Healthy And Hopeful During COVID19

April 9, 2020

First let me check in. How are you all doing during this incredibly challenging time?

How are you feeling about distancing from others?
I for one (as an extrovert) am realizing how tactile I am and how important connection is, in my life and with all of you! While we are still utilizing “tele” medicine and consults to support you, I am really missing seeing you in person and having that one on one connection. I want to remind you that this is a time (maybe now more than ever) to practice social connection, not distancing and so let’s rephrase the social distancing to “physical” or “spacial” distancing instead. Because the Spacial Distancing is working in flattening the curve, it certainly helps me stay motivated and I also know that it is temporary!
             
As an eternal optimist (thank you Dad), I am considering all the positives that may come from this time of transition.

I believe we have all been moving way too fast and taking on more stress than is healthy for our body, mind and spirit. It’s sad that a lesson to slow down comes from a worldwide Pandemic, but if that is what it takes, then let’s embrace this change for sure!

Are you finding you are less frenetic and frantic in the attempt to “get it all done?”
Are you realizing you don’t need to make as many trips or run as many errands as you use to in your car?
Is your desire for material accumulation shifting?
Are you connecting with people you might otherwise not have had the time before?
Are you learning how to exercise from home and finding creative ways to stay healthy, cook delicious meals and get your creative juices flowing again?

Also, let’s consider our precious environment and the positive impacts we are seeing with less burning of fossil fuels, emitting less car emissions and pollutants, buying less material / plastic goods, which all equate to cleaner air!

I read that Denver’s air pollution, heavy particulates, nitric oxide and nitrogen dioxide are decreased by 50% in some areas compared to last year and carbon dioxide is 80% less in downtown! Wow that is impressive! And I am sure our precious animals are reaping the benefits too. I am hearing the cacophony of birds in my neighborhood like never before!

 

I am also hopeful people will take these lessons and realize how important it is to be healthy and resilient so that we are better prepared in the future!

 

TESTING

I believe you all know the numbers in Colorado are not accurate, mostly because testing remains limited and while I do have a handful of tests available, I am not allowed to see patients in person based on the DORA mandate. Be assured that I am ready and able to support you when this is lifted or adjusted by the state. I am also keeping my eye on the antibody testing that is available by BioMedomics, who is distributing this test exclusively to Henry Schein and I am told it will be available soon. This blood test will detect Immunoglobulin response to COVID, showing if you have an active IgM response or a past exposure IgG, showing immunity now (until this virus replicates, which no one knows, when that will happen). The results are given in 15 minutes! I do not know the cost or whom it will be distributed to, but I am on the “list” at Henry Schein for when clinicians can purchase these tests. When I know more, I will let all of you know!

 

UPDATED COVID19 SYMPTOMS

In addition to the other symptoms I’ve previously discussed, they are now adding Conjunctivitis “pink eye” to the list of symptoms. They believe this is transmitted by aerosol contact with the conjunctiva.

         Conjunctivits can be allergic, viral or bacterial.
Allergic – Redness in both eyes, itching and burning, watery discharge on the eyelids, light sensitivity and possibly other allergy symptoms such as sneezing, If you are having allergic conjunctivitis, you are usually
Viral- Typically begins in one eye and then spreads to the other eye, redness, burning or gritty sensation, watery discharge, other cold symptoms like a sore throat, runny nose
Bacterial- Typically only seen in one eye and has redness, burning, itching with a thick, sticky discharge from the eye


COVID Viral Conjunctitivis would likely be accompanied with other symptoms such as fever, shortness of breath, dry cough, loss of smell/taste, GI upset and/or Diarrhea.

 

CONTAGIOUS PERIOD
A team of scientists from five universities in China and Canada released a study in mid-March that found that nearly 1 in 8 patients had incubation times longer than 14 days, leading them to question whether current quarantine recommendations are optimal. Their recommendation is to extend the isolation time to 21 days (but in some cases the virus was still shedding up to 33 days).
https://www.medrxiv.org/content/10.1101/2020.03.15.20036533v1.full.pdf

 

AEROSOL VS DROPLET (It's likely Both!)
By now most of you have heard the CDC and Colorado State’s recommendation to wear masks when you leave your home but unfortunately, I haven’t noticed this catching on very quickly.

I am curious if people are simply not paying attention or they don’t understand where

this recommendation is coming from. Either way, I thought I would explain why this is an excellent recommendation.

 

First, we know that nearly 25% of the population with COVID are not exhibiting symptoms, therefore it makes it impossible to know who has it and who does not.

Secondly, we know that the viral “shedding” period is much longer than previously thought (see above) which means there are plenty of people walking around with COVID who think they won’t spread it any longer or people are asymptomatic yet contagious.

