Corona virus, COVID-19, Education and Newsletters, Patty Shipley, RN, Naturopath

Bolstering Immunity-What You Should Know About Supplements

What’s Novel about COVID-19?

As an emerging infection, it’s important to note that there are no controlled studies on specific therapies for COVID-19.  However, as information emerges about how this virus works, we feel responsible to share that information.  We’re NOT experts in treating this virus, but have had many years of experience working with patients to treat infections, including viruses, so we’re drawing on that here, as well as sharing what we’re learning.  We’ve decided to turn this post into a “living post” that is updated as new information emerges.

ACE2 receptors

This virus uses ACE2 receptors on cells to gain entry. Different substances interact with and increase the number of receptors or bind and potentially block them, including Vitamins A and D, Zinc, ibuprofen and anti-hypertensive drugs.  Also, certain conditions can increase the number of these receptors on the cell surface: cardiovascular disease, diabetes and hypertension, conditions increasingly seen with aging and associated with worse outcomes.  Let’s drill down a bit…
While optimal levels of vitamins A and D are critical for a healthy immune response, there has been concern that high-doses of these vitamins during active COVID-19 infection may increase the number of ACE receptors on cell surfaces, allowing for more access points into the cells where these receptors are present (they’re especially abundant in the epithelia of the lung, small intestine, kidneys and blood vessels).
However, there is now emerging evidence that Vitamin D could be increasing only soluble ACE2, which would not increase viral access to cells, but instead act as a decoy, as described in this article from the journal Clinical Science.  In this video interview with Dr. Heather Zwickey, professor of immunology at The National University of Natural Medicine, she discusses ACE2 receptors, medications that increase their expression, and vitamin D’s role in ACE2 binding, which starts at 15:25.  So far, I’ve been unable to find any reference to vitamin A with regard to soluble ACE2, so our advice on that stands for now.

Vitamin A

Vitamin A is important for the health of the respiratory tract and mucus membranes, both of which play a central role in overall immune response However, in practice, I only see vitamin A deficiency in maaaaybe 5% of the nutrient tests I review, so aside from what’s in your multivitamin, this is a good one to leave out if you’re not sure you need to supplement extra, at last until we know more.

Vitamin D

If you’ve been living north of Georgia for the past 6 months, and you’re not taking vitamin D, you’re likely deficient, and should consider taking enough supplemental vitamin D to achieve a sufficient serum level to support overall immunity (50-80 ng/mL, which usually requires 3000-5000 IU daily).  If just starting vitamin D, it may make sense to double the suggested dosing range for 3-4 weeks to achieve sufficiency more quickly.

ACE-inhibiting drugs used for hypertension

There’s an urgent need for clinical trials to determine whether ACE-inhibitors (including drugs with the suffix “-pril”, angiotensin receptor blockers and thiazolidinediones) help or harm patients with active COVID-19. Here’s an interview with Dr. Josef Penninger, a molecular immunologist at Life Science Institute at the University of British Columbia that discusses some of the nuances of ACE2 receptors, as well as the newly emerging belief that there are now two strains, an S-type, which is more mild, and a more recent mutation, an L-type, associated with more pronounced symptoms.

Zinc

It appears zinc can benefit in two ways: by lowering the virus’s ability to enter cells through ACE2 receptors and also inhibiting replication once it’s gained access.  We recommend 30-50 mg/day, doubling the dose at the first classical signs of illness (shortness of breath, cough, loss of taste and smell).

Ibuprofen

Some observational studies have demonstrated an increase in ACE2 receptors with ibuprofen use, however, it’s still too soon to say for sure if it is significant enough to affect outcomes.  We’ve seen many advising acetaminophen as a safer alternative to addressing fever, but here’s our take on that:

Acetaminophen

Acetaminophen depletes a crucial antioxidant: glutathione.  In fact, we feel acetaminophen should be severely limited for any condition because it has a poor safety profile in general.

 

What CAN you do for a fever?

