clean eating, detox, nutrition, stress, supplements, vitamins

UPDATED Immune Support

Update 4.15.20 I have been advised to add a disclaimer to assure you that this post is in NO WAY medical advice or a treatment protocol for Covid 19.  Please seek your medical doctor for that advice.  This is general information for educational purposes only.
Updated 4.7.20
The IFM recently put out important information on Covid-19.  I wanted to take the opportunity to share with you this information.  You may know that the IFM is considered the Global Leader in Functional Medicine.  It is where I turn to get evidence based forward-thinking nutrition information and training.
You may ask, “How can Functional Medicine help?” Functional Medicine determines how and why illness occurs and restores health by addressing the root causes of disease for each individual. Practitioners applying Functional Medicine principles support patients in becoming more resilient and thus potentially less likely to contract infectious diseases such as COVID-19 and, if they do, less likely to suffer serious complications.
Here is my original post with some updates mixed in:
Hi All!  I am getting numerous questions about what I’m taking for immune support.  I haven’t changed a whole lot from my normal routine because  I do support my immune system on a regular basis.  I will outline my routine below and have added in a few extra to have on hand if you get sick.
But before I get into supplements, we must talk food.  The most important thing you can do to support your overall health: YOU MUST EAT THE RAINBOW and EAT CLEAN!  You can’t undo a bad diet with supplements.  Supplements are just that, a supplement.  They are not to replace food just to support and supplement what you are already doing.  A bad diet (i.e. sugar, processed food, artificial ingredients) will not support your body to help fight off this virus!
4/7/20 Polyphenols can play a role in modulating inflammation.  Pholyphenols are found in, you guessed it, plant foods!  Some examples are resveratrol (grapes, wine, dark chocolate, blueberries), curcumin (curries, turmeric), EGCG (green tea), and quercetin (leafy veggies, grapes, broccoli, red onions, peppers, tea).
Please do all the other things you have been seeing in the media:  Wash hands, don’t touch your face, REST, Sleep, minimize stress, social distance, etc.  Supplements can’t replace these things either.  Social distance is important because 50% of the cases that get sick are getting sick from people that are asymptomatic (they are contagious but have no symptoms)!
Most of the supplements below are direct link to Metagenics.  They are also available on my Fullscript dispensary and my Wellevate dispensary depending on which way you prefer to order.  They should all be about the same price. I discount my dispensaries to help you.  I know quality supplements are expensive.  Supplements are NOT regulated and buying from a random company on Amazon could be risky.  What you purchase may be contaminated or not even contain any of the active ingredients.  The brands listed below are trusted and I personally use them.
At the end of this post, I’ll link to some great info I’ve been reading on this virus.  I’ve been reading everything that comes across my desk and these links are hand selected as what I feel is important (as far as supplements, nutrition and immune go).
Also, please understand, these supplements are for healthy individuals and for general purposes.  This is what I am taking to hopefully strengthen my immune system and give me the best chance of prevention.  If you get sick, please go to the doctor and do not rely on these to get you well.  This virus is serious and you don’t want to take a wait and see attitude with this one!
My supplements pics are:
1.  A good multi.  Phytomulti is one of my favs.  It comes in tabs or caps, with or w/o iron.  I typically order a large bottle so I don’t have to order as often.  Metagenics also offers a discount if you auto-order.  I recommend you keep this one stocked!  Do not run out of this one!  This one has added phytonutrients so a great choice if you don’t eat a lot of fruits and veggies and/or just want that added boost.  You need 2/day for the full benefit.
Phytomulit
In my household, we also regularly use this one which can by purchased on Fullscript or Wellevate.  This one is a 1/day so a great choice if you want to limit your pills.  It also has 2000iu of vit D in it so a great choice if you want that dose of D included in your multi!  But this is important to know if you take a separate D.  You don’t want to overdo it.
ONE multi
2.  Vitamin D – I typically take a D w/ K2 and take about 5,000iu / day because I get tested regularly and typically taking this amount is enough for me to stay at a good level (50-70).  It comes in many different amounts and even in liquid if you don’t like pills.  If you have been tested (like many of my clients) and you KNOW you have a low vitamin D level, getting that level up is one of the most significant things (as far as supplements go) that you can do to support your immune system!  I see so many clients that know their D is low and they just forget to take the supplement.  This is NOT the time to have low vitamin D.  Please take it!  Find a way to remember.  Put it by the bed, put it by the toothbrush, by the coffee pot, add liquid to smoothie, etc. etc. 4.7.20 IFM recommends testing to check levels but maintains that 5,000iu may be helpful in absence of test. 
D 5000
3.  Omega – a great anti-inflammatory and very difficult to get enough daily in our food (unless you are eating wild caught salmon daily).
omega 720
