Valmisolek viirustega toimetulekuks.

Igal aastal sügisel saabub meile nö viiruste hooaeg. Lisaks meile tuntud viirustele, mh gripile, on meiega nüüd ka koroona ehk SARS-CoV-2 , mille poolt põhjustatud haigust nimetatakse COVID-19. Liikvel on erinevaid juhendeid, mida teha, et terve püsida või siis vähemalt haigus kergemini läbi põdeda. Samuti on soovitusi, kuidas käituda juhul, kui oleme siiski haigeks jäänud. Teen siin lühikese koondi Funktsionaalse Meditsiini Instituudi (IFM) soovitustest viirusperioodiks. Minu enda poolt lisatud tekst on kirjutatud kaldkirjas, originaalteksti olen lühendanud. Mitmed soovitused on võetud eelnevast informatsioonist teiste viirushaiguste ravi kohta, kuna COVID-19 spetsiifilisi uuringuid ei ole paljude taimsete toodete ja toidulisandite kohta  veel piisavalt, samas on mitmed viirustega toimetuleku protsessid universaalsed. IFM meeskond töötab pidevalt läbi selle valdkonna kirjandust ja hetkel on uuendusi juba kaks. Olen teksti kokku pannud kolmest erinevast osast ja tekstis leiduvad viited on seetõttu tähestikulises järjekorras. Iga soovija võib originaaltekstide ja viidetetga tutvuda IFM kodulehel (www.ifm.org). IFM on oma soovitustes hinnanud ka preparaatide ohutust, põhjendatust ja efektiivsust. Toon välja ka teatud ainete toimemehhanismid, mis võivad tunduda keerulised, paigutan need teksti lõppu. Tabelina on toodud vaid soovituslikud lisandid koos annustega.

SARS-CoV-2 võib olla ohtlik, kuna tal on võime stimuleerida kaasasündinud immuunsuse osa inflammasoomi – so erinevatest valkudest koosnev kogum, mis aktiveerudes käivitab immuunprotsessid. See stimulatsioon võib mõnedel inimestel põhjustada nn tsütokiinide tormi: vabaneb kontrollimatul hulgal põletikutsütokiine, mis võib tõsiselt kahjustada kudesid (nt hingamisteede limaskesta). SARS-CoV-2 aktiveerib NLRP3 infalmmasoomi ning on leitud, et seda võivad pidurdada resveratrool, kurkumiin, EGCG ja kvertsetiin, mõjudes enam kui ühele kohale selles patoloogiaahelas; samuti pärsivad need NF-kB-d, mis samuti vähendab põletikku.Taimsed komponendid on võimelised pärssima COVID-19 peamist proteaasi (üks kindel ensüüm), mis on vajalik viiruse paljunemiseks. Kliinilisi uuringuid ei ole veel piisavalt, samas soovitatakse neid standardsetes annustes, et hoida ära NLRP3 inflammasoomi aktivatsioon, vähendada NF-kB aktiivsust ja potentsiaalselt vähendada SARS-CoV-2 replikatsiooni. Ei ole veel kirjandust, mis võrdleks nende ainete kasutamist ainusekkumisena vs koos kasutatuna. IFM soovitab kasutada neid kas suuremas annuses või mitut ainet korraga, otsuse tegemisel on oluline inimese enda soov, haiguseelne põletikufoon, kaasuvad haigused jms.

Enne konkreetsete toodete tutvustamist on hea meenutada, et tervena püsimiseks on väga olulised kõige tavalisemad elustiilifaktorid:

