A NUTRITIONAL PROFESSIONAL’S RECOMMENDATIONS FOR CORONAVIRUS-19

The article reprinted below is by Dr Adria Rothfeld, DC, MS, CNS, an experienced nutritional professional. It contains a lot of timely information from Functional Medicine Research, most of it in abbreviated form.

Functional Medicine treats the whole patient, not the disease. It looks at the underlying causes of diseases and conditions in a particular person then works on rebalancing the body to return the person to full functioning. In comparison, Western Medicine (also sometimes referred to as Conventional, Traditional or Allopathic Medicine) generally looks at our symptoms and tries to match them up with medications to reduce those symptoms. In Western Medicine you’re often viewed as either ‘healthy’ or ‘sick’. If you’re ‘healthy’, you don’t need medication. If you’re ‘sick’, you’re generally prescribed something to control your symptom(s).

COVID-19 Functional Medicine Research Dr. Adria Rothfeld, DC, MS, CNS

 Adria Rothfeld on (3/28/2020)

About Dr Adria Rothfeld

Dr. Adria Rothfeld is a nutritionist in New Jersey and New York. With over 25 years experience, her qualifications include: DC: Doctor of Chiropractic, MS Clinical Nutrition, Certified Nutrition Specialist, First Line Therapy Personalized Lifestyle Medicine Certification, Member of the Professional Advisory Board for the Cancer Support Community of Tinton Falls, New Jersey, Lecturer at Memorial Sloan Kettering, Riverview and Centra State Hospitals, Former Nutritional Consultant for the Avon Corporation.

Dr Adria Rothfeld, author of the following article

The following is Dr Rothfeld’s article, reproduced from her own website:

I have compiled this document after a great deal of study as well as collaboration with highly respected colleagues in the field of integrative medicine. I would like to give credit to the following professionals who have devoted much of their time and resources to researching this topic:

  • Ilana Zablozki-Amir, MD: Together we compiled this document with research from multiple sources.
  • Designs For Health: Dr. Peter J. D’Adamo, ND, Dr. Todd Lepine, MD, Dr. David Brady, ND for their informative presentation earlier this week
  • Dietrich Klinghardt, MD, PhD of the Klinghardt Institute

Please be advised that I am not a medical doctor, I am a nutritional professional and this document covers evidence-based strategies to impact the pathways associated with viral spread and infection-it is NOT a substitute for medical diagnosis, care, or treatment. Do not implement without advice from your nutritional or medical professional. There can be interactions with medications as well as adverse side effects if done without appropriate guidance.

I will be updating this document often as additional information becomes available.

Stages of Viral Infection

Targeted Strategies for 4 Different Phases of Coronavirus:

  • Transmission/Incubation
  • Attachment to mucus membranes
  • Inhibit Replication: Cell division and advancement: Penetration to cell/nucleus to use our replicator machinery to create its own proteins.
  • Hijacking of immune system Cytokine Storm

A. Transmission-Preventing virus from entering the body

Surfaces: Can live multiple days on surfaces (depending on type ie cardboard vs metal vs plastic, etc. – average 3-9 days).

  • Use 70 percent alcohol-based cleaners, Hypochlorous acid, Hydrogen Peroxide, and Colloidal Silver
  • Heat over 108 Fahrenheit destroys the virus.

Hands: Most transmission is from hands to face. Biggest risk is touching face, mouth, nose, eyes.

  • Wash hands with soap and warm water thoroughly 30 seconds (see video called Proper Hand Washing Technique to see how easily areas are misse.d https://www.youtube.com/watch?v=cbX0xwKORjk
  • Antibacterial triclosan cleansers/wipes are not indicated since they deplete our protective bacteria.
  • Gloves: Most gloves- disposable, washable, dish gloves, winter gloves, etc. Especially important to remind us not to touch our face. Nitrile, latex or rubber gloves. If not disposable, you can wash the gloves with soap or grease cutting detergent-to destroy lipid envelope around virus. You can wash these gloves throughout the day while wearing, like you would your hands, if waterproof. If you plan to wash in laundry, can presoak in steamy hot water before laundry since hot water may not be enough to kill the virus in the machine.

Masks: protect against droplet spray. N95/99.

B. Incubation- You’ve been exposed, the virus has entered your body, but you are asymptomatic (ex. 4-5 days before developing symptoms). We want to interfere with the ability of the virus to attach to our mucus membranes. I believe this is where most of us need to start since it is almost impossible to assume in our higher risk regions that we have not come in contact with the

Resides in respiratory tract – mouth, tongue, nose, throat. One study showed very high viral counts in the mouth, especially the tongue. May also reside in GI tract.

