COVID has turned our world upside down. Both the disease and the measures to prevent it’s spread have wrought chaos in our lives. Getting and recovering from SARS CoV2 infection is hard enough, but this nasty novel virus has a sting in it’s tail. Once recovered, many patients still struggle with a litany of persistent symptoms, collectively known as Long Covid. While there are no approved natural treatments for Covid-19, there are many herbal and nutritional interventions that can support the body as it fights and recovers from viral infection.
Like the name suggests, the focus of functional medicine lies in how disease scenarios affect the function of our various biological systems. Disease itself is a manifestation of bodily processes gone awry. If we can locate what is setting a cat amongst our biological pigeons, and understand how physiological processes have been altered, we can try to mitigate the effect of the disruption and speed up recovery.
Covid can manifest in a multitude of ways, with symptoms ranging from fatigue, fever and body aches to gastroenteritis , pneumonia and stroke. Despite the wide range of symptoms and severity, there are just a few key processes that cause them. Primary among them is runaway inflammation.
Aggravating the Inflammasome
The inflammasome is a term used to describe the suite of cellular structures in our innate immune system that regulate our inflammatory response. When it is stimulated by an infection, it promotes the release of a cascade of molecules called pro-inflammatory cytokines, which act like sirens across your body[1]. They raise the alarm, and send your immune system into furious action. In a normal infection this would be a good thing, as your immune system would fight the invading pathogen, and then be sent back to their bases once the threat had past. In COVID however, these cytokines can spiral out of control in what is known as a cytokine storm, sending the immune system into hyperdrive and causing potentially deadly inflammation. The delicate respiratory epithelium can be damaged by this overzealous immune response, leading to the respiratory manifestations of COVID[2].
Fortunately, a range of plant phenols and nutritional interventions have shown promise in interrupting and mitigating runaway inflammation[3], some of which are explored below.
Quercetin
Quercetin, a plant polyphenol found in a variety of fresh red or purple fruits and vegetables, is a natural antiviral. Its been shown to inhibit viral replication in other non-COVID viruses[4]. It’s also a potent antioxidant that protects the body from free radical damage incurred as the body fights infection, and so can speed up recovery post-infection. Most importantly, quercetin appears to be effective at downregulating the inflammasome and speeding up recovery from viral infection[5].
Curcumin
Curcumin is well known for its anti-inflammatory properties. It can modulate the inflammasome[6], and an early preprint study suggests that it can reduce viral replication[7].
ECGC
Epigallocatechin Gallate, or ECGC, is the compound that gives green tea its well known health benefits. It is a potent antioxidant that may also inhibit the replication of SARS CoV-2[8]. It has been shown to help prevent influenza in healthcare workers, and downregulates the inflammasome[9].
NAC
N-Acetylcysteine, or NAC, promotes the production of glutathione, one of our most important cellular antioxidants. Glutathione is like our body’s trash collector: it binds to harmful substances and allows them to be carried out of the body without doing further harm. It has been shown to protect against severe influenza in both animal and geriatric studies. NAC may help reduce severity of symptoms and promote recovery after viral infection[10].
Resveratrol
When people suggest that red wine has health benefits, resveratrol is the reason why. While the benefits of red wine are debatable, the value of resveratrol in health is not. This well researched compound has been shown to be protective against a range of serious ailments, including cancer and heart disease. It potently modulates the inflammasome, and studies suggest that it protective against MERS-CoV[11] and influenza[12].
Vitamin D
Activated vitamin D acts as a steroid hormone which modulates the immune system[13]. It reduces the expression of pro-inflammatory cytokines [14] and can ward of the deadly cytokine storm associated with COVID[15]. It also promotes the production of potent antimicrobial molecules called AMPS, which are the immune system’s weapons against invading pathogens [16]. Vitamin D is well known for reducing susceptibility to respiratory tract infections[17]. Optimum vitamin D levels positively affect health in a myriad of ways, but supplementation should be undertaken with the guidance of a health professional to ensure your levels are maintained in the optimum range.
Melatonin
In addition to being an excellent sleep aid, melatonin is also a powerful inflammasome modulator. Multiple studies have discussed its utility in mitigating the inflammatory effects of COVID[18].
Elderberry
Elderberry, or Sambucus nigra, has long been a household treatment for flu[19][20]. While home preparations could be dangerous, medicinal formulations of Sambucus nigra may be a valuable prophylaxis against viral infections[21].
Zinc
Zinc is a crucial cofactor in a host of immune processes. Zinc deficiency depletes the immune system, so getting enough is essential to mounting an effective defense against any viral pathogen[22]. Those individuals suffering from the comorbidities that increase the risk posed by COVID, including obesity, diabetes, heart disease and chronic inflammation, also tend to be zinc deficient[23]. Zinc supplementation can reduce the severity and length of viral illness, as well as the risk of lower respiratory tract infections[24]. Care must be taken, however, not to supplement excessively as this can disrupt the body’s mineral balance.
Vitamin C
Vitamin C needs no introduction as an immune enhancing vitamin. It supports multiple arms of the immune response, and is essential to a speedy recovery. A vast body of research supports its effectiveness as both a preventative and a treatment for viral infections, including SARS CoV-2[25].
Using these interventions may not prevent SARS CoV-2 infection, but they could help to reduce the risk of severe illness, speed up recovery, and reduce the long term sequelae known as long COVID. Its best to co-create a protocol with an experienced functional medicine practitioner, as while these interventions are mostly very safe, they could do harm if used incorrectly. These interventions aim to restore whole body health, so there is really no downside to employing them correctly.
Improving our health is really the one intervention in this pandemic that has not received much attention. If we can lift up our eyes from the fear and stress that have haunted the past two years, and aim ourselves towards whole body vibrant health instead of mere safety, we will fare better both through the pandemic and beyond.
References:
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[2] Conti P, Ronconi G, Caraffa A, et al. Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung inflammation by Coronavirus-19 (COVI-19 or SARS-CoV-2): antiinflammatory strategies. J Biol Regul Homeost Agents. 2020;34(2):1. doi:10.23812/CONTI-E
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[15] DiNicolantonio, J. J., & O'Keefe, J. H. (2021). Magnesium and Vitamin D Deficiency as a Potential Cause of Immune Dysfunction, Cytokine Storm and Disseminated Intravascular Coagulation in covid-19 patients. Missouri medicine, 118(1), 68–73.
[16] Evans, J.M., Luby, R., Lukaczer, D., Rountree, R., Stone, P.M., Guilliams, T.G., Yanuck, S., Messier, H., Ramsdell, K. and Hanaway, P.J., 2020. The functional medicine approach to COVID-19: virus-specific nutraceutical and botanical agents. Integrative Medicine: A Clinician's Journal, 19 (Suppl 1), p.34.
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