Coronavirus

Staying Healthy, Peaceful, and Positive:

Dr. Shapiro’s heart centered advice about Coronavirus

Updated 4-7-20

In any outbreak, there is a lot you can do to protect yourself, your loved ones and support your community.

Supporting your immune system:

Diet:

Avoid sugar! Viruses, and apparently especially coronaviruses (which previously were just a form of the common cold), thrive on sugars. This sadly includes honey though a bit of honey is probably fine (a teaspoon or less daily)

Ditto for deep fat fried foods and unhealthy oils like trans fats and excess alcohol. Try to keep your system clean.
Eat lots of lacto-fermented foods to support your microbiome, unless these provoke a histamine reaction in you. If they do so, then avoid them for now, and instead use a probiotic supplement high in lactobacillus plantarum (lactobacillus plantarum helps make an enzyme called Diamine oxidase that actually breaks down histamine).

Think of your microbiome as an extension of your immune system which it is! If you cannot or do not eat lots of lacto-fermented foods, then consider taking a good quality probiotic. We can make some suggestions for you, if you like.

Eat lots of fresh veggies and some fruits as well, at least 5-7 total servings daily if you do not have food intolerances. Especially good are onions, berries, tomatoes, oranges, parsley, celery, ginger, turmeric and lemons

Think good thoughts:
Try not to worry and certainly do not panic. Breathe, meditate, connect with your heart. I am attaching my heart centered breathing exercises at the end of this handout. Consider joining a group meditation like the one Mingtong Gu is hosting now (free)
https://chicenter.com/meditation- series/

He has also offered a free online day long workshop that is still available on his site.
You might send love out to people who are suffering with this, from your heart to theirs.

Avoid focusing on things that scare you, fear is disempowering, weakens the immune system and will not help you stay healthy. It provides no benefit. Instead, celebrate what you love, focus on what you appreciate.

Enjoy Life:

Laughter is fantastic for your immune system. Try to laugh daily, watch silly movies, read funny stories.
Spend time in sunlight, let the sunlight shine on your eyes/eyelids Look for upliftment

Tell some jokes. Feel free to send some to my office for us all to enjoy.

Connect with the earth.
When possible, be outside, barefoot on grass or seated on earth (or even cement) at least 15 minutes a day, more if you have the time.

More immune boosting:
End your showers with 30 or more seconds of cold water (obviously not if you are sick), this provides a powerful boost to the immune system

Share with others. Share conversation, hope and resources. Reach out to those you care about and even those you do not know well who may be isolated or fearful. Support local businesses that you want to keep around. Eat takeout from places you like.

Get enough sleep!

Optimal sleep is at least 7 hours per night. Less than 5 hours of sleep nightly on average, increases the risk of getting a viral infection by 350%. Also specifically relating to COVID-19, sleep deprivation can increase inflammation via activation of the inflammasome (see below). Adequate sleep during nighttime hours also insures production of melatonin, which may decrease the virulence of the virus by current evidence. 


The inflammasome

is a multiprotein intracellular complex (in our bodies) that detects pathogenic microorganisms and sterile stressors, and that activates the highly pro-inflammatory cytokines interleukin-1b (IL-1b) and IL-18. These inflammatory cytokines contribute to cytokine storm, discussed below. 


Understanding Cytokine storm

One aspect of Coronavirus that makes it different from other infections, is the hyper activation of immune response called "Cytokine Storm". This was recognized over 10 years ago with the Asian Swine Flu and the original SARS outbreak. It’s a kind of infection induced auto-immune response, so the normal therapies, including integrative ones, used for the flu and fevers have to be looked at very carefully. I have now spoken personally with intensive care physicians I know who are actually treating COVID-19 and they confirm that cytokine storm is a large part of what lands people in the ICU on respirators. Wikipedia - Cytokine Release Syndrome https://en.wikipedia.org/wiki/Cytokine_storm

Antihistamines, both natural and pharmaceutical, may therefore be of value as they stabilize mast cells activated in cytokine storm

A few other current thoughts:

How long does the virus linger?
Up to three days on surfaces like countertops or tables, up to one day on clothing. If think you might be exposed, you might take clothing off in the doorway and leave outside for 1-2 days before bringing it into the home to wash.

