Medical Articles by Dr. Ray

Oct

2020

What can Happen to Your Body Over Months of Isolation

By Ray Schilling | Cardiovascular disease, Circadian rhythm, diet, exercise, fasting mimicking diet, Fitness, heart attack, melatonin, Obesity, Processed food, sleep, Stroke, vaccinations

A recent article by CNN describes what can happen to your body over months of isolation at home. The article is rather negative showing all the possible things that can go wrong. I have been isolated as well since March 2020. I handle the isolation differently than described in the article. I will comment to each point what can be done differently to avoid the complications mentioned.

Muscle loss

The CNN article makes the point that inactivity can make you lose muscle bulk within only one week. A lack of exercise weakens your muscle strength. And muscle strength has been associated with longevity.

My comment:

I do a brisk walk of 5 to 7 kilometers daily. This maintains my muscle bulk. But I have a treadmill in the basement and a couple of weights that I can use, if it rains outside.

There is a danger that heart and lungs get weaker

You need to raise your heart rate and you also need to perfuse your lungs through exercise. Many people do not like exercise. They sit in front of the TV for hours or they surf the net on the computer. Even just reading a book does not give you enough exercise to get your heart rate up and increase your lung perfusion.

My comment:

A brisk walk with proper distancing gives you fresh air, exercises your muscles, your heart and your lungs. It maintains your cardiovascular fitness.

Weight gain

Being home all the time allows you to look into the fridge more often and eat snacks that are processed. People tend to eat more often than 3 times a day. The end result is that you gain weight. In the beginning of the epidemic people stocked up on non-perishable foods. Often they contain more sugar and carbohydrates. Consuming these foods leads to weight gain. Wearing masks, frequent hand washing, isolation practices and change of normal routines makes people get stressed. Stress leads to overeating and weight gain.

My comment:

In the last 6 months that I did home isolation my body mass index (BMI) stayed in the 21.0 to 22.0 range. I ate three meals a day. I avoided processed foods as they are overloaded with sugar, salt and refined carbs. Once a month I do a 5-day fasting mimicking diet according to Dr. Longo. This ensures that my BMI stays within the range I indicated. Otherwise I eat a Mediterranean diet, which is anti-inflammatory.

Your posture could suffer

When you are seated in front of the computer or the TV you tend to engage in poor postures. This can lead to strains of your back, neck, shoulders and hips. Staring at the computer screen or the TV can also give you eye strain.

My comment:

The key is movement, such as getting up and walking around; doing other activities like lawn mowing, weed eating or doing dishes. This interrupts any longer stretch of bad posture.

Your sleep quality can suffer

The more exposure to sunlight during the day you get, the more vitamin D you produce in the skin. Some people lack the necessary enzymes in the skin to convert cholesterol into vitamin D. But exposure to sunlight also helps to reinforce your diurnal hormone rhythm. This is also called circadian rhythm. Avoid blue lights (TV, computer, iPhones etc.) in the evening before bedtime as this can interfere with a deep sleep later. Also go to bed early enough (between 10 and 11 PM) to allow your circadian rhythm to take over.

My comment:

Some people (above the age of 60) benefit from 3 mg of melatonin at bedtime. After the age of 60 people no longer produce enough melatonin in the pineal gland. If I wake up in the middle of the night, I take another 3 mg of melatonin prior to 3AM. Caution: after 3 AM melatonin can give you a bit of a hangover in the morning.

Your brain can slow down

The brain needs nutrition and exercise. Exercise can eliminate certain amino acid by-products that otherwise turn into neurotoxins. With exercise you even prevent neurotoxins to enter the brain.

My comment:

I find that I must at least do a brisk walk of 4 kilometers a day. It prevents back pain, helps me sleep better and keeps my mind clear. But as mentioned earlier I prefer doing a brisk walk for 5 to 7 kilometers a day. In the past (prior to March 2020 when the Covid-19 pandemic started) I went to the gym every day. When it finally reopened, they had one Covid-19 case at the gym. I decided that it is too dangerous to go back to the gym until a safe Covid-19 vaccine is available in the summer of 2021. I feel the same way about flying. It is not worth the risk. I can just stay local and do my own program. The pleasure of traveling can wait until the summer of next year.

What can Happen to Your Body Over Months of Isolation

Conclusion

A recent CNN article described the dangers of passively staying in home isolation. I felt that this article was on the negative side. I found that by including a regular brisk walking program into my daily lifestyle the day got more structured. I felt I had more energy and I had no aches or pains. If I spent too much time watching TV or spending in front of the computer, I developed back aches and felt sluggish. I incorporated a 5-day fasting mimicking diet according to Dr. Longo once per month into my regular Mediterranean diet. This allowed me to keep my body mass index in the 21.0- 22.0 range. Doing what I described above I could continue to hold my weight, have energy and stay pain free for many more months. But when the Covid-19 vaccine arrives in spring/summer of 2021 I hope that things will return to normal.

Oct

2020

Medical Myths about Aging

By Ray Schilling | andropause, cholesterol, Circadian rhythm, Dementia, diet, exercise, fractures, heart attack, High Blood Pressure, Hormones, lung cancer, Menopause, Mortality, Obesity, Pain, Smoking, Stroke

Medical myths about aging are easy to debunk. Many people believe that it is inevitable that they become disabled as they age, their lives become unbearable, without passion, boring and full of pain. Some aspects of your health may decline with age, none of the myths discussed below is inevitably happening in everyone. Studies showed that a positive outlook on aging and life in general will help you to live longer and stay healthier. Here I discuss 7 common myths about aging.

Myth 1: Everyone will experience physical deterioration

It is common for people to experience reduced muscle strength, increased blood pressure, excessive fat accumulation and osteoporosis. A study with 148 older patients showed that an expectation of reduced fitness in older age actually resulted in less physical activity when older age arrived.

But you can maintain good cardiovascular function and good muscle strength with a regular exercise program. This study showed that men and women can reduce mortality by exercising regularly, even in older age.

Myth 2: Older adults cannot exercise

There are several reasons why older people stop exercising or are afraid to start exercising. People use the excuse of their arthritis getting worse from exercise. But studies showed the opposite: joint function improves and joint pains are getting better with exercise. Your muscles get stronger and you are less likely to fall. Your heart and lungs are improving their functions and your mentation improves. Exercise increases the HDL cholesterol, which reduces the risk for heart attacks and strokes.

Myth 3: As we age, we need less sleep

For many years there was the notion that older people need less sleep. What was not known then was that people above the age of 60 have no appreciable secretion of melatonin from the pineal gland. But when they replace their melatonin deficiency by taking a nighttime dose of 3 mg at bedtime, they will sleep better and longer. They may need a second dose of melatonin in the middle of the night. We need 7 to 8 hours of sleep at night for our diurnal hormone rhythm.

This will also slow down our aging clock.

Myth 4: Your brain slows as you age

Dementia is common when you get older. 13.9% have it at age 71 and older. 37.4% have dementia over the age of 90. But the majority, namely 86.1% in the 71+ age group and 62.6% above the age of 90 do not have dementia. A Mayo Clinic study showed that when the person engaged in artistic activities in midlife or later in life the risk for mild cognitive impairment (MCI) development was reduced by 73%, involvement in crafts reduced it by 45% and engagement in social activities by 55%. In a surprise finding the use of a computer late in life was associated with a 53% reduction in MCI development. These are very significant observations.