1. Püüa vältida liigset stressi. Krooniline stressiseisund kahjustab immuunsüsteemi funktsioone ja inimene võib selles seisundis jääda kergemini haigeks, samuti põdeda haigust raskemini. Hea on teada just sinule sobivaid stressimaandamise viise ja neid regulaarselt praktiseerida.
2. Unel on väga suur mõju immuunsüsteemile, oluline on magada piisavalt ja järgida unehügieeni reegleid.Maga piisavalt ja mine magama enne keskööd, magamistoa temperatuur võiks olla jahedam, tuuluta ruume korralikult. Magamistuba olgu vaikne ja pime. Valmista end heaks uneks ette – ära söö kõhtu täis vahetult enne und, arvutid ja ekraanid võiksid olla välja lülitatud vähemalt tund enne voodisse minekut. Mida enam varasemaid probleeme teil on unega, seda enam on vajalik unehügieenile tähelepanu pöörata.
3. Mõõdukas regulaarne füüsiline koormus aitab samuti immuunsüsteemi virgutada – tõuseb nakkusega võitlevate valgevere rakkude ja antikehade  arv, paraneb vereringe ja väheneb stressihormoonide tase. Paras füüsiline treening ei aita mitte ainult ennetada hingamisteede haigusi, vaid parandab ka kognitiivseid protsesse ja füüsilist vastupidavust.
4. Toitumisel on samuti oluline roll immuunsüsteemi toetamisel. Uuringud viitavad, et piisavalt erinevat värvi köögi- ja puuvilju toidus mõjub paremini kui enamik toidulisandeid. Kaasa toiduvalikusse ka fermenteeritud aedvilja ja muid probiootilisi toite.
5. Ülekaal on üks suur riskifaktor mitte ainult raskekujulisele COVID-19-le, vaid mitmetele kroonilistele haigustele.

Enamik letil müüdavatest ravimitest leevendavad sümptomeid, mitte ei aita immuunsüsteemil haigusega võidelda. Kuigi alljärgnevad soovitused ei ole spetsiifilised koroonaviirusele, võid esimeste haigusnähtude ilmnemisel neid meetmeid rakendada, hiljem toon välja ka toidulisandid ja ravimtaimepreparaadid, millest võib abi olla eelkõige haiguse ennetamisel ja varases staadiumis.

Kui tunned esimesi hingamisteede haiguse ilminguid, hoolitse selle eest, et sa tarbid piisavalt vedelikku ja luba endale puhkust. Toitudest on parimad kodus valmistatud köögivilja- või kondipuljongid, ka soojad taimeteed aitavad keha vedelikutasakaalu hoida. Head valikud on siin piparmünt, ingver, eukalüpt, kummel, soe sidrunivesi, mesi ja kaneel.Mina soovitan haiguse ajal vältida piimatooteid ja gluteeni sisaldavaid vilju. Kui need muidu sulle sobivad, saad need haiguse möödudes taas kasutusele võtta. Haiguse ajal sobivad kergesti seeditavad, aurutatud, hautatud või keedetud toidud.

Kui tunned kurguvalu, kurista kurku sooja meresoolaveega. See lahustab lima ja tõrjub ka viirusi – soolases keskkonnas ei ole viirused kuigi elujõulised. Soe tee ja libejalaka pastillid aitavad leevendada valu ja põletikku limaskestadel. Samaks otstarbeks kasutatakse ka 2 teelusika täit mett sooja veega. Piparmündi- ja kummelitee aitavad vähendada ärritustunnet kurgus, rahustavalt mõjuvad ka lagritsajuur ja Marshmallow juur (Harilik altee).

Sinusiidi ja /või hingamisteede koguneva eritise puhul on hea kasutada aure, kasutusel võib olla toas õhuniisuti. Sõltuvalt haiguse raskusest võib hea olla ka aurusaun. Inhalaatorisse võid lisada veidi essentsiaalseid õlisid: eukalüpt, mentool, piparmünt või viiruk. Hea on kasutada ninaloputuskannu, ka ninna pihustatavat soolalahust.

Palaviku korral on hea teada, et see on eelkõige keha kaitsemehhanism – viirustel ei ole siis kerge paljuneda. Seetõttu ära võta palaviku liiga kergekäeliselt maha, kui enesetunne talutav, siis mitte enne, kui temperatuur on tõusnud 39 kraadini.

Kui eritised (nohu, röga) on sitked ja paksud, kasuta nt NACi ehk ACC-d (N-atsetüüktsüsteiini), apteegis on saadaval ka teisi samaks otstarbeks mõeldus taimseid tooteid.

Tee hingamisharjutusi, ära lama pidevalt selili.

Immuunsüsteemi toetavad toidud ja toidulisandid.

On olemas mitmeid mikrotoitaineid ja taimseid preparaate, mis võivad toetada immuunsüsteemi ja leevendada ka haigussümptomeid, samuti võivad nad lühendada haiguse kestust. Mõnede toidulisandite puhul on tõeneid siiski nii palju, et neid julgetakse ka laienalt soovitada. Kui selgitused tunduvad keerulised, siis leiad allpool asuvast tabelist vajaliku info lühidalt.Taimseid vahendeid on soovitav omavahel kombineerida, samas ei ole vajalik kasutada kõiki korraga.

