What vitamin and mineral supplements are recommended for viral infections?

Vitamin and Mineral Supplements for Viral Infections

For viral infections, supplementation with vitamins A, D, C, B vitamins, zinc, and selenium is recommended to support immune function, particularly in malnourished individuals, but routine supplementation with supraphysiologic doses is not supported by strong evidence for those with adequate nutritional status. 1

Key Micronutrients for Immune Support During Viral Infections

Vitamins

1. Vitamin D

   • Associated with reduced risk of respiratory viral infections 1
   • Deficiency linked to increased susceptibility to viral diseases including influenza 1
   • Supplementation particularly important for those with low baseline levels

2. Vitamin A

   • Known as an "anti-infective" vitamin 1
   • Supplementation has shown reduced morbidity and mortality in measles, diarrheal disease, and other infectious conditions 1
   • May improve outcomes in specific viral infections like HPV 2

3. Vitamin C

   • Supports immune function during viral challenges 3
   • Consider supplementation particularly during active infection

4. B Vitamins

   • B6 and B12 deficiencies associated with adverse outcomes during viral infections 1
   • Important for overall immune system function

Minerals

1. Zinc

   • Low levels associated with adverse clinical outcomes in viral infections 1
   • May shorten duration of viral illnesses, particularly in children with diarrheal disease 1
   • Supplementation should be considered especially during active infection

2. Selenium

   • Deficiency linked to worse outcomes in viral infections 1
   • Important for immune cell function

3. Iron

   • Should be considered in the assessment of micronutrients for viral infections 1

Practical Recommendations

For Malnourished Individuals

• Complete micronutrient supplementation is strongly recommended, including both multivitamins AND multi-trace elements 1
• Aim to provide daily allowances of vitamins and trace elements to maximize anti-infection nutritional defense 1

For Generally Healthy Individuals

• Routine empirical use of supraphysiologic amounts of micronutrients is not supported by strong evidence 1
• Consider elderberry supplements at the early course of viral illness, particularly for respiratory infections 1

During Active Viral Infection

• For patients with poor intake (<50% of usual intake):
  • Oral nutritional supplements containing micronutrients
  • Consider multivitamin, magnesium, phosphorus, vitamins B9, B1, and D supplementation 1

Important Caveats and Considerations

• Avoid overprovision: Just as micronutrient underprovision can compromise health, overprovision can also be harmful 1
• Complete supplementation: When supplementation is indicated, provide both multivitamins AND multi-trace elements rather than multivitamins alone 1
• Monitor for drug interactions: Some medications (e.g., proton pump inhibitors, diuretics) may affect micronutrient status 1
• Consider baseline status: Benefits of supplementation are most pronounced in those with pre-existing deficiencies

Special Populations

Children with Acute Diarrhea

• Zinc supplementation may shorten duration of acute diarrhea in children 6 months to 5 years by approximately 10 hours 1
• Greater benefit (27 hours reduction) observed in children with signs of malnutrition 1

Elderly and Immunocompromised

• Higher risk of micronutrient deficiencies
• May benefit more from supplementation during viral challenges 4
• Complete micronutrient supplementation particularly important due to potential for deficiencies to affect multiple organ systems 1

While supplementation with vitamins and minerals appears to be a safe and low-cost way to support optimal immune function against viral infections 3, the evidence is strongest for those with pre-existing deficiencies. Supplementation should always be in addition to a healthy diet and within recommended safety limits.