Covid 19 Recommendations

COVID19 Recommendations
Updated March 23, 2020

Your best defense against a viral infection is a healthy immune system which you can support with clean air, clean water and clean food. Focus on eating foods that are organic and rich in antioxidants (fruits and vegetables). Make sure that the water you drink is adequately filtered and do not drink out of plastic bottles. Use good quality HEPA filters in your home, especially your bedroom. Practice good hygiene with frequent hand washing with warm water and soap. Keep stress levels as low as possible and make adequate sleep a priority.
In addition to social distancing, frequent/adequate handwashing and sanitizing guidelines from CDC (https://www.cdc.gov/coronavirus/2019-ncov/index.html), here are Cov19 recommendations. Please keep in mind, information is changing daily. Covid-19, also known as SARS-CoV-2, is too new for us to have a body of literature on how specific nutrients or herbal remedies affect clinical outcomes. We therefore predict the risk/benefit based on understanding mechanisms involved and similarities between this virus and its most closely related viruses. Based on new concerns regarding this specific virus, we have amended our prior recommendations on high dose vitamin A and D.

These supplement regimens are not intended to cure Covid-19 but to help boost your body’s own immune response to the virus. If you suspect symptoms of Covid-19, we recommend that you call your primary care physician’s office or seek evaluation and testing through an Urgent Care center. A list of resources is available at the end of this document.

Adult Prevention Options: (supplements available through your online patient portal)
1. Vitamin C: 500-1000mg daily (CTW Complete Vitamin C)
2. Vitamin D: 2000IU -5000IU per day (CTW Liquid D3 or CTW Vitamin D3)
3. Omega 3 (EPA/DHA): 2500mg daily (CTW Omega 3 or Arctic Cod Liver oil) or (Metagenics SPM) 2 caps twice daily
4. Zinc glycinate: 15-30mg daily (Reacted Zinc or Zinc Drink)
5. N-acetylcysteine: 600mg daily (CTW Liver Support) or (Trizomal glutathione) 5mL once daily
6. (Biocidin LSF) mix 10 pumps with a bottle of over the counter nasal saline spray or Xlear and then spray twice into each nostril upon returning home from outside exposure like your office or the grocery store.
7. PEA: 2 caps daily. Recommend Vitalitus PEA or Metagenics Hemp Advantage Plus {PEA with CBD}.
8. Real Mushrooms 5 Defenders, providing >20% beta-D-glucans: 1 cap daily**
9. Real Mushrooms Reishi 415**: 1 cap daily**
**Mushrooms are highly complex. Certain compounds are immunostimulating. Is this a problem in COVID19, or a benefit? We don’t know the answer. There is also concern using immune stimulants in autoimmune patients**
Herbs such as elderberry, echinacea, astragalus, andrographis and beta glucans can help to boost immune function. However, we do not recommend taking these supplements if you have an existing autoimmune condition as these may flare your condition.

Pediatric Prevention Options: (supplements available on your online patient portal)
1. Vitamin C: 250mg daily (1/2 capsule of CTW Complete Vitamin C)
2. Vitamin D: 600IU-1000IU per day (CTW Liquid D3)
3. Omega 3: 500-1000mg daily (DHA Junior Liquid or Arctic Cod Liver oil) or (Metagenics SPM) 1 cap twice daily
4. Zinc glycinate: 15mg daily (Zinc Drink)
5. N-acetylcysteine: 300mg daily (CTW Liver Support) or (Trizomal glutathione) 2.5mL once daily
6. (Biocidin LSF) mix 10 pumps with a bottle of over the counter nasal saline spray or Xlear and then spray once into each nostril upon returning home from outside exposure that couldn’t be avoided….stay strong parents! No friend visits!
7. PEA: ages 5-14: 1 cap daily. Recommend Vitalitus PEA or Metagenics Hemp Advantage Plus {PEA with CBD}.
8. Real Mushrooms 5 Defenders, providing >20% beta-D-glucans: 1 cap daily**
9. Real Mushrooms Reishi 415**: 1 cap daily**
**Mushrooms are highly complex. Certain compounds are immunostimulating. Is this a problem in COVID19, or a benefit? We don’t know the answer. There is also concern using immune stimulants in autoimmune patients**
Herbs such as elderberry, echinacea, astragalus, andrographis and beta glucans can help to boost immune function. However, we do not recommend taking these supplements if you have an existing autoimmune condition as these may flare your condition.

