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7 Steps to Take if You Get COVID

Hi it's Dr. Jeffrey Mark.  I just want to talk to you today about viral infections and Covid -19 and what to do if you get infected. Over the past few weeks, we've been averaging one to two people that have reported to us that they've had recent COVID or recovering from COVID or just got COVID 19, and that's about one to two every one to two weeks. And then for the past week and a half, I’ve heard from people that they have COVID 19.  We've had one or two people tell me that I've just recently been diagnosed with COVID so what do I do, or well I have a family member with COVID and what should they do. So I decided after multiple explanations to people to go ahead and make this video. Hopefully this will help you or help your loved ones.

So let me just first start by saying, I usually give them seven steps to take. They should definitely do it if they've been exposed or got active COVID. I've been doing a lot of blogs on preventative care and new resiliency and optimizing immune system to get to the point where, even if you get some exposure that you're able to defend it off, or not to get active symptoms but today's talk we're going to be talking about people that actually have COVID that have symptoms. Although, mild symptoms, hopefully, and this is what I've been telling people and this is what I've been doing and recommending.

So the first step is to assess how your body is doing if you already know the common symptoms of COVID. Fatigue is short breath, loss of smell for some people, but later stages include diarrhea, to force the fever the chills, but people do get short of breath, and you kind of have to suggest you shouldn't have to look at how short of breath you are and there are studies that show especially in the UK in England, that a lot of people would call hypoxic or they're pretty low and oxygenation level, yet they didn't feel that bad they recall these have had hypoxic seems to be a disconnect between how you feel in terms of the brain, and what your oxygenation level was so the first step is to really do an assessment to where you're at. Now obviously if you're severely short of breath, you're going to want to go to the emergency room, make sure they get a pulse oximetry on you right away. But if you've only had mild symptoms and is still doing some of your usual activities, then what you can do is get a pulse oximeter, and you can get these on Amazon and we've actually told people to go buy one, and order one they can deliver it pretty quickly, and you want to see where your pulse oximeter indicates ; sometimes it takes about 30 seconds to get a reading. It’s better not to have nail polish on obviously so you can put it on your finger and then do the reading. And most of the time, most people should be 97% or higher if they are otherwise healthy. If you're low or lower in the 90 to 90 to 94% range. You should be more careful and assess yourself and if you experience shortness of breath or weakness and have questions you might want to go to urgent care or emergency room for an evaluation. If you're below 90%, you want an evaluation  for sure. You want to go to the emergency room because that means that you're not oxygenating well enough. There's an oxygen saturation for when you're on the low end of this church just before significantly drops off on how well you oxygen. Other things if, or if your nails or your mouth is kind of a little bit blue or you kind of look a little bit pale. And that may be indications that you have, lack of oxygen as well as well as headaches and other things that go along with that. So you really have to be careful and you want to monitor yourself. Just because there's this disconnect with people and symptoms.

