Category: COVID19

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Dietitians’ responsibilities include understanding medications.

While individuals wouldn’t need to know too much about the medications being considered for treatment of SARS-CoV2 because they would need to be prescribed by a medical professional, as a Registered Dietitian, I am not in the category of an individual or a patient.

My training and work experience as a dietitian included seeking more information about health strategies or treatments and disease process and changes in nutrient needs across the lifespan. I was trained and expected to understand the basic mechanism of action of drugs and any nutrient/medication interactions that might make a patient need more of a nutrient in their diet or to avoid a nutrient or food, or any disease processes that might increase need for a nutrient or make limiting a nutrient or nutrients important for maintaining or restoring function. As a medical professional it is in my job training and experience to actively seek and read medical research regarding any diagnosis that is rare enough to not have standardized guidance available for patients or practitioners.

Save a few lives and you have a real grasp of how fragile life can be and how precious. May peace and safety, and good health be with you.

Traditional Chinese Medicinals – Chen pi & other recommendations used in China for guidance for individuals to use at home for milder illness, & practitioners to use in addition to modern medications.

TCM Treatment of COVID-19, based on extensive experience in Chinese hospitals, by Adam Tate, March 20, 2020, updated March 25, 2020. (medicinetraditions.com) — This includes stages of severity of illness and examples of symptoms that occur in the different stages, and herbal recipes recommended for the specific stage and symptom set. The Chinese medical professionals have found that a combination of the traditional medicinal herb mixtures and modern medicines to be more effective than either alone for treating patients with more severe COVID19 infections.

Whole herbs often seem to work well or even better than single extracts as the various phytonutrients in the herb may work together synergistically – adding up to a greater benefit together than any one would alone. Ginger is one of them, and is a very potent anti-inflammatory root vegetable that contains over 400 medically active phytonutrients.

Acupuncture recommendations are also included for milder illness and some strategies for improving air quality within an apartment. For anyone questioning the validity of acupuncture – the Meridian network was found to represent an additional vascular system that develops in an embryo/fetus before the blood vessels and lymphatic vessels and somewhat is associated with the other vascular networks. Nodes in the acupuncture vascular system are involved in stem cell production and stimulating acupuncture points may benefit health in part by stimulating stem cell production. (2) And it may stimulate our own internal production of opiates. (3)

Foods and nutrient or herbal supplements that I take:

If interested, not a recommendation, just as an example – my list of vitamin, mineral & herbal supplements that I take, and which may have helped with my recovery from untested illness with symptoms similar to the current COVID-19 cases. I also try to include certain whole foods daily/regularly including a 1/2 teaspoon of oregano, 1-2 tablespoons of the inner membrane of pomegranate peel, orange with the white pithy inner peel left on, cumin, coriander, cardamom, rosemary, thyme, Gumbo file powder, cilantro, carrot, onion, celery, garlic, greens, beans, rice or amaranth, cashews, pumpkin seeds, almonds, pistachios and/or walnuts, omega 3 fatty acid fish oil, lemon juice, pomegranate juice, dried cherries and/or dried cranberries. Occasionally pears, coconut yogurt, commercial rice breakfast cereal. Other vegetables, mushrooms, parsnips, winter squash, sweet potato, leeks, chives, romaine lettuce, kale, etc, variety of foods increases variety of trace nutrients in the diet.

Due to autoimmune disease and other food intolerances I have to avoid many foods and ingredients refined from the food so I try to take some vitamins regularly to fill in gaps due to my restricted diet (no dairy due to congestion, gluten due to inflammation & autoimmune reactions, no animal products except the fish oil, because albumin became an autoimmune problem).

The 30% calories from carbohydrate nutrient analysis series was based on the foods I had been using typically at the time. See: post1, post2, post3.

Disclaimer: This information is provided for educational purposes within the guidelines of Fair Use. It is not intended to provide individual guidance. Please seek a health care provider for individualized health care guidance.

