2020 Questions “From the Heart” Series
With each day that passes, the numbers of cases keep going up. Lately, I wonder how many of us are starting to check ourselves for any little symptom showing up . . . a cough, a sneeze, feeling tired more than usual? Sound familiar? Since our nation is in the beginnings, case numbers are predicted to rise. Yet, our hopes and prayers with everyone doing what is needed to stay home and keep our distance, the numbers will eventually show a downward trend in the weeks and months ahead.
What changes have you made this week to protect your family and neighbors? I know I am sanitizing surfaces frequently. Also, when packages arrive, we keep the items in the garage for up to six days, and wash hand thoroughly in the garage before entering the house. We also wash our fruits, vegies, and our car’s steering wheel and doorknobs.
WHAT DOES YOUR DOCTOR TELL YOU?
Ever wonder what integrative/functional healthcare providers tell their patients compared to what our own doctors say? Let’s find out some basics recommended by integrative healthcare providers for Nutritional Support, Movement/Exercise, and Stress Management. One such Integrative/Functional Medicine is Dr. Aaron Hartman, MD, Richmond Integrative & Functional Medicine. Since the beginnings of this global health crisis, Dr. Hartman offers ongoing videos with general recommendations to boost immunity and general wellbeing from an integrative/functional medicine perspective. He considers the “. . . first pillar of functional medicine, Diet and Nutrition, applies today during a global pandemic . . . this is a way of leveraging things at home to boost your immune system.”
I have listened to his videos so far and have summarized his main recommendations. Dr. Hartman has been amazed at how much misinformation is out there. So, his goal is to help us become educated, calm some hysteria, and provide useful resources and action plan for families. As he stated, “We don’t need to be afraid, but we do need to take this seriously” and be wise. Along with doing what is advised and mandated, he encourages us to engage our culture and those around us to be more human and better connected. He also stresses the importance of thorough 30 second hand-washing, social distancing, and quarantining are paramount during this time.
Keep in mind, any general recommendations offered are for educational purposes only. Dr. Hartman asks you to always follow up with your own physician to ensure you are getting appropriate care from those healthcare providers who personally know your specific needs.
One of the tricky things about COVID-19 is there isn’t much on this new virus from peer-reviewed published data since this is all evolving preliminary data coming from multiple venues. That is why Dr. Hartman feels everyone should work with their healthcare providers who have years of clinical experience and can hopefully interpret the published and anecdotal data out there. The good news is there are significant 20 plus years of peer-reviewed published data on the benefits of healthy eating and targeted nutraceuticals integrative and functional medicine providers utilize in caring for their patients. At the end of this article are links you can access to become more informed about integrative/functional healthcare and wellness, along with COVID-19 links of interest.
For prevention, Dr. Hartman suggests people wipe down packages and let sit for 24 hours (cardboard) to about three days (plastic & metal). Also, the virus can stay airborne for about three hours after a person coughs or sneezes, which is the vital reason for social distancing and isolation. A hepa filter could also possibly remove viruses from suspended air. Based on his own personal routine, when he comes home from work, he has a separate entrance, removes his clothes, and takes a shower before greeting his family.
FOOD AS MEDICINE
Our first focus here will be on Nutritional Support. With “Food as Medicine,” Dr. Hartman suggests the following for foods and nutraceuticals/supplementation to discuss with your doctor for preventive and acute dosing depending on your age and condition. Also, make sure you have a healthy lung microbiome.
- Learn what are the core principles of healthy eating, health maintenance, disease prevention, awareness of your relationship with food
- Fruits and vegetables are rich phytonutrient sources, along with whole grains, legumes, herbs, spices, nuts, seeds, and teas. To promote good health, eat fruits and vegetables of varied color daily.
- Be aware of health problems of specific foods eaten frequently and avoid. It is important to learn how to eat an enjoyable, nutrient-dense diet for optimum health.
- Green Tea (active ingredient increases zinc into your cells and helps fight off infection better)
- Apples & Onions (active ingredient, Quercetin, helps zinc enter your cells, has antiviral activity)
We all know there are multiple dietary plans and supplement products out there. So, how do we choose the right ones? According to Lara Pizzorno, MDiv, LMT on Functional Perspectives on Food and Nutrition: The Ultimate Upstream Medicine, “From Hippocrates, we say, ‘Let your food be your medicine,’ but in functional medicine, we also say, ‘Food is information’—it is not just random. It is turning genes on and off, setting up the release of certain transcription factors and signaling cascades . . . It appears that regardless of whether the diet is Mediterranean, Paleo, or vegetarian/vegan, the key issue is the quality of foods consumed.”
