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Reducing COVID-19 Risk - Foundations of Immune System Support (updated August 2021)

 UPDATED AUGUST 2021

TAKE CONTROL OF YOUR HEALTH.
REDUCE RISK OF COVID-19 COMPLICATIONS USING LIFESTYLE FACTORS AND NATURAL AGENTS.

Like you, I was hoping we would be beyond this by now, but we are not.  Given the low rate of both worldwide and United States COVID vaccinations, the SARS-Cov-2 virus and COVID-19 infection are likely here to stay.  While those who are vaccinated are at significantly lower risk from COVID-19 complications than those unvaccinated (yes, I do recommend you get a COVID vaccine), even those vaccinated are not entirely without risk.  Immune system support is important for all.  As we move toward the Fall/Winter season - let's revisit the basics.

Foundations of Immune System Support - Using lifestyle factors and natural agents to reduce COVID-19 complications.

When it comes to reducing risk of COVID-19 complications, the best time to start is long before exposure to the SARS-Cov-2 virus.  The data on lifestyle interventions and natural agents to impact the viral life cycle is compelling, and as we enter cold, flu and COVID season there are a number of steps you can take to prime your immune system and reduce your risk of illness.

Your innate immune system is your first line of defense against any type of infection, so it’s important to have it primed and ready to recognize and attack a virus should you become exposed. The innate immune system is often described like an army. You want healthy, well-educated troops ready to respond quickly and efficiently to any situation they encounter.

LIFESTYLE FACTORS
SLEEP • DIET • STRESS • EXERCISE

Before you even think about taking vitamins or supplements, there are four key lifestyle factors that can have a powerful impact on your immune system:

SLEEP 
Studies show that people who don't get enough quality sleep are more likely to get sick after being exposed to a virus. Even one night of reduced sleep can lead to immune dysfunction, and better quality sleep is associated with less inflammation. How well are you sleeping?

• Aim for 7‐9 hours of quality sleep each night
• There are many fitness/biometric trackers that can provide sleep feedback (I use an Oura Ring).
• If you are not getting enough quality sleep, consider working with a psychologist or physician that specialize in sleep (such as Dr. Rebecca Roth in Northern Michigan). You can also consider melatonin, CBD, or other herbals.
• Check out these resources for better sleep on my website.

DIET 
Significant evidence suggests that fruit and vegetable intake can reduce the risk of chronic diseases.

  • Instead of processed foods, choose more plant‐based foods high in phytonutrients and fiber, which can help improve functioning of the immune system. Can you get close to 10 servings of vegetables and fruits per day? How many different colors of plants can you add?
  • Limit added sugar, salt and saturated fats which can all negatively impact your immune system.
  • Check out these resources on a phytonutrient-rich diet on my website


STRESS
Chronic stress can suppress your immune system and is associated with increased risk of viral infection.  Stress raises levels of Cortisol in your body, and those with higher cortisol levels have been shown to have greater mortality from COVID‐19.

  • Pay attention to your stress levels. Biometric trackers can measure heart rate variability as an objective measure of your stress.
  • Practice stress‐modifying techniques on a daily basis, including breathing, gratitude, time with family/pets, exercise and/or meditation. Check out these resources on my website to learn more about meditation.
  • If you are not able to get your stress response under control, consider working with a professional. Most therapists are now offering virtual video sessions. You can also work with your Integrative practitioner to incorporate herbal blends to help in protecting your body from the effects of stress.


EXERCISE
While a single bout of physical activity can stimulate immune function, regular exercise is most important for consistent effects.

  • Engage in moderate, regular physical activity. I encourage my patients to work up to 150 minutes weekly of cardiovascular exercise (30 minutes, 5 days per week).
  • If you are just starting an exercise program, start slow and gradually increase your activity.
  • There are MANY online exercise-at-home platforms. Some of my favorites are HASfit.com, FitOn.com and Peloton on-demand classes (meditations too).
  • Consider using a heart-rate monitor with exercise to ensure you are getting your heart rate into a safe fitness zone.

 

BOTANICALS & NUTRACEUTICALS
There are a number of botanicals and nutraceuticals with immune-modulating effects. The choice of which and how many natural agents to incorporate into your prevention plan will be different for each person. Factors to consider include vaccination status, cost, underlying chronic medical conditions, and the degree of possible virus exposure.  Combination products, liquids, chewable and powders can lessen the burden of daily capsules.

