What is the solution to Covid-19 is not some new expensive propriety drug, but rather vitamins, minerals, and over-the-counter supplements? There is a substantial amount of research supporting this point of view. And this website is dedicated to investigating this possibility. (You will also find information here on medications and vaccines, as natural supplements might be only a partial solution.)
The study which occasions this article was quite simple. The study began with two groups of patients, all of whom were hospitalized for Covid-19 and were over 50 years of age. So these patients are among the sickest with Covid. They were older, and we know that this disease hits older patients harder, and they needed hospitalization. The intervention group was given three supplements, each available over-the-counter: Vitamin D, Magnesium, and Vitamin B12. The dosing was as follows:
* Vitamin D 1,000 IU per day
* Magnesium 150 mg per day
* Vitamin B12 500 mcg per day
Now 500 micrograms (mcg) of B12 may seem like a high dose; the RDA for B12 is just 2.4 mcg. But B12 is known to be safe at this dosing. OTC supplements for vitamin B12 are often as high as 500 or 1000 or even 2500 mcg per tablet. And there is no tolerable upper limit set by the Institute of Medicine for B12. So 500 mcg is quite safe.
The above dosing for Vitamin D is relatively low. The tolerable upper limit of Vitamin D is 4000 IU, and yet this dosing calls for only 1000 IU. A higher dose could be given without issue. A 2011 study in Anticancer Research, by Garland et al., found that a dosage of 9,600 IU of vitamin D was needed to reach the serum vitamin D levels needed for what the study found to be the optimum level for reduction in risk of cancer . Though this is well above the tolerable upper limit, the study found that “no intakes of 10,000 IU/d or lower” would be toxic, and that “Universal intake of up to 40,000 IU vitamin D per day is unlikely to result in vitamin D toxicity.” 
The dosing for Magnesium is also modest. The tolerable upper limit (TUL) for magnesium from supplementation is 350 mg per day. For that value, the TUL of 350 mg, you only count magnesium from supplements, not also from food. So a dosing of 150 mg per day is safe for most adults. (Even so, do not take magnesium supplements unless you first consult your doctor.)
These are three common supplements given at common dosages, which are safe for most adults. And yet the difference this treatment made to the outcome was astounding.
“17 patients received DMB and 26 patients did not. Baseline demographic characteristics between the two groups were similar. Significantly fewer DMB patients than controls required initiation of oxygen therapy subsequently throughout their hospitalization (17.6% vs 61.5%, P=0.006). DMB exposure was associated with odds ratios of 0.13 (95% CI: 0.03 − 0.59) and 0.15 (95% CI: 0.03 − 0.93) for oxygen therapy need and/or intensive care support on univariate and multivariate analyses respectively.” 
Of the 17 patients receiving DMB, only 3 needed oxygen therapy. Of the 26 patients who did not receive the supplements, 16 needed oxygen therapy. Patients who did not receive DMB were over 3 times more likely to need oxygen therapy. Then, too, there was a significant difference between the two groups in the need for oxygen therapy and/or ICU support. Patients given DMB were 85% less likely to need one or the other or both.
This study needs to be repeated in a large randomized group. It was a controlled study, but not a randomized controlled study, and the number of patients was small. Even so, the result is remarkable, as the patients were older and were in need of hospitalization, and the intervention is safe, inexpensive, and widely available.
One of the many concerns that hospitals have during this Covid-19 pandemic is the supply versus the demand for ventilators. Another issue is that patients on ventilators tend not to do very well. It keeps them alive, but it doesn’t improve their condition. Patients on ventilation do not do well. They really don’t. Avoiding ventilation is greatly preferable. If the percentage of hospitalized patients needing oxygen therapy can be reduce more than threefold by these three supplements, it should be standard protocol for Covid-19 patients.
The endpoint of the study was the need for oxygen therapy and/or intensive care. The 85% reduction in this endpoint would be tremendously helpful in this battle against the Covid-19 pandemic, if it is borne out in larger studies. In fact, considering the ten other studies on vitamin D, here and here, prophylaxis with vitamins and other supplements should be a major part of our strategy to defeat the pandemic.
See the YouTube video by Dr. Mobeen Syed “Drbeen’s Medical Lectures” on this particular study, focusing on the magnesium.
Should We Wait for an RCT?
RCTs are the gold standard. Nothing should be done in medicine without an RCT! Let patients die in the streets, until we have an RCT approving of a treatment for them! Worship the golden calf of the gold RCT standard!
Or not. Maybe, as an alternative, and I hesitate to suggest this as I am not an all-knowing talk-show host or news commentator, why not take certain relatively safe over-the-counter supplements that studies say may provide a substantial protection from the more severe outcomes of Covid-19? Even when the information is from an admittedly lesser source, such as a cohort study or an observational study or even a case series, it is still useful. Physicians regularly use interventions based on their own experience, without a study of any kind, let alone an RCT. You go to war with the information you have, not the information you wish you had.
This intervention, DMB, is highly unlikely to be harmful. If the magnesium conflicts with a particular medication or condition, then don’t use it in that patient. But vitamin D has much research supporting its use (here and here), and vitamin B12 is known to be an inhibitor of SARS-CoV-2 .
