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Roger Seheult, M.D.: COVID-19 And Vitamin D | Found My Fitness With Dr. Rhonda Patrick

Key Takeaways

  • COVID-19 won’t be beaten by a single thing – it’s going to take a combination of pharmacological and lifestyle interventions
  • It’s worth your while to get a vitamin D level test and supplement accordingly
  • We can’t say vitamin D is the cure for COVID-19 but it’s certainly prudent to keep levels sufficient
  • Regardless of one’s BMI, age, race, gender – COVID-19 patients with lower vitamin D levels are more likely to have advanced symptoms, need hospitalization, need ventilators, and have higher rates of mortality
  • The benefits of COVID-19 vaccines far outweigh the risks of contracting COVID-19 itself – the disease has a huge grey area with more and more cases of “long-haulers” exhibiting symptoms from respiratory distress to psychosis months after infection
  • Sleep is critical to maintaining healthy immune function: the 2 hours of sleep before midnight are more important than the 4 hours of sleep after midnight
  • Hydrotherapy (hot shower, hot tub) and heat stress (sauna) can potentially enhance innate immune response and reduce hospitalizations
  • Tips for staying healthy: get enough sleep, shower with hot and cold water in the same session, eat antioxidant fruits, supplement with vitamin D, NAC, and zinc (under 40 mg)

Introduction

Dr. Roger Seheult, M.D. (@RogerSeheult) is a physician, professor, and co-creator of  MedCram Videos.

In this episode of Found My Fitness, Dr. Rhonda Patrick and Dr. Roger Seheult discuss the importance and complexity of vitamin D for COVID-19 and heat hydrotherapy. Dr. Seheult provides a unique perspective as a researcher and practicing clinician on the front line during the pandemic.

Host: Dr. Rhonda Patrick (@foundmyfitness)

Lessons From COVID-19

  • COVID-19 gave a platform to physicians, researchers, nutritionists who didn’t necessarily have an audience before
  • People were searching for answers and turned to scientists for information and data
  • Randomized controlled trials are the gold standard to confidently tell patients something will work
  • The system of approval we have for randomized controlled trials is not helpful in a global pandemic because we can’t get answers fast enough
  • Because of the flexibility we need to have for COVID-19, studies without controls are happening and approved – this is not business as usual
  • It’s difficult to scale up the production of any pharmacological intervention during a pandemic
  • Because of the supply and demand issue at the time of the pandemic, we have to turn to lifestyle remedies for prevention and some resolution (not necessarily cure)

COVID-19: Timing Of Treatment Is Critical

  • The timing of intervention is crucial in COVID-19
  • COVID-19 is all about timing – there’s an early portion and a late portion; the gray area in between is when you get pneumonia
  • In the late stages of COVID-19, patients are hospitalized and on oxygen
  • Timing of medication administration impacts the efficacy
  • Steroids: not efficacious in patients not on oxygen (in other words, early in the progression); but very beneficial to late-stage patients on ventilators
  • Remdesivir (anti-viral): efficacious early in the course of the disease but not for patients on ventilators

There’s No Silver Bullet For COVID-19

  • Preventing and treating COVID-19 is complex
  • What we know for sure: wear a mask over nose and mouth, make sure you’re not in an enclosed space for long periods of time with other people
  • Masks won’t protect us from everything – ventilation in closed spaces is critical
  • Ventilation on airplanes: air changes every 10 minutes through HEPA filters so planes are relatively safe
  • Even cloth masks help filter out particles if worn properly over one’s nose and mouth
  • COVID-19 won’t be beaten by a single thing – it’s going to take a combination of pharmacological and lifestyle interventions

