UPDATED 3-24-2020 by: Erik Lundquist, MD
Like it or not, coronavirus is descending upon us. School closing, travel bans, and quarantines are happening in and to the majorly affected countries. There is good news and bad news surrounding coronavirus, officially called COVID-19, right now. The bad news is that it continues to spread worldwide. Now almost all countries are affected, with hundreds of thousands of total cases. These numbers are continuing to grow rapidly and on a daily basis. The other bad news is that it appears to have a mortality rate of somewhere between 2% and 10% depending on age and country (https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30195-X/fulltext).
Further bad news is that companies within the dietary supplements and natural products industry are feeling the shockwaves. Many ingredients and raw materials for supplements are grown, produced, or processed in China. Industry executives say they expect significant supply chain disruptions.
The good news is that it does not seem to be gaining ground in China as the number of infected individuals seems to be hovering around 80,000 and not growing. Some cities and areas where a strict quarantine was in effect are now starting to see those restrictions loosened. This is a good sign that it may start to fizzle out in China.
More good news is that “Unprecedented, aggressive efforts have been taken to contain the spread and mitigate the impact of this virus.” As of today, there have only been 43 Confirmed & Presumptive Positive cases in the entire United States. An additional 47 people with confirmed Cases of COVID-19 have been repatriated to the United States, with the utmost care taken to ensure that these people do not spread the virus. The Centers for Disease Control and Prevention is regularly providing official updates. You can find the official current number of cases here.
The purpose of this article is to provide some basic recommendations and information regarding possible prevention and treatment of COVID-19. There are a few things that need to be clarified before we make any recommendations.
First, no preventative or treatment recommendations have been approved by the FDA or have been substantiated by significant scientific research or studies. Therefore, all recommendations should be taken with the understanding that they are recommendations to help strengthen one’s immune system and support the body in eliminating environmental toxins through natural means.
The second thing to clarify is that anyone's best hope against COVID-19 is to strengthen their immune system and avoid possible exposure. This is the reason that quarantines have been put into place and why individuals with a weakened immune system are most susceptible.
What is coronavirus and what symptoms does it cause?
Coronavirus is one of the most common causes of the common cold. What makes this particular strain of coronavirus, COVID-19, deadly, is that it gets down into the base of the lungs and causes the immune system to become overactive. Then, the immune system releases lots of inflammatory products that lead to increased mucus and fluid production in the lungs. This leads to a scenario called acute respiratory distress syndrome in those who are more susceptible. These individuals are most often smokers, or individuals with chronic obstructive pulmonary disease or cardiovascular disease. It seems to be affecting men twice as often as women. It also seems to be affecting middle-aged to older men.
An article released by the Lancet on some of the first infected with COVID-19 from the Wuhan, China area became the world’s first detailed case analysis. Chen and colleagues looked at 99 individuals and reported that fever (83%), cough (82%), and shortness of breath (31%) were the most common symptoms among the patients. Other symptoms included muscle ache (11%), confusion (9%), headache (8%), sore throat (5%), rhinorrhea (4%), chest pain (2%), diarrhea (2%), and nausea and vomiting (1%).
What to do if you have symptoms.
First, realize that COVID-19 is nearly impossible to distinguish symptomatically from the common cold or influenza virus since symptoms are the same. If within 14 days of symptom onset, you have traveled to infected areas or had contact with someone who has, then you may have contracted the virus. Otherwise, treat it as the common cold or flu.
If you have a medical appointment, call the office to tell them that you have flu symptoms or may have COVID-19. This allows the office and providers to take steps to keep other patients from getting exposed.
Treatment is primarily supportive, and your provider will discuss specific signs and symptoms in which you would need to seek medical attention. These include difficulty breathing, being unable to keep food/liquids down, and fevers that are not coming down appropriately. As with colds and influenza, not everyone needs to be seen, and staying home reduces spread. If you are unsure about whether you need to be seen, feel free to call us and we are happy to provide advice for your situation.
For optimal benefit, start treatment dosing of supplements as soon as you develop symptoms.
If you are looking to stock up on supplements ASAP, they are available at TCIM.
How do we strengthen our immune system?
The goals that we target to strengthen our immune system are as follows:
Enhance barrier integrity: improve the lining of our respiratory tract, gut, blood-brain barrier, and skin.
Increase production of antimicrobial peptides: small amino acid linked chains that fight against infections.
Promote phagocytosis: a process when white blood cells, such as macrophages, are better able to recognize and consume infected cells, microbes and/or viral capsids.
Decrease inflammation and restore redox balance: lots of oxygen free radicals lead to immune imbalance and increased inflammatory products.
Activate intracellular defense pathways: a process that allows cells that take on bacteria to kill them before they can replicate or cause damage (Nrf2 and SIRT1 activation.)