Then, if you haven't already been on supplements, and I've given lots of talks and blogs on these topics. I'll give you the links to where you can find the blogs, you definitely want to be on certain things. Definitely vitamin D. Vitamin D three and K two drops. So there was a study, and I can show you that study the shade study in the next slide that goes into why 50 60,000 international units, seven days to boost your vitamin D levels, especially if you haven't had any. That's where there's been a reduction in people, or an increase in people that know that quickly and efficiently and you do this for seven days. Now, there is a K2 component so if vitamin K in the product does interfere with, well it does help with coagulation. So if you want me to have your blood thinner, because of cardiac stents or other reasons like atrial fibrillation, and you're taking Coumadin or eliquis, or xarelto,  Plavix or any blood thinners that you need, you might not want to have the K two component and just go straight with just vitamin D zinc is also helpful well because the zinc will inhibit viral replication and help kill the virus but, of course, this only works really if there's a high concentration in the cells, because there's viruses that are obviously floating around. And then it gets incorporated into the cells and in the intracellular levels where you want higher zinc. Quercetin is a Zinc ionophore and there concentrates and gets the zinc inside the cells and is found in histamine and immune support, so you need to take that as  to optimize the zinc.  There is  Oxidation going on with oxidative stressors, the cytokine storm that I've mentioned before, and because of those things you do need antioxidants and glutathione is helpful. And there's studies that show that higher levels of glutathione in the blood do correlate with less severe disease and less need to end up being transferred to the ICU in patients that were hospitalized. So you want to take Liposomal glutathione  as well 1 teaspoon daily and place underneath  the tongue for 30 seconds and then swallow; Liposomal Vitamin C is like getting an IV dose of vitamin C, and you can do one teaspoon daily underneath the tongue as well. Immuno Max has several things including  monolaurin and Colostrum.  Other types of things that boost your immune system, because you want your innate immune system to go up, it has a beta glucan product as well which will  help boost the innate immune system, which, as you'll see, enhances and produces interferon which is your first line of defense against viruses especially this COVID-19, and I'll show you some slides and studies on interferon and we'll go through some basic pathways for that. And then ViraX is also very helpful as well this drag was and other types of herbal compounds that have been helpful. And some studies have shown ViraX which has Astragalus which were used successfully in India during the last pandemic in 1918.  And of course, sleep support, which has melatonin among other things, to make sure that you get enough sleep and also as an additional antioxidant that you can take during this infection or exposure of COVID viral infection. So here's a study that I didn't mention before on vitamin D in previous blogs, but this was a study that was done in India, or comes from India, and it's a short term boost of vitamin D because we already know that vitamin D plays a critical role and crucial role in optimizing the immune system, and also stabilizing blood vessels and other things from this cytokine storm. So this study showed how patients that had COVID-19 were given 60,000 international units for seven days, and that there was a reduction in the amount of, messenger RNA from COVID source code to which is COVID, and a reduction in fibrinogen, which as I mentioned is the clotting factors and as part of the cytokine storm. With this high dose regimen vitamin D. So based on this article we have the COVID-19.  That's why we actually want to, well, and of course the quercetin I mentioned, is a zinc ion a for which helps zinc go into the cells and be more highly concentrated is also has its own effects antiviral effects as well as you can see on this paper, which I won't go into extensively but I do mention that as a reference. And then of course, there are traditional treatments that are FDA approved.

And this includes monoclonal antibodies. There are two companies with monoclonal antibodies, Eli Lilly has one that's been approved with bamlanivimab,  and another cocktail from Regeneron includes casirivimab and imdevimab so these are antibodies that were found to be effective from people that are recovered from COVID-19 and they took these antibodies to make their drugs. And, of course, they made them from genetic modified processing into a drug so it's purified and given as an infusion. And they are, again FDA approved but more for high risk, people. Now there are other non FDA approved treatments but I will not be reviewing those here. Now I'll go into a little bit about the criteria in the next few slides here about what's considered high risk and who would qualify for getting an infusion of the monoclonal antibodies. And these are people that if you automatically have BMI or overweight obese grade 35. That's a body mass index, if you have kidney disease, it's chronic diabetes, which covers a lot of people as well. Any kind of immunosuppressive process going from Tory bowel disease that we have a lot of people on or some of the medications are behind on as well. And anything that is immunosuppressive treatment, people that have rheumatoid arthritis are being treated with biologics and things so all these treatment groups qualify for the monoclonal antibodies, and you can get assessed and seek an order from your medical provider. And we've talked to people about this as well. Now if you're over 55, and you've high blood pressure you also qualify and of course, that includes a lot of people as well so there's a lot of people that are not where they qualify for additional treatments and FDA approved regimens, but those with heart disease, as well, or lung disease. These are the criteria or qualifications for the younger people. If you have sickle cell. If you're significantly overweight or obese. If you're significantly in the higher range of your body mass index, as soon as you overweight or obese. You'd also qualify those with heart disease, you can see here, and asthma. So, there are broad people that may not be recognized that they could get a monoclonal antibody, which is, you know, successfully helped President Trump, and some of the other people like Giuliani and some of the others that have COVID, then you can see here the bottom line was that the study. On day 29 after receiving the antibody the study showed that there was only 1.6% of those that received the antibodies avoided being admitted to the hospital, while there were 6.3% ended up in the hospital that received placebo (no antibodies), and had a more significant disease progression of COVID.  So that this showed monoclonal antibodies were helpful. Now the reason this works is these massive spike proteins, they limit the spread of the virus initially so timing is of the essence. This is initially when you get infected, it usually takes four or five days for symptoms to develop. And then the next seven days, there could be a progression so as soon as you get the symptoms and you qualify if you get either the Regeneron or the Eli Lilly product. Early use is more optimal, because it buys your body time to make its own antibodies and for the interferon to kick in, and not necessarily be bypassed by the virus which I will go into a little bit in the next few slides as well. The key is, of course, having interferon work, and then your innate immune system to catch up. and to eliminate with T killer cells natural killer cells. The virus that's outside circular reading and also the virus that's been infecting cells, so that the infected cells don't replicate and make the process worse by spreading the virus to other cells. So, this is a time sensitive treatment so if I get a call from people that have symptoms and there's four or five days in the qualifying and scoops and I think that we try to get them to have the provider. At least consider monoclonal antibodies. These are the studies that show efficacy. I'm not going to go specifically into this but just show that it eliminates a lot of the messenger RNA and neutralizes things that are non FDA treatments. Also, but they shouldn't really be offered unless you speak with and get a medical evaluation and you need a thorough explanation and consent. I'm not going to go through any of these here.  There's information available, but  I'm just going through the FDA approved treatments, at this time.