Start with a quality Multivitamin/Multimineral, or a Comprehensive Micronutrient Test.
There are many nutrients that work together to support and enhance mucosal immunity (which lines the passageways of your nose, mouth, throat and lungs). Vitamins A, B6, B12, C, D, E, folic acid, zinc, copper and selenium all work together to support the immune system, and all are essential for the production of mucosal antibodies.  Given this, it makes sense to start with a high-quality multivitamin.  Alternatively, you can use a micronutrient test panel to see if you are meeting your needs with your current diet.

Additional nutrient foundations to prime immunity and prevent illness or complications:

  • Vitamins D, C and Zinc
  • Elderberry
  • Astragalus
  • Medicinal Mushrooms containing Beta-glucan
  • Echinacea


VITAMIN C

Vitamin C is an immune system powerhouse. This antioxidant reduces inflammation, increases the production of white blood cells, and helps to strengthen blood vessels. Vitamin C is essential in the formation of collagen, which promotes healthy skin and muscle tissue. A lack of Vitamin C makes you more prone to illness, and should you develop a respiratory illness, Vitamin C has been shown to reduce the duration and severity, and reduce complications by protecting your own tissues from damage.

Vitamin C has been used in many hospital ICUs for the treatment of COVID-19.

  • For prevention, 500-1000mg daily
  • Choose a buffered form of Vitamin C for less stomach upset

 

VITAMIN D

OPTIMIZE YOUR VITAMIN D! Vitamin D is known to activate and modulate many key aspects of the immune system involved in fighting viral and bacterial infection. Vitamin D is anti-inflammatory, and in many viruses Vitamin D has been shown to reduce the progression from exposure to illness and reduce the severity and duration of acute symptoms and complications. Evidence suggests Vitamin D supplementation may prevent upper respiratory infections.

Research has demonstrated a significant crude relationship between Vitamin D levels and both the number and mortality of COVID-19 cases. A small study in Spain of 76 patients showed that giving Vitamin D to hospitalized COVID-19 patients, otherwise given similar treatments, reduced ICU admissions from 50% to 2%.

  • For prevention, 2000-5000 IU Vitamin D3 daily with food
  • I routinely check 25,OH Vitamin D levels on my patients and aim for 50-80ng/mL

 

ZINC (acetate, citrate, picolinate, or glycinate)

Zinc has a large body of research showing its strong anti-viral properties against many viruses, and zinc supplementation has been found to reduce the duration of symptoms of the common cold.

Zinc promotes antibody and white blood cell production and reduces oxidative stress. In addition, zinc has properties that fight infection directly, and zinc lozenges may reduce the risk of developing a respiratory illness.

  • For prevention (zinc acetate, citrate, picolinate, or glycinate), 30-60mg daily in divided doses for three months, then reduce to 15-30mg daily.
  • For acute respiratory illness, begin zinc lozenges at the first sign of symptoms.


ELDERBERRY

Elderberry (Sambucus nigra) has widespread historical use as an anti-viral herb and has been used extensively in the prevention of influenza.

Elderberry is rich in vitamin C, antioxidants, and fiber. Research suggests that elderberry is most effective when used for prevention, or when taken early on in the course of a respiratory virus.

  • For prevention, consider 500mg orally, daily (of USP standard of 17% anthocyanosides).  Follow the instruction on your product.
  • Caution should be used in those with autoimmune conditions.

 

ASTRAGALUS

Astragalus membranaceus has many immune-boosting benefits with low risk of harm. Astragalus primes the innate immune system and reduces inflammation.

Astragalus has shown direct antiviral activity against SARS-Cov-2 virus by inhibiting a process necessary for viral binding.

  • Astragalus dose varies per preparation, follow instructions on product.


MEDICINAL MUSHROOMS (containing beta-glucan)
Shitake • Lion’s Mane • Reishi • Maitake

Various mushroom species have been shown to have a broad range of immune-modulating and immune-supporting mechanisms. Medicinal mushrooms also contain Beta-glucans which aid in priming the immune system and reducing inflammation. Numerous human trials have shown that beta-glucans reduce the symptoms of cold and flu and reduce upper respiratory tract infections.

  • Mushroom dose varies per preparation, follow instructions on product.
  • Dose of Beta-glucans: 250-500mg daily


ECHINACEA

Echinacea is a wildflower native to North America. Many species of Echinacea can stimulate the immune system. Echinacea preparations have been shown to reduce the frequency, severity, and duration of upper respiratory tract symptoms in several trials.

  • Echinacea dose varies per species and preparation, follow instructions on product.
  • Echinacea should be stopped if one develops symptoms of COVID-19

  

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.

