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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

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. 
  • 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 Coachwrote 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 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.

 

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HOW TO HANDLE CANCER DURING THE PANDEMIC

Do you have a health condition, like cancer, that you’d normally seek medical care for but you haven’t during the coronavirus pandemic?  Is this because you think you’re safer at home and going out would risk infection, or your usual physician is not available to see patients?  You aren’t alone.  

One of the most disconcerting things to me as a physician during this pandemic is that the other medical conditions people have been suffering with have mysteriously disappeared.  It makes sense that emergency rooms have noted a dip in occurrences like car fatalities and injuries since many of us are not out and about driving. However, what about heart attacks and strokes?  These are time-sensitive events that if treated early, make a significant difference in someone’s survival.  Many people are afraid to call an ambulance or go to the ER with concerning symptoms like chest pain or sudden weakness in parts of the body because they fear they will get infected with Sars-CoV2.  And unfortunately this is leaving many people to die at home or they are left with permanent disabilities because they received medical attention too late.  These are not conditions where the wait-and-see approach works.

SCREENINGS FOR CANCER DURING THE PANDEMIC

Have you been due for your regular screening colonoscopy or mammogram and have delayed calling to make that appointment because it isn’t an emergency or you decided it can wait until we have some clarity about returning to normal life? Again, you are not alone.

In a typical year, roughly 150,000 cases of cancer are detected monthly in the US population.  As a physician specializing in Integrative Oncology, I am very concerned that people with signs of cancer – a new mass or lump – are not being assessed quickly enough and that these new cases are being missed in the earliest stages when treatment is most effective.  Many people have been choosing to wait until it is “safe” to make the phone call for an appointment.  Every doctor and health system is doing their best to create a safe environment for patients, and while we don’t have all the answers, it is now time to reach out to your provider through telemedicine and share your concerns so that you can create a plan of action together.

CANCER AND COVID

As someone with cancer during the coronavirus pandemic,  are you concerned about what you can do beyond secluding yourself at home? 

During the past 3 months, I have been hearing from many of my cancer patients with concerns about what else they can do. Whether they have a past history of cancer, or are actively in treatment, these patients are looking to have an action plan in place that will help when they are going to reintegrate into the world.  

During this exceptional time, it has also been more difficult for my cancer patients to find some semblance of security in their treatment or monitoring.  Many have felt that their diagnosis has taken a backseat to the pandemic at large.  One of my patients called for a telemedicine followup with her oncologist to find that he was recruited by his hospital to work in the ER managing COVID-19 patients.  Another patient was told to forgo treatment for one month due to a high risk of exposure; her tumor markers became elevated the following month.  Others have found that when they questioned their current regimen, they were told to stay the course until things resumed to a more normal format.  And just like everyone else, those with cancer are very reluctant to go to an ER (whether for a cancer related issue or anything else like heart attack or stroke symptoms), because they are known to be a high-risk category because of a weakened immune system. 

INTEGRATIVE ONCOLOGY

I have been practicing integrative oncology for well over 15 years, helping people to navigate through conventional treatments by offering ways to naturally mitigate symptoms from chemotherapy, radiation and surgery as well as exploring other areas of evidence based treatments that lie outside of the box of their oncologist.  Often, people seek me out to support their treatment nutritionally or to “boost immunity” during treatment, and this is a good place to start.  But then most people discover there is a plethora of other adjunctive possibilities outside of what their oncology team has offered.  Cancer is a diagnosis that I hope that one would consider all angles and possibilities and various opinions to help construct the most solid plan to move forward and try to conquer the disease.

One of the areas that I focus on is supporting immunity and treating immune issues with these patients.  It is interesting to me that many of the natural herbal and nutraceutical treatments that I have used in cancer for various reasons, have activity in some format against Sars-CoV2. For example, I’ve  utilized Chinese Skullcap (also known as scutellaria baicalensis) in both breast and ovarian cancers (as well as other cancers such as colorectal and prostate cancer) because of its anti-proliferative activity against tumor cells but interestingly it has a place in combating Sars-CoV2 by enhancing not only immune function but also possessing anti-inflammatory activity for a variety of cytokines and can potentially block the virus from attaching to ACE-2 receptors that are unique to this virus.  A good review can be found HERE.

The field of integrative oncology is immense and I have always gravitated to working with cancer patients for a number of reasons.  It presents an incredibly difficult time that often necessitates a change in mindset, which allows me to show people that this challenge is an opportunity not only to make positive and sometimes radical change in one’s life. It’s also a time to take control and not always assume that there is nothing out there beyond what the oncologist or surgeon is offering.  And with over 100 peer reviewed publications that come out daily, the field is constantly evolving and my work is never “protocol.”  These are just a few reasons why I find working with cancer patients extremely rewarding. The current pandemic adds yet another layer to work through with patients and I accept the challenges ahead.

 

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.

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COVID-19 Nutrition 101: Let Food Be Your Medicine! 

A walk through the grocery aisles early this morning was a little shocking: The produce section was overflowing and the packaged processed food aisles were … empty.

The Number One thing you can do to support your immune system is: Eat Real Food

Your immune system is fueled by the food you eat. After all, over 75% of your immune system lives in your digestive tract. This means that every bite of food you eat influences your gut microbiome, which in turn determines your body’s ability to mount the appropriate immune response to invaders like COVID-19. 

Stroll on by the cookies, the sweets, the empty-calorie crackers, the high sodium frozen dinners and opt for packaged foods with minimal ingredients. Take a peek at the ingredient list and use this litmus test, “Am I willing to eat each ingredient with a spoon?

