Vitamin D and L-Cysteine Together Are Very Effective Against Covid-19

Now that we are heading into winter in the northern hemisphere, many of us may experience lower vitamin D levels as the sun is no longer capable of helping us produce it. Emerging research supports vitamin D's role in fighting cancer, heart disease, fractures and falls, autoimmune diseases, influenza, type-2 diabetes, depression, and Covid-19. The most at-risk populations for deficiency are darker-skinned people, older adults, people with fat malabsorption, people with limited sun exposure, and people with gastric bypass. (1)

A new study has very compelling results indicating how beneficial vitamin D supplementation can be against Covid. I will get to the details later. Also, low vitamin D has been implicated in worsening coronavirus and influenza infections, so I want to give a heads-up about your options to avoid low vitamin D. 

 Underlying Inflammation Makes Covid-19 Worse 

Many comorbidities increase the probability of death with Covid-19 infections. Cytokine storms, pneumonia, clotting, and heart problems are some of the main underlying issues seen in coronavirus mortality. The common thread to most of the comorbidities is that they are rooted in inflammation.  

What is the connection between Vitamin D and inflammation? 

One of our primary defense mechanisms against inflammation and viral infections is the presence of T Regulatory Lymphocytes (Tregs). Active circulating vitamin D can increase Tregs and, in the process, lower inflammation. Specifically, Cytokines, Pneumonia, upper respiratory infections, and blood clots (thrombosis) are all associated with low vitamin D. (2) Not surprisingly, strong correlations have been observed between the prevalence of severe vitamin D deficiency and the population mortality rate from COVID-19 in Europe when looking at data from 10 countries. (3) 

Recommended Levels of Vitamin D 

Most health experts recommend supplementation to ensure 40-60 ng/mL (100-150 nmol/L). Despite the attention, low vitamin D levels are widespread. About 42% of Americans are deficient. Risk factors for vitamin D deficiency include race, higher BMI, winter season, higher geographic latitudes, and inadequate dietary intake. (4) 

Natural Sources of Vitamin D 

Besides UV light from bright sunlight, food is the best delivery system for vitamin D. The best vitamin D sources are salmon, sardines, herring, shellfish like oysters and shrimp, and organ meat, especially liver. Other sources are eggs, including the yolks and full-fat non-pasteurized milk. Pasteurizing milk destroys vitamin D, and it must be artificially added back. Vegetables lack vitamin D completely. 

How Much to Supplement with 

The current recommendation is that people at risk of influenza or Covid-19 should take 10,000 IU/d of vitamin D3 for a few weeks, followed by 5000 IU/d. If you want more information on vitamin D, see my previous post on it here. 

Why Some People Don't Respond to Supplements 

The large doses of vitamin D3 needed do not always result in adequate circulating levels of the vitamin's active form. Vitamin D3 needs to be converted to calcidiol and then calcitriol in the Liver. The conversion is dependent on Vitamin D gene expression levels.  

The phenomenon of gene expression is known as epigenetics. In a word, genes don't always operate because they exist. Sometimes specific stimuli activate genes; others disable them. Obesity and low glutathione levels (we will get to glutathione next) diminish vitamin D gene expression.   

Glutathione: The Best Friend of Vitamin D 

 Low glutathione is known to make it easier to succumb to Covid-19. Glutathione is essential for the production of vitamin D in humans, which may, in part, explain why low glutathione is associated with poorer outcomes with Covid-19. (5) As glutathione falls, so does vitamin D production. As vitamin D levels wane, inflammation increases. As inflammation increases, mortality rates from coronavirus increase. Studies in rats have concluded that glutathione treatment turns on the genes responsible for converting vitamin D and boosts the active form. (6) 

How Can We Raise Our Glutathione? 

N-acetylcysteine (NAC), a common supplement, raises glutathione levels. There are no foods that contain NAC, but many foods contain cysteine as a component of protein, which appears to act similarly. Cystine is an amino acid, and cysteine is two of them bonded together. Any high protein food will contain cystine and cysteine, especially meat of any kind. In addition to the study that used glutathione to increase the active form of vitamin D, another study showed that supplementation with vitamin D3 plus L-cysteine demonstrated a significantly greater increase in circulating Vitamin D. In other words, cysteine/NAC stimulated glutathione production, which subsequently led to a rise in the active form of circulating vitamin D. 

Vitamin D: 93% Effective at Keeping Covid Patients Out Of The ICU 

A promising study showed that using a form of vitamin D called calcidiol reduced the risk of ICU admission by 93% in Covid-19 patients compared to the group that took no calcidiol. (7) As I mentioned earlier, some people don't respond to vitamin D3 supplementation. Calcidiol is only one step away from the active form of vitamin D and is more easily converted. It requires a doctor to administer. Vitamin D3, on the other hand, is widely available. An excellent strategy to ensure that the vitamin D3 is converted to the active form is to have acceptable glutathione levels. NAC is available over the counter and has proven to help elevate glutathione.  

NAC, Cysteine, Or Cystine?

It appears that they may be equivalent. The study I cited above used L-Cysteine directly to improve the active form of vitamin D levels. Since food is the best delivery system of nutrients, I would say food sources may be superior to isolated supplements of NAC or Cysteine. Still, no studies have been done to prove this. As a precaution, you may want to choose the supplement form to play it safe during the pandemic. 

How Much NAC Should You Supplement With? 

The standard recommendation is 400-1200 mg/D of N-acetyl cysteine daily (in divided doses). NAC is not recommended for patients taking nitroglycerine. It rarely causes side effects, but nausea, vomiting, diarrhea, or constipation are seen occasionally. Rarely, it can cause rashes, fever, headache, drowsiness, low blood pressure, and liver problems. (8) 

Conclusion 

Adequate vitamin D status helps prevent Covid-19 and diminishes its severity. It is not a stand-alone treatment, however. I always recommend food sources over supplements, but desperate times may require desperate measures. So, if you want to raise your level quickly, supplement away. Adding NAC or L-cysteine is like adding an insurance policy.  

Be Smart and See Your Doctor 

You Should have your vitamin D status checked by your doctor and listen to their recommendations. Vitamin D levels can get too high and pose health risks. Any time you supplement with it, blood levels should be monitored. Ask them about NAC but don't be surprised that they may not be familiar with it.

Covid-19 infections can rapidly spiral out of control, especially in patients with higher levels of inflammation. As always, any suspicion of a coronavirus infection should be followed up immediately by a visit to the doctor. Timely treatment is crucial.