 



Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Physicians specializing in Functional Medicine are trained and experienced in providing personalized guidance to patients in the use of nutrition, nutraceuticals, and lifestyle to prevent, reverse, and decrease the burden of complex, often chronic medical conditions.  I continue to see new and returning clients using our secure, easy video-visit format.  If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

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National Weight Control Registry

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The National Weight Control Registry (NWCR) is an ongoing research study established in 1994 that includes over 10,000 adults who have lost at least 30 pounds of weight and kept it off for at least one year.

Members complete annual questionnaires about their current weight, diet, exercise habits and behavioral strategies for weight loss maintenance.

The NWCR was developed to identify and investigate the characteristics of individuals who have succeeded at long-term weight loss.


HOW DID NWCR MEMBERS LOSE THE WEIGHT?
  • 98% of NWCR participants report that they modified their food intake in some way to lose weight.
  • 94% increased their physical activity, with the most frequently reported form of activity being walking.
  • Over half of participants lost weight with the help of some type of program.

HOW HAVE NWCR MEMBERS KEPT THEIR WEIGHT OFF? HERE ARE SOME LIFESTYLE HABITS THEY HAVE IN COMMON:
  • 78% eat breakfast every day.
  • 75% weigh themselves at least once a week.
  • 62% watch less than 10 hours of TV per week.
  • 90% exercise, on average, about 1 hour per day.
Like I frequently discuss with clients. this is not rocket science! These people (over 10,000) lost weight simply by changing their eating patterns in some way and moving more!


WANT TO LEARN MORE?

Visit the NWCR website www.nwcr.ws




Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including weight gain and obesity. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface” (using assessments like estrogen metabolite testing) to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
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Highlights from the Annual Nutrition & Health Conference

Earlier this week I attended the 12th Annual Nutrition & Health Conference, presented by the Arizona Center for Integrative Medicine under the direction of Andrew Weil, MD (pictured with me below). Each year, this conference brings together a variety of experts to focus on the central role of nutrition in health and healing, and provide a scientific basis for the integration of nutrition and medicine into practice. It is a medical conference like no other! I was inspired not just by the depth of research presented, but also by the quality and character of both the faculty and the fellow attendees. This is an organization that truly “walks the walk”.

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MY CONFERENCE TOP FIVE HIGHLIGHTS:
 
Thin mice become obese when they receive a fecal transplant from obese mice.  
Without any other change (including no change in diet/exercise), simply transplanting stool from an obese mouse into a thin mouse causes weight gain.  Now you know why I am so obsessed about the role of your gut microflora in your health…
 
Environmental exposures are directly linked to childhood obesity, especially Bisphenol A (BPA). 
Once again, it is not just about calories, there is more to the story.  Chemical exposure contributes to obesity.  On a positive note, research has shown that when children have their diet changed to organic food, the measured levels of pesticides in their urine is substantially lowered in less than a week.
 
When it comes to weight loss and reduction of hunger, it's not total daily protein intake, but rather adequate protein intake at key points during the day that matters. 
This was not news to me - but it was great to see the valid research backing up what I speak with my patients about daily!  For those patients in need of weight loss, food pairing with adequate protein at timed intervals during the day can be very effective in reducing hunger and preventing over-eating, especially curbing nighttime snacking.  
 
Mitochondria make up approximately 10% of your body weight.  
Don’t know what mitochondria are?  It’s time you learned.  Mitochondria are the “energy factories” in all of the cells of our body.  Certain cells have more mitochondria than others, such as heart cells, which need more mitochondria because they need more energy.  Healthy mitochondria are the key to healthy aging, and one of the best things you can do to keep your mitochondria healthy is to EXERCISE.
 
If an item displays a "USDA Certified Organic” label, it is non-GMO. 
I actually did not know this.  While there are separate labels for non-GMO, you do not have to look any further if you see this certified organic label.  No GMOs allowed.  That being said, as larger companies are buying up smaller organic companies, they are getting more seats on the government boards that set these definitions.  The number of allowed chemicals under the "USDA Certified Organic” label is changing yearly.  Something to keep an eye on...

If you have any questions about this conference or the topics above, please feel free to email me directly at This email address is being protected from spambots. You need JavaScript enabled to view it..

Be Well,

Carin Nielsen, MD
 


Carin Nielsen, MD Integrative MedicineLooking for a personalized approach to your healthcare? I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms and chronic disease simply by prescribing medication doesn't address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface" to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

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