Lifestyle Medicine & Wellness Blog

Immune Support: To Boost or Not to Boost with Covid-19? Thoughts on Nutrient Supplementation

Disclaimer: It is important that I state, and that you understand, the information I provide in these posts on tips for Coronavirus 19 are not done as medical advice, and are not meant to replace or substitute the constantly evolving and changing public health  recommendations.  These are meant to inform you and supply as much knowledge and understanding of this situation at this time, as seen through my eyes as a Functional Medicine practitioner, a lifestyle medicine practitioner, a nutritionist, exercise physiologist, a brain health coach, a preventive health and chronic disease management specialist and someone who understands that knowledge is power.  Knowledge gives some control to a situation that may seem out of control right now.  Knowledge gives you, and I, the power to make educated decisions on what we do to support our health.  These discussions are not by any means comprehensive and exhaustive but are meant to support you in your general understanding of this virus as it may relate to general health recommendations and guidance.
 
Specific health concerns and specific health advice require working with a health professional. For more information about how I can help, visit the Contact Us Page
 

Note: There’s so much information swirling out there right now as we try to figure out the mechanism of this novel virus, Covid-19, that it is hard to sort through it all.  Today I will cover some Do’s and Don’ts as they relate to nutrient supplementation based on the current research and my interpretation.  Please note that in functional medicine we look at what is happening at the cellular level and nutritional therapies use what we call, therapeutic doses of nutrients and not RDI levels.  During times of increased risk, and/or infection, the recommended levels may be even higher to achieve that therapeutic effect.  Nutrients are at the foundation of our physiology and modulate and affect our metabolic pathways.  Specific recommendations for your specific situation (particularly if you have medical conditions) cannot be made in an article like this.  These are some general guidelines to give you some understanding and empower you with some knowledge to make some decisions on supplementation as we navigate this crisis.  Dosing suggestions may change as an individual's situation changes, and if I am working individually with a client, we assess and reassess and modify. Following are some guidelines I am using for myself and for my family.  I hope this helps!  If you don’t want to sift through the science of it you can click below for a printable handout of my supplement recommendations

 
I have been in the Functional Medicine for over 15 years.  Over that time, my practice has organically moved towards gut health, because, as Hippocrates said, “All health begins in the gut.” Our guts are home to 70-80% of our immune system function and long term, strengthening and supporting our immune system by working on gut function is critical to keep us healthy and protect us from disease and illness.  (See my blogposts on gut health and its connection to many symptoms and medical conditions, including immune function).
 
In an upcoming blog on food and lifestyle recommendations I will address some strategies for keeping your gut health in good shape.  Today, I want to talk about some guidelines on supplementation that you can start today to boost your immune function as a strategy to increase your protection and ability to recover if you were to contract the virus.   To help you sort through the confusion, let’s look at some specific nutrients and how they may be beneficial or potentially detrimental regarding Covid-19 and what I might recommend and why. 

 

OVERVIEW OF COVID-19 VIRUS MECHANISM OF INFECTION

CV-19 is a novel, or new virus, and we don’t have a lot of research on it that we can look at for guidance for recommendations on it. So, instead, we look at the history of and research on other similar coronaviruses to study their mechanism and model recommendations around that. Some viruses that are similar in structure and function are SARS and MERS.  Covid-19 was initially named SARS2 because of its similarity to the SARS.  To review, viruses must gain entry into our cells in order to be able to replicate.  They do this through receptor sites on our cells. Covid-19 enters the cell through the ACE2 receptor sites, which are found on the cells of lung, kidney, intestinal and cardiovascular epithelial linings. Because Covid-19 gains entry into the cell through ACE2, we may not want to take nutrients that upregulate ACE2 during the time that the risk is high.
 
Below I’ll go through an overview of some of the pros and cons of taking certain nutrients right now to support and boost our immune system considering overall immunity, whether it upregulates ACE2 and if it plays a role in blocking attachment to ACE2, thereby blocking entry to the cells (where they eventually replicate and spread) and potentially helping with prevention.In general, I would recommend considering limiting supplements that upregulate ACE2.
 