Reference List

  1. Adam Tate, TCM Treatment of COVID-19, based on extensive experience in Chinese hospitals, March 20, 2020, updated March 25, 2020. medicinetraditions.com, https://www.medicinetraditions.com/tcm-treatment-of-covid-19.html?fbclid=IwAR0jWwy7J7H5ZN2OVzoAQnqMUMIQ5aIDRxCjEGj5R6eSSldTvS4hg5d0Dak
  2. Vitaly Vodyanoy, Oleg Pustovyy, Ludmila Globa, and Iryna Sorokulova, Primo-Vascular System as Presented by Bong Han Kim, in Special Issue: New Developments in Primo Vascular System: Imaging and Functions with regard to Acupuncture. Ev. Based Complimentary & Alt. Medicine, 2015, Article ID 361974, 17 pages, https://doi.org/10.1155/2015/361974 https://www.hindawi.com/journals/ecam/2015/361974/
  3. Donald D. Price, David J. Mayer, Evidence for endogenous opiate analgesic mechanisms triggered by somatosensory stimulation (including acupuncture) in humans. J of Pain, 4;1, P40-43, MARCH 01, 1995 DOI:https://doi.org/10.1016/S1082-3174(11)80074-7 https://www.jpain.org/article/S1082-3174(11)80074-7/pdf
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Updates/ Vitamin C Infusion is helping CoV-19 patients in New York.

Addition – Food sources of vitamin C, quercetin, and zinc are at the top of this document, which includes this blog post and a few others on the topic of COVID-19 (Antivirals in Foods) Eating good sources several times a day may help the body prevent infection or have a less severe case.

Virus enter a cell and are replicated to the cell’s capacity to produce them, at that point the cell bursts releasing the newly formed virus which go and infect other cells and force those cells to make even more virus to the cell’s capacity, and they all burst, releasing yet more virus – in an exponentially increasing number. Each time a cell bursts and releases the viral load, the cell dies. So the sooner you can help your body stop the viral replication the sooner you are protecting your cells from being killed by the process.

Megadoses of the nutrients that help stop viral replication may not be needed. Moderate amounts of good food sources may help the body fight the infection before it has spread to numerous cells and caused significant cell damage. Reducing infection load may also help prevent an over-reaction of the immune system to the infection. An over-reaction of the immune system can be deadly as the inflammatory chemicals can attack healthy cells and lead to organ failure and eventually death. The next section is about a nontoxic treatment that might help if an over-reaction of the immune system leads to a Cytokine Storm/sepsis reaction.

Foods contain antivirals that work in a similar manner to the chloroquine medications that we have been hearing about in the news. More production is needed before they are available for widespread use, and they are somewhat expensive and can be dangerous. Quercetin is a phytonutrient that is readily available in vegetables and fruits and as a bulk or individual supplement.

Nursing homes and hospitals could be adding the bulk supplement powder to a food at each meal and including zinc food sources. The zinc is carried into infected cells by the quercetin (or chloroquine) and the zinc disrupts viral replication. The chloroquine, quercetin, or zinc are not killing virus. White blood cells are the body’s patrol for killing and removing infected cells.

Health takes work and work takes nutrients.

  • Vitamin C helps the immune system fight infection. Good sources include: cabbage, tomatoes, green peppers, broccoli, asparagus, peas, kale, & citrus, strawberries, kiwi, papayas, cantaloupe. (Vit C Fact Sheet)
  • Good food sources of quercetin include: red onion, onion, garlic, kale, tomatoes, asparagus, broccoli, capers, nuts and seeds, red grapes, cherries, olive oil. Herbal supplements also containing quercetin include St John’s Wort, Gingko biloba, and American Elder. (WebMd) 
  • Good food sources of zinc include oysters, meats, poultry, dairy, cashews, pumpkin seeds. Other beans, nuts and seeds would also have some as vegan sources. Meats have more than the vegan sources, while oysters have so much zinc that it might risk excess if eaten regularly in large servings.  (Zinc Fact Sheet).

There are no guarantees in life, but trying a nontoxic strategy is at least safe. Medications may have risks of side effects – always see a medical professional for individualized health care guidance.

Vitamin C Infusion for Cytokine Storm immune overreactions.

