COVID-19, Part III: The Case for Chloroquine
Thursday evening, March 19, 2020, I attended a web conference by Dr. Dietrich Klinghardt MD PhD, who is widely known for his expertise in unusual infections and illnesses. I studied with him in 2008 and 2009. At that time, he expanded my understanding of how to treat parasitic infections; I gained a much deeper appreciation of energy medicine and kinesiology as well. Since then, I have followed his wide-ranging concerns and treatment for patients for a multitude of illnesses.
Dr. Klinghardt shared recent articles that are primarily coming out of China and France that discuss the use of chloroquine—and alternatively hydroxychloroquine and azithromycin—for treatment of acute pneumonia with SARS-CoV-2.
Wait... Don't you mean COVID-19?
Viruses, and the diseases they cause, often have different names. For example, HIV is the virus that causes AIDS. People often know the name of a disease, such as measles, but not the name of the virus that causes it (rubeola). Viruses are named based on their genetic structure to facilitate the development of diagnostic tests, vaccines and medicines. Virologists and the wider scientific community do this work, so viruses are named by the International Committee on Taxonomy of Viruses (ICTV). Diseases are named to enable discussion on disease prevention, spread, transmissibility, severity and treatment. Human disease preparedness and response is the role of the World Health Organization (WHO), so diseases are officially named by WHO in the International Classification of Diseases (ICD).
ICTV announced “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)” as the name of the new virus on February 11, 2020. This name was chosen because the virus is genetically related to the coronavirus responsible for the SARS outbreak of 2003. While related, the two viruses are different. On the same day, WHO announced “COVID-19” as the name of this new disease, following guidelines previously developed with the World Organization for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO).
Now, Back to SARS-CoV-2
To begin with, we have learned that asymptomatic patients are able to transmit the infection; therefore, until we are able to identify which asymptomatic patients are carriers by expanding our testing, we have to assume that anyone has the potential to spread the virus. Since we are not yet testing asymptomatic people, we do not know who the carriers are. A few weeks ago, the US had finally tested an accumulated 15,000 patients. South Korea was testing people at the rate of 15,000 DAILY.
The average incubation time is just over five days—with a range of four to seven days—and occasionally people develop symptoms after 12 days of incubation. If you have been home alone for seven to ten days and have not gotten sick, then it’s less likely that you have an asymptomatic infection, but it’s not ruled out. Now, more than ever, we need more social support, so use the technology we have to call, text, and video conference with your loved ones, but make sure you comply with local physical distancing recommendations!
If you must go out to see the sun and maintain your sanity, to get some groceries, to go to the pharmacy, etc., do these things to minimize your chances of bringing the virus into your home:
- When you get home, leave your shoes at the front door or in your garage. Don’t track any potential virus particles into your house by wearing your shoes into the house.
- Take your clothes off and wash them or don’t wear or touch them for three days so the virus can die.
- Take your daily shower after your last trip out of your home.
- Rinse out your nose with a saline/xylitol solution, preferably with a Neti pot, to wash out any virus particles in your nose that you may have been exposed to that day and thereby reduce your chances of contracting SARS-CoV-2. If you just cannot bring yourself to use a neti pot, spray inside your nose and throat several times with bio-active silver hydrosol (Sovereign Silver or Argentyn 23) or an herbal tincture of propolis to kill any virus that you picked up while outside. If you are going out several times, do this after your last trip outside your home.
For more information on how to make your own xylitol/saline solution, contact Chris at NVC. We also have Xlear brand nasal rinse kits and Xlear saline/xylitol packets!
To reduce our risk of getting sick we need to enhance our immune system. My first article mentioned several ways that you can boost your immune system with nutrients and supplements. Dr. Klinghardt recommends that the first of two easy orthomolecular (meaning “high dose vitamins and hormones”) prevention options for this coronavirus is to take melatonin at night, about 1 to 2 hours before sleep and 2 to 3 hours after your last meal. Melatonin has a calming effect on the immune system. It reduces or eliminates the cytokine storm which causes the pneumonia and severe lung disease. You may still get sick, but not develop this life-threatening complication. Cytokine storm is when your immune system goes into overdrive and over-reacts to a chemical, or a bacterial or viral infection—in this case SARS-CoV-2. Dr. Klinghardt suggests that the reason that pregnant women, children and young adults are relatively resistant to this complication of coronavirus is because they have higher levels of melatonin. Older people need to take more melatonin to protect themselves.
