Some Naturopathic Fundamentals to COVID-19 Prevention

Now that we're past the blatant political circus and mess of a national and public health response to a global pandemic, I wanted to provide some tools and therapies in line with Naturopathic principles to help prevent illness, viral infections, and COVID-19. In Naturopathic Medicine and in general with patient care, we aim to address what we refer to as a person's "Determinants of Health", first and foremost. We like to look at the whole ecology of a person in their specific life-context to aid us in the most fundamental question. What were the factors that made this person a better candidate for said disease? As opposed to the conventional mindset of just putting water on the fire; what aspects of your forest allowed for the fire to start and spread in the way it did in the first place?

This is why Naturopathic visits take more time in the short run, but ultimately save you from repeated visits to the doctor and less potentially harmful and uncomfortable side effects from overly aggressive medications or misdiagnoses.

So, what are these "Determinants of Health" and how do they help set you up for improved overall health and prevention from viruses like COVID-19? The main features that are focused on in nearly every visit are diet, exercise, sleep, hydration, and stress. These are some of the environmental fundamentals that we focus on correcting in aiding our treatment of every patient. This may sound pretty intuitive and possibly mundane, but this is the foundation that often determines whether someone becomes fertile ground for a pathogen like COVID-19.

Two general, yet critical factors that contribute to increased risk for contracting COVID-19 are increased inflammation/Inflammatory markers like CRP, hsCRP, and cytokines like IL-6, NFk-ß, TNF-α; and increased oxidative stress from excess stress, excess exposure to environmental chemicals(petrols, plastics, heavy metals, pesticide/herbicides), tobacco/Alcohol, and a fiber- and micronutrient-deficient diet.

Here are some specific recommendations regarding the determinants of health in relation to immune support for virus protection.

Sleep and Melatonin

• Sleep and Sleep hygiene(routine around your sleep and wake cycle) are critical factors in the healthy functioning of every bodily system, but they are especially important for immune, neurological, and hormonal health. Melatonin, your sleep-initiating hormone, also has powerful anti-inflammatory, antioxidant, and immune-modulating effects. "Melatonin exerts regulatory actions on the immune system and directly enhances the immune response by improving proliferation and maturation of natural killer cells, T and B lymphocytes, granulocytes, and monocytes in both bone marrow and other tissues." (Zhang, 2020) Improving natural melatonin production occurs with improved sleep hygiene practices, but specific sleep issues may need specific guidance and treatment. Supplementing melatonin is another option, but dosing is dependent on individual circumstances.

  • Zhang R, Wang X, Ni L, Di X, Ma B, Niu S, Liu C, Reiter RJ. COVID-19: Melatonin as a potential adjuvant treatment. Life Sci. 2020 Jun 1;250:117583. doi: 10.1016/j.lfs.2020.117583. Epub 2020 Mar 23. PMID: 32217117; PMCID: PMC7102583.

  
  

Sleep Quality and Duration

• Sleep quality and duration are also important factors for helping support lower inflammatory markers and improved immune response and resilience. Irwin et al. found that 7- 8 h of sleep/night is the sweet spot for immune modulation. More or less than 7- 8 h was associated with increased levels of CRP, hsCRP, and IL-6; all associated with general and specific types of inflammation. Identifying and correcting sleep apnea and/or different types of insomnia are also important for lowering oxidative and inflammatory stress.

  • Irwin, M. R., Olmstead, R., & Carroll, J. E. (2016). Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation. Biological Psychiatry, 80(1), 40–52. https://doi.org/10.1016/j.biopsych.2015.05.014

  • Irwin, M. R., & Opp, M. R. (2017). Sleep Health: Reciprocal Regulation of Sleep and Innate Immunity. Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology, 42(1), 129–155. https://doi.org/10.1038/npp.2016.148

  • Miller, M. A., & Cappuccio, F. P. (2021, February 1). A systematic review of COVID-19 and obstructive sleep apnoea. Sleep Medicine Reviews. W.B. Saunders Ltd. https://doi.org/10.1016/j.smrv.2020.101382

  
  

Sleep Hygiene Recommendations

• Avoid:

  • Blue Light

    • Television, computers, phones, and anything with a screen will emit blue light to some degree, which directly affects melatonin secretion by your pineal gland. "Memory, alertness, attention span, reaction times, learning ability and cognitive performance all perform much better under blue light; but it can also suppress melatonin secretion." (Gomes, 2015)

    • Gomes, C. C., & Preto, S. (2015). Blue Light: A Blessing or a Curse? Procedia Manufacturing, 3, 4472–4479. https://doi.org/10.1016/j.promfg.2015.07.459

    • If digital devices are impossible to avoid in your circumstances, there are also blue-light-blocking glasses that you may implement.