One thing to consider is the fact that we also want to be sure that we have foundational support for our immune system as well.  The CDC noted that 96% of people tested for CV-19 who had symptoms were negative.  That means they had another cold or flu bug that their immune system needed to fight off. I imagine is somebody got the flu first they may be more susceptible to getting the coronavirus if exposed, so we want to take into consideration foundational immune support as well. Finally, we look to see what things might directly stop the attachment of that virus to ACE2, thereby blocking entry to cells (where they eventually replicate and spread) and potentially, then, stopping infection
.
THE CYTOKINE STORM
 
Once the virus replicates, it can trigger in intense inflammatory immune response called a cytokine storm that results in scarring and tissue damage in the lungs and potentially in the heart.  A cytokine called IL-6,  inflammatory marker hsCRP (C Reactive Protein), and ferritin (also a sign of inflammation) have been elevated in patients with poor outcomes.  The triggering of the inflammasome in the cytokine storm triggers a fiery cell death called pyroptosis.  NSAIDs seem to contribute to this cytokine storm and rapid development of pneumonia with this coronavirus, and should be avoided.  Instead, I recommend taking a good curcumin supplement and a high quality fish oil to lower inflammation.  A fish oil I recommend is Metagenics, OmegaGenics Mega 10, which contains Omega 7 as well.  This blend powerfully lowers hsCRP, which is elevated in patients with poor outcomes in Covid-19.  Curcumin is the active ingredient in tumeric.
 
RECOMMENDATION BY SUPPLEMENT
 
Vitamin D – Recommended
Vitamin D is considered one of the big guns in our immune system support arsenal.  A good percentage of the population, especially during the winter months, are deficient in this nutrient. According to the NIH, 41.6% of the population is deficient in vitamin D, with the highest rates in blacks (82.1%) and Hispanics (69.2%). Vitamin D is a fat-soluble vitamin that most know is essential to a healthy immune system, is anti-inflammatory and affects mood as well.  Normally higher doses of Vitamin D are recommended to protect us from cold and flu and to boost our immune function, especially in the winter months where there is a lack of sunshine.  But Chris MasterJohn,PhD, a nutrition researcher, has some concerns about taking vitamin D with this virus.
 
MasterJohn, stated that vitamin D also increases the amount of ACE2 on our cells which may support the virus entry into the cells, and so, does not recommend taking any Vitamin D while the risk of CV-19 exists.  One study in the Journal of Steroid Biochemistry and Molecular Biology, noted that Vitamin D is a negative endocrine regulator of the RAS (renin angiotensin system), and that a deficiency in D increased the ACE enzyme activity and decreased the ACE2 receptor site.  Stated another way, this would indicate that increasing Vit D would lower ACE activity and increase ACE2 activity, something we, theoretically, would not want to do with this virus. 
 
Given this, I reached out to Dr Michael Holick, an internationally known Vitamin D expert to get his recommendations and to answer this question I posed to him, “I have seen some information that Vitamin D inhibits ACE and upregulates ACE2 receptors, potentially increasing risk of entry of this virus into the cells and infection.  I know there is a plethora of information on benefits for cold, flu and some other viruses, but given mechanism of entry, do you recommend not taking Vitamin D at this time?”
 
Dr Holick’s Response:
In my opinion this is not an issue it is just the opposite see below some of my comments.  Vitamin D plays a critical role in improving immune function and can help fight viral infections and reduce inflammatory responses.  I personally take 6000 IUs daily and recommend adults should take at least 3000 IUs and preferably 5000 IUs daily. Vitamin D acts in several ways to improve immunity. The 1st is that it is activated in macrophages once activated it regulates the production of a defensin protein called cathelicidin. This protein selectively kills infectious agents including bacteria and viruses. The 2nd way that it functions is to alter the activity and number of lymphocytes known as T 2 killer lymphocytes which have the ability to release factors improving immune function reducing risk of spread of infectious agents including bacteria and viruses. We have conducted 2 studies looking at the role of vitamin D on immune function in healthy adults. We showed for example that healthy adults who ingested 2000 IU's of vitamin D a day for 3 months altered the expression of 291 genes in their immune cells. Healthy adults taking up to 10000 IU daily for 6 months regulated upwards of 2000 genes improving immune function.” (See also his official statement on Vit D and the coronavirus, Boston University School of Medicine which can be found in the gallery of images at the top of this post)
 
