Category: Immune System

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How Viruses and Infections Trigger Autoimmune Diseases 

It’s been my mission to teach people how to balance and strengthen their immune systems since the release of my first book The Immune System Recovery Plan. With the emergence of Long Covid and prevalence of other viruses such as the flu and RSV, it’s more important than ever to keep your immune system in tip top shape to prevent autoimmune diseases. 

It’s also essential to have an understanding of the nature of viruses and how they can impact the health of your immune system in the long run. It’s so important that I recently added an entire new chapter to The Immune System Recovery Plan that has just been re-released this month!

Viruses. Sometimes you get sick from them and sometimes you don’t. 

Have you ever wondered why?  

Some people can clear these viruses out of the body easily after their cold or flu, while in others the virus can persist and run amok causing problems like autoimmune disease. How does that happen?  

This issue is important whether or not you have an autoimmune condition because persisting, active viruses can cause ongoing symptoms like fatigue, too.  And this is something we are clearly seeing after infection with SARS-Cov2, aka “Long Covid”. 

A healthy immune system should be able to respond to the infection and take care of business, clearing out the virus after a self-limited short illness. I think of a robust and well-functioning immune system as the product of good “soil” within your body.  

Another name for the inner soil that grows your immune system is your terrain. Your terrain is part of a larger ecosystem that determines the functioning of, well, every system in your body..  (note the gardening metaphors).  

If you have good inner terrain, you will “grow” normal functioning immune cells that can clear out the viruses. If you don’t, then they can persist. We do believe there is a genetic predisposition that allows viruses to persist and trigger autoimmunity.  

But that’s not all that’s going on. Twin studies have shown us that two people with the same genetics and the same triggering virus, can have two completely different responses, all because of their terrain.

3 Viral Triggers for Autoimmune Diseases 

When viruses linger in the body (again, most often because of terrain issues), it is called “chronic persistence.” This leads to an ongoing antiviral immune response, which can trigger autoimmunity in a few ways.

 

  1. Molecular Mimicry:  As the virus continues to spread its “proteins” around your body, there is mistaken identity as these proteins can look like your own tissue. We call this molecular mimicry.  This can be because the immune response becomes less specific and it spreads to other tissues. The tissue being attacked determines which autoimmune disease you have. For example, if this happens to the myelin in your brain, then you get MS; if it’s your thyroid, then you get Hashimoto’s thyroiditis or Graves’ disease.
  2. Bystander Effect: Autoimmunity can also happen when the virus infects the cells directly, living inside them and causing direct cell and tissue damage. There are two things that can happen as a result, both of them bad.

    The first is that your immune system reacts to the virus living inside the tissue and your body gets damaged in the crossfire. This is called a bystander effect.

    The second is that the infection inside your cell causes the cell to develop a different “name tag” on the outside of its cell surface. As a result, the immune system begins to see your own tissue as foreign. If the infection becomes a chronic situation, the immune system will continue attacking your cells because the infection is still inside. An infection can persist anywhere, including but not limited to your joints, brain, and thyroid. It is even possible for an infection to live inside your immune cells themselves, which can cause your immune cells to lose their tolerance for your own tissue. Epstein Barr Virus is a good example of a virus that wreaks havoc via its bystander effect, and by persisting inside your immune cells.
  3. Cell Damage: The final way that infections can exacerbate autoimmune conditions is when your tissues are already damaged from an autoimmune disease and then a virus is drawn to the inflammation and takes up residence in this tissue as a secondary problem. In studies that find viruses at the site of autoimmune damage, it is unclear whether the damage came first or if it was caused by the virus. Why do some people recover from an infection, whereas other peo-ple don’t? There is some evidence that in certain people bad genetics or damage from an environmental toxin or exposure has made their immune systems unable to get rid of a chronic infection. As a result, the infection triggers autoimmunity either right when the person first gets sick or because the infection persists. 

 

I go into more detail on viruses and autoimmunity, including information about the role of specific viruses in specific autoimmune conditions in the re-release of my best-selling book, The Immune System Recovery Plan.  I’ve added a whole chapter dedicated to this very topic. 

But you can see, no matter the mechanism, to prevent and treat autoimmunity that has been triggered by viruses, you want to make sure your immune terrain is functioning well so that the viruses are cleared out and not allowed to become chronic persisters.

Here is how to improve your terrain to create a robust and healthy immune system to clear out viruses:

Nutrition:  

Eat an Anti-inflammatory Diet: whole foods rich in antioxidants and fiber, low in sugar, animal and processed fats;  elimination of foods that trigger inflammation including gluten and genetically-modified foods.  Overall, eat less food from animals and more from plants.  Remember to focus on eating more of the GOOD foods, not just on eliminating the bad.  

Supplements: 

I’ve put together my favorite supplements that include vitamins, minerals and antioxidants that your immune system needs for optimal well being.

Balanced Hormones:  

    1. Make sure your stress system and adrenals are balanced and resilient.  To do this, you must focus on your lifestyle, which includes sleep, exercise, daily relaxation, reducing toxins in your food and environment, and eating nourishing food. The good news? These are things all of which you have control over!
    2. Sex hormones:  No matter where you are in your life, we all have hormones that we need to help our bones, muscles, life force and immune system.  As we age, sex hormone levels are tied into stress.  

Join our meditation classes and learn how to destress, relax and as a result improve the functioning of your immune system and hormones.

Healthy Gut:  

    1. Daily goal should be to support your Intestinal ecosystem.  A “good gut” means that you have adequate beneficial bacteria, good barrier function (no leaky gut), and no “weeds” in the inner garden.
    2. Digestion:  a healthy gut also has good stomach acid, bile acids, and pancreatic enzymes so that you are digesting and absorbing all the nutrients from the food you eat.  

