One possible problem for moderate to severe Covid-19 patients is the potential for significant damage to the lungs and possibly other organs like the liver, based on what is being seen in patients.
At this point, treatment options to try and prevent, repair or ameliorate this damage is very limited and not necessarily a very high priority for doctors yet, but still important to the patient in the long run to maintain good health quality overall.
Toward that end, I would like to talk about one of my favorite supplements that I have previously mentioned on Earth Clinic that may help these patients have a more complete recovery of the lungs and possibly other organs: Melatonin.
Post-Intensive Care for COVID-19
The aftermath for patients with Covid-19 has not been discussed at length yet because it is not currently the highest priority for doctor’s treating these patients.
Keeping them alive is obviously a primary concern right now, but preventing or ameliorating the significant amount of collateral damage caused by Covid-19 is very important also.
That subject, in time, will be quite popular as more people reach the recovery phase of Covid-19.
For many people who fall into the “high risk groups”, this information may be useful and timely to reduce your chances of succumbing to the disease if infected and if some scientists are right in their thinking that the virus can potentially mutate and return seasonally, similarly to the seasonal flu, then melatonin certainly seems like a very useful adjuvant treatment to keep in mind from this point forward!
If you survive the virus once and develop antibodies to it that will be very good, but if the virus mutates extensively, there is a chance that those antibodies may not be effective against the new strain similarly to vaccines for the flu, which sometimes work against the new strain and sometimes don’t as witnessed by people who have gotten the flu shot and still got the flu.
Melatonin has shown itself to be protective of the major organs of the body in many studies, which includes the lungs among its many potential health benefits.
There are several forum members currently using melatonin, including myself, so this could be useful information for them as well as other members who are trying to be as prepared as possible to deal with Covid-19.
Below is a link to a recent article that discusses the potential utility of melatonin as it would relate to Covid-19. Melatonin is just at the beginning of testing in Covid-19 patients with initial positive results. This article mainly discusses the effects of melatonin as it might relate to Covid-19 and includes its antiviral and anti-ARDS qualities among many other qualities. The article describes melatonin as “having a high safety profile” and suggests it might be useful before, during and after the disease process has ended.
Doctors may have a bit more latitude in using melatonin compared to all of the prescription drugs that have been mentioned on this forum and across the internet since melatonin is an OTC supplement sold at drug stores and big box item stores and almost all online supplement suppliers.
COVID-19: Melatonin as a potential adjuvant treatment
Life Sci. 2020 Jun 1; 250: 117583.
Published online 2020 Mar 23. doi: 10.1016/j.lfs.2020.117583
Rui Zhang,a Xuebin Wang,a Leng Ni,a Xiao Di,a Baitao Ma,a Shuai Niu,a Changwei Liu,a,⁎ and Russel J. Reiterb,⁎⁎
This article summarizes the likely benefits of melatonin in the attenuation of COVID-19 based on its putative pathogenesis. The recent outbreak of COVID-19 has become a pandemic with tens of thousands of infected patients. Based on clinical features, pathology, the pathogenesis of acute respiratory disorder induced by either highly homogenous coronaviruses or other pathogens, the evidence suggests that excessive inflammation, oxidation, and an exaggerated immune response very likely contribute to COVID-19 pathology. This leads to a cytokine storm and subsequent progression to acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and often death. Melatonin, a well-known anti-inflammatory and anti-oxidative molecule, is protective against ALI/ARDS caused by viral and other pathogens. Melatonin is effective in critical care patients by reducing vessel permeability, anxiety, sedation use, and improving sleeping quality, which might also be beneficial for better clinical outcomes for COVID-19 patients. Notably, melatonin has a high safety profile. There is significant data showing that melatonin limits virus-related diseases and would also likely be beneficial in COVID-19 patients. Additional experiments and clinical studies are required to confirm this speculation.
Here is a link to an article in the Washington Post that gives an idea of which organs can be impacted by Covid-19 which further illustrates why melatonin might be a very useful adjuvant treatment option which doctors can add to their arsenal against Covid-19. That arsenal is relatively small at this point, but hopefully will continue to expand.
Since the multiple health benefits associated with melatonin may apply in the case of this disease in multiple ways, it may be worth saving this post for future reference for yourself or a family member or friend to show to their doctor to see if it is something that will be compatible with all that they are taking and safe for you to take.
I cannot recommend melatonin to anyone as I am not a doctor, but your doctor can. I do use melatonin daily myself as I have previously stated on the forum for multiple reasons.
Health Benefits of Melatonin
Melatonin is mainly thought of as an over the counter sleep aid, but its abilities go far beyond being a common sleep aid for some people.
Not everyone can tolerate melatonin and that is another good reason to include your doctor in that decision making process.
The majority of people do tolerate melatonin well and it is naturally produced in the body by the pineal gland as daylight turns to night time. There are melatonin receptors found throughout the body suggesting that the body does have uses for it. Unfortunately melatonin production declines very significantly as we age and that may possibly be one contributing factor as to why older people do not fair as well as younger people with Covid-19.
Here is another article that discusses the potential for melatonin in respiratory diseases. If you want to read the full article, you will have to click on the blue rectangular button that says “Download full-text PDF” once you follow this link.