Tsink on oluline immuunsüsteemi kofaktor, toetades väga erinevaid rakufunktsioone nii omandatud kui ka kaasasündinud immuunsüsteemi osas. Tsingidefitsiit on suhteliselt sagedane, eriti COVID-19 riskigruppide hulgas. Tsingi lisa võib vähendada nii haigestumist viirusinfektsioonidesse kui ka haiguse raskusastet ning kestust. On ka näidatud, et tsink võib vähendada alumiste hingamisteede põletiku riski, mis võib olla oluline COVID-19 kontekstis.  Kui tarbida tsingilisandit esimese 24 tunni jooksul haiguse algusest, võib see lühendada haiguse kestust ja vähendada raskusastet. Piisav tsingi tase veres võib vähendada nakatumist. Soovituslik annus haiguse ajal on 30-60 mg päevas, jagatuna päeva peale. Ennetavalt võiks kasutada väiksemaid annuseid (15-20 mg), tsingi pikemaaegsel tarbimisel võib tekkida vase puudus, seega sobivad näiteks multivitamiinid, kus sees on nii tsinki kui ka vaske. Sobivad tsinkatsetaat, -tsitraat, -pikolinaat, -glütsinaat või -glükonaat. Tsingi kasutamise tõenduspõhisust peetakse tugevaks ja võimalikke riske minimaalseks.

Arooniad (Sambucus nigra) on olnud rahvameditsiinis laialdaselt kasutusel viirusvastase ravina. Loomkatsetes on näidatud, et arooniad on efektiivsed hingamisteede haiguste ennetamisel ja varases ravis. Kuigi ühes in-vitro uuringus leiti ka tõusnud TNF-alfa tasemed, ei ole seda hilisemates uuringutes näidatud. Soovituslik on kasutada kvaliteetseid arooniatest valmistatud lisandeid (nii marjadest kui ka õitest). Soovituslik annus 500 mg neli korda päevas (standardiseeritud toode 17% antotsüanosiide) kuni 12 nädalat. Aktiivsed komponendid soodustavad rakkude kaitse-ja paranemismehhanisme ja mõjutavad viiruste poolt põhjustatud patoloogilisi protsesse. On leitud, et arooniad leevendavad haigussümptomeid, nakatumine on harvem ja haiguse kestus lühem. Tõenduspõhisust peetakse tugevaks, võimalikke riske minimaalseks.

D-vitamiin, nn „päikesevitamiin”, on üks olulisemaid ja võimsamaid immuunsüsteemi toetajaid. Aktiveeritud D-vitamiin (1,25(OH)-D) on steroidhormoon, mis moduleerib immuunsüsteemi, vähendab põletikutsütokiinide teket ja soodustab makrofaagide funktsioone. D-vitamiin stimuleeerib ka tugevatoimelisi antimikroobseid peptiide (AMPd), mida leidub neutrofiilides, monotsüütides, naturaalkillerrakkudes ja hingamisteede epiteelrakkudes. D-vitamiin tõstab defensiinide kaudu antipatogeensete peptiidide sünteesi.Mitmetes uuringutes on näidatud, et see vähendab riski haigestuda erinevatesse viirushaigustesse, mh grippi. Kahjuks on D-vitamiini defitsiit vägagi levinud probleem, D3-vitamiini toidulisand on siinkohal vajalik kaitse. Mõningaid vasturääkivusi on selles, kui kõrge on optimaalne D-vitamiini (25(OH)-D) tase veres. Eestis on alampiiriks lepitud 75 nmol/l, optimaalseks peetakse siiski mõnevõrra kõrgemaid näite, isiklikult olen soovitanud hoida D-vitamiini tase 100-120 nmol/l vahemikus. Kuna D-vitamiini imendumine on indiviiditi erinev, on hea seda enne viirushooaega verest kontrollida.Kui vere taset ei saa kontrollida, on soovituslik annus 5000 IU. Tõenduspõhisus on haiguse ennetamiseks tugev, haiguse aktiivses faasis tinglik. Seega on D-vitamiiniga alustamine haigestumise ajal väiksema tähtsusega, kuid kui tase on juba saavutatud, on toime märkimisväärne. Võimalik kahju on minimaalne.