  • Eating less than 3 hours before bed

    • There's not much explicit research on this topic, but from a physiological perspective, this impacts insulin, slows digestive transit time, and may impact your melatonin/cortisol regulated circadian rhythm. Not to mention, it increases blood flow and physiological resources to the digestive system, which may take away from other homeostatic processes like tissue healing and the flushing of CSF by our brain's glymphatic system.

  • Drinking Alcohol:

    • "Alcohol disrupts sleep through multiple mechanisms, such as disrupting electrophysiologic sleep architecture, triggering insomnia, and contributing to abnormalities of circadian rhythms and short sleep duration (SSD) in cross-sectional studies."

    • He, S., Hasler, B. P., & Chakravorty, S. (2019, December 1). Alcohol and sleep-related problems. Current Opinion in Psychology. Elsevier B.V. https://doi.org/10.1016/j.copsyc.2019.03.007

• Implement:

  • Reading with amber or natural lighting.

    • Reading has so many benefits aside from the obvious gaining of knowledge or stepping into an alternate reality. It is calming to the nervous system and helps tire the mind and eyes; directly helping to stimulate sleep.

  • Aim to create a quiet space to allow your nervous system to calm. This is in regard to your autonomic nervous system (Sympathetic/Parasympathetic). With decreased stimuli and elements from the avoid list above, your "Rest and Rebuild" parasympathetic nervous system will help boost

  • Binaural Beats:

    • Stimulating your brain's Delta and Theta waves can help create a more relaxing and sleep-ready environment.

    • https://youtu.be/SaxEBIj7Cps

    
    

Hydration and Cellular Health

• Our general recommendation for those without chronic conditions that affect blood volume, kidney function, or who are taking medication that impacts those parameters: Half of your body weight in ounces of water/day, adding an electrolyte tablet or magnesium may help improve absorption of that water. Quality of water is another topic that we will save for later.

  • Mooventhan, A., & Nivethitha, L. (2014). Scientific evidence-based effects of hydrotherapy on various systems of the body. North American journal of medical sciences, 6(5), 199–209. https://doi.org/10.4103/1947-2714.132935

  
  

Diet and Micronutrients

• Eating a diversely colorful, primarily plant-based diet rich in vitamins, minerals, antioxidants, and fiber. Adding a few of your favorites to your already existing diet is a great way to start.

• Important Nutrients: (This is just to name a few)

  • ß-Carotene: Ex. - Carrots, sweet potatoes

  • Vitamin C: Ex - Citrus Fruits, Dark Leafy Greens, Apple Cider Vinegar

  • Vitamin E: Sunflower Seeds

  • Vitamin D/Omegas 3's: Eggs, Sardines, Cod-Liver Oil, Fish Oil

  • Zinc: Sunflower Seeds, Pumpkin Seeds, Pecan, most nuts and seeds

  • Selenium: Brazil Nuts

  • Magnesium: Dark Leafy Greens, Seaweeds, Nuts and Seeds

  • Alkhatib A. Antiviral Functional Foods and Exercise Lifestyle Prevention of Coronavirus. Nutrients. 2020 Aug 28;12(9):2633. doi: 10.3390/nu12092633. PMID: 32872374; PMCID: PMC7551447.

  • Bae, M., & Kim, H. (2020, November 16). Mini-Review on the Roles of Vitamin C, Vitamin D, and Selenium in the Immune System against COVID-19. Molecules (Basel, Switzerland). NLM (Medline). https://doi.org/10.3390/molecules25225346

  • You can use this link to find food rich in these nutrients: https://nutritiondata.self.com/tools/nutrient-search

Hydrotherapy and Immune Stimulation

• Contrast Hydrotherapy: General recommendations - take your normal hot shower and end with a 10-30second cold rinse; dry immediately after and dress in warm clothes. It's important that you are warm before the cold rinse and dry off right after, so the blood can return to the surface tissues as quickly as possible. You may even feel hot 5-10 minutes after this process.

  • This increases blood flow and perfusion in your small capillary beds, increasing cellular mitochondrial energy production, and helping your body eliminate toxins and waste via the lymphatic system.

