Day: December 13, 2022

• The U.S. Food and Drug Administration approved Tzield (teplizumab-mzwv), made by drugmakers Sanofi and Provention Bio, for use in adults and children 8 years and older who have stage 2, Type 1 diabetes

• Tzield is a monoclonal antibody injection that neither treats nor prevents Type 1 diabetes

• The treatment is intended to delay the onset of stage 3, Type 1 diabetes by only about 25 months

• The drug’s wholesale cost is $193,900 for a 14-day supply, and it comes with a risk of unknown side effects

• Tzield may cause cytokine release syndrome (CRS), an acute systemic inflammatory syndrome that includes fever and multiple organ dysfunction

• Lymphopenia, a reduced level of white blood cells, occurred in 78% of patients treated with Tzield

The U.S. Food and Drug Administration approved the first drug that delays onset of Type 1 diabetes.1 The American Diabetes Association called the approval a “historic moment”2 for those living with the condition. I call it absurdity on steroids, as this drug does not treat or prevent Type 1 diabetes. It only delays its onset for about two years.

Meanwhile, the drug’s wholesale cost is $193,900 for a 14-day supply,3 and it comes with a risk of unknown side effects. Type 1 diabetes is a serious condition, but marketing this drug as a savior of sorts is at best misleading and at worst downright dangerous.

Type 1 diabetes affects close to 2 million people in the U.S.4 It’s far less common than Type 2 diabetes, and affects only about 5% to 10% of people with diabetes.5 It’s believed to be caused by an autoimmune reaction, during which the body mistakenly attacks and destroys cells in the pancreas known as beta cells. Beta cells make insulin, so in Type 1 diabetes, your pancreas doesn’t make insulin or doesn’t make enough insulin to keep you healthy.

Without insulin, which is necessary for blood sugar to enter cells to be used as energy, blood sugar builds up in the bloodstream, causing damage.6 While it’s thought that genetics play a role in Type 1 diabetes, most people diagnosed do not have a family history of the disease.7 Further, environmental factors, including viruses, may trigger the condition. It can occur at any age but is most commonly diagnosed in children and young adults.8

There are three stages of Type 1 diabetes that are formally diagnosed. Stage 1 occurs when at least one diabetes-related autoantibody has been detected via screening tests, even though blood sugar levels are still normal and no symptoms are present.9

Stage 2 is diagnosed when two or more diabetes-related autoantibodies are present and blood sugar levels have become abnormal due to loss of beta cells. No symptoms are present during stage 2. In stage 3, clinical diagnosis is typically made. Symptoms are typically present, along with significant loss of beta cells.

Type 1 diabetes develops over the course of months or years and, as mentioned, symptoms may not develop until the later stages of the disease. By this time, the symptoms, which are caused by high levels of sugar in the blood, can be severe — even life threatening. These include:10

• Extreme weakness or fatigue

• Extreme thirst

• Increased urination

• Abdominal pain

• Nausea and/or vomiting

• Blurred vision

• Irritability

• Quick mood changes

The FDA approved Tzield (teplizumab-mzwv), made by drugmakers Sanofi and Provention Bio,11 for use in adults and children 8 years and older who have stage 2, Type 1 diabetes. Tzield is a monoclonal antibody injection that neither treats nor prevents Type 1 diabetes. Instead, it’s intended to delay the onset of stage 3, Type 1 diabetes. According to the FDA:12

“Tzield binds to certain immune system cells and delays progression to stage 3 type 1 diabetes. Tzield may deactivate the immune cells that attack insulin-producing cells, while increasing the proportion of cells that help moderate the immune response. Tzield is administered by intravenous infusion once daily for 14 consecutive days.”

The drug’s safety and efficacy were evaluated via a trial involving just 76 patients with stage 2, Type 1 diabetes. Participants received either Tzield or a placebo once daily via an intravenous infusion for 14 days. After a median follow-up period of 51 months, 45% of the 44 patients who received the drug went on to be diagnosed with stage 3, Type 1 diabetes, compared to 72% of the 32 patients who received a placebo.

