Vitamin E and Novel Coronavirus (Patreon)

Hey everyone,
I hope the Corona situation hasn't affected any of y'all too negatively. I was doing some research to make a video about that - something along the lines of "What could you do that might help and at the very least wouldn't cause any harm?" but decided against it and instead have been working on a video on "What makes things satisfying?"

I didn't think it would be helpful to put out a video that might give people false confidence that they are "resistant" to  the virus, which might encourage them to do less social distancing, be less careful with disinfecting things et cetera. I was planning to say something like "Consuming any of the foods or supplements presented in this video by no means make you "immune" or "protected" against the virus or anything along those lines - Social distancing (et cetera) should be considered the first line of defense against the virus. After you've got all that squared away, you could try taking this or that supplement..."

Anyhow, so you probably won't see a video but I can still share some information with you guys. 

Scarfers the Cat - Pop Quiz
You’re a fisherman and you’re returning to the marina with a big haul of fish, looking forward to see your beloved cat “Scarfers” waiting for you. You take a swig of whatever fisherman usually drink and slowly dock your boat at the marina with a clean cleat hitch. Scarfers is there as you expected, but he looks weird - bloated and fatigued. You offer him some of the fish you just cleaned and he eats it, but slowly. He eats the fish like a kid who ate half of his halloween candy the night before and is now laboriously attempting to enjoy the rest of the candy for breakfast. 

You arrive at the vet with Scarfers and the vet says: “We don’t often see this but it seems to me scarfers has ‘yellow fat disease.’  What does he eat other than fish?”

Given the disease Scarfers has, what is your answer most likely to be?

( 1 ) Haggis + gutted fish
( 2 ) Only gutted fish
( 3 ) Lamb eyes + gutted fish

That's right, Pansteatitis(yellow fat disease) is a rare condition mostly seen in carnivores not getting enough vitamin E (we do not suspect that Scarfers was poisoned or infected with a pathogen) or getting too much unsaturated fatty acids like fish oil.[R]

So why Haggis and why Lamb eyes?
Well, Vitamin E acts as an antioxidant, hence the issue with yellow fat disease is that the fat of the animal or the human is inflamed and damaged due to oxidation. Vitamin E's key role is preventing fat oxidation (when referring to the oxidation of fats, it's called "lipid peroxidation").

So it makes sense that you'd find vitamin E in animal fat and the liver, and since antioxidant activity of vitamin E is particularly effective in high oxygen areas, it makes sense that vitamin E would be concentrated in the eyes and lungs.[R]

Why do you need something to protect against fat oxidation in the lungs?
You might not think of the lungs as an organ that has much fat (lipids) in it. However, if there were no lipids present in the lungs, you couldn't breathe.

There are two types of alveolar(lung) cells - type 1 and type 2. Type 1 cells essentially get the oxygen from the air you breathe into your bloodstream (i.e. facilitate gas exchange). Type 2 alveolar cells produce something called "surfactant." Without this stuff, the little sacks in your lungs would collapse. Pulmonary surfactant is composed of 90% lipid and 10% protein.[R] So, if you're gonna give lungs to people so they can breathe, you better put surfactant in there so the lungs don't collapse, and you better have an antioxidant strategy in place in the lungs to prevent "lipid peroxidation."

Vitamin E (alpha tocopherol) to the rescue
Per Vitamin E as an Antioxidant of the Lung: Mechanisms of Vitamin E Delivery to Alveolar Type II Cells, "Alveolar surfactant is the first target of air-borne oxidants. ... Therefore, vitamin E (alpha tocopherol) could be important for protecting surfactant lipids against oxidation and subsequent lung injury."

Do you remember that "lipid bilayer" thing from high school?  The lipid bilayer is a universal component of all cell membranes. Considering vitamin E's role is to prevent oxidative damage to lipids, it's not a surprise that Pulmonary Strategies of Antioxidant Defense says vitamin E is the principal defense against oxidant-induced membrane injury in human tissue.

Vitamin E, (along with a copper carrying protein, iron carrying protein, vitamin C and the storage form of iron) are in the tiny air sacs in the lungs, and these compounds "help broaden the spectrum of antioxidant protection of the lower respiratory tract."  (Pro tip: don't vape synthetic vitamin E directly into your lungs.[R])

A few studies on Vitamin E and the respiratory tract
■Vitamin E prevents lung injury in endotoxin induced airway inflammation.[R]
■This study found a protective effect of Vitamin E supplementation on upper (but not lower) respiratory tract infections in the elderly.
■This old study found, "Administration of vitamin E during the acute stage of the respiratory distress syndrome in preterm newborn infants appears to decrease the incidence of neonatal chronic lung disease..."
■"...Vitamin E protects the lungs from the detrimental action of smoking..."[R]

Vitamin E helps prevent influenza induced lung cell damage
Corona and Influenza are different in several ways - for example influenza attaches to the cell receptor sialic acid whereas coronavirus attaches to ACE2. However, one similarity is of course the damage to the respiratory tract. 

