~ Please note ~

New Coronavirus Information (updated 18.5.2020) ~

Coronavirus (COVID19) guidance
To reduce the transmission of the illness and subsequent impact on the health and social care system, please follow this advice:
Use the following website to find out what to do if you have concerns about coronavirus https://111.nhs.uk/covid-19/ before calling NHS111 or your GP.
If you need a note for your employers use the following link: https://111.nhs.uk/isolation-note/
Contact the practice via telephone, eConsult or book a telephone triage appointment with a clinician online.
ONLY ATTEND THE PRACTICE IF YOU HAVE BEEN INVITED IN OR HAVE AN APPOINTMENT.

Important Update : We are upgrading to the next phase of the Electronic Prescription Service (EPS) from 20th May 2020 (next Wednesday).
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Vitamin Supplements to boost your immune system

No supplement will cure or prevent the disease. No research has confirmed the use of any supplements to protect against COVID-19 specifically, however research has shown that supplementing with certain vitamins, minerals, herbs, and other substances can improve immune response and give you a better chance if you do catch the virus.

Please note that some supplements can interact with prescription or over-the-counter medications you are taking. Some may not be appropriate for people with certain health conditions. If in doubt, you may check with the community pharmacist before purchasing.

At BHWC we are recommending our patients to take the following supplements:

Examples of brands which contain these vitamins are Redoxon, Vitabiotics Ultra, Haliborange.

Vitamin A: Playing an important role in supporting T Cells, which are a type of white blood cell that help identify pathogens (like viruses or infectious bacteria), vitamin A in can be found in all kinds of foods such as: liver, whole milk, cheese; which contain retinol – preformed vitamin A, and dark green leafy vegetables and orange-coloured fruits and vegetables, which contain beta carotenes that the body converts to vitamin A.

Vitamin B6: This vitamin helps produce new immune cells, helps process antibodies, and helps immune cells to communicate. It is found in poultry and fish, fortified breakfast cereals, egg yolk, yeast extract, soya beans, sesame seeds and some fruit and vegetables, like banana, avocado and green pepper.

Vitamin B12: This vitamin is important for producing new immune cells. Found in animal products like meat, fish, milk, cheese and eggs, as well as fortified breakfast cereals, or as part of a multivitamin supplement.

Vitamin C: Vitamin C supports the function of various immune cells and enhances their ability to protect against infection by helping immune cells attack pathogens, enabling us to clear away old immune cells from the site of infection, and also by helping maintain the skin, our external barrier to infection. Vitamin C also functions as a powerful antioxidant, protecting against damage induced by oxidative stress, which occurs with the accumulation of reactive molecules known as free radicals. Oxidative stress can negatively affect immune health and is linked to numerous diseases. Supplementing with vitamin C has been shown to reduce the duration and severity of upper respiratory tract infections. Vitamin C is found in oranges and orange juice, red and green peppers, strawberries, blackcurrants, broccoli, brussels sprouts, potatoes and tomatoes. If you take more than the recommended daily dose vitamin C can cause stomach pain, diarrhoea and flatulence.

Vitamin D:  A low status of vitamin D is associated with reduced immune response. Healthy levels of this vitamin may help lower your risk of respiratory infections. It may also improve response to antiviral treatments in people with certain infections. Our main source of vitamin D is from sunlight on our skin but food sources include salmon, tuna, sardines, milk, cheese, eggs yoghurt and fortified cereals. If you are self-isolating you may not be getting enough vitamin D. Taking too many vitamin D supplements over a long period of time can cause too much calcium to build up in the body (hypercalcaemia). This can weaken the bones and damage the kidneys and the heart. Do not take more than 100 micrograms of vitamin D a day as it could be harmful.

Copper: Often forgotten when thinking about nutrients, copper helps protect and fuel immune cells. It can be found in a range of sources, including: bread, wholegrain breakfast cereals, rice, quinoa, meat, fish and shellfish, pulses, avocado, dried fruit, nuts and seeds.

Curcumin: Curcumin is the main active compound in turmeric. It has powerful anti-inflammatory properties, and animal studies indicate that it may help improve immune function. Can be added to your meals.

Echinacea: is a genus of plants in the daisy family. Certain species have been shown to improve immune health and may have antiviral effects against several respiratory viruses, including respiratory syncytial virus and rhinoviruses. Taking this supplement may boost your pre-infection resilience for immunity.

Folate: Folate also plays an important role in producing new immune cells. It is found in green vegetables, pulses, oranges, berries, nuts and seeds, cheese, bread and fortified breakfast cereals.