Sometimes, the gut microbiome just needs a good “reboot” to clean out the bad bacteria and yeast that can grow as a result of stress, illness, antibiotics or other medication, poor food choices, to name a few.  Our Gut Cleanse Box was designed to help you easily treat your microbiome which can improve digestive symptoms, reduce inflammation, reduce food sensitivities, improve memory and mood, and even help you reach your ideal weight. The packets are filled with herbal antibiotics (pills) that clean out the bad bacteria and yeast.  If you would like to be guided by a wellness coach while you do your gut cleanse, check out our HealMyGut Programs.  

Well Functioning Liver:

    1. Daily goal should be to reduce your toxin exposure and eat foods that support your liver’s detox system so that you can maintain a low toxin load in your body.  Toxins damage the immune system.  It’s often the total amount of all toxins that make you sick, not just one in particular.  
    2. Clean up your environment and make sure your “biotransformation pathways” through your liver are working well
    3. This will also support your Estrogen detox pathways, something that everyone needs to pay attention to, because toxic estrogens can cause damage in the body.

It’s important to detox your liver safely and effectively. I’ve put together a Detox Repair Kit that will renew your body and reset your system by eliminating your toxic load.

Remember, you can’t avoid viruses! They are everywhere. Instead we work on creating resilience in the immune system so that the viruses don’t become chronic. To do this, we focus on the terrain of the immune system, which leads to the 4-step Immune System Recovery Plan, the focus of my first book on autoimmunity being re-released this month. Grab your copy here. 

 

References:  

Vieira et al.  Diet, microbiotia, and autoimmune diseases.  Lupus 2014 23: 518

Getts, D, et al.  Virus, infection, antiviral immunity, and autoimmunity.  Immunol Rev. 2013 September; 224 (1): 197-209.

Vanderlugt, C, and Miller, S.  Epitope spreading in immune-mediated diseases: implications for immunotherapy. Nature Reviews Immunology 2, 85–95 (1 February 2002)

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The 5 Steps to Ensure Your Immune System is Ready to Protect You

Here’s an important question: Is your immune system ready for the next hit?

This question has been at the top of my mind for months. Having struggled with chronic tick-borne diseases, I’m concerned about my immune system mounting a response against other pathogens, such as COVID, influenza and even the common cold. 

Perhaps you relate? The pandemic has been a reality check … we are not as big and strong as we’d like to think we are. One little virus brought our world to its knees. 

There’s good reason to be concerned. Infectious diseases are on the rise globally. From medical journals to the news, it seems something new is constantly popping up. Today we’re talking about Monkey Pox and Tomato Flu. What will be next?

The statistics are sobering: 

 

  • The World Health Organization reports infectious diseases kill more than 17 million people a year. In fact, 30 new diseases have emerged in the last 20 years.

  • A report from the CDC shows a three-fold increase in the number of diseases from mosquitoes, ticks and fleas like West Nile, Zika, Malaria and Lyme disease from 2004 to 2016. Climate change will only make this worse.

  • Viral infections, bacterial and spirochete infections, such as tick-borne diseases, are implicated in the root cause of autoimmune disease. Infections such as Epstein-Barr Virus and Lyme Disease have been well studied as triggers of autoimmunity. And, you guessed it, autoimmune diseases are increasing year over year – over a 50% increase in the last 25 years.

You read correctly: Pathogens are potential triggers of autoimmune disease and their flares. 

Autoimmune diseases are a family of more than 80 chronic, often debilitating and, in some cases, life-threatening illnesses. According to the National Institutes of Health, up to 23.5 million Americans (more than 7% percent of the population) suffer from an autoimmune disease.

This begs the question (stick with me, there is good news): If infectious diseases and autoimmune diseases and flares are on the rise, what are we to do?

Here’s the quick answer: Ensure that your immune system is working optimally. Period. End of story. 

And the good news is: You can do this!

The 5 Steps to Ensure Your Immune System is Ready to Protect You:

Give your undivided attention to your gut microbiome – Nearly 80% of your immune system lives in your digestive tract. Yep, 80%! Your gut plays a key role in your body’s ability to defend itself against infection. It is imperative that your gut is in top working order. Signs your gut needs attention: gas, bloating, constipation, diarrhea, heartburn, food intolerances, undigested food in your stool, feeling tired or lethargic. If you struggling with Long Covid or get sick a lot, this is an absolute must-do. 

Eat foods that support your immune system – Food is medicine, or food can be poison. –Minimize immune-suppressing foods, such as sugar, processed foods, refined carbs, fried foods, vegetable oils, artificial anything and alcohol. 

–Maximize vegetables, fruit, olive oil, whole grains, nuts, seeds, fermented foods and healthy fats, like avocado and wild caught salmon.

Reduce your toxin load and remove toxins from your home – We live in a world filled with toxins that can harm the immune system (and even trigger autoimmune disease). These include pesticides/herbicides, hormones and plastics in food and water, solvents and mold in our homes and heavy metals in the fish we eat and water we drink. Others can come from cosmetics and products we use at home. 

Become stress resilient – Bottom line: Stress damages the immune system. Even low grade stress (you know, they kind we wave away, like having to deal with a daily commute) depletes your immune system, opening you up to pathogenic infection, and fueling the fire of autoimmunity. Even good stress, like getting ready to go on vacation, can be problematic

Consider supplementation – There are targeted supplements that will support your immune system and make your body less hospitable to viruses. These include Vitamins A, C, and D3, Zinc, N-Acetylcysteine, mushroom extracts, and herbs, such as elderberry, astragalus, and echinacea. Not all of these are appropriate for everyone. If you have an autoimmune disease, the mushrooms and herbs may not be right for you. 

Bringing this full circle … if you are like me … if you are concerned that your immune system is up to the task of protecting you from infectious disease and the havoc it creates in the body, consider joining Dr. Blum and me for our newly-updated course — Immune System Strong. Two LIVE classes and four video classes with Dr. Blum, and 9 LIVE coaching calls with me, you’ll learn exactly what you need to do to fortify your immune system.

