Prevent and Fight Viruses 2.0

Created 5/19/2020, updated 9/4/2021

PREVENT AND FIGHT VIRUSES 2.0

Steve and Bonnie: While much of this protocol focuses on preventing and fighting COVID-19, much of the following can be applied to preventing and fighting other viruses.

Understanding the following will allow almost anybody to safely prevent and fight viruses no matter your age or state of health. We always suggest speaking with your physician and integrative health professional.

Until further notice, we urge you to continue with extra immune support. SARS-CoV-2 is not the only virus we fight. There is influenza (flu), norovirus (stomach flu), adenovirus (common cold), and four other coronaviruses (common cold), among others. Introduction Two of the most insidious characteristics of SARS-CoV-2 virus is that it evades our initial immune response (the innate immune response) and kills crucial immune cells (macrophages). By doing this, not only is our initial immune response delayed, but our second immune response (adaptive immune response) is as well. This is why focusing on preventive measures, which include helping our immune system recognize and fight off initial exposure to SARS-CoV-2, is critical. Conversely, for some patients with severe COVID-19, immune response becomes so overstimulated that it creates an inflammatory response that does not abate. This is where patients can become critically ill. Hence, SARS-CoV-2 put our immune system at odds. We need early activation but not continued overactivity. The following is the best way to do so. Four Phases in the Timeline of COVID-19 Phase One - Prevention Prevention means you are prepping your immune system for peak surveillance to detect SARS-COV-2, as well as reducing daily levels of inflammation, to improve outcomes if you become infected. Prevention encompasses stress reduction and optimal diet, lifestyle, supplements, and public health measures. If you are over 60 and/or have underlying conditions such as obesity, diabetes, and hypertension, extra prevention vigilance is warranted. Phase Two - Infection If you happen to be infected with SARS-CoV-2, support for infection emphasizes specialized immune activity against infection. Phase Three - Escalating Inflammation If SARS-CoV-2 overstimulates the immune response to the point that you are symptomatic, support is focused on anti-inflammatory measures. Phase Four - Recovery Once you are not symptomatic, support should still be focused on resolving inflammation, inhibiting tissue damage, curtailing losses of function, and restoring and reoptimizing function. Because patients have been observed to relapse into the Escalating Inflammation Phase, it is essential to communicate with your health professional to continue the following well into what may appear to be the Recovery Phase. In-Depth Strategies to Support the Four Phases We did not include public health measures such as wearing masks and social distancing, as you should be well aware of these measures by now.

Diet and Beverages Sugar Added sugars, sweets, desserts, and sweetened beverages of any kind should be looked upon as badly as the coronavirus. Sugar often provides the opening a virus needs to take hold because it weakens our immune system. Aside from the WHO stating the aforementioned, in Cell Metabolism, the largest study ever done on the link between glucose levels and COVID-19 found that the better your glycemic control, the better your COVID-19 outcome. Those with blood sugar disorders have to take precautions to another level, as diabetes is a malady associated with very poor outcomes in COVID-19 patients. Fruit and Vegetables Not only do they provide fluid and electrolytes, their phytochemicals protect the throat and lungs, and most importantly, help maintain your acid/alkaline balance. It is much tougher for viruses to take hold when the body's pH level is between 6.8 and 7.2, which is slightly alkaline. Being too acidic or too alkaline is not ideal. In addition, many fruit and veggies are rich in the mineral potassium, which is an integral nutrient for COVID-19 prevention and treatment. Fluids Drinks lots of fluids (warm or hot) to avoid dehydration. Electrolytes, especially potassium, are crucial. One of the things that happens with infection in severe cases is hypokalemia, which is potassium deficiency. Sodas, juices, and sweetened coffee or tea drinks are not recommended. A great tip, which has been recommended by numerous public health experts around the world, is to gargle with baking soda in warm water (spit out, don't swallow) upon waking and before bed. This will help neutralize pathogenic substances in the throat area. Some studies have found mouthwash to be effective as well.