The recommendations that we give in our immune-boosting prevention kit and immune-activating treatment kit are focused on vitamin and nutraceutical support targeted at achieving these immune support goals.
There are some preventative measures that can be accomplished without taking any supplements. These actions will help to boost the immune system and protect against exposure.
Wash your hands. It is super simple but incredibly important to not transmit the virus to others.
Minimize exposure to crowded areas. We do not recommend that you spend a lot of time traveling or frequenting densely crowded areas where one can be exposed to the coronavirus. Its transmission is through respiratory droplets. Therefore, in order to get infected by COVID-19, one must be exposed to these droplets.
When coughing or sneezing, use a tissue or cough or sneeze into your elbow. This will help to minimize the distribution of respiratory droplets.
Wear a mask if you are experiencing upper respiratory symptoms. Although there is no evidence to support that wearing a regular surgical mask will protect you from getting or spreading COVID-19, it will send a message to people to keep their distance from you. It also shows that you care about others in your community and environment and want to minimize passing on your infection to them.
Eat an anti-inflammatory diet, rich in beta-carotene and vitamin C but low in processed carbohydrates and environmental toxins, such as pesticides and herbicides. Do not underestimate the power of a healthy diet loaded with fruits and vegetables to help you remain healthy. Studies have found that vitamin C alleviates and prevents illnesses caused by viruses and bacteria. Others have found that consuming larger amounts of vitamin C as soon as you begin to feel ill has an even greater impact on shortening the duration of the cold. 6 - 8 grams per day shortened the cold by 17% - 19%. So, as soon as you begin to feel ill, be sure to consume plenty of vitamin C.
Consider stocking up on your food supply. In the unlikely event that your community is quarantined, it would be wise to have a few weeks of food and water stored in your home.
Get adequate sleep. Nothing impairs your immune system more than being sleep deprived. Make sure to get 7 to 8 hours of sleep each night.
Manage stress. Chronic stress can lead to a diminished immune system with an impaired response. Daily meditation, restorative exercise, and strong healthy relationships can bring balance to a weakened and impaired stress response. Adaptogenic herbs can be helpful in the recovery of the body’s innate stress response.
TCIM’s Immune Boosting Recommendations:
The following vitamins, botanicals, mushroom extracts, and probiotics have been shown in vitro, and in animal and some human studies to enhance the immune system in one or more of the ways mentioned under the section “How do we strengthen our immune system?”
These are the products we are prescribing and recommending to our patients in our clinic. They may be purchased in our clinic, or online through the links at the bottom of the page. We hope you find the products helpful. Please note that if you are pregnant or breastfeeding, it is important to check with your provider before adding or increasing the amounts of any vitamin, supplement, or immune-boosting product.
Immune Boosting Prevention Kit:
Vitamin C - 1000 mg per day. Metagenics UltraPotent C 1000 or LipoSpheric C 1000mg Packets
Beta Glucan - 250 mg, 1 capsule per day. ImmunotiX 250 from Xymogen - we have a limited supply of this product in the office.Additional Beta Glucan sources can be purchased from Fullscripts.
Melatonin - 3-5 mg, 1 capsule or tablet 30 min before bed. It is critical to make sure it is dark after taking. Do not take for long periods of time.
Immune Boosting Treatment Kit:
Argentyn 23 Colloidal Silver - 1 tsp orally or nebulized 3x per day Note: nebulizing can increase spread of coronavirus in the air and allow airborne particles of the virus for up to 2.7 hours, therefore ONLY nebulize in a place limited to treatment (ie personal bedroom, not living room) We do carry nebulizers in the clinic.
Vitamin C - 4000-6000 mg per day. Metagenics UltraPotent C 1000 or LipoSpheric C 1000mg Packets. - Note there is a shortage of LipoSpheric C in the office. You can make Liposomal Vitamin C with Vitamin C powder + liquid Phosphatidylcholine. Your body has a unique ability to uptake Vitamin C when you are ill. You may be able to tolerate 1000 mg every 4 hours while awake when you are ill. Decrease dose if you develop diarrhea. Metagenics uses a buffered Vitamin C that is preferred for those with sensitive stomach or with a compromised gastrointestinal function.
Probiotics with Saccharomyces Boulardii - 1 capsule twice per day. UltraFlora Acute Care or UltraFlora Spectrum from Metagenics or OrthoBiotic from OrthoMolecular. Another option is UltraFora Immune Booster by Metagenics.
IF having issues with sleep, Melatonin - 10 mg, 30 min before bed. It is critical to make sure it is dark after taking. Do not take for long periods of time. Melatonin helps to stabilize the inflammatory response (decreases inflammasome production from NLRP3), decreasing risk for cytokine storm.