We begin soon! I’ll be with you every step of the way. Learn More

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How to Treat Long Covid from a Functional Medicine Perspective

Long Covid is a term that has been used to describe people who have persistent symptoms after a recent documented Covid-19 infection.  With more than 43 million reported cases of Covid-19 in the U.S. alone, a number that keeps increasing daily, many are still experiencing symptoms for weeks and even months after the infection has cleared. 

It is believed that 15-30% of people who recover from Covid-19 experience Long Covid or what Dr. Fauci has coined post-acute sequelae of SARS-CoV2 infection (PASC).  This means that up to 30% of people who get sick with Covid-19 (mild or severe, it doesn’t matter) will have ongoing symptoms for months, including fatigue, brain fog, gut issues, shortness of breath, palpitations, muscle aches and headaches.  There is also an increased risk of Diabetes, high blood pressure, sleep apnea, new neuro or psychiatric diagnosis, and adrenal insufficiency.  

So far, we are just beginning to understand the underlying causes of all these symptoms.  Some are caused by direct damage to organs, such as the lungs.  But others are caused by deeper issues that we are now learning are related to damage to the mitochondria and to ACE2 enzyme activity, and also persistent inflammation in the body, all of which have a widespread effect in the body on multiple organs and systems.  

The Role of Mitochondria in Long Covid 

Mitochondrial dysfunction may also play a role in the difficulty recovering from COVID-19 infection. Your mitochondria make all the energy for all your cells and are concentrated highest in the brain (nervous system) and heart (muscle).  The free radical damage (also called oxidative stress) caused by a significant viral infection can cause destruction of these critical structures and this may contribute to the many symptoms that people experience, especially fatigue and cognitive impairment.  

Therefore to treat Long Covid, from a functional medicine perspective, in addition to reducing inflammation and rebalancing the immune system, we also need to work on restoring and improving function of the mitochondria.

Here is how to help your mitochondria recover and combat free radicals.

FOOD:

Eating a diet rich in plants, especially antioxidants is key!  Antioxidants are found as the usual known suspects like vitamin A, beta carotene, Vitamin C and E and polyphenols found in the rich colors of a rainbow diet.  Additionally, mitochondria love a compound called PQQ. Eating PQQ rich foods is a great idea. These include parsley, green peppers, kiwi fruit, papaya, green tea and tofu. 

EXERCISE:

While it’s important to exercise, make sure to focus on reconditioning and do not engage in strenuous exercise that causes a crash the next day.  That is counter productive.  Best to slowly gain your stamina back and only exercise to the level that you can sustain, day after day, without crashing.

STRESS & SLEEP:

Critical repair happens at night so make sure to get a good night sleep.  The goal should be to go to bed before 11pm and if you are having trouble falling asleep or staying asleep, you might benefit from a health coaching session to focus on improving this!

INTRAVENOUS VITAMINS:

In conjunction with the right diet, proper sleep, and easing into exercise, our new Long Covid Infusion Protocol of intravenous vitamins and amino acids work deep within the cells to help recover and repair any damage done to the mitochondria.  We’ve paired healing the mitochondria with powerful antioxidants to bring down inflammation and give your immune system and cells a reboot after fighting to clear a Covid-19 infection.

With so many people experiencing gut issues after a Covid-19 infection, we believe the best way to receive these nutrients is through an IV. An infusion bypasses the GI tract, ensuring your cells absorb 100% of our targeted formulation to help you recover and feel like your old self. 

Our innovative new protocol created by Dr. Blum, includes three infusion bags and an injection. The first IV bag is a foundational Myers cocktail with added L-Carnitine, NAC and Selenium.  Bag 2 is Alpha Lipoic Acid; Bag 3 is Glutathione; and the final injection is CoQ10.  All items are available a la carte, but bundled together gives you a 20% discount.

SUPPLEMENTS:

If you live far away and can’t come in for an Infusion, check our Dr Blum’s Long Covid Supplement Protocol here on Fullscript.  Please note you will need to set up a free account in Fullscript in order to view the supplement recommendations.  

For more information on our Long Covid drip, contact your practitioner or schedule a consultation with our Infusion Director at 914.652.7800.  We are open to existing patients and the public alike! 

 

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Fall Update on Supplement Usage During the Coronavirus Pandemic

As of 10.1.2020

By the team at Blum Center for Health:  Susan S. Blum, MD, MPH; Pamela Yee, MD; Elizabeth Greig MSN, FNP 

As the pandemic wears on and the seasons change, we find ourselves preparing for winter, a time when we will be back inside with less opportunity to see people, connect and socialize, as we might have been doing in warmer weather.  I can say that for me, I am not looking forward to this and am trying to stay focused on and appreciate this moment, when we have beautiful fall weather in the Northeast.  I encourage you all to spend as much time outdoors as possible while you still can!  Of course I am also making a commitment to myself to bundle up and still make myself go outside this winter…we will see!  

Since the pandemic began, I have been updating my recommendations for using supplements to support your immune system.  As time keeps marching on, and we prepare for month #8, and the likelihood of a surge in COVID during the winter months, I thought I would go back and update my supplement recommendations.  It’s really important that we step up our game and renew our vigilance for protecting ourselves from getting sick, and if we do get COVID, to have a mild course of illness and recover quickly.  From a Functional/Integrative medicine perspective, we continue to focus on nutrients and herbs that have been well studied, for their ability to support, modify or boost the immune system, or to fight viruses.  

**Please note that these recommendations are NOT medical advice.  Most are not safe for pregnant women, and if you are taking medication or have any serious health condition, please check with your doctor.

Immune Boosting Supplements 

These are generally safe for those with Autoimmune Conditions. For pregnancy check dosing with your doctor.  We recommend that you take Vitamins D and C now at a minimum, and add Vitamin A and NAC if you are exposed or get sick. 