Remember, everything we do will be working in concert with other things within our physiology, and in the big picture, sometimes positive effects may outweigh potential risks. In my practice, this is how I look at complicated patients that have multiple issues, prioritizing what I recommend when a nutritional therapy is recommended for one of their conditions and contra-indicated for another.  Based on the discussions about, and for overall immune health, I would still recommend Vitamin D3. We can get Vitamin D naturally from the sun, so I would recommend getting out in the sunshine (if you can find it). Just 20 minutes a day with your arms and face (at least) exposed will help you produce about 15000IU.  Eggs, butter, and mushrooms can all supply you with Vitamin D as well; however, to get the recommended dose without being in the sun I would recommend a supplement. I am currently taking 5000 IU/day of vitamin D with K a day myself. (Specific supplement recommendations attached in a separate handout).
 
Vitamin A – Recommended with Limitations
Vitamin A is another fat-soluble Vitamin that is highly protective for everyday immune function.  Vitamin A has hundreds of functions, mostly beneficial and necessary. In the integrative field, you will see ultra-high  dosing recommended at times to boost immune function and protection. However, the CDC estimated that only 1% of the population in the states is deficient in vitamin A. One of the first signs of vitamin A deficiency is night blindness.    Vitamin A is also a fat- soluble vitamin which means in can be stored in our tissues. If high dosing for extended periods, vitamin A can be toxic and for that reason I typically don’t recommend supplementation unless vitamin A levels have been measured and there is a deficiency. Still, vitamin A plays a critical role in strengthening our immune response and our ability to fight off infections. 
 
In relation to CV-19, MasterJohn notes concern that vitamin A increases ACE2 on the cells.  As discussed previously, the more ACE2 is upregulated, potentially the more CV-19 may have access to our cells.  MasterJohn, is not sure of ultimate affect of Vitamin A with this virus. Given the potential for toxicity, the low percentage of the population that is deficient, and the critical role that vitamin A play in immune function,  I think it is best to limit Vitamin A to natural sources right now.  You can eat as many fruits and veggies as you like.  Relatively high levels of Vitamin A are in organ meats like liver, and in cod liver oil.  Just 1 serving of liver, around 100 grams (28 g = 1 oz.), you’ll get 3000 IU of retinol (Vit A).  Eggs, milk and butter have lower levels and you can get natural levels if you eat a combination of those as well (about 250 IU per serving).
 
Vitamin E – Recommended
Recommended as a foundational support is Vitamin E in the form of tocotrienols, which protects our cell membranes. This form of vitamin E penetrates the cell membrane better than the tocopherol form, and they have a stronger, protective, anti-oxidant effect than the tocopherol form.  Our cells communicate with each other in order to function properly and if the cell membrane is not healthy, that communication is tempered.  Tocotrienols are highly protective for cardiovascular purposes and modulating blood lipids, so it is extremely helpful for overall cardiovascular and mitochondrial health. Since this virus attacks lung and cardiovascular tissue, and our mitochondria produce our energy, protecting the cell membranes is important.  Vitamin E is also effective at tempering IL-6, along with Vitamin C, and niacin, so may be beneficial in that regard as well.
 
Zinc – Highly Recommended
Zinc is another nutrient I would absolutely recommend taking to boost immune function. Zinc helps to activate T cells, which help to increase our defenses by fighting off infection.  T cells also help to regulate our immune responses.  Zinc and copper work together and need to be balanced. Too much of one can affect the other. So be sure to consume foods with copper in them. We aren’t sure where the virus enters the cells, but  oral zinc is good to be sure it gets to those lung tissues, and adding zinc lozenges may be a safeguard by working on the virus in the mouth and throat, so I have these on hand as well. Too high a dose at one time seems to lower SOD, superoxide dismutase, critical for handling free radicals, so I recommend a maximum of 30 mg at a time. The drug hydroxychloroquine (Placquinil) is an anti-malarial and autoimmune medicaition, and is being used as a treatment in concert with Azythromycin for Covid-19 with some success.  Interestingly, the hydroxychloroquine forces zinc into the cells that the virus has hijacked to replicate in.  Having enough zinc on hand to support this seems prudent. During the CV-19 risk period I am dosing 2x/day.  After the risk period I would lower my zinc intake.
 