Good news updates – a hospital chain in New York has found the use of high dose intravenous Vitamin C Infusions helpful for patients infected with the SARS-CoV-2 (COVID-19) novel coranovirus. “Dr. Andrew G. Weber, a pulmonologist and critical-care specialist affiliated with two Northwell Health” is providing his patients who have sepsis/cytokine storm symptoms an intravenous drip with 1500 mg of vitamin C three or four times per day. (1) Patients getting the Vitamin C treatment have been helped more than patients who did not according to Dr. Weber. A spokesperson for the Northwell Health system said that vitamin C is being “widely used” at their hospitals where 700 patients approximately are being treated for SARS-CoV2, however it varied by patient need and the clinician’s plan of care. (1, 2)

“The patients who received vitamin C did significantly better than those who did not get vitamin C,” Weber said. (1)

The protocol for the treatment also includes vitamin B1 generally but that news article doesn’t mention that ingredient of the IV mixture. The treatment is a much larger amount of vitamin C than the daily recommendation for a normal diet, however a patient with an overactive immune response is not in normal health. The treatment is used for patients who have had an overactive immune response to the infection and their own immune cytokines become produced in excessive amounts. The cytokines can then start damaging the patient’s own organs which can lead to organ failure and result in death.

The damaging immune chemicals in a normal response to infection would only attack the infected cells. The excessive amounts however use up all supplies of vitamin C in the patient’s body, and supplying vitamin C in high doses is then very helpful for protecting the patient from harm by the excess.

Quercetin plus zinc is a zinc ionophore, and is being tested as an anti-viral in human clinical trials for the treatment of SARS-CoV2 (COVID-19).

Good news update regarding quercetin and zinc as a zinc ionophore – the combination had already made it through animal trials for use against Ebola, and SARS-CoV(1) and was approved by the FDA for human clinical trials. Plans were underway for it to be trialed in China for patients with SARS-CoV2 (COVID-19). I haven’t found results yet.

  • CBC News Interview with “Dr. Michel Chrétien’s team at the Clinical Research Institute of Montreal” : Canadian team invited to do clinical trials in China for antiviral drug. Feb 28, 2020, (youtube).

UK What to do if at home with a Potential Infection, Guidance:

Stay at home: guidance for households with possible coronavirus (COVID-19) infection. Updated 24 March 2020, (gov.uk).

*The UK guidance recommends isolating for seven days after symptom onset, – it might be wise to use caution longer than, especially if trying to protect people in your home who are in a high risk group, which includes: Senior Citizens, people with asthma or other lung conditions, smokers, people with hypertension, and immune-compromised people.

While the infectious stage seems to start prior to symptom onset and to have the most risk of spreading the infection during the early days of symptoms, when a fever is also often a symptom, that might not be consistently true and not everyone infected with SARS-CoV-2 gets a fever. The longest a patient has been found to be infectious was 37 days and the shortest was eight days. The average for patients with severe symptoms being treated in a hospital to be infectious was 19 days and for patients with critical symptoms the average was 24 days to remain infectious. (4)

Sensible precautions if sharing a home with infected and non-infected people include:

  • Cover your coughs or wear a mask or bandana to catch respiratory droplets from your breath, coughs or sneezes. Try to avoid being in the same room with non-infected people if possible, at least during the highest risk days during the early onset of symptoms, or positive test result.
  • Wash hands often and sanitize or wash with soap any commonly used surfaces such as door knobs, kitchen and bathroom areas.
  • Don’t prepare raw foods for non-infected people if you can avoid it. Otherwise wash hands thoroughly or wear food preparation gloves if possible after the initial week or two of more severe feverish symptoms has passed.
  • US CDC guidance for home care of a person infected with SARS-CoV2 https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-spread.html

This is doable – the quercetin rich foods mentioned in the last post plus sinc supplements or foods may provide a protective effect against getting a viral infection. Stay calm and eat sauteed onions or citrus with a little of the peel left on, plus pumpkin seeds or meats. Best wishes for everyone’s health!

Request for plasma donations from people recently recovered from SARS-CoV2, Mount Sinai

There is a request for people who have recently recovered from SARS-CoV2 (COVID-19) and who would be willing to donate plasma if they have antibodies against the infection to contact Mount Sinai’s medical team. Antibody rich plasma can be given to severely ill patients with the infection to help them fight the virus. They can check for the presence of antibodies. Contact: COVIDSerumTesting@mountsinai.org, see (Statement from Mount Sinai Chief Medical Officer, (via @MikeDelMoro/via @joshchafetz).

