Post-COVID Syndrome: A Functional Medicine Approach with Dr. Elizabeth Boham - Transcript

Dr. Elizabeth Boham (00:00): We need to help people build an immune system that can do active surveillance and find viruses and get rid of them, but also not overreact and cause all this unwanted inflammation that is really underlying a lot of the significant illness and death from COVID-19. Dr. Mark Hyman (00:24): Welcome to The Doctor's Farmacy. I'm Dr. Dr. Mark Hyman, that's Farmacy with an F-A-R-M-A-C-Y, a place for conversations that matter. And if you're worried about COVID-19 and how to protect yourself from it and what to do if you get sick, and what's going on in general with the whole condition and what's happening to us from our perspective and functional medicine, then this podcast is one you're going to want to listen closely to. It's with my friend and colleague, the Medical Director of the UltraWellness Center, Dr. Elizabeth Boham, who is an extraordinary physician. She's also a registered dietician and an exercise physiologist. She teaches all over the world in functional medicine, is on the faculty of the Institute for Functional Medicine. She's just extraordinary physician. And I'm so happy to have you here talking about something that is not so fun, which is COVID-19. Dr. Elizabeth Boham (01:12): Thank you, Mark. It's great being with you. Dr. Mark Hyman (01:14): So tell us, where are we at today with COVID-19? How big of a problem is this? And sort of tell us, what is happening in the world of COVID? Dr. Elizabeth Boham (01:24): Yeah, it's not great, right? What are we at, 15 million people worldwide who've been- Dr. Mark Hyman (01:29): That's of what, today we're filming this is July 24th. 15 million people. Dr. Elizabeth Boham (01:32): Right. Have been infected. And, as we were mentioning, that's probably we're way underestimating because of just how many people we're testing and just the quality of the testing as well. And it's causing a lot of disease and death and illness and it's changing people's lives significantly, in terms of their day to day life, what they can interact, their job. So it's significant. Something we really need to be focusing on. Dr. Mark Hyman (02:04): Yeah. It's changed everything for everybody, right? Dr. Elizabeth Boham (02:04): Yeah. Dr. Mark Hyman (02:05): The fear factor is big. Dr. Elizabeth Boham (02:07): It's huge. Dr. Mark Hyman (02:07): And the actual disease is bad. It's not just like a flu. Now, some people get sick and they're fine. And could say, "Well, 99% people are fine." Yes, up to 20% end up in the hospital, which is a lot of people when you look at scale, right? Dr. Elizabeth Boham (02:25): Yes, it's a lot of people. Dr. Mark Hyman (02:25): There's 4 million Americans that have had it as of July 24th, and 20% of that is 800,000 people in the hospital. That's a lot of people. Dr. Elizabeth Boham (02:36): Right. And then 5% of people get really, really sick, right? Dr. Mark Hyman (02:39): And end up in the ICU and probably 1% die. But when you look at the rate, I mean the death rate, if you're over 60 is higher. If you're over 80, it's very, very high. So it's far more than 1%. Dr. Elizabeth Boham (02:51): And I think that's something we've been talking a lot about and trying to determine what can people do to have less complications from COVID. And that's what we're going to really be delving into today. But we definitely see, there are certain populations that are at much higher risk. People with underlying diabetes, obesity, cardiovascular disease, COPD. Those people are at much higher risk- Dr. Mark Hyman (03:16): Like emphysema. Dr. Elizabeth Boham (03:17): Yep, like emphysema. I mean, in fact, I just saw- Dr. Mark Hyman (03:20): Or asthma. Dr. Elizabeth Boham (03:20): The CDC just put out that they feel that 41% of Americans are at high risk for complications from COVID because of underlying health issues. Dr. Mark Hyman (03:30): Right. I mean, six out of 10 of Americans have a chronic illness. Dr. Elizabeth Boham (03:33): Right. Dr. Mark Hyman (03:34): 75% overweight, 42% are obese. Dr. Elizabeth Boham (03:38): We're not doing so great in this country, are we? Dr. Mark Hyman (03:39): One in two have prediabetes or diabetes. Yeah. 88% of us are metabolically unhealthy. And to varying degrees of how unhealthy you are, your risk goes up and up and up. Dr. Elizabeth Boham (03:47): And it's interesting that the diseases that are involved with obesity, heart disease, diabetes, our poor diet, really are some of the diseases that are really making an impact in terms of people's illness, morbidity and mortality from COVID-19. I think that's unfortunate, but interesting, because of their immune system probably, and we'll talk a lot about that. Dr. Mark Hyman (04:12): Yeah. I mean, all of these conditions, chronic disease, heart disease, diabetes, hypertension, these are inflammatory diseases. Being overweight is an inflammatory disease. Sometimes you don't even have to be overweight. You can just be over fat. You can look skinny, but actually your body mass is mostly fat, not muscle. And that makes you more likely to have