Beta Glucan - 500 mg 1 capsule daily ImmunotiX 250 from Xymogen. An alternative product is Transfer Factor Multi- Immune by Researched Nutritionals 2 capsules twice a day away from Meals. Beta Glucan can also be purchased through Fullscripts see below. - (for those with lyme do not use high doses of beta glucan). Do not take Transfer Factor Immune if pregnant.
Andrographis and mushroom extracts - 3 tablets twice a day of either Start mushroom extracts first and then two days later Andrographis. Options include:ImmunoCore, or Mycotaki as well as Andrographis Plus from Metagenics. Additional option is Innate Immune Support from Pure Encapsulations (astragalus, andrographis, reishi, and beta glucan) 2 capsules twice a day for illness. Andrographis should NOT be taken if pregnant or breastfeeding.
N-acety Cysteine (NAC) - 600 mg, 2 capsules twice daily. By Xymogen or Now Brand from a health food store. It helps with clearing mucus from lungs and increases glutathione production.
Magnesium - 200-340 mg daily has been shown to improve airway flow particular with persons with asthma.
Fish Oil - 2 - 4 grams daily can decrease airway inflammation markers
Zinc - 15-30mg daily. Required for normal functioning of white blood cells.
Tocotrienols (a specific form of vitamin E) (acgrace.com) 1 capsule for every 40 pounds of bodyweight for 3 months. Tocotrienols specifically prevent oxidation and protect the integrity of the cell membrane.
Liposomal Glutathione - Essential Pro Caps (Body Bio) potent antioxidant and helps with cell detoxification. 1 capsule daily for maintenance, 2- 3 per day for active infection. OR use Trizomal Glutathione ½ tsp daily for maintenance or 1 tsp up to 3x a day for respiratory illness. We carry Trizomal Glutathione (Apex Energetics) in the office. 1 -2 tsp gargled then swallowed can also help with sore throat pain. Trizomal glutathione is a unique blend of acetyl glutathione plus liposomal glutathione plus NAC to help support intracellular and antioxidant production and helps to balance the immune system.
ImmunoThrive - (Moringa, PineBark, Curry Leaf, Turmeric, Spirulina) --no need to take if you are healthy. Take 3 capsules daily. Provides inflammasome protection to cell membrane, helps to improve tissue oxygenation, and regulates the immune response.
Biocidin TS Throat Spray - 2-3 sprays 2-6 x a day to soothe sore throat.
Mucostop - by Enzymedica to help break down excess mucus. 2 capsule 3 x a day 1 hour before or 2 hours after meals
Immunoberry - by Designs for Health (ElderBerry, Mushroom extracts, and Beta Glucan)- 1 dropperful daily for prevention and 2 dropperful 2-3x per day for illness until symptoms improve.
Vitamin D3 - 400 - 1000 IU daily for children over 1 year of age for prevention. Increase 2-3 x dose for illness until symptoms improve.
Probiotics - MetaKids Probiotics by Metagenics - chew 1 tablet daily for prevention and increase to 2 x a day for illness. For INFANTS < 1 year of age Use MetaKids Baby Probiotic 6 drops daily for prevention may increase to 6 drops twice daily for illness.
Vitamin C -UltraPotent C Chewable by Metagenics 500 mg daily for prevention increase to 500 mg up to 3 x a day for illness. May increase dose for children >2 years of age.
Argentyn 23 Colloidal Silver - 0.5-1 tsp 2x per day in Nebulizer or up to 7x per day under the tongue.
Curcumin - helps to decrease NF-KB which is an activator of inflammation. Nordic Natural curcumin gummies Chew 1-2 gummies 1-2 x daily for illness.
Metagenics - products can be purchased at www.Metagenics.com
Practitioner Code: elundquist
Xymogen - products can be purchased at https://wholescripts.com/register/TCIM-LUNDQUIST
Practitioner Lundquist, Code: TCIM
Researched Nutritionals - https://www.researchednutritionals.com/product-category/health-products Use practitioner code: LUNMD
Dr. Lundquist is Board Certified in Family Medicine with ABFM and he is sub-specialized with the American Board of Integrative Medicine (ABoIM). He has also has received a certification from the American Board of Integrative and Holistic Medicine (ABIHM).
Dr. Lundquist has a special interest in Integrative and Holistic medicine. He is currently the founder and medical director for the Temecula Center for Integrative Medicine specializing in all aspects of Functional Medicine. He is a member of the American Holistic Medical Association as well as the Institute of Functional Medicine. He specializes in endocrine disorders, especially thyroid and adrenal dysfunction, chronic fatigue, migraine headaches, cardiometabolic disorders, and chronic pain.