Goals for prevention of infection:

Wash them out

Interfere with first parts of their life cycle:

  • with lipid envelope around virus
  • with ability to attach to mucus membranes

Mouth/Throat

  • Oil pulling: Helps remove because the virus has a lipid (fatty) envelope that attracted to oils. Swish 1 TBS oil around in mouth until completely saponified which means it loses its oily feel, and takes about 10-15 minutes of swishing/gargling around or so, then spit in trash not sink.

   Coconut oil is a good choice.

  • Toothbrush disinfection: 3 percent peroxide daily
  • Tongue Brushing

Herbs That Interfere with Viral Attachment: Those in the mint family: Target the structures on viral envelope that are responsible for attachment to our cell membranes.

Best is lemon balm, also oregano, mint, basil, sage, rosemary, savory, hyssop. Use throughout the day in meals and teas -no studies on how much but most important is a combination of herbs as they work better as a team.

Keep mouth bathed in herbs that block attachment: Herbal teas

Double strength-2 teabags per cup of hot water then as they cool can continue to drink or use as mouthwash/gargle. Lemon balm, caraway, Greek mountain tea, Elderberry which works well with green tea, ginger, mint, oregano: Mountain Tea from Traditional Medicinals. Stinging nettle tea: Upregulates antiviral cytokines.

Ellagic acid: Also interferes with attachment-berries

  • Blackberries, Raspberries, Rose hips, Pomegranate juice, Cranberries: in order from highest to lowest concentration.

Mannose Binding Lectins are inhibitors of SARS-like coronaviruses. Best food sources are leeks, garlic and onions. Fresh crushed garlic is probably the best source. Vitamin D also helps to raise MBL levels.

Colloidal Silver. ex ABL silver, Designs for Health Silvercillin- spray/swish in mouth, gargle

Throat Sprays-Honey propolis, Silver

Saltwater gargle

Nasal passages:

Aromatherapy with essential oils

Lemon balm, thuja, caraway, mint, oregano, rosemary, sage

Can bathe sinus passage-using diffuser

Or take Essential oil bottle, agitate closed battle with lid, the open and place bottle under nostril and slowly inhale at regular intervals throughout the day

Sprays/Washes:

  • Colloidal silver, spray -protects membrane barrier
  • Herbal Nasal wash- cleans out: Neti Rinse

GI Tract

Wash hands as above

Clean toilet seat

Protect GI Mucus Membranes

  • Pre and Probiotics
  • Zinc
  • Quercetin
  • Slippery Elm/Aloe
  • SBI protect powder

C. Penetration to Cell Cytosol and Nucleus and Replication:

The virus sabotages our cells for our machinery to replicate/reproduce, become powerful, and take residence.

Viruses are DNA or RNA type (or can be others like Retro, etc).      

Inhibit viral replication:

  • Zinc Lozenges 10-15 mg after meals
  • After each meal-good to bathe mouth and throat esp upper respiratory during initial days when the virus is replicating. Picolinate and oxide forms are least effective.
  • Oral zinc capsules, ideally with food or can get nauseous. Think Zinc deficiency in loss of taste, and/or smell that is associated with the virus.

Arginine Avoidance

Many Viruses love arginine since they need it to replicate.

Nuts, seeds, chocolate—may be best to limit when viruses are a concern. From highest arginine: Macadamia highest, sesame, pumpkin, sunflower, pistachio, cashew, chia, flax, pecans. Coconut and chestnut are negligible so are fine.

L-Lysine, an amino acid, competes with arginine 1000-1200 mg/day, slows replication and works well in combination with vitamin C and green tea.

Lemon balm- Strongly protects against attachment viral replication for a wide variety of virus types-also calms anxiety without causing drowsiness. Teas, aromatherapy, supplements

ACE2 Receptors-Coronavirus enters our cells via a receptor (doorways) known as ACE2.

These are found on epithelial cells and very prominent in mouth and on tongue, respiratory tract/lungs.

The question hotly debated now is do you suppress expression of the receptors (fewer doors), or do you want to enhance them because the virus ultimately destroys them and they are critical component of homeostasis/balance in the body.

Selenium, A, C, D, E and calcium increase the doorways/receptors.

Blood pressure medications including Ace inhibitors and ARBs upregulate them too- but on some studies, especially for ARBS- these have been found to be protective.

Elderberry targets the lipid envelope and halts upregulation of ACE2 receptor. Targets the envelope and as discussed above, viral attachment.