The mid-range time that elapsed before a diagnosis of stage 3, Type 1 diabetes was 50 months for those who received Tzield, compared to 25 months for the placebo group. “This represents a statistically significant delay in the development of stage 3, type 1 diabetes,” the FDA noted.13

Serious side effects were reported with Tzield use, however, including decreased levels of white blood cells, along with rash and headache. Warnings and precautions are warranted with use of Tzield, according to the FDA, including monitoring for symptoms of the following:

• Cytokine release syndrome

• Risk of serious infections

• Decreased levels of white blood cells called lymphocytes

• Risk of hypersensitivity reactions

Cytokine release syndrome (CRS) is an acute systemic inflammatory syndrome that includes fever and multiple organ dysfunction.14 Cytokines are a group of proteins that your body uses to control inflammation. If you have an infection or are given immunotherapy drugs, your body will release cytokines to help combat inflammation, but sometimes it releases more than it should.

If the cytokine release spirals out of control, the resulting “cytokine storm” becomes dangerous and is closely tied to sepsis.15 According to Provention Bio, “CRS occurred in TZIELD-treated patients during the treatment period and through 28 days after the last drug administration.”16

Because of this, patients are instructed to premedicate with antipyretics, antihistamines and/or antiemetics before using Tzield — and use these drugs to treat any related symptoms that develop during treatment. Provention Bio continued:17

“If severe CRS develops, consider pausing dosing for 1 day to 2 days and administering the remaining doses to complete the full 14-day course on consecutive days; or discontinue treatment. Monitor liver enzymes during treatment. Discontinue TZIELD treatment in patients who develop elevated alanine aminotransferase or aspartate aminotransferase more than 5 times the upper limit of normal (ULN) or bilirubin more than 3 times ULN.”

Regarding serious infections, Provention Bio stated that people with active serious or chronic infections should not use Tzield, and those who do should be monitored for signs and symptoms of infection during and after use. Lymphopenia, a reduced level of white blood cells often seen alongside infections like HIV, COVID-19 and tuberculosis, also occurred in 78% of patients treated with Tzield.18

The drug may also interfere with immune response to vaccination. As such, the FDA noted that “all age-appropriate vaccinations” must be administered “prior to starting Tzield.” Concurrent use of the drug and live, inactivated and mRNA vaccines must also be avoided.

Conventional medicine currently falls short in helping those with Type 1 diabetes, but Tzield only delays its onset by about two years — at a significant monetary cost and risk of serious side effects. Other options deserve further scrutiny — options that have only positive related effects, such as intermittent fasting or time-restricted eating (TRE).

An editorial written in the BMJ19 by noted research scientist James DiNicolantonio, PharmD.,20 discusses the results of several studies that have found repeated episodes of fasting may induce cell growth of pancreatic beta cells in mouse models. The growth is associated with an increased expression of Ngn3,21 a protein involved in converting DNA into RNA critical for endocrine cells in the pancreatic islets of langerhans, the cells responsible for producing insulin.

The increase in islet beta cells induced through intermittent fasting was accompanied by a marked improvement in blood sugar control in the animal studies. These observations were of greatest interest to individuals suffering from Type 1 diabetes, as they often experience near complete inflammatory destruction of the islet beta cells.

“With respect to Type 1 diabetes,” DiNicolantonio wrote, “production of new beta cells might enable its resolution if the autoimmune attacks that destroyed the original complement of beta cells can somehow be quelled.”22

Another option that’s free, safe and available to everyone is simply changing the order in which you eat certain foods. Among children with Type 1 diabetes, consuming carbohydrates at the end of the meal has been found to be beneficial. Twenty patients with Type 1 diabetes aged 7 to 17 years were included in a related study.23 They consumed two meals in random order. For the first meal, the protein and fat components were consumed first, followed 15 minutes later by the carbohydrates.

In the other meal, protein, fat and carbohydrates were consumed together, the way they would be in a typical meal. Mean glucose levels were 1 mmol/L lower when carbs were consumed last compared to the typical meal.

Dr. Jason Fung, a nephrologist (kidney specialist) and author of several books, explains you can get a more beneficial response, including reducing insulin and glucose, simply by frontloading protein and fats in your meal and leaving the carbs for later.24 He continued:25

“This might mean a lot of things, including you need less insulin, which might lead to less weight gain overall because we know that those high glucose levels, those high insulin levels, are going to drive weight gain.

