Immune Health - Carolina Total Wellness

February 10, 2022February 10, 2022

Long COVID

Susan D. Denny, MD, MPH

Over the past year I have seen an increasing number of patients with symptoms of post-acute sequelae of Covid 19 (PASC), also known as long Covid.

What is long Covid? As defined by the CDC, long Covid is a range of new, returning or ongoing health problems people can experience four or more weeks following SARS-COV-2 (Covid 19) infection. Symptoms can vary significantly by person and can include fatigue, brain fog, memory loss, anxiety, disturbed sleep, joint pain, gastrointestinal symptoms, loss of taste or smell or shortness of breath. Most of the patients I have seen with long Covid suffer from fatigue and brain fog and many have other accompanying symptoms.

In a recent systematic review of 57 studies comprising more than 250,000 survivors of Covid 19, most symptoms included mental health, pulmonary and neurologic disorders which were present 6 months after SARS-Cov-2 exposure. ¹

How many people are suffering from long Covid? Clinical trials have shown anywhere from 31% to 69% of people who have had Covid infection will suffer from long Covid. This is a present and emerging health care crisis with tens of millions of Americans currently suffering and millions more at risk of developing this syndrome. Chances are that you or someone you know has long Covid.

How long does long Covid last? This appears to vary significantly by person. Some clinical trials have shown average length to be about 3 months while others have shown that symptoms may last more than a year. An emerging consensus is that most people have symptoms for 6 months or more.

Who gets long Covid? While some clinical trials show a relationship to acute disease severity, others have shown a significant risk for long Covid even in mild or asymptomatic cases. In other words, it is possible to develop long Covid even if you had no symptoms of acute Covid infection.

A study just published in Cell on January 24, 2001 followed 200 patients over two to three months following their COVID-19 diagnoses. The researchers determined four biological factors that they say are associated with whether a person will develop long COVID.

The first factor is the level of viral RNA in the blood at diagnosis. The second is the presence of autoantibodies—those that attack the patient’s own body. Third is the reactivation of the Epstein-Barr virus, a common virus that most people are infected with and recover from early in life. The last is Type 2 diabetes. Interestingly, the most predictive factor for long Covid was the presence of autoantibodies in the blood. ²

Several other studies have found significant autoantibody levels in patients with long Covid. In one study just published this month, researchers found signals of autoantibody activity that are usually linked to chronic inflammation and injury involving specific organ systems and tissues such as the joints, skin and nervous system in patients with long Covid.³We know that certain viruses can trigger the body’s immune system to begin attacking itself through a process called molecular mimicry. That appears to be a significant source of cellular damage and inflammation in patients who develop long Covid.

Another study published in Gut examined changes in the gut microbiome in patients with long Covid. They found that an altered gut microbiome composition is strongly associated with persistent symptoms in patients with COVID-19 up to 6 months after clearance of SARS-CoV-2 virus. 4

Can long Covid be treated? Yes. While conventional medicine has yet to find a medication to treat long Covid, a functional medicine approach to this illness works well. Addressing the root cause(s) of ongoing inflammation in the body from the viral over stimulation of the immune system is a top priority. Evaluation and treatment of increased intestinal permeability (leaky gut), gut dysbiosis and a disrupted adrenal axis works well to help rebalance the immune system, calm inflammation and improve symptoms.

If you or someone you know is suffering from long Covid, please contact our office to make an appointment with one of our functional medicine providers.

In health,

Susan D. Denny, MD, MPH

References:

JAMA Netw Open. 2021;4(10):e2128568. doi:10.1001/jamanetworkopen.2021.28568
Su Y, et al. Cell. 2022;doi:10.1016/j.cell.2022.01.014.
Liu Y, et al. J Transl Med. 2022;doi:10.1186/s12967-021-03184-8.
Gut (2022). DOI: DOI: 10.1136/gutjnl-2021-325989

February 4, 2022February 4, 2022

Benefits of Infrared Sauna

Caroline Wilson, M.Ed., FMHC

January 6, 2022January 6, 2022

Food and Mood

Blair Cuneo, PA-C

I think about many things this time of the year with seasons changing and holidays approaching. As a functional medicine provider, I consider how changing landscapes not only affect my patient’s physical health, but also their emotional health. This landscape or “environment” of less direct sunlight, more time indoors, increased celebratory food and drink and increased holiday stress has a major impact on mental health for many of us.

