This article is meant to discuss immune health, building resilence, and recommendations with specific regards to COVID-19 in detail. There are, however, universal foundational truths to immune health that I will briefly list. Their importance to your immune health should not be underestimated.
- Sleep – The most essential thing we can do for our health is prioritize sleep. Sleep is particularly important for initiating effective adaptive immune responses that lead to long-lasting immunological memory.
- Diet – Focus on plant-based, whole foods. Limit highly processed foods and sugars. Flavonoids found in fruits and vegetables ameliorate the inflammatory symptoms in autoinflammatory diseases associated with NLRP3 inflammasome activation. NLRP3 inflammasomes are discussed in detail below. (19)
- Movement – Exercise training has the potential to decrease inflammation, reduce oxidative stress, improves blood and lymph circulation, improve oxygenation of tissues, and, support the immune system.
- Stress Reduction – Acute stress response is vital for survival and adaptation. You need to be alerted that there is a danger and be able to get yourself to safety. However, during times of chronic stress, the body cannot focus on regular metabolic functions such as mounting an appropriate immune response to things like viruses because its energy is going towards immediate survival. The body’s response to stress is also to elevate pro-inflammatory protein messengers called cytokines. More about this later.
- Digestive Health – A healthy microbiome (bacteria in your digestive tract) is essential for overall health. 70-80% of your immune system is found in your digestive tract! So, eliminating digestive tract inflammation and diversifying your microbiome is non-negotiable for immune function. You can start by eating a variety of vegetables and spices to get fiber as a source of prebiotics. Great probiotics sources through diet are things like Keifer, kombucha, sauerkraut, and yogurt.
Because of short attention spans please visit the CDC website for updated information regarding limiting the spread, ways to protect yourself and what to do if you become symptomatic.
We have addressed the basic ways to support immune health and again I cannot put enough emphasis on the importance those have in the prevention and recovery of illness. Now let us discuss COVID-19 because I am sure that is the only reason you are still reading.
What is the Difference Between COVID-19 and Other Coronaviruses Such as SARS-CoV, MERS-CoV or Other Viruses Such as Influenza?
Different viruses have specific proteins to recognize particular tissues in the body called spike proteins. The spike protein of the Coronavirus binds and recognizes a specific receptor called ACE-2. ACE-2 receptors are expressed in the lung, kidney, and GI tract. This is why common symptoms are fever, dry cough, shortness of breath, nasal congestion, runny nose, sore throat, and diarrhea.
Why is COVID-19 so Contagious?
COVID-19 is different than other Coronaviruses such as SARS and MERS due to a furin cleavage site. Why that is important is because, in order for the virus to get close enough to your body’s cells to fuse with them, the virus actually has to cut off the receptors on those cells. COVID- 19 has a furin cleavage site allowing it to cut off the receptors and gain access into a cell more readily. Most cell surfaces express furin, which allows for an increased ability for COVID-19 to fuse with different cells, enabling viral entry even in cells that have low expressions of the ACE2 receptor.
COVID-19 is incredibly virulent and is a thousand times more transmittable than other coronaviruses and influenza because of these furin cleavage sites that have the ability to fuse and enter into basically all cell types. This is why symptoms are not always straight forward and can manifest in different ways.
What is a cytokine Storm and Inflammasome?
It is possible at this point you have heard about a cytokine storm and its associations with the fatality of COVID-19. Before we can get to a cytokine storm we have to discuss inflammasomes. Once COVID-19 has gained access into your cells and becomes activated and starts replicating this, in turn, signals your immune system to mount a response to the infection. The response is an inflammatory cascade of signaling proteins and mediators and the collection of these proteins and mediators is termed an inflammasome, particularly NLRP3 inflammasome. Why do we care what type? Because that can target specific treatments. Those signaling proteins are called cytokines. Usually, cytokines are secreted in limited amounts to appropriately deal with an infection or injury, but sometimes pathogens can stimulate these cytokines to go out of control. In the case of COVID-19, one of the virulence proteins can trigger the overproduction of interleukin 1 beta, again we care because we can target specific treatments.
The out of control production of inflammatory cytokines “cytokine storm” is what leads to acute respiratory distress syndrome and acute lung injury (ARDS/ALI) and can become fatal.