Other Chewing xylitol gum (ideally from birch bark, not corn) has been shown to kill pathogenic organisms in the nasopharynx area. Keep alcohol to a minimum, if at all. Alcohol can have a detrimental effect not only on our immune system, but restorative sleep. Supplements Just eating a healthy diet will not suffice. You need supplemental support. The following are foundational supplements that should be taken not only for prevention phase, but through all phases if it comes to that. Supplements for All Four Phases, Especially Prevention VITAMIN C (Ascorbic Acid) Vitamin C is critical for almost every cellular function. It is especially important that you take vitamin C if you have the genetic mutation that impedes absorption. Dosage: 500mg - 700 mg twice daily for adults; 250mg - 350 mg twice daily for children.  **During Inflammation Phase, increase to 2,000mg - 4,000mg if tolerated digestively. ZINC Oral tablets/capsules along with zinc lozenges/zinc sulfate solution have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. And guess what, loss of smell (anosmia) and distorted sense of taste (dysgeusia), the most frequent complaint in those with COVID-19, are classic symptoms of zinc deficiency! It is especially important that you take zinc if you have the genetic mutation that impedes absorption. Dosage: 20mg - 30mg capsules/tablets with a 60mg maximum daily for adults (so if you take a multi with extra zinc you should be good). 15mg - 30mg for children. Always take oral zinc with a protein meal. For lozenges, let them dissolve in the back of your throat and nasopharynx. For children who cannot swallow a pill, a 15 mg. zinc sulfate solution can be added to water, or a sugar-free gummy is available. There is also a 2 mg zinc sulfate solution that can be gargled and swallowed twice daily by anyone as a preventive or for sore throats. **During Infection and Inflammation Phase, take at least 50-60mg supplemental zinc until Recovery Phase. MONOLAURIN (glycerol monostearate) This has been our "go to" for any kind of virus prevention for over 30 years. Similar to how washing our hands with soap kills viruses, monolaurin does a similar thing in our bodies at the cellular level. A natural antiviral derived from coconut, glycerol monostearate mirrors the immune property monolaurin, found in human breast milk. Monolaurin kills viruses by breaking down their phospholipid layer, leading to apoptosis (cell death). As a natural emulsifier, it takes the fight to viruses on the cellular level because of its natural foaming properties. According to a study from mSphere, monolaurin also inactivates lipid-coated viruses by binding to the lipid-protein envelope of the virus, thereby preventing it from attaching and entering host cells, making infection and replication impossible. Other studies show that monolaurin can also disintegrate the protective viral envelope, killing the virus (SARS-CoV-2 has this viral envelope). According to a study from Science Signaling, monolaurin can balance out T-cell antibody and cytokine overactivity. Dosage: 600mg daily for adults and teens; 300mg for young children. **During Infection and Inflammation Phase, increase to 2400mg daily for adults and teens, 1200mg daily for children. **Contraindicated in those with coconut intolerance. VITAMIN D3 As we reported recently, having optimal vitamin D levels can reduce severity of COVID-19 symptoms and mortality by 50%. This finding has been corroborated in several studies published around the world just last week. It is especially important to have enough vitamin D3 if you had a low level previously or you have genetic mutations of specific vitamin D genes that impede absorption. An optimal D3 level is between 50 and 75. Dosage: 5000IU (125 mcg) - 10,000IU (250 mcg) daily for adults until herd immunity is reached; 1000IU (25 mcg) - 5000IU (125 mcg) for children. VITAMIN A (not beta carotene) Vitamin A is critical not only because it helps vitamin D absorption, and vice versa, but it is a crucial immune nutrient for numerous viruses. It is even more critical to take supplement vitamin if you have a genetic mutation that blocks your ability to turn beta carotene into vitamin A. Dosage: 3000IU (900mcg) - 5000IU (1500mcg) daily for adults; 500IU (150mcg) - 1500IU (600mcg) daily for children. Note micrograms, not milligrams. **During Infection and Inflammation Phase, double the dose. MELATONIN Aside from exhibiting preventive characteristics against SARS-CoV-2, melatonin helps restorative sleep, which is important for recharging your immune system. Dosage: 3mg - 10mg daily for adults 20 minutes before bed; 0.5mg - 3mg for children. QUERCETIN Querectin helps transport zinc into the cell. In a new study looking for agents that could bind to SARS-CoV-2 viral spike protein and inhibit its activity, researchers found quercetin was the fifth most effective of 77 agents! Dosage: 500mg daily (250mg with breakfast and dinner) for adults; 125mg - 250mg for children. EPA/DHA FISH OIL Fish or cod liver oil are natural anti-inflammatory agents which are necessary to extinguish initial immune overactivity when presented with an infectious agent. Dosage: 1200mg - 2400 mg. daily total for adults; 600mg - 1200mg for children. **During Inflammation and Recovery Phase, double your daily dose or take SPMs (see below). **If you are on blood thinners, please speak with your physician. REDUCED GLUTATHIONE OR N-ACETYL CYSTEINE (NAC) The glutathione pathway is critical for assuring proper oxygen efficiency without extra inflammation. Much of the human population have genetic mutations that warrant supplemental use. However, some do not have the glutathione genetic mutation, in which supplementation can then be harmful. In this case especially, knowing your genetics is very important. NAC is the precursor to glutathione. Some health professionals prefer NAC to glutathione. We have always preferred glutathione in reduced form. Dosage for NAC: 900mg through all phases for adults; speak with pediatrician for children. Dosage for Reduced Glutathione: 100mg - 200mg for adults; speak with pediatrician for children. **During Inflammation and Recovery Phases, increase only glutathione to 500mg. MAGNESIUM GLYCINATE Magnesium is nature's Valium. It is critical for over 300 bodily functions, but during the pandemic is most helpful for stress, anxiety, and restful sleep. Dosage: 350mg daily for adult women; 400mg daily for adult men; 100mg - 200mg for children. Best taken upon waking and before bed. MULTIVITAMIN/MINERAL Foundational support to fill in other nutrient cracks. Some multis may contain sufficient amounts of the aforementioned nutrients.  Dosage: brand and amount is too broad to recommend here. Hopefully you are already taking one :)