Mount Sinai medical system has developed a test for checking for CoV-19 antibodies within hospitals and are sharing the technique: BREAKING: The First U.S. Test to Detect If a Person Has Potential Immunity to COVID-19 Was Just Developed (leapsmag.com)

Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

Reference List

  1. Lorena Mongelli and Bruce Golding, New York hospitals treating coronavirus patients with vitamin C. March 24, 2020, NYPost.com, https://nypost.com/2020/03/24/new-york-hospitals-treating-coronavirus-patients-with-vitamin-c/?utm_campaign=SocialFlow&utm_medium=SocialFlow&utm_source=NYPTwitter
  2. Dan Lyman, Coronavirus Patients Being Treated With Vitamin C at New York Hospitals. March 25, 2020, https://www.newswars.com/coronavirus-patients-being-treated-with-vitamin-c-at-new-york-hospitals/
  3. CBC News Interview with “Dr. Michel Chrétien’s team at the Clinical Research Institute of Montreal” : Canadian team invited to do clinical trials in China for antiviral drug. Feb 28, 2020, (youtube).
  4. Fei Zhou, Ting Yu, Ronghui Du, et al., Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet, March 11, 2020, DOI:https://doi.org/10.1016/S0140-6736(20)30566-3 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext#back-bib33
  5. Kira Peikoff, BREAKING: The First U.S. Test to Detect If a Person Has Potential Immunity to COVID-19 Was Just Developed. March 22, 2020 leapsmag.com, https://leapsmag.com/breaking-the-first-u-s-test-to-detect-if-a-person-has-potential-immunity-to-covid-19-was-just-developed/?fbclid=IwAR2z_hl9VZfsrjz2JL03Sze2cPscdqGTFD0VyBrSbUvx-bOP8f5lmz9BgdU
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Eat Food – Antivirals are found in common foods.

Chloroquine medications are dangerous, many medications are dangerous especially if taken in too large a dose. Chloroquines are typically used to treat malaria, a condition caused by a parasite. The mechanism of action is that the chemical can hold onto the mineral zinc and carry it into an infected cell where the zinc disrupts the replication of proteins, causing less virus replication. (6) It has been mentioned as a medication that potentially may be helpful for treating patients with the novel coronavirus that is currently causing a pandemic.

The chloroquine medications are also used by autoimmune patients and supplies of the drug are limited. Increasing production is a goal but will likely take some time. (7) There are other safer alternatives available in foods or phytonutrient extracts (1, 8, 9) that have an immune modulating effect – promoting removal of infected or damaged cells while also inhibiting an overactive immune response.

People with a heart condition may also be at more risk of dangerous side effects if taking chloroquines. The medication also needs to be given with zinc to be as effective as possible. The food or phytonutrient alternatives would also need to be used with zinc in the diet or added as a supplement. (1, 8, 9)

***** ONLY TAKE PRESCRIPTION MEDICATIONS THAT ARE PRESCRIBED FOR YOU BY YOUR OWN MEDICAL PROFESSIONAL *****

***** ONLY EAT FOOD *****

Someone is dead because they consumed a household product containing chloroquine because they thought it might protect them from coronavirus infection, (10), – dead is not infectable by a virus, but dead is also dead.

Quercetin plus zinc is also an antiviral that works as a zinc ionophore, (1), however it is readily available in some common foods or as a supplement and is nontoxic to cells. (1, 2) The zinc is disrupting protein replication within the infected cell so the virus can not be replicated to spread to other cells, for more replication, more infecting other cells, more replication, etcetera.

Onions are the richest source of quercetin (4) and citrus peel is also a very rich source. (3) Pumpkin seeds are the richest source of zinc in a vegetarian diet and is commonly available in meats in a non-vegetarian diet.

Pomegranate peel extract or the inner white membrane of a pomegranate is also a source of quercetin and another phytonutrient that acts as a zinc ionophore (epigallichatechin-gallate). (1) It also would be nontoxic to healthy cells and low risk compared to the chloroquine medications. (2) However it can have some side effects, acting as a diuretic and has COX2 inhibition activity. (recent post, older post) A tablespoon or two of the liquid extract or inner white membrane can be enough to provide some health benefits for an adult. (G13: Preparation & Benefits of Pomegranate)

Onions, citrus peel, pomegranate peel – we have choices, safe choices, to help our body’s own defense system stop the coronavirus. Chloroquines do not kill coronavirus – it helps our own defense system do its job – but with more risk to healthy cells, and normal function than onions, citrus peel or pomegranate peel or quercetin supplements. Zinc is a trace mineral which we need in small amounts, a larger dose taken for a week or two would be unlikely to build up to toxic amounts but please be aware that in large doses a zinc supplement could become toxic.

