I wrote here on COVID-19 a few weeks ago, comparing it to SARS and MERS, and discussing immune support protection in general. Since then, obviously, things have changed a lot. I’ll spare you yet another reference to the euphemism “these uncertain times” (you’re sure to hear it seventeen more times today). But I do want to update you on the new information we have, and what it means for you.
Disclaimer: because there are no double-blind placebo controlled trials (there can’t be for something this new), I can’t make any claims of any particular therapies either preventing or treating COVID-19. I’ll tell you what we do know, though, and how we’ve drawn the conclusions we have.
Cytokines and Cytokine Storms
As we’ve all heard, those most susceptible to severe illness due to COVID-19 are the elderly, those with underlying health conditions, and/or those who suffer from confections of other organisms, including bacteria and fungi. Many of these other organisms may be drug-resistant. This sets the stage for what’s known as a cytokine storm. Cytokines are inflammatory second messengers of the immune system, designed to marshal the body’s forces to fight against a foreign invader. The more fronts on which the immune system is forced to fight at once, the higher the cytokines climb, and at a certain point become a bigger problem than the invader(s) themselves. In potentially deadly cytokine storms, cytokine levels increase 4000-5000 fold.
Arguments have therefore emerged that some natural therapies which stimulate cytokines should be avoided, due to concern that they might trigger a cytokine storm. One herb in particular that has sparked controversy has been elderberry/sambucus, which can increase cytokine production by 1.3-6.2 fold. This is clearly orders of magnitude below that of a cytokine storm (again, 4000-5000 fold), and there is no evidence that elderberry can induce this. Elderberry also confers quite a few positive antiviral benefits, as do other natural therapies such as echinacea and Vitamin D (discussed more below). These also boost cytokine production, to a much lower degree.
Studies are showing that those with the most severe cases of COVID-19 illness are almost universally low in electrolytes as well, and particularly low in potassium. This is because the virus attacks enzymes known as ACE (which also happen to be the targets for the popular blood pressure drugs called ACE inhibitors).
The herb astragalus also has an anti-inflammatory effect on lungs. It’s also antiviral, and was specifically studied and found to be effective for Avian flu. Additionally, it’s an adaptogenic herb, meaning that it helps to offset and balance out the effects of stress. Useful at the moment! 🙂
Zinc and Its Antiviral Properties
Zinc is one nutrient specifically recommended for coronavirus, having been shown to be effective against other strains prior to COVID-19. It has also been shown to block replication of Respiratory Syncytial Virus (RSV), and it is commonly deficient in the elderly, which may be one reason for increased susceptibility among older populations. But zinc needs help getting inside cells in order to do its job.
One zinc “helper” (aka ionophore) that is getting a lot of attention is the antimalarial medication hydroxychloroquine. This drug is speculated to help treat COVID-19 by halting the cytokine storm, and I wonder if its role as a zinc ionophore may be part of how it does this.
There are other non-pharmaceutical zinc ionophores as well. These include quercetin and EGCG from green tea.
Other Antiviral Herbs
Like hydroxychloroquine, the herb artemisinin has both antiviral and antimalarial properties.
Berberine is one of my favorite herbal extracts for other purposes, but it’s also a great antimicrobial. Two berberine-containing herbs, goldenseal and oregon grape root, have been studied for flu as well as for bacteria, which may help to treat some of those secondary infections that might otherwise trigger a cytokine storm.
As mentioned above, both echinacea and elderberry confer antiviral activity. Echinacea has actually been tested as a prophylactic against different coronavirus strains, and elderberry is effective against respiratory viral illness.
There has also been a debate about whether or not NSAIDs such as ibuprofen and aspirin are safe in those with COVID-19. The crux of the argument revolves around the fact that, while these do block COVID-19 replication, at the same time they also block antibody production, weakening the immune system’s response. This article makes the argument that there is not yet enough data to say one way or the other whether they are helpful or harmful.
That said, decreasing lung inflammation is certainly desirable. This study shows that the sleep hormone melatonin provides this benefit in RSV, so it stands to reason that it would have a similar effect against other viruses that target the lungs. And again, astragalus fits in this category too.
We’re all learning as we go. New data is coming out all the time for suggested treatments and preventative measures for COVID-19. But many of the old tried-and-true naturopathic antiviral therapies and respiratory treatments make good clinical sense, even for a novel strain of coronavirus like this one.
Meanwhile, let me just throw in here that fear and panic also tank your cortisol levels, which weakens the immune system. I’d highly recommend developing a meditation and/or stress management practice if you haven’t already done so! To get you started, here’s a meditation from my podcast on Psalm 91, one of the most comprehensive psalms to specifically combat fear in all its various forms.