The Path to Resilience…

This is a medical “editorial” and my opinion only. Although I feel it is supported by as much scientific evidence that is currently being used to support any number of other interventions in medicine, it is certainly not considered a “standard of care” among conventional practitioners.   Nonetheless, in my opinion, individuals who are deficient in any one of several simple micronutrients are at risk for greater levels of morbidity and even mortality given the lack of herd immunity with this particular virus. There are more interventions that could be discussed, but in the interest of brevity, we will focus here on just a few.

Very few medical – or political for that matter – leaders have said much about the promotion of community “resilience” with respect to morbidity and mortality with the COVID-19 virus. The ability to predict who will and will not get critically ill with this illness remains a mystery despite some predictive value in risk factors such as age, comorbidities, etc. However, there are very old people for whom the virus is a minimal nuisance illness and there are seemingly healthy young people who become critically ill and might even succumb. What makes them different? There is a good deal of data strongly suggesting that immune response to viral illnesses has much to do with any number of different nutritional factors. Vitamin C, A, and D are all likely involved in just how “virulent” a viral infection might be. General mineral nutrition is important, but particularly selenium and zinc seem to be related to level of morbidity with viral illnesses. There is much to support this, and some of this evidence is not even very new. 

These nutrient factors are often critically low in an average population. How do I know this? Because I have spent the last 25 years exploring the relationship between nutrition and disease. We have routinely measured these nutrients. Today, occasional vitamin D levels are done, but we have been doing these and the other measurements since before 2000. Whether or not people are willing to follow the “perfect diet” that is rich in organic produce and therefore likely to contain higher levels of these nutrients is certainly an ongoing challenge. Some of these nutrients are richly contained in grains. Of course, grains have been vilified in the newer paleocentric and low-carb diets in the interest of being less fat. The latter, of course, is because most people – in America at least – spend their working and leisure time sitting. Nonetheless, relying on a simple diet is not very likely to produce optimal levels of many nutrients, particularly those critical for optimal immune function. On the contrary, many of the processed foods that we consume – particularly those enriched with sugar whether overtly or insidiously – can actually impair healthy immune function.

So, above and beyond simply playing a “passive host” fearing that the virus will somehow gain access to one’s biology, I would like to suggest a number of measures that would help with the limitation of morbidity if not mortality in individuals who might actually catch it.

In 2004 when the “Severe Acute Respiratory Syndrome” became known as SARS and long after the world became accustomed to the potential of viral pandemics with HIV, scientific inquiry began to look at host “resilience”. In fact, a review done at the University of North Carolina had this to say:

“What are the factors that contribute to the rapid evolution of viral species?  Various hypotheses have been proposed, all involving opportunities for virus spread (for example, agricultural practices, climate changes, rain forest clearing or air travel).  However, the nutritional status of the host, until recently, has not been considered a contributing factor to the emergence of infectious disease.  In this review we show that host nutritional status can influence not only the host response to the pathogen but can also influence the genetic makeup of the viral genome.  This latter finding markedly changes our concept of host-pathogen interactions and creates a new paradigm for the study of such phenomena.”

Well, that “new paradigm” is still  evidently extraordinarily “new” to current medical leadership.  In this same review cited above selenium deficient mice were compared with selenium-adequate mice infected with influenza A which normally induces only a mild pneumonia. However, the mice that were selenium deficient were found to develop very severe lung pathology even after infection. This did not happen in the selenium-adequate mice. These academics concluded that higher levels of oxidative stress in the host – induced by dietary deficiencies in key antioxidants or even by the increased consumption of pro oxidant nutrients (sugar and junk food) – provide a selective environment in which the more virulent genotype of viruses is able to become selected. In other words, the viruses are in fact mutating in a community of hosts who are poorly nourished to become yet more dangerous.  Why are we not teaching this to our literally “huddled masses”?

Although it is popular to designate a certain amount of any given vitamin as necessary on a daily basis to represent the so-called and magic “MDR” or “minimum daily requirement”, most informed doctors know –even if they did not pay attention to the one or two lectures in medical school pertaining to nutrition– that those numbers are the amounts of any vitamin that are barely enough to prevent a true deficiency disease. For many years the MDR for vitamin C, e.g., was 60 mg per day. This was the amount thought to be necessary to prevent scurvy. Now, we know that much more is necessary to promote optimal function. And what about the difference between a 110 pound woman and a 250 pound man? None of the conventional requirements ever talk about the amount necessary “per pound of body weight”. Recently, the recommended amounts of vitamin D were below 1000 international units per day – whether that was for a three-year-old or a 250 pound 40-year-old. It’s absurd.

However, now, due to the increasing efforts made by physicians with an interest in “functional medicine,” naturopathic medicine, and the reasons why people get sick (shouldn’t we all be interested in this?), to actually do these measurements, we know much more about it.  To wit:  a recent study that looked at vitamin D levels and interstitial lung disease (an autoimmune disease with a particularly poor prognosis) show that the “Vitamin D level was lower in patients with CTD-ILD and associated with poor prognosis. Continuous levels of Vitamin D may be an important serum biomarker of prognosis.”  That isn’t about COVID 19, but it is one of many new signs that upstream causes of disease vulnerability and morbidity with common infections is finally being looked at.  Common interventions such as melatonin turn out to play a big role in abetting the so-called cytokine storm associated with influenza and this coronavirus for reasons that are unclear. But the evidence is compelling, and the simplicity of the intervention has no downside. This may be the reason why children simply don’t get very sick with this virus because they have the highest melatonin output.

Which brings us to the situation we are in now.  Could it be that a healthy 40-year-old, “Jones” dies mysteriously from COVID 19 but yet a slightly overweight 55-year-old, “Smith”, has a mild illness due to the same virus from which he recovers simply because their nutrition differed?   Perhaps somehow Smith has been taking a strong multivitamin that meets or exceeds critical tissue levels of these components whereas Jones simply does not?  I would say that the stakes are so high that this hypothesis needs action, and we do not have time for a randomized controlled trial. Here is what I would recommend minimally for every man, woman, and child in the absence of any specific or unusual contraindications (to be discussed with one’s physician or provider) that would definitely help, in my opinion, with resilience should COVID-19 be contracted:

Vitamin A 100 IUs/lb/day (preferably as “mixed carotenoids” or the palmitate form)

Vitamin D 25 IUs/lb/d

Vitamin C 5 mg/lb/d  (preferably in the liposomal form)

Selenium 1 µg/lb/d

Zinc .2 mg/lb/d

Melatonin 3-6 mg at bedtime if older than 45 (even if no trouble sleeping)

Diet: minimize sugar unless contained in a whole food such as fruit. Vegetables should be consumed with some fruit in a 2:1 serving ratio not the other way around.

Daily use of PEMF or pulsed electromagnetic field therapy that promotes healthy immune function — but this is for another article/blog/day. For more information visit www.drpawluk.com 0r any number of other sites describing this new energy related modality and its effect on day-to-day health.