Physical activity reduces risk for dementia

Apart from stimulating your brain, physical activities also significantly reduce the risk for dementia. A synopsis of 11 such studies showed that dementia is reduced by 30% when physical activity is started in midlife and the person is aging compared to non-exercisers.

Myth 5: Osteoporosis occurs only in women

There is a serious misunderstanding about osteoporosis. Several factors work together that can cause osteoporosis. Women in menopause are more likely to develop it due to the missing ovarian hormones estrogen and progesterone. These hormones work together and stimulate vitamin D induced calcium deposition into bone as well as decreasing bone resorption.

Vitamin K2 also deposits calcium into the bone. In postmenopausal women who take bioidentical hormone replacement, vitamin D and K2 the bone density remains strong. Unfortunately, the opposite is true in postmenopausal women who take synthetic hormones. Synthetic hormones have side chains that do not fit the natural hormone receptors of a woman. This is why osteoporosis persist. And, yes, men get osteoporosis, but typically 10 years later. Typically, they get into andropause where testosterone production declines 10 years later.

Myth 6: People stop sex as they age

With age men can develop erectile dysfunction (ED) and women vaginal dryness, both of which can interfere with having sex. A large study showed that only 0.4% of men in the age group 18-29 had ED. In the age group of 60-69 there were 11.5% who suffered from ED. What this means though is that 88.5% of men age 60-69 did not suffer from ED. Fortunately for those who have ED drugs like Cialis and Viagra can correct their problem and they can have regular sex. What a change from 25 years ago when none of these drugs were available (approval of Viagra by FDA in 1998 and of Cialis in 2003).

Bioidentical hormone replacement beyond menopause and andropause preserves your normal sex drive as well. There are additional benefits of bioidentical hormones. They have positive effects on the heart, brain, bones and the muscle mass.

Myth 7: It is too late to stop smoking now

One of the myths that many older smokers like to say is that it would be too late to stop smoking. They think the damage to heart and lungs is permanent and quitting now is too late. Fact is that quitting smoking immediately improves your blood circulation and gives you more oxygen. In just 1 year the risk of getting a heart attack is cut into half. In 10 years, the risk of a heart attack or stroke is the same as that of non-smokers. There is a reduction of getting lung cancer by half.

Medical Myths about Aging

Conclusion

There are all kinds of medical myths about aging. We may think that physical deterioration is inevitable. Or we believe that older people cannot exercise. And we cannot help it, but our brain slows down as we get older. And there is the question whether we need less sleep as we age. Osteoporosis is a disease of women, is it not? These older couples, they don’t have sex any more, do they? And is it too late to stop smoking now that I am 65 years old? All of these myths exist, but there is a need to debunk them.

The truth behind the medical myths about aging

I explained in detail what the medical truths are behind these questions. Many of these myths have developed in the past. But with regular exercise, balanced nutrition (Mediterranean diet) and a positive attitude much of these old myths can be overcome. Bioidentical hormone replacement when hormones are missing is another powerful tool. Yes, we all age. But we are still living and can enjoy life as long as it lasts.

Oct

2020

Fibrotic Eye Disease Responds to Nicotinamide (Vitamin B3)

By Ray Schilling | Dementia, Vitamins and supplements

A new study from Mt. Sinai Hospital showed that fibrotic eye disease responds to nicotinamide (vitamin B3). In general, during wound healing there can be aggressive cell transformations. This can cause scarring, retinal detachment and finally loss of vision and even blindness. Notably, the following pieces of evidence support the notion that vitamin B3 (nicotinamide) helps to make eye diseases better.

Lab experiments made in Petri dishes

Specifically, researchers performed experiments in Petri dishes with human adult cells. After adding nicotinamide, they found the following.

There were no harmful cell transformations
Membrane formation in conjunction with scar formation was reversed
There is a slow-down regarding the development of eye diseases that lead to loss of vision and blindness

Vitamin B3 was first detected as a cure to Pellagra

Pellagra, the vitamin B3 deficiency was first described by the Spanish physician, Don Gaspar Casal in 1763. Typically, pellagra presents with dermatitis, diarrhea and dementia. If left untreated it will lead to death. The skin showed inflammation, particularly in areas where there was exposure to the sun or to friction. Affected skin may be darker. Pellagra occurs mainly in the developing world, particularly in sub-Saharan Africa.

Experiments with vitamin B3 on mice curing eye disease

In a mouse model researcher showed that vitamin B3 could largely prevent the development of glaucoma in aging mice. According to these researchers 93% of the mice with the higher dose of vitamin B3 did not develop glaucoma. Vitamin B3 (the precursor of nicotinamide) is important for the production of NAD+ and the phosphorylated form NADP, which are cofactors in the energy producing metabolism of mitochondria.

Experiments on rabbits showing a cure with nicotinamide

In a 1985 publication rabbits were subjected to a vitamin B3 inhibitor, namely 6-aminonicotinamide. This is an antimetabolite of nicotinamide. It was given by intraabdominal injection. The rabbits developed diarrhea, ascending paresis/paralysis and death. They also developed vascular lesions in the eyes, particularly the iris with an acute inflammation of the iris, which physicians call iritis. The ocular lesions could be prevented by administering nicotinamide. The researchers concluded that vitamin B3 deficiency was responsible for the eye lesions.

Clinical trials show a response of glaucoma to vitamin B3

In a clinical trial physicians compared 34 primary open-angle glaucoma (POAG) patients with a control group of 30 age- and sex-matched controls. The researchers measured plasma nicotinamide concentration in both groups. The POAG patients had on average 33% lower nicotinamide plasma levels than the control group. They concluded that glaucoma seems to be associated with lower plasma nicotinamide levels. The research team suggested that these findings need to be confirmed in a larger series of glaucoma patients. They also suggested that vitamin B3 therapy could become one of the treatment modalities.

Fibrotic Eye Disease Responds to Nicotinamide (Vitamin B3)

Conclusion

We know vitamin B3 deficiency mainly as pellagra. It occurs mainly in the developing world, particularly in sub-Saharan Africa. But newer experiments in vitro, in mice and in rabbits showed that vitamin B3 deficiency can also cause eye disease. Other studies showed that fibrotic eye disease responds to nicotinamide (vitamin B3). In addition, a clinical trial in humans showed that glaucoma can develop as a result of a 33% lack of plasma nicotinamide (vitamin B3) level. Regular supplementation in those who are prone to vitamin B3 deficiency may be curative for eye disease.

Sep

2020

A New Antibiotic Against Methicillin Resistant Staphylococcus aureus

By Ray Schilling | antibiotics, Infectious Disease

A US study describes a new antibiotic against methicillin resistant Staphylococcus aureus. It is a lysin-based antibacterial agent.

Physicians have been looking for years for a solution regarding the increasing antibiotic resistance problem. But several attempts in the past have failed.

Staphylococcus infections are the most common bacterial infections of human skin, of soft tissue, joints, bones, and pneumonia. In addition, it can cause endocarditis (=infection of heart valves) and lead to blood poisoning (septicemia).

Staphylococcus aureus is the underlying bacterium behind staph infections. With the introduction of new antibiotics it takes only 1 to 2 years before this bacterium learns to become resistant. Researchers noticed that the bacteria start to produce lysins and suddenly they are resistant to the latest antibiotic. Further research zeroed in on lysostaphin, which was active against resistant Staphylococcus bacterial strains.

