How to Support Your Immune System:

Integrative considerations during the COVID-19 pandemic

Although information is rapidly changing and evolving, we wanted to offer some immune strategies to help augment the public health measures being used to manage COVID-19. Please note that to date, no integrative measures have been validated in human trials. The following suggestions are supplemental considerations. 

WHAT WE KNOW: 

The presentation of COVID-19 can vary from mild to severe symptoms, and presents like other flu and respiratory conditions. These symptoms include: 

• Fever
• Cough
• Difficulty breathing 
• Muscle aches
• Fatigue 
• Headache
• Sore throat
• Runny nose 

More severe complications include pneumonia, kidney failure, and in some cases death. Most people who are infected will recover on their own. 

While the pathogenicity of COVID-19 is complex, it is important to understand the role of inflammation in this disease. The virulence and pathogenicity (including acute respiratory distress syndrome) associated with SARS corona viruses develops as the result of viral activation of inflammatory cells called inflammasome. This inflammasome releases pro-inflammatory cytokines, which dictate the pathogenic inflammation responsible for the virulence and symptoms¹. Understanding, and treating this inflammation, is the backbone to the following immune suggestions. 

HOW TO LOWER YOUR RISK, PRIOR TO SYMPTOMS: 

• Adequate sleep – Shorter sleep duration increases the risk of infectious illness. 
  • One study found that less than 5 hours of sleep increased risk of viral infections by 350% when compared with those getting 7 hours²
• Stress management – Psychological stress dampens the immune function and creates pro-inflammatory cells
  • Acute stress in mice specifically increased inflammasome activation⁶
• Zinc – Coronavirus appears to be susceptible to the viral inhibition of zinc
  • Zinc may prevent coronavirus entry into cells⁸ and appears to decrease its virulence⁹
• Veggies and Fruits (+ Isolated Flavonoids): Many flavonoids have been found, in vitro, to reduce inflammasome signaling¹⁰
• Vitamin C: Like flavonoids, ascorbic acid inhibits inflammasome activation.18 
  • Clinical trials have found that vitamin C shortens the frequency, duration and severity of the common cold and the incidence of pneumonia¹⁹
•  Melatonin: Melatonin has been shown to inhibit inflammasome activation²⁰
  • One proposed mechanism of action as to why older adults have more severe symptoms, is the age-related decline in melatonin 
  • Melatonin also reduces oxidative lung injury and inflammation during viral infections²¹
• Sambucus nigra (Elderberry): There is preclinical evidence that elderberry inhibits replication and viral attachment of another member of the coronavirus family. 
• Vitamin D: In certain conditions, vitamin D has been found to decrease inflamasome activation
  • Vitamin D does increase some inflammatory cells however, and thus should be used with caution during an infection 

HOW TO MANAGE SYMPTOMS OF INFECTION 

Given the integral role of inflammatory cells in the pathogenicity of COVID-19, it seems prudent to avoid high and regular use of immunostimulatory agents while one is displaying symptoms. To date, there are no human clinical trials on these substances however, caution is warranted with the following immune activating agents:  

• Elderberry 
• Polysaccharide extracts from medicinal mushrooms
• Echinacea
• Larch arabinogalactan
• Vitamin D

Other commonly used natural immunostimulatory and antiviral agents including the following, do not appear to increase pro-inflammatory cells. Several of these, in fact decrease inflammation, and may restore immune homeostasis. These are, therefore, likely safe to use both prior to, and during, COVID-19 infection:

• Allium sativum (garlic) 
• Quercetin 
• Astragalus membranaceus
• Full mycelium mushroom extracts
• Mentha piperita (peppermint)
• Andrographis paniculata
• Zinc
• Vitamin C

The information and understanding of COVID-19 continues to change rapidly. We encourage you to make integrative recommendations carefully and with consideration of the underlying mechanisms of both the COVID-19 infection and the intended intervention. It is also important to reiterate that there are no clinical evidence-based integrative prevention or treatment strategies for COVID-19 infection. 

At Sprout, we believe that knowledge is power – and we hope this blog offers just that. 

As mentioned, the research is evolving and time will offer new insight for infection management. For now, we hope you and your family stay healthy and safe. If you have any questions please do not hesitate to reach out or book a visit. 

We hope to see you soon!