May 15, 2020

Dr. Rhonda Patrick on The Joe Rogan Experience #1474

Key takeaways

• There are components to our immune system we can control:
  • Vitamin D levels: this might be a good time to supplement while we are indoors more often
  • Sauna: if you have access use the sauna regularly to improve cardiovascular health and immune functions – take a hot bath if you don’t have access
  • There’s a big difference between oral vitamin C and Intravenous vitamin C
    • You can take vitamin C orally but will need a big dose and it still won’t have the same effect; IV once per week if you can
  • Zinc + quercetin are an effective combination for stimulating antiviral activity and improving immune function
  • Sleep plays a crucial role in immunity, homeostasis, and regulation of body functions
• What is on the Horizon in Terms of Treatment?
  • People are actively working on monoclonal antibodies
  • Improved therapeutic treatments coming, including more repurposing of drugs that will make things less scary

Introduction

• Dr. Rhonda Patrick (@foundmyfitness) is a Ph.D. in biomedical sciences and the founder of Found My Fitness
• Host: Joe Rogan (@joerogan) 

Immune System Function and Relationship to SARS-CoV-2

• What can you do to strengthen immune system?
  • As you get older your immune system declines
  • There are lifestyle components of immune system you can be proactive about: exercise, sleep, supplements, nutrition, gut-microbiome health
• Immune system function and previous virus exposure
  • Besides age, the major regulator of immune function seems to be previous virus exposure, not genetics
    • At any given point you have antibodies against 10 different viruses but you’re not always getting sick
• Cytomegalovirus (CMV) and SARS-CoV-2
  • 50-80% of US population has had CMV and most people don’t ever know they have had it and show no symptoms 
    • CMV impacts immune function differently depending on when you get it
      • When you’re young, it enhances immune response but for older people it’s deleterious
    • Interesting tie-in to COVID-19 because we know older people are more prone to severity 
  • It’s likely that there’s some cross-immunity happening since SARS-COV-2 viruses is part of beta coronaviruses along with SARS-CoV-1 and MRSA
  • 15-30% of common colds come from coronaviruses so there’s a good hypothesis that potentially one or two of common cold virus antibodies could interact with SARS-CoV-2 and neutralize it
• SARS-CoV-2 and antibody dependent enhancement
  • Antibody binds to virus and instead of neutralizing it, changes the configuration so the virus can get into the cell better
    • This activates the immune system and causes pathology
  • This results in a higher viral load without antibodies to neutralize
  • We’ve seen it happen with coronaviruses, including SARS-CoV-1 and MRSA
• Spike region and SARS-CoV-2 mutations
  • The spike region is where antibodies bind and is also the region the virus uses to get into the cell
  • Currently seeing two major strain mutations in the spike regions – one mutation more prominent in Asia, one mutation more predominant in Europe and North America
    • Brings to light an interesting genetic link to mutations
  • There’s a theory that the mutation is causing people’s immune system to become more active and lead to severe COVID-19

Promising avenues for therapeutics

• Monoclonal antibodies: identify specific antibody that binds to spike protein and manufacture them
  • Problem is this will offer short lived protection since you are not making your own antibodies as you would with a vaccine
• Continuous exploration into repurposing drugs and combination drug treatments

Do Ventilators Cause More Harm Than Good?

• Anecdotally, the majority of people on ventilators die partly because ventilators cause more damage to the lungs and can induce more damage
• But it’s hard to say which came first – did the ventilator do the damage or was the damage so severe that the patient needed a ventilator

Is Having Type O Blood Protective Against SARS-CoV-2?

• People with Type O blood seem to be less susceptible to contracting COVID-19
• Mechanism:
  • People with Type O blood create Type A antibodies which bind to spike region and neutralize antibody so it can’t enter the cell  
    • We saw this in SARS-CoV-1 so maybe same for SARS-CoV-2
  • Another (unproven) theory: Type O blood people have lower levels of blood factor involved in clotting

COVID-19 and Prisons

• Hearing more stories that some prisoners are trying to contract SARS-CoV-2 to get out of jail by spitting in a cup and passing to others
• Reportedly, 98% of prisoners are positive but asymptomatic. Why?
  • First off, it’s important to distinguish between asymptomatic and pre-symptomatic 
    • Some people do not have symptoms at the time of testing but develop symptoms later so are actually “pre-symptomatic”
  • It’s possible that viruses have already gone around that environment so antibodies from those viruses are helping in immunity from SARS-CoV-2
  • Rhonda was also searching to literature to see whether inmates are vaccinated prior to entering but couldn’t find that information  

The Importance of Sleep

• Poor sleep has a huge impact on glucose and spikes and also plays a role in maintaining optimal immune functions
• Rhonda takes melatonin to help her sleep, 10 mg/day
• Regulating circadian rhythm is crucial for sleep 
  • Rhonda makes sure to have bright light exposure in the morning (e.g., opening curtains, walking outside), and changes the lighting in the house in the evening to red lights
• Joe’s advice for sleep apnea 
  • CPAP alternative called Full Breath Solution – mouthpiece with tongue depressor that prevents the tongue from sliding back, instead of CPAP machine

Why is vitamin D important?

