Your Natural Medicine Toolkit

We are living through interesting times. Back in the good ‘ol days, who would have thought we’d be experiencing a global pandemic? Not me, but here we are.

SARS-CoV-2 virus will likely be with us for decades, and COVID-19 vaccines are not going away: many already immunised and others feeling apprehensive but pressured to do so. Pressure spans medical, social, economic, and political realms. Access to the vaccines have been a challenge for some, whilst others who have access are strongly opposed due to genuine concerns. As a clinician, the emotional divide surrounding the various COVID vaccines has been extraordinary to witness and encounter. All the while, the pressure on our health care facilities and front-line workers is enormous. What a muddle we find ourselves in.

“The more you know, the more you don’t know”
— ARISTOTLE

Even though it’s looking undeniable that vaccination is effective at reducing severity of disease, in the novel context of COVID-19 there is still a lot to learn about the virus and its variants; and around the long-term safety of the novel mRNA vaccine mechanisms. Pfizer BioNTech states their data limitations here (updated 25 June 2021): https://www.fda.gov/media/144413/download which include insufficient data on long term safety, and on safe administration alongside other vaccines.

The science is continually updating in all aspects of our understanding of the COVID-19 disease and antibody production from both infection and immunisation. At this time, we are not even sure of the duration of immunity offered by the various vaccines (is it months or years?) and if re-infection is possible with new variants. It does look likely however that we will need annual adjusted vaccines and boosters, relevant to address the dominant strain of the time.

On a physiological level, I have been fascinated by the variable responses to both COVID-19 infection and vaccination seen so far. Why do some people recover quickly, while other people’s symptoms continue for months? Why do we see such variable responses? More than just relating to the unpredictability of the virus, research has shown us that co-morbid conditions such as some autoimmune and inflammatory conditions, obesity, metabolic syndrome, hypertension, asthma, plus individuals with perturbances to their microbiome or whom are Vitamin D deficient may all experience more severe symptoms of COVID-19 infection as well as adverse effects from the COVID-19 vaccines. Is it therefore reasonable to apply caution when considering vaccination in vulnerable groups such as people with underlying autoimmune or inflammatory conditions, people in the first trimester of pregnancy, and our children? For these people, ‘safe’ is a relative term, and it appears there is no risk-free solution. What are the implications of these people not vaccinating, considering people with autoimmune disease may be more prone to experiencing long-COVID, describing a range of persistent symptoms such as fatigue, shortness of breath and headaches following COVID-19 infection?

Whilst I don’t have all of the answers to these important questions, I do have a deep regard for the many factors and variants involved in the whole picture: which I have tried to summarise in this visual. The importance of a holistic and personalised approach to modulating and supporting the immune system ~ considering the whole person and their unique requirements ~ cannot be understated.

So, in addition to being informed about the SARS-CoV-2 virus, the disease it causes (COVID-19 infection) and how it spreads, and applying appropriate prevention strategies such as these ones listed by the Functional Institute of Medicine, https://www.ifm.org/news-insights/boosting-immunity-functional-medicine-tips-prevention-immunity-boosting-covid-19-coronavirus-outbreak/

I would like to remind you that there are still several steps you can take to favourably modulate cellular defence mechanisms and bolster your immunity in the event of exposure, and to prepare for vaccination.

As the global vaccination rate steadily increases, we as clinicians are developing a clearer understanding of how best to support our clients and patients. When the immune system isn’t properly fuelled and is impaired, this can then lead to poor defences and poor vaccine responses. For example, Vitamin D is known to possess immune-modulating effects and might impact the immunogenic response to influenza vaccination. A review of nine studies - together involving 2,367 people found that Vitamin D deficiency may contribute to the low efficacy of influenza vaccination. It’s also crucial to keep up your self-care. Optimising modifiable lifestyle factors ~ with strategies such as prioritising sleep, fresh air, moderate exercise, Vitamin D and a wholefoods diet ~ has been recommended by the Institute for Functional Medicine, to improve overall immune function and reduce chances of severe symptoms due to COVID-19.

Amazing image adapted from https://www.nature.com/articles/s41430-021-00949-8

Amazing image adapted from https://www.nature.com/articles/s41430-021-00949-8

Here are the tools you have in your Natural Medicine Toolkit to enhance the performance of your immune system:

Stress reduction

Chronic stress can negatively alter immune system responses, making you more likely to get sick. Identify your personal stress reduction strategies and practice them regularly. Regular bushwalking, nature gazing, yoga-nidra and music work for me ;-)

Get enough rest and prioritise your sleep

Chronic sleep deprivation impacts immune functions and general health by enhancing susceptibility to infections, creating a state of low-grade chronic inflammation, plus a reducing immune response to vaccination.

