Hello everyone, the past several weeks have been an unprecedented and challenging time for many of us. I thought this was an appropriate time to discuss my thoughts on the current COVID-19 pandemic and what actions you can take to stay healthy. I also will discuss vitamins and supplements that can help keep your immune system functioning optimally. This is not an exhaustive list of possible immune boosting supplements but does contain a fair amount of information that I find useful for my patients. If you would like to discuss other alternative herbal supplements for immune support, I would be happy to make recommendations. Can supplements boost your immune function? Yes, they likely can. Without adequate nutrients, vitamins, and minerals your body cannot perform optimally. However, to date, there has not been enough research to know if these supplements are effective against COVID-19. These are general guidelines, please contact us if you would like individual advice.

COVID-19
I know this is a stressful time for everyone. The unknown is scary and much of the information we are receiving is either incomplete or inaccurate. My personal opinion of this virus is that it is very contagious but that the mortality rate is likely nowhere as high as they are stating. Many people in the U.S. have already had this virus (I suspect millions already) and have had relatively minor symptoms such as congestion, cough, sore throat, headache and fever. Many people may have had no symptoms at all or mistaken their COVID-19 symptoms for seasonal allergies or a common cold. Recently, the University of Southern California and Stanford released studies showing between 2.49-4.1% of the Santa Clara population and 2.8-5.6% of the Los Angeles County population showed evidence of prior infection. This was up to 85 times higher than the current number of estimated cases (15). It is my opinion that more data like this will come out in the near future and will therefore show the mortality rate to be much lower than currently stated. It is however, important to remember that this virus can be very serious to certain populations and has been proven to be very contagious.

One way we are working on is to provide antibody testing for our patients to determine if you have already had or been exposed to the virus. This is not yet available but we will keep you informed as they become available. This test is a blood test that tells us if you have been exposed or infected with the virus in the recent past. It is not a test to determine if you are currently infected. We would like to stress that we would like for you to stay home if you are feeling ill. If you do become ill or would like to avoid the office during this time, we would be happy to set up a telemedicine consult for you.

What can you do to stay healthy?

1) Wear a face mask in public. Although face masks are not 100% effective, they do significantly reduce the risk of spreading the virus. This is especially true if the person infected (who remember may not have any symptoms) is wearing a mask. Due to this, it is my opinion that you should wear a mask when in public spaces.
2) Wash your hands thoroughly and often. Many people do not wash their hands effectively. According to the CDC: You should wet your hands thoroughly and apply an anti-bacterial soap. Lather your hands and scrub for 20 seconds (sing happy birthday twice) and rinse with clean running water. You should wash your hands after being in public, after touching surfaces or objects that are frequently touched (think doorknobs), and before eating or touching your face.
3) Sleep 7-8 hours each night
4) Exercise regularly
5) Eat a healthy and varied diet
6) Take supplements and medications as recommended by your physician and healthcare providers

Vitamins and Supplements
Vitamin D: Vitamin D is a fat-soluble nutrient that is essential to the function of your immune system as well as bone health and mood. Vitamin D improves the disease fighting ability of your white blood cells. Vitamin D3 is made in the skin in a reaction that is dependent on sunlight and can be taken as a supplement. True vitamin D3 deficiency is typically defined as <30ng/mL, but many functional medicine doctors (including myself) believe levels >60ng/mL are likely even better. I also always recommend vitamin K with vitamin D. Vitamin K promotes calcium accumulation in the bones while reducing calcium accumulation in soft tissues and blood vessels. (9)

Vitamin C: Vitamin C supports the function of various immune cells, enhances their ability to fight infection, and also is a powerful antioxidant. Some physicians are using high dose vitamin C given intravenously to treat those who are critically ill with COVID-19 (7,8). I am personally taking additional supplements of 1000mg three times daily and giving myself IV vitamins twice monthly to help my immune system highly functioning for the time being. While IV vitamin C is not a cure for COVID-19, I would insist on this treatment at least daily if I were to become seriously ill from COVID-19.

Vitamin E: Vitamin E is a fat-soluble vitamin that is a potent antioxidant found in cell membranes Vitamin E is found in nuts, and vegetable oils. Soybean, sunflower, corn, cottonseed oil are very good sources of vitamin E (10). Supplementation with vitamin E may improve several types of white blood cell function. Some studies have even shown lower rates of respiratory infections with vitamin E (10).

