Could an over the counter supplement help us fight viruses and depression? I regularly discuss the over-the-counter supplement N-acetylcysteine (NAC) with my psychiatric patients, mostly because of its potential benefits for depression, psychosis, and cognition. But it also may help fight viral infections. A 1997 Italian study gave NAC to about 250 people and tracked their flu symptoms over 6 months. The results were nothing short of remarkable. Among those who were infected with influenza, 79% taking placebo experienced symptoms, versus only 25% of those taking NAC (Figure 1). That is a huge difference. If these results hold up, it could fundamentally change how we experience flu season. Now for the head-scratcher: This study is over 20 years old. Why hasn’t this been tested again? If it holds up, it should be aggressively pursued as a safe, inexpensive treatment for this serious disease, and tested for other viruses. And if not, we need to know so we can move on to other things.
(hint hint hint hint if any research funders are reading this) Other studies done since (like this 2010 study) have shown that NAC probably does inhibit certain types of influenza virus and may help prevent lung damage during infection (like in this study). It also may help with chronic lung disease, and may inhibit other types of viruses, possibly even in the coronavirus family. And I previously mentioned how NAC may help with cognition. New research suggests that the flu may cause us cognition problems that last for months, long after we think we recovered from it. What if NAC helps prevent this impairment? That research needs to be done, and soon. THE TAKE HOME: What does this mean for you personally? It may be worth talking to your doctor more about NAC, especially if you have mental health concerns that might benefit from it.
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“Antibiotics are only for bacterial infections, they don’t work on viruses!” How many millions of times has this been repeated in clinics over the decades? This advice even pops up on the front of search engines as a warning if you search something related (I just tried). But it turns out this may not be totally accurate. Some antibiotics may indeed have antiviral effects, and this may have huge implications for nasty diseases like COVID-19. A very recent bombshell study showed the antibiotic azithromycin (the ingredient in Z-packs) appears strongly antiviral when paired with another medication (chloroquine), in patients suffering from coronavirus COVID-19 (see Fig 1 below). If these early results hold up, this is an absolute game changer in the war against the COVID-19 virus, brought to you in part by a well-known antibiotic.
After seeing the dramatic results against COVID-19, I wondered if scientists had already suspected that azithromycin (AZM) was antiviral before the COVID crisis. By doing a very casual search of the science literature, I stumbled across this 2015 study titled “Novel antiviral properties of azithromycin in cystic fibrosis airway epithelial cells.” The title itself says AZM is antiviral, and their research showed it works against rhinoviruses that cause the common cold. Another test of AZM on influenza in lab mice showed that it “successfully reduced viral load in the lungs.” So perhaps this antibiotic fights the flu, which kills tens of thousands every year. Yet another lab showed that AZM “greatly alleviated the disease symptoms and increased the survival rate in a mouse model severely infected with” enterovirus A7, another nasty bug. In the real world, a 2015 JAMA study showed that giving AZM to children with respiratory tract infections reduced the chances that it increased to a severe infection, and many of these cases were no doubt caused by viruses. It’s a real head-scratcher why this hasn’t been much more aggressively investigated over the past few years, especially since we already know the safety data on giving AZM to humans. But with COVID threatening us, looks like we are wising up and pushing ahead on testing quickly. THE TAKE HOME: Safe, well-known antibiotic azithromycin seems to also attack viruses, and may help fight really nasty ones like influenza and coronavirus. More experimental results from coronavirus testing may be coming soon, so stay tuned! We might have a safe, effective treatment for viral respiratory infections right under our noses. A 2019 study from one of the world’s top scientific journals showed that nasal irrigation and gargling with salt water may help fight viral respiratory infections - including those caused by coronaviruses. The method is safe and simple: if you have a respiratory infection, snort and gargle a solution of salt water a few times per day. Their website explains how to do it, and the gist of it is:
Participants in this study who irrigated their sinuses with the salt water had about 2 fewer days of illness (see the graph below), seemed to be less likely to infect others in the house, and seemed to be shedding fewer viruses from their noses. So why does irrigating noses with salt water help stop viral respiratory infections?
We don’t know all the details yet, but it looks like our cells can use the salt ions to make hypochlorous acid, the active ingredient in bleach. That means by snorting salt water, you might be helping your cells make their own equivalent of natural bleach to disinfect your sinuses. Now, the authors are quick to point out that this was a smaller study (around 60 people), and so can't be used to definitively prove how well this works, especially for any one kind of virus. That being said, the overall treatment effects were statistically significant, and other studies (also here and here) have also found significant benefits from salt water irrigation for respiratory infections. It definitely looks like there is something to this. THE TAKE HOME: Salt water washes are a safe, natural, and inexpensive tool that might help our cells fight off viral infection. Definitely worth talking to your doctor about. |
about the authorSJadon Webb, M.D., Ph.D.
Owner Bloom Mental Health Shannon Keane,
MSN, FNP-C, PMHNP-BC Clinical Director Disclaimer: this blog is NOT intended as medical advice and does not imply any kind of specific guidance or treatment recommendations, and should NOT be used to guide a treatment protocol. (read full disclaimer)
Afton Williamson,
DNP, MSN, FNP-BC Family Nurse Practitioner |