A-vitamiinon mikrotoitaine, mis on vältimatu nägemisfunktsioonides, soodustab kasvu ja arengut, kaitseb limaskesta terviklikkust. A-vitamiin osaleb ka immuunsüsteemi arengus, omab kriitilist rolli immuunsüsteemi aktiveerimisel, mõjutades T-abistajarakke, mille kaudu reguleeritakse nii rakulise kui ka humoraalse immuunsuse protsesse. A-vitamiin osaleb ka IgA ja tsütokiinide regulatsioonis. A-vitamiinil on näidatud raviefekti mitmete infektsioonide korral. Lühiaegsed kuurid, eriti mõõduka vitamiin A puuduse korral, võivad olla vägagi efektiivsedinfektsioonivastases võitluses, eriti hingamisteede haiguste korral.On näidatud, et lüheneb haiguse kestus, samuti on viiteid suremuse vähenemisele. Soovituslikud annused kuni 10000-25000 IU/päevas. Tõenduspõhisus on tugev, risk on väike, kui annuseid ei ületata. Rasedad ei peaks kasutama suuremaid annuseid kui 10000 IU päevas teratogeense (loote väärarenguid põhjustava) ohu tõttu.

C-vitamiinaitab immuunkaitses, toetades mitmeid rakulisi funktsioone nii kaasasündinud kui ka omandatud immuunsüsteemis. C-vitamiini kogutakse fagotsütaarsetesse rakkudesse nagu näiteks neutrofiilid, see võib võimendada kemotaksist ehk keemilist rünnakut, fagotsütoosi, reaktiivsete radikaalide sünteesi ning kõige lõpuks mikroobide hävitamist. C-vitamiin võib aidata ennetada nii viiruste kui ka bakterite poolt põhjustatud haigusi. Sepsise korral on kirjeldatud väiksemat suremust. On näidatud, et regulaarselt kasutatuna lühenevad nn külmetushaigused, haiguse ajal kasutatud suuremad doosid võivad toimida naturaalse antihistamiinikumina ja põletikuvastasena. Soovituslik annus 1-3 g päevas, jagatuna neljaks. Tõenduspõhisus on mõõdukas (sepsise korral), tinglik haiguse ennetamisel. Riskid on kerged soovituslike annuste korral, minimaalsed annuses 1-2 g neljaks jaotatult.

N-atsetüültsüsteiin(NAC) soodustab glutatiooni sünteesi. Ühes 6-kuud kestnud uuringus osales 262 vanurit. Need, kes said NACi 600 mg kaks korda päevas, põdesid platseebogrupiga võrreldes oluliselt harvem gripilaadseid haigusi ja veetsid vähem päevi voodis.Eestis on NAC registreeritud röga lahtistiva ravimina, kasutatakse enam lühendit ACC.Võimalik, et NAC moduleerib raku kaitse- ja paranemismehhanisme, vähendab sümptomite kestust ja raskusastet.Soovituslik annus on 600-900 mg kaks korda päevas. Soovituse tõenduspõhisus on limiteeritud, suukaudsel kasutamisel on risk minimaalne.

Kvertsetiinil on näidatud toimet nii RNA (nagu gripp ja koroonaviirus) kui ka DNA (nt herpesviirus) viiruste vastu. Kvertsetiin on antioksüdant, kuid toimib ka põletikuvastaselt. See mõjutab ka teatud mehhanisme, mis on seotud viirusinfektsiooni järgse paranemisega. Kvertsetiin võib soodustada viiruse neutraliseerimist või likvideerimist, pärsib viiruse replikatsiooni, moduleerib NLRP3 inflammasoomi aktiveerumist, vähendab koekahjustuste ulatust ja soodustab funktsioonide taastumist, osaleb nuumrakkude stabilisatsioonis ja on anti-fibrootiline. On näidatud , et leevendab haigusnähte. Tavalises ravivormis on soovituslik raviannus 1000 mg x 2, fütosoomses vormis 500 mg x 2. Soovituslik kuuri pikkus mitte üle 12 nädala. Tõenduspõhisus on limiteeritud, risk on soovitatud annuste juures minimaalne.