more severe complications and more likely to die. So these are modifiable factors that you have control over. So you don't have to just wait like a sitting duck, hoping you're not going to get COVID or hoping you're not going to get sick from it. So there's so much you can do. Dr. Mark Hyman (04:48): And unfortunately this isn't getting enough press. We're hearing about all these drug interventions. We're hearing about dexamethasone and remdesivir and monoclonal antibodies and convalescent plasma and all these things, which have some role. But when you look at the impact that they have, it's incremental. It's not like, wow, this is the cure for COVID-19. No. It just helps a little bit in reducing the severity, reducing the complications, maybe reducing the risk of death. We don't even know yet, but we're looking at, these drugs may be reducing the length of stay in the ICU from 15 days to 11 days. It's not like a blockbuster solution. Dr. Mark Hyman (05:32): So the real question is, how do we take this pandemic, which is causing so much disability and disruption and economic hardship for people, and how do we build a more resilient population using the principles of functional medicine? Dr. Elizabeth Boham (05:50): That's what we need to do. That's what this is going to help us do because, we need to help people build an immune system that can do active surveillance and find viruses and get rid of them, but also not overreact and cause all this unwanted inflammation that is really underlying a lot of the significant illness and death from COVID-19. And they're looking at this inflammasome, right? The NLRF ... NLRP3 inflammasome, that is involved in causing more cytokine production, that cytokine storm that causes significant issues. Dr. Mark Hyman (06:32): Those are the messengers of the immune system that create inflammation. Dr. Elizabeth Boham (06:36): Yeah. And they get out of hand in some people. So that question is which people do they get out of hand with, and ... Dr. Mark Hyman (06:41): People will come in pre-inflamed from diet. Dr. Elizabeth Boham (06:45): Right. I mean that same inflammasome, I guess, is upregulated also with obesity and diabetes and cardiovascular disease. So if people have that underlying inflammation already upregulated, and then this infection comes on top of it, it can be really difficult for certain populations. So that's something that we want to really be focusing on, and we know that there are things we can do that can influence it. Dr. Mark Hyman (07:08): Absolutely. We're going to talk about a lot of things, but other things that aren't really getting attention besides diet is our nutritional status as a population. Dr. Elizabeth Boham (07:19): Right. Dr. Mark Hyman (07:19): And I was talking to my colleague, Dr. Dariush Mozaffarian at Tufts, is the Dean of the Tufts School of Nutrition Science and Policy. And he said, they have a whole department of nutritional immunology there where they've identified the key nutrients that actually help to modify your immune response and improve your overall immune function and actually may be effective in various pathways that have to do with COVID-19. And they're wanting to do a large study on it. But you're not hearing about this. Who's funding these studies? Billions of dollars flowing into vaccines and to very expensive drugs, but nobody's talking about the simplest things you can do to make yourself more resilient in the face of COVID. Dr. Mark Hyman (07:59): So how do you make the host, you, more of a unwelcome place for the virus to land? Or if you do get the virus, how do you actually make your body work properly to fight it more effectively so you don't end up in the hospital or you don't end up dying? Dr. Elizabeth Boham (08:16): Absolutely. We're obviously not doing a great job here in the US, but interesting about the nutrients. I think it's fascinating. They say that 1.5 million people worldwide are at risk for zinc deficiency. And zinc is one of those nutrients that's so critical for the functioning of the immune system. It helps both the innate and adaptive immune system. So when somebody is not getting enough zinc, it has a huge impact on their risk of having issues with any illness. Dr. Elizabeth Boham (08:45): In fact, they did a study looking at patients with COVID-19 and they were in the hospital and they were getting medications. They had a cocktail of medications. One group, they put on extra zinc, and the other group, they didn't add the extra zinc. And the group that got the extra zinc had a much shorter hospital stay. So it's fascinating. And- Dr. Mark Hyman (09:04): This is only pennies a dose, so nobody's making out ... Dr. Elizabeth Boham (09:06): I know, right? Dr. Mark Hyman (09:06): Like a bandit. So nobody's pushing it. It's just incredible. Dr. Elizabeth Boham (09:11): Mm-hmm (affirmative). And zinc is not hard to get. It's in a lot of our food sources, it's in a lot of our protein, both animal protein and nuts and seeds. Dr. Mark Hyman (09:19): Pumpkin seeds, oysters. Dr. Elizabeth Boham (09:20): Oh yeah. But when people have issues with just not having good food