Nitric oxide nasal spray could be effective in avoiding COVID |

Nitric oxide nasal spray could be effective in avoiding COVID |


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BYLINE: By Keith Roach, MD

TITLE: Nitric oxide nasal spray could be effective in avoiding COVID

DEAR DOCTOR. COCKROACH: A doctor friend suggested that he buy a nitric oxide nasal spray from Israel. He suggested wearing it when going out to eat or hanging out with friends without a mask. Do you have any opinion about its effectiveness? I received the most recent booster and a flu shot. The reason I am concerned is that I see an increase in people around me getting COVID for the first or second time. And I spend a lot of time with my grandchildren. — IT IS

ANSWER: There are some reasons to be optimistic about this treatment. Two studies have shown improvements in people with COVID-19 who use the nasal spray, but there is no published data that I can find that shows the spray prevents infection in the first place. I found an ongoing study in people with asymptomatic COVID-19, but the results are not yet available. Unfortunately, the type of study needed to demonstrate efficacy in disease prevention is extremely large and expensive. Getting your booster, choosing wisely whether to wear a mask, and avoiding large crowds is still the best way to not get sick.

DEAR DOCTOR. COCKROACH: Am I taking too many vitamins and are there benefits to taking all these vitamins? I started taking fish oil for my heart; My gastroenterologist suggested 2,000 IU of vitamin D3; a multivitamin because my mom has macular degeneration; and started taking zinc and vitamin C because I heard it would help with COVID symptoms. –KPA

ANSWER: Vitamins in reasonable doses are rarely dangerous, although some vitamins can be in very high doses. Let’s take a look at each of your questions.

Fish oil has been shown to modestly improve blood pressure and cholesterol, and a prescription version reduced the risk of heart attack in people with high triglyceride levels in one study. In another study in people taking statins, fish oil had no added benefit.

Vitamin D has been very controversial. Recent studies have found that vitamin D did not “prevent cancer or cardiovascular disease, prevent falls, improve cognitive function, reduce atrial fibrillation, reduce the frequency of migraines, decrease age-related macular degeneration, or reduce knee pain”. Of course, there are some people who still benefit from vitamin D, such as people with osteoporosis, who can’t absorb vitamin D well, or who live where they never get sun exposure. The 2000 IU you are taking is safe.

People with the dry form of macular degeneration benefit from a particular multivitamin (called the AREDS or AREDS 2 formulation) to slow the progression of this condition that affects central vision. However, studies designed to show prevention of macular degeneration with the same formulation failed to show a benefit. Again, however, these supplements do no harm, except that smokers should not take the original formulation of AREDS, as they have an increased risk of lung cancer.

Multiple studies have sought to see if vitamin C, zinc, or vitamin D can prevent COVID-19 or reduce its severity; unfortunately, the preponderance of evidence does not show a convincing benefit. Taking supplements is not a substitute for vaccination and prudent behavior. Scientists haven’t proven that vitamin and mineral supplements benefit you for the conditions you’re concerned about, but it’s still possible there’s a benefit that’s too small to find in the kinds of studies that have already been done. The downside to these particular supplements at reasonable dosages is small.

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Dr. Roach regrets that he cannot answer individual letters, but will incorporate them into the column whenever possible. Readers can email questions to or mail to 628 Virginia Dr., Orlando, FL 32803.

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