Epigallokatehhiingallaat (EGCG). Roheline tee moduleerib NLRP3 inflammasoomi ja võimalik, et mõjutab SARS-CoV-2 peamist proteaasi, vähendades viiruse replikatsiooni. Lisaks on näidatud, et see ennetab grippi tervishoiutöötajatel. Teena soovitatakse 4 tassi päevas, EGCG-na 225 mg x 4. Tõenduspõhisus ennetuses limiteeritud, ravis tinglik. Risk on minimaalne, kerge kõrgemate annuste korral (>800 mg), sel juhul on kirjeldatud ajutist maksaensüümide tõusu.

Kurkumiin moduleerib samuti NLRP3 inflammasoomi ja võib mõjutada SARS-CoV-2 peamist proteaasi, vähendades viiruse replikatsiooni. Soovituslik annus 500-1000 mg kaks korda päevas (hea imendumisega vorm). Soovituse tõenduspõhisus on tinglik, risk minimaalne.

Melatoniin inhibeerib samuti NLRP3 inflammasoomi. On näidatud trombe ennetavat toimet. Soovituslik annus on 5-20 mg. Tõenduspõhisus on tinglik, riskid minimaalsed.

Resveratrool on looduslik polüfenool, millel on mitmeid tervisele soodsaid toimeid. See moduleerib NLRP3 inflammasoomi, loomkatsetes on näidatud viirusvastast toimet MERS-CoV puhul. Soovituslik annus on 100-150 mg neli korda päevas. Soovituse tõenduspõhisus on tinglik, riskid minimaalsed.

Seleen on immuunsüsteemi üks võtmekomponent, seleen on ka antioksüdant, aitab võimendada keha kaitsemehhanisme bakterite, viiruste ja kasvajarakkude vastu. Seleen võib kaitsta teatud gripiviiruse tüvede eest. Seleenisaab toidust kõige lihtsamini Brasiilia pähklitest, samas sõltub seleenisisaldus pähklipuude kasvupinnasest ja võib seetõttu olla väga erinev. Seleenipuudust on seostatud ka COVID-19 raskema haiguskuluga. Seleeni võib olla vaja ka toidulisandina juurde võtta, suuri annuseid ei ole turvaline võtta kaua, annus 200 mkrg päevason turvaline paari kuu jooksul, pikema tarbimise juures oleks vajalik määramine verest, et aine ei mõjuks kahjulikult.

Mesi, eelistatult kuumutamata, leevendab kerget valu ja põletikku limaskestadel. Meel on ka antioksüdatiivsed omadused ning mõned antimikroobsed toimed. Mett kasutatakse köha ja kurguvalu puhul, sobib sooja taimeteega. Ilmselt ka meie rahvameditsiinst tuntud taruvaik on omal kohal, uuringuid selle kohta ei leidnud.

Küüslauk sisaldab mitmeid komponente, mis võivad mõjutada immuunsüsteemi. On uuringuid, mis osutavad, et küüslauk ja mitmed küüslaugust valmistatud toidulisandid vähendavad viiruslike hingamisteede nakkuste raskusastet, samuti on leitud, et need mõjuvad viirushaiguste ennetamisel.

Probiootikumid mitte ainult ei toeta soolestiku tervist , vaid toimivad ka immuunsüsteemile. Probiootikumide kasutamine võib vähendada mitmetesse hingamisteede haigustesse nakatumist, eriti lastel.

Beeta-glükaanid on samuti immuunsüsteemi modulaatorid, osaledes kaasasündinud immunsuses PRR retseptorite kaudu, samuti tõstavad nad põletiku-vastaste tsütokiinide sünteesi, nad indutseerivad viirusvastaseid protsesse. Paljud uuringud näitavad, et beeta-glükaanid vähendavad gripi ja teiste viirushaiguste sümptomeid võrreldes platseeboga. Soovituslik annus on 250-500 mg päevas.Tõenduspõhisus on tugev, riskid minimaalsed.

Seened. Mitmete seeneliikide puhul on teada, et neil on immuunomoduleeriv toime. Toimemehhanismid on erinevad, mh tõuseb tsirkuleerivate B-rakkude hulk, paraneb soole immuunsus, stimuleeritakse peremeesorganismi immuunvastust, aktiveeruvad kaasasündinud immuunssüsteemi rakud ja tõuseb NK rakkude tsütotoksiline aktiivsus. Kuna siinkasutusel on erinevaid seeneliike ja erinevaid ekstraktsioonimeetodeid, siis annustamine on individuaalne. Tõenduspõhisus on limiteeritud ja riskid ebaselged, tingituna erinevatest seeneliikidest ja nende kombinatsioonidest.