A fever is your body’s way of fighting infection, and lowering it allows the cause of the illness to live for a longer period of time, so we usually don’t advise patients to attempt to lower it.  Most healthcare professionals would say to only treat a fever if it rises above 103 degrees, but temperatures up to 107 degrees are not associated with any lasting damage to the body, according to Medline Plus, a service of the Natural Institutes of Health and U.S. Library of Natural Medicine.  If you feel you must address a fever, try drinking cool water and putting cold packs under your arms, or sitting in a lukewarm bath.

 

Cytokine storm

When this particular virus gets going in your body, it can create what is called a cytokine storm, which is when your immune system reacts vigorously and releases an enormous amount of chemicals (cytokines) and free radicals to destroy the virus. This is generally a good thing, however, what is concerning is that in some people, COVID19 triggers an extreme cytokine storm, causing (among other things) acute respiratory distress (ARDS) and lung injury.

 

Though there are not yet human clinical studies to prove this, there are concerns that some immune-boosting supplements, based on their specific mechanisms, could make this inflammatory, oxidative process much worse in some people.

 

Hence, until we know more, our recommendation is to stop these supplements if you develop some of the more concerning classical symptoms (cough, shortness of breath, loss of sense of taste/smell).
  • Echinacea
  • Larch Arabinogalactan
  • High-dose vitamin A
**We’ve removed elderberry from the avoid list below after doing some additional research, some of which we’re sharing here:
  • Dr. Mark Iwanicki, ND, explains in this 5 minute video that, although elderberry has been found to raise IL-6, it has numerous other balancing effects on inflammation.
  • Dr. Elisa Song further elaborates and makes a few really great points: cytokine storms are RARE and anyone experiencing one will most likely be hospitalized and too ill for any type of herbal therapy.
  • Elderberry has possibly the most research behind it for use with RNA viruses, though to be clear, none on this particular virus.  Dr. James DiNicolantonio covers the depth of research available on elderberry in this 2 minute video.

 

Considered safe and beneficial during active COVID-19 infection:

  • Zinc
  • Probiotics
  • Vitamin C
  • Astragalus
  • Andrographis
  • NAC
  • Silver
  • Melatonin
  • Elderberry
  • Vitamin D

*I am aware that many other remedies are worth considering here, but there is no way to make this into an exhaustive list, so we’re including a focused list that prioritizes the remedies we feel are most important.   For The Institute for Functional Medicine’s recommendations that include quercetin, curcumin, PEA, green tea, resveratrol and others covered in this post, click here.

 

Zinc

Dosing: 30-50 mg/day, doubling dose if you get sick.  This article discusses zinc’s ability to inhibit the virus from gaining access into the cell, as well as its ability to inhibit viral replication once inside the cell.

Probiotics

Our favorites here for coronavirus prevention (Ultra Flora Immune Booster and Ultra Flora Balance) include specific strains that benefit the respiratory system, the system that is of utmost concern in severe cases.   Take 1-2 per day, preferably away from food.

Vitamin C

Because there is some controversy over whether oral high doses (above 3000 mg/day) may potentially cause harm, we recommend keeping your daily dose to 3000 mg, in divided dose, or less if you develop diarrhea or loose stools.  Liposomal vitamin C can be dosed twice daily for round-the-clock vitamin C protection.  Vitamin C helps stimulate production and function of white blood cells, and helps your body produce important proteins that bind invading microbes (antibodies) to neutralize them.

 

Update: In Wuhan, doctors have been using high dose intravenous vitamin C for those who are sick as well as for those in the hospital. Nearly all patients with symptoms received 50-100 mg/kg/day for mild symptoms and 100-200 mg/kg/day for severe forms.  Many hospitals in the US are now using intravenous vitamin C in the ICU.

 

Astragalus

Research indicates that astragalus stimulates white blood cells to engulf and destroy invading organisms and cellular debris as well as enhance the production of interferon (a key natural compound produced by the body to fight viruses).  Follow label directions for prevention and increase the frequency of dosing if symptoms appear.

