A Functional Medicine Approach to Pandemics
As a Functional Medicine doctor, I'm not on the front lines of the COVID-19 pandemic.
I am however, very much on the front lines of the chronic disease epidemic that has destroyed millions of lives and caused much more emotional and economical suffering than SARS-CoV2 ever will.
Since the beginning of this outbreak, it was clear to me that Functional Medicine practitioners can and will have an important impact on the trajectory of COVID-19 in our population.
In my own patient population, out of all the patients who have tested positive for SARS-CoV2/COVID-19, only 3 have felt like they were hit by a bus, and zero were bad enough that they had to be hospitalized.
This is largely due to the fact that my specific patient population is well equipped and healthier than the average American patient.
The current pandemic has forced us to reevaluate so much of how we've been living.
For me, it has given me a greater appreciation for helping people to achieve a level of health that now has a bigger meaning of self-preservation.
If this virus has taught us anything, it should be that Now more than ever, we need to focus on our personal health and well-being.
Here's a few sobering facts that I wish were not true:
- SARS-CoV2 is a novel virus which means that no one has immunity.
- Experts estimate it will infect 40% to 70% of our population—that’s over 150 million Americans.
- Currently, 80% have mild or no symptoms, 20% need hospitalization, and 5% will need intensive care.
- The mortality rates vary, depending on the population, but range from 0.6% to up to 15% in elderly patients with chronic disease.
Question: If you're not healthy – Why not? And what will it take for you to turn the corner?
American's Were At Risk Way Before SARS-CoV2
Recently we started hearing reports that “healthy” people are now succumbing to this disease.
I call bullshit. How are we defining health?
What were these people's average glucose levels like?
What was their average insulin, A1C hemoglobin and nutrient status?
Were their markers of inflammation low or high prior to infection?
I have personally evaluated the health of hundreds of people.
Sure, someone may not have a diagnosis of heart disease, diabetes or upper respiratory disease. But that doesn't mean they're healthy.
I cannot tell you how many times someone has told me that they're “healthy”, yet when we begin to dig in deeper into their biochemistry, they are far from it.
Let this sink in:
- Only 12% of Americans are metabolically healthy.
- 75% of Americans are overweight.
- 42% of Americans are obese.
- 50% of Americans are Pre-Diabetic or Type 2 Diabetic
Being Proactive, Not Reactive
Each of us has a chance to focus on strengthening our health and immunity to not only fight off COVID-19, but future pandemics and outbreaks.
There is now evidence that lifestyle and environmental factors can help to improve the immune response.
These factors can lend themselves to specific personalized intervention that is focused on the renewal of immune system function, as well as increased resilience.
Potentially modifiable social factors include things related to structure and behavior, including housing, transportation, communication, health care systems, politics, and economics.
What about our biology and biochemistry?
Here I would place modifiable factors like stress, environmental toxicity, diet and nutrition, physical activity, sleep, hydration, intestinal microbiome composition, and biological rhythms.
Specifically, while social and environmental factors are outside of an individuals control, biological factors are personal and therefore completely controlled by an individual.
We need to start quantifying our health, not based on symptoms or observation, but by improving the way we define “health” to include measurements of nutrient status, inflammation, glucose and insulin regulation and immune function.
This whole experience should really be a wake up call for anyone who knows they need to focus on their health and hasn't.
The truth is, if your body is strong enough to tolerate a virus, when you do get sick, the illness is mild and you won't contribute to an already burdened system.
There is strong evidence that personal factors such as diet quality, exercise, sleep, microbiome composition, and stress reduction can be significant in determining the course of HIV/AIDS in an individual who has become infected. [1, 2]
We now know that more than 20 million Americans routinely take medications that suppress the immune system and change the way the body responds to viral and bacterial infections.
In a study of lifestyle factors and the incidence of community-acquired pneumonia in men and women living in the US, it was found that smoking and weight-gain, along with reduced physical activity, were associated with increased incidence. 
Additionally, scientists have found that regular physical activity improves immune response to viral infections. 
In March 2020, a study published in the Journal of the American Medical Association titled “Association of Daily Step Count and Step Intensity with Mortality Among US Adults,” researchers found that a greater number of daily steps was significantly associated with lower all-cause mortality. 
It has also been reported that the Mediterranean Diet improves immune function and lowers the incidence of recurring viral respiratory infections.
