• Wendy Finkelstein

Emerging Perceptions about COVID-19

Updated: Jun 1

By Wendy Finkelstein PA-C, owner of Nephesh Enlightened Health and Functional Medicine


#COVID #covid16 #covidadas #covides #nephesh #nephesh-health




Emerging Pieces to the COVID 19 mystery

We all know that the behavior of COVID 19 is far from typical. The good news is that new theories and developments are emerging moment to moment giving us insight into how we can be better prepared if we were to come in contact.

Currently the most common initial symptoms are still fever, cough, shortness of breath and loss of taste and smell. In mild cases, like other viruses it runs its course and resolves with no negative sequalae. Unfortunately, for reasons we are now learning the virus severely impacts the oxygen delivery system of our bodies and vital organs and tissues begin to shut down leading to death.

Hospitals have been implemented protocols used when treating acute respiratory distress syndrome (ARDS). This includes using mechanical ventilation; forcing air into the air sacs of the lungs attempting to increase oxygen. The ironic finding is that ventilation is not working as great as should in theory. It has been suggesting that ventilation can even be damaging the lung tissue leading to an increase in inflammation.

Here are the emerging thoughts

· Scientist are realizing that although oxygen saturation is dropping, individuals are not showing the degree of distress that is seen when compared to the same oxygen saturations in ARDS.

· The loss of taste and smell are associated with zinc deficiency and not lung disease

· COVID-19 is behaving more like altitude sickness and malaria rather than ARDS

Let us first unpack a basic understanding of hemoglobin and oxygen delivery mechanisms in the body. After you take in oxygen through your breath it enters your blood and interfaces with an alveoli. Alveoli are very thin air sacs that connect with your smallest vessels called capillaries. This is where oxygen exchange occurs in the lungs

Before oxygen arrives to the alveoli in the lungs, the red blood cell (RBC) is needed along with the molecule hemoglobin. Imagine your RBC is a raft and hemoglobin’s are the people. The people hold the paddles. The paddles are the individual protein structures that make hemoglobin called heme groups. Just like the paddle makes the raft move, heme is needed to deliver oxygen. Heme has an iron metal core which is what enables it to carry oxygen. Without heme you cannot transport oxygen.

How is COVID like Malaria and Altitude Sickness?

While with COVID-19 we see low oxygen saturation, we do not see impaired respiratory function. In other words, at onset, the lungs are not under direct attack, but oxygen isn’t reaching them. This is almost the opposite scenario in ARDS where we see direct attack on the lungs thereby causing inflammation, low oxygen saturations and respiratory failure.

This is not to disagree that in COVID 19’s final stages the lungs are not severely damaged leading to respiratory failure, but rather to highlight that COVID-19 may be causing an enormous amount of oxidative stress leading to disrupted oxygen transport, rather than an intentional attack on the lungs.

To give this greater detail, the virus COVID-19 causes the paddles i.e. heme groups to leave the raft i.e. the RBC. This free heme which is no longer on the raft is called “free cell heme”. Free cell heme outside of the RBC is toxic, acidic and hugely inflammatory. The only other pathogen known to do this is malaria. When the heme leaves its raft, zinc often follows to neutralize the harsh environment. This may explain why the anti-malarial medication, hydroxychloroquine is being used as treatment.

Interestingly hydroxychloroquine has a direct relationship with zinc. It helps to transport the zinc back into the cell. However if there is deficiency in zinc, this medication work. Loss of smell and taste is a very common presentation of zinc deficiency.


COVID-19’s clinical presentation is quite like another respiratory illness – high altitude pulmonary edema, also known as altitude sickness.

Similarities include

· A decreased ratio of arterial oxygen levels to inspired oxygen

· Hypoxia (low oxygen levels) and tachypnea (abnormally rapid breathing)

· Low carbon dioxide levels

· A ground glass appearance in the lung tissues

· Elevated fibrinogen levels

· Diffuse alveolar damage

In altitude sickness, the lungs are functioning fine – but the decrease in atmospheric pressures causes a decrease in lungs capacity to absorb oxygen.

Clinical findings like altitude sickness would make sense if COVID-19 is in fact causing a dysfunction of red blood cells through production of massive oxidative stress rather than a direct problem with the lungs.

COVID still presents with many unknowns however on a positive note there are many interventions that help to decrease oxidative stress. As an integrative practitioner, I often measure oxidative stress in the blood and use markers such as CRP, lipid peroxidase, ferritin, APOE and many more. The intracellular levels of Vitamin C, magnesium and glutathione largely affect the bodies resilience to oxidative stress. Therefore you are seeing Vitamin C IV now being used in hospitals to treat the virus.

High Dose Vitamin C:

High dose vitamin C neutralizes the acidic environment created by free heme and mitigates the inflammatory response in the lungs. It also decreases the release of cytokines (chemical messengers involved in the immune response, and slows viral replication

Ideally, high dose vitamin C can be delivered intravenously, where it is more easily absorbed and utilized, however oral vitamin C can also be beneficial if taken correctly. While regular over the counter oral vitamin C causes diarrhea, liposomal Vitamin C at frequent intervals does not, and is an effective way to increase intracellular levels. Several New York hospitals have approved intravenous vitamin C as a therapy for the first time ever in studies being conducted on the virus.

