Category: Immune System

Covid is Here to Stay

It’s pretty clear that COVID is here to stay. It continues to not only infect new cases but continues to wreak havoc in the already infected longer than the traditional medical model previously considered possible. Long COVID is a poorly understood constellation of symptoms (both mental and physical) that persist for more than 2 months after infection of COVID that significantly impacts a person’s life and isn’t explained by an alternative diagnosis (Mikkelsen & Abramoff, 2023).

Long Covid Symptoms

The most common symptoms in long COVID are fatigue, difficulty breathing, joint pain, chest pain, and cough (Sudre & Et.al, 2020), but we are often seeing brain fog, anxiety, dizziness, and difficulty in regulating heart rate and blood pressure. Symptoms can also change day to day. We don’t know what causes long COVID and its unclear who is at most risk of developing long COVID due to conflicting reports. What we do know is 87% of patients hospitalized with COVID will still experience symptoms after 2 months (Carfi, Bernabei, & Landi, 2020), so this is not an uncommon issue. Meanwhile, most patients do start to see improvement in their symptoms in 4-9 months (Mikkelsen & Abramoff, 2023) even without intervention.

Why Do Some People Get It?

So, what is causing long COVID? We aren’t sure. There are a few ideas, but it boils down to the following themes: reactivation/reemergence of COVID or other viral illnesses like Epstein Barr virus (Gold, Okyay, Licht, & Hurley, 2021).  Other contributing factors are immune system dysregulation, energy metabolism defects, and imbalances of pro and anti-inflammatory processes.  

Treatment Options

Fortunately, as naturopathic physicians, we are very used to treating many of these proposed causes of chronic viral infections naturally. Data shows glutathione/NAC, antioxidants, quercetin, curcumin, magnesium all have potential to balance inflammation and treat spike protein related pathologies (Halma & Plothe, 2023). We can also use Ozone IVs and rectal insufflations to modulate inflammation and help the immune system to kill COVID viral particles (Cenci, Macchia, & ET.al, 2022). We can also use antiviral herbs like cat’s claw, lemon balm, and licorice that have evidence of very robust antiviral properties. We can use nutrients like acetyl l carnitine, alpha lipoic acid, vitamin C to help restore the energy metabolism defects.

Ultimately, treatment isn’t (and shouldn’t) be once size fits all.  Often we are supporting multiple body systems for overall improved health – helping the body to heal itself.   We customize our approach of testing and treatments to help address your long COVID symptoms and support your healing.

References

Carfi, A., Bernabei, R., & Landi, F. (2020, July 9). Persistent Symptoms in Patients After Acute COVID-19. Retrieved from JAMA Network: https://jamanetwork.com/journals/jama/fullarticle/2768351

Cenci, A., Macchia, I., & ET.al. (2022, April 21). Mechanisms of Action of Ozone Therapy in Emerging Viral Diseases: Immunomodulatory Effects and Therapeutic Advantages With Reference to SARS-CoV-2. Retrieved from National Library of Medicine: https://pubmed.ncbi.nlm.nih.gov/35531273/

Gold, J. E., Okyay, R. A., Licht, W. E., & Hurley, D. J. (2021, June 17). Investigation of Long COVID Prevalence and Its Relationship to Epstein-Barr Virus Reactivation. Retrieved from National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233978/

Halma, M. T., & Plothe, C. (2023, May 17). Strategies for the Management of Spike Protein-Related Pathology. Retrieved from National Library of Medicine: https://pubmed.ncbi.nlm.nih.gov/37317282/ Mikkelsen, M. E., & Abramoff, B. (2023, June 19). COVID-19: Evaluation and management of adults with persistent symptoms following acute illness (“Long COVID”). Retrieved from UpToDate: https://www.uptodate.com/contents/covid-19-evaluation-and-management-of-adults-with-persistent-symptoms-following-acute-illness-long-covid/print

Sudre, C. H., & Et.al. (2020, June 16). Symptom clusters in Covid19: A potential clinical prediction tool from the COVID Symptom study app. Retrieved from MedRxiv: https://www.medrxiv.org/content/10.1101/2020.06.12.20129056v1.full

Babesia is a little different from Lyme (borrelia) and Bartonella in that it is not a bacteria, but a parasite that is more similar to malaria than bacteria. Babesia has been found in all 50 states and likes to target the red blood cells. Babesia infection is often in addition to lyme infection as well and we often need to treat both.

Symptoms

• Symptoms vary from person to person but we tend to see more pulmonary involvement in Babesia.
• Most common symptoms are:
  • Shortness of breath with negative pulmonary tests, frequent sighing or air hunger, anxiety, night sweats and chills, flushing/hot flushes, the sensation of bugs crawling on your skin, pressure headaches on the top of your head.