Vitamin and mineral content of the diet may play an important role in reducing the risk to hepatitis C viral infection. 
Plant foods that contain phytochemicals such as flavonoids have been found to improve immune resistance to viral infection.
Finally, probiotics that help support a healthy intestinal microbiome have been reported to enhance the antiviral effects of vaccination in elderly patients, which demonstrates the important role the microbiome has in immune function. 
Lastly, vitamin D has also been identified to be a very important nutrient for the support of immune function. 
With cold and flu more prevalent during winter months, it has been suggested that this may be due to a lower level of sun exposure at that time of year, and therefore reduced vitamin D production. 
Finally, a whole food multivitamin would be an important factor to consider. In 2004, the New England Journal of Medicine published a study titled, “A Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality.
In this study, investigators compared supplementation consisting of multivitamins alone, vitamin A alone, or both with placebo in women in Tanzania, Africa who had HIV infection.
They found that women who were randomly assigned to receive multivitamin supplementation were less likely to have progression to advanced stages of HIV disease. These women were found to have better preservation of CD4+ T cell counts and lower viral loads. 
They also had lower HIV-associated illness and mortality.
Interestingly, it was found that vitamin A appeared to reduce the effect of the other multivitamins, and vitamin A alone had some negative outcomes.
Building up Health During a Pandemic
There are many things to consider when it comes to preparing for a pandemic.
Hopefully, if you understand what you just read – you get the idea that nothing is better than being prepared (mentally, physically, socially) for a pandemic before it happens.
Once again, it's not about the virus, but the state of the host (the body) that the virus infects.
All that said, 4 important factors to work on right now:
- Avoid Infection
- Boost Immune Function
- Optimize Nutrient Status
- Work with a Professional (Virtual Functional Medicine)
First and foremost, do what you can to avoid getting infected.
I would like to say that at some point, we are likely going to have to develop a level of herd immunity, but if you're not the healthiest right now, then you need to practice social distancing and good hygiene!
Social Distancing: I'm a hugger, so this is hard to do, but I would avoid unnecessary contact with strangers and friends.
Don't hug. Don't shake hands.
Opt for virtual high fives and fist bumps. Cancel vacations and business trips and work from home as much as possible.
Good Hygiene: Wash your hands for 20-30 seconds with plain soap and water as much as you can.
Boosting Immune Function
This shouldn't be a shocker, but the best way to boost immunity is to provide your body with adequate nutrients.
This means eat real, unprocessed, whole food while avoiding ultra processed, nutrient depleting products. If what you're eating is super crunchy, sugary or salty – it's probably not good for you.
Right now – avoid unnecessary sugar.
Sugar suppresses immunity and even contributes to making viral infections worse.
Oh, and not to be the party-pooper, but limit or stop alcohol altogether.
Not only does alcohol contribute to nutrient depletion, but it taxes your liver and suppresses immunity.
Foods with antiviral activity:
- Olives (Olive Oil)
- Green Tea
Immune boosting herbs and spices:
- Chili pepper
Before you assume you have optimal nutrient status, you'd want to get a comprehensive blood chemistry panel to identify what your nutrient status actually is.
Using Functional Blood Chemistry Analysis, which is a deep dive into your blood chemistry results, you can target what nutrients you're deficient in and begin the process of correcting it.
I don't recommend blindly taking supplements.
The worst supplements are the ones you don't need.
But when it comes to optimizing nutrient status, start with the basics:
- 1000-2000 mg of Vitamin C
- 20 mg of Zinc Bisglycinate
- 2 mg of Melatonin
- 600 mg of NAC or Glutathione
- Mushroom Extracts
I have seen hundreds of my own patients who have been able to dramatically transform their lives, recovering from chronic disease in a matter of months (sometimes even weeks) using the principles of Functional Medicine.
I have hundreds of patients who used to be severely obese, type 2 diabetics on insulin, people who have suffered from heart failure, kidney failure, high blood pressure, and more.
Changing their diet, addressing nutrient deficiencies, decreasing inflammation, balancing blood sugar and optimizing their immune function is how that happened.
There's no miracles or super pills. It's simply science and it's available to everyone who wants it.
Now more than ever, is the time to double down on self-care—not just for ourselves, but as our civic responsibility to contribute to the solution.