This actually has massive implications for the way we need to structure our meals … We might be able to take less medications. We may be able to lose weight, because again that lower level of insulin is going to cause less weight gain. And what it means is that you really have to frontload your meals so that you’re taking your protein, and your fat and your vegetables right upfront and leaving the carbohydrates to the end.”

For best results, he says, wait about 10 minutes after consuming the protein and fats before you eat the carbs, similar to the way you might eat an appetizer before your next course.

It’s unfortunate that a close-to-$200,000 drug is being heralded as a breakthrough for Type 1 diabetes, especially since it only delays its onset and is so risky for overall health. What’s needed to truly help those suffering from this devastating condition is research into safe and effective modalities for prevention and treatment.

Research has demonstrated, for instance, that pregnant women with optimal vitamin D levels significantly reduce their child’s risk of developing Type 1 diabetes. As noted by Carole Baggerly, director and founder of GrassrootsHealth Nutrient Research Institute, a nonprofit public health research organization dedicated to moving public health messages regarding vitamin D from research into practice:26

“We’re working with the Diabetes Research Center to see whether, even after the child is born, as long as they don’t have full-blown type 1 diabetes, what can we do to help stop it? And it turns out that the combination of vitamin D and omega-3 really matters.”

Black cumin (nigella sativa) also deserves special mention, as studies have shown it can help prevent both Type 1 and Type 2 diabetes.27 Instead of pouring research into toxic drug treatments, studies delving into vitamin D, TRE and environmental triggers of Type 1 diabetes, among other strategies, could offer real hope for those with or at risk of Type 1 diabetes.

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Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked.

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. The subscription fee being requested is for access to the articles and information posted on this site, and is not being paid for any individual medical advice.

If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products based on this content.

• Lead is one of three toxins shown to have the greatest negative impact on your life span. By competing with calcium at the cellular level, lead can disrupt several bodily systems, including your cardiovascular and neurological systems

• Research published in 2018 found lead levels in adults are strongly correlated with a higher risk of death, especially from cardiovascular complications

• Nearly 1 in 5 (18%) of all deaths and more than 1 in 4 (28.7%) of all cardiovascular deaths are related to lead toxicity

• Previous research suggests lead exposure can cause multigenerational DNA changes

• Aside from cardiovascular problems, lead exposure has been linked to an increased risk of reproductive problems in both men and women, miscarriage, premature birth or low birth weight, headaches, seizures, hearing and vision impairment, high blood pressure, nerve disorders, muscle and joint pain, brain damage, reduced IQ and learning difficulties

Lead is one of three toxins shown to have the greatest negative impact on your life span.1 One of the reasons for this is because lead is chemically similar to calcium. By competing with calcium at the cellular level, lead can disrupt several bodily systems,2 including your cardiovascular and neurological systems.

Research3 4 5 published in The Lancet Public Health in 2018 — which sought to quantify the contribution of environmental lead exposure to all-cause mortality and mortality from cardiovascular and ischemic heart disease specifically — concluded lead levels in adults are strongly correlated with a higher risk of death, especially from cardiovascular complications. As reported by the authors:6

“We included 14,289 adults in our study. The geometric mean concentration of lead in blood was 2·71 μg/dL). 3,632 (20%) participants had a concentration of lead in blood of at least 5 μg/dL. During median follow-up of 19·3 years, 4,422 people died, 1,801 (38%) from cardiovascular disease and 988 (22%) from ischemic heart disease.

An increase in the concentration of lead in blood from 1·0 μg/dL to 6·7 μg/dL, which represents the tenth to 90th percentiles, was associated with all-cause mortality (hazard ratio 1·37), cardiovascular disease mortality (1·70), and ischemic heart disease mortality (2·08).

The population attributable fraction of the concentration of lead in blood for all-cause mortality was 18·0%, which is equivalent to 412,000 deaths annually.

Respective fractions were 28·7% for cardiovascular disease mortality and 37·4% for ischemic heart disease mortality, which correspond to 256,000 deaths a year from cardiovascular disease and 185,000 deaths a year from ischemic heart disease.”