supply, they're just not getting a good, healthy diet for a whole host of reasons, or they're having a hard time with absorbing their zinc, or if they've got an inflammation in their digestive system that prevents optimal absorption of zinc, or if they're the elderly. Dr. Elizabeth Boham (09:42): I mean, what happens as we get older? We see a lot more zinc deficiency because people are eating less and less calories as they get older. And they just, it becomes one of those nutrients that people eat less of. They're maybe choosing tea and toast for breakfast or they're skipping meals. We do see zinc deficiency. And that's one thing that a lot of my patients, especially, well, actually most of my patients, but definitely my older patients, I have them take a little extra zinc because it's so important for their immune system. Dr. Mark Hyman (10:13): Absolutely. And I think zinc is one of the key nutrients, and it actually interrupts some of the mechanistic pathways that Sars-Cov-2 actually uses to enter the cell. So it actually, there's a lot of science behind how this works. It's not just, "Oh, we're all zinc deficient." It actually has been shown to be mechanistically the right thing to do. And the risk is low. You don't want to overdose on zinc, but having adequate zinc is really important. Dr. Mark Hyman (10:41): And then vitamin D is also one of those nutrients that's being used in various studies and showing benefit. And people who have low levels of vitamin D seem to be at much higher risk of severe complications and death. Dr. Elizabeth Boham (10:53): Absolutely. And we test vitamin D all the time and we see so many people low in vitamin D. When you start looking, you see a huge portion of our patients. I mean, we also work in the Northeast, but we get people from all over the world. And so many people are low in vitamin D for a whole host of reasons. Dr. Mark Hyman (11:09): I would say, unless you're a lifeguard, I mean, I would say 80% of our patients or more are low in vitamin D. And if you're not low in vitamin D, it's likely cause you're taking vitamin D. Dr. Elizabeth Boham (11:20): Absolutely. Dr. Mark Hyman (11:20): And I think, the question is what is low. And I think that's a debatable number. But if you look at the lab reference value, low could be less than 20 or less than 30. Optimal is probably 40 to 60 or 70. Dr. Elizabeth Boham (11:34): Absolutely. Dr. Mark Hyman (11:35): And then what's the level that you need to optimize your immune system. For COVID is probably like 50 or more. And I think that's not going to happen unless you're in the summer or if you're walking around naked half the day or you're living in a Southern country where you're exposed to sunlight all the time. But most of us are not like that. And most of are pretty significantly vitamin D insufficient or deficient. Dr. Elizabeth Boham (11:57): Yeah. I mean, I think one of the things that this has also highlighted is how much time we spend inside. Because now I'm always telling people, I'm telling myself spend more time outside because it's just healthier when there's COVID around. You want to be interacting with nature. You want to have parties outside or meetings. Not that you want big parties, but meetings with other people outside- Dr. Mark Hyman (12:20): Socially distancing- Dr. Elizabeth Boham (12:20): Socially distancing. Dr. Mark Hyman (12:21): I don't like the term social distance. It's physical distance. Dr. Elizabeth Boham (12:24): Yes. Dr. Mark Hyman (12:24): You don't have to socially distance yourself. You have to physically distance yourself. Dr. Elizabeth Boham (12:28): And I think it's actually been a wonderful thing that so many of us have been spending more time outside. Everybody in the Northeast is camping now and kayaking and getting out and spending more time in nature. And that's wonderful and is good for our vitamin D. Right? Dr. Mark Hyman (12:42): Yeah. So that's another easy thing to do, which has low risk and lots of benefit. Another thing that's being looked at is something called quercetin. So can you talk about what that is? And there's some really interesting data on quercetin and its effect on particularly COVID-19. Dr. Elizabeth Boham (12:59): So quercetin is a polyphenol. These are these phytonutrients, these components in our plant foods. Phytonutrients are components in our plant foods that have really great health benefits for us. We know we've got vitamins and minerals in our food, but we also have these phytonutrients. And these phytonutrients in the plant actually help the plant survive in nature. Dr. Elizabeth Boham (13:23): So what's amazing and what we're realizing is that our plant foods are packed full of these really great phytonutrients that have good health benefit for us. So they've been shown to be anti-inflammatory, they have high antioxidant capacity. We've been using these, and there's lots of research on all of the different phytonutrients in terms of cancer prevention and heart disease prevention. But we also see that they impact that inflammasome. So that inflammasome that causes that increased cytokine production, we know that