If you have COVID 19 and recover, the good news is that it is believed that living through the illness will confer long-term immunity

Wash hands with soap and hot water for at least 20 seconds, some say 30 seconds.

If you have had a suspected exposure remove all clothing that may be exposed as above and shower in hot water with soap on any contact surfaces

Supplements to consider:

Please note. This is all based on a great deal of research but there have been NO clinical trials of natural products for COVID-19 nor do I expect

any will be done any time soon. We are all trying to figure this out together.

You ABSOLUTELY do NOT need to take everything listed in any of these categories, and even should not overdo it! I am including so many choices because I know my patients are already on a number of these things so it will hopefully help them feel more at ease if they are, for example, taking Inflammablox for inflammation and/or Natural d-hist for current seasonal allergies

Generally important:

Liposomal vitamin C: one gram 2-3 times daily for prevention, and every 2-3 hours if ill, or feel you may be coming down with something whether or not it is coronavirus. Vitamin C is an excellent antiviral, was used in China to treat coronavirus cases, and is being used in several New York hospitals as well. Be cautious with Vitamin C is you have been diagnosed with GDPD deficiency. It can still be used, but only up to about 7 grams a day with this relatively rare genetic condition.

Zinc capsules or lozenges: one capsule daily plus, open into mouth 1⁄4 a capsule a couple of times daily, or if you can get zinc lozenges even better, but they are currently hard to find and we have not been able to obtain them. Zinc appears to kill the virus, especially while it is still in the oral and nasal mucous membranes. The problem is getting it into the cells. Zinc does not enter cells easily, so some sort of ionophore is used to open the channel into the cells. Many essential oils are ionophores, and can be used via inhalation. Also many of the flavonoids I mention below are ionophores as well.

Immune support and hopefully prevention: (this is mostly repeated below as well)
Chaga mushrooms 2 twice daily And/or Host defense 2 twice daily And/or transfer factor multi immune 2 twice daily or agaricus blazei or coriolus 2 daily or Astragalus tincture tea, capsules etc

D3 5000iu per day unless your level is already quite high. I am trying for a 25 hydroxy vitamin D level in well persons of 50-60
Vitamin A also excellent antiviral. It can be used in a variety of ways. 5000 iu daily for a while, 10,000 iu per day for up to 14 days, or 7500iu

three times a week and 50,000 iu daily for 7 days at the first sign of virus
Zinc (mentioned above)

Melatonin at bedtime. Melatonin is an excellent antioxidant, it is not dangerous, and there is evidence that it may favorably modify the course of the disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102583/

To reduce cytokines: here are a number of known natural products including some foods, that reduce cytokines. Someone might chose or already be using one choice from this group for support of prevention, and possibly a couple of choices for support of treatment in known or suspected positive cases, of if they just get sick.

Flavenoids: (these are also ionophores, mentioned above)
Green tea phytosome or green tea as a beverage, ECGC is the flavenoid in green tea: one cup of strong green tea twice daily or one capsule of the extract twice daily. More is fine as long as you do not get caffeine jitters (green tea was tested during SARS outbreak and found in one study to reduce mortality 85%). ECGC has been shown to have a wide range of antiviral activity against both DNA and RNA viruses. It also helps zinc get into cells where it is needed.
Black tea: one cup twice daily or more, is almost as good as green tea, esp if organic
Quercetin: 200mg twice daily (this is a main component of Natural d- hist so if you are already taking that for allergies you are ok, it is also in Histamine scavenger (professional health products) and we also have quercetin phytosome) . It is also found in onions, apples and the white part of citrus as well. It may also help zinc get into the cells where it is needed as an antiviral, enhancing zinc’s antiviral activity
Baicalin from Scutellaria Baicalensis (found in Inflammablox). Available as a single Chinee herbs Inflammablox has the added advantage of including propolis which Dr. Dietrich Klinghardt feels is one of the best antivirals for COVID-19 along with Turmeric/curcumin which is another flavenoid
Curcumin/Turmeric supplement (Some good form of turmeric like Turiva or Cura Pro or Meriva or Inflammablox or NrF2 accelerator (this one is more of broad based antioxidant): one twice daily with food. Or

just take up eating turmeric in food. Take with some fat, maybe take up making curries. I have taken to grinding my own spices with recipes from a book my niece mentioned, called 660 curries. Golden milk is also an option here. At our office we do have a golden milk protein powder blend.