See next page for graphic to review signs of illness and therapeutic options:

*** New data, obtained after this chart was generated, indicates that diarrhea occurs in up to half of all patients presenting the Covid-19***

At first sign of illness, adult therapeutic options:
1. Vitamin C: increase to 1 gram per hour x 6 hours per day. Reduce dose slightly if you develop loose bowel movements
2. Zinc liquid or lozenges: Swish liquid or allow lozenge to dissolve slowly, bathing the throat in zinc. Total zinc should be 60mg per day x 1 week. Recommended to divide this up with 1 teaspoon Zinc Drink 4 x day only to avoid copper depletion.
3. Biocidin LSF mix 10 pumps with a bottle of over the counter nasal saline spray or Xlear and then spray twice into each nostril two times a day.
4. Metagenics SPMs: Increase to 2 caps 3 times per day with first symptoms, continue x 6 weeks.
5. N-acetylcysteine: Increase to 600mg twice a day or Trizomal glutathione 5mL twice a day
6. PEA: increase to 2 caps three times per day with first symptoms. Continue for six weeks
7. Real Mushrooms 5 Defenders**: increase to 2 caps twice a day with symptoms
8. Real Mushrooms Reishi 415**: increase to 2 caps once to twice per day with symptoms.
**Mushrooms are highly complex. Certain compounds are immunostimulating. Is this a problem in COVID19, or a benefit? We don’t know the answer. There is also concern using immune stimulants in autoimmune patients**
Herbs such as elderberry, echinacea, astragalus, andrographis and beta glucans can help to boost immune function. However, we do not recommend taking these supplements if you have an existing autoimmune condition as these may flare your condition.

At first sign of illness, pediatric therapeutic options:
1. Vitamin C: increase to 500mg per hour x 6 hours per day. Reduce dose slightly if you develop loose bowel movements
2. Zinc liquid or lozenges: Swish liquid or allow lozenge to dissolve slowly, bathing the throat in zinc. Total zinc should be 60mg per day x 1 week. Recommended to divide this up with 1 teaspoon Zinc Drink 4 x day only to avoid copper depletion.
3. Biocidin LSF mix 10 pumps with a bottle of over the counter nasal saline spray or Xlear and then spray twice into each nostril two times a day.
4. Metagenics SPMs: Increase to 1 cap 3 times per day with first symptoms, continue x 6 weeks.
5. N-acetylcysteine: Increase to 300mg twice a day or Trizomal glutathione 2.5mL twice a day
6. PEA: increase to 1 cap three times per day with first symptoms. Continue for six weeks
7. Real Mushrooms 5 Defenders**: increase to 1 cap twice a day with symptoms
8. Real Mushrooms Reishi 415**: increase to 1 cap once to twice per day with symptoms.
**Mushrooms are highly complex. Certain compounds are immunostimulating. Is this a problem in COVID19, or a benefit? We don’t know the answer. There is also concern using immune stimulants in autoimmune patients**
Herbs such as elderberry, echinacea, astragalus, andrographis and beta glucans can help to boost immune function. However, we do not recommend taking these supplements if you have an existing autoimmune condition as these may flare your condition.

References:
https://www.drkarafitzgerald.com/2020/03/16/covid19-traditional-chinese-medicine-and-western-options-for-the-non-tcm-trained-clinician/?mc_cid=1cd528a9bd&mc_eid=fb7826b1c3

Coronavirus (COVID-19): What a Pediatrician Wants You to Know


https://www.drkarafitzgerald.com/2020/03/12/covid-19-preserving-your-familys-health-and-sanity-in-the-face-of-a-pandemic/?mc_cid=1cd528a9bd&mc_eid=fb7826b1c3

From the NC Health Department:
If you have questions about COVID-19 (coronavirus), dial 2-1-1 or 888-892-1162. Sign up for updates by texting COVIDNC to 898211.
For all other questions, the DHHS Customer Service Center can assist in finding programs and people to help you. Call 1-800-662-7030.

3708 Forestview Rd., #202 office@carolinatotalwellness.com T: 919-999-0831
Raleigh, NC 27612 www.carolinatotalwellness.com F: 888-394-6442

What Leaky Gut Is and Why Should You Care

919 why you should care about leaky gut

If you have been researching how to improve your health, you may have heard of leaky gut, also known as intestinal permeability. If that conjures an unpleasant image of your gut contents leaking into the rest of your body — that’s not too far off the mark.

Leaky gut happens when contents from the small intestine spill into the sterile bloodstream through a damaged and “leaky” gut wall. This contamination of the bloodstream by not only partially digested foods but also bacteria, yeast, and other pathogens begins to create a foundation for chronic inflammatory and autoimmune health disorders.