If you are currently being treated for kidney disease, consult your physician before taking a magnesium supplement as magnesium toxicity can occur with kidney disease. Also, please review the safety and drug interaction information for magnesium on this website: Linus Pauling Institute: Magnesium
Vitamin D and vitamin B12 are two of the most potent vitamins “as defined by the amount of vitamin required to elicit a biological response” . And they are both innocuous at fairly high doses, up to 40,000 IU/day for vitamin D  and up to 5.0 mg/day for B12 (5,000 mcg). As for magnesium, many persons take a magnesium supplement OTC without any issues. The chelated form of magnesium is preferable to avoid GI problems (such as diarrhea).
While we wait for a better study on this intervention, I’ll be taking these three supplements. You can do as you see fit, but if you have any chronic illness (or any illness or medical condition at all), consult your physician before taking the magnesium. The other supplements are safe to take: vitamin D at 1000 IU/day (or up to 10,000 IU/day) and vitamin B12 at 500 mcg/day.
Should Vitamin D, Vitamin B12, and Magnesium supplements be used as a prophylaxis by healthy persons, in case they contract Covid-19? Vitamin D definitely should be taken by nearly all adults, including those who are ill with Covid-19. There is enough evidence to make this recommendation. Note that I am not a doctor, nurse, or healthcare professional. I say this based on the studies cited above. As for the B12 and magnesium, the evidence is scant, but those supplements are generally healthful and safe, so you can make up your own mind.
It is important to understand that the time from when you are infected with Covid-19 to the time when you know you are sick because you begin to have symptoms (the incubation period) can be anywhere from 1 or 2 days up to 14 days. The average length of time is just over 5 days. That is the period of time when the virus is multiplying in your body, and yet you are not taking any medication because you and your doctor do not know that you are infected with Covid-19 as you have no symptoms.
If people take supplements while they are well, they will also be taking those supplements during the time when they are sick and don’t know it. The sooner a disease is treated, the better. But you won’t know you have Covid-19 for perhaps 5 days or more. This is the “treatment delay problem”. It’s what limits the benefits offered by any FDA-approved medication for Covid-19. You can’t be prescribed that medication until the doctor knows you are sick. And they are not going to give prescription medication to everyone who is well, just in case some of them are sick and don’t know it. Then, by the time you are sick, the medication is not as effective as it would have been if given early, as Goncalves, et al. assert in this article: .
Perhaps the solution is over-the-counter supplements shown by studies to help against Covid-19. And the above discussed study indicates that three supplements — Vitamin D, Magnesium, and Vitamin B12 — may be part of that solution. The evidence for this particular combination is limited. However, there is enough evidence to support a recommendation to take Vitamin D as a preparation for Covid-19. The above study combines with six studies on Vitamin D here and four more studies here, to make a total of 11 studies showing a benefit to taking vitamin D.
But don’t take my word for it. The MATH+ Covid-19 Management Protocol is a set of recommendations for treatment of Covid-19, issued by the EVMS Medical Group, and developed by Paul Marik, M.D. He’s the Chief of Pulmonary and Critical Care Medicine at Eastern Virginia Medical School, Norfolk, Virginia.
In addition, the Frontline COVID-19 Critical Care Working Group recommends the MATH+ protocol. This group is led by 10 physicians (listed here) who are professors of medicine, critical care chiefs, and other experts in caring for Covid-19 patients. The protocol they recommend includes supplements taken for prophylaxis (what to take while you are well) as well as a list of what to take if you are diagnosed with Covid-19 but are sent home. And for every patient and even for persons who are not yet sick, the protocol recommends Vitamin D (as well as other supplements).
While you are well, the protocol includes 1000 to 4000 IU vitamin D per day. Then for symptomatic patients at home, the protocol includes 2000 to 4000 IU vitamin D per day. Zinc, vitamin C, quercetin, and melatonin are also recommended for both situations (while well; sick at home). These will be discussed in a future article specifically on the MATH+ protocol. Download the MATH+ protocol here.
A randomized placebo controlled trial on the use of Vitamin D for Covid-19 is currently taking place in Spain (information here). They are using 10,000 IU of vitamin D per day.
Finally, note that a recent study in the New England Journal of Medicine  found that using hydroxychloroquine as a prophylaxis provided no statistically significant benefit. So we have 11 studies proposing that vitamin D may provide a benefit, whether it is taken before or during illness, and we have top physicians on the frontline of the battle against Covid-19 saying take the vitamin D. I’ll be listening to them.
Ronald L. Conte Jr.
Note: the author of this article is not a doctor, nurse, or healthcare provider.
1. Tan, Chuen Wen, et al. “A cohort study to evaluate the effect of combination Vitamin D, Magnesium and Vitamin B12 (DMB) on progression to severe outcome in older COVID-19 patients.” medRxiv (2020).
2. Gonçalves, A., J. Bertrand, and R. Ke. “Timing of antiviral treatment initiation is critical to reduce SARS-Cov-2 viral load. medRxiv.” Preprint 10.2020.04 (2020): 04-20047886.
3. Garland, Cedric F., et al. “Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention.” Anticancer research 31.2 (2011): 607-611.
4. Narayanan, Naveen, and Deepak T. Nair. “Vitamin B12 may inhibit RNA-dependent-RNA polymerase activity of nsp12 from the SARS-CoV-2 Virus.” (2020).
5. Rucker, Robert B., et al. Handbook of vitamins. CRC Press, New York; 2007, fourth edition.
6. Boulware, David R., et al. “A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19.” New England Journal of Medicine (2020). — Hydroxychloroquine did not work as a prophylaxis against Covid-19.