When nearly 1 in 5 (18%) of all deaths and more than 1 in 4 (28.7%) of all cardiovascular deaths are related to lead toxicity, it would certainly make sense for doctors to check patients’ lead levels. Yet, that almost never happens.

“Failure to address lead not only risks the patient’s life, but also that of their children and grandchildren, especially if it’s a female patient.”

Instead, patients with symptoms of heart disease are simply given a statin, which does absolutely nothing to address this toxic underlying cause. This is an egregious error, considering lead exposure has multigenerational impacts. This means failure to address lead not only risks the patient’s life, but also that of their children and grandchildren, especially if it’s a female patient. As reported by The Allegheny Front in 2016:7

“[Research8] out of Wayne State University suggests lead exposure can … cause changes to DNA that might affect several generations. ‘When a mother drinks leaded water … she’s exposing her fetus, so that’s going to directly affect brain development of her baby,’ says Doug Ruden, co-author of the study and Director of Epigenomics at Wayne State’s Institute of Environmental Health Sciences.

‘What most people don’t realize is that you’re also expressing the germ line cells, and that can affect the grandchildren, and even potentially beyond that.’

Ruden’s study looked at blood lead levels in 35 mothers and their babies in Detroit. They observed a correlation between elevated blood lead levels in the mothers and changes in DNA.

‘If the mothers had high blood lead levels when they were born, then their grandchildren have changes in their DNA,’ he says. ‘And the changes in the DNA we were looking at weren’t permanent changes. They’re what we call epigenetic mutations’ …

‘The way you think about it is — if a mother is pregnant with a baby, she’s also carrying the baby’s children too … Because it’s like a Russian doll. All of the eggs that a person has in life are actually developed in the fetus, during the fetal period, and all the sperm progenitor cells in the boy babies, the boy fetuses, are also present in the fetus,’ he says.”

There is no known safe exposure to lead, and exposure — aside from heart disease — has been linked to an increased risk of reproductive problems in both men and women, miscarriage, premature birth or low birth weight, headaches, seizures, hearing and vision impairment, high blood pressure,9 10 nerve disorders, muscle and joint pain, brain damage, reduced IQ and learning difficulties.

Symptoms of chronic exposure or lead poisoning usually don’t appear until years later, but sudden high exposure to lead has been known to induce insanity rather rapidly.

All of these neurological impacts can be explained by the fact that, in your brain, lead disrupts neurons that use calcium to transmit information.11 The presence of lead will cause some neurons to fire more and decrease the signals in others. Other research has demonstrated that lead:12 13 

• Generates superoxide and hydrogen peroxide, which in turn reacts with nitric oxide and produces peroxynitrites 

• Stimulates vascular smooth muscle cell proliferation and phenotypic transformation

• Disturbs vascular smooth muscle calcium signaling

• Modifies vascular response to vasoactive antagonists

• Raises plasminogen activator inhibitor-1 production

• Suppresses proteoglycan production

• Causes endothelial injury

• Impedes endothelial repair

• Inhibits angiogenesis

• Promotes inflammation

Leaded gasoline was for decades a primary source of lead exposure in the general population. The U.S. introduced leaded gas in 1923, to make the fuel more efficient and reduce engine knocking. This was done despite the well-recognized hazards of lead exposure, and despite the fact that 10% alcohol had been found to achieve the same goals, all while having the added benefit of clean combustion, which eliminated soot emissions.

The only reason lead was selected was because manufacturing the lead additive, tetra-ethyl lead, would allow them to make greater profits. As explained in the video above, by adding a percentage of alcohol to the gasoline, the oil industry stood to lose up to 20% of its petroleum sales, depending on how much alcohol was added. On the other hand, by adding lead to gasoline, the oil industry had a product it could control in its entirety, and that was their aim.

The auto and chemical industries used the same techniques back then as they do now; promoting, defending, manipulating government officials, and molding public opinion to profit from a toxic product, all while knowing exactly the kind of harm it causes.

Manipulated science, industry propaganda and political corruption allowed lead to remain in gasoline for 80 years, until Clair Patterson, Ph.D., was finally successful in getting it removed. Patterson is an unsung public health hero of the 20th century that most people have never heard of. The featured video is a 30-minute summary of the evolution of leaded gas and, ultimately, its removal.