Dr. Klinghardt recommended that people take approximately 50 mg at night and smaller doses throughout the daytime so that 40% of the total dose is divided into smaller, equal portions to be taken every two hours during the day as needed, and so that 60% is taken at bedtime. The final dose should be completed by 10 PM at the very latest. During the daytime, use lower doses: 5-10 mg in the morning and afternoon (on an empty stomach). Pills and creams are available. ADVISORY: This daytime suggestion does not apply to people who are diabetics or who have insulin resistance since melatonin is able to suppress insulin. Be aware that blood sugar levels may rise! If this happens to you, do not take melatonin before three in the afternoon; only take it at night.
I know, you are rolling your eyes at these doses. I understand; they are big doses, so work up to it! Start with 5, 10 or 20 mg at night. Slowly increase the dose as tolerated. (If you get wild and crazy dreams, back down on the dose and try to increase it more slowly.) Know that certain patients with cancer are using high dose melatonin—60 mg four times a day—to fight the cancer, so it is possible to adjust to higher doses.
Lower your ambient light at night: on your phone, computer, TV, and in your home.
Light disrupts your own natural melatonin production.
The second orthomolecular treatment is ascorbic acid (the purest form of vitamin C). Ascorbic acid does two things: 1) as a powerful antioxidant, it protects your cells against free radicals, which may play a role in heart disease, cancer and other diseases, and 2) it kills viruses, including SARS-CoV-2. It accomplishes these two things by reducing the severity of viral symptoms and lowering the chances of developing the inflammatory pneumonia that kills patients. At higher intravenous doses of vitamin C, it treats the pneumonia and Acute Respiratory Distress Syndrome (ARDS) caused by the virus.
For a simple, easy-to-use guide to determining how much vitamin C you need, contact Chris at NVC
For prevention, start with a dose of 1 gram, or 1000 mg, of vitamin C two to three times a day. Increase if tolerated and if needed. You will need more vitamin C if you get an active infection. The maximum dose of vitamin C if you are older and/or more susceptible to COVID-19 is one gram (1000 mg) hourly to total 10 to 18 grams per day, depending upon your tolerance level. If you experience loose stools, cut back on your dose.
Also, keep your vitamin D level in the high-normal range (i.e. between 80 and 100 ng/ml) and minimize use of NSAIDS, which theoretically may make the infection worse.
If you are infected, you may have an unlimited tolerance for vitamin C. Your tolerance may increase above 100 grams or more. This is normal. In severe cases, it is possible to increase the body’s biological efficiency by adding 1/2 teaspoon of rosehip powder with most Vitamin C doses.
NOTE: DO NOT SELF TREAT! Find an integrative physician to work with before you get sick or call your conventional doctor to be assessed.* Deterioration in lung function can happen very quickly.
Now, let’s look at the pharmaceutical treatments being published overseas for patients who are symptomatic.
A study released on February 4 from China by Wang, M. et al showed that chloroquine phosphate (CQ) effectively inhibited the growth of SARS-CoV-2 in vitro i.e. not in patients, but in the laboratory in a test tube.
A February 20 consensus paper from China by Zhonghua, et al recommended that patients with COVID-19 pneumonia receive CQ 500 mg twice daily in a tablet form for 10 days since this drug has shown good activity against other coronaviruses. Initial results were promising, and others are ongoing.
Another study out of France by Gautret, P. et al published on March 17 showed that hydroxychloroquine (a cousin of CQ) combined with azithromycin (Zithromax Z-Pak) reduced the amount of the virus that they were carrying by day six. This was a much lower carrying duration than untreated patients. In part, the study reports:
Among candidate drugs to treat COVID-19, repositioning [or repurposing] of old drugs for use as antiviral treatment is an interesting strategy because knowledge on safety profile, side effects, posology and drug interactions are well known.
