

I found this forum and started reading..... a lot. It lead me to flecainide which converted me to SR in just a few hours. Much, much better. But the episodes were still quite frequent, almost daily now. They got the thyroid down with thiamazole but that didn't seem to help either. So it looked like I would need to take the flec daily, or have the ablation.

I had been taking supplements like Mg/K+/taurine/Q10 before all this but it seemed to have little effect on me. Then I stumbled upon your posts George and noticed a lot of similarities. I read about your success with ginger and decided to stop the flec and give that a try. That was 6 weeks ago, the AF episodes immediately stopped the day after I started taking ginger. I started feeling different too, much more confident to be quite active and exercise again. So I thought I'd share my story and express my gratitude. I owe you. Thank you for sharing.

What has baffled me in all this is the attitude the otherwise very competent medical community here has towards prescribing amiodarone and how very different that is from the way it is perceived in the US. So many people are still taking amiodarone. I contacted to the European Medicines Agency (FDA equivalent) about this but the response was disappointing. So to anyone like me taking amiodarone (Cordarone) reading this I'd like to repeat the obvious: it should only be taken as a LAST RESORT. Talk to your doctor, insist on knowing WHY you need to take it.

Now Covid-19 is upon us, it's really not looking good here in Europe. My family and I have isolated ourselves to avoid infection. I learned about a french trial combining hydroxylcholorquine and azithromycin. It was a small trial but I very much like the way that graph looks. Could it be that simple? treatment trial

Johan,

You can’t really start/stop amiodarone. It has to build up in the body’s tissues. That’s probably why you took 5 days to convert. If you want a pill-in-pocket approach to AF, your choices are basically Propafenone or flecainide.

Hi George,

A question about ginger please.

What does this look like to you?

[www.amazon.co.uk]

Is not being standardised to 5% gingerols a problem? Is that dose too strong??

If you take a look at the options on Amazon.uk, what would your selection be please??

Hoping all good with you, Theresa and the family.

Regards,

Mike

Johan,

Thanks! I'm glad this is working for you!!

Quote
mwcf
Hi George,

A question about ginger please.

What does this look like to you?

Hi Mike,

When I tried this, I just used organic ginger spice that I got that the natural foods store. Because I'm a bit of a bull in a china shop when I do things, I recall putting a tablespoon in warm water to make a ginger "tea." Here is my quote "After reading Hans' recent posting on ginger, I started taking a tablespoon of organic powdered ginger 2x/day, which I later reduced to 1/2 teaspoon ginger in the morning and 1 tsp in the evening. The abnormal vagal responses with their ectopic beats ceased immediately." from here. Some other ginger posts are here..

When I eliminated calcium from dairy, my afib control went back to what it had been, so I didn't need to take the ginger any more. My other afib remission program started working very well again (which is very similar to what I successfully suggested for my son-in-law, though my magnesium tolerance and intake is much higher)

George

Hi Mike,

I'm actually taking this ginger root extract 3 times a day. Hope ginger helps you as much as it has me.

All the best
Johan

Thanks George and Johan. I just ordered Johan's suggestion.

From Daisy's post here, "Each of these drugs alone can cause QT prolongation and chloroquine, hydroxychloroquine and azithromycin are on the CredibleMeds’ list of drugs known to cause TdP."

Hence it is likely advisable NOT to take hydroxychloroquine and azithromycin at the same time.

Posted this also in another thread: My experience with a Plaquenil (hydroxychloroquine) script in Colorado. Won't fill it unless you've been taking on an ongoing basis. My doc friend, who lives in a small mountain town, said they are only filling for medical professionals in her town. Had no issues getting Z-pack and Losartan filled. So thanks for that, PC!

I had no problem getting mine filled. It depends on the area I believe. If there is a shortage due to the demand from Lupus patients, a med vital to that condition, you most likely wont get it.

In this article, they note that "Azithromycin was added because it is known to be effective against complications from bacterial lung disease but also because it has been shown to be effective in the laboratory against a large number of viruses, the infectious disease specialist explained."

On chloroquine, "While the mode of action against COVID-19 is not established, Prof May said, he pointed out that many viruses enter host cells via endocytosis, as a result of which they are initially taken up into an intracellular 'compartment that is "typically fairly acidic".

"Chloroquine would alter the acidity of this compartment, which can interfere with the ability of viruses to escape into the host cell and start replicating."

He continued: "Another possibility is that chloroquine may alter the ability of the virus to bind to the outside of a host cell in the first place," adding that the drug "has subtle effects on a wide variety of immune cells…and it may be that one of these effects helps stimulate the body's ability to fight off COVID-19."

George:

Sounds good, there have been people that took this drug and got better quickly.

Take care
Liz

Hi Shannon,

This thread has very limited relevance to LAF.

Please feel free to transfer to the General Forum, if you so chose. Whatever you think. I don't think anyone will care or be offended.

My favorite Dr. Seuss quote

"Be who you are, say what you think; those that mind don’t matter, and those that matter don’t mind."

Nah, this thread is fine. It has relevance to many issues people with AF face.

I just received an advance copy of a soon to be published article that has not yet been peer reviewed from a professional Italian colleague. He practices in Milan, ground zero for COVID-19 in Italy, but the article originates in Iran. The English is a little stilted.

[www.preprints.org]

Inhibition of Viral Macrodomain of COVID-19 and Human TRPM2 by losartan (posted today March 31)

Conclusion
It seems Losartan can inhibit the viral macrodomain and TRPM2 so that it can interrupts the cell cycle of the virus and apoptosis, necrosis, fibrillation, and cytokine storm consequence of the COVID-19 infection. Therefore, Losartan, with preventing the induction of overexpression of the inflammatory cytokine, may decrease the severity of the disease and time of hospitalization. Presumably, Losartan with inhibition of these proteins activate the production of the interferon- gamma and intracellular defense against the COVID-19 virus, so enhancement resistance of person to the coronavirus.

Very good post PC MD - especially considering the date you posted this. Well done!

PC - While I understand the importance of the inhibition potential for Losartan for this use, what about the known side effects for those with history of arrhythmia? I recall a person who experienced arrhythmias when she started on Losartan. Thanks, Jackie

Cardiac

- heart rate irregularities (including ventricular and supraventricular tachycardia, premature ventricular contractions, and atrial fibrillation)
- slow heart rate
- electrocardiographic alterations (including second-degree heart block, QT/QTc interval prolongation, and ST segment depression)
- palpitations
-fainting (rarely and predominantly with intravenous losartan)
-transient ECG changes including QT/QTc interval prolongation have been reported

[www.rxlist.com]