Patterson first began his health crusade to eliminate environmental lead in 1965, with the publication of his book, “Contaminated and Natural Lead Environments of Man.” It would be 11 years before he finally succeeded, after fighting against the massive lobbying power of the oil and auto industries.

Then, as now, these industries used their influence to launch a massive discrediting campaign against him and his research. In 1971, he was excluded from a National Research Council (NRC) panel on atmospheric lead contamination, even though he was the world expert on the subject at that time.

Despite these massive discrediting efforts, he doggedly pursued the elimination of lead from gasoline, which finally occurred in 1986. Thanks to Patterson’s persistence, blood lead levels in Americans dropped by 80% by the late 1990s.

Eliminating lead can be a long and arduous journey that needs to be done very carefully to avoid creating more harm in the process. A scientific review14 published in 2016 highlighted the benefits of chelation therapy using edetate disodium (EDTA).

According to that paper,15 EDTA chelation effectively lowered the risk for future cardiovascular events, with a number needed to treat (NNT) of 12 to prevent one cardiovascular event over five years. Mainstream health care, however, still maintains that EDTA chelation therapy is a form of quackery that has no discernible benefit.

EDTA does have its risks, however, as it draws out not only lead but also important minerals. (This is part of why chelation must be done with a qualified doctor who can monitor your nutritional status and recommend appropriate supplementation.)

A far safer and more readily available alternative is N-acetyl-cysteine (NAC), a precursor to glutathione, which your body requires for efficient detoxification. A study16 from 2008 found NAC protected against lead-induced genotoxicity in human liver cancer cells (HepG2 cells). As noted in that paper:17

“[NAC] has an impressive list of protective effects including: antioxidant activity, decrease of the biologically effective dose of carcinogens, anti-inflammatory activity, immunological effects, inhibition of progression to malignancy and metastasis, and protection from the adverse effects of chemopreventive and chemotherapeutic agents …

[We] hypothesized that the antioxidant, n-acetyl-l-cysteine attenuates oxidative stress and genotoxicity, and thereby provides cellular protection against lead toxicity …

[The] addition of NAC in vitro showed a significant reduction (p < 0.05) in the comet tail length, percentage of DNA cleavage, comet tail moment, as well as comet tail arm respectively in cells co-treated with NAC and lead nitrate.

Findings from these studies demonstrated that NAC inhibits malondialdehyde (MDA) production and genotoxicity in lead nitrate-treated HepG2cells in a dose-dependent manner.”

Shortly after it was discovered that NAC also provides several benefits in the treatment of COVID-19, the U.S. Food and Drug Administration started cracking down on NAC, claiming it’s excluded from the definition of a dietary supplement. As a result of the FDA’s bogus crackdown on this supplement, which has been sold as such for 57 years, Amazon quit selling it. Fortunately, it’s still available in many other places.

Sauna bathing can also be a useful strategy to remove nearly every toxin from your body including lead. In the U.S. this means either a far or near infrared sauna. My personal preference, as I have previously discussed, is a near IR sauna as it will also help with photobiomodulation that far IR sauna cannot do. I personally use it three times a week. Using it every day is not a good strategy. Every other day is ideal.

Of course, successfully eliminating lead from your body also requires you to stop putting more in. Today, gasoline exhaust is not a source of lead. Instead, primary sources include:

• Drinking water

• Cigarette smoke

• Lead paint in older homes

• Cheaply made household objects and children’s toys and apparel — As just one example, Disney character clothing was recalled in late November 2022 due to high levels of lead in the textile ink. More than 80,000 pieces of clothing were recalled18 19

To protect yourself and your family against lead exposure, consider the following recommendations:

• If your home was built before 1978, get it inspected to determine whether it has any lead paint — Lead paint removal must be done by a certified professional to ensure safety, as the dust is highly toxic. For more information on this, see the U.S. Environmental Protection Agency’s “Lead-Based Paint Resources” page.20

• Get your water tested for lead — Millions of older water service lines across the U.S. are made from lead and could be carrying contaminated water into your home on a daily basis. Your safest and most economical choice to get lead out of your water supply is to use a high-quality filter rated for lead removal.