Testing

• Like all tick-borne infections, testing is difficult. You can get antibody testing at a general lab or Igenix. These tests are often not very sensitive and can come back falsely negative.
• FISH testing: FISH testing is looking for unique RNA codes in Babesia. It has been the gold standard for testing Babesia and is available through Igenix.

Treatment

• Treatment has more in common with treating malaria than Bartonella or Borrelia.
• Prevention is the best cure! Here are some handy tips from Igenix on how to prevent Lyme disease. https://cdn.igenex.com/wp-content/uploads/2022-Lyme-Disease-Awareness-Month-Tips.pdf
• Herbal Treatment: The favorite herbs to treat babesia are Artemisia (wormwood), just like malaria. Other herbs that are effective are Japanese Knotweed, Cryptoleptis, Chinese Skullcap. Japanese Knotweed, Cryptoleptis, and Chinese Skullcap are luckily also effective at Lyme and Bartonella as well!
• Antibiotics: Antibiotics of choice are Bactrim, Atovaquone, and Azithromycin.
• Ozone therapy: ozone kills bacteria, viruses, and fungi.
• Treat other supportive body systems: address the thyroid, adrenal glands, vitamin levels, and multiple other organ systems to ensure your body can fight the Babesia and other co-infections.

As with the other co-infections and Lyme, I find it is easiest to assess which infection is causing the most issues symptomatically and start treatment focused on that microorganism, eventually expanding treatment to cover all co-infections as tolerated.  

Dr. Falkner has attended ILADS (International Lyme and Associated Diseases Society) conferences as well as has years of experience treating Lyme both naturally and with antibiotics.

For more information – here are more Dr. Falkner articles: 

• https://boisenaturalhealth.com/bartonella-a-lyme-look-a-like/
• https://boisenaturalhealth.com/lyme-disease/

Lyme disease is caused by the bacteria Borrelia Burgdorferi or Borrelia Miyamotoi (tick borne relapsing fever). This disease was first discovered in the 80s and is often categorized as acute disease vs chronic disease. Lyme disease has been documented in all 50 states, so even states with relatively low tick populations are not spared. Acute Lyme is fairly well recognized and treated in mainstream medicine, but there is contention over the existence of chronic Lyme disease and other tick-borne co-infections. This is because the symptoms are often migratory and span multiple body systems. Because of this lack of clear diagnostic tools and guidelines, it has been estimated that undiagnosed Lyme disease costs Americans $712 million to 1.3 billion dollars per year in treatment and medical visits (Aucott 2015). Lyme disease profoundly affects both patients and loved ones.

Symptoms

• Symptoms vary depending on each person and how long the bacteria have been in the body. Most common symptoms are as follows:
  • Swollen, painful joints; neuropathies; migraines; POTS and changes in heart rhythms and rate; sudden new onset anxiety; brain fog; fatigue; mood changes, GI symptoms.
  • Many of the symptoms are often migratory in nature (if pain) or come and go with seemingly no reason.

Testing

• Testing is notoriously difficult with Lyme because of its unique ability to change shape when exposed to antibiotics. CDC criteria is very exclusive and oftentimes does not recognize the changes in the immune system that Lyme can cause.
• General labs:
  • CD57 – this is a particular white blood cell that is “spent” fighting Lyme and other diseases. If low, likely an infection is causing symptoms.
  • Western blot – Not very specific. Most often will only detect 84% of positive Lyme cases.
  • Antibodies to Borrelia – also not super specific and Borrelia is particularly good at avoiding the immune system and not “following the rules” of the immune system.
• Specialized labs:
  • Igenix – We use Igenix laboratory as they are the gold standard of Lyme detection. Their testing is much more sensitive than the general labs. Average sensitivity is closer to 90-96%. This means that the test can catch up to 12% of Lyme cases missed by standard western blot testing. https://igenex.com/the-igenex-advantage/

Treatment

• Prevention is the best cure! Here are some handy tips from Igenix on how to prevent Lyme disease. https://cdn.igenex.com/wp-content/uploads/2022-Lyme-Disease-Awareness-Month-Tips.pdf
• Herbal treatment – There are many herbs including Japanese Knotweed and Cat’s Claw that are effective in treating Lyme. Herbal treatments are often easier to adjust the dosing to tolerance as well as easier to take long term.
• Antibiotics – doxycycline is the antibiotic of choice for Lyme.
• Ozone therapy – ozone kills bacteria, viruses, and fungi.
• Treat other supportive body systems: address the thyroid, adrenal glands, vitamin levels, and multiple other organ systems to ensure your body can fight the Lyme.

Lyme disease does not have to be forever. Treatment can take a long time, but there are many examples of patients improving their quality of life when diagnosed and treated appropriately.

Dr. Falkner has attended ILADS (International Lyme and Associated Diseases Society) conferences as well as has years of experience treating Lyme both naturally and with antibiotics.