Licorice extract: one dropper twice daily (not if high blood pressure), Apigenin: in chamomile tea, parsley and celery. Also in chamomile essential oil, and if you are already using hipep for heartburn there is some in that

Myricetin in tomatoes, oranges, berries and many nuts

More suggestions for prevention of cytokine storm and/or antiviral activity:
Garlic or allicilin: one twice daily (excellent broad antiviral), or fresh garlic which has been chopped or grated and left on a cutting board for at least 5 minutes so the sulfhydryl bonds solidify

Vitamin E: one daily
Coconut oil: coat mouth with a bit 1/8 teaspoon a few times daily, and use in foods, also excellent antiviral and also helps zinc into cells Resveratrol: one twice daily eg resveratrol supreme or a cup of grape juice, or the odd glass of red wine
Oregano Oil (excellent general antiviral)
Any of these antivirals (you may already be on one): olive leaf, monolaurin/lauricidin , licorice root (not if high blood pressure), ginger tea, fresh garlic, lemon juice, bee propolis, breathing/inhaling essential oils especially lavender, citrus, eucalyptus radiata (not regular eucalyptus globulus though as it is too drying), chamomile, ravintsara Astragalus tincture, capsules or tea
Peppermint tea, or a tiny bit of essential oil on the back of the neck in ADULTS not children, if there is a headache
Perhaps ossilococcinum if flu symptoms
NAC (n-acetyl cysteine): supports both the lungs, is an excellent antioxidant and enhances glutathione production. I usually advise 900mg one daily, helps body clear debris, this was something I advised daily during the fires.

IF you are at all ill, or even just worried 

STOP TAKING:

1. ACE inhibitor drugs (switch to something else, with Dr. Shapiro or your primary care doctor). ACE inhibitor drugs are implicated in how the virus enters the lungs, which is via ACE 2 receptors (angiotensin 2). When someone is on one of those drugs, the body actually upregulates (makes more) ACE 2 receptors. So consider changing off of ACE inhibitor drugs.. These include: captopril, lisinopril, benazepril, zofenopril, perindopril, tradolapril, enalapril, ramipril.

If you are on one of these drugs for high blood pressure contact us, or your primary care doctor as soon as possible to change to a different medication. But please do not just abruptly go off your blood pressure medication without an alternative!

A great alternate choice appears to be an ACE receptor blocker (ARB) (sounds similar but quite different mechanism): These will blockade ACE2 receptors, potentially for the virus as well, and do NOT cause upregulation of the number of receptors. Angiotensin receptor blockers include Losartan (Cozaar) irbesartan one of these, it appears good to stay on it, but DO NOT add it if you are just trying for prevention of the virus.

2. Selenium. I was recommending selenium for immune support, but new evidence indicates that it may act as an ACE inhibitor. If you have been taking Selenium, don't worry, if is excellent for viral prevention, the potential risk is only after the illness has taken hold and is starting to enter the lungs. And it is not nearly as strong in this regard as the ACE inhibitor drugs. So just go off it now if you are starting to feel ill. This would also be true temporarily, I suppose, for going off brazil nuts that I have recommended in the past for patients to support the thyroid. This caveat is only if you have any sign of illness. Selenium is supportive to immune function, if you are well and just doing prevention

3. NSAIDS including Ibuprofen or Aleve 

Avoid aspirin, ibuprofen, etc. It is now fairly certain that use of ibuprofen leads to worse outcomes. Recently the French government and the French Health Minister, Olivier Veran, issued a warning that patients infected with COVID-19 should avoid taking nonsteroidal anti-inflammatory drugs NSAIDS), including ibuprofen (brand name Advil). Based on their experience with infected patients, they believe that use of NSAIDs could be a factor is making COVID-19 infections much worse.

https://www.paintreatmentdirectory.com/posts/be-safe-don’t-take-ibuprofen-during-the-coronavirus-pandemic

Unofficial studies of one hospital in Vienna show that the many problems in Italy came from Ibuprofen in connection with Coronavirus

Dr. Shapiro is also advising avoiding Tylenol (acetaminophen) as it challenges the liver, but it is the safest of the analgesics if you must have one.