Eat food – that is what our body is designed for. If the GI tract is inflamed and the idea of eating food is no longer appealing due to pain or constant diarrhea than please see the recent post: ACE2, Diarrhea, & COVID19 – it gets complicated. and try to eat small servings of something that might help heal and stop the inflammatory reaction in the intestinal tract.

If nausea and vomiting are also symptoms, hold off on the food and just sip water that has a dash of lemon or lime juice or apple cider vinegar. Those all have a type of acid that is similar to stomach acid. In cases of severe nausea even plain water can be unsettling and larger amounts of anything can be a problem. Start gradually with small sips of the lemon water, or a lime or lemon popsicle may be soothing and not cause more vomiting.

Once feeling better some of the mucilaginous or hydrolyzable tannin foods mentioned in the recent post (ACE2, Diarrhea…) can help replace the mucous lining that coats the intestinal tract during times of health. It also serves as a defense system, helping to prevent entry of virus or other pathogens into the body between intestinal cells. And white blood cells patrol the area and actively defend against pathogens.

Pomegranate peel also provides hydrolyzable tannins if the white membrane is used in prepared foods like a bean soup (G8: Cookies & Bean Soup/recipes) or sweet potato dish. Pomegranate peel and citrus peel and onions (less so) are also sources of vitamin C which also helps our body’s natural anti-viral defenses. (5)

Addition: Table of drugs and phytonutrients that are being investigated for use as a COVID19 treatment, (@rubbersoul23,Eric/table) based on A SARS-CoV-2-Human Protein-Protein Interaction Map Reveals Drug Targets and Potential Drug-Repurposing, March 23, 2020, (biorxiv.org)

Disclaimer: This information is provided for educational purposes within the guidelines of Fair Use. It is not intended to provide individual guidance. Please seek a health care provider for individualized health care guidance.

Reference List

  1. Husam Dabbagh-Bazarbachi , Gael Clergeaud, Isabel M Quesada, et al., Zinc Ionophore Activity of Quercetin and Epigallocatechin-Gallate: From Hepa 1-6 Cells to a Liposome Model. J Agric Food Chem, 62 (32), 8085-93 2014 Aug 13. https://pubmed.ncbi.nlm.nih.gov/25050823/
  2. Houston DMJ, Bugert JJ, Denyer SP, Heard CM. Potentiated virucidal activity of pomegranate rind extract (PRE) and punicalagin against Herpes simplex virus (HSV) when co-administered with zinc (II) ions, and antiviral activity of PRE against HSV and aciclovir-resistant HSV [published correction appears in PLoS One. 2017 Nov 20;12 (11):e0188609]. PLoS One. 2017;12(6):e0179291. Published 2017 Jun 30. doi:10.1371/journal.pone.0179291 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5493292/
  3. Shafiya Rafiqa, Rajkumari Kaula, S.A. Sofia, et al., Citrus peel as a source of functional ingredient: A review. J of the Saudi Society of Ag Sci, 17;4, Oct. 2018, pp 351-358 https://www.sciencedirect.com/science/article/pii/S1658077X16300960
  4. Quercetin, Pharmacology, Toxicology and Pharmaceutical Science/Quercetin, ScienceDirect.com, https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/quercetin
  5. Kim Y, Kim H, Bae S, et al. Vitamin C Is an Essential Factor on the Anti-viral Immune Responses through the Production of Interferon-α/β at the Initial Stage of Influenza A Virus (H3N2) Infection. Immune Netw. 2013;13(2):70–74. doi:10.4110/in.2013.13.2.70 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659258/
  6. Xue J, Moyer A, Peng B, Wu J, Hannafon BN, Ding W-Q (2014) Chloroquine Is a Zinc Ionophore. PLoS ONE 9(10): e109180. https://doi.org/10.1371/journal.pone.0109180 https://journals.plos.org/plosone/articleid=10.1371/journal.pone.0109180
  7. Eva Schrezenmeier, Thomas Dörner, Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology. Nat Rev Rheumatol 16, 155–166 (2020). https://doi.org/10.1038/s41584-020-0372-x https://www.nature.com/articles/s41584-020-0372-x
  8. Wang T1, Men R1, Hu M, et al., Protective effects of Punica granatum (pomegranate) peel extract on concanavalin A-induced autoimmune hepatitis in mice. Biomed Pharmacother. 2018 Apr;100:213-220. doi: 10.1016/j.biopha.2017.12.110. Epub 2018 Feb 9. https://www.ncbi.nlm.nih.gov/pubmed/29428670
  9. Hou L, Huang H. Immune suppressive properties of artemisinin family drugs. Pharmacol Ther. 2016;166:123–127. doi:10.1016/j.pharmthera.2016.07.002 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5035609/
  10. Anne Flaherty, Sophie Tatum, Man dies after ingesting aquarium product containing chloroquine: Hospital network. March 23, 2020, abcnews.go.com, https://abcnews.go.com/Politics/man-dies-ingesting-chloroquine-prevent-coronavirus-banner-health/story?id=69759570
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ACE2, Diarrhea, & COVID19 – it gets complicated.

