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3-20 Covid-Article-imageWinning the Virus War: Building up your immune system is essential…

You have undoubtedly listened for countless hours over the past couple of months to various media sources talking about the ever expanding coronavirus (Covid-19) pandemic, hearing the same recommendations often enough that you can recite them in your sleep. Finally, in the March 15th USA News is an article discussing potentially new therapies.1 The article discusses three ways to prevent or treat coronavirus that all involve immune mechanisms; using serum from previously infected and recovered patients to transfuse into currently infected ones (potentially available in the near future); use of manufactured monoclonal antibodies (not available anytime soon); and a vaccine (also some time away). Before reading on, ask  yourself one question: does it make sense to optimize your immune system? If it does, then please take a few minutes of your time to read something you haven’t heard before relating to improving immune function, and to consider some or all of my strategies as an additional tool in your armory to better protect your health.

This article is extremely comprehensive…it will give you a much better understanding of the complexities of how your body works, and how best to fight this invisible enemy. Read it all if you want to know the intricate details, or read the summaries below, to see the appropriate action steps to start right now!

Recommendations Summary

A reasonable plan of action includes the following:

  • Comprehensive multivitamin designed to enhance immune function
  • Vitamin D- 5000 IU/day (or more depending upon your size and bodyweight)
  • Vitamin C- to bowel tolerance
  • Probiotics- multi strain, 100-200 billion per day
  • Prebiotic/glutamine blend
  • Astragalus extract, alone or in combination with other Traditional Chinese Medicine herbs for immune support
  • Mushroom extracts

There are a number of ways to optimize immune function, which acts as a risk mitigation factor to improve your chances of avoiding becoming infected with Covid-19, influenza, and the common cold (or any other pathogen for that matter). The remainder of this article discusses the research-proven rationale behind these recommendations.

As the Covid-19 pandemic spreads rapidly, with thousands of new cases identified every day, it is becoming apparent that the standard recommendations being made by various government and health agencies are not stemming the rising tide of infections. It is time to take a closer look at strategies to enhance each individual’s chances of avoiding becoming a Covid-19 fatal statistic.

Risk Management Strategies Summary

  • Public Health Measures
    • Social Distancing
    • Sanitation/Disinfection
  • Individual Health Measures
    • Immune System Optimization

Let’s start by placing the guidelines we have all become familiar with for risk reduction into categories, which constitute sound public health advice measures. At the present time, current  guidance from health care professionals falls into two classes: social distancing and sanitation. At the risk of redundancy, and for brevity, we all know that distancing ourselves from potentially infected individuals reduces risk of infection, and that basic sanitation measures such as frequent hand washing (for 20 seconds), use of disinfectants on surfaces, not touching ones face, etc., are prudent steps that should be followed. Unfortunately, social distancing and improved sanitation alone are insufficient for complete risk management for you as an individual, versus the public in general.

Is there perhaps another class of valuable information  that has not been discussed, and if not, why?

We  have all heard the discussions comparing and contrasting the Covid-19 to the flu, with which we are all very familiar, as flu outbreak is an annual event. At this time, we know that Covid-19 is about 35 times more lethal than the flu, with a mortality rate of about 3.5% vs. 0.1% for the flu. It is this much higher mortality rate that makes it such a major threat.  Both are respiratory illnesses, and both are mainly transmitted by airborne particles, and perhaps transmitted by contact with surfaces contaminated by the virus.

With respect to the flu, we also know that it is seasonal, peaking in colder months and that it infects 7-10% of the population annually. We don’t yet know if Covid-19 is seasonal, or how many people it will infect. However many scientists in a position to know, have stated clearly that the Covid-19 virus does not tolerate heat well at all. Hopefully in our ideal climate here in the Napa Valley our weather will be of great help in fighting this challenge.

