Metametrics’ Immune-Boosting Protocol to Reduce COVID-19 Risk
Get Adequate sleep
Shorter sleep increases the risk of infectious diseases. One study has found that sleeping less than 5 hours per day over the course of 7 days can increase the risk of developing rhinovirus-associated cold by 350% as compared to individuals who slept longer (Odds Ratio = 4.50, 95% Confidence Interval, 1.08-18.69).
Important for COVID-19 prevention: sleep deprivation increases CXCL9 levels—a monokine induced by interferon that increases lymphocytic infiltration, which is implicated in NLRP3 inflammasome activation. Adequate sleep also ensures the secretion of melatonin, a molecule crucial to reducing coronavirus virulence (see Melatonin below).
Psychological stress disrupts immune regulation and is specifically associated with increased pro-inflammatory cytokines, such as IL-6. Various mindfulness techniques, such as meditation, breathing exercises, and guided imagery among others, can reduce stress, activated NFkB, and CRP, and can prevent the increase inflammatory cytokines.
Coronavirus is susceptible to the viral inhibitory effects of zinc, of which can prevent coronavirus entry into cells and reduce coronavirus virulence. A typical daily dose of 15mg to 30mg lozenges can potentially provide direct protective effects in the upper respiratory tract.
Vegetables and Fruits +/- isolated Flavonoids
Flavonoids are considered a cornerstone of anti-inflammatory diet. Many flavonoids have been found, in vitro, to reduce NLRP3 inflammasome signaling, and consequently, NFkB, TNF-a, IL-6, IL-1B, and IL-18 expression. Some specific flavonoids shown to have this effect can be found in daily diet and/or dietary supplements that include:
- baicalin and wogonoside in Scutellaria baicalensis (Chinese skullcap);
- liquiritigenin in Glycyrrhiza glabra (licorice)
- dihydroquercetin14 and quercetin in onions and apples
- myricetin in tomatoes, organs, nuts, and berries
- apigenin17 in Matricaria recutita (Chamomile), parsley, and celery
At least 5 to 7 servings of vegetables and 2 to 3 servings of fruit everyday can provide a repository of flavonoids.
Like flavonoids, ascorbic acid inhibits NLRP3 inflammasome activation. Clinical trials have found that vitamin C shortens the frequency, duration, and severity of the common cold and the incidence of pneumonia. A typical daily dose ranges from 500mg to 3000mg, with even higher doses for acute infection.
Melatonin has been shown to inhibit the activation of NFkB and NLRP3 inflammasome. In fact, age-related decline in melatonin production is one of the proposed mechanisms for explaining why children do not appear to have the same severe symptoms in adults. Melatonin also reduces oxidative lung injury and inflammatory cell recruitment during viral infections. Dosage can vary widely, ranging from 0.3mg typical daily use, or up to 20mg daily for oncological purposes.
Sambucus nigra (Elderberry)
There is pre-clinical evidence that elderberry inhibits replication and viral attachment of Human coronavirus NL63, or HCoV-NL63 (a member of the coronavirus family but different than COVID-19). Sambucus appears to be most effective for prevention or during early stages of corona virus infections. Sambucus significantly increases inflammatory cytokines, including IL-B124, and should be discontinued at the sight of symptoms, infection, or positive viral test result. An evidence-based systematic review of elderberry conducted by the Natural Standard Research Collaboration concluded that there is level-B evidence that supports its usage for influenza, which may or may not be applicable to COVID-19 prevention. A typical daily dose of 2:1 elderberry extract is approximated at 10mL -60mL for adults and 5mL-30mL for children.
In certain conditions, vitamin D has been found to decrease NLRP3 inflamasome activation, where vitamin D receptor activation reduces IL-1b secretion. However, 1,25 (OH) vitamin D has also been found to increase IL-1b levels, and therefore, should be used with caution or even discontinued if symptoms of infection are manifested.
A study conducted with in 84 women has found that a daily dose of 25,000iu for 4 months resulted in lower serum IL-1b and IL-1b/IL-4 ratios in obese women. Oral vitamin A can cause hypervitaminosis A, especially at doses greater than 25,000 IU daily for more than 6 years, or 100,000iu daily for more than 6 months.
Testing to monitoring liver function for hepatotoxicity during vitamin A dosing of any duration, even at lower doses, is advised to address varying individual sensitivities.
DISCLAIMER: The information and understanding of COVID-19 continues to change rapidly. We encourage you to make integrative recommendations carefully and with consideration of the underlying mechanisms of both the COVID-19 infection and the intended intervention. It is also important to reiterate that there are NO clinical, evidence-based, integrative prevention or treatment strategies for COVID-19 infection.
Rolando A. Balburias MD, FPCP, IFMCP
- The Institute for Functional Medicine shared resources for IFM Certified Practitioners
- Lise Alschuler ND
Professor of Clinical Medicine, University of Arizona College of Medicine
Assistant Director, Fellowship in Integrative Medicine, Andrew Weil Center for Integrative Medicine