  • Vitamin D: 5000 IU daily in absence of serum levels from blood test   
  • Vitamin C: 1-3 grams daily
  • N-Acetylcysteine (NAC): 600 – 900 mg twice/day (precursor for Glutathione (GSH), or can take GSH
  • Vitamin A: up to 10,000 – 25,000 IU/day (not safe for pregnancy)

We do not recommend the following supplements for those with Autoimmune Conditions or pregnancy.We recommend that you take 1 of the following at the recommended dose, or a blend that includes several of these, in which a lower dose of each are typically used:

  • Elderberry: 500 mg daily (of USP standard of 17% anthocyanosides)
  • Beta Glucans: 250 – 500 mg daily
  • Mushrooms: Shiitake, Lion’s mane, Maitake, Reishi. D Mushrooms: Shiitake, Lion’s mane, Maitake, Reishi. Dose depends on preparation
  • Astragalus: Dose depends on preparation
  • Echinacea: Dose depends on preparation
  • Andrographis: 200 mg/day

To make this easy for you, we added our favorite herbal blend to our store, called Immune Support. You can read more about it HERE.

Anti-Viral Supplements

These are generally safe for those with Autoimmune Conditions. For pregnancy, check dosing with your doctor.
We recommend that you take Zinc and add Quercetin if you are exposed or get sick:

  • Zinc: 30 – 60 mg daily in divided doses
  • Quercetin: 1 gram twice/day. Phytosome: 500 mg twice/day

At BlumHealthMD.com we offer our signature Antiviral Bundle, with all the supplements you need to keep your immune system strong, plus a Mediterranean Food Plan to follow! Check it out here.

Reduce Cytokine Storm

The illness caused by coronavirus, COVID-19, can cause a “runaway train” of inflammation in some people, causing terrible tissue and organ damage that can lead to the worst outcomes. This group of herbs and supplements appear effective in turning off this overactive immune response and helping bring the immune system back into balance. 

These are generally safe to use for those with Autoimmune Conditions. For pregnancy check dosing with your doctor.

We recommend that you choose a minimum of 1 of the following and add more if you get sick:

  • Curcumin: 500 – 1000 mg twice/day. Choose absorption enhanced.  
  • EGCG: 4 cups daily or 225 mg daily.
  • Resveratrol: 100 – 150 mg/day
  • Melatonin: 5-20 mg/day

Remember, you should also be focused on improving the functioning of your immune foundations.  Here are the things you should continue to do for risk reduction:

  • Good gut health: which means lots of beneficial bacteria. Take a probiotic every day with at least 20 billion cfu of mixed strains lactobacillus and bifidus species and join our 10-Day Spring HealMyGut Coaching Program! 
  • Balanced stress hormones: Get a good night’s sleep and don’t overwork yourself during flu season. Stress harms your ability to fight viruses.  Practice some form of mediation daily.  Melissa, Blum Center’s Health Coach,  wrote a great blog with tips for managing stress during this time. 
  • Eat foods that are good for your immune system: Avoid processed foods and focus on fruits and veggies that are rich in antioxidants and vitamins. Support the removal of toxins by eating lots of cruciferous veggies, which boost the detox system in your liver.

Sending prayers and good wishes for you and all of us to stay safe and well during this challenging time!

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It’s Flu Season – Is the Flu Shot Right for You

Every year, this is a common question I get asked from our patients and also submitted by the public on social media and online. This year it’s even more confusing and the answers aren’t easy for many with chronic illness or autoimmune conditions.  It doesn’t help that public health officials and the media are promoting the flu shot as a critical part of the fight against COVID-19.  The main concern is that people could get both illnesses at the same time, which would increase the risks of severe complications or death if this happened.  

However, let me just add a few words of calm into this storm.  First, if you are a high risk person and quarantining this winter, or at least being extremely cautious and wearing a mask and maintaining social distance guidelines when outside your home or your “quarantine bubble”, then you are unlikely to get either the flu or Covid.  The same measures you are doing not to get coronavirus will drastically reduce your likelihood of getting the flu.  

I think we need to continue to discuss the flu shot in the same context that I have talked about it for years.  In my opinion, all medical decisions should be based on comparing the risks vs. benefits of any medication or treatment for each individual person. This approach is called Personalized Medicine, and how we approach all treatment decisions through the lens of Functional Medicine at Blum Center for Health.  What is good for your friend might not be good for you.

IS THE FLU SHOT RIGHT FOR YOU?

In general I do recommend the flu shot, especially this year, for people who could likely become hospitalized or die from getting the flu: children, anyone over 65; those with pulmonary or respiratory diseases like asthma and emphysema; and people with any chronic illnesses like cancer or severe/life threatening illnesses.  And for those at high risk of becoming hospitalized or dying from COVID:  people with obesity, diabetes, high blood pressure, cardiovascular disease.  Also important to note, if you are a caretaker for the elderly or anyone at home who fits the criteria above, or if you are a parent to children living at home, these would be additional situations you need to keep in mind as accepted indications for receiving the influenza vaccination.  And this holds true for this winter, during the COVID pandemic.

However, on the flip side, some people with autoimmune conditions, or who take immune suppressing medications, should talk to their doctor before getting the shot.  The aluminum used as adjuvants, and the mercury used as preservatives, can cause side effects or flares for those with autoimmunity, and those on certain immune suppressing medication might not even become immune after getting the vaccine.  For you, it is a personalized decision and I cannot give you medical advice about that here.  But it might be that during this pandemic, your decision might be different than it usually is.

In either case, my approach is to help you build a strong immune foundation so that you don’t get sick from any virus. A strong immune system is the basis for staying healthy in general, and should be a year round strategy…not just during flu season. This is, by far, the best prevention and protection! 

Click here for more on supplement recommendations to strengthen your immune system.

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5 Ways to Protect Yourself From the Flu and COVID-19 This Fall and Winter

As we move into fall, many people are asking, “What is going to happen when COVID-19 meets influenza and the common cold? What can I do to protect myself?”  Beginning this fall we will have to deal with a flu season wrapped in a global pandemic. Many experts are expecting it to be the “perfect storm.” 