certain phytonutrients and polyphenols can lower, they can lower that cytokine production and influence it in a healthy way. Dr. Elizabeth Boham (14:09): Quercetin is a mass cell stabilizer. We use it as a phytonutrient all the time for people with allergies and asthma and mass cell issues. But it's also being looked at impacting somebody's response to COVID-19. And if people are taking, like some people take supplements, 500 milligrams, a couple of times a day, or even more, 1000 milligrams, a couple of times a day. But also what's cool is it's in our plant foods. It's in things like dill and it's in broccoli and it's in- Dr. Mark Hyman (14:41): Onions. Dr. Elizabeth Boham (14:41): Onions and capers and ... Dr. Mark Hyman (14:44): Capers? Dr. Elizabeth Boham (14:44): Apples and berries. It's in so many of our foods. So what we're always working with people on is saying, "Okay, let's get those eight to 12 servings of phytonutrients every day." So they can be coming from your vegetables, your fruits, your spices, your teas. So many of these phytonutrients are phenomenal for your overall health and can lower that cytokine release and that inflammation that can come from an infection. Dr. Mark Hyman (15:12): Yeah. We're looking at all these expensive drugs, but there is actually research going on, on things like quercetin. For example, it binds to the spike protein of the virus, which is necessary for it to bind and enter into the cell of a host. It actually inhibits all sorts of inflammatory pathways, like we mentioned. It actually is directly antiviral. Dr. Elizabeth Boham (15:35): Yes, antiviral. Dr. Mark Hyman (15:36): So it has anti-viral capacities and it inhibits the replication of infected cells. So it has all these different benefits and it's completely safe. It's in our food, but you can take it as a supplement. Dr. Elizabeth Boham (15:49): Yep, absolutely. Dr. Mark Hyman (15:50): So there's another one also that people are looking at, which is called EGCG, which comes from green tea. Dr. Elizabeth Boham (15:55): Yeah. EGCG is Epigallocatechin gallate. It comes from your green tea. It's a component in green tea. And we've been studying it forever, especially in the cancer prevention world. It's got a lot of antioxidant, anti-angiogenic properties. But it also helps with production of glutathione, which we'll talk more about. The EGCG in green tea is phenomenal in terms of this phytonutrient that has tremendous benefit in our body. So they're looking at recommending four cups of green tea a day or 225 milligrams if you're getting it from a supplement, can really do a lot of good benefit. Dr. Mark Hyman (16:37): So let's see. You should have a meal with oysters and pumpkin seeds for the zinc, you should have onions and dill for the quercetin, a little green tea in there. Dr. Elizabeth Boham (16:47): Yeah, we can't forget about mushrooms. Dr. Mark Hyman (16:49): You can have mushrooms for the vitamin D. Dr. Elizabeth Boham (16:51): Yep. And the natural killer cell activity, right? Dr. Mark Hyman (16:53): Yes. Herring. So that sounds like an interesting meal. Dr. Elizabeth Boham (16:57): And a little broccoli, because that also has ... Broccoli has sulforaphane in it. That we know is really important for also for production of glutathione. And there's really interesting research now looking at what's the connection with glutathione depletion and outcome from COVID-19. Dr. Mark Hyman (17:15): Hey everybody. It's Dr. Hyman. Thanks for tuning into The Doctor's Farmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you to all the experts that I know and I love, and that I've learned so much from. Dr. Mark Hyman (17:26): I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements, to gadgets, to tools, to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you do is go to to sign up. That's, P-I-C-K-S. And sign up for the newsletter. And I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Now, back to this week's episode. Dr. Mark Hyman (18:10): Back up a little bit. So what is glutathione? Dr. Elizabeth Boham (18:12): Oh yeah. Dr. Mark Hyman (18:13): Why is it important and why should we care? Dr. Elizabeth Boham (18:17): I love talking about glutathione. It's like my favorite thing. Dr. Mark Hyman (18:20): Me too. I love glutathione. Dr. Elizabeth Boham (18:22): It is a master antioxidant and detoxifier in the body. We also know that it has tremendous impact on the immune system, so it can increase natural killer cells- Dr. Mark Hyman (18:34): An anti-inflammatory. Dr. Elizabeth Boham (18:35): Yes, it's an anti-inflammatory too. It can increase natural killer cells, which are the cells in your innate immune system, which go around and gobble up things that shouldn't be there like viruses. So it can increase natural killer cell activity. It helps with increasing the function of the immune system. It can help with preventing the immune system from upregulating. Or I'm sorry, of overreacting, getting too inflamed. Dr. Mark Hyman (18:59): Overreact. It's like the brake kind of on the immune system. Dr. Elizabeth Boham (19:01): Yeah. So we said, we want the immune system to