Deimmunized lysostaphin

Lysostaphin is an antibacterial peptide described here in detail. But there still was some interference with immunologically active surface antigens that scientists were later able to overcome. Researchers succeeded lately in removing some of the surface antigens and develop deimmunized lysostaphin. This is what this publication is all about.

It describes how T cells cannot detect the surface antigen properties of deimmunized lysostaphin. This way none of the strength of deimmunized lysostaphin gets lost in the fight against resistant staphylococcus that normally form anti-drug antibodies. Researchers pointed out the importance of the deimmunization process to make deimmunized lysostaphin invisible to the T cells of the immune system.

Vigorous testing of deimmunized lysostaphin

The researchers who investigated the efficiency and safety of deimmunized lysostaphin did the following tests.

Although lysostaphin was deimmunized, it retained potent in vitro and in vivo anti-staphylococcal activity. In vitro studies involving Petri dishes with methicillin resistant Staphylococcus aureus showed the effectiveness of deimmunized lysostaphin. In vivo testing in a mouse and rabbit model also showed effectiveness.
Deimmunized lysostaphin showed reduced immunogenicity in vivo. Researchers tested this in mice and compared the results to regular lysostaphin, where there was a swift immunological response.

More points regarding deimmunized lysostaphin

Immune evasion allows for repeated efficient dosing of deimmunized lysostaphin. This means that the physician can administer the antibiotic (the deimmunized lysostaphin) to fight the methicillin resistant Staphylococcus aureus with several daily doses.
The deimmunization process allows deimmunized lysostaphin to evade the immune response that occurs to regular lysostaphin. This prevents future resistance development. It also prevents that the immune responses weaken the anti-methicillin resistant Staphylococcus aureus response.
Researchers showed in a difficult rabbit endocarditis model that deimmunized lysostaphin treats MRSA infection successfully. Endocarditis is an infectious disease, which is both difficult to treat in rabbits, but also in humans. For this reason, rabbits are often used as a model when new antibiotics are developed. If they are successful in the rabbit model they often get approval later for human treatments.

Deimmunized lysostaphin in humans

Unfortunately, we are still a few years away from using deimmunized lysostaphin in humans. After successful use of lysostaphin in mice and rabbits the next logical application is to launch human clinical trials. I am convinced that this will be the next step and very likely will be successful.

A New Antibiotic Against Methicillin Resistant Staphylococcus aureus

Conclusion

Researchers found a new antibiotic against methicillin resistant Staphylococcus aureus in a lysin-based antibacterial agent. This peptide has surface antigens that scientists had to removed to make it more effective. The end result was a deimmunized lysostaphin. Researchers tested this new antibiotic that is effective against many antibiotic resistant strains of bacteria successfully in mice and rabbits. The next step is testing in humans. This involves several phases of clinical trials. These clinical trials have to show that there is a lack of toxicity. In addition, they have to show that the new antibiotic is effective against resistant bacteria. I estimate that this process can still take about 5 years from now before the clinician can use this antibiotic routinely. As the new antibiotic is a polypeptide, it the patient cannot take it orally, as the gut is digesting it. The patient has to take it by injection.

Sep

2020

Hair Style Products are Mostly Safe

By Ray Schilling | breast cancer, Cancer, lung cancer, toxins

A recent study concluded that hair style products are mostly safe when it comes to causing cancer. In the past there was some concern that the dyes for hair coloring could cause cancer. In a previous blog I mentioned that hair stylists are at a greater risk for developing bladder cancer. But in customers who had their hair colored this was more difficult to prove. The new study reviewed by CNN was based on a large cohort of 117,200 female nurses at Brigham and Women’s Hospital in Boston.

These 30-55-year-old nurses were observed for 36 years. Detailed information about hair coloring was part of the study.

Results of the hair coloring study

Women with light and medium use of hair dyes did not develop non-melanoma skin cancers, hematopoietic cancers or squamous skin cancers. The same was true for bladder cancer, melanoma, estrogen receptor positive breast cancer, progesterone receptor positive breast cancer and hormone receptor positive breast cancer. Furthermore hair coloring did not cause brain cancer, colorectal cancer, kidney cancer and lung cancer. 5% of women who ever used hair dyes did develop basal cell skin cancer; there was a total of 22,560 basal cell cancers that occurred.

The BJM showed that women who colored their hair regularly (termed “cumulative dose”) developed 24%-31% more breast cancer. This breast cancer was estrogen negative breast cancer (31%) and progesterone negative breast cancer (24%). They also developed 24% more ovarian cancers and 17% colorectal cancer than controls who did not dye their hair. Myeloid leukemias were also more common in the heavy use hair coloring group with 29% and follicular lymphomas with 13%. Other forms of leukemia were not more frequent.

Discussion

50% to 80% of women and about 10% of men ages 40 and older are using hair dye regularly in the United States and Europe. The above cited cancer frequencies were based on women with dark hair and a cumulative dose of more than 200 applications of permanent hair dye. Translated into years of application of hair dye this means coloring your hair for 16 to 17 years, if you color your hair once a month. The study is very powerful due to the large number of women examined and the amazingly long time of 36 years of observation.

Heavy use, medium and light use of hair dyes

It is interesting to note that only the heavy use of hair dye resulted in a few significant cancer figures. The light use (1 to 99 times) and medium use (100 to 199 times) of hair dyes did hardly lead to any cancer. There were some exceptions where light use of hair dye led to 34% more bladder cancer and to 67% more follicular lymphomas. These were oddities, because the lighter use of hair dyes led to higher amounts of these cancers than medium and heavy use. This is not what the researchers expected.

Hodgkin’s lymphoma and breast cancer

Hodgkin’s lymphoma was about 3- to 5-fold more common in all hair coloring categories compared to non-use of hair dye. The authors discussed subgroups of women as well. They noticed that black women using permanent hair dye had a higher risk to develop breast cancer than white women who only had a borderline increased risk. Estrogen negative, progesterone negative and hormone negative breast cancer was more likely to be caused by heavy use of hair dyes.

No association between the following cancers and hair dye use

The present study could not find an association between ever using hair dye and the following. The study found no association with cutaneous squamous cell carcinoma, melanoma, ovarian cancer and colorectal cancer. In addition there also was no association with kidney cancer, lung cancer, and brain cancer. But it found a slight increased risk (5%) of basal cell carcinoma.

The study contains no information regarding the specific ingredients in hair dye that are carcinogenic. In the US supervision of permanent hair dyes by the FDA is rather loose. This leaves the manufacturer mostly in charge regarding the composition of the hair dyes. This is different in Europe and in Japan. Here manufacturers removed several carcinogenic substances from hair dyes because of regulations by the local regulatory bodies. This could have a cancer-lowering effect in these countries.

Hair Style Products are Mostly Safe

Conclusion

This large study from the British Medical Journal, published Sept. 2, 2020 explains the relationship of cancer risk to permanent hair dyes. The study lasted 36 years and involved 117,200 female nurses. More than 96% of the women were Caucasians. This study showed that for most people who use permanent use hair dyes there is no association with most cancers. However, there was an association between a few cancers and the use of hair dyes. These were in 5% basal cell skin cancers. But breast cancer (31% estrogen receptor negative, 24% progesterone receptor negative), ovarian cancer (24%) and 17% colorectal cancer were among these too. There was also an increased risk of Hodgkin’s lymphoma.