Symptoms and disorders linked to leaky gut include fatigue, depression, brain fog, skin problems, joint pain, chronic pain, autoimmune disease, puffiness, anxiety, poor memory, asthma, food allergies and sensitivities, seasonal allergies, fungal infections, migraines, arthritis, PMS, and many more. Basically, your genetic predispositions will determine how leaky gut manifests for you.

Leaky gut is referred to as intestinal permeability in the scientific research. It means inflammation has caused the inner lining of the small intestine to become damaged and overly porous. This allows overly large compounds into the small intestine. The immune system recognizes these compounds as hostile invaders that don’t belong in the bloodstream and launches an ongoing attack against them, raising inflammation throughout the body. Also, some of these compounds are very toxic (endotoxins) and take up residence throughout the body, triggering inflammation wherever they go.

At the same time, excess intestinal mucous and inflammation from the damage prevents much smaller nutrients from getting into the bloodstream, which can lead to nutrient deficiencies and poor cellular function.

Leaky gut is increasingly being recognized as a common underlying factor in most inflammatory symptoms and disorders.

Medicine finally recognizes leaky gut

Conventional medicine has long ridiculed leaky gut information and protocols as quack science and alternative medicine folklore, but newer research now establishes it as a legitimate mechanism. In fact, pharmaceutical companies are even working on drugs to address leaky gut.

Research has established links between leaky gut and many chronic disorders. It’s good this long-known information is finally being validated in the dominant medical paradigm as the gut is the largest immune organ, powerfully influencing the rest of the body, as well as the brain.

Current studies link intestinal permeability with inflammatory bowel disorders, gluten sensitivity, celiac disease, Crohn’s disease, type 1 diabetes, depression, psoriasis, and other chronic and autoimmune conditions. Given what we know about the connection between gut health and immunity, it’s vital to include a gut repair protocol in overall treatment of inflammatory and autoimmune disorders.

How to mend leaky gut

Sometimes, repairing leaky gut can be as simple as removing inflammatory foods from your diet. Other times it’s more complicated. Most importantly, you need to know why you have leaky gut. Either way, however, your diet is foundational.

Many cases of leaky gut stem from a standard US diet of processed foods and excess sugars. Food intolerances also contribute significantly, especially a gluten intolerance. A leaky gut diet, also known as an autoimmune diet, has helped many people repair intestinal permeability. Keeping blood sugar balanced is also vital. If blood sugar that gets too low or too high, this promotes leaky gut. Stabilizing blood sugar requires eating regularly enough to avoid energy crashes. You also need to prevent high blood sugar by avoiding too many sugars and carbohydrates. Regular exercise is also vital to stabilizing blood sugar and promoting a healthy gut.

Also, failure to eat enough fiber and produce leads to leaky gut by creating a very unhealthy gut microbiome, or gut bacteria. Our intestines (and entire body) depend on a healthy and diverse gut microbiome for proper function. A healthy gut microbiome comes from eating at least 25 grams of fiber a day and a wide and rotating variety of plant foods.

Other common things that lead to leaky gut include antibiotics, NSAIDs such as ibuprofen, excess alcohol, hypothyroidism, and autoimmunity.

A leaky gut protocol can help you improve your health, relieve symptoms, boost energy, make you happier, and clear your brain fog. Ask my office for advice on improving your well being through a leaky gut diet and protocol.

How You Were Born Could Shape the Rest of Your Life

916 microbiome and birth

Whether you’re fat or thin, anxious or relaxed, sickly or resilient — this could all stem from the way you were born thanks to the effects of bacteria in our first few seconds of life. Babies born via c-section are shown to have less desirable gut bacteria, or a gut microbiome, compared to babies born vaginally, who have healthier microbiome “signatures.”

Results from the largest study of the newborn microbiome were recently published. The study found that newborns delivered via c-section lack the healthy gut bacteria found in vaginally delivered babies. Their guts also contain strains of harmful microbes — Enterococcus and Klebsiella — commonly found in hospitals.

In fact, the lead researcher said the levels of harmful hospital bacteria in the c-section newborns was “shocking.” These babies were also deficient in the healthy bacteria that made up most of the guts of the vaginally born babies.

The difference was so profound that he said he can tell you how the baby was born simply by analyzing the bacteria in their stool.

C-section babies missing strain vital for health, weight management, and immune resilience

After several months the gut microbiomes between the two set of infants became more similar with one striking difference — the c-section babies had significantly lower levels of Bacteroides, a strain vital to human health.

Bacteroides are a key strain when it comes to health challenges modern societies face. A number of studies have shown Bacteroides levels are lower in people with obesity. Studies in both mice and humans show that when gut bacteria from thin subjects are transplanted into the colons of obese subjects, most subjects lose weight.

