With the ongoing pandemic of Coronavirus (COVID-19) there is a big question on everyone’s minds: What can I take for immune support? Will immune system supplements help me avoid getting the virus? I will go over some of the essentials for protecting the immune system and some of the research, or lack thereof, of products that can help the immune system. I will go over some of the recent studies from China on Coronavirus patients and break down some of the herbs that companies and people have been making claims about on the internet. I will go into several of the most popular immune system supplements.
This overview is not intended to prevent, treat, or cure any disease. Most of these products have research based on past studies on the immune system and not specifically COVID-19. The most important thing to avoid infection is to prevent exposure by following the latest CDC and World Health Organization recommendations. Washing your hands with soap and hot water for at least 20 seconds, social distancing, and avoiding groups are some of the ways we have been hearing to avoid infection. Taking immune system supplements does not guarantee that you will not be infected. Refer to these links below:
Center for Disease Control
World Health Organization
Vitamins & Minerals for the Immune System
Potassium will not prevent coronavirus infection. However, there was a recent study in China of moderate to severe cases of COVID-19 patients involving hypokalemia, which is a severe deficiency in potassium. Potassium is not generally considered to be one of the main immune system supplements but may play a role in immune system health.
A group of 175 patients hospitalized with COVID-19, 69 (39%) had hypokalemia and another 39 (22%) had severe hypokalemia. Supplementing with about 3 grams of potassium daily helped correct these deficiencies in most patients, with patients responding best as they began to recover. Low potassium levels can cause heart problems, one of the problems seen in COVID-19. Heart muscle damage was associated with more severe hypokalemia. Hypertension was associated with the severity of hypokalemia. However, there was no association with hypokalemia in those with the common upper respiratory symptoms. The study has not yet been peer-reviewed and is new medical research that has not been evaluated. (1)
The apparent reason for hypokalemia in COVID-19, is that the point of entry into cells for the coronavirus SARS-CoV-2 is an enzyme on cell surfaces called angiotensin I converting enzyme 2 (ACE2). This enzyme helps regulate blood pressure through effects on sodium and potassium. The virus inactivates ACE2, leading to excess excretion of potassium. They also found excess potassium in the urine of patients with hypokalemia, indicating that the potassium loss is mainly through the kidneys as opposed to diarrhea, which is also common in COVID-19.
Generally speaking, I do not recommend supplementing with 3g a day of potassium. Most of the potassium we get daily comes from food and the FDA only allows potassium in pill form to be 99mg. Powders may be about 200mg, usually mixed with other electrolytes. The Recommended Daily Allowance for potassium is 3,500mg to 4,700mg a day (2,3) according to the World Health Organization and British Medical Journal. The best food sources of potassium include beet greens, yams, white potatoes, soybeans, avocado, sweet potatoes, spinach, edamame, salmon, coconut water, and bananas. Make sure to check with your doctor to see if you are deficient in potassium, as supplementation can help support healthy potassium levels. How common potassium deficiency is in the U.S has been debated, but a National Institute of Health study has shown that most adults do not consume enough. (4) Individuals taking potassium-sparing diuretics (such as spironolactone), ACE inhibitors (such as captopril), or trimethoprim/sulfamethoxazole should not take potassium supplements without medical supervision as dangerous levels of potassium may develop. Those with high risk for potassium specific kidney stones should not supplement with potassium. Always make sure to check with your medical care professional before taking any new supplements.