• Vitamin D is a hormone, impacting 5% of human genome and crucial for lung and respiratory functions
• Vitamin D deficiency
  • 70% of US population has insufficient Vitamin D levels; 28% are deficient
  • Body can generate naturally when exposed to sun daily
  • Elderly people are more deficient
  • Obese people in US are also more likely to be vitamin D deficient
• What is happening in the body that’s causing people to be vitamin D deficient?
  • Genetic polymorphisms: people that have variations in genes that cause them to have less vitamin D
    • These people are more likely to die from respiratory infection
  • African Americans in the US are 28x more deficient in vitamin D than Caucasians
•        How are vitamin D and SARS-CoV-2 related?
  • A recent study that looked at COVID-19 patients observed an inverse relationship between vitamin D levels and COVID-19 symptoms: the lower the vitamin D levels, the higher the severity of COVID-19
  • In Indonesia almost all patients that died from COVID-19 were vitamin D deficient
  • Melanin blocks ability to produce Vitamin D
    • In the US and Europe, African Americans and black people are more likely to die from COVID-19
    • Even when adjusting for SES and lifestyle factors, this was still true so something else must be happening 
• Hypothesis needs to be tested about correlation between vitamin D and COVID-19
• Vitamin D dosing
  • Tolerable upper intake is 4000 IUs per day but it’s best to get vitamin D blood test to measure levels
• Therapeutic studies of vitamin D
  • There are clinical studies exploring the role of vitamin D but not many in the US
  • Rhonda wants to see nurses and first responders take vitamin D to see the role in prevention but those studies are not being done

Game Changing Impact of Saunas

• Joe uses the sauna 7 days/week, 180-degrees for 25 min
• Rhonda uses the sauna 5 days/week, 180-degrees for 25 min
• Saunas mimic moderate physical activity
• Heart rate variability improves, blood pressure goes down, cardiovascular health improves, all-cause mortality decreases
• Sauna use also improves immune system and makes you more resilient against infection
• Brain-derived neurotropic factors (BDNF) increases with exercise and heat stress (sauna)
  • BDNF regulates neuroplasticity, the brain’s ability to adapt to changing environment
• The positive benefits of physical activity on the cardiovascular system were enhanced when sauna was added
  • Association between sauna bathing and fatal cardiovascular and all-cause mortality events by Laukkanen T, Khan H, Zacardi F, Laukkanen JA
  • Cardiovascular and other health benefits of sauna bathing: A review of the evidence Laukkanen JA, Laukkanen T, Kunutsor S
• Heat shock protein, sauna use, and immune system
  • Sauna use increases heat shock proteins which prevent muscle atrophy, neurodegenerative genes, and have anti-depressant effects
  • People who sat in 160-degree sauna for 30 minutes had a 60% increase in heat shock protein compared to baseline
  • Large Harvard study being done to assess whether hot yoga increases heat shock protein
  • Heat shock protein have antiviral activity against influenza A 
• Infrared vs standard dry sauna vs hot bath
  • Regular sauna is heating ambient air which in turn raises core body temperature
  • Infrared saunas are directly heating body without heating the ambient air – for example, in a heating tent or blanket
  • We know more about the effects of dry sauna
  • For people who don’t have access to sauna, a hot bath is a good modality for heat shock protein
• Future direction of therapeutic uses of saunas
  • Studies being done to assess whether sauna can have anti-depressant effect on depressed patients
  • Saunas could also provide an avenue for giving sedentary and disabled people the benefits of physical activity without exercising

Cold Shock Protein: Ice Bath and Cold Shower vs Cryotherapy

• Ice baths and cold showers can be comparable to cryotherapy but you have to stay in the cold water longer
• How does it work?
  • Cold shock protein hasn’t really been measured in humans, instead what’s measured is norepinephrine which has been shown to increase
  • Cold shock protein and hot shock protein have been shown to improve mood as well

Vitamin C: Oral vs Intravenous (IV)

• The pharmacokinetics of vitamin C are very different in oral vs IV consumption
•  “The difference between IV and oral vitamin C is apples and oranges” -Rhonda
  • Oral vitamin C is good for immune function, etc. but IV vitamin C is for therapeutic treatment
  • IV vitamin C is routinely used for sepsis and has been shown to reduce mortality of sepsis patients, especially in combination with thiamine
  • IV vitamin C has also been shown to improve outcomes for cancer patients and plays a role in fat oxidation
• What about people who argue your body only absorbs a certain amount so there’s no point in taking vitamin C?
  • When taken orally, there is a saturation level so once you go above that you excrete a lot in urine but if you look at plasma levels, you’re still increasing
• IV vitamin C overcomes saturation mechanisms
  • Dosing and Frequency: How often should you receive IV vitamin C?
    • You want at least 10g IV vitamin C
    • It’s not something you do daily, it’s more for a purpose such as fighting the common cold; somewhere between once per week and once per month
    • Rhonda was receiving once per week prior to shutdown

Zinc and Immune Function

• Zinc is important for immune function and has been shown to dramatically decrease duration of common cold
• Zinc is readily available in meat and poultry so there isn’t a lot of zinc immune deficiency in the US but vegetarians are more prone to zinc deficiency
• Zinc is a positive ion so you want to supplement with quercetin
  • Quercetin is actually known to have antiviral activity against SARS-CoV-1
  • Quercetin has been identified as a possible compound that can clean out senescent cells (non-functioning cells that secrete cytokines and things that age in cells)

COVID-19 and Kids

• A lot of studies looking at children that are asymptomatic, symptomatic, uninfected
• Children that are asymptomatic are shedding as much virus as children that are symptomatic and adults that are symptomatic

Other COVID-19 Thoughts

• Joe regularly tests himself and tests everyone that goes into the studio
• Should we wear masks?   
  • The cloth mask is to prevent you from spreading, not necessarily as protective against breathing in droplets
  • If you’re asymptomatic, a cloth mask will help in preventing spread

Miscellaneous

• Can chewing gum kill cavities?  
  • Xylitol gum kills s. mutans, the bacteria that causes cavities
  • Studies showed that women who chew xylitol gum during pregnancy improve the microbiome of their mouth and have children with lower incidence of s. mutans as measured by oral bacteria

Joe Rogan Experience : coronavirus, covid-19, health, joe rogan, nutrition, rhonda patrick, supplements
Notes By Maryann