Potential role of adjuvant micronutrient therapy in the management of respiratory tract infections: a narrative review

Respiratory tract infections (RTIs) are highly prevalent and variable in nature, and are accountable for considerable morbidity and mortality. Acute respiratory tract infections (ARIs) are the third leading cause of death worldwide and the most common cause of antibiotic prescription among adults. It is common knowledge that inappropriate or overuse of antibiotics for RTIs is a crucial contributing factor with respect to the emergence of microbes that are resistant to the drug’s effects. Overuse of antibiotics and antibiotic resistance is a global issue that is becoming a serious concern. There is a growing need for novel approaches and adjuvant therapies for such infections, particularly in the setting of worsening antibacterial resistance. The strategy of supporting the immune system of the host in advance of infection exposure would decrease the number and severity of infections and thus decrease antibiotic use. Micronutrients have varied roles throughout every stage of the immune system and help in strengthening and maintaining immune function. Deficiencies of micronutrients are associated with varied health outcomes and can impact both innate and adaptive immunity profoundly, causing immunosuppression and thus leading to increased susceptibility to infections. Moreover, in view of the COVID-19 pandemic situation, the factors that help the proper functioning of the immune system have garnered much interest and hence the maintenance of an optimal status of certain micronutrients could be particularly beneficial.

Combination of Micronutrients for Bone (COMB) Study: Bone Density after Micronutrient Intervention

Along with other investigations, patients presenting to an environmental health clinic with various chronic conditions were assessed for bone health status. Individuals with compromised bone strength were educated about skeletal health issues and provided with therapeutic options for potential amelioration of their bone health. Patients who declined pharmacotherapy or who previously experienced failure of drug treatment were offered other options including supplemental micronutrients identified in the medical literature as sometimes having a positive impact on bone mineral density (BMD). After 12 months of consecutive supplemental micronutrient therapy with a combination that included vitamin D3, vitamin K2, strontium, magnesium and docosahexaenoic acid (DHA), repeat bone densitometry was performed. The results were analyzed in a group of compliant patients and demonstrate improved BMD in patients classified with normal, osteopenic and osteoporotic bone density. According to the results, this combined micronutrient supplementation regimen appears to be at least as effective as bisphosphonates or strontium ranelate in raising BMD levels in hip, spine, and femoral neck sites. No fractures occurred in the group taking the micronutrient protocol. This micronutrient regimen also appears to show efficacy in individuals where bisphosphonate therapy was previously unsuccessful in maintaining or raising BMD. Prospective clinical trials are required to confirm efficacy.