So, there are seven steps. Step four is to get at least 78 hours of sleep a night. And this is important because sleep is tied in with your immune system as well. If you get less than six hours of sleep, then you're relying on antibodies. And as your immune defense, because you need more like seven to eight hours of sleep, which is the part of the system with the natural killer cells and lovely T cells and gold cell the cell that can help eliminate active virus that occurs or spreading the antibodies are more kind of stop get a stop gap long range. Means of defense, and also is prone to autoimmune disease is because there's, you know, certain antibodies against certain things like DNA, joint,  thyroid tissues and things so dramatically higher risk for that if you're relying more and more on antibodies. And the fact is that with the innate immune system that is what enhances and goes through the reduction of interferon and it's actually all about interferon at the beginning and early part of the disease course that will determine if you grass or are you able to catch up and overcome and capture and neutralize the virus and get immunity. So, the other aspect about sleep, initially was that they used to swab. College students with adenoviruses respiratory tract infections. And they found that if those have got enough sleep, they tend not to get infected. So sleep was a major factor, not just having people sneeze on you or touching surfaces and things like that. So that, what we talked about in functional medicine is that it does influence growth hormone which is produced about one to 2am in the morning in deep sleep. So you want to be in bed and asleep by 10:30 PM, otherwise you won't get to stage three four or deeper sleep at 1am to 2am. If you don't get enough sleep earlier, just going to bed at midnight and getting eight hours is not as good as getting eight hours and starting from 10:30pm. So that's also another aspect and if you have a question on functional medicine you can contact us and we go into more details on that as well. So this is all about interferon on these next few slides, and why it's important. So there's several studies out there that show that the initial interferon response makes a big difference is whether you're going to have a severe course of COVID, or whether you're going to have mild or moderate symptoms effects of others several aspects of interferon. One is that there are people that make antibodies against interferon and that's kind of unfortunate and these are the people who already rely on antibody defense, probably chronically lack of sleep, it's hard to say. But we do know that these autoantibodies and there may be a little bit of a genetic component as well, that if you have them that you tend not to do well in terms of having severe disease because without interferon as a stopgap measure to slow things down the virus is pretty much like the Germans were with blitzkrieg running through tanks, just going straight through. So the interferon is your stopgap measure to slow things down to get your defenses back up, so that you can defend yourself. Otherwise, the virus just runs right through you without this initial defense. The second aspect of interferon is that some people do have genetic alteration that I briefly mentioned before, and that does interfere with the way they produce and use interferon and that also makes them susceptible to more aggressive form infection and you can see on this paper here that that goes through that. Now, these are the characteristics of people that have severe COVID-19 again it's the fact that interferon is not there to support them initially. And that means that a lot of T cells and the natural killer cells are not activated to get rid of viral particles and viral infected cells, and there's inflammation, it needs to be activated in order to be able to handle removal of the virus, and then you get this increase in cytokines as well. Again, the cytokine storm, so that things are out of balance without the interferon without the T cells, and the innate immune system, balancing and regulating and calling the shots to manage things. You, this is not a virus that you can handle with antibodies now there are people that have naturally. Some antibodies because coronavirus does have certain cross characteristics because there are families. After all, they are related in a family of viruses, but we found that without interferon please biding your time to get the right antibodies and up and running and mountain defense. It's going to be very difficult so I'm going to be talking about other things that help enhance interferon which include heat and other things and I've talked to you about that in just a few minutes. So again, this is a picture of the virus and the  role of interferon with the virus course attaching to the alveoli, and the bronchioles in the lungs, with the ACE2  receptors and then getting in replicating and then stopped by the interferon here. Now of course, any good opponent or enemy has a good knowledge and adapts to their opponent very well. So the virus causes them problems. So they actually have means of trying to bypass or interfere with interferon and we think that after this first initial defense of interferon that and some people or many people, they have this continuation of replication despite the interferon, at least the initial stopgap measure occurs and then we know the virus adapts but that's where the innate immune system comes in, so that you don't have to stop measuring first it just runs right through but even with the stock measure. There are ways that the virus does bypass interferon and this is kind of a second surge kind of thing. But by then hopefully your system has been activated, and fully functional your T cells and natural killer cells. So there's multiple phases that go on here, and we do know that the virus adapts to the interferon eventually as well and sometimes you have such a vigorous defense of interferon that you don't get many symptoms, so it's a little bit complicated here but the initial interferon is needed to slow down on the progress and nurture the innate immune system to catch up.

