Content Library Articles A Functional Medicine Approach to COVID-19

A Functional Medicine Approach to COVID-19

April 1, 2020

As a Functional Medicine doctor on the front lines of our chronic disease epidemic, it has become clear to me that we can have an important impact on the trajectory of COVID-19 in our population. And it is within our reach. In fact, it may be as close as our fork.

The coronavirus pandemic is forcing us to reevaluate so much of our lives, to focus on those we love, and what is most important. As an act of self-preservation and as an act of service to all our friends, neighbors, co-workers, and fellow Americans it is imperative that we now, more than ever, focus on our personal health and well-being.

Here’s why. These are sobering facts that I wish were not true. The faster and smarter we act individually and collectively, the more we can lessen the suffering. This is a novel virus which means that no one has immunity. Experts estimate it will infect 40% to 70% of our population—that’s over 150 million Americans. Currently, 80% have mild or no symptoms, 20% need hospitalization, and 5% will need intensive care. The mortality rates vary depending on the population but range from 0.6% to up to 15% in elderly patients with chronic disease.

Here’s the bad news. Only 12% of Americans are metabolically healthy. 75% of us are overweight, 42% are obese, and one in two Americans have pre-diabetes or type 2 diabetes.

Those with underlying chronic diseases (diabetes, heart disease, cancer, etc.)—affecting 6 in 10 Americans—are at the greatest risk with mortality rates of five to ten times that of healthy COVID-19 patients. Obesity increases the risk of death almost 3 fold. We are seeing up to 40% of the hospitalizations in 20 to 54-year olds, and most of those are obese and overweight.

While this is a terrible finding, it is something we can quickly begin to change. Each of us must now focus on strengthening our immunity to better fight the risk of COVID-19. Then if we do get sick, the illness is mild and we can unburden the health care system which is already buckling from the onslaught of the virus.

I have seen hundreds of patients dramatically transform their lives quickly, recovering from chronic disease in a matter of weeks using the principles of Functional Medicine and food is medicine. Like Janice, who at 65 was severely obese, a type 2 diabetic on insulin, and suffered from heart failure, early kidney failure, high blood pressure, and more. Changing her diet allowed to her to get off her insulin in 3 days and reverse all her conditions in 3 months and lose 43 pounds. This is not a miracle. It is science and it available to everyone now.

Now more than ever, is the time to double down on self-care—not just for ourselves, but as our civic responsibility to contribute to the solution.

There are five things that will help us minimize suffering, loss, and death, by slowing and stopping the pandemic:

1. Each of us optimizing our own health, especially metabolic health.
2. Social distancing. This is a sad and massively disruptive reality that will likely continue in some form for 12-18 months.
3. Herd immunity, a medical term that means when the majority of a population gets infected and develops immunity, the virus can’t spread as easily.
4. The development of a vaccine that optimistically will be in 18 months.
5. The development of treatments, both conventional and unconventional (see below).

I wish I never had to write this, that none of us had to face this in our lives. But I do and we do. These suggestions will hopefully guide you in navigating how to take care of yourselves and your families in the midst of this pandemic. For some of these guidelines, there is strong evidence of benefit, others are common sense and yet others are more experimental and time will reveal their utility.

In every infection, there are two factors at play. The microbe and the host. We can’t control the microbe but we have extraordinary control over us, the host. Functional Medicine is the science of creating health, of creating resilience, and making your system an inhospitable place for disease.

Here’s what we will cover:

1. How Can I Protect Myself, My Family, and My Community
2. How to Eat to Boost Immune Function
3. Immune Boosting Lifestyle Interventions
4. What Supplements Should I Take
5. What is the Status of Treatments and Vaccines?
6. How to Do a Sugar Detox
7. Options for Telemedicine and Functional Medicine Care

How Can I Protect Myself, My Family, and My Community

There are many potential approaches from proven to experimental to ensure you, your family, and community remain safe. It falls into two categories. The first is how to not get it in the first place and reduce the spread. The second is how to support your immune system so you are more resilient to infection. This pandemic can bring out the best in us or the worst. It is a time for kindness, for calling friends, for Facetime with family, or hunkering down with loved ones and family in your home, cooking meals from scratch, and for finding ways to help those who are in need.

How to Avoid Infection with COVID-19

• Social Distancing. This is among the most effective ways to prevent spread. Don’t shake hands. Keep a 6-foot radius from others (unless they are healthy uninfected people who live in your home). Cancel vacations and business trips. Restaurants, bars, schools, yoga classes, fitness clubs and more are shutting down. Work from home if you can.
• Practice Good Hygiene. Wash your hands for 20 to 30 seconds with soap and water. Hand sanitizer is ok but not necessary. If you are out and about do your best to wash hands frequently and avoid touching your face (hard to do).
• Stay Home. Since restaurants, bars, sporting events and gatherings of more than 10 are not recommended, stay home, work on projects you have neglected. Write letters, play games, and prepare home-cooked food. If the whole country stayed home for 14 to 21 days we could significantly slow the pandemic.
• Protect those at Risk. The CDC recommends that people over 60 stay home and avoid unnecessary contact. If you have elderly parents find ways to support them with food and supplies. If you have an autoimmune disorder, cancer, or are on transplant medication be especially careful.