4. Zinc – I take this daily (15mg because I was tested and I was low) but will bump up during an illness(15-30mg short term).  Oysters are a good food source. Also, research says that zinc lozenges are the best source for a supplement (if you are sick or have a sore throat).  They are hard to find right now so I’ve just been taking this one.  A quick search for “zinc lozenges” on Fullscript or Wellevate will take you to a few good brands.
zinc
5.  Probiotics – there are so many good brands of probiotics.  I tend to keep a few of them on rotate.  Most of your immune system is in the gut.  You must keep your gut healthy to have a healthy immune system.  That includes feeding your microbiome with complex carbs, probiotics, fermented foods and fiber/prebiotics.  One of the best ways to support your immune system is to have a healthy gut.  This could include a full gut health program which I am not going into in this post but will be glad to discuss with you if you message me.  Probably the number 1 question I get is, “Which probiotic should I take?”.  It can get overwhelming choosing one since there are so many.  Some probiotics are for general health or immune (like this one below) and some are targeted for specific things.  It is a good idea to work with a practitioner that can help you select a good one just for you.  I typically take a general one and lately have been taking an additional one for targeted gut health.  I will be glad to recommend one for you!
spectrum
6.  Vitamin C – You can really bump this up now.  Vitamin C is water soluble and it will give you diarrhea if you take too much.  So, as long as you aren’t taking enough to get the runs (lol), you are probably ok (sorry for the TMI).  I’ve been taking this powdered one below in smoothies.  I also take this liposomal liquid too.  Vitamin C is hard to find right now so if you can get it, take it!  If you have it at home, take it!  It is one of the best things to take right now to keep your immune system strong.  This virus doesn’t like vit C 🙂
4.7.20 IFM recommends 1-3 grams daily (I suggest splitting up throughout the day)
C powder
lipo C
7. Elderberry – I can’t direct link to this but you can search on Wellevate.  I love this brand and typically use this syrup or the caps.  I take this daily during flu season or if anyone in the house is sick.  If I feel like I am coming down with something, I bump up the dose.  There is a lot of conflicting info on Elderberry in association to the virus right now.  So, what I am doing is taking it now.  If I get the virus, I will likely stop taking it.  Also, I don’t rec taking this if you have autoimmune disease.  You can also make your own syrup which I have also done.  Just don’t eat the berries as they must be cooked (they are toxic).  Message me if you need a recipe. 4.7.20 IFM states “…it is highly implausible that consumption of properly prepared elderberry products (from berries or flowers) would contribute to an adverse outcome related to overproduction of cytokines or lead to an adverse response in someone infected with COVID-19.”
Also, there are many other ways to support your health and immune system so if you are not comfortable with Elderberry, there is no need to take it.  The conventional community and even some other integrative sources (not IFM) are recommending not taking it.  There are many other options to support your system.
GaiaHerbs_BlackElderberry
8. Mushrooms – There are a variety of ways to take this.  You can find this powder below at Wellevate.  I typically don’t use this unless I feel like I’m coming down with something or feel I need a boost.  I would typically make it in to a broth and “down it”.  This product also comes in caps.  I have used in smoothies too. 4.8.20 some practitioners are recommending not taking this at this time.
ECONUG-1008-2
9.  Glutithione – this is not specific for immune but it is a master antioxidant and helps support your body’s detox pathways.  I take it daily.  I figure if your body is burdened with stress and other toxins, it is more likely to catch something.  I have used all three of the products below and are all A+.  4.7.20 IFM is recommending NAC which is a precursor to glutithione.  Either one should be good.  
lipo glutathione
sulforaclear
10. Garlic is well researched and a must have.  I’ve been taking this daily as well.  This one is awesome because it is super concentrated and you only need 1 tab.
Garlic
4.7.20 IFM recommendations in addition to what was highlighted above:  All can be purchased via Wellevate or Fullscript.
Quercetin – phytosome 2 per day on wellevate or see Metagenics sinuplex below
Quercetin
Curcumin 
inflavonoid intensive care
ECGC – IFM suggests 4 cups per day of green tea.  Alternately, you can try a supplement.
egcg
NAC – NAC is a precursor for glutithione which is a master anti-oxidant.  I take straight glutithione as mentioned above but you can also take NAC to help in the body’s production of glutithione.
Resveratrol – 100-150 mg daily per IFM
Melatonin – 5-20 mg every day per IFM
Vitamin AIFM suggest 10,000-25,000iu per day.   Caution with pregnancy and double check all supplements to be sure you are not overdoing Vitamin A as it is a fat soluble vitamin that can be stored in the body.  Work with a practitioner to assure you do not take too much.
The following are my friend Becky’s pics.  Becky is an RD and the Metagenics Account rep.  You will see some overlap and some specific to respiratory health.  
Basic Immune Support :
Phytomulti – contains a B complex, 1,0000 IU’s of D3, and the antioxidant equivalent of 10 servings of fruits and vegetables in just 2 tablets.
Phytomulit
D3 we offer a comprehensive line of vitamin D products ranging from 1,000 IU’s to 10,000 IU’s. Please reach out directly if you need help choosing which one is right for you.
UltraFlora Spectrum– this comprehensive probiotic contains 7 different strains of bacteria for overall gut and immune support.
spectrum

