Cancer, diabetes, cardiovascular disease, obesity, smoking, and respiratory conditions – On September 4th 2020, at the United Nations press conference, they discussed these non-communicable diseases and behaviours in light of those with these have increased vulnerability to COVID and developing more severe outcomes (1). What do all these conditions have in common? INFLAMMATION. There has been an increasing amount of research coming out discussing that inflammation can increase the risk of severe manifestations from the SARS-COV-2 virus and research from Cruikshank (2020) highlights diabetes and obesity – both of which are pro-inflammatory conditions (2). More research is still needed as this is such a big area.
Inflammation is like the body is on fire! It is triggered when our immune system generates inflammatory products called cytokines like IL-6 and TNF-alpha in response to an infection, resolve an injury or damage from a chronic health condition, a response to allergies/food sensitivities, or in an autoimmune condition. Inflammation can be good in the long-term because it helps to get rid of the threat however it can go overboard if it isn't controlled or managed. These cytokines can create joint pain, fatigue, muscle pain, digestive issues, headaches, and more. Chronic inflammation can throw off our hormones, affect sleep, affect your weight and so much more.
With respect to this SARS-COV-2 virus, you may have read that it can create a ‘cytokine storm’ which increases the severity of symptoms – a ‘cytokine storm’ means there is an excess of these inflammatory products. The ‘cytokine storm’ is more pronounced in those with pre-existing inflammatory conditions like the ones mentioned by the United Nations but also those with unmanaged autoimmune conditions like colitis, IBD, Hashimoto’s thyroiditis or Grave’s Disease, lupus, rheumatoid arthritis, and others; chronic infections including gut infections; chronic injuries; and, other inflammatory conditions where there are already inflammatory cytokines circulating in their body and then you add the cytokines your immune system produces in response to the virus if you are exposed to it.
Uncontrolled diabetes leads to high blood sugar (hyperglycemia). We have known for a long time that sugar feeds and promotes inflammation hence why when someone follows an anti-inflammatory diet, sugar is avoided/minimized.
Some recent research out of the University of Manchester has shown that glucose specifically may have another mechanism for increasing the susceptibility of damage by the SARS-COV-2 virus because glucose increases a protein called ACE2 on specific immune cells (macrophages and monocytes) and the virus uses this ACE2 protein to attach to cells (2). Typically, macrophages and monocytes are supposed to help destroy the infectious threat, repair damaged tissue, and attract other immune cells for help when necessary. Now that these cells have ACE2, the virus attaches to them and invades the cell infecting it so it cannot do its job. This also leads to reactive oxygen species which means your body needs tons of antioxidants like glutathione to ‘quench’ these reactive species otherwise this can generate greater inflammation which can potentiate a cytokine storm (2).
It is best to ensure your glucose levels are under control and minimize your sugar intake.
Glutathione is a major antioxidant in our body and often is known for its “skin brightening” properties. It is necessary to help combat inflammation as well. You can read more on glutathione’s antioxidant ability here. In respect to the support for infections, glutathione also helps increase TH1 and NK cell immune cell activity – TH1 T-cells and NK cells are the cells that help fight infections, specifically viral infections (3). There has also been some research that shows glutathione helps increase the vitamin D receptor and makes vitamin D work more efficiently (3). So as much as Vitamin D being important for the immune system, it is important to have sufficient glutathione available as well so that vitamin D can do its important work. Read more on all the benefits of Vitamin D here.
Naturopathic doctors can order Vitamin D Testing via Calgary Lab Services for a nominal fee but if you have been supplementing for a long time, it’s very important to test your levels to make sure you are absorbing the supplements. NDs also have functional testing options available that include a glutathione assessment and we can order tests to assess for inflammation too.
So, while we still don’t have any research-proven treatments to prevent and/or treat COVID-19, the best advice is if you have a chronic disease like something mentioned above or increased inflammation in your body, this is a great time to regain control of your health and manage your condition. This doesn’t necessarily mean you will not get the SARS-COV-2 virus or severe manifestations but whatever you can do now may help to optimize outcomes down the road for your overall health. This can be via seeing your medical doctor, naturopathic doctor, or another healthcare professional that can help you manage your health condition.
The United Nations has also recently updated their website to include a #Healthyathome section where they mention the following are integral to reducing your risk of diabetes, cancer, obesity, and heart disease – the non-communicable diseases they mention are most at risk of severe outcomes (4).
- Engaging in physical activity
- Eating healthy
- Reducing alcohol intake
- Stopping smoking
- Taking care of your stress and mental health
Ensuring your glutathione and vitamin D levels are optimal is important too.
Don’t worry, I know what you are thinking … lockdown got you more stressed, you ate more junk food and sugar, stopped exercising, drank more alcohol (if you are legal) but hopefully didn’t start smoking. Perhaps you gained an extra pound or two or more. There is still enough time to get back to your healthy regime even though we are still in the midst of the pandemic and physical distancing mode. Plus it pays to manage the stress levels now!
As a naturopathic doctor, I work with a lot of people on general wellness optimization and prevention and/or managing people’s chronic health conditions. There’s a lot we can do from a nutritional and herbal approach to help optimize your health and reduce their risk of chronic disease and inflammation. So if you need a little kick start to get back to your healthy regimes, come in for an assessment, and let’s build an action plan together!
- World Health Organization (WHO). Coronavirus (COVID-19) Pandemic “WHO – Press Conference”. 4 Sept 2020. Retrieved on 5 Sept 2020 from https://www.who.int/emergencies/diseases/novel-coronavirus-2019?gclid=Cj0KCQjw7sz6BRDYARIsAPHzrNLZl4WmAa9uMB-gLHSATObHo4ioR2Dhgf_eovmH8Q5KlY_hLN4x4O0aAkejEALw_wcB
- Cruickshank, S. “Inflammation: the key factor that explains vulnerability to severe COVID” in The Conversation. The University of Manchester. 26 Aug 2020. Retrieved on 1 Sept 2020 from https://www.manchester.ac.uk/discover/news/inflammation-the-key-factor-that-explains-vulnerability-to-severe-covid/
- Polonikov A. Endogenous Deficiency of Glutathione as the Most Likely Cause of Serious Manifestations and Death in COVID-19 Patients. ACS Infect Dis. 2020 May 28;6(7):1558-1562
- World Health Organization (WHO). #Healthyathome. 2020. Retrieved on 4 5 Sept 2020 from https://www.who.int/campaigns/connecting-the-world-to-combat coronavirus/healthyathome