IMMUNITY IN PRACTICE
The Institute for Functional Medicine reported that a coronavirus such as SARS-CoV-2 showed to trigger the NLRP3 inflammasome-mediated IL-1beta production, causing the uncontrolled release of pro-inflammatory cytokines, leading to a cytokine storm. Certain nutraceuticals and botanicals showed to be potent inhibitors of the NLRP3 inflammasome-mediated IL-1beta production, able to reduce a cytokine storm.
Question 1:
The results of medical research are classified by the strength of their evidence. On which basis is evidence evaluated classified as strong, moderate, limited or conditional?
Answer 1:
Strong: Two independent human studies demonstrating a correlation between intervention and patient oriented outcome; mechanistic plausibility or one additional independent human study required.
Moderate: Two independent human studies demonstrating a correlation between intervention and patient oriented outcome; mechanistic plausibility required.
Limited: One human study demonstrating correlation between intervention and outcome, or real-world evidence demonstrating patient orientated outcome. Must be accompanied by compelling Functional Medicine model factors and/or patient contextual factors and mechanistic plausibility.
Conditional: Human trails with conflicting outcomes, or lack of published human trails. Must be supported by extensive historical experience of effectiveness, consensus of expert opinion, mechanistic plausibility and compelling Functional Medicine model factors.
Question 2
Which nutraceuticals and botanicals are effective to fight off COVID-19?
Answer 2
| Agent | Benefits | Strength of research evidence | Commercial name or food items |
|
Curcumin 500-1000mg 2x/day |
Reduce inflammation and decrease viral activity for COVID-19 | Conditional |
Metagenics: Inflavonoid and Invlavonoid Intensive care |
| Quercetin
Regular: 1000mg 2x/day Phytosome: 500mg 2x/day |
Decrease viral growth | Moderate | Fruit and vegetables e.g apple
Linctagon: effervescent Metagenics: Immune active and Sinuplex |
| N Acetylcysteine (NAC)
600-900mg 2x/day |
Promotes the production of glutathione, the strongest antioxidant made by the body and reduces the severity of the flu | Limited | ACC 200
Metagenics: Immune active, GlutaClear and Sinuplex |
| Melatonin
5-20mg at bedtime |
Promoting restful sleep and reduce inflammation | Conditional | Circadin
Metagenics: Benesom |
| Elderberry (Sambucus nigra)
500mg daily
|
Rich in vitamin C, dietary fibre and antioxidants | Strong | Viral Guard
Sambucol
|
| Palmitoylethanolamide
(PEA) Prevention: 300mg 2x/day Treatment: 600-900mg 3x/day for 2 weeks |
Anti-inflammatory agent, shown to improve outcomes in acute respiratory disease and influenza | Strong regarding prevention
Conditional regarding treatment |
Metagenics:
Hemp Advantage Plus |
| Green tea or epigallocatechin gallate (EGCG)
4 cups daily 225mg daily |
Reduce inflammation, enhance immune system, involved in the inhibition of COVID-19 replication | Conditional | Green tea
Metagenics: Immune Active |
| Resveratrol
100-150mg 2x daily |
Activity against MERS-CoV | Conditional | Red grapes
Metagenics: PhytoMulti |
| Beta-glucans
250-500mg daily |
Anti-inflammatory and enhances immune system especially regarding upper respiratory track infections caused by viruses | Strong | Oats fibre
Viral Guard |
| Medicinal mushrooms | Antioxidant and anti-viral effects | Limited | Metagenics:
Andrographis Plus |
| Chinese skullcap (baicalin or baicalein)
750-1500mg daily |
Enhances innate immunity, reduces viral growth and lung specific inflammation | Limited | Metagenics:
Candibactin-BR Nazanol |
| Licorice root (glycyrrhizin)
200-400mg daily |
Supports immune function and reduces viral growth | Moderate | Metagenics:
Licorice Plus, and Echinacea Synergy |
|
Andrographis paniculate 100-600mg daily of 30% andrographolides |
Inhibition of furin protease
Priming innate immunity Viral inactivation |
Strong |
Metagenics: Andrographis Plus |
|
Astragalus Membranaceus (in dried root powder form) 1-20mg daily |
Priming innate immunity
Inhibit viral binding and promote viral inactivation |
Conditional
|
Metagenics: Nazanol |
|
Berberine 500mg 2-3x/day |
Priming innate immunity
Aldose reductase inhibition Promoting viral inactivation |
Limited | Goldenseal
Goldthread Metagenics: Berberine GT |
| Echinacea | Priming innate immunity
Promoting viral inactivation |
Strong regarding prevention
Conditional regarding treatment |
Airmune Metagenics: Echinacea synergy |
|
Luteolin 100-200mg 2-3x/day |
Inhibition of SARS-CoV infection.
Binding to viral S protein and furin. Promoting viral inactivation. Anti-inflammatory |
Conditional |
Fruit and vegetables e.g. peppers, celery, chicory and lemons Metagenics: Echinacea synergy and Perimine |
Question 3
How do I use previously mentioned supplements, nutraceuticals and botanicals during the prevention, infection, escalating inflammation, and recovery timeframes of a COVID-19 infection?
Answer 3
| Supplemen-tation | Prevention | Infection | Escalating inflammation | Recovery | |
| Foundation | Vit D: 5-10 000 IU
Vit A: 5-10 000 IU Zinc: 60mg Vit C: 1g or more Melatonin: 3-10mg Quercetin: 500mg Fish oil: 3g Potassium rich food |
Yes | Yes
Increase potassium in the diet |
Yes
Increase Vit C according to bowel tolerance
|
Yes |
| Antioxidant support | N-Acetyl Cystein (NAC):
Glutathione (GSH) |
Yes
If possible |
Yes
If possible |
Yes
Yes, emphasis during inflammation |
Yes |
| Innate immune (NK cell) support | Choose any 2:
Astragalus Andrographis Reishi |
Yes | Yes, emphasis during infection | Stop | Stop |
| Adaptive immune (Th1) support | Choose 1:
Berberine Baicalin Echinacea Goldenseal |
Yes | Yes, emphasis during infection | Stop | Stop |
| Anti-inflammatory support | Choose 1:
Curcumin Bromelain Resveratrol Sulforaphane Boswella |
Yes | Stop, continue with known CRP elevation or highly inflammatory underlying condition | Continue with known CRP elevation or highly inflammatory underlying condition | Continue with known CRP elevation or highly inflammatory underlying condition |
MINIMUM SUPPLEMENTATION: VIT C, VIT D, ZINC
Janet has worked in the field of dietetics for 20 years. She commenced her career in local hospitals, before moving on to the private sector as a private dietitian.
She has also co-authored health recipe books and is currently working at a gymnasium where she specializes in sport nutrition. Furthermore, from time to time she also locums as a dietitian for a prominent rheumatologist in Pretoria. She is married and has three children.
