• Tracy Shulsinger


Updated: Mar 27, 2020

As we learn about research and information that is important to share, we will continue to update you. The purpose of this information is to be protective and supportive.

Wishing you well and in good health!

RESEARCH CONSIDERATION: Please keep in mind that COVID-19 had only been among us for 3 months. In this short time, scientists and medical professionals are working relentlessly to find treatments. Below is some new information under investigation - some supplements and medications can exacerbate the infection, and some may be protective. This may change as more time produces more findings and studies.

WARNING - BLOOD PRESSURE MEDICATIONS IN THE CLASS OF ACE-I & ARBs Many people who have underlying Cardiovascular problems, Hypertension and Diabetes are on medications called ACE Inhibitors or Angiotensin II type 1 receptor Blockers or ARB’s. Both types of drugs increase the expression of Angiotensin-Converting Enzyme 2 or ACE2. ACE2 receptors are found in the lungs, intestines, kidneys and blood vessels. The Coronavirus binds to the ACE2 receptor and can increase the risk of the virus spreading in the body (4).

ACE - I’s / ACE-Inhibitors:

  • benazepril (Lotensin, Lotensin Hct),

  • captopril (Capoten),

  • enalapril (Vasotec),

  • fosinopril (Monopril),

  • lisinopril (Prinivil, Zestril),

  • moexipril (Univasc)

  • perindopril (Aceon),

  • quinapril (Accupril)

ARB’s / Angiotensin Receptor Blockers:

  • Azilsartan (Edarbi)

  • Candesartan (Atacand)

  • Eprosartan.

  • Irbesartan (Avapro)

  • Losartan (Cozaar)

  • Olmesartan (Benicar)

  • Telmisartan (Micardis)

  • Valsartan (Diovan)


Ibuprofen also increases ACE2, therefore it is recommended to avoid Ibuprofen at this time (4, 7). This subject is currently controversial however, as the World Health Organization recently released that there in no evidence that Ibuprofen makes Coronavirus more severe(8). However, some medical providers on the front lines have observed that patients with Ibuprofen in their systems, did fare worse (9). Another over the counter pain relief medication alternative that does not enhance ACE2 is Tylenol. Even better, however, is to take Curcumin or Fish Oil to reduce pain and inflammation. Regarding suppressing a fever, keep in mind that the immune system creates a fever in order to fight infections. If a fever is going over 103 degrees, that is the best time to suppress the temperature with Tylenol.

WARNING - SELENIUM Selenium is commonly found in over the counter supplements and Vitamins, specifically products that support Thyroid function such as Thyrotain and others. It has been effective against other viruses and to reduce thyroid antibodies in Hashimoto's thyroiditis due to its ability to clean up free radicals. Unfortunately, it may enhance Angiotensin Converting Enzyme 2 or ACE2 expression, which can exacerbate the effects of Coronavirus.

HIGHEST RISK POPULATION: Researchers are sharing information about the COVID-19 virus from the frontlines and what was observed in other countries with high rates of hospitalization. The population over 65 years with comorbidities such as Cardiovascular disease, Diabetes and Hypertension were shown to be at higher risk. However, in a study of people who recovered from the virus and showed inflammatory lung changes, 70 % were in the 21-50 year age group (1). So even people in the younger age ranges are encouraged to exhibit protective behaviors. Additionally people who smoke cigarettes are having more severe reactions (2).

INFLAMMATION: Coronavirus symptoms can be as mild as cold symptoms to pneumonia of varying severity. These viruses can inhibit the immune system or cause an overactive response of the immune system, specifically in inflammatory substances called inflammasomes. These can stimulate an immune response that causes swelling and inflammation that can be damaging. They induce an inflammatory pathway called NF-kB and can create complexes in cells that aggravate lung inflammation. This can cause the respiratory symptoms of shortness of breath and cough with fever and reduce oxygen levels (1). There are a few remedies under investigation that support the immune system and may reduce the excessive inflammatory effects.

MELATONIN: First, some interesting facts to ponder:

  • Infants and children under the age of 9 years did not have severe symptoms of COVID-19.

  • None of the pregnant mothers admitted to the hospital in China with the virus developed severe pneumonia.

One common factor of these two populations is a high level of melatonin. Young children produce 10 times the amount of Melatonin as a healthy adult senior. Pregnant women in the third trimester have much higher levels of Melatonin (1) Melatonin appears to be a protective hormone against the severity of the Coronavirus. Melatonin’s action as an anti-inflammatory hormone may :

  • Reduce clinical symptoms

  • Protect lungs against mechanical ventilation

  • Reduce oxidative stress on many body tissues

  • Prolong survival times, giving the patient's immune system more time to resolve the infection (5).

  • Dosing: see below in “WHAT YOU CAN DO”

Use of Blue Blocking glasses and lowering the light at night increases levels of melatonin naturally before bed.

VITAMIN D Correcting vitamin D deficiency has been shown to reduce episodes of asthma severity. It is also shown to improve immune function in general (4). Dosing: see below in “WHAT YOU CAN DO”

VITAMIN C Nitric Oxide inhibits the activation of the inflammatory process. Vitamin C or Ascorbic Acid was shown to support the production of Nitric Oxide and can suppress the overactivation of inflammatory immune response caused by this virus. (1) Dosing: see below in “WHAT YOU CAN DO”


  • Reduce or stop any Selenium containing products. We do not actually know how much may be ok, or too much, so we recommend stopping Selenium containing supplements for now.

  • If you are taking an ACEI or ARB medication for high blood pressure, call to schedule an appointment so we can change your medication. Do not abruptly stop taking your medication, as this can cause an increase in your blood pressure.

  • Begin taking Melatonin 0.5mg at bedtime, for protection. Take 2-3 hours after eating and 1-2 hours before sleep.

  • Take higher dose Melatonin if you contract Coronavirus, beginning at 1mg at night and slowly increasing to 5mg at night. (1)

  • Increase your vitamin C intake daily in 500-1000 mg doses. Take 4,000-8,000mg a day for protection/prevention, and take more if you tolerate more (not having loose stools) (6).

  • Vitamin D: Typically 5,000IU a day will generate blood levels in the optimal range. Taking Vitamin K2 along with Vitamin D3 is recommended for healthy bones and heart.

  • Options for high-quality supplements: Fullscript

May this information serve you, your family and your community well. Be well, Janet Krein, PA and Tracy Shulsinger, FNP


  1. https://www.evolutamente.it/covid-19-pneumonia-inflammasomes-the-melatonin-connection/

  2. http://www.tobaccoinduceddiseases.org/COVID-19-and-smoking-A-systematic-review-of-the-evidence,119324,0,2.html

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812815/

  4. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext

  5. https://www.nature.com/articles/s41421-020-0153-3

  6. https://www.mdpi.com/2072-6643/9/4/339https://www.thelocal.fr/20200314/coronavirus-french-health-minister-issues-warning-over-anti-flammatories

  7. https://www.healthline.com/health-news/what-to-know-about-ibuprofen-and-covid-19#Fever-(medication)-frenzy

  8. https://www.cnn.com/2020/03/16/health/coronavirus-ibuprofen-french-health-minister-scn-intl-scli/index.html

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