• Be mindful that certain household objects may contain lead — For information about lead-containing products and recalls, see the Consumer Products Safety Commission’s website.21

• Get your child tested for lead — Ideally, all children should be tested at ages 1 and 2, and again at ages 3 and 4 if you live in an older home. It’s also recommended to test your child’s level whenever there’s concern about exposure. Also get yourself tested for lead, especially if your doctor suspects you have heart disease. A level of 3.5 mcg/dL or higher is considered dangerous.22

• Use filtered cold water for drinking or cooking. Never cook or mix infant formula using unfiltered hot water from the tap.

Subscribe to Mercola Newsletter

Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked.

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. The subscription fee being requested is for access to the articles and information posted on this site, and is not being paid for any individual medical advice.

If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products based on this content.

• Due to it being an enveloped virus (meaning its single-strand RNA is enveloped in a bubble of lipid or fatty molecules), COVID-19 (as all other coronaviruses) is highly susceptible to soap and disinfectants

• To disinfect and sterilize surfaces around your home, you need to clean the surface first. Soap and water is a good choice. Once the surface is clean of dirt and sticky grime, spray your chosen disinfectant on the surface and let it set for up to several minutes before wiping

• If using an alcohol-based disinfectant to inactivate and protect against coronaviruses on surfaces around your home, make sure it contains between 60% and 80% alcohol. Higher concentrations are less potent

• Chlorine disinfectants such as household bleach have broad antimicrobial activity and effectively kills bacteria, fungi and viruses, including influenza viruses

• Accelerated hydrogen peroxide (AHP) is more effective than 3% hydrogen peroxide and appears to be the most effective virucide overall. It can kill viruses in as little as 30 seconds. Other easy but effective home disinfectants include 10% malt vinegar and distilled white vinegar in combination with 3% hydrogen peroxide (see safety precautions)

COVID-19, the novel coronavirus identified in Wuhan City, China, in December 2019, is part of a family of viruses with a crown- or halo-like (corona) appearance.1 As explained on the Virginia Department of Health website, seven human coronaviruses have currently been identified:2

• Types 229E, NL63, OC43 and KHU1 are quite common and cause mild to moderate respiratory infections such as the common cold.

• SARS-CoV (Severe Acute Respiratory Syndrome coronavirus), discovered in China in 2002, spread to 26 countries3 before disappearing in 2003. No SARS cases have been reported since 2004, anywhere in the world. As the name implies, SARS-CoV is associated with severe respiratory illness4 and had a mortality rate of approximately 10%.5

• MERS-CoV (Middle East Respiratory Syndrome coronavirus), discovered in 2012, originated in Saudi Arabia and spread to 27 countries before being contained. Like SARS, MERS causes more severe respiratory infections than the four common coronaviruses and has a mortality rate of about 35%.6

• SARS-CoV-2 (initially called 2019-nCoV) quickly spread to hundreds of countries and regions around the world.7 While causing milder symptoms than SARS, and having a far lower mortality rate than either SARS or MERS, its infection rate appears far more accelerated.

  There may be several reasons for this. According to preliminary findings, SARS-CoV-2 can remain airborne for three hours, and can survive on plastic and stainless steel surfaces for up to three days, thus facilitating its spread.8

  Bioweapons expert Francis Boyle also believes SARS-CoV-2 has been weaponized with so-called “gain of function” properties that allow it to spread through the air up to 7 feet, which is greater than normal.

  SARS-CoV-2 appears to affect a disproportionate number of older people; the older you are, the greater your susceptibility.9 At present, the mortality rate for SARS-CoV-2 is estimated to be between 3% and 6%.10

Due to it being an enveloped virus (meaning its single-strand RNA is enveloped in a bubble of lipid or fatty molecules), COVID-19 (as all other coronaviruses) is highly susceptible to soap and disinfectants, which is good news. Some disinfectants are more effective than others, however, which is the focus of this article.