Lagritsal(Glycyrrhiza species) on mitmeid toimemehhanisme, mh viiruse replikatsiooni pärssimine,blokeerides ACE2 retseptoreid, Th1 rakkude stimuleerimine, põletikutsütokiinide inhibeerimine, prostaglandiinide ja NO tootmine. See pärsib ka hüdrokortisooni lagundamist 11 beeta-HSD ensüümi abil, ning seda mehhanismi peetakse ka lagritsa põletikuvastase toime võimalikuks põhjuseks.Hiina meditsiinis on lagritsat kasutatud SARS-CoV-1 ja H1N1 vastu ja selle efektiivsust on vaadeldud ka SARS-CoV-2 vastu. Soovituslik on kasutada lagritsajuurt standardiseeritud glycyrrhizinina, annus on 200-400 mg päevas jagatuna väiksemateks annusteks. Kasutatakse lühiaegselt, alla nelja nädala.

Andrographis paniculata lehti on kasutatud sajandeidülemiste hingamisteede haiguste, sinusiitide ja köha ennetuses ja ravis. Süstemaatilised ülevaated näitavad, et see on efektiivne nii üksi kui ka kombinatsioonis teiste taimedega.See on põletikuvastane, viirusvastane ja stimuleerib immuunsüsteemi. In-vitro on näidatud, et see on efektiivne linnugripi A (H9N2 ja H5N1) ja inimese gripiviiruse A H1N1 vastu. Sellel on valuvaigistav ja palavikku alandav toime, ta  vähendab tsüklooksügenaas-2te ja pidurdab trombotsüütide poolt aktiveeritud faktor-vahendatud põletikuvastust.Andrographis alandab ka furiinproteaasi aktiivsust, mis on vajalik samm SARS-CoV-2 ogavalgu aktivatsioonis ja sisenemises limaskesta rakkudesse. Soovituslik annus standardiseeritud ekstrakti puhul (tavaliselt 30% andrografoliide) on 100-600 mg päevas, sageli on ta kombinatsioonis teiste taimedega. Tõenduspõhisus on tugev, riskid minimaalsed.

Astragalus membranaceus on Hiina meditsiinis olnud kasutusel sajandeid. Teda peetakse viirusvastaseks, põletikuvastaseks, kaasasündinud immuunsuse toetajaks, samuti vähendab see NLRP3 inflammasoomi poolt vahendatud põletikku. Lisaks taime alkaloid swainsoniin inhibeerib glükosülatsiooni, mis on vajalik, et SARS-CoV2 ogavalk saaks tungida inimese rakku.Soovituslik annus varieerub 1-20 grammini päevas, sõltudes astragalosiidide ja teiste immuunaktiivsete polüsahhariidide sisaldusest. Hiinas on see saadaval kuivatatud juure jahvatusena. Tõenduspõhisus on tinglik ja riskid minimaalsed.

Berberiin on alkoaloid, misa leidub erinevate taimede (läiklehine mahoonia, koldjuur, kolmelehine koptis) juurtes, risoomides, ka koortes. Berberiinil on leitud viirusvastane toime mitmete viiruste vastu. Berberiin aktiveerib 5’AMP-aktiveeritud proteiinkinaasi (AMPK), mis on otseselt põletikuvastane. Ta alandab NFkB-d ning võimalik, et teatud põletikutsütokiine. Berberiin alandab ka veresuhkrut, inhibeerib furiini ja võimalik, et inhibeerib aldoosreduktaasi. Soovituslik annus on 500 mg kaks või kolm korda päevas. Tõenduspõhisus on limiteeritud, riskid minimaalsed.

Echinacea ehk päevakübara (erinevad liigid) immunoloogilised toimed näivad tulenevat koostisainete kombinatsioonidest. Punane päevakübar stimuleerib makrofaagide ja NK rakkude aktiivsust nii inimestel kui ka loomadel ja võib olla seotud tsütokiinide produktsiooniga. Erinevad päevakübara tooted on viirusvastase toimega. On näidatud, et päevakübara kasutamine vähendab ülemiste hingamisteede haiguste sagedust, raskusastet ja kestust, koos teiste taimedega on samuti näidatud sümptomite vähenemist. Annus sõltub aktiivsete ühendite sisaldusest, samuti ekstraktsiooni-protsessist ning konkreetsest päevakübara liigist. Tõenduspõhisus on haiguse ennetuses tugev, ravis tinglik, riskid minimaalsed.

