Pearls of Integrative Medicine and COVID-19

Updated: Mar 25, 2020

Dear Patients,

I know this is a scary for time for all of us. Like you, I'm awake at night wondering what the future holds for myself and my family.

"Did I buy enough essential supplies?" "Do I have COVID-19 right now and I just don't have symptoms yet?" "Did that friend I had coffee with 14 days ago have it and infect me?" "How am I going to weather this financial storm?" "What can I do to keep myself healthy right now??"

I wanted to share some pearls of integrative medicine to help our bodies stay strong during this unprecedented time. Most importantly, I want to acknowledge the CDC's warning that there are NO known alternative/herbal treatments to prevent or "cure" this virus. I agree. We do not have enough evidenced-based studies on this illness and what protect against it or what might make it worse.

However, there are some tried and true modalities that throughout time have supported the body's immune system. I am going to list them here, but I want to advise and emphasize that this is NOT individualized--meaning, what might be safe for one person might be very unsafe for another. For example, some herbs interfere with blood clotting. Some may be dangerous to the liver of one person but not to another based on that person's unique medical history or meds they are taking.

Therefore, I advise all of you to contact me personally if you'd like to discuss in further detail which herbs/supplements are best for you and which should be avoided. If I'm not your PCP/family medical provider, please contact whoever is.

Also, I would like to thank and acknowledge Aviva Romm, MD, for the following thoughts which I will augment with my own. I will cite her resource below.

Most importantly, SOCIAL DISTANCE--this means each person has a 6 foot bubble of air safety inside and 10 ft outside (due to gusts of wind). Do not invade this space. This is the BEST way to keep yourself and others safe right now, since COVID-19 can be contagious even before someone is showing symptoms and after they are showing symptoms!

Wash your hands and hair frequently! Also, use hand sanitizer. Clean surfaces with bleach, Lysol or Cholorx, which are proven to kill the virus. Heat also may kill the virus.

Eat your ORGANIC (if possible) produce (raw is best!) Plants have powerful phytochemicals, nature's apothecary.

Drink LOTS of healthy fluids (now is NOT the time to be guzzling immune-suppressing alcohol or caffiene or sugary drinks). Lemon water with local honey is a great nutritional drink as are smoothies with spinach, yogurt, and blueberries.

Mediate, pray, laugh, journal, hug (only household members), exercise--these are all PROVEN methods of decreasing stress hormones cortisol and adrenaline (hormones that decrease white blood cells--immunity).

GET SLEEP--one of the most important ways to keep your immune system strong.

Zinc plays an important role in immunity, helping the body to fight invading bacteria and viruses, and may help the lining of the respiratory passages prevent against viral replication and inflammation. This has been demonstrated in clinical studies.

Best form: zinc acetate

Do: take daily during for prevention--it does not work as effectively if taken only for short duration while ill

Don’t: use nasal sprays which can alter sense of smell, or zinc tablets or pills, as they aren’t as well absorbed.

How much: A dose of 5 to 10 mg/day is typically enough, but you can take up to 45 mg/day for up to a few weeks (lower doses for pregnant women and breastfeeding women)

Pro Tip: zinc can cause nausea and vomiting, so preferably take your zinc supplement with a meal, though many combination lozenges that contain other herbs and honey, for example, are less nauseating.

Special considerations: Zinc supplements can interfere with the absorption of certain medications including quinolone or tetracycline antibiotics. It may also interfere with diuretics (like some medications for blood pressure) and medication used to treat Rheumatoid Arthritis – so check with your provider if you’re taking either before supplementing with zinc.

Vitamin D is a fat soluble vitamin that has an important effect not only on bone health, but on immune function and ability to fight infections. Low vitamin D can impact mental health such as exacerbate depression and anxiety.

Dose: The best form of vitamin D for maximal absorption is Vitamin D3, and supplementing between 1000- 2000 IU/day is a safe and ample dose for most people, and is safe during pregnancy and breastfeeding. Too much vitamin D can result in renal injury and even kidney failure. I always try to check a baseline blood level on my patients so they don't get toxic and so we have an idea of the best dose for them.

Per the Office of Dietary Supplements, up to 4,000 IU/day for children 9 years and older, adults, and pregnant and lactating women is considered quite safe. Children’s doses are typically 400 to 800 iu daily.

Pro tip: For best absorption, try taking Vit D3 with a meal that also contains healthy fats, like salmon or avocado, though it can be taken any time. Food sources of Vitamin D include fatty fish such as salmon, tuna, and mackerel, and cheese, while egg yolks provide small amounts.

Breastfed infants not supplemented with formula should get 400 IU drops daily

Vit D is best absorbed when taken with Magnesium and Calcium Citrate--do not take calcium within 2-4 hours of your iron pill or thyroid medication as it can decrease their absorption.

Get sunshine for natural Vitamin D. 15-20 min a day minimum to the trunk or face is enough.

Vitamin C Most of you know this one, but to solidify it, a 2013 Cochrane Database Meta-analysis, based on 29 trial comparisons involving 11,306 participants, had to say:

  • Vitamin C appears to lead to a 50% reduction in the likelihood of catching a cold in athletes who “perform regular or acute bouts of intense exercise” compared to athletes who don’t take Vitamin C.

  • Cold duration may be reduced by about 8% in adults who take vitamin C regularly, and colds may also be less severe.

Dose: A typical adult dose is up to 2000 mg daily. This dose is also safe for pregnant and breastfeeding people. Oranges and grapefruits are important sources of Vitamin C, as are red and green peppers, kiwifruit, broccoli, strawberries, cantaloupe, and baked potatoes, so eat a wide variety daily.

L-Lysine: An essential amino acid that is safe and part of our normal diet. It decreases viral activity in some studies and can also help with anixety. I usually advise 1500 mg daily for prevention, and I increase this in patients when they have active viral illness. It is not only safe in pregnancy but encouraged.

What about Probiotics?

Evidence is scant a