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CORONAVIRUS BIOLOGY and PREVENTION OF DISEASE


I am extremely grateful for all the work Dr. Leo Galland has done putting together a way of thinking about prevention that is completely specific to this virus. He has been described as the Anthony Fauci of Integrative Medicine. I am very grateful to him for his work and his generosity in teaching.

CORONAVIRUS BIOLOGY AND HOW IT IMPACTS YOU:


The COVID19 virus is an RNA virus which is extremely infectious. It has a spike on its surface which is perfectly designed to bind to receptors in the alveoli of our lungs, where oxygen is exchanged. But these same receptors exist on our hearts, and if the virus isn't stopped early, it can spread to the heart also. It is associated with a state of respiratory distress which is accompanied by blood clotting (in lungs and brain), and with a severe inflammatory state called "Cytokine Storm" which is difficult to treat, but against which we are making advances. There are some nutritional things we can do to prevent illness, some of them are also used in hospital protocols. These interventions are NOT evidence-based, for the most part; rather they are based on physiology and microbiology, with studies in the test tube and some in animal models.

  1. ACE-2:  HOW THE VIRUS ENTERS CELLS

    2. In order to cause disease, the virus must attach to cells in the lungs. COVID-19 attaches to a protein on the cell surface called ACE-2. ACE-2 is an enzyme with strong beneficial effects.   When corona virus binds to ACE-2, ACE-2 becomes inactive.   In the words of one scientist, COVID-19 produces “ACE-2 exhaustion”. Scientists believe that this “exhaustion” is partially responsible for the severity of pneumonia. Natural products shown to enhance ACE-2 include curcumin, resveratrol (found in red grapes and other foods), and alpha-lipoic acid, which is an antioxidant. There are other herbs which improve ACE-2 function: Pueriaspp (kudzu), Salvia miltiorrhiza and Ginkgo biloba.

  2. PROTEASES:COVID-19 MUST SPREAD TO MORE CELLS

    3. Once they have multiplied, corona viruses damage human cells by producing an enzyme called 3CL protease, which allows them to spread to adjacent cells.  3CL is the subject of new anti-viral drug development. Luteolin and Quercetin, which are both found in Elderberry fruit (Sambucusnigra) and the medicinal herb Houttuynia cordata both inhibit the viral enzyme 3-CL protease and have been shown to inhibit coronavirus activity in cells. Both are also potent stimulators of anti-viral immune responses. Elderberry seems to be most effective if started before infection and continued through the initial period of infection. It may be contra-indicated in Phase Two of COVID-19, because of its immune enhancing effects.  Quercetin is being studied in China as a drug treatment, based on research initiated at McGill University.

  3. FURINS

    4. For COVID 19 virus to lock onto ACE2, the spike on it must be altered by an enzyme called Furin. Unlike ACE2, it is vital for cell function.   Natural substances which inhibit Furin include the herb Andrographis, and the flavonoid luteolin (found in many foods, including olive oil, and with beneficial effects on osteoporosis).

  4. INFLAMMASONES: WREAKING HAVOC

    5. Inflammasomes are an integral part of our immune system.  They sense pathogens and patterns associated with danger.  The activation of inflammasomes releases proinflammatory cytokines, causing what is called a cytokine storm, and acute respiratory distress.  This occurs in very ill COVID patients and can result in death. Melatonin inhibits inflammasomes.  It’s very potent, and you don’t need more for impact, unless you are very sick, in which case, the dose is higher. Vitamin C can dose-dependently inhibit inflammasomes both in vitro and in vivo, This combination may be very helpful in inhibiting inflammasomes.   Some herbs which has been found to decrease the impact of the disease by decreasing cytokine release are Japanese knotweed, Chinese skullcap, Cordyceps, kudzu,  and boneset. You can learn more about those on Dr. Buhner’s website.
    https://www.stephenharrodbuhner.com/wp-content/uploads/2020/03/coronavirus.txt.pdf

  5. IMMUNITY: A DELICATE BALANCE

    6. A well-functioning immune system is vital to preventing infection. Vitamin D, vitamin A and zinc are essential for innate immunity but excess levels of these impair immune function. Almost everyone should supplement with Vitamin D through the winter, but the dose needs to be individualized over a range of 1000 to 5000 IU/day.
    Medicinal mushrooms, such as turkey tail, shiitake and reishi enhance immunity. Prebiotics and probiotics are also important. Quercetin has numerous activities helpful in fighting COVID19. One of these is that it brings Zinc into cells and helps it to fight the infection. Another may be a direct anti-viral effect on COVID. If you take Quercetin, and are not Zinc deficient, you do not need to supplement with Zinc, and it might even disrupt the delicate balance in our bodies between various minerals.