In a 2019 study, which was not a human trial, Elderbery was found to be active against coronavirus. Dose: 700- 1000mg/day since that was dose recommended for flu and similar viruses. It is recommended to stop elderberry if sick at approximately day 8 or sooner if lung symptoms since it can aggravate the later inflammatory phase of the virus.

Another mechanism is instead of trying to alter the number of ACE2 receptors would be to interfere with the ability to use them as a doorway to enter the cell.

To travel through receptor/doorway the virus uses S protein spikes to unlock the gate.

Emodin containing herbs interfere with this interaction and help to keep the door closed: These include Japanese Knotweed, (Polygonum Multiflorum/Cuspidatum)

Chinese Rhubarb Root (Da Huang) Yellow Dock (Rumex)- Aloe Vera

Please speak to your health care provider as some of these can have a laxative effect.


D. Immune response Parasympathetic/Sympathetic Nervous System Balance:

The immune system works at its best when feeling calm, centered, balanced. When we enter the panic/fight or flight phase (SYMPATHETIC), the body prioritizes and shuts down the immune and digestive systems. We instead want to support and upregulate the rest and digest PARASYMPATHETIC RESPONSE.

Coherence strategies-Heartmath

Relaxation: Mindset, play, breathe, pray, meditate, movement, laugh, nature, etc.

Melatonin: 3-5 mg: Inflammasomes of the innate immune system activate the inflammatory process. The NLRP-3 inflammasome has been found to be key to activating ARDS and acute lung injury. C, melatonin and humming helps to silence the inflammasome. Propolis as well.

Vitamin C essential for an immune response especially early!!! 1 week prior to infection -so the bottom line is, start now.

  • Dosing for resp infections- minimum 4g/day-cautious if you have a history of kidney stones, or high iron levels. Smaller doses divided throughout the day and not more than 4 hrs apart.
  • Food sources not enough-but still recommended to eat because of bioflavonoids that help vitamin C do its job. (Peppers, Broccoli, Berries, Citrus)
  • High dose used in China Dr. Chang WuHan: Treated with 10-20g IV and no deaths in his group of 50 and they left hospital 3-5 days sooner. Can’t take these orally. You’d get diarrhea.
  • Our recommendation is liposomal vitamin C which uses phospholipids to enhance vitamin C’s absorption. Liposomal forms bypass the normal mechanisms of absorbing vitamin C so show higher bioavailability-meaning how well it absorbs into the system.

Other practical tips for supporting the immune system:

Fever: The body is intuitive:

Fever boosts immune function by activating immune cells at an accelerated rate. Fever suppressors can inhibit antibody production

How to support fevers that are 103 and under: Dress warmly, cozy socks, warm beverages-broth, tea, etc. If fever goes higher, you may want to cool things down:

  • Dress lighter, drink cooled peppermint tea.
  • Vitamin C can lessen discomfort

Controversy about Ibuprofen and aspirin- Known to inhibit antibody production more than Tylenol but Tylenol may also blunt antibody production. Tylenol also inhibits the glutathione pathway. Glutathione is immune supportive and antiviral. Treat fever that goes above 103 or if you are feeling miserable and Acetaminophen is the better choice for most. Low grade fevers do not always require medical intervention. Best to discuss with your health care provider.

https:/www.jimmunol.org/content/186/1_Supplemnt/45.18 

https://pubmed.ncbi.nlm.nih.gov/2172402/

Visualization/guided imagery to help guide immune response

Herbs- Immune-boosters vs Immune-modulators

When not to boost immune function is a big concern in discussions and a large source of confusion for many:

Lines of defense: All levels are communicating for our protection:

  1. Barrier defense- Included mucus membranes, bacteria and healthy viruses: like the walls and moat of a castle.
  2. Innate Immune Response- Destroys strangers/invaders: Natural Killer cells, macrophages (eat and present the invader to the Acquired Immune system), neutrophils (soldiers that fight the monsters).
  3. Acquired- T and B cells that are instructed by Innate. B cells make antibodies to alert the T
  4. IMMUNE Overload-this is what we want to avoid-The cell danger responses go awry- body sees all barriers and defenses as breached and sets up a no holds barred defense that comes in like a tsunami of inflammation to ward off invaders. This is what leads to the aggressive stages -ARDS-acute respiratory distress syndrome, and CYTOKINE

The Coronavirus hijacks our immune systems’ communication network by first suppressing the information and communication response and then it creates a storm of overload. That is when the respiratory symptoms become more severe, since the immune response is too aggressive. The cytokine storm is what kills people, not necessarily the virus.

