Quercetin and Zinc: Zelenko Treatment Protocol

As of July 2024, more than 35 studies on the topic of zinc and COVID-19 (c19zinc.com) (constantly updated) and more than 10 studies on quercetin and COVID-19 have been published (c19quercetin.com). 

Dr. Zelenko’s main hypothesis based on the data showing that early intervention and treatment of high-risk patients with COVID-19 results in significantly few hospitalizations and deaths. This treatment regimen involving zinc, low-dose hydroxychloroquine, and azithromycin (published in the International Journal of Antimicrobial Agents) is also apparently known as, “The Zelenko Protocol.”

Quercetin and Zinc

The Zelenko Covid-19 Protocols was developed by Dr Vladimir Zelenko. The protocol has as its centerpiece, but not exclusive piece, the combined use of Hydroxychloroquine (HCQ) and Zinc as a means by which a person can both help to prevent or mitigate the contraction of COVID-19, or can actually treat the disease once it has been diagnosed. 

Quercetin is a natural antihistamine and anti-inflammatory plant pigment that boosts your immune system and may work to control viral replication, according to some research. It allows zinc to exert its proven antiviral properties; in treating COVID-19, quercetin may also lower inflammation, help clear mucus, prevent ventilator-induced damage, support immunity and might also be a valuable candidate for treatment of malaria and different kinds of leishmaniasis (Journal of Parasitic Diseases 2023).

Foods high in quercetin include onions, kale, tomatoes, broccoli, asparagus, berries, red wine, citrus fruits, cherries, and tea. 

According to the research, quercetin has been shown to help fight obesity, Type 2 diabetes, circulatory dysfunction, chronic inflammation and mood disorders. It has even been found to help lower blood pressure. Researchers have found that quercetin can trigger tumor regression and begin the process of apoptosis. This is programmed cell death, without which cells can grow uninterrupted and develop into cancerous growths.

Quercetin was initially found to provide broad-spectrum protection against SARS coronavirus in the aftermath of the SARS epidemic that broke out across 26 countries in 2003. Now, some doctors are advocating its use against SARS-CoV-2, in combination with vitamin C, noting that the two have synergistic effects.

Quercetin helps zinc by acting as a zinc ionophore (PubMed 2014), the same mechanism of action that hydroxychloroquine has via helping zinc pass the cell wall where it might halt viral replication.

This zinc ionophore activity of quercetin facilitates the transport of zinc across the cell membrane. It is known that zinc will slow down the replication of coronavirus through inhibition of enzyme RNA polymerase (PubMed 2010). 

The COVID-19 is an RNA (RiboNucleicAcid) virus and requires the RNA polymerase to replicate. Do take note that the study publication was a 2010 publication and is referring to a different coronavirus as compared to the latest coronavirus (COVID-19); though both are from the same family of coronaviruses.

A word about quercetin: Some physicians are recommending this supplement to reduce viral illnesses because quercetin acts as a zinc ionophore to improve zinc absorption into cells. It is much less potent than HCQ (hydroxychloroquine) as a zinc transporter, and it does not reach high concentrations in lung cells that HCQ does. Quercetin may help reduce risk of viral illness if you are basically healthy. But it is not potent enough to replace HCQ for treatment of COVID once you have symptoms, and it does not adequately get into lung tissue.

That said, if you simply cannot get hydroxychloroquine or ivermectin, quercetin is a viable stand-in. Quercetin works best when taken with vitamin C and Bromelain, as vitamin C helps activate it and bromelain helps with the absorption. 

Update: Recently, Ivermectin has come to the fore as a more effective (also long standing, cheap, generic drug), in all three stages of COVID-19. Dr Zelenko has also updated his protocols to incorporate ivermectin as an option for both the prophylactic and treatment protocols as shown below.

Zelenko Covid-19 Prophylaxis Protocol

Prophylaxis is an action taken to prevent, preventative or protect against a specified disease i.e. action taken before getting the infection. Greek in origin, from the word "phylax", meaning "to guard" and "watching." The Zelenko prophylaxis protocols are categorised based on the risk profile of the patients i.e. low, moderate or high risk.