STOP SMOKING. This seems obvious, but if at all possible consider this a great opportunity to finally quit smoking if you have not so far. Feel free to contact Dr. Shapiro, for advice on smoking cessation or to get a medication or herbal regimen to support you. Studies are showing, that smokers with COVID 19 often have a more severe course of illness. Smokers are also typically depleted in vitamin C and zinc, so if you are unable to stop smoking, double the zinc and vitamin C recommendations.

Also avoid for now:

Honey, chlorella, spirulina, chocolate, echinacea as these can increase inflammatory cytokines. This list is not for certain, but best avoided until there is more clarity on whether or not they would help or hinder. Though, on the other hand, many people feel elderberry, like selenium, is fine and even excellent for prevention/immune support but should be discontinued at the first sign of potential infection with COVID-19. I now think that is probably accurate.

More to consider:

Nitric oxide testing:
Nitric oxide is essential in a healthy immune response. If it is low people can have reduced ability to fight viruses and enhanced inflammatory responses. It directly supports the lungs and the blood flow to the lungs. It is one of our most important antioxidants to quell free radicals and kill invading bacteria and viruses
And there is evidence that NO is directly reduced by the COVID-19 virus and that is possibly part of the pathogenesis.
Add Nitric oxide booster if depleted or low, especially if hypertension or cardiac issues or over 60 years old. 2 daily after a meal. We have test strips that we can send you if you want to check your status.
Foods that are rich in Nitric oxide include green leafy veggies like parsley, arugula, dandelion greens, beet greens, beet root, celery juice.

A patient just sent me this today, there is actually a trial of inhaled nitric oxide in Covid-19 patients underway:

https://www.bostonherald.com/2020/04/06/massachusetts-general-hospital-among-first-to-test-nitric-oxide-on-pandemic-patients/

Basic immune support supplement list:

Kforce or K2D3: one daily. Possibly stop this if you get acutely ill-more research is needed, but definitely consider use for prevention Mycelized A: one drop a day (5000iu) or Vitamin A softgels (7500iu): one every other day

Lypo C: one packet daily or even better twice daily. If this is not available, any vitamin C will work, but at higher doses
Chaga or Host defense/My Community or agaricus blazei: 2 capsules daily or consider mycopure protein beverage from designs for healht Zinc picolinate, supreme, or reacted: one daily approx. 30mg

Plus one or two things to decrease cytokines: a turmeric extract, EGCg, (green tea extract) or green tea, Quercetin, Curcumin, Resveratrol, Inositol, Artichoke Extract, Boswellia, Black Seed Oil, Rhodiola, PQQ, Andrographis, Zinc,

The very most basic supplement recommendations:

Vitamin A or vitamin A rich foods: 5000 iu per day
Vitamin D and/or vitamin D rich foods 5000 iu per day
Liposomal Vitamin C: adults 1 gram 2-3 times daily , or regular vitamin C 500mg three times daily
Zinc 30mg daily

If you feel sick:

Please do not come to our office to be evaluated, we are not seeing patients in person, but feel free to phone or email. Dr Shapiro is checking emails and responding to patients daily, even on weekends order to be of extra support to patients at this time. If urgent, of course, please go to the emergency room, but if you just want to discuss your not urgent symptoms with Dr. Shapiro, then she is happy to have a phone appointment with you as soon as she is able, and is actually checking emails daily in. While we are scheduling phone appointments during all of our normal hours and then some, we are not seeing any patients in person. Also feel free to have a phone visit to discuss your ongoing, non coronavirus concerns, during this quarantine period.

Remember that even if you are ill, chances are good, that you do not have Coronavirus , you could have a cold, or the regular flu or seasonal allergies. It is quite an intense allergy season this year. Of the patients who have symptoms that Dr. Shapiro, has spoken with, she only suspects possible coronavirus in a handful.
But if necessary, get tested for coronavirus at an emergency room. We will be looking into where else you might be referred for non urgent testing.
We do not have test kits at this time but are looking into them.

