“Zinc supplementation benefits are not limited to seniors.” activation of the Vit D receptor (VDR), inducing the nuclear expression of lysosomal enzymes, cathelicidin, and b defensin. Activation of these antimicro-bial enzymes depend on the available level of Vit D. (5) Vit D also assists in attenuating the immune response by reducing the pro-duction of pro-inflammatory cytokines, potentially reducing the risk of a cy-tokine storm. In response to infection the innate immune response generates both pro and anti-inflammatory cy-tokines. Vit D may help to reduce both IFNg, and TNFa inflammatory cy-tokines potentially quelling an over-zealous immune response. (6) Vit D truly works as an immune modulator. Gut health is a cornerstone to health. Another mechanism of immune sup-port, Vit D incurs its role in maintain-ing a healthy gut barrier. Tight junc-tions, gap junctions, and adherens junctions rely on Vit D Viruses can disturb junction integrity and gain entry to the host. (6) Healthy gut integ-rity is an important physical barrier defense mechanism for the body and requires adequate Vit D to do so. Suggested dose: 2000-5000 IU/d with food, monitor levels as a preven-tion strategy. Although the recent paper by Grant et al suggests taking 10,000 IU/d for three weeks and reducing to 5000 IU/d, the goal is to raise the 25(OH)D concentra-tions between 100-150 nmol/L. “Test don’t guess” is always a good strategy when there is a potential for side effects. There are several factors that affect Vit D concentration variability including genetic SNP’s of VDR, and levels of Vit D binding protein, these situations could necessitate higher dosing. Take 250mg of magnesium daily with Vit D. Magnesium is involved with many enzyme pathways in the body, as it is with most of the enzymes that metabolize Vit D. Although the focus of this discussion is on prevention, the role of Vit D in the treatment of acute respiratory disease has been explored with positive out-comes for time spent in ICU. (6) 22 Chiropractic and Naturopathic Doctor June 2020 4. There are intervention trials under-way looking at the role of Vit D in the treatment of COVID-19. (7) Although severe deficiency is rare, mild to moderate deficiency is common worldwide, unlike other minerals such as iron, zinc does not have a storage system in the body. Why: Low zinc level is associated with severe impairment of the immune system, compromising both adaptive and innate function. Long term zinc deficiency contributes to pathological processes in chronic inflammation. (8) Zinc supplementation has been shown to reduce symptoms of the common cold; however, the real value may be in the prophylactic use of zinc. In a study looking at seniors aged 55-87, 45mg of zinc was supplemented for 12 months. There was a significant reduction in infections, inflammatory cytokines and markers of oxidative stress in the sup-plemented group. (9) Zinc supplementation benefits are not limited to seniors. A study by Sazawal et al demonstrated a 45% re-duction in incidence of acute lower respiratory infections in zinc supple-mented children. (10) How: During infection, the first re-sponders of the innate system employ chemotaxis and phagocytosis as an early defense and signaling, this is reduced when there is zinc deficiency, and re-versed with zinc supplementation. Zinc also induces thymulin activity, necessary for the maturation of T-cells. Based on numerous studies suggest-ing multiple mechanism of action, it can be concluded zinc’s role as an an-tiviral fall in two categories: 1. Supplementation improves antivi-ral response and systemic immu-nity in those who are zinc deficient 2. Supplementation used as a treat-ment to specifically inhibit viral replication or infection related symptoms. (11) 3. zinc supplementation imple-mented to improve the antiviral response and systemic immunity ZINC in patients with zinc deciency, and 2)zinc treatment performed to specically inhibit viral replication or infection-related symptoms zinc supplementation imple-mented to improve the antiviral response and systemic immunity in patients with zinc deciency, and 2)zinc treatment performed to specically inhibit viral replication or infection-related symptoms Zinc, similar to Vit D, is important to epithelial barrier function. Zinc has a role in maintaining tight junctions and adheren junctions. When zinc is defi-cient, these barriers are compromised. This can also be seen in lung epithelial cells. This results in leakage cross the alveolar lung epithelium which may lead to uncontrolled neutrophil migra-tion through disrupted junctions re-sulting in exacerbated inflammation leading to further mucosal damage. (12) Suggested dose: 15-30mg/day, 45mg/day for seniors. High dosing of zinc is not recom-mended and may induce a copper de-ficiency. Zinc follows a U-shaped curve in its therapeutic benefit, deficiency in-creases risk of disease while too much zinc may also negatively affect health. VITAMIN C A well-known antioxidant and a com-monly used nutrient, Vit C may not seem as “exciting” as other nutrients. Vit C’s role in preventing and possibly treating respiratory and systemic infec-tion proves to be very interesting. Why: Vitamin C deficiency is com-mon in elderly, smokers, diabetics, and in fact it is 4th most common deficiency in the US. (13) Vit C deficiency nega-tively affects immune function and results in a high susceptibility to infec-tion. Infection itself may further en-hance the need for greater levels of vi-tamin C due to higher metabolic need during such times. (13) How: Vit C’s role in preventing or reducing severity of the common cold has been debated. Vit C is however important in initiating the immune response. Vit C activates neutrophil migration, enhances phagocytosis, ox-idant generation, and microbial killing. It also “assists in the resolution of the www.Cndoctor.ca
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