How to Eat to Boost Immune Function

Now, more than ever, we have time to reclaim our kitchens. Or if you have never cooked, now is the time to start. It is a wonderful, grounding, healing activity to do together with your family. And at the end, you get to enjoy delicious healing food!

• Eat a real, whole foods, unprocessed diet. I have written about this before extensively in my book Food: What the Heck Should I Eat? and the companion cookbook, Food: What the Heck Should I Cook? I jokingly call it the Pegan Diet and you can read the principles here.
• Stop consumption of all industrial ultra-processed foods. They suppress immunity with their abundant sugary, starchy, salty calories.
• Cut the sugar and starch (think of them as the same thing). Data is clear, sugar suppresses immunity and worsens viral infections. If you struggle, try the program I have used with my patients for years—the 10 Day Reset.
• Limit or stop alcohol. This may also suppress immune and depletes key nutrients.

Eat Your Medicine: Food as Medicine

Focus on flavonoids with anti-viral properties:

1. Kaempferol (spinach, cabbage, dill)
2. Quercetin (dill, onion, oregano, chili pepper, apples, leafy green vegetables, broccoli)
3. Hesperidin (oranges, grapefruit, lemon, tangerines)
4. Oleuropein (olives and extra virgin olive oil)
5. Catechins and epicatechin gallate (green tea)
6. Lauric acid (unrefined virgin coconut oil and breast milk!)

Heap Up on Anti-Viral and Immune Boosting Herbs and Spices:

1. Ginger
2. Garlic
3. Turmeric
4. Rosemary
5. Chili pepper
6. Oregano

Protein for Immunity:

1. While most Americans eat adequate amounts of protein, some do not such as the elderly and vegan populations. Protein is critical for immune function and protein malnutrition is a big risk factor for death from infections. Eat approximately 1 gram/kg or about half your body weight in grams of protein a day, or about two four-ounce servings of organic, clean animal protein. Plant-based proteins (legumes, nuts/seeds) are adequate if consumed in enough quantity. Try tofu and tempeh from non-GMO soy for the highest protein concentrations.
2. Amino acids are the building blocks for your immune defense systems.
3. The most important are taurine, carnosine, anserine, and creatine from beef and lamb. Adequate amounts are not found in plant proteins.

Supercharge Your Microbiome:

1. Healing your microbiome (your gut bacteria) is critical for regulating inflammation and most of us have an inflammatory microbiome connected to obesity and nearly all chronic diseases.
2. 60% of our immune system is in our gut which is why it is critical to focus on gut health now.
3. Eat prebiotic foods. Dandelion greens, Jerusalem artichokes, garlic, onions, leeks, asparagus, artichokes, bananas, apples, konjac root (try shirataki noodles), cocoa, burdock root, flax seeds, jicama root, and seaweed.
4. Eat probiotic foods. Grass-fed sheep, cow, or coconut yogurt, kefir, sauerkraut, tempeh, miso, natto, kimchi, pickles.

Chicken Soup:

1. Yes, it has proven immune-boosting properties. Try my Jewish mother’s chicken soup recipe:
2. Put 1 whole organic chicken in a big pot, just cover with water, throw in big chunks of onion, carrots, celery, small red potatoes, parsnips, 5-6 whole garlic cloves, and 2-inch chunk of ginger sliced. Add 2 teaspoons salt and lots of black pepper and for fun add a few star anise and a few pieces of clove. Cover and simmer for 1-2 hours and eat!

Immune Boosting Lifestyle Interventions

• Get sufficient sleep! We all know sleep restores and heals the body. Without adequate sleep, optimal immune function is next to impossible! Get in a better rhythm and head to bed earlier. Aim for seven to eight hours a night. Incorporating various relaxation and breathing techniques throughout the day to help with stress and allow the mind to rest is also very helpful!
• Get regular exercise. Mild to moderate exercise (for approximately 30-45 minutes) helps boost the immune system. Avoid overexertion such as training for endurance events when you are feeling run down. This will lower your immune defenses. If you are able to exercise outside in less populated areas, great. If not find workouts and yoga classes online. Try the 7-Minute Workout app.
• Practice meditation and yoga. The data are clear. Increased levels of stress increase susceptibility to viral infections. In one study, volunteers had cold viruses injected into their nasal passages. Only ones who scored high on the stress questionnaire succumbed. Now is the time to learn meditation, double down on your practice, do yoga, take hot baths, do deep breathing, practice home massage with your loved ones.
• Start a garden. If you live in an area with a lawn or some access to land, grow some of your own food. During WWII, victory gardens produced 40 percent of the food in America.
• Stay connected. Being in close touch with those you love is essential for your mental and emotional health. Thank God for FaceTime and Zoom— have virtual dinner parties.
• Get outside. Talk walks, get fresh air, but be safe.