This very recent (March 20, 2020), brief and interesting link takes you to an opinion page where a doctor is discussing how melatonin might be used as adjunctive treatment for Covid-19 in patients with and without pneumonia and is relatively short and straight forward. He is advocating for use of melatonin “now” in Covid-19 patients. He feels that melatonin also would be an effective antiviral and antibacterial, but that is not yet known in Covid-19.
This is worth reading!
The same doctor from the article just above, Dr. Richard L. Neel M.D., MPH., has actually started treating Covid-19 patients with melatonin and vitamin C as this link explains.
I like what he is doing by practicing what he is preaching. His treated patient count is low at this point, but you have to start somewhere and a hospital seems a safe place to do that if you are already infected with Covid-19! A quick mention to the fact that there are a couple of ads at the 1/3 point and 2/3 point in the following article so please scroll past each ad to make sure you read the whole article, its interesting. This is a good read.
One more update about Dr. Neel. He says he has treated 10 patients now giving them 80 mgs of melatonin per day. Click here.
One of my supplement experiments involved taking 70 mgs of melatonin per day so I already have an idea of what 80 mgs will be like for me. Another good read and not long.
Melatonin Levels Decline Sharply As We AgeThis graph can potentially explain 4 important points about melatonin and Covid-19.
- It can explain why young children are resistant to getting C-19.
- It can explain why senior citizens are more likely to be harmed or killed by C-19.
- Bats have high levels of melatonin and even though they are thought to carry the virus, they are not affected by it.
- This can explain why Dr. Neel and the hospital in the Philippines are having success in their C-19 patients using melatonin! It may just be a coincidence, but it is an interesting one!
This article highlights a lot of the known health benefits and effects in the human body of melatonin and then illustrates how these would apply toward treatment of Covid-19 patients and mentions that melatonin may go a long way in ameliorating or preventing the cytokine storm, pneumonia and damage to other organs.
It is an easy read and is written in an easy to understand and follow way. Once you click on the link, it will show you the abstract and there will be a small rectangular blue button that says, “Download full-text PDF”. Once you download the PDF, you can read the entire article for free. It’s a good read!
This abstract suggests that the combination of Melatonin and Quercetin may help reduce inflammation related to hypoxia (oxygen deprivation to the tissues ) and modulate the measured parameters of the study to near normal levels, possibly helping to ameliorate or prevent the cytokine storm which has shown itself to be deadly in many people. Hypoxia can also cause damage to other organs that are starved of oxygen and this is seen in Covid-19 patients so it is very important in understanding the value of melatonin in Covid-19 patients!
This recent article (March 2020) goes into greater detail on the role of melatonin as it relates to Covid-19, inflammation and pneumonia.
The following short abstract suggests that melatonin alleviates lung injury :
The following article explains how Covid-19 can negatively affect the liver in a fairly high percentage of cases. Melatonin has shown itself to be a liver protectant.
The following article discusses many facets of melatonin as it applies to Covid -19 and also discusses concomitant use with hydroxychloroquine as well as whether melatonin may preclude the need for mechanical ventilation and other relevant points. An important point that it covers is fibrosis as seen in the wake of Covid-19 and how melatonin may also ameliorate this growing problem. After reaching the abstract page, you will have to download the PDF by selecting the black rectangular button that says, “Download PDF” to read the entire article which gives some insight as to the multiple reasons why melatonin may be of great value in the treatment of Covid-19 patients.
The following article discusses a hospital in the Philippines that is using melatonin in their Covid-19 patients with apparently good results. They are using a lower dose than Dr. Neel with dosing in the 36 to 72 mg range. This may be because Filipinos are generally smaller people. Dr. Neel is using an 80 mg dose for the adults he has treated. The article is a little long and covers other topics related to Covid-19, but here is a quote from the article:
…”One of the young cardiologists we’re mentoring texted me the good news about her father, a prominent physician in one of the teaching universities in the country, who has just been discharged after battling COVID-19. He was already about to be intubated and hooked to a breathing machine because all drugs given him didn’t seem to work and his pneumonia was getting worse. After three days on high-dose melatonin, he turned around, and nine days later, he was sent home.
We’re reporting our experience in a scientific journal, so hopefully, it could help save some COVID-19 patients, especially the elderly, who are reportedly left to die in some cities in Italy and Spain, so that doctors could allocate their resources to younger patients. If this information could save a few of these lives, it shall have been worth all that we’ve gone through convincing our local colleagues about it.”