Supplements for Infection Phase (at first sign of symptoms; these can be stopped after symptoms abate) ANDROGRAPHIS Andrographis is a herb with a long history of use in both Ayurveda and Traditional Chinese Medicine for treating viral infections, particularly of the upper respiratory tract, and relieving cold and flu symptoms. The bitter herb is a powerful immune modulator, down to the andrographolides in the plant which are thought to enhance the production of white blood cells, to support the release of interferon, and to promote the healthy activity of the lymphatic system. Dosage: 1800mg (divided equally at three meals) for adults; halve for children. **During Prevention Phase, 200 mg is optional. GRAPEFRUIT SEED EXTRACT GSE oral tablet/capsule and via liquid or throat spray if symptoms begin. Dosage: 250mg - 500 mg for adults; 125mg - 250 mg for children **During Prevention Phase, 125mg - 250mg is optional. **Do not take with certain heart medications, especially statins or if you are intolerant to grapefruit. POTASSIUM COVID-19 depletes potassium at an alarming rate. During infection phase, high potassium foods is not enough. We suggest speaking with your physician before taking supplemental potassium, especially if you are on meds for hypertension or other heart-related issues. Dosage: 99mg - 200 mg; not advised for children unless authorized by a pediatrician. Supplements for Escalating Inflammation and Recovery Phases (pick only one) The goal for these two phases is to stop your immune system from harming your own tissue, as well as heal enough to achieve optimal health (homeostasis).These do not have to be long-term. SPECIALIZED PRO-RESOLVING MEDIATORS (SPMs) This antinflammatory agent is naturally occurring in fish oil in small amounts, but you'd have to take a ton of fish oil to get what is provided in a therapeutic dose of SPM supplement.