find the infection, get rid of it, but not overreact and produce too many of these cytokines, unwanted cytokines. So glutathione actually does that. And we've seen this forever, that glutathione has this tremendous ability in somebody's immune system. We know when people have toxicity that depletes their body of glutathione, they're more at risk for getting infections. So they're really looking at people who are glutathione depleted and risk for COVID-19 or bad outcomes from COVID-19 really. And then, so you want to think about what can I do to boost my glutathione in my body? Dr. Mark Hyman (19:41): Yeah. Dr. Elizabeth Boham (19:41): And we know that food has a tremendous impact here. We know that a lot of our vegetables naturally have glutathione in them. We know that a lot of our vegetables, like the cruciferous vegetables, the broccoli, cauliflower, cabbage, kale help the body with production of glutathione. And we know- Dr. Mark Hyman (19:59): And green as we mentioned. Dr. Elizabeth Boham (20:00): And green tea helps with production of glutathione. We know that garlic and onions and shallots help with production of glutathione. So our diet has a tremendous impact on our glutathione status. But then there's some people we give a little bit of extra love to in terms of glutathione. We'll give them extra things like NAC. Dr. Mark Hyman (20:20): Yeah, which also has been looked at in COVID-19 as a- Dr. Elizabeth Boham (20:22): Absolutely- Dr. Mark Hyman (20:23): ... compound that helps boost glutathione and improve immune system and reduce infection. Dr. Elizabeth Boham (20:27): Yeah. And it's phenomenal. 600 milligrams a couple of times a day often we might us. And then we sometimes give people actual glutathione. You can get ... Glutathione is a tripeptide. It's made up of three different proteins. Dr. Mark Hyman (20:45): Amino acids. Dr. Elizabeth Boham (20:46): Amino acids, yes. Thank you. So it gets digested in the digestive system. So optimally, you want to get glutathione that's lyposomal, which means it's a small particle that gets absorbed through the mucosa, through the mouth or the digestive system, without getting broken down. Or we'll give glutathione IV or inhaled- Dr. Mark Hyman (21:08): Intravenously, yeah. Dr. Elizabeth Boham (21:09): Yep, yep. Intravenously or inhaled. There's so many ways to give it, but it can be really helpful for somebody's immune system. Dr. Mark Hyman (21:15): And I've been keeping my eye on the literature and seeing case reports of intravenous glutathione in COVID-19 patients with remarkable quick results. Also, I've been hearing reports of inhaled glutathione, or inhaled N-acetylcysteine, which we actually use all the time for asthma or cystic fibrosis patients. Dr. Mark Hyman (21:34): These are treatments that are available in traditional medicine, but they're not often used. And it's not like any one of these things is going to cure COVID or prevent you from getting it. But it all will help to bolster your own resiliency and your immune system and your ability to fight the infection. So instead of being sick for weeks and weeks and months, you might be having a shorter course. You might not really get sick at all. Or you might recover a lot faster. And there's a few other things that people are using out there. And I think that we're talking about. One of them is melatonin, which also has some benefits as well in terms of this. Dr. Elizabeth Boham (22:08): Yeah, there's some interesting research on melatonin. We know it has antioxidant capacity and it does have an influence on our immune system. So they're looking at melatonin for COVID as well, even three to five milligrams even at night or maybe higher for some. It's interesting. We see ... I definitely have seen a bunch of patients who've had COVID-19, and I actually just ordered some inhaled glutathione just the other day, through a nebulizer, which was really helpful for this patient, for her COVID-19. And she got, she recovered really well. And with somebody who had an immune system that we weren't sure how she was going to do. Dr. Mark Hyman (22:51): Amazing. Dr. Elizabeth Boham (22:52): It seemed to be very helpful. But we do have some patients that struggle. I've had a few patients who were sick March and April and still a few months later are dealing with fatigue, shortness of breath. That seems to be some of the lingering symptoms we see more of. Dr. Mark Hyman (23:13): Yeah. So one is, how do you protect yourself so you don't get it, which is the lifestyle issues, diet, exercise, sleep, stress management, taking your basic supplements that we talked about. And then if you get it, what do you do? There's some sort of more advanced things you can do around, maybe inhale glutathione or NAC and other treatments we're going to talk about in a minute. Dr. Mark Hyman (23:36): But then there's this whole phenomenon we're seeing called post-COVID syndrome, which is terrifying to me because with SARS, the previous infection, SARS one I guess you'd call it, at three years, 40% of people who got this and survived had chronic fatigue syndrome. And there was a study that was just