The reason lung edema and diarrhea and other digestive symptoms (30) are potential symptoms of the novel coronavirus, (SARS-CoV2, also called COVID-19), and not infrequent as a way for the symptoms to start, (13); is because the virus is infecting cells by entering at ACE2 receptors. ACE2 receptors seem to have a role in cardiovascular health and they are more prevalent within the lungs and in the duodenum of the GI tract. ACE2 receptors also tend to be present in more quantity in men, in smokers, (people with excess weight will also have more, due to having more adipocyte/fat cells which also have ACE2 receptors, (32, 33)), and in people taking one of two different groups of medications.

“It has also been confirmed…SARS-CoV-2 uses the same receptor, the angiotensin converting enzyme II (ACE2), as the SARS-CoV [11]”  “a 3D structural analysis indicated that the spike of SARS-CoV-2 has a higher binding affinity to ACE2 than SARS-CoV [23]”

Xiaolu Tang, Changcheng Wu, Xiang Li, et al., On the origin and continuing evolution of SARS-CoV-2. 29-Feb-2020. (academic.oup.com/nsr/advance-article/doi/10.1093/nsr/nwaa036/5775463)

The ACE Inhibitors (list) block an enzyme involved in the chemical pathway and Angiotensin Receptor Blockers (ARBs, list) inhibit the ACE2 receptor in addition to inhibiting Angiotensin Receptors. Angiotensin is involved in the chemical pathway which gets complicated – watch the video: Coronavirus Pandemic Update 37: The ACE-2 Receptor – The Doorway to COVID-19 (ACE Inhibitors & ARBs). (1) (And for more information: an overview article on the ACE2/Angiotensin chemical pathway. (6))

Part of the complicated part is also the question of what to do about those medications while there is risk of infection – the consensus is, more information is needed. While having been on one of them may increase the risk of infection due to there being more ACE2 receptors than usual, stopping abruptly wouldn’t immediately get rid of the extra ACE2 receptors and the medications, particularly the ARBs which block the ACE2 receptors may have a protective effect once exposure to the virus occurs. (1)

As the viral infection advances in severity – more and more virus have been replicated and many cells are infected – the patient’s symptoms tend to become similar to genetic knockout mice bred to have zero ACE2 receptors. The mice don’t do well over time, developing cardiac problems and other symptoms similar to COVID19 patients with more severe cases. (1) If the viral load was very large than the patient’s ACE2 receptors might all have been filled with virus – making the patient phenotypically similar to a mouse with zero functional ACE2 receptors.

ACE2 enzyme is also present in the body in a free floating form, not just as a receptor embedded within cell membranes. A potential treatment possibility early in exposure would be to give the patient large amounts of the soluble ACE2, (7), – the free floating enzyme would attract virus to lodge into the enzyme but it would have no cell to enter and it is our cells, or another infected species cells in which virus are replicated. The viral design takes over our own gene replicating processes within the cell and set our own body to work making many many copies of the virus. When a cell is maxed out on replication of the virus the cell bursts and the many, many virus are free to circulate looking for more cells with ACE2 receptors to enter and set to more replication.

Symptoms include chest pain, difficulty breathing, a feeling that a breath isn’t really getting oxygen (because it isn’t, lung function is significantly reduced, requiring a ventilator or other breathing support). With more severe illness, all those infected cells that burst to release virus are dead and the area would have inflammatory damage from the cellular debris. Some patients who recover have been found to have continuing decreased lung function by ~ 20-30%, enough to leave them winded, short of breath, after minimal exercise such as walking. Reinfection also seems to be possible as the antibodies against the virus don’t seem to last very long. (4) Which suggests that pinning our hopes on a vaccine or herd immunity would be foolish.

