Challenging Times
News from the practice of Aileen Burford-Mason PhD
At the start of this year I could never have imagined the challenges we are now facing. Although alarms were being sounded about the situation in China, we could not have dreamed how rapidly the virus we now call COVID 19 would spread, or the disruption to daily life it would bring.
It is my hope that the supplement regimes I have my clients develop, as well as the ongoing nutritional education I have tried to pass on for the last 20 years, will now bear fruit and help you and your families stay strong in these anxious times.
Needless to say, our office has been inundated with many questions regarding any additional advice I could offer that would benefit immunity and give an extra edge in the battle against COVID-19. This newsletter is my attempt to pull together my best current advice and to answer some of those questions.
- Protect yourself, your family and your community – stay a hockey stick apart from others.
Our health doesn’t only depend on what we do to protect ourselves, but also needs the coordinated effort of our family, friends and community. To slow the spread of this highly contagious virus, social and physical distancing – 6 feet or two meters apart from the nearest person – is essential at all times. If you find this distance hard to visualize, it’s about the length of a hockey stick.
Regular and thorough hand washing should now be part and parcel of your day. Don’t forget to use hand cream to stop hands getting dry and cracked.
- If you get sick
Most people who get the virus have mild to moderate symptoms and are not currently recommended to seek medical attention. Rest, stay hydrated and isolate from other family members who are still well. The Ontario Government has prepared a questionnaire you can use to determine if you need medical attention (https://www.ontario.ca/page/2019-novel-coronavirus) and if so, how to go about getting it.
- Reduce stress
The anxiety of uncertainty and the isolation that comes with social distancing can seriously impact mental and physical health. Stay active. Go for a brisk walk every day, or create a walking track around your home. Try to do 10,000 steps but remember they don’t all have to be done at once.
Use any tool you can to relax. Meditation and mind-body practices like yoga, tai chi, qi gong, and deep breathing exercises are well documented stress reducers. To help you destress now might be a good time to learn some new tricks. There are many exercise and meditation videos you can find on-line.
Don’t underestimate the power of a simple phone call or video chat with family and friends. Connecting with one another during stressful times can help reduce feelings of isolation. But if you are working from home save personal calls for the evening.
- Focus on sleep
Stress can disrupt sleep, and this in turn compromises our ability to fight a virus. Although sleeping pills are widely prescribed they are not without side effects.[1] Before resorting to medication, try creating the best possible environment for sleep. Sleep in a cool room with full blackout.
Melatonin is a hormone we make naturally which controls sleep but also plays an important role in immune functioning. We make less melatonin as we age, and light pollution in our bedrooms interferes with our natural production. If you can see the outline of furniture in your bedroom there is too much light to make melatonin. Wearing an eye mask can help you sleep sounder and for longer.
- Be wary of misinformation
Make sure that anything you are reading on the internet is from a trusted source. Unfortunately there are always unscrupulous people seeking to exploit our anxiety to sell products that may be worthless using unsubstantiated health claims.
The flip side of the coin is that some ‘experts’ interviewed on TV will dismiss many of the supplements you are using, saying they are unproven and therefore not worth taking. Often such comments come from physicians or other healthcare practitioners with little knowledge of nutrition, or familiarity with the scientific literature on nutritional supplements.
Please don’t stop taking your current supplements based on these sorts of dismissive comments.
SUPPLEMENTS AND COVID 19
Those of you who take supplements following my protocols should be taking a well-rounded supplement regime optimized to your personal needs. Since all essential nutrients work as a team to support immunity, it is important to continue the whole programme. The basic programme will include a multivitamin, additional vitamins C, D and E, magnesium and omega 3 fats (fish oil).
Many of you are also wondering if you should increase your intake of certain supplements or include new supplements during the pandemic. Here are a few to consider.
Vitamin C.
In scurvy (severe and usually fatal vitamin C deficiency) one of the most frequent complication and cause of death is pneumonia.[2] Vitamin C impacts immunity in many ways. It acts as an antioxidant, protecting immune cells against the inflammatory damage – oxidative stress – caused to the lungs as immune cells fight to subdue infection. Vitamin C can also decrease the replication of viruses.[3]
Some COVID 19 patients in New York hospitals are being treated with high dose vitamin C intravenously[4] and China has begun a clinical trial to determine if vitamin C reduces the severity or death rate from, COVID 19. But we will have to wait until later in the year before we know the results.
Stress increases the need for vitamin C as your adrenal glands depend on vitamin C to make essential stress hormones. Most non-primate animals make their own vitamin C, and when stressed rapidly increase their output. Humans rely on diet or supplements for vitamin C and studies have shown we also need more when stressed.
Time release formulations are the only form of vitamin C I recommend. When you take up to 200mg of vitamin C orally it stays in the blood for about 20 days – enough to prevent scurvy. But if you take higher doses, vitamin C has a very short half-life – 30 minutes – so a lot of what you have taken does not remain in blood but is excreted in urine.
To overcome this you would either need to take regular vitamin C in small doses continuously throughout the day, or use time-released forms of vitamin C. These tablets are formulated to break down slowly, releasing small amounts over a period of about 12 hours.
Recommendation: Time release formulations are the only form of vitamin C I recommend.
If you are currently taking 1000mg twice daily, increase dose to 2000mg twice a day.