• Low Risk Patients: Young healthy people do not need prophylaxis against Covid-19. In young and healthy people, this infection causes mild cold-like symptoms. It is advantageous for these patients to be exposed to Covid-19, build up their antibodies and have their immune system clear the virus. This will facilitate the development of herd immunity and help prevent future Covid-19 pandemics. However, if these patients desire prophylaxis against Covid-19, then they should take the protocol noted below.
• Moderate Risk Patients: Patients from this category are healthy but have high potential viral-load exposure. This group includes medical personnel, caregivers of high-risk patients, people who use public transportation, first responders and other essential personnel who are crucial to the continued functioning of society. These patients should be encouraged to take prophylaxis against Covid-19 in accordance with the protocol noted below.
• High Risk Patients: Patients are considered high risk if they are over the age of 45, or if they are younger than 45 but they have comorbidities, that is, they have other health conditions that put them at risk. These patients have between a 5 to 10% mortality rate if they are infected with Covid-19. These patients should be strongly encouraged to take prophylaxis against Covid-19 in accordance with the protocol noted below.

Protocol for Low and Moderate Risk Patients

The Zelenko protocol for low to moderate risk patients contains four nutrients that can be easily purchased over-the-counter or online i.e. quercetin, zinc, vitamin C and D3.

• Zinc (elemental) 25mg 1 time a day (PubMed) 
• Vitamin D3 5000 iu 1 time a day (vdnmeta.com) 
• Vitamin C 1000 mg 1 time a day (PubMed)
• Quercetin 500mg 1 time a day 

If Quercetin is unavailable, then use Epigallocatechin-gallate (EGCG) 400mg 1 time a day

Protocol for High Risk Patients:

• Hydroxychloroquine (HCQ) 200mg once a day for 5 days, then HCQ 200 mg one time a week (ScienceDirect) (Find a Doctor)
• Vitamin D3 5000 IU/day 
• Zinc 25 mg/day | How much zinc to take with hydroxychloroquine?

If HCQ is unavailable, then use the Protocol for Low and Moderate Risk Patients.

Z-Stack Supplement: In an effort to make it easier for patients, Dr Zelenko has developed an oral supplement that contains all four: vitamin C, quercetin, vitamin D3 and zinc. It’s called Z-Stack Vitamins. 

Related: 

• List of Doctors that will prescribe Ivermectin
• List of Pharmacies that will fill Ivermectin

Notes: 

• Although ivermectin and hydroxychloroquine (HCQ) are relatively safe drugs, they are still synthetic chemicals that can have side effects. Vitamin D, C, Zinc and Quercetin are nutrients that your body require for optimal health. Nutrients are safer alternatives especially if your risk is low e.g. age below 50 and no other chronic illness. Discuss with your doctor on the benefit vs risk for each treatment.
• Some 200 peer-reviewed studies (C19Study.com) by government and independent researchers deem HCQ safe and effective against Coronavirus, especially when taken prophylactically or when taken in the initial stages of illness along with zinc and azithromycin. Unfortunately, some of the RCTs that have been conducted to date used toxic doses of HCQ and/or were given very late in the disease.
• Inorganic zinc such as zinc sulfate, is not as effective or useable by your body as chelated zinc sources. Zinc lozenges are preferred so that the tissues of the nose and throat are rich in zinc as soon as they encounter the virus.

Zelenko Protocol - Treatment Plan for Patients with Covid-19 symptoms

Fundamental Principles (Dr Zelenko Protocol When to Start)

Treat patients based on clinical suspicion as soon as possible, preferably within the first 5 days of symptoms. Perform PCR testing, but do not withhold treatment pending results.

Patient Categories

Low risk patient - Younger than 45, no co-morbidities, and clinically stable
High risk patient - Older than 45, younger than 45 with co-morbidities, or clinically unstable

Treatment Options

Low risk patients - over the counter options:

Supportive care with fluids, fever control, and rest

1. Zinc (Elemental) 50mg 1 time a day for 7 days (PubMed)

2. Quercetin 500mg 2 times a day for 7 days (PubMed)

3. Vitamin C 1000mg 1 time a day for 7 days

4. Vitamin D3 5000 IU 1 time a day for 7 days 

Alternative for Quercetin: Epigallocatechin-gallate (EGCG) 400mg 1 time a day for 7 days (J. Agric. Food Chem) 

Moderate / High risk patients

1. Zinc (Elemental) 50-100mg once a day for 7 days
2. Vitamin C 1000mg 1 time a day for 7 days
3. Vitamin D3 10,000 iu once a day for 7 days or 50,000 iu once a day for 1-2 days
4. Azithromycin (Z Pack) 500mg 1 time a day for 5 days (Clin Drug Investig) OR Doxycycline 100mg 2 times a day for 7 days
5. Hydroxychloroquine (HCQ) 200mg 2 times a day for 5-7 days (ScienceDirect)

and/or

Ivermectin 0.4-0.5mg/kg/day for 5-7 days (ivmmeta.com). (Find a Doctor)

Hydroxychloroquine and ivermectin combined? Either or both HCQ and IVM can be used, and if one only, the second agent may be added after about 2 days of treatment if obvious recovery has not yet been observed etc.