Finally, something they aren’t talking about as much is the fact that this virus appears to be shedding micro droplet particles at greater distances than large particle droplets and therefore, the 6ft recommendation may

Droplets are larger particles that get expelled during coughing and sneezing and fall onto ground within minutes and usually travel less than 6ft, whereas Aerosol droplets contain micro droplet particles that can be transmitted through heavy breathing (think running and biking on trails) and forceful talking and are smaller, can linger longer (studied up to 20 minutes) and travel father than 6ft. Both particles can spread more readily in closed spaces with poor ventilation. Therefore, its best to keep windows open if sharing space indoors (such as an office).While it is safer to be in the fresh, breezy outdoors, wearing a mask / covering will still add additional protection for you and others.Nature Medicine published an article on April 3rd 2020 showing that wearing face masks reduce the exposure of aerosol

 

dropletshttps://www.nature.com/articles/s41591-020-0843-2

 

We still don’t know how well these micro droplet particles will invade our body causing disease but it usually takes a certain number of those particles for them to evade the immune system, get past the mucus barrier that’s in your nose and throat, come into contact with a cell that has the virus receptor on it, and then get into the cell and start replicating.

https://www.biorxiv.org/content/10.1101/2020.03.08.982637v1https://www.medrxiv.org/content/10.1101/2020.03.23.20039446v2

If you are interested in a visual, I recommend you watch this video on Micro-droplet particles and transmission. https://www.youtube.com/watch?v=vBvFkQizTT4&feature=youtu.be&fbclid=IwAR0XXV0CTqggLBaWxtC6R6-

 

CYTOKINE STORM
You might be asking, what if I do get sick with COVID and I feel terrible but, am not sick enough to go to the hospital?
 
I do have additional nutrient recommendations for you (besides the obvious of hydration, electrolytes, cough syrup and rest) on ways to reduce inflammation and blunt a Cytokine Storm for mild to moderate cases, but please remember if you are deteriorating, go to the Emergency Room ASAP, as there can be a rapid decline requiring ventilation and other supportive measures to save your life. This is most likely for people with heart disease, pulmonary disease, Diabetes and a compromised immune system, but it can happen to anyone, so please be careful in watching your symptoms closely.

First of all it would be good for you to know how this virus replicates in your body and why it can progress so quickly. COVID enters our body and attaches to our ACE2 receptors and binds to two cells in the lungs - goblet cells that produce mucus and cilia cells which have hairs on them. The virus attacks these cells and starts to kill them, so your lungs begin to fill with fluid making it hard for you to breathe. This phase of the disease is thought to last about a week. At this point your immune system will start to kick in and fight off the invaders. You will develop a fever and your high body temperature will create a hostile environment for the virus. Other symptoms such as coughing may initiate at this point of the disease process. If you’ve got a great immune system, your symptoms may be mild or moderate at this stage but in some people, particularly the elderly and those with other health conditions, the immune system can go into overdrive triggering a 

Cytokine Storm.
Cytokine Storm (in short it’s essentially an overly activated immune response) occurs when large numbers of white blood cells, including B cells, T cells, Natural Killers cells, macrophages, dendritic cells and monocytes release inflammatory cytokines, which activate more white blood cells in a positive feedback loop of pathogenic inflammation. Immune cells are activated by infected cells (such as COVID) through receptor-ligand interactions. The cytokines produced by immune cells recruit more effector immune cells such as T Cells and inflammatory monocytes (which differentiate into macrophages) to the site of inflammation or infection. In addition, pro-inflammatory cytokines binding their cognate receptor on immune cells results in activation and stimulation of further cytokine production. This process, when dysregulated, can be life-threatening due to systemic hyper-inflammation, hypotensive shock, and multi-organ failure. They believe this is why patients are declining so rapidly with the COVID infection.The Cytokines of particular problem in COVID 19 are the IL,1, IL-6, IL-18, IL-1BDrug treatment therapies are being studied to block these receptors to slow the Cytokine Storm.

We can protect ourselves by reducing overall inflammation by eating a low inflammatory diet, which includes avoiding gluten, dairy, corn, soy, alcohol, sugar & coffee, as well as supporting the gut microbiome, getting enough sleep and regular exercise, but here are additional supportive foods to add to your diet.  
Onions
Garlic
Apples
Tomatoes
Nuts
Berries
Parsley
Celery
Tumeric
Ginger
From a natural medicine approach, there are many studied supplemental/botanical therapies that reduce an over activated immune system. It is important to make note that there are no clinically evidence-based integrative prevention or treatment strategies for COVID-19 infection. Recommendations below are based on literature on how these substances reduce inflammation and I am offering them as suggestions as possible therapies to support mild to moderate cases of COVID-19 that are causing an exaggerated immune response. Again, if you are having any severe symptoms you must go to the ER!

I have already discussed supplements and foods to help PREVENT COVID and other viral infections from entering the receptors/cells/immune system, so below are suggestions to reduce the inflammatory response if you get sick.
Vitamin C (as I have discussed extensively)
Melatonin
Quercetin
Curcumin
Green Tea and other Antioxidants like NAC, Vitamin C flavonoids, polyphenols
Olive leaf
Garlic
Andrographis
Zinc
Vitamin A
Below are additional links/resources and studies on these nutrients.
For additional recommendations and doses if you are feeling symptomatic, you may book a “tele” appt with Carrie

 

SUPPLEMENT ORDERS
We are still here to serve your product ordering needs as best we can! With limited staff, we are asking that you please give us up to 24 hours to prepare your order for shipment or for pick up. 