Andrographis Plus by Metagenics

Over the years, we’ve trialed other brands of andrographis without the same success, so this is the only andrographis we typically stock (lately, because of shortages from our suppliers, we’re trialing a powder form that was recommended by an acupuncturist who has seen good results).  Though you can take this as a preventive, I find that it truly shines at the first sign of infection, and since it has been difficult to keep in stock, we recommend reserving it for fighting infection, not prevention. Most of the time, patients report that if they’re able to start taking this immediately at the first sign of infection, after 3-5 hourly doses, symptoms are completely resolved.

NAC

Used in hospitals to treat acetaminophen poisoning, NAC is also used as a mucus thinner that targets the lungs, improving respiration.  Dosing is typically 600-3000 mg, and in hospitals, if available, it can be administered as an IV or taken orally, as an aerosol spray.

Silver

Silver is an earth element that has broad-spectrum effects when targeting infections.  Most brands taste like water, so it’s an easy thing to add, especially with kids. We’re now using 2 brands of silver with good success: Smart Silver from DesBio and Silvercillen from Designs for Health.  We recommend 1 tsp twice daily as prevention (though we typically don’t use silver as a long-term remedy), increasing to 1 tbsp twice daily with signs of infection (or more – neither of these brands will cause blue skin – this is a condition associated with colloidal forms of silver taken excessively over prolonged periods of time).  We’ve recently heard from one of our providers that her husband, who had developed a severe upper respiratory illness (no testing done), responded well to nebulized silver. It does make sense to deliver treatment directly to the area most affected, so we are now stocking home-use nebulizers for those in need.

Melatonin

Many researchers now believe one of the reasons younger people are not as affected by this virus is their melatonin status.  Melatonin is a hormone that declines with age, which could explain some of why the risk of death with COVID-19 increases with age.  Melatonin has been used for years as a natural therapy for cancer (usually 10-30mg is used if tolerated) because of its anti-inflammatory and anti-oxidative properties, not to mention that it can help with sleep, the loss of which impacts the immune system.  We recommend using a dose that helps improve sleep, but doesn’t cause drowsiness the following morning, and we offer a variety of doses to allow for this individualization.

Wrapping it up

With so many options, many patients have asked me what I do for myself as prevention and how would I address symptoms if they were to appear.  Andrographis Plus is the herbal formula that helps me the most and the quickest when I’m fighting infection. At the first sign (typically a sore throat for me), I begin taking 1 andrographis hourly, and if available, I pair it with 1 tab of Essential Defense from Metagenics (recently on a long backorder but starting to trickle in) and Herbal Throat Spray from Medi-Herb (as often as I think about it when sore throat is present–it’s antiseptic and has a lovely numbing effect from the clove oil it contains) since most viruses start in the throat (silver throat spray and other natural antiseptic throat sprays are available).  I find vitamin C drinks soothing (I now prefer LiquiMins Power Pak over EmergenC because it’s buffered with minerals, tastes great and only contains 1g of sugar).  For prevention, I’m currently taking melatonin 5-10mg, zinc, vitamin C and a probiotic.

Addendum: treating active infection

Many stories are emerging on natural interventions that may help shorten the duration and severity of COVID19.  We’re including links here, though as stated previously, we are NOT experts in treating this infection.  We simply want to ensure that you are able to access important information if you or a loved one becomes ill.

The EVMS Medical Group is providing guidance for healthcare providers treating COVID-19 patients. This approach to COVID-19 is based on the best (and most recent) available literature and the Shanghai Management Guideline for COVID. Their continually updated article can be found here.

Jill Carnahan, a well known functional medicine doctor, pulls together information from many sources that illuminate what we are learning about how this virus behaves in the body.  She is also continually updating her blog that can be found here.

Lastly, for now, here is a link to the clinical trials currently underway to determine effective treatments, including MANY natural interventions! It’s exciting to see.