Complexity And Importance Of Vitamin D

  • Vitamin D is so much more than a vitamin
  • In the U.S. 70% of the population is vitamin D insufficient
  • The structure of vitamin D is more similar to that of cortisol and other hormones
  • Standards of vitamin D dosage depend on the indication
  • Part of the complexity with vitamin D is our standard of doses are based on bone studies, not immunological data
  • It takes time for vitamin D to be metabolized in the liver; in an acute situation it may be more important to supplement with 25-hydroxyvitamin D – the major circulating metabolite of vitamin D
  • The problem is we don’t have a gland that makes vitamin D – it’s produced through one’s skin
  • Prior to COVID-19, a meta-analysis showed supplementation with vitamin D decreased acute chest infections by 50%
  • There are vitamin D receptors in immune cells
  • Many of the things we see in COVID-19, we see in vitamin D deficiency: higher risk with age, race – darker skin affected more (even in controlled studies), BMI (obesity is associated with higher morbidity)
  • Relevant study: SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels by Harvey W. Kaufman, Justin K. Niles, Martin H. Kroll, Caixia Bi, and  Michael F. Holick 
  • Regardless of race, gender, age, BMI – there’s an association between low levels of circulating vitamin D and increased positivity of SARS-CoV-2
  • Patients with lower vitamin D levels are more likely to have advanced symptoms, need hospitalization, need ventilators, and have higher rates of mortality
  • Relevant study: Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19 by G. E. Carpagnano, V. Di Lecce, V. N. Quaranta, A. Zito, E. Buonamico, E. Capozza, A. Palumbo, G. Di Gioia, V. N. Valerio, and O. Resta
  • We can’t say vitamin D is the single antidote for COVID-19 but it’s fair to say we should all stay vitamin D sufficient
  • Get a test to measure vitamin D levels and supplement accordingly
  • Recent data showed African Americans in Chicago have to stay in the sun 6x as long as Caucasians to produce the same amount of vitamin D
  • Vitamin D is the least toxic fat-soluble vitamin

Sleep And Immune Function

  • Sleep is complicated because most people have trouble sleeping but it could be medical or maladaptive behaviors
  • Sleep is critical for immune function
  • Slow-wave sleep: the sleep you get at the beginning of the night, also associated with secretion of growth hormone
  • REM sleep: occurs later in the night and the stage where dreams take place – less relationship to the immune system but important for other reasons
  • Cortisol levels are slower when you sleep more
  • With poor sleep, you have higher levels of cortisol and stress which compromises your immune system
  • Sleep apnea raises cortisol
  • Sleep and vaccine: people who have proper sleep prior to vaccination (any vaccination) have a higher immune system response and produce more antibodies
  • When people are implanted with a virus, people with 7+ hours of sleep with good sleep efficiency were 5-7x less likely to contract the virus
  • Sleep is not a cure but a good place to start
  • Late exposure to light shifts and delays circadian rhythm: over the past 50 years we cut into our most important deep sleep period
  • The 2 hours of sleep before midnight is more important than 4 hours after midnight
  • Tips for better sleep: (1) bright light exposure when you wake up; (2) avoid blue light exposure at night – either with glasses, red light, dim light in the house

Heat Stress & Heat Therapy For Innate Immunity

  • SARS-CoV-1, SARS-CoV-2, and MRSA all suppress innate immune system early in the disease
  • The innate immune system is robust in children but wanes over time
  • Key tools used by the innate immune system: fever, interferons
  • In order to have a mild to moderate course of the disease, you need an early and adequate interferon response
  • 80% of all symptomatic COVID-19 patients in the United States are not hospitalized because their innate immune system adequate handles the virus
  • Hydrotherapy (such as hot shower) and heat (such as sauna) increase innate immune system response
  • We can use hydrotherapy at home to rev immune system and manage infection low risk – potentially changing the course of the disease and avoiding hospitalization
  • Instead of having people wait at home until they’re sick enough to go to the hospital, we should try hydrotherapy at home
  • 20-minute home hydrotherapy option: boil hot water towel and place on back and chest; use ice-cold towel on head and neck – heat up the body but not thermostat (in the brain) so you don’t sweat
  • Relevant book: Rational Hydrotherapy by John Harvey Kellogg

COVID-19 Vaccines & mRNA Technology

  • mRNA is in the cytoplasm of the cell
  • Analogy to understand mRNA technology: mRNA vaccines are like an envelope with a message in it and that message tells the cell what type of protein to make
  • When you get a viral infection the virus fuses with cells and tells cells to make foreign proteins  
  • The Pfizer and Moderna mRNA vaccines tell the cell to make a portion of the protein to recognize so if it ever comes around again, the immune system is ready to attack and prevent invasion
  • AstraZeneca-Oxford vaccine uses a different vector: this is a DNA vaccine – the DNA goes into the nucleus where it is transcribed into mRNA then follows the same process as the other vaccines
  • mRNA vaccine benefits: if mutation or variant is significant, manufacturers can quickly change information on mRNA so it matches variant and immune system can response
  • Most long-term side effects appear in the first month or two
  • Benefits of vaccines outweigh risk: risk of getting post-infective autoimmune pathology is higher if you get COVID-19 versus if you get vaccinated

Tips For Staying Healthy

  • https://thor.ne/AYOyZGet enough sleep
  • Contrast shower: 3 min as hot as you can tolerate + 1 min as cold as you can tolerate, keep cycling a few times
  • Plenty of antioxidant fruits – blackberries, blueberries, strawberries, pineapple
  • Supplement with: vitamin D, NAC (N-Acetyl Cysteine), Zinc (not more than 40mg)
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