Summary Ruminations on Covid-19 Empowerment (in the home stretch)
Spring 2021 brings hope on the horizon! There’s plenty that can be done to strengthen your body, whether you’ve got the vaccine already or are patiently waiting your turn. As Spring is a time of rebirth and renewal, I am asking all of my patients this question: How will you end this pandemic healthier than you started it?
Yes, vaccinate, when it’s your turn. What can you do while waiting for the vaccine? Get empowered and consider the below. If you’ve been vaccinated do the below recommendations still apply? Absolutely, YES.
An anti-inflammatory lifestyle will boost your body’s ability to fight off infections effectively, not to mention reduce cardiovascular disease, dementia and cancer! How can you reinforce your basics?
Fresh farm & garden foods, mostly foods without a label
Slightly breathy movement, try a few squats between Zoom meetings
Sound sleep in a quiet, darkened room
Meditation, prayer and anything that brings you joy
Media & negativity distancing!
What about supplements? While there are not any supplements that have been definitely proven to prevent or treat Covid-19, there is mounting research that supplements may help to modify your internal terrain to be optimized against inflammation and infection.
“Supplements are not anti-Covid. Your own IMMUNE SYSTEM is anti-Covid. Supplements support your immune system.”
Prevention: These supplements have research associating them with a stronger immune system, less inflammation and/or decreased Covid-19 incidence, severity and mortality:
Vitamin D 1000 IU (25 mcg) minimum daily, with your biggest meal
Melatonin 1-6 mg nightly, as tolerated. Higher doses may cause vivid dreaming.
Omega-3 fish oil 2000mg EPA + DHA daily.
Probiotics
Multivitamin (which contains Vitamins A/Bs/C/D/E, selenium and at least 15mg zinc for immune support)
Turmeric 500mg, with a meal
Quercetin 250mg daily
Treatment: These supplement & OTC medications have been proven to shorten the duration of typical cold viruses (and support the immune system), and/or are associated with reduced severity of Covid-19 infection in research studies. I generally recommend starting at the first sign of symptoms, without waiting for the test result. Yes, this a lot of pills -- use what you’ve got -- all of these support the body in different ways during Covid-19 (mitigate inflammation & cytokine release, immune system reaction, blood clots), potentially lessening severity of this complex illness:
Vitamin D “high dose boost” 10,000 IU (250 mcg) daily, with biggest meal x 5 days only
Zinc 75mg daily x 5 days
Quercetin 250mg twice a day
Omega-3 fish oil 2000mg daily
Melatonin 1-10mg nightly, as tolerated
Aspirin 325mg daily (unless contraindicated) vs Turmeric 500mg twice a day
Vitamin C 1000 mg every 8-12 hours
Probiotics
Multivitamin
Famotidine (Pepcid) 20mg twice a day
Antihistamine (ie. Claritin, Zyrtec, Allegra) as directed on box
Prescription treatment, such as Ivermectin, Fluvoxamine and monoclonal Antibody Treatment: At this time, there is emerging evidence that these treatments may be clinically helpful in reducing severity and death in active Covid-19 infection. While waiting for more data, I feel that in many cases, the potential benefits may outweigh the downsides, especially since 10% of Covid-19 cases (even mild ones) may result in Post-Acute Covid-19 Syndrome (PASC, formerly known as Long Haul Covid). It remains to be proven how effective these are, and whether their use truly decreases PASC, in addition to morbidity and severity in Covid-19.
Any potential treatment is most effective when started ASAP, ideally the day of a positive Covid-19 test. Do not wait for symptoms to worsen. With Covid-19, it’s “easier to blow out a match than a forest fire” -- these treatments (as with the supplements above) should be started early.
1. Monoclonal antibody infusion (such as Bamlanivimab, usually in local ER). Best for:
Obese (BMI >35)
Chronic kidney disease
Diabetes mellitus
Immunocompromising condition
Currently receiving immunosuppressive treatment
Aged ≥65 years
Aged ≥55 years and have:
Cardiovascular disease; or
Hypertension; or
Chronic obstructive pulmonary disease/other chronic respiratory disease.
For everyone else to consider:
2. Ivermectin: [Update 10/2021: no longer recommended given alternatives with more consistently positive data] https://www.cochrane.org/news/ivermectin-preventing-and-treating-covid-19
3. Fluvoxamine: 50mg twice a day for up to 14 days. No caffeine while on this medication. As with ivermectin, research is emerging around repurposing this old OCD drug (which happens to have anti-inflammatory characteristics as well), and the pros/cons of off-label use should be individualized for each person. For more information, read this JAMA Network study. Its mechanism is detailed here, and Fluvoxamine has been getting more attention lately, though more research is underway.
With a blend of healthy lifestyle, science, supplements and medications (when needed), we can feel confident about moving forward as the world opens up again! We’re in the home stretch.
There is so much that we can do to empower ourselves as we ride out this pandemic and embrace the rest of 2021 with renewed spirit and vitality. May you and your family be well and thrive.
Written by Gina Serraiocco MD, Sutter PAMF Physician, board-certified in Internal Medicine and Integrative Medicine. She has a lifelong passion for helping patients discover their innate healing abilities. Dr. Serraiocco empowers patients to gain vibrant health via personalized nutrition paradigms and lifestyle-based programs through the Integrative Medicine Department at Sutter PAMF.
*These recommendations are considered safe for the generally healthy population. Consult with a knowledgeable practitioner if you have any history of kidney/liver disease, or are on medications or blood thinners.