published in the Journal of the American Medical Association, looking at how patients who've been hospitalized with COVID did after discharge. Dr. Mark Hyman (24:08): 60 days later, they reached out to these patients. And these were COVID positive patients who were quite sick, 143 patients. And 72% had pneumonia. So they were quite sick. The average day was about 13 days in the hospital and about 5% were on ventilators. At two months, only about 12% were free of symptoms. The rest had fatigue, shortness of breath, joint pain, chest pain, and worsen quality of life. So 87% of people had symptoms like shortness of breath or fatigue at two months. Dr. Mark Hyman (24:43): I'm seeing some people do recover, but there's a whole group that don't really get better. And now is this infection just lingering? Did it just script their immune system? What's happening? So from a functional medicine perspective, we're thinking about how do we address these patients? How do we help them recover from this? Dr. Mark Hyman (24:59): Just like we treat chronic fatigue patients with functional medicine, who've been- Dr. Elizabeth Boham (25:03): Absolutely- Dr. Mark Hyman (25:03): ... maybe affected by viruses or tick infections. We know how to do this. So I really think, if it's true that we now have 4 million people in America with COVID, which is probably actually 10 times that according- Dr. Elizabeth Boham (25:16): Probably right- Dr. Mark Hyman (25:17): ... to the study, because many people aren't tested or diagnosed or have more mild cases. So we have 40 million people in America with COVID. A bunch of those are going to have this post-COVID syndrome. And the question is, what can be done to help these people over time? Dr. Elizabeth Boham (25:29): Yeah. And I think looking at their glutathione status is really important. We do that with markers of ... We have some biomarkers we can look at. And we can just work to things like oxidative stress and glutathione biomarkers that can be helpful to give us a sense of what somebody's levels are. Dr. Elizabeth Boham (25:49): And then we work to really boost up that glutathione with like we were talking about, the precursors to it, the actual glutathione, the diet. And then we look at all aspects of that person's health, in terms of, how do we boost their adrenal gland? How do we boost their mitochondria, which, and help it heal after getting an illness like this? Sometimes you do need a little extra TLC after you get sick to bounce back. Dr. Elizabeth Boham (26:18): And we definitely see people, like you said, we've seen this for years with other sorts of infections and we're seeing it now for some proportion of people with COVID-19. They just need a little extra support for their body to truly recover. And it's an interesting thing to be paying attention to. Dr. Mark Hyman (26:37): Yeah, absolutely. And we skipped over it a little bit, but there are other things that people are looking at as well for helping prevent or even treat COVID, which is something called NAD, which is helping your energy set system. But it also seems to be effective in some of the problems that we see as well. And also our gut is a big player. And people who have more gut dysfunction because COVID also affects the gut seem to have more issues. Dr. Elizabeth Boham (27:04): Yes. A lot of people have some GI issues that then we need to think about how can we help support. You think about things like probiotics because our good bacteria that line our digestive system, that line our nasal passageways, that actually is, we've talked about this before is like the first line of defense in the body. That's really important for our immune system. Dr. Elizabeth Boham (27:26): So eating a diet that feeds our good bacteria or taking extra probiotics really can help support the immune system. And there are certain strains that they're really looking at that may be effective for prevention of getting the virus, as well as things that can help with recovery of the digestive system. Dr. Mark Hyman (27:43): Yeah. And then also pre and probiotic foods that we've talked about a lot. So those are always to support yourself. And there's other things that can be helpful such as herbs, like astragalus and mushrooms like Reishi. Talk a little bit about how these things work and why would we sort of want to use herbs in this context? Dr. Elizabeth Boham (28:00): Yeah. I love the medicinal mushrooms. I love the Asian mushrooms because they have tremendous ... They can really strengthen our immune system through improving our natural killer cell activity. So they are- Dr. Mark Hyman (28:16): Those are a little Pac-Man, they go around and kill things. Right? Dr. Elizabeth Boham (28:18): Yeah, absolutely. We like the Asian mushrooms, Shiitake, Maitake, Reishi. They're really powerful both to cook with. And then some people take extra supplements or teas or coffees with them in them. So they're really something we focus on a lot. And I think the one ... Dr. Elizabeth Boham (28:38): You were asking about herbs in general. As we were mentioning before about the polyphenols, the components in our plant foods