Per Vitamin E and Influenza Virus Infection
"Influenza pathogenesis is associated with two processes in the human body: (i) lung damage due to viral replication ... and (ii)inflammatory burst inducing an increase in reactive oxygen species generation that causes extensive damage in cellular membranes of the small vessels. ...Among the antioxidants tested in influenza virus infections in mice, vitamin E occupies the leading position because of its efficacy in preventing oxidative damage... Although vitamin E is not possessing specific antiviral action, its antioxidant effect probably plays important role in lung and liver protection."

Vitamin E deficiency worsens viral infections
・Study title is straightforward: "Vitamin E deficiency intensifies the myocardial injury of coxsackievirus B3 infection in mice." (This is in rodents, is not on coronaviruses, and not looking at the lungs. Not sure the mechanism. May have to do with cell membrane permeability)

・Another straightforward title: "Vitamin E supplementation decreases lung virus titers in mice infected with influenza." ("virus titer" is the same as "viral load" or "amount of virus")

・"Supplements of vitamin E and C reduce oxidative stress in HIV and produce a trend towards a reduction in viral load."[R] Vitamin C has antioxidant properties itself, but interestingly, it can regenerate vitamin E  [R]

・"...deficiencies in either Selenium or vitamin E results in specific viral mutations, changing relatively benign viruses into virulent ones."[R]  "Vitamin E and selenium (Se) act synergistically in protecting membranes against lipid peroxidation." per Textbook of Veterinary Physiological Chemistry, Chapter 46

・Quotes from this study:
(1)"Vitamin E supplementation in old mice resulted in significantly lower viral titer and preserved antioxidant nutrient status following influenza virus infection."

(2)"The results of this clinical trial show that vitamin E supplementation significantly reduces the incidence rate of common colds and the number of subjects who acquire a cold among elderly nursing home residents." (However doesn't specify whether it was viral and bacterial colds)

Bottom line: Vitamin E is good for you and it might, just maybe guard against Covid-19 lung damage a little bit.
We can't pump our vitamin E levels up more and more and become superhumans impervious to all forms of lipid peroxidation. If you already maintain sufficient vitamin E levels and are not deficient, putting extra vitamin E on top won't make much of a difference.

However, unsaturated fats increase your need for vitamin E. [C. Masterjohn specifically says PUFAs here, but Textbook of Veterinary Physiological Chemistry says "unsaturated fats"]

Do you take fish oil?
Then you need more vitamin E than if you didn't.
Do you consume vegetable oils?
You better believe that's a paddlin'.

As Chris Masterjohn explains in this video of his, considering that the polyunsaturated fats from vegetable oils can accumulate in your body for 4 years and it would take four years of not eating them to completely rid your system of them, your requirement for vitamin E will be elevated for 4 years.

Meaning, most people will probably benefit from a daily low dose of vitamin E, and I mean even if the new Coronavirus didn't exist. This is why I'm comfortable saying "Vitamin E might help with coronavirus" because, best case scenario: some people receive a benefit from it. Worst case scenario: you took vitamin E, it didn't help with Corona but you needed it anyways and it didn't do any damage. (OK the real worst case scenario is someone assumes vitamin E is a miracle, it's not.)

So do I have to eat fish eyeballs and lamb lungs everyday or what?
When you're considering sources of vitamin E, you want to be aware of vitamin E per gram PUFA. When you consider it this way, palm oil is the best, then wheat germ oil, then olive oil, then butter (and grass fed butter is as good as olive oil).[S]
All those are fats, but if you are getting vitamin E from a supplement, take the supplement with the fattiest meal of your day. You absorb 3 times more vitamin E with a fattier meal than with a no-fat meal.[S]

If you're going to use a supplement, Masterjohn recommends this particular brand as it comes from palm oil, isn't a super high dose and has a good spectrum of tocopherols.
Most supplements give you a crap ton (100's of mgs) of alpha-tocopherol, but loading up on alpha-tocopherol can drown out gamma-tocopherol function. See here for more on that.

Looking forward to seeing any questions or comments.
-Joseph