Respiratory/lung health : We know this virus attacks the respiratory system.

 

UltraFlora Immune Booster clinically researched probiotic to support nasal, sinus and respiratory health.
immune booster
Nazanol– supports healthy nasal and sinus function, and can help ease sinus congestion.

nazanol

Sinuplex– features a unique blend of vitamin C, quercetin, stinging nettle root extract, bromelain, and N-acetylcysteine—designed to support healthy respiratory function.
sinuplex
Targeted Immune Support:
Ultra Potent C- This form of vitamin c is 25% more bioavailable than standard ascorbic acid, gentle on the GI tract and shown to increase natural killer cell activity. We have a comprehensive line of vitamin C products, including tablets, chewable and powder. Please reach out directly if you need help choosing which one is right for you.
C powder
Zinc A.G.- highly absorbable and well tolerated form of zinc, and especially important for immune and tissue health.
zinc
Immucore– features Ultra Potent-C®—developed for enhanced cellular uptake of vitamin C—combined with zinc, vitamin D, and a concentrated blend of mushroom extracts.
immucore
Acute Formulas (to be taken at the onset of symptoms) :
Essential Defense- traditional herbal formula, ideally taken with 24-48 hours of symptoms.

essential defense

UltraFlora Acute Care– a unique blend of “friendly” bacteria and Saccharomyces boulardii to support immune health.

acute care

Stress:
Consider the negative impact stress can have on your immune systems, especially in times such as these. If you would like to learn more about how to assess your current stress levels and address with an individual plan, please reach out directly so that we can talk further. Metagenics has a comprehensive line of stress formulas, allowing each patient to find their perfect fit.
Please message me if you would like other brand options. There are many good ones and many different forms.  If you prefer liquid, liposomal, powder, combination, etc., I can help you find something right for you.  I discount my dispensaries to help you afford these supplements as they can be expensive.  Also, don’t waste your money guessing what you need.  Please do not hesitate on contacting me for help.  Many of these products are similar and I can help you find the right one for you.
Stay Well!
Here are some links to some great resources!
I’ve been reading everything that comes across my desk and these are the best that I’ve found: (not in any particular order)
So important to have a healthy gut!  It’s where most of your immune system lives.  We could talk for hours and hours about this.  Basically, feed it and keep it healthy.  We can work together on a full gut health program.  It is what I do with most of my clients.  Now is not the time to destroy your gut with sugar, processed foods and stress.  Feed it with the right foods and lifestyle.

Cytokine Storms, Elderberry, Ibuprofen, and Tylenol, Oh My!

OK, I can’t take it anymore! Sometimes I would love to just pull the plug on the internet, honestly. Amazing how things are taken out of context, go viral, and then doctors like me get hundreds of emails and texts in a panic about things like “cytokine storms”!

Cytokine Storm Issue: OK, this whole thing started from an isolated report about potential cytokine storm, a very rare occurrence and poorly understood phenomenon, with two patients in China, one who survived and one who didn’t. This morphed into a cockeyed theory being propagated across the internet that anything that is immune simulating, such as the herb Elderberry, could be dangerous because it could cause a cytokine storm. Firstly, this is totally BS and there is zero data that I am aware of showing this. Elderberry’s main anti-viral actions do not even involve cytokine responses at all, and rather involve its neuraminidase inhibition, similar to the drug Tamiflu. It also has an amphoteric effect (not in the strict acid-base definition, but in that it can correct from both sides of a metabolic process) on cytokines, meaning it upregulates then when necessary, and downregulates them when necessary.