This is one key reason to do our homework and work with our healthcare providers. You can no longer think by grabbing a coffee and a two-minute media soundbite while racing to your next appointment is going to work this time or ever again! So, let’s get started.
To help boost your immune system, begin with your choice of whole foods and menu tailored to your own needs for optimum health. Learn to prepare meals that provide your family with all the basic immune boosting nutrients. Some of the most nutrient dense foods include Salmon, Kale, Spinach, Sweet Potatoes, Cruciferous foods (i.e. broccoli, cauliflower), Almonds, Liver, Sardines, Blueberries, Raspberries, Lentils, even Potatoes and Egg Yolks, just to name a few! And don’t forget all those awesome herbs and spices, such as turmeric, basil, garlic, ginger, and more to lift your flavor palate and immunity.
One must, of course, create a menu that supports your own health conditions. The National Cancer Institute’s “nutrient-dense foods” definition is “Food that is high in nutrients but relatively low in calories. Nutrient-dense foods contain vitamins, minerals, complex carbohydrates, lean protein, and healthy fats. Examples of nutrient-dense foods include fruits and vegetables, whole grains, low-fat or fat-free milk products, seafood, lean meats, eggs, peas, beans, and nuts.“
Dr. Hartman stated about 53% of coronavirus cases have digestive problems with fewer other more typical symptoms. So, he suggests people consider their food sources and distribution setup for receiving foods. Most distribution setups involve at least three plus people handling the foods from farm to you. Consider safety and sanitizing concerns when you come home with your groceries.
As you look over these options for boosting your immune system, remember the foods you are eating and drinking that provide essential nutrients along with when choosing supplements. It may also prove helpful to have a nutritional status test(s) done to determine which nutrients to initially focus on. There are multiple specialty labs for this purpose. Ask your healthcare providers which ones they utilize.
Dr. Hartman strongly recommends checking with your doctor and compounding pharmacy for high quality nutraceutical/supplement products used by physicians. Do your due diligence in choosing quality, safe sources, appropriate use & dosage, and duration for taking them based on nutrient testing levels, particularly with children. And take into account any good or bad prescription drug interactions of medicines you may be taking. Not all supplements are equal, nor are our bodies. Dr. Hartman’s suggested daily dosages are for healthy adults, not children.
- Vitamin D3 (5000IU; combined with C & E reduces “cytokine storm” or dis-regulation risk; helps reduce respiratory tract infections, Journal of Pharmacology & Pharmacotherapeutics)
- Vitamin A & non-vitamin A carotenoids (helps balance two sides of our immune and antibody systems, TH1 & TH2; supports phagocytes function; be cautious of dosage on vitamin A; elderly tend to be low in Vit A)
- Vitamin complex (B6 50mg, B12 500-1000mcg, Folate 400-800mcg)
- Vitamin C (2000+mg; helps recycle l-glutathione; has antiviral effects; increase T cell response and antibody production; combination C, E, Selenium for pneumonia)
- Vitamin E-mixed tocopherols (200-400IU; helps protect cell membranes; elderly tend to be low in Vit E)
- N-Acetyl Cysteine (NAC) (improve respiratory tract function; helps recycle L-Glutathione for immunity and energy)
- Zinc (30-50mg; supports innate immune system; antiviral; Lancet data, Reducing mortality from 2019-nCoV: host-directed therapies should be an option)
- Selenium (200-400mcg; supports innate and adaptive immune system, anti-inflammatory)
- Omega 3 & 6 (balanced ratio with 600/400 EPA & DHA)
- Echinacea, Elderberry, or Herbal antiviral modulating blend-i.e. Viracid (useful when symptoms appear but not long term preventive without breaks)
Other integrative providers who sent me a list include IP-6 (inositol hexaphosphate), allicin extracted from fresh garlic, water-soluble form of wild Oregano, and fermented/high concentrated form of Glutamine. Some are giving their patients IV Myer’s Cocktail for a variety of conditions. China has actually did clinical trials and used IV Vitamin C for critical cases. Each healthcare provider has their own clinical experience with certain products for prevention and treatment of ailments. We then, with healthcare provider input, will need to decide which ones, not all, to consider during this evolving challenge.