Effect of screening by FDA regarding carcinogenic substances in hair dyes

All this data was based on the hair dyes used in the US. Supervision of permanent hair dyes by the FDA is rather loose, with the manufacturer being mostly in charge. This is different in Europe and in Japan. Here local regulatory bodies instructed manufacturers to remove several carcinogenic substances from hair dyes. This could have a cancer-lowering effect in these countries.

Sep

2020

How to Manage Clot Formation with Covid-19

By Ray Schilling | blood clots, heart attack, immune system, Infectious Disease, Inflammation, Lung Disease, Mortality, Stroke

A publication in the Canadian Medical Association Journal describes how to manage clot formation with Covid-19. A significant amount of cases among Covid-19 patients come down with clotting problems. This means that an infection with SARS-CoV-2 (or Covid-19 coronavirus) may initially present with a fever and cough. But a few days later it can suddenly turn into a dangerous disease with severe clots, multiple organ failures and death.

Clot occurrence with Covid-19

It is important to realize that most patients with SARS-CoV-2 do not need hospitalization. But physicians admit 10 to 15% of patients to the hospital. Of these 20% end up with treatment in the Intensive Care Unit (ICU). Of all the hospitalized patients between 5% and 30% develop some form of thrombotic event. Notably, complications of clot formation can be a stroke, a heart attack, a pulmonary embolism or a deep vein thrombosis in the leg. In a recent study from the US 400 random hospitalized patients with Covid-19 144 patients were admitted to the ICU. 4.8% had radiologically confirmed deep vein thrombosis. Overall there were 9.5% with thrombotic events that developed during the hospital stay.

How does a coagulopathy develop with Covid-19?

Truly, SARS-CoV-2 enters the body cells through an interaction of its viral spike protein with the angiotensin-converting enzyme 2 (ACE2) receptor. To explain, numerous organs and tissues express this receptor. This includes lung alveolar type 2 epithelial cells, endothelium, the brain, heart and kidneys. To emphasize, ACE2 leads to angiotensin II degradation. With the SARS-CoV-2 stimulation of the ACE2 receptor there may be an accumulation of angiotensin II, which causes a procoagulant state. Injury of the endothelium explains inflammation in the lining of the blood vessels in multiple organs. Commonly affected organs are lungs, heart, kidneys and intestines. The inflammatory reaction is what can lead to clot formation. When part of an organ has died off because of mini clots that destroyed part of the organ, this process can eventually lead to organ failure. Lung failure, heart failure and kidney failure can develop in these sick patients.

Adequate vitamin D blood levels are important for the immune system

By all means, vitamin D is very important for the integrity of the immune system. With vitamin D blood levels below 15 to 20 ng/mL (37.5–50 nmol/L) the immune system is paralyzed, and any viral or bacterial infection tends to overwhelm the body. Of course, this is the reason why the mortality due to Covid-19 coronavirus is highest in patients with these low vitamin D blood levels. People with secondary illnesses (diabetes, arthritis, autoimmune diseases, cancer) and patients above the age of 60 have the lowest vitamin D blood levels and have the highest mortality rates. This publication describes this in more detail.

Best vitamin D blood level is in the upper normal range (50-80 ng/mL)

Above a vitamin D blood level of 30 ng/mL (=75 nmol/L) a patient’s immune system is functioning normally. However, the immune system is strongest at a vitamin D blood level of 50–80 ng/mL (125–200 nmol/L), which is the upper range of the normal level for vitamin D in the blood.

Keep in mind that vitamin D toxicity occurs only above 150 ng/mL (375 nmol/L).

Specific effects of vitamin D on Covid-19

There are three major effects that vitamin D has.

A strengthening of the epithelial barrier not allowing the coronavirus to penetrate into the lung tissue as easily.
Release of defensins and cathelicidin, two crucial antiviral polypeptides that eradicate any virus in the system.
Interruption of the “cytokine storm”, an overwhelming inflammation which is responsible for viral pneumonia to develop. Without the cytokine storm there is no damage to the lungs and people do not need treatment in the ICU. This is particularly important for people above the age of 60 and for people with pre-existing diseases.

In like manner, with the stabilizing effect of vitamin D regarding the immune function more severe forms of Covid-19 can turn into less severe forms with a better outcome.

Treatment of patients with Covid-19 who have clotting problems

Patients need to be assessed with respect to their risk of developing clots. This publication describes that high risk patients have elevated D-dimer levels. When blood clots dissolve the body produces D-dimer, a protein fragment. Normally the D-dimer test is negative in a person that does not produce clots. But in sick patients with Covid-19 who form clots this blood test typically shows D-dimer >2500 ng/mL. In addition the tests show high platelet counts (more than 450 × 10⁹/L), C-reactive protein (CRP) >100 mg/L and an erythrocyte sedimentation rate (ESR) >40 mm/h.

Indeed, with this constellation of blood tests in a severe Covid-19 case in the ICU setting, the physician uses heparin intravenously or subcutaneously to counter clot formation. However, this needs to be balanced against the risk of causing severe internal bleeding.

Separate from the anticoagulant effect, heparin seems to also suppress inflammatory cytokine levels. In addition, heparin suppresses neutrophil chemotaxis and migration. Physicians rescued many patients from death using heparin therapy.

Risk versus benefit clinical trials of heparin therapy are required

At this point there are only retrospective clinical trials available to describe risk versus benefit of heparin therapy. Some show no difference, others do. There are two international clinical trials on their way to shed more light on this situation. Until the results of these clinical trials are available, physicians need to treat patients to the best of their knowledge.

How to Manage Clot Formation with Covid-19

Conclusion

Clot formation in sick Covid-19 patients is responsible for many deaths in Covid-19 patients. The SARS-CoV-2 (or Covid-19 coronavirus) causes a cytokine storm with injury to the lining of the arteries. This can affect multiple vital organs and the condition may lead to organ failure. This activates the clotting system and causes clots all over the body. When this process occurs, patients get very sick and the death rate climbs. Physicians were able to rescue some patients with heparin therapy. Two international clinical trials are on the way. Hopefully these trials answer questions about this newer treatment method. The downside of heparin therapy is the complication of massive bleeding, which causes deaths as well. When it comes to Covid-19, don’t rely on curative medicine. Strengthen your immune system by preventative therapy like vitamin D3 that can interrupt the cytokine storm.

And even with a “well-prepared” immune system it is extremely important to follow all the guidelines of distancing, disinfecting and wearing face masks. We need all the help we can get!

Aug

2020

Health Benefits from Vitamin C Supplements

By Ray Schilling | Cancer, Cardiovascular disease, Diabetes, diet, heart attack, High Blood Pressure, immune system, Mortality, Stroke

Notably, there are health benefits from vitamin C supplements as I will explain below. A recent publication in the Journal of Intensive Care stated that vitamin C may lower ventilator time for sick patients in the ICU. In this case, researchers performed a meta-regression analysis. It is important to realize that higher doses of vitamin C changed the need for ventilation. Vitamin C given intravenously or by mouth significantly reduced the need for ventilation in sick patients. To explain, the researchers pooled eight clinical trials and compared them to a control group who did not receive vitamin C treatment. In detail, the researchers noted that there was a 14% reduction with regard to ventilator use in the treatment group. To clarify, they had received vitamin C infusions while patients who did not receive vitamin C infusions served as controls.

Five of the clinical trials involved patients who received 10 hours or more ventilation treatment. Certainly, these patients were sicker than the average ICU patients. They experienced a 25% reduction of ventilator time after receiving between 1 and 6 grams of vitamin C. The physicians gave this intravenous or orally.