While there are many chemical disinfectants, I’ll focus on those that are most readily available for home use. You can learn more about other disinfectants and sterilizing agents used in health care settings on the CDC’s Chemical Disinfectants for Infection Control webpage.11

Alcohol-based disinfectants will contain either ethyl alcohol or isopropyl alcohol at various levels of strength (50% or greater). While alcohol primarily kills bacteria, it also has potent fungicidal and viricidal activity at concentrations above 60%.12

According to the U.S. Centers for Disease Control and Prevention,13 the microbial action of alcohol is thought to be due to its ability to denature proteins. Straight ethyl alcohol is less bactericidal than alcohol mixed with water, as the presence of water allows proteins to be denatured more rapidly.

When it comes to viruses, different alcohols are more or less effective depending on the type of virus in question.

• Ethyl alcohol — Provided the concentration is higher than 60%, ethyl alcohol effectively inactivates lipophilic viruses such as influenza viruses, coronaviruses and many (but not all) hydrophilic viruses

• Isopropyl alcohol — While killing lipid viruses such as coronavirus, isopropyl alcohol is ineffective against nonlipid enteroviruses

If using an alcohol-based disinfectant to inactivate and protect against coronaviruses on surfaces around your home, make sure it contains between 60% and 80% alcohol. According to the World Health Organization:14

“Alcohol solutions containing 60–80% alcohol are most effective, with higher concentrations being less potent. This paradox results from the fact that proteins are not denatured easily in the absence of water …”

What’s more, while alcohol-based disinfectants are highly effective against gram-positive and gram-negative bacteria, they can be more or less effective against viruses, depending on the type of virus.

They’re quite ineffective against nonenveloped (nonlipophilic) viruses, but tend to work better against enveloped viruses,15 16 which is what SARS-CoV-2 is. Keep in mind that for hand sanitation, soap and warm water is the most effective. Only use alcohol-based hand sanitizers if soap and water are unavailable.

Chlorine disinfectants such as household bleach, which typically contains 5.25% to 6.15% sodium hypochlorite, have broad antimicrobial activity and effectively kills bacteria, fungi and viruses, including influenza viruses.17 18 It has several major biological drawbacks, however. For example, bleach:19

• Can irritate your mucus membranes

• Decomposes, forming deadly gasses, when exposed to heat or light

• Can damage some household surfaces

• Can be highly reactive if mixed with other chemicals. Never mix bleach with another product as deadly gasses can form, and make sure you have good ventilation in the area. Examples of common household cleaning agents that should never be mixed with bleach to avoid serious injury or death include:

  • Bleach and vinegar — forms highly irritating chlorine gas

  • Bleach and ammonia — forms toxic chloramine gas

  • Bleach and rubbing alcohol — forms highly toxic chloroform gas

• Decomposes over time, so buy recently produced stock and avoid overstocking

Also make sure you dilute bleach with cold water, as hot water will inactivate it, rendering it ineffective for sterilization.20 Ideally, use mask and gloves when using bleach. You should also dilute it before using. “Infection Prevention and Control of Epidemic- and Pandemic-Prone Acute Respiratory Infections in Health Care” recommends diluting bleach containing 5% sodium hypochlorite to 0.05% before using.21

Hydrogen peroxide has the ability to kill or inactivate bacteria, viruses, spores, yeast and fungi. A list of brand name sterilants and disinfectants cleared by the U.S. Food and Drug Administration that contain 1% to 7.5% hydrogen peroxide can be found on the FDA’s website.22 As explained by the CDC:23

“Hydrogen peroxide works by producing destructive hydroxyl free radicals that can attack membrane lipids, DNA, and other essential cell components.

Catalase, produced by aerobic organisms and facultative anaerobes that possess cytochrome systems, can protect cells from metabolically produced hydrogen peroxide by degrading hydrogen peroxide to water and oxygen. This defense is overwhelmed by the concentrations used for disinfection.”

Commercially available 3% hydrogen peroxide is stable and effective for disinfecting a wide variety of surfaces. Contrary to bleach, hydrogen peroxide is molecularly very similar to water — it just has an additional oxygen atom — so it doesn’t produce any dangerous compounds when breaking down. Its inherent safety (provided you don’t drink it) makes it an excellent choice for home sanitation.