Our relationship with food is complex, as is our body’s response to our culinary selections. We hope that our bodies can effectively digest food and absorb its nutritious content, but how do we know if it doesn’t? We hope the foods we are eating are contributing to healthy neurotransmitter production, healthy immune system messaging, but what does it feel like if that’s not the case?

You’d think that your stomach would definitely let you know if any of the above was amiss, but consider this: approximately 30% of us will have a gastrointestinal/gut symptom if there are imbalances in digestion or immune activation, while the majority of us will have a “beyond the gut” symptom first, such as headaches, mood changes, sleep disruptions, fatigue and pain. Thus, the majority of people may not be thinking of a direct relationship between green bean casserole and their anxious or sad days.

Several things need to happen when we eat a meal. First, we need to be in a “rest and digest” state. This signals to the body it’s time to produce digestive acids, enzymes and bile to sterilize the food, break it down and absorb it well. Next, we need healthy proteins that can be broken down by these digestive supports to become the basic amino acids that our body will use as the building blocks to create neurotransmitters like dopamine and serotonin. Neurotransmitters are signaling molecules, providing communication between nerves. The balance of neurotransmitter production, absorption and clearance, affects mental and physical health. Further, this building of neurotransmitters requires cofactors of several micronutrients like zinc, vitamin B6, magnesium and vitamin D.

To cap things off, there can be immune system reactions to foods, allergies and/or sensitivities that are contributing to inflammatory messaging that starts in the gut, but travels “beyond the gut”, affecting our emotional state.

In my practice, I regularly see low levels these cofactors, low levels of digestive enzymes and gastric acid, high stress and of course, the daily challenge in regularly making healthy eating and drinking choices.

In order for a body and mind to be healthy, each of these areas needs to be considered, evaluated and addressed.

While there are objective tests available for providers to check your nutrient and digestive status, there are also excellent lifestyle supports to begin making a shift in your wellness today.

-Eat at regular intervals. It is less stressful for the body when it knows it can count on you to feed it. This also helps the timing of the digestive acids/enzymes release where there are patterns in meal timing.

-Whole foods. Limit processed foods. Head to the refrigerator, before you head to the pantry. Each meal should contain a protein, small amount of fat, and colorful fruits and vegetables.

-Mindful eating, not distracted eating. Try to avoid multitasking while eating. As often as you can, eat at a table, focused on your food and the company that you share. Look, smell, taste and chew well! Even the process of chewing is signaling release of enzymes.

-Connect with your healthcare provider to review your micronutrient and vitamin status. You might discuss multivitamin, magnesium and/or zinc supports and also test your vitamin D to help assign dosing recommendations.

Remember, Food can be medicine! Make sure you use it wisely!

Your Partner in Health!

Blair Cuneo, PA-C

January 6, 2022January 6, 2022

Magnificent Magnesium

Frances Meredith, MD

In the times of COVID, so many nutrients seem to be in the news these days from quercetin to Zinc, to Vitamin D. Overlooked I believe is the nutrient essential for every cell and every process in our body including immune readiness: Magnesium!

Magnesium is a cofactor for over 300 enzymatic reactions, supporting DNA and RNA synthesis, cell growth and reproduction. Magnesium enters the energy cycle as a cofactor in at least 12 different steps in the process, and is essential for the little batteries in every cell, our mitochondria, to transport electrons and create energy. It is necessary for bone growth and strength, stabilizing the cell membrane, and maintaining normal nerve and muscle function.

Magnesium sits within the cell, balancing all of our cells, keeping calcium outside the cell from overstimulating cellular activity in all parts of the body. For example, Mag balances Calcium in the NMDA glutamate receptor, controlling its opening, avoiding “neuroexcitation”. Thus, lack of Magnesium sets the stage for nerve overactivation, hyperexcitability (think chronic anxiety, chronic pain, chronic states of inflammation created by lack of Magnesium). When we are Mag deficient this NMDA glutamate receptor activates. This is good for survival when we are under intense stress, but not something we want to live with on a day in and day out basis.