Dr. Hartman explains that nutraceuticals are basically food extracts or “super purified foods”, such as curcumin as an extract from turmeric. Drugs can also be extractions, such as with statins coming from red rice yeast, or pencillin from mold that has also been super purified. Utilizing any drug, nutraceutical, or supplements needs to be assessed based on your own body’s interaction and health condition.
This is particularly important when a fever is involved as to when and what to use. A fever, according to Dr. Hartman, “. . . is your body’s natural response. When your body temperature goes up one degree your . . . antibody production is boosted a lot.” He included interferon that also boosts your innate immune system. So, unless the fever has reached a dangerous level, the body needs to do what it is designed for. Another good reason to have your healthcare provider involved.
During this challenging time we have this opportunity to reflect on Food as Medicine that can significantly boost your immunity and reduce the pervasive chronic, life-threatening diseases in our nation. With COVID-19, life-threatening risk is more significantly accelerated for those with chronic conditions. Isn’t it time, therefore, to make permanent health enhancing changes in our daily lives and nation now? What are you going to do to slow down the predicted US and Texas case numbers and peak from becoming real as modeled by Covid Act Now? Let’s hope, pray, and take action so their predicted numbers don’t happen. Most of these predictions are based on how we will respond to isolation and quarantine. If we don’t do our part, the numbers will only escalate.
One hopeful perspective Dr. Hartman emphasized is “About 80% of people who get this infection will either have no symptoms whatsoever or will have a mild respiratory tract infection. About 20% of the people will need to interact with the healthcare system, with the doctor, get hospitalized. About 5% will go into an intensive care unit . . . what we have been focusing on is slowing that 20% being exposed and needing hospital intervention . . . So, how can we make more people able to boost their immune system so we have less getting sick and need to interact with the healthcare system?”
Dr. Hartman also mentioned another hopeful possibility in a Wall Street Journal article, March 24, saying “. . . There’s little evidence to confirm that premise [kill millions without shelter-in-place orders and quarantines]—and projections of the death toll could plausibly be orders of magnitude be too high.”
No matter what unfolds, he believes through each one of our actions, we can reduce the burden on our healthcare system and our own lives so we will be stronger and prepared in the future. And although everything is preliminary for where this is taking us, another piece of hopeful news, according to the Washington Post, comes from John Hopkins and others that the virus has not mutated to any significant extent, being more stable, suggesting a vaccine would offer lasting protection.
Again, only time, published COVID-19 outcomes, and recovered patients will tell us what prevention, containment, mitigation tools in our nation’s healthcare/wellness toolkit has made all the difference. Yet, let us all as patients help ourselves, neighbors, and our doctors become informed, proactive advocates for the health of us all. The next article, part 4, will cover the other two basics, Movement/Exercise and Stress Management.
To Learn More:
Food Data Central, USDA (provides expanded data on nutrients and other foods components as well as links to sources of related agricultural, food, dietary supplement, other info)
Integrative Medicine: A Clinician’s Journal (peer-reviewed journal providing practitioners with a practical & comprehensive approach to integrating alternative therapies with conventional medicine)
Integrative Practitioner (to foster collaboration and dialog among licensed practitioners and healthcare professionals who aim to advance integrative medicine and interact with leaders in their respective fields)
Institute of Functional Medicine (Functional Medicine is a systems biology–based approach that focuses on identifying and addressing the root cause of disease)
Alternative Therapies Journal (to promote the art and science of integrative medicine and a responsibility to improve public health)
Office of Dietary Supplements (NIH)
Today’s Practitioner-COVID-19 Resource Center
American Nutrition Association-COVID19
Boerne COVID-19 website
Kendall County website
Boerne Mayor Handren’s March 23 declaration
Kendall County, Texas, Judge Lux’s March 20 declaration
15 Days To Slow The Spread (Kendall County)
“Essential Services” Attachment – Boerne Mayor 3rd Declaration (March 23)
City of Fair Oaks Ranch
State of Texas Executive Order (March 19)
Covid Act Now (National; organization team of data scientists, engineers, and designers in partnership with epidemiologists, public health officials, and political leaders to help understand how the COVID-19 pandemic will affect each US region by state; Texas)
John Hopkins Interactive COVID-19 Map (Global)
Centers for Disease Control (CDC)
World Health Organization (WHO)