One thing we know for sure is that COVID-19 is deadly, and it does not seem to be seasonal. Remember in March when many people believed it would “die off” in the summer when actually it surged?

We can only expect that COVID-19 will complicate our upcoming flu season.

But, there are very tangible steps you can take to protect yourself.  We’ve got you covered!

This is exactly why Dr. Blum created Immune System Strong — an 8-week LIVE online course designed to fortify your immune system to fight viruses, like COVID-19, influenza and the common cold as we move into flu season Learn more here

5 Ways to Protect Yourself From the Flu and COVID-19 This Fall and Winter

The basics: As we move indoors it will be important to wear a mask in public places at all times, and wash your hands throughout the day. COVID, influenza and the common cold are all spread person to person through respiratory droplets — talking, coughing, sneezing — from contaminated surfaces and by direct touch. So come winter, you will be protecting yourself, and others, from not only COVID, but also influenza, pneumonia and the common cold. 

Make sure your immune system is functioning at its absolute best. Since over 75% of your immune system lives in your digestive tract, your gut plays a key role in your body’s ability to defend itself against infection. It is imperative that your gut is in top working order. Signs your gut needs attention: gas, bloating, constipation, diarrhea, heartburn, food intolerances, undigested food in your stool, feeling tired or lethargic. If you get sick a lot, this is an absolute must-do. 

Eat an immune-boosting diet. Food is medicine, or food can be poison. Minimize immune-suppressing foods, such as sugar, processed foods, refined carbs, fried foods, vegetable oils, artificial anything and alcohol. 

Maximize vegetables, fruit, olive oil, whole grains, nuts, seeds, fermented foods and healthy fats, like avocado and wild caught salmon.

Detoxify your body and your environment. We live in a world filled with toxins that can harm the immune system (and even trigger autoimmune disease). These include pesticides/herbicides, hormones and plastics in food and water, solvents and mold in our homes and heavy metals in the fish we eat and water we drink. Others can come from cosmetics and products we use at home. 

Consider supplementation. There are targeted supplements that will support your immune system and make your body less hospitable to viruses. These include Vitamins A, C, and D3, Zinc, N-Acetylcysteine, mushroom extracts, and herbs, such as elderberry, astragalus, and echinacea. Not all of these are appropriate for everyone. If you have an autoimmune disease, the mushrooms and herbs may not be right for you. 

If you’re as concerned as I am about shoring up your immune system to protect yourself from infections like COVID-19, influenza and the common cold as we begin to move indoors, consider joining Dr. Blum and me for our new course — Immune System Strong. Four LIVE classes with Dr. Blum, 8 coaching calls with me, you’ll learn exactly what you need to do to fortify your immune system. We begin soon! Learn More

 

Meet Melissa: Melissa Rapoport is the Manager of Health Coaching and Lifestyle Programming at Blum Center for Health in Rye Brook, NY. She combines her graduate work in Developmental Psychology with her education in nutrition, health and coaching to create highly individualized programs that result in lifetime change. A contributing author to three international bestselling books, Melissa’s greatest joy is her relationship with her two daughters. To learn more about Melissa’s coaching practice at Blum Center for Health, click here.

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Your Autoimmune Disease and COVID-19

It’s September!  I don’t know about you, but this is usually this time of year I am preparing to buckle back down to work after a summer spent outdoors, with some of it on vacation. If you are raising school age or college kids, and this is usually back-to-school time.  

But, as we are in the midst of an infectious disease pandemic, these are not usual times. In fact, as we are preparing to move into fall, you might be struggling through and muddling along, coping with coronavirus and hoping not to get COVID-19, the illness that is caused by this virus.

But some of us worry more than others about what would happen if we get this virus.  I am thinking about all of my autoimmune patients, who have been writing and asking me very specific questions about how their autoimmunity might change their risk, and what to do about the supplements they should take to prevent the virus from making them very sick were they to be exposed.  I decided to write this blog to answer these questions all in one place.  For all of my autoimmune patients, clients, friends and family, this is dedicated to you!

Does my Autoimmune condition put me at a higher risk for getting very sick if I get COVID-19?

The most important thing to understand is that there are over 100 different autoimmune conditions and they are all different.  Thus, it is hard to answer this with a quick answer.  But there are some guidelines that you can follow:

FIRST: There is no evidence that your Autoimmune disease itself puts you at a higher risk for getting very sick with COVID-19.  The underlying imbalance in Autoimmunity, where the immune system is mis-directed and attacks your own body, hasn’t been identified as a risk factor. 

However, in studying the underlying mechanisms of autoimmunity in people with systemic rheumatological diseases like Lupus (SLE), Sjogren’s Syndrome, Scleroderma, Polymyositis among others, researchers have found that while part of the immune system is overactive, the lymphocytes that fight viruses might be underactive.  

Therefore, if you have one of these conditions, you might be at a higher risk of getting COVID if you are exposed.  But there are supplements you can take to boost this part of your immune system, and I will share that below. 

SECOND: If you have an Autoimmune condition, is that you might have secondary issues like weight gain, high blood pressure, or disease-specific issues, like increased risk for making blood clots, and other possible problems that would influence your risk.  To determine if your specific Autoimmune issue could be putting you at risk, you need to check with your doctor.

THIRD: If you are taking immunosuppressant medications to treat your condition, you are definitely at increased risk for getting sick because these medications can reduce your ability to fight the virus, and you should follow the strictest social distancing and mask wearing guidelines.  

That being said, never stop your medication on your own.  But it’s good to set out a goal for being able to stop.  First, meet with your doctor and see if you have any other options.  Second, from my perspective, using a Functional Medicine approach and treating the underlying issues like repairing the gut microbiome and reducing toxic load, it is possible to taper off medication as you feel better and your condition improves.  

If I get COVID-19, will my Autoimmune Disease get worse?