Addition: As many of half of patients who tested positive for CoV-19, in nations that have been doing mass testing, have been found to have no symptoms or only very mild cough or fever, or even oddly, a loss of the sense of smell or taste – the virus may be affecting the olfactory bulb area of the nose and brain, which may be blocking nerve signals from the nose or mouth to the brain. (27) The brain has ACE2 receptors also, the significance of this symptom to long term health of the brain is unknown at this time. (29)

Of the patients testing positive two studies have shown an average of 17.9% had no symptoms and over half of people became infected in contact with some who had not developed symptoms yet. (28) This is why we need more testing to help stop spread of infection by people who don’t realize they are infected. In the meantime it would be cautious for everyone to practice Universal Precautions – avoid body fluids and respiratory droplets from everyone.

Diet tips that might help inflammatory GI symptoms.

Now, change of topic, what to do about diarrhea and other digestive symptoms? The digestive symptoms may include stomach pain/nausea, vomiting, and intestinal pain after eating, particularly after some types of foods. Inflammatory digestive conditions can be helped by eating foods that are similar to the layer of mucus that lines the intestines during normal health.

Foods that are mucilaginous – a little sticky and gooey – include:

  • the vegetable okra and the powdered sassafras leaves used in Creole gumbos known as Gumbo File.
  • Slippery Elm Powder is an ingredient in some herbal teas designed for use with a sore throat. Marshmallow Root Powder is very similar in healing benefits and a little less expensive than Slippery Elm Powder (and yes, marshmallows were originally made from Marshmallow Root Powder, now marshmallows are just another corn product).
  • Flax meal powder (21) when mixed with boiling water and stirred for two minutes will become mucilaginous and can be used as an egg replacer as it can act as an emulsifier. Gumbo File can also be mixed with boiling water and used in place of eggs as an emulsifier. It has a stronger flavor than flax meal powder but is a finer grind. Golden flax meal is slightly less gritty in texture than regular brown flax meal. Flax seeds are very tough and will not be digestible or chewable unless ground before use.
  • Egg replacer ratio that I use- 10 tablespoons water, bring to a boil and quickly remove before over-evaporating, stir into a bowl with pre-measured two tablespoons of Golden Flax Meal or Gumbo File. Stir for two minutes until thickened and the flax meal would turn the water from clear into an opaque creamy white color. Gumbo File is greenish and dark, and would be least noticeable in a chocolate brownie type of recipe.
  • Gelatin, bone broth, Jello (TM), are all mucilaginous from the collagen/gelatin from animal products. Agar is a vegetarian gelatin substitute made from seaweed and Irish Sea Moss can also be used to make gelatin like desserts. Tapioca starch can also be used to make a gelatin like dessert that is slightly more dense in texture than Jello (TM). The Gumbo File could be used to thicken fruit juice or fruit also for a gelatin dessert like effect but the flavor again might be more noticeable than if Agar, Tapioca Starch or traditional animal derived gelatin were used.
  • Psyllium Husk powder is a mucilaginous fiber sold as a fiber supplement and stool softener. (21) All of these mucilaginous foods could help with constipation by increasing moisture content of the bowel movement or help with diarrhea by helping absorb water content of the bowel movement as well as by reinforcing the mucus like lining of the intestinal tract.
  • ” chan (Hyptis suaveolens L.), chia (Salvia hispanica L.), or basil (Ocimum basilicum L.), all belonging to the Lamiaceae family, are applied to drinks or food with beneficial health effects. ” (21)
  • Aloe, cactus, Lotus Root, Chinese yams, See: Word of the Day: Mucilage.
  • Artichoke hearts/artichoke leaves are a better source of insoluble fiber (thedailymeal) which adds bulk to a bowel movement so it isn’t too watery and helps everything move along a little faster. A diet that has little fiber and more processed foods, refined grains, and meat and dairy products can take many days to pass through, increasing risk of cancer and constipation pain and hemorrhoids.
  • Jerusulem artichoke, carrot, turnip – (1850) These root vegetables would be a source of soluble fiber. Sweet potato and oat bran are also good sources of soluble fiber. (Mucilage/ScienceDirect) Black beans and other beans, nuts, seeds, broccoli, pears, nectarines, apricots, apples, guava, barley, figs, (Top 20 Foods Rich in Soluble Fiber)