Here are 6 no-nonsense things you can do right now to help boost your immune system and keep your body healthy.

Choose whole, nutrient-dense foods. 

Eat the rainbow! Focus on fruits and vegetables of all colors — They  are filled with antioxidants that support your immune system, and fiber that feeds your healthy gut bacteria. Choosing foods that mirror the colors of a rainbow ensures that you eat a large variety of vitamins, minerals, antioxidants, and phytochemicals that have enormous protective and healing powers.  

These rainbow foods are particularly good right now: 

Green produce helps boost the immune system and detoxify the body.

All healthy diets require green-colored produce and that is particularly true now. In fact, research suggests that green vegetables are the source of a chemical signal that is important to a fully functioning immune system. They do this by ensuring that immune cells in the gut and the skin known as intra-epithelial lymphocytes (IELs) function properly. (1)  Include green vegetables, such as arugula, asparagus, broccoli, Brussels sprouts, collard greens, green beans, kale, peas, romaine lettuce, spinach, swiss chard, and zucchini. Enjoy fruit, such as avocado, green grapes, and kiwi. 

Orange and yellow-colored produce help improve immune function.

Chock full of beta-carotene, a powerful antioxidant, vitamin A and vitamin C, these include vegetables, such as carrots, sweet potatoes, all varieties of winter squash, yellow summer squash, orange and yellow peppers and golden beets. It also includes fruits, such as oranges, grapefruit, lemons, mangoes, papayas, pineapple and peaches. 

Pro Tip: A great way to ensure you’re getting enough vegetables is to make your plate at lunch and dinner is at least half vegetables. 

Here are a few resources for getting organic, healthy foods delivered:

Check out Misfits Market — they will send you a box of seasonal produce at up to 40% less than what you would pay at the grocery store. (Use the code COOKWME-DY5XFK for $25 off.)

You might have access to a local CSA that will deliver to your door. Do a google search for your area or you can start with https://www.localharvest.org/csa/

Check out Butcher Box — they deliver 100% grass-fed beef, free range organic chicken and heritage breed pork directly to your door. 

Ditch sugar and processed foods.

The stress and anxiety of COVID-19, combined with “Sheltering at Home” creates the perfect recipe for craving sugary and processed foods — they temporarily make us feel energized but a big crash comes shortly afterward. Beyond that sugar and processed foods SUPPRESS your immune system. To help you kick the sugar habit, enroll in our 7-Day Sugar Detox Here

Eat high quality protein foods.

Protein is critical for immune function. What’s an adequate amount? Roughly half your bodyweight in grams a day. These include plant-based proteins, such as legumes and nuts and seeds, as well as organic, clean, humanely-sourced animal protein. 

Plant-Based Protein Superstars:

  •     1 cup cooked lentils = 18 grams
  •     3 tbsp. hemp seeds = 10 grams
  •     I cup cooked quinoa = 6 grams
  •     3 ounces extra firm tofu = 9 grams
  •     1 cup chopped broccoli = 8 grams
  •     ¼ cup raw almonds = 8 grams
  •     ¼ cup raw sunflower seeds = 7 grams
  •     2 tbsp. chia seeds = 6 grams
  •     2 cups chopped kale = 4.5 grams

Wild-caught salmon has 13 grams, chicken has 18 grams, and ground beef, 11 grams — all per 2 ounces.

Eat cultured and fermented foods to feed your microbiome and support immune health.

Include sauerkraut, kimchi, natto, chickpea miso, yogurt made from coconut or almonds. These foods give your body a dose of healthful probiotics — live micro-organisms crucial to a healthy intestinal microbiome (the microbial community in the gut) — which plays a role in supporting the immune system and warding off damaging inflammation inside the body. 

Make friends with mushrooms.

Mushrooms are medicinal!  They have immune-boosting polysaccharides that have anti-viral, antibiotic properties. Shiitake, maitake and oyster mushrooms are easy to prepare — a simple roast, sauté or simmer will do. In fact, you can throw them in everything — soups, omelettes, stir fries, stews, vegetable dishes. 

Add garlic, onions, cloves, cinnamon, ginger, turmeric, rosemary, oregano and more when cooking. 

These herbs and spices not only add flavor to your food, they are anti-inflammatory powerhouses. Add them to soups, stews, vegetables, oatmeal, or just about anything! Did you know that garlic and onions offer wide spectrum antimicrobial propertiess.

Drink plenty of fluids.

Your body depends on it, as does your immune system. Water and herbal teas,of course, but soups and broths also count! Stay away from fruit and vegetables juices — they are full of sugar (yes, even the so-called healthy ones.) 

Wondering what else you can do?

Join Dr. Blum’s FREE Friday Open Office Hours Q & A, to have all your lingering questions answered: Register Now

Schedule a 45-Minute Immune Support Consult with one of our healthcare practitioners.  Schedule an informational call here

Read my recent blog post: 10 Ways to Reduce the Coronavirus Stress Response 

 

Check out Dr. Blum’s FREE 3-part video series! Last month I led live classes on the immune system and I’m happy to share with you the three videos:  How To Boost Your Immunity and Resiliency to Viruses: DOWNLOAD FREE NOW

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.

Resources:

  1. Ying Li, Silvia Innocentin, David R. Withers, Natalie A. Roberts, Alec R. Gallagher, Elena F. Grigorieva, Christoph Wilhelm, Marc Veldhoen. Exogenous Stimuli Maintain Intraepithelial Lymphocytes via Aryl Hydrocarbon Receptor Activation. Cell, 13 October 2011 DOI: 10.1016/j.cell.2011.09.025