There is no information that I have read about people with Autoimmunity and what happens to their illness when they have COVID-19.  But based on medical logic and experience, my guess is that your current health issues are likely to flare and get worse if you were to get sick.  This might be triggered by the virus itself, but more likely from the widespread immune and inflammatory reaction the body mounts against the virus. If your Autoimmune disease is very active and you still have symptoms and are still struggling, consider yourself at high risk and practice stricter social distancing and mask wearing.

Which immune-boosting supplements are good for me and which one’s should I avoid?

I have a great Blog on supplements for boosting immunity to fight coronavirus.  You can read it HERE.  For this discussion, I want to zero in on the concerns of my patients with Autoimmunity.

GOOD FOR EVERYONE: First, here are the categories of supplements that are all completely safe for all of you, and my previous blog reviews the dosing:

  1. Antioxidants:  Vitamins A, C, Glutathione, NAC, Quercetin, EGCG
  2. Antiviral and Immunomodulators:  Zinc, Vitamin D
  3. Anti-inflammatory:  Fish oil, Curcumin.

See dosing  HERE.

IF YOU HAVE AN AUTOIMMUNE CONDITION: You need to choose supplements carefully.  The concern is that these are immune boosting, which means they stimulate an increase in your natural killer cells.  On one hand, this is a great thing for fighting viruses.  However, for some people with autoimmunity, this could conceivably make your condition worse, although this is a theoretical concern because there haven’t been any studies on this.  Therefore, I recommend you check with your health practitioner before taking these.

Immune Boosting Supplements:  take with caution

  1. Mushrooms:  maitake, reishi, shitake, beta glucan
  2. Astragalus and echinacea
  3. Elderberry and Andrographis

If you’d like to learn more about how to use supplements to protect yourself from viruses, like COVID-19, consider joining my new LIVE course, Immune System Strong, led personally by me! Learn More 

What can I do to reduce my risk of getting very sick with COVID-19?  

Let’s end this blog on a high note!  There is plenty you can do to improve your immune function and reduce your risk of getting sick with COVID.  These same steps will also help repair your immune system and reverse your Autoimmune condition.  My main focus as a Functional Medicine physician is on the foundations of a healthy immune system:  food, stress, gut health, toxin load, oxidative stress and inflammation. 

The popularity of these questions is exactly why I designed a new just-in-time, 8-week program called Immune System Strong to teach you in real time with verified, no-nonsense information on how to fortify your immune system to fight viruses, like COVID-19, as we move into winter flu season!  We begin soon! Learn More

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The #1 Thing You Can Do For Your Immune System Starting Today

So, let’s be real … with COVID still sweeping through communities, you might be wondering what you can do to protect yourself as we move into the flu and cold season. Yes, very soon, we will be moving indoors with closed windows and that begs the question, “How will I keep myself safe?”

With over 70% of your immune system living in your digestive tract (yes, that’s true!), it makes sense that the food you eat is the first stop in empowering your immune system to fight infections and keep you healthy. 

There are foods that are particularly good at boosting immunity, but the reality is the first order of business is to use “food as medicine” to reduce inflammation. Often when I talk with people about “reducing inflammation” their eyes glass over. It’s not easy to grasp.

Inflammation. When it’s on the outside, like arthritis, we can see it.  When it’s on the inside we can’t see it. And often we can’t even feel it. (Although I’ve heard so many times, “I didn’t realize I wasn’t supposed to feel that way.”) But if you get sick often, if you’ve taken lots of antibiotics in your life, if you’ve had stress or trauma, or if you eat inflammatory foods (like sugar) or the Modern American Diet, you’ve likely experienced inflammation. In fact, you’re likely inflamed right now.

Inflammation is when your immune system or other cells in your body release irritating chemicals that cause irritation on the inside.  Remember this is a normal process because this is how your body fights infections or an injury, and the inflammation resolves once the infection or injury is over.  

However, if high levels of these inflammatory chemicals are released continuously (which can happen if you are eating a lot of SUGAR), the normal functioning of your cells can be interrupted, and healthy tissue gets damaged, including your immune system. This is not so good-especially since more and more studies link inflammation in the body to many serious illnesses and conditions.

To make sure your immune system is in tip top shape, which will protect you from foreign invaders like COVID-19, influenza and the common cold, it’s important to avoid processed foods and eat an anti-inflammatory, antioxidant-rich diet, full of vegetables, fruits, cultured foods, healthy fats, planted-based proteins and minimal animal protein.  

If there’s only one diet change you choose to make it’s this: 

GET RID OF SUGAR TO REDUCE INFLAMMATION!

Sugar is inflammatory and suppresses your immune system. Sugar stimulates your immune cells to actively release inflammatory molecules that travel throughout your body causing damage and irritation. 

Avoid high glycemic foods like soda, white flour and processed sugar. When it comes to sugar, you always want to choose low-glycemic vs. high-glycemic foods. The glycemic index determines how quickly a particular food raises your blood sugar level. High blood sugar causes inflammation and damages your immune system, and puts you at risk for diabetes, high blood pressure, and cardiovascular disease. Any food processed with white sugar or white flour is high-glycemic and should be eliminated. That means bagels, breads, breakfast cereals, cakes, cookies, crackers, candy, and soda.

Avoid an over-focus on carbohydrates as the main source of calories for the day. Make your plate for lunch and dinner half vegetables — that’s a great start. Natural, unprocessed foods, like fruits, vegetables, legumes and whole grains provide health-promoting vitamins, minerals, fiber, and phytochemicals — all good for your immune system. Use rice and other grains like condiments.

Read the labels of everything that comes in a package. Food manufacturers are sneaky. They often add sugar (and a lot of sugar) to foods that need very little sugar. Yeah, I know our panels are in grams. Definitely annoying, but here’s what you need to know: We recommend keeping your added sugars at about 24 grams. And, 4 grams of sugar = 1 teaspoon. So, if that granola bar you love has 24 grams of sugar — that’s six teaspoons (and your allotment for the day).