Vitamin D
The control of immune responses is very dependent on vitamin D. Although no studies have yet shown that higher blood levels of vitamin D can protect against COVID 19 we do know that vitamin D is very important for healthy lung function and for protecting against infection in general. Lower blood D in winter compared to summer is thought to be responsible for the increased incidence of upper respiratory tract infections in the winter months.[5] Low D levels also increase the risk of pneumonia.[6]
It has also proposed that adequate vitamin D is needed to prevent the development of a cytokine storm – where the immune system goes into overdrive and produces an overabundance of anti-inflammatory molecules, overwhelming organs and their capacity to respond normally.[7] This is when viral infections like SARS and COVID 19 turn lethal. According to Health Canada’s last survey 1/3rd of Canadians have insufficient blood levels of vitamin D.[8]
Recommendation:
If you have been working with me for some time and have had your blood tested for vitamin D (25-hydroxy D) we will have identified an optimal daily intake of vitamin D for you. Continue taking this dose – you are unlikely to benefit from more.
For everyone else I recommend taking 4000 IU daily. This is the amount Health Canada says anyone from the age of nine can safely take without supervision or blood tests. Take vitamin D with food for proper absorption.
Zinc
Zinc is required for optimal innate immune responses. [9] Innate immunity requires no previous exposure to a virus to work, and is therefore our first-line defense against novel infections like COVID 19. Zinc has been shown to reduce the symptoms and duration of colds[10] which are often caused by coronaviruses, so possibly it would be helpful for COVID 19 too. However, zinc is a tricky supplement to dose correctly – either too little or too much can compromise immunity.[11]
Zinc deficiency affects our ability to taste and smell things normally. It is interesting that one of the symptoms recently recognized as a clue that someone may test positive for COVID 19 is loss of the sense of smell and taste.[12] If you are taking a multivitamin it will usually contain 10-15mg of zinc, and for most people this is sufficient for regular use. However, during infection, extra zinc may be required.
Recommendation:
Sucking low dose zinc lozenges (8-10mg each) up to a total daily dose of 80mg has been shown to shorten the duration of sore throats and colds.[13] However, for some people 80mg might be a bit too much. Luckily there are ways to tell when you are taking too much zinc.
Most zinc lozenges have some strong flavoring like licorice or elderberry added. As you start to take them they taste good. But as you take more they may begin to taste unpleasantly metallic. This is your sign to stop taking the lozenges for that day. Resume taking them the next day but make sure to stop when they begin to taste bad again. Regardless of how they taste, stick to a maximum of 80mg of extra zinc per day (not counting what may be in your multivitamin).
One sign of ongoing poor zinc status is little white flecks on your nails, known medically as leukonychia.
If your nails look like those above, you definitely need more zinc. If you already take a multivitamin and still have leukonychia, start taking zinc lozenges as described above.
Melatonin
Melatonin acts as an “immunological buffer” – it will help restore immunity in immunosuppression or chronic stress, but can also suppress the overreaction of the immune system – the cytokine storm.[14] Melatonin supplements appear quite safe. They are not habit forming so you won’t become addicted or dependent on them. However, in my experience dosages that work well vary a lot from person to person.
To improve sleep start with a low dose – 3mg or even 1.5mg. If you have difficulty falling asleep, take melatonin 30-60 minutes before bed. If you fall asleep easily but wake too soon, take melatonin immediately before bed.
You can try increasing your dose by 1-2mg every 2-3 days to find the dose that works for you and gives you the most satisfying sleep. I usually recommend not going beyond 10mg without professional advice.
Stay
well and keep busy!
[1]. Benzodiazepines and Related Drugs as a Risk Factor in Alzheimer’s Disease Dementia. Miren Ettcheto et al. Front Aging Neurosci. 2019; 11: 344.
[2]. Vitamin C may affect lung infections. Hemilä H, Louhiala P. J R Soc Med. 2007; 100(11): 495–498
[3]. Ibid.
[4] Time Magazine March 27th 2020. https://www.newsweek.com/new-york-hospitals-vitamin-c-coronavirus-patients-1494407
[5]. Age and low levels of circulating vitamin D are associated with impaired innate immune function. Alvarez-Rodriguez L et al. J Leukoc Biol. 2012 May;91(5):829-38.
[6]. The association between vitamin D deficiency and community-acquired pneumonia: A meta-analysis of observational studies.
Zhou YF et al. Medicine (Baltimore). 2019 Sep;98(38):e17252.
[7]. The possible roles of solar ultraviolet-B radiation and vitamin D in reducing case-fatality rates from the 1918-1919 influenza pandemic in the United States.Grant WB, Giovannucci E. Dermatoendocrinol. 2009 Jul;1(4):215-9
[8]. https://www.dairynutrition.ca/nutrients-in-milk-products/vitamin-d/vitamin-d-status-of-canadians-results-from-the-canadian-health-measures-survey
[9]. Modulating the immune response by oral zinc supplementation: a single approach for multiple diseases. Overbeck S et al. Arch Immunol Ther Exp (Warsz). 2008;56(1):15-30.
[10]. Zinc for the common cold. Singh M1, Das RR. Cochrane Database Syst Rev. 2011 Feb 16;(2):CD001364
[11]. Modulating the immune response by oral zinc supplementation: a single approach for multiple diseases. Overbeck S et al. Arch Immunol Ther Exp (Warsz). 2008;56(1):15-30.
[12]. https://www.bloomberg.com/news/articles/2020-03-28/have-coronavirus-and-can-t-smell-harvard-scientists-explain-why
[13]. The effectiveness of high dose zinc acetate lozenges on various common cold symptoms: a meta-analysis. Hemilä H, Chalker E. BMC Fam Pract. 2015 Feb 25;16:24.
[14]. Immunoregulatory action of melatonin. The mechanism of action and the effect on inflammatory cells. Mańka S, Majewska E. Postepy Hig Med Dosw (Online). 2016 Oct 4;70(0):1059-1067.