Vitamin cocktail for COVID is harmless but not helpful

Dear Dr. Roach: You stated in a recent column that there is no evidence to support taking vitamins D, C and zinc when treating/ preventing COVID-19. I recently spoke to an infectious disease doctor who told me that doctors are giving this very vitamin “cocktail” to hospitalized patients with COVID. Lots of resources say having these vitamin levels optimum in your body does indeed fight and prevent illness, including COVID.

While it’s definitely not the equivalent of medication and vaccines for treatment/prevention, is it not true that these vitamins and minerals are crucial to maintaining the body’s immune system? Can you shed some light on this? There are so many misconceptions surrounding COVID-19. — K.C.

Dear K.C.: Studies have looked at whether giving these treatments improves outcomes in COVID-19, and the answer has been that they do not appreciably improve outcomes such as reducing the risk of needing a ventilator or dying. Physicians may still prescribe them, since there is no risk of harm at reasonable doses, and the studies may not have had the power to show smaller benefits. Physicians who have been treating this disease since the beginning of the pandemic want to have something they can offer, even without clear proof of benefit. There are certainly theoretical reasons why these treatments can support the immune system. Very severe deficiencies of these nutrients are associated with immune system weaknesses.

I would be very cautious about recommending these for treatment when there is not strong evidence for benefit, because I do not want people to think they don’t have a need for vaccination, mask-wearing and appropriate physical distancing. Vitamins C and D and zinc are not very effective for treatment or prevention, if at all.

I know you didn’t mention these, but since you did mention many misconceptions about COVID-19, I wanted to reiterate that there is strong evidence that ivermectin and hydroxychloroquine can be toxic, especially at high dosages, and no good evidence that they are helpful (at least at the time of this writing), so I recommend strongly against these until/unless further studies show benefit.

Dear Dr. Roach: I seem to have an issue with nightmares. They are very vivid, and I wake up feeling more tired than when I went to sleep. Oddly, they only happen when I am sleeping on my back. People who have observed me when I sleep have indicated I often hyperventilate while I’m having one of these nightmares. If I can make myself sleep on my side or my stomach, I seem to be able to sleep through the night without issue. Does sleeping position actually matter when it comes to nightmares? Should I see my doctor? — N.E.

Dear N.E.: The association of sleep position with nightmares has been evaluated since the time of Freud. I found evidence that sleeping on the back is associated with a higher frequency of nightmares than side sleeping, but left-sided sleepers have more nightmares than right-sided sleepers. In at least one case report, the person with nightmares only on his back was found to have obstructive sleep apnea, and his nightmares improved when started on CPAP therapy.

If you have risk factors for sleep apnea (such as being overweight) or additional symptoms (morning headache, snoring, falling asleep easily during the day), I would definitely discuss with your doctor.