Options for Ordering;
We can ship your orders to you from our office with an approximate charge of $9 for the freight.
You can pay for your items over the phone and pick them up from the bin outside our office.
You can browse our Vendors and place orders directly online with their drop ship methods that are available! Xymogen Products are ordered through Wholescripts, Mountain States Health Products, or Emerson through Fullscripts (See images below)
Feel free to give us a call, or send us a text or email! Please remember to list out all details including; the Product name, brand, & size and let us know how many are needed. 
ie: One bottle of Xymogen Methyl Protect 120 capsules. 

I know this subject can be very anxiety and fear producing for many of you. My hope is that this information will merely help you feel empowered in your health and the decisions you make every day to protect yourself, your loved ones, and our greater communities. Please continue to do your part in “flattening” this curve and embrace this new recommendation and wear a mouth/nose covering when leaving your home. While we are practicing “Spatial Distancing” let’s not practice social distancing, as it’s important to stay connected to others now more than ever! Please make an extra effort to call someone who might be living alone.

 

We will get through this together and I believe we will come out stronger than ever in the end!!!
 
Thank you for your continued business!
May you stay healthy and hopeful and connected to all!
 
– Carrie
 
Links/Resources
Melatonin has been shown to inhibit NFkB activation and NLRP3 inflammasome activation. In fact, the age-related decline in melatonin production is one proposed mechanism to explain why children do not appear to have severe symptoms and older adults do. Melatonin also reduces oxidative lung injury and inflammatory cell recruitment during viral infections. Typical dosing of melatonin varies widely from 0.3mg to 20mg (the latter used in the oncological setting as cancer prevention).
https://www.melatonin-research.net/index.php/MR
https://www.sciencedirect.com/science/article/pii/S1756464619302452
https://www.sciencedirect.com/science/article/pii/S0024320520303313
(BIH carries a few of these brands with different doses.)

Quercetin
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6273652/
https://www.thorne.com/products/dp/quercenase-reg

Curcumin
https://www.ncbi.nlm.nih.gov/pubmed/25600522
https://www.orthomolecularproducts.com/traumeric/551090/
https://www.thorne.com/products/dp/meriva-500-sf-120?gclid=Cj0KCQjwybD0BRDyARIsACyS8muhWj4tf0lQAtgCMBchehIe-usAUx9PktE5bdUuzJmgoQA1W7ae6SoaAobXEALw_wcB
(BIH carries these)

Green Tea and other Antioxidants like NAC, Vitamin C flavonoids, polyphenols
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711683/
https://www.ncbi.nlm.nih.gov/pubmed/26299975
https://www.sciencedaily.com/releases/2007/11/071108115608.htm
https://www.lifeextension.com/magazine/2014/1/turn-off-the-cytokine-switch
https://www.xymogen.com/formulas/products/74
(BIH carries these)

Olive leaf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566934/
https://biocidin.com/products/olivirex

Garlic
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537651/
https://www.sciencedirect.com/science/article/abs/pii/S0006291X1530262X
https://allimax.ca/
(BIH carries Allimax)

Andrographis
https://www.nature.com/articles/s41598-017-04673-x
https://www.sciencedirect.com/science/article/abs/pii/S1286457917301247
https://www.orthomolecularproducts.com/viracid/viracid/525060/
https://www.xymogen.com/formulas/products/238
https://mhpvitamins.com/antivirii.html
(BIH will be starting to carry both the Xymogen, Orthomolecular, and Mountain States Vitamins products with Andrographis. Shipments will be periodic for the foreseeable future. Please reach out to the front desk to put in an order for this product and to inquire if you're able to order direct from our vendor with a provider code.)

Zinc
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3407988/
https://www.orthomolecularproducts.com/reacted-zinc/
(BIH carries this)

Vitamin A
https://academic.oup.com/advances/article/8/2/197/4558144
https://academic.oup.com/intimm/article/28/3/139/2614137
https://www.bioticsresearch.com/node/1655
(BIH carries this)

Vitamin D
Likely Safe: Other commonly used natural immunostimulatory and antiviral agents including the following do not appear to increase IL-1B or IL-18 as a part of their immunomodulatory actions. Several of these, in fact, reduce these cytokines and may restore immune homeostasis. These are, therefore, likely safe to use both prior to, and during, COVID-19 infection. Whether these agents mitigate the symptoms or virulence of COVID-19 is unknown and therefore the benefit of these agents during COVID-19 infection is unknown.

Additional botanicals to explore to protect against COVID
https://www.worldhealth.net/news/scientific-look-botanical-plants-and-supplements-against-coronavirus/
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30628-0/fulltext
https://www.medrxiv.org/content/10.1101/2020.03.02.20029975v1
 

iicTQpiMffn1t4ybL6LYP4du7Uu07K7tYBOM not be enough.

What? This virus is Aerosol too? Yes we now believe that COVID is both transmitted by droplet and aerosol

, making it that much more contagious.

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