What Supplements Should I Take

There is a lot of information and misinformation out there now about what supplements can help or hurt your chances of fighting off and recovering from COVID-19. There is a lot of good science on the importance of a variety of nutrients in immune function but we are all flying blind and guessing when it comes to COVID-19, with a few expectations. After decades of collective experience our team at The UltraWellness Center developed the following guidelines. These are generally safe but you should always consult with your health care provider before starting anything new.

The Basics

Those most helpful for supporting your immune function are the following:

• A multivitamin and mineral.
  • Other options: PhytoMulti, VitaPrime, MultiThera
• Vitamin C: 1000-2000 mg a day
  • Other options: Vitamin C with R-LA
• Vitamin D3: 1000-4000 IU a day
  • Other options: Liquid D3
• Zinc: 20 mg a day
• Quercetin Ascorbate: ¼ teaspoon twice a day
  • Other options: Quercetin and Nettles
• Melatonin: 1-2 mg at night, sustained release
• Probiotics

Enhanced Immune Support

1. NAC: (n-acetylcysteine) 600 mg twice a day
2. Alpha-Lipoic acid :100 mg twice a day

Herbal Therapies

1. Curcumin
2. Andrographis (this is on backorder, will update when available)
3. Elderberry (this is on backorder, will update when available)
4. Astragalus (this is on backorder, will update when available)
5. Mushroom Extracts such as reishi, maitake, shiitake, turkey tail, and cordyceps. These provide immune-supporting properties. Cooking with medicinal mushrooms like shiitake is also helpful. (this is on backorder, will update when available)

Gut Support

1. Immunoglobulins (like colostrum or transfer factor)

What is the Status of Treatments and Vaccines?

There are currently no approved treatments other than supportive care with fluids, symptomatic care, and ventilators if needed. However, many are hard at work looking at various treatment options. Here are the most promising:

• Plaquenil (hydroxychloroquine) or chloroquine (a malaria drug) are medications used for autoimmune disease. It is widely available as a generic medication, low in cost but has potentially lethal side effects such as heart arrhythmias. The recommended dose is 200 mg twice a day for 10 days. This has been combined with the antibiotic Zithromax but has not been proven by clinical trials yet. This should NOT be used unless prescribed by a doctor.
• Remdesivir, an antiviral drug developed for Ebola, given only intravenously. Studies underway and medications promise faster approval than vaccines.
• Convalescent plasma therapy, which means taking the blood of a recovered patient and extracting the antibodies from their blood and giving it to those who are sick.
• Cytokine blocking drugs (tocilizumab, sarilumab, etc.) which can reduce the inflammatory storm that leads to death. Cytokines are inflammatory messenger molecules that can spin out of control with COVID-19.
• Interferon B. In Cuba, they have developed a drug that can calm down an out of control inflammatory response. More data is needed but seems promising.
• Vaccines will likely take 12 to 18 months to progress with human trials for safety and efficacy. And the virus is already mutating which makes this even harder.
• Theoretically beneficial medically supportive therapies. Some therapies are being suggested based on their mechanism of action such as theophylline (bronchodilator), ARB medication (blood pressure medication), amantadine (anti-viral), and sodium bicarbonate (Alka Seltzer Gold to increase the pH making it harder for a virus to thrive).

Out of the Box Treatments

• High dose intravenous vitamin C. In Wuhan, doctors have been using high dose intravenous vitamin C for those who are sick and 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. This, unfortunately, is not widely available in the US but trials are underway for use in the ICU for people with overwhelming infections. Many hospitals in the US are now using intravenous vitamin C in the ICU.
• Ozone therapy. This may be unknown to many but is used extensively in other countries for infections. It is the most potent disinfectant and can be given intravenously, rectally, or nasally. It also helps to improve immune function and antioxidant systems in the body. More research is needed but it may be an effective option for treatment. Italy has approved intravenous ozone therapies for COVID-19.

How to Do a Sugar Detox

The best thing we can do for our individual bodies, and our collective body is to fix our metabolic health as fast as possible. The best way to do that is a quick reset that is designed to help you get off sugar and starch painlessly, cut cravings, and fix your metabolism quickly. If you are on blood sugar lowering medicine, insulin, or blood pressure medication be sure to consult your doctor because your blood sugar and blood pressure may drop quickly when you change your diet and you will need to adjust your medication. My team and I have created The 10 Day Reset to make it simple, seamless, and delicious. If you are overweight or have any chronic health conditions this is a perfect time to get your health back on track for your own protection and to make it less likely you will end up in the hospital with COVID-19 if you do get it (which is likely for most of us).

Options for Telemedicine and Functional Medicine Care

Many of us have put off taking care of our health, but now is the time more than ever to focus on getting healthy. At The UltraWellness Center our team of health care providers and nutritionists have over 60 years of collective experience in helping patients reclaim their health with Functional Medicine. We are now fully equipped to take new patients using telemedicine. Simply register at our Get Started page. Please be patient, we are getting many requests but we will be back to you. We will also be doing group visits to help accommodate the demand which are very effective for many patients.

Please stay tuned. This article will be updated as we have new information.

Please stay safe and as my wife Mia now says: TO SURTHRIVAL!