Consider herbs this way which can help to sort out some of the confusion about what to use and when.

Days 0-5 or 0-7 Depending on symptom progression: Immune Stimulators/Boosters for early support and prevention:

Astragalus, ashwaganda, cordyceps, elderberry, garlic, panax ginseng,  mushrooms, zinc-here you actually want to support antibody production and a little bit of inflammation.

Day 8 or earlier if shortness of breath or lung symptomsRemember this is definitely the time to contact your health care provider if not sooner, this is when you would need medical intervention– Now is when we don’t want to keep stimulating the immune system, we want immune modulators:

Want to quench/modulate response:

Andrographis, rhodiola, eleuthero. Siberian ginseng and consider Stopping the earlier immune boosting herbs. Andrographis should be combined with Rhodiola or Siberian Ginseng.

Exact doses not known

Foundational Recommendations for Immune Support:

Avoid high glycemic foods: These suppress the immune response

Get enough sleep: Sleep has a restorative effect on the immune system

Encourage Autophagy: This is the body’s cleanup crew that is active only during fasting. This is when the immune system mops up infected cells. The number of hours between the last meal of the day and breakfast influences autophagy. 8 hrs. eating/16 hrs. fasting is optimal for immune function. Aim for at least a 13 hour overnight fast. More than16 isn’t better under these circumstances since that can instead activate stress hormones.

Exercise: Can profoundly influence the immune response. Prolonged intense exercise can actually depress immunity, while regular, moderate exercise is beneficial. Important to promote lymphatic circulation: Rebounder, jumping jacks, trampoline.

https://pubmed.ncbi.nlm.nih.gov/26477922/?from_term=Exercise+AND+immune&from_pos=1

https://pubmed.ncbi.nlm.nih.gov/26477922/?from_term=Exercise+AND+immune&from_pos=1

Reduce exposure to WiFi: WiFi is immunosuppressive. Suppresses melatonin production.

You’re sick: What actions to take: This always depends upon your symptoms, as we know this virus isn’t entirely predictable. At any point if you have difficulty breathing and lung involvement, you need to contact your medical professional.

Foundational Support for the phase where you are focusing on prevention with the possibility of exposure:

Good multivitamin/mineral: With aging we see micronutrient deficiencies that are associated with impaired immunity. A, C, E, B vitamins, folate, iron, selenium, zinc, copper.

Vitamin C 3-4g/day liposomal or ascorbic acid in divided doses. Also prevents cytokine storm.

Melatonin: 3-5 mg: Inflammasomes of the innate immune system activate the inflammatory process. The NLRP-3 inflammasome has been found to be key to activating ARDS and acute lung injury. C, melatonin and humming helps to silence the inflammasome. Propolis as well.

D3K2: Vitamin D helps block inflammatory chemicals.

GI support: Probiotics, SBI powder, Quercetin

Elderberry 750-1000mg

Zinc-lozenges or capsules

Quercetin: Sits on cell wall surfaces and can disrupt viral docking. Also supports intestinal barrier function. Can use high doses: 1g quercetin with 1g C several times/day.

Tocotrienols: Work along with quercetin: Quercetin is on the outside of the cell membrane, tocotrienols on the inside. They can block surface active proteins. Help quench the cytokine fire.

Herbal blends with Andrographis, Skullcap, Cordyceps, Astragalus, Japanese Knotweed

One formula is Wellness Herbal Defense (this would replace multivitamin but need addition of B complex) and additionally Skullcap, Japanese Knotweed and Cordyceps

Nettle Root Now Food Brands

Skullcap: Blocks viral attachment.

Cordyceps: Blocks viral attachment

NAC: Mucolytic, antiviral or Glutathione liposomal which also enhances immune function

L-Lysine: 1000-2000mg/day on empty stomach. Works well with green tea and vitamin   C.

SPM for its potent ability to resolve inflammation: Proresolving Mediators

Blocking IL-1b: which contributes to leaky lung/leaky vasculature permitting increased antigen penetration and further inflammation- Sulforaphane (cruciferous vegetables) as well as Melatonin, Quercetin, Cordyceps, Curcumin

Oil Pulling

Nasal/Sinus Support: Aromatherapy with essential oils: lemon balm, thuja, caraway, mint, oregano, rosemary, sage Can bathe sinus passage-using diffuser or take Essential oil bottle, agitate closed battle with lid, the open and place bottle under nostril and slowly inhale at regular intervals throughout the day

Nasal Sprays: Argentyn silver

Throat Spray: Honey gardens propolis, silver mouth/throat gargle

Dietary: Foods/Herbs/Teas: lemon balm, also oregano, mint, basil, sage, rosemary, savory, hyssop.