It is important to note that the inflammasomes are an integral part of our innate immune system and needed to fight viral infections. You don’t want to shut the inflammatory response down completely you just want to stop the out of control production of cytokines.
Is the Increased Virulence of COVID-19 Just the Type of Virus or is the Population More Vulnerable?
I believe both contribute and we need to realize that both the external and internal environments put our immune health at a disadvantage. Environmental toxins can damage cell membranes resulting in direct or indirect disruption of our body’s cellular function and signaling. Continuous exposure to environmental toxins means we increase our body’s burden to eliminate these toxins—this constant burden results in a decreased efficiency in eliminating toxins out of our body which creates toxic overload. Toxic overload increases system inflammation, reactive oxygen species, immune dysregulation and breakdown of membrane function and communication.
Every disease has some known level of inflammatory etiology including osteoarthritis, cardiovascular disease, osteoporosis, diabetes, neurodegenerative disease, autoimmunity, and cancer. The population is in a state of chronic inflammation, weakening their immune system and making them not only susceptible to viral infection but unable to have an appropriate immune response.
A new study from Harvard T.H. Chan School of Public Health determined that people with COVID-19 who live in U.S. regions with higher levels of air pollution are more likely to die from the disease than people who live in less polluted areas. (20) Addressing toxic burden and supporting biotransformation, excretion, and elimination of toxins should be part of any treatment plan. For more information, you can read previous blog posts regarding detoxification on my blog page.
Supplements and Botanicals
I want to discuss the supplements, pharmaceuticals, and therapies that have been discussed in the prevention and treatment of COVID-19. It is important to state that there is no cure for COVID-19, everything I am going to discuss can help optimize immune function, reduce inflammation, reduce oxidative stress, support antioxidant pathways, support mitochondrial function and help decrease viral load and replication. The goal of supporting the immune system is to help with prevention and keeping the disease in those who have it in its mildest form if possible and hopefully recovering quickly.
This list is comprehensive because I wanted to cover anything that you might have heard or read about. I am not recommending you take everything on this list and I am also not including dosing because that is an individualized treatment that varies from person to person and also depends on what stage of pathology. I am happy to consult individually for those recommendations.
- Vitamin D – Low Vitamin D levels have been shown to increase the risk of developing viral upper respiratory tract infections. Vitamin D has also been shown to have anti-inflammatory and immune modulation properties.
- Vitamin C/Ascorbic Acid – Ascorbic acid can act on multiple levels, reducing oxidative stress, improving mitochondrial membrane potential, decreasing furin expression, and modulation of immune defenses to stem the progression of cytokine storms. (2) It also can reduce the NLRP3 inflammasome.
- Vitamin A – is vital to many specific immune functions, including maintenance of mucosal barriers and improved innate immunity supporting the body’s responses to infection.
- Zinc – Zinc deficiencies are linked to specific immune susceptibilities and increased risk of pathogenic infections. Zinc has been shown in multiple studies to decrease the duration of the common cold and is thought to do this by stopping viral replication. A study done for SARS-Cov in 2010 showed Zn inhibited the ability of the virus to replicate (14). Zinc, however, needs to get into the cell which is where ionophores come in. More about that later.
- Mushroom extracts – Have a variety of immune benefits including supporting the immune system to fight viruses.
- Melatonin – reduces inflammation caused by coronavirus infection. Melatonin has recently been shown to suppress NLRP3 inflammasomes and interleukin 1 beta. (15)
- Propolis – is a resin produced by bees with potent antimicrobial activity against strains causing upper respiratory tract infections. Shown in studies to improve pulmonary function and reduce inflammation. (8)
- Andrographis (Chuān Xīn Lián) – is an herb used often in Chinese medicine for the treatment of upper respiratory infections and the common cold. A systemic review of Seven double-blind, controlled trials found Andorgaphis to be a safe and efficacious treatment for the relief of symptoms of uncomplicated upper respiratory tract infection. (9)
- Elderberry – is a potent antimicrobial herb that has been beneficial for the prevention and treatment of influenza and upper respiratory infections. A meta-analysis of randomized, controlled clinical trials with a total of 180 participants found supplementation with elderberry to substantially reduce upper respiratory symptoms. (10)
- Curcumin, resveratrol, rosmarinic acid, and alpha-lipoic acid all can improve ACE2 and decrease Inflammation.