It is essential to get plenty of sleep. Practice good sleep hygiene and maintain consistent sleep hours—turn off screens, ensure the room is cool, quiet, and dark, and set a reminder to help yourself go to bed on time.

Further reading:

·       https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/

·       https://pubmed.ncbi.nlm.nih.gov/34176995/

·       https://pubmed.ncbi.nlm.nih.gov/34220430/

Exercise

Moderate, regular physical activity helps to boost immune system function by raising levels of infection-fighting white blood cells and antibodies, increasing circulation, and decreasing stress hormones. Establish and follow an exercise program to not only help prevent respiratory infections but also to improve cognitive and physical resilience.

Nutritious foods/diet

Research indicates that brightly coloured vegetables and fruits boost immunity better than most supplements. Eat plenty of fruits and vegetables—aim for 10 servings per day. Include fermented vegetables or other probiotic-containing foods.

Self-care

When battling upper respiratory infections, top priorities are plentiful hydration and rest. Drink plenty of fluids; homemade vegetable or bone broths are also extremely beneficial. Various herbal teas/hot drinks can help with hydration and reducing symptoms; good choices include lemongrass and ginger, turmeric, lemon and manuka honey. Salt water gargles are also excellent for loosening mucous and help to fend off bacterial infections.

Other tools that we have in natural medicine ~ including nutraceuticals and herbal medicines ~ can also make a tremendous difference in health outcomes. Some of the below points may help you feel more in control of your health & immune competency: 

Look after your microbiome

Microbiome loss impairs antibody response in patients. If you’ve experienced a recent GIT infection or a course of antibiotics, correcting gut microbiome dysbiosis prior to vaccination with probiotic oral supplementation might be a solution for the management of Covid-19 vaccine-induced adverse reactions.

Further reading:

·       https://www.bmj.com/content/372/bmj.n149/rr-20

·       https://www.mdpi.com/2076-2607/8/6/921

·       https://www.bmj.com/company/newsroom/make-up-of-gut-microbiome-may-influence-covid-19-severity-and-immune-response/

Ensuring your Vitamin D levels are robust

There is some very interesting evidence around how an individual’s Vitamin D levels impact severity of viral upper respiratory tract infections, including a 2019 meta-analysis showing an inverse relationship between Vitamin D concentrations in serum and risk of acute Respiratory tract infection.

Lower circulating 25(OH)D concentrations have been reported to associate with susceptibility to SARS-CoV-2 infection and COVID-19 severity.

In addition to the potential benefits of Vitamin D sufficiency to the body’s responses to both COVID-19 infection and immunisation, optimising vitamin D status will certainly have benefits for bone health and mood.

Further reading:

·       https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6747229/

·       https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30268-0/fulltext

·       https://bmjopen.bmj.com/content/11/5/e043737

·       https://jamanetwork.com/journals/jama/fullarticle/2775003

·       https://pubmed.ncbi.nlm.nih.gov/32397511

·       https://pubmed.ncbi.nlm.nih.gov/32621392/ 

Other nutraceuticals, such as Zinc, Vitamins C and A, and N-acetylcysteine may be worth reading about.

A large body of research shows that zinc has strong anti-viral properties against many viruses, and Vitamin C contributes to immune defence by supporting various cellular functions of the immune system. Vitamin C has been used in hospital ICUs as adjunctive therapy to manage COVID-19 infection. N-acetylcysteine or NAC has antioxidant, anti-inflammatory and immune-modulating characteristics that may prove beneficial in the treatment and prevention of SARS-Cov-2 when used in conjunction with other antiviral treatments, according to an evidence review published recently.

Further reading here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649937/

Whilst I strongly encourage a personalised approach to health & bolstering of the immune system and response, (including preparation for COVID-19 vaccination), you can find some general clinical nutraceutical recommendations plus mechanisms of action written by the Institute for Functional Medicine, here:

https://www.ifm.org/news-insights/the-functional-medicine-approach-to-covid-19-virus-specific-nutraceutical-and-botanical-agents/

It is important to clarify that the above nutraceutical or lifestyle interventions are suggested with the intention of enhancing the performance of your immune system and are not recommended to be used in lieu of other recommended treatments. As always, I strongly encourage you to consult your Doctor, Specialist or health care provider for more personalised perspective and advice.

So, whilst we don’t know what we don’t know, I hope the above discussion leaves you feeling a little more confident in your self-care, and with some resources to investigate should you want to read more. As with any polarising topic, I encourage you to look for common ground with those who have a different belief system to you, and to remember always to be kind.

I am always happy to offer support to the best of my capacity and experience and I love working collaboratively with your other providers to ensure you are getting the best integrative support.

So until I see you in the clinic (or on Zoom) next, stay safe and take care.

Tabitha x

REFERENCES

  • Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: a review.EXCLI J. 2017;16:1057-1072. doi:10.17179/excli2017-480

Tabitha McIntosh