Luteoliin on flavonoid, mida leidub mitmetes ravimtaimedes ja ka puu- ja aedviljades, nt paprikad, seller, punane sigur, sigur ja sidrunid. Luteoliinirohkeid taimi kasutati Hiina meditsiinis hüpertensiooni, põletikuliste haiguste ja vähiravis.Hiljutised uuringud viitavad, et luteoliin on üks kanditaatmolekul, mis blokeerib SARS-CoV-2 sisenemist rakkudesse ning moduleerib põletikuvastust.Samuti inhibeerib see peamist proteiini, seob viiruse S-proteiini ja inhibeerib furiini. Soovituslik annus on 100-200 mg 2-3 korda päevas. Tõenduspõhisus on tinglik, riskid minimaalsed.

Kokkuvõtlik tabel olulisemate toidulisandite toimest.

Toidulisand	Toime	Toetab immuunvastust	Vähendab viiruse paljunemist	Leevendab sümptomeid
Kurkumiin 500-1000 mg, 2xp	Kurkumiin vähendab põletikku ja vähendab koroonaviiruse aktiivsust.	x	x	x
Quercetin tavaline vorm 1000 mg  x 2 fütosoomne vorm 500 mg x 2	Quercetiini on puu-ja köögiviljades, sel on mitmeid toimeid, mh viiruse kasvu pidurdamine.	x	x	x
Zn-atsetaat, -pikolinaat, – glütsinaat või glükonaat 30-60 mg/p, jaotatult päeva peale	Uuringud näitavad, et tsink aitab viirusvastases võitluses paljude erinevate viiruste korral.	x	x	x
N-atsetüültsüsteiin (NAC) 600-900 mg x2	NAC osaleb glutatiooni sünteesis, mis on tugev antioksüdant, toetab seeläbi immuunfunktsioone. Samuti leevendab gripisümptomeid.	x		x
D-vitamiin 5000IU/p	D-vitamiin toetab immuunsüsteemi funktsioone, vähendab viiruse kasvu, võib vähendada ülemiste hingamisteede põletikke.	x	x	x
A-vitamiin 10000-25000IU/p	A-vitamiin on põletikuvastane, tugevdab immuunfunktsioone ja toetab hingamisteede limaskesta funktsioone.	x		x
C-vitamiin 1-3 g/p	C-vitamiin toetab immunkaitset läbi erinevate rakufunktsioonide, kautatakse ka haiglate intensiivravis COVID-19 infektsioonide korral.	x	x	x
Melatoniin 5-10 mg/öö	Toetab und, kuid vähendab ka põletikku ja võimalik, et ka trombiohtu.	x	x
Arooniad	Sisaldavad palju C-vitamiini , kiudaineid ja antioksüdante. Neid on varasemalt kasutatud gripiennetuses.	x	x
Roheline tee või epigallokatehhiin-gallaat (EGCG) 4 tassi päevas (tee) vüi 225 mg/p (EGCG)	Lisaks põletiku vähenemisele toetab roheline tee immunfunktsioone ja mõjutab ka COVID-19 viirusega seonduvaid protsesse.	x	x	x
Resveratrol 100-150 mg x 2/p	Resveratroli leidub nt tumedates viinamarjades, sel on mitmeid tervisetoimeid, laboris on näidatud teiste koroonaviiruste vastane toime.	x	x
Beeta-glükaanid 250-500 mg/p	Beetaglükaanid on nii põletikuvasased kui ka toetavad immuunfunktsioone, mõju tuleb esile ka ülemiste hingamisteede viirusinfektsioonide korral.	x	x	x
Meditsiinilised seened. Annused on individuaalsed ja sõltuvad ka konkreetsest seeneliigist.	On näidatud, et meditsiinilised seened toetavad immuunsüsteemi, neil on nii antioksüdatiivsed kui viirusvastased toimed.	x	x
Lagritsajuur (standardiseeritud glütsirriisiinile) 200-400 mg/p jaotatuna (lühiaegne kasutamine alla 4 nädala)	Lagritsat kasutatakse palju traditsioonilises hiina meditsiinis, see toetab immuunfunktsioone ja vähendab viiruse kasvu.	x	x	x

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