Hydrolyzable tannins along with gelatin like foods can also be soothing during a diarrhea illness. (8) They help reduce inflammation by reducing the amount of the inflammatory chemical lipo-polysaccharides. (16) An excessive amount, an overly large serving of hydrolyzable tannins may increase irritation of mucus membranes so the rule holds: dose makes the poison, dose makes the cure. Hydrolyzable tannins are tannins that can bind with water and other molecules and form large complexes.

Condensed tannins don’t bind with water and are even more prevalent in leaves, making up as much as fifty percent of the tannin content within leaves of most plants. (12) Plants tend to make either condensed tannins or hydrolyzable tannins, but not both. The plant makes more in response to hotter sunny summer days, and in response to insect damage – the plant’s protection against cancerous effects of UV light, and a toxin if eaten in quantity by the insects. (17) See the Reference list for a longer list of plant sources of hydrolyzable tannins. (18)

Hydrolyzable tannins may help protect against cancer cells and other damaged or infected cells by promoting apoptosis (9) – the killing and engulfing of debris or a damaged cell by white blood cells. They have antiviral capability. (31) They also act as antioxidants and help reduce levels of oxidative chemicals. (19) Hydrolyzable tannins also act as COXII inhibitors (20) as do other antioxidants (last post).

Tannins are typically found in tea (tea leaves) and other tree leaves such as Sassafras leaves made into Gumbo File or Bay Leaves that are added to a soup broth at the beginning of cooking and removed before serving the food. Condensed tannins don’t bind with water and are even more prevalent in leaves, making up as much as fifty percent of the tannin content within leaves of most plants. (12)

Oak leaves are also a source of tannins, and are traditionally used to “tan” hides – with the tannin rich oak leaves. The initial soaking process with the tannin rich leaves prepares a deer skin so the hair can be scraped off the leather hide more easily – it still is a lot of work to tan a hide in the traditional way. Oak barrels are used in the aging of wine and liquors possibly because of the gradual addition of tannins to the aging alcohol product.

Walnuts also have hydrolyzable tannins and the binding of water and other nutrients is visibly noticeable when walnuts are cooked with sweet potatoes in a casserole – the dish can turn brown in color instead of the pretty orange color of sweet potatoes. It has not turned bad, it has hydrolyzed the tannins. The hydrolyzed tannins bind with other nutrients too and can slightly reduce nutrient availability for absorption out of the intestines , (15), – however if the goal is to heal inflamed and painful intestines than having more nutrients stay in the intestines may be part of the benefit – literally reforming the mucus lining of the GI tract that would be continually lost when severe watery diarrhea is an all day problem.

A larger quantity of tannins can also be obtained from pomegranate peel. The white inner part of the peel has slightly less than outer peel which makes it less bitter in flavor and less of a diuretic. Tannins have a diuretic effect and a larger serving of pomegranate peel products can have too much of a diuretic effect. I use a vegetable peeler to remove the outer reddish-purplish rind and then I separate the white membrane from the seeds and trim away any bad spots from the white membrane and remove any discolored or spoiled seeds.

The white membrane of the pomegranate peel can be minced and added raw to a salad or added to a soup. In foods that are acidic the color of the membrane and the dish you are preparing will become more reddish in color or might turn brownish if the tannins are hydrolyzing with other ingredients and the water content. In foods that are alkaline the color will turn brown. This is least noticeable in black bean soup, white beans will have a brown broth and greenish split pea soup looks odd (warning – foods are chemistry and this is kind of fun).

The red part of the peel can be used in tea or to make a liquid concentrate that is used in small amounts but it is too bitter to eat and the diuretic properties can be potent – have the extract or tea early in the day and drink plenty of water throughout the day to help it pass through before you hope to sleep through a night. Why would you bother then? Pomegranate peel has a long list of medicinal benefits potentially including cancer treatment or prevention. It is antimicrobial, anti-worm, etc, a long list, see this webpage for health benefits, preparation and menu ideas: G13: Pomegranate. A bean soup recipe using dry beans is the last recipe on page, G8: Cookies and Bean Soup.

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

Reference List

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