- Resveratrol has been shown to inhibit the growth of the MERS coronavirus and reduce corona virus-induced inflammation. (16)
- Nitric Oxide – is actually an extremely effective antiviral against the SARS-CoV coronavirus. During the SARS outbreak in 2004, the use of nitric oxide in patients infected with the coronavirus was able to reverse pulmonary hypertension, improve severe hypoxia and reduced the duration of ventilator support compared to matched control patients infected with SARS-CoV. (17)
- Quercetin – is a plant flavonoid with endless beneficial properties including anti-carcinogenic, anti-inflammatory, antiviral, and antioxidant. It is often used in allergies as a mast cell stabilizer inhibiting capillary permeability. It has even been shown to stimulate mitochondrial biogenesis! Quercetin is also a zinc ionophore. Which means it helps zinc get into the cell to disrupt viral replication. (18)
- Artemisium Annua – Artemisinin and its derivatives are widely used in the world as the first-line antimalarial drug. Recently, growing evidence reveals that artemisinin and its derivatives also possess potent anti-inflammatory and immune-modulating properties (1)
- CDP Choline – The coronavirus uses PLA2 to enter the cell and replicate CDP-Choline could be tried as an inhibitor of early virus entry and replication. This is based on studies with cell cultures and is currently theoretical.
- Homeopathy – Remedies are different for different individuals and you would need to consult a homeopath for proper remedies and dosing. The idea is to have people react/adapt to the virus, move through the illness without becoming severely ill, and then move on with their lives. One way it does this is by raising cellular frequency. That statement will make sense when you finish this article.
Other therapies to consider peptides, cytokines, ozone, intravenous vitamin C, exosomes, and stem cells. These have potential to be very efficacious, but are out of the scope of this article.
- Chloroquine and hydroxychloroquine are anti-malarial medications. They are Zinc ionophores that increase intracellular Zinc concentrations. As discussed zinc stops the viral replication. As with all pharmaceuticals, there are side effects and the safety vs benefit is being debated.
- Intravenous Vitamin C is starting to be implemented more in some hospitals.
- Vaccine development is underway but may take 18 months before it is ready for the public. Natural immunity is also something being researched more.
- Plasma exchange using antibodies from individuals that have had COVID-19 and recovered.
In closing, I would like to say that never has there been such an important time for all forms of medicine to work together. They have all shown to have positive, efficacious effects at various stages of the virus and supporting immune function.
Also, it is an interesting time to realize that your individual actions and thoughts affect all those around you. We all have a vibration, that is not some esoteric philosophy that is physics and cell biology. In a study conducted by MIT on red blood cells and malarial infection, the researchers were able to correlate the cells’ vibrational frequencies with the progression of the disease. (5) They were able for the first time to create technology that could measure the frequency at which red blood cells vibrate and show that those frequencies reflect the health of the cells.
The field of quantum physics goes a step further to show that your environment, thoughts, and emotions change your cellular frequency these things can actually change what genes in your body get turned on and off. Emotions such as gratitude, appreciation, love, and compassion raise the frequency of each cell. These same emotions also create a coherent state when measuring heart rate variability. When heart rate variability is in a coherent state is allows are nervous system to be more adaptable and respond to stressors more efficiently, it also results in decreased inflammatory markers and improved immune system response.
So, the higher are cellular vibration and the more coherent our heart rate variability the better our immune system will function.
So, meditate, pray, breathe, and find things that bring you joy during this uncertain time. If you are afraid that is okay to feel that, do not suppress that, explore it. Also, explore the other end of the spectrum love and compassion because it does affect your immune function and affects those around you. Please sleep, eat whole foods, find ways to cope with stress and move your bodies and above all else WASH YOUR HANDS, and send compassion and love at an appropriate distance of six feet away.