Here are some substitution suggestions for common high glycemic foods: 

Do you like soda, fruit juice, sweetened drinks? Drink filtered water, herbal teas, mineral water, fruit-infused water.

Do you consume products with corn syrup, cane sugar, or any other added sugar (check your condiments!)? Try paleo ketchup, mustard, fancy vinegars, and herbs and spices, such as basil, cinnamon, cumin, dill, garlic, ginger, rosemary, tarragon, thyme, turmeric.

Do you eat dried fruit, frozen yogurt, ice cream, sorbet, cookies, candy or other sweets? Try coconut milk yogurt with your own fruit, dark chocolate covered almonds and carob.

Do you typically eat pretzels, potato chips, corn chips, cookies and crackers made from white flour, muffins, waffles, pancakes, popcorn or bagels? Switch to gluten-free whole grain cookies, gluten-free almond meal crackers with hummus or guacamole, nuts, seeds, fresh fruit. 

P.S. If you’re as concerned as I am about shoring up your immune system to protect yourself from infections like COVID-19, influenza and the common cold as we begin to move indoors, consider joining Dr. Blum and I for our new course — Immune System Strong. Four LIVE classes with Dr. Blum, 8 coaching calls with me, you’ll learn exactly what you need to do to fortify your immune system. We begin soon!

Meet Melissa: Melissa Rapoport is the Manager of Health Coaching and Lifestyle Programming at Blum Center for Health in Rye Brook, NY. She combines her graduate work in Developmental Psychology with her education in nutrition, health and coaching to create highly individualized programs that result in lifetime change. A contributing author to three international bestselling books, Melissa’s greatest joy is her relationship with her two daughters. To learn more about Melissa’s coaching practice at Blum Center for Health, click here.

 

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The Never Ending COVID-19 Summer and What to Expect This Fall

It’s been a while since I wrote or spoke on the Public Health issues with COVID-19 swirling around us.  When the pandemic started I held open live office hours every Friday for about 8 weeks to answer your questions, and to share my Public Health expertise to make sense out of what we were going through collectively. 

As our long summer days at home (and hopefully outside, too) come to an end, I feel the need once again to provide information and to offer my view of where we are and what to expect as we are now moving into the fall.

THE GREAT MASK DEBATE

Public health is the understanding that decisions need to be made by the government to protect the health of the public — with the known understanding, and acceptance, that these laws or rules can infringe on someone’s personal liberties. The idea is that individual people need to sacrifice some personal liberties for the sake of the community.  

Public health has always been the place where there has historically been tension between individual rights and the collective.  And nowhere has this been on grand display but in the United States for the past few months and the great debate over whether it’s ok to make people wear masks. 

While in many places in our Country you are seeing a shift toward individual sacrifice for the greater good, not everyone feels this way. I am not saying this to make a political statement, but to point out this has always been understood as a classic public health dilemma, and we are seeing it play out right before our eyes.  

Evidence continues to mount every day proving that wearing a mask slows the virus spread, and my hope is that this battle will finally end.  We seem to be moving in the right direction.  But the battle lines have already been drawn, and I expect other public health initiatives (like vaccines) to be met with resistance in many parts of the country.  Our country’s internal war has added to the stress and burden that we all carry during the pandemic.

WHEN WILL COVID-19 END?

I am not terribly optimistic. Get used to your current living situation, or make plans for the winter now, because I predict we will be living like this until Spring 2021.  Here are the various ways we will get out of the pandemic, with my rating of the likelihood of each one:

COVID-19 VACCINE

We still don’t know how long immunity lasts, which means that even if we get a vaccine, we don’t know how long it will protect you. Any early vaccines will be fought over between all the countries of the world, and in our country, it will be doled out, based on who-knows-what formula. Which means that I wouldn’t expect the general public to have anything until next spring. Which suits me just fine, because I wouldn’t recommend being the first guinea pigs to get the vaccine for the first few months anyway!  

Bottom line: Don’t count on the vaccine to save you this winter.  Hopefully there will be available vaccines that work by the spring. And…be prepared for the possibility that no vaccines will work.

BETTER COVID-19 TREATMENT 

Some promising drugs are out there, but there hasn’t been a centralized effort to get enough doses produced to distribute to everyone. Remdesivir is a good example of a drug that has been shown to work in hospitalized people to reduce virus load and decrease hospital stay.  It has been distributed to only some hospitals, and even those hospitals are now running out. Everyone is fighting for a share of the limited supply.  Without a national response, treatment is hodge-podge depending on what hospital you go to, and which state you are in.  And there is the issue of affordability now that the drug company is charging full cost going forward. This in my opinion has been a disaster.  I think we won’t get this organized until there is national leadership on this issue.  

There are some interesting new treatments in the pipeline, but I don’t expect we will see them before the winter if they even prove effective.

Here’s one:

https://www.scientificamerican.com/article/costa-rica-readies-horse-antibodies-for-trials-as-an-inexpensive-covid-19-therapy/

And this one I think is really interesting:

https://www.ucsf.edu/news/2020/08/418241/aeronabs-promise-powerful-inhalable-protection-against-covid-19

Bottom line: Don’t count on life going back to normal again this winter based on the treatments that we have so far.

HERD IMMUNITY 

Think of herd immunity as something that happens when the virus runs its course through a population.  It keeps going until it infects enough people and then fizzles out because there aren’t enough uninfected people to keep it burning.  Public health dogma has always been that at least 50% of people need to be infected for this to happen, and we are far away from this number.  Unless there is a drastic change in our approach or some big medical breakthrough (which would be GREAT), this virus will continue like a forest fire that will keep burning until it’s done.  If this is the scenario, then we will all be home perhaps longer than next spring.  

HOWEVER, cases have started leveling off in our country (probably due to more widespread mask wearing and social distancing) and some areas are doing well, like here in NY.  I am wondering if the virus might also be slowing down in some areas (like NY) because there is more immunity in the community then we think, and/or that herd immunity is being reached sooner than we expected in areas that saw the worst outbreaks. These are intriguing ideas and I am hoping these are true!  