Here is a list of antiviral and supportive strategies for people who are noticing they may be a little sick, even with mild possibly coronavirus symptoms, but are not so ill that they need hospitalization or immediate medical attention and are not in a high risk group. If possible, if you are worried, check in with Dr. Shapiro about your symptoms so she can follow you. Please discuss with her any financial concerns if you are hesitant to call for that reason.

As far as we can tell, the virus first enters the oral cavity, eye or nasal mucous membranes and stays there for approx. 7 days. At this stage it can often be cleared by vitamin C (esp liposomal), zinc, antivirals like garlic, andrographis, propolis, while supporting oneself with cytokine storm blocking agents like quercetin, turmeric and baicalen

In this case, I have also been advising either NAC to enhance glutathione recycling and/or r-glutathione (orthomolecular) or s-acetyl glutathione (professional health products) 1 twice daily.
Melatonin 1-6 mg to potentially reduce virulence of Covid-19

Zinc 30-60 mg capsule once daily plus open some into the back of the throat
Natural d-hist 2 twice daily or quercetin phytisone one twice daily or apples or onions twice daily

Curcumin (as above)
Propolis throat spray or nasal spray. Dr. Shapiro has ordered some bulk propolis which should arrive midweek if you are unable to obtain any commercially. Dr. Dietrich Klinghardt reports on his free webinar that he has had great success with this.
http://www.sophiaeducate.com/klinghardt_virus_webinar/ Andrographis tincture: one ml 4-6 times a day
Or lomatium tincture: 1 ml 4-6 times daily
Vitamin A 50,000 iu a day for up to 7 days in an adult

Potassium citrate 99mg: one twice daily. There is evidence that the body dumps potassium during Covid-19 and this is implicated in late stage cardiac arrythymias after coronovirus.
Peppermint tea

And if ill, go off, but still fine for prevention if not ill:

Elderberry Sambucus significantly increases inflammatory cytokines, including IL-B128 so should be discontinued with symptoms of infection (or positive test, there` is some in Viracid).
Echinacea (same reason, there is some in Viracid)

Vitamin D (conflicting information here-some say stay on. Here is an excellent report that lays out the controversy:

https://www.sciencedirect.com/science/article/pii/S1550830720301130

Larch arabinogalactans (these are in the product GALACTAN, and transfer factor multi immune)
Beta glucans (there are some in transfer factor multi immune) Selenium (as above)

Even though this is intense, remember that the regular flu this year was still already worse than this (without a general quarantine), and we are all working so hard to contain this epidemic.
As of February 22
nd, there were at least 18,000 deaths from the regular flu in the US and at least 310,000 hospitalizations. Most of those deaths were in the elderly, those with underlying health conditions, and the very young. https://www.cdc.gov/flu/about/burden/preliminary-in-season- estimates.htm

Typically the flu will not flourish in warmer weather, so we only have 2- 3 more weeks of regular flu season ahead. Hopefully this will prove true for coronavirus as well.

Now finally, remember! Don't worry. Try to relax, and to enjoy this time out of time. Maybe more is going on than meets the eye. Maybe there is a profound opportunity right now, for us to connect with our inner wisdom, and to help create a profoundly positive transformation of consciousness on the planet. Lets envision together the world we would love. Feel free to dream into being the best of your hopes for world peace, clean environment, harmony, health and expansion of

consciousness. Stabilize your heart field by cultivating peace of mind, and connect with your heart! Love to you all!

Heart Centered Breathing Exercises:

a. Breathe in through the top of your head and out through your heart (breastbone). Do at least 3 breaths.
b. Then, breathe in through your heart, and out through your solar plexus (upper abdomen/stomach). You can also go back and forth: in through heart out through solar plexus, then in through solar plexus, out through heart. Do at least 6 breaths.

Include a word as you breathe if you like. A word that is soothing like peace, joy, freedom, love, or ease can be especially helpful. Breathe that word in and breathe it out.
c. Then Breathe in through your heart and out through your lower abdomen (below the navel). Do at least 3 breaths

d. Then get into a thought that when you think of it gives you joy. Something that gives you “falling in love feelings.” Bask in that, enjoy at least 30-60 seconds
Breaths can be normal, or slightly deeper than normal. They do not have to be very deep.
Stay healthy! 



Magic Pet Publishing 2012 Copyright Marcey Shapiro MD