The field of microbiome research is exploding, from autism to autoimmune disease and even branching out into the new field of psychobiotics (probiotics for mood/mental health). Ultimately, we are finding we are much more than just what we eat; many of our health parameters and even our quality of mental health are tightly linked to the bacterial community that lives in our gut. The microbiome refers to the balance of good and bad bacteria populations that live in our large intestine. Many factors can change the microbiome including even how we were born! Other things that can influence the microbiome’s health is eating fermented foods, exercise, food and alcohol habits, smoking, stress, and use of certain medications and antibiotics. An altered microbiome has long been linked to abdominal pain, altered bowel movements, and IBS.

The truly interesting and new info is that we are finally linking the microbiome to autoimmune diseases and diseases that are not classically thought of as GI diseases. Autoimmune diseases are where the body no longer can differentiate between self and foreign invader and will attack particular tissues that have been misidentified as “not ourself”. Lupus, rheumatoid arthritis, antiphospholipid syndrome have all been identified as possibly being started by disruptions in our microbiome. What might be more exciting is a Canadian research group was recently given a sizeable grant to study the potential treatment of ALS (Aka Lou Gehrig’s disease) with a specific strain of probiotics! This could be ground-breaking! Researchers are also calling for more research in the treatment of autism spectrum disorders with probiotics as well! I linked a few of the studies and articles below.

Naturopathic medicine always has believed that much of health is created in the gut and the basis of treatment in my practice for autoimmune diseases specifically has always been to begin with digestion. It’s nice to see science following suit and what we intrinsically knew many years ago is being shown to be correct.

Test your Gut Microbiome with a Simple Stool Sample
https://pubmed.ncbi.nlm.nih.gov/29920643/
https://alsnewstoday.com/news-posts/2022/02/25/1-6-million-canada-grant-supports-trial-probiotic-slowing-als-progression/

SARS-CoV-2 and other infectious pathogens enter the nasopharynx (nose-throat) to replicate.  One way to reduce your risk of covid and other respiratory illness with with  nasal rinsing.  Not just an old-as-time natural treatment, the conclusion of one study of people who tested positive covid revealed “participants initiating nasal irrigation twice daily for 14 days were over 8 times less likely to be hospitalized than the national rate.”   Many people are intimidated but its easy and done correctly, is not uncomfortable. 

Nasal rinsing vs nasal sprays

To be effective, we need to use a volume of water of at least 1 oz (30 ml) to 2 oz (60 ml) or more.  This is NOT the same as nasal sprays which are good for moisturization but are not enough to wash out the nose and back of the throat.

To wash your nose out, 3 things are needed:

1. Device to get the water up your nose.
   1. Positive pressure squeeze bottle system or machine
   2. Neti Pot which works with gravity
2. Water. It needs to be distilled or boiled for 5 minutes. Heating it to body temperature makes it more comfortable.
3. Saline solution.

The easiest way to get started:

NeilMed Sinus Rinse – available at most drug stores or online https://shop.neilmed.com/collections/sinus-rinse

NeilMed makes it super easy!  This company has everything you need including product options and instruction videos.  The saline packets are premeasured and inexpensive. 

If you want to make your own saline solution, here’s a basic recipe.  You can experiment with a little more salt and baking soda for comfort. 

• 1 cup warm water.  (250 mL) Distilled, sterile or boiled for 5 minutes.
• ¼ teaspoon of non-iodized salt and a pinch of baking soda.  No anti-caking agents or preservatives

For extra infection control you can add ½ tsp of 10% povidone-Iodine to the above saline solution (do not use if you have an allergy to shellfish or iodine).  Be careful as iodine stains. 

Another antimicrobial choice is to use 1 part 3% hydrogen peroxide with 2 parts of saline solution.

Webmd has a slide show that walks you through how to do it:

https://www.webmd.com/allergies/ss/slideshow-nasal-irrigation

More information:

Another option is Nasal Sprays.  Xylitol & Grapefruitseed Extract products have been studied with covid.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7645297/

This nasal spray called Taffix has been studied with covid.  It works by creating an acidic environment that lasts for 5 hours. 

https://taffixprotect.com/

A literature review about hydrogen peroxide in nasal rinse for covid.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262503/

Essential oils have been shown in studies to have antimicrobial as well as antiviral effects.  If you use essential oils in your nasal rinse, be careful as the oils can very easily irritate the delicate tissues.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612361/

Here is a summary of studies on this topic.

https://health-desk.org/articles/what-do-we-know-about-mouth-and-nose-rinses-washes-sprays-or-creams-to-prevent-covid-19

This is an informative 13-minute video of Dr. Amy Baxter talking about lots of ins and out of covid and nasal irrigation. 
https://paincarelabs.com/health-wellness/the-ins-and-outs-of-nasal-irrigation/