If HCQ is not available, Quercetin 500mg 3 times a day for 7 days OR
EGCG 400mg 2 times a day for 7 days

Both protocols can be viewed from his website.

Other treatment options (Editor's edition)

• Dexamethasone 6-12mg 1 time a day for 7 days OR Prednisone 20mg twice a day for 7 days, taper as needed (not suitable during viral phase)
• Budesonide 1mg/2cc solution via nebulizer twice a day for 7 days (not suitable during viral phase)
• Blood thinners (i.e. Lovenox, Eliquis, Xarelto, Pradaxa, Aspirin) (Amazon)
• Colchicine 0.6mg 2-3 times a day for 5-7 days (MedRxiv 2021)
• Monoclonal antibodies
• Home IV fluids and oxygen
• Curcumin: 500 mg twice a day (Ref)  (Amazon)
• Fluvoxamine: 50 mg twice daily for 10–14 days. Add to ivermectin if: 1) minimal response after 2 days of ivermectin; 2) in regions with more aggressive variants; 3) treatment started on or after day 5 of symptoms or in pulmonary phase; or 4) numerous co-morbidities/risk factors. Avoid if patient is already on an SSRI (selective serotonin reuptake inhibitor). If you can’t get fluvoxamine (Luvox), using 30mg once a day of fluoxetine (Prozac) is equally effective (equivalent to 50mg twice a day of fluvoxamine).
• Pulse Oximeter: Monitoring your oxygen saturation with a pulse oximeter and to go to the hospital if you get below 94%. (Amazon)
• Mouthwash: 3 x daily – gargle (do not swallow) antiseptic mouthwash with cetylpyridinium chloride (e.g. Crest, Scope mouthwash™) or povidone/iodine 1 % solution as alternative (Betadine® Antiseptic Sore Throat Gargle™). (Ref)
• Nasal Spray: Xlear Nasal Spray with Xylitol (Ref) (Amazon)
• Aspirin: 325 mg/day unless contraindicated. (Amazon) (not suitable during viral phase)
• NAC (N-Acetyl Cysteine) 500 mg twice a day.
• Bromhexine 8 mg three times a day (Ref) (Lazada Malaysia*)

* Not available on Amazon

Notes:

• Precautionary Note: Ivermectin has a number of potentially serious drug-drug interactions. Please check for potential drug interaction at Ivermectin Drug Interactions - Drugs.com. The most important drug interactions occur with cyclosporin, tacrolimus, anti-retroviral drugs, and certain anti-fungal drugs. 
• Due to the possible drug interaction between quercetin and ivermectin (may increase ivermectin levels), these drugs should not be taken simultaneously (i.e. should be staggered morning and night). 
• Ivermectin is also lipophilic and therefore, bioavailability is maximised on a full stomach; or best to be taken with meal.
• Vitamin D3 RDA (Recommended Daily Allowance) is 800–1000 IU/day. The safe upper-dose daily limit is likely < 4000 IU/day. Be aware that most of the 'treatment' dosages for nutrients are above the recommended dietary allowance (RDA) and therefore such dosages should not be maintained on a long term basis. 
• Vitamin D deficiency has been associated with an increased risk of acquiring COVID-19 and from dying from the disease. Vitamin D supplementation may therefore prove to be an effective and cheap intervention to lessen the impact of this disease, particularly in vulnerable populations, i.e. the elderly and obese. 
• When Is the Best Time to Take Vitamin D? Morning or Night? It is possible that increasing vitamin D levels during the day may act, in part, as a signal that suppresses melatonin generation (source). Therefore, it's better to take vitamin D (with meal) during the day and melatonin to be taken just before bedtime.
• It is likely that vitamin C and quercetin have synergistic prophylactic benefit. Quercetin should be used with caution in patients with hypothyroidism and TSH levels should be monitored.
• Please consult with a qualified doctor and only use human ivermectin. Ivermectin for animals contain excipients (binding and storage compounds such as polyethylene glycol (PEG)) that are known to cause liver failure in high doses. 