Here is a link to that article: https://lifestyle.inquirer.net/361003/high-dose-melatonin-3-other-drugs-seen-as-effective-against-covid-19/
The following link discusses repurposing of existing drugs including melatonin. It is quite lengthy if you are pressed for time and don’t have time to read it, here is a quote from the article:
“Inflammatory pathways play essential roles in viral infections56,57. As a biogenic amine, melatonin (N-acetyl-5-methoxytryptamine) (Z = –1.72 and GSEA score = 2) plays a key role in various biological processes, and offers a potential strategy in the management of viral infections58,59. Viral infections are often associated with immune-inflammatory injury, in which the level of oxidative stress increases significantly and leaves negative effects on the function of multiple organs60. The antioxidant effect of melatonin makes it a putative candidate drug to relieve patients’ clinical symptoms in antiviral treatment, even though melatonin cannot eradicate or even curb the viral replication or transcription61,62. In addition, the application of melatonin may prolong patients’ survival time, which may provide a chance for patients’ immune systems to recover and eventually eradicate the virus. As shown in Fig. 5e, melatonin indirectly targets several HCoV cellular targets, including ACE2, BCL2L1, JUN, and IKBKB. Eplerenone (Z = –1.59), an aldosterone receptor antagonist, is reported to have a similar anti-inflammatory effect as melatonin. By inhibiting mast-cell-derived proteinases and suppressing fibrosis, eplerenone can improve survival of mice infected with encephalomyocarditis virus63.”
The following 2 links, while not related to Covid-19, takes you to two abstracts of a study where melatonin was used at a dose of 70 mg per day in children with Duchenne muscular dystrophy for 9 months to good effect. I’m adding this one just to show that melatonin is relatively safe in children who might get Covid-19, even at 70 mg/day. They used it everyday for 9 months, whereas it may only have to be used for a much shorter time period in Covid-19 patients.
This article adds further confirmation to the idea of melatonin for C-19:
One of the important points the authors are making is that melatonin seems to attenuate the serious viral activity response by your body while your body builds an effective and measured attack instead of an over response of a cytokine storm. It takes the body time to generate appropriate antibodies and melatonin seems to help by essentially calming the bodies over response until the body is able to generate enough antibodies and effectively destroy the virus. This tends to confirm what Dr. Neel is seeing in his patients of very significantly reduced symptoms in 24 hours.
I am not recommending melatonin, just putting the information out on Earth Clinic so anyone interested can discuss it with their doctor or health care professional and to also make sure it is compatible with everything you may be taking.
I hope that you will be able to get enough information from this post to see that what Dr. Neel is suggesting is a non-invasive way to assist in the treatment of Covid-19 and possibly in the interim period where you might be told to stay home and rest and then go to the emergency room if you have trouble breathing.
Remember, there are drugs which are working to various degrees, but will we be able to get them and how long will we have to wait before we are tested and accepted as a patient in the hospital to receive those treatments if they are available?
If melatonin is as effective as Dr. Neel and the Philippines have seen so far, melatonin may be a consideration between you and your doctor during that period while you are waiting for your breathing to become difficult enough to be allowed into the hospital.
If it works as they have seen so far, perhaps that trip to the hospital may never be needed! Dr. Neel is talking about positive effects in as little as one day.
Some of the drugs that are being tested for Covid-19 have significant side effects and judging by what is already known about melatonin, it may even help to ameliorate the severity of some of those effects while also helping to alleviate symptoms of the disease itself. His hope, as he mentioned is that melatonin may prevent a patient from ever needing to go on a ventilator in the first place.
Given that some hospitals don’t want to accept you in until you are having a hard time breathing, to me, if I feel I am getting sick in any way, I will continue to take the melatonin that I am already taking plus the difference to get up to his dosing schedule in the hope that I never even have to go to the hospital!
These are just more reasons why I refer to melatonin as one of my favorites!
Melatonin Dosage for Lung and Organ Damage Caused by COVID-19
To briefly summarize what Dr. Neel and the hospital in the Philippines are doing to combat the damage caused by Covid-19, Dr Neel is giving his adult patients 80 mg of melatonin each day.
He has them take that 80 mg in 4 equally divided doses so that they take 20 mg at each dose and they take that dose 4 times per day spread out through the day.
The hospital is doing similar, but with a slightly lower dose because they are using a dose range of 36 to 72 mg per day and they are dividing the dose into 4. They don’t say why they are using a lower dose, but it may be because they are dealing with children and younger people as well as adults whereas Dr. Neel has so far only treated adults. Another factor may be that in general, Filipinos are a smaller people.
Where to Buy Melatonin
You can find melatonin at most pharmacies, health food stores, grocery stores, and of course, online.
Here are a few links to Amazon:
I would also like to mention that I recently restocked my melatonin supply and they came very quickly compared to my zinc picolinate order and my vitamin D and C orders! Since I have been taking melatonin for years, much of this is information about melatonin I was aware of and why I looked for a possible connection in the first place.
I was not aware of its potential use as adjuvant treatment for Covid-19. Melatonin’s ability to help protect the lungs and other major organs could be a very useful adjuvant treatment in trying to protect the body as a whole from most of the potential damage which Covid-19 has shown the ability to inflict on people infected with SARS CoV-2 and act as a potent antioxidant and also act as a potent antiinflammatory, all well known melatonin attributes and this is a very big thing for Covid-19 patients to help protect almost all of the organs that Covid-19 is now thought to involve in addition to the lungs.
A drug that can safely destroy the virus is extremely important, but ameliorating or preventing the damage caused by the virus is important now and later for the patient!
I am sorry for the length of this article, but since melatonin has not previously been discussed for this purpose on this forum, I wanted to include as much pertinent information as possible to give some background.