Potassium – Recommended
Studies out of China indicate that patients that didn’t fare well often had low potassium levels, potentially from a degradation of ACE2 (which affects the RAS system – renin angiotensin system) which ultimately affects sodium and potassium levels.  This study noted that patients were losing potassium (particularly in their urine) resulting in the low potassium levels. Keeping potassium levels stable may improve patient outcomes.  Patients with severely low potassium had a higher prevalence of dyspnea (trouble breathing) and it is common knowledge that hypokalemia adversely affects heart function.  We are not sure if these patients had low potassium levels before the infection but focusing on high potassium foods doesn’t pose any risks and may be protective. Fruits tend to be higher potassium and coconut water is a great source with about 500 mg per serving.
I also have keep on hand Endura, a Metagenics product for maintaining electrolyte balance.  Typically promoted as a sports supplement, I see the benefit of using it now to keep potassium levels up, particularly if you get symptoms.  Remember, the opposing electrolyte here is sodium, so keep your salt intake moderate to keep your Na:K ratio on track.
 
NAC - Recommended
NAC, or N-Acetylcysteine, is a precursor to glutathione, our master anti-oxidant that gets depleted in times of oxidative stress. Anti-oxidants like glutathione and the tocotrienols we’ve already discussed,  essentially help to protect against free radical damage in the cells.  They stop oxidation, which is why we call them an anti-oxidant.
 
Low glutathione levels can affect our redox potential – or ability to fight off free radicals.  Inflammation creates free radicals; and free radicals produce inflammation.  This viscous cycle damages tissues and can result in damage to many body systems. NAC is also used in our detoxification system. Broccoli, and other brassica vegetables, are high in sulforaphane.  Sulforaphane is protective against cancer and can be taken to increase something called Nrf2, which does many things, including raising glutathione. NAC, or N-Acetyl Cysteine is potentially protective against CV-19. 
 
Nitric Oxide – Oxygen to the cells. A quick thought.
Lack of oxygen affects tissue health and function as well. Boosting nitric oxide levels opens up blood vessels and allows more blood, nutrients and oxygen to reach your cells. Beets and/or beet powder increases NO quickly.  You can add some beets to your salads, and /or beet powder to your morning shakes to help with this.  Lack of sleep, sleep apnea, flying at high elevations, being sedentary, poor circulation, cardiovascular dysfunction all can affect oxygen levels.  Getting a good night’s sleep is important.  Moderate aerobic exercise is important and helps counter many of these issues. 
Lifestyle can play a big role in how our immune system functions, and I’ll be talking in more detail on these types of things in my upcoming lifestyle and CV-19 blogpost coming soon.
 
Niacin -B3 -Recommended
Along those lines we need to look at niacin, or B3, and its critical role in our mitochondria (the energy organelles in our cells), and in the production of energy.  The mitochondria function to donate electrons to make ATP in the Kreb’s Cycle.  We need our energy system functioning optimally as a foundation for health.  Much of our illness and aging stems from poorly functioning mitochondria.  This system of donating electrons creates positive and negative charges which trigger reactions within the energy system. When the mitochondria are damaged, or there is a disturbance of these charges, the mitochondria can thicken the protective bilayer around the mitochondria.  The ultimate effect is that there can be an increase in inflammation through highly damaging particles called reactive oxygen species (ROS).  ROS damages tissues and increases inflammation (cytokine production).  Niacin, (NAD) is needed in the Krebs cycle and this inflammatory flare depletes the enzyme needed produce NAD, making it difficult to produce energy efficiently, and increasing inflammation (cytokines).  Supporting our ability to produce energy and to fight off inflammation are important strategies to keeping well.
The second part of the niacin piece important for immune support, is the fact that it is a potent inhibitor of inflammatory cytokines. A study in Clin Exp Immunol 2003 stated that they not only confirmed niacinamide down-regulated tNF-alpha (a highly inflammatory particle), but also that it is “a potent modulator of several proinflammatory cytokines.”  Given the cytokine storm that is produced with this Covid-19 virus once it is established, it seems prudent to me to add niacin to your protocol.  Additionally, niacin specifically lowers IL-6, elevated as the storm begins.  I use Metagenics Lipotain, 500 mg at least once a day.  I am currently adding a second dose at night for a total of 1000 mg.
 