 

Early Treatment Prevents 'Long Haul' Side Effects

It's worth noting that when you treat early, your risk of developing long-term side effects, commonly referred to as "long-haulers," is virtually nil. Not a single one of Zelenko's patients who received treatment within the first five days of symptom onset went on to develop long-haul symptoms afterward.

According to Dr Zelenko:

 

"I had patients that were long-haulers, but they came to me after that window, and they were already advanced in the inflammatory process. At that point, the cytokine storm had already taken hold. They had developed blood clots, some of them had pulmonary infarct, or strokes actually.

Others developed ARDS or catastrophic lung damage and pneumonias, and others just are not themselves. I don't know how to describe it, but it ate away part of their souls. They're not the same people. There's depression, there's lack of energy. There's a psychological impact as well.

So, it's not that I don't deal with long-haulers, I do. But the way to prevent the long-hauler syndrome is to intervene within the first five days, with appropriate antiviral medication in high-risk patients. That is 100% successful."

Z-Stack Supplement

In an effort to make it easier for patients, Dr Zelenko has developed an oral supplement that contains all four key ingredients: vitamin C, quercetin, vitamin D3 and zinc. It’s referred to as 'Z-Stack Supplement'. 

Z-Stack Vitamin cocktail provides key ingredients needed in order to help your body fight off this deadly invader. The Z-Stack Vitamins are Kosher certified, GMP certified and made in the USA.

The cost of the Z-STACK vitamin cocktail is $55 per bottle for a one month supply. 

Where to buy Z-Stack: Z-stack is available on Dr Zelenko's website. Here is the link: Z Stack Supplement 

Note: To get 5% OFF, please use this coupon code: ONEDAYMD

 

About Dr Vladimir Zelenko

He graduated with a B.A. degree with high honors in Chemistry from Hofstra University. After receiving an academic scholarship to attend S.U.N.Y. at Buffalo School of Medicine, he earned his M.D. degree in May 2000. Dr. Zelenko completed his family medicine residency at South Nassau Communities Hospital in Oceanside, N.Y. in May 2004. Since then, Dr. Zelenko has practiced family medicine in New York’s Hudson Valley. He has been described by his patients as like a family member to thousands of families, and is a medical adviser to the volunteer ambulance corps in Kiryas Joel, New York.

When asked about studies that seemed to discredit the efficacy of HCQ in treating the Chinese coronavirus, Zelenko explained “You don’t fire a gun without a bullet in it and then say the gun doesn’t work when you don’t kill the target. The studies that were done on HCQ did not include the use of Zinc.  HCQ is what opens the cell and enables Zinc to attack the virus. One is not effective without the other, or without a suitable substitute for HCQ. The studies were designed to fail.”

Dr. Zelenko says that both prophylaxis measures and actual case treatments need to be customized to the individual. As a general rule, he says, those people who are in the higher risk groups, both by age and by other pre-existing conditions, require more aggressive actions on both the preventative and diagnostic side.

“This virus remains relatively stable inside the host for about the first five days,” Zelenko says. “After that it starts to multiply rapidly. It also starts to migrate from sinus to lungs and cardio areas where involvement becomes more severe and treatment becomes more difficult. The key is early intervention.” Zelenko again mentioned his 84% success rate in high-risk patients.

References:

1.https://www.sciencedirect.com/science/article/pii/S0924857920304258

2.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365891/

3.https://pubs.acs.org/doi/10.1021/jf5014633

4.https://vdmeta.com/

5.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318306/

6.https://pubs.acs.org/doi/10.1021/jf5014633

7.https://www.sciencedirect.com/science/article/pii/S0924857920304258

8.https://ivmmeta.com/

9.https://www.nejm.org/doi/full/10.1056/NEJMoa2021436

10.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392554/

Scientific Papers from Dr. Zelenko and his collaborators

• Kory, Pierre MD, Meduri, Gianfranco Umberto MD, Varon, Joseph MD, Iglesias, Jose DO, Marik, Paul E. MD: Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19, American Journal of Therapeutics: May Jun 2021 - Volume 28 - Issue 3 - p e299-e318
• R. Derwand, M. Scholz, "Does zinc supplementation enhance the clinical efficacy of chloroquine/hydroxychloroquine to win today's battle against COVID-19?", Medical Hypotheses 142 (2020), 109815
• Scholz, M.; Derwand, R.; Zelenko, V. "COVID-19 outpatients - early risk-stratified treatment with zinc plus low dose hydroxychloroquine and azithromycin: a retrospective case series study", International Journal of Antimicrobial Agents 56 (2020), 106214 [press release]
• Peter A. McCullough, Ronan J.Kelly, Gaetano Ruocco, Edgar Lerma, James Tumlin, Kevin R.Wheelan, Nevin Katz, Norman E. Lepor, Kris Vijay, Harvey Carter, Bhupinder Singh, Sean P.McCullough, Brijesh K.Bhambi, Alberto Palazzuoli, Gaetano M.De Ferrari, Gregory P.Milligan, TaimurSafder, Kristen M.Tecson, Harvey A.Risch: "Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection", The American Journal of Medicine 134 (2020), 16-22
• Peter A. McCullough, Paul E. Alexander, Robin Armstrong, Cristian Arvinte, Alan F. Bain, Richard P. Bartlett, Robert L. Berkowitz, Andrew C. Berry, Thomas J. Borody, Joseph H. Brewer, Adam M. Brufsky, Teryn Clarke, Roland Derwand, Alieta Eck, John Eck, Richard A. Eisner, George C. Fareed, Angelina Farella, Silvia N. S. Fonseca, Charles E. Geyer, Jr., Russell S. Gonnering, Karladine E. Graves, Kenneth B. V. Gross, Sabine Hazan, Kristin S. Held, H. Thomas Hight, Stella Immanuel, Michael M. Jacobs, Joseph A. Ladapo, Lionel H. Lee, John Littell, Ivette Lozano, Harpal S. Mangat, Ben Marble, John E. McKinnon, Lee D. Merritt, Jane M. Orient, Ramin Oskoui, Donald C. Pompan, Brian C. Procter, Chad Prodromos, Juliana Cepelowicz Rajter, Jean-Jacques Rajter, C. Venkata S. Ram, Salete S. Rios, Harvey A. Risch, Michael J. A. Robb, Molly Rutherford, Martin Scholz, Marilyn M. Singleton, James A. Tumlin, Brian M. Tyson, Richard G. Urso, Kelly Victory, Elizabeth Lee Vliet, Craig M. Wax, Alexandre G. Wolkoff, Vicki Wooll, Vladimir Zelenko."Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19)", Reviews in Cardiovascular Medicine 21 (4) (2020), 517-530
• Brian C. Procter, Casey Ross, Vanessa Pickard, Erica Smith, Cortney Hanson, Peter A. McCullough. "Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection", Reviews in Cardiovascular Medicine 21 (4) (2020), 611-614

Ivermectin vs Hydroxychloroquine

Clinical evidence to date has reported promising results for Ivermectin in prevention, early treatment as well as late treatment for COVID-19. While both Ivermectin and Hydroxychloroquine might be useful for early treatment, Ivermectin has a broader potential benefit i.e. prevention, early treatment as well as late treatment / hospital treatment.

Can hydroxychloroquine and ivermectin be used together? The 2 drugs do not seem to have a between-drug interaction. However, no in vitro or in vivo studies have been conducted on the combined effect of HCQ and ivermectin on COVID-19 infection.

That said, the Zelenko protocol recommends that both hydroxychoroquine and ivermectin can be used together, especially for high risk patients. If you have started with only one, the second agent may be added after about 2 days of treatment if obvious recovery has not yet been observed.

Quercetin is a viable stand-in, if you simply cannot get hydroxychloroquine or ivermectin. Quercetin works best when taken with vitamin C and Bromelain, as vitamin C helps activate it and bromelain helps with the absorption. Do not forget to combine it with zinc.

Although ivermectin and hydroxychloroquine are relatively safe drugs, they are still synthetic chemicals that can have side effects. Quercetin and Vitamin D, C, Zinc are nutrients that your body require for optimal health. Nutrients are safer alternatives especially if your risk is low e.g. age below 50 and no other chronic illness. Discuss with your doctor on the benefit vs risk for each treatment. If you are on multiple medications, be aware of supplement-drug interactions that might enhance the possibilities of adverse effects.

Related: 

• FLCCC I-MASK+ Protocol for COVID-19

• Best Pulse Oximeter

• Best Quercetin and Zinc Supplement