History of Mega doses of vitamin C

Indeed, in the 1940’s mega doses of vitamin C were given intravenously in an attempt to treat polio. Eventually, in the late 1960’s Linus Pauling called high doses of vitamin C the “healing factors for diseases”. But subsequent clinical investigations showed that vitamin C had limitations. The Oregon State University website reports that some of the claims about vitamin C in the past went overboard. Here are some points about vitamin C that we need to remember.

Vitamin C is an important cofactor in many enzymatic reactions, such as the biosynthesis of collagen, carnitine and neuropeptides. In addition, the regulation of gene expression requires vitamin C and vitamin C is an important antioxidant.
A prospective cohort study showed that higher vitamin C blood levels lowered the risk of high blood pressure, coronary heart disease and strokes.

More effects of vitamin C

Patients in need of a surgical procedure benefitted from vitamin C. Researchers showed that vitamin C was a valuable adjunct to conventional medicine in cardiovascular disease Vitamin C reduced arrhythmia and myocardial injury following cardiac procedures.
There is insufficient evidence that regular vitamin C intake prevents cancer. Randomized controlled clinical trials reported no effect of vitamin C on cancer.
10 grams per day of vitamin C has no association with toxic or adverse effects in most people. However, some adults are more sensitive to vitamin C and develop gastrointestinal disturbances and diarrhea with megadoses of vitamin C. For these people physicians recommend taking up to 2 grams per day of vitamin C.

Vitamin C and disease prevention

Several clinical trials involving vitamin C supplements showed significant positive effects on patients. Below I am briefly reviewing these clinical trials.

Endothelial function

Endothelial function was improved with doses of above 500 mg of vitamin C. This likely is the reason that there is a reduction of cardiovascular disease in people who consume 1000 mg of vitamin C daily.

High blood pressure

Vitamin C at 500 mg daily lowers high blood pressure. A clinical trial found that 500 mg of vitamin C daily lowers the systolic blood pressure by 3.84 mm mercury and the diastolic blood pressure by 1.48 mm mercury. Over several years’ time this can prevent premature heart attacks and strokes.

Vitamin C and the immune system

Vitamin C is a powerful antioxidant. It can neutralize reactive oxygen species, which are produced when the immune cells fight viruses and bacteria. Neutrophils, lymphocytes and phagocytes are all supported by vitamin C. Vitamin C and E co-operate in their antioxidant functions. Vitamin C is essential for a strong antibody response with bacterial or viral infections. I take 1000 mg of vitamin C once daily.

Heart failure, strokes and heart attacks

Many studies showed some effects on reduction of heart attacks, strokes and congestive heart failure. With respect to strokes there was a 42% risk reduction over 9.5 years when the highest vitamin C plasma level was compared to the lowest level. But results regarding heart attack prevention and prevention of CHF were only marginal.

Cancer and vitamin C

Stomach cancer: there was a 45% reduction of stomach cancer when high vitamin C plasma level cases were compared to low plasma level cases.

Colon cancer: A pooled study based on 13 prospective cohort studies showed that vitamin C supplementation reduced colon cancer risk by 19%.

Large B cell lymphoma: After 11 years of follow-up the Women’s Health Initiative found that vitamin C supplementation reduced diffuse large B cell lymphoma by 31%.

Researchers could not show significant effects of vitamin C on other cancers.

Type 2 Diabetes (=adult onset diabetes)

A large European study going on for 12 years showed a strong inverse relationship between blood levels of vitamin C and the onset of diabetes. Patients with the highest vitamin C blood levels had a 62% lower risk of developing diabetes. Physicians compared this to low level vitamin C controls.

Mortality reduction with vitamin C supplementation

In the EPIC-Norfolk prospective study a clear inverse relationship was found with higher vitamin C blood levels and a reduction in risk of all-cause mortality.

Recommended dietary allowance for vitamin C

The official dietary recommendation for vitamin C in adults is 90 mg daily for males and 75 mg daily for females. However, in view of the above mentioned clinical trials I would recommend the following. Supplement with 500 mg to 1000 mg of vitamin C daily to have enough vitamin C reserves. The reason I say this is that the official dietary recommendation was based on preventing scurvy, the historic insufficiency disease of vitamin C. In addition, as mentioned before, vitamin C is safe to take up to 10 grams per day. Many physicians recommend taking a smaller amount of vitamin C found to prevent strokes, high blood pressure, type 2 diabetes, improve endothelial function and strengthen the immune system.

Health Benefits from Vitamin C Supplements

Conclusion

In my review I discussed health benefits from vitamin C supplements. Briefly, doctors noted that severely sick patients on respirators in the ICU setting were able to reduce the ventilator use. This was significant after they received between 1 and 6 grams of intravenous or oral vitamin C. However, patients with the highest vitamin C supplementation had a 62% lower risk of developing diabetes than low level vitamin C controls. Vitamin C lowered high blood pressure moderately and prevented strokes by 42%. Vitamin C stimulates the immune system together with vitamin D, A, E and some trace minerals. There are many more health benefits from vitamin C supplements. The official dietary recommendation for vitamin C in adults is 90 mg daily for males and 75 mg daily for females. However, I take 1000 mg of vitamin C daily as the evidence shows that this is healthier.

Aug

2020

Poor Diets Threaten Americans and Cause Diseases

By Ray Schilling | alcohol, Alzheimer’s disease, Cardiovascular disease, diet, exercise, fish oil, Fitness, food, heart attack, Hormones, lifestyle, Lung Disease, Nutrition, Obesity, polyunsaturated oil, Smoking, Stroke, sugar

A new Federal Nutrition Research Advisory Group stated that poor diets threaten Americans and cause diseases. More than 500,000 people in the US are dying every year because of poor nutrition. 46% of adults have unhealthy diets; but children have even more, namely 56%. In 1979 the US healthcare cost was 6.9% of the gross domestic product. Compare this to 2018 when the US healthcare cost was 17.7% of the gross domestic product.

The Federal Nutrition Research Advisory Group states: “Poor diets lead to a harsh cycle of lower academic achievement in school, lost productivity at work, increased chronic disease risk, increased out-of-pocket health costs, and poverty for the most vulnerable Americans.”

You can improve your diet quality

When you start cutting out junk food and other processed foods, the quality of your food intake is improving. Eat more vegetables, and fruit. Eat wild salmon, which provides omega-3 fatty acids. Do not consume vegetable oils like soybean oil, canola oil, safflower oil, corn oil and grapeseed oil. They all contain omega-6 fatty acids. Omega-6 fatty acids are essential fatty acids and they convert mainly into energy. But the problem is that our western diet contains too many omega-6 fatty acids. Omega-6 fatty acids can convert into arachidonic acid, which causes inflammation. This in turn can cause heart attacks and strokes on the one hand and arthritis on the other. Use cold-pressed extra virgin olive oil instead for cooking and on salads.

How does poor quality food affect your health?

Researchers are aware of trans fats causing Alzheimer’s disease, heart attacks and strokes for a long time. They increase the bad LDL cholesterol, decrease the good HDL cholesterol. Rancid oils contain free radicals that oxidize LDL cholesterol and attack the lining of your arteries through small dense LDL cholesterol. The FDA has started to initiate steps in 2015 to make the use of trans-fats in the food industry illegal. Completion of this in the US occurs in early 2020.