Berberine – Recommended
Berberine is one of my favorite nutrients with a plethora of gut health, cardiovascular health, blood sugar control, and dyslipidemia benefits.  Berberine is a yellow alkaloid found in goldenseal. It is an antioxidant that is antibacterial, antiparasitic, antifungal, antiviral, anti-amoebic and has also been shown to decrease insulin resistance and lower blood sugar.  “It was effective is stopping replication of the H1N1 influenza A virus among a variety of cell types, including human lung cells. Researchers found that goldenseal accomplished this by blocking the virus’ ability to alter and transfer DNA and other protein information – stopping its ability to replicate.” The active constituent believed by the researchers to be central in these effects is berberine.
 
The researchers also found that berberine blocked inflammatory factors related to the influenza A H1N1 virus. These included TNF-α and PGE2, which stimulate inflammation related to the viral infection – causing fever and aching pain among other symptoms. The researchers concluded that the mechanisms involved in blocking these inflammatory factors were separate from Goldenseal’s ability to block the growth of the virus. Berberine is another nutrient that affects Nrf2 and that will also boost glutathione levels. There aren’t many supplements that you get as much bang for your buck as berberine.   I recommend supplementing berberine 2-3 x/day.
 
Vitamin C - Recommended
Vitamin C has been used at very high doses to kill infections, and there are some reports out of China that IV Vitamin C is being used as a treatment option.  For our purposes, vitamin C is an immune supporting nutrient that is water soluble, so in general, excess intake is eliminated in the urine.   Melatonin, nitric oxide and vitamin C  work together affecting ACE2.  "Melatonin, nitric oxide and ascorbic acid (vitamin C) (also) can reduce COVID-19 virulence by inhibiting NLRP3 inflammasomes to stop the perpetuation of cytokine storms."  (see more under Melatonin) Vitamin C also scavenges those ROS (damaging free radicals) in the mitochondria, and we want to protect the function of our mitochondria with this virus.
There may be some concerns for people with oxalate issues with taking high doses of vitamin C,, but for the rest of us, I would include vitamin C. Orthomolecular.org recommends starting with a minimum of 3000mg spaced throughout the day as a preventive.  If symptoms develop, dosing is much higher.  The recommendations I've seen are "1 gram every 15 to 30 minutes, depending on the severity of symptoms.  If symptoms don't resolve, increase to 2 grams every 15 to 30 minutes." 
I use a liposomal vitamin C.  Each packet is 1000 mg. and when I feel a cold or flu coming on I take up to 3 a day or more.   The liposomal C may be hard to get right now, so I list chewable, tablet and a powdered form  in my supplement recommendations. which may be easier to take in larger doses.
 
Curcumin and Fish Oil - Recommended
 
Curcumin is the active anti-inflammatory in tumeric and is one of the most powerful anti-inflammatory substances in our toolbox.  "A study looked at how curcumin influences cytokine release and cytokine storm. The article reported on the effects of curcumin on cytokine expression in a mouse model of virus-induced acute respiratory distress syndrome. The authors stated: “Curcumin blocks cytokine release, most importantly the key pro-inflammatory cytokines, interleukin-1, interleukin-6 and tumor necrosis factor-α. The suppression of cytokine release by curcumin correlates with clinical improvement in experimental models of disease conditions where a cytokine storm plays a significant role in mortality.” The research team concluded that curcumin may offer support to those experiencing cytokine storms."
 