that have tremendous health benefit, they have many of them have a really nice anti-inflammatory benefit for the body. And one of the things we really want to focus on is cooling down that inflammatory response in the body, because that is what is causing a lot of that continued, whoops, probably what's causing a lot of that continued shortness of breath feeling and fatigue. Dr. Mark Hyman (29:12): Yeah. And I want to be clear what we're talking about. We're not wearing saying these are cures or going to fix everything. But what we're saying is that there are ways to make yourself more resilient, to improve your immune function, to make it less likely that you're going to get sick. Or if you get sick, less likely you're going to get very sick or end up in the hospital or even dying. Dr. Mark Hyman (29:32): So when it's not just any one supplement that's going to cure you, it's like, you just take zinc and that's it. No, you have to eat right. You have to exercise. You have to sleep. You have to deal with your stress. And you have to make sure your nutritional status is optimized. And I think all of these things can be extremely helpful. Dr. Mark Hyman (29:49): And for those listening, you're probably trying to furiously take notes. And what was that thing you said? And what was that supplement? All of this we're going to have in the show notes. So you're going to have a list of everything we're talking about, both in terms of what to do for prevention, what things you can do to support yourself if you do get sick, and what to do afterwards, to make sure that you address what we are calling post-COVID syndrome. Dr. Mark Hyman (30:10): But what's interesting in the literature to me, Dr. Boham, Liz is that there are a number of countries doing things that we're not doing here that are seemingly very effective. Dr. Elizabeth Boham (30:19): Yes. Dr. Mark Hyman (30:20): And a lot of these are what we call oxidative therapies. So oxidative therapy seems like a crazy idea because why are we all taking anti-oxidants and why would we want to take something that's going to oxidize us? But these compounds seem to have an ability to create a response in the body that sort of activates its defenses. So it's like you get punched in the face. All of a sudden you're going to like, put your fists up, you're going to start fighting. It's the same way with the body. When it gets a little stress, it actually starts to kick in its own immune function. It's all- Dr. Elizabeth Boham (30:51): It's okay. I got to get working. Dr. Mark Hyman (30:52): Right. It's all STEM cells. So things like vitamin C intravenously been used in China showing effect, intravenous glutathione, there's been studies on that, intravenous NAD, and something called ozone, which is something we've talked a little bit about. But this is something that's involved in helping to create an increased immune response for the anti-inflammatory stuff and decreasing the inflammatory stuff in your body. It also may be germicidal. And right now there's many trials going on in Europe. Not here, but in Europe, there's 800 people being enrolled in trials in over 26 hospitals. Dr. Mark Hyman (31:31): The case reports that are coming out are pretty extraordinary. I just reviewed case series of three patients that was published in a medical journal, which showed that there ... And these were patients sick with pneumonia and with very high levels of these markers, like D-dimer which shows your blood's clotting or C-reactive protein, which shows that you have a lot of inflammation, or ferritin, which shows you have a lot inflammation. And these are really objective biomarkers. And they also looked at CAT scans and x-rays. Dr. Mark Hyman (32:01): And you could see within literally days, these people got better and their oxygen levels came up. Their inflammatory markers went down. Their x-rays cleared within a couple of days. And these patients are going home after three days, where the average day is like 10, 11, 12 days for these patients with COVID. This is a game-changer. There's no other therapy like that. Dr. Mark Hyman (32:22): I'm not saying it's the cure for COVID-19, but I do think it's one of those things we should explore. The problem is that it's such a weird therapy. It's not really something that's part of conventional thinking or medicine in the United States. In many other countries it's used in hospitals, whether it's South America, Europe, China. Dr. Mark Hyman (32:40): I think we need to start thinking about how do we look at these therapies given that this is probably in my lifetime and most of our lifetimes, the biggest threat we've seen to our social fabric, to our economic welfare, to just our sense of being able to be in the world again. I mean, because yes, there's a pandemic of the virus, but there's also the pandemic of fear, which is going to outlast the virus. Dr. Elizabeth Boham (33:06): That's so true. Dr. Mark Hyman (33:07): And if we could have a way of treating people, which help them feel confident that, like, "Wow, if I get a strep throat, I'll take an antibiotic, I'll be fine." So I'm hoping some of these