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UPDATED SEPTEMBER 2021
IT'S TIME TO TAKE CONTROL OF YOUR HEALTH. REDUCE COVID-19 RISK USING LIFESTYLE FACTORS AND NATURAL AGENTS.MAKE A PLAN SHOULD YOU BECOME EXPOSED OR INFECTED.
In my recent blog, Reducing COVID-19 Risk - Fundamentals of Immune System Support (updated August 2021), I outlined recommendations for reducing risk of COVID-19 complications prior to viral exposure for those at average risk, focusing on prevention of illness through immune system support. Today I am switching gears to review steps you can take to reduce complications if you become exposed to the SARS-Cov-2 virus or develop symptoms of COVID-19 illness. This blog takes on a very different feel in Fall 2021 than it did a year ago, as we now have three approved COVID-19 vaccines. I remain steadfast in my support for these vaccines and feel vaccination is important not only in reducing individual risk, but also to reduce risk of serious illness in those most vulnerable. Nevertheless, breakthrough infection is possible for those vaccinated, and many are still opting not to get a vaccine, which makes having a plan should you become exposed to or infected with the SARS-Cov-2 virus of continued importance. THE TIMELINE OF COVID-19 INFECTIONWhile variations exist, below is a general time-frame of COVID-19 infection, from exposure to illness.
DAY 0= EXPOSED TO SARS-Cov-2 VIRUSWe consider the day you are exposed to the virus Day Zero.
DAYS 2-3 THROUGH DAYS 10-12 = VIRAL SHEDDINGWith or without symptoms, most become contagious on days 2-3, and continue to be contagious through day 12. Most are contagious before they develop symptoms.
DAY 5 = SYMPTOMS BEGINA vast majority will develop symptoms of COVID-19 between days 2-7 of exposure to the virus (day 5 on average). View list of possible COVID-19 symptoms HERE.
DAYS 5-12 = MILD TO MODERATE SYMPTOMSMost who develop symptoms will have only mild to moderate symptoms during the first two weeks.
DAY 12 = RECOVERY vs HOSPITALIZATIONMoving from weeks 2 to 3 of illness is a critical time. On average, 12 days after exposure is when symptoms either begin to resolve or become significantly worse - potentially requiring hospitalization. Keep day 12 in mind as a critical point in the course of infection, as a point where symptoms may rapidly worsen.
IF YOU HAVE BEEN EXPOSED TO THE SARS-Cov-2 VIRUS, BUT HAVE NO SYMPTOMSIf you have been exposed to the SARS-Cov-2 virus, or if you have been in a situation where exposure is likely, the first important step is to ISOLATE yourself from others. Remember, you can be highly contagious without any symptoms at all! Isolation is especially important for those unvaccinated. You may also want to arrange for a COVID test, ideally 5-8 days after exposure. A COVID test in the first 4 days after exposure will have a much higher false-negative rate, meaning you may get a negative test result and still be contagious and/or develop COVID-19 illness. If exposed, there are a number of botanicals and natural agents that may be introduced as part of your plan to reduce risk of complications.
INCREASE DOSES OF ELDERBERRY AND MELATONIN. • Melatonin: increase to 10-20mg at night. • Elderberry: dose varies per preparation, follow instructions on product and increase to higher range of recommended dosages.
Add or increase agents with potential to directly interrupt the ability of the virus to enter cells and replicate:• Curcumin -increase to 1000mg twice daily • Resveratrol - increase to 100-150mg twice daily • Zinc - up to 60mg daily, ideally in the form of lozenges spread throughout the day. • Quercetin - regular 1gram twice daily, phytosome 500mg twice daily • EGCG - 4 cups green tea or approx 225mg EGCG daily • Astragalus - dose varies per preparation, follow instructions on product and increase to higher range of recommended dosages.
IF YOU DEVELOP SYMPTOMSIf you have had known or likely exposure to the SARS-Cov-2 virus and develop symptoms of COVID-19 (with or without a positive test):• continued isolation/quarantine is critical to reduce risk of spreading the virus to others.• closely monitor your symptoms, designate a friend or family member to check in on you.• consider purchasing a home blood oxygen saturation monitor to use in case of illness, especially for those unvaccinated or at elevated risk.• treat your symptoms, and seek medical care if necessary. Targeted natural agents may be continued during active infection. Care should be individualized for each patient, and I recommend that you work with a Functional Medicine practitioner to determine what is appropriate for you. The Institute for Functional Medicine recommendations for the use of botanicals and natural agents with active symptoms of COVID-19.* STOP zinc and echinacea as they are not felt to be helpful during the symptomatic phase. If you haven’t already done so, increase melatonin to 10-20mg at night. Add or continue curcumin, resveratrol, quercetin, and EGCG at higher dose ranges (see above).
OTHER CONSIDERATIONSConsider adding additional anti-inflammatory agents - PEA and SPMs. Consider adding additional anti-inflammatory agents to reduce the “cytokine storm” of inflammation responsible for many COVID-19 complications. I recommend these agents especially for my patients who already have chronic medical conditions associated with chronic inflammation and for those unvaccinated. Palmitoylethanolamide (PEA) PEA is a naturally occurring anti-inflammatory agent that has been shown to improve outcomes in acute respiratory disease and influenza. I follow the recommendation of Functional Medicine specialist Dr. Kara Fitzgerald, ND: Metagenics Hemp Advantage (with PEA) or PEA Relief: 2 caps three times per day with first symptoms. Continue for six weeks. Specialized Pro-resolving Lipid Mediators (SPMs) SPMs are part of the omega-3 fatty acid spectrum that has a powerful effect on reducing inflammation. SPMs help to signal the immune system to shut down the immune response and resolve inflammation (I think of them like a hose putting out a fire). While SPMs are synthesized naturally in the body, many with chronic medical conditions that place them at higher risk for COVID-19 complications do not effectively make SPMs on their own. Dose: During active infection, 1 gram SPM formula three times daily. Continue at least 4 weeks.
Please note: Due to the novelty of COVID-19, minimal peer-reviewed research has been published regarding the effectiveness of dietary or lifestyle interventions for its prevention or treatment. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. Consult your healthcare provider prior to use of any botanical or nutraceutical.
RESOURCESEvidence Supporting a Phased Immuno-physiological Approach to COVID-19 From Prevention Through Recovery Yanuck S, Pizzorno J, Messier H, Fitzgerald K. The Functional Medicine Approach to COVID-19: Virus-Specific Nutraceutical and Botanical Agents Resistance, Resilience, and Recovery: Patient Care in a Pandemic. (IFM Continuing Education Course)
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Integrative Medicine, Carin Nielsen, MD413 Waukazoo Ave.Petoskey, MI 49770