 As previously mentioned, EPA and DHA, Omega 3 fatty acids in fish oil is very anti-inflammatory and affects all of our body systems.  Metagenics OmegaGenics Mega 10 blend also contains Omega 7.  A finding in patients that don't do well with Covid-19 is an elevated hsCRP (C Reactive Protein).  Mega 10 shows over a 60% decrease in CRP over a 2-3 months time period and is the blend I would recommend for this program. 
 
Mushrooms - Recommended  
Mushrooms are highly supportive of immune function. Beta-glucans are long-chain polysaccharides and are found in several medicinal mushrooms, like maitake, reishi, turkey tail, shiitake and caterpillar fungus (cordyceps). (They are also found in the cell walls of cereals, so can be found in a healthy choice like oatmeal as well). Mushrooms have been used in the treatment of inflammatory diseases such as cancer and autoimmune disease, hypertension and HIV, and I recommend them for immune support.  (Roundtree, Fellowship A4M)  I take a liquid blend, particularly when I feel like I am trying to fight off a cold or flu. 
One exponential benefit of consuming mushrooms is they are a food source of copper you can eat to balance your zinc supplementation.  For example, a cup of stir-fried white button mushrooms provides 0.3 milligram of copper per serving, and 40 g ( 28 g= 1 oz) of shiitake mushrooms contains 2 mg of Copper.
 
Melatonin-Recommended with Limitations
Melatonin has long been known to be very anti-inflammatory and has been used in the integrative field in higher doses with cancer patients. Melatonin seems to be protective to take prior to and during the risk period of this coronavirus.  Melatonin, nitric oxide and vitamin C  work together affecting ACE2.  "Melatonin, nitric oxide and ascorbic acid (vitamin C) (also) can reduce COVID-19 virulence by inhibiting NLRP3 inflammasomes to stop the perpetuation of cytokine storms."  Inflammasomes are a large multiprotein immune complexes that produce inflammation in the tissues.  Inflammation, as a first line of defense, is a protective part of the immune response.  But, chronic inflammation, or an elevated inflammation response like the cytokine storm in Covid-19 is damaging.  NLRP3, is a gene that triggers inflammation (inflammasomes) that are part of the cytokine storm in this virus mechanism.
I am currently taking 3-5 mg at night, and if infected you can dose during the day as well.  Recommendations for dosing is 3-30 mg. (used with cancer patients) of melatonin.  CAUTION:  "If you are taking an ACE inhibitor medication, have cardiac conditions, or hypertension consult your physician before adding melatonin to your program." See the references on melatonin for more complete discussion.
 
DOUBLE CHECK YOUR INTAKE
 
Calcium – Recommended with Limitations
Nutrients work in concert with each other, and certain nutrients need to be balanced with another for proper functioning, virus or not.  One example of this type of relationship is between calcium and phosphorus.  MasterJohn recommends making sure you are not taking excess calcium right now as too high a Ca:PH ratio may increase ACE2 as well.
Although I’m still looking for research on the calcium effect, I recommend you continue taking it for a medical reason like osteoporosis, or bone health.  What you need to do though, is to look at your supplement and be sure it has a balance of calcium and phosphorus.  I use pharmaceutical grade bone building supplements and will continue taking daily, and these supplements have the proper calcium:phosphorus ratio, whereas many over the counter calcium supplements do not.
 
A SPECIAL CASE
 
Elderberry
Elderberry may play a role in two different ways with this virus.  First, it seems to be able to stop the virus from attaching to the ACE2 receptor site, potentially preventing infection in the first place. Additionally, viruses have a sort of lipid coating on them.  Washing your hands is so effective because the soap breaks up this lipid coating.  Elderberry breaks down the lipid later in some bird coronavirus strains, so it potentially be protective in that way as well.  Given all of this, it seems like taking elderberry for prevention might be a potential strategy.
 
Once symptoms start though, and when infected, it may contribute to the cytokine storm because it produces additional cytokines. (see my blogpost To Elderberry or Not with Covid-19? My Take for a more complete look). I recommend taking Elderberry as a preventive, but if you get symptoms of Covid-19, stop taking it and focus on other anti-inflammatories like curcumin and fish oil and some of the other nutrients I discuss here like niacin.
 