therapies are going to get studied and looked at a little more in depth. Dr. Elizabeth Boham (33:21): We see that all the time in our clinic. When we have patients and we've had with chronic fatigue from other viruses, Epstein bar or a tickborne infection, often the thing that helps them get better for the people that are having a really hard time recovering is a lot of these IV therapies and IV C, IV ozone. That's when we start to see some people turn the corner. And for the people that are really struggling and their body's not kicking in and improving, we see big improvements, so. Dr. Mark Hyman (33:53): Yeah. It's sort of like jumpstarting your body's own healing system because the body has a healing system and often it gets stuck. And I think that's what's happening with COVID. You get this insult and the body gets stuck in this cycle of being sick- Dr. Elizabeth Boham (34:05): And inflammation, right? Dr. Mark Hyman (34:05): Yeah. And I've been talking to people, even young people in their 20s and 30s who get it. And it's not like they're back to normal. They're struggling with fatigue. They're struggling with shortness of breath, with chest tightness. Their tests are negative. Does the virus persist? We don't know, but I think this is certainly a real thing. And I think we are really focused at the UltraWellness Center and Functional Medicine, trying to help people through this process using a very science-based, coherent, and safe and effective way to help support their own body in their healing response that they can create through these various treatments. Dr. Elizabeth Boham (34:43): Yeah, absolutely. Dr. Mark Hyman (34:44): Yeah. I think we are all struggling with coronavirus, both personally, and how it's affecting all of our lives, and professionally and in the healthcare system, it's kind of overwhelming. The cases now are just skyrocketing. I think the cases in Florida and the South and Texas are just on the rise. And I think this is far from over. Dr. Mark Hyman (35:07): So I think these kinds of approaches, if we could scale up a nutritional awareness approach, imagine if the government was like, "Okay, let's have a public health awareness campaign. Eat these foods. Don't eat these foods." Like if we all got metabolically healthy. And it doesn't take years, I mean, you take someone with diabetes who's 400 pounds who has gastric bypass surgery. Their diabetes is gone in two weeks. They're still very overweight. What changed wasn't their weight. What changed was their diet. Dr. Elizabeth Boham (35:36): Yep. Dr. Mark Hyman (35:37): And you can quickly change your metabolic health. You can quickly change inflammation- Dr. Elizabeth Boham (35:40): After a meal. After a meal, right? Dr. Mark Hyman (35:42): Yeah. One meal, one meal. Give yourself 10 days of a clean diet- Dr. Elizabeth Boham (35:45): There you go. Dr. Mark Hyman (35:46): And you're going to see a dramatic change. So we should be educating people about that. We should be educating them about nutritional support. And people just taking a multivitamin and vitamin D, that's usually enough for most people. It has the zinc in there. Maybe you want to add a little quercetin. But I think, these are things that are very safe. They're very effective. And unfortunately they're underutilized. Dr. Mark Hyman (36:09): And when we see the studies showing that 88% are metabolically unhealthy and over 90% are nutritionally deficient in one or more nutrient, including things like vitamin D and zinc and Omega threes, all the things that really matter, these are things that we can do something about as a society. Dr. Mark Hyman (36:25): And yes, we have to do all the things we need to do to investigate new drugs. The vaccine issue's a whole quagmire, I'm not going to go down that rabbit hole, but hopefully it's a miracle vaccine. Although, I think there are a lot of challenges to that. I think both in terms of people adopting it and actually working. But I think that these kinds of things we're talking about today are things that we can all do now, that we can all do to support ourselves. Dr. Mark Hyman (36:50): So in the show notes, there's going to be all this information, what to do and how to eat and what supplements we recommend. So I encourage you to check that out and don't fret because fear is the worst thing about this. I think to quote Franklin Delano Roosevelt, he said, "The only thing we have to fear is fear itself." And I think if you can feel empowered by understanding what to do, both to prevent it, if you get it and afterwards, I think it will reduce a lot of that. Dr. Elizabeth Boham (37:18): I agree. I agree. Dr. Mark Hyman (37:20): Well, Dr. Boham, Liz, thank you so much for being on The Doctor's Farmacy. It's been great having this conversation about this very tough subject. But there is hope and I encourage everybody listening to this. If you love this podcast to share with your friends and family on social media. Leave a comment. We'd love to hear from you. And subscribe wherever you get your podcasts. And we'll see you next time on The Doctor's Farmacy. Dr. Elizabeth Boham (37:40): Thank you Mark.