So lets take a little bit break on the biology part by going to step five and then we'll go back a little bit into how we can enhance the interferon response. So of course you're going to with any viral infection. Stay hydrated. Because if you do run a fever, you're going to be using a lot more of fluids that water is the best you can, if you don't like the taste or lack of taste of water. you can add a slice of lemon slice of orange, lemon, I just have a hint to that fruit essence that same kind of things that you can get at the hotels that you used to stay at and juices can also hydrate but they do contain sugar and sugar does suppress your immune system so you have to be careful with that. If you do have some sugar, have some protein as well that will decrease the rate of rise of blood sugars, as well, because that does trigger insulin and you get a spike in blood sugar than a spike of insulin and a decrease in blood sugar and you get this roller coaster ride kind of thing but again. For those of you have more questions on this and explanations in functional medicine, how this system works. You can look at the other webinars or ask us for more information. So, you can also if you feel like you're dehydrated because of nausea or other things you can suck on popsicles. You can use Pedialyte, or use this little recipe here to try to stay hydrated. And you have other ways as well ginger ale sometimes helps with nausea jello is technically a clear liquid so that if you feel like you want to have something more solid which can keep anything down much. This may help as well.

Now, I did talk about the interferon and the innate immune system so you want to use heat actually as an ally and initially your body uses heat because it generates a fever, and that  which is why some of the people obviously know that they have COVID or viral infection because of the fever. Now, we know that the fever can enhance the effects of interferon, and it does activate and help with the innate immune system so that if you do have the fever I try to tell people well if it's not excessively high like 103 or so Fahrenheit, then maybe let it run for about 24 hours or even longer if you tolerate. This is going to help with the whole interferon system so don't knock it down from Advil or Tylenol, but you can actually let it run its course a little bit. There are three studies that I'm going to be showing you in the next few slides. But basically, the bottom line is that the studies show that people that were immersed in water, or heated through other means, or through exercise they got a temperature and 39.5 degrees Celsius, which is a core body temperature bonds with interferon and with monocytes and clearance of endotoxins and also tumor Croesus factor alpha gets expressed which goes into the innate immune system and activation and removal of the virus and activation of the immune system so that 39.5 just to give you a reference 37.5 is just considered borderline for fever so this is actually a couple degrees above that. There were studies that showed people that had this hot body temperature through exercise or through thermal. The thermal type of exposure to heat, and then they would cool them off rapidly and they thought maybe the initial cold exposure might cause more problems but actually it invigorated the immune system. It actually helped increase, mobilize new T cells,  als, natural killer cells were selectively increased. And there's interleukin six was also elevated as well.  All these interleukins and interferons definitely helped with the innate immune system and the ability to fight against the viral infection. And in fact it is very interesting that if you do achieve 39 degrees Celsius, as a core temperature that there's been a tenfold increase that's been seen from lymphocytes at that temperature. So, all of a sudden you get this big rise and bump in terms of the immune system at that temperature, now show you these slides here. So this one is a general one from Zelnar, “Human monocyte stimulation by experimental whole body hyperthermia”, and this goes into the raising of the body temperature with a hot bath water or hot water bath. And this one goes into new changes during after cold exposure after sheets and exercise. And you can see here that after you get some core temperature up either like you said with the heating externally or through exercise. Then, it increases leukocytosis and granulocytosis and rise and interleukin six, and then the persistent and then out of cold exposure acute cold exposure, then has this stimulating effect. Afterwards, they are subjected to 18 degrees centigrade water, and then there's all leukocyte granulocyte and monocyte response occurs so it's almost like the heat primes the system to get things going. And then, after the coldness kind of really shocks the system into really taking it up a notch. So that's kind of an interesting way that's why some will alternate between hot and cold showers not that I'm saying you have to do that but this is very interesting that this helps augment, and decrease interferon responses I mentioned the interferon is what's going to buy you time for you need system to get kind of going. And this one here again shows that if you can keep the temperature of 39 degrees, that's the core body temperature, then you'll have a tenfold increase in interferon and I mentioned that is interferon initially that buys you the time for the innate system to get going, and obviously the higher more effective interferon you have more likely that you're going to have a milder course and less severe COVID. In fact,  it's not easy necessarily to get to a core body temperature up to 97 degrees, and at this temperature it usually means that you're going to be sweating profusely. So you can do whatever it takes for that to occur. Some people can do hot spas, or saunas or hot showers may or may not do it unless you have some kind of exercise as well but again you do what you have available to you.