NOT RECOMMENDED
 
Selenium – Not Recommended
Under normal circumstances, Selenium is very protective and supportive for the immune system.  It works in concert with other nutrients in our anti-oxidant arsenal. It is a strong scavenger of free radicals, and believed to be effective against viruses such as Ebola, HIV and influenza A virus.  But selenium upregulates the ACE2 receptor site (by decreasing activity of the ACE enzyme, ACE inhibitor) where the CV-19 virus binds to get into the cells, so, although I have been seeing people recommending this for protection against this virus for now, I would not be supplementing with it.
 
NSAIDS – Not Recommended
The cytokine storm with Covid-19 is the most dangerous part of this virus. Once infected, the virus hijacks the immune response and it can trigger in intense inflammatory immune response called a cytokine storm that results in scarring and tissue damage in the lungs and potentially in the heart.  NSAIDs, which trigger a part of the immune system that increases many of these cytokines, seems to contribute to this cytokine storm and should be avoided. 
 
Instead, I recommend taking a good curcumin supplement as an anti-inflammatory and avoiding NSAIDs which may increase the inflammatory response of Covid-19.  I take a curcumin supplement twice a day as part of my foundational program.  Curcumin can be hard to absorb, so one that has a bioprene and a lipid base is helpful.  Many of these come with pepper, which I am allergic to, so I use one without.  There are also good delivery systems for some non-oil products, and one that has several supportive nutrients in it that I take daily is Metagenics Inflavonoid  IC (discussed below in the recommendation list).  This has highly bioavailable curcumin and xanthohumol with boswellian spices AND ginger.  Fish oil is foundational for immune support and is highly anti-inflammatory.  Recommended amounts really depends on the fish oil you are taking (see my recommended blends in the supplement recommendation list), but in general, at least 3000 mg as a foundational dose.
 
Iron - A RED FLAG
I haven't researched this fully yet, but saw a journal article noting a finding of high ferritin levels in those that don't survive Covid-19 infection.  Elevated ferritin can indicate an inflammatory process, which of course we have with this virus.  Iron is a nutrient I never recommend people take unless they are deficient and have been tested, because it can oxidize and become very inflammatory and dangerous, particularly within the cardiovascular conditions.  Although I am not sure yet of a relationship between this virus regarding elevated ferritin and iron intake, it might be prudent to not supplement with iron unless prescribed by your physician right now.  I'll be looking for more information and will update here as I find it.
 
A SPECIAL NOTE ON HYDRATION!!
 
More on the specifics of this in the upcoming lifestyle blogpost but be sure to stay hydrated!  Most of us are chronically dehydrated and dehydration lowers immune function!  Drink half your body weight in water daily!
 
IMMUNE SUPPORT SUGGESTIONS WITH THE NEW VIRUS
 
Click below for a printable handout on my supplement recommendations, what I use, and how to order. All of the supplements I recommend are pharmaceutical grade and meet the highest regulatory requirements for purity, dissolution, and absorption. All products are GMP certified. 
 
 
Remember, these are general guidelines.  For specific help with your health concerns, you can contact me directly at nancy@youroptimalhealthsolutions.com to setup an appointment.
 
 
Stay healthy and watch for more posts on my FB page
 
Nancy Lark, MMS, MESS, RDN, FAARFM, ACCBHC, CGP
 
 
REFERENCES
 
 
 
Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? – The Lancet Respiratory Medicine https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext?fbclid=IwAR0_oLtc0-5KXduN0-5w6MMsrUyHfo7xDWThnXJEtcPO5S1xPwnzHi8Pw7U#bib4
 
 
 
P Yang, H Gu, Z Zhao, W Wang, B Cao, C Lai… - Scientific reports, 2014 - nature.com
 
 
 
 
YC Li, G Qiao, M Uskokovic, W Xiang, W Zheng… - The Journal of steroid …, 2004 – Elsevier
 
LB Andersen, L Przybyl, N Haase… - Journal of the …, 2015 - Am Heart Assoc
 
Holick, M.F. Vitamin D Deficiency. New Engl. J. Med. 2007. 357:266-81.
 