I hope you find this article helpful.  Please feel free to reach out in the comments below with questions or comments.  And above all, stay home and stay well!
Caitlin Pfeil, FMCHC, CPT, NCAA Personal Trainer, Leaves of Life Practitioners, Uncategorized

Meet Caitlin Pfeil, FMCHC, CPT, NCCA Personal Trainer

Hi! My name is Caitlin and I’m so excited to be part of the incredible team here at Leaves of Life. The kind of world I want to live in celebrates holistic health with a focus on balance, where body positivity is the norm, diet culture is not, and where “bad” foods don’t exist. It’s possible with small but powerful steps, accountability, support, and making it fun!

I’m a Functional Medicine Certified Health Coach certified through the Functional Medicine Coaching Academy with the Institute of Functional Medicine. I’m also an NCCA Certified Personal Trainer, with a specialization in fitness nutrition. On the Leaves of Life team, I’m a one-on-one Health Coach in partnership with practitioners. Working collaboratively with doctors, nurses, and lifestyle educators offers a clear treatment plan. I also provide laser allergy treatment for patients who need help with environmental and food allergies and other imbalances.

Over eleven years ago, I knew I had to make a change. At my heaviest, I was fifty pounds overweight, tired and moody, with skin issues, environmental allergies, food sensitivities, and frequent headaches. I joined a gym, became certified as a Personal Trainer and my passion for the gym led me to fitness competitions. Most recently I competed in the Arnold Classic. Competing has taught me extreme drive, intrinsic motivation, patience, and discipline, but definitely not balance. Now, I’m an advocate for balancing physical, mental and emotional health, which I’ve seen spill over into and improve all different areas of my own life and in the lives of my family, friends, and clients.

I’ve been working as a part of the holistic health world for about a decade now! I have owned and operated a successful nutrition club and storefront, led many large group fitness classes, taught dozens of nutrition workshops and seminars, managed thousands of supplements as a buyer for a health food store, and I’ve appeared on 10TV Columbus multiple times leading health, fitness and cooking segments. I spend hours every week self-studying to stay up to date in the ever-expanding world of natural health, and I enjoy continuing education conferences and seminars. I look forward to meeting you and working with you to help you achieve your goals and live your best, balanced life!

Corona virus, COVID-19, Dr. Emily Roedersheimer, Education and Newsletters, Karen Bush, NBC-HWC

Bolstering Immunity by Managing Stress

Stress… We use this word so often that we don’t even take it seriously anymore.

Stress occurs when life’s events surpass our ability to handle them. It comes in many forms: rush hour traffic, unexpected bills, your boss yelling at you, your kids fighting, or worst yet, there’s no toilet paper to be found in central Ohio! Add the corona virus to this list and our stress levels are boiling over. During this time in history we need our immune systems to be ready for anything and one of the best ways to help with that is to decrease stress.

Why? Because believe it or not, stress lowers immunity.

Fight or Flight

The immune system is a complex network of cells and proteins that defend the body against infection. Think of it as an army poised and ready to go to war for you if needed to prevent infections of all kinds – viruses, bacteria – and even cancer cells.  This army works best when we’re in a calm, rested state.

You’ve likely heard of the “fight or flight” response that kicks in when we’re under stress. This system is uniquely designed by our bodies to prepare us to flee or fight if we’re attacked. Now with our modern day “attacks” being more ongoing (work, bills, kids, TP, etc) we tend to stay in the fight or flight state. In preparation to fight or flee, our body shuts down the less important functions (ie, immunity) that aren’t needed in what should be a short-term stress response. Who cares about that cold virus or cancer cell if we’re about to be eaten by a tiger?! Unfortunately, with our current pace of life in America, most of us tend to stay in that fight or flight state all the time. So, we tend to get sick much more easily than our non-stressed friends (if you have any of those!)

Responding to stressors

How we handle our stress will determine the impact it will have on our immune system. Some situations cannot be changed – an ailing loved one, paying taxes – but we can change how we respond to these stressors. If we can consider stress reduction to be something we need to work on daily (like healthy eating, sleep and exercise), then we can help to change our body’s response to stress and maintain a healthy immune system. Given the right information, environment and directions, our bodies will choose healing over disease any day!

