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Dr Catherine Crofts has been a pharmacist for over 20 years. Read her blog to find out more about supplements that may boost your immune system and what evidence there is around them; medications that can pose a risk in the face of COVID-19; and some general tips around pharmacies.
This is a time when pharmacists get asked a lot of questions; questions like, “Is there anything that I can take to help prevent the spread of these viruses?” and “What can I take to boost my immune system?”.
Prof Grant Schofield asked me this afternoon, whether garlic is any good for boosting the immune system and preventing the spread of this disease. My honest answer was, if you take enough of it, it will help with your social distancing. Joking aside, the reality is there’s actually not a lot out there.
Vitamin C and zinc
There’s some evidence for vitamin C, but it’s mixed, and we don’t know enough about it. It seems to have come through more from sports science, with people who are under heavy physical stress. Is it going to hurt to take? Probably not, but the thing I would recommend before supplementation is to make sure that you’ve got your diet sorted out and that you’re getting enough sleep.
The less stress you can put on your body, the more your innate supplies within you will manage the stresses on your immune system better. There is a little bit of evidence for vitamin C and there is a little bit of evidence for zinc, but in lozenge form, not tablets. Bottomline – none of those things are going to hurt to take.
There is possibly some evidence for elderberry extract. The current trade name is Sambucol. There is some evidence against some viruses. Is it something that I’m running out to get? Not at this stage. The same with another probiotic called Blis streptococcus salivarius K12. It’s actually a Kiwi product. There’s not a lot of evidence around it, but it may help, for some people. It’s a natural probiotic for the back of the mouth and throat, and back of the nose. People who have higher levels of strep salivarius K12 seem to pick up lower amounts of infections, but we still need more evidence through with that.
There is also a lot of information – good, bad, and indifferent – about other products out there at the moment, especially some of the anti-hypertensives. There are some reports that people who are on certain types of anti-hypertensives, especially the ACE inhibitors or the angiotensin receptor blockers (also known as ACE2s) sometimes have had a worse reaction when they’ve had the virus if they’re taking these medicines. That may be true. We also know that people who have got hypertensive issues had slightly poorer outcomes associated. Whether it’s the anti-hypertensive medicine or whether it’s the underlying condition – we don’t fully know these answers yet.
What I will say is, don’t stop taking any of your medicines in a hurry without talking to your prescriber or pharmacist first.
Uncontrolled blood pressure or other medical issues will be far more damaging to your health in the long term than the potential issue associated with these medicines, so please don’t stop taking any of your regular medicines.
Ibuprofen worsen virus?
Anti-inflammatory medicines are also being discussed in the media at the moment – ibuprofen, also known as Nurofen, Maxigesic or Voltaren diclofenac. There are some reports coming through that these medicines have worsened the virus for some people. Again, it’s still too early to say, but there are a couple of important things around this:
- If you’re taking these medicines for regular medical conditions, do not stop taking them.
- These medicines are very commonly taken when people have a fever.
Fever a defence mechanism
One of the things that we do know about fevers within the body is it’s a defence mechanism against viruses. It seems that most viruses thrive best in the body when the body is at a normal body temperature. The fever is the body’s way of trying to drive out the virus. A mild fever may – and I’m saying may, we don’t know fully – be beneficial for helping the body’s defences get rid of the virus.
Could saunas help?
This might be why we’re getting some mixed reports as to whether saunas might be boosting immune systems. Raising the body temperature might aid the body’s natural defence systems. But at the same time, excessively high temperatures are detrimental to the body. That’s why we do want to manage fevers, and we often recommend people take medications to help with this.
In the first instance, I would be taking paracetamol, not ibuprofen.
Be kind to your local pharmacist
Remember to be kind to your local pharmacists. They are doing their best to protect people coming into the pharmacy, and to protect their staff so we can keep supply chains going.
- Don’t run out of medicine
If you’re taking a regular medicine, this is the time to phone your local medical centre to find out if they can fax your prescription through to the pharmacy. There might be some charges around this, but it might be better than showing up in person.
- A lot of pharmacies will do deliveries
Again, there’s often an extra cost, and you won’t necessarily get your medicine immediately, but if you are older, immunosuppressed, wanting to maintain your preventative health distances and maintaining social isolation, this can actually be a good thing.
- If you are in the pharmacy, please drop your prescription off, find out when it will be ready and leave.
Please don’t stay in the shop because a lot of very vulnerable people will be coming in, and we want to maintain their safety, and everybody’s safety, including the staff, so that we can keep the pharmacies open.