Garlic: has powerful anti-inflammatory and antiviral properties. It has been shown to enhance immune health by stimulating protective white blood cells like NK cells and macrophages. Garlic is found to have antiseptic properties. During an illness you can eat large amounts of raw garlic, peeled and swallowed whole or crushed with lemon and honey.

Ginseng: is an herbal supplement that has been used for centuries in Chinese medicine. It has antioxidant and anti-inflammatory effects, strengthens the immune system, fights fatigue and enhances the function of certain immune components in the bronchi, which are the main airways in the lungs. There is some evidence that ginseng enhances immune activity once you are ill but does not help prevent an illness. Ginseng can be bought as a supplement from your health food store, grocery store or pharmacy.

Ginger: is high in gingerol, a substance with powerful anti-inflammatory and antioxidant properties and can help lower the risk of infections. Don't consume more than 4 grams of ginger in any given day in any form Ginger can be used fresh, dried, powdered, or as an oil or juice.

Horseradish: belongs to the Brassicaceae family, as does broccoli, cabbage, mustard, and wasabi. It contains volatile pungent compounds called mustard oils. It has long been used for relief of upper respiratory tract congestion. The volatile compounds it contains are thought to help dilate the nasal passages which may help to clear the sinuses. It is often used for mild upper respiratory tract infections such as colds. Horseradish can also be of benefit if a cough is present. Another benefit of horseradish is its antimicrobial properties. By helping to fight bacteria, it may help your body combat bronchial complaints and respiratory congestion if caused by bacteria.

Iron: Helping to maintain the health of immune cells, iron has a variety of meat and vegetable sources. Haeme-iron, which comes from meat sources of iron, like offal, red meat and fish, is more easily absorbed than non-haeme iron, which is found in plant-based sources.

Licorice: contains many substances, including glycyrrhizin, that may help protect against viral infections. According to test-tube research, glycyrrhizin exhibits antiviral activity against severe acute respiratory syndrome-related coronavirus.

Marshmallow: the plant (not sweeties) is demulcent (soothes/coats the mucous membranes) as a lot of people have described very harsh dry soreness of the nose/throat. Can be bought as Bronchostop.

Medicinal mushrooms: including cordyceps and turkey tail, may offer immune-enhancing and antibacterial effects.

Selenium: is a mineral that is essential for immune health. Animal research demonstrates that selenium supplements may enhance antiviral defence against influenza strains, including H1N1 This nutrient is vital for producing new immune cells and can help to strengthen response to infection. It’s found in nuts and seeds, particularly Brazil nuts, cashews and sunflower seeds, as well as eggs, offal poultry, fish and shellfish.

Thyme: has antiseptic and diaphoretic (promoting sweating ie cooling) properties and tonic to the airways, it can be taken as a tea using dried or fresh herb so can keep up the regular sipping of warm fluids with this. (Brew with a cover/lid on to trap volatile oils). Bronchostop is a syrup of marshmallow and thyme

Zinc: Essential for immune system function, zinc helps produce new immune cells, helps develop ‘natural killer cells’ that help to fight off viruses, supports communication between immune cells, plays an important role in inflammatory response and it has been shown to protect against respiratory tract infections. Zinc may be beneficial for those who are already sick by reducing the duration of the illness. Found in a wide range of sources from meat and poultry, to cheese and wholegrains. Excessive doses may interfere with copper absorption, which could increase your infection risk and lead to anaemia and weakening of the bones.

Alternatively, spring tonics that optimise health pre-infection can be found for free right now: wild garlic (Recipe idea ), nettle, cleavers, plantain, dandelion (Recipe idea )

Stinging nettles - pick them with gloves, wash and add to soup (leek and potato for example) for a great post viral recovery as they are packed with nutrients (especially calcium, vitamin C and antioxidants)

Cleavers - sticky stalky plants found in hedgerows, these can be simply infused in cold water overnight then drank as a cooling tea which works as a gently cleansing spring tonic

Wild garlic - found in shady woodlands, the leaves taste like mild garlic and be added to salads, omelettes, soup, bread or made into pesto

Dandelion - once washed, the flowers can be eaten in a salad, the leaves are pleasantly bitter making them a good digestive tonic and can be eaten raw or wilted like spinach, and the root is used to make tinctures/bitters

Maintaining a balanced diet, getting enough sleep, engaging in regular physical activity, and not smoking are some of the most important ways to help keep your immune system healthy and reduce your chances of infection and disease.

Shilpa Patel

BPharm, IP

Shilpa Patel is the lead clinical pharmacist and practice partner. She started working at BHWC in 2016 when NHS England started a pilot programme to bring pharmacists into GP practice to help GPS. She has 17 years of experience in community pharmacy. Shilpa...