Low Magnesium can express itself in so many ways including fatigue, muscle cramping/tension, PMS, headaches, especially migraines, constipation, insomnia, tinnitus, brain fog, heart arrhythmias, anxiety and depression, TMJ, ADHD, and blood sugar issues. Sound familiar? If that’s not enough, Magnesium deficiency is implicated in diabetes, osteoporosis, and hypertension. It is a natural “calcium channel blocker” (think drugs that do this such as amlodipine used for hypertension). The lower the Magnesium levels the greater the progression of Alzheimer’s. Fibromyalgia improves with Magnesium treatment. Increasing Magnesium intake is correlated with a decrease in stroke, diabetes, heart failure, fracture risk and all-cause mortality. Sounds like we all need more, yes?

Why are we so deficient? The answer lies both in the disruption of our food chain and the breakdown of our food choices. The soil is now deficient in Magnesium due to lack of crop rotation, pesticide use and overproduction; in addition, the use of fertilizer heavy in nitrogen and phosphate blocks the plants’ ability to absorb Magnesium. Further, as foods are processed, Magnesium is leached out. The end product: less for us.

Testing for Magnesium is easy, with red blood cell levels being the most accurate form of testing. Body signals, however, are much more important than a test result. Symptoms such as myofascial and muscular tightness/tension/cramping, sluggish bowels, and low energy point to low Magnesium and a trial of Magnesium is warranted even without checking a blood level.

So how can we optimize Magnesium for all of the cells in our body to “sing”? It is clear that plant-based Magnesium is much more effective than the mineral in supplement form. This is due to the fact that Magnesium is at the heart of chlorophyll, responsible for the green pigment in our green foods. Plant based Magnesium is very absorbable and is already charged, essential for its function. The big winners for high magnesium are pumpkin seeds, spinach, almonds and cashews. This great link from Cleveland Clinic lists the magnesium content of many foods.

https://my.clevelandclinic.org/health/articles/15650-magnesium-rich-food

Magnesium in supplement form can be very helpful, and must be attached to a “chelator” to get across the intestinal border. They are best taken with food to improve stability. Magnesium comes in forms including glycinate, citrate, theonate, asparate, orotate, and oxide, with different benefits associated with the specific chelators.

For example, the Mag oxide form is only minimally absorbed and very unstable, drawing water into the intestinal tract, helpful for severe constipation or impaction but not helpful to get Magnesium into cells elsewhere in the body. In contrast the Magnesium glycinate is more stable, better absorbed and better for anxiety or insomnia. Mag citrate is helpful for intestinal motility/constipation as well as energy as it plugs directly into our “Krebs cycle” to create energy.

In addition, optimal intestinal absorption is necessary, with Magnesium absorbed mostly in the ileum of our small intestines. Therefore, if things go awry in the ileum, our ability to absorb Magnesium (as well as other nutrients) will be impacted (think leaky gut, small intestinal bacterial or fungal overgrowth).

Sounds like most everyone would be better off with a little more Magnesium! If any of the above-mentioned symptoms or conditions apply to you, your functional medicine provider at Carolina Total Wellness would be most happy to discuss this with you.

Your Partner In Health

Frances T. Meredith, MD

November 15, 2021November 28, 2022

PEDIATRIC COVID-19 Vaccination Prep

Supporting Resiliency for Children 5 years – 11 years

The Centers for Disease Control (CDC) and American Academy of Pediatrics (AAP) have announced recommendations for COVID-19 vaccination in children 5 years and older, who do not have contraindications.

At Carolina Total Wellness (CTW), we seek to empower our patients and their families with up to date information and provide medical recommendations through our personalized approach.

If you have questions regarding vaccinations, please reach out to your established medical provider.

PEDIATRIC COVID-19 Vaccination prep:
Supporting resiliency for children 5 years – 11 years

Start 2 weeks BEFORE and continue for 1 week AFTER vaccination:

1. Clean water: ½ body weight in ounces
2. Vitamin C: 125-500mg two times a day
3. Daily Multivitamin (ActivNutrients chewables)
4. Daily Probiotic (Ther-biotic complete chewables)
5. Vitamin D: 1000IU per 25 lbs, daily (CTW Liquid D3)
6. Zinc 7.5mg daily (Zinc Drink liquid)
7. SPM Active 1 caps daily: cut/puncture the softgel and squeeze out contents onto spoon, ok to take/mix with food.

In the days leading up to your vaccination, fuel your child’s immune system with healthy, organic colorful foods that are nutrient dense. Avoid pro-inflammatory junk foods and sugary foods. Stick to sleep schedules/healthy sleep hygiene and aim for quality sleep the two nights before the vaccination.