    Once ill, it’s more important to down-regulate our immune system, and recommendations change. At that point we stop immune enhancers. And at that point, Astralagus and Cordyceps may be more helpful.

    If you suffer from an autoimmune disease, it may not be advisable to use melatonin,mushrooms, elderberry, prebiotics or probiotics that stimulate innate immune function. If you become sick with symptoms of COVID-19, you should stop the use of medicinal mushroomselderberry and immune-enhancing pre- or probiotics.

  6. REPURPOSING OLD DRUGS

    7. Old drugs, Hydroxychloroquine (HCQ), especially have been found to have activity against COVID-19. Previously used for malaria, autoimmune disorders, and Lyme Disease this seems to have effectiveness against COVID 19 when begun early and limited or no effectiveness when begun late. Since most studies on HCQ are on patients who are very sick with pneumonia and respiratory distress, the results are disappointing. No studies are planned for patients with early disease. Other drugs which show efficacy against COVID-19 are Ivermectin and Alinia, (Nitazoxanid) both anti-parasitics. There are no studies using these in people.

    H2 blockers used for reflux have been found to decrease viral load in HIV (not studied with COVID) and may be useful for people who have been exposed or are just beginning to get ill. But they are not to be used if you've been sick any length of time.

  7. A NOTE ON ZINC

    8. Zinc is used in our cells to prevent viral replication in several ways. It does it in the cytoplasm, or cell body, and in the nucleus. But Zinc does not just enter cells on its own; it has to be carried. Substances which carry Zinc are called ionophores. Quercetin is a good zinc ionophore. So are all quinolones, the type of drug that is hydroxychloroquine. Quercetin is one of the most important supplements listed, because of its ability to carry zinc into the cell and nucleus. I'm not recommending that people take extra zinc when well, as we generally have plenty of it onboard, and it exists in balance with other metals, such as copper. But if you feel the least bit of viral illness, this is one of the most important things you can take.

 

PREVENTION RECOMMENDATIONS::


(Don’t worry if you don’t have these; links to buy online are below.)

Everybody should buy a pulse oximeter to measure blood oxygen: If you get a reading of 93 or lower, go to an ER. If you are feeling ill, you will need this. Pulse oximeter

  • LOWER THE CHANCE OF COVID BINDING TO YOUR LUNGS: ACE 2
  1. Liposomal curcumin (200 mg) and resveratrol (75 mg) twice a day with food. (If unable to get a liposomal form, take curcumin 500 mg and resveratrol 200 mg twice a day).
  2. Alpha-lipoic acid 300 mg twice a day with food
  3. Rosmarinic Acid (found in rosemary and oregano) 700mg whole leaf twice a day

  • SUPPRESS SPREADING WITHIN YOUR LUNGS: 3CL inhibition/Furins
  1. Elderberry as above; discontinue if you get sick; consider skipping if you have an auto-immune illness like lupus or rheumatoid arthritis
  2. Houttuynia: Dr. Zhang's HH2 (Houttuynia) 2 capsules twice a day. Dr. Leo Galland recommends starting these at the first sign of illness, at which time you should also seek immediate medical attention.
  3. Andrographis: 400 mg whole herb 2 Capsule twice a day
  4. Astralagus: 1Gm root in capsule form twice a day

  • ENHANCE IMMUNITY
  1. Get lots of sleep, meditate, and eat a protein rich diet.
  2. Elderberry extract as described above.
  3. Vitamin D3, 5000 IU/day with a large meal
  4. Quercetin: 300 mg twice a day
  5. Medicinal mushrooms: turkey tail, Shiitake, reishi are all well-studied

  • SUPPRESS THE HAVOC OF INFLAMMASOMES
  1. Melatonin: <1mg taken an hour before sleep which return you to physiological levels
  2. Vitamin C: 1000-2000 mg/day of liposomal Vitamin C. This helps avoid diarrhea. Take the highest dose you are comfortable taking.

