Please practice good prevention: wash hands frequently, minimize physical contact with others while maintaining social cohesiveness, and stop all non-essential travel. Please reach out to loved ones and neighbors via phone and email from safe distances and use kind gestures to support one another. Be kind to yourselves too. Embrace a slower pace if possible, trust the process, get good nutrition and rest, and get outside each day for exercise or fresh air if safe for you.
Other suggestions: check that you and loved ones have 2-3 months of essential medications related to any underlying pulmonary condition (COPD, asthma, cancer or fibrosis in the lung, cystic fibrosis) or cardiovascular condition (congestive heart failure, coronary artery disease), as well as diabetes.
When to seek urgent care for your best safety and prevention:
If you are in a high risk health category (** see CDC list below) for contracting COVID-19 AND are experiencing symptoms of flu, contact your primary health care team and seek care as guided and using your best judgement. If you are experiencing severe symptoms seek urgent health care.
Severe symptoms include: difficulty catching your breath or getting enough air to feel comfortable (whether from coughing, activity or at rest), pain with coughing, symptoms that prevent eating or staying hydrated, fever that doesn’t respond to acetaminophen/ Tylenol, and inability to swallow liquid or food. For these or other severe symptoms do seek immediate care by going to an urgent care facility or hospital.
What about other, non-severe symptoms? Some people may experience mild or ongoing nausea/vomiting/diarrhea in addition to other flu symptoms such as sinus congestion, cough, fever, sore throat and/or generalized aches and pains. If not experiencing severe
symptoms you may be safely guided by your health care team to use supportive care at home. I can be a resource for you in supportive care as well. However, If your symptoms are severe and prevent good airflow in your airways or prevent you from eating/drinking, seek urgent care.
If you have non-severe symptoms of the flu, are an established client and would like to schedule a brief 30 minute naturopathic prevention /supportive care telehealth consult please email firstname.lastname@example.org and use the subject “flu consult.”
I cannot address individual flu related questions by email.
Do not consume supplements known for general “immune support” without guidance. With what we know currently, the virus can cause overstimulation of the immune system for some people. This means that some supplements could possibly worsen flu symptoms via immune stimulation. Examples of what NOT to take right now are: supplements containing echinacea, mushroom extracts and larch arabinogalactan (or Berry Well Immune). If you are taking any of these currently, please hold /discontinue for now.
Therapies that are likely safe to continue if you are already taking them (and provided you have no allergy to them) include: mint, elderberry, goldenseal, berberine, Oregon grape root, multivititamin, astragalus, fish oil, turmeric, curcumin, melatonin, probiotics, green tea, vitamin E, quercetin, B complex, MCT, sesame oil, DIM, theanine, ashwagandha, eleutherococcus solid extract, fruit anthocyanins, berry solid extracts, vitamin D3, and homeopathics. If supplements you are taking are not on any list in this message, or if unsure, please hold/discontinue them for now and focus on prevention steps, nutrition, exercise, stress reduction, sleep, and self-care. Use of essential oil steam inhalations may also be helpful in supportive care. Read more here.
To best support existing clients, I created a list in Fullscript called “Daily Viral Immune Support” to include supplements that are safe and evidence based for supportive care.
You will also note several essential oils on that list and attached please find an education instruction for home steam inhalations using essential oils. Many of the supplements in the fullscript list are in capsule form. If you are someone who cannot swallow pills/ capsules, I trust we have discussed alternatives already such as opening capsules into food. Also, zinc lozenges containing 3 – 7 mg zinc gluconate are a safe supportive therapy to use 3-4 times daily and are available over the counter in addition to Zinc piccolinate capsules. Many local natural food stores are re-stocking this frequently. Please note: you are not obligated to buy supplements in Fullscript or take any supplements in this list.
Here is the “Daily Viral Immune Support” list in Fullscript:
Other supportive care suggestions for risk reduction:
Get enough sleep. It supports your immune system! Shorter sleep duration increases the risk of infectious illness. One study found that less than 5 hours of sleep (over 7 days) increased the risk of developing rhinovirus associated cold by 350% when compared to individuals who slept at least 7 hours per night.1 Important to COVID-19, sleep deprivation increases CXCL9 levels. CXCL9 is a monokine, induced by interferon, and which increases lymphocytic infiltration,2 and which is implicated in NLRP3 inflammasome activation.3 Adequate sleep supports the secretion of melatonin, a molecule which may play a role in reducing coronavirus virulence.
To access the "Daily Viral Immune Support" list in Fullscript, you can log into your Fullscript account and click on Catalog--> Categories--> then Daily Viral Immune Support. You can access supplements in your recommendations, and the "Daily Viral Immune Support" list. At this time the full catalog is not available beyond my selected recommendations for clients. Please know that backorders happen, requiring me to locate substitutions the best I can. Fullscript is quickly restocking for backordered supplies ongoing so please check back.
Of course, everyone is unique, so if you have questions about supportive care for your symptoms or whether these or other suggestions are right for you, please request a tele-health consult. If you become ill and would like a consult or have underlying conditions and want to discuss prevention or supportive care, I will try to schedule you as soon as possible. If you have your next consult scheduled, we will keep those appointments for your regular weekly or monthly consult. If you have remaining visits on your package plan and would like to schedule please let me know. At this time, I will be slow to respond to all emails however brief and ask that you hold all non-urgent email questions until our follow up visits. I will receive and review labs and imaging via faxes per usual. Any questions via email you may have sent in the last week will be answered during follow up consults if not sooner. Thank you for your patience and understanding.
For the next 2 weeks, I will offer brief 30-minute flu focused supportive care visits via teleconsultation, and will not do in-person visits until further notice. If you are not an existing client, email me about establishing care.
Please know I am thinking about you all. I hope you are staying safe and finding opportunities for connection with yourself and loved ones. With good wishes for your continued health,
**From CDC Website:
"Those at high-risk for severe illness from COVID-19 include:
Share facts not fear poster: https://www.cdc.gov/coronavirus/2019-ncov/about/share-facts-h.pdf
1 Prather AA, et al. Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep. 2015;38(9):1353-9.
2 Gorbachev AV, et al. CXC chemokine ligand 9/monokine induced by IFN-gamma production by tumor cells is critical for T cell-mediated suppression of cutaneous tumors. J Immunol. 2007;178:2278–2286.
3 Romero, JM, et al. A Four-Chemokine Signature Is Associated With a T-cell-Inflamed Phenotype in Primary and Metastatic Pancreatic Cancer. Clin Cancer Res. 2020 Jan 21 [online ahead of print]
4 Black D and Slavich GM. Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Ann NY Acad Sci. 2016;1373(1):13.
5 Phillips JM, et al. Neurovirulent Murine Coronavirus JHM.SD Uses Cellular Zinc Metalloproteases for Virus Entry and Cell-Cell Fusion. J Virol. 2017;91(8).
6 Han Y-S, et al. Papain-like Protease 2 (PLP2) From Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV): Expression, Purification, Characterization, and Inhibition. Biochemistry. 2005;44(30):10349.
7 Hardeland, R. Melatonin and inflammation – Story of a Double-Edged Blade. J Pineal Res. 2018;65(4):e12525.
8 Silvestri M and Rossi GA. Melatonin: its possible role in the management of viral infections – a brief review. Ital J Pediatr. 2013;39:61.