So, after getting through, hopefully, COVID at four or five days of the immune system seven days later, during the following seven days then you'll know whether you progress and if you've been doing okay then obviously this whole time you've been self-isolating, and you want to optimize the ventilation in the home to try not to infect others. The infection, of course occurs through these respiratory droplets through droplets initially that are projected with mucous, but then there are also aerosolized fine viral particles that actually do get attached a little bit to some kind of mucus from the respiratory tract, and eventually it'll travel throughout the whole home unless you have some kind of ventilation. That means a cracked window or some kind of HEPA filter, or if you have a very good HVAC system in the home, to make sure that you have released a MERV13 class filter well. And that's because they can help trap these viral particles that are attached to the fine particles of mucus. So that way it'll kind of neutralize that and minimize the spread throughout the house. This is about the spread of ventilation and filtration systems and you can look up some of the information on the internet.

I’ve had questions about what to do as people recover and want to return to work. So, the official guidelines are for health care workers here but they're actually applicable to everybody. And as you want to wait at least 10 days after the first symptoms appeared. And then at least 24 hours that you don't want to have a fever, and then most of your symptoms should have improved. Now if you're immunocompromised and you taking things like biologics to control rheumatoid arthritis or  inflammatory bowel disease, then, that may suppress your immune system you may need other things as well. And there's a little bit of controversy with the testing. If you have a very mild case, you may not need a testing because if you do test with a nasal swab  they'll pick up some viral particles, sometimes even smaller amounts of viral particles by the PCR polymerase chain reaction test which can be extremely sensitive. Testing may pick up small amounts of virus which may not be high enough to be infectious. So, there is a little bit of controversy to that. However, if you do have a high load, and you are immunocompromised then you may need other consultation with infectious specialists or we can help you with that as well. But that's what I've been telling people, and this has been hopefully helpful.

So I want to thank you for investing in yourself by going through this video, and hopefully this helps you or helps you help resolve others that have COVID. So for all the topics that we talked about for the previous blogs, you can find them on www.allfunctionalhealth.com/blog.  If you are seeking to get some of those supplements and you haven't been taking them or you think now's the best time to optimize things or you're undergoing COVID and you'd like to optimize your chances of a good recovery and mild disease, then you can contact us at info@jeffreymarkmd.com  or call 925-736-9028. And if you have more information on how functional medicine can help you with your health, and that includes optimization of the gut, brain or immune health contact us at info@jeffreymarkmd.com, or call 925-736-9028. So, with that, I want to thank you. Take care, and stay healthy.

 

Jeffrey Mark, M.D.

Author
Jeffrey Mark, M.D. Helping clients with compassionate and comprehensive medical care for over 25 years with 4 board certifications in functional medicine, gastroenterology, internal medicine, and anti-aging/ regenerative medicine . IFMCP, ABIM Gastroenterology, NPAS Internal Medicine, ABAARM.

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