My health coach, Karen Bush, has offered some of her wisdom on how to handle stress in our lives.

From Karen Bush:

Often, we don’t even realize what symptoms of stress look like. It doesn’t have to be a significant worried or anxious feeling. It can simply be feeling unfocused with tasks, leaving things half done, going on social media too often during the day, reaching for food when you aren’t hungry or not eating enough, moodiness, procrastination and persistent fatigue. Once we see and recognize it, we can start to create change around us.

Let’s start with daily consistent practices and then move into things you can do right in the moment when you’re triggered into stress, anxiety or worry.

Consistent practices that support your health and well-being around stress should be a daily practice, not just something we reach for when we’re stressed or in a stressful situation.

Here are a few places to start:

Create a morning routine

Create a simple morning routine that starts the day out in a calm, contemplative and intentional way. Here are some examples:

    1. Drink 16 oz of water upon rising to replenish hydration after 8 hrs of loss while sleeping.
    2. Take 5 minutes to do some breathing – in for 4 seconds, hold for 4 seconds, out for 4 seconds, hold exhale for 4 seconds and repeat.
    3. Take 5 minutes to follow a guided meditation or journal. Meditations can be found on apps such as Insight Timer, Calm or Headspace.
    4. Do some sort of movement for at least 10-15 minutes to get your day started: Walking outside, doing a short yoga sequence (on YouTube with Adrienne or “Do yoga with me”), or even going up and down the stairs 3-4 times!

Set a schedule

Now that we’re all home more during this time it is more important than ever to set a schedule around what we are doing to feel more grounded. Even if you aren’t functioning at full capacity at work, set up your day with things you want to accomplish and include time for white space or down time.

    • Schedule times to do work
    • Set up times to be with kids, doing schoolwork and/or play time
    • Plan time for stress relief – breathing, exercise, meditation, prayer, alone time, time outside, mindful walks, walking outside on the grass with shoes off (grounding).
    • Really take a look at your day and take an honest assessment of what you’re spending your time focusing on. What could be contributing to stress? What you give attention to is strengthened. With that in mind, some questions to ask yourself:
      • How much time are you spending reading or watching the news?
      • How much time are you in conversation about anxiety-producing things you have no control over?
      • How often does your mind go to negative or worrying thoughts?

Make a shift

Now that you’ve taken a look at what your day looks like and what your habits may be in a day, you can make a few choices to shift to things that are healthier.

Here is a way to shift your mindset and gather some awareness around your thinking.

    • The practice of consistent breath work/meditation/prayer makes you more aware of your thinking.
    • Decide how much time you want to spend paying attention to the news and balance that out with joyful, happy activities.
    • When you catch yourself thinking in a way that produces stress, pause…take a moment to breathe.
    • Take the negative or stressful thought and shift to a thought around gratitude or appreciation.
    • Shift language:
      • Instead of anxious, breathe in CALM
      • Instead of stress, breathe in EASE
      • Instead of Bored, breathe in RESPONSIBILITY
      • Instead of Judgment, breathe in TOLERANCE
      • Instead of Anger, breathe in EASE TO COOL DOWN
      • Instead of Financial worries, breathe in ABUNDANCE/GRATITUDE
      • Instead of Lonely, breathe in CONNECTED and APPRECIATED
      • Instead of self-pity, breathe in DIGNITY

Remember that it takes time to shift behavior, so don’t expect it to happen overnight or even in 21 days! But daily practice leads to overall changes and what better time to start than now!?

To help you along these lines, Karen Bush and I are leading a free online stress support/meditation class this Wednesday, March 25, at 7 pm. Click the link to join us! We hope to see you there!

Education and Newsletters, Uncategorized

Robusting Your Immune Response: Supplement Strategy Basics

Many patients are asking what they can do to boost their immune system.  While none of us have encountered this particular Coronavirus previously, we do know the fundamentals of shoring up immunity.