Vitamin A: Vitamin A is a fat-soluble vitamin that is crucial for maintaining vision, supporting growth, and supporting healthy immune function. Vitamin A is important for the function of T cell signaling and IL-2 secretion. Vitamin A likely has several other functions in supporting the immune system. Vitamin A is found in sweet potatoes, cod liver oil, fortified grains and milk, carrots, spinach, broccoli, and fruits such as apricots or cantaloupe.

Vitamin B6: B6 deficiency has been shown to slow the growth and development of white blood cells (5), and B6 supplementation has been shown to improve the immune response of critically ill patients (6). Vitamin B6 can be given as a supplement and is found in fish, poultry, pork, whole grains, and vegetables.

Zinc: Zinc is a mineral that is needed for immune cell development and communication. Zinc has been shown to improve response to the common cold and likely help prevent respiratory infections (13). In addition, zinc may improve the response of those who are already sick.

Selenium: Selenium may be important in immunity. Research shows that selenium helps fight influenza in animals. Selenium supplementation with 100ug/day has been shown to increase T cell responses and help a number of immune functions (citation). Selenium is found in the soil and is delivered to your body through plants grown in the soil. Interestingly, Australia and New Zealand are deficient in selenium. (3)

Magnesium: magnesium is arguably the most important micronutrient in your body. It is involved in hundreds of enzymatic reactions in the human body and is important in bone health, electrical activity of heart cells, muscle function and more. The full role of magnesium in the immune system is not known but it has been shown to be a cofactor for antibody synthesis and immune cell function (2). Magnesium is found in green leafy vegetables, whole grains, bananas, avocados, beans, almonds, and cashews.

Sleep: Sleep is important for recovery and recharging. Studies have shown that sleep deprivation can weaken the immune system. Also, certain immune functions peak during sleep (12).

Exercise: Exercise has many benefits from improved cardiovascular risk, reduced obesity and diabetes, enhanced mood and self-confidence but also supports healthy immune function. Regular moderate exercise is fairly well accepted to support healthy immune function. Studies have even shown that near daily brisk walking reduced the number of sick days taken by half. (11)

TH-1 Support: This is a supplement from Pure Encapsulations. This supplement contains zinc, berberine, Chinese skullcap, broccoli sprout extract, and ginger root. Ginger is an anti-oxidant and may help prevent the generation of free radicals as well as have immune supporting and anti-cancer effects (citation). This supplement is designed to help balance cytokines and to support Th1 cell differentiation. Th1 cells are a major part of cell-mediated immunity against viral infections. (14)

IV Therapies: We offer several types of IV therapy. Our immunity boost IV contains high doses of vitamin C, glutathione, and B complex vitamins (vitamins B1,2,3,5&6). We also offer the Myers cocktail, which has been used for decades for many different issues. We can also use additional medications or vitamins based on your individual needs.

Thyro-essentials: While this supplement is designed to support thyroid health, I often recommend it (and take it personally) for other reasons. Thyroessentials contains Ashwaganda, which is an adaptogenic herb used in adrenal support and chronic stress. Thyro-essentials also contains vitamins A/D/B12/Riboflavin as well as selenium, magnesium and zinc.

Please let us know if you have any specific questions or concerns. Thank you for trusting us with your health.

Nick Gentry, M.D.

References:

  1. Ginger: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665023/
  2. Magnesium: https://www.nature.com/articles/1601689
  3. Selenium https://onlinelibrary.wiley.com/doi/full/10.1111/j.1747-0080.2008.00260.x
  4. Vitamin A https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2906676/
  5. Vitamin B6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358464/
  6. Vitamin B6 https://www.nature.com/articles/1602439
  7. Vitamin C https://www.ncbi.nlm.nih.gov/pubmed/29099763
  8. Vitamin C https://journal.chestnet.org/article/S0012-3692(16)62564-3/fulltext
  9. Vitamin D https://pubmed.ncbi.nlm.nih.gov/30675873/
  10. Vitamin E https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266234/#!po=0.574713
  11. Exercise http://www.luzimarteixeira.com.br/wp-content/uploads/2011/04/exercise-immune-system.pdf
  12. Sleep https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/
  13. Zinc https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2277319/
  14. Th-1 Support https://www.pureencapsulations.com/th1-support.html
  15. COVID-19 Antibody testing https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1