…Hydroxychloroquine (an analogue of chloroquine) has been demonstrated to have an anti-SARS-CoV activity in vitro. Hydroxychloroquine clinical safety profile is better than that of chloroquine (during long-term use) and allows higher daily dose and has fewer concerns about drug-drug interactions.
…Azithromycin added to hydroxychloroquine was significantly more efficient for virus elimination.
This was an open label, non-randomized clinical trial. There was a total of 40 patients. The 20 in the treatment group were cured!. Six patients were asymptomatic, 22 had upper respiratory tract infections, and eight had lower respiratory tract infections.
On March 23 an article by Dr. Jeff Colyer and Dr. Daniel Hinthorn entitled, These Drugs Are Helping Our COVID–19 Patients was published on the opinion page of the Wall Street Journal. They used the protocol outlined from China for treatment of patients with COVID-19, employing the use of chloroquine with success; however, they then switched to the combination described in the above French study using Zithromax and hydroxychloroquine. They stated, “Our experience suggested hydroxychloroquine, with or without a Z-Pak, should be a first line treatment. Unfortunately, there’s already a shortage of hydroxychloroquine. The federal government should immediately contract with generic manufacturers to ramp up production. Any stock piles should be released... Rapid and strategic use of these drugs could help arrest the spread of the disease." They also stated that “the public expects an answer, and we don’t have the luxury of time. We have a drug with an excellent safety profile but limited clinical outcomes—and no better alternatives until long after this disaster peaks. We can use this treatment to help save lives and protect others from becoming infected. Or we can wait several weeks and risk discovering we didn’t do everything we could do in this pandemic as quickly as possible.”
A review from this country by Todaro, J. & Rigano, G., et al, in consultation with Stanford University School of Medicine, reported that:
Recent guidelines from South Korea and China report that [CQ] is an effective antiviral therapeutic treatment against [COVID-19]. Use of [CQ] (tablets) is showing favorable outcomes in humans infected with Coronavirus including faster time to recovery and shorter hospital stay. US CDC research shows that [CQ] also has strong potential as a prophylactic (preventative) measure against coronavirus in the lab…
[Since we do not have a vaccine yet, CQ] is an inexpensive, globally available drug that has been in widespread human use since 1945 against malaria, autoimmune, and various other conditions.
Since CQ is not available in Korea, doctors there are using hydroxychloroquine 200 mg twice daily, as the drug is widely available. “Treatment is suitable for 7 to 10 days, which can be shortened or extended depending on clinical progress.”
NOTE: These pharmaceuticals must be prescribed and taken under the direction of a physician who is familiar with these drugs.
Lastly, in Part 1 of my discussion of this viral pandemic, I sided with The Orthomolecular Society, who suggested that individuals who are on ACE inhibitors should stay on these while COVID-19 rages across the country. There is some debate about that, and Dr. Klinghardt is one physician who disagrees. He argues that SARS-CoV-2 infects host cells through binding to the ACE-2 receptors. ACE inhibitors, which are generally safe, are known to increase the expression of ACE-2 receptors and, therefore, are believed to increase the virulence of the virus.
Selenium is also a mild ACE inhibitor, so we should not push the dose of selenium too high—no more than 50-100 µg is reasonable. Dr. Klinghardt suggests that using ACE inhibitors, either through medication or supplements, may risk elevating SARS-CoV-2 infection and thereby develop severe or even fatal disease complications.
So, what are we to conclude? Is it excessive stimulation of the ACE-2 receptors that causes the problem? Or is it that the two groups of patients who are most commonly on ACE inhibitors are diabetics and/or have hypertension, both of which are considered to be immunocompromised and thus are at increased risk of more severe SARS-CoV-2 illness? I do not know the answer, but I can tell you not to stop an ACE inhibitor abruptly. One must taper off any antihypertensive slowly, over six weeks. As one tapers off, those increased numbers of ACE-2 receptors go away slowly, too. It doesn’t happen overnight. Older men who are at highest risk of the pneumonia complication from this coronavirus may want to discuss this with their physician. (And take melatonin and Vitamin C regularly!)
By Elizabeth R. Vaughan, MD