Japanese trans-fat study (Alzheimer’s disease)

This Japanese study followed 1,628 Japanese community residents (men and women) for about 10 years. Researchers used the typical trans fatty acid, elaidic acid to monitor the accumulation of trans fats in patients. This is possible with a simple blood test, which serves as a marker for industrial trans fats. 377 participants developed dementia (247 Alzheimer’s disease and 102 vascular dementia). Based on the blood elaidic acid levels earlier in the study individuals with higher trans-fat levels were more likely to develop Alzheimer’s disease as the study progressed. Patients whose trans-fat blood levels were in the higher range were 50% to 75% more likely to develop Alzheimer’s disease or dementia.

Diseases caused by poor lifestyle habits

It is important to review the diseases that shorten life expectancy due to having poor lifestyle habits. Note that it is not only your dietary habits that determine this, but in addition, several lifestyle factors.

Cardiovascular disease

Smoking, lack of regular exercise and poor eating habits result in being overweight or developing obesity. All of these are risks with LDL cholesterol elevation and HDL cholesterol lowering that leads to heart attacks and strokes. Here is a study that shows how life is shortened after a heart attack. It is clear from this how important it is to give up all of the poor lifestyle habits to avoid this from happening.

Cancer

90% of lung cancers are the result of cigarette smoking. Heavy drinking can contribute and also lead to cancer of the liver, esophageal cancer, cancer of mouth and throat and cancer of the breasts in women. In addition, consuming too much alcohol causes cancer of the colon and rectum in both sexes.

Diabetes

There are a variety of risk factors causing diabetes. Obesity, a lack of exercise, a bad diet with too much carbohydrates and the aging process are what contributes to the development of type 2 diabetes.

We see again that it is largely lifestyle issues that drive the onset of this disease. People who have developed diabetes need to control their blood sugar very closely to avoid complications of diabetes. This includes making healthier choices.

Otherwise complications of diabetes are diabetic nephropathy, blindness from macular degeneration of the cornea, heart attacks, stroke and diabetic neuropathy. In addition, vascular complications also include artery occlusions in the lower extremities with frequent foot or below knee amputations.

Chronic diseases

Often chronic diseases develop when there is generalized development of inflammation. COPD, chronic kidney disease and arthritis are examples of such conditions. In addition, Alzheimer’s disease, arthritis, asthma, Crohn’s disease, cystic fibrosis and diabetes belong into this category. All of these chronic diseases have in common that cytokines produce inflammation in the body. This keeps the chronic disease going and makes it more difficult to cure. When the person with a chronic disease makes poor lifestyle choices, the inflammation just becomes more chronic.

Smoking is one of the factors that makes chronic inflammation more chronic. Having a body mass index above 25.0 (being overweight) and above 30.0 (obesity) also creates more inflammation in the body. Excessive alcohol intake damages body cells and releases free radicals. These in turn cause inflammation and make the chronic disease more difficult to treat. An unhealthy diet tends to raise the bad LDL cholesterol, introduces pesticides and other chemicals into your system and adds to chronic inflammation. Finally, a lack of exercise is not contributing to a healthy circulation and lowers the protective HDL cholesterol, paving the way for heart attacks and strokes.

Poor Diets Threaten Americans and Cause Diseases

Conclusion

A new Federal Nutrition Research Advisory Group has been formed, which noted that many Americans follow very poor diets. 46% of adults in the US have unhealthy diets; but children have even more poor diets, namely 56%. This is of concern, because in time this causes a variety of diseases discussed here. Instead of just treating the symptoms of these diseases, it is important to improve the diet people are on, which prevents the development of these diseases. A well-balanced diet not only prevents diseases, it also leads to longevity and healthy aging without Alzheimer’s disease. Take care of what you eat, and be sure it is healthy!

Part of this text was published before here.

Aug

2020

Eating Fish Protects the Brain from Air Pollution

By Ray Schilling | Dementia, diet, fish oil, Inflammation, omega-3 fatty acids

Research on white women aged 70 years or older found that eating fish protects the brain from air pollution. Dr. Ka He from the Columbia University of New York published the new study on July 15, 2020 in the online issue of Neurology®, the medical journal of the American Academy of Neurology.

1,315 women who did not have dementia at the start of the study enrolled in it. Researchers measured the air pollution of the areas where the women lived. They also measured their omega-3 fatty acid blood levels. They found that women from polluted areas who ate the lowest amounts of fish and had the lowest amounts of omega-3 fatty acids in their blood, had the highest amount of brain shrinkage.

Methods of determining brain shrinkage, omega-3 fatty acids and pollution

The amount of brain shrinkage was determined with MRI scans of the brain. The amount of white brain matter was measured, particularly the size of the memory-sensitive hippocampus. Blood omega-3 fatty acid content was determined in red blood cells. Pollution was determined by the fine particulate matter in air pollution at the address where the patient lived. Every woman in the study received a diet questionnaire regarding fish consumption. From this information the researchers determined the average fish consumption per week. This included broiled and baked fish, non-fried shellfish, canned tuna, tuna casserole and tuna salad. Deep fried fish was not part of the list, because other studies showed that deep-frying damages omega-3 fatty acids.

More details regarding the study

The researchers adjusted the study according to age, smoking status, and other factors that could affect brain shrinkage. Women with the highest intake of omega-3 fatty acids had the highest volume of white matter in their brains as MRI scans showed. Specifically, the researchers noted the following findings:

Women with the highest omega-3 fatty acid level had 410 cubic cm white matter
Women with the lowest omega-3 fatty acid level had 403 cubic cm white matter
Each quartile increase in air pollution caused shrinkage of white matter by 11.52 cubic cm in those women with low omega-3 fatty acid consumption
In women with higher omega-3 fatty acid levels each quartile increase in air pollution caused shrinkage of white matter by only 0.12 cubic cm
Women with the highest omega-3 fatty acid intake had the highest volume of the hippocampus

Comments by the lead author of the study

Dr. Ka He stated: “Our findings suggest that higher levels of omega-3 fatty acids in the blood from fish consumption may preserve brain volume as women age and possibly protect against the potential toxic effects of air pollution.” But Dr. Ka He cautioned: “It’s important to note that our study only found an association between brain volume and eating fish. It does not prove that eating fish preserves brain volume. And since separate studies have found some species of fish may contain environmental toxins, it’s important to talk to a doctor about what types of fish to eat before adding more fish to your diet.”

Limitations of study

The study was involving older white women. This means that the results cannot be generalized to Afro Americans, Hispanics or Asians. The researchers examined exposure to pollution only later in life, not in early life or midlife. Hopefully future studies will examine what happens with lifelong exposure to pollution.

How to limit mercury exposure when eating fish

Omega-3 fatty acids are abundantly present in fish. It has plaque-reducing properties and also reduces the risk for abnormal heart beats. Overall this means less cardiovascular disease. The American Heart Association recommends a 3.5 oz. serving of fatty fish (salmon, mackerel, lake trout, herring or sardines) twice per week.

Mercury and other pollutants

Pollution of the air, soil and rivers is causing accumulation of mercury and other heavy metals in ocean water.

This affects fish that live in the ocean. There is a pecking order of predators with the larger fish feeding on the smaller fish. The bigger the predator fish, the more mercury and other pollutants they accumulate. According to this link the safest seafood is wild salmon, pollock and oysters.