At-risk population summary

  • People over 65 years old
  • People with co-morbidities (conditions that make you more vulnerable)
    • Cardiovascular disease
    • Diabetes
    • Asthma or other respiratory diseases
    • Smokers
    • Autoimmune conditions
    • Concurrent infections
    • Immunologically compromised individuals (Chemo therapy or blood cancers for example)

What we have learned in the brief time that it has been present in the human population, is that 80% of those infected with Covid-19 have mild cases. In general, those with severe cases, and those that die are older, and have co-morbidities (complications) such as cardiovascular disease, diabetes, are smokers, or have other chronic conditions that weaken their body’s ability to fight this infection. This was clearly evidenced by the high mortality rate among the group of elderly people infected in the nursing home in Washington at the beginning of the epidemic in the U.S. We also know that if the numbers from China are to be trusted, that it appears to have a natural curve of rapid spread followed by a rapid reduction in infection rate. This pattern now also appears to be a parallel event in South Korea.

This information about these two viral respiratory infections should tell us something important, that as far as I’m aware, has not been seriously discussed in the media. What should be obvious is that exposure to the flu, Covid-19, or any pathogen (bug) for that matter, does not equal symptomatic infection. If we have a room full of people, who are all exposed to the same pathogen, why do some get sick, while others do not? We are all probably exposed, to varying degrees, to the flu virus during the flu season (and at other times of the year as well), but only a small percentage of the population becomes ill with the flu. Two key reasons are: 1) the amount or quantity of exposure and 2) the status of one’s immune system. Again, this should be apparent as those most seriously affected have compromised immune systems.

The amount of particles one is exposed to is a function of the distance one is from an infected person (hence social distancing), and of course whether they cough, sneeze or otherwise disperse airborne particulates containing the pathogen.

Why has the dialogue of this been limited to simply stating the obvious, that immunologically compromised individuals, in other words, people who are already weak or sick, are likely to be at higher danger of illness and or death? Why has there been virtually no serious conversation about reducing risk by improving immune function? Perhaps it is because, although there are drugs that suppress immune function, there really are none that safely and selectively improve immune function.  Standard Western medicine focuses on  answers for the first two classes of risk management, which are public health measures, but have no answers  for the third class, which is how to improve your health as an individual.


Is it possible to improve immune function?

The answer is an emphatic yes. It certainly is possible to increase disease resistance. This discussion will necessitate a basic understanding of immunity and how it works, and of some basic things you can do to improve your odds of getting through these trying times safely.

Keeping it simple, there are two fundamental parts of the immune system Innate Immunity and Adaptive Immunity.

Innate immunity is your first line of defense against foreign invaders, like viruses. It is like a rapid response force that is ready to go at short notice, and is always doing surveillance to see if it needs to “gear-up”. This part of the immune system plays a key role in preventing you from getting sick in the first place. The cells of this part of your immune system can recognize over 1000 different molecular patterns from a variety of pathogens (Bacteria or virus), as well as a similar number from damaged tissues. Several chemical signals from cells stimulate a type of white blood cell called a neutrophil to become activated. They in turn engulf (eat up) foreign particles and also alert other cells called macrophages to in turn eat them, in a process called apoptosis. In addition, other inactive white blood cells called monocytes are stimulated to convert to more active macrophages to increase the process of killing invaders and clearing cellular debris. A third type of innate immune cell called a dendritic cell grabs parts of (in this case) the virus, called an antigen, and presents it to the adaptive immune system, thereby activating it.

Adaptive Immunity (in a normally functioning otherwise healthy person), is generally “turned off” or turned way down if no pathogen is present. It responds to an infection and is responsible for minimizing the damage caused by the invading organism, once it has overwhelmed the innate immune system. It takes several days to ramp-up. There are basically two parts to it, called T-cells and B-cells. The dendritic cells show the T&B-cells a variety of antigens from the invader, which leads to activation or cloning of certain T&B cells that recognize each antigen (B-cells can recognize over 10 million different antigens). Thus inactive or “naive” cells of the immune system, over a period of several days become “activated”.

For our purposes, immature T-cells can differentiate into two different cell lines called Th1 and Th2. Without getting too technical, we want most of the cells to become Th1, as this cell type can become a natural killer” cell that kills virally infected cells. NK-cells also kill virus particles and cells that have been covered by antibodies produced by B-cells. NK-cells act as a bridge between the innate and adaptive immune systems and work in conjunction with macrophages, where they engage in a positive feedback loop where a chemical produced by NK-cells (interferon gamma) stimulates macrophage activation. The activated macrophages then produce another chemical (Interleukin-12) that causes additional NK-cell activation. These are all good things to fight infections.