*Day of and day after vaccination, add extra C to above protocol:
Vitamin C: 500mg two times a day

After your vaccination, think muscle, immune and lymphatic system support:

Engage your deltoid! This is the shoulder muscle which received the vaccine. Movement and engagement of the muscle will reduce the tenderness and soreness which can start setting in a few hours later. Example exercises include arm circles, push-ups, patty-cake!

Run around! Walk, run, play after the vaccination to provide a healthy stimulus for the immune system for optimal response and reduce side effects.

Stimulate lymphatic system! After the vaccine, you can begin gentle skin brushing of the vaccinated arm. When able, incorporate whole body lymph support with options like whole body dry skin brushing, gentle rebounding (jumping, hopping), or deep breathing (blowing bubbles, square breath).

AAP statement:
https://www.aap.org/en/pages/covid-19-vaccines-in-children-and-adolescents-policy/

CDC statement:
https://www.cdc.gov/vaccines/covid-19/planning/children.html

Please contact our office for an appointment to further support and personalize your path to wellness.

Your Partner In Health!

Blair Cuneo, PA-C

August 29, 2021November 28, 2022

Gluten in Medication

“What? There’s gluten in my Advil?”

Those with food sensitivities are always on the lookout to avoid exposure to foods we know cause trouble for us. As someone with food sensitivities myself, I was horrified to discover that a migraine medication I was taking contained food proteins to which I knew I was sensitive. How could that be?

Medications, both over the counter (OTC) and prescription, need to have “fillers” to hold the tablets together. These often come from corn or potato starch, but can also have ingredients that contain gluten or soy as well.

Most prescription medications now are gluten free though not all are certified as such by the manufacturer. Several blood pressure medications contain gluten. Gluten containing OTC medications include Advil Liquid Gel and Advil Liquigel Migraine Caps.
“Red flag” Ingredients in medications that can have gluten hidden within include:- modified starch, pregelatinized starch (can be derived from potato, corn, tapioca or wheat)
-dextrate and dextrin (can be derived from potato, corn, tapioca, or wheat)
– dextrimaltose (may be derived from barley malt)
-Maltodextrin (may be derived from potato, corn, tapioca, or wheat)
– sodium starch glycolate (usually derived from potato, but may come from corn, tapioca, or wheat)
-caramel coloring (when barley malt is used).
-All of above are suspect if the source is not specified

Now, let’s talk more about “inactive” ingredients. Ingredients such as corn starch or potato starch may be labelled as “inactive”, however, for some of us they can certainly trigger some very “active” immune responses.

Corn starch is a frequent filler in many OTC meds as well as prescription meds. These include multiple forms of Advil, blood pressure medications such as amlodipine, birth control pills, cholesterol medicines, such as atorvastatin, and common antibiotics such as azithromycin.

Other inactive ingredients may be important, causing immune reactions in some people. For this reason, I always advise choosing the cleanest version of a medication possible when needed. An example of this is the difference between NP Thyroid and Armour. Armour contains inactive ingredients which may be reactive for some, including sodium starch glycolate (gluten free), a food coloring, and microcrystalline cellulose. NP Thyroid contains maltodextrin (gluten free), mineral oil, calcium stearate, and dextrose monohydrate as inactive ingredients. These tend to provoke fewer immune reactions.

Often the “inactive” ingredients are not evident on the label. For over the counter medications you will need to peel back the label and look underneath. If there is no information on ingredient sources, call the 1-800 number on the label to be certain.

A most helpful resource is www.glutenfreedrugs.com On this website, kept up to date by a pharmacist, you can look up most drugs to find whether gluten, potato, corn, or soy are within. Another helpful resource is www.beyondceliac.org .

Your most valuable resource is your pharmacist. Speak to them personally to get them on your team, letting them know your particular food sensitivities. They will add this to your profile and double check any medication to make sure it is absent of your food triggers. They can also be helpful checking ingredients on any over the counter product you might consider using. Though they cannot do this on the spot, they can research the ingredients and get back to you. My pharmacist at Publix has been an immense help to me. I am so grateful to have her on my “team”.

Your Partner in Health!
Frances Meredith, MD

August 29, 2021August 29, 2021

Tips To Slow Down

It has never been easier to connect with someone on the other side of the world, yet it’s so easy to feel disconnected from the people closest to us. We have more tools than ever to simplify tasks and accomplish more things quickly, yet our to-do lists have never been longer. Life is short, and time flies, especially in today’s fast-paced world.

