03/24/2020
Good Afternoon! (Med questions and New Symptom)
I have had a question come up about use of medicines covered in the news lately and how they might help to fight coronavirus (including having them on hand at home). So...regarding potential efficacy of Azithromycin and Plaquenil (Hydroxychloroquine) and Vitamin D:
1) First of all, I really need to assess you if you develop any of the Covid-19 symptoms including cough, fever, shortness of breath, diminishing taste or sense of smell, as as of today, lower GI symptoms such as diarrhea and cramping, as well as change in mental status or blue-ish face/lips. If you feel you are developing Bronchitis, it's not going to be helpful if you self-medicate with Azithromycin and actually have pneumonia or Flu or Covid-19. It's what I would call a :set up for failure." If you feel you are getting sick... call me. I will come see you to evaluate.
2) Secondly, Azithromycin and Plaquenil need to be monitored if taken at the same time, meaning if you take them together you can develop a cardiac arrhythmia that can be fatal.
3) Thirdly, Plaquenil (Hydroxychloroquine generic) is a potent medication that can build up toxicity in your system and several people in Africa have already died having taken too much of it thinking it would spare them coronavirus. It is a sad situation. The World Health Organization states the drug is under investigation for use, but we need to be sure it's safe for patients in this circumstance, and even then it will be a case by case basis as to whether or not it would be appropriate. So as it's tested more, we will have more information. Time will tell.
4) Vitamin D - Dr. Thomas Frieden, former Director of CDC, has put forth the following:
"Vitamin D supplementation reduces the risk of respiratory infection, regulates cytokine production and can limit the risk of other viruses such as influenza. A respiratory infection can result in cytokine storms – a vicious cycle in which our inflammatory cells damage organs throughout the body – which increase mortality for those with COVID-19. Adequate Vitamin D may potentially provide some modest protection for vulnerable populations. This is especially important for people who are Vitamin D deficient – and, surprisingly, that might include more than 40 percent of US adults. People who live in the northern part of the U.S. are at greater risk of deficiency. There is evidence of seasonality in some respiratory illnesses, including influenza and tuberculosis. A leading hypothesis is that seasonality is due to the reduction in Vitamin D because of decreased exposure to sunlight in winter months. There is no seasonality of influenza or tuberculosis in some tropical climates (such as south India), where weather – and sunlight exposure – remains more constant throughout the year."
My thoughts - if you are Vitamin D deficient, you should be taking it already. Regarding Covid-19, it might help, it can't hurt... so why not.
IMPORTANT NEW SYMPTOM ADDED: Lower GI symptoms such as diarrhea and abdominal cramping have been reported in 50% of positive coronavirus patients.
Take care...
Dr. W.