Double strength-2 teabags per cup of hot water then as they cool can continue to drink or use as mouthwash/gargle. Lemon balm, caraway, Greek mountain tea, elderberry which works well with green tea, ginger, mint, oregano: Mountain Tea from Traditional Medicinals. Stinging nettle tea root reduces inflammation.

Reduce Dietary Arginine: Nuts, seeds, chocolate—may be best to limit when viruses are a concern. From highest arginine Macadamia highest, sesame, pumpkin, sunflower, Pistachio, cashew, chia, flax, pecans. Coconut and chestnut are negligible so are fine

Days 0-5 or 7: Immune Stimulators/Boosters for early support and prevention:

Astragalus, ashwaganda, cordyceps, elderberry, garlic, panax ginseng, zinc, C 3-4g dose, E lower dose-here you actually want to support antibody production and a little bit of inflammation.

Andrographis blocks furin which is a protein that allows viruses to enter cells and make them easily transmissible. Should be used early in the treatment of infected or suspected infection. Prevention: 1 dropper 3-4x/day.

SPM to support resolution of inflammation

Day 8 or earlier if shortness of breath or lung symptoms-Remember this is definitely the time to contact your health care provider if not sooner, this is when you would need medical intervention– Now we don’t want to keep stimulating the immune system, we want immune modulators:

Want to quench/modulate response:

Andrographis, rhodiola, eleuthero. Siberian ginseng and consider Stop earlier immune boosting herbs Andrographis should be combined with Rhodiola or Siberian Ginseng. Higher dose vitamin C with quercetin.

Melatonin in higher doses

Quercetin

With respiratory symptoms: Carnosine, Bromelain, Curcumin, SPM, Melatonin, Vitamin C higher dose.

May become hypokalemic: Low in potassium, important to support.

Blood type and COVID-19: If you are type A, boost up fermented soy products, great northern and fava beans and mushrooms as well as foods from the Allium family: Garlic, onion, shallots, leeks.

Research: I will post more research so keep an eye out

Melatonin: Prevents NLRP3 from activating the inflammasome that leads to runaway inflammation.

COVID-19: Melatonin as a potential adjuvant treatment

https://www.sciencedirect.com/science/article/pii/S0024320520303313?fbclid=IwAR0OwrBxD7iwCfaQYtC79cGKyVzkFJOLO746pIwGXdKGTeFPXOBLFD1vLyA

https://academic.oup.com/cardiovascres/advance-article-abstract/doi/10.1093/cvr/cvz312/5644338?

https://pubmed.ncbi.nlm.nih.gov/26888116/?from_term=melatonin+AND+inflammasome+AND+lung&from_pos=1

Vitamin C:

https://www.researchgate.net/publication/305624280_Vitamin_C_inhibits_the_activation_of_the_NLRP3_inflammasome_by_scavenging_mitochondrial_ROS

Cordyceps:

Cordyceps Militaris Alleviates Severity of Murine Acute Lung Injury Through miRNAs-Mediated CXCR2 Inhibition https://pubmed.ncbi.nlm.nih.gov/26202360/?from_term=cordyceps+AND+virus&from_pos=9

Skullcap:

https://pubmed.ncbi.nlm.nih.gov/19874244/

Anti-H1N1 Virus, Cytotoxic and Nrf2 Activation Activities of Chemical Constituents From Scutellaria Baicalensis

https://pubmed.ncbi.nlm.nih.gov/26578185/

Broad-spectrum Antiviral Properties of Andrographolide

https://pubmed.ncbi.nlm.nih.gov/27896563/

Andrographolide Sulfonate Attenuates Acute Lung Injury by Reducing Expression of Myeloperoxidase and Neutrophil-Derived Proteases in Mice

https://pubmed.ncbi.nlm.nih.gov/30174607/

FULL REFERENCE TO DR ROTHFELD’S ARTICLE

Rothfeld, A. (3/28/2020). COVID-19 Functional Medicine Research Dr. Adria Rothfeld, DC, MS, CNS. See: https://thenutritionalwellnesscenter.com/covid-19-functional-medicine-research-dr-adria-rothfeld-dc-ms-cns/

© Copyright 2020. Joan Rothchild Hardin. All Rights Reserved.

DISCLAIMER:  Nothing on this site or blog is intended to provide medical advice, diagnosis or treatment.