Bottom line:  Even if there are pockets of immunity to the virus, most areas are still very susceptible and this fire will continue to burn well through the winter.

BEST CASE COVID-19 SCENARIOS

OK, now that I’ve been a real downer, I will end this blog by sharing what I hope will happen.  This is the information you should be looking for in the news to give you some optimism.  

Here is what to pray for every day:

  1. Antibodies to the Coronavirus last at least 1 year after infection or vaccine, and protects you from reinfection.  This is a requirement for almost everything else to work!  
  2. A mutation in the virus makes it less deadly (this is the one that I pray for the hardest because it doesn’t rely on humans to figure out the solution).  I think there is a fairly good chance this might happen.
  3. Herd immunity happens much sooner than anyone thinks.  Some new mathematical models suggest for this virus, it could be 20-30% of the population instead of 50-60%.  This would mean the forest fire would still rage unchecked for months, but self-extinguish sooner.  There are signs this might be happening!
  4. The people in our country unify around best public health practices to slow the spread and save lives. I pray that our internal war on Public Health will end.

WHAT YOU CAN DO TO BOOST YOUR IMMUNE SYSTEM

It is frustrating to have such little control over the world around us. But you can feel more empowered if you take control over your own health. Making sure your immune system is primed and ready to go, just in case it encounters the coronavirus, should be your number one job during the pandemic.  

I have written before in previous blogs about supplements, but my main focus as a Functional Medicine physician is on the foundations of a healthy immune system:  food, stress, gut health, toxin load, oxidative stress and inflammation.   If you haven’t read my book on this topic, The Immune System Recovery Plan, what are you waiting for?!  

I have a lot more great info coming out in the next weeks and months on this topic.  To start, check out my FREE 3-part video series!  How To Boost Your Immunity and Resiliency to Viruses: DOWNLOAD FREE NOW

Keep your eyes peeled for my new LIVE course: Immune System Strong!  Slated to start late September (it will be here before you know it!) Immune System Strong will feature 4 LIVE classes with me that feature tangible next steps that you will be able to implement immediately, as well as community, accountability, group coaching and access to the answers you need on a daily basis.

Details will be available soon! Get On The First-To-Know List (even if you’re only a little bit interested), because we’ll be rewarding with an offer that won’t be available to anyone else.) I want the special reward!

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Can Vaccine Repurposing Help During Covid-19?

With the imminent arrival of fall there are many unanswered questions about how we will be functioning in the world with COVID-19. Will schools be open? Will we have to go on lockdown again? What happens when the cold and flu season hits and we are also dealing with a variety of other common seasonal viruses? 

As I have been advising patients through this entire process, my approach has evolved: information we knew early on has drastically changed; whereas once the use of mask wearing was in question, there is now no doubt that it is essential in significantly decreasing infection from COVID-19. This has led to a lot of confusion as people try to make sense of the latest data and is complicated by some offering up doubts and conspiracy theories. This makes for a good book, but one story I would rather us not be living in.

What is quite clear to me is that we will not have a vaccine in time for the fall flu season. 

So what more can we possibly do?  

I think a reasonable possibility at this time might be the exploration of repurposing existing older vaccines. Last year, my area in Rockland county New York had a major outbreak of measles. A disease that we had not witnessed in many decades began to re-surface. 

Prior to this many susceptible populations, like newborns and infants, were protected by what is known as herd immunity. Herd immunity works only if a significant portion of the population has immunity against the disease. 

As a result, my son’s school was shut down for a period of weeks until the unvaccinated were vaccinated, and the number of cases began to significantly decline; an interesting precursor to times ahead. But now we know on a magnified scale of that event and dealing with a virus we have just started to understand.

The question now becomes: can we support our immune response in an unprecedented time like this?

I recall reading some research as early as May of this year where expert virologists had suggested that giving the Polio vaccine, one that most of us have received, may stimulate the body’s innate immune system in such a way that it could provide protection from a more severe manifestation of COVID-19*.  

Mind you, this is the live oral polio vaccine which is no longer offered in the United States but still available in other countries. We now have an injectable inactivated form of the vaccine. There is a push to do more research in this area and hopefully be able to bring this therapy available to the U.S. again. Dr. Robert Gallo, the director of the Institute of Human Virology at the University of Maryland School of Medicine and co-founder of the Global Virus Network, a coalition of virologists from more than 30 countries, is leading the push for this cheap and easily accessible preventative strategy. 

How does that information help Americans since we can’t access that easily?  Recently, another report hypothesized, with supportive rationale, similar effects from the Measles Mumps Rubella (MMR) vaccine –the same one you need to get immunity against measles. The report discussed the potential protection in dampening the severe effects associated with COVID-19 infection. And, many of us have had waning immunity to vaccines we got a lifetime ago.  

Referencing the measles outbreak last year, many people in the New York area began to look at their measles titers to see if they had immunity.  Interestingly, many found that they no longer had adequate protection against measles and sought to revaccinate again. So, a thought occurred to me: maybe this is a great time to do testing for MMR titers. If there is an indication that there is a blunted immune response, then revaccinate. It’s possible that by doing so, you may offer some level of protection against COVID-19. If you are living outside of the U.S. where the oral polio vaccine is offered, that may be yet another option you have.

As a natural “prepper” (I like planning in general and preparedness for unexpected life events like hurricanes and superstorms have led me to think more catastrophic possibilities these days), I urge you to get your MMR titers tested, and consider this possibility of re-vaccination as another layer of protection as we all prep for the coming months.

 

 

Pamela Yee, MD is an Integrative Physician at Blum Center for Health in Rye Brook, NY where she creates highly personalized treatment plans for each of her patients. Dr. Yee has a special interest in integrative cancer care, immune disorders, and lyme disease. She lives in Nyack NY where she and her husband manage their own organic micro-farm.