Bacteroides has also been linked with preventing anxiety, and boosting and regulating immunity to prevent inflammatory disorders. This may explain why people who were born via c-section are at increased risk for obesity and asthma.

The study is part of a larger Baby Biome study that is following thousands of newborns through childhood.

Why method of birth affects the gut microbiome

Research suggests that the vaginal canal imparts beneficial bacteria to the infant during birth, while c-section babies are deprived of that and instead immediately exposed to the bacteria of the hospital and the people attending the birth. Studies are underway in which babies born via c-section are swabbed with the mother’s vaginal microbes.

Other factors to consider beyond birth

It may not just be the birth that determines a c-section baby’s poorer microbiome status. Women who undergo c-sections also receive antibiotics, which may transfer to the newborn through the placenta and later through breast milk. These babies also tend to stay in the hospital longer and thus are exposed to more hospital bacteria.

How to develop healthy gut bacteria

Developing good gut bacteria is not neccesarily as simple as taking probiotics. You may also be overrun with detrimental bacteria that need to be “weeded.”

Perhaps most important is whether your diet supports a healthy gut microbiome.

What the gut microbiome needs most is an ample supply of vegetables and fruits on a regular basis in a wide, ever changing variety. Eating a diverse and abundanat array of plant foods will help create a diverse and abundant gut microbiome.

Ask my office for more advice on how we can help you improve your gut microbiome and overall health.

New Research Provides More Clues in PANDAS

912 new pandas insights

Children who recently had a strep infection and then go on to suddenly develop symptoms of obsessive-compulsive disorder (OCD), Tourette’s, tics, odd behaviors, emotional instability, and other psychiatric and neurological disorders are believed to have PANDAS.

PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.

In some children, a strep infection appears to trigger an autoimmune attack against the brain, causing a sudden onset of neuropsychiatric symptoms.

PANS, or Pediatric Acute-Onset Neuropsychiatric Syndrome, is similar, except environmental factors or other infections trigger symptoms.

PANDAS/PANS isn’t believed to be fully credible by many experts or doctors, in part because it must be diagnosed by symptoms and because the supporting research hasn’t been very strong. Instead, they diagnose affected children with conditions such as OCD.

However, recent research sheds new light on the disorder and why it affects some children and not others.

PANDAS/PANS causes inflammation in an area of the brain called the basal ganglia, which helps govern emotions and motor control. When the immune system creates antibodies to the strep infection, these antibodies mistakenly attack tissue in the basal ganglia as well.

In 2018, researchers isolated cells in the basal ganglia, called cholinergic interneurons, which are affected by the immune attack. Previous research has shown these cells are depleted in Tourette’s syndrome.

These cholinergic interneurons fire less when strep antibodies attach to them, which is believed to cause the symptoms associated with PANDAS/PANS.

Normally, antibodies would not be able to cross the blood-brain barrier to cause immune attacks in the brain. However, research shows the spike in inflammatory immune cells called TH-17 from a strep infection can cause the blood-brain barrier to open up. This is commonly called leaky blood-brain barrier and can allow strep antibodies and other pathogens to enter into the brain.

It has been found that most of these TH-17 cells pool in the olfactory bulb, an area of the brain that receives signals from the nasal passages.

This creates a path through which antibodies can enter, especially with repeat strep infections.

Genetic susceptibility has also been found to be a link in PANDAS/PANS.

PANDAS diagnosis criteria

  • Significant obsessions, compulsions, tics
  • Abrupt onset of these symptoms or relapsing and remitting symptom severity
  • Onset prior to puberty
  • Association with strep infection
  • Association with neuropsychiatric symptoms, including PANS symptoms

PANS diagnosis criteria:

Abrupt, dramatic onset of OCD or severely limited food intake and the addition of at least two of the following:

  • Anxiety
  • Emotional swings and/or depression
  • Irritability, anger, oppositional behavior
  • Regression
  • School performance deteriorates
  • Sensory or motor abnormalities
  • Sleep disturbances, urinary frequency, bed wetting

Functional medicine for PANDAS/PANS

Functional medicine strategies can help reduce inflammation and autoimmune attacks in PANDAS/PANS and support immune and brain health.

Functional medicine strategies may include removing inflammatory triggers from the diet and the environment; nutritional therapies to lower inflammation and support brain health; addressing blood sugar, gut health, and toxicity; supporting neurotransmitters; and repairing mitochondrial function and the blood-brain barrier.

Quick action can improve outcome. For more information, contact my office.