- Shi C, Li H, Yang Y and Hou L. Anti-Inflammatory and Immunoregulatory Functions of Artemisinin and Its Derivatives. Mediators of Inflammation Volume 2015, Article ID 435713, 7 pages http://dx.doi.org/10.1155/2015/435713
- Nitric Oxide Gas Inhalation for Severe Acute Respiratory Syndrome in COVID-19. – Full Text View – ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT04290871
- COVID-19, Furins & Hypoxia – The Vitamin C Connection – EvolutaMente.it https://www.evolutamente.it/covid-19-furins-cancer-a-tale-of-vitamin-c-hif/
- Mitochondria & The Coronavirus – The Vitamin C Connection (Part 3) – EvolutaMente.it https://www.evolutamente.it/mitochondria-the-coronavirus-the-vitamin-c-connection-part-3/
- Vibrating Cells Discolse their elements. MIT Technology Review. https://www.technologyreview.com/2008/09/09/33557/vibrating-cells-disclose-their-ailments/
- Mitochondria are the powerhouses of immunity | Nature Immunology https://www.nature.com/articles/ni.3704?draft=marketing
- Diverse Roles of Mitochondria in Immune Responses: Novel Insights Into Immuno-Metabolism | Immunology https://www.frontiersin.org/articles/10.3389/fimmu.2018.01605/full
- Speciale A, Costanzo R, Puglisi S, et al. Antibacterial activity of propolis and its active principles alone and in combination with macrolides, beta-lactams and fluoroquinolones against microorganisms responsible for respiratory infections. J Chemother. 2006;18(2):164–171. doi:10.1179/joc.2006.18.2.164
- Coon JT, Ernst E. Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy. Planta Med. 2004;70(4):293–298. doi:10.1055/s-2004-818938
- Hawkins J, Baker C, Cherry L, Dunne E. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Complement Ther Med. 2019;42:361–365. doi:10.1016/j.ctim.2018.12.004
- Keith, P., Day, M., Perkins, L. et al. A novel treatment approach to the novel coronavirus: an argument for the use of therapeutic plasma exchange for fulminant COVID-19. Crit Care 24, 128 (2020). https://doi.org/10.1186/s13054-020-2836-4
- Natural Medicine Jounal. Important Clarifications Regarding Covid-19 and Natural Medicine Dispelling myths and misconceptions. interview Heather Zwickey, PhD March 31, 2020.
- Velthuis, Aartjan & van den Worm, Sjoerd & Sims, Amy & Baric, Ralph & Snijder, Eric & Hemert, Martijn. (2010). Zn Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture. PLoS pathogens. 6. e1001176. 10.1371/journal.ppat.1001176.
- Melatonin administration to wild‐type mice and nontreated NLRP3 mutant mice share similar inhibition of the inflammatory response during sepsis – Rahim – 2017 – Journal of Pineal Research – Wiley Online Library https://onlinelibrary.wiley.com/doi/abs/10.1111/jpi.12410
- Lin SC, Ho CT, Chuo WH, Li S, Wang TT, Lin CC. Effective inhibition of MERS-CoV infection by resveratrol. BMC Infect Dis. 2017;17(1):144. Published 2017 Feb 13. doi:10.1186/s12879-017-2253-8
- Keyaerts E, Vijgen L, Chen L, Maes P, Hedenstierna G, Van Ranst M. Inhibition of SARS-coronavirus infection in vitro by S-nitroso-N-acetylpenicillamine, a nitric oxide donor compound. Int J Infect Dis. 2004;8(4):223–226. doi:10.1016/j.ijid.2004.04.012
- Dabbagh-Bazarbachi H, Clergeaud G, Quesada IM, Ortiz M, O’Sullivan CK, Fernández-Larrea JB. Zinc ionophore activity of quercetin and epigallocatechin-gallate: from Hepa 1-6 cells to a liposome model. J Agric Food Chem. 2014;62(32):8085–8093. doi:10.1021/jf5014633
- Lim H, Min DS, Park H, Kim HP. Flavonoids interfere with NLRP3 inflammasome activation. Toxicol Appl Pharmacol. 2018;355:93–102. doi:10.1016/j.taap.2018.06.022
- Xiao Wu MS, Rachel C. Nethery PhD, M. Benjamin Sabath MA, Danielle Braun PhD, Francesca Dominici PhD All authors are part of the Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA