Is there conclusive evidence that curcumin, N-Acetylcysteine (NAC), or Nattokinase are effective in addressing symptoms or the root cause of long COVID?

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Last updated: June 10, 2025View editorial policy

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From the Guidelines

There is currently no conclusive scientific evidence that curcumin, N-Acetylcysteine (NAC), or Nattokinase effectively treat long COVID symptoms or address its underlying causes. While some studies suggest that certain supplements may have potential in alleviating symptoms of long COVID, such as coenzyme Q10 and D-ribose 1, there is no specific evidence to support the use of curcumin, NAC, or Nattokinase for this condition.

The current management of long COVID focuses on symptom-specific treatments and rehabilitation under medical supervision, with some treatments showing promise in subsets of populations, such as pacing, symptom-specific pharmacological options, and non-pharmacological options 1. Some studies have also investigated the use of antiviral medications, such as Paxlovid, and anticoagulant regimens in the treatment of long COVID, with promising results 1.

It is essential to note that exercise can be harmful for patients with long COVID who have ME/CFS or postexertional malaise and should not be used as a treatment 1. Patients experiencing long COVID symptoms should work with healthcare providers to develop personalized treatment plans rather than relying on unproven supplements.

Key considerations for managing long COVID include:

  • Developing and validating biomarkers for diagnosis and treatment response 1
  • Using symptom-specific treatments and rehabilitation under medical supervision 1
  • Avoiding exercise in patients with ME/CFS or postexertional malaise 1
  • Investigating promising treatments, such as antiviral medications and anticoagulant regimens 1

From the Research

Addressing Symptoms and Root Cause of Long COVID

There is evidence to suggest that certain supplements may be helpful in addressing symptoms or the root cause of long COVID. The following points summarize the findings:

  • N-Acetylcysteine (NAC): Studies have shown that NAC may be effective in managing COVID-19 due to its antioxidant and anti-inflammatory properties 2, 3. It has been proposed as a potential therapeutic agent for COVID-19, and its use as an adjuvant treatment for post-COVID-19 pulmonary fibrosis has been suggested 4.
  • Nattokinase: Research has found that nattokinase can degrade the spike protein of SARS-CoV-2, which is essential for viral entry 5. A study also proposed a base spike detoxification protocol composed of oral nattokinase, bromelain, and curcumin to aid in the resolution of post-acute sequelae after SARS-CoV-2 infection and COVID-19 vaccination 6.
  • Curcumin: While there is limited direct evidence on the effectiveness of curcumin in addressing long COVID, it has been included in a proposed base spike detoxification protocol alongside nattokinase and bromelain 6.

Controlled Trials and Recent Research Papers

Several studies have investigated the potential benefits of these supplements in addressing COVID-19 and its complications. These include:

  • A review of the pathogenesis of SARS-CoV-2 infection and the mechanisms of action of NAC 2
  • A study on the rationale for the use of NAC in both prevention and adjuvant therapy of COVID-19 3
  • Research on the degradative effect of nattokinase on the spike protein of SARS-CoV-2 5
  • A clinical approach to post-acute sequelae after COVID-19 infection and vaccination, including a proposed base spike detoxification protocol 6
  • A study on the potential use of NAC as an adjuvant treatment for post-COVID-19 pulmonary fibrosis 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Rationale for the use of N-acetylcysteine in both prevention and adjuvant therapy of COVID-19.

FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 2020

Research

N-acetylcysteine as a therapeutic approach to post-COVID-19 pulmonary fibrosis adjunctive treatment.

European review for medical and pharmacological sciences, 2022

Research

Degradative Effect of Nattokinase on Spike Protein of SARS-CoV-2.

Molecules (Basel, Switzerland), 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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