High mercury content of predator fish

Tuna is too high in mercury, so is swordfish, and shark is even worse. I only consume fish from freshwater lakes or rivers, as well as salmon, oysters and shrimp. This way I get the lowest exposure to mercury. Why is mercury bad for you? It is a neurotoxin. It can harm your brain, heart, kidneys, lungs and the immune system. Specific symptoms can include loss of peripheral vision and lack of coordination with balancing problems. There may be impairment of speech and hearing. The key is to avoid mercury exposure.

Smaller fish low in mercury

The first line of defense is to stick to the smaller fish. They are they prey of the large predator fish. The following fish/mussels belong into the low mercury group (alphabetical order): anchovies, catfish, clam, crab, crawfish, flounder, haddock, herring, mackerel, mullet, oyster, perch, pollock, salmon, sardines, scallops, shrimp, sole, squid, trout and whitefish.

Molecularly distilled omega-3 fatty acid supplements

You may want to supplement your omega-3 fatty acid intake by fish oil capsules. It is important that you choose the more expensive higher potency products. A molecular distillation process that removes mercury, PCB and other heavy metals creates these higher potency products. This way you only get the enriched omega-3 fatty acids in pure form. EPA and DHA in one capsule should be in the 900 mg to 1000 mg range, not less. I take 2 capsules twice per day as a daily supplement. This helps you to balance the omega-6 to omega-3 ratio, which cuts down any inflammatory process (from too many omega-6 fatty acids) in you.

Eating Fish Protects the Brain from Air Pollution

Conclusion

A new study from the Columbia University of New York has shown that women older than 70 can preserve the white matter of their brains by consumption of fish. This included the hippocampus which is crucial for memory. The researchers measured the recent exposure of these women to pollution. They noted that the women who were exposed to the highest amounts of pollution had the best protection of the white matter of their brains by the highest consumption of omega-3 fatty acids from fish. Omega-3 fatty acids are also important to prevent heart attacks and strokes. Omega-6 fatty acids can cause inflammation, but when enough omega-3 fatty acids are part of the nutrition, the omega-6/omega-3 fatty acid ratio switches towards anti-inflammation and health.

How to consume omega-3 fatty acids safely

Omega-3 fatty acids are in fish and seafood. Unfortunately, mercury is contaminating these foods. But when you stick to the smaller fish and use molecularly distilled omega-3 supplements you can largely avoid this problem.

Parts of this text has been published before here.

Jul

2020

The Immune System Changes With Age

By Ray Schilling | autoimmune disease, diet, fish oil, food, immune system, Infectious Disease, lifestyle, omega-3 fatty acids, vaccinations, Vitamins and supplements

When we are young, we do not think about our immune system, but the immune system changes with age. When we are older than age 60, we notice that we may be taking longer to recover from a flu.

How does the immune system work?

There are two parts to the immune system, the innate immune system and the adaptive immune system. The innate immune system works to protect us from bacteria, viruses, toxins and fungi from the time we are born. The adaptive immune system uses B lymphocytes from the bone marrow to produce antibodies against viruses. This provides often lifelong immunity against this specific virus, but takes 3 to 5 days to kick in. Vaccinations can also trigger antibody production to protect us from viruses in the future. Both the adaptive and the innate immune system work together closely.

What are the ingredients for a fully functioning immune system?

The immune system consists of various immune organs that are distributed throughout the body. The bone marrow produces lymphocytes, granulocytes, macrophages, eosinophils and basophils. The adenoids in the back of the nasal passages and the tonsils in the back of the throat contain a lot of lymphocytes that are ready to protect us from colds and flus. We have lymph nodes throughout the body and they are connected with lymphatic vessels. The lymph nodes filter the lymph fluid that travels in the lymphatic vessels.

Other sites of lymphocyte production

The small intestine contains the Peyer’s patches, a collection of lymphocytes that protect our gut from invading bacteria or viruses. The spleen is located in the left abdominal cavity under the diaphragm. It removes old red blood cells and provides lymphocytes for the immune system. The thymus gland is located between the breast bone and the trachea. It changes bone marrow derived lymphocytes (B cells) into T lymphocytes that can process antigens from viruses and pass them on to the adaptive immune system for a full antibody response.

Cellular interactions between various players of the immune system

Back in the 1970’s it was already known that there were bone marrow derived B lymphocytes and thymus processed T lymphocytes. We knew then that B cells were involved in antibody production (adaptive immunity). T lymphocytes were thought to turn into killer T lymphocytes to kill cancer cells. But some T cells were T helper cells to process antigen and present it to B lymphocytes for antibody production.

More research since then refined what we know about the cells of the immune system.

Natural killer cells (NK cells)

Natural killer cells (NK cells) are part of the innate immune system. They attack cancer cells and cells that are infected by viruses. It takes about 3 days for their full action to develop. NK cells utilize the cell surface histocompatibility complex to decide whether to destroy a cell or not. T cell lymphocytes do not have the ability to do that. In the Covid-19 coronavirus situation NK cells play an important role to combat the disease right away.

Monocytes

They are large white blood cells that can differentiate further into macrophages and dendritic cells. Monocytes are part of the innate immunity, but they have an antigen presenting capability, which makes them also part of the adaptive immunity.

Memory T cells

The immune system learns to adapt to viruses and bacteria that we have come in contact with. The reason for the memory of the immune cells are the memory T cells. They replicate like stem cells, which keeps a clone of T lymphocytes, T helper cells and cytotoxic T killer cells in the background. They circulate through the body including the lymph glands and the spleen.

Immunosenescence as we age

There are several factors that come together, which age our immune system. The term for this is “immunosenescence“. There are genetic differences and differences due to the sex hormones. Estrogens increase the response of the immune system. In contrast, progesterone and androgens (including testosterone) decrease the immune response. This may be the reason why women tend to live longer than men.

As we age there are more and more memory T cells (both cytotoxic T cells and T helper cells). This weakens the formation of the natural killer cells (NK cells) of the innate immune system. Even the initiation of the adaptive immune system can be slower when we age and also the response to the flu vaccine. In addition, this can pave the way to autoimmune diseases.

The immune system changes with age: Evidence of immunosenescence

The following 3 factors show whether a person has immunosenescence:

The immune system has difficulties to respond to new viruses/bacteria or to vaccines
Accumulation of memory T cells crowding out cells of the rest of the immune system
Low-grade inflammation that is chronic and persists (“inflamm-aging”)

The process of immunosenescence starts with the involution of the thymus gland around the time of puberty. At that time the sex hormone secretion is highest. At the same time a growth factor from the bone marrow and the thymus gland decreases. It has the name interleukin-7 (IL-7). The end result is a slow decrease of the innate immune system with age and a more substantial weakening of the adaptive immune system due to a lack of naïve T and B cells.

Chronic viruses can weaken the immune system further

The varicella herpes zoster virus causes chickenpox. In some people the chickenpox virus can persist, but the immune system actively keeps it controlled. In the 60’s or 70’s when the immune system is weakened from aging, there can be a flare-up as shingles, a localized form of the chickenpox virus.

Another virus, the human cytomegalovirus can cause a chronic infection that often persists lifelong. In this case the immune system is chronically weakened because of a massive accumulation of T memory cells, which keeps the human cytomegalovirus infection at bay.