The Elderberry and cytokine storm issue was commented on, most eloquently, by my brilliant friend and colleague, Dr. Peter D’Adamo, as follows:

“Should I worry about my supplements triggering a cytokine storm? No. We need to stop worrying about an herb or vitamin triggering a ‘cytokine storm, (CS) a massive immunologic overreaction that is seen at the end stage of certain viral infections. Most of the time CS is not triggered by the virus but rather another end-stage consequence, septic shock, and with it, multiple organ failure. Septic shock is triggered by molecules known as TLRs (toll-like receptors) that are usually activated in response to bacterial toxins known as lipopolysaccharides (LPS). Activation of TLR leads to the production of ‘inflamasomes’ (principally one known as NLRP3), which then trigger the release of cytokines. NLRP3 is inhibited by nitric oxide (NO) a small signaling molecule produced by virtually every cell in the body. Matter of fact, you might have benefited from elderberry, since it has been shown to enhance NO blockage of inflammasome activity and actually suppress TLR4. Dark pigmented fruits have been known to block LPS activation of inflammasomes for decades. So let’s get things straight. This is man-bites-dog stuff. If you’re headed for this type of consequence, a cytokine storm preceded by septic shock, I can assure you they we need not worry about the elderberry you’ve taken. In fact PubMed shows zero studies when ‘elderberry’ and ‘cytokine storm’ are entered as search terms. Zero. It’s the equivalent of waiting for a commuter train, seeing a brown bag lunch on the track and worrying that it might potentially derail your ride. I’ll put it in even simpler terms, virtually all rational natural therapies for Covid19 are not potent enough to do this level of harm. If they did, that would be bad, but then again we’d have some really great new drugs for a slew of other human ailments, like cancer.”

See this link https://lindseyelmore.com/cytokine-storm-what-causes-immun…/ which intelligently addresses the Elderberry issue and cytokine storm. Again, there is zero evidence that Elderberry induces such an event, and in-fact, it has an adaptogenic or amphoteric balancing effect on cytokines per need, and other anti-viral mechanisms.

“Don’t Take Ibuprofen and NSAID Medication” Issue:

This is on the internet and has some truth behind it, although the issue is based on limited anecdotal reports, mainly from the UK. Some have equated this to the Elderberry rumor, but in-fact is quite opposite. Those who have been given Ibuprofen, or similar NSAID compounds, have been seemingly recovering less well. This is not terribly surprising, as these drugs’ main mechanism of action is the suppression on the innate immune response, or in other words “inflammation”. That is what they do! Do you want a key element of your immune response dampened when you are trying to recover from a serious viral infection, even if it may alleviate some of your symptomatic discomfort? No. So instead they advise to use Tylenol, but is this wise?

“Use Tylenol (Acetaminophen) Instead” Issue:

This is an entire subject that makes my blood boil (No pun intended). Western medicine has fallen into a very lazy reactive situation when it comes to fever, and this flies in the face of the understanding of physiology, common sense, and certainly naturopathic medicine principles. The minute a person spikes a fever we should not be advising them to immediately reach for a bottle of Tylenol (acetaminophen)! Yes, it is an analgesic (pain reliever) and anti-pyretic (fever reducer), and may make you feel a bit less symptomatic. However, your body is spiking a fever for a reason! Your immune system is working hard to produce that elevated body temperature with a plan in mind, which is to make it too hot for the pathogen infecting you to want to stay around, or for it to survive in you. Why would you want to immediately sabotage your own immune response like that? We all understand that an uncontrolled and excessive fever can be deadly, but that does not mean we should immediately attempt to suppress any level of fever. We need to “control” a fever, not eliminate it. The magic number here is 103 degrees, as anything above that can become life-threatening. Keeping a fever in control by the use of hydrotherapy using a tepid bath with sponging or immersion in water lower than the temperature of the body (85–90 degrees Fahrenheit, or 29.4–32.2 degrees Celsius). This works just fine in most situations. Report to fever lowering medications and seek medical attention only when there is difficulty in keeping the beneficial fever in a safe range.

Take Aways:

If you want to believe the unsupported rumor mill on the internet than immediately stop taking anything that may enhance your immune response and body’s ability to fight infection, including viruses. Good luck with that. Is Elderberry, or other herbs such as Andrographis, dangerous in viral infections? Not that we know of, and we have plenty of scientific evidence and hundreds, if not thousands, of years of traditional use to back up their value in such circumstances. If you are still not comfortable with the use of botanicals/herbals, then I would at least advocate that you consider taking some key vitamins and nutrients that support healthy immune function, such as quercetin and vitamins C, D, and A, and zinc. I would not use Ibuprofen or other NSAIDS if you think you may be suffering from COVID-19 infection. I would also not immediately use fever-suppressing therapies, such as Tylenol (acetaminophen), but instead manage the fever with tepid baths and only resort to medical suppression of a fever if it becomes necessary. Finally, I would really advocate that everyone relax and take a few deep breaths! David Brady

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