Because 70-80% of immune function is found in the GI tract, any issues there should be prioritized.  This starts with a healthy diet, with a particular focus on lots of veggies, some fruits and avoidance of high glycemic and especially refined carbs.  Healing there can be assisted by probiotics, antimicrobials, colostrum, mucosal barrier support and other specifics based on individual concerns.  An advanced stool test like the one we use here at Leaves of Life is a great way to know exactly what needs addressed to help optimize the largest part of your immune system.

Also important is managing stress, since our immune system can be inactivated during times of high stress.  This is an adaptation carried over from the days when we had natural predators…it’s not important, after all, to fight a cold or flu virus if we’re about to be eaten for lunch.  Managing stress can be easier said than done when infection and death tolls are being discussed on every newscast.  It’s important to remember that this virus is much like other infectious agents…the healthier you are and the stronger your immunity, the less vulnerable you are. This can empower you to calmly take protective measures.

Sufficient sleep is essential for optimal immune function.  If you’re practicing good sleep hygeine and still have trouble sleeping, consider seeking help from a professional.  We get great results here with several different products: Perfect Sleep (DesBio), CBD, Melatonin and Alpha GABA PM.

Stay hydrated.  This includes making sure your environment has a good level of humidity since bugs spread and persist more easily in dry air.  The optimal level of hydration is 40-60% and can be tested and adjusted by purchasing a hygrometer for $10 or less. Hygrometer link here.

Aside from addressing GI concerns, eating healthy, managing stress and optimizing sleep and hydration, there are also natural products that can help enhance your immune response.  Here are some of our favorites: (We’ve included many options because some of these are or will go on backorder as companies try to meet the demand.)

Vitamin D

If you’ve not been taking vitamin D and you live north of Georgia, you’re likely deficient and should start with 10,000 IU daily for the next 3 weeks.  At that time, we would suggest testing your blood level to determine dosing going forward.  Your goal is 60-90 ng/ml.  In my opinion, Vitamin D is one of the most crucial elements of protecting immunity.  Here are a couple of studies from  British Medical Journal and Scientific American that support that advice.

Andrographis Plus AND Essential Defense by Metagenics

Technically, the Essential Defense is meant to be taken when you’re fighting a new infection, and Andrographis Plus for once you’re actually sick, however, we find that they work best when taken together at the first sign of illness, 1 of each every hour.  Often after 3-5 doses, patients are no longer sick.  We suggest continuing to dose until you are symptom-free, though you can take less often as symptoms begin to abate.

Herbal Throat Spray, Propolis Throat Spray or Silver Throat Spray

Begin use at the first symptom of sore or tickly throat.  Spray directly at the back of your throat 2-4 times every 1-2 hours or as needed for symptom relief. This can also be backed down as symptoms resolve.

Silver (we use Smart Silver from DesBio-dosing may vary based on ppm of silver)

1-3 tsp daily for prevention and increase to 1 tbsp 3 times daily if symptoms appear, lowering as symptoms resolve.  You can also add silver to a spray bottle to use as a throat spray, add it to a neti pot for sinus rinsing, or apply it topically to disinfect wounds.

Ultra Flora Immune Booster

Helps with frequency, intensity, duration and onset of upper respiratory illness. Take one per day.

Vitamin C

There are many different kinds of vitamin C to choose from, and you should know that taking too much can create diarrhea.  This will quickly resolve if you lower your dose.  Some doctors recommend dosing to bowel tolerance (just below the dose that would create diarrhea), while others recommend 1-3 grams daily.  Whatever your strategy, know that vitamin C is water-soluble (unless labeled as liposomal) and will wash out within a few hours of ingestion.  Liposomal provides a time-released, constant blood level, or you can simply divide your water-soluble vitamin C into several doses throughout the day.

Zinc

We have several products to choose from – your provider can assist you in making the best selection for you, but be aware that chronic ingestion can cause imbalances in other minerals.

Elderberry, Viracid and Immucore are several more options should any of the options above be out of stock.  

Our providers are available if you have questions or concerns surrounding symptoms or prevention.  Let’s get through this together!

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