  • Daily cold exposure via this method from a 5day-6week period helps to raise your immune system's Natural Killer Cells and T-Lymphocyte counts(to name a few) to help directly fight off and kill virally infected cells. (Mooventhan et al., 2014)

    • Mooventhan, A., & Nivethitha, L. (2014). Scientific evidence-based effects of hydrotherapy on various systems of the body. North American journal of medical sciences, 6(5), 199–209. https://doi.org/10.4103/1947-2714.13293

    
    

Stress and Cortisol

• Cortisol is one of your body's stress hormones that, if elevated for prolonged periods, causes elevated blood glucose/insulin, increased abdominal adiposity(fat), and suppresses the immune system. This is why we can sometimes see a trend with adults and children when they finally get a break or vacation from work or school; they may get sick in the first few days or weeks as their cortisol finally lowers and the immune system begins to fight off an infection that had been flying under the cortisol-laden radar.

• Stress reduction is a difficult yet crucial factor during this time; boosting the immune system and helps prevent infection. This can happen through any kind of movement/exercise, a friendly/meaningful conversation, time spent alone or with loved ones in nature, or sitting down to read a good book.

• One technique that seems to stimulate your rest and digest nervous system the quickest is breathing and mindfulness practices. Diaphragmatic breathing or "Belly breathing" directly stimulates this pathway. I enjoy using guided meditation and breathwork apps like Calm, HeadSpace, and Breath Easy to help focus my mind and notice my "monkey mind" and possibly destructive self-talk or thoughts.

• If you want to get out of the house to help alleviate stress and reduce cortisol levels, refer to the next bullet.

  • Shevlin, M., McBride, O., Murphy, J., Miller, J., Hartman, T., Levita, L., . . . Bentall, R. (2020). Anxiety, depression, traumatic stress and COVID-19-related anxiety in the UK general population during the COVID-19 pandemic. BJPsych Open,6(6), E125. doi:10.1192/bjo.2020.109

  
  

Exercise and Improved Vascular Perfusion

• Continue to strengthen your respiratory, cardiovascular, and immune systems by walking, running, or moving in any desired fashion. Sedentary lifestyles are a large contributing factor in general elevation of stress, cortisol, mental health conditions, and musculoskeletal problems.

• "During moderate and vigorous-intensity aerobic exercise bouts of less than 60min duration, the antipathogen activity of tissue macrophages occurs in parallel with enhanced recirculation of immunoglobulins, anti-inflammatory cytokines, neutrophils, NK cells, Cytotoxic T-cells, and immature B-cells, all of which play critical roles in immune defense activity and metabolic health." (Nieman et. al., 2019)

• Nieman, D. C., & Wentz, L. M. (2019, May 1). The compelling link between physical activity and the body’s defense system. Journal of Sport and Health Science. Elsevier B.V. https://doi.org/10.1016/j.jshs.2018.09.009

Botanicals and Targeted Antiviral Support

• These are dependent on the individual and any concurrent chronic or acute conditions.

• Connect with a Naturopathic Doctor or me in your state to discuss if this is needed in your given circumstances.

Sunshine and Vitamin D

• Vitamin D production via sunshine or supplementation has been shown to have a significant immuno-protective role against COVID-19 and the cytokine storm that it ensues. More specifically, it aids in decreasing levels of pro-inflammatory Interferon(IFN) gamma, TNF-a, and helps to regulate our secondary(adaptive immune response) through inhibiting Th1 cells (produce pro-inflammatory cytokines)and inducing Th2(Produce anti-inflammatory cytokines) and T-lymphocyte production to address the infection.

• It also produces antimicrobial peptides like cathelicidin and defensins against bacteria, viruses, and fungi.

• "Vitamin D deficiency can be involved in COVID-induced Acute Respiratory Distress Syndrome(ARDS) and heart failure in some severe cases.

  • Ali, N. (2020, October 1). Role of vitamin D in preventing COVID-19 infection, progression and severity. Journal of Infection and Public Health. Elsevier Ltd. https://doi.org/10.1016/j.jiph.2020.06.021

  • Bae, M., & Kim, H. (2020, November 16). Mini-Review on the Roles of Vitamin C, Vitamin D, and Selenium in the Immune System against COVID-19. Molecules (Basel, Switzerland). NLM (Medline). https://doi.org/10.3390/molecules25225346

These are all pretty general, yet foundational for everyone who is looking to bolster their immune systems and improve their health and well-being during this pandemic and beyond.

Continue to stay informed about COVID-19 with your state’s Department of Health, the CDC, and WHO. Make an appointment with your local Naturopathic Doctor. If insurance is an impedance at least call and ask about coverage, sliding scale, income-based payments, or standard cash payments for new patients. Having a doctor that considers your unique and whole self and is focused on treating a person, not a disease, is important in these confusing healthcare days. Disclaimer:

The information provided in this article is for educational purposes only and is not intended as medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional before making changes to your healthcare routine or beginning any new treatment.