Glutathione: A Nutraceutical Supplement That Acts As An Adjunctive Therapy For The Management Of Covid -19
COVID-19 still remains a public healthcare challenge all over the world despite availability of several vaccines and drugs. To date, no antiviral has shown efficacy against SARS-Cov-2. Nutraceuticals may help in boosting the immune system, reducing the viral load and inflammation in people with COVDI-19. Use of nutraceuticals in combination with standard treatment is a simple and effective strategy to limit infection and severe disease.
Glutathione, a cellular antioxidant is a vital part of cells that is naturally created and recycled inside the body. It is synthesized from three amino acids – cysteine, glycine, glutamate. Reduced form of Glutathione helps in removal of reactive oxygen species (free radicals or oxidants). Free radicals formation is a normal process, but when it`s levels are too high, redox status is disrupted. Oxidative stress leads to inflammation by activation of NF-kB pathway. Moreover, O3 (free radical)-induced oxidative stress negatively affect macrophage function. In cases of high oxidative stress, organs may get damaged which can potentially lead to multi system organ failure and death. Oxidative stress is combated by certain antioxidants including glutathione, the master antioxidant. People with chronic diseases like hypertension or diabetes, in the older age group, having lung infection, poor nutrition and sedentary lifestyle have high oxidative stress and sub-optimal levels of glutathione. The amount of glutathione in their body is not sufficient to resist an infection. Thus, oxidative stress or other conditions deplete GSH in the epithelium of the oral, nasal, and upper airway may, therefore, enhance susceptibility to viral infections.
About the author -
Director Strategic Medical Affairs, Adroit Biomed Ltd.
COVID-19 may contribute to the generation of free radicals. The infection by SARS-CoV-2 is thought to induce accumulation of viral and other proteins that are not degraded, thus disrupting redox homeostasis and causing toxic effects in the infected cell. Glutathione, the powerful antioxidant helps in combatting the enormous oxidative stress in COVID-19 patients. Research shows the role of glutathione in protecting against severe inflammatory response triggered by COVID-19. Firstly, glutathione inhibits ACE activity. Secondly, it decreases production of reactive oxygen species (ROS) and finally glutathione reduces NF-kB activation. Glutathione also regulates the balance between innate immunity or leukocyte infiltration at the site of infection to kill bacteria, and inflammation or leukocyte infiltration to the lung to cause organ failure. The antiviral action of glutathione can prevent the virus from replicating efficiently, producing lower viral loads and, therefore, milder symptoms. Optimal levels of glutathione can preserve redox balance, reduce of oxidative stress, enhance mitochondrial detoxification, and control the immune system activity. Glutathione prevents inflammatory cytokine reactions and the elevated levels of GSH promote Th1.
Research supports the use of glutathione in pre-COVID (prevention), during COVID (management) and post-COVID (recovery). An interesting fact is that Paracetamol, the medicine used to treat fever, actually depletes the levels of glutathione. Considering the amount of Paracetamol use in Covid-19 patient, glutathione levels deplete rapidly.
The benefits of glutathione in COVID-19 are attributable to its anti-inflammatory and antiviral property, apart from being an excellent antioxidant. The body has a unique defense mechanism called the immune system which is made of up different immune cells. Immunity can be enhanced to fight infection caused by various pathogens. In a one month pilot study, Glutathione supplementation in the dose of 500mg or 1000 mg/day reduced oxidative stress markers and improved immune function. The natural killer (NK) cells were elevated upto 400 times and lymphocyte proliferation had increased. Thus immunity boosters such as glutathione may help in preventing severe COVID-19.
There are certain reasons why most COVID-19 patients are asymptomatic or have mild-moderate disease, while only very few people suffer from severe COVID-19. If the body`s defense system is not strong enough to withstand the “cytokine storm (period of high inflammation in the body), the patient may progress from mild to severe infection or even die. Glutathione reduces inflammation in the lungs and other organs, lowers viral load and thus may speed up the recovery process. 2 g of PO or IV glutathione was used in two Covid-19 patients that improved their dyspnea within 1 h of use. Repeated use of both 2000 mg of PO and IV glutathione was effective in further relieving respiratory symptoms. Thus oral and intravenous glutathione may represent a new treatment approach to block NF-κB and control “cytokine storm syndrome” in patients with COVID-19-derived pneumonia.
The dose is not clearly defined but research suggests that up to 2gm of glutathione can be used in COVID-19 patients depending on CRP, fever, ferritin and other laboratory tests. Clinical trials are being conducted for glutathione in managing COVID-19. Glutathione also helps detoxify the liver. COVID-19 patients may be prescribed many drugs including Paracetamol, antibiotics and antiviral. These drugs may put stress on the already stressed liver. Glutathione removes viral toxins and harmful chemicals (unused or metabolized drug) thereby making the organs stronger. Thus, glutathione can be used in combination with other medicines to combat COVID-19
Recovering from COVID-19 is a slow process and may take even longer for some people. People feel tired and exhausted, their muscles feel sore. In simple terms, this is chronic fatigue syndrome. Glutathione is known to improve muscle strength. Thus, glutathione is expected to help in recovery from virus, improve physical strength and endurance.
To summarize, glutathione in COVID-19 may reduce the recovery time and it balances Th1 and Th2 cytokines response pattern. Oral glutathione can be used for prevention and recovery, while intravenous glutathione may be beneficial in the management of COVID-19. Certain people at risk of low levels of glutathione may be benefitted from glutathione supplements. Various GSH replenishing molecules such as N-acetyl cysteine (NAC) have been used in management of Covid-19.