Holick, Michael. Boston University School of Medicine. RE: Coronavirus and vitamin D in Asia statement. Mr.5, 2020.
 
Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011;31(1):48–54. doi:10.1016/j.nutres.2010.12.001
 
Xu.H. et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa.  Int. J. Oral Sci. 12. 8 (2020)
 
Eby. G.A., 3rd. Zinc Lozenges as cure for the common cold—a review and hypothesis.  Med Hypotheses 74, 482-492 (2010).
 
Novick, S.G., Godfrey, J.C. Godfrey, N.. & Wilder, H.R.  How does zinc modify the common cold?  Clinical observations and implications regarding mechanisms of action.  Med. Hypotheses 46, 295-302 (1996).
 
Dong Chen, et.al.  Hypokalemia and Clinical Implications in Patients with Coronavirus Disease 2019 (COVID-19).
 
 
 
Ungerstedt, J.S., et. al.  Nicotinamide is a potent inhibitor of proinflammatory cytokines. Clin Exp Immunol 2003; 131:48-52.
 
Chris MasterJohn, What I’m Doing for Coronavirus
 
 
 
Favero G et al. Melatonin as an anti-inflammatory agent modulating inflammasome activation. Int J Endocrinol. 2017;2017:1835195.
 
Nitric oxide suppresses NLRP3 inflammasome activation and protects against LPS-induced septic shock   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3567828/
 
Vitamin C inhibits the activation of the NLRP3 inflammasome by scavenging mitochondrial ROS   https://www.researchgate.net/publication/305624280_Vitamin_C_inhibits_the_activation_of
_the_NLRP3_inflammasome_by_scavenging_mitochondrial_RO
 
Covid-19: Consider Cytokine Storm and Immunosuppression, March 20, 2020.

 

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Hippocrates once said, “All health comes from the gut” and we understand more today than ever just how true that statement is. There are many things that can disrupt the balance of bacteria in the gut. One of the most common and powerful disruptors of a healthy microbiome - antibiotics. What many people don't know is that the disruption of the gut microbiome by antibiotics can trigger mood disruption. In a 2015 study looking at multiple types of antibiotics, it was found that even one dose of any of the antibiotic groups was associated with a higher risk of depression, while recurrent antibiotic use increased the participants risk factors even more.

Manage Your Holiday Stress

Most people don't realize that the stress response triggers a cascade of physiological actions in the body that can shut down stomach function and create digestive upset! There are ways to counter the effects of Holiday Stress this season - read on!

Optimizing Body Composition and Weight Loss by Optimizing Gut Health!

In my practice I work with patients to optimize gut health as a means of optimizing their health. Patients come to me with a plethora of symptoms such as brain fog, digestive issues, skin rashes such as eczema, low energy, muscle pain and fatigue, weight gain, cardiovascular issues like increased cholesterol and atherosclerosis, food allergies and sensitivities, immune system issues and autoimmune disease and more. Most everything begins in the gut whether they realize it or not. Gut imbalance creates inflammation and inflammation sets up increase in fat storage; the excess fat then creates more inflammation and a cascade of health issues over time!

The Gut Microbiome and Health

The Human Microbiome Project has shown that the intestinal microbiome has communication networks with other organ systems including the gut-brain, gut-liver, gut-adipose axes, and it plays a critical role in our health, brain function, body weight and fat maintenance. Nature, 2012.

The Mind-Gut Connection

Did you know you have two brains? One in your head, another in your gut, and the health of your gut can result in many "non-gut" symptoms!

Breast Milk, “Good Bacteria” and Immune Health

Why is mother's milk so healthy for the baby? Not only does the composition of the milk change from week to week to best suit the needs of the baby, we have known that breastfed babies have better immune function and protection in later life than bottle fed babies.

Looking to Get Healthy? Focus on the Gut!

New Years Resolutions nearly always include a goal of weight loss. And this year will be no different in that sense. What is different in the last few years is that we now know that weight loss is not just calories in = calories out anymore!