Th1 and Th2 are like a teeter-totter. Increasing one can decrease the other. For our purposes, we want to optimize Th1 which acts to kill viruses, while also increasing macrophages to further help the innate immune system. Simultaneously, we do not want to over activate Th2.

So how can we stimulate immune response in general, and specifically help the innate immune system and the Th1 aspect of the adaptive immune system? There are multiple answers to that question that are discussed next.


Improving Immune System Function

Essential common-sense steps you can take to optimize your  personal immune function:

  • Get at least 7-8 hours of high quality sleep each night. Avoid TV, computers or LED lights that all emit blue light, for 2 hours before bed
  • Reduce intake of sugar and other junk foods. Improve your diet with fruits, vegetables, and lean protein sources. Go organic when possible.
  • Avoid common food allergens, including foods containing gluten, dairy, soy, and beans. If you are sensitive you can activate the Th2 part of your immune system, thereby reducing Th1 that fights viruses.
  • I highly recommend that you take a high quality, broad spectrum multivitamin/mineral. Here is why- even a single nutrient deficiency or even a sub-optimal level has a negative effect on the immune system. Use of multivitamin and mineral supplements and their reputed benefits was tudied to determine the effect of a daily supplement on infection and well-being. The conclusion: A multivitamin and mineral supplement reduced the incidence of participant-reported infection and related absenteeism in a sample of participants with type 2 diabetes mellitus and a high prevalence of subclinical micronutrient deficiency2.
  • Probiotic bacteria are well known to modulate and improve immune function3,4,5,6. Take a high quality, multi-strain probiotic with at least 100 billion live bacteria per day.
  • Vitamin D- 5,000IU/day. Vitamin D is a major modulator of immune function, and improves innate immunity while reducing risk of respiratory infections. The majority of patients I test, are low in Vitamin D, which may have an adverse effect on immunity7,8,9
  • Vitamin C is a well-known essential nutrient in respiratory viral infections17. It acts in multiple manners, including increasing of interferon alpha (an anti-viral cytokine), by reducing pro-inflammatory chemicals, is an essential anti-oxidant, a co-factor in many enzymatic reactions, increases T-cells in the spleen, and increases natural killer cell activity10. Linus Pauling, the two-time Nobel Laureate was the first to propose large doses of Vitamin C for the prevention of viral illnesses. He recommended taking it to “bowel tolerance”.

With this method you take about 1 gram per hour until you develop mild GI discomfort or mild diarrhea. Back off that amount by 1-2 grams and use that as your daily amount in divided doses.

This breaking news is just in! Why have we not heard about it? This was just reported by the Orthomolecular News Service on March 1818. All patients in Shanghai with Covid-19  were treated at the Shanghai Public Health Center. About 50 cases with moderate Covid-19 were treated with 10,000 mg. of intravenous Vitamin C per day for 7-10 days. Severe cases were treated with 20,000mg. No patient died and treated patients were released 3-5 days before the typical non- Vitamin C treated patient.


Improving Your Innate Immune System

An infection occurs when the balance between the immune system and an invading pathogen favors the pathogen. The following statement elegantly states this fact:

there is a critical bacterial (insert virus for our purposes), concentration above which infection develops, and below which neutrophils defeat the bacteria. Whereas with normal neutrophil concentration and function, an infection may develop when the initial bacterial concentration is very high, under low neutrophil conditions or when there is neutrophil dysfunction, the critical bacterial concentration can be lower, within the clinically relevant range… We conclude that critical bacterial concentration has clinically relevant implications. The individual maximum bearable bacterial concentration depended on neutrophil concentration, phagocytic activity and patient barrier integrity…thus the resulting maximal bearable bacterial concentration may vary by orders of magnitude between patients11.

So optimizing neutrophil number and function is key in preventing infection. In addition to the above recommendations, Vitamin A (Retinoic Acid) and zinc are needed for neutrophil activation, so 10-15,000 IU of Vitamin A, and 10-30mg of zinc may be of benefit. Neutrophils, once activated, only live a short time, so extending their useful lifespan is another tool to optimize function. Reishi mushrooms have been shown to do just this.

