When I started practice in 1981 within a short time frame I started recommending to my patients take a daily supplement that had Calcium(Ca), Magnesium(Mg), and Zinc(Zn) along with me and my family. That combination was readily available at drug stores and I remember researching it because I found it strange that they were selling that particular combination? I wondered why? Why not take a pill with Chromium, Manganese, and Chloride for example. Who came up with the idea for that combination? What I discovered was there were hundreds of well-done research articles in the medical literature going back decades that clearly demonstrated that those 2 of those minerals boosted your immune system and for most of us that is a good thing. It was felt the Ca was needed for bone health. A few years later I discovered the benefits of Vitamin D again in regards to bone health as well as being demonstrated to cut the number of falls in a nursing home by ½. Back then there was not a lot of information or consensus as to what the correct or best dose might be as well as the concern it might be different for men and women. The Government had their recommended daily allowance(RDA) so that is what we went with for the time. I should mention that other than pregnant or menopausal women and children and adolescents I generally do not recommend Calcium supplementation as our diet provides what we need and I rarely see a low calcium level on blood work, in fact, more often than not the calcium levels are high. In addition where I live in South Georgia and Northeast Florida, we are known as the Kidney Stone capital of the world in that our water supply and groundwater is high in calcium leading to an increased incidence of kidney stones here.
Covid has focused a lot of research over the past 2 years and as they told us in medical school the exam questions never change but the answers do. We now know that we have been taking too little of those supplements and we now have a better idea as to what the correct therapeutic window is. What is a therapeutic window you ask? Each drug and/or supplement has a therapeutic window which is the minimum dose/concentration in your bloodstream where the substance actually effectively does what it is supposed to and the maximum dose/concentration in your bloodstream where the substance is toxic or poisonous to you. Good examples here are Tylenol and Aspirin. In general two(2) pills twice a day works fine and does the job. A bottle full(actually in Tylenol’s case over 6 extra-strength tablets a day) can cause organ damage and even death. This is important as in the case of zinc the therapeutic window is narrow. The articles cited, the most recent from Israel this past week, clearly document that zinc supplementation daily provides a significant boost to your immunity and can present Covid, cancer, and other infections. But the dose is 25 mg a day and no more. When you buy it at the drug store they sell it at 50 mg a pill and that is too high and can cause harm. So you must break the pill in half to take it and I don’t think they tell you that on the bottle as they obviously want you to buy more. But you can’t. Stick with the 25 mg once a day and you will do fine. Have your doctor check your serum blood level of zinc a couple times a year. You want the result to be around 1 mcg/ml. My recent level was 0.92 mcg/ml which is close enough. Labs report normal at 0.66 to 1.10 mcg/ml.
We now know Vitamin D is more critical than we previously knew to support the immune system and the highest death rates from Covid were in patients with Vitamin D levels under 25 ng/dl but labs today still report normal as 20 ng/dl to 40 ng/dl. Trust me you want your Vitamin D level above 40 ng/dl and my family is now consistently above 60 ng/dl which I believe we all should be. To get that level you need to take 4000 IU a day, not the recommended dose of 1000 to 2000 which is ½ what you should take. Another way to do it is take a 50,000 pill 3 or 4 times a month and again follow with measuring your serum levels. In general Vitamin D has a large or substantial therapeutic window so it is hard to overdose on Vitamin D and super high doses at least over short periods of time don’t hurt you. The best example here is a study done in Norway where they gave people 2 million IU of Vitamin D at one time once a year and followed them. There was no harm but it didn’t work and it didn’t boost the immune system. This means it is important to take Vitamin D on a regular basis to get the benefit. Trust me taking one pill a year is very appealing as opposed to having to take one a day. No one likes taking pills every day but if it doesn’t work it is what it is.
In the list of articles to check out we now know Magnesium is important for immune health. There are multiple formulations of Magnesium in Chloride, Citrate, Oxide, and other forms. In general, Chloride and Citrate have fewer side effects. Currently, the proper dose seems to be 400 mg a day and you want your level to be 1.7 mg/dl to 2.2 mg/dl with above 2.4 mg/dl considered too high, so again what we would consider a narrow therapeutic window. Also taking too much will cause diarrhea. That is why Milk of Magnesia treats constipation.
The bottom line is we know unequivocally that Vitamin D 4000 IU a day, Zinc 25 mg a day, and Magnesium 400 mg a day for most people significantly boosts their immunity and reduces the chance and incidence of many infections, especially Covid, and in the long run prevent many cancers. My family currently takes all three as described. If you are into the research minutia I have links below to some current articles that support the above information.