 

SHOPPING LIST: Prevention

 

Everybody should buy a pulse oximeter to measure blood oxygen: If you get a reading of 93 or lower, go to an ER. If you are feeling ill, you will need this. Pulse oximeter

 

Liposomal Resveratrol 1 capsule twice a day
Liposomal Curcumin 1 capsule daily
Alpha Lipoic Acid 1 capsule twice a day
Quercetin 1 capsule twice a day
Melatonin 1 before sleep
Dr Zhang Houttuynia cordata HH2 2 capsules twice a day
Elderberry 2 capsules three x / day
Vitamin D3 1 daily
Liposomal Vitamin C: 1 daily
Turkey Tail Mushroom 1 twice a day
Rosemary 2 twice a day
Andrographis 2 twice a day
Astralagus capsules 3 twice a day

 

SHOPPING LIST: If you get sick

 

Alka Seltzer Gold twice a day with lemon
Cordyceps 2 twice a day

 

IF YOU GET SICK

  1. If you haven't already, buy a pulse oximeter to measure blood oxygen. Pulse Oximeter on amazon. People with COVID19 can have a precipitous drop in oxygen without realizing it. If you are feeling ill, check this regularly. If you get a reading below 93, proceed to a hospital.
  2. At the first symptom, try taking the H2 blocker, Famotidine, (Pepcid) As it has flown off the shelves you will need to get a doctor's prescription for it.
  3. Continue all supplements except Elderberry and Turkey Tail. If you take probiotics, this is the time to stop them, too.
  4. Add Zinc, (preferably Zinc picolinate) 30-60mg/day.
  5. Increase the Vitamin C to the highest you can tolerate; take every couple of hours. If you are taking liposomal, 4-5Gm should be do-able.)
  6. Increase melatonin to 6 - 20 mg at night (optimal dose is unknown; increase to the highest dose you can tolerate and be able to function during the next day)
  7. Increase Quercetin 500 mg twice a day
  8. Buy a pulse oximeter to measure blood oxygen:  FDA Approved Pulse Oximeter If you get a reading of 93 or lower, go to an ER
  9. Take N-acetylcysteine (NAC) 600mg three times a day
  10. Alka Seltzer Gold: (or bicarb) if salt is not a problem for you, alkalinize with 1 dose twice a day, preferably with a lemon

 

IF YOU WOULD LIKE MY HELP IF YOU FEEL YOU ARE GETTING SICK, PLEASE EMAIL OR CALL FOR A TELE-MEDICINE CONSULTATION

 

SELECTED REFERENCES FOR RECOMMENDATIONS

 

(1) Resveratrol and ACE-2
https://www.ncbi.nlm.nih.gov/pubmed/2940788

(2) Curcumin and ACE-2
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651552/

(3) Research on quercetin as treatment for COVID-19 (McGill Tribune)
http://www.mcgilltribune.com/sci-tech/montreal-researchers-propose-a-treatment-for-covid-19-170320/

(4) The role of mast cells in COVID-19 infection (luteolin inhibits mast cells)
https://www.biolifesas.org/biolife/2020/02/04/mast-cells-contribute-to-coronavirus-induced-inflammation-new-anti-inflammatory-strategy/

(5) Anti-viral effects of H2 blockers on HIV
https://www.sciencedirect.com/science/article/abs/pii/S002432059600553X

(6) * Basak, Ajoy. et al. Inhibition of proprotein convertases-1, -7 and furin by diterpines of Andrograhispaniculata and their succinoyl esters, The Biochemical Journal 338 (1999): 107-13.

(7) ACE-2 is X-linked:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010099/

(8) Effect of H2 blocker Famotavine (Pepcid) on HIV
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3157302/

(9) Effect of H2 blocker Cimetadine on HIV
https://www.sciencedirect.com/science/article/abs/pii/S002432059600553X

(10) Eastern Virginia Medical School Protocol:
https://www.evms.edu/media/evms_public/departments/internal_medicine/Marik-Covid-Protocol-Summary.pdf

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