There are also strategies to help improve macrophage function. Astragalus extract has been shown to be an immune stimulant, positively affecting macrophage function12.13.14. In fact, astragalus and other herbs used in Traditional Chinese Medicine  have a long historical record of use in pandemic from the past. They have also been studied in recent outbreaks of Covid-19 relatives SARS and H1N115.  SARS (Covid1 – COVID19’s viral sibling) has been present in Asia since 2003, and TCM has been researched in clinical trials with significant results. A just-published study that reviewed prior studies concluded “ There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza. None of the participants who took CM contracted SARS in the 3 studies. The infection rate of H1N1 influenza in the CM group was significantly lower than the non-CM group…Based on historical records and human evidence of SARS and H1N1 influenza prevention, Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population. Prospective, rigorous population studies are warranted to confirm the potential preventive effect of CM.”16

It’s worth restating the importance of these finding: NONE of the more than 4500 people in these three studies contracted SARS. And these weren’t just people from the general population, they were frontline healthcare workers!


Improving Adaptive Immunity

The adaptive immune system works with innate immunity and the two act to promote each other. In addition, Th1 kills pathogens, and importantly maintains a memory of those pathogens so they won’t infect you again (this is how vaccines work). There are a number of natural products that can positively influence Th1. One way of doing this is by inhibiting Th2. Astragalus also works in this capacity. Other ways to increase Th1 include the use of immunobiotics (heat killed probiotics), and extracts of certain species of mushrooms.

Our body has various “barrier” systems, that act to protect us from our environment, including pathogens. The skin is the most obvious barrier. The entire respiratory and digestive systems are lined with epithelial cells that act as a barrier. Barriers secrete many different chemicals that act non-specifically to kill pathogens. Seventy percent of our immune system lies in the GI tract. An antibody called Secretory Immunoglobulin A (SigA) is secreted in the respiratory and digestive systems and acts to“coat” the epithelial cells to deny pathogens access to cell surfaces and receptors, as well as by activating the innate immune system. Increasing SigA is yet another way to enhance immune function. Probiotics and prebiotics (food for probiotics), and L-glutamine (food for epithelial cells) can all assist in this regard.

As always, we are here as a team to help you win the battle for your health. We will support your structure to reduce overall physical stress, and allow you to move, sleep, and perform at your best. By fortifying your body with the best supplements possible, you can improve your ability to stay healthy. You may reach out to us at any time via telephone at 707-255-4424 or email Dr. Douglas Weed at info@loseweightnapa.com, for Dr. Scott Heun  drheun@heunchiropractic.com,  or Dr. Ken Fraser  drfraser@heunchiropractic.com. We are here to help you continue on a path of health from chiropractic care to weight loss programs to functional nutrition plans. Thank you.


References

  1. (https://www.usatoday.com/story/news/health/2020/03/15/coronavirus-treatment-could-coming-doctors-say-still-no-vaccine/5052788002/).
  2. PMID: 12614088 [PubMed – indexed for MEDLINE] Free Article.
  3. J Med Food 11 (4) 2008 652-656
  4. https://www.ncbi.nlm.nih.gov/pubmed/24638909
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006993/
  6. https://www.intechopen.com/books/immunopathology-and-immunomodulation/probiotics-and-immunity
  7. BMC Gastroenterology2012, 12:57 doi:10.1186/1471-230X-12-57
  8. Clin Endo November 2009, Volume 71, Issue 5, Pages: 666-672
  9. https://doi.org/10.1017/S0022215109992684
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659258/#
  11.  J Clin Invest. 2012 Aug 1: 122(8): 3002-11
  12. https://doi.org/10.1089/jmf.2008.0044
  13. https://doi.org/10.1371/journal.pone.0029320
  14. https://doi.org/10.1016/j.aquaculture.2005.06.038
  15. https://www.cochrane.org/CD004559/ARI_chinese-medicinal-herbs-for-influenza
  16. https://www.ncbi.nlm.nih.gov/pubmed/32065348
  17. http://orthomolecular.org/resources/omns/v16n20.shtml
  18. Orthomolecular Medicine News Service, Mar 18, 2020. Successful High-Dose       Vitamin C Treatment of Patients with Serious and Critical COVID-19 Infection