An even better alternative is accelerated hydrogen peroxide (AHP), sold under the brand name Rescue and some others. Compared to pharmaceutical grade 3% hydrogen peroxide, AHP works much faster, so you don’t need to wet the surface for as long. AHP can kill viruses in as little as 30 seconds.24 According to Solutions Designed for Health Care:25

“AHP® is composed of hydrogen peroxide, surface acting agents (surfactants), wetting agents (a substance that reduces the surface tension of a liquid, causing the liquid to spread across or penetrate more easily the surface of a solid) and chelating agents (a substance that helps to reduce metal content and/or hardness of water).

The ingredients are all listed on the EPA and Health Canada Inerts lists and the FDA Generally Regarded as Safe List (GRAS). All chemicals used in the formulation of AHP® are commonly found in commercial and industrial cleaners and disinfectants.”

According to Virox Technologies Inc. (a manufacturer of AHP), Health Canada named AHP the surface disinfectant of choice for health care facilities during the 2003 SARS outbreaks.26 Overall, AHP appears to be one of the best and safest broad-spectrum viricidals available.

Another common household staple that can be used to disinfect viruses is 10% malt vinegar (made from malted barley grain, which is also used to make beer; a second fermentation turns the ale into vinegar27).

As noted in the 2010 article, “Effectiveness of Common Household Cleaning Agents in Reducing the Viability of Human Influenza A/H1N1,” published in PLOS ONE:28

“Our findings indicate that it is possible to use common, low-technology agents such as 1% bleach, 10% malt vinegar, or 0.01% washing-up liquid to rapidly and completely inactivate influenza virus.

Thus, in the context of the ongoing pandemic, and especially in low-resource settings, the public does not need to source specialized cleaning products, but can rapidly disinfect potentially contaminated surfaces with agents readily available in most homes …

The addition of any of 1% bleach, 50% and 10% malt vinegar and 1%, 0.1% and 0.01% washing up liquid were all effective at rapidly reducing viable virus below the limit of detection, while a low concentration of vinegar (1%) was no more effective than hot water alone …

While a strong oxidizing agent such as bleach is effective at reducing both genome detection and virus infectivity, low pH and detergent are equally efficacious virucidal agents. These results also indicate that whilst vinegar and detergent disrupt the viral envelope proteins reducing infectivity, only bleach disrupts the viral genome.”

While 10% malt vinegar appears to be effective enough as a viral disinfectant, distilled white vinegar with an ascetic acid range of 4% to 8% is a rather poor choice, according to Talk CLEAN to Me, a blog by experts in chemical disinfection for infection prevention:29

“… the various organic acid disinfectants … typically lack a broad spectrum of kill compared to higher level disinfectants such as bleach and hydrogen peroxide … You may be thinking ‘Hey, wait! Vinegar and acetic acid have been used for hundreds of years as methods of disinfection and sanitization.’

However, it is important to note that these only show strength against relatively easy to kill organisms such as pseudomonas. There is no current data that concludes that organic acids bolster a broad spectrum of kill.”

In short, white vinegar has a low speed of disinfection (you’d have to leave it on for at least 10 minutes), and kills only the most easily destroyed microbes. That said, you could boost the effectiveness of white vinegar by using it in combination with hydrogen peroxide.

An important caveat here is that you must use them separately and not mixed together, as the chemical reaction will form a highly corrosive and unstable form of peracetic acid. A recipe by Susan Sumner, associate dean of College of Agriculture and Life Sciences at Virginia Tech, is offered by Cleaning Business Today:30

1. Pour 3% hydrogen peroxide into one spray bottle and distilled white vinegar (5% ascetic acid) into a second bottle. Do NOT mix together in one bottle as they will create an unstable and highly corrosive form of peracetic acid

2. Clean the surface with soap and water. Dry with clean cloth or paper towel

3. Spray the surface with either the hydrogen peroxide or the vinegar. The order does not matter; just don’t spray them on at the same time as when mixed they will create an unstable form of peracetic acid

4. Let it set for at least five minutes before wiping off with a clean cloth or paper towel

5. Repeat with the second bottle

If your aim is to disinfect and sterilize, keep in mind that you need to clean the surface first. Soap and water is likely one of the best alternatives here, as the soap will effectively inactivate viruses.

Once the surface is clean of dirt and sticky grime, spray you chosen disinfectant on the surface and let it set for up to several minutes before wiping. The time required will depend on the disinfectant you use.

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