What we need when the immune system changes with age

Vitamin A

Both the innate and adaptive immunity depend on vitamin A and its metabolites. The skin cells and mucosal cells function as a barrier, which is important for the innate immunity. The skin/mucosal lining of the eye, the respiratory tract, the gastrointestinal and genitourinary tracts help the innate immunity to keep viruses and bacteria out of the body. Vitamin A is important to support macrophages, neutrophils and natural killer (NK) cells. In addition, vitamin A supports the adaptive immune system, namely T and B lymphocytes, so that the body can produce specific antibodies against viruses.

I do not take vitamin A supplements as I eat diversified foods like spinach, vegetables, poultry, Brussels sprout, fish and dairy products that contain vitamin A and carotenoids.

Vitamin C

This vitamin is a powerful antioxidant. It can neutralize reactive oxygen species, which are produced when the immune cells fight viruses and bacteria. Neutrophils, lymphocytes and phagocytes are all supported by vitamin C. Vitamin C and E co-operate in their antioxidant functions. Vitamin C is essential for a strong antibody response with bacterial or viral infections. I take 1000 mg of vitamin C once daily.

Vitamin D

The immune system is very dependent on vitamin D as the immune cells all contain vitamin D receptors. People who have less than 10 ng/mL of vitamin D in the blood are vitamin D deficient. They have much higher death rates when they get infected with the Covid-19 coronavirus.

Vitamin D regulates the expression of target genes. At the center is the vitamin D receptor, which is a nuclear transcription factor. Together with the retinoic X receptor (from vitamin A) the vitamin D receptor binds small sequences of DNA. They have the name “vitamin D response elements” and are capable of initiating a cascade of molecular interactions. The result is a modulation of specific genes. Researchers identified thousands of vitamin D response elements that regulate between 100 and 1250 genes.

You need enough vitamin D for your immune system

When enough vitamin D is present in the blood (more than 30 ng/mL) the immune system releases the peptides cathelicidins and defensins, which effectively destroy bacteria and viruses.

Vitamin D has mainly an inhibitory function regarding adaptive immunity. It inhibits antibody production from B cells and also dampens the effect of T cells. Researchers reported that vitamin D3 is useful in the treatment of autoimmune diseases.

I am a slow absorber of vitamin D3 as repeat blood vitamin D levels showed. I need 10,000 IU of vitamin D3 daily to get a blood level of 50-80 ng/mL (=125-200 nmol/L). This is the higher range of normal. Everybody is different. Ask your physician to check your blood level of vitamin D. Toxic vitamin D blood levels are only starting above 150 ng/mL (= 375 nmol/L).

Vitamin E

This is a vitamin that is fat soluble and helps the body to maintain its cell membranes. But researchers found that vitamin E also stimulates the T cell-mediated immune response. This is particularly important for the aging person to prevent respiratory tract infections. I take 125 mg of Annatto tocotrienols per day (this is the most potent form of vitamin E).

Vitamin B6

This vitamin is important for antibody production by B cells. Vitamin B6 regulates the metabolism of amino acids, which in turn form proteins. Antibodies and cytokines require vitamin B6. The T helper immune cells that initiate an adaptive immune response depend on vitamin B6 as well. I take a multi B complex vitamin (Mega B 50) twice per day, so I supplement with a total of 100 mg of vitamin B6 daily.

Folate

Folic acid is a coenzyme for the metabolism of nucleic acids and amino acids. Studies in humans and animals have shown that folate deficiency leads to increased susceptibility to infections. People with folate deficiency develop a megaloblastic anemia with immune weakness that leads to chronic infections. With my B complex supplement I get 2 mg of folic acid daily.

Vitamin B12

Methylation pathways depend on vitamin B12 as a coenzyme. Vitamin B12 is also involved as a coenzyme in the production of energy from fats and proteins. In addition, hemoglobin synthesis depends on vitamin B12. Patients with vitamin B12 deficiency develop pernicious anemia. These patients also have a weak immune system due to natural killer cell activity suppression and because circulating lymphocyte numbers are significantly decreased.

Treatment with cyanocobalamin reverses the immune weakness rapidly and treats pernicious anemia at the same time. I take 50 micrograms twice per day as part of the Mega-B50 multivitamin tablet. But I also inject 1000 micrograms of vitamin B12 every 6 months subcutaneously to be sure it is absorbed into the body. In older age the intrinsic factor from the stomach lining, which is required for absorption of vitamin B12 in the small intestine, can be missing, leading to vitamin B12 deficiency despite swallowing supplements.

Minerals required for a good immune response

Researchers identified five minerals that are essential for a strong immune system. They are zinc, iron, selenium, copper and magnesium.

Zinc

Zinc is important for a normal function of the innate and adaptive immune system. As zinc cannot be stored in the body, taking regular zinc supplements (30 to 50 mg daily) is important. I take 50 mg of amino acid chelated zinc daily.

Iron

Iron is important for cell oxygen transport and storage, DNA synthesis and for mounting an effective immune response. In particular it is the T cell differentiation and proliferation where iron is needed. Iron deficient people get a lot of infections because the immune system is paralyzed. I eat one spinach salad or steamed spinach daily, which gives me enough iron supply per day.

Selenium

Selenium is a trace mineral that is important for a normal immune response and for cancer prevention. When selenium is missing, both the adaptive and innate immune system are suffering. In this case viruses are more virulent. With selenium supplementation cell-mediated immunity is improved and the immune response to viruses is more potent. I take 200 micrograms of selenium per day.

Copper

Deficiency in copper results in a very low neutrophil blood count and causes susceptibility to infections. Copper is a trace mineral that participates in several enzymatic reactions. It is important for the innate immune response to bacterial infections. A well-balanced Mediterranean diet contains enough copper, which is why I do not supplement with extra copper.

Magnesium

An important cofactor for vitamin D in the body is magnesium. Magnesium participates in many enzymatic reactions. Between vitamin D and magnesium, the immune system is strengthened. I take 150 mg of magnesium citrate twice per day. By the way, magnesium also helps us to get a restful sleep, if we take it at bedtime.

Other dietary factors that strengthen the immune system

Polyunsaturated omega-3 fatty acids

It is important to note that polyunsaturated omega-3 fatty acids are essential for the body and help to modulate the immune system. I take 1800 mg of omega-3 (EPA/DHA) twice per day. I also like to eat fish and seafood at least 3 times per week.

Probiotics

Prebiotics benefit both the innate and the adaptive immune system. They strengthen the epithelial gut barrier, which is an important innate immune defence. Probiotics also lower the risk for Clostridium difficile gut infections. I take one probiotic every morning.

The Immune System Changes With Age

Conclusion

The immune system consists of different organs like the bone marrow, the spleen, lymph glands, Peyer’s patches in the gut, the thymus gland and more. There is the innate immune system, which responds immediately to a virus like the Covid-19 coronavirus. The adaptive immune response involves antibody production against, for instance, the measle virus or the mumps virus. With the aging process the immune system slows down (immunosenescence). This involves an accumulation of memory T cells and a depletion of natural killer cells (NK cells). This means that the innate immunity is getting weaker as we age and chronic inflammation occurs more often. This is the reason why people above the age of 65 get more severe symptoms from the Covid-19 coronavirus. They are also more affected by influenza-type illnesses.

Take supplements to strengthen the immune system

I reviewed the cofactors of a healthy immune system in some detail. It is important that you pay attention to these, particularly the vitamin D3 intake. With a strong immune system, we can survive viral infections better, including the current Covid-19 coronavirus. Future research will likely detect how to reactivate a sluggish immune system in older people. This way vaccination responses following flu injections will become more reliable in seniors.