Glutathione:

Glutathione is a potent antioxidant naturally found in most of the cells in your body.

There is a growing mountain of evidence finding that the most effective way to take glutathione may be through inhalation. Inhaled glutathione (aerosolized or nebulized) is already being used in the treatment of a variety of respiratory-related conditions and has been garnering attention as a possible treatment option for COVID-19.20

Other Antiviral Drugs:

Several other antiviral medications are being studied for their potential to treat COVID-19. These include:

· Methylene Blue: Methylene Blue is a medication that has been used in the treatment of malaria due to its powerful antiviral properties – killing the virus at an impressive speed.23 It’s also used in the treatment of a condition known as methemoglobinemia – a condition in which individuals have too much methemoglobin which is a form of hemoglobin that is much less effective at carrying oxygen. Methylene blue works by converting methemoglobin into a type of hemoglobin that can more effectively transport oxygen.24

· Remdesivir: Remdesivir is another antiviral drug used for Ebola. Remdesivir is showing benefit in solid studies – a small but well-conducted study on severe cases in the US, Canada, Europe, and Japan concluded that Remdesvir caused clinical improvement in 68% of patients.25

· Favipiravir: Favipiravir is a powerful anti-viral agent that inhibits the virus from replicating and spreading.26 It has been approved in China and Japan for the treatment of influenza and is undergoing research to determine its potential efficacy in treating COVID-19.27

Hyperbaric Treatment:

Hyperbaric treatment works in two ways. First, inspired oxygen concentration is increased to nearly 100%. Secondly, ambient pressure is increased to about three times higher than the air pressure we normally breathe. This combination is designed to essential “hyper oxygenate” your blood – improving oxygen delivery to your tissues.28

Hyperbaric treatment may be an effective adjunct therapy to help COVID-19 patients recover, especially when administered early.

Give Your Immune System the Support It Needs


· IV Vitamin C and Glutathione: A powerful combination of two of the most potent antioxidants delivered intravenously so they can be immediately used by the cells to combat oxidative damage.

· Inhaled Glutathione: Inhaling glutathione delivers it directly to your lung cells – replenishing their antioxidant stores that are quickly used up when fighting inflammation.

· Inhaled Hydrogen: Pairing inhaled hydrogen’s impressive anti-inflammatory effects with Vitamin C and glutathione makes for a robust and powerful trio of antioxidant therapies.

· Nasal Ozone: Ozone gas held in the sinuses helps your body more effectively uptake oxygen and activates a healthy immune response. Ozone should not be inhaled as may damage the lungs


Order your Immune Boosting Supplements here


References

https://www.jillcarnahan.com/2020/04/16/emerging-theories-that-may-help-us-solve-the-covid-19-puzzle/?utm_source=Flatiron+Functional+Medicine+Newsletter&utm_campaign=3184a5e4e6-EMAIL_CAMPAIGN_2017_10_06_COPY_01&utm_medium=email&utm_term=0_a07715eedd-3184a5e4e6-137826201&mc_cid=3184a5e4e6&mc_eid=3ffa3e8d0f

1. https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html

2. https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/

3. https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173

4. https://khn.org/news/mysterious-heart-damage-not-just-lung-troubles-befalling-covid-19-patients/

5. http://www.chemistry.wustl.edu/~edudev/LabTutorials/hemoglobin.htm

6. https://www.esicm.org/wp-content/uploads/2020/04/684_author-proof.pdf

7. https://link.springer.com/article/10.1007/s00109-008-0368-5

8. https://jamanetwork.com/journals/jama/fullarticle/2762996

9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182877/

10. https://www.researchgate.net/post/Is_a_combo_of_chloroquine_and_Zinc_a_cure_for_coronavirus

11. https://www.hindawi.com/journals/omcl/2018/9156285/

12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5488004/

13. https://link.springer.com/chapter/10.1007/978-4-431-68120-5_2

14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096066/

15. https://clinicaltrials.gov/ct2/show/NCT04264533

16. https://www.sciencedirect.com/science/article/pii/S0033062020300372?fbclid=IwAR0UMWXFiQvxpIBxCOvg8zpFQLBgq8zTUmI5LOc-HDd0G32SzeBbcv9cFz0#bb0070

17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048347/

18. https://www.ncbi.nlm.nih.gov/pubmed/19393193

19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684116/4

20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2249747/

21. https://www.researchgate.net/publication/47676317_Inhaled_Hydrogen_Gas_Therapy_for_Prevention_of_Lung_Transplant-Induced_IschemiaReperfusion_Injury_in_Rats

22. https://www.ncbi.nlm.nih.gov/pubmed/23852510

23. https://www.sciencedaily.com/releases/2018/02/180205195624.htm

24. https://www.drugs.com/mtm/methylene-blue-injection.html

25. https://www.nejm.org/doi/full/10.1056/NEJMoa2007016

26. https://www.ncbi.nlm.nih.gov/pubmed/28769016

27. https://www.jwatch.org/na51293/2020/04/09/favipiravir-potential-antiviral-covid-19

28. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/hyperbaric-oxygen-therapy

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