Dosage: 2g - 4g for adults; 1g - 2g for children (note this is grams, not milligrams). CURCUMIN Not recommended for anyone who has GERD, salicylate intolerance, or is overtly acidic. Dosage: 1000mg for adults; 250mg for children. BROMELAIN Do not use if you have pineapple intolerance. Dosage: 600mg - 2400 mg for adults; 200mg - 800mg for children.  Supplements for Sleep and Adrenal Support Of course, getting at least 6-8 hours of sleep daily and minimizing stress is crucial for a properly functioning immune system. If you need extra assistance beyond the aforementioned:  RHODIOLA ROSEA For adrenal and mood support. Dosage: 100mg - 200 mg for adults and teens; not recommended for children. VALERIAN ROOT, L-THEANINE, HEMP OIL For extra sleep assistance if melatonin is not enough. Hemp Oil should only be used if none of the other sleep supplements are effective. None of these should be used if taking sleep medication. Dosage varies widely depending upon brand and source. Lifestyle SLEEP Healthy sleep promotes immune response that supports anti-viral immune response. Disordered sleep also promotes inflammation. Data shows that patients hospitalized with COVID-19 are often those who have the slept the least. 6 to 8 hours of sleep is ideal. STRESS Stress is inherently inflammatory. The immune suppressive effects of the stress hormone cortisol are well known. The experience of having COVID-19 is considered a source of acute stress, but in many cases, acute stress is occurring on top of weeks or months of chronic stress associated with social isolation and related factors. This is where stress management and targeted nutrients such as magnesium are critical. Use a stress management therapy that is right for you, be it something as simple as deep breathing exercises, or as intense as transcendental meditation.  Limit your media exposure to two updates daily max. MICROBIOME BALANCE Both the lung and the GI tract have a microbiome and the complex relationship between the microbiota of the lung and GI tract, and immune system, is emerging. Disrupted balance of GI microbiome bacteria has been shown to be a source of systemic inflammation. Consuming ample dietary fiber helps the gut, but also perpetuates beneficial lung health. Eat your fruit and veggies! If a probiotic supplement has been already prescribed for you, continue taking. EXERCISE AND MOVEMENT The key is not too much and not too little. It is also essential to move around, even if you just get up every 20 minutes or so. To decrease inflammation, the right exercise intensity is critical with moderate levels effective at lowering inflammatory markers, while overtly intense exercise does not. Caution should be used when considering the form and duration of exercise during the pandemic. OUTDOOR TIME One thing the media has gotten right is their emphasis on spending time outdoors. Not only does transmission of the virus go way down, but being outdoors, especially in nature, has multimodal beneficial effects. ADJUNCTIVE PREVENTIVE AND TREATMENT THERAPIES

• Far Infrared Sauna Therapy (if you have at home);

• Balance Body Structure With Chiropractic;

• Hyperbaric Oxygen Therapy - some hospitals are already using hyperbaric oxygen in patients with hypoxia (lacking oxygen);

• Acupuncture and acupressure;

• Humidify Your Domicile - Viruses love dry conditions, which is a reason why it is bad in fall and winter. Keep your home at 25-35% humidity.

CONCLUSION One of the most honest accounts of the coronavirus saga was uttered by WHO official Mike Ryan: "This virus may become just another endemic virus in our communities, and this virus may never go away". Yes, coronavirus could become a long-term fact of life that must be managed, not an enemy that can be permanently eradicated. The sooner we come to this realization, and not pine away for a "moon shot vaccine," as Mr. Ryan put it, we will be able to function as a society. Now that we've provided a sobering dose of truth, the moral of the story is that we can successfully live with SARS-CoV-2, as we have with myriad viruses, including other coronaviruses, over millennia. The best way we can get on with the rest of our lives is taking better care of ourselves and our families. You now have the most up-to-date knowledge to do so.