These exercises are meant to help you slow down, enjoy life, and focus on the most important parts of your day. Take the time to prioritize daily objectives.
By focusing on the most important tasks to get done, we eliminate the hustle and stress of trying to accomplish everything at once.
Cut personal Internet use by half.
Technology has become a major element in most of our lives. Social networking, email, and web-surfing can occasionally cause our minds to lose focus and wander through hundreds of topics, thoughts and ideas.
Try to use half your designated Internet time to explore new hobbies, exercise, or meditate.

Enjoy nature.
When time permits – take a five to ten minute break to step outside and breathe in some fresh air. Disconnect from the rest of the world and concentrate on the beauty of nature.

Eat slower.
A lot of us tend to speed through meals – missing the chance to appreciate different textures and flavors. Start to chew foods slower and distinguish new tastes, aromas, and consistencies.

Connect and make time for yourself.
Acknowledge and consciously thank yourself for taking care of YOU. When did you last spend valuable time with yourself? Take a night to find a new book, watch a favorite movie, try yoga, meditate, or cook a new recipe.

Give yourself more time.
Some of us like to stick to a tight schedule and plan all our daily events. Next time you’re jotting down new tasks in your planner, try to factor in a few extra minutes when estimating how long things will take. This will help you not rush through daily tasks.

Take the scenic route.
Next time you’re driving a somewhat long distance – try taking the scenic route. Driving through open fields, mountains, or viewing a city skyline can be very relaxing.

Sit for a moment with your eyes closed when you start your computer. Even just a few moments of meditation can set the tone for the rest of your day. Try to empty your mind and take deep breaths before jumping into your day’s tasks.

Remember your goals and aspirations.
Each morning when you wake up, take a few moments to think about your life goals and aspirations. Try to recall the milestones you’ve already made in your life, and your drive to achieve new ones. Try doing this for about five minutes before getting out of bed to start your day.

Take the time and share this with someone you love that may need some support in slowing down…

Your Partner in Health!
Clarissa Kussin, ND, RYT 500

August 29, 2021August 29, 2021

Health Benefits of Napping

August 24, 2021November 28, 2022

COVID-19 UPDATED

March 31, 2021August 28, 2021

COVID-19 Vaccination Prep: Supporting Resiliency

By: Blair Cuneo, PA-C

Start 2 weeks before and continue for 1 week after vaccination:

1. Clean water: 8–10 glasses a day or ½ body weight in ounces

2. CTW Complete Vitamin C: 1 cap (500mg) two times a day

3. CTW Daily Multivitamin 2 caps two times a day OR MitoCore: 2 caps two times a day

4. Daily Probiotic

5. Vitamin D3 4000IU daily

6. Zinc Glycinate 15mg daily

In the days leading up to your vaccination, fuel your immune system with healthy, organic colorful foods that are nutrient dense. Avoid pro-inflammatory junk foods and sugary foods. Rest when you need to rest.

If able, consider receiving the vaccination the day before you have time off work to have a day to rest.

Day of and day after vaccination:

CTW Vitamin C: 2 caps twice a day

After your vaccination, think muscle, immune and lymphatic system support:

Engage your deltoid! This is the shoulder muscle which received the vaccine. Movement and engagement of the muscle will reduce the tenderness and soreness which can start setting in a few hours later. Example exercises include arm circles, shoulder presses or modified push ups.

Go on a walk! Perform some light cardio and exercise after your vaccination to provide a healthy stimulus for your immune system for optimal response and reduce side effects.

Stimulate your lymphatic system! After the vaccine, you can begin gentle skin brushing of the vaccinated arm. When able, incorporate whole body lymph support with options like whole body dry skin brushing, gentle rebounding, or deep breathing.

If you have questions about COVID 19 vaccinations, please contact your provider!

Category: Immune Health

Long COVID

Benefits of Infrared Sauna

Food and Mood

Magnificent Magnesium

PEDIATRIC COVID-19 Vaccination Prep

Gluten in Medication

Tips To Slow Down

Health Benefits of Napping

COVID-19 UPDATED

COVID-19 Vaccination Prep: Supporting Resiliency

Functional Medicine

Allergy Testing & Drops

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